Branded Drugs Research Articles

A PROSPECTIVE, OBSERVATIONAL DRUG UTILIZATION STUDY IN THE DERMATOLOGY OUT-PATIENT DEPARTMENT OF A GOVERNMENT HOSPITAL, NANDYAL, ANDHRA PRADESH

Objective: The data regarding drug utilization in dermatology departments of southern parts of India is limited. Recent studies on drug utilization in dermatology across India, reported high prescription of branded drugs, low adoption of essential drugs and polypharmacy. Hence, this study was conducted to analyze the drug utilization pattern for common skin diseases as per WHO prescribing indicators. Methods: This study was done in the Out-patient department (OPD) of dermatology at Government General Hospital (GGH), Nandyal, in collaboration with department of Pharmacology for a period of 4 mo and Institutional ethical committee (IEC) permission was taken before conducting the study. Results: A total number of 344 prescriptions were analyzed. Average number of drugs per prescription was 2.5 (including Fixed drug combination (FDC) drugs). Total number of drugs accounted to 860. Majority of prescriptions have 3 drugs per prescription (57.1%) and only 8.7% of prescriptions have more than 3 drugs per prescription. Analyzed data as per World Health Organization (WHO) prescribing indicators indicate 74% of prescribed drugs were from National List of Essential Medicines (NLEM), 2.5% were FDC drugs and 13.14% of the drugs prescribed were antibiotics. Polypharmacy was noted to be only 0.7% in the study. Conclusion: A periodic audit of prescriptions will reduce errors and motivate the health care professionals for rational drug use. Special consideration is to be given to extended public health initiatives to prevent skin infections because they account for about 70% of diseases in daily life.

Magnitude and associated factors of prescribing drugs by their brand names among prescribers working at selected hospitals in Addis Ababa, Ethiopia

Background One possible mechanism for lowering expenditure on drugs and increasing their accessibility is by prescribing generic drugs, which are less costly and have equivalent safety and effectiveness profile as brand drugs. However, in Addis Ababa brand-prescribing practice is so common to the extent of making the health department administration of the city to write letters to subcities and hospitals discouraging brand prescribing. This study tried to identify the magnitude and factors affecting brand prescribing in the city. Objective: General objective of this study was to assess magnitude and associated factors of prescribing drugs by brand names at Addis Ababa. Methods An institution based analytical cross-sectional study design was employed from May to August, 2022, using a sample of 485 prescribers. The hospitals were selected by using simple random sampling method and prescribers from different departments were selected by using systematic random sampling method. Data was collected using semistructured, self-administered questionnaire and entered into Statistical Package for Social Sciences version 25 for analysis. The data was described using percentages, graphs and tables. Mean and standard deviations were calculated to identify measures of central tendency and dispersion. Association between dependent and independent variables was checked using bivariate and multivariable logistic regression models. Statistical significance was declared at 95% confidence interval and p < .05. Results The magnitude of prescribing drugs by their brand names was 54.0%. Being trained on good prescribing practice (AOR: 6.81; 95%CI: 2.08-22.28), confidence on Ethiopian Food and Drug Administration Authority (AOR: 18.18; 95%CI: 6.78-48.80), and knowledge about generic drugs (AOR: 11.86; 95%CI: 4.76-29.55) were found to be independent predictors of prescribing drugs by their brand names. Conclusion and recommendation Brand medicine prescribing is positively associated with training on good prescribing practice and knowledge about generic drugs. Hence, training prescribers on good prescribing practice and educating them about generic drugs can minimize brand prescribing.

Uncovering patients’ preferences for brand among essential classes of coronary heart disease medications using a discrete choice experiment

Patient preferences for medications strongly correlate with adherence; one area of interest is the choice between branded and generic drugs. Despite extensive research about brand-versus-generic drug preferences, few studies have explored severe-illness patients like those with coronary heart disease (CHD). We could not locate studies measuring preference weights of branded drugs in different classes within guideline-recommended regimens using discrete choice experiments (DCE). We aimed to explore the preference for branded medications used for secondary prevention of CHD events among patients receiving treatment at one of the largest Egyptian health insurance clinics. Patients with CHD were interviewed to choose between various therapy regimens containing brand-name and generic versions of aspirin, beta-blockers, statins, and renin–angiotensin–aldosterone system blockers (RAAS blockers). The study employed a DCE technique and followed the recommendations of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR). Seventy-two percent (149) of the 208 patients questioned were dissatisfied with at least one of their generic medications. The majority of unsatisfied patients displayed brand preferences across the four medicine classes, primarily due to the notion that generics may be less effective. Patients preferred the RAAS blocker brand the most (adjusted odds ratio [AOR]: 3.14; 95% confidence interval [CI] 2.83 to 3.48), followed by beta-blockers (AOR: 2.06; 95% CI 1.88 to 2.27) and statins (AOR: 1.5; 95% CI 1.50 to 1.61). The relative importance of each class from the patient’s perspective showed the highest importance with RAAS blockers (22.2%) and beta-blockers (14.1%), while statins and aspirin had minor importance (7.8% and 6.6%, respectively). In the present study, branded drugs for secondary CHD prevention were preferred over generic alternatives. This finding has two implications for clinical practice. Firstly, physicians and pharmacists need to assure patients about the quality of generics to insure patient satisfaction and adherence to medication. Secondly, health insurance providers need to confirm the effectiveness of generics through observational studies. Despite the well-proven protective effects of aspirin and statins, they had minor importance from the patient’s perspective, highlighting the need to enhance patient knowledge. DCE was demonstrated to be a useful tool for eliciting the genuine preferences of patients treated within the setting of health insurance.

Managing Pharmaceutical Promotion Mix in the Rise of Social Media

ABSTRACTA manufacturer of a branded prescription drug typically uses traditional promotional tools to communicate with consumers (i.e., direct‐to‐consumer advertising) and physicians (i.e., detailing, sampling, and journal advertising). These promotions seek to enhance brand drug visibility and, eventually, increase brand sales. As medical communication norms generally dictate how healthcare information is communicated, the emergence of social media challenges such norms and potentially inflates (or deflates) the efficacy of pharmaceutical marketing communication. In such situations, a crucial research question revolves around how marketers will adjust their promotional strategies. In this study, the authors analyze the longitudinal data of 41 brand drugs from 7 therapeutic classes between 2007 and 2014. Through the lens of signaling theory, they empirically show that the volume and valence of social media posts can enhance or hinder the sales impacts of different promotional activities. Specifically, the volume and valence of social media posts have the potential to amplify the sales impact of detailing and direct‐to‐consumer advertising, while diminishing the effects of sampling and journal advertising. The volume and valence of brand drug mentions as well as consumer passion toward the brand drug display similar effects on the efficacy of pharmaceutical promotions. The findings shed new light on conventional pharmaceutical promotion practices in the presence of social media and provide novel implications for promotion mix management.

How promotion mix helps sustain brand sales during market transitions: insights from the pharmaceutical industry

Purpose Pharmaceutical marketers use detailing, sampling and direct-to-consumer advertising (DTCA) to promote a branded prescription drug (brand drug) to health-care professionals and consumers. These promotion mix elements help raise brand awareness, increase prescription likelihood and guard a product market against competing brand drugs. However, the extent to which these elements remain effective when a brand drug goes off patent and its marketing exclusivity expires, allowing low-price generics to enter the market, remains unclear. This study aims to explore the effectiveness of promotion mix elements before and after the market entry of a generic drug. Design/methodology/approach The authors collected and analyzed a panel data set of 41 brand drugs from 7 therapeutic classes between 2007 and 2014 (3,201 observations) using the two-stage control function approach to address potential endogeneity. Findings The effectiveness of promotion mix elements changes significantly, but not in a universally uniform way, during a market transition. Detailing and DTCA are increasingly effective after a brand drug’s generics enter the market. In contrast, sampling is more effective before the market transition. The positive effects of sampling on brand sales are stronger when the price of a brand drug is higher than the average price of its competing brands. Sampling also helps amplify the positive influences of detailing and DTCA on brand sales. Research limitations/implications This study shows that pharmaceutical promotion is not equally effective in the brand drug market with/without generic competitors. Detailing and DTCA are increasingly effective when generic competition intensifies. In contrast, the distribution of free drug samples is less effective after more generic drugs enter the market. Practical implications Incumbent brands’ promotion expenditures often drop dramatically when the expiration of their patents is near, a practice that likely continues after generics enter the market. Taking into consideration these industry norms and their findings, the authors suggest that promotional decisions during a market transition should not overly focus on cutting promotional expenditures across the board. Since a firm’s promotional expenditure tends to be expensive, factoring in information on the effectiveness of each promotion mix element helps marketers make well-informed strategic decisions on resource allocation during the transition from a market without generics to a market with generics. Originality/value Previous studies do not explicitly account for structural changes in the brand drug market over time. However, the expiration of patent and marketing exclusivity marks a transitional period in which a brand drug eventually competes with its generic counterparts. Given the criticality of such structural change, the authors examine brand drugs’ promotion effectiveness in the presence of their generic counterparts.

Assessment of knowledge, attitude and practices of generic drugs and their potential nocebo effects among second year medical students in a rural tertiary care teaching hospital: a cross-sectional study

Background: As drugs contribute significantly to healthcare costs, reduction in their cost by using generics offers a significant advantage so evaluation was done of knowledge, attitude, and practices of generic drugs and their potential nocebo effects among second year medical students in a tertiary care teaching hospital. Methods: A prospective, observational, and questionnaire-based study was conducted after approval by the Institutional Ethics Committee. Pretested and validated questionnaire consisting of 26 questions about generic drugs was filled by 92 participants. The filled questionnaires were collected and analyzed on Microsoft Excel sheet. Results: Majority (90.2%) students had heard about generic drugs, however, only 18.5% students thought there was a nocebo effect associated with the use of generic drugs. Majority of the study population had a positive attitude towards use of generic drugs and believed them to be equally efficacious as branded drugs in addition to not having more side effects than branded drugs, though their current practices did not reflect this knowledge and attitude. 63% also said that following this study, they were likely to prescribe or consume generics as future doctors and patients. Conclusions: The participants had sufficient knowledge and positive attitude towards use of generic drugs. Knowledge regarding the possible nocebo effects of generic drugs was lacking.

Comparison of the efficacy of a generic plerixafor versus Mozobil as adjunct peripheral blood stem cell mobilization agents in multiple myeloma patients.

Plerixafor is an adjunct peripheral blood stem cell (PBSC) mobilization agent with well-demonstrated safety and efficacy. The routine use of the originator brand drug (Mozobil) has been limited by cost. This retrospective study was conducted to compare the mobilization efficacy of a lower-cost generic plerixafor and Mozobil in multiple myeloma (MM) patients. The study included two near-concurrent cohorts of MM patients mobilized with brand (n = 64) or generic (n = 61) plerixafor in addition to filgrastim. Collection and early engraftment outcomes were compared. The two cohorts had comparable distributions of sex, age, and weight. Previous treatment histories and proportions of upfront versus just-in-time plerixafor use were similar. There was no significant difference in their median overall cumulative total yield (106 CD34+ cells/kg) (brand, 5.91; generic, 5.80; p = .51). However, the generic cohort had a significantly higher median yield after the first dose (4.79 vs. 3.78, p = .03), and consequently lower median numbers of plerixafor doses (p = .001) and collection days (p = .002). Only 31.1% of patients in the generic arm required more than one dose versus 59.4% of patients in the brand arm (p = .006). All transplanted patients in the brand and generic arms (90.6% and 85.2% respectively, p = .42) achieved engraftment. There was no significant difference in their median times to platelet and neutrophil engraftment, nor their transfusion requirements during the first 30 days post-transplant. The generic plerixafor produced comparable cumulative collection yields and early engraftment outcomes as Mozobil, but fewer doses and collection days were needed to reach collection goal.

An Analysis of Consumer Awareness Regarding Jan Aushadhi Kendras

India has made significant advancements in various health aspects, including an increase in the life expectancy of both men and women, low infant and maternal mortality rates, improved immunization coverage, and the elimination of diseases like polio and smallpox. According to the World Health Organization, around 5.8 million Indians succumb to diseases like diabetes, cancer, stroke, and heart and lung diseases. Non-communicable diseases (NCDs) pose a substantial health challenge in India, with one out of every four Indians dying before the age of 70 due to an NCD. The Indian healthcare system is grappling with rising healthcare costs, which disproportionately burden the poor, as well as the emergence of new diseases and non-communicable diseases. Approximately 100 million Indians fall into poverty each year due to high healthcare expenses, with out-of-pocket spending constituting over 50 percent of this burden. To reduce healthcare costs, the government has established Jan Aushadhi Kendras, which offer generic medicines with the same composition as branded ones at affordable prices. A recent study focused on identifying the key factors influencing the purchase of generic drugs from Jan Aushadhi medical stores, public awareness of these stores, and consumer satisfaction. The study found that 40 percent of the public is unaware of Jan Aushadhi, and consumers opt for generic medicines due to their affordability, even though the quality is lower than that of branded drugs. Jan Aushadhi Kendra is known for selling significant quantities of sanitary pads. While most consumers are satisfied with Jan Aushadhi products, some express dissatisfaction due to differences in quality and composition. Government agencies and health departments must enhance the quality of generic medicines and educate healthcare professionals and the general public about them.

Analisa mutu tablet ibuprofen generik berlogo dan generik bermerek yang diproduksi industri X di Gresik

Ibuprofen tablets are one of the most widely used antipyretic analgesic drugs for self-medication in pharmacies. According to the Biopharmaceutical Classification System (BCS), Ibuprofen is included in Class II or drugs with low solubility, but high permeability. This study was carried out to determine the physical quality of branded generic and branded generic ibuprofen drugs. This research was carried out by dissolution testing on ibuprofen tablets. The results obtained from the physical quality test met the specified requirements. The dissolution test showed that Q30 had dissolved more than 70%. The conclusion is that the drug meets the requirements and there is no difference between generic drugs with the logo and branded generics.

Strategic behavior and entry deterrence by branded drug firms: the case of authorized generic drugs.

Pharmaceutical firms that market brand-name drugs lose substantial market share to generic manufacturers after patent expiration. As a response to the threat of generic competition, branded manufacturers pursue defensive strategies. One such strategy is the launch of authorized generic drugs. Authorized generic drugs are produced by branded manufacturers to compete against other generic drug entrants. Such competition may lower the expected profits of generic drug manufacturers and hence deter future generic drug entry. This paper models and empirically examines whether the introduction of authorized generic drugs changes the independent generic firms' decisions on entering the market. We use an instrumental variable approach to evaluate the effect of authorized generic drugs on the responses of generic manufacturers. The results show that the entry of authorized generic drugs deters and delays the entry of generic drugs.

An Analysis of Consumer Awareness Regarding Jan Aushadhi Kendras

India has made significant advancements in various health aspects, including an increase in the life expectancy of both men and women, low infant and maternal mortality rates, improved immunization coverage, and the elimination of diseases like polio and smallpox. According to the World Health Organization, around 5.8 million Indians succumb to diseases like diabetes, cancer, stroke, and heart and lung diseases. Non-communicable diseases (NCDs) pose a substantial health challenge in India, with one out of every four Indians dying before the age of 70 due to an NCD. The Indian healthcare system is grappling with rising healthcare costs, which disproportionately burden the poor, as well as the emergence of new diseases and non-communicable diseases. Approximately 100 million Indians fall into poverty each year due to high healthcare expenses, with out-of-pocket spending constituting over 50 percent of this burden. To reduce healthcare costs, the government has established Jan Aushadhi Kendras, which offer generic medicines with the same composition as branded ones at affordable prices. A recent study focused on identifying the key factors influencing the purchase of generic drugs from Jan Aushadhi medical stores, public awareness of these stores, and consumer satisfaction. The study found that 40 percent of the public is unaware of Jan Aushadhi, and consumers opt for generic medicines due to their affordability, even though the quality is lower than that of branded drugs. Jan Aushadhi Kendra is known for selling significant quantities of sanitary pads. While most consumers are satisfied with Jan Aushadhi products, some express dissatisfaction due to differences in quality and composition. Government agencies and health departments must enhance the quality of generic medicines and educate healthcare professionals and the general public about them.

Consumer Out-Of-Pocket Drug Prices Grew Faster Than Prices Faced By Insurers After Accounting For Rebates, 2007-20.

The rising price of branded drugs has garnered considerable attention from the public and policy makers. This article investigates the complexities of pharmaceutical pricing, with an emphasis on the overlooked aspects of manufacturer rebates and out-of-pocket prices. Rebates granted by pharmaceutical manufacturers to insurers reduce the actual prices paid by insurers, causing the true prices of prescriptions to diverge from official statistics. We combined claims data on branded retail prescription drugs with estimates on rebates to provide new price index measures based on pharmacy prices, negotiated prices (after rebates), and out-of-pocket prices for the commercially insured population during the period 2007-20. We found that although retail pharmacy prices increased 9.1percent annually, negotiated prices grew by a mere 4.3percent, highlighting the importance of rebates in price measurement. Surprisingly, consumer out-of-pocket prices diverged from negotiated prices after 2016, growing 5.8percent annually while negotiated prices remained flat. The concern over drug price inflation is more reflective of the rapid increase in consumer out-of-pocket expenses than the stagnated inflation of negotiated prices paid by insurers after 2016.

Perception and coping mechanisms of patients with diabetes mellitus during the COVID-19 pandemic in Ibadan, Nigeria.

The 2019 coronavirus disease (COVID-19) ushered in a period of fear and uncertainty, resulting in structural instability across the globe. Vulnerable individuals, such as patients with diabetes mellitus, are predispose to have adverse effects and complications of COVID-19 when infected. We explored the perception of diabetes mellitus patients during the COVID-19 pandemic and their coping mechanisms at the University College Hospital, Ibadan. We employed an exploratory qualitative study design to explore diabetes mellitus patients' perceptions and coping mechanisms during the COVID-19 pandemic. A purposive sampling technique was used to recruit 32 participants (2 health professionals and 30 diabetes mellitus patients). In-depth interviews were used to collect the data from the participants. All the recorded audio data were transcribed verbatim and exported to NVivo software for thematic data analyses. Most diabetes mellitus patients were not fearful of the pandemic but were optimistic that it would not affect their health. Mechanisms such as the usage of herbal medicines and adherence to COVID-19 precautionary measures were noticed among patients. The study also revealed that the hospital's coping mechanism during the COVID-19 pandemic include prolonged appointments, limiting the number of patients attended per clinic day, and the provision of telehealth service. Patients in our study utilised negative coping mechanisms such as reduced drug dosages, subscriptions to cheaper drug brands, and reliance on religious institutions rather than a clinic for health instructions. The study has shown that diabetes mellitus patients were not fearful of the COVID-19 pandemic. The utilisation of telehealth, encouragement of daily monitoring of sugar levels, provision of avenues for a medication review, and adherence to the safety protocols were coping mechanisms employed by the health system and diabetes mellitus patients. We recommend that the government and other healthcare stakeholders reinforce the resilience of diabetes mellitus patients by alleviating their health burdens during the pandemic. This could be done by subsidizing the prices of drugs, tests, and consultation fees for patients with diabetes mellitus. Also, more efforts should be made to elevate the health system through the reduction in waiting and appointment times in the diabetes clinic and employing more health personnel in the clinic.

A Review on Consumer Patterns and Behaviours’ Towards Generic Medicines

Generic medicines have become an important topic in healthcare due to their potential to reduce costs while providing equivalent treatment to branded drugs. This review article investigates consumer patterns and behaviors related to generic medicines, focusing on awareness, purchasing factors, and satisfaction levels. The research employs a systematic literature review methodology, analyzing peer-reviewed journals, government reports, and industry studies on generic medicines and consumer behavior. Various statistical techniques, such as percentage analysis, chi-square tests, factor analysis, Garrett ranking, and Likert scales, are used to summarize demographic profiles, examine relationships, identify influencing factors, prioritize purchase constraints, and measure satisfaction levels. Key findings reveal that consumer awareness of generic medicines varies widely, influenced by factors such as age, education, and exposure to information from healthcare providers. Government initiatives like India's Pradhan Mantri Jan Aushadhi Yojana aim to increase access to affordable generics, yet awareness remains limited in some areas. Price is a major motivator for purchasing generics, but other factors like perceived quality, doctor recommendations, availability, and prior experience also play significant roles. Generally, consumers express positive experiences with generics, citing effectiveness, cost savings, and quality. However, some consumers and healthcare providers harbor concerns about the safety and efficacy of generics compared to branded versions. This review underscores the need for ongoing efforts to enhance consumer confidence in generics through education and awareness campaigns, ensuring the success of initiatives aimed at making essential medicines affordable and accessible to all.

AN OVERVIEW OF THE COMMUNITY KNOWLEDGE LEVEL TOWARDS THE USE OF GENERIC DRUGS IN TUPA VILLAGE, NORTH BULANGO DISTRICT, BONE BOLANGO REGENCY, GORONTALO PROVINCE, IN 2022

Generic drugs are medications with generic names, as defined by the Indonesian Pharmacopoeia and International Non-proprietary Names (INN) from the WHO, and they do not use trade names or manufacturer logos. Examples of these include amoxicillin and metformin. The public often perceives generic drugs to be inferior to patented drugs because of their relatively lower prices. The purpose of this study is to describe the knowledge level of the community about the use of generic drugs in Desa Tupa, Kecamatan Bulango Utara, Kabupaten Bone Bolango in 2022. This study employs a descriptive method using a quantitative approach. Data were collected through questionnaires that were distributed to 30 randomly selected respondents. A univariate analysis was conducted by creating frequency distributions to determine the community's awareness level regarding generic drugs. The survey results indicated that most residents of Desa Tupa have limited information about the use of generic drugs. The study concluded that, in terms of knowledge level about generic drugs, 30% of respondents had heard of generic drugs, 22% knew that generic drugs were named according to INN (International Non-proprietary Names), 11% understood that generic drugs are those that have expired patents, 9% recognize that generic drugs do not use brand names, and 28% are aware that generic drugs are more affordable than branded drugs.

Blockchain adoption of pharmaceutical firms in a competitive market: Pricing, drug traceability and consumer awareness

To cope with counterfeit drugs reaching consumers all over the world, pharmaceutical firms increasingly regard blockchain technology (BCT) as a promising solution to achieve drug traceability. This study proposes a game-theoretic model to investigate the impact of BCT adoption on pharmaceutical firms’ pricing and performance in a competitive market, where one firm offers a branded drug and the other offers a generic version. We consider three contrastive cases with no BCT adoption, unilateral BCT adoption of the branded drug firm and bilateral BCT adoption and characterize consumer traceability awareness, which represents the fraction of consumers sensitive to drug traceability. We find that when BCT is unilaterally adopted, a high consumer traceability awareness level may lead to either higher or lower drug prices. The bilateral adoption of BCT always benefits the generic drug firm due to the enhanced drug traceability, but may damage the branded drug firm attributed to the mitigated differentiation between the two drugs. Compared with the unilateral adoption of BCT, bilaterally adopting BCT can lead to a win-win or lose-lose outcome, depending on the trade-off of drug traceability, drug differentiation and pricing competition. In addition, the adoption of BCT improves consumer welfare when consumers hold a high level of traceability awareness.

Clinical Benefit and Revenues of Drugs Affected by Rare Pediatric Disease Priority Review Vouchers, 2017-2023

To determine the clinical benefit of drugs that earned or redeemed rare pediatric disease priority review vouchers (PRVs) from 2017 through 2023, and the revenues generated by such drugs. In this cohort study, Federal Register documents, publicly available health technology agency (HTA) assessments, and financial filings were used to identify drugs that were issued or redeemed using a rare pediatric disease PRV from 2017 through 2023, and to assess their added therapeutic benefit and drug-specific global revenues. Among the 36 drugs whose approval resulted in issuance of a rare pediatric PRV, therapeutic benefit ratings were available for 17 (47%), with 9 (53%) rated as high by at least 1 organization. Mean annual global revenues were $363 million (year 1), $621 million (year 2), and $850 million (year 3). The median annual list price for drugs issued a voucher was $788,705. Vouchers were then redeemed for 15 different drugs; out of 13 drugs with therapeutic benefit ratings, 4 (31%) were high value. Drugs that treat rare pediatric diseases generate similar revenues compared with other brand drugs, and drugs with high therapeutic benefit tend to generate more revenue than those with low therapeutic benefit. Drugs that earned the rare pediatric disease PRV for their manufacturer generate significant revenues and the voucher may not be necessary to incentivize drug development in the rare pediatric disease space.

EUMENOL—Merck’s Patent Emmenagogue and its Chinese Connections (1896–1961)

This article examines the rise and fall of Eumenol, Merck's patent emmenagogue extracted from danggui (當歸), and its destined connections with China. Understood to affect the blood, danggui, one of the most prolifically used substance among Chinese materia medica, had been included in recipes for women aged from before menarche to after menopause since the twelfth century, but it was not until its production and advertisement by the German pharmaceutical company that the multi-functional material was placed on the international stage with a sharpened gendered image. For Merck customers around the world, Eumenol was a long-awaited, harmless emmenagogue made from an obscure Chinese material; for Chinese who had been using the root to treat a wide range of disorders, the branded drug was a scientific refinement of a time-honored medicine. The success of Eumenol gave advocates of Chinese medicine a concrete example with which to rejuvenate their medical traditions, but the later cessation of Chinese imports forced Merck to eventually stop marketing the emmenagogue. Within this intersection of medicinal exchanges, Eumenol emerged as an indispensable piece of the puzzle in terms of both the history of an ancient remedy and the modernization of Chinese medicine.

Physician Prescribing Behavior of Medicines in Developed and Developing Countries: A Systematic Review

ABSTRACT A physician’s prescribing decision is a complex process, as it calls for the contribution of multiple stakeholders across the value chain. Physicians’ prescribing behavior constitutes elements such as product-related characteristics, product-promotional efforts, physician’s professional characteristics, and physician personality traits. Collaborative efforts involving government agencies, physician societies, and pharmaceutical organizations can enhance physician awareness and improve prescribing practices, leading to better disease management with improved patient quality of life. Based on existing studies in these economies, this systematic review explored physicians’ prescribing behavior in developed and developing countries. The ultimate goal of this systematic review is to empower physicians to make better prescribing decisions, ensuring patient safety and faster recovery. Using relevant keywords, the search was conducted with Scopus and Google Scholar databases from 2011 to 2024, with cross-sectional and longitudinal studies, and reviews were included, whereas narrative reviews, case reports, opinion polls, and letters to the editor were excluded from the study. All three reviewers independently extracted data based on study design, year, country, participant characteristics, setting, and other details for conducting qualitative analysis based on the central tendency to study year-on-year publication trends and demographics characteristics were analyzed. Our review demonstrated that various promotional tools positively impacted prescribing behavior in developed and developing economies. However, physicians in developing countries expressed concerns about the value provided by pharmaceutical representatives, indicating a need for better knowledge dissemination about the product. Physicians prefer branded drugs for quality and efficacy, supported by health-care infrastructure and insurance in developed countries, but in developing countries, physicians prefer branded generics over branded drugs due to cost considerations.

Cost analysis of anticancer chemotherapy and chemoirradiation regimens considering the drugs marketed through Jan Aushadhi (People's Medicine) stores and their branded counterparts: First cost comparison study.

Chemotherapy in an integral part of cancer treatment, either administered alone or in combination with radiation. However, the cost of these drugs is often prohibitively high for most patients. To address this issue, the Government of India has established Jan Aushadhi (JAS) stores across the country, where affordable generic medicines are available. In the current study, we performed a cost minimization analysis comparing JAS drugs with branded chemotherapeutic drugs used in various cancer treatment regimens. This study was to conduct a cost-minimization analysis by comparing the costs of different regimens when using JAS drugs, the most expensive branded drugs, and the least expensive branded drugs in the treatment of cancer in India. The study focused on conducting a cost minimization analysis of various chemotherapy drugs used in the treatment of different cancers, considering the availability of anticancer drugs at JAS stores. The costs for different chemotherapy regimens, including both anticancer and supportive drugs, were calculated for single and complete cycles. The costs of the most expensive and least expensive branded drugs were noted from the Current Index of Medical Stores. The cost difference (CD) was calculated by subtracting the cost of the cheaper drug from that of the costliest brand. The cost ratio (CR) and the percentage of cost variation (PCV) were calculated for India-specific conditions. The study analyzed the CD for various regimens using JAS drugs for chemotherapy treatment of breast, esophagus, rectal, colon, stomach, prostate, ovary, endometrial, cervical, head and neck, lung, multiple myeloma, testicular, and lymphoma cancers. It also considered chemoirradiation regimens for brain, head and neck, anorectal, esophageal, and uterine cervical cancers. Significant CDs were observed when both anticancer and supportive drugs were obtained from JAS stores. To the best of the authors' knowledge, this is the first study to consider the CD, CR, and PCV for various regimens using JAS drugs, as well as the costliest and cheapest branded drugs in standard cancer treatment regimens. The results of this study are expected to assist healthcare professionals and pharmacists in understanding the cost-saving benefits of substituting expensive branded drugs with more affordable chemotherapeutic drugs for the treatment of cancer. This substitution can provide financial benefit for socioeconomically marginalized population.