Distribution Of Prescription Drugs Research Articles

Pharmacy Benefit Managers and the Federal Trade Commission

This Viewpoint provides a brief history of pharmacy benefit managers (PBMs), describes the ways in which PBMs have acquired influence in the prescription drug distribution system, and suggests possible scenarios surrounding the June 2022 decision by the Federal Trade Commission to launch an investigation into PBM business practices.

Social media markets for prescription drugs: platforms as virtual mortars for drug types and dealers

PurposeInternet use has changed the mechanics of drug dealing. Although this has spurred some initial academic interest in how markets and their users have been changing, the issue is still under-researched. The purpose of this paper is to understand how the organisation of the distribution of prescription drugs and other illegal drugs overlap in these online markets by analysing data gathered from observation of the Swedish Facebook drug market and its participants.Design/methodology/approachData were gathered during three months of digital ethnography conducted among Swedish Facebook posters supplemented by 25 interviews with sellers (20) and buyers (5). Screenshots and interview data were coded by carrying out an NVivo-based content analysis. The analysis is based on descriptive statistics of drug types, co-occurrence with other drugs, group size and the demographic characteristics of sellers. Additionally, the interviewees’ descriptions of the marketplace and their drug dealing or buying activities were included in the analysis.FindingsIn total, 57 Swedish Facebook groups that sold illegal substances were located. The groups rarely specialised in specific drug types, but were convened around demographic factors, such as specific cities and locales. The sales of prescription drugs were part of the overall activity of groups selling other illegal drugs, but they were more often sold in separate Facebook posts, possibly by specialist sellers. Swedish Facebook sales primarily concerned alprazolam, tramadol, pregabalin and clonazepam, and were sold by both professional and amateur sellers.Originality/valueThis study reports findings from a Nordic comparative study on social media drug dealing, representing the first in-depth study of digitally mediated prescription drug dealing outside of cryptomarkets.

A New Tool to Tackle the Opioid Epidemic: Description, Utility, and Results from the Maine Diversion Alert Program.

The opioid epidemic continues to impact the United States, and new strategies are needed to combat this epidemic. The objective of this study was to analyze 2015 drug arrest data from Maine's Diversion Alert (DA) program (diversionalert.org), compare arrest data between the first quarters of 2015 and 2016, and provide an analysis of the sex differences in the arrests as well as information about DA use. This was a population-based descriptive study using data from the Maine DA program. The study population consisted of persons arrested for prescription, nonprescription, or illicit drugs. DA database. The DA program addresses Maine's prescription drug abuse epidemic with innovative resources that provide access to drug arrest data for health care providers to identify and respond to patients at risk for overdose, those engaged in illegal prescription drug distribution, and those who need treatment. Drug arrest data from 2015 (2723 arrests) and the first quarter of 2016 (788 arrests) were compared and analyzed. The drugs implicated in the arrests were organized by Drug Enforcement Agency (DEA) schedule category and whether they were pharmaceuticals (synthesized and distributed by a pharmaceutical company) or nonpharmaceuticals (grown or synthesized in clandestine laboratories). Most arrests were for possession (64.5%) followed by trafficking (23.8%). Heroin was listed in more than three-quarters (76.4%) of the Schedule I arrests, followed by marijuana (11.7%) and "bath salts" (6.3%). Cocaine and crack cocaine were implicated in almost half (46.7%) of the Schedule II arrests, followed by oxycodone (21.0%) and methamphetamine/amphetamine (15.8%). Buprenorphine was responsible for almost all (96.7%) of the Schedule III arrests. The benzodiazepines alprazolam (34.3%), clonazepam (33.8%), diazepam (11.9%), and lorazepam (8.5%) were listed in the preponderance of the Schedule IV arrests. Arrests increased in 2016 by 49.2% for heroin (p<0.01) and 170.0% for methamphetamine (p≤0.0005) relative to 2015. Arrests for trafficking increased by 42.9% (p<0.05). Males outnumbered females 2:1 in DA. Schedule IV agents accounted for only 6.8% of arrests for males versus 11.5% for females (p≤0.0001). Conversely, Schedule I agents were implicated in 33.0% of arrests for males versus only 27.3% for females (p<0.005). DA is an important tool for providing timely information for health care providers regarding individuals with a history of past misuse of psychotherapeutic agents, particularly opioids and stimulants.

USA Criminal and Civil Prosecutions Associated with Illicit Online Pharmacies: Legal Analysis and Global Implications

The rise of digital technologies has created a complex online environment that now includes illicit Internet pharmacies, online facilitators, advertising sites, and foreign entities. Collectively, these networks create significant patient safety risks, including acting as unregulated access points encouraging prescription drug abuse. Although law enforcement is active in combating this form of cybercrime, there are several difficulties in prosecuting individuals involved in online prescription drug distribution. We characterize these challenges by conducting a comprehensive legal review and analysis of USA civil and criminal cases associated with online pharmacies. This is accomplished by reviewing legal documents/filings available via the Public Access to Court Electronic Records (PACER) database, the Drug Enforcement Agency's website, and structured search queries using the Google search engine. We found more than 100 cases, including criminal indictments, sentencing documents, judgments, forfeiture orders, motions, civil complaints, and restitution documents. Our review indicates that current legal tools and regulatory policies do not effectively deter this highly profitable criminal activity. Hence, we issue a “Call to Action,” advocating the need for more robust legal remedies and criminal penalties, and greater legal and policy coherence at the domestic, regional, and global level aimed at improving patient safety and ensuring the integrity of the drug supply chain.

Examining How Prescription Drugs Are Illegally Obtained

The rise in prescription drug abuse is changing crime patterns among drug users and the structure of illegal drug markets. The illegal distribution of prescription drugs is different from traditional street drug markets because prescription drugs can be obtained from multiple sources including doctors, pharmacies, friends, and street-level dealers. Drawing from drug-market research, this article investigates whether there are individual and ecological predictors of how prescription drugs are illegally obtained. Our study uses multilevel analyses to examine a random sample of 366 drug offenders arrested in Maricopa County, Arizona. Our findings indicate that individual-level characteristics such as mental illness and street drug use, as well as residential mobility within neighborhoods, are significant predictors of how prescription drugs are obtained for nonmedical purposes. This research suggests that an individual’s routine activities and neighborhood characteristics are related to their methods for obtaining prescription drugs. Theoretical and policy implications are discussed.

VITAL SIGNS: Top 10 Channels for Prescription Drug Distribution in 2008

VITAL SIGNS: Top 10 Channels for Prescription Drug Distribution in 2008

Vital Signs: Top 10 Channels for Prescription Drug Distribution in 2008

Vital Signs: Top 10 Channels for Prescription Drug Distribution in 2008

Veterinary Prescriptions and Drug Distribution

Veterinarians have come to expect reliable and predictable services from wholesale drug distributors. Due to valid concerns regarding counterfeit human medications and the security of the drug supply chain, changes at the federal and state levels have directly affected veterinary wholesale drug distributors. This manuscript will highlight state and federal regulations that influence production animal medicine business models where veterinary prescription drugs are sold/delivered to end users upon the valid order of a veterinarian within the context of a veterinarian-client-patient relationship (VCPR).&#x0D; This presentation will review federal acts and state statutes and regulations that affect the sale and distribution of prescription drugs used in production animal medicine. Additionally, it focuses on regulatory affairs and regulatory compliance issues that impact practicing veterinarians and veterinary drug distributors.

Vital Signs: Top 10 Channels for Prescription Drug Distribution in 2007

Vital Signs: Top 10 Channels for Prescription Drug Distribution in 2007

Vital Signs: Top 10 Channels for Prescription Drug Distribution in 2007

Vital Signs: Top 10 Channels for Prescription Drug Distribution in 2007

The Impact of New Drugs on US Longevity and Medical Expenditure, 1990–2003: Evidence from Longitudinal, Disease-Level Data

A number of econometric studies (Charles R. Hulten 1992; Byong-Hong Bahk and Michael Gort 1993; Plutarchos Sakellaris and Daniel J. Wilson 2004) have investigated the hypothesis that capital equipment employed by US manufacturing firms embodies technological change, i.e., that each successive vintage of investment is more productive than the last. Equipment is expected to embody significant technical progress due to the relatively high research and development (R&D) intensity of equipment manufacturers. The method that has been used to test the equipment-embodied technical change hypothesis is to estimate manufacturing production functions, including (mean) vintage of equipment as well as quantities of capital and labor. These studies have concluded that technical progress embodied in equipment is a major source of manufacturing productivity growth. Embodied technical progress may also be an important source of economic growth in healthcare. One important input in the production of health—pharmaceuticals—is even more R&D intensive than equipment. According to the National Science Foundation (NSF), the R&D intensity of drugs and medicine manufacturing is 74 percent higher than the R&D intensity of machinery and equipment manufacturing. Therefore, it is quite plausible that there is also a high rate of pharmaceutical-embodied technical progress. This study examines the effect of changes in the vintage distribution of prescription drugs on US longevity and medical expenditure during the 1990–2003 period. We will estimate the following model, using longitudinal disease-level data:

Medicine. Magic bullet gone astray: medications and the Internet.

Internet pharmacies have become major access points for illegitimate sales and distribution of prescription drugs from sources around the world. In the United States, drug importation from foreign markets has reached record levels. National and international policymakers have identified key issues arising from purchasing medications through the Internet that can threaten patient welfare. The authors of this Policy Forum recommend cooperation among international healthcare organizations and governments to meet these challenges.

Many Brazilian Women Hospitalized for Incomplete Abortion Report Using Ulcer Drug as Abortifacient

Two hospital-based surveys conducted in Brazil revealed widespread use of misoprostol as an abortifacient agent. This prostaglandin marketed for the treatment of gastric ulcers was selected because it was inexpensive and could be self-administered. Of the 803 women admitted to 7 public hospitals in Rio de Janeiro during April-December 1991 for complications they acknowledged were related to induced abortion 57% had used misoprostol; another 13% had taken a drug they could not name which may well have been misoprostol. 84% of misoprostol users heard of the drug from friends relatives or co-workers. 70% obtained misoprostol directly from a pharmacist; about half of these women were advised on how to use the drug to terminate pregnancy. 65% took the drug orally 6% administered it intravaginally and 29% used both routes. The median dose was 800 mcg with a range of 200-16800 mcg. Only 4% had a complete abortion and 85% required surgical intervention. Three misoprostol users died 2 from sepsis and 1 from a ruptured uterus. The second study examined the records of women undergoing uterine evacuation during January 1990-July 1992 at the main obstetric hospital in Fortaleza after attempted induced abortion. Of the 593 such patients in 1991 75% had used misoprostol. However after the sale of misoprostol was banned in Ceara State in July 1991 the monthly number of uterine evacuations fell to about 20. Researchers attribute the misuse of the drug to inadequate knowledge of and access to family planning services the illegality of abortion in Brazil and poor control over the distribution of prescription drugs.

Practitioners’ Knowledge of Laws Governing Prescription Drug Distribution

Practitioners’ Knowledge of Laws Governing Prescription Drug Distribution

The Mail-Order Prescription Drug Industry

THE PRACTICE of mailing prescription and other medications to consumers in the United States probably had its origin in rural America. Before the general availability of the automobile, rural inhabitants often were dependent upon the U.S. mail for delivery of medicines and health supplies from their local pharmacy. This practice was not only a convenience to the consumer, but an essential health service as well-one in which physician, pharmacist, and patient were active participants. The Veterans Administration has used the mails for distributing medicines to its ambulant patients for many years. This practice was expanded greatly with the return of veterans after World War II and has continued to grow, proving convenient and economical for both parties. In more recent times, the National Retired Teachers Association and American Association of Retired Persons (NRTA-AARP) has been distributing prescription medications to its members through a program that is now a featured service. As the volume of prescriptions delivered by mail has increased, the practice has come under continuing, and at times critical, surveillance, particularly by organized pharmacy. Because available information to characterize the nature and extent of the mail-order prescription industry has not been collected and scrutinized, we undertook to assemble as much factual information as could be obtained. Professional organizations and State boards of pharmacy were contacted for the names of firms engaged in high-volume, mail-order distribution of prescription drugs. A list of approximately 60 organizations was compiled. Data were then collected through a combination of personal and telephone interviews from 10 of the larger organizations, using a standard set of questions relating to the data reported in the remainder of this paper. These organizations are responsible for approximately 90 percent of the volume of mail-order prescription drugs in the United States. This report constitutes a profile of the mail-order prescription drug industry as constructed from our study. For purposes of convenience, mail-order Dr. Wertheimer and Dr. Knoben were formerly on the stafi of the Pharmacy-Related Programs Branch, National Center for Health Services Research and Development, Health Resources Administration. Dr. Wertheimer is now associate professor, University of Minnesota College of Pharmacy; DP. Knoben is now at Yale University. Tearsheet requests to Dr. Albert I. Wertheimer, University of Minnesota College of Pharmacy, Minneapolis, Minn. 55455.