Pharmacoeconomics and Pharmaceutical Economics Commons^™

Optimization Of Guava Leaf Extract Cream Formulation Through Variations Of Xanthan Gum And Stearic Acid For Wound Cure In Rats, Ayudia Cipta Khairani, Mia Ariasti

Pharmacology and Clinical Pharmacy Research

Cuts are among the most common skin injuries caused by sharp objects and can lead to infection if not properly treated. Natural ingredients such as guava leaves have been widely investigated for their wound-healing potential. Guava leaves contain bioactive compounds including flavonoids, saponins, alkaloids, and tannins, which contribute to anti-inflammatory, antibacterial, and tissue regeneration processes. This study aimed to formulate and evaluate the physical properties and wound-healing effectiveness of guava leaf ethanol extract cream with varying concentrations of xanthan gum and stearic acid as emulsifiers. The extract was obtained by maceration using 70% ethanol and formulated into four cream formulas …

Drug-Related Problems In Hemodialysis Patients With Chronic Kidney Disease: A Study At X Hospital (January–May 2022), Muhammad Refki Abrari, Jatmiko Susilo

Pharmacology and Clinical Pharmacy Research

The prevalence of chronic kidney disease (CKD) in Indonesia has increased from 2.0 ‰in 2013 to 3.8 ‰in 2018. The presence of complex comorbidities associated with CKD causes varied therapy regimens (poly-pharmacy), leading to an increased risk of drug-related problems (DRPs). To overcome these complications, dialysis is often used to remove metabolic waste and rebalance electrolytes to maintain life in patients experiencing rapid loss of kidney function. This study aims to evaluate drugs consumed as well as DRPs experienced by patients diagnosed with CKD undergoing hemodialysis at X Hospital from January to May 2022. The study procedures were carried out …

What Is The Hospital Pharmaceutical Care? Perceptions And Expectations Of Doctors In Interprofessional Collaboration In 2 Types Of Indonesia Hospitals, Anisyah Achmad, Savvy Augustin Tirta, Titi Annisa Bella, Ratna Kurnia Illahi, Bambang Sidharta, Valentina Yurina, Wara Rejeki

Pharmacology and Clinical Pharmacy Research

Hospital Pharmaceutical Care (HPC) is the pharmacist’s direct responsibility to aim for patient safety and quality of life. HPC is a means of avoiding medication and human errors. Carrying out a HPC requires a good collaboration between doctors and pharmacists in treatment management. The aim of the research was to determine the relationship between doctors’ perceptions and expectations of clinical pharmacists at HPC. This research is descriptive quantitative observational with a cross-sectional approach. The data were collected using purposive sampling (type A hospital) and total sampling (type C hospital) through interviews using perception and expectations questionnaires on doctors’ to pharmacists …

Β-Glucan As A Potential Modulator Of Tgf-Β Signaling And Emt-Driven Resistance In Triple-Negative Breast Cancer, Hanifa Dinda Hayati, Riezki Amalia, Gemilang Lara Utama, Dika Pramita Destiani

Pharmacology and Clinical Pharmacy Research

Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer that lacks expression of estrogen, progesterone, and HER2 receptors, limiting the effectiveness of targeted therapies and making chemotherapy the primary treatment option. However, resistance to chemotherapy remains a major clinical challenge, often driven by dysregulation of the transforming growth factor-β (TGF-β) signaling pathway. TGF-β plays a dual role in cancer, initially acting as a tumor suppressor but later promoting tumor progression through mechanisms such as epithelial–mesenchymal transition (EMT), immune evasion, and the establishment of cancer stemness. This review aims to explore the role of TGF-β signaling and EMT …

Comparative Analysis Of Tuberculosis Treatment Costs: Drug-Resistant Vs. Drug-Sensitive Cases In Vietnam, Thi-Kim-Thang Dao, Dao Dinh, Mai-Hien Chuc, Hai-Anh Ha

Bulletin of Faculty of Pharmacy Cairo University

This study analyses the economic and clinical implications of treating pulmonary tuberculosis (TB), focusing on direct treatment costs and patient outcomes at Da Nang Hospital for Lung Diseases in Vietnam. Data were collected from 448 inpatient TB cases throughout 2022, encompassing both drug-sensitive and drug-resistant forms of TB. Analysis revealed that drug-resistant TB patients incur significantly higher treatment costs compared to those with drug-sensitive TB, with costs escalating further among older adults and patients with multiple comorbid conditions. Specifically, treatment for drug-resistant TB averaged $463.84 per patient, significantly surpassing the $217.09 average for drug-sensitive cases, indicating the economic burden posed …

Pharmacist Quality Of Work-Life During Covid-19 Pandemic In Cagayan De Oro, Junnin Gay Labrigas Garay, Rugine Riel D. Barsobia, Zoe Kyra Evasco, Bonnie Louise Elorde

Pacific Journal of Health

During the COVID-19 pandemic, pharmacists have been one of the most accessible healthcare workers working in the frontline providing the medication and drug needs of patients. Their roles and responsibilities in work expanded and to some redefined as the pandemic hit. Adjustments in their work, and workplaces were also implemented in adherence to the pandemic situation. The quality of work life of frontline pharmacists were affected because of the changes brought by the pandemic. A descriptive qualitative study design was used to determine the pharmacist’s quality of work-life during the COVID-19 pandemic in Cagayan de Oro City. The place was …

Cost Of Illness Pada Pasien Hipertensi Rawat Jalan Di Puskesmas Gamping 2, Yuni Andriani, Sephia Wulandari, Niken Larasati

Jurnal Ekonomi Kesehatan Indonesia

Hypertension is characterized by increased blood pressure due to various risks that do not function normally in stabilizing blood pressure. According to WHO, the number of hypertension patients worldwide in 2020 reached 972 million (26.4%) and increased in 2021 to 1.2 billion (29.2%). Hypertension treatment must be carried out long, requiring a substantial aggregate treatment cost. Based on BPJS data, in 2014, hypertension accounted for approximately Rp2.8 trillion in healthcare costs, which increased annually until 2016, reaching around Rp4.2 trillion. The purpose of this study is to describe the overall estimated cost of hypertension treatment for outpatients at Puskesmas Gamping …

Correlation Between Drug-Related Problems And The Treatment Cost For Geriatric Ischemic Stroke Patients In Tulungagung, Dhanang Prawira Nugraha, Martanty Aditya

Jurnal Ekonomi Kesehatan Indonesia

Ischemic stroke was one of the diseases that frequently occurred in geriatric patients, while hemorrhagic stroke had a higher prevalence. Geriatric patients who experienced a stroke were not exempt from drug-related problems (DRP) due to the complexity of treatment and comorbid factors they encountered. This study aimed to determine the correlation between DRP and the cost of care for ischemic stroke patients, particularly in the geriatric population. The study design was cross-sectional, with data collected retrospectively, and the sample comprised 53 geriatric stroke patients who met the inclusion and exclusion criteria. DRP was assessed using the PCNE 6.2 criteria, and …

Exploring The Link Between Physicians’ Familiarity And Biosimilar Prescribing In Thailand, Ekapong Kachai, Chaoncin Sooksriwong, Wanruchada Katchamart, Tuangrat Phodha

The Thai Journal of Pharmaceutical Sciences

Background: Despite the availability of various biosimilars in Thailand, the link between physicians’ familiarity and biosimilars prescribing practice remains still unclear.

Objectives: This study aimed to find the association between physicians’ familiarity and biosimilars prescribing practice among physicians in Thailand.

Methods: This research adopted an extended analysis framework, utilizing survey data from a pilot study on the surveillance of Thai physicians regarding biosimilar uptake. The familiarity with biosimilars among respondents was evaluated.

Results: The result showed that 82 respondents were included in the study. There was 79.3% of respondents indicated prescribing biosimilars. Overall, most respondents (75.6%) showed an “adequate” level …

Pharmacogenetic-Guided Antiplatelet Therapy For Personalized Medicine In Patients With Stroke And Transient Ischemic Attack Without Cardioembolic Stroke: A Systematic Review Of Economic Evaluations, Nathapol Samprasit, Chamipa Phanudulkitti, Nattanichcha Kulthanachairojana, Jatapat Hemapanpairoa

The Thai Journal of Pharmaceutical Sciences

Background: Stroke is a major global public health burden. Ischemic stroke is the most common type of all stroke cases worldwide. Antiplatelet therapy is a key strategy for secondary prevention in patients with stroke and transient ischemic attacks (TIAs) without cardioembolic stroke. Dual antiplatelet therapy (DAPT) with clopidogrel is recommended in patients with early mild stroke or high-risk TIA, followed by long-term single antiplatelet therapy (SAPT). Clopidogrel is often used as an alternative for patients with aspirin resistance or intolerance. However, clopidogrel is a prodrug metabolized by the CYP2C19 enzyme, leading to variability in its effectiveness.

Objectives: This study aims …

Cost-Utility Analysis Of Riluzole Treatment Compared With Supportive Care For Patients With Amyotrophic Lateral Sclerosis, Thaiphat Rattana-Amonloet, Ampai Pimkrai, Piyameth Dilokthornsakul, Unchalee Permsuwan

The Thai Journal of Pharmaceutical Sciences

Background: In Thailand, riluzole, a drug used to treat amyotrophic lateral sclerosis (ALS), was costly and had not yet been included in the National List of Essential Medicines. In addition, no studies have been conducted on the cost-effectiveness of the drug. Objective: This study aimed to evaluate the cost-utility of riluzole in treating patients with ALS compared with supportive care from the perspective of societal and health-care providers. Methods: A Markov model was employed to analyze costs and benefits from a societal and the health-care provider’s perspective. Outcomes were measured in quality-adjusted life years (QALYs). The analysis calculated an incremental …

Mergers And Acquisitions (M&As) In Pharmaceutical Markets: Associations With Market Concentration, Prices, Drug Quantity Sold, And Shortages, J. Daniel Mcgeeney M.S., Aylin Sertkaya Ph.D., Leah Ross M.A., Fred Ledley M.D., Cody Hyman Ph.D.

CISI Publication

In recent decades, the pharmaceutical industry has become increasingly concentrated in the United States, in part due to mergers and acquisitions (M&As) between drug manufacturers. This consolidation from M&As has been cited as a key factor affecting drug prices and drug shortages (U.S. Federal Trade Commission, 2022). In this study, we assessed trends in pharmaceutical M&As during 2010–2023 and evaluated the characteristics of drugs and companies involved in those M&As. We considered the effects of M&As on market concentration, drug prices, drug quantity sold, and drug shortages. We also considered how these associations vary by drug characteristics, including brand drugs …

Pharmaceutical-Telehealth Confederacies, Michael S. Sinha

All Faculty Scholarship

Access to prescription pharmaceuticals has historically been controlled by a physician’s pen. As a result, pharmaceutical companies spend billions of dollars on advertising and promotion to mitigate this barrier: first and primarily, to physicians and other prescribers, and more recently, to the general public through direct-to-consumer advertising. The success of these promotional efforts can be seen in greater prescribing of costly brand-name medicines, even in settings where lower-priced generic alternatives exist. Brand-name prescriptions now make up only 10% of all prescriptions written yet account for 87% of drug spending. Despite these substantial returns on investment, companies continue to seek opportunities …

The Revised Cdc Chronic Pain Guidelines And Payer Opioid Analgesic Policies In Michigan, Victoria Tutag Lehr, Cynthia L. Arfken

Michigan Journal of Public Health

Abstract

The 2016 publication of A Guideline for Prescribing Opioids for Chronic Pain by the Centers for Disease Control and Prevention motivated commercial and Medicaid payers to restrict their opioid prescribing policies including the imposition of hard limits on opioid daily dosages and duration. One result of these policies was an increase in abrupt opioid discontinuation and rapid tapering events for patients receiving long-term opioid therapy. Responding to this misapplication of the 2016 guideline, the 2022 revised guidelines emphasized individualized opioid therapy and exclusion of certain chronic diseases. However, it is not known if the payers changed their policies to …

Use Of Public Research And Manufacturing Enterprises To Lower Prescription Drug Prices And Increase Innovation, Alex Moss, Dana Brown, S. Sean Tu

Law Faculty Scholarship

This article proposes building on the success of publicly funded drug research and development and expanding the model to include the full cycle development, testing, manufacture and distribution of innovative and affordable new drugs.

Policies And Price Controls On The Research And Development Of Orphan Drugs In The United States And The European Union, Bena Pearl Filipczak Smith

Master's Theses

There is substantive literature surrounding the impact of price controls on the research and development (R&D) of new pharmaceutical products. The European Union (EU) and United States (US) are often studied in contrast to examine the influence of price controls as the US has fewer pharmaceutical price controls than the EU.

We find moderate evidence that the US spent more on annual domestic pharmaceutical R&D than the EU between 2004 and 2021, on average, before and after adjusting for GDP growth per capita and year. We find strong evidence that the US increased annual domestic R&D spending at a faster …

Payment Disrupters And Opportunities: Key Trends That Impacted Pharmacy In 2024, Craig Kimble, Thomas Pile, Alberto Coustasse

Management Faculty Research

In 2023, the United States experienced the most significant increase in prescription drug spending (13.6%), totaling $89 billion.1 This was driven by higher utilization and the introduction of new, expensive specialty and biotech drugs. In 2024, other factors continue to drive costs and disrupt the pharmacy landscape, including the implementation of new business models, pharmacy benefit manager (PBM) practices, the rebate system, regulatory changes, advancements in provider status, and potential Federal Trade Commission (FTC) interventions.

A Systematic Review Of Economic Evaluations Of Clinical Pharmacy Services In The United States: 2018-2022, Abdullah Alsharif, Bertha De Los Santos, Micheal Kim, Daniel Touchette, Alexandra Perez

HCA-NSU MD Research Day

Title: A systematic review of economic evaluations of clinical pharmacy services in the United States: 2018-2022 Authors: Bertha De Los Santos PharmD MS, Michael Kim PharmD, Abdullah Alsharif PharmD, Daniel Touchette PharmD MA, Alexandra Perez PharmD MS Background: Our objective was to identify, evaluate and synthesize evidence on the economic impact of clinical pharmacy services (CPS) compared to usual or alternative care in the United States. Methods: We searched Ovid MEDLINE, PubMed, IPA, Embase, and CINAHL in September 2023 for US-based pharmacist-led clinical interventions published between January 2018 and December 2022. We excluded articles with a team-based intervention where the …

Pharmacoeconomics And Health Technology Assessment - Letter To The Editor, Samar Farid

Bulletin of Faculty of Pharmacy Cairo University

This is letter to the editor

Cost-Utility Analysis Of Adding Daratumumab To Bortezomib Plus Dexamethasone To Treat Relapsed/Refractory Multiple Myeloma In Egypt, Menna M. Elsherbiny, Ahmed M. Kamel, Samar F. Farid

Bulletin of Faculty of Pharmacy Cairo University

Background: According to the CASTOR trial, DARA is shown to be effective as a second line for RRMM patients either as monotherapy or in combination with the gold standard regimen. The current study is the first to evaluate the cost-effectiveness of DARA based on the full results (~80-month follow-up) of the CASTOR trial. The study aimed to assess the cost-effectiveness of incorporating DARA, with bortezomib and dexamethasone, in treating patients from the perspective of a healthcare payer over a lifetime horizon.

Methods: A partition survival model (PSM) was adopted. The alternative arms chosen were daratumumab added to bortezomib plus …

Comments Re: Draft Nih Intramural Research Program Policy: Promoting Equity Through Access Planning, Fred Ledley M.D., Edward Zhou Pharmd., Paula Chaves Da Silva Ph.D.

CISI Publication

We commend the NIH initiative to require that licensees of technologies that enable discovery or development of FDA-approved products arising from the NIH intramural program to include an Access Plan to promote “product affordability, availability, acceptability, and sustainability” and recognition that such protections are essential to ensuring a “return on taxpayers' investment in biomedical research.” Recognizing the complexity of anticipating appropriate terms for products that are in pre-clinical or early clinical development at the time of licensing, we also support the proposal that the Access Plan be submitted in late-stage clinical development, though we argue that …

Developing Public-Private R&D Consortia To Accelerate Alzheimer’S Disease Drug Development, Joel West, Paul Olk

Management: Faculty Scholarship

Efforts to accelerate Alzheimer's disease (AD) drug development have been spurred on by the creation of open science, public-private R&D consortia. An R&D consortium provides an improved structure for generating and disseminating AD knowledge across a range of organizations while also aligning their interests. Drawing from archival and interview data collected on 46 public-private R&D consortia focused wholly or in part on AD, we uncover two important innovations: the creation of novel consortium types that facilitate coordination beyond the individual consortium, and the practice of organizations joining multiple consortia. Collectively these innovations provide member organizations with different pathways for advancing …

Utilizing Biosimilars To Help Increase Patients Access And Minimize The Financial Burden Of Health Care System In Egypt, Doaa M. Abd-El-Rady, Iman A. El-Baraky, Samar F. Farid

Bulletin of Faculty of Pharmacy Cairo University

Background: Biologics have provided enhanced clinical advantages, but at expense of enormous expenditures. The exorbitant expense of biologics was somewhat mitigated by the development of biosimilars. But biosimilars market access is still recessed in many countries including Egypt. To achieve biosimilars market sustainability, countries need to evaluate the health economic barriers that biosimilars face in gaining market access.

Methods: A retrospective budget impact analysis was conducted to compare the cost of biosimilars to that of their reference biologics from Egyptian regulatory perspective over a five-year period (2018-2022). Time series forecasting analysis was conducted to predict the cost savings …

Medicare Drug Price Negotiation Program Draft Guidance, Fred Ledley M.D., Edward Zhou Pharmd, Paula Chaves Da Silva Ph.D.

CISI Publication

This comment focuses on Section 50.1, provisions 1 & 3 of the draft guidance regarding the negotiation of a “maximum fair price” under the Inflation Reduction Act (IRA), research and development (R&D) costs of the primary manufacturer, and prior federal financial support for novel therapeutic discovery and development. Specifically, we argue that a negotiated, “maximum fair price” must consider both public sector (federal) and private sector (manufacturer) investments and provide returns to both commensurate with the scale and risk of their investments. This comment addresses three issues and makes specific recommendations regarding each:

1. In negotiating a “maximum fair price,” both …

Assessing The Impact Of Tuberculosis On Economic Growth In Asean Countries: A Conceptual Framework And Panel Data Analysis, Agus Fitriangga, Alex Alex

Jurnal Ekonomi Kesehatan Indonesia

Tuberculosis (TB) remains a major global health issue, particularly in Southeast Asia, where its impact extends beyond public health to affect economic performance. This study evaluates the economic implications of TB incidence on gross domestic product (GDP) growth across eight ASEAN countries from 2000 to 2020. We employed a panel data regression approach, utilizing Common Effect Model (CEM), Fixed Effects Model (FEM), and Random Effects Model (REM) to analyze the relationship between TB incidence and economic growth. The dataset included annual GDP figures, TB incidence rates, foreign direct investment (FDI), labor force size, and trade openness, sourced from international databases. …

Analisis Penerapan Activity-Based Costing Tindakan Debridemen Bedah Pada Diagnosis Tunggal Di Kamar Operasi Rskd Duren Sawit Tahun 2022, Reynaldi Fattah Zakaria, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

In 2022, RSKD Duren Sawit has officially held operating room services. The demand for more comprehensive operating room services increased rapidly. The temporary operating room rates were set by adapting the rates of other regional hospitals and the Governor of DKI Jakarta's regulations. There is a huge difference in costs between the hospital rates and the INA-CBGs claim rates, especially for surgical debridement performed in the operating room. One of the factors causing the difference is the undetermined cost for debridement based on the unit cost component. Knowing the unit-cost debridement in the operating room according to the cost per …

Analisis Pembiayaan Berdasarkan Lama Rawat Pasien Bpjs Diabetes Melitus Tipe Ii Komplikasi Sirkulasi Perifer Di Rsu Pku Muhammadiyah Bantul, Firman Firman, Kartika Lestari

Jurnal Ekonomi Kesehatan Indonesia

Length of stay (LOS) can increase hospital rates and become a cost issue for patients, potentially resulting in a discrepancy between hospital rates and INA-CBGs rates at the hospital. This study aims to determine the difference between the actual costs and BPJS claim costs for diabetic patients based on the length of stay and class level. The research method is observational with a descriptive approach. The data collection technique used retrospective medical record data from 50 patients. The results showed that the largest average difference between hospital costs and BPJS claim costs was for patients with a length of stay …

Cost Variation Analysis Of Oral Hypoglycemic Drugs In The Egyptian Market, George G. Abdelmessih, Aya M. Abdelmagid, Samar F. Farid

Bulletin of Faculty of Pharmacy Cairo University

Introduction: Type II diabetes mellitus is a lifelong condition requiring lifelong medication. This study aims to analyze the cost variation of the oral hypoglycemic drugs in the Egyptian pharmaceutical market.

Methodology: Egyptian drug database of the Egyptian Drug Authority was used to get the official prices of drugs in the Egyptian pharmaceutical market analyzed in this study. The cost ratio and the percentage cost variation were calculated. The price was documented using unit dose of 1 tablet per EGP.

Results: Out of 15 oral hypoglycemic drugs in the Egyptian market at closing 2022 (9 monotherapy and 6 combination therapy) of …

A Cross – Sectional Observational Study On Pharmacoeconomics Burden Of Covid -19 In Ashmoun Fever Hospital Delta Egypt, Marwa Helmi Desouki, Marwa G. Elhennawy, Samar F. Farid

Bulletin of Faculty of Pharmacy Cairo University

Background: A wide range of respiratory illnesses like common colds, Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) are caused by coronaviruses.

In 2019 scientists in Wuhan, China discovered a new coronavirus (COVID-19). Unknown new coronavirus that infected people for the first time and causes losses for humans. It has caused a large number of deaths around the world and a greater number of injuries, and the countries of the world began to take measures and closures to confront the spread of this virus, and the economy was greatly affected.

Aim of Study: This study provides …

Approvals, Utilization, And Cost Of Biologics For The Treatment Of Rheumatoid Arthritis, Roya Hosseini

Pharmaceutical Sciences (PhD) Dissertations

Introduction: RA treatment has been revolutionized by the development and approval of biologic disease-modifying antirheumatic drugs (bDMARDs). However, the approval status, utilization, and high cost of bDMARDs pose challenges in RA management.

Objectives: This dissertation evaluated the association between the utilization of bDMARDs and the sociodemographic characteristics of the RA patient population. It also identified the FDA approval status of bDMARDs and assessed the annual cost of bDMARDs used in RA treatment, evaluated the factors explaining annual cost at market entry.

Methods: In the retrospective analysis of Medical Expenditure Panel Survey (MEPS) data from 2010-2021, the population includes RA patients …