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How can pharmacist remuneration systems in Europe contribute to generic medicine dispensing?
Dylst,Pieter; Vulto,Arnold; Simoens,Steven;
Pharmacy Practice (Internet) , 2012, DOI: 10.4321/S1886-36552012000100002
Abstract: generic medicines can generate larger savings to health care budgets when their use is supported by incentives on both the supply-side and the demand-side. pharmacists′ remuneration is one factor influencing the dispensing of generic medicines. objective: the aim of this article is to provide an overview of different pharmacist remuneration systems for generic medicines in europe, with a view to exploring how pharmacist remuneration systems can contribute to generic medicine dispensing. methods: data were obtained from a literature review, a master thesis in pharmaceutical care at the catholic university of leuven and a mailing sent to all members of the pharmaceutical group of the european union with a request for information about the local remuneration systems of community pharmacists and the possible existence of reports on discounting practices. results: pharmacists remuneration in most european countries consists of the combination of a fixed fee per item and a certain percentage of the acquisition cost or the delivery price of the medicines. this percentage component can be fixed, regressive or capped for very high-cost medicines and acts as a disincentive for dispensing generic medicines. discounting for generic medicines is common practice in several european countries but information on this practice tends to be confidential. nevertheless, data for belgium, france, the netherlands and united kingdom indicated that discounting percentages varied from 10% to 70% of the wholesale selling price. conclusion: pharmacists can play an important role in the development of a generic medicines market. pharmacists should not be financially penalized for dispensing generic medicines. therefore, their remuneration should move towards a fee-for-performance remuneration instead of a price-dependent reimbursement which is currently used in many european countries. such a fee-for-performance remuneration system provides a stimulus for generic medicines dispensing as pharmac
How can pharmacist remuneration systems in Europe contribute to generic medicine dispensing?  [cached]
Dylst P,Vulto A,Simoens S
Pharmacy Practice (Granada) , 2012,
Abstract: Generic medicines can generate larger savings to health care budgets when their use is supported by incentives on both the supply-side and the demand-side. Pharmacists’ remuneration is one factor influencing the dispensing of generic medicines.Objective: The aim of this article is to provide an overview of different pharmacist remuneration systems for generic medicines in Europe, with a view to exploring how pharmacist remuneration systems can contribute to generic medicine dispensing.Methods: Data were obtained from a literature review, a Master thesis in Pharmaceutical Care at the Catholic University of Leuven and a mailing sent to all members of the Pharmaceutical Group of the European Union with a request for information about the local remuneration systems of community pharmacists and the possible existence of reports on discounting practices.Results: Pharmacists remuneration in most European countries consists of the combination of a fixed fee per item and a certain percentage of the acquisition cost or the delivery price of the medicines. This percentage component can be fixed, regressive or capped for very high-cost medicines and acts as a disincentive for dispensing generic medicines. Discounting for generic medicines is common practice in several European countries but information on this practice tends to be confidential. Nevertheless, data for Belgium, France, the Netherlands and United Kingdom indicated that discounting percentages varied from 10% to 70% of the wholesale selling price.Conclusion: Pharmacists can play an important role in the development of a generic medicines market. Pharmacists should not be financially penalized for dispensing generic medicines. Therefore, their remuneration should move towards a fee-for-performance remuneration instead of a price-dependent reimbursement which is currently used in many European countries. Such a fee-for-performance remuneration system provides a stimulus for generic medicines dispensing as pharmacists are not penalized for dispensing them but also needs to account for the loss of income to pharmacists from prohibiting discounting practices
Generic drug prescribing in central Saudi Arabia : Perceptions and attitudes of physicians.  [cached]
Alghasham Abdullah
Annals of Saudi Medicine , 2009,
Abstract: Background and Objectives: Physicians play a key role in generic drug prescribing, but their behavior is affected by many determinants. We examined physician practices and attitudes and other factors influencing the prescription of generic drugs. Methods: A self-administered questionnaire was used to collect information from a random sample of physi-cians from different settings in central Saudi Arabia. Data were analyzed to describe all variables and test any significant difference between groups of physicians. Results: The study included 772 physicians from different affiliations. The majority of physicians (n=741, 96%) reported that they knew enough about the therapeutic value of generic drugs. The majority (75%) reported that they knew the price differences, and this knowledge helped 72% of them to switch to generic prescription medication. Most physicians (79%) support generic substitution, but they indicated that there are certain clini-cal situations where they prefer to use brand name drugs. Physicians reported receiving visits and samples more frequently from representatives of brand name companies. Physicians did not report a significant difference in pressure from patients to prescribe either generic or brand drugs. Most physicians had a positive attitude towards the government role in assuring the quality of local drug products (80%) and in enforcing physicians to prescribe generic drugs (85%). Conclusion: Physicians face competing forces to prescribe either brand name or generic drugs. The majority support generic drug substitution. There are multiple factors that support prescription of generic drugs.
Site Visits in Family Medicine: Stakeholders Perspectives on How Site Visits Can Be Improved to Maximize Preceptor Support and the Quality of Medical Student and Resident Supervision  [PDF]
Colla J. MacDonald, Edward Seale, David Tobin, Michael Hirsh, Douglas Archibald, Madeleine Montpetit, Martha McKeen
Creative Education (CE) , 2013, DOI: 10.4236/ce.2013.46A006
Abstract:

In 2012, the Department of Family Medicine at the University of Ottawa conducted a study to identify stakeholder’s perspectives of site visits and how they can be improved to support preceptors and provide the best learning experience for medical students and residents. Two data sources were utilized to address the research questions: interviews with stakeholders (both focus group and individual interviews) and online surveys with preceptors. The findings assert that establishing a process for site visits to maximize preceptor support and the quality of medical student and resident supervision is a complex process. Perceptions of quality site visits for all stakeholders were strongly linked to: 1) having clear expectations; 2) making site visits a priority and supplying the necessary support and resources; 3) supporting preceptors to be better teachers; 4) the quality and timeliness of preceptor feedback from residents and medical students; 5) involving the medical student and resident in the site visit process; and 6) an integration and collaboration among curriculum, faculty development and evaluation resources. As researchers continue to build site visit recipes based on theory and reflection of practical experiences, the resulting insights will enable all stakeholders in family medicine programs to make more informed decisions to positively impact the quality of the site visit experience, support preceptors in being better teachers and improve the quality of the supervision of residents and medical students. This study takes one step toward building a broad base of theoretical knowledge informed by practical experiences on site visits.

Identification of features of electronic prescribing systems to support quality and safety in primary care using a modified Delphi process
Michelle Sweidan, Margaret Williamson, James F Reeve, Ken Harvey, Jennifer A O'Neill, Peter Schattner, Teri Snowdon
BMC Medical Informatics and Decision Making , 2010, DOI: 10.1186/1472-6947-10-21
Abstract: Software features were identified by a literature review, key informants and an expert group. A modified Delphi process was used with a 12-member multidisciplinary expert group to reach consensus on the expected impact of the features in four domains: patient safety, quality of care, usefulness to the clinician and usefulness to the patient. The setting was electronic prescribing in general practice in Australia.A list of 114 software features was developed. Most of the features relate to the recording and use of patient data, the medication selection process, prescribing decision support, monitoring drug therapy and clinical reports. The expert group rated 78 of the features (68%) as likely to have a high positive impact in at least one domain, 36 features (32%) as medium impact, and none as low or negative impact. Twenty seven features were rated as high positive impact across 3 or 4 domains including patient safety and quality of care. Ten features were considered "aspirational" because of a lack of agreed standards and/or suitable knowledge bases.This study defines features of e-prescribing software systems that are expected to support safety and quality, especially in relation to prescribing and use of medicines in general practice. The features could be used to develop software standards, and could be adapted if necessary for use in other settings and countries.Medicine prescribing and health information record-keeping are changing from paper-based to computerised processes in healthcare systems all over the world. Electronic prescribing (e-prescribing) can be a stand alone process, but is usually part of an electronic health record system which may also link to pathology, radiology and patient administration systems. In the UK, Australia and some European countries the majority of prescribing in primary care is computerised, whereas uptake is less extensive in hospitals. In the United States, e-prescribing is widely used in some hospital-based organisations b
Investigation into the prescribing patterns and cost of antidiabetic medicine in South Africa  [cached]
Rianda Steyn,Johanita R Burger,Jan HP Serfontein,Martie S Lubbe
Health SA Gesondheid , 2007, DOI: 10.4102/hsag.v12i3.262
Abstract: The general objective of this study was to investigate the prescribing patterns and cost of antidiabetic medicine in the private health care sector in South Africa by using a medicine claims database. Opsomming Die algemene doelstelling van hierdie studie was om die voorskryfpatrone en koste van antidiabetiese medisyne in die private gesondheidsorgsektor van Suid-Afrika te ondersoek. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
Generic medicines: Perceptions of Physicians in Basrah, Iraq  [PDF]
Adheed Khalid Sharrad,Mohamed Azmi Hassali,Asrul Akmal Shafie
Australasian Medical Journal , 2009,
Abstract: BackgroundThe use of cheaper generic medicines is a strategy promotedin many countries to reduce rising health care costs. The aimof this study was to explore factors affecting generic medicineprescribing by physicians in Basrah, Iraq.MethodologyA purposive sample of ten physicians practicing in Basrahwas interviewed using a semi-structured interview guide.ResultsAnalysis of the interviews identified seven major themes:medicine prescribing practice, knowledge of therapeuticequivalency of generic medicine, patients’ acceptance ofgeneric medicine, counterfeit medicine, drug informationsource and effect of drug advertising on medicines choice,brand substitution practice by community pharmacists, and,finally strategies to improve generic medicine usefulness.Participants identified helpful strategies to increase genericprescribing including; physician and patient education ongeneric medicine; persuading physicians about the safety andefficacy of generic medicines; and finally educating seniormedical students on generic prescribing.ConclusionThe data suggest that participants were enthusiasticabout prescribing generic medicines. However physiciansinsist that pharmacists should not be allowed tosubstitute generic drugs without prior approval ofdoctors.
Local cohomology with support in generic determinantal ideals  [PDF]
Claudiu Raicu,Jerzy Weyman
Mathematics , 2013, DOI: 10.2140/ant.2014.8.1231
Abstract: For positive integers m >= n >= p, we compute the GL_m x GL_n-equivariant description of the local cohomology modules of the polynomial ring S of functions on the space of m x n matrices, with support in the ideal of p x p minors. Our techniques allow us to explicitly compute all the modules Ext_S(S/I_x,S), for x a partition and I_x the ideal generated by the irreducible sub-representation of S indexed by x. In particular we determine the regularity of the ideals I_x, and we deduce that the only ones admitting a linear free resolution are the powers of the ideal of maximal minors of the generic matrix, as well as the products between such powers and the maximal ideal of S.
Generic medicine pricing: on track in Europe?
Associate Professor Marc A Koopmanschap, PhD
Generics and Biosimilars Initiative Journal , 2012,
Abstract: There are many variables responsible for the pricing of generic medicines in Europe. This editorial looks at the many policy initiatives currently being undertaken.
A review of generic medicine pricing in Europe  [cached]
Professor Steven Simoens, MSc, PhD
Generics and Biosimilars Initiative Journal , 2012,
Abstract: Introduction: Switching from originator products to generic equivalents is a key method used by governments to reduce costs and keep their healthcare systems sustainable. The aim of this article is to review generic medicine pricing in Europe by analysing the factors that influence them.Methods: The literature review focused on selected studies that highlighted generic medicine pricing in ambulatory care in Europe. PubMed, the Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, and EconLit were searched up to August 2011. Search terms included, ‘pharmaceuticals’, ‘generic medicines’, ‘Europe’, ‘pricing’, ‘discount’, and ‘rebate’. Bibliographies of included studies were checked for relevant studies and the status of generic medicines pricing in Europe was also documented via accessing the European Generic medicines Association market survey.Results: Ex-manufacturer prices for generic medicines were found to vary substantially between European countries, which suggests that pricing not only reflects production costs, but is also influenced by the domestic regulatory environment. The penetration of generic medicines is more successful in countries that permit free pricing of medicines than in those that have price regulation. Although tendering systems may reduce (generic) medicine prices in the short term, little is known about the overall long-term impact of such systems.Conclusion: No single approach towards developing generic medicine pricing policies and attaining cost savings was evident.
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