¿Cuál es el impacto de introducir competencia en el mercado farmacéutico sobre el precio de los medicamentos?: síntesis rápida de evidencia / What is the impact of introducing competition in the pharmaceutical market on drug prices?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO La decisión de suscribir el acuerdo internacional Trans Pacific Partnership (TPP) promovido por EEUU, involucra el trabajo conjunto de diversos sectores del Estado. En ese sentido, este acuerdo tendría ciertas implicancias para el sector salud y, específicamente, para el mercado de fármacos en Chile. El TPP traería consigo cambios en la protección de información no divulgada, nuevos indicaciones clínicas y usos descubiertos, lo que impactaría fuertemente en el mercado de productos de síntesis biológica. En este contexto, el Departamento de Políticas Farmacéuticas solicita esta síntesis de evidencia con el objetivo de conocer si la introducción de competencia en el mercado de medicamentos generaría una reducción en el precio que los usuarios pagarían por estos productos. METODOLOGÍA Se formuló una estrategia de búsqueda para ser utilizada en las bases de datos PubMed, Cochrane Library, PDQ y Health System Evidence el objetivo de identificar revisiones sistemáticas del tema. Al no encontrar, se seleccionaron estudios primarios realizados en los últimos 5 años que abordaran la pregunta definida. No se incluyeron artículos que no abordaran directamente la intervención definida, tales como intervenciones para regular precios (precio de referencia, precio mínimo, reembolso máximo), drogas falsas, estudios que no incluyeran el precio o el gasto como resultado. RESULTADOS El resumen no utiliza revisiones sistemáticas -Los estudios considerados en esta síntesis rápida muestran que el ingreso de competencia al mercado de medicamentos reduce el precio promedio de venta. -El efecto se debe a la entrada de nuevos productos, el aumento de la participación de mercado de los competidores (en ventas) y el número de competidores en un mercado particular. -Dada su naturaleza más compleja, los medicamentos biosimilares necesitan establecer mecanismos costosos de bioequivalencia, lo que constituiría barreras de ingreso al mercado. -Producto de una escasa competencia en el mercado, se podrían generar pseudogenéricos, los cuales generarían un efecto paradójico (alza en los precios), al capturar gran participación de mercado o realizar altas inversiones en publicidad.

Study on Circulation System Structure and Circulation Costs of Drug Market / 中国药房

OBJECTIVE:To investigate the rule for circulation system structure of drug market,and to analyze drug circulation costs.METHODS:The rules for macrostructure and microstructure of drug circulation were analyzed.The quantitative conception of circulation links(y),circulation extents(n),last nodes(m) and transaction relations were introduced and their relationship were investigate using mathematic model.The proportions of transaction relation in various sections were adopted to analyze circulation cost.RESULTS:There were rules for macrostructure and microstructure of drug circulation.The microstructure showed as a dendrogram circulation structure.Last nodes(m) and circulation extents(n) determinated circulation links(y),relationship between them was y=lnm/lnn.The proprotion of transaction relations in the last link was much higher than in the middle links.CONCLUTIONS:According to the mathematic model,transaction relations mainly concentrate in the last link.As a result it is not possible for us to cut down the quantity of transaction relations and the circulation costs through compaction of the middle links.

Brief Discussion on the Exploitation and Improvement of Rural Drug Market / 中国药房

OBJECTIVE:To discuss how to exploit and improve the rural drug market.METHODS:The status quo,major problems and the causes of which in China rural drug market were analyzed by referring to recent relative data and information on rural drug market.RESULTS&CONCLUSION:The chief causes of the current problems in China rural drug market lie in the supplying network and supervising network,the exploitation and improvement of which require the co-ef?forts of the government and pharmaceutical enterprises.

A New Concept of Over-the-Counter(OTC)Drugs Marketing——Emotional Marketing / 中国药房

OBJECTIVE:To search a new concept of marketing for the dog-eat-dog OTC drug market.METHODS:The concept of emotional marketing was explained and the application of which in each link of the OTC drug marketing was ana-lyzed.RESULTS&CONCLUSION:The consumption of OTC drugs has come into to an emotional marketing stage.Adopting emotional marketing strategy,seizing consumer's psychology and moving customers by real affection can consolidate status of OTC drugs in the trade war.

Characteristic factors of health sector influenced on the drug market in Vietnam during 1991-2000

An investigation of drug and medical equipment in port and export companies, pharmaceutical companies and factories, international pharmaceutical enterprises, hospitals and pharmacies, and morbidity structure, pharmaceutical and medical science and technology, drug distribution networks...to find the objective and subjective causes that impacted on the drug market in Vietnam has shown that there were many factors impacted on the drug market, including physicians, patients, morbidity structure, health economy, health policy, medical and pharmaceutical science which generated a various, exciting drug market during 1991-2000. All factors promoted the production and business to meet the needs of user.

Study of the macro-strategies regulating the chaotic drug market / 中华医院管理杂志

In light of the scientific procedure of policy making and based on the logical deduction of direct and indirect factors related to the chaotic drug market, the authors found the root of the chaos, viz. The mechanism of reimbursement ofr medical institutions that formed a vicious circle. Inview of the root, a policy model was developed and verified, viz. The optimal utilization of medical resources. The prerequisite condition to the implementation and success of the policy is the exertion of concerted efforts by various departments concerned underthe centralized leadership of the government. And it has been proven by experience that to tackle the chaos of the drug market it is necessary to start with medical institutions and the logical order of the steps to be taken to carry out the policy is as follows: control of the total drug expenses, gradual control of the gross profit from drugs, extrication of medical institutions from their dependence on drugs, improvement of the management of the frug market,perfection of the "rules of game" of the market, and development of key techniques for each procedure. Evaluation of the results of the implementation of the policy indicates that the policy is scientific, rational and easy to operate and the steps are feasible.

About the drug market at communal level

A survey has been carried out at 36 communes from 9 provinces represented for the whole country from January to March 1996 in order to evaluate the drug sale, the drug management in commune health stations and in private pharmacies. The results indicate that there are also many limitations and weaknesses in performance of certain regulations of MOH. The authors have proposed some procedures to improve these limitations.

Study of the macro strategies regulating the chaotic drug market / 中华医院管理杂志

In light of the scientific procedure of policy making and based on the logical deduction of direct and indirect factors related to the chaotic drug market, the authors found the root of the chaos, viz. The mechanism of reimbursement for medical institutions that formed a vicious circle. In view of the root, a policy model was developed and verified, viz. The optimal utilization of medical resources. The prerequisite condition to the implementation and success of the policy is the exertion of concerted efforts by various departments concerned under the centralized leadership of the government. And it has been proven by experience that to tackle the chaos of the drug market it is necessary to start with medical institutions and the logical order of the steps to be taken to carry out the policy is as follows: control of the total drug expenses, gradual control of the gross profit from drugs, extrication of medical institutions from their dependence on drugs, improvement of the management of the drug market, perfection of the “rules of game” of the market, and development of key techniques for each procedure. Evaluation of the results of the implementation of the policy indicates that the policy is scientific, rational and easy to operate and the steps are feasible.

Present Status and Prospects of Biotechnology Drug Market in the World / 中国药房

Rapid development of biotechnology necessarily brings about a revolutionary change in drug production. It is estimated that the annual sales of biotechnology drugs will reach 50 billion dollars in 2000. The pharmaceutical factories in USA, Japan and West-European Countries focus their attention on biotechnology drugs. Now, human somatotropin, human insulin and erythropoetin produced by r-DNA technic have occupied an important place in drug market. We believe that the 21st century will be a new era of biotechnology drugs.

Estimation of the Trend of Domestic Drug Market in 1991 / 中国药房

The production, sell and price of drugs have had great variation in recent years. There is always a greater increase and decrease in drug market. In clinical therapeutic practice, the drugs required in smaller quantities are always out of stock, but the drugs required in larger quantities are usually in a state of supply over demand. An imbalance in supply and demand has been induced. The key for solution of the problem is to make market as guidance and production depend on need. The industrial and product structures should be urgently adjusted to make drug supply and demand toward benign circle. A general equilibrium in supply and demand is therefore attained.

The Present and the Future of Drug Markets in the World / 中国药房

At present the annual sales of drugs in the world are over 100 billion dollars. America, Japan and West-Europe are the three large pharmaceutical markets. In the past ten years, cephalosporins are the most important antibiotics. Fluoroquinolone products have been developed rapidly in recent years. The sales of cardiovascular drugs occupy the first position in drug markets. ACE inhibitors and calcium antagonists are considered as a big breakthrough. The sale amount of H_2-antagonist, ranitidine is reported in the lead. In the future, OTC products and biotechnological preparations will increase share in the world drug markets.

Canadian Drug Regulatory System / 中国药房

OBJECTIVE: To illustrate the Canadian drug regulatory system.METHODS: Literature review and descriptive analysis.RESULTS & CONCLUSIONS: Based on the Canadian health system and drug market,the Canadian drug regulatory system is an integrated system in terms of its regulation on drug approval,price review as well as reimbursement management.