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The traditional de novo drug discovery is time consuming, costly and in some instances the drugs will fail to treat the disease which result in a huge loss to the organization. Drug repurposing is an alternative drug discovery process to overcome the limitations of the De novo drug discovery process. Ithelps for the identification of drugs to the rare diseases as well as in the pandemic situationwithin short span of time in a cost-effective way. The underlying principle of drug repurposing is that most of the drugs identified on a primary purpose have shown to treat other diseases also. One such example is Tocilizumab is primarily used for rheumatoid arthritis and it is repurposed to treat cancer and COVID-19. At present, nearly30% of the FDA approved drugs to treat various diseases are repurposed drugs. The drug repurposing is either drug-centric or disease centric and can be studied by using both experimental and in silico studies. The in silico repurpose drug discovery process is more efficient as it screens thousands of compounds from the diverse libraries within few days by various computational methods like Virtual screening, Docking, MD simulations,Machine Learning, Artificial Intelligence, Genome Wide Association Studies (GWAS), etc. with certain limitations.These limitationscan be addressed by effective integration of advanced technologies to identify a novel multi-purpose drug.Copyright © 2023, Association of Biotechnology and Pharmacy. All rights reserved.
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Objectives Drugs and medical supplies counterfeiting is one of the worldwide major problems that pose a significant threat to both global public health and the economy. Nowadays, one of the major unprecedented challenges of the COVID-19 pandemic is the disastrous repercussions on the economy worldwide. The latter brought forth a noticeable rise in pharmaceutical and medical counterfeit products. Drug counterfeiting has thrived parallel to the expansion of electronic networks and the Internet during the COVID-19 pandemic. The objective of the current study is to explore the perceived influence of the COVID-19 lockdown on the circulation of counterfeit drugs and medical supplies through the electronic market in Jordan. Methods A cross-sectional survey study was conducted in Jordan. The questionnaire was self-administered to the public as they are the probable counterfeit medicine victims and as drug counterfeiting is a nationwide problem. To capture participants' views, a total of 460 respondents were recruited and a simple random sampling strategy was used to collect data. The inclusion criteria were consumers aged 18 years old and above, who use the Internet when purchasing drugs and medical supplies, and are willing to participate in the study. Key findings The study indicated an increase in using electronic websites when purchasing medicines during the COVID-19 lockdown. Additionally, there was a significant correlation the between COVID-19 lockdown and the circulation of counterfeit drugs and medical supplies through the electronic market in Jordan. Conclusions The study indicated that the COVID-19 lockdown had influenced counterfeit drugs and medical supplies circulation through the electronic market in Jordan.Copyright © The Author(s) 2022.
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Background: Pharmaceutical businesses had enormous difficulties in product distribution during COVID-19, and the solution to this perpetual issue is a resilient supply chain. Aim(s): The study aims to understand the vulnerabilities to which it subjected the pharmaceutical product distribution supply chains during the COVID-19 pandemic and further develop an adaptive model through which the pharmaceutical product supply chain can enhance its resilience capabilities. Material(s) and Method(s): The conceptual model is developed for the supply chain of pharmaceutical companies based on the literature survey, and then the conceptual model is explored through factor analysis. Researchers have developed a validated model after a statistical analysis using Cronbach's alpha. Subjective analysis has concluded that the pharmaceutical supply chain's resilience is driven by factors such as "trade cost," which comprises transport cost, business practices, and raw material sourcing cost;"shock propagation," which comprises country-specific shocks, production shocks, and policy changes;and "technological infrastructure bottleneck," which relates to the availability of cold chain storage warehouses and refrigerated transport vehicle facilities. Result(s): An empirical model pertaining to supply chain resilience may be further studied with different geographies, like Pune, Hyderabad, and Delhi NCR, for the purpose of generalizing the study. Conclusion(s): The identified major factors were trade cost, shock propagation, and technological infrastructure bottlenecks. The sensitivity of the issue under investigation required a personal touch to the survey, as the COVID-19 pandemic had left these respondents emotionally vulnerable. As COVID-19 is the recent catastrophe that has hit humanity, it has made the pharmaceutical product distribution channel vulnerable during the pandemic. This difficult time of pandemic has really tested the pharmaceutical products' supply chain capabilities as well.Copyright © 2023, Association of Pharmaceutical Teachers of India. All rights reserved.
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From 2013 to 2019, expenditure growth rates have increased sharply in almost all European countries. This increase followed a period of stabilization, or in many cases a negative trend in health expenditure ratios across the European Union, resulting from the economic crisis that began in 2008. Expenditure in 2020 in all European states was significantly affected by the COVID-19 disease pandemic. The level of health expenditure and how it changes over time depends on a wide range of factors, including the organizational structure of the health system. Examination of these data reveals wide fluctuations in the levels, with increase of expenditures, especially in the financing of countries to deal with the pandemic. The European Union has financed its member-states through special programmes, in order to cope with the increased demands. This article attempts to analyze the health costs before the COVID-19 period and the ways in which they have been affected during the pandemic. In addition, the impact of the spread of the pandemic on the supply chain of medical supplies and medical equipment, and its expenditure, at the national and the European Union level, is presented.Copyright © Athens Medical Society
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The coronavirus disease (COVID-19) was first detected in Wuhan, China, in the month of December 2019. Further, in March 2020, the COVID-19 epidemic was described by the World Health Organisation (WHO) as a global pandemic. COVID-19 quickly spread around the world in the following months, affecting about 2.5 million individuals by April 2020. World markets, including the pharmaceutical industry, were devastated by this pandemic. Although no specific solution for this emerging infectious disease is currently available, the pharmaceutical industry is helping policymakers meet unmet COVID-19 desires, ranging from research and advancement initiatives on possible prevention methods to the management of the supply chain of drugs in times of crisis. Changes in demand, commodity shortages, contact adjustments, etc., are hindering developments in the mechanism of technology, research and development and are putting an impact on the health market of COVID-19. Other implications of COVID-19 on the physical condition and pharmaceutical market may include acceptance delays, heading to self-sufficiency in the delivery chain, etc. In addition, the pharmaceutical markets are battling to sustain natural consumer flows, as the latest pandemic has had an effect on access to essential drugs at reasonable rates, which is the key priori-ty of all pharmaceutical systems.Copyright © 2022 Bentham Science Publishers.
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Background: Covid-19 vaccine hesitancy is prime hurdle in control and eradication of Covid-19 pandemic. The rapid Procedure of development of new vaccines resulted in a lot of false information and rumors leading to decrease trust of the public in the safetyand effectiveness of the vaccine. Aim(s): To study the frequency and causes of Covid-19 vaccine hesitancy amid population of Lahore. Method(s): This cross sectional study design was done on a sample of 385 participants from lahore were included in the study. Frequency and causes were recorded on the prescribed questionnaire. Result(s): Frequency of hesitancy was found to be 41.7%. 12.8% had doubts related to efficacy and safety of the vaccine. 9.9% were of the view that the risks of the vaccine are greater than its benefits. 5.7% assumed that vaccines were promoted for gains of pharmaceutical companies. 4.4% were concerned about the immediate side effects of the vaccine. 2.6% responded by saying that vaccine was not recommended by health professionals. 2.3% had myths related to vaccine. And lastly, 1.63% said vaccine was not available free of cost. Conclusion(s): Hesitancy of covid-19 vaccine is seen more in illiterate people and the main cause of hesitancy is uncertainty related to protection and efficacy of covid-19 vaccine.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Introduction COVID-19 has impacted the delivery of services provided throughout the National Health Service. Innovative ways of working remotely has been a challenge to provide safe and effective care to patients in a timely manner. The Gastroenterology and Nutrition Team at Birmingham Children's Hospital, treat one of the largest cohorts of paediatric patients in Europe with: Inflammatory Bowel Disease, intestinal failure receiving home parental nutrition and other gastrointestinal diseases. Many patients are on long-term medication and the pandemic increased the demand for remote prescription requests. The Advanced Nurse Practitioner recognised and developed a service improvement initiative to prescribe safely through remote consultations. Aim To provide a standardised approach to provide remote consultations in order to issue repeat prescriptions in a safe and effective manner. To adhere to current guidance, to promote best practice, work in partnership with GPs and to audit the findings following implementation. Method Searches were conducted for literature surrounding remote prescribing. Using current guidance, the ANP implemented a seven step approach in performing prescribing consultations (see figure 1). Results 232 patients requested repeat prescriptions, with a total of 435 medications. These figures are from booked clinics and any requests outside of these were not included in these findings. Figure 2 outlines the outcome from implementing stage 5 of the process (figure 1). Combining the number of GPs who agreed to prescribe, with the agreed Clinical Commissioning Groups (CCG's) funding, amounted to 54.74%. 17 CILT funding requests are pending, therefore 60.06% of requests are likely to be funded. 40 patients (17.24%) were removed from the medication requests for a variety of reasons and 48 requests (20.68%) are pending a response. In 18 consultations, recommendations were needed to promote patient safety, for example: . Unwell patient booked into a face to face clinic for review . Abnormal bloods - neutropenic (Azathioprine placed on hold) . Insufficient blood levels highlighted to consultant - increased medication dose/duration . Missed blood monitoring - arranged . Poor compliance - booked into Clinical Nurse Specialist clinic . Missed clinic appointments - booked in Summary By recognising and applying a new way of working has improved patient safety as it allows for a planned consultation to be completed in a timely assessment by an advanced practitioner. Auditing the process has reported that remote prescribing clinics have streamlined the process, provided accountability with clear documentation and facilitates working in collaboration with colleagues, all of which promote prescribing governance. This service improvement pathway has led to reducing drug costs within the department whilst generating income to the Trust, although figures are to be finalised. Conclusion It appears that from implementing a remote prescribing clinic, it has allowed a timely consultation to assess the patient, review investigations, identify evidence-based treatment options, present options and reach a shared decision. Working collaboratively with colleagues in primary care, by documenting and offering Effective Shared Care Agreements has developed patient care and reduced drug costs in the department. Many medications used in paediatrics are unlicensed. Where GPs have felt unable to prescribe in partnership with specialists, by offering paperwork to decline prescribing, has allowed the Gastroenterology Team work with the Commissioning Interface Liaison Team which has gained funding from the local CCG to cover the cost of supplying, dispensing and delivering the medication.
ABSTRACT
Introduction COVID-19 has impacted the delivery of services provided throughout the National Health Service. Innovative ways of working remotely has been a challenge to provide safe and effective care to patients in a timely manner. The Gastroenterology and Nutrition Team at Birmingham Children's Hospital, treat one of the largest cohorts of paediatric patients in Europe with: Inflammatory Bowel Disease, intestinal failure receiving home parental nutrition and other gastrointestinal diseases. Many patients are on long-term medication and the pandemic increased the demand for remote prescription requests. The Advanced Nurse Practitioner recognised and developed a service improvement initiative to prescribe safely through remote consultations. Aim To provide a standardised approach to provide remote consultations in order to issue repeat prescriptions in a safe and effective manner. To adhere to current guidance, to promote best practice, work in partnership with GPs and to audit the findings following implementation. Method Searches were conducted for literature surrounding remote prescribing. Using current guidance, the ANP implemented a seven step approach in performing prescribing consultations (see figure 1). Results 232 patients requested repeat prescriptions, with a total of 435 medications. These figures are from booked clinics and any requests outside of these were not included in these findings. Figure 2 outlines the outcome from implementing stage 5 of the process (figure 1). Combining the number of GPs who agreed to prescribe, with the agreed Clinical Commissioning Groups (CCG's) funding, amounted to 54.74%. 17 CILT funding requests are pending, therefore 60.06% of requests are likely to be funded. 40 patients (17.24%) were removed from the medication requests for a variety of reasons and 48 requests (20.68%) are pending a response. In 18 consultations, recommendations were needed to promote patient safety, for example: . Unwell patient booked into a face to face clinic for review . Abnormal bloods - neutropenic (Azathioprine placed on hold) . Insufficient blood levels highlighted to consultant - increased medication dose/duration . Missed blood monitoring - arranged . Poor compliance - booked into Clinical Nurse Specialist clinic . Missed clinic appointments - booked in Summary By recognising and applying a new way of working has improved patient safety as it allows for a planned consultation to be completed in a timely assessment by an advanced practitioner. Auditing the process has reported that remote prescribing clinics have streamlined the process, provided accountability with clear documentation and facilitates working in collaboration with colleagues, all of which promote prescribing governance. This service improvement pathway has led to reducing drug costs within the department whilst generating income to the Trust, although figures are to be finalised. Conclusion It appears that from implementing a remote prescribing clinic, it has allowed a timely consultation to assess the patient, review investigations, identify evidence-based treatment options, present options and reach a shared decision. Working collaboratively with colleagues in primary care, by documenting and offering Effective Shared Care Agreements has developed patient care and reduced drug costs in the department. Many medications used in paediatrics are unlicensed. Where GPs have felt unable to prescribe in partnership with specialists, by offering paperwork to decline prescribing, has allowed the Gastroenterology Team work with the Commissioning Interface Liaison Team which has gained funding from the local CCG to cover the cost of supplying, dispensing and delivering the medication.
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Indian witnessed its record lowest ever currency fall in a matter of few days. The Rupee loss meant that it's a gain for the US Dollar. There have been numerous reasons which paved way to the diminishing value of Indian rupee. Within a timeframe of just 75 years a sharp rise to 79INR/1USD could be witnessed in the year 2022. The value of Rupees has diminished by about seventeen times during this time frame. There has been numerous reasons for the fall in the vale of Rupee such as the Russia-Ukraine war, inflation rate, crude oil price change etc. the fall in Rupee value has put the Indian economy in great stress and challenge creating an impact on the economy. This paper attempts to make a Rupee-Dollar comparison since 2016 to 2022 using data collected from reliable sources and using SPSS software to evaluate the results obtained. Copyright © 2022, Anka Publishers. All rights reserved.
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INTRODUCTION: Tocilizumab is recognized as a safe and efficacious treatment option for critically ill patients with COVID-19. Controversy remains regarding appropriate criteria for use. This evaluation assessed tocilizumab use for COVID-19 treatment and clinical outcomes following implementation of an institutional guideline. METHOD(S): This was a 2-center (1 community;1 academic), retrospective review of adult patients admitted to the ICU that received tocilizumab for COVID-19. Baseline demographics, length of stay (LOS), mechanical ventilation (MV), morbidity, mortality, and drug cost were collected. C-reactive protein (CRP), ferritin, and lactate dehydrogenase (LDH) were reviewed and compared to institutional criteria for use. RESULT(S): Forty (26 community;14 academic) critically ill patient cases were reviewed. No differences were observed in baseline demographics, with a pool median age and weight of 58 (49-65) years and 102 (88-117) kg, respectively. No difference (community, 4 [15.4%] vs academic, 0 [0%];p=0.28) was seen in vaccination status. No differences were seen in time to tocilizumab administration, dose, hospital and ICU LOS, or progression to MV. Pooled median inflammatory markers included a CRP 131 (92-200) mg/L, ferritin 1074 (418-1936) ng/mL, and LDH 589 (414-803) IU/L with no differences between groups. Median ferritin values were noted as numerically higher, but non-significant in the community group (1331 [614-2306] ng/L vs 555 [341- 1851] ng/mL;p=0.16). Pooled all-cause in-hospital mortality was observed in 14 (35%) patients, with numerically higher, but non-significant rates in the community group (12 [46.2%] vs 2 [14.3%];p=0.08). Median charge per patient was $15,625.55. CONCLUSION(S): Critically ill patients receiving tocilizumab for COVID-19 treatment have high rates of mortality despite early use upon ICU admission. Baseline inflammatory markers were markedly above institutional criteria for use, leading to adjustments in the institutional guideline. Routine evaluation of tocilizumab use criteria may be warranted during strained supplies and COVID-19 surges.
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Background. The COVID pandemic shifted antimicrobial stewardship resources at community hospitals. One reason for this shift was new COVID treatments, the first of which was remdesivir, which received initial emergency use authorization (EUA) for the treatment of COVID-19 in May 2020. The UNC Health Southeastern (UNC SEH) pharmacy director stewarded remdesivir by reviewing patients to ensure they met emergency use authorization (EUA) and guideline-based appropriateness criteria. The infectious diseases physician resolved any disputes regarding patient candidacy for remdesivir. The goal of remdesivir stewardship was to optimize care;however, the shift in workflow presented an unrecognized opportunity for stewards to reduce remdesivir costs. Methods. The percentage of COVID patient admissions receiving remdesivir at UNC SEH for calendar years 2020 and 2021 was benchmarked against 32 community hospitals in the Duke Antimicrobial Stewardship Outreach Network (DASON) (Figure 1). UNC SEH purchasing data were used to calculate remdesivir expenditures for 2020 and 2021. Next, the anticipated cost if the hospital had prescribed remdesivir to the same percentage of admissions as the DASON mean was calculated. The difference was calculated to determine the cost avoidance achieved by having below average use of remdesivir (Table 1). Results. At UNC SEH, 28.1% of COVID admissions received remdesivir in 2020 and annual remdesivir expenditures were $693,680. In 2021, 47.45% of COVID-19 admissions received remdesivir and drug expenditures were $1,248,000. The DASON mean % of COVID admissions receiving remdesivir in 2020 was 44.08% and 60.07% in 2021. A total cost avoidance of $726,407 was calculated based on the hospital's below-benchmark use of remdesivir (Table 1). Conclusion. UNC SEH achieved significant cost-savings in 2020 and 2021 due to active remdesivir stewardship. The team created a patient-centered model that focused on using drugs for the right patients and the organization realized cost-savings while ensuring that patients received therapy in accordance with remdesivir EUAs and published guidelines.