Is This Safe? Examining Safety Assessments of Illicit Drug Purchasing on Social Media Using Conjoint Analysis.

Background: Illicit substance sales facilitated by social media platforms are a growing public health issue given recent increases in overdose deaths, including an alarming rise in cases of fentanyl poisoning. However, little is known about how online users evaluate what features of social media posts convey safety, which can influence their intent to source illicit substances. Objectives: This study adapts conjoint analysis which assessed how attributes of social media posts (i.e., features) influence safety evaluations of mock posts selling illicit substances. 440 participants were recruited online for self-reporting use or purchase of controlled substances or prescription medicines recreationally. The following attributes were tested: drug packaging, drug offerings, profile photo of seller, payment info provided, and use of emojis. Results: Packaging was ranked the most important attribute (Average Importance =43.68, Offering=14.94, Profile=13.86, Payment=14.11, Emoji=13.41), with posts that displayed drugs in pill bottles assessed as the most safe. Attribute levels for advertising multiple drugs, having a blank profile photo, including payment information, and including emojis also ranked higher in perceived safety. Rankings were consistent across tested demographic factors (i.e., gender, age, and income). Survey results show that online pharmacies were most likely to be perceived as safe for purchasing drugs and medications. Additionally, those who were younger in age, had higher income, and identified as female were more likely to purchase from a greater number of platforms. Conclusions: These findings can assist in developing more precise content moderation for platforms seeking to address this ongoing threat to public safety.

Pharmaceutical Purchasing: a Review of the Landscape and Implications for Antidotal Therapies.

The management of the poisoned patient often requires the utilization of uncommonly used pharmaceutical interventions. These interventions can be associated with significant costs to both the patient and treating institution. Pharmaceutical supply shortages and issues with accessibility of antidotal therapies complicate the management of many toxic exposures. These challenges are an inherent property of the pharmaceutical purchasing infrastructure in the United States, which is a complicated network of public and private intra-institutional agreements. The cost and availability of any given therapy is dependent on the individual contracting agreements between the treating institution, payer, pharmacy benefit manager, manufacturer or wholesaler, and in some cases a specialty pharmacy. Small or remote hospitals may experience greater challenges related to insufficient patient volume to achieve predicable prescribing patterns of rare and expensive medications, necessitating consignment purchasing arrangements. Although pharmaceutical costs are the focus of recent legislative attention, these reforms are not expected to significantly alter the cost or availability of antidotal therapies.

Has the Volume-Based Drug Purchasing Approach Achieved Equilibrium among Various Stakeholders? Evidence from China.

Volume-based drug purchasing by China's health insurance system currently represents the largest group purchasing organization worldwide. After exchanging the market that accounted for nearly half of the volume of the healthcare system for the ultra-low-price supply of limited drugs, what are the effects on patient and funding burdens, drug accessibility, and clinical efficacy? We aimed to verify the effectiveness of the policy, explore the reasons behind the problem and identify regulatory priorities and collaborative measures. We used literature and reported data from 2019 to 2021 to conduct a stakeholder analysis and health impact assessment, presenting the benefit and risk share for various dimensions. The analysis method was a multidimensional scaling model, which visualized problematic associations. Seventy-nine papers (61 publications and 18 other resources) were included in the study, with 22 effects and 36 problems identified. The results indicated favorable affordability and poor accessibility of drugs, as well as high risk of reduced drug quality and drug-use rationality. The drug-use demand of patients was guaranteed; the prescription rights of doctors regarding clinical drug use were limited; unreasonable evaluation indicators limited the transformation of public hospitals to value- and service-oriented organizations; the sustainability of health insurance funds and policy promotion were at risk; and innovation by pharmaceutical companies was accelerated. The problems associated with high co-occurrence frequencies were divided into the following clusters: cost control, drug accessibility, system rationality, policy fairness, drug quality, and moral hazards. These findings suggested that China has achieved short-term success in reducing the burden on patients and reducing fund expenditure. However, there were still deficiencies in guaranteed supply, quality control, and efficacy tracking. The study offers critical lessons for China and other low- and middle-income countries.

Predictors of using social media to purchase drugs in New Zealand: Findings from a large-scale online survey.

BACKGROUND: There are increasing reports of social media being used to buy and sell illegal drugs internationally. Studies of social media drug markets to date have largely involved general explorations of social media drug transactions in select countries. Social media drug markets may operate differently for different drug types and in different country contexts. AIMS: To identify predictors of the use of social media to purchase cannabis, methamphetamine, LSD and ecstasy/MDMA in New Zealand using a large-scale online survey sample. METHODS: The annual New Zealand Drug Trends Survey (NZDTS), an online convenience survey promoted via targeted Facebook™ campaign, was completed by 23,500 respondents aged 16+. Logistic regression models were fitted to identify demographic, drug use and drug market predictors of reporting the use of social media to purchase cannabis, methamphetamine, LSD and ecstasy/MDMA. RESULTS: Fifty-one percent of the sample had purchased cannabis, methamphetamine, ecstasy/MDMA or LSD in the past six months, of which 22% had done so via social media (n = 2,650). Cannabis was the drug type most purchased from social media among drug purchasers (24%), followed by ecstasy/MDMA (13%). Sixty percent of social media purchasers had used Facebook™, 48% Snapchat™, and 20% Instagram™. The leading advantages of social media purchasing were "high convenience" (74%), and "fast transaction speed" (43%). Younger age was a significant predictor of social media purchasing for all drug types (particularly among 16-17 year olds). Purchasing from someone identified as a "drug dealer" was a predictor of social media purchasing among respondents for all drug types. CONCLUSION: Social media drug markets may have significant implications for drug purchasing by youth through providing greater access to supply and breaking down age-related barriers between social supply and commercial drug markets. Our findings highlight the importance of incorporating social media platforms into youth drug prevention and harm minimisation strategies.

Negative Consequences of the Widespread and Inappropriate Easy Access to Purchasing Prescription Medications on the Internet.

BACKGROUND: The purchase of prescription medications via the Internet is a global phenomenon with significant economic, social, and health-related impacts. The growth of online purchasing of prescription medicines is significant and has been amplified by social isolation related to the COVID-19 pandemic, with many patients unable to obtain medicines as they normally would. By contrast, there are licensed, certified, legitimate retail pharmacies that provide significant and vital services to patients. OBJECTIVE: To review the major public health threat from illegal entities that sell any type of prescription medicines to individuals without proper physician oversight. DISCUSSION: Rogue and inappropriate online vendors are providing counterfeit and substandard medications fraudulently with untold impacts on morbidity and mortality globally. This article presents the differentiation between the types of legal and illegal Internet pharmacies, as well as the actions that are currently in play to affect the illegal online purchase of prescription medicines. Much must be done in a collaborative, global effort to address the public health threat of obtaining prescription drugs via the Internet. CONCLUSION: Global, federal, state, health professional, societal, and patient-specific collaborations are necessary to affect the significant threat that is now present via the increasing ease of access to online medication purchases.

Prospects for development of group purchasing organizations (GPOs) in China within the context of national centralized drug procurement.

Healthcare group purchasing organizations (GPOs) are considered to play an integral role in the healthcare supply chain by keeping prices low and helping all members of the healthcare system achieve their objectives. China has been exploring GPOs in the field of drug procurement since 2015, and there are currently three GPO models in Shanghai, Shenzhen, and Guangzhou. Although the three models operate differently and they have each been examined, they have all achieved certain results and demonstrated the ability to control drug expenditures. In 2018, the National Healthcare Security Administration implemented a national centralized drug procurement policy, also known as the 4 + 7 procurement policy ("4+7 Policy"). This policy context has also led to changes in the strategy for development of GPOs in China. GPOs need to explore strategies that do not overlap with the scope of 4 + 7 procurement, and they need to develop dynamic and personalized procurement plans that are more in line with first-line clinical practices to have a synergistic effect in combination with the "4+7 Policy." In the future, GPOs will grow rapidly in China. The number of GPOs need to be increased to prevent monopolies, and GPOs need to expand their diversified value-added services to perform more tasks in terms of supply chain management and data analysis.

"4+7" city drug volume-based purchasing and using pilot program in China and its impact.

In order to deepen the health system reform and improve the mechanism for the formation of drug prices, in January 2019, the General Office of the State Council of the People's Republic of China issued the "National centralized drug purchasing and using pilot program", selected 11 cities in mainland China to carry out "4+7" city drug volume based purchasing pilot work. This paper introduces the specific implementation plan, organizational structure and drug selection process of China's "4+7" city drug volume-based purchasing pilot work, and expounds the initial effects, existing problems and policy development after the implementation of the policy. After the implementation of the policy, the prices of 25 selected drugs were significantly lower, compared with the minimum purchase price of the same drugs in 11 pilot cities in 2017, the average drop was 52%. After the pilot scope was extended to the nation, compared with the minimum purchase price of the Union in 2018, the proposed price of the 25 drugs have an average price drop of 59%, compared with the selected price of the "4+7" pilot cities, the average price drop was 25%, and the price of drugs dropped further. By the end of August 2019, the implementation progress of 25 selected drugs in the "4+7" city drug volume-based purchasing was better than expected, the burden of patients' drug expenses was reduced, and the pilot work was beginning to bear fruit. The long-term influence and effect of the "4+7" city drug volume-based purchasing and policy implementation after the expansion needs to be further observed.

Study on the Implementation Status of Drug Procurement with Target Quantity of Public Hospitals in China / 中国药房

OBJECTIVE:To provide reference for improving the drug procurement system of public hospitals in China. METH-ODS:The drug collective procurement documents in each province were retrieved after publishing the document [2015] No.7 of the State Council and the document [2015] No.70 of the National Health and Family Planning Commission,the drug bidding data was collected,and form and implementation of drug procurement with target quantity were analyzed. RESULTS:Procurement with tar-get quantity included scattered procurement with target quantity,national centralized procurement with target quantity and provin-cial centralized procurement with target quantity. In scattered procurement with target quantity,actual purchase price was opaque, and the procurement was similar to"second negotiation"in individual province. National centralized procurement with target quanti-ty was implemented well. Provincial centralized procurement with target quantity was not fully implemented,only Shanghai carried out centralized procurement with target quantity,and the pilot had good effects. CONCLUSIONS:In order to promote procurement with target quantity,it's suggested that we should definite"procurement with target quantity"in the governmental document,pub-lish actual procurement price of scattered procurement with target quantity,try to implement centralized procurement with target quantity without quality levels distinguished,improve the centralized procurement with target quantity with quality levels distin-guished and improve supporting measures,such as hospital procurement system,provincial procurement platform, pre-payment mechanism by health-care funds,and so on.

Effect,Existing Problems and Suggestions on the Implementation of Drug Purchasing System Based on the Investigation of Primary Medical and Health Institutions in Chongqing City / 中国药房

OBJECTIVE:To provide reference for the further improvement of the drug purchasing system in Chongqing city. METHODS:30 primacy medical and health institutions in Chongqing were selected to collect the data about cost changes and busi-ness development in above-mentioned institutions from 2009 to 2013,the purchasing price,use and supply of essential medicines were collected via Chongqing Municipal Health and Family Planning Commission to evaluate and analyze the effects and existing problems of drug purchasing system,and suggestions were put forward. RESULTS:Compared with 2009,the non-essential drugs’ prices fell an average of 28.00%in 2013,prices of 307 varieties in National Essential Medicine System(2009 edition)fell an aver-age of 32.97%,205 varieties in supplementary list of local prices fell an average of 43.78%. The proportion of sales amount(not including Chinese herbal medicine)in primacy medical and health institutions increased from 76.48% in 2010 to 92.07% in 2013, the average rate of essential medicines increased from 6.84% to 28.12%. Compared with 2009,the average drug cots and inpatient drug costs decreased 16.78% and 25.85% in 2013,the proportion of drugs decreased from 56.32% in 2009 to 49.70% in 2013. CONCLUSIONS:Generally speaking,the implementation of drug purchasing system in Chongqing is successful,but also exists some problems,such as imperfect pricing mechanism,difficult supply of low-cost drugs,slow rise of average outpatient costs in primacy medical and health institutions and irrational drug use. It is suggested to improve it from aspects of perfecting drug pricing mechanism,optimizing logistics and distribution,strengthening the role of the medical insurance institutions,regulating medication overuse and improving compensation policy of medical institutions.

Investigation on the Effect of Drugstore Salesclerk Factors on the Consumers'Drug Purchasing Behavior in Beijing Citizens / 中国药房

OBJECTIVE:To investigate the effect of salesclerk factors on the consumers'purchasing behavior in drugstores in Beijing citizens,and provide reference for better satisfaction of consumers'requirements. METHODS:Clustering random sampling method was launched among the drugstore consumers in 16 districts of Beijing,the results were statistically analyzed,and then the suggestions were provided. RESULTS:Totally 180 valid questionnaires were collected from the 208 questionnaires with effective re-covery rate of 86.5%. 70.6% consumers preferred the salesclerk to ask actively when they entered a drugstore;moderate depen-dence on the salesclerk was found mainly in the aspect ofmedicine selection,medication methods guidingandhelping disease judgment;moderate trust to the salesclerk was found,andthe poor professional knowledge,poor service attitudeandpoor professional ethicswere the main reasons for the distrust;the professional moralandknowledgeof salesclerks were the most-ly expected qualities;the licensed pharmacist in the drugstore was not recognized by 66.1% consumers. CONCLUSIONS:Drug-store should understand the consumer's expectations and requirements to its salesclerk and improve accordingly in the respect of strengthening the train of professional quality,enhancing the ability of pharmaceutical care,increasing the propaganda of licensed pharmacist,conducting medication consultation actively,exploring the diversity of consumer's requirements,and meeting the con-sumer's requirements more extensively.

Scientific Optimizing of Flow of Drug Purchasing in Hospital / 中国药房

OBJECTIVE:To construct a high-efficiency, high-performance, low-cost flow of drug purchasing. METHODS: The defects involved in the current drug purchasing flowsheet prevalent in many hospitals were analyzed and the optimized flowsheet was put into practice by combining the actuality of our hospital. RESULTS & CONCLUSIONS: The traditional drug purchasing modality can not meet the requirement of current hospitals in that it involves large work load and high probability of error, and it is tedious and time-consuming. The establishment of drug catalog database and the online drug purchase by means of instant communication software can help simplify drug purchase flow, lessen work load, enhance work efficiency, and effectuate a high-efficiency, high-performance, low-cost flow of drug purchasing.

Application of ARIMA Model to Drug Storeroom in Drug Purchasing Prediction / 中国药房

OBJECTIVE:To explore the new drug purchasing mode using autoregressive integrated moving-average (ARIMA) prediction model for improvement of the working quality and efficiency in hospital drug storeroom.METHODS:Drug consumption data from week 1 to week 47 in 2008 were collected.According to ABC method,category A drugs were defined among which 10 kinds of drugs were sampled randomly.Based on the data of from week 1 to week 44 in 2008,software SPSS13 was applied for the modeling and fitting of ARIMA model.The established model was applied to predict the data of from week 45 to 47,with the predicated data compared with the actual consumption data.RESULTS:The predicted purchasing amount using ARIMA model were consistent with the actual consumption data,with prediction accuracy for quantity at 89.19% and prediction accuracy for whole unit of purchased drugs at 97.56%,respectively.CONCLUSIONS:Good fitting and high short-medium term predication accuracy were obtained in the prediction using ARIMA model,and which could provide scientific support for drug purchasing and help manage the drug stock reasonably without appearance of out of stock or overstock.

Supervising of the Centralized Public Bidding in Drug Purchasing of Medical Institution Should be Strengthened Urgently / 中国药房

OBJECTIVE:To regulate centralized public bidding activity in the drug purchasing of medical institution and to promote the sound development of the pharmaceutical industry.METHODS:The problems in the public bidding of drug purchasing of the medical institutions,drug suppliers,medium agencies and monitoring departments were analyzed and some related countermeasures were put forward.RESULTS&CONCLUSION:A variety of groups are involved in the public bid?ding of drug purchasing,whose interests should be regulated well.It is especially needed to strengthen the supervising in the public bidding so as to ensure the carrying out of the“Sunshine Purchasing”policy and guarantee the smoothly and orderly operation of the public bidding in the drug purchasing.