Overtreatment and benevolent provider moral hazard: evidence from South African doctors

Overtreatment is widespread in health, with potentially dire consequences for patients, health systems and public health. It may be fueled by providers when they do not bear the cost of treatment (moral hazard), even they do not profit financially from it (i.e. benevolent providers). We test this hypothesis by creating an exogeneous change in the incentives faced by private doctors in South Africa. We find that provider moral hazard has no effect on overtreatment in volume but fuels overtreatment in cost. By contrast, when they bear the marginal treatment cost, doctors choose cheaper drug. While these results suggest that provider moral hazard contributes to overtreatment in primary care, we consider other plausible channels, such as responses to a perceived demand for high-quality drugs or market segmentation. We discuss the potential scope for supply-side cost-sharing incentives to reduce inefficiency in future health system reforms in South Africa

Evaluation of medication package inserts in Saudi Arabia

Sinaa A Al-aqeelClinical Pharmacy Department, King Saud University, Riyadh, Kingdom of Saudi ArabiaPurpose: The aim of this study was to examine if package inserts (PIs) supplied with prescribed and over-the-counter medications in Saudi Arabia contain information relevant for the safe and appropriate use of these medications.Methods: Sixty PIs for prescription-only medications (n = 37) and over-the-counter medications (n = 23) were evaluated against a set of safety criteria compiled from the literature.Results: Analyzed PIs were defective in many aspects. Particularly of concern were unclear dosage instructions, lack of measures to be taken when an administrative error was made, inappropriate presentation of side effects, and lack of measures to be taken if serious side effects occurred.Conclusion: This study indicated that information relevant to the safe and appropriate use of medications was not uniformly mentioned in the PIs analyzed. To avoid medication errors due to deficits in the current PIs, we recommend improvement in the existing PIs based on best practice for information content and design.Keywords: drug information, patient education, patient information leaflets, package insert

Influenza pandemic: plan needed for federal and state response

40 pages.Report on government plans for an outbreak of pandemic influenza. Includes brief information on previous influenza outbreaks in the United States

Practical Strategies for Pharmacist Integration with Primary Care: A Workbook.

This workbook is a practical set of tips and resources to assist pharmacists in providing clinical pharmacy services to primary care providers and their patients. The content was written based on experiences in Vermont in 2014, however the topics should generalize to pharmacists in other areas

DRUG UTILIZATION PATTERN AND PHARMACOECONOMIC ANALYSIS OF ANTIHYPERTENSIVE DRUGS PRESCRIBED IN SECONDARY CARE HOSPITAL IN GUJARAT, INDIA

ABSTRACTObjective: Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if notdetected early and treated appropriately. A large number of antihypertensive drugs alone or in various combinations are available, and physiciansneed to choose most appropriate drug for a particular patient. Pharmacoeconomic and drug utilization studies at regular intervals help physicians toprescribed rational drugs with high efficacy along with minimal cost.Methods: The prospective observational study was conducted at Seth H. J. Mahagujarat Hospital from July to December 2013. 250 hypertensivepatients, attending medicine outpatient department were included for drug utilization study and 100 hypertensive patients, attending in patientsdepartment were included for pharmacoeconomics analysis during the study period.Result: The most frequently prescribed antihypertensive drug as monotherapy, as combination therapy and in fixed dose combinations was calciumchannel blocker (Amlodipine). Generic drugs showed same efficacy as brand drug, but both drugs were significantly differed in the prize. Among 100inpatients admitted for the hypertensive condition in general ward total of direct medical cost was 65.19% and total of indirect medical cost was34.81%. β-blocker and diuretics were the most effective therapy which is followed by the clonidine, envas (Enalapril), and then, amlodipine.Conclusion: We concluded from this study that use of β-blockers and diuretics were most cost-effective for the hypertensive patients in this study.Keywords: Antihypertensive drugs, Drug utilization study, Pharmacoeconomics analysis.Â