Impact of the elements of legal environment on pharmaceutical business

Article analyses the legal acts of the Republic of Lithuania, which regulate pharmaceutical business. These laws are compared with EU Directives and essential differences are outlined, which have the direct influence on the performance and results of pharmaceutical company's work in Lithuania. The article contains the analytical data about the laws and regulations in all fields of pharmaceutical business as well as comparison with EU Directives and EU countries legal practice. The differences in the Law on VAT, Law on Pharmaceutical activity and Law on Public Procurement are found as most important in limiting pharmaceutical activities and decreasing competition ability of pharmaceutical companies in Lithuania. The direct negative impact on company's activities have also the elements of numerous governmental regulations and orders, regulating drug registration, charity, quality control etc., increasing significantly the costs of activity, protecting state institutions, violating the free market economy rules and free competition. The article presents summary of most important elements of legal environment, which have to be changed in the process of harmonisation with EU in order to reach the equal conditions for all the participants of pharmaceutical market

Evaluation of daily outpatient multidisciplinary rehabilitative treatment of patients with musculoskeletal, neurological and traumatic disorders in a municipality outpatient setting

Background and objective: Musculoskeletal, neurological, and traumatic injuries are a considerably increasing problem. There is a lack of studies evaluating the results of outpatient rehabilitative treatment of patients with the abovementioned diseases. The aim of this study was to determine the effectiveness of daily outpatient multidisciplinary rehabilitation. Materials and methods: This observational study enrolled 223 adult people undergoing outpatient rehabilitation performed in a municipality outpatient clinic during 14 days. The functional assessment of disability was performed by using the Barthel index (BI), functional performance was estimated by the modified Keitel functional test (MKFT), and pain perception was evaluated by the visual analogue scale (VAS). The mean scores of the tests were compared before and after outpatient multidisciplinary rehabilitation. Results: Significantly reduced disability and pain perception as well as increased functional performance were documented after outpatient rehabilitation. The mean scores of BI, MKFT, and VAS before and after rehabilitation did not differ significantly among patients ranked to each cluster of diseases. Increased functional performance of patients had a moderate-to-weak association with decreased disability and pain perception. The positive changes in health status considering disability, functional performance, and pain perception were documented after 14-day rehabilitation. Conclusions: Multidisciplinary outpatient rehabilitation can be considered as effective treatment. However, it is necessary to implement specific, well-adapted consuming assessment instruments in order to evaluate the outcomes of daily multidisciplinary outpatient rehabilitative treatment