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Preface | p. ix |
About the authors | p. xi |
Introduction | p. 1 |
Economic development | p. 1 |
Systems analysis | p. 3 |
Actors in the pharmaceutical systems | p. 8 |
Evaluations | p. 17 |
Data collection | p. 20 |
Summary of results and formulation of conclusions | p. 20 |
Social constructionism and social representation theory | p. 21 |
The actor-spectator paradox | p. 25 |
Decision-making processes in the drug system | p. 26 |
How attitudes and beliefs change - the balance model | p. 29 |
Summary | p. 32 |
References | p. 33 |
A historical perspective of drug research and diffusion | p. 39 |
The period of folk medicine | p. 39 |
The merchant period (1500 AD to the end of the eighteenth century) | p. 39 |
The chemical period (the nineteenth century) | p. 44 |
The animal testing period (from 1900 to the end of the 1930s) | p. 47 |
The drug innovation period (from 1940 to 1964) | p. 49 |
The post-Thalidomide period (1965 to present) | p. 51 |
Future perspectives | p. 56 |
Summary | p. 56 |
References | p. 57 |
National drug policies | p. 61 |
Efficient organization of drug support | p. 62 |
Efficient organization of drug research | p. 63 |
Efficient organization of drug production | p. 65 |
Efficient organization of drug distribution | p. 66 |
An efficient system for drug consumption | p. 68 |
A satisfactory system of drug information | p. 69 |
Choice of drugs with high therapeutic powers | p. 70 |
Choice of drugs with few side effects | p. 75 |
Low drug costs | p. 77 |
How to develop and implement a national policy | p. 78 |
Summary | p. 78 |
References | p. 78 |
Planning the drug support | p. 81 |
Patent and exclusivity policies | p. 81 |
Trade name policy vs. generic name policy | p. 84 |
Generic and therapeutic substitution | p. 85 |
Generic prescribing | p. 87 |
Drug registration | p. 88 |
Drug reimbursement policies/national health insurance systems | p. 90 |
The public and private drug sectors of developing countries | p. 93 |
The primary health care policy | p. 95 |
The essential drugs (ED) policy | p. 99 |
Summary | p. 102 |
References | p. 103 |
Drug research | p. 109 |
Drug company strategies | p. 110 |
Factors which determine the resources a drug company spends on R&D | p. 112 |
The selection of research areas by a drug company | p. 115 |
The research process | p. 116 |
The project decision | p. 118 |
The research administration after a project has been accepted | p. 120 |
Research productivity | p. 122 |
Ethical concerns in drug research | p. 124 |
Summary | p. 125 |
References | p. 126 |
Drug production | p. 129 |
Background | p. 129 |
Variations between countries | p. 133 |
The decision regarding which drug(s) to produce | p. 134 |
The organization of production lines | p. 139 |
Production of drug raw materials | p. 141 |
Drug quality | p. 142 |
Principles of technical assistance support | p. 144 |
The decision where to locate the plant | p. 145 |
Determination of production quantities | p. 146 |
Export decisions | p. 146 |
Summary | p. 147 |
References | p. 148 |
Drug prices, cost controls and profits in the drug industry | p. 151 |
Price setting of raw drug materials | p. 151 |
Price setting of ready-made drugs | p. 154 |
Price setting of patented drugs | p. 156 |
Price setting of non-patented drugs (generic drugs) | p. 157 |
Price Competition | p. 158 |
Cost controls | p. 160 |
The prices a patient has to pay in the public sector in countries which have a public distribution system | p. 163 |
Drug prices at private pharmacies in developing countries | p. 164 |
The profits of drug companies | p. 164 |
Summary | p. 166 |
References | p. 167 |
Drug wholesaling and procurement | p. 171 |
Importation | p. 172 |
Different types of wholesale systems | p. 173 |
How to evaluate a wholesaling system | p. 174 |
Procurement | p. 176 |
Summary | p. 178 |
References | p. 178 |
Drug retail distribution | p. 181 |
Pharmaceutical care | p. 182 |
The degree of formal government control of outpatient pharmacies | p. 184 |
Drug distribution aims | p. 188 |
Summary | p. 200 |
References | p. 200 |
Drug consumption | p. 205 |
Historical perspective | p. 205 |
Measurement of drug consumption | p. 206 |
Factors which determine the volume of a drug consumed in a country | p. 209 |
Factors found to be related to the volume of drug consumption | p. 211 |
Factors which influence drug consumption at the individual level | p. 213 |
Qualitative studies of drug consumption | p. 215 |
Summary | p. 216 |
References | p. 217 |
Marketing of drugs | p. 219 |
Historical background | p. 219 |
The contextual factors which affect the diffusion of a drug | p. 221 |
The marketing goals of drug companies | p. 222 |
Factors determining what a drug company spends on the marketing of a new drug | p. 223 |
The relative effects of different media and messages in commercial drug information to prescribers | p. 228 |
Commercial media directed at the general public | p. 230 |
A national perspective on commercial drug information | p. 230 |
Summary | p. 233 |
References | p. 233 |
The market structure | p. 237 |
The existing international market structure | p. 237 |
The market structure in a specific country | p. 239 |
Summary | p. 240 |
References | p. 241 |
Drug control | p. 243 |
Definition of drug control | p. 243 |
Process model of the drug control system in a country | p. 244 |
The processes to ensure that each aspect of drug control complies with the necessary norms or standards | p. 247 |
Control measures | p. 248 |
Clinical trials | p. 251 |
Summary | p. 252 |
References | p. 252 |
Drug prescribing | p. 255 |
Normative studies | p. 255 |
Sociological studies | p. 258 |
Information process studies of drug prescribing | p. 260 |
Prescription studies based on a cognitive perspective | p. 262 |
How standard selections change | p. 267 |
Making a diagnosis | p. 268 |
Placebo prescribing | p. 269 |
Summary | p. 270 |
References | p. 271 |
Patients' attitudes and behaviour | p. 277 |
Background | p. 277 |
Explanatory models | p. 278 |
A process model: how a layperson deals with medical symptoms | p. 280 |
OTC drugs | p. 288 |
Patient compliance | p. 289 |
Summary | p. 294 |
References | p. 294 |
Drug information | p. 301 |
Background | p. 301 |
The role of mass media | p. 303 |
Drug information sources used | p. 305 |
Drug information from a sender's perspective | p. 308 |
Mass media campaigns | p. 313 |
The value problem | p. 314 |
Summary | p. 315 |
References | p. 316 |
Index | p. 319 |
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