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Κυριακή, 29 Ιουνίου 2014
Προς σκέψη κάποιων διευρυμένων...
Σάββατο, 14 Ιουνίου 2014
Όπως αναφέρεται ρητά
1) Αν δεν πέσουν οι τιμές στα otc μέχρι 31 Ιουνίου 2014 τότε αυτόματα απελευθερώνεται η διακίνηση τους μέσω τρίτων καναλιών (f there is no substantial reduction of OTC
prices by end-June 2014, retail channels will be liberalized immediately for all OTC products)
2) Ποσοστό κέρδους. Κλιμακωτό ποσοστό ώστε το τελικό να ανέρχεται στο 15%. Στα χέρια του Βορίδη και των λογιστών η ερμηνεία του 15%..
2. On the basis of the report on the impact of the new profit margins of pharmacies, introduces
regressive mark-ups and reduces the profit margins down to 15%, starting from 1st June
3. Ensures that EOPYY negotiates a 5% discount through price-volume or risk sharing
agreements focusing on the top spending medicines sold in EOPYY pharmacies
Liberalize ownership/operation of pharmacies
(e.g., requirements for owner to be pharmacist,
one pharmacy per pharmacist, minimum
distance between pharmacies, etc.)
Τι έκανε ο Άδωνις
Abolish (i) the restriction of one pharmacy
per pharmacist; (ii) all geographical
restriction on minimum distances between
pharmacies; and (iii) prior authorization by
Prefecture for establishing a pharmacy.
Τι Θα γίνει τον Οκτώβρη (Βορίδης)
Prior action Review by end-September 2014 the
practices in other EU countries, and
legislate by end-2014
the changes needed
to bring the framework in Greece on
pharmacy ownership in line with EU best
Το κείμενο ΕΔΩ
Και παρακάτω ένα ενδιαφέρον άρθρο!!!
Globalisation and its Impact on the Indian Pharmaceutical IndustryD.P. Dubey
Globalisation is a process which involves economic inter-dependence of countries world-wide removing all barriers for economic integration as if the whole world is a single village. Obviously, in this process, the rich nations with their superior financial power, control the scenario and the poor and the developing nations are forced to integrate surrendering their economic independence knowing fully well what they are forced to accept is really prejudicial to their own interest. In this process the world financial institutions like the World Bank, IMF and now the WTO advance the interest of the rich countries alone. The draconian policies of the World Bank and the IMF under the structural adjustment programme resulted in the net transfer of $178 billion between 1984 and 1990 from the poor countries to the commercial banks of rich nations. (UNDP Human Development Report, 1994). The Transnational Corporations (TNCs) of the rich nations are practically controlling the world finances. Today, the whole world is colonised by global finance and the TNCs supported by the neo-colonial structure including the World Bank, IMF and WTO are controlling the financial situation world-wide. The governments of third world countries are powerless against global finance and are unable to control its movement within their own national boundaries.
The situation of the world drug industry is no different. 'Operating at the behest of the Pharmaceutical Research and Manufacturers' Association (PhRMA) for a decade and a half, the U.S.Government has waged a ruthless crusade to force third world countries to adopt strait jacketing intellectual property rules at the expense of protecting public health', says the editorial comment in the June 1998 issue of Multinational Monitor, a journal published from Washington.
The structural adjustment programme introduced by the government of India at the behest of the IMF, World Bank and WTO created a serious impact on India's drug industry, health care system, on the workers engaged in the industry and ultimately on the people of the country. These reform policies are mainly the reduced role of the Government, cut in subsidy in the social sector, increase in administered prices, liberalisation of trade by increasing tariff rates providing incentives for foreign investment, privatisation of the public sector, equating foreign companies with Indian companies, de-regulating the labour market etc. This is aimed at the withdrawal of the state initiative from the social and welfare sectors like health, education, public distribution etc.
In this article I shall try to show how the workers of the drug industry and the people of our country are affected by the impact of globalisation.
Attempts to change the Indian Patent Act 1970 are a part of this globalisation programme. The imposition of an unequal trade treaty like the World Trade Organisation (WTO) is a step towards globalisation in favour of the MNCs of rich nations. With its help, the market of the developing nations is forced open for the developed countries. Most of the developing countries were forced to sign the WTO agreement without realising its implication: as a result, the developed countries are the gainers. Already, at the dictates of the IMF, World Bank and WTO, the Government of India is slackening all checks and controls to invite the MNCs in all industries including the pharmaceutical industry. FERA and MRTP Acts have been amended. Customs duties and corporate taxes have been lowered. Relief, concessions and facilities have been extended to the MNCs as to Indian companies. All these, already, had an adverse impact on the indigenous drug industry. As per the requirement of WTO guidelines for the product patent regime, the availability of new drugs in our country may be delayed depending on the desire of the patent holders. As per the guidelines, a product patent is granted for 20 years and a process patent for another 20 years. At present, newer drugs are made available in our country within a 4-6 years period. Prices of drugs will go up by 5 to 10 times as it is evident from the prices of drugs in India and other countries like Pakistan, U.K. and U.S.A. where product patents are in force. Ranitidine is sold by Glaxo in India at Rs. 7.20. The same product is sold by the same company in Pakistan at Rs. 65 and in the U.S.A. at Rs. 545. Similarly, the anti-viral drug Aciclovir costs Rs. 33.75 in India while the same drug is sold in Pakistan at Rs. 363. There are many such examples. The drug prices in the U.S.A., U.K. and other developed countries have gone up so high that the health care expenditure in those countries is predominantly funded by insurance companies at a very high premium. In those countries people cannot think of treatment without insurance coverage. Product patent regime will definitely hamper India's drugs exports as countries will be forced to purchase from patent holders only.
Prices of drugs are increasing by leaps and bounds along with the prices of other commodities in recent times. The drug manufacturers are flouting the Drug Price Control Order (DPCO). The DPCO was first introduced in 1970. In 1970 most of the drugs were under price control. In 1987 this was diluted and the number of drugs which were restricted declined to 347, in 1987 it was brought down to 163 drugs and in 1994 only 73 drugs were under DPCO. Even then industry is not happy; they want the control to be abolished totally. They have already demanded decontrol of 17 bulk drugs and further recommended full decontrol within 3 years time (Economic Times, 28th September, 1998). Many developed countries of Europe control drug prices directly. In the U.K., the government determines the profit level of drugs supplied by individual companies.A company has to reimburse excess profits to the Department of Health.
A recent study shows that the prices of many life-saving bulk drugs have gone up steeply. Drugs policies in our country are decided not by the need of our people, the pattern of diseases or by the purchasing capacity of the people, but by the profit motive of the industry and the Central Government is playing the role of a silent onlooker.
We are giving below the prices of twelve essential drugs before the liberal decontrol of DPCO in 1995 and today.
|Lignocaine Hcl||Anaesthetic||30 ml.||4.16||12.40||198%|
|Promethaxine Hcl||Anti allergic||10||1.25||3.23||158%|
|Antacid liq.||Gastritis||200 ml.||13.00||23.00||77%|
|Oxyfedrine Hcl||Angina pectoris||10||10.44||21.41||105%|
Further, under the WTO agreement and the imposition of a products patent regime, the prices of all new drugs (patented) will go up without any control of domestic law. The DPCO will become further irrelevant and Indian people's accessibility to newer drugs will be restricted only to the rich of the country. We are giving below the high prices of some of the new drugs introduced in 1997 in the Indian market.
|Sporanox||Ethnor||100 mg||4 tablets||173.00|
|Lumicil||Novertis||250 mg||14 capsules||1247.00|
|Spariex||Sun Pharma||200 mg||6 tablets||154.00|
|Rispid||Panacea||50 ml||1 mg/ml capsule||141.00|
|Amate||Mesco Pharma||50 mg||12 tablets||180.00|
|Adnoject||Inca||3 mg||2 ml. vial||210.00|
|Roxisara||Sarabhai||300 mg||6 tablets||165.00|
|Celex||Glaxo||250 mg||4 tablets||140.00|
Moreover, with the rapid development in technology, a greater number of new drugs are being introduced. Experts say that very few of them are having therapeutic advantages over the existing drugs. 'Out of 348 new drugs introduced by 25 big US companies during 1981 to 1988 only 3 per cent made important potential contribution while 84 percent made little or no potential contribution' said the US federal authority. Hence the introduction of new costly drugs should be properly monitored by the central government.
In their attempt to shift the production to the third party manufacturing already, Hindustan Ciba Geigy, Roche, Abbot, Boehringer Mannheim, Boots, Park Davis, Unichem etc. have closed their factories and offered a voluntary retiring scheme to workers and they have sold the land of their factory premises at a premium price. Apart from these closures, Pfizer, Rhone Poulenc, Hoechst, Glaxo etc. have reduced their work force. Crores of rupees have been spent to give VRS. These companies are manufacturing their products with the help of loan licences. Some of the companies have opened new smaller factories in new places and appointed workers with lower wages and more workload. More casual workers are being appointed. In the last two years in the Mumbai Thane region of Maharashtra around 30,000 workers have lost their jobs in the pharmaceutical industry.
Apart from the factory workers the distribution workers are gradually being replaced by Cost & Freight agency system. In this system, the original company does not have any responsibility for the workers. They are employed by agents with more workload and lower wages. In the last decade around 15 thousand distribution workers have lost their jobs in the pharmaceutical industry. Moreover, through the agency system the Government is deprived of sales tax.
In marketing also the field workers or the sales promotion employees are facing tremendous attacks in the name of franchise, co-marketing, appointment of communicators etc. many permanent sales promotion employees are losing their jobs. Many others are appointed in the name of so-called executives to remove them from the fold of the union. More casual and contractual workers are being recruited.
|Company||Year||Reduction of work force|
|Knoll Pharma (Boots)||1995||600 (All workers)|
|Smith Kline Beecham||1995||208|
|Hindusthan Ciba Geigy||1993||907|
|Roche||1996||All 320 workers|
|Boehringer Mannheim||1997||All 335 workers|
|Park Davis||1997||All 650 workers|
It is not because of any inherent weakness but due to the lack of political will, deliberate efforts to destroy them, corruption and mismanagement that these public sector units have been rendered commercially unviable.
Moreover, the number of workers engaged in these units have been reduced drastically. When IDPL was established it had a strength of more than 15,000 workers. Today, it has been reduced to less than 7,000.
With the pharmaceutical industry taking a leap towards biotechnology development world-wide, only the public sector drug companies, with the backing of the Central Government, could have faced the challenge effectively from the MNCs in the new situation.
In coming days, with the help of international financial companies the MNCs will capture and take control of Indian companies to control the Indian market.
To match the situation created by international mergers and takeovers, Indian companies are adopting the same path. For example Wockhardt took over Merind and Tata Pharma, Ranbaxy took over Croslands, Nicholas Piramal took over Roche, Boehringer, Sumitra Pharma. The inevitable results are job loss of workers. Because of overlapping of jobs large numbers of workers are declared surplus. After merger Glaxo-Welcome and Ciba-Sandoz announced a reduction of 15 thousand and 10 thousand of their work force respectively world-wide. Upjohn and Pharmacia decided to close 24 of their 57 plants in different countries after their merger.
Some countries are adopting the 'buy and grow' method. They are taking over some popular brands and increasing their business. SKB took over Crocin from Duphar, Ranbaxy took over 7 leading brands from Gufic, Dr. Reddy's Lab purchased 6 products of Dolphin and two each from Pfimex and SOL Pharma. Sun pharma purchased all leading brands of NATCO, after selling the popular brands the companies are becoming sick and closing their shutters throwing the workers on the street.
The governments permission to the MNCs to come to India with 100% equity have threatened the existing companies with the same origin and their workers.
Through the process of mergers, acquisitions and takeovers MNCs will gradually perpetuate their grip on the Indian industry by the creation of a limited number of mega companies having monopoly control and domination world wide. In the absence of competition people will have to pay any price as it happens in the sellers market.
The question is why this pressure and hurry? The main aim is to impose the conditionalities of WTO and to change the Indian Patent Act as MNCs need more markets and are eyeing Asia which is the largest continent of the world where 60% of the world population lives but contributes only 20% of the world pharmaceuticals business. With a high rate of population growth it is expected that the need of drugs will tremendously increase in the third world countries including India in the next millennium. India contributes 16.1% of the world population, but it produces only 1.2% of world drug production (See Table V). Hence the MNCs are trying to have more control over the pharmaceutical markets of the developing nations.
Developed countries are backing their own big companies to capture markets in other countries even at the cost of the interest of the people there. The United States has successfully battled for the inclusion of strict intellectual property rules in international trade agreements such as NAFTA and GATT. Often the U.S. position has literally been drafted by PhRMA. These trade agreements disregard public health considerations and have forced dramatic changes in the intellectual property rules the world over. Still PhRMA is not satisfied. And when PhRMA is not happy the office of U.S. Trade Representative (USTR) is not happy, says the editorial comment of Multinational Monitor.
The above comments clearly indicate the intention of the USA and other rich nations. Unfortunately, the Government of India is dancing to their tune. Against this, it is necessary to develop and launch broad-based movements everywhere with the active support of people hailing from all walks of life to force the government to change their stand.
|Dow Chemicals||Marion Labs||1986||$ 6.21 bn.|
|Bristol Myers||Squibb Corp||1989||12.09 bn.|
|Beecham group||Smith, Kline & French||1989||7.9 bn.|
|American Home Products||American Cynamide||1994||9.7 bn.|
|Hoffman La Roche||Syntex Lab.||1994||5.3 bn.|
|Eli Lyly||PCS Health System||1994||4 bn.|
|Smith Kline Beecham||Sterling||1994||2.9 bn.|
|Glaxo||Burroughs Wellcome||1995||14.2 bn.|
|Hoechst||MMD Roussel||1995||7.2 bn.|
|Rhone-Poulenc Rorers||Fison||1995||2.7 bn.|
|Ciba Geigy||Sandoz||1996||30.1 bn.|
|Hoffman la Roche||Comage Ltd.||1997||11 bn.|
|Hoechst A.G.||Rhone Poulenc||1998|
|Country||% of world|
|% of world|
The author is General Secretary of the Federation of Medical and Sales Representatives of India.
Τετάρτη, 11 Ιουνίου 2014
Δευτέρα, 9 Ιουνίου 2014
Αν κ στις ΗΠΑ, το συστημα υγειας έχει ηδη καταρρεύσει, και τα παντα γίνονται επι πληρωμή...
In the emergency department at Children's Medical Center in Dallas, pharmacists who specialize in emergency medicine review each medication to make sure it's the right one in the right dose.
It's part of the hospital's efforts to cut down on medication errors and dangerous drug interactions, which contribute to more than 7,000 deaths across the country each year.
Juan Pulido/Courtesy of Children's Medical Center
Medication errors can be caused by something as simple as bad handwriting, confusion between drugs with similar names, poor packaging design or confusion between metric or other dosing units, according to the Food and Drug Administration. But they're often due to a combination of factors, which makes them harder to prevent.
At Children's in Dallas, there are 10 full-time emergency pharmacists, more than anywhere else in the country, and they are on call 24 hours a day. The pharmacists provide a vital safety net, according to Dr. Rustin Morse, chief quality officer and a pediatric ER physician.
"Every single order I put in," Morse says, "is reviewed in real time by a pharmacist in the emergency department prior to dispensing and administering the medication."
That may sound obvious, but Morse says doctors like him, are used to jotting down a type and quantity of drugs and moving on. If there's a problem, a pharmacist will hopefully catch it and get in touch later. But later won't work in the emergency room.
The extra review is particularly important at Children's because medication errors are three times more likely to occur with children than with adults. That's because kids are not "just little adults," says Dr. Brenda Darling, the clinical pharmacy manager for Children's Medical Center.
"They have completely different metabolic rates that you have to look at," Darling says, "so you have to know your patients."
On any given week, pharmacists at Children's review nearly 20,000 prescriptions and medication orders, looking at things like the child's weight, allergies, medications and health insurance.
There are also automatic reviews by an electronic medical record system designed to essentially "spell check" orders to prevent errors. You need both, says Dr. James Svenson, associate professor of emergency medicine at the University of Wisconsin, because the electronic medical record doesn't catch all errors.
Svenson co-authored a study in the Annals of Emergency Medicine that found that even with an electronic medical record, 25 percent of children's prescriptions had errors, as did 10 percent of adults'. Now his hospital also has a pharmacist in the emergency department 24 hours a day.
So why doesn't every hospital do this? The main reason, Svenson says, is money.
"If you're in a small ER, it's hard enough just to have adequate staffing for your patients in terms of nursing and techs, let alone to have a pharmacist sitting down. If the volume isn't there, it's hard to justify."
Hiring pharmacists is expensive, but Morse points to research showing prescription reviewcan reduce the number of hospital readmissions, thereby saving money and lives.
"People do make mistakes," Morse says, and you need to make sure "a patient doesn't get a drug that could potentially stop them breathing because it's the wrong dose."
The city of Chicago has filed a sweeping lawsuit against five major drug companies, alleging they have directly contributed to the country’s epidemic of prescription drug abuse by deceptively marketing their products. Chicago is now seeking damages for the cost of providing its residents with prescriptions for highly addictive medications.
According to the suit, the city has paid nearly $9.5 million in claims for opioid prescriptions since 2007. Chicago officials allege that most of those prescriptions were medically unnecessary, as well as largely harmful to public health, because the drugs are very addictive and prone to abuse. They accuse pharmaceutical companies of deceiving the city about the reality of their products through misleading marketing that’s “unsupported by science.”
“For years, Big Pharma has deceived the public about the true risks and benefits of highly potent and highly addictive painkillers in order to expand their customer base and increase their bottom line,” Mayor Rahm Emanuel said in a statement this week announcing the lawsuit. “Today, we’re saying enough is enough — it’s time for these companies to end these irresponsible practices and be held accountable for their deceptive actions.”
Indeed, prescription drug abuse has risen to record levels over the past decade, and now kills about 50 Americans every day. More women now die from painkiller overdoses every year than from car crashes and cervical cancer. And those soaring death rates have corresponded with a 300 percent rise in the sale of opioid drugs like OxyContin and Vicodin in the years since 1999.
Although these FDA-approved medications used to be almost solely used to treat pain in cancer patients, it’s become increasingly common for opioids to be prescribed for common ailments like back pain. Chicago’s lawsuit claims that pharmaceutical companies have helped guide public perception toward the assumption that it’s safe and necessary to use these drugs for that purpose — driving prescription drug abuse to epidemic levels.
“Although the drug manufacturers themselves don’t write prescriptions to patients, their deceptive marketing has caused doctors to more frequently prescribe their drugs, boosting sales and profits at the expense of patients and the City of Chicago,” city spokesperson Shannon Breymaierexplained to VICE News.
Big Pharma companies are often accused of wielding outsized influence on the health industry by paying doctors to promote their products, helping to boost prescriptions unnecessarily with an eye on their profits. This September, thanks to a provision in Obamacare, data on the financial compensation that physicians receive from Big Pharma will become publicly available in a searchable database.
Chicago’s lawsuit is very similar to a suit that was filed by two California counties last week, which is attempting to hold the same five drug makers accountable for their deceptive marketing practices. TheAssociated Press reports that the same law firm, Cohen Milstein Sellers & Toll, is working on both cases.
Πέμπτη, 5 Ιουνίου 2014
Με βάση ποιο κριτήριο ρε Υπουργάρα?
52,14 η Τeva (γνωστή από τις εισηγήσεις Μόσιαλου)
69,02 το Τopamac..
Θέλει δε θέλει, ο ασθενής πρέπει να πληρώνει ανα κουτί στην καλύτερη 19€ διαφορά για μια πάθηση κρίσιμη και στην οποία κάθε μικρή αλλαγή απορρυθμίζει για πλάκα τον ασθενή..
Δυστυχώς, το 20% των Ελλήνων το εγκρίνει αυτό και το στηρίζει..