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    ABSTRACT: Objective The objective of this paper was to undertake a narrative review of the literature regarding strategies and interventions promoting the acceptance and uptake of generic medicines. Method A literature search was performed between November 2011 and January 2012 to identify published full text original research articles documenting interventions to promote the use of generic medicines. Keywords used were: “generic medicine”, “generic drug”, “intervention”, “promotion”, “acceptance”, “uptake”, “generic/therapeutic substitution” and their related root words. The electronic databases comprised of Embase (1980- present), Google, Google Scholar, Medline (1948- present), PubMed, Science Direct, Scopus, Springer Link and The Cochrane Library.An interpretative narrative synthesis was undertaken and emergent themes analysed and reported. Results Eighteen studies were included in the final analysis. There were seven main themes which including;education, financial incentives,advertising to promote generic medicines, free generic medicine trials, administrative forms and medicines use review (MUR). These themes were further classified into subthemes. Education was subdivided into consumer and physician education.Financial incentives included the influence of financial incentives on both consumers and physicians. The subthemes in the financial incentives category included the changes in co-payment for consumers,reward payment for physicians and fundholding schemes.Advertising included the sub-themes of print media and the use of anthropomorphic images, while free generic medicines trial was made up of free vouchers for generic medicines and generic medicines sampling system. Conclusions The studies have mixed results; some interventions in some settings were useful, while others were not. Not all interventions consistently improved the uptake of generic medicines. There was limited literature available and further work is required to develop a range of interventions to support the uptake of generic medicines within and across different countries.
    Full-text · Article · Sep 2014 · Health Policy
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    ABSTRACT: Objectives To identify priority medicines policy issues for New Zealand. Setting Stakeholders from a broad range of healthcare and policy institutions including primary, secondary and tertiary care. Participants Exploratory, semistructured interviews were conducted with 20 stakeholders throughout New Zealand. Primary and secondary outcome measures The interviews were digitally recorded, transcribed and coded into INVIVO 10, then compared and grouped for similarity of theme. Perceptions, experiences and opinions regarding New Zealand's medicines policy issues were recorded. Results A large proportion of stakeholders appeared to be unaware of New Zealand's (NZ) medicines policy. In general, the policy was considered to offer consistency to guide decision-making. In the context of Pharmaceutical Management Agency's (PHARMAC's) fixed budget for procuring and subsidising medicines, there was reasonable satisfaction with the range of medicines available—rare disorder medicines being the clear exception. Concerns raised were by whom and how decisions are made and whether desired health outcomes are being measured. Other concerns included inconsistencies in evidence and across health technologies. Despite attempts to improve the situation, lower socioeconomic groups (including rural residents) Māori and Pacific ethnicities and people with rare disorders face challenges with regards to accessing medicines. Other barriers include, convenience to and affordability of prescribers and the increase of prescription fees from NZ$3 to NZ$5. Concerns related to the PHARMAC of New Zealand included: a constraining budget; non-transparency of in-house analysis; lack of consistency in recommendations between the Pharmacology and Therapeutics Advisory Committee. Constraints and inefficiencies also exist in the submission process to access high-cost medicines. Conclusions The results suggest reasonable satisfaction with the availability of subsidised medicines. However, some of the major challenges include access to medicines in vulnerable groups, increasing costs and demand for new medicines, access to prescribers, budgetary constraints, cultural and health literacy, patient affordability and evidence requirement for gaining subsidy for medicines.
    Full-text · Article · May 2014 · BMJ Open
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    ABSTRACT: Bioadhesive liposomes and solid lipid particles (SLPs) modified by pectin and chitosan for oral administration of bovine lactoferrin (bLf) were prepared using a 2(4) full factorial design to identify the key formulation variables influencing particle size and drug encapsulation efficiency (EE). Net like structures of the polymer-particle mixture consisting of a polymeric network in which multiple particles were imbedded were observed by scanning electron microscopy (SEM). Chemical stability of bLf after encapsulation into pectin and chitosan modified liposomes and SLPs was confirmed by Fourier transform infrared spectra (FTIR). Bovine lactoferrin was located within phospholipids bilayer, whereas in SLPs bLf was within the matrix. The crystalline nature of bLf after encapsulation was investigated by differential scanning calorimetry (DSC) of drug-loaded particles, indicating amorphous dispersion of bLf in the polymer-lipid matrix of pectin and chitosan modified liposomes and SLPs. In vivo pharmacokinetic investigation of bLf in pectin and chitosan modified liposomes and SLPs showed prolong mean residence time (MRT) of bLf in rat blood and increased the relative bioavailability (Fbio %) by 1.95 to 2.69 fold compared with free bLf. The developed carrier systems are considered to be promising vehicles for oral delivery. This article is protected by copyright. All rights reserved.
    No preview · Article · Dec 2013 · Chemical Biology & Drug Design
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