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A review essay on books by (1) Benjamin J. Cohen & Charles Lipson (Eds), Issues and Agents in International Political Economy: An International Organization Reader (Cambridge, MA: MIT Press, 1999); (2) Paul N. Doremus, William W. Keller, Louis W. Pauly, & Simon Reich, The Myth of the Global Corporation (Princeton, NJ: Princeton U Press, 1998); (3) Randall D. Germain (Ed), Globalization and Its Critics: Perspectives from Political Economy (Hampshire: Macmillan, 2000); (4) Charles Lipson & Benjamin J. Cohen (Eds), Theory and Structure in International Political Economy: An International Organization Reader (Cambridge, MA: MIT Press, 1999); (5) Kevin H. O'Rourke & Jeffrey G. Williamson, Globalization and History: The Evolution of a Nineteenth-Century Atlantic Economy (Cambridge, MA: MIT Press, 1999); & (6) Robert K. Schaeffer, Understanding Globalization: The Social Consequences of Political, Economic, and Environmental Change (Lanham, MD: Rowman & Littlefield, 1997). The contemporary revival of interest in the field of international political economy (IPE) has coincided with the apparently unprecedented restructuring of the world economy that tends to be labeled "globalization." The forces of change associated with globalization have been felt throughout state-societies to such an extent that they have become the focus for a large amount of research undertaken across the social sciences. The ability of IPE to become firmly established as a recognized field of inquiry in its own right is, therefore, undermined unless IPE scholars can make a distinctive contribution to our comprehension of globalization. With globalization representing such a critical juncture for the development of IPE, mainstream visions of IPE that draw narrowly on a combination of international relations & liberal economics do not seem capable of providing the foundations necessary for the consolidation of the field. This is most starkly revealed once we reflect on contributions made to our knowledge of the emerging global economy from across the social sciences & on critical visions for IPE that engage openly with interdisciplinary insights. Adapted from the source document.

In a previous commentary in INNOVATIONS in Pharmacy, the case was made that a major oversight in approving the establishment of medical marijuana programs through commercially and not-for-profit operated dispensaries is the failure to put in place standards for the monitoring and reporting of outcomes. It was pointed out that the evidence base is limited for the range of dosing options, administrative routes and conditions treated. The concern is that the ease that patients have in obtaining medical marijuana certification in many states means that a medical marijuana program is, in effect, little different from a recreational program. Dispensaries understandably focus on sales and returns to investors with scant attention given to tracking and reporting outcomes across the range of conditions and symptoms presented. While this no doubt appeals to investors in reducing administration costs, it makes it virtually impossible to deliver the appropriate and coordinated level of care that patients should expect if a medical marijuana dispensary is to meet it responsibilities in its duty of care. This places dispensaries at malpractice risk. Given this, this commentary focuses on the questions that legislators should ask in licensing medical marijuana dispensaries to ensure they meet a defensible duty of care to their patients.

In a previous commentary in INNOVATIONS in pharmacy, the question was raised as to the questions legislators should ask for the licensing of medical marijuana dispensaries. The case was made that if dispensaries accept they have a duty of care then they should be required to monitor patients over the course of their treatment with botanical cannabis, including hemp based product, to evaluate the response of patients to therapy. One option would be for individual dispensaries (or owners of multiple licenses and dispensary locations) to adopt a registry format and implement an on-line reporting system by registry staff and patients for the conditions being treated. Unfortunately, under present legislative rules for dispensaries there is no incentive for dispensaries to make the necessary investment. It is also unlikely that legislators would be prepared to mandate a registry requirement. The purpose of this commentary is to offer an alternative solution. Rather than dispensary specific registries, a state-wide low cost registry is proposed where dispensaries are required to log in and track patients with specific conditions. In the case of severe pain, a dispensary would log in patients presenting with this condition and the patient tracked over their course of treatment. A further advantage with a statewide registry is that if a patient visits a different dispensary they can still be tracked as they would be identified by their marijuana card number. The ability to track patients by condition, while still resident in a state, would not only minimize the issue of incomplete records, but would provide a comprehensive, research quality framework for evaluating claims for botanical cannabis. This could then provide feedback to legislators and establish a robust basis for rule making.

In a previous commentary in INNOVATIONS in pharmacy, the question was raised as to the questions legislators should ask for the licensing of medical marijuana dispensaries. The case was made that if dispensaries accept they have a duty of care then they should be required to monitor patients over the course of their treatment with botanical cannabis, including hemp based product, to evaluate the response of patients to therapy. One option would be for individual dispensaries (or owners of multiple licenses and dispensary locations) to adopt a registry format and implement an on-line reporting system by registry staff and patients for the conditions being treated. Unfortunately, under present legislative rules for dispensaries there is no incentive for dispensaries to make the necessary investment. It is also unlikely that legislators would be prepared to mandate a registry requirement. The purpose of this commentary is to offer an alternative solution. Rather than dispensary specific registries, a state-wide low cost registry is proposed where dispensaries are required to log in and track patients with specific conditions. In the case of severe pain, a dispensary would log in patients presenting with this condition and the patient tracked over their course of treatment. A further advantage with a statewide registry is that if a patient visits a different dispensary they can still be tracked as they would be identified by their marijuana card number. The ability to track patients by condition, while still resident in a state, would not only minimize the issue of incomplete records, but would provide a comprehensive, research quality framework for evaluating claims for botanical cannabis. This could then provide feedback to legislators and establish a robust basis for rule making. Article Type: Commentary

The acceptance by a large number of state governments of medical marijuana dispensaries and the regulatory framework to support their licensing has put to one side the issue of monitoring and reporting outcomes. This is a major oversight. It is an untenable situation given the limited evidence base for the clinical benefits and risks associated with dispensed botanical marijuana. The purpose of this commentary is to propose that, as a condition of licensing, marijuana dispensaries should be required to establish a registry to support ongoing monitoring of patient response associated with botanical cannabis formulations. Patients should be monitored over the course of their treatment to assess, in the case of severe non-cancer pain as an example, pain intensity and functional status by pain location. The dispensary, in meeting required audit standards, should be in a position to report on patient response over baseline to the provider who has recommended botanical cannabis. As well, registries should be in a position to report to state licensing agencies response to therapy by target patient groups. Establishing site-specific registries should go some way to meeting the present evidence deficit for botanical marijuana, reducing barriers to its acceptance by providers, patients and health agencies.

The European Network for Health Technology Assessment (EUnetHTA) guidelines for health economic evaluations represent a consolidated view of non-binding recommendations for assessments of the relative effectiveness of pharmaceuticals or other health technologies. EUnetHTA views itself as the scientific and technological backbone of the development of health technology assessment in the European Union and among its member states and other partners. Unfortunately, the standards for health technology assessment proposed by EUnetHTA do not meet the standards of normal science. They do not support credible claims for the clinical and comparative cost-effectiveness of pharmaceuticals. In rejecting the standards of normal science the guidelines put to one side the opportunity not only to re-assess and replicate clinical and cost-effectiveness claims but to provide meaningful feedback on claims assessment to health care decision makers. The purpose of this review is to make the case that, in failing to support standards for experimentation, EUnetHTA is advocating its partners support the creation of modeled or simulated imaginary or false worlds. While EUnetHTA is not alone in recommending the construction of imaginary worlds to support formulary decisions, there is still the opportunity to revisit these recommendations and decide whether or not to encourage a scientifically rigorous approach to health technology assessments - to abandon a commitment to intelligent design in favor of natural selection. Conflict of Interest None Type:Commentary