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Intro -- Preface -- Contents -- List of Figures -- List of Tables -- 1: Medicines Safety in the Globalized Context -- Medicines Safety -- Hospital Admissions and Adverse Drug Reactions -- Pharmacovigilance Systems -- Organization of Pharmacovigilance Activities -- Pharmacovigilance Methods -- Stimulated Reporting -- Active Surveillance -- Passive Surveillance -- Post-Marketing Surveillance and Spontaneous Reporting -- Pharmacovigilance in the Developed World -- Pharmacovigilance System of Australia -- Pharmacovigilance System of Canada -- Pharmacovigilance System of European and Nordic Countries -- Pharmacovigilance System of Japan -- Pharmacovigilance System of Singapore -- Pharmacovigilance System of New Zealand -- Pharmacovigilance System of the United Kingdom (UK) -- Pharmacovigilance System of the United States of America (USA) -- Pharmacovigilance in Low- and Middle-Income Countries (LMICs) -- Pharmacovigilance System in Pakistan: A Case Study -- Legal Basis for Pharmacovigilance in Pakistan -- Pharmacovigilance: The Reporting of Mixed Methods and Intervention Study in Pakistani Setting -- Directions and Recommendations to Improve Medicines Safety -- References -- 2: Managing the Pharmaceutical Supply Chain-To Sustainability and Beyond -- Introduction -- Medicines Supply-The Current Landscape -- Putting the Patient at the Centre of the PSC -- Medicines Availability -- Innovation in the Pharmaceutical Supply Chain -- Theoretical Innovations -- Technological Innovations -- Workforce Development -- Conclusions -- References -- 3: Generic Medicines and Biosimilars: Impact on Global Pharmaceutical Policy -- Background -- Clinical, Economic and Social Aspects -- Policies in Relation to Generic Medicines and Biosimilars -- Conclusions -- Important Links and Websites -- References -- 4: Global Access to Cancer Medicines -- Introduction.

Cover -- Title Page -- Copyright Page -- Dedication -- Contents -- Contributors -- Foreword -- Chapter 1 - Access to High Cost Medicines: An Overview -- Abbreviations -- 1.1 - Defining HCMs -- 1.2 - Value of HCMs -- 1.3 - Accessibility of HCMs -- 1.4 - Approaches for promoting access to HCMs -- 1.5 - Conclusion -- Note -- References -- Chapter 2 - Health Technology Assessment -- 2.1 - Introduction -- 2.2 - What is health technology assessment (hta)? -- 2.3 - Technologies -- 2.4 - Principles underpinning HTA processes -- 2.5 - Evidence-based decision-making for the subsidy of health technologies -- 2.5.1 - Criteria Used to Inform Subsidy Decisions -- 2.5.2 - Threshold for Value for Money -- 2.5.3 - Considering Multiple Criteria in Decision-making -- 2.6 - Who's involved? Stakeholders at the table -- 2.7 - Future directions in health technology assessment for high cost medicines -- 2.8 - Summary -- References -- Chapter 3 - High-Cost Medicines in England -- 3.1 - Introduction -- 3.2 - Background -- 3.2.1 - Policy in History -- 3.2.2 - National Arrangements -- 3.2.3 - NICE Guidance -- 3.2.4 - The Carter Review -- 3.3 - High-cost drugs -- 3.3.1 - Specialised Services -- 3.3.2 - Cancer Drugs Fund -- 3.3.3 - Hospital Medicines Optimisation -- 3.4 - The way ahead -- 3.5 - Conclusions -- References -- Further Reading -- Chapter 4 - Managed Entry Agreements and High Cost Medicines (European Perspective) -- 4.1 - Rationale for mea -- 4.2 - Definition and taxonomy of mea -- 4.3 - Diffusion of mea in europe -- 4.4 - Impact evaluation and future perspectives -- References -- Chapter 5 - Setting a Public Health Agenda to Support Access to High-Cost Medicines -- 5.1 - Introduction -- 5.2 - The emerging significance of the impact of high-cost medicines -- 5.3 - European cooperation -- 5.4 - G7 and G20 -- 5.5 - The un high-level panel on access to medicines

Foreword -- Preface -- Contents -- Chapter 1: Introduction -- 1.1 Pharmaceutical Policy and the Right to Health -- 1.2 Pharmaceutical Production and Supply -- 1.3 Access to Affordable Drugs -- 1.4 Conclusion -- References -- Part I: Low and Lower Middle Income Countries -- Chapter 2: Pharmaceutical Policy in the East African Community: Burundi, Kenya, Uganda, Rwanda, Tanzania -- 2.1 Background -- 2.1.1 Focus of This Chapter -- 2.1.2 Health System of the EAC (Health System and Health Indicators) -- 2.2 Pharmaceutical Situation of the EAC -- 2.3 EAC Medicines Policy, Legislative and Regulatory Environment -- 2.4 Conclusions: Summary and Way Forward -- References -- Chapter 3: Pharmaceutical Policy in Pakistan -- 3.1 Pakistan -- 3.1.1 Country Profile -- 3.2 Health System of Pakistan -- 3.2.1 Health System -- 3.2.2 Health Indicators -- 3.3 Pharmaceutical Situation of the Country -- 3.3.1 Pharmaceutical Industry and Key Statistics -- 3.4 Country's Regulatory Environment -- 3.4.1 Medicines Regulatory Authority -- 3.4.2 Quality Control -- 3.4.3 Pharmacovigilance -- 3.4.4 Counterfeit Medicines -- 3.5 Medicines Supply System -- 3.5.1 Procurement -- 3.5.2 Distribution -- 3.6 Medicines Financing -- 3.6.1 Medicines Expenditures in General -- 3.6.2 Medicines Pricing -- 3.6.3 Affordability -- 3.6.4 Generic Medicines -- 3.7 Medicines Use (Issues Impacting on Rationale Medicines Use in the Country) -- 3.7.1 Medicines Use in General (in Community Pharmacies, Dispensing Doctors and General Hospital Sector) -- 3.7.2 Essential Medicine List, Selection of Essential Medicines and Standard Treatment Guidelines -- 3.7.3 Prescribing Behaviour in General (Factors Affecting Prescribing Behaviour) -- 3.7.4 Medicines' Promotional Practices -- 3.7.5 The Role of Pharmacist in Community and Hospital Environments

Economic Evaluation of Pharmacy Services provides the latest on the trend to a more product-centered and service-centered practice, eschewing traditional economic evaluation techniques that focus on product-to-product comparisons in favor of evaluating processes that measure costs and health outcomes. Complete with examples focusing on best practices, including various study designs, types of pharmacy services, and types of outcomes being evaluated, the book emphasizes case studies and examples that help readers understand economic evaluation techniques. Many of these techniques are transferable across countries, especially where there are advanced and stable health systems in place. With the help of this practical guide, readers will gain a thorough understanding of the application of economic evaluation of pharmacy services

The book is an essential, comprehensive text onglobal drug pricing and covers a range of pharmaceutical pricing issues. It has twenty-two chapters in total;nineteenof which are case studieson an array of high, middle, and low income countries. The final three chaptersdiscussvalue-based pricing, innovation, prices and the pharmaceutical industry and the link betweenpharmaceutical policy and pricing. As the pharmaceutical market continues to expand, a number of pharmaceutical pricing strategies have been employed to control drug expenditures. The book explores this phenomenon further and willserve a valuable resource for policy makers, funders, social insurance institutions and drug companies. About the author Zaheer-Ud-Din Babar, PhD is the Head of Pharmacy Practice at the School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, New Zealand. A pharmacist by training and a PhD in pharmaceutical policy, Dr Babar is a recipient of the prestigious "Research Excellence Award" from the University of Auckland. His research program covers areas related to pharmaceutical policy and practice, encompassing access to and affordability of medicines, issues related to medicine pricing and pharmacoeconomics. Dr Babar has delivered invited lectures at Boston University School of Public Health, Harvard Medical School, the Austrian Health Institute and the Universities of Reading and Kingston. He has also acted as a consultant for the World Health Organization, Health Action International, the International Union against Tuberculosis and Lung Disease, the International Pharmaceutical Federation (FIP) and the Pharmaceutical Management Agency of New Zealand in the area of medicines pricing and policies. Dr Babar is the Editor in Chief of the Journal of Pharmaceutical Policy and Practice, www.joppp.org and can be reached at z.babar@auckland.ac.nz

The use of mobile phones, in this era of technology, is considered to be an innovative (Quick learning resource) learning method in the field of education. The way technological advancement is playing its role to boost up the effectiveness of different education-based activities around the globe is also worth considering. This study, therefore, aims to explore the impact of different Discussion Groups over academic performance of the students. The fundamental objectives of the study are to examine the trends of using WhatsApp discussion groups among students, and to analyze the impact of its usage on their academic performance. Population of the study is comprised of the students enrolled in different universities of Lahore. These universities are further divided into two strata i.e. Private-sector universities and Public-sector universities (1-public and 1-private). Students from these universities are then selected using convenience sampling on second level. Similarly, survey method has been used to collect the data from sample of 200 students i.e. 100students from each university both male and female i.e. 50/50 male and female from each university.

BACKGROUND: Prices of cancer medicines are a major contributor to the cost of treatment for cancer patients and the comparison of these cost needs to be assessed. OBJECTIVES: To assess the prices of cancer medicines for the three most common cancers ((breast, prostate and colorectal) in the private healthcare sector of South Africa. METHODS: The methodology was adapted from the World Health Organization (WHO)/ Health Action International (HAI) methodology for measuring medicine prices. The Single Exit Price (SEP) variations between product types of the same medicine between the highest- and lowest-priced product and between Originator Brand (OB) and its Lowest Priced Generic (LPG) of the same medicine brand was compared, as of March 2020. The affordability of those medicines for cancer usage based on treatment affordability in relation to the daily wage of the unskilled Lowest-Paid Government Worker (LPGW) was also determined. Also, a comparison of the proportion of the population below the poverty line (PL) before (I(pre)) and after (I(post)) procurement of the cancer medicines was determined. RESULTS: SEP Price differences ranged from 25.46 to 97.33% between highest- and lowest-priced products and a price variation of 72.09% more for the OB than the LPG medicine, except for one LPG that was more expensive than the OB. Affordability calculations showed that All OB treatments for all three cancers (breast, prostate and colorectal), except for paclitaxel 300 mg (0.2 days wage) and Fluorouracil (Fluroblastin) 500 mg (0.3 days wage) costs respectively were more than 1 day's wage, with patients diagnosed with colorectal cancer needing 32.5 days wages in order to afford a standard course of treatment for a month. CONCLUSION: There was a considerable variation in the price of different brands of cancer medicines available in the South African private sector.

As the lockdowns are being observed all over the globe and the national level pharmacy professionals are performing frontline roles, this editorial highlights the role of pharmacists in the COVID − 19 pandemic. Pharmacists globally are providing services amidst pandemic, including TRIAGE services, seeing patients and reducing the patients' burden on health care facilities such as hospitals and GP practices. Pharmacists are also working to providing home deliveries, as well as dealing with the increasing number of patients coming through to pharmacies with the other ailments. Pharmacy associations have issued their guidelines and in this editorial, several global examples of pharmacists' role in the COVID 19 are being discussed. Pakistan is used as a country case study in this editorial. The editorial also elaborates how pharmacists in the UK and Pakistan have teamed up together to compile 10-steps protection guidelines for the pharmacy teams in Pakistan in English and Urdu language. This 10-point guidance educates community pharmacies for safety and standard operation as the number of patients in the country continues to rise. These guidelines are endorsed by the government and private bodies. These can be adopted and adapted by any country; keeping in view their laws and regulations.

BACKGROUND: In China, some medicines had a supply problem. In 2015, to address this problem, the Chinese government issued a policy to raise the price cap for some shorted low-cost medicines (LCMs). The objective was to assess the effects on medicine prices and supply of medicines from a medicine pricing policy reform point of view. METHODS: This study was conducted in Shandong, an eastern province of China with a population of 99.4 million. We collected procurement data of all (n = 1494) LCM medicines available between April 2014 and February 2017 from the web-based Provincial Drug Centralized Bidding Procurement System. This study used the Drug Price index and the average price to reveal the price change of LCMs and used the interrupted time series to evaluate the effects of LCM policy on medicine supply by measuring the change of monthly procurement volume, the number of products, and the average delivery time of LCMs. RESULTS: After the policy implementation in October 2015, the quarterly average price of all LCM products, especially traditional Chinese medicines, showed a sudden growth trend. Then after two-quarter implementation of policy, the price recovered to the same trend before policy intervention, which is consistent with the trend of the Drug price index. There were 466 of LCM products available in October 2015. After the policy intervention, the number of products available increased by 109.87% (n = 978) in February 2017, at a growth rate of 6.44% per month (Value = 30.02, P < 0.001). Besides after the intervention in October 2015, the monthly procurement volumes of LCMs increased rapidly, on average, at a rate of 28.93% per month (Value = 474,000, P < 0.001) for all LCMs. The average delivery time of LCMs kept on decreasing from 33.37 days to 10.69 days at a reduced rate of 3.63% (Value = − 1.21, P < 0.001) per month before the policy, while no significant changes were noted. Also, average monthly delivery time was stable at 9 days after the intervention. CONCLUSIONS: The policy promoted ...

Objectives Standard drug use indicators have been developed by the World Health Organization/International Network for Rational Use of Drugs (WHO/INRUD). The purpose of this systematic review was to examine and report the current status of health facilities in different regions of the world in terms of drug use based on WHO/INRUD core drug use indicators. Design Systematic review of the literature following PRISMA guidelines. Methods The INRUD bibliography, WHO archives, Google Scholar, Medline, PubMed, SpringerLink, ScienceDirect and Management Sciences for Health (MSH) resource databases were searched between 1985 and 2015 for studies -containing 12 WHO/INRUD core drug use indicators. Secondary data sources were also searched. Results Four hundred and sixty three studies were retrieved and 398 were excluded as they did not provide relevant information or fulfill the selection criteria. Sixty articles met the criteria and were selected for final review. With respect to prescribing indicators, studies of "drug use" showed mixed patterns across geographic regions. Overall trends in "patient-care" and "facility-specific" indicators were similar across most of the World Bank regions. However, based on the Index of Rational Drug Use (IRDU) values, East Asia and the Pacific region demonstrated relatively better drug use practices compared with other regions. Conclusions This systematic review revealed that the drug use practices in all regions of the world are suboptimal. A regulated, multi-disciplinary, national body with adequate funding provided by governments throughout the world are a basic requirement for coordination of activities and services, to improve the rational use of drugs at a local level.

The out-of-pocket payments for prescription medications can impose a financial burden on patients from low- and middle- incomes and who suffer from chronic diseases. The present study aims at evaluating the affordability of cardiovascular disease (CVD) medication in Iran. This includes measuring affordability through World Health Organization/Health Action International (WHO/HAI) methodology. In this method, affordability is characterized as the number of days' wages of the lowest-paid unskilled government worker. The different medication therapy scenarios are defined in mono-and combination therapy approaches. This method adds on to WHO/HAI methodology to discover new approaches to affordability assessments. The results show the differences in the medicines affordability when different approaches are used in mono-and combination therapy between 6 main sub-therapeutic groups of CVD. It indicates the medicine affordability is not a static concept and it changes dynamically between CVD therapeutic subgroups when it used alone or in combination with other medicines regarding patients' characteristics and medical conditions. Hypertension and anti-arrhythmia therapeutic groups had the most non-affordability and hyperlipidemia had the most affordable medicines. Therefore, affordability can be considered as a dynamic concept, which not only affected by the medicine price but significantly affected by a patient's characteristics, the number of medical conditions, and insurance coverage.

Objectives: Due to the absence of necessary rules, poor coordination, and various challenges, the pharmacovigilance system of Pakistan is not optimally functional at all levels of the health system. The objective of the study was to assess the stakeholders' perceptions of the current ADR reporting system and to identify the pharmacovigilance policy issues and problems of effective coordination. Methodology: Stakeholders from a broad range of disciplines, academia, regulatory authorities, the pharmaceutical industry, international health organizations, as well as pharmacovigilance experts, and healthcare professionals were included in the study. A total of 25 stakeholders throughout Pakistan were interviewed during exploratory semi-structured interviews. The interviews were recorded digitally, transcribed, coded, compared, and grouped according to their similarity of themes. Participants provided insights into gaps, limitations, and challenges of Pakistan's current ADR reporting system, issues with proposed pharmacovigilance rules, and coordination difficulties. Results: The majority of the participants considered the ADR reporting system in Pakistan to be improving but in a nascent phase. The identified gaps, challenges, limitations of the system, and barriers to reporting were labeled as reasons for limited functioning. Almost all stakeholders were aware of the existence of draft pharmacovigilance rules; however, participants in the industry were familiar with the contents and context of draft pharmacovigilance rules. Bureaucratic red tape and lack of political will appeared to be the top reasons for delaying the approval of the pharmacovigilance rules. Wider consultation, advocacy, and awareness sessions of policymakers and HCPs were suggested for early approval of rules. Participants unanimously agreed that the approval of rules shall improve the quality of life and reduce the economic burden along with morbidity and mortality rates. The need for greater and collaborative coordination among the stakeholders ...

The world currently faces unprecedented health challenges as COVID-19 poses a huge threat to health systems, economies and societies as we know it. The events of the current COVID-19 pandemic have further emphasised existing issues within our health systems. There is no better time than now to come together in global solidarity to tackle these evolving threats of COVID-19 pandemic. The Commonwealth is an ideally placed network to tackle these global health challenges, with its wide-reaching networks of governmental, non-governmental and civil society organisations across all continents. Although the biennial Commonwealth Heads of Government Meeting (CHOGM) originally scheduled to take place in Kigali in Rwanda 22–27 June 2020 has been postponed in view of COVID-19, Commonwealth country discussions are continuing, centred on the CHOGM key theme of 'Delivering a Common Future: Connecting, Innovating, Transforming', and five subthemes of Information and Communications Technology (ICT) and Innovation; Trade; Environment; Governance and the Rule of Law; and Youth. The planned CHOGM and Commonwealth itself provides all members a timely platform to consider innovative ways to connect, innovate and transform healthcare to meet the needs of their populations. This commentary considers these five CHOGM subthemes and how member nations can be supported to achieve universal health coverage through optimising medicines use and outcomes, in the midst of a global pandemic in line with the global health agenda.

The world currently faces unprecedented health challenges as COVID-19 poses a huge threat to health systems, economies and societies as we know it. The events of the current COVID-19 pandemic have further emphasised existing issues within our health systems. There is no better time than now to come together in global solidarity to tackle these evolving threats of COVID-19 pandemic. The Commonwealth is an ideally placed network to tackle these global health challenges, with its wide-reaching networks of governmental, non-governmental and civil society organisations across all continents. Although the biennial Commonwealth Heads of Government Meeting (CHOGM) originally scheduled to take place in Kigali in Rwanda 22–27 June 2020 has been postponed in view of COVID-19, Commonwealth country discussions are continuing, centred on the CHOGM key theme of 'Delivering a Common Future: Connecting, Innovating, Transforming', and five subthemes of Information and Communications Technology (ICT) and Innovation; Trade; Environment; Governance and the Rule of Law; and Youth. The planned CHOGM and Commonwealth itself provides all members a timely platform to consider innovative ways to connect, innovate and transform healthcare to meet the needs of their populations. This commentary considers these five CHOGM subthemes and how member nations can be supported to achieve universal health coverage through optimising medicines use and outcomes, in the midst of a global pandemic in line with the global health agenda.