Health Services Research and Practice: Pharmaceuticals

Andy Stergachis, Ph.D. R.Ph.

Epidemiology and Pharmacy

Topics

Medication Use

Variations in Drug-Related Services

Pharmacoepidemiology & Drug Safety

Rx Expenditures: selected countries

0

20

40

60

80

100

120

140

160

180$US Bil

Source: IMS HEALTH: MIDAS, 2001 * Pharmacy only ** Hospital only

Sale

sRx

$422 $417 $410$379

$352 $347 $341

$291

$0

$50

$100

$150

$200

$250

$300

$350

$400

$450

Rx Spending Per Capita

Source: OECD Health Data, 1999

Rx

Variations in Drug-Related Services

Pharmacies and pharmacists Financing Advertising and promotion OTCs and drug schedules Drug approval Complementary medicine

71% 11% 12% 4% 2%

6,2256,225

935935 1,0671,067328328 167167

PRECLINICALPHASE I PHASE IIPHASE III PRE-REG

Source: IMS Lifecycle CD ROM December 2001

2001 Global Pipeline

To December 2001 8,722 Products

New

Product

s

Sources of Risk from Medical Products

Pharmacoepidemiology as a Continuum

Surveillance/Signal Generation Adverse event reports

Verify/Confirm and Quantify Risk Case-control and cohort studies

Improved Patient Care and Regulatory Decision Making Risk-to-benefit

Issues

Affordability, access and equity How safe is safe enough? Variations in pharmacy practice Variations in regulatory agencies Drug reimportation concerns Patterns of use, e.g., antimicrobial

resistance

More Information

www.fip.org:

Humanitarian Organizations (for example):

Other Organizations (eg. pharmacoepi.org)

stergach@u.washington.edu