[e-drug] Dec 2012 Issue of Southern Med Review

e-drug
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E-DRUG: Dec 2012 Issue of Southern Med Review
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December 2012 issue of the Southern Med Review was released few days ago and the complete journal file and individual articles are accessible from the journal's website:

http://southernmedreview.org/new/

Here are the highlights:

Editorial

Ethnicity, Migration and Minority Groups: Medicines Access and Use in High-Income Economies. Southern Med Review (2012) 5; 2:1-2
http://southernmedreview.org/new/?p=495

Commentary
Improving Access to Medicines in Low and Middle Income Countries: Corporate Responsibilities in Context. Southern Med Review (2012) 5; 2:3-8
http://southernmedreview.org/new/?p=497

Research Articles
Mexican Pharmacies and Antibiotic Consumption at the US-Mexico Border. Southern Med Review (2012) 5;2:9-19
http://southernmedreview.org/new/?p=500

Asthma Self-Management: A Study in an Emergency Room of a Chest Hospital in Delhi, India. Southern Med Review (2012) 5; 2:20-25
http://southernmedreview.org/new/?p=504

A Cross Sectional Study of Public Knowledge and Attitude towards Antibiotics in Putrajaya, Malaysia. Southern Med Review (2012) 5;2:26-33
http://southernmedreview.org/new/?p=507

Impact of External Price Referencing on Medicine Prices – a Price Comparison among 14 European countries. Southern Med Review (2012) 5;2:34-41
http://southernmedreview.org/new/?p=511

Barriers and Facilitators to Adoption of a Web-based Antibiotic Decision Support System. Southern Med Review (2012) 5; 2:42-50
http://southernmedreview.org/new/?p=514

Letter to the Editor

The Importance of Medicines Safety. Southern Med Review (2012) 5;2:51-52
http://southernmedreview.org/new/?p=517

Kind Regards

Zaheer
---
Zaheer-Ud-Din Babar, PhD
Senior Lecturer & Head of Pharmacy Practice
School of Pharmacy
Faculty of Medical & Health Sciences
The University of Auckland
Private Mail Bag 92019, Auckland
New Zealand
Ph: +64 9 3737599 Ext 88436
Fax: +64 9 3677192
z.babar@auckland.ac.nz<mailto:z.babar@auckland.ac.nz>

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E-DRUG: Medical supply chains - Learning from Coca Cola
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[Please don't be put off by the title - Atieno has some points to make about how to think of addressing supply chain issues for medicines. However, I must admit to some exasperation and scepticism with all the free publicity that this soft drink manufacturer is getting. I experienced many occasions of shortage of their products at times of high demand while living in Africa, even in the city never mind rural areas - inadequate production capacity, lack of plastic/glass for packaging, limited transport capacity, fuel shortages, etc. Some of these issues were not 'the supply chain' but the financing and other external (political) factors but these same issues affect public sector distribution currently and need to be solved for any logistics solution to work. DB]

Dear E-druggers.

First of all, Wishing you all a great new year 2013. May your expectations be fulfilled.

Most likely, over this festive season, you had access to a Coca Cola product wherever you were. The success of the Coca Cola distribution network has often been cited. If Coke can be found in every village, why not essential medicines?

One of the Stanford Social Innovation Review articles 2012 compares Coca Cola Supply chain with that for medical products. The article does not address the inherent differences between Coca Cola products and medicines. Apologies that the article requires subscription and I am unable to share my access.

http://www.ssireview.org/articles/entry/learning_from_coca_cola

More than 3,500 years ago, Egyptians treated wounds with honey, resins and metals known to be antimicrobial. They also had laxatives such as bran, figs, and castor oil. Celery was used for management of rheumatism. Presumably, these were freely available near the patient and did not require an elaborate supply chain.

The year is 2013. Can the pharmaceutical fraternity start to look at the inherent unique features of medicines that make it challenging to replicate the Coca Cola model or simply simplify medicine distribution and access? Are there innovative ways of eliminating or mitigating against these challenges?

I have here below three major challenges. Perhaps you have more?

1. Medicines are POISONS. It is the information that accompanies the medicine that allows for its safe use. There are adverse events even within the "safe use" limits. The risks associated with inappropriate use of medicines currently warrant a high regulatory and quality control system. Can the industry make all medicines with a very wide therapeutic index and therefore very low safety risk? Any way to ease up on the regulation and QC?

2. Medicines are about the only product where the consumer has very little knowledge and virtually no capability to make a choice. The information asymmetry is explained by the uniqueness of each medicine or group of medicines as well as its use in relation to a specific disease condition (The same medicine can have more than one use). Currently, the medicines used by a consumer are chosen for them by a healthcare provider, even for Over-The-Counter Medicines. What can we do about this?

3. Medicines are not homogeneous in their supply chain requirements - They all differ in terms of Time (expiry date), temperature and humidity requirements. We may have lessons to learn here from the food industry?? Can we make ALL medicines with standardized Time, temperature and humidity requirements?

I challenge us to all not just think outside the box, but to actually throw out the box and think innovatively.

Dr Atieno Ojoo (Ms)
Technical Specialist, Pharmaceuticals
Medicines and Nutrition Center
Unicef Supply Division
2100 Copenhagen
Denmark
Tel; +45 35 27 31 03
Fax: +45 35 26 94 21
http//www.unicef.org/supply