{"title":"Ownership changes in the pharmaceutical industry: understanding the 2023 pharma mergers and acquisitions landscape of Europe.","authors":"Daniel Fabian, Claudia Wild","doi":"10.1080/20523211.2026.2659063","DOIUrl":"https://doi.org/10.1080/20523211.2026.2659063","url":null,"abstract":"<p><strong>Background: </strong>The pharmaceutical industry is experiencing significant transformations driven by mergers and acquisitions (M&A), leading to complex debates regarding their impact on innovation. This study examines the intricate relationship between M&A activities and innovation within the sector, analysing whether the traded firms have received public funding and revealing diverse scholarly perspectives on the balance of benefits and drawbacks.</p><p><strong>Methods: </strong>We conducted a targeted literature search for a narrative review using a combination of various terms in academic databases (PubMed), complemented by grey literature to find studies that analysed the impact of M&A on R&D. For the case study on the European pharmaceutical M&A landscape of 2023, we used the proprietary database Orbis to find such deals. We then combined information from company websites, investor news, governmental funding agencies, academic news, and academic publications to find public spending for the companies that were acquired in 2023 and used a category system we developed for public contributions.</p><p><strong>Results: </strong>Existing literature suggests that M&A in pharmaceuticals is primarily motivated by technological and geopolitical shifts. However, concerns about market concentration during the drug discovery-to-development pathway highlight potential regulatory challenges. Our analysis of 2023 M&A deals shows that four out of 29 firms traded originated from academic spin-outs, with almost all small and medium enterprises (SMEs) involved having received public funding at some point (18 out of 21).</p><p><strong>Conclusion: </strong>The lack of a comprehensive, publicly accessible register for such contributions complicates analysis. We advocate for mandatory reporting of all publicly funded projects to a single agency, enhancing transparency. The study concludes that while M&A activities can foster innovation, they also pose risks that must be carefully managed through informed policy and regulatory frameworks, particularly concerning publicly funded biotech firms and academic spin-outs.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2659063"},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fina Aryani, Dika P Destiani, Satibi Satibi, Budi Harsanto, Ivan S Pradipta
{"title":"Determinants, Models, performances, and strategies of supply chain to address medicine stockouts in primary health care: a scoping review.","authors":"Fina Aryani, Dika P Destiani, Satibi Satibi, Budi Harsanto, Ivan S Pradipta","doi":"10.1080/20523211.2026.2659077","DOIUrl":"https://doi.org/10.1080/20523211.2026.2659077","url":null,"abstract":"<p><strong>Background: </strong>Medicine stockouts (MSOs) remain a significant challenge to delivering quality health services in primary care, primarily due to inefficiencies in Medicine Supply Chain Management (MSCM). This study reviewed existing MSCM models and key factors to develop strategies for strengthening their implementation in primary care settings.</p><p><strong>Methods: </strong>A scoping review was conducted, including original studies published in the PubMed, Scopus, and EBSCO databases between January 2010 and January 2025. The included studies assessed pharmaceutical supply chain models or interventions addressing MSO in primary health care. Studies focused on industry supply chains, wholesalers, vaccines, or reviews were excluded. The Antecedent, Decision, and Outcome (ADO) method was used to lead a systematic scoping review. Antecedents were defined as factors associated with MSCM, decisions referred to the MSCM models, and outcomes represented their performance. Data were thematically analysed using the Pharmaceutical Management Framework, and the reported study followed PRISMA-ScR guidelines.</p><p><strong>Results: </strong>Out of 307 identified articles, 28 met the inclusion criteria. Some countries adopted digital solutions, such as stock tracking tools and Geographic Information Systems. At the same time, those with limited infrastructure focused on strengthening governance and supervision, such as through the Supervision, Performance Assessment, and Recognition Strategy. Contributing factors to MSOs include weaknesses in medicine management, inadequate managerial support, policy gaps, and external disruptions to the supply chain.</p><p><strong>Conclusion: </strong>Successful models for MSOs integrate key factors such as digital technology, strengthened human resource capacity, and supportive governance structures. Future strategies should prioritise systems that are adaptable, data-driven, and backed by strong government commitment.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2659077"},"PeriodicalIF":2.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaime Espín, Santiago Palacio-Ciro, Ana Amaris, Pamela Gongora-Salazar, Veronika J Wirtz
{"title":"Developing a framework to assess off-patent medicines policies in Latin America and the Caribbean.","authors":"Jaime Espín, Santiago Palacio-Ciro, Ana Amaris, Pamela Gongora-Salazar, Veronika J Wirtz","doi":"10.1080/20523211.2026.2651399","DOIUrl":"https://doi.org/10.1080/20523211.2026.2651399","url":null,"abstract":"<p><strong>Background: </strong>Countries in Latin America and the Caribbean (LAC) often lack a systematic approach to assessing the maturity and effectiveness of their policies for promoting off-patent (generic and biosimilar) medicines. Currently, no comprehensive, region-specific methodology exists that encompasses both generics and biosimilars. The objective of this paper is to develop a framework for assessing the performance of off-patent medicines policies that LAC countries can use to identify opportunities to improve access to these medicines in their territories.</p><p><strong>Methods: </strong>Through a scoping review of over 300 studies, this study identifies key supply- and demand-side policy interventions to promote generics and biosimilars, along with corresponding outcome indicators. This informs a logic-model-based framework, where supply-side policies are organized according to the pharmaceutical value chain, and demand-side policies are based on the target population.</p><p><strong>Results: </strong>The framework maps key policy actions, such as regulation, pricing, and substitution, to expected outcomes, such as affordability, uptake, and trust. The review highlights major regional gaps, including insufficient biosimilar policies, limited empirical evaluations, and the unique duality between public and private healthcare sectors in LAC. The existing literature gives greater attention to demand-side policies as potential factors driving higher market participation in generic and biosimilar medicines. Within this component, the emphasis is on factors aimed at education and awareness initiatives for users (41.6%). Supply-side policies are discussed less frequently, with price regulation (28.9%) most cited. By contrast, limited attention is given to other key factors such as horizon scanning, and mark-up regulation.</p><p><strong>Conclusion: </strong>The proposed framework serves as a diagnostic, analytical, and benchmarking instrument for policymakers and academia. It facilitates structured assessment, supports policy design, and fosters regional learning. Piloting and further empirical research are recommended to refine and validate the framework using a specific tool designed for this purpose.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2651399"},"PeriodicalIF":2.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shahad H Alhefel, Binny Thomas, Mohamed Sherbash, Sara Hayder, Mohamed Izham Ibrahim, Rajvir Singh, Ahmad H Alhefel, Salam Abou Safrah, Ahmed Karawia, Ameena Alyazeedi
{"title":"The prevalence and predictor factors of urinary tract infection in type 2 diabetes mellitus patients receiving SGLT2 inhibitors in Qatar: A retrospective cohort study.","authors":"Shahad H Alhefel, Binny Thomas, Mohamed Sherbash, Sara Hayder, Mohamed Izham Ibrahim, Rajvir Singh, Ahmad H Alhefel, Salam Abou Safrah, Ahmed Karawia, Ameena Alyazeedi","doi":"10.1080/20523211.2026.2645913","DOIUrl":"https://doi.org/10.1080/20523211.2026.2645913","url":null,"abstract":"<p><p><b>Background and aims:</b> Urinary Tract Infections (UTIs) are common in Type 2 Diabetes Mellitus (T2DM) patients. While Sodium-Glucose Co-Transporter 2 (SGLT2) inhibitors improve T2DM treatment by lowering blood glucose, they may increase UTI risk. Research findings on this association are mixed. This study aims to determine UTI prevalence and identify risk factors in elderly T2DM patients using SGLT2 inhibitors, to enhance treatment strategies and patient safety.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at two hospitals to evaluate UTI prevalence and predictors in elderly T2DM patients treated with SGLT2 inhibitors. Data from electronic health records over one year were analysed. Patients aged 60 + with a UTI diagnosis within 90 days of starting SGLT2 inhibitors were included. The primary outcome was UTI prevalence; secondary outcomes included factors like age, gender, comorbidities, HbA1c levels, and kidney function.</p><p><strong>Results: </strong>In a cohort of 1,024 elderly T2DM patients, 49% experienced UTIs. Significant predictors included gender, nationality, and age. Females had a higher UTI prevalence (68% vs. 32%, <i>p</i> < 0.001), and Qatari patients had a higher UTI prevalence compared with non-Qatari patients (63% vs. 37%, <i>p</i> = 0.03). Older age was associated with higher UTI risk (<i>p</i> < 0.001). There were no significant associations with HbA1c levels, creatinine levels, or medication duration. Logistic regression confirmed females and older age as significant UTI predictors. These findings highlight demographic factors' importance in UTI risk among T2DM patients on SGLT2 inhibitors.</p><p><strong>Conclusion: </strong>The study identified varying risks of urinary tract infections (UTIs) among users of SGLT2 inhibitors, influenced by factors like gender, age, and existing health conditions. This underscores the need for cautious prescribing of SGLT2 inhibitors, emphasising personalised risk assessment and careful evaluation of benefits versus risks. Future research should focus on refining UTI risk prediction and developing targeted interventions for this patient population.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2645913"},"PeriodicalIF":2.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Farha Sayyeda, Irfhan Ali Hyder Ali, Sabariah Noor Harun, Mei Lan Tan
{"title":"Asthma and chronic obstructive disease overlap (ACO), a systematic review of prevalence and co-morbidity factors based on diagnostic criteria.","authors":"Farha Sayyeda, Irfhan Ali Hyder Ali, Sabariah Noor Harun, Mei Lan Tan","doi":"10.1080/20523211.2026.2654490","DOIUrl":"https://doi.org/10.1080/20523211.2026.2654490","url":null,"abstract":"<p><strong>Background: </strong>Asthma and chronic obstructive pulmonary disease (COPD) overlap (ACO) is a complex pathological condition involving features of both asthma and COPD. While the individual diagnoses of asthma and COPD are well defined, there is no consensus on the definition or diagnostic criteria for ACO. This lack of standardisation contributes to inconsistencies in data interpretation and reported prevalence. In this study, we aimed to systematically review the differences in diagnostic criteria and prevalence of ACO across studies, to identify the co-morbidities, and provide insights into the clinical factors associated with ACO.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA guidelines. A total of 1,033 articles were identified from three electronic databases, of which 37 studies met the inclusion criteria and were included in the final analysis.</p><p><strong>Results: </strong>The reported prevalence of ACO varied widely depending on the study population and diagnostic criteria used. ACO prevalence ranged from 0.55% to 12.9% in the general population, 11.8% to 53.3% among asthma cohorts, 10.5% to 56.2% among COPD cohorts, 4.3% to 47.8% among combined asthma and COPD cohorts, and 3.2% to 18.4% among other respiratory or chronic airway disease cohorts. ACO was commonly associated with co-morbidities such as cardiovascular disease, gastroesophageal reflux disease, diabetes, and allergic rhinitis. Clinical factors linked to ACO included higher body mass index, smoking history, and reduced lung function (FEV1%).</p><p><strong>Conclusion: </strong>The wide variability in ACO prevalence reflects differences in diagnostic definitions and study populations. Patients with ACO experience increased morbidity, including higher rates of exacerbations, hospitalisations, and poorer quality of life, likely due to the presence of multiple co-morbidities. Standardised diagnostic criteria are essential to improve disease recognition and management.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2654490"},"PeriodicalIF":2.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annabelle Fowler, Anupama Tantri, Julia Spencer, Kathleen Grieve, Tanushree Pendharkar, Salome Da Silva Duarte Lepez, Tim Wilsdon
{"title":"Quantifying public and private investment in biopharmaceutical R&D: a study of seven middle- and high-income countries.","authors":"Annabelle Fowler, Anupama Tantri, Julia Spencer, Kathleen Grieve, Tanushree Pendharkar, Salome Da Silva Duarte Lepez, Tim Wilsdon","doi":"10.1080/20523211.2026.2643774","DOIUrl":"https://doi.org/10.1080/20523211.2026.2643774","url":null,"abstract":"<p><strong>Background: </strong>Fostering biopharmaceutical R&D has been a key element of industrial and innovation policy worldwide. Typically, this requires complementary investments from the public and private sectors. However, there is little empirical evidence on the extent of public and private biopharmaceutical R&D investment in countries outside of the US and Europe.</p><p><strong>Methods: </strong>We conducted a literature review to assess the biopharmaceutical R&D environment and related public policies in seven middle- and high-income countries outside of Europe and the US, selected for geographic diversity and data availability: Australia, Brazil, India, Japan, Singapore, South Africa, and South Korea (<i>n</i> = 7). We researched and reported levels and shares of public and private investment in biopharmaceutical R&D via an aggregation of granular, public data from the most recent pre-Covid year available for each country, which ranged from 2017 to 2020. We contrast these figures to those estimated from supranational data sources such as the OECD and WHO.</p><p><strong>Results: </strong>Aggregating across countries, the private sector accounted for 74% of biopharmaceutical R&D spending. Private sector spending within countries ranged from 35% to 92%, with a simple average of 58%. We contextualise differences between these estimates and those from supranational sources. Overall, the public and private sectors both have important roles in biopharmaceutical innovation across countries. The public sector often funds R&D in universities and basic science, with public funding for later stages of R&D, such as clinical trials, varying by country. There are differences in the extent to which countries invest in initiatives to bridge academia and the private sector.</p><p><strong>Conclusion: </strong>Aggregative biopharmaceutical R&D spending data may lead to different insights than data from supranational sources. Given the complementary nature of public and private R&D spending, countries wishing to encourage biopharmaceutical R&D should consider targeted public sector investment to spur an environment conducive to private investment. Since data are sparse and not always comparable across countries, there is a need for increased and consistent tracking of data on R&D spending. Further research is needed to connect country-specific data to policies that support R&D sector productivity.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2643774"},"PeriodicalIF":2.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Community pharmacy based point-of-care testing for early detection of undiagnosed type 2 diabetes mellitus: a study protocol.","authors":"Khaled Alshorman, Rabia Hussain","doi":"10.1080/20523211.2026.2654489","DOIUrl":"https://doi.org/10.1080/20523211.2026.2654489","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) remains substantially underdiagnosed worldwide, contributing to delayed treatment and increased risk of long-term complications. Community pharmacies are highly accessible healthcare settings and may play a critical role in early case detection through structured screening programs. This study protocol aims to evaluate the implementation of point-of-care testing (POCT) for diabetes screening in community pharmacies and its potential to identify undiagnosed T2DM among adult pharmacy visitors in Irbid Governorate, Jordan.</p><p><strong>Methods: </strong>This study will employ a two-phase design. In phase one, a cross-sectional screening will be conducted among adults without a prior diagnosis of diabetes visiting selected community pharmacies. Participants will be assessed using the Finnish Diabetes Risk Score (FINDRISC). Individuals classified as high or very high risk will proceed to phase two, which involves glycated haemoglobin (HbA1c) measurement using a National Glycohemoglobin Standardization Program (NGSP)-certified point-of-care analyzer. Participants with abnormal HbA1c results will be referred to general practitioners (GPs) for diagnostic confirmation. They will be followed for six months to assess referral outcomes, treatment initiation, and changes in glycemic control. Descriptive, inferential, and multivariate regression analyses will be conducted.</p><p><strong>Results: </strong>The study is expected to determine the proportion of individuals at high risk for T2DM and the prevalence of previously undiagnosed dysglycaemia detected through pharmacy-based POCT. It will also describe referral patterns, confirmation rates of T2DM diagnosis, treatment initiation, and glycaemic outcomes over a six-month follow-up period.</p><p><strong>Conclusion: </strong>Community pharmacy - based diabetes screening integrating FINDRISC assessment and POCT HbA1c testing has the potential to enhance early detection of undiagnosed T2DM and improve referral pathways within primary healthcare systems. Findings from this study may inform future large-scale implementation of pharmacist-led screening programs and contribute to national diabetes prevention strategies.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2654489"},"PeriodicalIF":2.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effectiveness and safety of ceftazidime/avibactam versus polymyxin B in liver transplant recipients with carbapenem-resistant organism infections: a real-world cohort study.","authors":"Weiwei Zhang, Chuanlin Chen, Desheng Li, Zhengdon Zhou, Bo Sheng, Yongfang Hu, Zhenyu Zhang","doi":"10.1080/20523211.2026.2641111","DOIUrl":"https://doi.org/10.1080/20523211.2026.2641111","url":null,"abstract":"<p><strong>Background: </strong>Treatment options for carbapenem-resistant organism (CRO) infections remain limited, with ceftazidime/avibactam (CAZ/AVI) and polymyxin B (PMB) being the main therapeutic choices. However, comparative evidence regarding the efficacy and safety of liver transplant (LT) recipients is scarce.</p><p><strong>Methods: </strong>This single-center retrospective cohort study was conducted in the liver intensive care unit of Beijing Tsinghua Changgung Hospital from January 2018 to December 2024. Adult LT recipients with CRO infections who received intravenous CAZ/AVI or PMB for > 48 h were included. Propensity score matching (PSM) was performed at a 1:1 ratio to balance baseline variables. Logistic regression analyses were used to evaluate microbial clearance, clinical success, and acute kidney injury (AKI). Cox proportional hazards models assessed the 90-day all-cause mortality and factors associated with survival outcomes.</p><p><strong>Results: </strong>Among the 106 LT recipients with postoperative CRO infections, 45 received CAZ/AVI (n = 23) or PMB (n = 22). After PSM, 22 patients were included in each group. The rates of microbial clearance (59.1% vs. 63.6%), clinical success (54.6% vs. 54.6%), and 90-day all-cause mortality (22.7% vs. 27.3%) were comparable between the CAZ/AVI and PMB (<i>p</i> > 0.05). However, AKI occurred significantly more frequently in the PMB group than in the CAZ/AVI group (81.8% vs. 50.0%, <i>p</i> = 0.026). Complete withdrawal of immunosuppressive therapy was independently associated with increased 90-day mortality (hazard ratio [HR] = 4.46, 95% CI 1.29-15.35, <i>p</i> = 0.018).</p><p><strong>Conclusion: </strong>CAZ/AVI and PMB achieved similar clinical effectiveness and survival outcomes in LT recipients with CRO infections; however, PMB carries a higher risk of nephrotoxicity. Discontinuation of immunosuppressive therapy during infection significantly affects patient survival. These findings highlight the importance of individualised antimicrobial selection, renal safety monitoring, and pharmacist-led stewardship in managing CRO infections in liver transplant patients.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2641111"},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing access to treatment and programmes for viral hepatitis in an endemic country: a narrative review of literature from 2000 to 2025 (Mongolia).","authors":"Gantuya Dorj, Undram Lkhagva, Gereltuya Dorj, Batsukh Badamnachin, Unenbat Gurbadam, Oidov Baatarkhuu, Javkhlan Jargalsaikhan, Baasandorj Erdenetsetseg, Amarjargal Choijoo","doi":"10.1080/20523211.2026.2650542","DOIUrl":"https://doi.org/10.1080/20523211.2026.2650542","url":null,"abstract":"<p><strong>Background: </strong>Mongolia continues to experience the world's highest incidence of hepatocellular carcinoma (HCC), driven by chronic hepatitis B (HBV) and hepatitis C (HCV) infections. In response, the Mongolian Government has implemented comprehensive public health interventions, including the national 'Healthy Liver Programme,' to reduce viral hepatitis transmission and liver-related morbidity. This narrative review aims to evaluate national strategies, progress, and ongoing challenges in HBV and HCV control.</p><p><strong>Methods: </strong>Policy documents from government agencies, WHO, and NGOs were reviewed, along with scientific publications retrieved from PubMed, and Embase using terms such as 'HBV,' 'HCV,' and 'treatment access.' Grey literature was also analysed. The review focused on (i) national strategies and action plans; (ii) programmatic interventions, vaccination, screening, and treatment scale-up; and (iii) reported trends in coverage, treatment uptake, and progress towards WHO 2030 elimination targets. Findings were synthesised by comparing policy commitments with implementation outcomes and triangulating evidence across multiple sources.</p><p><strong>Results: </strong>Forty-four peer-reviewed articles and 12 policy documents were included. Mongolia has achieved >95% infant HBV vaccination and 93.9% hepatitis A coverage, reducing HBsAg prevalence among children under five to 0.3% by 2023. Among adults, HBsAg prevalence declined from 6.9% in 2015 to 5.5% in 2023, while HCV prevalence decreased from 6.7% to 3.7%. More than 120,000 HCV infections have been diagnosed, with over half treated through national initiatives; by 2023, 4,700 HBV and 66,959 HCV patients had initiated therapy. Liver cancer incidence decreased from 39.1% in 2016 to 32.7% in 2021, and annual HCC cases fell from 857 in 2015 to 567 in 2022.</p><p><strong>Discussion: </strong>Mongolia aims to reduce viral hepatitis prevalence by 90% and liver-related mortality by 85% in the coming decade.</p><p><strong>Conclusion: </strong>While substantial progress has been made, strengthened health system capacity and improved monitoring mechanisms are essential to close remaining gaps and accelerate progress towards hepatitis elimination.</p><p><strong>Summary: </strong><b>Policy implementation:</b> Mongolia implemented several key policies, including the Targeted Prevention and Control Program to Eradicate Viral Hepatitis (1988-2000), mandatory HBV vaccination, and the Healthy Liver programmes (2016-2020 and 2022-2025).<b>Vaccination programmes:</b> Mongolia was among the first to introduce hepatitis B vaccination for newborns in 1991 and added a pentavalent vaccine in 2005. The HAV vaccine was introduced in 2012, with high coverage rates for children under one year.<b>Healthy liver programme:</b> This programme improved access to diagnostic and treatment options for viral hepatitis, including introducing antiviral medicines and reimbursement for antiviral the","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2650542"},"PeriodicalIF":2.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of PharmaTE trial on glycemic control, diabetes knowledge, medication adherence, and quality of life in type 2 diabetes patients: a mixed-methods study protocol.","authors":"Nour Aymn Ahmad, Rabia Hussain","doi":"10.1080/20523211.2026.2645906","DOIUrl":"https://doi.org/10.1080/20523211.2026.2645906","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is a significant public health issue that requires lifelong management. Effective management requires a comprehensive approach integrating technology and clinical pharmacists into the healthcare team to improve glycemic control, patient knowledge, medication adherence, and quality of life. This study aims to evaluate the impact of a clinical pharmacist-led tele-educational intervention (PharmaTE trial) on glycemic control and patients' outcomes among patients with type 2 diabetes at a secondary care hospital in Ras Al Khaimah, United Arab Emirates (UAE).</p><p><strong>Methods: </strong>A mixed-methods embedded design will be employed, consisting of a randomised controlled trial (RCT) as the quantitative phase and a prospective descriptive qualitative study, a total of 154 adult patients diagnosed with uncontrolled type 2 diabetes, will be recruited and randomly assigned to either the (PharmaTE trial) intervention group (IG), which will receive five tele-education sessions led by a clinical pharmacist, or a control group (CG) receiving standard care. The primary outcome will be improved glycemic control, specifically achieving a target HbA1c level < 6.5% for individuals aged 18-65. Secondary outcomes will include improved diabetes knowledge, medication adherence, and quality of life, assessed using a validated Arabic version of the questionnaires: the Michigan Diabetes Knowledge Tool (MDKT), Morisky Medication Adherence Scale (MMAS), and Diabetes Quality of Life (DQOL). Moreover, the glycemic control will be evaluated by measuring HbA1c levels.</p><p><strong>Discussion: </strong>Compared to the control group, participants with uncontrolled glycemic levels are anticipated to show improvements in glycemic control, disease knowledge, medication adherence, and quality of life upon completion of the PharmaTE trial. These expected outcomes highlight the importance of adopting innovative, technology-based strategies and integrating clinical pharmacists into multidisciplinary care teams to enhance diabetes management. The PharmaTE intervention may offer an effective model for improving patient engagement, optimising treatment adherence, and ultimately advancing overall diabetes care and outcomes among patients with type 2 diabetes. The study protocol was registered as a clinical trial on ClinicalTrials.gov with the identifier NCT07043816 on June 20, 2025, and it was registered prospectively.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT07043816.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2645906"},"PeriodicalIF":2.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}