Australia and New Zealand health policy最新文献

{"title":"Assessing outcomes of health and medical research: do we measure what counts or count what we can measure?","authors":"Robert Wells,&nbsp;Judith A Whitworth","doi":"10.1186/1743-8462-4-14","DOIUrl":"https://doi.org/10.1186/1743-8462-4-14","url":null,"abstract":"<p><p>Governments world wide are increasingly demanding outcome measures to evaluate research investment. Health and medical research outputs can be considered as gains in knowledge, wealth and health. Measurement of the impacts of research on health are difficult, particularly within the time frames of granting bodies. Thus evaluations often measure what can be measured, rather than what should be measured. Traditional academic metrics are insufficient to demonstrate societal benefit from public investment in health research. New approaches that consider all the benefits of research are needed.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2007-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26802622","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":"Operationalising a model framework for consumer and community participation in health and medical research.","authors":"Carla Saunders,&nbsp;Sally Crossing,&nbsp;Afaf Girgis,&nbsp;Phyllis Butow,&nbsp;Andrew Penman","doi":"10.1186/1743-8462-4-13","DOIUrl":"https://doi.org/10.1186/1743-8462-4-13","url":null,"abstract":"<p><p>The Consumers' Health Forum of Australia and the National Health and Medical Research Council has recently developed a Model Framework for Consumer and Community Participation in Health and Medical Research in order to better align health and medical research with community need, and improve the impact of research. Model frameworks may have little impact on what goes on in practice unless relevant organisations actively make use of them. Philanthropic and government bodies have reported involving consumers in more meaningful or collaborative ways of late. This paper describes how a large charity organisation, which funds a significant proportion of Australian cancer research, operationalised the model framework using a unique approach demonstrating that it is both possible and reasonable for research to be considerate of public values.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2007-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26797132","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":"Targeting services to reduce social inequalities in utilisation: an analysis of breast cancer screening in New South Wales.","authors":"Stephen Birch,&nbsp;Marion Haas,&nbsp;Elizabeth Savage,&nbsp;Kees Van Gool","doi":"10.1186/1743-8462-4-12","DOIUrl":"https://doi.org/10.1186/1743-8462-4-12","url":null,"abstract":"<p><strong>Background: </strong>Many jurisdictions have used public funding of health care to reduce or remove price at the point of delivery of services. Whilst this reduces an important barrier to accessing care, it does nothing to discriminate between groups considered to have greater or fewer needs. In this paper, we consider whether active targeted recruitment, in addition to offering a 'free' service, is associated with a reduction in social inequalities in self-reported utilization of the breast screening services in NSW, Australia.</p><p><strong>Methods: </strong>Using the 1997 and 1998 NSW Health Surveys we estimated probit models on the probability of having had a screening mammogram in the last two years for all women aged 40-79. The models examined the relative importance of socio-economic and geographic factors in predicting screening behaviour in three different needs groups - where needs were defined on the basis of a woman's age.</p><p><strong>Results: </strong>We find that women in higher socio-economic groups are more likely to have been screened than those in lower groups for all age groups. However, the socio-economic effect is significantly less among women who were in the actively targeted age group.</p><p><strong>Conclusion: </strong>This indicates that recruitment and follow-up was associated with a modest reduction in social inequalities in utilisation although significant income differences remain.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2007-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26760813","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":"'Linkage' pharmaceutical evergreening in Canada and Australia.","authors":"Thomas A Faunce,&nbsp;Joel Lexchin","doi":"10.1186/1743-8462-4-8","DOIUrl":"https://doi.org/10.1186/1743-8462-4-8","url":null,"abstract":"<p><p>'Evergreening' is not a formal concept of patent law. It is best understood as a social idea used to refer to the myriad ways in which pharmaceutical patent owners utilise the law and related regulatory processes to extend their high rent-earning intellectual monopoly privileges, particularly over highly profitable (either in total sales volume or price per unit) 'blockbuster' drugs. Thus, while the courts are an instrument frequently used by pharmaceutical brand name manufacturers to prolong their patent royalties, 'evergreening' is rarely mentioned explicitly by judges in patent protection cases. The term usually refers to threats made to competitors about a brand-name manufacturer's tactical use of pharmaceutical patents (including over uses, delivery systems and even packaging), not to extension of any particular patent over an active product ingredient. This article focuses in particular on the 'evergreening' potential of so-called 'linkage' provisions, imposed on the regulatory (safety, quality and efficacy) approval systems for generic pharmaceuticals of Canada and Australia, by specific articles in trade agreements with the US. These 'linkage' provisions have also recently appeared in the Korea-US Free Trade Agreement (KORUSFTA). They require such drug regulators to facilitate notification of, or even prevent, any potential patent infringement by a generic pharmaceutical manufacturer. This article explores the regulatory lessons to be learnt from Canada's and Australia's shared experience in terms of minimizing potential adverse impacts of such 'linkage evergreening' provisions on drug costs and thereby potentially on citizen's access to affordable, essential medicines.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26754817","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":"Generic drug policy in Australia: a community pharmacy perspective.","authors":"Grahame Beecroft","doi":"10.1186/1743-8462-4-7","DOIUrl":"https://doi.org/10.1186/1743-8462-4-7","url":null,"abstract":"<p><p>This article provides a commentary, from a community pharmacy perspective, on the policy environment for the pharmacy sector in Australia, with a particular focus on present challenges arising from proposals to achieve substantial PBS cost savings from an anticipated surge of new generic drugs. Some $2 billion of medicines currently on the PBS will come off patent in the next 4 years. This growth comes from a low base where generics currently account for only 15% of the total PBS budget. Remuneration for PBS dispensing is fixed through five year agreements with the government, so trading terms on generics are important for the cross-subsidy of other dispensing activities and professional services. These trading terms (discounts provided by generics suppliers) have become part of the overall cost and revenue structure of pharmacies. Despite these arrangements, generic substitution rates in Australia are lower than in most comparable countries, which the government views as an opportunity to promote generic use. The future of generic drug supply via the PBS is important to allow consumers access to medications at the lowest possible price and to provide space for PBS listing of new and expensive drugs. But considerations of PBS reform need to take account of the role and viability of community pharmacy sector as provider of pharmaceuticals in a timely and efficient manner to Australian residents.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26754816","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":"Challenges for Australia's Bio/Nanopharma Policies: trade deals, public goods and reference pricing in sustainable industrial renewal.","authors":"Thomas A Faunce","doi":"10.1186/1743-8462-4-9","DOIUrl":"10.1186/1743-8462-4-9","url":null,"abstract":"<p><p>Industrial renewal in the bio/nanopharma sector is important for the long term strength of the Australian economy and for the health of its citizens. A variety of factors, however, may have caused inadequate attention to focus on systematically promoting domestic generic and small biotechnology manufacturers in Australian health policy. Despite recent clarifications of 'springboarding' capacity in intellectual property legislation, federal government requirements for specific generic price reductions on market entry and the potential erosion of reference pricing through new F1 and F2 categories for the purposes of Pharmaceutical Benefits Scheme (PBS) assessments, do not appear to be coherently designed to sustainably position this industry sector in 'biologics,' nanotherapeutics and pharmacogenetics. There also appears to have been little attention paid in this context to policies fostering industry sustainability and public affordability (as encouraged by the National Medicines Policy). One notable example includes that failure to consider facilitating mutual exchanges on regulatory assessment of health technology safety and cost-effectiveness (including reference pricing) in the context of ongoing free trade negotiations between Australia and China (the latter soon to possess the world's largest generic pharmaceutical manufacturing capacity). The importance of a thriving Australian domestic generic pharmaceutical and bio/nano tech industry in terms of biosecurity, similarly appears to have been given insufficient policy attention.Reasons for such policy oversights may relate to increasing interrelationships between generic and 'brand-name' manufacturers and the scale of investment required for the Australian generics and bio/nano technology sector to be a significant driver of local production. It might also result from singularly effective lobbying pressure exerted by Medicines Australia, the 'brand-name' pharmaceutical industry association, utilising controversial interpretations of reward of pharmaceutical 'innovation' provisions in the Australia-US Free Trade Agreement (AUSFTA) through the policy-development mechanisms of the AUSFTA Medicines Working Group and most recently an Innovative Medicines Working Group with the Department of Health and Ageing. This paper critically analyses such arguments in the context of emerging challenges for sustainable industrial renewal in Australia's bio/nanopharma sector.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26754818","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":"The global biopharma industry and the rise of Indian drug multinationals: implications for Australian generics policy.","authors":"Hans Löfgren","doi":"10.1186/1743-8462-4-10","DOIUrl":"https://doi.org/10.1186/1743-8462-4-10","url":null,"abstract":"<p><p>This article provides a synopsis of the new dynamics of the global biopharma industry. The emergence of global generics companies with capabilities approximating those of 'big pharma' has accelerated the blurring of boundaries between the innovator and generics sectors. Biotechnology-based products form a large and growing segment of prescription drug markets and regulatory pathways for biogenerics are imminent. Indian biopharma multinationals with large-scale efficient manufacturing plants and growing R&D capabilities are now major suppliers of Active Pharmaceutical Ingredients (APIs) and generic drugs across both developed and developing countries. In response to generic competition, innovator companies employ a range of life cycle management techniques, including the launch of 'authorised generics'. The generics segment in Australia will see high growth rates in coming years but the prospect for local manufacturing is bleak. The availability of cheap generics in international markets has put pressure on Pharmaceutical Benefits Scheme (PBS) pricing arrangements, and a new policy direction was announced in November 2006. Lower generics prices will have a negative impact on some incumbent suppliers but industrial renewal policies for the medicines industry in Australia are better focused on higher value R&D activities and niche manufacturing of sophisticated products.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26754819","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":"Reshaping Australian drug policy: the dilemmas of generic medicines policy.","authors":"Hans Löfgren","doi":"10.1186/1743-8462-4-11","DOIUrl":"https://doi.org/10.1186/1743-8462-4-11","url":null,"abstract":"","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26754820","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":"Towards enhancing national capacity for evidence informed policy and practice in falls management: a role for a \"Translation Task Group\"?","authors":"Roslyn G Poulos,&nbsp;Anthony B Zwi,&nbsp;Stephen R Lord","doi":"10.1186/1743-8462-4-6","DOIUrl":"https://doi.org/10.1186/1743-8462-4-6","url":null,"abstract":"<p><strong>Background: </strong>There has been a growing interest over recent years, both within Australia and overseas, in enhancing the translation of research into policy and practice. As one mechanism to improve the dissemination and uptake of falls research into policy and practice and to foster the development of policy-appropriate research, a \"Falls Translation Task Group\" was formed as part of an NHMRC Population Health Capacity Building grant. This paper reports on the group's first initiative to address issues around the research to policy and practice interface, and identifies a continuing role for such a group.</p><p><strong>Methods: </strong>A one day forum brought together falls researchers and decision-makers from across the nation to facilitate linkage and exchange. Observations of the day's proceedings were made by the authors. Participants were asked to complete a questionnaire at the commencement of the forum (to ascertain expectations) and at its completion (to evaluate the event). Observer notes and the questionnaire responses form the basis of analysis.</p><p><strong>Results: </strong>Both researchers and decision-makers have a desire to bridge the gap between research and policy and practice. Significant barriers to research uptake were highlighted and included both \"health system barriers\" (for example, a lack of financial and human resources) as well as \"evidence barriers\" (such as insufficient economic data and implementation research). Solutions to some of these barriers included the identification of clinical champions within the health sector to enhance evidence uptake, and the sourcing of alternative funding to support implementation research and encourage partnerships between researchers, decision-makers and other stakeholders.</p><p><strong>Conclusion: </strong>Participants sought opportunities for ongoing networking and collaboration. Two activities have been identified as priorities: establishing a \"policy-sensitive\" research agenda and partnering researchers and decision-makers in the process; and establishing a National Translation Task Group with a broad membership.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2007-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26750130","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":"Performance reporting for consumers: issues for the Australian private hospital sector.","authors":"Margo Sheahan,&nbsp;Russ Little,&nbsp;Sandra G Leggat","doi":"10.1186/1743-8462-4-5","DOIUrl":"https://doi.org/10.1186/1743-8462-4-5","url":null,"abstract":"<p><p>A group of consumers of private hospital services and their carers collaborated with staff of a Melbourne private hospital and with industry representatives to develop a consumer-driven performance report on cardiac services. During the development process participating consumers identified situational and structural barriers to their right to be informed of costs, to choice and to quality care. Their growing appreciation of these barriers led them to a different perspective on performance reporting, which resulted in their redirecting the project. The consumer participants no longer wanted a performance report that provided comparative quantitative data. Instead they designed a report that outlined the structures, systems and processes the hospital had in place to address the quality and safety of services provided. In addition, consumer participants developed a decision support tool for consumers to use in navigating the private health care sector. The journey of these consumers in creating a consumer driven performance report for a private hospital service may assist those responsible for governance of Australia's health system in choosing appropriate strategies and mechanisms to enhance private hospital accountability. The situational and institutional industry barriers to choice, information and quality identified by these consumers need to be addressed before public performance reporting for private hospitals is introduced in Australia.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"4 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2007-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-4-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26750406","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}