Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.

This book is open access under a CC-BY license. The importance of the pharmaceutical industry in Sub-Saharan Africa, its claim to policy priority, is rooted in the vast unmet health needs of the sub-continent. Making Medicines in Africa is a collective endeavour, by a group of contributors with a strong African and more broadly Southern presence, to find ways to link technological development, investment and industrial growth in pharmaceuticals to improve access to essential good quality medicines, as part of moving towards universal access to competent health care in Africa. The authors aim to shift the emphasis in international debate and initiatives towards sustained Africa-based and African-led initiatives to tackle this huge challenge. Without the technological, industrial, intellectual, organisational and research-related capabilities associated with competent pharmaceutical production, and without policies that pull the industrial sectors towards serving local health needs, the African sub-continent cannot generate the resources to tackle its populations' needs and demands. Research for this book has been selected as one of the 20 best examples of the impact of UK research on development. See http://www.ukcds.org.uk/the-global-impact-of-uk-research for further details.

Making Medicines is a concise, chronological discussion of the history of therapeutics and pharmacy from the Egyptians through to the present day. It focuses on the discovery and uses of medicines to treat illness through the ages, and the evolving role of the pharmacist. Each chapter is contributed by an expert in the period or field, and illustrates how wider social, political and economic developments have influenced drug development and shaped pharmacy practice.The book has two colour-plate sections illustrating how pharmacy has developed over the centuries. Numerous photographs are also included in the text.Written by an expert in the field, this book will appeal to pharmacists and pharmacy students, as well as to other healthcare practitioners and medical historians.

Pharmacy has become an integral part of our lives. Nearly half of all 300 million Americans take at least one prescription drug daily, accounting for $250 billion per year in sales in the US alone. And this number doesn't even include the over-the-counter medications or health aids that are taken. How did this practice become such an essential part of our lives and our health? A Brief History of Pharmacy: Humanity's Search for Wellness aims to answer that question. As this short overview of the practice shows, the search for well-being through the ingestion or application of natural products and artificially derived compounds is as old as humanity itself. From the Mesopotamians to the corner drug store, Bob Zebroski describes how treatments were sought, highlights some of the main victories of each time period, and shows how we came to be people who rely on drugs to feel better, to live longer, and look younger. This accessible survey of pharmaceutical history is essential reading for all students of pharmacy.

Based on extensive archival research in Peru, Spain, and Italy, Making Medicines in Early Colonial Lima, Peru examines how apothecaries in Lima were trained, ran their businesses, traded medicinal products, prepared medicines, and found their place in society. In the book, Newson argues that apothecaries had the potential to be innovators in science, especially in the New World where they encountered new environments and diverse healing traditions. However, it shows that despite experimental tendencies among some apothecaries, they generally adhered to traditional humoral practices and imported materia medica from Spain rather than adopt native plants or exploit the region’s rich mineral resources. This adherence was not due to state regulation, but reflected the entrenchment of humoral beliefs in popular thought and their promotion by the Church and Inquisition.

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.

The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.