National health services

London, shows, for example, that every year more than 800,000 patients using the UK National Health Service experience adverse drug reactions [13 and references therein]. 

As already outlined, health-care decision models hold little water in the sophisticated environment of evidence-based medicine. Nevertheless, two UK evaluations (Davies and Drummond, 1993 Matheson et al, 1994) do give some insight into the outcomes of using clozapine in the UK National Health Service, although model data were largely derived from the USA. 

The advent of novel atypical antipsychotic drugs has sharpened the debate in the UK about the cost burden of schizophrenia to the National Health Service (NHS) and the relative cost-effectiveness of these drugs. Schizophrenia has a prevalence of about 0.5% and a lifetime risk of 1%. Because the disease affects adolescents and has a lifetime course associated with a high degree of hospital and social... 

In this book I will share with you the process by which I came to this conclusion and the scientific evidence on which it is based. This includes evidence that was known to the pharmaceutical companies and to regulatory agencies, but that was intentionally withheld from prescribing physicians, their patients and even from the National Institute for Health and Clinical Excellence (NICE) when it was drawing up treatment guidelines for the National Health Service (NHS) in the UK. 

Current estimates suggest that there are around 30,000 alcohol-related deaths a year in the UK. The NHS (National Health Service) spends over 164m a year treating alcohol-related conditions, and one in four male hospital beds is occupied by someone with an alcohol-related illness. Alcohol adversely aflfects numerous aspects of health, even in those who are only moderate drinkers. However, the effects of high volumes over long periods are certainly the most serious and life-threatening. Alcohol passes through the stomach and small intestine and is then absorbed into the blood stream from where it is metabolised by the liver (the first-pass effect Chapters 3 and 9). 

Our empirical evaluation of competition between pharmaceuticals was based on information on prescription drug consumption by non-hospital patients in the National Health Service (NHS) in England in 19% and the Sistema Nacional de Salud or SNS (National Health System) in Spain in 1997. The authors wish to thank Statistics Division IE of the UK Department of Health and the Directorate-General of Pharmacy and Health Products of the Spanish Ministry of Health and Consumer Affairs for supplying us with these data. As can be seen from Table 4.1, public consumption of pharmaceuticals... 

Since 1990, responsibility for containing the public pharmaceutical bill in Spain has fallen to a variety of instruments, none of which has proved particularly effective at cost containment, as can be seen from Table 6.1. These instruments have included stricter control over the National Health Service (NHS) (Sistema Nacional de Salud or SNS) budget for pharmaceuticals, modifications to the co-payment rates for certain drugs for chronic diseases, the exclusion of certain drugs from public financing (negative lists) and agreements with laboratories and pharmacies.1... 

It is extremely difficult to forecast what the Spanish health system of even the near future will be like, particularly if it continues to be anchored in the dynamics offered today by national health services services as if they were just another administrative service, national implying a strong tendency towards uniformity and health denoting an intention that is not always translated into the best integration (for instance, between ultimate objectives and the provision of services, or between health sector policies and all the other economic and social sector policies). 

NHS NSEA NSER National Health Service non-safe and effective drag approved non-safe and effective drag rejected... 

At age thirty-one Erica began medical school at the University of Colorado. She completed a three-year family practice residency in a Denver hospital, then went to Cuba, New Mexico, where she served as the medical director of a rural hospital as repayment for her National Health Service scholarship. After serving in that capacity she was married for two years. She has one son who is now ten years old. 

In a prospective study of over 900,000 adults in the USA, increased BMI was associated with increased death rates from all cancers combined, as well as for cancers at multiple specific sites." The authors of this study estimated that obesity and overweight in the USA could account for 14% of all deaths from cancer in men and 20% in women. As well as the substantial human cost from obesity-associated disease and premature mortality, obesity has serious consequences for the economy. In the UK, it has been estimated that obesity leads to 18 million sick days a year, 40,000 lost years of working life and shortening of life by 9 years on average. Treatment costs to the National Health Service are of the order of 0.5 billion a year and the impact on the wider economy may be as high as 2 billion. ... 

The ABPI is the trade association that represents the manufacturers of prescription medicines. Formed in 1930, it now represents some 80 companies, which produce over 80% of the medicines supplied to the National Health Service (NHS). The ABPI has had a code of practice since 1958, the Code of Practice for the Pharmaceutical Industry, which governs the promotion of medicines to health professionals, and has operated a system whereby complaints made about the advertising of prescription medicines are taken up and considered under the Code. It is a condition of membership of the ABPI to abide by the Code of Practice. In addition, some 70 companies that are not members of the ABPI have given their formal agreement to abide by the Code and to accept the jurisdiction of the PMCPA over complaints made under the Code. Thus, the Code... 

In the United Kingdom, annual expenditure on the National Health Service (NHS) is... 

Abel-Smith B, Titmus R. The Cost of the National Health Service in England and Wales. Oxford Oxford University Press, 1956. 

In the United Kingdom, prescriptions are required for all medicines supplied under the National Health Service (NHS) and for all prescription-only medicines. Prescriptions may only be written by a doctor or dentist registered in the United Kingdom. 

The National Health Service spends more than 8.6 billion a year on medicines, yet this represents less than 13 per cent of its total expenditure. Medicine exports are worth over 10 billion a year - the United Kingdom s third largest foreign exchange earner in manufactured goods. Nearly a quarter of the world s top 100 medicines were discovered in Britain. 

The Association of the British Pharmaceutical Industry (ABPI) is the trade association representing manufacturers of prescription medicines. It was formed in 1930 and now represents about eighty companies which supply nearly 80 per cent of the medicines used by the National Health Service. 

Promotional material should be tailored to the audience to whom it is directed. For example, promotional material devised for general practitioners might not be appropriate for hospital doctors and, similarly, material devised for clinicians might not be appropriate for use with National Health Service administrative staff. 

The ABPI examinations for medical representatives and generic sales representatives are based on a syllabus published by the ABPI which covers, as appropriate, subjects such as body systems, disease processes and pharmacology, the classification of medicines and pharmaceutical technology. Information on the National Health Service and pharmaceutical industry forms an additional core part of the syllabus. The syllabus is complementary to, and may be incorporated within, the company s induction training which is provided to representatives as a pre-requisite to carrying out their function. 

Clause 18.1 does not prevent the provision of medical and educational goods and services which will enhance patient care or benefit the National Health Service. The provision of such goods or services must not be done in such a way as to be an inducement to prescribe, supply, administer, recommend or buy any medicine. They must not bear the name of any medicine but may bear a corporate name. 

There is not a bottomless pit of resources, says Phil Wadeson, finance director for the National Health Service unit that oversees hospitals and doctors offices in Liverpool. We reached the point a while ago where there is far more medical intervention than any health-care system can afford. ... 

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