Patients marketing

Since patient/market/legislative data have to be incorporated in modem product presentation, it is essential that the text remain legible throughout the shelf life. Printed material should be scuff abrasion tested, under agreed conditions, to meet visual standards of performance. 

In addition to catering for conventional thermoformed blisters using a plastic tray and a foil-based lid, most blister machine manufacturers now offer facilities to increase moisture protection, by use of either a tropicalised blister (by an additional foil over cover) or a cold formed, foil-based tray. Considerable competition is expected between these and similar options, where a high level of climatic protection is required. The other options include blisters in sachets and overwraps to cartons. Output speeds, climatic protections achieved, overall cost and patient/marketing preference, will influence the final pack choice. 

A new generation of antiinflammatory agents having immunosuppressive activity has been developed. The appearance of preclinical and clinical reports suggest that these are near entry to the pharmaceutical market. For example, tenidap (CP-66,248) (12) has been demonstrated to inhibit IL-1 production from human peripheral blood monocytes in culture (55). Clinically, IL-1 in synovial fluids of arthritic patients was reduced following treatment with tenidap. Patients with rheumatoid or osteoarthritis, when treated with tenidap, showed clinical improvement (57,58). In addition to its immunological effects, tenidap also has an antiinflammatory profile similar to the classical NSAIDs (59). Other synthetic inhibitors of IL-1 production are SKF 86002 (20) andE-5110 (21) (55). 

Acetyl-i-carnitine (4) is marketed in Italy for dementia as of this writing it is also in Phase III clinical trials in the United States and Europe. In a double-blind, placebo-controUed clinical trial over a one-year period involving 130 patients with clinically diagnosed AD, a slower rate of deterioration in 13 of the 14 outcome measures was observed in the dmg-treated group (28). Earfler smaller scale pilot studies in demented patients had also shown some improvement of various behavioral and cognitive functions (29). 

A broad-based cardiomyoplasty market should emerge by the late 1990s. Successhil development of a small-diameter graft to use in coronary bypass surgery instead of the patient s saphenous vein or mammary artery seems likely to occur by the year 2000. Development of appropriate materials and manufacturing methods are needed to maintain patency without damaging blood in grafts below 4 mm in diameter. 

Implantable valves, particularly mechanical valves which continue to encroach on tissue valves, are unique. Methods such as valvuloplasty, mitral valve repair, or use of ultrasound are unlikely to reduce the number of valve replacements into the twenty-first century. Valve selection remains in the hands of the surgeon because of the critical nature of the procedure. If anything goes wrong, the result can be catastrophic to the patient. Cost of a valve, from 3000— 4000, is a relatively small part of the cost of open-heart surgery which can mn as high as 30,000. Growth of the cardiovascular valve market has slowed in the United States with the decline of the threat of rheumatic fever. 

The worldwide market for vascular grafts was approximately 150 million and growing at about 5% annuaUy as of 1995. The vascular graft area has tremendous market potential in development of smaU-diameter grafts of 3—4 mm for coronary bypass surgery. The total market for the intra-aortic baUoon pump, a cardiac-assist device, is ca 80 million worldwide. About 75,000 patients were supported by these baUoon pumps in 1994. This market is thought to have peaked. 

On looking at all the facts presented, the patient will attain, comparatively speaking, the least satisfactory outcome with the clas.sical tea or tea mixture, because the preparation of the tea encompasses the largest number of uncertain factors. Rather belter results are to be expected from tea bags (outside pharmacies, nowadays this is the form of tea which has by far the largest part of the market), provided that the requirements of quality of content... 

There are also differing standards between the markets in each of these countries. For instance, the telecom market has vastly different safety requirements than the patient-contact medical market. So, it is important to determine the target market early in the product design process. These market differences will also be included in the lEC standards harmonizing efforts. 

The glucan synthase inhibitor caspofungin (intravenous formulation) is new on the market for the treatment of invasive aspergillosis in patients whose disease is refractory to, or who are intolerant of, other therapies. During the clinical trials fever, infused vein complications, nausea, vomiting and in combination with cyclosporin mild transient hepatic side effects were observed. Interaction with tacrolismius and with potential inducer or mixed inducer/inhibitors of drug clearance was also seen. 

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