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PubMed2003

The human genome sequence: impact on health care.

The recent sequencing of the human genome, resulting from two independent global efforts, is poised to revolutionize all aspects of human health. This landmark achievement has also vindicated two differeint methodologies that can now be used to target other important large genomes. The human genome sequence has revealed several novel/surprising features notably the probable presence of a mere 30-35,000 genes. In depth comparisons have led to classification of protein families and identification of several orthologues and paralogues. Information regarding non-protein coding genes as well as regulatory regions has thrown up several new areas of research. Although still incomplete, the sequence is poised to become a boon to pharmaceutical companies with the promise of delivering several new drug targets. Several ethical concerns have also been raised and need to be addressed in earnest. This review discusses all these aspects and dwells on the possible impact of the human genome sequence on human health, medicine and also health care delivery system.

Animals↗
PubMed1987

Harvey A.K. Whitney lecture. Intimations on a profession: retrospect and prospect.

The evolution and development of institutional pharmacy and its pathfinders are discussed, and future directions for the profession are suggested. From the Bulletin of the American Society of Hospital Pharmacists to the American Journal of Hospital Pharmacy, hospital pharmacy literature has helped the profession evolve by providing specialized information while continuing to meet practitioners' changing needs over time. Editorials help to establish unity of purpose among members by encouraging consensus development. Other publications and programs of ASHP extend its mission into institutions nationwide. To achieve unity of purpose, the profession relies on the formal organization (ASHP and its chapters) for providing order and the informal organization (meetings) for exchanging information and providing motivation. Pharmacy "trains its own" via residency programs, whose prototypes, nonacademic internships, were designed by pathfinder preceptors like Harvey A. K. Whitney. These programs have ensured continuity in improving practice standards and a source of skilled professionals. Women have been leaders in the history and development of hospital pharmacy. The sound economic management of the Society has led to accelerated developments for institutional pharmacy. In the future, ASHP should seek to become more involved in public policy issues concerning health care in general; develop a written set of ethical standards to guide institutional practitioners; and prepare an updated history of ASHP and the hospital pharmacy movement, including an interpretation of events, or a cultural perspective. ASHP has established a strong foundation for hospital pharmacy as envisioned by the early pathfinders; young pharmacists are the pathfinders for future progress.

Ethics, Professional↗
PubMedDate not supplied

Future European health care: cost containment, health care reform and scientific progress in drug research.

The cost of the development of a new pharmaceutical product from its conception and synthesis through to the regulatory approval process has more than quadrupled in the last 20 years. Both clinical and total development times have increased substantially. To amortize the costs incurred, the pharmaceutical industry has taken an international dimension. The incentives for pharmaceutical firms to discover and develop new drugs depend on the length of the development and regulatory review process plus the potential market size. Recent regulatory, economic and political changes may have significant implications for the future of new drug developments in Europe. The European Union industrial policy felt that there is a need for convergence in the area of pricing. It is recommended that the policy should aim to contain growth in pharmaceutical expenses by means specific to reimbursement rather than direct price controls. By encouraging doctors to prescribe and customers to use generics, competition is enhanced to bring down drug prices. More emphasis is being laid by government in educating customers to cost-awareness and cost-benefit ratios with regard to pharmaceuticals. Concerning clinical trials, European harmonization has been achieved by significant developments: the rights and integrity of the trial subjects are protected; the credibility of the data is established; and the ethical, scientific and technical quality of the trials has improved. Future European health care forecasts a whole change in the pharmaceutical business. Important issues in cost and outcome measurement should be carefully planned and considered in drug development. Due to important mergers and acquisitions, the pharmaceutical sector will consist mainly of important multinational corporations. In this way, valuable new products may be brought to the market.

Cost Control↗