Big pharma has been a hot button topic for some time in the United States. The costs of medications can make obtaining easily affordable healthcare for the masses difficult to say the least. Many other countries cap the costs of pharmaceuticals such as Spain, South Korea and the UK, while the US continues to allow pharmaceutical companies to set the price point presumably to allow innovation (Keyhani, et al., 2010). In the study written by Keyhani, et al., they analyze 288 new drugs developed in more than 20 different countries. What they found was interesting in that pharmaceutical innovation that stemmed from the US was proportional to its spending on prescription drugs. Other countries with direct price control were found to have proportionally more innovation when compared to their own prescription drug spending (Keyhani, et al., 2010). Take-away: price controlled countries produce proportionally more new drugs at a cheaper cost to their patients compared to the United States where there is no price control.
Keyhani, S., Wang, S., Hebert, P., Carpenter, D., & Anderson, G. (2010). US pharmaceutical innovation in an international context. American journal of public health, 100(6), 1075–1080. https://doi.org/10.2105/AJPH.2009.1
Discuss the development of new drugs in the United States as compared to other countries and evaluate the pharmacoeconomic issues that lead to high prescription costs in the United States.
The development of new drugs in the United States is a long process. According to Adams et al., (2016), the process can take several years to be approved. Once the drug’s trade name is approved (proprietary product or brand name), the drug developer has the exclusive right to this drug for 17 years. The reason behind having these exclusive rights is so the drug developer can recoup the millions of dollars it costs in research and development of the new drug.
The pharmacoeconomic issues that lead to high prescription costs in the United States are because the exclusive rights that are given to the developer can lead to an increase in the cost of the drug because no one else has access to the drug and the generic form is not available yet. once the drug name is approved (Adams, et al., 2016). In contrast with the United States, all other countries have some form of drug pricing regulation to keep the cost of medications low (Keyhani et al., 2010)
Adams, M. P., Holland, N., & Urban, C. Q. (2016). Pharmacology for Nurses (5th ed.). Pearson
Education (US). https://online.vitalsource.com/books/9780134255378
Keyhani, S., Wang, S., Hebert, P., Carpenter, D., & Anderson, G. (2010, June). US pharmaceutical innovation in an international context. American journal of public health. Retrieved January 7, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/
Docusate sodium (Colace)
Classification: Stool Softener
Mechanism of action: lowers surface tension of stool, allowing water and lipid absorption into stool mass. This results in softer stool that can pass through the intestines easier (Hannoodee, 2022).
Administration: Comes in a variety of forms for oral administration including tablet, capsules, liquid and syrup. Can be administered rectally as enemas or suppositories. Frequency is in daily or divided doses. Promote increased fluid intake to absorb into stool.
Adverse Effects: For normal use, abdominal cramping is the noted adverse effect. Excess use of medication can result in diarrhea, vomiting and anorexia (Hannoodee, 2022).
Pregnancy Category: C. Considered generally safe for breastfeeding.
Contraindications: Allergy to any ingredients. Nausea and vomiting because increased fluid intake is required. Acute abdominal pain, appendicitis or intestinal obstruction.
Examples of when drug is used: There is no textbook definition delineating what constipation actually is, however many would consider infrequent bowel movements of less than three per week (Hannoodee, 2022). Symptoms may include abdominal cramping, hard stool, difficulty passing stool and incomplete evacuation of stool.
One interesting indication that many people don’t know about is its use as a ceruminolytic. Buildup of cerumen in the ear canal may be treated with 1mL of liquid docusate. The ability of docusate to lower the surface tension of cerumen allows it to soften for better irrigation with normal saline afterwards. One clinical trial involving 50 individuals tested between using Cerumenex versus docusate and favored better results with docusate 81% success rate versus 35% (Singer et al., 2000).