Earticle

Objective: To summarize and analyze the available literature around risk-sharing agreements and related concepts. Summary: As both payers and manufactures continue to try and maximize the value of new pharmaceutical technologies, it has become increasingly clear that the previous methods of in-market evidence generation and review have been insufficient, proving to be too costly, time consuming, and removed from real-world aspects of treatment. To counter these limitations, risk-sharing agreements have been proposed as a way to develop evidence for the market (once safety is proven) while still offering incentives to manufactures to continually develop new technology. Manufacturers can use the agreements to first get covered within a market, and then to build trust and good faith in their products with payers by proving their therapeutic value via real-world evidence collection. This literature review summarizes the available literature on the topic of risk-sharing agreements and provides key examples of agreements that were previously signed.

Osteoporosis has become a rapidly social burden for public health in South Korea, but the lack of epidemiological study on osteoporosis patients. We investigated a demographic information, health behavior, socio -economic level and quality of life for non-treated osteoporosis patients with the Korea National Health and Nutrition Examination Survey (KNHANES) 2005. 1,089 subjects (≥ 40 years) with osteoporosis were included. The mean age was 66.0 ± 9.1 years in treated group being older than non-treated (64.7 ± 10 years) and the medical aid coverage was higher with treated group (64.1% vs. 58.9%). The treated patients group reported a significantly higher frequency of weight management, non- drinking, regular health examination, but smoking and regular exercise did not differ between groups. Mobility and pain/discomfort with treated patients group were statistically lower than non-treated in QoL. Factor of osteoporosis treated was significantly associated with the medical aid (OR: 1.73, 95% CI: 1.16-2.57) and overall QoL-VAS (OR: 0.91, 95% CI: 0.85-0.98, Unit: 10 points) after adjusted age and comobidity of osteoarthritis. People between middle and high socio-economic level consider that osteoporosis consider that osteoporosis is a mild disease and they do not manage the disease intensively. A public health program or policy should be adapted to manage their disease with anti-osteoporosis agents and other medical interventions.

Background: After the separation of prescribing and dispensing in Korea, the stagnancy of business activities for the nonprescription drugs has been continued for 10years. Objectives: The aims for this study were to evaluate and clarify the current opinions of the pharmacists for the recognition level on nonprescription drugs. Methods: A 14-questionquestionnaire was developed and pilot tested. For 17 days of survey by on-line, it was carried out on 284 pharmacists working at the community pharmacies on a national scale. Results: Most of pharmacists have broadly positive mind that nonprescription drugs are helpful for their pharmacy management. But they think that more information and education would be needed. Conclusion: To activate the market of the nonprescription drugs, the most important thing is to make good reciprocal relationships between the comunity pharmacists and the pharmaceutical companies.

The number of patients with cerebrovascular disease, cardiovascular disease and peripheral arterial disease has recently grown. Accordingly, the prescription of anti-thrombotic agents to prevent or treat those macrovascular diseases has been dramatically increased. The objectives of this study were to investigate the prescribing patterns of oral anti-thrombotic drugs in outpatients and assess the appropriate use of those drugs based on KFDA indications and DUR criteria. Out of 17, 376, 715, only 482 prescriptions were finally selected which they contained both multiple drugs and oral anti-thrombotics. The analysis of the selected prescriptions revealed that 43.4%, 36.0% and 29.0% were coded with cerebrovascular, cardiovascular and peripheral arterial disease, respectively. The average (±SD) number of oral anti-thrombotics per prescription was 1.51 (±0.70). Among the oral anti-thrombotic agents, aspirin (34.2%) was prescribed the most, followed by clopidogrel (23.4%), cilostazol (8.7%), sarpogrelate (8.2%), limaprost (5.9%), triflusal (4.2%), beraprost (4.1%), mesoglycan (3.8%), warfarin (3.3%), sulodexide (1.2%), sulfomucopolysaccharide (1.2%), ticlopidine (1.0%) and indobufen (0.7%), whereas dipyridamole was not prescribed at all. Monotherapy (59.5%) exceeded multiple therapy (40.5%) and the most common combination was aspirin plus clopidogrel. It was found that 27.4% of aspirin containing prescriptions did not have any responsible disease code, suggesting that aspirin was used for primary prevention. In case of limaprost, it was used even more for the treatment of spinal stenosis (69.8%) than peripheral arterial disease (30.2%). As a result of the prescription adjudication, 72.8% of total prescriptions were acknowledged to be appropriate, and the rate of inappropriate use was calculated as follows; sulodexide (78%), beraprost (67%), sarpogrelate (60%), ticlopidine (57%), cilostazol (46%), sulfomucopolysaccharide (44%), triflusal (41%), mesoglycan (39%), clopidogrel (36%), limaprost (23%), indobufen (20%), aspirin(1%) and warfarin (0%). Our findings indicated that aspirin was the most commonly prescribed oral anti-thrombotic agents for preventing or treating macrovascular diseases, and this prescribing patterns corroborated text books and clinical practice guidelines.