Background: Antimicrobial resistance is one of the most significant challenges of the twenty-first century, and the illegal sale of antimicrobial drugs at community pharmacies is a driver of antimicrobial resistance. This study explores the knowledge, attitudes, and practices (KAP) of pharmacy staff toward antimicrobial stewardship programs (ASPs). Methods: We conducted a descriptive cross-sectional study among community pharmacy staff in Northeastern China, from April 1 to 31 May 2019, using a self-administered KAP questionnaire comprising 20 items. The data analysis was carried out by employing Mann-Whitney and Kruskal-Wallis tests. Results: A response rate of 98.5% (394/400) was obtained. The majority of participants (94.9%) demonstrated a good understanding of antimicrobial use, but they lacked an adequate understanding of ASPs. Nearly half of the participants (40.6%) reported that they sold antimicrobials to patients without a prescription. Education level, age, occupation, and experience were all significantly associated (P < 0.05) with participants' median ASPs scores. Besides, the presence of a licensed pharmacist (OR 46.327, 95% CI 2.443-878.451, P = 0.011) was the main factor associated with the pharmacy staff's understanding of antimicrobial use policies. Conclusions: The participants' knowledge of antimicrobials was good, and their attitudes regarding ASPs were positive, but their practices regarding ASPs were poor.
Network externality is an important feature of the era of network economy. The competition between online and offline retail pharmacies caused by network externality is getting fiercer and fiercer. In this context, we studied the long-term market competition evolution of two-channel retail pharmacies under the network external environment, in order to obtain higher profits, two-channel retail pharmacies prefer to choose profit maximization marketing strategy or market share maximization marketing strategy. Using evolutionary game theory, an evolutionary game model of two-channel retail pharmacies was established. Through the establishment of the model, obtain the payment matrix of different marketing strategies selected by the two-channel retail pharmacies and the evolution and stability of the selection of marketing strategies. The results show that when the strength of the network externality is within a certain range, the traditional retail pharmacies with higher marketing cost choose to pursue the profit maximization strategy, while online pharmacy with lower marketing costs choose market share maximization strategy to achieve greater profits; when the network externality is large, in order to maintain a certain market share in the long-term market evolution, the traditional retail pharmacy with high marketing cost chooses to pursue the market share maximization marketing strategy in order to obtain greater profits, while the online pharmacy with low marketing cost chooses to profit from the profit maximization marketing strategy.
Government subsidies can supplement R&D investment within pharmaceutical firms and strengthen industry knowledge spillovers effectively. Based on the inter-firm spillovers, a differential game model is established to investigate the government subsidy strategies under the different innovative drug R&D strategies of pharmaceutical firms. With the Hamilton-Jacobi-Bellman equitation, the optimal R&D investment, the pharmaceutical technical levels, and the optimal benefits are obtained under the strategies of no pharmaceutical firms conduct R&D innovation, one side innovates alone and R&D cooperation. It can be concluded that the R&D investment of pharmaceutical firms and the effort level of the government is positively related to the technical level and their comprehensive benefits, while it is a negative correlation to the cost coefficient. In addition, an increase in spillover coefficient produces an increase in government subsidy. Furthermore, when the spillovers are low, the government should give a higher subsidy to the strategy of R&D cooperation. As the spillovers increase, the government should allocate more subsidies to pharmaceutical firm who conduct independent R&D of innovative drugs. INDEX TERMS Differential game, government subsidies, R&D of innovative drugs, spillovers.
In order to develop the biomedical industry, government subsidy of biosimilars is an incentive policy which has been used by the government. Different government subsidy strategies have an impact on drug price, consumer surplus, social welfare, the income of biosimilars enterprises and the demand of biosimilars, which have been deeply analyzed through backward induction of the dynamic game theory. The analysis shows that the price coefficient and the influence of the subsidy on demand will affect the choice of government subsidy strategies. It is concluded that under different subsidy strategies, consumer surplus, social welfare and the income of biosimilars enterprises are positively correlated with the amount of subsidy per unit product. This paper provides a decision-making basis for developing government subsidy strategies scientifically.
With the development of economic globalization and information technology, enterprises pay more attention to the sustainable development of their e-commerce. Under this trend, we study the subsidy strategy commonly used by pharmaceutical e-commerce platforms in two-sided market. Based on the two-sided market theory, we set up the two-sided user's utility function and formulate the subsidy strategy as the decision of platform profit optimization. We show that the platform chooses to subsidize consumers only if the net income from consumer is lower than the total revenue of drug retailers and platforms in each transaction; the maximum profit for platform increases with the intensity of the network externality. This study provides theoretical support and decision-making suggestions for the pharmaceutical e-commerce platforms to capture the market share, obtain higher profits and ultimately achieve the sustainable development goal.
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