Jordan dramatically strengthened the level of intellectual property protection it provides for pharmaceutical products in consequence of joining the World Trade Organization in 2000 and signing a Free Trade Agreement with the United States in 2001. This study assesses the impact of higher levels of intellectual property protection on access to medicines by quantifying the effects on the private retail pharmaceutical market of delayed market entry of generic products. Adjusted for increased sales volume and inflation, from 1999 to 2004 there was a 17% increase in total annual expenditure for medicines in Jordan. When assessing originator medicines that were marketed in both 1999 and 2004, and for which there were generic equivalents, the weighted average price of originator medicines increased while the weighted average price of equivalent generic medicines decreased. Delayed market entry of generics due to enhanced intellectual property protection is estimated to have cost Jordanian private consumers approximately 18 million U.S. dollars in 2004. Jordan should consider amending its current regulatory scheme on data protection and amending the Unfair Competition and Trade Secrets Law of 2000. Jordan should also consider increased spending on public health to offset the adverse impact on consumers of strengthening its intellectual property protection relevant to pharmaceutical products.

In 2009, Greece entered into one of the most serious economic downturns in its modern history. In May 2010, the country was put under the supervision of Troika (EU, ECB and IMF). Retail pharmaceutical market with size c. a. € 6.5 bn in retail prices for 2009 (public pharmaceutical expenditure € 5.2 bn), was one of the main targets for change through the implementation of new policies and drastic spending cuts. The purpose of this study was to measure the impact that these new policies for pharmaceutical spending had and how this was attributed to the levers of price, market volume and product mix. MethOds: An economic model was used, based on IMS Hellas' and Hellenic Statistical Authority data, to measure the contribution that (a) price; (b) market volume; and (c) product mix had on the reduction in the size of the retail market for pharmaceuticals in the period 2009-2014. The detailed approach decomposes the market change, as measured in values, into those attributed to (a) price (assuming market volume and product mix are constant); (b) market volume (assuming prices and product mix are unchanged); (c) product mix. Results: The analysis indicated that, the major contributor in the reduction of the pharmaceutical market size was the price of medicines. It has been estimated that 87% of the reduction (> € 1.2 bn) is coming from price. Volume contributed an additional c. a. 38% (> € 0.5 bn) in the reduction of the size but, at the same time, it was partially offset from substitution with pricier medicines. cOnclusiOns: Price was the major driver for the reduction in the size of the retail pharmaceutical market during the period of crisis. Volume had an impact as well but it was partially offset by switch towards more expensive medicines.

Our analysis revealed the importance of population size and EPR implementation on drug price levels; however, EPR results in higher pharmaceutical prices in lower-income countries compared to non-pharmaceutical services.

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Melatonin, a widespread substance with antioxidant and anti-inflammatory properties, has been found to act as an antidiabetic agent in animal models, regulating the release and action of insulin. However, the molecular bases of this antidiabetic action are unknown, limiting its application in humans. Several studies have recently shown that melatonin can modify calcium (Ca(2+)) in diabetic animals, and Ca(2+) has been reported to be involved in glucose homeostasis. The objective of the present study was to assess whether the antidiabetic effect of chronic melatonin at pharmacological doses is established via Ca(2+) regulation in different tissues in an animal model of obesity-related type 2 diabetes, using Zücker diabetic fatty (ZDF) rats and their lean littermates, Zücker lean (ZL) rats. After the treatments, flame atomic absorption spectrometry was used to determine Ca(2+) levels in the liver, muscle, main types of internal white adipose tissue, subcutaneous lumbar fat, pancreas, brain, and plasma. This study reports for the first time that chronic melatonin administration (10 mg per kg body weight per day for 6 weeks) increases Ca(2+) levels in muscle, liver, different adipose tissues, and pancreas in ZDF rats, although there were no significant changes in their brain or plasma Ca(2+) levels. We propose that this additional peripheral dual action mechanism underlies the improvement in insulin sensitivity and secretion previously documented in samples from the same animals. According to these results, indoleamine may be a potential candidate for the treatment of type 2 diabetes mellitus associated with obesity.