Objectives Currently published papers and clinical guidelines regarding the effects of tocilizumab in severe and critical COVID-19 are contradictory. The aim of this meta-analysis was to combine the results of clinical studies of different designs to investigate the efficacy and safety of tocilizumab in severely-to-critically ill COVID-19 patients. Methods A systematic search was performed in PubMed, Embase, CENTRAL, ClinicalTrials.gov, Scopus, and preprint servers up to 26 December 2020. Since a substantial heterogeneity was expected, a random-effects model was applied to calculate the pooled effect size (ES) and 95% confidence interval (CI) for each study outcome. Results Forty-five comparative studies involving 13,189 patients and 28 single-arm studies involving 1,770 patients were analyzed. The risk of mortality (RR of 0.76 [95%CI 0.65 to 0.89], P < 0.01) and intubation (RR of 0.48 [95%CI 0.24 to 0.97], P = 0.04) were lower in tocilizumab patients compared with controls. We did not find any significant difference in secondary infections, length of hospital stay, hospital discharge before day 14, and ICU admission between groups. Conclusion Tocilizumab can improve clinical outcomes and reduce mortality rates in severe to critical COVID-19 patients. Large-scale randomized controlled trials are still required to improve the statistical power of meta-analysis.

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Purpose The purpose of this paper is to develop a conceptual model to determine whether organizational climate (OC) mediates the effect of managerial skills (MSs) on business performance in small businesses, such as pharmacies. Design/methodology/approach The model proposed in this research was tested using separate questionnaires specifically designed for managers, employees and clients. The data set consists of responses from 301 managers, 470 clients and 328 employees from community pharmacies in Tehran, capital of Iran, which were analyzed using structural equation modeling. Findings Although the results indicated no significant direct relationship between MSs and pharmacy performance (PP), they also confirmed that having a context-appropriate set of MSs can positively affect PP via the mediating effect of OC. Originality/value This is the first study investigating how MSs improve performance in retail pharmacies. Although this research focuses specifically on small businesses in the pharmaceutical industry, it nevertheless contributes to the literature by showing the importance of OC.

Purpose Given the important role of corporate social responsibility (CSR) in today’s business world, this study aims to investigate how it affects the performance of pharmaceutical distribution companies by using the balanced scorecard (BSC). Design/methodology/approach Drawing upon the existing literature, a questionnaire consisting of 32 questions was prepared and distributed to examine ongoing practices and to probe uninvestigated domains related to CSR. To confirm the efficiency of the research model and the accuracy of the measurement model – which was utilized to examine the correlation between different variables – variable scores were acquired from a national study and were entered into a structural equation model. Findings Analysis of 933 completed questionnaires revealed the existence of large correlation between subsets of the considered dimensions. The questionnaire contained five underlying dimensions: employee relations, corporate governance, societal concern, economic and financial concern and environmental concerns. All CSR variables can be condensed into these five dimensions, which are the main features of the CSR model proposed for the Iranian pharmaceutical distribution companies. Not only did the results support the research model but also indicated that CSR’s impact on BSC and its four components – financial perspective, customer perspective, internal process perspective and learning and growth perspective – was both positive and significant. Practical implications This paper identifies five dimensions through which CSR practices can effect positive changes in an organization’s performance in relation to the four BSC perspectives. Thus, in focusing on these dimensions, a company increases its likelihood of enhancing its performance and, consequently, realizing significant gains. In addition, as managers play the most significant role in CSR implementation, they should support all associated practices to achieve their strategic goals. Originality/value Pharmaceutical distribution companies tend to apply CSR – which is commonly described as informal and voluntary humanitarian activities – to different domains, including the workplace, marketplace, community and environment. This study contributes to the existing literature by shedding light on various domains in which CSR practices are applied to enhance organizational success in pharmaceutical distribution companies.

Purpose In recent years, corporate social responsibility (CSR) has taken on a more prominent role in both large and small businesses because of its significant impact on various aspects of business performance. To date, a growing body of literature has demonstrated the mechanisms whereby CSR practices affect organizational outcomes; however, there has been little research examining how CSR practices contribute to customer loyalty within the pharmacy context. As such, this study aims to explore how CSR practices influence the loyalty of pharmacy customers, particularly in relation to the mediatory effects of customer-company identification (CCI) and customer trust. Design/methodology/approach A survey questionnaire was developed and administered to collect the required data from the pharmacy context. The resultant data were subjected to exploratory factor analysis to identify the scale dimensions, followed by multiple regression analysis to test the hypotheses. Findings Analysis of the results (n = 528) revealed that perceived CSR indirectly impacts loyalty through the mediatory effects of trust and CCI. All hypothesized effects were also confirmed via empirical testing. Originality/value The findings of this research suggest that not only are CSR activities responsive to societal concerns, but they can also promote customer identification with pharmacies and strengthen customer trust, which can, in turn, lead to long-term customer loyalty.