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Objective: As gatekeepers in health continuum, physicians play a pivotal role in persuading patients to consume a specific medicine, and their prescription behavior has a great effect on both healthcare costs and pharmaceutical markets. Taking the important role of physicians in healthcare system into account, in this study we have tried to empirically prioritize those factors that affect physicians' loyalty behavior in prescribing branded medicines. Methods: This research is grounded on a survey through which 437 specialist physicians were randomly invited to fill out the questionnaire of the survey. Structural Equation Modeling was performed to evaluate the research model and to test the research hypotheses. In addition to demographic section, six measures were used to evaluate the prescription behavior of physicians in terms of loyalty. Key findings: The results revealed that there are some factors influencing physicians' loyalty to branded medicines, among which professional influence is perceived to be the most important factor as compared with others. In contrast, the results rejected this hypothesis that promotional tools such as tangible rewards have a significant effect on physicians' loyalty behavior. Conclusions: The results contribute to the pharmaceutical companies endeavoring to develop fair, ethical, and effective marketing strategies to increase physicians' loyalty to their products. Furthermore, by comparing the results of similar studies, this research has shed light on this fact that influencing factors on brand loyalty may be different across countries over the world.

Providing pharmaceutical care significantly improved HRQoL of hemodialysis patients especially in the role-emotional, mental health, social functioning, and general health dimensions.

Human tissue kallikreins (KLKs) are members of a multigene family of serine proteases aberrantly expressed in many cancer types. In ovarian cancer, 12 KLKs are upregulated, and of those KLK5, 6 and 10 have been the focus of investigations into new diagnostic and prognostic biomarkers. However, little is known about the contributions of KLK5, 6 and 10 to ovarian cancer pathophysiology.In this study, a panel of 13 human ovarian cancer cell lines was screened by ELISA for secretion of KLK5, 6, 8, 10, 13, and 14. The ES-2 cell line, devoid of these kallikreins, was transfected with expression vectors of KLK5, 6 and 10 individually or in pairs. Co-expression of KLK5, 6 and 10 was correlated with lessened aggressivity of ovarian cancer cell lines as defined by reduced colony formation in soft agar and tumorigenicity in nude mice. ES-2 clones overexpressing KLK5, 10/5, 10/6, 5/6 made significantly fewer colonies in soft agar. When compared to control mice, survival of mice injected with ES-2 clones overexpressing KLK10, 10/5, 10/6, 5/6 was significantly longer, while KLK6 was shorter. All groups displaying a survival advantage also differed quantitatively and qualitatively in their presentation of ascites, with both a reduced incidence of ascites and an absence of cellular aggregates within those ascites. The survival advantage conferred by KLK10 overexpression could be recapitulated with the exogenous administration of a recombinant KLK10. In conclusion, these findings indicate that KLK5, 6 and 10 may modulate the progression of ovarian cancer, and interact together to alter tumour pathophysiology. Furthermore, results support the putative role of KLK10 as a tumour suppressor and suggest it may hold therapeutic potential in ovarian cancer.

Objective Improving access to effective and safe medicines is one of the major goals of all health systems. To achieve this goal, assessment is a fundamental phase of national medicine programs for access improvement. Collecting and compiling applicable indicators and impart a comprehensive framework for assessing access to medicine, are the aims of this study. Methods To investigate the published materials on access to medicines framework or indicators, a literature review with a systematic search was conducted using PubMed/ Medline, Scopus, and Google Scholar databases. The results were completed with a general search of documents in Iran Food and Drug Administration (IRFDA). Two independent researchers reviewed all the articles and documents. Thereafter the related indicators were extracted. In focused group discussion of academics and IRFDA experts, duplicate entries or ineffectual concepts were cleaned from the preliminary indicators. In the next step, Delphi questionnaire was sent to the 17 experts that work in academia, Social Security Insurance, IRFDA, Ministry of Health and Iran Pharmacist Association. The results of Delphi technique were finalized in an expert panel. Results One hundred and thirty one indicators were found in systematic search. After primary extraction of related indicators, 77 indicators were sent to the 17 experts in a Delphi form. The results of Delphi were finalized in a specialized-working group and 67 indicators were accepted in 5 categories including physical availability and geographical accessibility (19 indicators), affordability (23 indicators), human resources (4 indicators), quality and safety (5 indicators), information and rational use (16 indicators). Conclusion The indicators that inclusively assess the full access to medicine in the concept of rational use have been categorized into five categories in this study. To determine the access to medicine status in each country further local surveys are necessary for all several indicators in each category. Keywords Health services accessibility. Access to medicine. Accessibility. Availability. Pharmaceutical services. Health status indicators. BHealth care quality. Access. and Evaluation^. Affordability. BCosts and cost analysis^. Health policy. National medicine program. Pharmaceutical policy