Cancer diagnosis is increasing day by day all over the world. Deaths due to cancer are among the most common causes of death. Access to cancer drugs is a priority of health policies. The aim of this ...study is to evaluate access to cancer drugs through drug box sales data by modeling population growth, cancer incidence, and Fixed Euro Exchange (FEE) rate parameters used in drug pricing in Türkiye.
Access to cancer drugs was evaluated by drug box sales figures obtained from IQVIA. Box sales data were classified according to diagnosis codes (ICD-10), reference, or generic status. Consumption of cancer drugs was examined over time with panel regression analysis, taking into account variables of population growth, cancer incidence, and the FEE rate in drug pricing in Türkiye.
The incidence of cancer in Türkiye was 215.1 in 2010 and 223.1 (per hundred thousand) in 2017. Whereas there was a 127.02% increase in the real euro exchange rate, there was an 89.6% increase in the FEE rate. With the regression approach, there is a negative relationship between the real and fixed exchange rate difference (RFED) and reference and generic drug consumption data. Medicine access is affected depending on diagnosis codes at different levels. Colorectal cancer medicine sales had negative correlations for each variable, namely, exchange rate, population growth, and cancer incidence. On the contrary, there was a positive correlation between non-small-cell lung cancer and relevant variables. Innovative medicine groups such as monoclonal antibodies and protein kinase inhibitor consumption showed a negative correlation.
According to our results, pricing strategy may be an access barrier for oncology medicines in Türkiye. It should be reviewing the pricing policy that is beneficial for oncology medicine access in Türkiye.
Aim: The top 100 medicines having the highest annual average sales between the years 2006 and 2015, had exceeded one-fourth of the total pharmaceutical market’s value in these years. We aimed to ...study the status of biotechnological medicines among these medicines and evaluate the effects of policy interventions on their sales.
Methods: Sales of all medicines on an annual average value basis were calculated. The top 100 medicines with the highest annual average sales were included in the study. Time series analysis has been used for prospective estimations.
Results: Up to 2007 biotechnological medicines had not been in the top ten medicines; it increased dramatically after 2007 and in 2016, the sales of biotechnological medicines reached to 82% in top 10 sales in Turkey. On the other hand the number of biotechnological medicines among the top 100 medicines was 4 in 2003; it reached to 27 in 2016. However the number of biotechnological medicines in the top 10 medicines was 1 in 2003 and it reached to 8 in 2016.
Conclusion: The shares of biotechnological medicines in both the total pharmaceutical market and in the group of medicines with high sales are increasing every year. New policies should be developed to ensure the stability of the reimbursement system.
To study the variation in CYP1A2 activity in relation to smoking, gender, age and CYP1A2 polymorphisms.
CYP1A2 activity was determined by plasma paraxanthine:caffeine ratio (17X:137X) 4 h after the ...intake of a standardized cup of coffee in 146 Turkish healthy volunteers. Seven CYP1A2 polymorphisms (-3860G>A, -3113G>A, -2467del/T, -739T>G, -729C>T, -163C>A and 5347T>C) were analyzed.
The 17X:137X ratios were increased in smokers (p < 0.0001) and tended to be higher in men both among nonsmokers (p = 0.051) and smokers (p = 0.064). Age-related differences were observed only among nonsmoking women (p = 0.024). The -163C>A polymorphism correlated with 17X:137X ratios only in smokers (p = 0.006). Furthermore, increased 17X:137X ratios were observed in CYP1A2 haplotype H4 (-3860G, -3113G, -2467del, -739T, -729C, -163A and 5347T) carriers in the overall study population (p = 0.026). Multiple regression analyses including smoking, gender, -163C>A genotype and age revealed a significant influence of smoking (p < 0.0001) and gender (p = 0.002) in the overall study population. However, in nonsmokers only the influence of gender remained significant (p = 0.021), while in smokers the influence of the -163C>A genotype held the statistical significance (p = 0.019). The influence of haplotype H4 remained significant (p = 0.028) in the overall study population in similar analyses.
Smoking has the strongest impact on CYP1A2 activity, while gender and haplotype H4 showed marginal effects. The influence of the -163C>A polymorphism on CYP1A2 activity in smokers suggests an effect on the inducibility of the enzyme.
The endocannabinoid system and prostaglandins are important modulators in the genitourinary system. This study aimed to investigate the possible interactions between the endocannabinoid system and ...the cyclooxygenase (COX) pathway on rat vas deferens. For this purpose, the concentration responses of the endocannabinoid anandamide, prostaglandin F
2α
analog latanoprost, and prostaglandin E
1
analog misoprostol on the electrical field stimulation (EFS)-induced contractile responses were obtained. The concentration responses to anandamide were obtained again in the presence of nonselective COX inhibitor flurbiprofen and prostaglandin analogs, while the concentration responses of latanoprost and misoprostol were obtained in the presence of cannabinoid receptor antagonists and fatty acid amide hydrolase (FAAH) enzyme inhibitor URB597. FAAH, COX-1, and COX-2 enzyme levels in vas deferens tissue samples were also determined. The cumulative addition of anandamide was not different from the vehicle; however, the EFS-induced contractile responses were significantly increased with the incubation of latanoprost or flurbiprofen in the prostatic portion. Flurbiprofen and misoprostol decreased FAAH enzyme levels in both portions of the vas deferens, while latanoprost induced the inhibition in the prostatic portion. The cumulative administration of latanoprost and misoprostol significantly enhanced the contractile responses in the prostatic portion. This effect of latanoprost was significantly antagonized by URB597 and AM251. The enhancing effect of misoprostol was antagonized by anandamide, URB597, AM251, and AM630. Anandamide, AM251, AM630, and URB597 decreased enzyme levels of COX-1 and COX-2 in both portions of the vas deferens. These results demonstrate an intricate crosstalk between endocannabinoids and prostaglandins in modulation of the vas deferens contractility.
ADHD Medication Trends in Turkey: 2009-2013 Öner, Özgür; Yilmaz, Esra Şafak; Karadağ, Hasan ...
Journal of attention disorders,
12/2017, Volume:
21, Issue:
14
Journal Article
Peer reviewed
Objective: To investigate the change of ADHD medication prescriptions in Turkey between 2009 and 2013. Method: Consumption data of ADHD medications, immediate release (IR) methylphenidate (MPH; ...Ritalin), OROS MPH (Concerta), and atomoxetine (Strattera) were obtained from IMS Health database for the November 2008 to October 2013 period. Defined daily dose (DDD) of each drug was calculated according to WHO definitions and time-series analysis was conducted. Results: There was a significant seasonal effect for prescription of all drugs. Annual use of ADHD medications increased 2.18 times for all ADHD medications combined. DDDs per 1,000 population per day for all ADHD medications were 0.28 in 2009, 0.41 in 2010, 0.52 in 2011, and 0.59 in 2012. OROS MPH represented almost 75% of all ADHD medication utilization. Conclusion: As reported from several other countries, ADHD medication use increased in Turkey. Results suggested that over- and underdiagnosis might be seen at the same time.
The effect of chronic lithium treatment on morphine-induced analgesia was studied in a time-dependent manner in old mice. All mice received lithium chloride via drinking water of 600 mg/l for three ...weeks. Both basal pain sensitivity and morphine-induced analgesia were determined with a hot-plate test before and after chronic lithium drinking at six different times of the day every four hours. Chronic lithium exposure did not cause any significant change in basal pain sensitivity but the circadian rhythm of morphine analgesia disappeared in old mice. These findings suggest that biological rhythms may alter pharmacokinetic and pharmacodynamic properties of drugs and conversely drugs may alter the rhythmic properties of biological functions. Thus, administration time of drugs should be considered in both experimental designs and clinical settings.
With the rise in life expectancy, the burden of chronic diseases, including obstructive pulmonary diseases, has increased throughout the world.
To evaluate the sales trends of inhaler ...pharmaceuticals.
The changes in box sales and sales amounts (in Turkish lira) of inhaler pharmaceuticals during the period 1998 to 2015 were examined and sales were projected for the next 3 years. Pharmaceuticals were classified according to form and pharmacological groups.
The sales of inhaler pharmaceuticals have increased rapidly since 2008. The fastest increase in consumption has occurred in short-acting β2 agonist preparations and nebulizer pharmaceuticals. Inhaled corticosteroid and long-acting β2 agonist combination sales have been the highest since 2002, when these products entered the Turkish market.
The inhaler pharmaceutical market has grown over the years, and this growth will continue in the future. The increased use of short-acting preparations, which should be used as symptom relievers, indicates that treatment management continues to be inadequate.
Vaccaria hispanica
is an interesting species with attractive agronomic properties and a wealth of valuable bioactive compounds, potentially useful for many different purposes. Surprisingly, the ...number of studies focused on the development of in vitro tools for a rapid production of clonal populations is extremely limited. In the present study, two wild Turkish genotypes, previously characterized as high starch and saponin producers, are used to explore the possibilities of regenerating clonal plants through somatic embryogenesis and organogenesis. This work investigates the independent effects of genotype, type of explant and composition of the culture medium, and the interactions among them, in the growth and proliferation of calli from the explants, and the induction of somatic embryogenesis and organogenesis fron the callus surface. Some of the interactions were found significant to promote these processes.
V. hispanica
proved to be especially responsive for callus induction from all the explants tested. Particular explant types and combinations of plant growth regulators have been identified as especially suitable to induce the different morphogenic processes.
V. hispanica
is remarkably prone to produce thin adventitious roots, which may be a problem when trying to induce somatic embryogenesis or shoot organogenesis. However, this can be exploited to develop a convenient system for in vitro secondary metabolite production.
Key Message
Vaccaria hispanica
has proven to be responsive to callus formation, somatic embryogenesis and organogenesis. Also, it is prone to producing thin adventitious roots important for in vitro secondary metabolite production.
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