| 1. |
- Carlsen, H., et al.
(författare)
-
Assessing socially disruptive technological change
- 2010
-
Ingår i: Technology in society. - : Elsevier BV. - 0160-791X .- 1879-3274. ; 32:3, s. 209-218
-
Tidskriftsartikel (refereegranskat)abstract
- The co-evolution of society and potentially disruptive technologies makes decision guidance on such technologies difficult. Four basic principles are proposed for such decision guidance. None of the currently available methods satisfies these principles, but some of them contain useful methodological elements that should be integrated in a more satisfactory methodology. The outlines of such a methodology, multiple expertise interaction, are proposed. It combines elements from several previous methodologies, including (1) interdisciplinary groups of experts that assess the potential internal development of a particular technology; (2) external scenarios describing how the surrounding world can develop in ways that are relevant for the technology in question; and (3) a participatory process of convergence seminars, which is tailored to ensure that several alternative future developments are taken seriously into account. In particular, we suggest further development of a bottom-up scenario methodology to capture the co-evolutionary character of socio-technical development paths.
|
|
| 2. |
- Godman, Marion
(författare)
-
But is it unique to nanotechnology? : Reframing nanoethics
- 2008
-
Ingår i: Science and Engineering Ethics. - : Springer Science and Business Media LLC. - 1353-3452 .- 1471-5546. ; 14:3, s. 391-403
-
Tidskriftsartikel (refereegranskat)abstract
- Attempts have been made to establish nanoethics as a new sub-discipline of applied ethics. The nature of this sub-discipline is discussed and some issues that should be subsumed under nanoethics are proposed. A distinction is made between those issue that may ensue once nanotechnology applications become available and procedural issues that should be integrated into the decision structure of the development. A second distinction relates to the central value of the ethical issue. The conditions for the ethical debate differ depending on whether the value(s) in question is internal to the technological development (i.e. health and safety) or external to it (i.e. privacy, equity etc).
|
|
| 3. |
- Godman, Marion, et al.
(författare)
-
European public advice on nanobiotechnology - Four convergence seminars
- 2009
-
Ingår i: NanoEthics. - : Springer Science and Business Media LLC. - 1871-4757 .- 1871-4765. ; 3:1, s. 43-59
-
Tidskriftsartikel (refereegranskat)abstract
- In order to explore public views on nanobiotechnology (NBT), convergence seminars were held in four places in Europe; namely in Visby (Sweden), Sheffield (UK), Lublin (Poland), and Porto (Portugal). A convergence seminar is a new form of public participatory activity that can be used to deal systematically with the uncertainty associated for instance with the development of an emerging technology like nanobiotechnology. In its first phase, the participants are divided into three "scenario groups" that discuss different future scenarios. In the second phase, the participants are regrouped into three "convergence groups", each of which contains representatives from each of the three groups from the first phase. In the final third phase, all participants meet for a summary discussion. This pilot project had two aims: (1) to develop and assess the new methodology and (2) to gather advice and recommendations from the public that may be useful for future decisions on nanobiotechnology (NBT). Participants emphasized that they wanted the technology to focus on solutions to environmental and medical problems and to meet the needs of developing countries. The need for further public participation and deliberation on NBT issues seemed to be acknowledged by all participants. Many of them also raised equality concerns. Views on the means by which NBT should be steered into socially useful directions were more divided. In particular, different views were expressed on how much regulation of company activities is needed to curb unwanted developments. The participants' responses in a questionnaire indicate that the methodology of the convergence seminars was successful for decision-making under uncertainty. In particular, the participants stated that their advice was influenced both by access to different possible future developments and by the points of view of their co-participants, which is what the method is specifically intended to achieve.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Malmström, Rickard E., et al.
(författare)
-
Dabigatran - a case history demonstrating the need for comprehensive approaches to optimize the use of new drugs
- 2013
-
Ingår i: Frontiers in Pharmacology. - : FRONTIERS RESEARCH FOUNDATION. - 1663-9812. ; 4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There are potential conflicts between authorities and companies to fund new premium priced drugs especially where there are safety and/or budget concerns. Dabigatran, a new oral anticoagulant for the prevention of stroke in patients with non-valvular atrial fibrillation (AF), exemplifies this issue. Whilst new effective treatments are needed, there are issues in the elderly with dabigatran due to variable drug concentrations, no known antidote and dependence on renal elimination. Published studies have shown dabigatran to be cost-effective but there are budget concerns given the prevalence of AF. There are also issues with potentially re-designing anticoagulant services. This has resulted in activities across countries to better manage its use. Objective: To (i) review authority activities in over 30 countries and regions, (ii) use the findings to develop new models to better manage the entry of new drugs, and (iii) review the implications for all major stakeholder groups. Methodology: Descriptive review and appraisal of activities regarding dabigatran and the development of guidance for groups through an iterative process. Results: There has been a plethora of activities among authorities to manage the prescribing of dabigatran including extensive pre-launch activities, risk sharing arrangements, prescribing restrictions, and monitoring of prescribing post-launch. Reimbursement has been denied in some countries due to concerns with its budget impact and/or excessive bleeding. Development of a new model and future guidance is proposed to better manage the entry of new drugs, centering on three pillars of pre-, pen-, and post-launch activities. Conclusion: Models for introducing new drugs are essential to optimize their prescribing especially where there are concerns. Without such models, new drugs may be withdrawn prematurely and/or struggle for funding.
|
|
| 7. |
- Martin, Andrew, et al.
(författare)
-
Measures to improve angiotensin receptor blocker prescribing efficiency in the UK : findings and implications
- 2014
-
Ingår i: Journal of Comparative Effectiveness Research. - : Becaris Publishing Limited. - 2042-6305 .- 2042-6313. ; 3:1, s. 41-51
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Generic losartan provides an opportunity to enhance angiotensin receptor blocker (ARB) prescribing efficiency, with all ARBs essentially being similar. Initially, there was limited activity in NHS Bury (UK). This changed in March 2011 with therapeutic switching and other measures encouraging the prescribing of losartan following generics to enhance its utilization versus patented ARBs. Aim: This study aims to assess the impact of multiple measures on losartan utilization, its price and total ARB expenditure. Methods: An interrupted time series analysis was performed. Utilization was measured as prescription items dispensed, typically 28 days. Results: No immediate change in losartan utilization was observed following generics. This changed after the multiple initiatives with losartan accounting for 65% of all single ARB items dispensed by the study end. ARB expenditure was 59% below prestudy levels by the study end, which was helped by a 92% reduction in expenditure per item for losartan. Annual net savings from the program were estimated at just under GB 290,000 pound, which is over eight-times the cost of implementation. Conclusion: Multiple measures can enhance prescribing efficiency. Health authorities cannot rely on a spillover' effect from other classes in order to affect changes in physician prescribing habits.
|
|
| 8. |
- Wilking, Nils, et al.
(författare)
-
Drug utilization research in the area of cancer drugs
- 2016
-
Ingår i: Drug Utilization Research: Methods and Applications. - 9781118949788 ; , s. 315-327
-
Bokkapitel (refereegranskat)abstract
- Increased biological understanding of cancer diseases has resulted in a paradigm shift in the medical treatment of cancer. Despite encouraging advances, most cancer types are still incurable and cancer is the second most common cause of death in developed countries.The high price of cancer drugs is a major challenge to equal access and puts heavy strains on public health care payers. After sharp increases in the 2000s, total expenditures on cancer drugs have levelled off due to patent expiration of many expensive and widely used drugs.Cancer drug utilization studies cover a great variety of topics. Four main research areas are patient adherence, physician adherence to guidelines, effectiveness and safety (outcomes research) and access (market uptake).Most cancer drugs are classified under Anatomical Therapeutic Chemical (ATC) group L. The use of defined daily dose (DDD) as a measurement unit is feasible for oral cancer drugs. As most cancer drugs are administered as infusions or injections at hospitals, usage is commonly measured in milligrams.Drug utilization research in the area of cancer is faced with a lack of data. Comparisons are challenging, as prices and population bases vary across regions. The linkage of registries and health care databases that include cancer drug usage will create improved opportunities in the future.
|
|
