Dictionary of Evidence-based Medicine.pdf

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Dictionary of Evidence-based Medicine 125 that prices, profits and costs are within acceptable limits. Historically, profits of about 20% are deemed reasonable and aggregate expenditure on sales promotion is limited to 9% of total sales. For comparison most large established pharmaceutical companies spend about 10% of total sales on research and development. The PPRS system is meant to be voluntary but clearly the perceived penalty attached to non-acquiescence ensures that most companies adhere to the scheme. The complexity of transfer pricing by multinationals makes this system difficult to police. The Public Accounts Committee reviews the agreement at regular intervals. There is much controversy about the value of PPRS. The UK government would point out that its application has led to a thriving pharmaceutical industry but others have argued that it is a disincentive to investment in research and development (Green DG, Brown P, Burstall ML et al. (1997) Should pharmaceutical prices be regulated Institute of Economic Affairs, Health and Welfare Unit, London). Practice guidelines Practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances (Field MJ, Lohr KN (eds) (1990) Clinical practice guidelines: directions for a new program. National Academy Press, Washington DC). Pragmatic trial (see under Intention to treat analysis) P re-certification Pre-certification refers to the system whereby clinicians, usually within a managed care system, must seek permission to provide specific services to patients before initiating such treatment. Pre-consent randomization design (see under Post-randomization consent design) Prescribing analysis and cost data (see PACT data) Prescription Drug User Fee Act 1992 The Prescription Drug User Fee Act 1992 (PDUFA) is a US law which authorizes the US Food and Drug Administration to levy user fees on
126 Dictionary of Evidence-based Medicine manufacturers who submit licence applications to the agency. The objective was to generate additional funding to eliminate the backlog of applications and speed up approval time for new drug and biological applications. The aim was to complete the review of 90% of priority applications within six months and standard applications within 12 months. A recent review indicates that the approval time for user fee drugs was considerably shorter than for non-user fee drugs - 14.5 versus 31 months (Prescription Drug User Fee Act 1992. Public law 102-571 (October 29, 1992); 21 USC 379; 106 Stat 4491. Kaitin KI (1997) The prescription user fee act of 1992 and the new drug development process. American Journal of Therapeutics. 4: 167-72). Price sensitivity Price sensitivity refers to how sensitive sales of a product are to changes in price. Unlike price elasticity, price sensitivity is a qualitative concept (Nagle TT, Holden RK (1994) The strategy and tactics of pricing: a guide to profitable decision making. 2nd edn. Prentice-Hall Inc, Englewood Cliffs). Primary care Primary care has recently been defined as the function of providing 'integrated, accessible health care services by clinicians who are accountable for addressing a large majority of health needs, developing a sustained partnership with patients, and practising in the context of family and the community' (Donaldson MS, Yordy KD, Lohr KN, Vaselow NA (eds) (1996) Primary care: America's health in a new era. National Academy Press, Washington). Primary care groups Primary care groups (PCGs) are a new organizational entity announced by the UK government in its 1997 White Paper on proposed reforms of the National Health Service (DoH (1997) The new NHS. Cmd 3807. HMSO, London). The PCGs will unify the budgets and management of teams of general practitioner (GP) practices and are intended to replace health authorities and individual GP fundholders. The PCGs will have the opportunity to become freestanding primary care trusts. The government's intention is for each PCG to contain up to 50 GPs from as many as ten practices and typically cover populations of 100 000.
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Dictionary of Evidence-based Medici
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Preface This book was conceived at
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A Ability to pay Ability to pay is
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Figure I Audit: Clinical audit cycl
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B Balanced design In an experiment,
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Figure 9 Concept of externality Dic
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G Game theory Game theory, first de
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Page 86 and 87: I ICD (see International Classifica
Page 94 and 95: K Keynes, John Maynard (1883-1946)
Page 100 and 101: M Macroeconomics Macroeconomics is
Page 112 and 113: N N of I trial An N of 1 trial is a
Page 116 and 117: o OBM (see Opinion-based medicine)
Page 140 and 141: Figure 25 Measuring quality of life
Page 150 and 151: S Scarcity Scarcity is often referr
Page 158 and 159: T TDM (see Therapeutic drug monitor
Page 162 and 163: u Unique value effect This term is
Page 170: Z Z variate A random variable which
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