Mar 20 2014

How important is patient brand loyalty in the uptake of generic drugs?

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by Joan Costa Font, Caroline Rudisill and Stefanie Tan

Many western countries have developed policies to promote the substitution of branded ‘originator’ drugs with generic drugs, with the aim of containing pharmaceutical costs. However, success has been patchy and in some countries the phenomenon of the ‘generics paradox’ has been observed, where manufacturers are able to increase the prices of branded drugs after the market has been opened to generics. Using data from Spain, our study explored the extent to which the brand loyalty of patients – as opposed to their doctors or health insurers – plays a part in keeping the market penetration of generic drugs at a low level. Its findings suggest that the uptake of generics could be increased through targeted education and information on the identical properties of generics and the branded drugs they are intended to replace.

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Mar 18 2014

Strengthening child health and health services

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by Sherry Merkur, Anna Maresso and David McDaid

Because children are not just small adults, efforts to improve their health and the relevant health services they use must be tailored accordingly. Each stage of early life – from infancy to adolescence – has distinct illnesses, developmental issues and challenges. Furthermore, children rely on their families and other caregivers to identify and manage any ill health and are particularly sensitive to the effects of social conditions. The latest issue of Eurohealth (volume 20, issue 1), which has just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner), looks at some recent developments in this area. It aims to draw attention to the challenges of child health and health services in Europe, and to strengthen our understanding of the challenges facing European Member States and health systems in this regard.

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Mar 17 2014

The role of managers in promoting social acceptance among people with depression in the workplace

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by Sara Evans-Lacko and Martin Knapp

Our research highlights the important role that managers and organisations can play by creating supportive working environments that promote social acceptance for employees with depression. By doing so, employees will feel more comfortable in discussing any potential mental health issues early on. Our findings suggest that some responses, such as flexible working hours, may be helpful but are not necessarily adequate, and also emphasise the importance of support and openness of managers in addition to flexible working hours.

Depression is the leading cause of disability worldwide. Although 30 million people in Europe and 350 million people worldwide struggle with depression, many workplaces underestimate its impact. Given the high prevalence and the significant economic consequences associated with depression, employers and managers need to take a proactive approach to supporting employees with depression.

Despite a lot of publicity surrounding mental illness and the growth in efforts to reduce stigma, such as the Time to Change campaign1 there is still a major stigma associated with depression and many employers are not dealing with it adequately.

To look at this issue more in depth across Europe, we analysed data from 7065 employees and managers recruited from seven European countries: the United Kingdom, France, Italy, Spain, Germany, Turkey and Denmark to better understand the social impact of depression in the workplace and the role of managers and employers in facilitating a positive work environment and access to appropriate and effective treatment in order to mitigate the risk and impact of depression in the workplace.

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Mar 11 2014

The Mental Capacity Act and social care research

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by Michael Clark

The Mental Capacity Act (MCA) 2005 came in to force in 2007 in England and Wales and provides a legal framework to protect people who lack the capacity to make decisions for themselves. It has significant implications for health and social care practice, details of which are covered in some excellent resources (for example see SCIE guidance). The Act also has implications for researchers in the field. Michael Clark, from the NIHR School for Social Care Research, describes what should be considered when planning to include people who lack capacity to make decisions in research projects.

The provisions in the MCA for health and social care research are included in Sections 30-33. These clauses make it lawful to conduct intrusive research involving people who lack capacity. The intention behind these sections was to clarify practice in a previously grey area and to enable research to include people. It was not intended to be seen as a barrier to be being inclusive in research.

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Feb 24 2014

A hidden face of community mental health care in Africa

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by Victoria de Menil, David Ndetei, Milka Waruguru, Martin Knapp, David McDaid

© Victoria De Menil

© Victoria De Menil

In much of sub-Saharan Africa, community mental healthcare and specialist mental healthcare are not synonymous. Apart from traditional and faith healing, primary care providers are thought to be the sole purveyors of mental healthcare outside of hospital settings, while specialists operate through hospital-based outpatient clinics. While true of the public sector, this dichotomy is missing something. The hidden face of community mental healthcare in Africa is private specialist providers in outpatient settings.

Kenya serves as an interesting case study, since its private health sector is particularly well developed. We conducted a small-scale study, administering semi-structured interviews to 11 private mental health specialists (8 psychiatrists, 3 psychiatric nurses) from the capital and a more rural area to better understand what services they provide, what type of patients were accessing those services, and at what cost.

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Feb 21 2014

New Eurohealth on EU cross-border health care collaboration

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by Anna Maresso and David McDaid

By 25th October 2013, European Union Member States should have transposed the Directive on the application of patients’ rights in cross-border healthcare into national law, thus promoting a new era of opportunities for patients seeking health care services in an EU country other than their own.

This issue’s Observer section starts with an overview that examines the complex reasons why cross-border care is needed and the driving factors that have underpinned the eventual passage of the new Directive. The authors highlight that despite bringing much needed clarity to cross-border health care issues, there are gaps in the Directive that could be addressed fruitfully in the future.

Ten case study articles follow, based on the results of research undertaken as part of the Evaluating care Across Borders: European Union Cross Border care Collaboration (ECAB: EUCBCC) project which has sought to analyse a number of the collateral issues connected to cross-border care and collaboration which are sometimes not fully accounted for in the Directive.

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Feb 18 2014

Are economic recessions at the time of leaving school associated with worse health in later life?

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by Philipp Hessel and Mauricio Avendano

Men who leave school or university during a recession experience better health in later life than men graduating during a boom, while women experience worse health if leaving school or university during a recession.

Youth unemployment in Europe has recently reached unprecedented levels with about a quarter of those aged between 15 and 24 unemployed, making this group the most affected by the recession. Recent graduates spend an average of 5.5 months looking for a job, and face serious concerns about their future career prospects.

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Feb 5 2014

The European Observatory on Health Systems and Policies launches new web platforms on health systems and financial crisis

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by Cristina Hernández-Quevedo, Jon Cylus and Anna Sagan, on behalf of the European Observatory on Health Systems and Policies

Two new web platforms have been recently launched by the European Observatory on Health Systems and Policies to promote international comparison and support evidence-informed policy making in health. Through the new platforms, policy makers and other interested stakeholders will be able to monitor how health systems develop in a range of different countries, and to access the growing body of evidence around health and the financial crisis.

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Jan 31 2014

Research highlight: Unit cost programmes at PSSRU

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For more than 20 years, the Personal Social Services Research Unit (PSSRU) at Kent and LSE has been pioneering approaches for estimating the costs of public sector services. Today we highlight some of the outstanding unit cost research – past and present – that has come out of the Unit.

What are unit costs and why are they needed?

Understanding the way money flows through organisations and feeds into services is crucial to ensuring high quality service provision. Unit costs – the cost of one unit of “output”, such as one hour of GP time or one case review performed by a social worker – are an important aspect of assessing performance and “value for money”.

The underlying idea is a simple one: Resources, such as social worker time, are needed to provide a service such as child protection services. Estimating the cost of resources going into service provision is what unit cost work is all about.

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Jan 28 2014

Helping family carers of people with dementia to cope is cost-effective

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by Martin Knapp, Derek King, Gill Livingston, Renee Romeo

Much policy attention is now being focused on dementia, and this includes attention to the many thousands of unpaid family carers who support people with this most devastating of illnesses. Those carers are often very stressed by their caring responsibilities. A new coping strategy delivered to individual carers could help. We describe the strategy and show how a careful evaluation demonstrated that it was both effective and cost-effective.

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