International Journal of Pharmaceutical and Healthcare Marketing

The retail health clinic model: economically viable? : Table of Contents

Eric W. Hayden — Sun Jun 21 14:15:05 BST 2009

Abstract:
Purpose – In early 2008, the Massachusetts Public Health Council voted to allow walk-in healthcare clinics to operate in the state. The charged public debate leading up to the decision pointed to the need for an objective examination of retail health care delivery – the concept, historical evolution, and relative pros and cons – as well as an assessment of its long-term prognosis. This paper aims to assess the situation. Design/methodology/approach – An online literature review identified several useful background resources, including a business school case, a medical journal article, and a cost study. The internet also provided access to the web sites of major clinic operators, the positions of various physician groups, news releases, and investor conference calls of the industry leader. The research was further informed by the findings of a third-party interactive survey of clinic users and a small onsite sampling by the author. Findings – Less than a decade old, the retail health care clinic business is in the midst of significant consolidation, with CVS Caremark and Walgreens emerging as the key players. Still a loss-leader, the business stands to gain from several structural changes underway in the American health care industry, discussed in the paper. Benefiting from those changes, however, will require a significant increase in foot traffic into the host stores, i.e. to the clinics themselves and also for ancillary shopping. Until then, the economic viability of the clinics remains unclear. Originality/value – The paper provides a concise assessment of the status of a business with significant potential to help contain health care costs.

Price discrimination by pharmaceutical companies across Central American countries : Table of Contents

Mariano Rojas — Sun Jun 21 14:15:05 BST 2009

Abstract:
Purpose – Price becomes a main instrument for rationing pharmaceutical drugs in Central America as a consequence of pro-market reforms implemented in the 1980s. Under market-rationing conditions, people's access to branded drugs does depend on their purchasing power and on the vector of prices they face. The purpose of this paper is to study the regional pricing strategy followed by pharmaceutical firms across Central American countries. These countries differ in such economic factors as per capita income, income distribution, market size, and nature and extent of their social-security system; thus, there are conditions that foster the implementation of price-discrimination practices across the region. Design/methodology/approach – The investigation takes advantage of a large database with information about prices of identical drugs sold across Central American countries and produced by 17 large pharmaceutical companies. Regression analyses are used to study whether price discrimination exists in Central American drug markets and what pricing strategies are followed by different pharmaceutical companies. Findings – Results show that there are significant differences in the prices of identical drugs across the Central American countries, as well as that pharmaceutical companies follow different pricing strategies. Originality/value – Cross-country price comparisons are usually based on constructed price indices, which imply losing detailed information about the products being compared. This investigation uses prices of identical drugs, rather than constructed price indices, to study cross-country price differences by pharmaceutical companies across the Central American region. The study of price discrimination is crucial to understanding how markets end up rationing such an essential product as pharmaceutical drugs.

Cloned food labeling: history, issues, and bill S. 414 : Table of Contents

Jennie Feight, Nashat Zuraikat — Sun Jun 21 14:15:05 BST 2009

Abstract:
Purpose – The issue of cloned food labeling came to the forefront on January 15, 2008, with the release of a controversial report by the Food and Drug Administration (FDA). This paper aims to explore issues surrounding cloned food sources, specifically the increasingly vocal demands by the American public for mandatory labeling. Design/methodology/approach – This paper reviews literature to examine the culture and structure of the FDA over the past ten years. Ethical, economic and public health concerns surrounding cloned food sources are also examined. Comparisons are made to the shared history of genetically modified organisms (GMOs). Political process and implementation of the Cloned Food Labeling Act (S. 414) are explored. Findings – The FDA faces legal and cultural pressure to speed medications to market. The processes created by this struggle also affect the regulation of agriculture; this can be seen in the similar histories of GMOs and cloned food. Ethical issues surrounding cloned food labeling include animal welfare and the usurpation of the creator's role. Other ethical issues are entwined in health and economic concerns. Health issues include the capacity of the FDA to track allergic reactions and the possibility of future protein abnormalities among consumers. Environmental and herd health are identified as more global health concerns. Practical implications – The combined economics of the biotech cloning and agricultural industries invert the usual law of supply and demand. This economic dynamic may either hurt small farmers or potentially benefit those who eschew cloning due to ethical or financial constraints. The current political climate exerts an interesting dynamic on the cloned food labeling debate. Consumer issues are pushed aside in the excitement of a new administration and more pressing issues such as the recessed economy. Biotech industries have the ability to maintain focus in the midst of distracting national issues; however, legislative opponents may have newfound strength with a majority congress. Originality/value – Functioning as an historical overview and theoretical framework for those studying cloned food safety and labeling issues, this paper is useful in engendering ethical discussions. It also highlights the need for statistical and public health research on cloned food safety.

The endogenous modeling of the effect of direct-to-consumer advertising in prescription drugs : Table of Contents

G.K. Kalyanaram — Sun Jun 21 14:15:05 BST 2009

Abstract:
Purpose – The purpose of this paper is to study two major research objectives. The first objective is to investigate the effect of direct-to-consumer advertising (DTCA) on market share in the pharmaceutical drugs industry by modeling advertising decision of the firm as an endogenous decision. The second objective is to examine and determine whether there is any empirical support for the argument advanced by medical insurers and providers that DTCA advertising encourages brand switching. Design/methodology/approach – Data on sales, price, DTCA, direct-to-physician advertising (DTPA), and average cost of consumption per usage for three prescription (Rx) drugs categories was obtained for the period, January 1998 to December 1999. A simultaneous model of market share and DTCA is proposed. Market share is modeled as a function of DTCA, price, the intensity of competition as represented by the number of competitive brands, and DTPA. DTCA is modeled as a function of its lagged market share (with the optimal number of lags to be determined empirically), and the average cost per consumption usage. Findings – This paper finds that there is a positive and significant effect of DTCA on market share when advertising decision is modeled as an endogenous decision. The empirical results suggest brand switching by consumers. There is, thus, some evidentiary support for the argument made by the insurance providers. Originality/value – This paper is unique for two reasons. First, the paper estimates the effects of DTCA in a simultaneous model accounting for endogenous decision by the firm. Therefore, the estimates are unbiased and robust. Second, the paper investigates the important public policy question of the social welfare of DTCA.

Understanding health, culture, and empowerment in a disability context : Table of Contents

Poh-Lin Yeoh — Sun Jun 21 14:15:05 BST 2009

Abstract:
Purpose – The purpose of this paper is to understand the different kinds of health-promotion activities undertaken by Chinese individuals in managing their disability from multiple sclerosis (MS). Design/methodology/approach – The theory of control behavior was used in this study to understand the different kinds of primary and secondary health-coping strategies used by participants and their impact on intra- and inter-personal empowerments. Using semi-structured interviews, interpretive phenomenology was used to elicit and analyze attitudes and behaviors of Chinese participants' management of MS. Findings – Unlike previous studies which only emphasized the tangible aspects of physical health, the current paper suggests the importance of viewing health benefits in a more holistic manner. It was clear from the Chinese participants that “disability” and “healthy” were not viewed as two separate concepts. Being healthy does not mean an absence of disease but as role functioning, energy and vitality, social relationships, and emotional well-being. The exploratory paper also found that empowerment outcomes involved an interaction of both the inter- and intra-personal components and, at the same time, were driven by primary and secondary control-related preferences. Research limitations/implications – Future research should include individuals with other disabilities and different demographic and socio-cultural characteristics to confirm the generalizability of the findings uncovered here. Practical implications – The impact of culture and contextual/situational variables on individual's choice of primary and secondary control strategies has important implications for developing health strategies across different ethnic minority groups. Originality/value – The results provide support for the view that there are two dimensions to the process of patient empowerment. Rather than emphasizing primary control strategies, individuals can empower themselves by maintaining a balance between primary and secondary control strategies with respect to their health-related goals.