Prescribing for off-label use and unauthorized medicines in three paediatric wards in Finland, the status before and after the European Union Paediatric Regulation

2013 ◽  
Vol 39 (2) ◽  
pp. 144-153 ◽  
Author(s):  
L. Lindell-Osuagwu ◽  
M. Hakkarainen ◽  
K. Sepponen ◽  
K. Vainio ◽  
T. Naaranlahti ◽  
...  
2017 ◽  
Vol 44 (1) ◽  
pp. 17-21 ◽  
Author(s):  
M. Drenska ◽  
I. Getov

Abstract Despite the increasingly strict legislation on medicinal products, the „off-label use“ or „use of medicinal product outside the approved summary of product characteristics (SmPC)“ is a weak point of today’s drug regulation and raises many questions about the risk, ethics, and legality of this type of practice. In recent years, through guidance and legal changes in some countries were defined the conditions and responsibilities, but in the most European countries still lack rules for off-label prescribing. The purpose of this study was to identify and analyse different approaches to regulation, adopted by some member states as well as to summarize the efforts in demand of common harmonized approach to solve this problem within the European Union. In the study, we used the available regulatory information in different electronic resources associated with the off-label drug use in selected European countries without limited time range. The results show that decisions taken to regulate the issue have significant differences and specific approach, while none of them is enough satisfactory and comprehensive. In conclusion, it can be claimed that the existing regulatory rules in various countries require significant improvement and update.


2020 ◽  
pp. 1-22
Author(s):  
Wolney da Cunha SOARES JÚNIOR

Many governments have implemented a controlled off-label use of medicines as a tool combined with reimbursement decisions, among other policies, to avoid pharmaceutical firms gaming regulatory systems based on the requirement for marketing authorisation. This article aims to compare the drug regulations in selected European Union countries (France, Italy and Germany) in order to identify specific provisions and concrete solutions implemented by them regarding that matter. The employment of an economic analysis of the law as a theoretical framework allows for the identification of the incentives created in the long run by the referred regulations. The scholarly literature identifies a myriad of drawbacks and advantages associated with off-label practices, and a welfare analysis is ambiguous. Off-label practices are a reality; thus, it is advisable to elaborate policy measures in order to address these practices and condition them on some requirements, taking into account that off-label practices imply trade-offs among access to healthcare, protection of public health, competitiveness and innovation in the industry.


2011 ◽  
Vol 1 (2) ◽  
pp. 203 ◽  
Author(s):  
Julijana Angelovska

The objective of the research is to investigate the impact of political events – “name issue” on the Macedonian Stock Exchange (MSE). Structural changes in volatility of Macedonian capital market seems to be more a consequence of political changes, especially from the perspective of international politics and the association of the country into NATO and the European Union. The research analyzes the response of capital markets to political events. Such an event is the summit in Bucharest as the day D (03/04/2008) which certainly had an impact because of prolonged unresolved problem of the name imposed by Greece. Visa liberalization and the day of solving the status of candidate country for accession to the European Union will be discussed too. An event methodology is employed, and the results suggest that the market respond to all political events connected “name issue”. The results also indicate that there is no difference between the means of abnormal returns before and after the event. Sensitivity of the Macedonian investor related to any information connected to the word "name" is enormous. The Macedonian investor belief is that if “name” issue would be solved, regardless of possible negative real economic flows stock exchange will increase. The paper provides information regarding the effects of solving this name issue on Macedonian investor, and his expectation on this issue. But even if it is solved, the global economic crises and difficult economic situation in Macedonia especially this situation will be temporary and due to low liquidity, foreigners may use local optimism to sell their shares.


Pharmacia ◽  
2019 ◽  
Vol 66 (4) ◽  
pp. 165-170
Author(s):  
Maria Drenska ◽  
Savina Elitova ◽  
Velina Grigorova ◽  
Emilia Naseva ◽  
Ilko Getov

Introduction: The off-label use of medicines is a common practice that covers a wide range of therapeutic areas in both, adults and children. So far, the extent of off-label use among neurology patients in Bulgaria has not been studied. The aim of this study is to provide data on the off-label use in neurology patients in Bulgaria and to contribute to planning actions by the European Commission and EMA to provide a harmonized guideline and to regulate the off-label use of medicines within the European Union. Materials and methods: The data on prescriptions of 360 neurology outpatients, treated in a 1 – year period, were recorded and provided for analyses. The Summaries of Product Characteristics, were used as reference documents for assessment of prescriptions. Results: The results from this study show that most neurology patients (63%) were exposed to off-label use. Most of the medicines prescribed off-label (90%), were used for a therapeutic indication, other than the one listed in the authorized product information. Meloxicam is found to be the most commonly prescribed off-label medicine. Other medicines, like trasadone, pentoxyfylline and fupentixol / melitracen were prescribed less frequently, but deserve special attention, as they were found to be used off-label to a very large extent, some of them in 100% of prescriptions. Half of the top 10 medications, most commonly used off-label in neurology, were found to be non-steroidal anti-inflammatory drugs. Conclusion: The results reveal a big gap between the authorized medicines and the real medical needs. Further studies based on a larger number of medical centers are needed to establish more accurate data on off-label prescribing in neurology patients on a national level.


2021 ◽  
Author(s):  
Renske Caminada ◽  
Max Polano ◽  
Anna M. G. Pasmooij ◽  
Violeta Stoyanova-Beninska

Aim: Off-label prescription is not regulated on the European Union (EU) level and therefore not harmonised in the EU Member States (MS). Despite this, the use of medicines outside of the drug label occurs in clinical practice, and it can be included in treatment guidelines and/or reimbursed in some cases. It is, however, currently not clear to what extent off-label use can be included in regulatory discussions at a European level at the different committees at the European Medicines Agency. In this article, we provide an overview of the current legislation on MS level regarding off-label prescription in order to support EU regulatory discussions. Methods: Relevant national legislation regarding off-label prescription from MS was identified by distributing a questionnaire to EMACOLEX. Case law was excluded. The identified categorical elements and prerequisites in the national legislation were then categorised. Subsequently, a comparison was made to the five Good Off-Label Use Practice (GOLUP) principles. Results: Based on the obtained responses from 10 MS, we observed a large heterogeneity in the legislation of MS regarding off-label prescription. Five (out of 10) MS regulate off-label prescription explicitly and seven (out of 10) MS have prerequisites. One or more prerequisites per MS were reflected in the GOLUP principles as formulated in 2017. Conclusion: The main contribution of this work is to flag that off-label prescription actually needs to be well defined and understood before it can be appropriately taken into consideration in regulatory discussions. There is a heterogeneity in legislation regarding off-label prescription in the investigated MS, which may lead to different perspectives. A common understanding of the concept and more alignment in off-label prescription practices and their regulation at MS level may contribute to further regulatory discussions.


2020 ◽  
Vol 20 (1) ◽  
pp. 29-56
Author(s):  
Dorota Dabek ◽  
Jerzy Supernat

The article identifies and describes the fundamental dimensions and elements of the Polish administrative state before and after the accession of Poland to the European Union, beginning with the critical question of how to preserve the status of a state in a supra-state organization. The authors explain the essence of the European Union, or Europeanization, in the field of Polish administration and administrative law. Analysis of the Europeanization of Polish administrative law is focused on its basic aspects grouped under six headings: sources, cooperation, paradigm (constitutionalization), administrative democracy, scope and depth, and outcomes. Separate attention is given to the notion of public administration, as the widely applied definition of the concept framed by Jan Boć became obsolete after accession to the European Union and required transformation and extension. With language being a key feature of public administration, the text points to the post-accession impact of the English language on Polish administration and administrative law. The article concludes with outcomes of Europeanization on the gestalt of the administrative state in Poland. The general outcome stresses that Polish administration and administrative law operate not only within the context of the Polish state and Polish law, but increasingly within a supra-state European administrative framework and European legal space and European public law.


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