title: Special report from the World Federation of Neurology. The worldwide impact of new drugs: development, distribution, and use.
abstract: Access to appropriate drug treatments and preventive agents for neurologic disorders is determined by medical, economic, political, social, and personal choices and policies. The development of new agents is dominated by large, often transnational companies located in economically advanced countries. Adequate breadth and stability of pharmaceutical supplies may be jeopardized by local economic, physical, and organizational constraints. Appropriate medical choices of drugs, their number, routes of administration, and sources, are made by physicians informed by their basic and continuing medical education but also influenced to varying degrees by patient expectation, financial incentives, and marketing information provided by the drug industry. Attempts to increase the availability of necessary drug treatment for all include initiatives by the World Health Organization, attention of national health planners to drug development, supply, and use, and industry-government cooperation. Although there are significant differences among countries, many national health planners have taken similar approaches: increasing attention to cost-effectiveness in prescribing and to competitive purchasing; the use of essential drug lists, formularies, and generic drugs; the devising of economic incentives for the development of needed but unprofitable drugs; careful planning of drug procurement and storage; and an emphasis on professional and patient education.
authors.affiliation: World Federation of Neurology Research Group on Organization and Delivery of Neurological Services, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Bergen
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D016527:Drug Costs; D004345:Drug Industry / Q000331:legislation & jurisprudence; D004363:Drug Utilization; D015507:Drugs, Investigational; D017850:Economics, Pharmaceutical; D014943:Global Health; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D009313:National Health Programs / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D014944:World Health Organization
chemical_list: D000927:Anticonvulsants; D015507:Drugs, Investigational