Evidence map›Paper›PMID 37846800›Full record

ReviewThe Journal of clinical endocrinology and metabolism2024

Global Barriers to Accessing Off-Patent Endocrine Therapies: A Renaissance of the Orphan Disease?

Nipun Lakshitha de Silva, Harsha Dissanayake, Sanjay Kalra, Karim Meeran, Noel P Somasundaram, Channa N Jayasena

Abstract readReview
In one paragraph

Review in The Journal of clinical endocrinology and metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nipun Lakshitha de SilvaDepartment of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana 10390, Sri Lanka.ORCID 0000-0002-4467-3659
Harsha DissanayakeDepartment of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka.
Sanjay KalraDepartment of Endocrinology, Bharti Hospital, Karnal, Haryana 132001, India.
Karim MeeranDepartment of Metabolism, Digestion and Reproduction, Imperial College, W12 0NN, London, UK.ORCID 0000-0002-7112-2756
Noel P SomasundaramDiabetes and Hormone Centre, Colombo 00200, Sri Lanka.
Channa N JayasenaDepartment of Metabolism, Digestion and Reproduction, Imperial College, W12 0NN, London, UK.ORCID 0000-0002-2578-8223

Funding

andMRCNational Institute for Health and Care Research (NIHCR)NIHR Biomedical Research Centre Funding SchemeNIHR/Imperial Clinical Research Facility
6 · The paper itself

Abstract

contextClinical endocrinology encompasses many diseases requiring long-term drug therapy. Prohibitive pricing of some endocrine drugs classified as essential by the World Health Organization has created suboptimal care of patients with endocrine disorders. EVIDENCE ACQUISITION: This review is based on evidence obtained from several databases and search engines including PubMed, Google, and Google Scholar; reference searches; manual searching for web pages of international regulatory bodies; and the authors' experience from different healthcare settings. EVIDENCE SYNTHESIS: After the expiry of a patent, generic versions with the opportunity for increased availability and a price reduction are expected. There are access barriers worldwide for many off-patent endocrine drugs. The high price is the main issue for several medicines including insulin, hydrocortisone, testosterone, and gonadotropins. This is caused by several factors including the market monopoly due to the lack of registered generics or suppliers limiting the benefit of competition and a complex supply chain. Additionally, the lack of some medicines has been concerning due to market factors such as the relatively small number of patients, making it less attractive for the manufacturers. Commissioning of nonprofit manufacturers and state manufacturing as well as strict price control measures could alleviate this situation.

conclusionLack of availability and disproportionate price inflation affecting essential off-patent endocrine therapies is common due to several interrelated factors. Global collaboration among healthcare organizations with the support of policymaking bodies might be needed to mitigate this.

Indexed as

Drug CostsRare DiseasesCosts and Cost AnalysisDrugs, GenericHumansDrugs, Genericaccessavailabilitycostendocrinemedicinesoff-patent

Identifiers

PMID37846800
PMCPMC11031238

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.