Self-Reflection and Peer-Assessments Effect on Pharmacy Students' Performance at Simulated Counselling Sessions.

Introduction: Verbal communication is a vital skill for pharmacists and essential for improving patient care. The aim of this study was to explore students' perception of the impact of self-reflection and self- and peer-assessment on simulated patient counselling sessions.

Methods: Focus groups explored student perceptions of how this course and way of learning has impacted their performance at counselling patients.

Consumer perspectives of accelerated access to medicines: a qualitative study.

Purpose: In this study, the authors aimed to explore consumer perspectives on accelerated access to medicines. The authors were particularly interested in how they balance competing considerations of safety, efficacy, equity and access; whether and how their views change when there are different levels of uncertainty surrounding the safety and efficacy of new medicines; and the procedures that they think should be used to make decisions about accelerated access to new medicines.

Design/methodology/approach: This was an exploratory qualitative study.

A survey of Australian public attitudes towards funding of high cost cancer medicines.

Background: In the past decade many novel, and in some cases transformative, cancer medicines have entered the market. Their prices and the amount spent on them by governments have increased rapidly, bringing to the forefront trade-offs that must be made. In this paper we explore the Australian public's attitude towards the funding of high cost cancer medicines (HCCM) to inform reimbursement and health technology assessment (HTA) policy.

Formulating an Ethics of Pharmaceutical Disinvestment.

There is growing interest among pharmaceutical policymakers in how to "disinvest" from subsidized medicines. This is due to both the rapidly rising costs of healthcare and the increasing use of accelerated and conditional reimbursement pathways which mean that medicines are being subsidized on the basis of less robust evidence of safety and efficacy. It is crucial that disinvestment decisions are morally sound and socially legitimate, but there is currently no framework to facilitate this.

Physicians' attitudes towards accelerated access to medicines.

In recent years, a variety of 'accelerated access' schemes have been introduced by pharmaceutical regulators and funders globally. These schemes aim to overcome perceived regulatory and reimbursement barriers to accessing medicines - particularly for patients with limited time or therapeutic options. However, patient access to approved medicines is mediated by a number of third parties including regulators and payers, and physicians who act both as gatekeepers and guides to prescribed medications.

"Place-ing" Dementia Prevention and Care in NunatuKavut, Labrador.

Le vieillissement de la population autochtone du Canada a mis en évidence l'importance du milieu de vie et de la culture sur la santé et la résilience dans le parcours de vie. La présente étude expose les résultats d'un projet Photovoix portant sur les expériences des Inuits du Sud lors de transitions associées au troisième âge et à la démence au NunatuKavut (Labrador). Dans cette région, la culture et l'environnement naturel occupent une place prépondérante dans les descriptions des activités de promotion de la santé et des trajectoires de soins.

An ethical framework for the creation, governance and evaluation of accelerated access programs.

There are increasing demands on regulators and insurers internationally to provide access to medicines more quickly, and often on the basis of less robust evidence of safety, efficacy or cost-effectiveness than have traditionally been required. These demands arise from a number of sources, including those advocating for access to medicines for patients with life-threatening diseases, rare diseases, or subsets of common diseases and where entire populations are threatened in the context of public health emergencies. In response to these demands, policymakers have instituted a number of initiatives aimed at speeding up access to medicines, which we refer to collectively as "accelerated access" programs.

Caution needed in introduction of provisional approvals for medicines.

The Australian government recently released its response to the Review of Medicines and Medical Devices Regulation, accepting most recommendations. One recommendation involves the introduction of provisional approvals for perceived life-saving and innovative new treatments, allowing these to be approved on the basis of more limited data on the condition that further safety and efficacy data (including real-world evidence) are collected to determine whether full approval should be granted. However, experience with similar schemes overseas raises significant questions about the safety and efficacy of products made available through these pathways.

LEGITIMACY OF MEDICINES FUNDING IN THE ERA OF ACCELERATED ACCESS.

Objectives: In recent years, numerous frameworks have been developed to enhance the legitimacy of health technology assessment processes. Despite efforts to implement these "legitimacy frameworks," medicines funding decisions can still be perceived as lacking in legitimacy. We, therefore, sought to examine stakeholder views on factors that they think should be considered when making decisions about the funding of high-cost breast cancer therapies, focusing on those that are not included in current frameworks and processes.

Accelerated Access to Medicines: An Ethical Analysis.

In recent years, a range of initiatives have been introduced to provide patients with access to medicines outside of traditional regulatory and/or funding channels; we term these processes "accelerated access to medicines." These generally take 1 of 3 forms: those that provide access by making existing regulatory and funding processes more efficient, those that provide access despite uncertainties surrounding safety or efficacy, and those that provide access despite uncertainties surrounding cost-effectiveness. These latter 2 types are the subject of intense debate, as they generally require us to suspend or override accepted standards of evidence of safety, effectiveness, and/or cost-effectiveness.

Expanding the Circle of Knowledge: Reconceptualizing Successful Aging Among North American Older Indigenous Peoples.

Objectives: Indigenous older peoples' voices and experiences remain largely absent in the dominant models and critical scholarship on aging and late life. This article examines the relevance of the model of successful aging for Indigenous peoples in North America.

Method: This article presents the results of a review of the published conceptual literature on successful aging among Indigenous peoples.

Informal Dementia Caregiving Among Indigenous Communities in Ontario, Canada.

Recent studies suggest dementia is an emerging health issue for Indigenous peoples in Canada. In this article, we explore findings concerning informal dementia caregiving in Indigenous communities. Our research has been carried out in partnership with Indigenous communities in Ontario, Canada, over the past 4 years.

Improving the Legitimacy of Medicines Funding Decisions: A Critical Literature Review.

Many health care systems globally provide publicly subsidized access to prescribed medicines. Decisions about which medicines to fund affect a range of stakeholders, and it is not reasonable to expect that medicines funding decisions are supported by all stakeholder groups all the time. A more realistic aim may be for decisions to be understood and accepted as legitimate by stakeholders; however, several shortcomings of existing processes make it difficult to achieve this aim.