Category: Pharmacy

Promoting Pharmacy Based Smoking Cessation Service

Introduction

Tobacco smoking is the major cause of morbidity and avoidable death worldwide.1 Globally, there are over a billion smokers and approximately 80% are in low-and-middle-income countries.2 More than 6 million of the deaths resulted from direct tobacco consumption while estimated 900,000 mortality records were due to exposure of nonsmokers to secondhand smoke.2 It is estimated that by 2030, the death toll could rise to over 8 million yearly.3

Non-infectious diseases account for about 80% of preventable deaths in Nigeria and most other developing nations and the lone major preventable risk factor these diseases is tobacco smoking.4 Training pharmacy students to educate patients about lifestyle-modification strategies such as smoking cessation might reduce the burdens of chronic diseases.5

Traditional training for healthcare students focuses on treating diseases with little attention towards preventing disease occurrence .6,7 Based on the need to change the landscape of healthcare students training, various stakeholders now recommend curriculum changes to include courses about public health ranging from health promotion, wellness, and disease prevention.8-10

The much-needed roles of pharmacists in providing smoking cessation advice and services have been well-documented in many literatures11-13, being one of the most accessible healthcare providers. The International Pharmaceutical Federation (FIP) published a policy statement that promotes pharmacist’s roles in reducing tobacco consumption. This policy statements further reiterated that pharmacists should provide smoking cessation services to anyone who wants to quit tobacco consumption or to anyone who suffers from smoking-related diseases.14

Owing to the fact that the origin of knowledge that contribute to one’s career are usually acquired while undertaking a degree, it is therefore essential that mapping knowledge and attitude of future pharmacists would be an important marker of their “level of awareness” about smoking cessation. It may also be hypothesized that experience with providing smoking cessation services and counselling practice should increase the knowledge and skill base of pharmacy students and that pharmacists would have greater understanding, awareness and more positive attitudes toward their role in pharmacy-based smoking cessation services.

Currently, there is paucity of data/information on whether pharmacy schools in Nigeria train future pharmacists on smoking cessation or not. Therefore, this study aimed at assessing knowledge and attitude of pharmacy students in the University of Ibadan, Nigeria regarding smoking cessation.

Methods

Study design and settings

This study was a cross-sectional survey using self-administered questionnaire among undergraduates of the Faculty of Pharmacy, University of Ibadan between August and December 2019. Eligible participants were registered undergraduate pharmacy students (first year to fifth year) for 2018/2019 academic session and consented to partake in the study. Students that were absent and non-consenting were excluded from the study.

Sample Size Determination

Based on the population of 360 registered students obtained from the faculty management, the confidence level was set at 95% and the alpha error at 5%, a sample size of 189 was obtained using Yamane’s formula.15 Additionally, to cater for the possibility of low response rate which is not uncommon among students, an attrition rate of 60% that will allow for a large sample size of 315 was agreed to by the researchers.

Sampling and data collection procedure

From first year to fifth year in the faculty of pharmacy, a compulsory course was identified. The study respondents were consecutively approached shortly after the mandatory course. The researcher informed them on the aims and objectives of the study. The questionnaire was then self-administered to all consented pharmacy students and retrieved within 20–25 minutes of completion of the questionnaire. Study participation was voluntary and the students were informed of the possibility of withdrawing from the study anytime. Response anonymity and confidentiality were reiterated to the respondents. Measures were put in place to prevent multiple filling of the questionnaire by the respondents.

Pretest and content validation

Content validity of the questionnaire was conducted by two pharmacists in academia from the department of Clinical Pharmacy and Pharmacy Administration, University of Ibadan, to ascertain the inclusiveness of question-items vis-à-vis the study objectives, as well as ensuring appropriateness and specificity of questions or statements. The questionnaire was then administered to eight students from the Faculty of Pharmacy, University of Ibadan to be sure of ease of comprehension of questions or statements in the questionnaire. These students were not included in the actual study and the feedback from the students led to some modifications in the questionnaire.

Data Collection Instrument

A semi-structured questionnaire was developed by the researchers following comprehensive review of relevant studies16,17, as well as employing researchers experience. The questionnaire consisted of three parts. Part A captured socio-demographic (participants) characteristics, Part B comprised questions on smoking status and habit, Part C comprised knowledge and attitude statements. The questionnaire consisted of 17 knowledge statements and 12 attitude statements.

Knowledge and Attitude Index

For each knowledge statements, a correct response was assigned a score of “1,” and an incorrect response, I don’t know and neither agree nor disagree response were scored as “0.” The overall knowledge score was attained by adding the scores for all knowledge responses. Then, an “overall knowledge percent score” was calculated by multiplying the total knowledge score for each participant by 100 and diving by 17.

For each attitude question, a correct response was assigned a score of “1,” and an incorrect response, I don’t know and neither agree nor disagree responses were scored as “0.” The total attitude score was obtained by adding the scores for all attitude responses. Then, an “overall attitude percent score” was calculated by multiplying the total attitude score for each participant by 100 and diving by 9.

Data Analysis

The administered questionnaires were sorted, crosschecked and coded serially at the end of each day of the study. Data were sorted, coded and analysed using SPSS (version 23). The data were summarized using descriptive statistics with frequency and percentage. In this study, the overall score by our respondents in the knowledge and attitude domains was converted into percentage to ensure uniformity in the scores.

In the knowledge domain, a total score  60 % was considered as “good” knowledge, while score < 60 % signified “poor” knowledge. Thus, a percent score  60 % indicates a raw score of >10 out of the 17 questions that evaluated the general knowledge of smoking and smoking cessation among pharmacy students. While for the attitude domain, a total score of  80 % was considered as “good” attitude, while score < 80 % signified “poor” attitude. Thus, a percent score  80 % indicates a raw score of >7 out of 9 questions on attitude. Bloom’s cut-off point criteria, as well as review of other studies were employed in determining the binary categorization.18,19

Results

Demographics characteristics and smoking cessation related descriptive

Table 1 shows out of the 315 copies of questionnaire administered to the pharmacy students, 277 completely filled questionnaires were returned given a response rate of 81.5 %. One hundred and fifty (54.2%) were males. The mean age was 21.55 (±3.12), with majority 168 (60.0%) aged above 20 years. Most of the participants 263 (94.9%) have not attended any specific smoking cessation training and 180 (65.0%) are willing to attend smoking cessation training. Majority 265 (95.7%) were nonsmokers and 70 (25.3%) of the participants claimed that pharmacy school provided knowledge and skills on smoking cessation.

Students’ knowledge on smoking and smoking cessation

Three-quarters of the students were aware tobacco smoking is an addiction 207 (74.7%), while 33 (11.9%) knew nicotine does not cause cancer. In all, 74 (26.7%) had score  60 % indicating “good” knowledge of smoking and smoking cessation among pharmacy students. Table 2

Pharmacy students’ attitudes toward smoking and smoking cessation

Two hundred and three (73.2%) agreed that “It is pharmacists’ responsibility to help their patients quit smoking.” Majority 226 (81.6%) agreed that “Pharmacy students need more training on how to counsel patients on smoking cessation.” In all, 152 (54.9%) had a score ≥ 80 indicating “good” attitude toward smoking cessation. Table 3

Awareness of smoking cessation products among pharmacy students

Less than one-tenth 27 (9.7%) of the respondents had learnt about available options to smoking cessation, while nicotine gum 13 (48.1%) was the most identified products among the students. See Table 4.

Discussion

After an extensive review of the literature, it was observed that a survey of pharmacy students related to the knowledge and attitude regarding smoking cessation has not been conducted in Nigeria. Our study revealed relatively low smoking rate, positive attitudes towards smoking cessation and a poor knowledge of smoking cessation among pharmacy students. Compared to a study among University of Lagos pharmacy students20, our study revealed lower smoking prevalence. However, the smoking prevalence in our study was higher than the prevalence reported among medical students of University of Ibadan.21

Poor knowledge of smoking and smoking cessation was reported in more than three-quarters of our respondents. Furthermore, a knowledge gap on the awareness of smoking cessation products was documented among the pharmacy students and majority of the students reported that smoking cessation training content of their curriculum is not satisfactory. The gap in awareness and knowledge might signify the need for creating awareness as well as advocating training among pharmacy students on smoking cessation. This finding is similar to a study conducted in a university community, where awareness level of smoking cessation products was low22, and another study reported in Japan among pharmacy students where only one pharmacy school teaches smoking cessation.23 Various study in the literature had reported the inadequate knowledge of smoking cessation and tobacco dependence treatment among medical students.24-28 A possible explanation for the low awareness of the products might be deficient pharmacy school curriculum on smoking cessation products, non-availability of the products in the pharmacies and cost implication of the product in Nigeria. Studies conducted in Germany, Italy and England among medical students showed that the knowledge of smoking epidemiology was also unsatisfactory.26,28

The literature encourages the inculcation of tobacco cessation in the curricula of undergraduate future health professionals.29 Studies have also shown that healthcare professionals who do not receive formal training on smoking cessation are less likely to have positive impacts on quitting rates than those who are formally trained.30,31 Tobacco cessation counselling and services are an essential public health service rendered by pharmacists globally. To deliver these services effectively and with much-needed impacts, incorporation into the pharmacy curriculum is advocated.32

The overall positive attitudes to smoking cessation and practice were observed among the pharmacy students. Majority advocated for more training on how to counsel patient on smoking cessation and most believes that pharmacists should not smoke and set good examples for their patient. Although, majority of the student shows anti-smoking attitude, about half of the students agreed that medical advice has little effect on smoking cessation. This can be compared to similar study carried out in Argentina, where 30.9% agreed that medical advice has little effect on smoking cessation.16

There is possibility of response bias from respondents either due to over- or under-reporting of the information provided. In addition to this, the study was conducted in one pharmacy school, therefore, there is a need for cautiousness in generalising outcomes to the whole pharmacy students in Nigeria.

Conclusion

There is a deficit in smoking cessation knowledge among our respondents. However, pharmacy students’ show positive attitude toward smoking cessation. Therefore, there is a need for inclusion of smoking cessation strategies and procedures in pharmacy school curriculum, so as to equip the future healthcare providers and improve the quality of public health especially smokers in Nigeria.

Pharmacy Critics Application: Pros And Cons

GENERAL INTRODUCTION

The project based on “PHARMACY CRITICS” is being developed for the purpose of storing the information of the medicine where it maintains all the data related to pharmacy. It maintains all the Supplier and Customer information who supplies medicine to the pharmacy and those who purchase medicine from the pharmacy.

We developed this system Pharmacy Critics to make the work easier for the pharmacy people by storing the data digitally. The user can maintain all the purchased and sold of medicine details. It also maintains the Reports for the particulars.

This will avoid user to maintain the data manually where it cannot store huge data and it leads to loss of data. This can be easily used by the software people and is more user friendly software.

PROBLEM STATEMENT

Pharmacy management has kept paper record in filing cabinets. Managing a very large pharmacy with records on papers will be tedious and difficult to keep track of inventories with regards to the drugs in the store, expiry date, quantity of drugs available based on the categories and their functions. The pharmacist has to order drugs to replenish the already diminishing stock. In addition, ordering of drugs is being carried out manually. Significant amount of time is allocated for writing the order as the pharmacist needs to go through the stock balance and make rough estimate of the amount to order based on Figures. Drugs are not supposed to be used after they have expired. This project work will prompt the pharmacist about drugs that are close to expiry, preventing those drugs from being sold and also providing solution to the earlier stated problems.

EXISTING SYSTEM

The data is being stored manually across many files where it leads to loss of data and the updating of data cannot be performed easily. Often the data is mismanaged and data inconsistency may occur. The data is also not secured and is difficult to maintain. It also leads to some human errors. Consumes lot of space in maintaining records.

REVIEW OF LITERATURE

As long as there have been societies, there have been specialists and physician whose sole purpose was to prepare and administer medicinal treatments. The earliest healers engaged in what is now called Pharmacognosy, which is the study and application of plants and herbs for healing. Evidence that early man used pharmacognosy to treatillness is indisputable, with archaeological discoveries attesting to the fact pre-dating even the development of farming or animal husbandry.

The beginnings of pharmacy are ancient. When the first person expressed juice from a succulent leaf to apply to a wound, this art was being practiced. In the Greek legend, Asclepius, the god of the healing art, delegated to Hygeia the duty of compounding his remedies. She was his apothecary or pharmacist. The physician-priests of Egypt were divided into two classes: those who visited the sick and those who remained in the temple and prepared remedies for the patients (Homan, 2008).

The pharmacy profession can be traced back at least as far as the Sumerian population, living in modern day Iraq from around 4000 BC, they used medicinal plants such as liquor ice, mustard, myrrh, and opium. There were separate people who worked to prepare medicines, as a separate role from diagnosis and treatment which was carried out by medics. These precursors to pharmacists also combined their role with that of a priest. The Sumerians wrote the earliest surviving prescriptions from at least 2700 B.C. so nearly 5000 years ago (Griggs, 1999).

The Ancient Egyptians had specific preparers of medicine, known as Pastophor. Pharmacy was viewed as a high status branch of medicine, and again, like the Sumerians, these pharmacists were also priests who worked and practiced in the temples (Anderson, 2005).

The National Health Service made prescription medicine available to all. Until the introduction, in the 1950s, and subsequent hefty increasing of prescription charges, proprietary medicines were no longer seen as a cheap alternative to seeing the doctor.

Ibuprofen was first synthesized by a team at the Boots Pure Drug Company in December.

Introduction of Adverse Drug Reaction ‘yellow card’ scheme in response to the thalidomide tragedy of 1961

The modern drugstore varies significantly from its ancient counterparts. While the proprietors of pharmacies in the far distant past were often making numerous medical decisions – diagnosing and treating patients without the consultation of physicians – pharmacists in the modern drugstore are tasked instead with the responsibility of evaluating the appropriateness and managing the dispensation of pharmaceuticals prescribed to patients under a doctor’s care. Among the most important of pharmacist jobs is assuring that the patient has not been prescribed two drugs which will have an adverse interaction. An in-depth study of pharmacology is required to make such evaluations and in all states such positions are highly regulated and require testing before the issuance of a pharmacist’s license.

CONCLUSION

Owing to the vastness of the information to be stored and the diverse tasks of PHARMACY CRITICS involves, maintaining the Database becomes enormous. A well designed project can go a long way in the efficient management of all the information. The PHARMACY CRITICS application has been implemented to store the pharmacy information and user friendly Interfaces. The implementation of the project using the concept of singly linked list and files and linear search. Change is the only constant thing in this world .A Heart full attempt is made to the software to be bug free as we know “To err is Human”, there may be some bugs.

The scope of this project is limited to the activities of a pharmaceutical store which includes will improving health outcomes, reduce hospital and long term care admissions, enhance access and care in the Estate and surrounding communities and ensuring best use of resources, the use of a computer based management system for improving the efficiency of a pharmacy is needed and it is an essential part of any modern continuously evolving society. The system will not be able to handle drug prescription, drug to drug interaction. The system will not be able to handle contraindication and polypharmacy in a prescription; this implies that these services will be manually completed by the pharmacist.

REFERENCES

TEXT REFERENCE

1. Roger S. Pressman : Software Engineering – A Practitioners approach, 7th Edition, Mc-Graw Hill Education, 2012
2. Algorithms in C: Fundamentals, Data Structures, Sorting, Searching, parts 1-4, 3e.
3. The complete reference – C++ & C 4th edition [Herbert Schildl] 2000,2003
4. Beginning of C 4th Edition – Ivor Horton[2007]
5. Let us C – Yashwant Kanetkar 3rd edition 1999
6. C Under DOS Test – Riku Parikh, Anup Jalan, Suham Desai 1st edition 1993
7. Programming in ANSI C 4th edition – E Balagurusamy

WEB REFERENCE

1. https://msdn.microsoft.com/en-us/library/mt590198(v=sql.1).aspx
2. https://www.scribd.com
3. https://www.greeksforgeeks.org
4. https://www.studytonight.com
5. https://www.tutorialspoint.com
6. https://en.wikipedia.org/wiki

The Use Of Vaccination Should Not Be Mandatorily

The introduction of vaccination to the world has been considered as one of the most advanced progress in the Pharmacy industry. From measles, smallpox to rubella, vaccination has been recognized to not only cure but also to eradicate a lot of diseases. The outstanding successes of vaccinations have made such a great impact on the world’s healthcare that many developed countries have required scheduled vaccinations for children. Despite the effective uses of vaccines in many parts of the world, there have been many arguments stating that the choices of vaccination should not interfere, or rather, the use of vaccines should not be mandatorily required

With the growth of science in the pharmacy industry, many studies have been conducted so far proving the ingredients in vaccines are safe for children. However, the arguments around the safety of ingredients in vaccines have been one of the most controversial issues regarding this topic. According to the CDC (n.d), most found ingredients in vaccines include Aluminum, Thimerosal, which are used for vaccines preservation or to stimulate their effectiveness. What many people may not be aware of are those ingredients are indeed dangerous and may affect people’s health negatively. Aluminum, being a toxic metal, has been revealed to be accumulated in bones and brain for a premature baby with just 10 micrograms of consumption and might even reach a noxious level for the patients with impaired kidney function (Pond 2011). Thimerosal, the compound usually found in the ingredients for preserving vaccines, with mercury is the main element, is extremely dangerous as mercury is one of the most poisonous elements on earth (WHO 2011). Imus (2018) states, in more than 80 studies, human health is reported to be tremendously affected when exposed to mercury, including difficulties such as autism or vision loss.

In another argument, many people have claimed that our world today has become healthier with fewer diseases thanks to the introduction of vaccines, with approximately ten million deaths were prevented from 2010 to 2015 (WHO, n.d). While it can be seen clearly that such disease like smallpox or polio has been eradicated by vaccines (CDC, n.d), we are now facing with such new matters related to healthcare. According to Fisher (2017), reports from the CDC, the USA, showed that American children have been immunized four more times nowadays than the previous generations as the government schedules more compulsory vaccinations for children with the aim for better disease prevention. However, figures have shown otherwise as Fisher (2017) also states that the proportion of children with autism increased by 3%, asthma by 8% compared to the 1980s with unprecedented growing numbers of children with seizures, depression, and many other life-threatening illnesses, according to reports. Hence, as a result of more mandatory vaccines, the number of outbreak diseases shows no sign of declining.

Lastly, with the development of modern society, the obstacle of religious practices are opined to should have been erased when it comes to vaccinations, many argued. Although this might seem rational in the modern world concerning the healthcare aspect, religious beliefs are always considered the major barrier for vaccination refusal as it belongs to the personal choice of belief and rights, something that not everyone could fully understand. Merekiene et al. (2012) reveal in their study that the Orthodox community in the Netherlands opposes vaccination as they believe human health sent by God should not be interfered with by mankind, while the Amish communities suppose that vaccinations weaken the immune system. According to McKee and Bohannon (2016), a report evaluates the violation of vaccinations to the religion most generally comes from the vaccines’ components as some vaccines are produced from animal-derived gelatin, human fetus, resulting in the biggest concerns. Mckee and Bohannon (2016) also state that the rate of vaccination exemptions in schools regarding religions has risen significantly from 2000 to 2011. All things considered, the compulsory requirement of vaccines towards religions is completely unethical as people should not be forced into something beyond their beliefs.

Online Pharmacy And Its Management System

Introduction

Introduction to System

In Our System we can provide the online Platform to deal with people who are pharmacy management owner or vendor. In this system we can provide web application which is user by doctors or any hospital person so we have make one quotation system for the user and customer also so here we can put our product in our system and customer can buy that product from our system and as well as he/she can order or submit the quotation threw our system. The practice of pharmacy involves the general implementation of medical orders which entails the evaluation and the interpretation of the medical orders, the administration of drugs, dispensation of prescribed drugs from qualified medical practitioners, the review of prescribed drug regimen, and the correct storage of drugs. The American Pharmacists Association has described pharmacy as having a mission which is the responsibility of ensuring the use of medication in the right way and manner, and enjoying the services of drugs to ensure the achievement of optimized results in therapeutic applications, In addition, the birth of modern pharmacy has brought with it some positive effects in the society; like the increase in life expectancy globally from 45 years to 50 years, which some argue is as a result of the number of breakthroughs recorded in pharmacy over the last century. These breakthroughs such as: the discovery of new compounds in battling existing ailments and the invention of methods and devices to accurately dispense drugs have been welcomed with open arms by the society More so, the hospital pharmacy is usually located in hospitals (government-owned or private) and provides in-house pharmaceutical care to patients. Hospital pharmacists are those that function within a hospital pharmacy system and are tasked with the dispensing of prescriptions, the purchase of medicines, and the testing of these medicines. In the hospital pharmacy, access to medical records make it easy to influence the selection of drugs based on allergies or previous problems encountered. Subsequently, the power to control the process of going into the acquisition of drugs and other pharmaceutical devices, help in ensuring the supply of premium quality drugs. Furthermore, Hospital pharmacies which are owned by the government have little or no problems with financing projects due to backing from the government. Also, the community pharmacies may not have the permission to dispense certain drugs which may be due to the nature of such drugs and the prices of drugs are not as subsidized as those in hospital pharmacies, The proposed system aims to connect and serve as an intermediary between hospital pharmacies and drug manufacturers, through a platform that allows the order of drugs with the click of a button, and simultaneously keeps track of what drugs have been ordered and in what quantity.

Economic Feasibility

Economic feasibility is very important in development of the software for any company.Because it gives an idea , whether the project going to be developed can be completed at a cost affordable by the team.

The availability of the required hardware and software used to develop our project makes it economically feasible.

Operational Feasibility

The following factors suffice for considering the given project as Technically Feasible.

AS the system is going to be developed at the place where it is going to be implemented, the track of the operations related to the software is constantly monitored by them and sufficient support is available.

Tools and Technology Used

Hypertext Markup Language (HTML) is the standard markup language for documents designed to be displayed in a web browser. It can be assisted by technologies such as Cascading Style Sheets (CSS) and scripting languages such as JavaScript.

Web browsers receive HTML documents from a web server or from local storage and render the documents into multimedia web pages. HTML describes the structure of a web page semantically and originally included cues for the appearance of the document.

HTML elements are the building blocks of HTML pages. With HTML constructs, images and other objects such as interactive forms may be embedded into the rendered page. HTML provides a means to create structured documents by denoting structural semantics for text such as headings, paragraphs, lists, links, quotes and other items. HTML elements are delineated by tags, written using angle brackets. Tags such as directly introduce content into the page. Other tags such as surround and provide information about document text and may include other tags as sub-elements. Browsers do not display the HTML tags, but use them to interpret the content of the page.

jQuery is a JavaScript library designed to simplify HTML DOM tree traversal and manipulation, as well as event handling, CSS animation, and Ajax. It is free, open-source software using the permissive MIT License. As of May 2019, jQuery is used by 73% of the 10 million most popular websites. Web analysis indicates that it is the most widely deployed JavaScript library by a large margin, having 3 to 4 times more usage than any other JavaScript library.

jQuery’s syntax is designed to make it easier to navigate a document, select DOM elements, create animations, handle events, and develop Ajax applications. jQuery also provides capabilities for developers to create plug-ins on top of the JavaScript library. This enables developers to create abstractions for low-level interaction and animation, advanced effects and high-level, themeable widgets. The modular approach to the jQuery library allows the creation of powerful dynamic web pages and Web applications.

My SQL

MySQL is written in C and C++. Its SQL parser is written in yacc, but it uses a home-brewed lexical analyzer. MySQL works on many system platforms, including AIX, BSDi, FreeBSD, HP-UX, eComStation, i5/OS, IRIX, Linux, macOS, Microsoft Windows, NetBSD, Novell NetWare, OpenBSD, OpenSolaris, OS/2 Warp, QNX, Oracle Solaris, Symbian, SunOS, SCO OpenServer, SCO UnixWare, Sanos and Tru64. A port of MySQL to OpenVMS also exists.

The MySQL server software itself and the client libraries use dual-licensing distribution. They are offered under GPL version 2, beginning from 28 June 2000 (which in 2009 has been extended with a FLOSS License Exception) or to use a proprietary license.

Support can be obtained from the official manual. Free support additionally is available in different IRC channels and forums. Oracle offers paid support via its MySQL Enterprise products. They differ in the scope of services and in price. Additionally, a number of third party organisations exist to provide support and services, including MariaDB and Percona.

MySQL has received positive reviews, and reviewers noticed it ‘performs extremely well in the average case’ and that the ‘developer interfaces are there, and the documentation (not to mention feedback in the real world via Web sites and the like) is very, very good’. It has also been tested to be a ‘fast, stable and true multi-user, multi-threaded sql database server’.

.NET Framework

.NET Framework (pronounced as ‘dot net’) is a software framework developed by Microsoft that runs primarily on Microsoft Windows. It includes a large class library named as Framework Class Library (FCL) and provides language interoperability (each language can use code written in other languages) across several programming languages. Programs written for .NET Framework execute in a software environment (in contrast to a hardware environment) named the Common Language Runtime (CLR). The CLR is an application virtual machine that provides services such as security, memory management, and exception handling. As such, computer code written using .NET Framework is called ‘managed code’. FCL and CLR together constitute the .NET Framework.

FCL provides user interface, data access, database connectivity, cryptography, web application development, numeric algorithms, and network communications. Programmers produce software by combining their source code with .NET Framework and other libraries. The framework is intended to be used by most new applications created for the Windows platform. Microsoft also produces an integrated development environment largely for .NET software called Visual Studio.

Future Enhancement

In the future pharmacy manager can generate prescription as labels and we can put that prescription details in product also. The whole project will be made available as an web app for far more ease of use and mobility.Increasing facilities of this software.Medicine Purchase Request & Order to manage the purchase requests and order requests received for the medicines.Physical stock verification & adjustment is responsible to verify the physical stock and the decision, regarding adjustment (if required) can take place.Destruction of Expired Items is again vital to have the information of expired items that need to be destructed so that the process can be held timely.Return of items nearing Expiry is a record of items nearing the expiry date, so this way they can be returned on time

Conclusion

Pharmacy management system is actually a software which handle the essential data and save the data and actually about the database of a pharmacy and its management. This software helps in effectively management of the pharmaceutical store or shop. It provides the statistics about medicine or drugs which are in stocks which data can also be updated and edited. It works as per the requirement of the user and have options accordingly. It allow user to enter manufacturing as well as the expiry date of medicine placing in stock and for sales transaction. This software also has ability to print reports and receipts etc.

References

1. https://patents.google.com/patent/US20050015291A1/en?q=online &q=student&q=activity&q=managment&q=system&q=employe&clustered=true
2. https://patents.google.com/patent/US20040267595A1/en?q=online &q=student&q=activity,information,details&q=managment&q=system&q=marks+&page=1&clustered=true
3. https://patents.google.com/patent/US6470171B1/en?q=~patent%2f US20030044762A1&clustered=true
4. https://everything.explained.today/Entity%E2%80%93 relationship_model
5. https://www.usg.edu/galileo/skills/unit04/primer04_01 .phtml
6. The Diagrams of Architecture
7. Visual Basic NET
8. The Merriam-Webster Dictionary
9. Pharmacy management
10. Library Learning

The Advantages And Disadvantages Of Online Pharmacy

ABSTRACT

The tremendous increase in accessibility to internet in recent years has changed the global scenario of many fields by technological advancements. One of such development in e-pharmacy service is now being replaced the traditional way of prescribing and dispensing of medicines through online ordering and mail delivery via internet on electronic prescription network. In 1997 the WHO called on its member states to tighten controls on the sale of medical products through internet and intact concerned that this may bypass national drug authorities there by liberating medical products onto the market which are unsafe, unapproved, fraudulent or in-effective.

In India, e-pharmacy came under the purview of the drugs and cosmetics act 1940 and the information technology act 2000 doesn’t distinguish between online and offline pharmacies. So specific amendments are required to this act to bring e-pharmacies within the scope of drug and cosmetics act. The current study is to analyse the advantages and drawbacks of E-pharmacy services. The laws governing pharmacies and their regulations and the future perspective of the trend of online pharmacy services in modern India.

INTRODUCTION

The 21st century has witnessed the drastic changes in globalization with continuous process of development with advancements in science and technology. In context of developments in cyber technology, the massive growth rate can be seen in online business and services in the market termed as e-commerce.

e-commerce is a business model where in the goods and services are done through transmission of data and funds from consumer to producer or the service provider over an electronic network through internet. This made easy for the consumers to directly place an order of their choice on website and avail the products on their doorstep from the producers. Globally a modern trend has been raised, termed as e-pharmacy/ online pharmacy which enables the patients to buy the medicines/drugs of his choice online in his fingertips. This trend is similar to the online shopping of other materials such as clothes, grocery and electronics etc. This is mainly because the % of population using internet have been increased dramatically since2010. Reports suggest that recently in India, the reliance jio scheme added more number of smart phone users. This advancements in technology made easy access to the drugs through internet even for a very common man. The popularity of e-pharmacies is because of 24*7 access, transparency, convenience, time saving & money saving and there are few challenging factors like cost, quality, availability, services, legality, low e-tailing penetration & high pharmacies/ drug store penetration etc will decide the success of e-pharmacies.

Types of online pharmacies

The online pharmacies basically can be classified as two:

1. Legitimate internet pharmacy; the websites providing high quality pharmacy services after verification of standards.
2. Illegitimate internet pharmacy; these are not verified and may not comply with national international professional standards and regulations.

Role of prescription

Online pharmacies will promote drug abuse, misuse, self-medication etc. The self-medication practice is encouraged by the online sale of drugs. It is dangerous and even potentially life-threatening when any medication is taken without medical supervision, certain categories such as Schedule X and Schedule H should be sold only on prescription. So, the prescription plays an important role in purchasing drugs online. The prescription copy should be retained by the licensed pharmacist for 2years after dispensing the drug.

e-prescription networking

The necessary elements in improving patients care according to early visionaries of EHR (electronic health records) inclusion are note documentation, direct order entry and decision support capability. Computerised physician order entry (COPE) system including electronic-prescribing (e-prescribing) are an integral part of EHR. COPE has the major impact on work-flow of physicians & nurses compared to paper- based methods, the e-prescribing system got high adaptation rates and acceptance due to its positive impact on reduction of medication errors & ADE’s, and thus the e-prescription is being implemented in online pharmacy sector for its ease of use of medications. The approved e-prescription is uploaded online to the supplier who verify and supplies the right medicine to the patient’s door steps. This methodology is now being incorporated at most in e-pharmacy services as a part and made easy for patient, prescriber and supplier too.

LOCAL PHARMACIES VS ONLINE PHARMACIES

The price is a major factor in which the cost of medicines in online pharmacies is less compared to local conventional pharmacies since there is no particular production unit and physical store for medications storage and dispensing and the sites will have a large network of retailers to draw medicines from.

Its more convenient for consumers when the online pharmacies work on basis of submission of prescription in a convenient business hour and dispense medicines to the doorsteps than the local pharmacies where there is a need to rush to pharmacies during working hours.

The online pharmacies are large chains works 24*7, and have an access to wide range of medication supplies where in local pharmacies are small independent business plans which may be restricted in quality of drugs they procure.

The responsibility of pharmacist is to dispense the right medicine and counsel the patient about side effects and dosage. This can be achieved in local pharmacies but not in online pharmacies since there is no possibility of an interaction between patient and pharmacist. The benefits of using online pharmacy over local pharmacy reflects the advantages found in online pharmacy. They include convenience, access to medical information, cost efficacy, wide range of availability, ability to avail medicines in a same day. The disadvantages include lack of physical interaction between pharmacists and patient and medication misuse by patients as well as illegal websites.

LEGISLATIVE RECOMMENDATIONS

• ·Drugs and cosmetics act,1940: As per section 18 (c) of drugs and cosmetics (D&C) act only a licensed retailer is allowed for the sales of drugs on the basis of prescription of a doctor. Section 27 of D&C act has provisions for penalty in the form of imprisonment and monetary fine for manufacture & sale without license. Section 10 prohibits import of drug that is substandard, misbranded, adulterated or spurious requires a license for import. D&C act,1940 and D&C rules,1945, recommends specific guidelines for the sale of schedule H and schedule X can be sold only on prescription by registered medical practitioner (RMP). The prescription should be a duplicate copy which is to be retained by pharmacist for 2years.
• The pharmacy act,1948: Section 42 and Sub-section 1 of Indian pharmacy act,1948, quotes “no person other than a registered pharmacist shall compound, prepare, mix, or dispense any medicine on the prescription of RMP” and who ever contravenes the provisions shall be punishable. Drugs and magic remedies act,1954: This act mentions a list of ailments for which no advertising is permitted. The act prohibits false and misleading advertisements that may end up making wrong claims. In India it is been increasingly exposed to advertise for prescription drugs despite legal prohibitions.
• Indian medical council act,1956: Regulation 5.3 of medical council of India (MCI) stipulates that both pharmacists and doctors should work together. But, because of e-pharmacies this relationship is lost. Regulation 7.14 of MCI, does not allow RMP to disclose the patient information in the exercise of his/her profession. According to regulation 6.4 of MCI, giving or receiving rebates or commissions are prohibited. But, e-pharmacies may provide rebates and commissions to doctors to provide prescriptions on basis of online information filled by patient.
• Narcotic drugs and psychotropic substances act,1985: This act provides a strict guideline for un-monitored and un-controlled sale of narcotic drugs listed under the act. This is enforced with due regard of minimising the misuse of habit forming drugs.
• Information technology act,2000: This act governs few legal issues pertaining to online dealings but it is silent on the aspect of e-pharmacy. This act deals with data protection or privacy in India under Section 43A of IT act, 2000 and IT rules,2011. In 2013 the privacy bill is proposed which focuses on protection of sensitive personal data of persons. There is an ambiguity in Indian law whether a pharmacy is allowed to take money prior to delivery of medicines but, medicines certain provisions mandate the money to b collected only after physical handover to the customer.
• Pharmacy practice regulations,2015: The regulation declared by pharmacy council of India in January 2015, states that electronic prescription must be valid for dispensing medicines. This also defines the prescription as a written or electronic direction from a registered medical practitioner or other licensed dentist, veterinarian, etc. to a pharmacist to compound and dispense a specific type of drug to a patient. Based on the regulations the scanned copy of prescription can be considered as valid prescription, but for the purchase of medicines from e-pharmacies has still been questioned.

BENEFITS OF e-PHARMACIES

1. Privacy/Anonymity: it is convenient to order medicines from online drug stores privately as well as to get free delivery. Consumer feels comfortable purchasing online or over the phone rather than in person. In order to prevent the use of consumer’s personal information for any unauthorised purposes, make sure the pharmacy has appropriate privacy policies.
2. Convenience: the online pharmacies provides greater convenience as they are one stop shops for ample of products. The access to product information at these sites is way easier than conventional walk-in pharmacies. They provide the convenient service and supply to the consumer when he/ she find it physically difficult to make it to the pharmacy, have a busy schedule live in remote rural area etc. Hence, it is easy to submit prescription and avail the medicines at their convenient time schedule.
3. Medical information: few online pharmacies provide the essential information regarding medications and diseases as well as links to medical resources.
4. Lower cost: several studies conducted by research institutes have shown that shopping drugs online helps consumer to save as much as one-third cost.
5. Avails greater cost: the online stores provides the drugs ample enough to cater to the consumers living far from the pharmacy and this provides an option to compare the prices before placing an order.
6. Drug approval: most of the legal online pharmacies have the process of drug approval. They require a prescription to supply medications. They offer a drug only after filling up a questionnaire and this questionnaire is reviewed by a doctor before dispatching.
7. Patient safety: an estimated 1.5million ADE’s occur annually in US. The avoidable errors such as selection of incorrect or unavailable drug, dosage form / dose; duplication of therapy, omission of information and misinterpretation of the order due to illegible handwriting. These all problems can be overcome by e-prescribing pattern which is equipped with point of care decision support that notifies provider of potential prescription errors.

DRAWBACKS OF e-PHARMACIES

1. Unauthorised or un-licensed pharmacies: purchasing drugs from these drug stores can increase chances of buying counterfeit, substandard or adulterated products. Few international pharmacies are licensed particularly to import and export medications in a free trade zone area but may not be within the domestic jurisdiction. They require proper inspection over safe dispensing practices and the licensed pharmacists.
2. Lack of physical evaluation: the meaningful interaction with physician, pharmacist and the patient is minimised because of online pharmacies not having any processes of medical supervision or physical evaluation. The lack of licensed health professional may lead to unauthorised decision-making process.
3. Inadequate safeguard of health: online pharmacies fails to require a prescription and you could take the medication inappropriate for you. This can disturb your health conditions. Some illegal online stores deal in counterfeit, substandard or contaminated drugs that can lead to dangerous drug interactions.
4. Lack of personal and financial security: every pharmacy websites should publish their privacy policy, one which promises not to share any personal and financial information with third parties. The online financial transactions must be secured through adequate support of encryption technology.
5. Illegal websites: it is important for any pharmacy website to publish their contact information to enquire about the medication information or other issues. It is important to have proper contact details and helps consumers to raise the question, complaint or the concern about drugs and their cost.
6. Selling of potent drugs: a very few sites have the pattern of obtaining an order by an online questionnaire to those medications which should be dispensed under prescription. Some times other restricted drugs such as Accutane, Thalomidare which are not controlled substances but dangerous if taken without medical supervision.
7. Sudden change in price: few sites post low-ball prices to attract the customers and raise them more abruptly. This may confuse the consumer and it is necessary to make sure the prices listed in sites are up to date and accurate.

MEASURES TO OVERCOME PROBLEMS

The responsibility of governing bodies across the country is to improve the safer use of online pharmacy websites to achieve proper usage, few of the key factors should be considered:

• Designing a website or a body to check the legality of e-pharmacy
• Make specific guidelines for both consumers and sellers for safer use of sites.
• Bring some essential policies for legal operation of e-pharmacies and blacklist the illegal sites providing services.
• The role of central and state government should be well defined for the drug regulation.
• All the sites selling medications online, should be licensed and registered from a regulating body.
• Watch should be kept on dispensing of potent, banned drugs which don’t come under specific categories under jurisdiction.
• A strict adherence to laws is required to ensure efficient and smooth running of e-pharmacies with greater compliance.

REFERENCES

1. Priyanka VP, Ashok BK (2016) e-pharmacies regulation in India; Bringing new dimensions to pharma sector. Pharmaceut Reg Affairs 5;175, doi:10.41 72/2167-7689. 1000175
2. Pillai MA, Agarwal KK (2016) IMA white paper: IMA white paper on online pharmacy, IMA
3. Nautiyal S (2015) DCGI to study global regulations to frame rules on online pharmacy soon. Pharmacy and trade.
4. Malvai E (2015) legality of selling medicines online India, iPleaders.
5. Nagaraj A et al, (2014) Counterfeit medicines sale on online pharmacies in India. J Res Pharm Pract 3:145-146
6. Ashwin Kumar Chaturvedi, et al. (2011) Online pharmacy: an e-strategy for medication. IJPFR, April-June 2011; 1(1): 146-158
7. G. Prashanthi, et al. (2017), A review on online pharmacy. IOSR journal of pharmacy and biological sciences. E-ISSN: 2278-3008, Vol (12), Issue (3) Ver 5, 32-34.
8. Warholak TL, Rupp MT, Analysis of community chain pharmacists’ interventions on electronic prescriptions. J Am Pharm Assoc (2003). 2009, 49:59-64.
9. Institute of medicine committee on quality of health care in America. Kohn LT, Corrigan JM, New health system for the 21st century. Washington, DC: National academy press; 2001
10. Megan Ducker et al. (2013) Pros and Cons of E-prescribing in community pharmacies. US pharm. 2013; 8(38) (P&T suppl); 4-7

Impact Of Work-life Balance Issues On Performance Of Pharmaceutical Sales Managers

ABSTRACT

In terms of Indian context, the concern over work-life balance is gradually becoming a common talk. When employees go back to their homes, they should not carry any organizational stress with them. An individual has two roles to play- personal and professional; each role having different set of demands. When such role demands overlap, multiple problems are faced leading to losses for all concerned: the individual, the family, the organization and the society. In sales job, the performance pressure is considerably high leading to stress and other problems. This exploratory research is an attempt to study the work-life balance issues with reference to area sales managers working in pharmaceutical sector. The results derived from data analysis reveal significant results with respect to work-life equilibrium. The study has wide implications for industry in particular.

INTRODUCTION

Sales have been considered as one of the most rewarding and challenging fields of employment in India. This field has its own charm and identity, which is different from other fields of specializations. Due to attractive remuneration package, extensive traveling involved and target-driven performance incentives, many ambitious candidates enter into sales and get success. This field is most suitable for aggressive, extrovert, result-oriented persons, who like extensive traveling and meeting people. This field of employment has been usually dominated by male aspirants. However, due to opening of markets and attraction for sound remuneration, many female incumbents have started entering into sales.

Among all the industry sectors, pharmaceutical sector is known for its unique marketing approach. Barring on-the-counter drugs, pharma companies cannot directly float their advertisements on various channels. They have to depend solely on direct sales. The uniqueness of the pharma sector lies in the fact that the companies do not target the customer or consumer, rather they target the reference person i.e. the medical practitioner. A sales person in Pharma Company has to meet the doctors, explain about the medicines and request for prescriptions. Similarly, he/she has to contact the medicine retailers (medical stores) for ensuring regular supply of company’s products. In this manner, the job of sales person in pharma becomes more special and difficult since he/she has to convince a person who is more qualified than him/her.

Primarily, a working person has two roles to play: professional and personal roles. This has a significant role in shaping the performance of an individual especially in Indian context. Along with the role of an employee, the person has to do justice with various other roles of like: son/daughter, husband/wife, father/mother etc. Each role demands specific expectations from incumbents. Due to factors organizational and personal factors, role clashes are observed which lead to adverse effects on performance at all levels. Role clash is also caused by the reverse relation i.e. personal level stress affecting job performance. This role clash results into stress and burnout leading to work-life imbalance. Work-life balance is a state where an individual manages real or potential conflict between different demands on his or her time and energy in a way that satisfies his or her needs for well-being and self-fulfillment (Clutterbuck, 2003).

Work-life imbalance is a common phenomenon seen in salespersons. In sales, one has to work on toes to complete the sales targets. At times, their performance goes down due to internal and external factors. This starts affecting their personal lives as well. Work-life balance can be represented as two spheres indicating two lives: personal and professional. Figure 1 represents regular interaction between two spheres. The semi-permeable spheres denote regular contact of these spheres with external environment. As shown in figure 2, when organisational life sphere starts intruding into personal life sphere or vice- versa, imbalance gets started.

There must be proper balance between these spheres. The achievement of better work-life balance can yield dividends for employers in terms of having a more motivated, productive and less stressed workforce that feels valued; attracting a wider range of candidates; increased productivity and reduced absenteeism; gaining the reputation of being an employer of choice; retaining valued employees; achieving reduced costs and maximizing the available labour (Byrne, 2005). In Indian context, the concern of work-life balance becomes imperative for all concerned. This study is an attempt to throw light on work-life balance issues with reference to area sales managers in pharma companies. Area sales manager in pharma company is the position typically above the frontline salespersons (i.e. medical representatives), who has to report to regional sales manager.

LITERATURE REVIEW

In this section, a review of selected research work conducted in this subject matter is mentioned. Moncrief et al (1997) have examined the precursors and consequences of salesperson job stress. According to authors, there are a number of organizational variables including met expectations, role conflict, role ambiguity, job satisfaction, organization commitment and intention to leave which influence job stress. Low et al (2001) have studied the antecedents and outcomes of salesperson burnout with special reference to Australia. They found that intrinsic motivation, role ambiguity and role conflict are significant antecedents of burnout and performance is the outcome. Crooker et al (2002) have studied the relationship between life complexity and dynamism that affect work-life balance. The authors have explained individual value systems on the relationship between life complexity and work-life balance. Guest (2002) has explored the reasons why work-life balance has become an important topic for research and policy in some countries.

Mcdowell (2004) has elaborated the ways in which organizations and institutions operate at a range of scales as well as new sets of responsibilities towards co-workers, members of households and the public. Byrne (2005) has highlighted the concept of the work-life balance as a means of tackling the problem of increasing amounts of stress in the work-place. Morris and Madsen (2007) have shown the importance of work-life balance. By better understanding work-life theory, HR professionals can contribute to the strategic development of policies, practices, programs and interventions. Moore (2007) conducted a research to compare work-life balance issues workers and managers of an MNC. It was concluded that many of the managers are not able to achieve work-life balance.

In a research, Hughes and Bozionelos (2007) observed that work-life imbalance was not only a source of concern, but also that it was the major source of dissatisfaction for participants. To establish and illustrate the levels of awareness of work-life balance policies within the surveying profession in Australia and New Zealand, Wilkinson (2008) conducted a research. It was concluded that the consequences of an imbalance between work and personal or family life is emotional exhaustion, cynicism and burnout.

OBJECTIVES OF THE STUDY

In India, the rising cases of stress-related problems among people give an alarming situation. Now, people in the age groups of 30s and 40s are suffering from health problems due to work pressure and other problems. In this study, the major issues concerning work-life balance are delved into with reference to area sales managers in pharma companies in Andhra Pradesh. The objectives of research are as follows:

1. To study the work-life balance issues with reference to area sales managers in pharma Companies.
2. To study the factors affecting work-life balance of such managers.
3. To determine the factors leading to work- life imbalance of such managers.
4. To suggest measures for perfect equilibrium between effective work and life.

RESEARCH METHODOLOGY

Sample size

It was an exploratory study for the purpose of looking into work-life balance concerns in case of area sales managers employed in pharma companies in Andhra Pradesh. There were 120 respondents selected from Vijayawada and Guntur. All of them were married male incumbents having one or two children. Medical representatives were not included in the study.

Sampling Technique: It was a simple, non- probability sampling that comprised of area sales managers.

DATA COLLECTION METHODS

Secondary data were collected from Internet, books, newspapers, journals, business magazines etc. For primary data collection, a self-administered and non-disguised five-point scale questionnaire containing 13 statements was used. The scale was Likert’s five-point scale where the respondents had to fill one choice ranging from strongly agree to strongly disagree. The questionnaires were handed over to 125 respondents, out of which 120 were received. After collecting the data, it was tabulated in Excel sheet and analyzed by using z-test Tools for data collection and analysis

HYPOTHESES OF THE STUDY

Null hypotheses were framed and tested for significance to prove the objectives in a systematic manner. The null hypotheses were as follows:

• H01 –There is no significant impact of nature of job on work-life balance proposition with respect to area sales managers in pharma companies.
• H02 – There is no significant impact of work-life equilibrium on overall performance of area sales managers.

The above null hypotheses were tested and results were drawn.

RESULTS OF THE STUDY

On applying the formula of z-test, both the null hypotheses were found to be rejected at 0.05 level of significance. The result of hypothesis testing by z-test is shown in table 1. It shows that there is significant impact of work-life equilibrium on overall performance of area sales managers. Similarly, work-life equilibrium has major impact on overall performance of sales people. It can be largely attributed to the nature of job. The job of area sales manager involves monitoring medical representatives and reporting to regional sales manager. They have to work with medical representative and solve their problems concerning doctors’ prescription, retailer issues etc. Some of them reported the feeling of getting ‘sandwiched’ between their juniors and seniors (i.e. medical representatives and regional managers). It seemed that they were happy at the position of medical representatives. Some respondents mentioned the examples of medical representatives who were working on the same position for a long time because they have not accepted the promotion as area sales manager.

In pharmaceutical sales, one has to enter as medical representative and get promoted as area sales manager, regional sales manager and zonal manager. Due to the entry of big players, the competition has become fiercer than ever. The doctor has much wider choice of prescription for his patients. While a representative is answerable to a limited market; area sales manager has a broader domain to control. He is responsible for collective efforts of his team of representatives in terms of sales performance. Moreover, due to extensive traveling, the area manager feels exhausted. Some respondents have cited the examples of companies whom they call ‘pressure cooker’. These are the companies known for extreme sales pressures. In this sector, job hopping has become a common trend. This causes multiple problems in personal and social life as well. It can be finally inferred that work-life imbalance is a significant factor leading to overall performance of sales persons.

CONCLUSION AND SUGGESTIONS

The study has many implications for pharmaceutical companies in particular. Increasing cases of work-life imbalance have resulted into high rates of employee turnover. In this study, more than one-third of respondents have wished to quit the field of sales and try their destiny elsewhere. This is the high time when HR people should make more serious efforts towards striking a balance between work and life for their sales persons. It will finally end up in a win-win equation for all. When employees reach their homes, they should not carry any organizational stress with them. Work-life balance policies are beneficial for individuals, their families, organizations, and society (Brough et al, 2008).

The toughest challenge faced by HR managers is retention of talent. There is a need to make the job profile of sales persons more promising and less stressing. The nature of a specific job position cannot be changed, but the way it is performed requires a change. Sales department is the most vital function in a pharmaceutical company; it is the life blood. There are some pharma companies as reported by the respondents, which are known for relaxed working environment, flexibility and autonomy in sales department. These companies have most stable employees and fairly good financial yields. In a nutshell, there should be a human side in managing the sales performance.

This study was confined to pharma-sector area sales managers in two cities of the state. The findings of the study should not be generalized for non-pharma salespersons. The results may also differ in case of managers in other functional areas. Further studies can be carried out on a large sample size and sector-based comparison can be done.

REFERENCES

1. Brough, P., Holt, J., Bauld, R., Biggs, A. and Ryan C. (2008). “The ability of work-life balance policies to influence key social/organisational issues”, Asia Pacific Journal of Human Resources, Vol. 46. Issue 3, pp. 261-274.
2. Byrne, U. (2005). “Work-life balance: Why are we talking about it at all”, Business Information Review. Vol. 22, pp. 53-59.
3. Clayton, Don. (2004). “Leadershift: The Work-life Balance Program”, Victoria: Australian Council for Educational Research. pp. 126-127.
4. Clutterbuck, David. (2003). “Managing the Work-Life Balance”, UK: Chartered Institute of Personnel and Development. pp. 8-9.
5. Coussey, Mary. (2000). “Getting the right work-life balance: Implementing family- friendly practices”, UK: Chartered Institute of Personnel and Development. pp. 2- 18.
6. Crooker K., Smith, F. L., and Tabak, F. (2002). “Creating work-life balance: A model of pluralism across life domains”, HRD Review. Vol. 1, pp. 387-419.
7. Davis, M. F., Fagnani, J., Giovannini, D., Hojgaard, L. and Clarke, H. (2004). “Fathers and Mothers’ Dilemmas of the Work-life Balance: A Comparative Study”, Netherland: Kluwer Academic Publishers. pp. 209-210.
8. Guest, D.E. (2002), “Perspectives on the Study of Work-life Balance”, Social Science Information. Vol. 41, pp. 255-279.
9. Hughes, J. and Bozionelos, N. (2007). “Work-life balance as source of job dissatisfaction and withdrawal attitudes: An exploratory study on the views of male workers”, Personnel Review. Vol. 36, pp. 145-154.
10. Low, George S., Cravens, David W., Grant, K. and Moncrief, William C. (2001). “Antecedents and consequences of salesperson burnout”, European Journal of Marketing, Vol. 35. Issue 5/6, pp. 587-611.
11. Mcdowell, L. (2004). “Work, workfare, work/life balance and an ethic of care”, Progress in Human Geography. Vol. 28, pp. 145-163.
12. McIntosh, Stewart. (2003). “Work-Life Balance: How Life Coaching Can Help”, Business Information Review, Vol. 20, pp. 181-189.
13. Moncrief, William C., Babakus, Emin., Cravens, David W. and Johnston, Mark. (1997). “Examining the antecedents and consequences of salesperson job stress”, European Journal of Marketing, Vol. 31. Issue 11/12, pp. 786-798.
14. Moore, Fiona (2007). “Work-life balance: Contrasting managers and workers in an MNC”, Employee Relations. Vol. 29. Issue 4, pp. 385-399.
15. Morris, M. L. and Madsen, S. R. (2007). “Advancing work-life integration in individuals, organizations, and communities”, Advances in Developing Human Resources. Vol. 9, pp. 439-454.

Unethical Management Practices of Valiant Company

The share prices of Valeant dropped in just a few weeks from $ 262 to $ 27. This was due to the main reasons – the company’s pricing strategy, the company’s $ 600 million overestimation of its target earnings and the debt problems.

Valeant used a pricing strategy where they increased the prices of the drugs of the acquired company to abnormal amounts every time an acquisition occurs. It was noticed that there was a 5500 percent increase in one of the drugs called ‘Cuprimine’ and it now cost $30,000. Valeant had easy access to cheap money to buy drug companies that produced high-value medicines for Valeant.

One example was Salix Pharmaceuticals. Valeant increased the price of Salix’s ‘Glumetza’ diabetes medicine by about 800 %. Similarly, on 10 February 2015, Valeant acquired two drug brands, Nitropress and Isuprel, from Marathon Pharmaceuticals. The two drugs’ prices skyrocketed on the same day, as reported by the Wall Street Journal.

The price-raising strategy of Valeant has become its leading money-making scheme. And it used R&D expenses as an excuse when questioned about the high prices. Traditional drug firms rely on innovation and are offset by higher market share and income. Valeant does not invest as much money as other drug companies in research and development (R&D). The company allocated only 3% of its sales revenues to R&D, much less than 15-20% in traditional drug companies. Sometimes, after acquiring the target firms, Valeant even cut R&D investments.

Companies such as Valeant earn tremendous profits by taking advantage of those patients diagnosed with rare diseases and asking insurers for large bill payments. Therefore, insurance companies tend to avoid payment of insurance for such overpriced drugs. Even if insurance companies are willing in the foreseeable future to pay the unreasonably expensive drug prescriptions, the insurance premiums will inevitably increase to cover the extra expense. Ultimately, consumers pay for these increases. Companies like Valeant do not expect patients to pay drug prices that are incredibly high. Instead, they want insurance companies ‘ money, as insurance plans usually cover the larger proportion of medical expenses and require only small co-payments from U.S. policyholders. However, insurance companies are taking action to stop some overpriced medicines being covered. Price gouging isn’t Valeant’s only misconduct. This rapidly growing business has also been criticized for its misleading financial disclosures. Because of its unsustainable growth model and lack of integrity by the management, Warren Buffett, chairman of Berkshire Hathaway, declined to invest in Valeant.

The event was initiated by a small pharmacy based in California, R&O Pharmacy. R&O received a letter from Valeant requesting a payment of $ 69 million on September 4, 2015, although R&O had no direct business relationship with Valeant. It was discovered that Valeant had an affiliation with R&O in the sense that Valeant’s stakeholder, Philidor Rx, had listed on their website the same contact address and telephone number as R&O’s and that Philidor had purchased an option to purchase Isolani, a major R&O shareholder, and had acquired a similar option contract to purchase all R&O shares. More surprisingly, Valeant was the only client of Philidor, and Valeant had an option to buy Philidor as well.

The contract between Valeant and Philidor has a technical name for this type of option contract, ‘Variable Interest Entity’ (VIE). Valeant should list its VIE holdings on its balance sheet, and Valeant did so, according to the Financial Accounting Standards Board (FASB). However, it is not clear whether and how Philidor should consolidate the results of R&O. The management of Valeant had worked so well that the connections between these firms could hardly be seen by outsiders.

Suspiciously, Valeant has never specifically and explicitly disclosed its option contract details (namely the VIE) on Philidor, but it has consolidated the financial results of Philidor profitably into its financial statements. Philidor’s reports from the Wall Street Journal used “aggressive tactics to get insurance companies to pay reimbursements for the often high-price drugs of Valeant”. Philidor was found to have altered prescriptions with the intention of filling more prescriptions with medicines marked with Valeant. Valeant might have conspired against insurers with Philidor, so Valeant could get insurance companies to pay for their expensive drugs.

The drug price strategy, growth model and accounting methods of Valeant are in no way ethical. This company needed to replace both management and the real core culture and practices of the company to achieve ethical and stable business practices.

– the theme is  Management of multiple sclerosis please using these theme come u

– the theme is  Management of multiple sclerosis please using these theme come up with a title for the paper on what you’re specifically going to write about.
-This paper should include a “table of contents” including a abstract and introduction with at least 7 more headings in the table of contents. 
-please use title 
-This paper should be at least 1500 words 
-please Harvard reference all information 
– please include pictures a minimum of 2 relating them to the paper and giving them a figure 1, 2 etc.. with a small description of what it is showing. 
– please use own words
-try to use peer reviewed sources or professional ones. 
– please create a title for the report
-please follow the template provided

– the theme is  Management of multiple sclerosis please using these theme come u

– the theme is  Management of multiple sclerosis please using these theme come up with a title for the paper on what you’re specifically going to write about.
-This paper should include a “table of contents” including a abstract and introduction with at least 7 more headings in the table of contents. 
-please use title 
-This paper should be at least 1500 words 
-please Harvard reference all information 
– please include pictures a minimum of 2 relating them to the paper and giving them a figure 1, 2 etc.. with a small description of what it is showing. 
– please use own words
-try to use peer reviewed sources or professional ones. 
– please create a title for the report
-please follow the template provided

– the theme is “Interventions to improve quality of life in people with autism”

– the theme is “Interventions to improve quality of life in people with autism”  please using these theme come up with a title for the paper on what you’re specifically going to write about.
-This paper should include a “table of contents” including a abstract and introduction with at least 7 more headings in the table of contents. 
-please use title 
-This paper should be at least 1500 words 
-please Harvard reference all information 
– please include pictures a minimum of 2 relating them to the paper and giving them a figure 1, 2 etc.. with a small description of what it is showing. 
– please use own words
-try to use peer reviewed sources or professional ones.