Why Do Medicines Cost So Much?

£ 9.99 GBP

Written for all levels, this booklet unravels the complex realm of medication pricing. Amid widespread concerns about rising medicine costs, it invites the reader to look beyond the pharmaceutical industry's often vilified role. Instead, it explores the intricate processes of drug discovery, development, and marketing, busting common myths about medication pricing and development costs, and answering common questions surrounding these topics, helping guide readers towards better informed healthcare decisions.

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Why Do Medicines Cost So Much?

The Hidden World of Drug Development and Pricing

Major Heading

The descriptiomn

Our health is one of the most precious things we have; often only recognised as such when we are in the danger of losing it.

Being "healthy" means different things to different people, at different times in their life, but for all of us, one of the crucial issues is having confidence that we are receiving the best advice and treatment available. And just like other goods and services we choose, the range and variety of healthcare treatments are continually increasing. And just as in other aspects of our lives, because drugs and treatments are "new and/or approved" doesn't necessarily mean they are the best choice for us.

This booklet is one of a series, designed to shed light on how decisions in healthcare are made. It looks in particular at the evidence supporting the safety and efficacy of new drugs; how that evidence is gathered, evaluated and used. We hope it helps to answer some fundamental questions about healthcare decisions.

Ruth Whittington

CEO of Rx Values Group Ltd
Ruth combines a background in nursing, teaching, and medical writing with a specialisation in HEOR. A respected member of ISPOR, her passion for education and clear communication has led to successful industry workshops and several insightful publications on health economics.


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Is there a limit to the amount of content that should go on a medical poster?
A poster should provide key findings without overwhelming. Too much text can deter readers. Striking a balance between relevant details and uncluttered presentation is essential.
How should our organization measure the success of our medical writer?
Success can be gauged by key metrics such as the adherence to timelines, quality and effectiveness of the documents produced, feedback from colleagues and clients, compliance to regulatory standards, and advancement in learning and skills.
What are the challenges faced by medical writer?
Medical writers face challenges such as remaining up-to-date in their specialty area, dealing with large amounts of complex data, maintaining clarity and accuracy, meeting tight deadlines, and complying with ever-changing regulations.
What role do medical writers play in drug development?
Medical writers are crucial in drug development. They create study protocols, track and report trial progress, write documents needed for regulatory submissions, and develop scientific publications based on the trial data.
How much cross-department collaboration is advisable for poster creation?
Cross-department collaboration can provide deeper insights and fresh perspectives. Although too many contributions can complicate coordination, a balanced approach involving key stakeholders from relevant departments generally yields the best results.
How long does a literature review usually take to complete?
The time taken to conduct a literature review varies depending on its scope and complexity. A rough guideline could be weeks to a few months for undergraduate reviews to 1-2 years for comprehensive systematic reviews.
How are medical writers instrumental in grants and proposal writing?
Medical writers can greatly contribute to writing robust grant proposals by clearly defining the objectives, outlining a comprehensive methodology, strategically presenting outputs, and producing a persuasive, error-free script.
What are some models for analyzing individual patient data in systematic reviews?
Individual patient data meta-analyses allow for more detailed and robust analyses by using original data instead of aggregate study data. Choices of statistical models (e.g., one-stage or two-stage model) will depend on data properties and research questions.
How are medical writers involved in the investigation of product complaints?
In investigating product complaints, medical writers help in documenting the issue, compiling associated data, and drafting responses. This contributes to transparency and facilitates understanding of the problem for both the organization and regulatory bodies.
What is a meta-analysis and how does it relate to a literature review?
A meta-analysis is a statistical technique used in a systematic review to integrate the results of multiple studies. It provides a more precise estimate of effect size than individual studies, enhancing the evidence base for informed decision-making.
How do literature reviews contribute to evidence-based practice?
Literature reviews play a pivotal role in evidence-based practice by summarising and critically assessing the quality of available evidence. This helps healthcare professionals make informed decisions, ensuring the most effective and efficient practices are adopted.
How has medical writing evolved over time?
As medicine advances, medical writing has evolved to keep up, becoming more specialised and more focused on transparency, data integrity, and patient-centric documentation.
How can medical writing improve the quality of regulatory submissions?
Quality medical writing improves readability, preciseness, and coherence of regulatory submissions, facilitating quicker understanding and possible approval of the submission by regulatory bodies.
How are literature reviews structured?
Literature reviews start with an introduction setting the context, followed by the main body that discusses the literature under thematic, methodological, chronological, or other organisational schemes. They end with a conclusion summarising major findings and suggesting areas for future research.
How are medical writers trained?
Training can be through academic courses, in-house training in organisations, or certificate programmes. It mainly involves understanding medical data and regulatory requirements, and developing technical and language skills.
What does a flow diagram in a systematic review show?
A flow diagram visualises the progression of information throughout the different stages of a systematic review. It displays the number of articles identified, screened, deemed eligible and included in the final review, providing a transparent overview of the process.
How is medical writing helpful in understanding complex health issues?
Medical writing helps decipher complex health issues by effectively translating scientific data into more understandable language. It contributes to healthcare communication, knowledge sharing, and informed decision-making.
Do I need a background in the subject to understand a literature review?
While basic knowledge about a topic can be beneficial, a well-written literature review should provide sufficient background information, making it accessible even for non-experts. Still, understanding the technical jargon may require a certain level of expertise.
How to interpret the result of a meta-analysis and what are the potential limitations?
Meta-analysis results provide a combined effect size from all included studies. Interpretation should consider the magnitude and direction of the effect, confidence intervals, heterogeneity, and potential publication bias. Understanding the clinical context is key to interpret its relevance.
Can students create and submit medical posters?
Absolutely. In fact, many conferences encourage student participation, recognising the valuable fresh perspectives they bring. Student category awards are also common.
Can we include a call-to-action in our poster?
A subtle call-to-action can be included, directing the audience to your research paper or relevant additional resources. However, avoid direct product promotion or overtly commercial messages.
How can medical writers help us in meeting deadlines?
Medical writers can aid in meeting deadlines by effective project planning, prioritising tasks, liaising smoothly with various teams, and using efficient software or tools to boost productivity.
How can medical writers streamline coordination between cross-functional teams?
Medical writers have a crucial role in communication and coordination between teams. They often act as the central point of contact, translating discussions into well-structured documents, and managing revisions based on stakeholders' feedback.
What is a literature review?
A literature review is a comprehensive evaluation and summary of existing research on a particular subject. It synthesises the findings to deliver important information, highlighting major trends, gaps, and inconsistencies to provide a clearer understanding of the topic.
What role does a literature review play in a dissertation or research paper?
In a research paper or a dissertation, a literature review aids in setting context and demonstrating knowledge of the existing work. It provides a theoretical backdrop and reveals gaps in previous research, justifying the necessity for the new study.
How are literature reviews updated?
Literature reviews are updated when substantial new evidence becomes available, affecting the understanding of the current landscape. Such updates ensure reviews stay relevant, providing accurate information to guide research, policy, and practice.
How can we best use the data we have available now, and will have in the future, to provide valid and reliable evidence to each of those audiences?
- Clear and concise study protocols, study reports, brochures and slide decks for investigator meetings - Advisory boards for future planning activities or value demonstration strategies - Regulatory documents
Are there differences between online and offline medical posters?
Online posters can offer interactive elements like zooming and links. In contrast, physical posters must make all content - textual and visual - immediately visible.
How is the registration of systematic review protocols helpful?
Registering systematic review protocols guards against selective reporting, duplication of effort and provides transparency. Prospective registration platforms like PROSPERO enhance credibility and allow others to learn about ongoing reviews.
Can non-English studies be included in systematic reviews?
Studies in non-English languages may be included, subject to adequate translation, to avoid language bias. However, practical constraints like translation resources and time may limit such inclusion.
How does sensitivity, specificity & diagnostic odds ratio affect the meta-analysis of diagnostic test accuracy studies?
Sensitivity, specificity, and diagnostic odds ratio all provide valuable information in the meta-analysis of diagnostic test accuracy studies. They describe the test's ability to correctly identify those with and without the condition. Therefore, they impact interpretation and application of test findings.
How is a literature review different from a literature survey?
A literature survey provides an overview of existing literature in a specific field without necessarily offering a critical evaluation. On the other hand, a literature review critically assesses research in a field, discussing patterns, contradictions, gaps, and future directions.
Are there different criteria for posters that are designed for online congresses versus onsite?
With virtual posters, consider load time, screen readability, and incorporating interactive elements. Onsite posters rely on physical aesthetics and should include contact details for attendees to follow up post-event.
What is a quality assessment in a systematic review?
Quality assessment in a systematic review evaluates the methodological rigour of included studies. It helps to assess the risk of bias and the reliability of findings, influencing the weighting of studies in synthesising evidence.
What are literature databases?
Literature databases are digital platforms containing academic journals, conference papers, theses, reports etc. Some popular databases for health-related literature include PubMEd, Embase, and Cochrane Library -- invaluable for conducting systematic literature reviews.
What evidence, level of understanding and communication channel will influence that particular decisionmaker to make the right healthcare decision, and how would that evidence be best presented?
A medical communications agency worth its salt should help find the answers to these questions, take the evidence available, perform the necessary competitor and benchmarking analyses and be able to come up with a publications plan and/or communications strategy that fulfils these criteria for the decisionmakers that are most important to the client.
How do I interpret the results of a literature review?
Results from a literature review can be interpreted by examining the key findings, methodological flaws, and future recommendations. Assessing the strength of the evidence, the quality of included studies, and consistency of results can aid interpretation.
How do pairwise and network meta-analyses differ?
Pair-wise meta-analysis compares two interventions directly using the data from studies which have compared them. Network meta-analysis compares multiple treatments simultaneously by analysing direct and indirect comparisons, providing a ranking of effectiveness among all treatments.
What is the difference between primary, secondary, and tertiary literature?
Primary literature refers to original research reports authored by the investigators themselves. Secondary literature includes reviews, summaries, or analyses of primary research. Tertiary literature like textbooks or encyclopedia provides summarised version of primary and secondary literature.
How do medical writers ensure confidentiality?
Medical writers ensure confidentiality by adhering to privacy laws, ethical guidelines, and company-specific regulations. They handle sensitive data responsibly and maintain professional standards.
How is the quality of a systematic review measured?
The quality of a systematic review is usually assessed using the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) checklist. It covers aspects like protocol registration, literature search, data extraction, risk of bias assessment, and conflict of interest statement.
What elements should be prioritised in a medical poster to draw more attention?
To draw attention, make the title compelling, let the biggest finding 'pop', use high-quality visuals, and convey your story in a clear, engaging manner. Keep the design clean and aesthetic.”
What skills and tools are necessary for conducting a literature review?
Conducting a literature review requires skills in project management, critical analysis and synthesis, and scientific writing. Along with these, familiarity with database searching and referencing tools, and statistical software (for meta-analysis) is beneficial.
How to deal with studies having zero events in meta-analyses?
Dealing with studies having zero events in meta-analyses can be challenging. Various statistical methods, such as adding a continuity correction or using specific statistical models or Bayesian techniques, can be used to accommodate this issue.
How do you keep track of information flow in a systematic review?
The PRISMA flow diagram is a common tool for tracking the flow of information through different stages of a systematic review. It records the number of records identified, included, and excluded and reasons for exclusions.
What’s the role of a medical writer in preparing clinical study protocols?
In preparing clinical study protocols, medical writers determine the document's structure, write the methods section in collaboration with investigators, and ensure that the document is clear, concise and comprehensive.
How can a systematic review be used in public policy formation?
Systematic reviews synthesise all available evidence on a topic, aiding decision-making in public policy. They can identify effective interventions, assess costs and benefits, highlight gaps, and provide recommendations, facilitating implementation of evidence-based policies.
How long does it typically take to prepare a regulatory document?
The preparation time can vary greatly depending on the complexity of the document, the raw data available, the team’s expertise, availability of subject matter experts and the approval process in place.
What is the purpose of critiquing literature in a literature review?
Critiquing literature allows researchers to assess the strengths and weaknesses of existing studies, identify methodological flaws, and understand the context and limitations of research findings. This contributes to a comprehensive and balanced literature review.
How are sources selected for a literature review?
In literature reviews, sources are chosen based on their relevance to the research question. Comprehensive searches in databases, hand-searching of key journals, and manual reviews of references are common ways to select sources.
What is the PRISMA guideline?
PRISMA stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. It's a guideline ensuring the explicit and comprehensive reporting of systematic reviews and meta-analyses, enhancing the clarity and replicability of research.
How can computational tools aid in conducting literature reviews?
Computational tools like Rayyan for citation screening, Covidence for data extraction, and RevMan for data synthesis can aid in conducting literature reviews. They facilitate collaboration, reduce manual errors, and streamline the review process.
Is there a potential conflict of interest in medical writing?
To prevent conflicts of interest, medical writers should uphold transparency, declare affiliations or financial incentives, follow ethical guidelines to avoid bias, and completely report study results.
How is risk of bias assessed in systematic reviews?
Risk of bias is assessed using standardised tools that evaluate various domains such as selection bias, performance bias, detection bias, attrition bias, and reporting bias. The Cochrane Collaboration’s tool and ROBINS-I are commonly used.
Can you provide an example of a well-written literature review in the health field?
Examples of well-written literature reviews abound in academic medical journals such as BMJ, JAMA, and the Cochrane Database of Systematic Reviews. These generally have rigorous protocols, standardised methods, and transparent reporting, offering lessons for writing high-quality reviews.
Do medical writers work alone or in teams?
Medical writers can work both individually and within teams, depending on the size and scope of the project. Working in a team often occurs when dealing with large-scale projects or within larger organizations.
How is narrative synthesis incorporated in systematic reviews?
Narrative synthesis is often part of a systematic review, especially when quantitative synthesis (meta-analysis) isn’t possible or sufficient. It narratively summarises and explains the findings of included studies, highlighting similarities, differences and overall patterns.
How do Indirect comparisons and evidence synthesis work in systematic reviews?
Indirect comparisons refer to inference of the comparative efficacy of two interventions, based on their effectiveness compared to a common comparator. Evidence synthesis refers to the integration of findings from various studies to reveal an overall picture.
How to conduct a network meta-analysis?
A network meta-analysis compares multiple treatments simultaneously by analysing direct comparisons of interventions within randomised controlled trials and indirect comparisons across trials. It's beneficial when multiple treatments are available and lack direct comparisons.
How are systematic reviews used in medical education?
Systematic reviews play crucial roles in medical education, delivering a comprehensive overview of existing evidence. They provide a foundation for evidence-based medicine, train students to critically appraise research, and help educators develop relevant curricula.
How are medical writers involved in producing manuscripts for peer-reviewed journals?
Medical writers liaise with researchers to convert clinical trial data into robust manuscripts. They follow journal guidelines, ensure ethical reporting, provide cohesion and flow in the write-up, and manage revisions till acceptance.
What’s the role of systematic reviews in Health Technology Assessments (HTAs)?
Systematic reviews are often employed in Health Technology Assessment (HTA), where they summarise evidence on the effectiveness, cost-effectiveness, and safety of a technology, thereby guiding reimbursement decisions and policy-making.
How can you conduct a systematic review of pharmacoeconomic studies?
A systematic review of pharmacoeconomic studies would follow similar steps as any systematic review while emphasising including economic evaluations, considering perspectives, time horizons, type of economic analysis, discounting, sensitivity analyses and quality of health economic study.
Are systematic reviews considered high-quality evidence?
Yes, systematic reviews are considered high-quality evidence. They rigorously summarise all existing studies on a topic, control for biases, and provide a consolidated picture of global knowledge, generally occupying the highest level in the hierarchy of evidence.
What distinguishes a good abstract in a poster presentation scenario?
A good abstract is concise yet comprehensive. It captures attention with compelling language, clearly lays out the research objective, succinctly describes the methods, results and insightfully comments on implications.
Does the abstract content need to perfectly match that of the final poster?
While minor adjustments can be made to the poster after the abstract is submitted, substantive differences between the abstract and the final poster could confuse the audience and potentially challenge the credibility of your presentation.
Who uses the products of medical writing?
Physicians, researchers, regulatory bodies, pharmaceutical companies, and patients use the products of medical writing for decision-making, education, strategy, and guidance.
Can social media help in the dissemination of systematic review findings?
Social media platforms like Twitter, LinkedIn or ResearchGate can increase the visibility and reach of systematic review findings. Sharing bite-sized key messages, graphics, or video summaries can enhance public understanding and application of health evidence.
How to tackle controversial or sensitive subjects in a medical poster?
Controversial topics should be presented with scientific rigour, impartiality and respect for varying viewpoints. Avoid loaded language and base conclusions on solid evidence, not personal beliefs.
Can a literature review contain opinions?
Literature reviews should be based on facts and evidence from existing research, not personal opinions. They reflect a balanced perspective, evaluating each study objectively while highlighting strengths, weaknesses, and areas of uncertainty.
How does one enter the field of medical writing?
To enter medical writing, a strong foundation in life sciences is crucial. Adding a qualification in medical writing or gaining writing experience, initially under guidance, can pave the path to a career in this field.
How do you manage conflicts of interest in systematic reviews?
Conflicts of interest should be declared. These include any financial, personal, or professional relationships that could influence the review's results. Transparency aids credibility and allows readers to judge potential bias.
Are there any common mistakes to avoid when creating a medical poster?
Common mistakes include overcrowding with text, too small font sizes, lack of logical flow, and excessive jargon. Clarity, legibility, and simplicity should guide poster creation.
How can AI augment the process of literature review?
Artificial Intelligence, especially Natural Language Processing and Machine Learning, can augment the process of systematic review by automating citation screening, data extraction, even bias assessment, reducing manual workload and accelerating the process.
What is a narrative review?
Narrative reviews provide comprehensive overviews of topics, but unlike systematic reviews, they don’t use systematic methods to search, appraise, and summarise available evidence. They offer a broad perspective rather than an exhaustive summation of all available research.
How to conduct a sensitive and specific search strategy in systematic reviews?
For a sensitive and specific search strategy, start broad and narrow down with tailored keywords and MeSH terms. Use Boolean operators, truncations and wildcards appropriately. Search multiple databases and consider peer-reviewed grey literature.
How should medical writers ensure compliance with regulatory guidelines?
Ensuring compliance entails understanding relevant laws, guidelines and industry standards. It also involves thorough editing, cross-checking facts, maintaining transparent record-keeping and closely working with internal or external auditors.
How are new techniques like living systematic reviews changing the landscape?
Living systematic reviews are an innovative approach that continually update with new evidence. They leverage technology, streamlined methodologies, and community engagement to provide timelier updates, enabling decision-makers to base their decisions on the latest evidence.
What subject areas can a literature review cover?
Literature reviews can cover any subject from healthcare, education, social sciences, engineering, to arts. The scope is vast; the aim is to synthesise available literature on the subject in question.
Why is medical writing important?
Medical writing is vital to communicate scientific and health-related information. Clinical trials, patient data, and new medical methods all need to be documented clearly for both professionals and the public.
How to create a standout academic abstract for a poster?
Your abstract needs to be concise, comprehensive, attention-grabbing, and correctly formatted. It should not be overly technical and should articulate why your research matters in the larger context.
How are prognostic factor reviews conducted?
Prognostic factor reviews identify factors associated with the outcome of a disease in patients. They involve five steps: background, search and selection, data collection, synthesis and findings, and discussion. Quality assessment tools specifically developed for prognostic factor reviews are employed.
What is the role of the software in systematic reviews?
Software helps streamline the process of systematic reviews, from citation screening (Rayyan), data extraction (Covidence), statistical analysis (RevMan), to tracking project progress (EPPI-Reviewer). These tools foster efficiency, collaboration, and reduce manual errors.
What is a day in the life of a medical writer like?
A medical writer’s day may involve researching, writing, editing or proofreading documents, attending team meetings, consulting with subject matter experts, and staying updated on industry trends and news.
How does medical writing contribute to healthcare?
Medical writing supports healthcare through creating documents required in research and clinical trials, through providing regulatory information, and in production of materials educating patients on diseases and treatments.
Are there software tools that can aid in medical writing?
Diagnostic tools like spellcheckers and grammar checkers, and software like EndNote for reference management, LaTeX for document formatting, and GraphPad Prism for creating scientific graphs, can aid medical writing.
How to interpret funnel plots in meta-analyses?
Funnel plots are simple scatter plots used in meta-analyses to assess publication bias. An asymmetrical plot typically suggests publication bias. However, other study-related factors, such as poor methodological quality, could also cause asymmetry.
Are literature reviews published in academic journals?
Yes, literature reviews are frequently published in academic journals. Systematic reviews, scoping reviews, meta-analyses, and narrative reviews constitute a large part of published literature across a wide range of disciplines.
Is it beneficial to submit a medical poster abstract before the complete poster?
It can provide early exposure to your work and invite valuable feedback. However, all data and methodologies should be thoroughly validated before abstract submission to prevent later discrepancies.
How to base clinical guidelines on systematic reviews?
Clinical guidelines should ideally be based on high-quality systematic reviews, the highest form of evidential hierarchy. Systematic reviews provide a rigorous synthesis of all available evidence, assisting guideline panels in making consistent, evidence-based recommendations.
How do I know if a literature review is reliable?
A reliable literature review follows a clear, reproducible methodology. It gives special attention to the selection criteria, search strategy, data extraction, quality assessment and synthesis methods. Check for concrete explanations and transparency in reporting.
What's the contribution of medical writers towards medical education?
Medical writers contribute to medical education by generating teaching materials, creating content for e-learning platforms, writing review articles, summarising latest advancements in scientific language, and developing patient information leaflets.
How to handle studies with multiple treatment arms in meta-analyses?
Multi-arm trials, where several interventions are compared to a control group in a single study, are common in healthcare research. Techniques like adjusted indirect comparison can be used to include multi-arm studies in a meta-analysis.
What does a sensitivity analysis in a systematic review involve?
Sensitivity analysis in systematic review examines how changes in specific parameters or assumptions affect the review's outcomes. It's a way to test the robustness of results and understand how uncertainties might impact the conclusions.
What is the role of Grey literature in systematic reviews?
Grey literature refers to unpublished or non-commercially published documents, such as reports, theses, conferences abstracts. Including grey literature in systematic reviews can reduce publication bias and provide a more comprehensive view of the available evidence.
How can we improve communication and understanding of systematic review findings?
Improvements can be made by using plain language summaries, infographics, interactive summary-of-findings tables, webinars, and media releases. Engaging patients, the public, health professionals, and policymakers in the dissemination process can enhance comprehension and application of findings.
Is the job of a medical writer overlooked?
Although behind-the-scenes, the role of medical writers is invaluable to disseminate medical knowledge, facilitate critical decision making in healthcare, and advance science through clear, precise communication.
What are umbrella reviews and how do they contribute to research synthesis?
Umbrella reviews consolidate evidence from multiple systematic reviews into one accessible document. They offer a high level of evidence, summarising all relevant information on a single topic, aiding decision-making.
Can promotional materials be handed out alongside the poster presentation?
Some conferences allow promotional materials, although these should not distract from the scientific content. Items might include copies of the research papers, model representations, brochures about an ongoing study etc.
What strategies can I use to avoid bias in my review?
Avoid bias in literature reviews by following rigorous and transparent protocols, utilising comprehensive search strategy, employing dual independent screening and data extraction, declaring potential conflicts of interest, and adopting objective data synthesis methods.

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