<p>In this dissertation, I study medicalization, a wide spread phenomenon in this world but understudied in the current literature. The main theoretical focus of this dissertation is on expanding the medicalization theories. Questioning the breadth of conceptualization, the feasibility of measurement, and the depth of empirical implications in the extant medicalization theories, this dissertation proposes a new conceptual model of medicalization and further develops a quantitative measure of medicalization by disaggregating it into empirically valid dimensions that could be used to examine how degree of medicalization is related to social outcomes. Specifically, I conceptualize medicalization as an institutionalization process whereby the medical model becomes increasingly dominant in the explanation of health, illness, and other human problems and behavior. Medicalization is multidimensional and is represented by expansions in the three major components of the health care system: increasing medical investment, medical professionalization/specialization, and the relative size of the pharmaceutical industry. </p><p>Based on this new conceptual model and measurement, I probe three research questions: (1) how medicalization may impact population health in the context of recent epidemiologic transitions and how this impact may differ by the stages of epidemiologic transition and socioeconomic development; (2) what are the mechanisms that reproduce medicalization; and (3) how the lay public may respond to medicalization, the institution of medicine, and the medical profession.</p><p>This dissertation links several lines of theoretical and empirical research from medical sociology, demography, epidemiology, health economics and management, and medical science, and extensively employs OECD Health Data, World Development Indicators, the World Values Survey, the European Values Study data, the U.S. General Social Survey, and the U.S. National Health Interview Survey. It uses several advanced statistical methods, e.g., multiple imputations, latent variable analysis, mixed models, generalized estimating equations models, generalized method of moments models, difference-in-difference models, and hierarchical-age-period-cohort models.</p><p>Results for the first research question suggest that various dimensions of medicalization vary in importance on population health and these effects also differ by the stages of epidemiologic transition and socioeconomic development. I discuss the mechanisms linking various dimensions of medicalization to population health and then discuss these findings in the context of epidemiologic transition, fundamental causes of disease and death, and global health movement. </p><p>Results for the second research question suggest that medicalization at both the societal and individual levels negatively affect individual subjective health, which leads to increasing health care utilization. These social processes function together to promote and reproduce medicalization at societal level. I discuss several pathways linking medicalization to lower subjective health and other agents of medicalization.</p><p>Results for the third research question suggest that American's "confidence in the medical institution and profession" has continuously declined in the last three decades and groups with higher socioeconomic status report lower obedience to doctors' authority, but are more likely to trust doctors' ethics than their counterparts. I discuss the mechanisms for the changes in public confidence in the medical institution and profession, the status of medicine and the medical profession in the era of medicalization, the paradox of opposite trends in attitudes toward medicine and health utilization behavior, and group differences in obedience and trust.</p> / Dissertation

The Swedish pharmaceutical industry is going through structural changes due to the increased cost of drug development. This has led pharmaceutical firms to outsource clinical trials to Clinical Research Organisations (CRO). This thesis explores the inter-firm relationships between pharmaceutical firms and CROs in the Stockholm area, with focus on the development of trust and commitment. The empirical material gathered from nine qualitative interviews with representatives from both parties suggests that trust and commitment are both important factors. Trust is based on competence and reputation whilst commitment is developed through communication. Commitment is highly valued by the companies that wished to develop long-term relationships. The results also point to challenges in the area mainly regarding patient recruitment that due to the high competition amongst the CROs can lead to opportunism when they are overly optimistic of what they can deliver. This is an issue that needs to be addressed as it affects the whole industry.

University of Macau / Institute of Chinese Medical Sciences

University of Macau / Institute of Chinese Medical Sciences

University of Macau / Institute of Chinese Medical Sciences

Measuring marketing effectiveness is critical for marketers as the pharmaceutical industry is under great pressure for cost control. Pharmaceutical marketers need to optimally allocate these resources and ensure that they achieve the highest possible return on investment for the firm. Pharmaceutical manufacturers utilize a variety of marketing vehicles to promote their products to physicians and consumers. At the physician level, effects of detailing are typically identified to be positive. Direct- to-consumer advertising does impact the choice probability, but the impact of promotions aimed directly at physicians is significantly higher. Measuring value of marketing activities is important for a company to achieve a profit margin and best allocate its resources. To define and deliver quantitative measurements that justify how investment in specific marketing programs are paying off, marketers need metrics to show that their programs work. Then, selected metrics should be meaningful and related to financial performance. There are a few metrics regularly used by marketers such as brand awareness, market share, consumer attitudes toward brand, purchase intention, return on investment, lifetime value of an activity, and brand equity. The paper uses a case study to review and evaluate the effectiveness of a marketing plan for a new launch product. Specifically, return on investment (ROI) for patient programs and lifetime value of activity (LVA) for physician education programs were calculated in the case study. A company is able to increase sales profit by reallocating resources to activities with higher ROI and LVA. To conclude, marketers need to identify meaningful metrics, set up a tracking process, and regularly follow up all relevant marketing activities. The process of measuring marketing effectiveness through the tracking process will help companies to understand how the marketing activities work and whether these programs deliver profitable value growth. The follow up action to fine-tune budget plans can then optimize return of marketing investment and maximize profitability.

As the increase of competition levels, the ability of generating a continuous stream of innovation occupies an exceptionally important role in the development and manufacturing of companies, especially in bio-pharmaceutical industry in United States. This paper presents an empirical perspective on the nature of innovation of the U.S. bio-pharmaceutical companies. Several issues discussed here are central to a study of R&amp;D expenditure's determinates of top listed bio-pharmaceutical companies sampling from U.S. market. It begins with the background information of innovation in overall bio-pharmaceutical sector, and then moves on to detail of R&amp;D activities in bio-pharmaceutical industry. Next it discusses the estimated factors which influence R&amp;D expenditures, following by previous literatures review. The purpose of this thesis is to investigate and to test financial and non-financial factors determining R&amp;D expenditures for individual top technique bio-pharmaceutical listed firms through literature review using data for the 2001 to 2010 periods by both single variable analysis and multiple variable analyses empirically. Moreover, the further step in this study is to investigate the real relations between those factor and R&amp;D expenditures individually and synthetically. In this way, this work helps us have a more clear understanding on the relationship between firm performance and firm R&amp;D expenditures. More specifically, the study provides evidence on three essential issues. To answer there three questions, the paper conducts both single variables analysis and multiple variable analysis. For single variable analyses, first step is to draw scatter plots based on 97 sets of data by using MARLAB software. Following this step, to illustrate the exact correlation between the given independent variable and dependent variable (the natural logarithm of R&amp;D), after processing data filter the paper adopt curve fitting based on varying sets of data. According to the results from this study, the conclusions obtained can be divided into two streams. First type is the one that the hypothesis get support from this study. For instance, there is a significantly positive correlation between firm size and R&amp;D expenditures as expected. Also, just as expected, a high sales growth rate is positively correlated with R&amp;D expenditures based on given sample. Besides, it is proved in this paper that R&amp;Di,t-1 have a lagged effect on the R&amp;Dit expenditures. The other type is that hypothesis cannot be proved, no significant evidence have been found or not as effective as what have been estimated in hypothesis. For example, it is not reasonable to say the R&amp;D expenditures and operating profit margin have a positive correlation. Moreover, the lnR&amp;Dit and cash flow to sales income rate also have no obvious correlation. According to the analyses of two multiple variable models, all six variables can be regarded as the determinants of R&amp;D expenditures; especially the variable of firm 3 / 105 size is the major. Additionally, some interesting findings provided in the end of this study.

Pharmaceutical companies experience new challenges in the face of steadily increasing costs for drug production coupled with a decrease in the number of approved drugs. While the pharmaceutical industry remains tentative in Sweden, it is extensively growing in China. Chinese businesses are now on the lookout for foreign experience and know-how in production and R&amp;D. This provides an opportunity for both parties to engage in strategic alliances. Nevertheless, strategic alliances present risks that partner firms need to be aware of. This study investigates how Swedish pharmaceuticals can manage perceived risks when cooperating with Chinese pharmaceutical firms. Through academic journals, two main mechanisms were identified as being of particular influence in the management of perceived risk: trust and control. A qualitative study of nine interviews was conducted in order to determine how Swedish pharmaceutical companies manage risk when engaging in strategic alliances with Chinese partners. Six men and women employed in three different pharmaceutical companies were interviewed along with three experts from the industry. The empirical investigation results in a description of a sequence of trust-enhancing activities and control mechanisms. Network and communication are found to be essential trust-enhancing activities, enabled by a Chinese employee. The study conclusively determines that a Chinese connector is the key in the management of perceived risk.

The aim of this thesis is to make policy recommendations for Turkey in order to facilitate innovative activities resulting in more patent applications in pharmaceutical industry through comparing her with the selected countries / USA, EU, Japan, India, China and Korea. The comparison is performed in terms of the patent, research and development (R&amp / D) expenditures and basic research. This study begins with firstly indicating the relationship between patents and innovation in sector basis. When it is looked at this relationship patents are the most necessary tool for pharmaceutical industry. Therefore, in the main part of the thesis the patents and innovations in pharmaceutical sector are analyzed mostly. However, this analysis is not done in all aspects but it is done in terms of research and development expenditures and basic research. Patent is mainly a result of research and development activities. Besides, basic research is also effective in making innovations and so in patent system. Because of these reasons, the relationship between patents and innovations in pharmaceutical industry are covered in terms of these two aspects-R&amp / D expenditures and basic v research-. These relationships are analyzed in country level. In this thesis, in order to see the right route for Turkey and give some advises to Turkish patent and innovation system especially in pharmaceutical industry Turkey is compared with USA, EU, Japan, China, India and Korea. The reason to take USA, EU and Japan is that, these countries are developed countries, the biggest patent offices in the world are in these countries and the number of patent applications is the highest in the offices of these countries. On the other hand, China, India and Korea are taken as subject to the comparison because these countries are developing countries like Turkey and the development levels of these countries are not too higher than Turkey. In this thesis, through comparing Turkey with the selected countries, some policy recommendations are done for Turkey and this thesis may open door to further studies on the patent and innovation system of Turkey especially in pharmaceutical industry.

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