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International audience ; China is the second largest pharmaceutical market in the world. This sector grew by 21.4% between 2002 and 2012. In OECD countries, spending on medical drugs accounted for approximately 17% of total health spending or 1.5% of gross domestic product (GDP) in 2009. That same year, spending on pharmaceutical products in China represented 43% of the total healthcare expenditure. Aware of the issue, the Chinese government has reacted. A limitation on the hospital mark-up on drugs has been implemented and a list of key drugs that are considered essential has been set up. Drugs on this list have to be accessible to everyone, with a regulated price to be kept as low as possible. To keep prices low, procurement is made through centralized bidding at provincial level, pharmaceutical companies delivering directly to medical facilities. Yet, in the field, the reality remains at times complex, with different ways to circumvent these constraints.

International audience ; China is the second largest pharmaceutical market in the world. This sector grew by 21.4% between 2002 and 2012. In OECD countries, spending on medical drugs accounted for approximately 17% of total health spending or 1.5% of gross domestic product (GDP) in 2009. That same year, spending on pharmaceutical products in China represented 43% of the total healthcare expenditure. Aware of the issue, the Chinese government has reacted. A limitation on the hospital mark-up on drugs has been implemented and a list of key drugs that are considered essential has been set up. Drugs on this list have to be accessible to everyone, with a regulated price to be kept as low as possible. To keep prices low, procurement is made through centralized bidding at provincial level, pharmaceutical companies delivering directly to medical facilities. Yet, in the field, the reality remains at times complex, with different ways to circumvent these constraints.

International audience ; China is the second largest pharmaceutical market in the world. This sector grew by 21.4% between 2002 and 2012. In OECD countries, spending on medical drugs accounted for approximately 17% of total health spending or 1.5% of gross domestic product (GDP) in 2009. That same year, spending on pharmaceutical products in China represented 43% of the total healthcare expenditure. Aware of the issue, the Chinese government has reacted. A limitation on the hospital mark-up on drugs has been implemented and a list of key drugs that are considered essential has been set up. Drugs on this list have to be accessible to everyone, with a regulated price to be kept as low as possible. To keep prices low, procurement is made through centralized bidding at provincial level, pharmaceutical companies delivering directly to medical facilities. Yet, in the field, the reality remains at times complex, with different ways to circumvent these constraints.

International audience ; China is the second largest pharmaceutical market in the world. This sector grew by 21.4% between 2002 and 2012. In OECD countries, spending on medical drugs accounted for approximately 17% of total health spending or 1.5% of gross domestic product (GDP) in 2009. That same year, spending on pharmaceutical products in China represented 43% of the total healthcare expenditure. Aware of the issue, the Chinese government has reacted. A limitation on the hospital mark-up on drugs has been implemented and a list of key drugs that are considered essential has been set up. Drugs on this list have to be accessible to everyone, with a regulated price to be kept as low as possible. To keep prices low, procurement is made through centralized bidding at provincial level, pharmaceutical companies delivering directly to medical facilities. Yet, in the field, the reality remains at times complex, with different ways to circumvent these constraints.

Organised crime groups prefer existing ties, such as family and friendship, to maximise trust. However, they might also win from a certain degree of heterogeneity. External individuals might add value in the form of skills, expertise or money. Accordingly, including suitable co-offenders is an important activity for the organised crime group. This article studies the entry mechanisms of individuals into the synthetic drugs market in Belgium, namely by gaining insight into the factors and mechanisms introducing people into this market. Interviews with 29 inmates detained for their involvement in the production and/or trafficking of synthetic drugs in Belgium revealed that: (1) poly drug supply markets exist in Belgium; (2) financial reasons to enter the market are common; and (3) there are six different entry mechanisms, in which trust is crucial, namely criminal family ties, criminal friends, drug use, earlier time in prison, outlaw motorcycle gang membership, and criminal professional ties.

This paper reviews empirical evidence on drug prices and discusses implications for understanding of drug markets and for policy. The most striking characteristics of drug prices are their high levels and extreme variability over time and space. High prices deter consumption but have ambiguous effects on drug-related crime. The consequences of the variability are largely unexplored and are difficult to determine. Conclusions are mixed with respect to the ability of policy to influence prices. Prohibition plus some degree of enforcement can drive prices far above what they would be if drugs were legal. In certain circumstances, additional severity of enforcement can create transient spikes in price or alter the source of drugs by driving up prices from one source relative to another. However, increasing enforcement over and above an already strongly enforced prohibition appears to have only limited ability to drive prices up further.

BACKGROUND: Illegal drug markets are shaped by multiple forces, including local actors and broader economic, political, social, and criminal justice systems that intertwine to impact health and social wellbeing. Ethnographic analyses that interrogate multiple dimensions of drug markets may offer both applied and theoretical insights into drug use, particularly in developing nations where new markets and local patterns of use traditionally have not been well understood. This paper explores the emergent drug market in Kisumu, western Kenya, where our research team recently documented evidence of injection drug use. METHODS: Our exploratory study of injection drug use was conducted in Kisumu from 2013 to 2014. We draw on 151 surveys, 29 in-depth interviews, and 8 months of ethnographic fieldwork to describe the drug market from the perspective of injectors, focusing on their perceptions of the market and reports of drug use therein. RESULTS: Injectors described a dynamic market in which the availability of drugs and proliferation of injection drug use have taken on growing importance in Kisumu. In addition to reports of white and brown forms of heroin and concerns about drug adulteration in the market, we unexpectedly documented widespread perceptions of cocaine availability and injection in Kisumu. Examining price data and socio-pharmacological experiences of cocaine injection left us with unconfirmed evidence of its existence, but opened further possibilities about how the chaos of new drug markets and diffusion of injection-related beliefs and practices may lend insight into the sociopolitical context of western Kenya. CONCLUSIONS: We suggest a need for expanded drug surveillance, education and programming responsive to local conditions, and further ethnographic inquiry into the social meanings of emergent drug markets in Kenya and across sub-Saharan Africa.

Drug prices and cost of healthcare are two major concerns globally. This entails to examine the structure and performance of domestic pharmaceutical industry and Indian market's pricing policy of drugs. This article contributes to the debate around regulation of drug prices in India from the perspectives of the healthcare of the poor and affordability.

Abstract Since the enforcement of Generics Act (1999), three types of pharmaceutically equivalent products are marketed in Brazil: innovative reference (REF), "similar" (S) and generic (G) drugs. The S (brand name) and G (generic name) borrow from REF (brand name) clinical data on safety and efficacy and dosage regimen. G (but not S) is bioequivalent to and interchangeable with REF. Starting in 2003, Brazilian Sanitary Surveillance Agency (Anvisa) has required data on relative bioavailability tests (with REF) to approve (or renew registration of) S drugs. In 2014, Anvisa extended interchangeability notion to similar drugs with a "comparable" bioavailability, i.e., an "equivalent" similar drug (EQ). Drugs for chronic diseases and "critical dose medicines" are listed among the EQ drugs approved. Interchangeability of nonbioequivalent medicines raises deep concerns regarding therapeutic failures and adverse events. Concerns are even more worrisome if patients switch from one drug to another during an ongoing treatment for illnesses such as epilepsy, congestive heart failure, hypertension, diabetes and/or substitutable drugs have a narrow therapeutic index.

Food and Drug Regulation in an Era of Globalized Markets provides a synthesized look at the pressures that are impacting today's markets, including trade liberalization, harmonization initiatives between governments, increased aid activities to low-and middle-income countries, and developing pharmaceutical sectors in China and India. From the changing nature of packaged and processed food supply chains, to the reorientation of pharmaceutical research and funding coalesced to confront firms, regulators, and consumers are now faced with previously unknown challenges. Based on the 2014 O'