pharmacy services in the united states brenda waning january 2002 outline overview description drug development production repacking distribution wholesalers prescribing dispensing human resources use regulation market based system supply and demand arguments for phrma promotes competition innovation highest quality of patient care a cost effective manner price controls limit choice lower increase overall health costs discourage against cracks gaps coverage business vs social welfare manufacturers hundreds companies explosion biotech 1990 2000 significant merging consolidation into mega regulated by fda preclinical research investigational nda filed clinical testing phase 1 2 3 review approval pms average time from synthesis new to 1960s 8 years 1990s 14 tufts university center study 1999 activity approved 35 molecular entities 5 biological products fastest ever 12 months manufacturer 104 75 ndas web site over 000 drugs currently 100 aids 350 cancer 176 neurological diseases 26 alzheimer s disease 122 heart stroke 25 diabetes 200 children www
