Background: Cinnovex is a biosimilar form of intramuscular (IM) interferon beta-1a (IFNβ-1a) manufactured in Iran for management of multiple sclerosis (MS). The present study aimed to determine the cost-utility of Cinnovex versus Avonex for patients with relapsing-remitting MS (RRMS) from Iranian health ministry perspective.Methods: A Markov model was developed to determine 10-year cost and quality-adjusted life-years (QALYs) of patients with transition through health states based on Kurtzke Expanded Disability Status Scale (EDSS). To estimate the cost of each method, we inquired the subsidies allocated to Avonex and Cinnovex by Iran’s health ministry. Moreover, to estimate the quality of life (QOL) of patients in each group, a cross-sectional study was conducted among two groups of patients who had used Avonex and Cinnovex (n = 50 and n = 50, respectively), using the multiple sclerosis quality of life-54 (MSQOL-54) questionnaire. Finally, one-way sensitivity analysis (tornado diagram) was performed in order to examine the strength of the results.Results: According to results, the estimated 10-year discounted cost per patient for Avonex and Cinnovex were 21346.5 international dollar ($Int) and 47436.6 $Int, respectively; while the estimated total discounted QALYs per person were 3.76 and 3.89, respectively. The incremental cost per QALY for Cinnovex compared with Avonex was 162718.55 $Int.Conclusion: It is concluded that Cinnovex in patients with progressive relapsing MS is cost-effective associated with increased benefits compared with Avonex.

Background: Many countries including Iran have used “audit and feedback” (A&F) and “printed educational materials” (PEMs) interventions to improve physicians’ drug prescribing behavior. In addition, several trials have shown low to moderate effects of the two interventions. Nevertheless, few studies have assessed physicians’ satisfactions with A&F or PEM interventions. This is a cross-sectional survey which was carried out in Tehran and Mashhad Cities, Iran, in 2014.Methods: 181 general physicians, pediatricians and infectious disease specialists working in outpatient practices completed the questionnaire covering demographic characteristics, satisfaction with the A&F and PEM, and the perceived effectiveness of the interventions in improving physicians’ behavior.Results: Almost all physicians who reported receiving A&F or PEM reports, indicated reading them. In addition, 84% and 86% of the physicians agreed with the efficiency of feedback reports and PEM, respectively.Conclusion: Findings showed that general physicians study A&F reports more carefully or frequently than the specialists. Physicians believed that revising the feedback report’s format and content could increase its effectiveness.

Background: Parents behavior is an important factor to reduce self-medication, which not only affects health outcomes negatively but also influences health economy. In the present study, parents behavior regarding self-medication using antibiotics for children and its relation to their social status, especially education, are studied in primary schools.Methods: A cross-sectional descriptive analysis was performed using a self-administered anonymous questionnaire.Results: 600 anonymous questionnaires were distributed among the children’s parents in primary schools in Tehran, Iran, and 62.0% of which were returned. Responses showed that 11.1% of parents did not visit a physician to treat their children seasonal cold, while about half of them did self-medication. Furthermore, 52.8% of those who had visited a doctor in the first seasonal disease of their children did not refer again in next events and just refilled their last prescription. In addition, the results of this study indicated significant correlation between self-medication and mothers' education (P < 0.05); that means mothers with higher education had higher rates of physician visits.Conclusion: Mothers' education and health literacy are main factors in the rational use of medicines in children and should be addressed by policy makers in public health training programs.

Background: Today, the skill of business model analysis has become one of the key sources of competitive advantage and the development of innovative ideas in many industries. The purpose of this article is to identify and describe the business model dimensions and components of pharmaceutical companies as one of the most important strategic industries in any country.Methods: In the first step, by studying theoretical literature, we obtained an early model of the dimensions and components of a business model. Then a qualitative method was used. We tried to find this primitive pattern with the requirements of pharmaceutical companies. In this regard, we conducted 19 in-depth interviews with managers and experts of eight human pharmaceutical companies. The qualitative data were analyzed using analogous content analysis.Results: The results indicated that the business model of pharmaceutical companies consists of four main dimensions including value proposition, value receivers and interactions, value architecture, and received value. The first dimension consists of eleven components or attributes. The second dimension consists of three components. The third dimension consists of three components, and the fourth one consists of two components.Conclusion: This research differentiated the business model of pharmaceutical companies in four main dimensions, so that the elements that make up each dimension are different from the elements in the business model of other industries.

Background: Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in children, often prevalent in children between the age of 2 and 6 years. However, it can lead to a loss of many years of life in these patients. Therefore, considering the importance of quality of life (QOL) for patients during treatment or after treatment discontinuation, and the extent of the therapeutic protocols, tools, and methods used to measure the QOL of children, we have undertaken a comprehensive review of the QOL of these patients.Methods: In designing a review of the outcomes, consultation with internal clinical experts was implemented first to identify relevant keywords and outcomes. We reviewed all English-language studies from 2000 to 2015 based on the Web of Science, PubMed, and Scopus databases.Results: 2621 studies were first identified in relevant electronic databases. However, only 10 studies met our inclusion criteria. Most of the selected studies used Health Utilities Index Mark 2 (HUI2) and 3 (HUI3) for assessing children's QOL. Some were interviewed by proxy, such as parents and even doctors and nurses involved in the treatment process. Most of the studies reported improvement of utility from 0.67% to 0.96% that in survivors varied from 0.71% to 0.94%.Conclusion: The results of this study illustrated that the treatment of patients with ALL in recent years has developed dramatically in different countries; and consequently, the QOL of these patients improved both during and after treatment.