Generic drugs: international trends and policy developments in Australia

Public and private third-party payers in many countries encourage or mandate the use of generic drugs. This article examines the development of generics policy in Australia, against the background of a description of international trends in this area, and related experiences of reference pricing programs. The Australian generics market remains underdeveloped due to a historical legacy of small Pharmaceutical Benefits Scheme price differentials between originator brands and generics. It is argued that policy measures open to the Australian government can be conceived as clustering around two different approaches: incremental changes within the existing regulatory framework, or a shift towards a high volume/low price role of generics which would speed up the delivery of substantial cost savings, and could provide enhanced scope for the financing of new, patented drugs.

Scripting, ritualising and performing leadership: interrogating recent policy developments in Australia

In this article, we argue that leadership of schools is a form of performance that has become ritualised and routinised through the official scripting of policy texts that mandate how leadership of schools should occur. Our interrogation of recent policy scripts in Australia reveals that there is limited scope for leadership in schools to occur as accountability mechanisms and policy directives codify the professional expertise that leaders are required to possess, act out and act on.

Gender inclusivity policy developments in Australia

This article traces two chronologies of gender inclusive policy development in Australia's national and state education policy arenas to demonstrate, from a feminist perspective, their limited applicability at the school level. Although gender inclusive principles are seen as desirable, inadequate policy conceptualizations are viewed as limited in the extent to which gender inclusiveness can be realized in schools. In particular, it is argued that more transformative conceptions of gender inclusiveness evident in the feminist academy should be promoted in policy.

Biopharmaceutical innovation and industrial developments in South Korea, Singapore and Taiwan

South Korea, Singapore and Taiwan are well known as export-oriented developmental states which for decades employed industrial policy to target particular industries for government support. In the past fifteen years, these three countries all identified the biopharmaceutical industry as a strategic sector. This article explores, through economic analysis, the rationale for this decision and the strategies chosen for linking into the global bio-economy with the objective of catching up in biopharmaceuticals. The paper identifies three comparative advantages enjoyed by these countries in the biopharma sector: (1) public investments in basic research; (2) private investments in phase 1 clinical trials; and (3) a potentially significant contract research industry managing latter-stage clinical trials. Governments employ a range of industrial policies, consistent with these comparative advantages, to promote the biopharmaceutical industry, including public investment in biomedical hubs, research funding and research and development (R&D) tax credits. We argue that the most important feature of the biopharmaceutical industry in these countries is the dominant role of the public sector. That these countries have made progress in innovative capabilities is illustrated by input measures such as R&D expenditure as share of gross domestic product, number of patents granted and clinical trials, and volume of foreign direct investment. In contrast, output indicators such as approval of new chemical entities suggest that the process of catching up has only just commenced. Pharmaceutical innovation is at the stage of mainly generating inputs to integrated processes controlled by the globally incumbent firms.

Determinants of Central bank independence and governance : problems and policy implications

Central bank independence and governance (CBIG) is a term subject to conflicting definitions and so its related studies are difficult to compare. This paper therefore focuses on developing of a more useable definition, and an index model identifying the determinants of independence and governance and their possible policy implications. It also examines various independence measurement tools such as ranking and index. The index model resulting centres on key central bank independence and corporate governance issues, such as, legal aspects, political aspects, price stability objective aspects, exchange rate policy aspects, monetary policy and deficit financing aspects and finally, transparency and accountability aspects.

Conserving koalas: A review of the contrasting regional trends, outlooks and policy challenges

The koala (Phascolarctos cinereus), one of the world's most iconic faunal species, was recently listed under Australian government legislation as vulnerable in the northern states of Queensland and New South Wales and in the Australian Capital Territory, but not in the southern states of Victoria and South Australia. This review synthesises empirical evidence of regional koala population trends, their conservation outlook, and associated policy challenges. Population declines are common in the northern half of the koala's range, where habitat loss, hotter droughts, disease, dog attacks and vehicle collisions are the major threats. In contrast, some southern populations are locally overabundant and are now subject to managed declines. The koala presents the problem of managing a wide-ranging species that now primarily occurs in human-modified landscapes, some of which are rapidly urbanising or subject to large-scale agricultural and mining developments. Climate change is a major threat to both northern and southern populations. The implementation of policy to conserve remaining koala habitat and restore degraded habitat is critical to the success of koala conservation strategies, but habitat conservation alone will not resolve the issues of koala conservation. There needs to be concerted effort to reduce the incidence of dog attack and road-related mortality, disease prevalence and severity, and take into account new threats of climate change and mining. Many of the complex conservation and policy challenges identified here have broader significance for other species whose population trends, and the nature of the threatening processes, vary from region to region, and through time.

General practitioners' perspectives regarding competence and confidentiality in an adolescent with suspected anorexia nervosa: legal and ethical considerations

In Victoria, Australia, the legal position regarding young people's competence to make medical treatment decisions has not been clarified in legislation, and a number of often vague common law decisions must be relied on for guidance. This situation produces a degree of uncertainty about appropriate professional practice, while also potentially impeding young people's rights claims in health care settings. With this in mind, the present research explored general practitioners' competence and confidentiality decisions regarding a 17-year-old female who presented with symptoms of an eating disorder. Questionnaires were sent to a random sample of 500 Victorian general practitioners, of whom 190 responded. After reading a case vignette, general practitioners indicated whether they would find the hypothetical patient competent and if they would maintain her confidentiality. Seventy-three per cent of respondents found the patient competent and most would have maintained confidentiality, at least initially. However, subsequent analysis of the rationales supplied for these decisions revealed a wide diversity in general practitioners' understandings and implementations of extant legal authority. This research highlights the need for general practitioners to be exposed to up-to-date and clinically relevant explanations of contemporary legal positions.

Providing health services to migrants and refugees settling in Victoria, Australia: an analysis of the complexity, cost and policy implications for public health

The aim of the research was to identify factors related to the increased costs of providing health services to clients from a non-English speaking background (NESB), using a cross-sectional analysis of the administrative records of clients using community health services in the Northern Metropolitan region of Melbourne for the 2001/2002 financial year. The higher cost of providing services to NESB clients was influenced by four factors: increased consultation time, group attendance to an appointment, increased interpreting costs and the type of service provider. Family members and multilingual staff play a significant role in providing informal interpreting services or low-cost support for NESB consultants, and these activities should receive appropriate support. Additional funding is needed to support interpreting requirements when dealing with the health needs of NESB clients.

Cervical cancer services for Indigenous Women: Advocacy, Community-Based Research and Policy Change in Australia

Collaborative research undertaken in the state of Queensland, Australia, resulted in major changes in cervical cancer screening and treatment for Indigenous women. Guided by an Indigenous statewide reference group and with an Indigenous researcher playing a lead role, qualitative data were collected using interviews, focus groups, and larger community meetings; and case studies were conducted with health workers and community members from diverse rural, remote and urban communities, to explore the different cultural and structural factors affecting understanding and awareness of cervical cancer and Indigenous women's use of and access to health services for screening, diagnosis and treatment. These data were supplemented by an analysis of clinical data and health service checklists. We discuss the methodology and summarize the key social and structural factors that discourage women from presenting for screening or returning for follow-up. These include women's misunderstanding of cervical cancer screening, fear of cancer, distrust of health services, poor recall and follow-up systems, and the economic and social burden to women presenting for treatment. We describe how the research process and subsequent activities provided Indigenous women with a vehicle for their own advocacy, resulting in important policy and program changes.

Conflict resolution and policy making mediation in the Mekong River Basin

The Mekong River serves China, Myanmar, Thailand, Laos, Cambodia and Vietnam covering an area of approximately 795, 000 square kilometres and the Mekong River basin is a delicate eco-system rich in natural resources and bio-diversity. Competing demands for increasingly scarce supplies of water, the reciprocal impacts of land and water uses and inadequate governance arrangements have given rise to conflicts that has to be resolved by policy making to facilitate a process, whereby the main principles adopted in the Mekong River Agreement can be implemented.

Competition law and policy : cases and materials

This book evaluates Australian competition law including the economics and politics that lay at its heart. This fully revised second edition draws together a comprehensive collection of material providing an excellent and up-to-date guide to Australian competition law.

Silly us! Of course the grid doesn`t work : reading methodologies and policy texts on principals' work

This symposium presents work in progress from an ARC (discovery grant) funded investigation of principal supply, conducted by Jill Blackman, Judyth Sachs and Pat Thomas. Our research goals are to examine claims of an impending shortage of school principals in particular schools and localities, critically evaluate a range of possible reasons for this shortage, and ultimately, through woprk with principals' organisations, to develop some possibilities for policy action. In this symposium we focus on: (1) existing studies of principal supply (2) trends apparent from demographic and employment data, and (3) a text and interview based study of 'human resources' policy. We invite discussion on the implications of this first stage for the next - a national survey and interviews with teachers in pre-service training and in their first years of teaching.