Pharmacoeconomics evaluate the effectiveness of existing and new prescription drugs in relation to their risks and costs. It is the study of how medications are used by physicians and patients; it helps to develop methods for optimal prescription drug use.

The branches of pharmacology:

Animal Pharmacology

Chemotherapy

Clinical Pharmacology

Comparative Pharmacology

Pharmacodynamics

Pharmacoeconomics

Pharmacoepidemiology

Pharmacogenetics/Pharmacogenomics

Pharmacognosy

Pharmacokinetics

Pharmacy

Posology

Therapeutics/Pharmacotherapeutics

Toxicology

Pharmacoeconomics is the name for an approved drug list used by hospitals and managed care pharmacies to control costs.

Those studying for a PhD in pharmaceutical marking and management can choose from a variety of topics. Topics include: pharmacoeconomics, health outcomes research, health systems operations, and pharmacy business administration.

In Pakistan, pharmacy education was already there when it came into existence, but it has been neglected and has failed to contribute significantly to national healthcare. In the last 5 years, there has been a rise in the number of pharmacy institutions in the country; currently about 17 universities are imparting pharmacy education. Although the number of institutions has almost doubled, the change is more quantitative than qualitative. In 2004, the Higher Education Commission (HEC) of Pakistan revised the pharmacy syllabus and changed the 4-year bachelor of pharmacy (BPharm) degree to a 5-year doctor of pharmacy (PharmD) degree. The syllabus was revised but it still shows insufficiencies and shortcomings and does not meet international standards. It is informative to look at the evolution of the PharmD degree in the United States. In the early 1960s, pharmacy practice changed its focus from industrial and compounding pharmacy towards patient-oriented and hospital-based practice. Gradually, practice-based programs were renamed as PharmD programs. One of the early institutions to start this practice was the University of California at San Francisco. This clinical and community-based pharmacy model was largely welcomed in all parts of the world and later adapted by the United Kingdom and some other European countries. In the mid 1980s and 1990s, Asian and Middle Eastern countries such as UAE, Kuwait, and Saudi Arabia also started recognizing the patient-oriented role of the pharmacist. Malaysia and Hong Kong were early countries to include clinical and social aspects of pharmacy in their syllabi and later they started master's degree program in clinical pharmacy. Soon other Asian countries such as Korea, Taiwan, Japan, and China also realized the need and reshaped their syllabi and subsequently started offering postgraduate studies in clinical pharmacy. Thailand has recently implemented a PharmD program and has established a college of pharmacotherapeutics. An analysis of all these programs shows they are clinically oriented and similar to the US model. The purpose of practice-based or PharmD models in these countries was to focus on patient care and to include a societal perspective on pharmacy. But PharmD in Pakistan is only slightly related to these models. A detailed evaluation of the PharmD syllabus on the HEC website has shown that the clinical and social aspects of pharmacy have been largely ignored. The content and the subjects in the final year (fifth year) are just an extension of the first 4 years. Areas such as pharmacogenomics (how an individual's genetic makeup affects the body's response to drugs), pharmacoinformatics (drug information), and the use of traditional medicines have been mostly ignored. Also, the syllabus does not include other areas such as drug abuse, geriatric pharmacy, patient counseling, patient compliance, research methods, and evidence-based medicine. Subjects such as pharmacoeconomics (economic evaluation of drugs) and pharmacoepidemiology (drug utilization studies), public health pharmacy, and drug policy have also been largely undermined. Some subjects have been named as clinical pharmacy but the substance and content have little relation to the concept and practice of clinical pharmacy. There is no hospital attachment and training, which is indeed central to this concept. In its current context, the syllabus seems to be a shadow of the original PharmD degree program as the real essence is being taken away by largely ignoring a practice-based component. The syllabus overly emphasizes quality control, pharmaceutical chemistry, pharmaceutical analysis, pharmaceutics, and other physical and biological sciences, which have been cut down not only in Western countries but also in some of the Asian countries. This debate also raises 2 fundamental questions: first, why was there a need for a PharmD degree? What was the purpose of changing the curriculum to 5 years? Was it to embark upon a practice-based model? A possible explanation to the first question is that our graduates were facing difficulties in obtaining jobs in the Middle East and Europe with the 4-year degree. This argument is absurd as many countries, including the UK, Singapore, and Australia still have 4-year programs. But let us say this is correct-then why was a PharmD started without a clear vision, objectives, and policy? The shortcomings and pitfalls in the syllabus can largely be explained by the composition of the HEC curriculum committee. The overwhelming majority of the committee members belong to the old school of thought, having expertise in pharmaceutical chemistry, pharmaceutics, microbiology, and other basic sciences. Their qualification and experience might not be relevant in making recommendations for a clinical and community-oriented syllabus. The same dilemma could be seen with not having properly qualified lecturers to teach clinical pharmacy and drug policy issues. The academicians only source of inspiration and guidance could be textbooks, without much substance of reasoning, thinking, scholarship, and debate. The weakness in pharmacy education has marginalized the pharmacy profession and hindered pharmacists from consolidating their role. As a result, pharmacy practice has been affected and subsequently poses adverse effects on the country's healthcare sector. One of the consequences is that the pharmacist's role is not protected, for example a pharmacy assistant can also open a pharmacy and dispense the drugs. As a result of this practice the public is vulnerable to untrained drug traders and quacks. Most of the clinical and administrative pharmacy services such as total parenteral nutrition, therapeutic drug monitoring, and ward pharmacy services are nonexistent at the majority of the public hospitals. There are no independent drug information services at public hospitals and this provides opportunities for drug detailers and medical representatives to disseminate biased drug information to doctors. Medication errors and adverse drug reactions go unreported because of the lack of pharmacy support services. The pharmacist's role in public hospitals is merely that of a storekeeper and they are hardly involved in decision-making processes. The overwhelming majority of our citizens use traditional medicine for their health needs, but the safety and efficacy of these medicines are not taught. Healthcare cost is on the rise worldwide including in Pakistan, but we do not familiarize our students with the economic evaluation of drugs. Pharmacogenomics, a new key area for improving therapies through biotechnology, is absent in our research and development agenda. We do not emphasize drug policy, rational drug usage, or medicine promotion, and as a result, our graduates have a poor knowledge of rational prescribing and pharmaceutical promotion. In almost all the world, after gaining a degree in pharmacy, students have to undergo a 1-year compulsory apprenticeship either in a hospital, industrial or drug regulatory setting. But in Pakistan this is not compulsory and a pharmacist can be registered with the pharmacy council as soon as he passes the examination. This practice needs to be changed, as new graduates are not trained to meet the challenges they will face in the healthcare system. The Pakistan Pharmacist's Association and the Pharmacy Council of Pakistan (the professional authority responsible for the registration of pharmacists in the country) have shown negligence to the profession in the last few decades and have failed to establish standards of practice in the country. As a result, most of the pharmacy graduates in the country are underutilized and have nominal roles in national healthcare policy. In this scenario, starting a PharmD program without making a substantive change in the curriculum could be futile. The needs of the healthcare system should be identified and pharmacy education and practice must be tailored to fit those needs. There is a need to interlink the institutions of pharmacy education, practice, and regulation, namely HEC, the Pharmacy Council of Pakistan, and the Ministry of Health. The Pharmacy Council of Pakistan should also draft guidelines to improve professional pharmacy practice in the country. The Higher Education Commission is keen to establish and encourage research in the country, but without first prioritizing areas this exercise could be meaningless. Research projects should be granted on the basis of practical implications such as drug use in society and research and development of new pharmaceutical processes and molecules. The pharmaceutical industry should also be bound by the state to start meaningful collaborative projects with educational institutions. The Higher Education Commission should send academics to foreign institutes of higher learning in the above-mentioned deficient areas of pharmacy. Without these steps the future of pharmacy education and practice in Pakistan will be less than they could be.