Introduction: The U.S. pharmaceutical industry is defined by the U.S. Census Bureau as “companies engaged in researching, developing, manufacturing and marketing of medicines and biological for human or veterinary use”. Besides its main role in improving human health, the US pharmaceutical industry represents one of the most critical, key decision makers’ lobbying prone and competitive sectors in the economy. The cost in the environment of very limited government price regulation remains one of the major problems fuelling aggregate health care cost inflation. Pharmaceuticals have created huge benefits for public health and economic productivity by the means of saving lives, increasing life expectancy, reducing illness related suffering, preventing surgeries and decreasing hospital stays. Purpose: The goal of this review paper is to show the present conditions and future trends of the pharmaceutical industry in the U.S. Methodology: This paper represents a thorough literature review of the multifaceted sources including: studies, books, peer reviewed journals, U.S. government sources (i.e. U.S. Census Bureau, U.S. Bureau of Economic Analysis, etc.). Discussion: In the thirty years pharmaceutical companies have consistently developed and launched new medicines, bringing hope to sick or – at risk patients. They also usually provide above the average financial returns for its shareholders. U.S. pharmaceutical companies had as their goal to discover blockbuster drugs. Blockbuster drugs are generally defined as drugs that solve medical problems common to hundreds of millions of people and, at the same time generate large sales increases and profits for the pharmaceutical companies. The main approach of these companies includes huge investments in research and development (R&D), innovation, marketing and sales. The trend analysis shows that for the most part the era of blockbuster drugs is nearing an end. Conclusion: Numerous blockbuster drugs will be coming off patent in the next few years, opening the way to generics and eliminating a major source of the industry’s profits. Still, there is plenty of room for improvement in the medications people take while there is no shortage of human suffering to alleviate. It is doubtful whether big pharmaceutical firms will be able to pursue these goals within the old model of developing exclusive new drugs that can be sold further in the future. In the past, medicines for the ailments that were never before addressed, like anti-cholesterol or anti-depression drugs were developed. Currently, and in the future, it is expected that only blockbuster modifications will be developed. This phenomenon is expected to create market saturation, which will significantly reduce profits. The business model that drove the major drug makers’ success is not working anymore. Pharmaceutical companies must create new ways and to bring new ideas. The survivors will be those that market strategies supported by innovative approaches and winning capabilities.

The Western Balkan countries are in agreement about one thing: they all want to become members of the European Union (EU). Accession to the EU has become a national priority for Croatia, Serbia, Montenegro, Macedonia, Albania, Kosovo and Bosnia and Herzegovina (B&H). The first decade of the EU accession of some EU countries meant progress. Years of economic growth and prosperity are behind us. In 2013, EU is overindebted, with millions unemployed and unable to address the present economic crisis. It is losing its share of global market for goods and services and aging population threatens to collapse the "welfare state." The inability of the EU to resolve the accumulated economic problems undermined the credibility of the European integration, opening the hazardous speculations on the nature and necessity of the union. Certain states, such as Great Britain, are openly announcing a referendum to remain in the EU. Some countries are partially affected by the economic crisis and achieved outstanding economic results. Along with some Asian countries, Turkey is an example of how, even without EU membership, a country can efficiently solve present economic problems. Small and underdeveloped countries, such as B&H, can learn a lot from Turkey. The essence of success is the open competition, simplified registration procedures and operations, the attraction of investors, innovations and management of innovations. The introduction of innovations is important in all aspects of the B&H society, but it is particularly interesting in health care. B&H annually allocates 11.0% of its GDP to health care. The study, which we had conducted, showed that there are different views regarding the quality of health care services, between service recipients (citizens and patients - clients) and service providers (nurses and doctors). Nurses and doctors believe that the current quality of health care is good, while patients and citizens argue the opposite. If we put the patients at the center of our attention, then we have to respect their opinions and all our measures and actions must be subordinated to their satisfaction. Innovative approaches and innovation management do not need additional funding. The use of the best techniques and practices, which already exist at our hospitals and clinics raise quality of health care while reducing costs. It should be kept in mind that the process of quality improvement must be continuous. A survey that we carried out on 313 patients in the Federation of B&H shows that the managers of health institutions are not satisfied with the quality of health care and believe that this situation needs to be improved. For innovation in health care it is necessary to create a critical mass of qualified managers - innovators who will be supported by the key decision makers. To this end it is necessary for health care institutions, as in all other areas of B&H society, to create a climate conducive to innovation as the part of national policy. Keywords: Management, Innovation, Economic Crisis, Health Care, Quality, Innovation Management, EU Accession.

Material and method: Using the survey data obtained from doctors in Connecticut, we estimate the “true” costs of defensive medicine and medical malpractice awards via litigation in the overall aggregate picture of U.S. national annual health expenditures. Results and discusion: Progressives claim that these costs amount only to approximately 2% of total annual health expenditures, while conservatives claim that these costs are much higher, in the neighborhood of 10%. Conservatives want to reform the current medical malpractice system because the savings could be significant. Progressives claim that this issue is a “red herring” in the overall picture of health care reform and that other factors such as hospital costs, payments to physicians and pharmaceutical prices are the largest contributors to runaway health care costs, currently amounting to 18% of GDP. The health of the national economy, deficit reduction and future prosperity will depend upon the speed and quality of the cost reducing solutions. Conclusion: An in-depth look into cost and profit structure of each provider’s procedure and legislative push for price and quality transparency of the informed and educated constituents are recommended to improve this serious national, socio-economic problem.

The purpose of this research paper is to compare health care systems in three highly advanced industrialized countries: The United States of America, Canada and Germany. The first part of the research paper will focus on the description of health care systems in the above-mentioned countries while the second part will analyze, evaluate and compare the three systems regarding equity and efficiency. Finally, an overview of recent changes and proposed future reforms in these countries will be provided as well. We start by providing a general description and comparison of the structure of health care systems in Canada, Germany and the United States.

INTRODUCTION In this study the authors have analyzed the costs associated with the immunosuppressive therapy in patients who underwent organ transplantation in two countries: the United States of America and Bosnia and Herzegovina (i.e. the entity Federation B&H). AIMS OF THE STUDY The goal of this paper is to compare and contrast the costs of the immunosuppressive therapy in two countries against the total costs of the organ transplantation. Further, the costs, dosages and effectiveness of the particular types of immunosuppressant were also analyzed. Problem of the Study: Immunosuppressive medications are essential in preventing kidney transplant rejection. Most available pharmaco-economic information to date is for induction and maintenance therapies, while the data on the financial impacts of the rejection are still limited. Immunosuppressive regiments are expensive in the socio-economic environment of limited resources and constraints. MATERIAL AND METHODS This academic article has utilized the publicly available sources of information from the Federation Entity of B&H, (i.e. Federal Department of Insurance and Reinsurance) in period 2006 to 2010, as well as peer-reviewed academic articles, books, private and government data from the United States of America from 2006 to 2010, including projections for 2011. RESULTS In the U.S. the cost of the immunosuppressive medications for the major types of organ transplantations typically range from US $19,300 to $34,600 per year based on commonly prescribed doses at average wholesale prices. In the Federation entity of B&H in 2009, the average cost per patient in F.B&H in 2010 was 6,009.00 KM (U.S.$4,292.00), which represents an absolute cost decrease of 740 KM or 11.00%, when compared to the higher average cost per patient in 2009, which was 6,749.00 KM (US $4,821.00). DISCUSSION The process of finding the ideal medication regiments to minimize morbidity and mortality, while maximizing quality of life and optimizing the cost is the major challenge to the transplantation community. Pharmaco-economic analysis can provide valuable insight toward achieving of these, rather difficult goals. CONCLUSION A sensitive pharmaco-economic analysis must be undertaken in order to achieve the best results in the world of limited/constrained resources and increasing demands for the expensive and quality of life improving immunosuppressive therapy in organ transplantation.

INTRODUCTION This study researched the distribution of desirable, borderline and high-risk values of certain lipid status parameters in healthy young individuals. AIM The purpose of this study was to research the statistical distribution of desirable, borderline and high-risk values of certain lipid status parameters in healthy young individuals (i.e. medical university students). MATERIAL AND METHODS In this research we tested 112 students studying at the University of Sarajevo, of both genders and 20-30 years of age. RESULTS Total serum cholesterol was minimally elevated in 7.1% of tested students, elevated with high risk in 2.7% and triglycerides were minimally elevated in 1.8%. Presence of elevated LDL cholesterol was found to be 2.7% minimally and 1.8% with high risk. HDL cholesterol was minimally decreased in 1 tested student. DISCUSSION Standard biochemical methods were used to determine the values of total cholesterol, triglycerides and HDL-cholesterol. The level of LDL cholesterol was also calculated. CONCLUSION Our results point to the need for performing gradual laboratory diagnostic procedures for routine check-ups of university students.