Background: Overactive bladder (OAB) is a common condition that has a significant impact on patients’ health-related quality-of-life and is associated with a substantial economic burden to healthcare systems. OnabotulinumtoxinA has a well-established efficacy and safety profile as a treatment for OAB; however, the economic impact of using onabotulinumtoxinA has not been well described.
Methods: An economic model was developed to assess the budget impact associated with OAB treatment in France, Germany, Italy, Spain and the UK, using onabotulinumtoxinA alongside best supportive care (BSC)—comprising incontinence pads and/or anticholinergic use and/or clean intermittent catheterisation (CIC)—vs BSC alone. The model time horizon spanned 5 years, and included direct costs associated with treatment, BSC, and adverse events.
Results: Per 100,000 patients in each country, the use of onabotulinumtoxinA resulted in estimated cost savings of €97,200 (Italy), €71,580 (Spain), and €19,710 (UK), and cost increases of €23,840 in France and €284,760 in Germany, largely due to day-case and inpatient administration, respectively. Projecting these results to the population of individuals aged 18 years and above gave national budget saving estimates of €9,924,790, €27,458,290, and €48,270,760, for the UK, Spain, and Italy, respectively, compared to cost increases of €12,160,020 and €196,086,530 for France and Germany, respectively. Anticholinergic treatment and incontinence pads were the largest contributors to overall spending on OAB management when onabotulinumtoxinA use was not increased, and remained so in four of five scenarios where onabotulinumtoxinA use was increased. This decreased resource use was equivalent to cost offsets ranging from €106,110 to €176,600 per 100,000 population.
Conclusions: In three of five countries investigated, the use of onabotulinumtoxinA, in addition to BSC, was shown to result in healthcare budget cost savings over 5 years. Scenario analyses showed increased costs in Germany and France were largely attributable to the treatment setting rather than onabotulinumtoxinA acquisition costs. 相似文献
This paper studies the duration of two cohorts of entrants in the Italian financial intermediation industry. Using the Cox (1972) Proportional Hazards Model, it analyses the link between duration of each newborn firm and its start-up size, as well as a series of industry-specific characteristics. It emerges that not only did regulatory reform in 1990 result in a process of branch proliferation and industry concentration, but it also set in motion a pre-entry selection mechanism. Conversely, before completion of the regulatory reform, in 1989, entry was possible even for very small firms, and larger new entrants survived longer than their smaller counterparts, and this independently of the features of spatial and structural competition. First version received: Nov. 98/final version received: Oct. 99 相似文献
The main purpose of this paper is to analyse the relationship between firm size and innovation activity using Spanish data at firm level corresponding to the manufacturing sector for the period 1990-93. This exercise is different to previous applications because we allow for different size effects in the decision to innovate and the innovation count equation, in the context of a double-hurdle approach. Several tests confirm the hurdle negbin model. We find that firm size is a relevant factor, although size effects are different in both decisions. A robust result from the different specifications estimated is the rejection of the Gilbert and Newbery hypotheses. We find out that the behaviour of firm size is neither linear in the decision nor in thc count equation. We also provide additional, and sometimes different, evidence to previous Spanish studies on R&D. 相似文献
Forest farmers’ organizations (FFOs) have recently gained scholarly attention as a collective action instrument to upgrade value chains. However, insights into possible business models and organizational forms of FFOs remain fragmented. This study thus aimed to co-create FFO business models in order to assess the business models in the context of the regulatory framework and the value chain upgrading theory. The Input–Output scheme and the Business Model Canvas (BMC) were merged to create an analytical lens. Participatory workshops with two farmers’ organizations, each in Ethiopia and Tanzania, were conducted and triangulated with ten focus group discussions and 25 key informant interviews. The co-created business models reflected the grassroots entrepreneurial potential of smallholders to envision FFOs. The gaps requiring external support, namely the know-how in accessing microfinance, silvicultural practices, and entrepreneurship, were revealed. We argue that the transformation from a farmers’ organization to an FFO enables wood value chain upgrading. Diversifying wood with non-wood products is key for FFOs. Regardless of how the regulatory framework shapes external support, the local government plays a pivotal role in facilitating the connection between FFOs and (non-)governmental support actors. Through this research, we develop suggestions for further empirical studies and offer several recommendations for decision-makers. 相似文献
