Cost analysis of plasma-derived factor VIII/von Willebrand factor versus recombinant factor VIII for treatment of previously untreated patients with severe hemophilia A in the United States

Background: Inhibitor development to factor VIII (FVIII) hemophilia therapy results in increased complications and substantial economic costs. The SIPPET study, the first randomized controlled trial to compare the immunogenicity of plasma-derived FVIII (pdFVIII)/von Willebrand factor (VWF) and recombinant-DNA-derived FVIII (rFVIII), demonstrated higher inhibitor rates in previously untreated patients (PUPs) treated with rFVIII than in PUPs treated with pdFVIII/VWF.

Objective: To quantify the economic impact of treating PUPs with pdFVIII/VWF vs rFVIII.

Methods: An Excel-based clinical and economic model was developed from a US healthcare payer perspective and run over a 5-year period. The analysis utilized a cohort approach to model patient treatment and outcomes over a monthly cycle to quantify differences in costs of FVIII, bypassing agents, and hospitalizations for serious bleeds. Rates of high-titer inhibitor development were obtained from the SIPPET study. Patients developing high-titer inhibitors were treated with immune tolerance induction (ITI). Patients who developed low-titer inhibitors and those who did not develop inhibitors continued their usual FVIII treatment. Patients who were successfully treated with ITI returned to FVIII treatment, while unsuccessfully treated patients received bypassing agents. Total costs per treated patient were estimated and a one-way sensitivity analysis was conducted to quantify the impact of parameter uncertainty on the model outcomes.

Results: Total cumulative costs per patient over 5 years were $834,621 for pdFVIII/VWF patients and $1,237,163 for rFVIII patients, representing a total saving of $402,542 per patient over the 5-year period, for an average annual saving of $80,508 per patient.

Conclusions: Based on data from the SIPPET study, this analysis found that initiating FVIII treatment in severe hemophilia A PUPs with pdFVIII/VWF has the potential to offer substantial cost savings to healthcare payers, amounting to a one-third reduction in costs.     

Intercountry feedback and spillover effects within the international supply and use framework: a Bayesian perspective*

This paper proposes a new framework for the estimation of product-level global and interregional feedback and spillover (FS) factor multipliers. The framework is directly based on interregional supply and use tables (SUTs) that could be rectangular and gives a possibility of taking account of the inherent input–output data uncertainty problems. A Bayesian econometric approach is applied to the framework using the first version of international SUTs in the World Input–Output Database. The obtained estimates of the global and intercountry FS output effects are discussed and presented at the world, country and product levels for the period of 1995–2009.     

辽西北地区农业干旱危险性评价与区划

[目的]开展农业干旱危险性评价与区划研究,为辽宁省西北地区农业防旱抗灾工作提供科学依据。[方法]文章根据联合国国际减灾战略署(ISDR)对农业干旱危险性的定义,分析了构成研究区作物干旱危险性的致灾因子和孕灾环境因子,采用层次分析法确定了各因子的权重,构建了研究区农业干旱危险性评价指标和模型。以2009年为例,通过利用降雨、土壤、农业生产类型及地形等数据计算了辽西北地区农业干旱危险性评价指数,利用自然间断点法分级干旱危险性评价指数,并借助GIS技术,绘制研究区农业干旱危险性等级区划图。[结果] 2009年作物生长期间研究区农业干旱危险性由高到低排列为:朝阳市葫芦岛市锦州市阜新市铁岭市沈阳市。[结论]辽西北地区农业干旱危险性等级区的划分,能够帮助政府管理部门为面临干旱威胁不同的区域建立适当的防灾方法和有效的应急预案。     

An evolutionary Cournot oligopoly model with imitators and perfect foresight best responders

We consider the competition among quantity setting players in a linear evolutionary environment. To set their outputs, players adopt, alternatively, the best response rule having perfect foresight or an imitative rule. Players are allowed to change their behavior through an evolutionary mechanism according to which the rule with better performance will attract more followers. The relevant stationary state of the model describes a scenario where players produce at the Cournot‐Nash level. Due to the presence of imitative behavior, we find that the number of players and implementation costs, needed to the best response exploitation, have an ambiguous role in determining the stability properties of the equilibrium and double stability thresholds can be observed. Differently, the role of the intensity of choice, representing the evolutionary propensity to switch to the most profitable rule, has a destabilizing role, in line with the common occurrence in evolutionary models. The global analysis of the model reveals that increasing values of the intensity of choice parameter determine increasing dynamic complexities for the internal attractor representing a population where both decision mechanisms coexist.     

Factor allocation,economic growth and unbalanced regional development in China

On the basis of development accounting techniques and a factor misallocation framework, we use panel data of 30 Chinese provinces from 2000 to 2013 to assess how factor allocation affects economic growth and unbalanced regional development in China. In particular, we decompose economic growth into three parts, namely sector productivity (SP ), factor market efficiency (FME ) and factor endowment (FE ). We then conduct counterfactual analyses to investigate the short and long‐run roles of factor allocation in the income distribution across provinces. The results show that SP , FME and FE can explain 23%, 8.5% and 68.5% of economic growth, while labour, capital and energy reallocation account for aggregate productivity growth of about 47%, −4.8% and −0.1%. Furthermore, when the factors are efficiently allocated, transferring labour (capital, energy) from agriculture (service, industry) to the other sectors will increase the income per capita by 29.5% and 42.5% in the short and long term. Meanwhile, efficient factor allocation accounts for 32% and 29.7% of aggregate productivity and reduces the income variation across provinces by 25.5% and 23% in the short and long run, respectively.     

包容性金融发展与农村居民贫困减缓——基于全要素生产率视角的分析

本文用DEA—Malmquist指数法测算了全要素生产率指数，结合2006—2016年中国内地省际面板数据，基于全要素生产率视角，运用中介效应模型实证分析了包容性金融发展对农村居民贫困的影响。实证结果表明：（1）包容性金融发展能够通过全要素生产率的中介效应发挥减贫作用。（2）进一步的研究发现，包容性金融服务渗透度的提升对贫困的影响最为显著；同时，包容性金融发展可通过技术进步和效率提升作用来推动全要素生产率增长，进一步作用于贫困。（3）稳健性检验表明，我国东部与中西部地区包容性金融发展水平差异较大，对全要素生产率的提升乃至农村减贫的贡献表现出较大不平衡性。本文的政策建议为：首先，应持续推进包容性金融发展，充分发挥全要素生产率的中介效应，以更快实现2020年全面脱贫目标；其次，要继续加强农村金融基础设施建设，以实现金融 服务均等性，充分发挥金融减贫的优势；最后，要合理配置金融资源，注重地区间发展的公平性，以实现经济社会均衡发展。     

Measuring Inflation Anchoring and Uncertainty: A U.S. and Euro Area Comparison

We use several U.S. and euro‐area surveys of professional forecasters to estimate a dynamic factor model of inflation featuring time‐varying uncertainty. We obtain survey‐consistent distributions of future inflation at any horizon, both in the U.S. and the euro area. Equipped with this model, we propose a novel measure of the anchoring of inflation expectations that accounts for inflation uncertainty. Our results suggest that following the Great Recession, inflation anchoring improved in the United States, while mild de‐anchoring occurred in the euro area. As of our sample end, both areas appear to be almost equally anchored.     

Farm size and productivity growth in the United States Corn Belt

In recent decades, agricultural production in the U.S. has continued to shift to large-scale operations, raising concerns about the economic viability of small and midsized farms. To understand whether economies of size provided an incentive for the consolidation of production, the study estimates the total factor productivity (TFP) of five size classes of grain-producing farms in the U.S. Heartland (Corn Belt) region. Using quinquennial Agricultural Census data from 1982 to 2012 the study also compares TFP growth rates across farm sizes to gain insight into whether observed productivity differences are likely to persist. The finding of a strong positive relationship between farm size and TFP suggests that consolidation of production has contributed to recent aggregate productivity growth in the crop sector. The study estimates the extent to which sectoral productivity growth can be attributed to structural change versus other factors including technological change. The study also explores some tradeoffs associated with policies that raise the productivity of small versus large farms.     

The determinants of austerity in the European Union 2010–16

This paper aims at decteting what drove the adoption of austerity policies over the period 2010–16 in a panel of 28 European countries. Austerity is identified by year increases in the ratio between the structural primary balance and potential GDP. By means of principal component factor analysis we select the aggregate factors that might affect austerity, namely (i) fiscal consolidation (correction of high deficits and debts), (ii) market discipline (high sovereign spreads, low ratings), (iii) rule-based fiscal discipline (compliance with the Eurozone rules), and macroeconomic stabilisation (consideration for the cyclical position of the economy). Then we estimate a dynamic panel model with the system-GMM method. Results show that the most important contributions to austerity are provided by the market discipline and fiscal consolidation factors together with Excessive Deficit Procedures, with no significant role played by concomitant macroeconomic conditions. Overall, governments complied with orthodox fiscal principles and rules.