基于经济新常态的长春市水资源开发利用潜力评价

以长春市为研究对象,基于未来经济处于新常态的发展态势,构建包含水资源、社会、经济、生态环境4个子系统的评价指标体系,并确定各指标的评价等级标准;基于模糊数学理论以及层次分析法构建包括目标层、准则层、指标层的3层模糊综合评价模型,以2015年为现状水平年,应用模型对长春市水资源开发利用潜力进行综合评价。结果表明:长春市水资源开发利用程度处于中等偏上水平,各辖区水资源开发利用规模不平衡,可通过产业结构调整提高全市用水效率,为经济持续增长提供保障。     

When does economic model type become a decisive factor in health technology appraisals? Learning from the expanding treatment options for relapsing–remitting multiple sclerosis

Objectives: Specific economic model types often become de facto standard for health technology appraisal over time. Markov and discrete event simulation (DES) models were compared to investigate the impact of innovative modeling on the cost-effectiveness of disease-modifying therapies (DMTs) in relapsing–remitting multiple sclerosis (RRMS). Fingolimod was compared to dimethyl fumarate (DMF; in highly active [HA] RRMS), alemtuzumab (in HA RRMS) and natalizumab (in rapidly evolving severe RRMS). Comparator DMTs were chosen to reflect different dosing regimens.

Materials and methods: Markov and DES models used have been published previously. Inputs were aligned in all relevant respects, with differences in the modeling of event-triggered attributes, such as relapse-related retreatment, which is inherently difficult with a memoryless Markov approach. Outcomes were compared, with and without different attributes.

Results: All results used list prices. For fingolimod and DMF, incremental cost-effectiveness ratios (ICERs) were comparable (Markov: £4206/quality-adjusted life year [QALY] gained versus DES: £3910/QALY gained). Deviations were observed when long-term adverse events (AEs) were incorporated in the DES (Markov: £25,412 saved/QALY lost, versus DES: £34,209 saved/QALY lost, fingolimod versus natalizumab; higher ICERs indicate greater cost-effectiveness). For fingolimod versus alemtuzumab, when relapse-triggered retreatment was included in the DES, large cost differences were observed (difference between incremental cost is £35,410 and QALY is 0.10).

Limitations: UK payer perspective, therefore societal approach was not considered. Resource utilization and utilities for both models were not derived from the subpopulations; as the focus is on model type, input limitations that apply to both models are less relevant.

Conclusions: Whilst no model can fully represent a disease, a DES allows an opportunity to include features excluded in a Markov structure. A DES may be more suitable for modeling in RRMS for health technology assessment purposes given the complexity of some DMTs. This analysis highlights the capabilities of different model structures to model event-triggered attributes.     

Economic evaluation of human urinary kallindinogenase for patients with acute ischemic stroke in China

Objectives: In China, both human urinary kallindinogenase (HUK) and 3-n-butylphthalide (NBP) are recommended for clinical use to improve cerebral blood circulation during an acute ischemic stroke (AIS). The objective was to evaluate the economic value of HUK vs NBP for patients with AIS from a Chinese payer’s perspective.

Methods: An economic evaluation based on data of patients who have been treated with either HUK (n?=?488) or NBP (n?=?885) from a prospective, phase IV, multi-center, clinical registry study (Chinese Acute Ischemic Stroke Treatment Outcome Registry, CASTOR) was conducted to analyze the cost and effectiveness of HUK vs NBP for AIS in China. Before the analysis, the patients were matched using propensity score. Both a cost-minimization analysis and a cost-effectiveness analysis were conducted to compare the matched pairs. A bootstrapping exercise was conducted for the matched arms to demonstrate the probability of one intervention being cost-effective over another for a given willingness-to-pay for an extra quality-adjusted life-year (QALY).

Results: After propensity score matching, 463 pairs were matched. The overall medical cost in the HUK arm is USD 2,701.20, while the NBP arm is USD 3,436.83, indicating HUK is preferred with cost-minimization analysis. Although the QALY gained in the HUK arm (0.77176) compared with the NBP arm (0.76831) is statistically insignificant (p?=?.4862), the cost-effectiveness analysis as exploratory analysis found that, compared with NBP, HUK is a cost-saving strategy with the lower costs of USD 735.63 and greater QALYs gained of 0.00345. Among the 5,000 bootstrapping replications, 100% indicates that HUK is cost-effective compared with NBP under a 1-time-GDP threshold; and 97.12% indicates the same under a 3-time-GDP threshold.

Conclusion: This economic evaluation study indicates that administrating HUK is a cost-saving therapy compared with NBP for managing blood flow during AIS in the Chinese setting.     

基于熵权Topsis的淮河生态经济带水资源承载力评价

[目的]评价发展规划驱动下的水资源承载力特征,为区域发展提供科学依据。[方法]以淮河生态经济带为对象,采用熵权重的Topsis评价方法,分析淮河生态经济带水资源承载力的区域差异及其影响因素。[结果] 2015年不同市县水资源承载力综合得分介于0. 305 8～0. 698 8之间,其中盐城市最高,桐柏县最低;境内江苏、安徽、河南3省的水资源承载力分别为0. 585 2、0. 478 2、0. 524 9。[结论](1)淮河生态经济带水资源承载力具有在淮河干流上、下游承载力高,但中游偏低的空间分布特征。(2)水资源系统层面,水资源总量是承载力高低的供给侧决定性因素,是水资源承载力高低的重要基础。(3)社会系统中,用水量与用水结构是提升和优化水资源承载力的调控性因素。(4)城镇化发展与人口增加是水资源承载力高低的胁迫性因素,而经济发展水平是水资源承载力调控的重要保证。     

On the rebound: estimating direct rebound effects for Australian households

Reducing dependence on fossil fuels by decreasing energy consumption is a common environmental policy. One mechanism used to achieve this is to encourage increased energy efficiency. However, improving efficiency may have an opposing effect and cause an increase in energy consumption if the intensity of use changes. This phenomenon is known as the rebound effect. We estimate direct rebound effects for energy use in Australia based on both aggregate residential energy use data and on household energy expenditure data. Our approach implements a new methodology developed by Hunt and Ryan (2014, Catching on the rebound: Why price elasticities are generally inappropriate measures of rebound effects. Surrey Energy Economics Discussion Paper Series SEEDS 148; 2015, Energy Economics 50, 273) that explicitly relates energy service use with energy source demand and directly incorporates measures of efficiency changes. The results indicate that the rebound effect is relatively high for energy use by Australian households. Due to the unique nature of our household data set, we can examine the influence of demographic and housing characteristics. We find that low‐income households and households with vulnerable members have the largest rebound effects. The relatively large rebound effects found here suggest that consumers gain from efficiency by improved energy services, and thus, policy targeting energy efficiency is not likely to be successful at reducing energy consumption.     

Yen or Yuan? The law of one price and economic integration in Asia

Using highly comparable local retail prices of 146 goods and services across 18 Asian countries over 1990–2014, we analyse price dispersion and test convergence to the law of one price (LOP ) for these prices around three price benchmarks—Asia‐average, Japan and China prices—to gain insight about market integration in overall Asia as well relative integration of Asian economies to Japan and China. Cross‐Asia price dispersion around China‐price benchmark, for both tradables and non‐tradables, diminishes significantly over the sample period whereas that around Japan‐price benchmark increases considerably, particularly after the 2008 crisis. There is convergence to the LOP for about half of goods and services in China‐ and Asia‐average price benchmarks. The percentage of convergent prices is significantly smaller in Japan‐price benchmark. Direct estimates of the convergence speed parameter also confirm these observations. Overall, our results show evidence of increasing economic integration in Asia in the last two decades. The process of price convergence appears to be driven by the emergence of China as the centre of economic gravity in the region. There is much room for improvement as economic integration in Asia is still far below that in Europe in the 1990s or USA in the 1980s.     

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.     

Dynamics of capital account and current account in Sri Lanka

This paper enquires the dynamics of current account and capital account in Sri Lanka for the period 2001:Q1 to 2016:Q1 and also examines the role of some policy variables such as exchange rate and interest rate in this dynamics. Estimated autoregressive distributed lag (ARDL) bound testing approach to cointegration followed by error correction representation of the ARDL model have found that current account is caused by capital account and exchange rate, where capital account causes to produce a deficit in current account. In the dynamic adjustment of current account due to exchange rate, an evidence of J-curve phenomenon is noticed. Capital account is neither caused by current account nor by exchange rate but interest rate has a positive impact on it. Robustness of these findings is testified by the vector autoregression model, Wald test of Granger causality followed by an impulse response analysis and a variance decomposition analysis. These analyses, in addition, establish a negative impact of interest rate on current account. With the best of knowledge this is the first study that reveals the dynamics of current and capital account of Sri Lanka. Such a dynamics is critical from the policy perspective. Policy makers should caution before capital account liberalization.     

Local fiscal multipliers and spillover effects: Evidence from Philippine regions

Fiscal policy in developed countries has been a rich topic since the Great Recession. However, research has remained limited for developing countries despite their similar use of fiscal policy and concerns about the efficiency of public spending. To help address this research gap, this paper provides a case study of multiplier effects of local government spending in regions in the Philippines as well as spillover effects of local government spending across regions. An instrumental variable based on the country’s intergovernmental transfer system is used to identify regional public spending in panel regressions. The local fiscal multiplier is estimated to be above one, where a 1-peso rise in spending by local government units in a region corresponds to a 1.2-peso rise in regional output. Multiplier effects are highest for capital expenditures and appear to be primarily driven by the services sector. Spillover effects are comparatively large, at around 1.8–2.0, highlighting the important role of domestic trade when stimulating regional economic activity.