Pharmacoeconomic analysis for pemetrexed as a maintenance therapy for NSCLC patients with patient assistance program in China

Objective: This study is to evaluate the costs, clinical efficacy, and social benefits of a patient assistance program (PAP) implemented by the China Primary Healthcare Foundation for the use of pemetrexed as a first-line non-squamous non-small cell lung cancer (NSCLC) maintenance therapy in China.

Methods: A survival analysis was conducted on the clinical data of 1,366 patients who participated in the PAP. The progression-free survival (PFS) and median maintenance treatment cycle of pemetrexed were analyzed. A 36-month Markov model from a payer’s perspective was constructed to analyze the cost and effectiveness associated with the PAP for pemetrexed. The inputs of the model were sourced from the PAP clinical database and published literature. The study estimated the incremental quality adjusted life-years (QALYs) (pemetrexed plus best supportive care [BSC] vs BSC only), the cost saving of the PAP, the impact on the percentage of catastrophic health expenditures (CHE), and poverty headcount ratio (HCR).

Results: The median of PFS and maintenance treatment cycles were 187 days and five cycles (total nine cycles, which included four cycles of induction therapy), respectively. The pemetrexed plus BSC treatment with PAP resulted in an additional 0.12 QALYs over BSC only. The total cost was $48,034.46 and $96,191.57 for the patients who had or had not joined the PAP in 3 years, respectively. Compared to the patients without PAP, the percentage of CHE and HCR with PAP was reduced from 98.39% to 19.91% and 66.98% to 4.89%, respectively, indicating that the PAP substantially decreased the number of patients who had CHE and fallen into poverty.

Conclusion: The study concluded that the pemetrexed PAP generated noticeable clinical and economic benefits to society and to patients. The program also increased patients’ compliance with chemotherapy by allowing patients, for whom the pemetrexed treatment was unaffordable, to continue to receive it.     

日本车用氢能的产业发展及支持政策

氢能作为最具发展潜力的清洁二次能源,由于其具有低碳零污染和能源高效等特点,开发和利用氢能正成为全球能源科技革命的重要方向。从应用终端来看,车用氢能是氢能主要发展领域。在日本,车用氢能全产业链包括从燃料电池研发到燃料电池汽车(FCV)生产等一系列核心价值链,并以下游终端应用为推力。日本车用氢能产业发展以国家战略为政策引领,面对氢燃料电池汽车成本高,加氢站等基础设施不足等问题,政府运用经济刺激和部门协同等多项政策举措加以应对,同时搭建"政府+大学+企业"的合作开发创新平台,加强技术与产业的协作,利用市场带动产业发展,以FCV作为下游终端发展重点,多层次协同推进车用氢能产业的发展。     

Budget impact of erlotinib for maintenance therapy in advanced non-small cell lung cancer

Abstract

Objective:

Assess the budgetary impact of adding erlotinib for maintenance therapy (MTx) in advanced non-small cell lung cancer (NSCLC) from a US health plan perspective.

Methods:

A budget impact model was developed to analyze the costs (drug, administration, adverse events) associated with adding erlotinib MTx to a hypothetical 500,000 member US health plan. Treatment durations and dosing were derived from randomized controlled trials, FDA labeling, and National Comprehensive Cancer Network guidelines. Treatment patterns and assumptions were based on market research data, the SEER registry, and published literature. Cost data were obtained from Centers for Medicare and Medicaid Services payment rates and a drug pricing database. Sensitivity analyses were conducted to assess uncertainty.

Results:

Overall health plan expenditures increased by $0.010 per member per month (PMPM). The main driver of additional cost was the erlotinib drug cost (～$66,000) with the administration ($464) and side-effect ($47) costs being relatively modest. One-way sensitivity analyses showed that the results were most sensitive to the proportion of members receiving MTx; however, the PMPM did not exceed $0.013.

Conclusions:

The overall budget impact to a health plan of expanding the use of erlotinib from the 2nd/3rd-line advanced NSCLC setting to include the maintenance setting was relatively small. This was primarily due to the proportion of patients who would receive erlotinib MTx, the low cost of side-effects and minimal cost of drug administration. Additional research may be warranted to estimate the relative clinical and economic impacts of erlotinib MTx versus alternative MTx treatments.     

Assessing the Legitimacy of Stem Cell Research: An Instrumental Valuation Principle Approach

Research on embryonic stem cells has elicited much public and political debate. By promoting the use of the Instrumental Valuation Principle, it is argued here that institutionalists can offer a framework for policy analysis that ensures that the debate on stem cell research is informed by the instrumental use of knowledge and that it is not controlled by upper-level hegemonic powers. Our contention is that the first decade following the initial harvesting of human embryonic stem cells (1998-2008) in the United States was characterized by institutional and policy responses that created a non-deliberative environment that hindered the process of instrumental valuation of stem cell research. This paper concludes that the current conditions of limited corporate involvement are favorable toward a democratic discussion of the legitimacy of stem cell research, but this will require overt challenges to political elites' attempts to control the creation and flow of instrumental knowledge on stem cell research.     

从DNA复制看企业文化传播

从生物学的独特视角，将细胞分裂的方式、特点以及DNA的复制过程与企业文化在企业内部的传播过程进行类比，可看出企业文化传播与细胞分裂具有相似性。企业可以借鉴细胞分裂的特征构建合理的企业文化传播模式，帮助企业成功地传播自己的文化，增强企业的核心竞争能力。     

16排螺旋CT在膀胱移行细胞癌中的应用

目的:探讨16排螺旋CT对膀胱移行细胞癌的诊断价值。方法:回顾性分析36例经手术病理证实为膀胱移行细胞癌癌患者的CT及临床资料。结果:36例术前CT检出33例,3例未见异常。CT表现为局限性膀胱壁增厚7例,呈菜花状向腔内突出23例,乳头状突向腔内6例;增强扫描肿块均有不同程度强化。结论:16排螺旋CT对膀胱移行细胞癌的诊断有其独特的优越性,临床应用价值较高,可在临床推广应用。     

采用ITO纳米粒子喷墨印刷制备透明电极

本文讨论了喷墨印刷氧化铟锡（ITO）电极在有机太阳能电池（OSCs）中的应用。利用纳米ITO晶体进行喷墨印刷并在450℃时迅速退火，可以直接获得平均透光率为84．14％、方块电阻为202．7Q／口的ITO电极。由喷墨印届4直接制造的ITO电极制备的有机太阳能电池具有0．57V的开路电压、8．47mA／cm^2的短路电流、44％的填充因子以及2．13％的能量转换率。这表明从有机太阳能电池印刷成本效益来讲，相对于溅射工艺，由于无须光刻工艺且ITO材料的利用率更高，直接利用喷墨印刷制备ITO电极成为一种可行的选择。     

Risk‐Utility Paradigms for Statistical Disclosure Limitation: How to Think,But Not How to Act

Risk‐utility formulations for problems of statistical disclosure limitation are now common. We argue that these approaches are powerful guides to official statistics agencies in regard to how to think about disclosure limitation problems, but that they fall short in essential ways from providing a sound basis for acting upon the problems. We illustrate this position in three specific contexts—transparency, tabular data and survey weights, with shorter consideration of two key emerging issues—longitudinal data and the use of administrative data to augment surveys.     

PHS基站信号再生设备的设计与实现

介绍了一种新型PHS基站信号再生设备的设计与实现方法,完成了该系统的硬件模块设计和软件设计及编译,并对软件流程进行了详细的介绍。该系统主要采用小灵通基带芯片ML7338(ARM7TDMI核)和RDA5206射频模块,实现对射频信号的解调,同时对基带信号重新编码再调制发射,很好地解决了普通直放站射频干扰问题。所设计的信号再生设备能实现对PHS信号的变换与转发,能够有效解决当前小灵通网络的盲区问题。     

红花萱草离体繁殖技术研究

用地下块茎做为外植体对红花萱草进行离体繁殖,效果较好;在接种4～5周由愈伤组织直接诱导出不定芽,芽诱导以MS 6-BA2mg/L KT1mg/L IBA0.5mg/L为最佳;增殖培养以MS 6-BA2mg/L NAA0.1mg/L为好,其增殖系数较高,幼苗生长快而健壮;而根的诱导则以1/2MS NAA0.2mg/L相对理想.