Pharmacoeconomic analysis of paricalcitol and calcitriol in the treatment of secondary hyperparathyroidism in haemodialysis: impact of hospitalisations and survival

Summary

The objective of this study was to evaluate the cost effectiveness of paricalcitol injection compared with calcitriol injection when used to reduce parathyroid hormone levels in patients undergoing haemodialysis. A decision tree was developed to model the 1-year costs and outcomes of therapy for secondary hyperparathyroidism from a US government payer's perspective (2005 US$). Probabilities of hospitalisations and survival with paricalcitol and calcitriol were obtained from published observational studies.

When only drug costs and survival were considered, the incremental cost effectiveness of paricalcitol over calcitriol was $9,900 per life saved. When utilities were included, the incremental cost-effectiveness ratio for paricalcitol compared with calcitriol was $13,200 per quality-adjusted life year. When both drug and hospitalisation costs were included in a cost analysis, paricalcitol treatment was cost saving compared with calcitriol, and when hospitalisation costs were included in both the cost-effectiveness analysis and cost-utility analysis paricalcitol demonstrated first-order dominance, cost savings and cost effectiveness.

This decision analysis demonstrated that paricalcitol injection is both cost effective and cost saving compared with calcitriol injection.     

提高我国扶贫开发效益的对策研究

本文从贫困识别、扶贫项目选择、扶贫资源投入整合、公共供给等方面对我国扶贫开发工作进行分析,提出可操作的对策,旨在提高扶贫开发效益,有效改善贫困群体民生。     

Effective Nonverbal Communication Techniques

Developing effective marketing strategies for profes- sional service firms presents many unique challen es and is an im- portant area of practice development that many &ns often wer- look. Professional service firms ossess very distinctive P characteristics which differentiate them rom other service firms and require specialized marketing strategies. The purpose of this article is to assist practitioners in their efforts to develop promotional strat- egies which will enhance their firm's professional image and in- crease the firm's ability to engage new clients. These strategies arc aimed specifically at certified public accountants, lawyers, archi- tects, and other professionals.     

中国民营上市公司债务融资破产威胁功效的实证研究

以2002～2007年陷入财务危机的民营上市公司（ST公司）为研究样本．通过相关分析实证检验了中国债务融资的破产威胁功效.研究发现，中国民营上市公司债务融资总体上对财务状况恶劣的公司起到了债务治理作用，发挥了破产威胁功效。短期债务能够对陷入财务危机的民营上市公司起到改善业绩的作用，较好地发挥破产威胁功效，而长期债务未能发挥破产威胁作用。银行贷款能够促进陷入财务困境的民营上市公司改善业绩，发挥破产威胁功效，而商业信用却没能发挥破产威胁功效。     

公司性质的争议:从视角组合的角度分析

通过逻辑学中视角组合,可以发现公司法定论和公司契约论的明显差异。由此得出一个好的探讨公司性质的进路,不仅能够在对象概念所含要素这样一个表层上是以归属视角建立基础的,还能在此之上,继续用归属视角或效用视角在要素的现实层面扩展构建,即能够建立一个现实的语境内涵。     

领导团队相对进步效度动态测评分析

领导团队已经成为现代社会管理的核心方式,以往大多通过领导团队绩效的对照期指标的比值来测算绝对进步效度,文章真实地反映了领导团队在同等参照前提下的有效进步程度,结合团队成员的有效努力程度和个体相对进步指数,应用数据包络分析方法来测算相对进步效度,将有助于领导团     

Predicting IJVs＇ effectiveness based on their autonomy levels and the characteristics of their parent companies

Separate research streams have identified relationships between IJV autonomy and IJV effectiveness, and between functional/dysfunctional parent-company differentiation and IJV effectiveness. This study attempts to integrate these two literature streams by examining how these two sets of independent variables interact in terms of predicting IJV effectiveness. Results partially support our hypotheses that the autonomy-effectiveness relationship is less positive with greater functional differentiation and more positive with greater dysfunctional differentiation. The results provide strong support for our hypotheses that activities closer to the local operating environment will influence these relationships such that autonomy becomes more important to effectiveness when an activity has strong local ties.     

Outcomes of tumor necrosis factor inhibitor cycling versus switching to a disease-modifying anti-rheumatic drug with a new mechanism of action among patients with rheumatoid arthritis

Objectives: To examine treatment patterns, treatment effectiveness, and treatment costs for 1 year after patients with rheumatoid arthritis switched from a tumor necrosis factor inhibitor (TNFi) (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab), either cycling to another TNFi (“TNFi cyclers”) or switching to a new mechanism of action (abatacept, tocilizumab, or tofacitinib) (“new MOA switchers”).

Methods: This retrospective cohort study used administrative claims data for a national insurer. Treatment persistence (without switching again, restarting, or discontinuing), treatment effectiveness (defined below), and costs were assessed for the 12-month post-switch period. Patients were “effectively treated” if they satisfied all six criteria for a treatment effectiveness algorithm (high adherence, no dose increase, no new conventional synthetic disease-modifying anti-rheumatic drug, no subsequent switch in therapy, no new/increased oral glucocorticoids, and <2 glucocorticoid injections). Multivariable logistic models were used to adjust for baseline factors.

Results: The database included 581 new MOA switchers and 935 TNFi cyclers. New MOA switchers were 39% more likely than TNFi cyclers to persist after the switch (odds ratio [OR]?=?1.39; 95% confidence interval [CI]?=?1.12–1.74; p?=?.003) and 36% less likely to switch therapy again (OR?=?0.64; 95% CI?=?0.51–0.81; p?p?=?.006). New MOA switchers had 16% lower drug costs than TNFi cyclers (cost ratio?=?0.84; 95% CI?=?0.79–0.88; p?p?Limitations: Claims payments may not reflect rebates or other cost offsets. Medical and pharmacy claims do not include clinical end-points or reasons that lead to new MOA switching vs TNFi cycling.

Conclusions: These results support switching to a new MOA after a patient fails treatment with a TNFi, which is consistent with recent guidelines for the pharmacologic management of established rheumatoid arthritis.     

税收与财政补助促进融资租赁发展的对比研究--基于行业异质性和不同企业类型视角

本文基于行业异质性和不同企业类型视角,对比分析税收与财政补助促进融资租赁发展的作用。结果表明：税收和财政补助对融资租赁业发展的促进路径有三条,承租方、供货方和担保机构在其中起到中介效用;税收的作用程度高于财政补助的行业有：电信、工程机械、交通运输、矿业和制造加工;财政补助的作用高于税收的行业有： IT、医疗和印刷;在风险投资融合型和革命型的企业中,税收政策的作用高于财政补助,在冒险型的企业中,财政补助政策的作用程度高于税收政策。     

自然圣境的生态保护功能及其实现路径

自然圣境是对人类具有特殊精神意义的自然区域,自然圣境除了具有精神文化价值,在生态环境保护方面也发挥了重要作用。自然圣境的生态保护功能主要体现在保护生态环境和自然资源以及为珍稀濒危物种提供栖息地。目前,因旅游和工程项目过度开发、土地利用变化、所属权转移、价值观念的变化和自然环境变迁等因素,造成自然圣境的生态保护功能面临挑战。面对这些问题,应加强对自然圣境及其生态保护功能的正确认知,将自然圣境纳入保护地和生态补偿体系当中,发挥自然圣境生态文化的灵魂作用,并制定与自然圣境保护相关的法律法规。