Sentencing Illicit Drug Traffickers: How do the Courts Handle Random Sampling Issues?

While many European justice systems distinguish between possession of and trafficking in illicit drugs, sentencing in drug cases in those countries tends not to depend (at least formally) upon the quantity of drugs seized from a defendant, but rather on the circumstances in which the defendant was found with drugs. Courts in the United States, on the other hand, penalize those convicted of drug crimes through an elaborate system of sentencing rules and guidelines. These sentences depend only upon the amount of drugs (possibly adjusted for circumstances) and the defendant's criminal history. Because of the enormous amount of work needed to determine drug type and quantity in each case, sampling the evidence and estimates of drug quantity have been accepted in most courts in the United States. During the last two years, several major developments in U.S. federal sentencing have taken place. It all started in June 2000 with the Supreme Court case Apprendi v. New Jersey , in which Justice O'Connor, in dissent, termed a "watershed in constitutional law". Prior to Apprendi , a judge would sentence a convicted drug trafficker to imprisonment using the preponderance standard of proof on the quantities of drugs seized. The affect of Apprendi is to make more juries decide the quantity of drugs by the reasonable doubt standard. Although Apprendi had nothing to do with illicit drugs, the implication now is that all federal sentencing protocols are under revision. Since Apprendi was decided, huge numbers of cases involving convicted drug traffickers have relied upon its reasoning on appeal, with the result that a ruling from the Supreme Court on further clarification of this issue is expected. This article discusses the impact so far of Apprendi on statistical issues involved in estimating total drug quantity and considers possible future directions under the changing protocols.     

Impact of treatment heterogeneity on drug resistance and supply chain costs

The efficacy of scarce drugs for many infectious diseases is threatened by the emergence and spread of resistance. Multiple studies show that available drugs should be used in a socially optimal way to contain drug resistance. This paper studies the tradeoff between risk of drug resistance and operational costs when using multiple drugs for a specific disease. Using a model for disease transmission and resistance spread, we show that treatment with multiple drugs, on a population level, results in better resistance-related health outcomes, but more interestingly, the marginal benefit decreases as the number of drugs used increases. We compare this benefit with the corresponding change in procurement and safety stock holding costs that result from higher drug variety in the supply chain. Using a large-scale simulation based on malaria transmission dynamics, we show that disease prevalence seems to be a less important factor when deciding the optimal width of drug assortment, compared to the duration of one episode of the disease and the price of the drug(s) used. Our analysis shows that under a wide variety of scenarios for disease prevalence and drug cost, it is optimal to simultaneously deploy multiple drugs in the population. If the drug price is high, large volume purchasing discounts are available, and disease prevalence is high, it may be optimal to use only one drug. Our model lends insights to policy makers into the socially optimal size of drug assortment for a given context.     

543份药品说明书的调查分析

目的:调查并分析、整理药品说明书中存在的问题,建议有关部门规范管理药品说明书,以保证患者的用药安全,促进药品的合理使用。方法:收集某医院药剂科543份药品说明书,参照药品说明书和标签管理规定和中华人民共和国药典《临床用药须知》化学药和生物制品卷的相关要求进行分析与对照。结果:在统计的543份说明书中存在错别字和格式错误的8份,占1.47%;内容缺失的12份,占2.21%;语义不明的13份,占2.39%;用法用量、规格及溶媒存在问题的18份,占3.31%。其中不合理的说明书占9.58%;合理的说明书占90.61%。结论:在不合理的说明书中,用法用量、规格及溶媒存在问题占的比例最大,影响了药品的正常使用与推广和患者的健康,说明书规范化管理有待进一步加强。     

机械装配图中零件序号和明细栏标填的标准化

介绍了一种在机械装配图中零件序号的标注和明细栏填写的新方法。该方法可把标准件和非标准件分开，有利于零件的汇总、统计和分类，也有利于技术管理和生产管理。建议把该方法标准化。     

药品物流作业活动调查与工作分析

通过对药品物流企业物流作业活动的调查研究和工作分析,详细描述药品物流作业活动内容、目标、要求,从事药品物流作业活动人员所需职业能力;概括说明药品物流特点和药品物流从业人员必须知识与能力,为药品物流企业建立物流作业活动的标准操作规程,物流人才的培养、从业人员职业能力的提升提供参考。     

离子导入对降钙素经皮促渗作用的研究

为了提高大分子生物药经皮给药的治疗浓度,以多肽类生物药鲑降钙素为模型药物,研究离子导入法和化学促渗剂对鲑降钙素经皮渗透的影响。利用水平双室扩散池的方法,考察了离子导入法、化学促渗剂氮酮以及离子导入-氮酮并用对鲑降钙素经皮渗透的促渗作用。     

南方医科大学南方医院住院病人退药情况分析及其对策

目的:了解我院住院病人退药情况,分析退药原因,为减少并规范临床退药提供参考。方法:收集我院2011年1-4月的住院病人退药申请单1341张,对退药原因,退药科室和药品种类进行统计分析。结果:消化科,普外科和血液科居前三位;病人临时出院,医生更改医嘱和医嘱录入错误是主要原因;抗微生物药的退药频次最高。结论:应规范医疗行为,加强用药管理,建立健全的退药制度,加强医、药、护、患的沟通,减少退药发生。     

我国医药逆向物流运作障碍及其实现价值研究

对目前我国医药逆向物流的类型进行分析,根据退回药品的状态将医药逆向物流分为无缺陷药品逆向物流、缺陷药品逆向物流及失效药品逆向物流三类。从国家立法、经济效益及社会效益三个角度阐述了我国发展医药逆向物流的必要性及价值。最后对医药逆向物流目前运作模式、特点及其适用性进行讨论。     

Counter-intuitive effects of domestic law enforcement policies in the United States

In spite of the increase in domestic law enforcement policies in the U.S. drug related crime has followed a non-monotonic trend and cocaine and heroin prices, instead of increasing, have been dropping or remained stable over time. All this in a context of an increase in these drugs’ consumption during the 1980s and a small decrease during the 1990s. This paper provides an explanation to these counter-intuitive effects of domestic law enforcement policies. We model how drug lords respond to this type of policy within a conflict framework over the control of distribution activities for illegal drugs, which is novel. The model predicts drug distribution activities, drug prices and drug consumption. These predictions appear to be consistent with the empirical evidence in the United States.     

Potential Tax Revenue from a Regulated Marijuana Market A Meaningful Revenue Source

A bstract . Dissatisfaction with current drug policy measures has led to a push for the regulation of drugs , especially marijuana . On the premise that such regulation is a real possibility, estimates of potential tax revenue from a regulation scheme and critical comments on other estimates of the size of the marijuana market are presented. For 1991, potential tax revenue is estimated to range from 2.55 to 9.09 billion dollars. The uncertainty surrounding the price elasticity of demand for marijuana, home cultivation of marijuana by individual users, and the extent to which purchases may still be made from the black market are discussed, as are their implications for potential tax revenue.     

The effect of patent expiration on the market position of drugs

A sample of 12 major drugs is used to examine the effect of patent expiration on market shares and prices in the US market. The results indicate that patent expiration has, at least for the first few years, only a small effect on the market shares and prices of the original drags. Efforts to increase price competion in drug markets, however, may change this situation in the future. The declining effective patent period for drugs and the declining profitability of drug innovation raise the concern that efforts to foster price competition might result in lower levels of innovation.     

新药研发项目的功能价值评价

在对标准普尔评级的10大潜力新药入选原因的分析的基础上,提出明确新药的功能价值分类,同时汇总了四种新药功能价值的评估方法,为价值工程在新药研发中的应用提供了理论支持。目前国内研发实力薄弱、研发投入不断增加,采用功能价值评估,深入挖掘新药功能价值,才能更有效地利用研发投入,实现新药研发形势的稳步改善。     

Robustness of normal theory statistics in structural equation models*

A condition is given by which optimal normal theory methods, such as the maximum likelihood methods, are robust against violation of the normality assumption in a general linear structural equation model. Specifically, the estimators and the goodness of fit test are robust. The estimator is efficient within some defined class, and its standard errors can be obtained by a correction formula applied to the inverse of the information matrix. Some special models, like the factor analysis model and path models, are discussed in more detail. A method for evaluating the robustness condition is given.     

Applying management science in developing countries: ABC analysis to plan public drug procurement.

Despite the vital role of pharmaceuticals in the prevention and treatment of major causes of death and disability in the developing world, high costs and frequent shortages remain chronic problems for drug supply programs. Yet, management techniques developed to optimize the use of scarce resources have had limited application in the settings of greatest need. An important determinant of the cost and supply of drugs is the procurement pattern. This study reviews procurement patterns in selected public supply programs and, using management science techniques, compares alternative procurement patterns in terms of inventory costs and shortages. Using drug cost and quantity estimates from two countries, a simulated ABC analysis was performed. This analysis showed drug inventories to be typical of industrial inventories: Over 80% of the consumption in dollars was accounted for by less than 20% of the drugs. Procurement patterns with more frequent purchasing or delivery of high usage drugs could reduce average inventories 20-50% over the commonly observed annual purchasing pattern. Sensitivity analysis of the results confirmed that variability in the delivery time and consumption pattern has a significant impact on the efficiency and economy of a procurement system. Closer supplier monitoring and better forecasting should reduce this variability.     

Do Off‐Label Drug Practices Argue Against FDA Efficacy Requirements? A Critical Analysis of Physicians' Argumentation for Initial Efficacy Requirements

The amended Food, Drug and Cosmetics Act requires efficacy certification for a drug's initial uses (“on‐label”), but does not require certification before physicians may prescribe the drug for subsequent uses (“off‐label”). Does it make sense to require FDA efficacy certification for new drugs but not for new uses of old drugs? Using a sequential online survey, we carried on a “virtual conversation” with some 500 physicians. The survey asked whether efficacy requirements should be imposed on off‐label uses; almost all physicians said no. It asked whether the efficacy requirements for initial uses should be dropped, and most physicians said no. We then asked respondents whether opposing efficacy requirements in one case but not the other involved an inconsistency. In response, we received hundreds of written commentaries. We organize and discuss these commentaries with an eye to understanding how the medical market certifies off‐label drug uses and how this compares to FDA certification. Does off‐label medicine use suggest that efficacy requirements should be placed on new uses of old drugs? Does it suggest that efficacy requirements on new drugs should be lifted? We explore these questions, and ask whether the response of many of the doctors exhibits the familiar behavior bias toward the status quo.     

Non‐parametric Analysis of Gap Times for Multiple Event Data: An Overview

Multiple event data are frequently encountered in medical follow‐up, engineering and other applications when the multiple events are considered as the major outcomes. They may be repetitions of the same event (recurrent events) or may be events of different nature. Times between successive events (gap times) are often of direct interest in these applications. The stochastic‐ordering structure and within‐subject dependence of multiple events generate statistical challenges for analysing such data, including induced dependent censoring and non‐identifiability of marginal distributions. This paper provides an overview of a class of existing non‐parametric estimation methods for gap time distributions for various types of multiple event data, where sampling bias from induced dependent censoring is effectively adjusted. We discuss the statistical issues in gap time analysis, describe the estimation procedures and illustrate the methods with a comparative simulation study and a real application to an AIDS clinical trial. A comprehensive understanding of challenges and available methods for non‐parametric analysis can be useful because there is no existing standard approach to identifying an appropriate gap time method that can be used to address research question of interest. The methods discussed in this review would allow practitioners to effectively handle a variety of real‐world multiple event data.     

Cobweb dynamics and price dispersion in illicit drug markets

Extreme price dispersion is a hallmark of illegal drug markets, and this apparent contradiction to the law of one price has long puzzled drug market economists. We propose a novel explanation for this dispersion: the coupling of dealers’ unwillingness to hold inventory with dealers’ imperfect foresight concerning future prices and/or random lead times when “ordering” drugs from higher-level suppliers. Unwillingness to hold inventory means drug markets might operate consistent with a cobweb model. The classic cobweb model was inspired by the observation of cyclic (typically annual) fluctuations in commodity prices. However, with minor changes that make the model more realistic the resulting price trajectories can be highly variable or even chaotic, not just periodic. Cobweb dynamics can also amplify the variability created by supply chain disruptions.     

Cointegration Analysis of Seasonal Time Series

This paper reviews various recent approaches to cointegration analysis of seasonal time series. In addition to the usual decisions concerning data transformations and univariate time series properties, it is necessary to decide how seasonal variation is included in the multivariate model and how standard cointegration methods should accordingly be modified. Seasonal cointegration and periodic cointegration methods are discussed, as are some of their recent refinements. An overview of further research topics is also provided.