Healthcare costs for Crohn’s disease patients treated with infliximab: a propensity weighted comparison of the effects of treatment adherence

Objective:

The objective for the research was to evaluate the direct healthcare costs for Crohn’s disease (CD) patients categorized by adherence status.

Methods:

Adult patients with ≥1 claim for infliximab and ≥2 claims for CD who were continuously insured for 12 months before and after their first infliximab infusion (index date) were identified in a 2006–2009 US managed care database. Patients were excluded if they had rheumatoid arthritis claims, received infliximab billed as a pharmacy benefit, or received another biologic drug. Patients were categorized as being either adherent or intermittently adherent to infliximab using a pre-defined algorithm. Total and component direct costs, CD-related costs, rates of surgery, and days of hospitalization were estimated for the 360-day post-index period. Propensity weighted generalized linear models were used to adjust the cost estimates for potential confounding variables.

Results:

The total propensity weighted cost for infliximab adherent patients was $40,425 (95% CI?=?[$38,686, $42,242]), compared to $41,082 (95% CI?=?[$38,163, $44,223]) for the intermittently adherent (p?=?0.71). However, adherent patients had lower total direct medical costs, exclusive of infliximab, that were $13,097 (95% CI?=?[$12,141, $14,127]) compared with $20,068 (95% CI?=?[$17,676, $22,784]) for intermittently adherent patients as a result of substantially lower hospital and outpatient costs (p?Conclusions:

Greater drug-related costs for infliximab adherent patients were offset by lower costs from hospitalization and outpatient visits. These findings indicate that adherent patients have improved clinical outcomes, at a similar aggregate cost, than patients who are only intermittently adherent to therapy.     

中巴陆上边界问题的解决及边海合作面临的挑战

中巴两国陆地边界接壤地区主要是今巴控克什米尔地区。两国过去存在的边界问题与历史上英国对中国西部领土的侵略扩张和印巴分治息息相关。随着中巴双边关系的发展,两国开始解决双边陆地边界问题。两国先是妥善处理了克什米尔问题,并经过两年多的边界谈判,最终顺利解决了中巴双边陆地边界问题。中巴双边陆地边界谈判过程受到了印度和美国的压力。中巴两国顺利解决双边陆地边界问题为促进中巴两国合作与发展奠定了良好的基础。从喀喇昆仑公路建设,到共同应对恐怖主义,再到中巴经济走廊建设,中巴合作有着广泛的基础和良好的前景。     

How Large are the Welfare Gains from Technological Innovation Induced by Environmental Policies?

This paper examines whether the welfare gains from technological innovation that reduces future abatement costs are larger or smaller than the Pigouvian welfare gains from optimal pollution control. The relative welfare gains from innovation depend on three key factors—the initially optimal level of abatement, the speed at which innovation reduces future abatement costs, and the discount rate. We calculate the welfare gains from innovation under a variety of different scenarios. Mostly they are less than the Pigouvian welfare gains. To be greater, innovation must reduce abatement costs substantially and quickly and the initially optimal abatement level must be fairly modest.     

耳鸣的神经内科诊治

目的探讨耳鸣的神经内科临床诊治。方法对神经内科门诊就医的耳鸣患者资料进行回顾性分析。结果80例耳鸣患者中,42例存在睡眠、心理障碍,无明显器质性变化;38例诊断为耳部或非耳部疾病。结论耳鸣具有比较复杂的病因,医生在对耳鸣患者进行诊治时,应拓展思路,在临床诊断中培养正确思路,通过细致问诊、进行相关检查能有效减少对患者的误诊率。     

金融风险社会化的最后防线及我国的现实选择

金融风险社会化是金融风险从金融系统溢出,蔓延至实体经济、国家财政甚至社会公众的过程,这种风险扩散后患无穷。通过对历次金融危机的梳理,总结金融风险社会化的一般路径,厘清国家财政必须承担起金融风险社会化最后防线的责任,并参考国际经验和我国国情,提出防范金融风险社会化的政策建议。     

Are the new rules relating to disclosures of derivative financial instruments workable?

Accounting for derivatives has created uncertainties for preparers, auditors, regulators, and users of financial statements alike. The complexity and variety of instruments as well as hedging and risk management techniques make derivatives reporting a difficult subject. Developing consistent accounting rules in this area is made even more challenging since derivatives are used in conjunction with assets and liabilities that, under the current accounting system, may be carried at historical cost, fair value, or some hybrid of fair value and historical cost. Further, derivatives are used in connection with portfolios of items as well as with economic assets and exposures that may not be recorded in financial statements under the current model.     

Evaluation of a Truthful Revelation Auction in the Context of Energy Markets with Nonconcave Benefits

We describe a Vickrey-Clarke-Groves auction for supply and demand bidding in the face of market power and nonconcave benefits in which bidders are motivated to bid truthfully, and evaluate its use for power and gas pipeline capacity auctions. The auction efficiently allocate resources if firms maximize profit. Simulations, including an application to the PJM power market, illustrate the procedure. However, the auction has several undesirable properties. It risks being revenue deficient, can be gamed by cooperating suppliers and consumers, and is subject to the information revelation and bid-taker cheating concerns that make single item Vickrey auctions rare.     

The Antonelli Versus Hicks Elasticity of Complementarity and Inverse Input Demand Systems

A true measure of input substitution associated with exogenous changes in input quantities requires that the output level be held constant. To this effect, this study presents the Antonelli elasticity of complementarity characterised by the distance function. The more common Hicks elasticity of complementarity assumes that marginal cost is constant and hence does not capture pure substitution effects. The two elasticities of complementarity are related to inverse demand systems and are shown to be equivalent under constant returns to scale. A framework for estimating the Antonelli elasticity from the uncompensated demand system is presented. Estimation results reveal substantial bias of input substitutability with the use of Hicks' measure.     

Product Differentiation and Public Education

We demonstrate that differentiation in public services can arise as a way of reducing competition among cities. Quality differentiation can be particularly relevant to the provision of education. If cities finance education through a property tax that generates "tax competition," we find that quality differentiation in education changes the amount of educational services provided. In the case of property-value maximization, this means a reduction in educational services in both the city with high quality and that with low quality. The reduction in educational services means that under reasonable conditions property values in both cities can increase.