Healthcare burden and reimbursement of hospitalization during chemotherapy for adults with Ph-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia in France: a retrospective chart review

Objective: Philadelphia chromosome negative [Ph(?)] relapsed or refractory (R/R) B-precursor acute lymphoblastic leukemia (ALL) is an extremely rare condition requiring intensive treatment. This retrospective chart review aimed to quantify hospitalizations and reimbursement in this patient population in France.

Methods: Patients aged ≥18 years and with at least one hospitalization for Ph(?) R/R B-precursor ALL were included in the study. They were relapsed with first remission lasting <12 months, relapsed after first salvage therapy, relapsed any time after hematopoietic stem cell transplant (HSCT), or were refractory to initial or salvage therapy. Data were collected from the index date (first diagnosis of R/R ALL) until death or loss to follow-up. The chemotherapy period was defined as the first chemotherapy date after the index date to the earliest of death, loss to follow-up, last chemotherapy dose plus 30 days, or initiation of HSCT. The primary outcome was the percentage of time hospitalized during the chemotherapy period.

Results: Thirty-three patients were included, with a mean age of 49 years. The mean proportion of time spent in the hospital during the chemotherapy period was 46% (95% CI =34–57%). Patients had a mean of 2.2 (SD =1.5) inpatient hospitalizations and the mean length of stay per hospitalization was 16.8 (SD =14.8) days. During the chemotherapy period, the mean amount reimbursed per hospitalization was €31 067 (SD = €4850) and the total hospitalization reimbursement per patient was €68 344. From the index date to death, excluding HSCT, the total reimbursement per patient was €108 873.

Limitations: The sample size was small, although this was expected given the rarity of the patient population.

Conclusions: Adults with Ph(?) R/R B-precursor ALL had repeated and prolonged hospitalizations during salvage chemotherapy. Approximately half the follow-up period was spent in the hospital, and this time was associated with high economic burden in France.     

Monte Carlo theoretical trials of methods for assessing statistical significance for differences between adjusted odds ratios

Odds are generally defined as the number of successes divided by the number of failures in a given number of trials. An odds ratio is the ratio of one odds divided by another. Odds ratios can be adjusted to reflect associations with the outcome independently of the influence of associations with other variables. These are adjusted odds ratios. There are several well known methods for comparing odds ratios and testing for statistically significant differences between them. Analogous methods for adjusted odds ratios are not well known or well documented. One method for comparing adjusted odds ratios is explained by Hosmer and Lemeshow (Applied logistic regression, 2000). This method is used for the odds ratios for two variables from the same data set. The purpose of this analysis was to apply this method to a different situation: comparing odds ratios for the same variable from two different data sets. Monte Carlo trials were used to assess the performance of the method and these indicated the method performed well.     

Inference of the Russian drug community from one of the largest social networks in the Russian Federation

The criminal nature of narcotics complicates the direct assessment of a drug community, while having a good understanding of the type of people drawn or currently using drugs is vital for finding effective intervening strategies. Especially for the Russian Federation this is of immediate concern given the dramatic increase it has seen in drug abuse since the fall of the Soviet Union in the early nineties. Using unique data from the Russian social network ‘LiveJournal’ with over 39 million registered users worldwide, we were able for the first time to identify the on-line drug community by context sensitive text mining of the users’ blogs using a dictionary of known drug-related official and ‘slang’ terminology. By comparing the interests of the users that most actively spread information on narcotics over the network with the interests of the individuals outside the on-line drug community, we found that the ‘average’ drug user in the Russian Federation is generally mostly interested in topics such as Russian rock, non-traditional medicine, UFOs, Buddhism, yoga and the occult. We identify three distinct scale-free sub-networks of users which can be uniquely classified as being either ‘infectious’, ‘susceptible’ or ‘immune’.     

Multi-product capacitated facility location problem with general production and building costs

This research introduces the multi-product capacitated facility location problem with general production and building costs (MP-CFLPGC). The MP-CFLPGC extends previous problems found in the literature by including multiple products and general production and building cost functions that allow the modeling of different behaviors like economies of scale and congestion. The MP-CFLPGC is formulated as a mixed integer linear program (MILP). To evaluate the performance of the proposed formulation we analyze the results of a commercial optimizer on a set of 288 randomly generated test instances that resemble the Colombian cement industry supply chain. After one hour the optimizer achieved an optimality gap of 1.0 % or less in 55 % out of the 288 test instances. On average the optimality gap was 3.57 %. Additionally, we propose a randomized mathematical-programming-based heuristic for the test instances where the MILP formulation presents significantly high optimality gaps.     

Projections of Russia’s agricultural development under the conditions of climate change

This paper analyzes the possible impact of irrigation on the development of agriculture in the Volga River Basin and Black Sea Basin. Scenarios of the development of agriculture in Russia up to 2030 under the conditions of the expansion of irrigation and persistence of the current situation with irrigation have been calculated and analyzed based on the IMPACT-3 econometric partial equilibrium model.     

The evaluation of the long-term economic development of the Irkutsk region in the system of the all-Russian forecasting

The long-term forecasting of the development of the Irkutsk region by economic sectors is considered. The evaluations of the structural changes and the interregional relationships by the variants of the potential trends of development of the economy of Siberia and Russia in a whole are presented. The forecast is made by the production output data, which are the basis of the target growth of the final consumption.     

Decentralized Bribery and Market Participation

I propose a bribery model that examines decentralized bureaucratic decision‐making. There are multiple stable equilibria. High levels of bribery reduce an economy's productivity because corruption suppresses small business, and reduces the total graft, even though the size of an individual bribe might increase. Decentralization prevents movement towards a Pareto‐dominant equilibrium. Anticorruption efforts, even temporary ones, might be useful to improve participation, if they lower the bribe levels demanded and thus encourage small businesses to participate.     

Comparative assessment of state involvement in the economy in OECD studies

The role and features of state involvement in the economy have been analyzed based on the system of special indicators of the countries of the Organization for Economic Cooperation and Development (OECD). The change in the nature of state influence on the economic system in the geopolitical context that manifests at the national and international levels has been shown. The state uses various economic policy instruments, including soft power in the form of sanctions and countermeasures, which make it possible to strengthen its control of the economy. In the past two years, this tactic has manifested in Russia’s relations with Western countries.     

Analysis of the status and trends of applications of advanced manufacturing technologies in Russia

The article has analyzed trends in applying advanced manufacturing technologies in Russia in 2005–2014. The dynamics of technical process structures in the context of applications has been considered. The dynamics of the age structure and the structure of technologies in use in annual terms by the place of acquiring has been assessed. The start-up, availability, and removal balance of technologies has been formed, the effective start-up level, and possible ways to improve the state statistical indicators of innovation development have been determined.