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71.
Ana Clara Kneese Virgilio do Nascimento Joyce Maria Annichino-Bizzacchi Claudia de Alvarenga Maximo Eimy Minowa Guilherme Silva Julian 《Journal of medical economics》2017,20(8):884-892
Aims: Although several therapeutic options are available for chronic immune thrombocytopenic purpura (cITP), little is known about the treatment of cITP in Brazil.Materials and methods: A multi-center, retrospective chart review, observational study was designed to describe the treatment patterns, clinical burden, resources use, and associated costs for adult patients diagnosed with cITP and treated in public and private institutions in Brazil. Patient charts were screened in reverse chronological order based on their last visit post January 1, 2012. (All costs were calculated using 1.00 USD?=?3.9571 BRL, from February 2016.)Results: Of 340 patient charts screened, 50 patients were eligible for inclusion in the study. Single-drug therapy (prednisone, dexamethasone, or dapsone) was the most commonly used treatment, followed by combination therapies (azathioprine?+?prednisone, azathioprine?+?prednisone?+?danazol, and prednisone?+?dapsone). Splenectomy was performed in 22% of patients after at least first-line treatment. Platelet count and number of bleeding episodes at diagnosis were 31,561.1/mm3 (SD?=?±26,396.1) and 40 episodes, respectively; in first-line, 92,631.1/mm3 (SD?=?±79,955.3) and 19 episodes, respectively; in second-line, 96,950.0/mm3 (SD?=?±76,476.4) and 17 episodes, respectively. Private system patients had a higher median cost compared to public system patients (USD 17.49/month, range?=?0–2,020.77 vs USD 9.51/month, range?=?0–192.64, respectively).Limitations: This study does not allow conclusions for causal explanations due to the cohort study design, and treatment patterns represent only the practices of physicians who have agreed to participate in the study.Conclusions: The data indicate that available therapeutic strategies for second- and third-line therapies appear to be limited. 相似文献
72.
Brahim K. Bookhart Lloyd Haskell Luke Bamber Maria Wang Jeff Schein Samir H. Mody 《Journal of medical economics》2014,17(10):691-695
Objective:Venous thromboembolism (VTE) (deep vein thrombosis [DVT] and pulmonary embolism [(PE]) represents a substantial economic burden to the healthcare system. Using data from the randomized EINSTEIN DVT and PE trials, this North American sub-group analysis investigated the potential of rivaroxaban to reduce the length of initial hospitalization in patients with acute symptomatic DVT or PE.Methods:A post-hoc analysis of hospitalization and length-of-stay (LOS) data was conducted in the North American sub-set of patients from the randomized, open-label EINSTEIN trial program. Patients received either rivaroxaban (15?mg twice daily for 3 weeks followed by 20?mg once daily; n?=?405) or dose-adjusted subcutaneous enoxaparin overlapping with (guideline-recommended ‘bridging’ therapy) and followed by a vitamin K antagonist (VKA) (international normalized ratio?=?2.0–3.0; n?=?401). The open-label study design allowed for the comparison of LOS between treatment arms under conditions reflecting normal clinical practice. LOS was evaluated using investigator records of dates of admission and discharge. Analyses were carried out in the intention-to-treat population using parametric tests. Costs were applied to the LOS based on weighted mean cost per day for DVT and PE diagnoses obtained from the Healthcare Cost and Utilization Project dataset.Results:Of 382 patients hospitalized, 321 (84%), had acute symptomatic PE; few DVT patients required hospitalization. Similar rates of VTE patients were hospitalized in the rivaroxaban and enoxaparin/VKA treatment groups, 189/405 (47%) and 193/401 (48%), respectively. In hospitalized VTE patients, rivaroxaban treatment produced a 1.6-day mean reduction in LOS (median?=?1 day) compared with enoxaparin/VKA (mean?=?4.5 vs 6.1; median?=?3 vs 4), translating to total costs that were $3419 lower in rivaroxaban-treated patients.Conclusion:In hospitalized North American patients with VTE, treatment with rivaroxaban produced a statistically significant reduction in LOS. When treating DVT and PE patients, clinicians should consider newer anti-coagulants with less complex treatment regimens. 相似文献
73.
The present study provides evidence on the mobility effects of researchers from the public R&D system with regard to firm's innovation process. This issue is particularly novel and important as these researchers contribute to the production and transfer of knowledge previously developed and accumulated in the public R&D system. The findings confirm that scientific knowledge which public researchers provide has a positive influence on both inputs and outputs of the firms' innovation process. The fact that firms have access to additional knowledge which is complementary to that they already hold represents a spur for exploiting and applying this new knowledge. The firms in this study continually increased their in-house R&D investments. As a result of these investments firms create new knowledge of a unique and valuable type. The study draws two important conclusions geared to providing a greater efficiency in human resource management and to improve the design of technology policies. 相似文献
74.
Maria Montero 《Games and Economic Behavior》2002,41(2):274
This paper studies non-cooperative bargaining with random proposers in apex games. Two different protocols are considered: the egalitarian protocol, which selects each player to be the proposer with equal probability, and the proportional protocol, which selects each player with a probability proportional to his number of votes. Expected equilibrium payoffs coincide with the kernel for the grand coalition regardless of the protocol. The equilibrium is in mixed strategies and the indifference conditions can be reinterpreted in the language of the kernel. 相似文献
75.
This article investigates the employment impact of innovation in services, using the data gathered through the 1993-95 Italian innovation survey. The empirical evidence shows that the impact of innovation on employment varies greatly across industries and according to the level of qualification of the labour force. Among small firms and in less than a half of the service sectors considered, the employment impact of innovation is positive, particularly in industries that have a strong scientific and technological base. A negative impact of innovation on employment is, on the contrary, found among large firms, capital-intensive industries and in all financial-related sectors (banking, insurance and other financial services). In these industries the labour-saving effect of innovation seems to be linked to the widespread use of Information and Communication Technologies (ICTs) which displace the least qualified employees. In the case of Italy, an overall negative impact of innovation on employment is found. It is argued that this result is affected by the Italian economy's specialisation in the most traditional service industries. 相似文献
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78.
This paper responds to recent research by Ruland et al. [Ruland, W., Shon, J., Zhou, P., 2007. Effective controls for research in international accounting. Journal of Accounting and Public Policy, 26(1), 96–116.] that addresses the effectiveness of experimental controls for research in international accounting, with focus on Ndubizu and Sanchez [Ndubizu, G.A., Sanchez, M.H., 2006. The valuation properties of earnings and book value prepared under US GAAP in Chile and IAS in Peru. Journal of Accounting and Public Policy 25 (2)]. We attempt to remove some misconceptions about effective experimental controls that have surfaced in the debate. We argue that theory and refined proxies alleviate many of the control issues that have surfaced in the literature. 相似文献
79.
We analyze the cross-country determinants and financial stability implications of the mix of international banks’ foreign claims. We distinguish between local claims – extended by host country affiliates – and cross-border claims – booked outside the receiving country. Using data on Italian, Spanish, and US banks’ foreign claims, we find that the share of local claims is driven by restrictions on banking sector openness and by local scale economies/business opportunities. The impact of limits on property rights, entry requirements, start-up and informational costs is less robust. Finally, foreign claim volatility is lower in countries with a larger share of local claims. 相似文献
80.
This paper analyzes how economic deregulation impacts firm strategies and environmental quality in the electric utility industry. We find evidence that the deregulation introduced to this historically staid industry has stimulated environmental differentiation. Differentiation is most likely to appear where its point of uniqueness is valued by customers, and we confirm this relationship in our sample. Specifically, utilities that served customers who exhibited higher levels of environmental sensitivity generated more ‘green’ power. The tendency for firms to differentiate in this way is lessened if they are relatively more dependent on coal‐fired generation or relatively more efficient. Thus, there is evidence that firms sort themselves into either differentiation or low‐cost strategies as the competitive realities of a deregulated world unfold. Deregulation and the ensuing environmental differentiation illustrate how utilities exploited formerly unmet customer demand for green power. The result has been greater levels of renewable generation and, hence, a cleaner environment. Copyright © 2007 John Wiley & Sons, Ltd. 相似文献