Cost-effectiveness analysis of ramucirumab treatment for patients with hepatocellular carcinoma who progressed on sorafenib with α-fetoprotein concentrations of at least 400 ng/ml

Abstract

Objective: This study aimed to compare the cost-effectiveness of ramucirumab versus placebo for patients with hepatocellular carcinoma who progressed on sorafenib with α-fetoprotein concentrations (AFP) of at least 400?ng/ml in the United States.

Methods: A Markov model was constructed to assess the cost-effectiveness of ramucirumab. Health outcomes were measured as quality-adjusted life years (QALYs). With TreeAge software, the disease process was modeled as three health states: progression-free survival (PFS), progressive disease (PD), and death. Costs were extracted from the REACH-2 trial, and utility was derived from published literature. Incremental cost-effectiveness ratios (ICERs) were calculated to compare ramucirumab with placebo. Probabilistic sensitivity analyses were developed to examine the robustness of the results.

Results: In the base case analysis, ramucirumab therapy had a cost of $55,508.41 and generated 0.54 QALYs, while placebo therapy had a cost of $761.09 and generated 0.47 QALYs, leading to an additional $54,747.32 in costs and 0.07 QALYs. The ICER was $782,104.57 per QALY, which was much higher than the willingness-to-pay threshold of $100,000 per QALY. According to sensitivity analyses, the utility of PD in the two groups was the dominant parameter influencing the ICER.

Conclusion: Although ramucirumab was associated with prolonged survival for patients with advanced hepatocellular carcinoma who progressed on sorafenib treatment with an AFP of at least 400?ng/ml, it is not a cost-effective treatment from a United States payer perspective.     

Beyond trade creation: Preferential trade agreements and trade disputes

This study investigates the effects of preferential trade agreements (PTA) on bilateral trade disputes. We construct a unique and comprehensive dataset on inter-country trade disputes from 1995 to 2007. The dataset covers 110 countries and 1,162 bilateral country-pair trade disputes. Using this dataset in a gravity-type model of trade dispute analysis, we find that countries belonging to the same PTA tend to experience fewer trade conflicts among themselves than with non-member countries. By studying various types of PTA with different dispute settlement mechanisms, we further find that the dispute-reducing effect only comes from PTA with specific provisions on dispute settlement mechanisms. Moreover, the effect is stronger if those PTA explicitly stipulate that members can also resolve their disputes via the WTO Dispute Settlement Body. However, having PTA that do not address how members should resolve their disputes may lead to more dispute initiations than in cases without PTA.     

IOS移动平台互动绘本的设计

绘本随着计算机软硬件的发展和无线网络技术的进步，正由纸质图书形式向数字化屏式过渡，其自身可以根据故事的画面与技术手段相结合，从而产生新的绘本形态---互动绘本。在这种应用背景的推动下，指出纸质绘本的优缺点，调查分析IOS移动平台互动绘本发展的前景与优势，从研究互动绘本的设计特征着手，探讨互动绘本设计在数字技术支撑下的设计要素与设计方法，可对互动绘本的设计与发展有所借鉴，并实现其艺术价值与市场应用价值。     

以马斯洛需求层次理论指导会计职业道德教育

本文提出基于马斯洛需求层次理论,以＂需求实现＂保障会计职业道德教育实效,结合学生的职业生涯发展,以＂需求愿景＂构建会计职业道德约束,并提出系统重构与实施会计专业人才培养方案,为会计职业道德教育提供了新的思路与实践方向。     

Board Attributes,Corporate Social Responsibility Strategy,and Corporate Environmental and Social Performance

In this paper, we draw on insights from theories in the management and corporate governance literature to develop a theoretical model that makes explicit the links between a firm’s corporate social responsibility (CSR) related board attributes, its board CSR strategy, and its environmental and social performance. We then test the model using structural equation modeling approach. We find that the greater the CSR orientation of the board (as measured by the board’s independence, gender diversity, and financial expertise on audit committee), the more proactive and comprehensive the firm’s CSR strategy, and the higher its environmental and social performance. Moreover, we find this link to be endogenous and self-reinforcing, with superior CSR performers tending to further strengthen their board CSR orientation. This result while positive is also suggestive of the widening of the gap between the leads and laggards in CSR. Therefore, the question arises as to how ‘leaders’ are using their superior CSR competencies seen by many scholars as a source of corporate (at times unfair) competitive advantage. Stakeholders of corporations therefore need to be cognizant of this aspect of CSR when evaluating a firm’s CSR activities. Policy makers also need to be cognizant of these concerns when designing regulation in this field.     

信息共享下生鲜农产品供应链库存的建模与仿真研究

针对一个动态、多级的生鲜农产品供应链库存系统,运用系统动力学的方法构建其库存模型,选取信息不共享、信息低度共享和信息高度共享等三个决策变量在Vensim PLE平台上运行系统模型,结果显示供应链各主体实现信息共享后,其库存水平都呈现明显的下降趋势,且随着信息共享程度的提高,效果更加显著。     

关于“钓鱼执法”问题的法律思考

＂钓鱼执法＂事件引发了社会各界的广泛关注。这种非理性执法行为不仅有损法律的尊严和政府公信力,还存在着极大的道德风险。我们应在深入剖析具体事件根源的基础上,从立法、财政体制、教育等层面探讨制度上的应对方法。     

WTO成立十年来的十大特征(上)

本文拟对WTO成立十年来所体现出的重要特征进行梳理、归纳和总结,并由此揭示WTO在十年风雨中取得的成就,面临的困难与挑战。     

反倾销税与反倾销补贴的经济学思考

文章从经济学角度分析一国采取反倾销税时对该国经济福利的影响,同时使用反倾销补贴的新概念并与之比较。文章对两国厂商在几种不同的成本情况下分别采取反倾销税和反倾销补贴时对本国经济福利会产生怎样的影响进行对比分析。采取反倾销补贴与反倾销税相比较能带来更大福利,反倾销补贴可以更大程度地防止反倾销的滥用,而且可以更有效地阻止掠夺性倾销。     

人民币购买力平价成立吗?——基于人民币兑欧元的多样本协整分析

选取人民币兑非主权国家货币——欧元的名义汇率,中国CPI指数及欧元区调和HICP指数的数据,以欧元正式成为欧元区唯一合法货币的起点2002年7月到2018年12月为样本,依据影响中欧汇率的重要节点事件对样本进行分段与结合,对人民币兑欧元购买力平价(PPP)成立与否进行协整检验。实证结论有:人民币汇率形成制度改革及欧元平稳运行后的(2005年8月—2018年12月)人民币兑欧元购买力平价协整检验成立;非主权国家货币欧元同样适用经典的购买力平价理论;2008年金融危机是影响汇率市场的重要节点事件,但长期不影响人民币兑欧元购买力平价成立;对PPP冲击影响最大的首先是汇率本身,其次依次是欧元区HICP、中国CPI。因此,购买力平价在一定程度上能够解释人民币兑欧元汇率,对中欧经贸往来有一定的指导作用。