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.     

价值链视角下科技人才分布对区域创新系统效率的影响

科技人才作为科技创新的主体,是区域创新系统的重要投入,其省际分布状况潜在影响着各区域创新效率。基于2009-2016年我国内地30个省级区域科技人才与研发面板数据,在创新价值链分解的基础上,分别考察科技人才数量与结构维度对区域创新系统三阶段效率的影响。结果发现：在数量维度下,科技人才分布规模对区域知识创新效率、专利创新效率有非线性倒U型影响,先后从人才聚集规模经济效应转向不经济效应;整体集中度提高即全国科技人才分布相对集中有助于提升各地区专利创新与产品创新效率;在结构维度下,科技人才队伍中女性与博士研发人员越来越高的比重对知识创新效率表现为负向影响作用。最后,结合新旧动能转换背景,提出积极发挥人才集聚正向效应的建议。inno[]rlzb[]rlzb[]czpz[]czpz[]cyjg[]cyjg[]dwkf[]dwkf〖BHDG1*3,WK7*3ZQ,WK6。9DWW〗     

学术印记、网络惯例与大学衍生企业产业嵌入

在大学衍生企业创业实践中,与产业主体间缺乏合作默契已成为大学衍生企业向产业网络嵌入的重要阻滞因素。针对该问题,基于网络惯例新视角,从大学衍生企业学术创生背景带来的异质性入手,构建“学术印记—网络惯例—产业网络嵌入”作用模型,探索技术动荡性的调节效应。运用多元回归分析等方法,对379家大学衍生企业调研数据进行实证检验。结果表明,大学衍生企业学术印记对网络惯例建立具有积极促进作用。同时,在向产业嵌入过程中,网络惯例对产业网络嵌入两个维度的作用机制存在差异,与结构嵌入存在倒U型关系,但正向促进关系嵌入。技术动荡性在“学术印记—网络惯例—产业网络关系嵌入”关系中具有正向调节作用。     

中国服务业发展悖论——基于“两波”发展模式的研究

本文借鉴最新文献对服务业发展规律的测度方法,用中国1952—2010年的地区面板数据对我国服务业比重变化的长期规律和阶段性特征进行了测度,结果认为:宏观国家层面上,我国服务业比重的变化确实有悖于世界经济整体服务化的趋势;但在地区层面上,我国服务业比重与人均GDP的关系基本符合"服务业比重随经济发展不断上升"的普遍规律,所谓经济服务化的"中国悖论"在地区层面上并不存在;对服务业发展的阶段性特征和地区差异进行分析发现,我国大部分地区仍然处于以传统服务业为主的第一波发展阶段,只有少数地区进入了以现代服务业发展为主导的第二波。文章最后对我国服务业发展规律的成因进行了一般分析和实证检验。     

异质机构、企业性质与自主创新

本文通过放松经理人市场的完全竞争性假定,拓展了经典职业生涯模型,藉此研究了中国制度背景下的机构持股、企业性质与企业创新的关系,并基于2004—2009年923家上市公司的数据,从R&D投入和专利申请两个维度对本文拓展模型的命题进行了实证检验。结果表明:(1)异质机构对企业创新有不同的影响,证券投资基金对企业创新有显著的负效应,这种负效应在国有企业中表现得更为明显;(2)民营企业中机构投资者持股促进了企业的创新活动,国有企业中机构投资者持股与企业创新呈显著的负相关关系;(3)机构投资者整体持股对全样本企业的专利申请有不显著的正效应,而对R&D投入则有显著的负效应。     

关于促进工业设计产业发展的财税金融政策研究

工业设计产业是生产性服务业的重要组成部分,对于中国工业转型升级,提升企业自主创新能力具有重要的意义。当前,中国发展工业设计产业还存在资金投入不足,引导社会投资、激励企业创新力度不够,多层次资本市场发育不完善等财税金融问题,为促进其发展,在结合中国国情,并对配套财税金融政策的分析的基础上,提出了政府引导工业设计产业健康发展的相关建议。     

Computing DSGE models with recursive preferences and stochastic volatility

This paper compares different solution methods for computing the equilibrium of dynamic stochastic general equilibrium (DSGE) models with recursive preferences such as those in Epstein and Zin, 1989, Epstein and Zin, 1991 and stochastic volatility. Models with these two features have recently become popular, but we know little about the best ways to implement them numerically. To fill this gap, we solve the stochastic neoclassical growth model with recursive preferences and stochastic volatility using four different approaches: second- and third-order perturbation, Chebyshev polynomials, and value function iteration. We document the performance of the methods in terms of computing time, implementation complexity, and accuracy. Our main finding is that perturbations are competitive in terms of accuracy with Chebyshev polynomials and value function iteration while being several orders of magnitude faster to run. Therefore, we conclude that perturbation methods are an attractive approach for computing this class of problems.     

中国央行票据对人民币利率和汇率的影响——来自香港地区离岸市场的证据

本文采用事件分析法量化分析中国离岸央行票据发行对在岸和离岸人民币利率、汇率和汇率预期的影响。实证结果发现:第一,离岸央行票据发行对在岸和离岸人民币利率具有明显预公告效应,且在发行事件后对在岸和离岸人民币利率下跌有短期抑制作用;第二,离岸央行票据发行对离岸人民币汇率有预公告效应和缩小人民币贬值幅度的作用,但并不能抑制在岸人民币汇率的贬值趋势;第三,离岸央行票据发行使在岸和离岸人民币汇率均出现了短暂的汇率升值预期。     

青藏高原东坡一座充满神奇魅力的城市——雅安市生态旅游景观资源研究

基于较详尽的资料,分析雅安市自然、社会、经济概况,生态旅游可持续发展的原则,生物、地文、水体和人文生态等旅游景观特色资源。结果表明:(1)3N生态旅游已成为当今世界的潮流。(2)雅安市是一个充满独特魅力的生态旅游城市。(3)雅安市具有世界罕见的生物生态旅游景观资源,非常丰富的地文、水体和人文生态旅游景观资源,各种资源分布广泛,相互交叠。(4)雅安市素有天府之肺之称,空气和水资源质量优异。(5)雅安市生态旅游景观资源具有储量丰富、资源类型众多、文化多元和区位优势良好等特色。(6)在雅安市生态旅游资源开发中应注意遵循永续利用、保护性开发、特色性、协调性、社会经济效益和环境效益相统一等原则。