Economic modeling to evaluate the impact of chronic myeloid leukemia therapy management on the oncology care model in the US

Abstract

Objective: To develop an economic model to evaluate changes in healthcare costs driven by restricting usage of branded tyrosine kinase inhibitors (TKIs) through substitution with generic imatinib among chronic myeloid leukemia (CML) patients in a typical Oncology Care Model (OCM) practice, and examine the impact on Performance-Based Payment (PBP) eligibility.

Methods: An Excel-based economic model of an OCM practice with 1,000 cancer patients during a 6-month episode of care was developed. Cancer types and proportions of patients treated in the practice were estimated from an OCM report. All-cause healthcare costs were obtained from published literature. It was assumed that if a practice restricts usage of branded TKIs for newly-diagnosed CML patients, 80% of the market share of branded imatinib and 50% of the market shares of 2^nd-gen TKIs would shift to generic imatinib. Among established TKI-treated patients, it was assumed that 80% of the market share of branded imatinib and no patients treated with 2^nd-gen TKIs would shift to the generic.

Results: Four CML patients were estimated for a 1,000-cancer patient OCM practice with a total baseline healthcare cost of $51,345,812 during a 6-month episode. If the practice restricts usage of branded TKIs, the shift from 2^nd-gen TKIs to generic imatinib would reduce costs by $12,970, while shifting from branded to generic imatinib lowers costs by $25,250 during a 6-month episode. Minimum reductions of $3,013,832 in a one-sided risk model and $2,372,010 in a two-sided risk model are required for PBP eligibility; the shift from 2^nd-gen TKIs to generic imatinib would account for 0.4% and 0.5% of the savings required for a PBP, respectively.

Conclusions: This analysis indicates that the potential cost reduction associated with restricting branded TKI usage among CML patients in an OCM setting will represent only a small proportion of the cost reduction needed for PBP eligibility.     

AX与面粉品之间的关系

本采用不同品种的小麦为原料,首先通过测定小麦籽粒和面粉的品质特性及其阿拉伯木聚糖(AX)含量,对AX含量与小麦粉品质间的关系进行探讨。主要研究结果如下:(1)对小麦品质指标的测定,结果显示不同品种的小麦籽粒间存在较大的差异。面粉中AX含量与蛋白(r=0.27)、麸星含量(r=-0.16)存在存在一定的正相关,而AX含量与白度和降落数值存在微弱的负相关,面粉中AX中含量与面粉的吸水率、面团的形成时间、面团的稳定时间和弱化度呈弱相关性,相关系数分别是r=-0.34、r=0.27和r=-0.09;(2)不同的面粉中AX含量与峰值粘度呈显著负相关,与最低粘度、最终粘度呈弱负相关,当面粉中AX含量增加时,峰值粘度、最低粘度、最终粘度都会降低;峰值粘度与最低粘度、最终粘度呈显著正相关。     

凯氏定氮法测定粮食蛋白质含量方法研究

对凯氏定氮法测定粮食蛋白质含量的3个国家标准检验方法进行了对比,研究了蛋白质测定的消化、蒸馏、结果计算等主要操作步骤对测定结果的影响,并对蛋白质含量的国家标准检验方法及质量控制回收率测定提出了建议,对保证蛋白质检测结果的真实可靠具有重要意义.     

Investment responses to Japanese tax reforms: A cross-industry comparison

This paper examines the investment responses to past Japanese tax reforms for individual industries. To identify the tax effect, this paper estimates investment functions by using a covariate of the change in tax-adjusted q caused by tax reform. This method alleviates the measurement error problem and enables the derivation of estimates indicating the valid adjustment cost of investment. Moreover, the findings suggest that firms’ investment responded significantly to tax reforms in the 1980s in general. Also, investments of only a few industries responded to those in the late 1990s, implying that the manner of investment response slightly differs among industries.     

分布式地矿点源信息系统的构件化体系结构设计

应用数据集市技术、分布式构件技术以及Java技术,本文提出了一种以Internet为运行平台的新的分布式地矿点源信息系统设计方案。文中从数据库体系结构和应用系统的体系结构方面,探讨其构件化体系结构设计的原理与方法。实践结果表明,这种新的设计方案可以使该系统的新一代产品以更低的代价发挥更大的效益。     

Land administration “best practice” providing the infrastructure for land policy implementation

Land administration systems, and particularly their core cadastral components, are an important infrastructure which facilitates the implementation of land use policies. While most land administration systems traditionally have a primary objective of supporting the operation of land markets, they are increasingly evolving into a broader land information infrastructure which supports economic development, environmental management and social stability in both developed and developing countries. While a great deal of attention is given to land use policies worldwide concerned with such areas as forest management, coastal zone management, environmental sustainability and managing the urban environment, less attention is given to the infrastructures which facilitate the implementation of the associated policies and programmes. Importantly, all these activities rely on some form of land administration infrastructure which permits the complex range of rights, restrictions and responsibilities in land to be identified, mapped and managed as a basis for policy formulation and implementation. As a result, there is an increasing interest in the concept of land administration infrastructures and their core cadastres, in the principles and policies concerned with establishing such infrastructures and in “best practices”. In addressing this need, this paper attempts to explain the evolving concept of land administration infrastructures, the concept of “best practice” and the concept of a land administration “tool box” of principles, policies, laws and technologies which are useful in reforming or re-engineering land administration systems in support of a broader land policy agenda.     

陕西省优秀竞技健美操运动员冬训期机能监控

本文通过对陕西省优秀竞技健美操运动员冬训期Hb、CK、BUN、T的跟踪监控,试图分析与研究其训练特点和相关生理生化指标的变化规律。研究结果表明其基本上适应训练计划负荷,训练安排比较合理科学,机能监控发挥了非常重要的作用。     

Loïc Wacquant's ‘Ghetto’ and Ethnic Minority Segregation in the UK: The Neglected Case of Gypsy‐Travellers

This article utilizes Loïc Wacquant's concept of the ghetto as an analytical tool in understanding the marginal and ambivalent position of Gypsy‐Traveller populations resident on sites (or camps) in Britain. The article argues that the fruitful work of quantitative urban scholars on ethnic segregation in the UK has neglected Gypsy‐Travellers. It suggests that the theoretical concept of the ghetto can elucidate the ways in which the spatial marginality of sites serves as a weapon of ‘confinement and control’ for the dominant, and an ‘integrative and protective device’ for the stigmatized Gypsy‐Traveller population. Drawing on qualitative empirical data, key characteristics in Wacquant's definition of the ghetto are shown to hold true for Gypsy‐Traveller sites; these include ethnic homogeneity, spatial confinement, shared cultural identity, mutual distancing and a retreat into the private sphere of the family. This comparison also reveals key differences in terms of economic function, parallel institutionalism and the relationship with the state. The article points to the potential offered by Wacquant's theory and suggests that the dismissal of the ghetto concept within the UK ignores its power as a tool of comparison. The article suggests that qualitative and theoretical approaches should seek to complement the work of quantitative social scientists through focusing on everyday social relations and encounters between ethnic minority groups and ‘host’ populations — both within and outwith residential boundaries. It also questions the urban‐centred focus of debates on ethnic segregation.     

Tourism and rural settlements Nepal’s Annapurna region

Functional and humanist perspectives relevant to counterurbanization studies are applied to examine the processes of growth and development of rural settlements affected by tourism. Based on a survey of tourism lodges located in several settlements in the Annapurna region of Nepal, this paper analyzes tourism-induced growth in such accommodations and its implications on changing characteristics. Results suggest the emergence of a hierarchical structure of rural settlements with core and peripheral traits. A normative classification of induced patterns defined by their development stage, size, and function is proposed. Historical, social, and economic influences on the transformation of rural settlements are discussed.