Comparison of costs and outcomes of dapagliflozin with other glucose-lowering therapy classes added to metformin using a short-term cost-effectiveness model in the US setting

Objective: To compare 1-year costs and benefits of dapagliflozin (DAPA), a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, with those of other treatments for type 2 diabetes (T2D), such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), sulfonylureas (SUs), thiazolidinediones (TZDs), and dipeptidyl peptidase-4 inhibitors (DPP-4i), all combined with metformin.

Methods: A short-term decision-analytic model with a 1-year time horizon was developed from a payer’s perspective in the United States setting. Costs and benefits associated with four clinical end-points (glycated hemoglobin [A1C], body weight, systolic blood pressure [SBP], and risk of hypoglycemia) were evaluated in the analysis. The impact of DAPA and other glucose-lowering therapy classes on these clinical end-points was estimated from a network meta-analysis (NMA). Data for costs and quality-adjusted life-years (QALYs) associated with a per-unit change in these clinical end-points were taken from published literature. Drug prices were taken from an annual wholesale price list. All costs were inflation-adjusted to December 2016 costs using the medical care component of the consumer price index. Total costs (both medical and drug costs), total QALYs, and incremental cost-effectiveness ratios (ICERs) were estimated. Sensitivity analyses (SA) were performed to explore uncertainty in the inputs. To assess face validity, results from the short-term model were compared with long-term models published for these drugs.

Results: The total annual medical cost for DAPA was less than that for GLP-1RA ($186 less), DPP-4i ($1,142 less), SU ($2,474 less), and TZD ($1,640 less). Treatment with DAPA resulted in an average QALY gain of 0.0107, 0.0587, 0.1137, and 0.0715 per treated patient when compared with GLP-1RA, DPP-4i, SU, and TZD, respectively. ICERs for DAPA vs SU and TZD were $19,005 and $25,835, respectively. DAPA was a cost-saving option when compared with GLP-1RAs and DPP-4is. Among all four clinical end-points, change in weight had the greatest impact on total annual costs and ICERS. Sensitivity analysis showed that results were robust, and results from the short-term model were found to be similar to those of published long-term models.

Conclusion: This analysis showed that DAPA was cost-saving compared with GLP-1RA and DPP-4i, and cost-effective compared with SU and TZD in the US setting over 1 year. Furthermore, the results suggest that, among the four composite clinical end-points, change in weight and SBP had an impact on cost-effectiveness results.     

论名誉权保护视野之下的公众人物

随着大众传媒的快速发展,公众人物进入了公众视野。公众人物具备较高的社会知名度和社会影响力,并具有近用媒介的权利。公众人物在名誉权等人格权方面具有特殊性,需要准确界定公众人物的内涵和外延。公众人物只包括自愿性公众人物,而不包括非自愿性公众人物。公众人物名誉权解决的是私人之间的权利冲突,而官员的名誉权涉及的是公权利。公众人物具有私法属性,而官员则是具有公法属性。在我国现行的新闻体制和机制下,对官员名誉权实现严格保护,而对公众人物名誉权则是差别保护。官员名誉权问题的解决是通过行政权力干预,而公众人物名誉权问题的解决基本是诉诸于司法程序。     

Do foreign institutions outperform in the Taiwan options market?

This paper investigates comparative information advantage for foreign and domestic institutions on Taiwan's index options by examining the intraday information content of limit orders placed by foreign and domestic institutions, respectively. The height and length of limit order book provided by either foreign or domestic institutions exhibit predictive power on subsequent price changes in options, especially for put options. The information advantage is more significant for foreign institutions with respect to both call and put options. On the other hand, the results are mixed when order imbalance is used as the proxy of information on limit order book. Foreign institutions outperform domestic institutions for put options, not call options. Order imbalance, ignoring differential aggressiveness of limit orders, fails to capture comparative information advantage for foreign institutions. The superior information advantage for foreign institutions persists during the financial tsunami of 2008–2009 and periods of substantial price changes.     

机械式现场光纤快速器结构设计

本文主要描述机械式现场光纤连接器的设计原理、设计结构、产品特点以及该产品主要应用场合。     

VMS-type Cu-Pb-Zn矿床的地质特点

火山成因块状硫化物矿床是指产于海相火山岩系中,与海相火山-侵入活动有关的,在海底环境下由火山喷气(热液)作用和喷气-沉积作用形成的块状或次块状的硫化物矿床。本文从成矿地质背景、形成时代、矿床地质特征等方面总结了VMS-type CuPb-Zn型矿床的特点。     

A theory of iterative choice in lists

In a list, alternatives appear according to an order and the decision maker follows this order to evaluate alternatives. He records the first alternative as the initial survivor and then at every stage, he compares the current survivor with the next alternative in the list to determine whether the next alternative replaces that to become the new survivor. When the entire list is exhausted in this manner, the agent chooses the survivor in the last stage. We call this procedure “iterative” and provide an axiomatic characterization for it when the order in every list is observable. Then, we also study characterizations of the iterative procedure that is prone to the well-known primacy and recency effects. Finally, we analyze situations where the order of alternatives is unknown to an outside observer and provide a characterization result that enables such an outsider with limited information to understand whether the decision maker can indeed be an iterative list chooser for some order.     

“东三省一分”的前尘往事

1929年,张学良主政东北时,为配合国民党政府推行新货币政策,铸行了新的＂一分＂辅币。＂东三省一分＂制行时间很短,随着日军的侵略很快沦为战争硝烟的牺牲品。但因其图案精美、制作精良,且带有不可磨灭的历史印记,具有很大的收藏价值。     

Financing behaviour of Portuguese SMEs in hotel industry

In this study, using panel data models, we analyze whether the capital structure decisions of SMEs in the hotel sector follow the predictions of Pecking Order and Trade-Off theories. The results suggest that these theories are not mutually exclusive in explaining the capital structure decisions of SME hotels. The results obtained indicate that these firms follow a hierarchical order in their selection of financing sources, corroborating the assumptions of theory. The results also show that SME hotels adjust the level of actual debt towards optimal debt ratio as well as size, asset tangibility, growth opportunities, non-debt tax shields, and risk influence debt. These results suggest that the financing behaviour of SME hotels is in agreement with the predictions of theory. Therefore, Pecking Order and Trade-Off theories contribute to explaining the financing behaviour of SMEs in the hotel sector.     

Has the global financial crisis produced a New World Order?

Described by Ben Bernanke, Chairman of the Board of Governors of the Federal Reserve System, as the worst financial crisis in global history, the economic impact of the global financial crisis would have been much worse had it not been for Asia (excluding Japan). In broad terms, the crisis has accelerated the secular emergence of Asia, whereas the US recovery is weak by historical standards and problems in Europe continue. What accounts for this two-tier pattern of world growth? Does this juxtaposition signal a permanent re-ordering of world business - in other words, a New World Order?     

关于完善林权法律制度的思考

通过考察林权一词在党和政府文件中的使用情况,可以看出林权的内容随着社会经济的发展在不断丰富,但是林权的内涵和外延却始终没有一个准确的法律界定,这种状况妨碍了林权的流转,影响了林业改革的深入,通过对现行法律制度中有关森林、林木、林地所有权和使用权、林地承包经营权等制度设定方面问题的分析,表明当前亟需通过法律明确林权权利性质及其内容、完善林权权利的登记和保护制度,保障林业经济的持续健康发展。