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.     

Political economy of the US–Mexican tomato trade agreement

We develop a political economy model to analyse the US–Mexican tomato trade agreement by treating the minimum import price as a negotiated settlement. We incorporate the special characteristics of the US–Mexican tomato dispute, namely trade among large countries, the role of competing fresh and processed tomato lobbies, quota revenues accruing to Mexican producers, bargaining for a minimum import price rather than a tariff, and the role of the Canadian tomato market. We show the importance of the size of the lobby group's supply, the weight elected officials' place on national welfare, and the elasticities of export supply and import demand in determining the optimal price wedge. For the United States, larger fresh tomato or cherry–grape tomato supply intensifies the degree of protection awarded to US growers, while US processors work to mitigate this effect. From Mexico's perspective, larger Mexican fresh or cherry–grape output induces a push towards free trade due to the agreement's depressing effect on Mexican prices, while Mexican processors and quota revenues exacerbate the price wedge.     

浅析美联储“量化宽松”的货币政策

从2008年3月27日至2010年3月18日,美联储面对汹涌而来的金融危机打开印钞机,资产总额大幅上升,基于美联储所采取的种种举动,总结出美联储量化宽松的货币政策的特点,并且分析它所产生的影响。     

中美制造业发展百年对比研究

文章从政策环境、技术创新与应用、人才培养与引进以及市场开发四个方面分析了美国制造业在19世纪末20世纪初迅速发展、并长期保持国际领先地位的主要原因,并在此基础上对比分析了中国制造业的现状。文章认为,中国要成为真正的制造强国,必须坚持改革开放的道路、发展具有自身特色的高新技术产业和采用信息化的科学管理方式,以人为本,不断培养和吸引高端人才。同时,在政策方面要扶持核心产业、保护国内资源;在技术创新方面,要加大科研力度,提升创新质量;在人才方面,要提高教育质量,鼓励留学人才归国、吸引海外高技术人才来华发展;在市场方面,要保持国际市场,激发国内需求。     

What caused the rise of Airbnb? An examination of key macroeconomic factors

The social and economic implications of the Airbnb phenomenon have been the subject of much research. Yet, the academic literature on Airbnb is nascent. Specifically, the issue of whether major macroeconomic conditions affect the supply of Airbnb has not been investigated. To address this gap, we propose a conceptual model that explains the determinants of Airbnb supply and examine the extent to which major macroeconomic factors affect the supply of Airbnb. Specifically, we analyze the effects of hotel room rates (ADR), hotel demand, tourism demand, house prices, gross domestic product (GDP), wages and unemployment on the supply of Airbnb in 50 U.S. states. Results show that increases in hotel ADR, house prices, and GDP have contributed to an increase in the supply of Airbnb, whereas increases in unemployment rates and wages have adverse effects on Airbnb supply. Theoretical and policy implications are discussed within realms of macroeconomic theory.     

美国金融风暴的特征、原因及对策分析——马克思金融理论的现代解读

由2007年美国次贷危机引发的全球性金融风暴影响范围之广、破坏之严重百年一遇.这场风暴是由于美国虚拟经济的虚假繁荣、严重偏离实体经济和信用的恶性膨胀而引发:资本主义内部矛盾引发的经济周期性衰退和劳动人民消费能力不足是爆发危机的基础.危机已经引起国际金融市场的动荡,正在向实体经济迅速蔓延.为了保持实体经济稳定发展,国际社会要摒弃歧见,协力合作,积极采取务实而有效的政策措施防止金融危机的蔓延和扩散,维护世界金融的稳定和有效运转,恢复市场的信心和信用关系,促进实体经济健康、持续的发展.     

美国转基因生物安全行政监管特点分析

美国的转基因生物安全行政监管主要由农业部、环保署及食品药品管理局负责,部门之间分工明确,且建立了高效的协调机制和良好的公众参与制度;监管部门均设有下属专业的管理单位,强调检测评价报告以科学为依据,在管制方法上,以研究者为核心,以公司财产为担保,采用"自律"管制.这些特点的产生主要依赖于较完善的法律体系以及相当稳定的社会规范.根据我国转基因生物安全监管的现状,美国的监管体系值得我们借鉴:管理机构问的高度协调机制、专家知识的充分利用与信息共享,以及良好的公众参与制度.     

美国农产品行业协会成功的治理经验及启示

文中介绍了美国农协的形成、法律地位及构建原则,从组织架构、权力机构与决策机制、运行等几个方面对农协治理成功经验作了总结。并对我国农协发展提出了改进建议。     

美国关于科技资源共享的法律和法规

1966年美国国会通过由总统批准的《信息公开法》,开创了政府信息公开的先河,同时也是立法促进政府数据和信息资源公开、共享的首例。1976年又通过了《政府阳光法案》,由此形成了注重科技资源开放和共享的联邦政府政策体系。同时,实行分类管理科学数据,促进私营部门加入科技资源共享,解决关系国家安全、贸易秘密和隐私权的科研数据问题。     

论俄美中亚博弈中俄罗斯形象的变迁

在重塑大国地位的思想指导下,面对美国在中亚的步步紧逼,俄罗斯以强化能源外交、加强军事合作、尊重中亚各国的选择和维护中亚各国现政权的稳定为手段,积极发挥自身优势,极大地扭转了在中亚地缘政治中的颓势,与中亚诸国的关系迅速回暖。双方在政治、经济和军事安全领域的合作逐步得到加强与深化,影响一体化进程的关键问题相继得以解决,相互关系出现了罕见的积极发展势头。