疫苗药物经济学评价中有关成本和效果的测算方法探讨

与一般药物相比,疫苗具有外部性、保护率和作用时间不确定等特性,因此疫苗的经济学评价应当有其特殊性.本文回顾了近十几年世界有关疫苗经济学评价的研究报道,综合概括了疫苗经济学评价方法的最新进展.本文讨论的主要内容包括间接成本法、边际成本法、选择合适流行病学模型测量健康结果、成本和效果的贴现等.     

Pharmacoeconomic analysis of paricalcitol and calcitriol in the treatment of secondary hyperparathyroidism in haemodialysis: impact of hospitalisations and survival

Summary

The objective of this study was to evaluate the cost effectiveness of paricalcitol injection compared with calcitriol injection when used to reduce parathyroid hormone levels in patients undergoing haemodialysis. A decision tree was developed to model the 1-year costs and outcomes of therapy for secondary hyperparathyroidism from a US government payer's perspective (2005 US$). Probabilities of hospitalisations and survival with paricalcitol and calcitriol were obtained from published observational studies.

When only drug costs and survival were considered, the incremental cost effectiveness of paricalcitol over calcitriol was $9,900 per life saved. When utilities were included, the incremental cost-effectiveness ratio for paricalcitol compared with calcitriol was $13,200 per quality-adjusted life year. When both drug and hospitalisation costs were included in a cost analysis, paricalcitol treatment was cost saving compared with calcitriol, and when hospitalisation costs were included in both the cost-effectiveness analysis and cost-utility analysis paricalcitol demonstrated first-order dominance, cost savings and cost effectiveness.

This decision analysis demonstrated that paricalcitol injection is both cost effective and cost saving compared with calcitriol injection.     

How Does Executive Strategic Human Resource Management Link to Organizational Ambidexterity? An Empirical Examination of Manufacturing Firms in China

Despite a plethora of studies that demonstrate the positive impact of strategic human resource management on firm performance, existing knowledge of the processes through which such gains can be achieved remains limited. This study aims to extend our knowledge by investigating the mechanism through which a teamwork‐oriented executive strategic human resource management system impacts organizational ambidexterity. Specifically, by integrating the resource‐based view and information‐processing theory, we examine the mediating role of top management team effectiveness and the moderating role of knowledge–sharing intensity from middle managers to top management teams. Drawing on a multiple‐source and multiple‐respondent survey from 144 manufacturing firms in China, we show that top management team effectiveness partially mediates the effect of the executive strategic human resource management system on organizational ambidexterity. Moreover, knowledge‐sharing intensity from middle managers to top management teams strengthens the effect of the executive strategic human resource management system on organizational ambidexterity. © 2016 Wiley Periodicals, Inc.     

传记式资料测量：人力资源甄选的一种方法

本文主要对传记式资料测量的理论基础和传记式资料问卷的开发程序进行了系统描述，并分析了该方法在甄选中的实施效果。     

经理人特性影响到了基金绩效吗?——来自中国股市的经验实证

依据可获取的描述基金经理人特征变量的统计信息,以沪深两市2011年746只基金作为研究样本,通过逻辑回归检验了基金绩效与基金经理人特征之间的关系。与大多数研究结果不同的是,实证结论表明,年龄、学历、其他教育背景、性别、工作年限、专业背景对基金绩效均没有显著的影响,而基金经理管理的基金数对绩效有显著的正向影响。同时对于投资于股票市场的基金,管理人单独决策的效率产生的收益超过团队协作带来的收益,从而使得基金管理的人数对绩效产生了冲击。另外,替换基金经理对基金的绩效可能有负的影响。     

Outcomes of tumor necrosis factor inhibitor cycling versus switching to a disease-modifying anti-rheumatic drug with a new mechanism of action among patients with rheumatoid arthritis

Objectives: To examine treatment patterns, treatment effectiveness, and treatment costs for 1 year after patients with rheumatoid arthritis switched from a tumor necrosis factor inhibitor (TNFi) (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab), either cycling to another TNFi (“TNFi cyclers”) or switching to a new mechanism of action (abatacept, tocilizumab, or tofacitinib) (“new MOA switchers”).

Methods: This retrospective cohort study used administrative claims data for a national insurer. Treatment persistence (without switching again, restarting, or discontinuing), treatment effectiveness (defined below), and costs were assessed for the 12-month post-switch period. Patients were “effectively treated” if they satisfied all six criteria for a treatment effectiveness algorithm (high adherence, no dose increase, no new conventional synthetic disease-modifying anti-rheumatic drug, no subsequent switch in therapy, no new/increased oral glucocorticoids, and <2 glucocorticoid injections). Multivariable logistic models were used to adjust for baseline factors.

Results: The database included 581 new MOA switchers and 935 TNFi cyclers. New MOA switchers were 39% more likely than TNFi cyclers to persist after the switch (odds ratio [OR]?=?1.39; 95% confidence interval [CI]?=?1.12–1.74; p?=?.003) and 36% less likely to switch therapy again (OR?=?0.64; 95% CI?=?0.51–0.81; p?p?=?.006). New MOA switchers had 16% lower drug costs than TNFi cyclers (cost ratio?=?0.84; 95% CI?=?0.79–0.88; p?p?Limitations: Claims payments may not reflect rebates or other cost offsets. Medical and pharmacy claims do not include clinical end-points or reasons that lead to new MOA switching vs TNFi cycling.

Conclusions: These results support switching to a new MOA after a patient fails treatment with a TNFi, which is consistent with recent guidelines for the pharmacologic management of established rheumatoid arthritis.     

A review of research on personality in teams: Accounting for pathways spanning levels of theory and analysis

Over the last half century there has been a great deal of interest in the role of personality in teams. In this article we review the theoretical and empirical research on this topic to summarize what we have learned and also to provide a foundation for future research necessary for application of this knowledge to human resource management decisions. We describe research that emphasizes both team- and individual-levels of analysis and theory, and we discuss recent efforts that attempt to bridge these two levels. We conclude by identifying several issues that should take precedence in research in order to advance our understanding of the role of personality in teams.     

甩挂运输经济效益的定量计算

从实现甩挂运输经济效益的概念理解、前提条件、定量计算和辩证思考四个方面对其进行探讨,其中重点是通过将甩挂运输与普通的公路运输组织形式进行比较来定量计算其经济效益,即甩挂运输所创造的相对高于普通公路运输的经济效益。具体将甩挂运输的经济效益分作车辆购置与运营固定成本效益、车辆运用效益、装卸转运与包装成本效益、运输站场成本效益、人力成本效益、其他效益六个方面,参照了集装化运输的经济效益计算方法,通过与普通公路运输经济效益作差算得。通过将甩挂运输的经济效益内容分类并进行定量计算,以达到对其更具体深入的认识,为进一步提高经济效益提供更有针对性的参考。     

语文课堂教学任务的反思与重构——西部地区中学语文课堂教学低效现象研究

课堂教学任务是为达到课堂教学目标对课堂教学活动内容所做的系统性规定与要求。长期以来语文课堂教学存在的"任务错位"现象,是导致语文课堂教学效率低下的主要原因。要改变这种状况,就要科学认识语文课堂教学任务的构成要素及其关系,重构语文课堂教学任务要素系统。语文课堂教学任务要素包括境、情、知、思、读、写、听、说、悟。这九种任务要素又可以分为三个层次。其中"境、情、知、思"是基础层任务要素,"读、写、听、说"是操作层任务要素,"悟"是发展层任务要素。     

A short-term cost-effectiveness study comparing robot-assisted laparoscopic and open retropubic radical prostatectomy

Abstract

Objective:

To evaluate cost effectiveness and cost utility comparing robot-assisted laparoscopic prostatectomy (RALP) versus retropubic radical prostatectomy (RRP).

Methods:

In a retrospective cohort study a total of 231 men between the age of 50 and 69 years and with clinically localised prostate cancer underwent radical prostatectomy (RP) at the Department of Urology, Aarhus University Hospital, Skejby from 1 January 2004 to 31 December 2007, were included.

The RALP and RRP patients were matched 1:2 on the basis of age and the D’Amico Risk Classification of Prostate Cancer; 77 RALP and 154 RRP.

An economic evaluation was made to estimate direct costs of the first postoperative year and an incremental cost-effectiveness ratio (ICER) per successful surgical treatment and per quality-adjusted life-year (QALY). A successful RP was defined as: no residual cancer (PSA <0.2?ng/ml, preserved urinary continence and erectile function. A one-way sensitivity analysis was made to investigate the impact of changing one variable at a time.

Results:

The ICER per extra successful treatment was €64,343 using RALP. For indirect costs, the ICER per extra successful treatment was €13,514 using RALP. The difference in effectiveness between RALP and RRP procedures was 7% in favour of RALP. In the present study no QALY was gained 1 year after RALP, however this result is uncertain due to a high degree of missing data. The sensitivity analysis did not change the results noticeably.

Limitations:

The study was limited by the design resulting in a low percentage of information on the effect of medication for erectile dysfunction and only short-term quality of life was measured at 1 year postoperatively.

Conclusion:

RALP was more effective and more costly. A way to improve the cost effectiveness may be to perform RALP at fewer high volume urology centres and utilise the full potential of each robot.