A sequential model for cracking down on street markets for illicit drugs

This paper develops a sequential decision-making model for assisting law enforcement officials in allocating resources during a crackdown operation on illicit drug markets. The sequential crackdown model (SCM) considers a probabilistic framework, where the probability of incarceration of a dealer and the probability of dealing are modeled as a function of the size of a drug market, crackdown enforcement level, drug dealer's financial hardship, and other market characteristics.The model was developed and tested in consultation with enforcement officials from Philadelphia, PA and Camden, NJ. We present a detailed, step-by-step implementation scheme for updating parameters on each day of the crackdown. Parameter estimation along with examples of model usage is provided. Through these examples, we illustrate how the SCM could be helpful in understanding the response of illicit drug markets to various enforcement strategies. We further show conditions under which an alternating crackdown policy (referred to as a crackdown-backoff) or a consistent use of maximum possible enforcement would be optimal strategies for managing a drug crackdown operation. Within the context of the model and parameter estimates, we show that a much quicker and less costly collapse could be implemented if the available enforcement resources are increased. Finally, the model provides possible conditions under which a crackdown operation would be unsuccessful in eliminating a drug market.     

浅析药价调控

本文对于药品的经济学特征进行阐述,从而分析政府调控药价难的主要原因。并总结药价调控方法,提出可进一步加强的措施为政府有效的调控药品价格,防止药价失控提供借鉴意义。     

我国零售药店实行药品分类管理的影响因素分析

药品分类管理制度的实行直接关系到药品资源的有效利用,直接关系到确保人民用药安全和我国人口素质。为全面了解和把握我国零售药店实行药品分类管理的现状和影响因素,文章对全国零售药店进行随机抽样的调查问卷进行了统计分析。结果显示,药店所在地经济状况、地理位置、有无执业药师或药学相关人员等是零售药店实行药品分类管理的影响因素。在此基础上文章提出了强化意识、重点引导与扶持、人才培养与加强监管等相应对策建议。     

Economic evaluation of anti-epileptic drug therapies with specific focus on teratogenic outcomes

Abstract

Background:

Anti-epileptic drugs are known to be teratogenic, yet many women do need to continue the anti-epileptic drug use during pregnancy.

Objectives:

To perform an economic evaluation of the anti-epileptic drug choice in young women who potentially wish to become pregnant. In particular, to estimate the impact of teratogenicity on the costs per quality adjusted life year (QALY).

Methods:

A decision-tree model is used to calculate the costs per QALY, taking into account the malformation risk in offspring due to the exposure to carbamazepine, lamotrigine or valproic acid, based on the European birth cohort of 2007. Probabilistic sensitivity analyses were performed using Monte Carlo simulation.

Results:

Valproic acid is dominated by carbamazepine after rank ordering on costs. The incremental cost-effectiveness of lamotrigine vs carbamazepine was estimated at €175,534 per QALY. Although valproic acid was dominated by carbamazepine in terms of costs and related effects, it is clinically relevant to compare lamotrigine with valproic acid. In particular, treatment options are dependent on several individual and clinical characteristics and these agents are therefore not always considered as interchangeable for all specified populations. The incremental cost-effectiveness for lamotrigine vs valproic acid was estimated at €13,370 per QALY. With assuming a willingness to pay threshold of €50,000 per QALY, results from the probabilistic analysis resulted in an acceptance level for lamotrigine vs carbamazepine and lamotrigine vs valproic acid of 4% and 99%, respectively.

Conclusion:

Based on epidemiological data it is advised to whenever possible avoid valproic acid during pregnancy. Both carbamazepine and lamotrigine are estimated to be cost-effective treatment options vs valproic acid if focused on teratogenicity.     

非处方药的网络DTC营销

本文旨在为非处方药网络DTC营销策略提出建议。通过文献收集和资料分析后,本文初步得到以下结论:(1)全球OTC市场中,我国以11%的增长率成为增长最快的地区;(2)2006年我国网络营销市场规模突破60亿;(3)超过80%的城市居民对一些可自我识别的疾病或某些慢性疾病进行自我药疗;(4)截至2007年1月,我国网民总数为13700万人。基于此,本文认为电子邮件营销,网络DTC广告和DTC网站这三种网络DTC营销方式的发展前景看好。     

突发事件中药品应急物流体系构建分析

通过对我国药品应急物流的特点和存在的问题进行分析,结合我国药品应急物流的现状,从应急物流的流程和药品应急物流的特点出发构建我国药品应急物流体系,并提出保障机制。     

The 21st Century Cures Act: pharmacoeconomic boon or bane?

Barriers to entry in healthcare markets constitute one of the overriding concerns of health economists. The recent enactment of the 21st Century Cures Act in the United States reduces statutory entry barriers to the discovery, development, testing, and licensing of drugs and medical devices. Drug and device makers also see the burdensome and time-consuming requirements of the Food and Drug Administration?s approval process as key barriers to lowering the costs of their products, considering it takes a decade of research amounting to $1 billion just to bring a single drug to the market. Along with novel opportunities for medical product innovation and faster treatment of diseases, the expedited approval process carries with it contentious challenges involving the safety, efficacy and value of drugs and devices. The ensuing trade-offs and unintended consequences of such a regulatory game-changer bring to the fore one of the most enduring debates between medicine and economics: Whether – or to what extent – cost and efficiency factors affect clinical inquiry into possible solutions to human illnesses. The practical and theoretical contributions of pharmacoeconomics should enlighten contemporary and future issues and discussions surrounding the implementation of this landmark legislation. After all, despite its undeniably good intent and far-reaching significance, no law can ever be perfect.     

5省市二线抗结核药品供应保障现状调研及政策建议

通过对中国5个省市地区二线抗结核药品的供应保障情况进行调研,对关键知情人进行焦点小组访谈,分析供应保障问题,为相关政策制定提供参考.调研发现,我国三级结核病防治网络建设基本完善,各地耐药患者疗程用药方案基本配齐.部分药品存在采购价格过低、采购量不足、供应效率低等问题.相关方存在缺乏国家层级政策统筹、医保实际报销水平较低...     

论我国药品费用快速增长的原因与控制

本文将我国现阶段药品生产领域的基本状况、药品流通领域的基本状况、药品价格管理模式,以及基本药物制度建设进展情况作为我国药品费用的现实基础进行研究,发现并分析其中存在的问题,为控制药品费用提供方向性的参考。