中国药品价格和数量指数及偏倚的实证分析

本文利用我国三个城市样本医院的招标采购数据,测算了2002～2005年抗生素类和循环系统药品价格和数量水平的变化趋势,并检验了Gerschenkron效应.结果显示,我国城市间的医疗模式具有较大差异,北京市使用品种比较集中,佛山市比较分散;抗生素类药品价格下降,循环系统类药品价格上升;4年间药品数量上升了许多倍.尤其是...     

The war against drug producers

This paper develops a model of a war against illegal drug producers. This war occurs on two fronts. First, to prevent the cultivation of crops the state engages the drug producers in conflict over the control of land. Second, to impede further the production and exportation of drugs the state attempts to eradicate crops and to interdict drug shipments. The model includes an interested outsider who uses both a stick and a carrot to strengthen the resolve of the state in its war against drug producers. We use numerical calibrations of the model to evaluate the effectiveness and efficiency of Plan Colombia. The authors wish to thank an anonymous referee, Michelle Garfinkel, Jean Hindriks, Carlos Esteban Posada, and Marc St-Pierre for helpful comments and suggestions, as well as seminar participants at Brown, Yale, the CEPR conference on Crime and Conflicts, Marseilles, October 2004, LACEA, San José, November 2004, the AEA meetings, Philadelphia, January 2005, the ESWC, London, August 2005, and Banco de la República. Herschel Grossman died on October 9, 2004 in Marseilles during a conference where we were presenting this paper.     

Treatment patterns and resource utilization and costs among patients with pulmonary arterial hypertension in the United States

Abstract

Objective:

To explore treatment patterns and resource utilization and cost for subjects with pulmonary arterial hypertension (PAH).

Research design:

Retrospective claims database analysis of 706 patients with PAH enrolled in a large, geographically diverse US managed-care organization.

Results:

In the final sample of PAH patients treated with bosentan (n?=?251) or sildenafil (n?=?455), average age was 57 years, 86% of patients were commercially insured, and 52% of patients were male. Gender distribution varied significantly across subgroups, with a lower proportion of males in the bosentan (30%) subgroup compared with the sildenafil group (64%) (p?<?0.001). Average baseline Charlson comorbidity score was 2.4. Average numbers of fills per month were 0.8 and 0.4 for bosentan and sildenafil patients, respectively (p?<?0.001). Over 80% of patients received only one PAH treatment in the first 90 days following the index date, with 28% of bosentan and 13% of sildenafil patients receiving combination therapy (p?<?0.001). Over one-third of bosentan patients and one-quarter of sildenafil patients experienced a dose increase in the follow-up period (p?=?0.009). Sixteen percent of sildenafil patients experienced a dose decrease in the follow-up period, while a smaller proportion of patients receiving bosentan (4%) experienced a dose decrease (p?<?0.001). On average, number of PAH-related per subject per month (PSPM) inpatient stays and emergency department visits and PSPM length of inpatient stays were statistically similar between the subgroups. PAH-related PSPM healthcare costs were high for both subgroups, with average monthly costs of $5,332 and $3,632 among bosentan and sildenafil patients, respectively (p?=?0.003). Differences in total costs were driven mainly by differences in pharmacy expenditures.

Conclusions:

Of the oral agents approved for treating PAH at the time of this study, sildenafil was most commonly prescribed as index therapy and was also associated with the lowest costs, largely due to significantly lower pharmacy costs. This study is characterized by limitations inherent to claims database analyses, such as the potential for coding errors and lack of information on whether a drug was taken as prescribed. Furthermore, PAH severity (WHO functional class) was not assessed.     

我国冷藏药品冷链物流的现状及问题研究

文章通过对我国冷藏药品冷链物流的现状分析,提出了目前我国冷藏药品冷链物流存在的问题,同时借鉴发达国家冷藏药品冷链物流的经验,给出了发展我国冷藏药品冷链物流的对策,为加快我国冷藏药品冷链物流的发展提供参考。     

Modelling a dynamic market potential: A class of automata networks for diffusion of innovations

Innovation diffusion processes are generally described at aggregate level with models like the Bass Model (BM) and the Generalized Bass Model (GBM). However, the recognized importance of communication channels between agents has recently suggested the use of agent-based models, like Cellular Automata. We argue that an adoption or purchase process is nested in a communication network that evolves dynamically and indirectly generates a latent non-constant market potential affecting the adoption phase.Using Cellular Automata we propose a two-stage model of an innovation diffusion process. First we describe a communication network, an Automata Network, necessary for the “awareness” of an innovation. Then, we model a nested process depicting the proper purchase dynamics. Through a mean field approximation we propose a continuous representation of the discrete time equations derived by our nested two-stage model. This constitutes a special non-autonomous Riccati equation, not yet described in well-known international catalogues. The main results refer to the closed form solution that includes a general dynamic market potential and to the corresponding statistical analysis for identification and inference. We discuss an application to the diffusion of a new pharmaceutical drug.     

我国在合理用药中的问题与对策

目的探讨促进合理用药的有效措施,为药品使用管理提供参考。方法结合实际,通过对影响因素及原因进行具体分析,提出有针对性的建议。结果与结论我国药品使用环节的制度尚不完善,建议通过制度完善限制医生处方权,提高药品自身各方面水平,提高社会对药品合理使用的认识,以促进合理用药。     

反义核酸技术及其应用

反义核酸作为一种新的抗病毒、抗肿瘤药物,它的应用受到越来越多的重视,但反义核酸技术的研究也面临一些挑战。相信伴随这些问题的解决,反义药物能够被广泛应用,给疾病的治疗带来益处。文章对反义核酸、反义药物及反义核酸技术的应用进行了综述。     

药价昂贵:究竟谁惹的祸

药品价格昂贵、药费负担沉重已成为制约和谐社会构建的严重社会问题，本文从表里两个层面分析了造成药价昂贵的原因和运行机理，指出药价昂贵的表层原因主要是药品收入加成制度滞后、医德医风滑坡、药品生产流通秩序混乱、政府价格管理失控和虚假药品广告泛滥，而深层原因主要体现为国家卫生资源总体匮乏、结构布局失衡、管理部门角色缺失和社会医疗保障体系的残缺不全。     

渔药对水产品质量安全的影响

渔药的不规范使用和残留已经成为影响水产品质量安全的重要问题。论文通过对渔药使用现状、存在的主要问题进行梳理,分析了药物残留对水产品质量安全造成的危害,并对此提出了对策和建议。