Economic evaluation of pharmacological treatments for overactive bladder from the perspective of the UK National Health Service

Abstract

Objective:

To evaluate the costs and outcomes associated with different sequences of oral anti-muscarinic agents and the selective β₃-adrenoceptor agonist, mirabegron, for the treatment of overactive bladder (OAB).     

Productivity cost model of the treatment of rheumatoid arthritis with abatacept

Background: The cost of the biological drug abatacept may be partly offset by reductions in the cost of productivity losses due to employee absences and reduced effectiveness at work because of rheumatoid arthritis (RA).

Methods: This was a 1-year productivity cost model based on epidemiologic and economic data. The setting was private industry in the US and the primary outcome measure was the difference in the costs of lost productivity and drug treatment with and without abatacept (‘cost difference’).

Results: The lost productivity cost of RA for a firm of 10,000 was $1.69 million, largely due to the cost of RA-related absenteeism ($1.55 million) rather than to worker displacement ($0.12 million) or care-giving for spouses with RA ($0.02 million). In the base case analysis (excluding presenteeism), 37% of the acquisition cost of abatacept was offset by reductions in the cost of RA-related productivity losses. In some industry groups (Utilities and Finance), and in models that included presenteeism, reductions in lost productivity costs exceeded the abatacept cost.

Conclusions: Much of the acquisition cost of abatacept may be offset by reductions in the cost of productivity losses due to RA. Abatacept treatment could be cost saving in some industry groups.     

Aggregate trading behaviour of technical models and the yen/dollar exchange rate 1976–2007

The study analyzes the interaction between the trading behaviour of 1024 moving average and momentum models and the fluctuations of the yen/dollar exchange rate. I show first that these models would have exploited exchange rate trends quite profitably between 1976 and 2007. I then show that the aggregate transactions and positions of technical models exert an excess demand pressure on currency markets since they are mostly on the same side of the market. When technical models produce trading signals almost all of them are either buying or selling, when they maintain open positions they are either long or short. A strong interaction prevails between exchange rate movements and the transactions triggered by technical models. An initial rise of the exchange rate due to news, e.g., is systematically lengthened through a sequence of technical buy signals.     

异质交易者视角下的人民币外汇市场微观结构模型研究

本文基于异质交易者视角构建了人民币外汇市场微观结构模型以考察市场中基本面交易者和技术交易者的动态调整机制和人民币汇率的运动规律。通过对模型的求解,本文得到不同情况下汇率收敛于基本面汇率的市场微观结构条件和运动轨迹方程。当汇率基本面受到重大的外部冲击时,技术交易者、基本面交易者和做市商等参与者的相互作用会最终导致人民币汇率过度反应,汇率的运动轨迹会不断偏离汇率的基本面价值。而当外部冲击的大小在一定范围内时,人民币汇率会温和的最终趋向汇率的基本面价值。研究结论在一定程度上解释了汇率超调之谜和非线性之谜产生的机制,为促进人民币外汇市场稳健发展提供了政策启示。     

张家界旅行社人员流动效益分析

张家界是以旅游为主导的专业化旅游城市。伴随着旅游经济的发展,旅行社人力资源管理矛盾日益突出,旅行社人员流动频繁的情况尤严重。控制旅行社人员流动,根本目的在于控制过高的人员流动率,应留住核心人才,优化企业人才结构,提高企业与员工的双向信任度,从而增强企业凝聚力,创造真正的企业文化,最终提高企业效益。     

Impact of novel agents on patient-relevant outcomes in patients with previously untreated chronic lymphocytic leukemia who are not eligible for fludarabine-based therapy

Background: Chronic lymphocytic leukemia (CLL) is an orphan disease that primarily affects the elderly. The majority of symptomatic patients eligible for frontline treatment are unfit for fludarabine based chemoimmunotherapy. Historical treatment includes chlorambucil (Chl), bendamustine/rituximab (BR), and chlorambucil/rituximab/ChlR combination. Clinical guidelines now recommend the use of novel agents, such as ibrutinib (Ibr), in both frontline and relapse settings and other novel agents, such as idelalisib (with rituximab), in relapse settings. Despite compelling clinical results for novel agents, follow-up in clinical trials is relatively short and, thus, the comparative long-term benefits are still unknown.

Materials and methods: The authors developed a simulation model to generate treatment specific lifetime estimates of Overall Survival (OS) and Quality Adjusted Life Years (QALYs) for treatment with BR, Chl, ChlR, and Ibr. Two potential clinical scenarios were modelled: with and without novel agents for treating CLL. The model was based on health states relating to first- and second-line progression-free survival (PFS), post-progression survival, and death.

Results: Where novel agents were assumed unavailable, mean OS ranged from 5.4–8.5 years and QALYs from 3.5–6.1. Where novel agents were available, the mean OS increased to 10.0 years, with a corresponding increase in QALYs to 7.6. Frontline Ibr use followed by Physician’s Choice, including novel agents at relapse, resulted in projected increase in OS of between 18% (1.5 years) and 85% (4.6 years), corresponding to a 25–117% increase in QALYs, compared with currently available traditional therapies.

Limitations: The limitations of this analysis include immature OS data and the assumption of equivalent efficacy across all novel agents in terms of their impact on PFS and OS.

Conclusions: The use of novel agents is predicted to yield substantive gains in predicted lifetime OS and QALY improvements compared to traditional therapies in CLL patients who are ineligible for fludarabine-based chemoimmunotherapy.     

EMERGENT COMPLEXITY IN AGENT‐BASED COMPUTATIONAL ECONOMICS

Abstract In this paper, we shall review two kinds of emergent complexity in agent‐based computational economics (ACE). The first kind is based on the complex systems initiated in the 1980s or even earlier by mathematicians and physicists, whereas the second kind is based on the idea of complex adaptive systems composed of autonomous agents, for which many representative works have been collected in Rosser. For the latter, we shall go further to examine the two elements which have just recently been incorporated in agent‐based economic modelling, namely, intelligence and modularity. This augmentation leads to the development of neurocognitive software agents, which can guide the generation and direction of future ACE studies with a multistage ‘brain/behaviour‐to‐emergency‐to‐brain/behaviour’ approach.     

在线拍卖中的代理研究综述

在线拍卖站点的不断增加给在线竞买人提出了具大的挑战,竞买人需要从大量的拍卖站点中选择一个恰当的拍卖站点,以保证在满足他们偏好的前提下得到他们希望的物品。不同的拍卖站点采用的拍卖方式和竞价策略是不同的,因此,不同的拍卖站点其竞价代理的设计策略也不同。本文主要对目前在线拍卖代理研究进行综述。     

The impact of using kiosk on enterprise systems in service industry

The hospitality industry services many types of travellers. Each of them needs to be analysed differently in order to accurately determine their respective service quality attributes and customer delight. The effective and efficient enterprise information systems (EISs) play a significant role in traveller’s experience and in the competitive advantages that hotels can gain. For this study, self-service kiosks and guest service agents as part of hotel’s EISs are used to investigate the impact each has on the experience of business and leisure travellers. This study provides empirical results that further investigate how to improve the service quality for both types of travellers during the registration process. This process is the first physical interaction between the travellers and the hotel. Any problem in registering would generate a long-lasting negative first impression on the travellers, thus diminishing the customer delight. In the light of our findings, this study will contribute to the effective and efficient design of self-service kiosk systems, hotel’s EISs, and improved front office management to better accommodate the specific needs of both types of travellers.