The economic burden of advanced Parkinson’s disease: an analysis of a UK patient dataset

Abstract

Background:

To evaluate the cost burden of patients with advanced Parkinson’s disease (PD) according to the waking hours per day spent in OFF state. An analysis of resource use comprising medical services, professional care and informal care data from an observational, cross-sectional study was conducted.

Methods:

A total of 60 physicians comprising 40 neurologists and 20 geriatricians across the UK participating in the Adelphi PD Disease Specific Programme took part. There were 302 PD patients at H&Y stages 3–5. Patients were characterised according to the percentage of time per day spent in OFF state (<25%, 26–50%, 51–75%, >75%).

Results:

Average 12-monthly total costs increased according to the time spent in OFF state from £25,630 in patients spending less than 25% of their waking hours in OFF to £62,147 for patients spending more than 75% of their time in OFF. Overall, 7% of costs were attributed to direct medical care, while 93% were split between direct non-medical professional care (50%) and indirect informal care (43%).

Limitations:

Low patient numbers in the more advanced disease stages of PD led to very little or no data to directly inform some of the severe health states of the analysis. Data gaps were filled in with data derived from a regression analysis which may affect the robustness of the analysis.

Conclusion:

This study illustrates the increasing costs of advancing PD, in particular related to the time spent in OFF state, and identifies that the foremost cost burden is associated with the care needs of the patient rather than medical services.     

Cost-effectiveness of partially-hydrolyzed formula for prevention of atopic dermatitis in Australia

Abstract

Objective:

To perform an economic evaluation of a specific brand of partially hydrolyzed infant formula (PHF-W) in the prevention of atopic dermatitis (AD) among Australian infants.

Methods:

A cost-effectiveness analysis was undertaken from the perspectives of the Department of Health and Aging (DHA), of the family of the affected subject and of society as a whole in Australia, based on a decision-analytic model following a hypothetical representative cohort of Australian newborns who are not exclusively breastfed and who have a familial history of allergic disease (i.e., are deemed ‘at risk’). Costs, consequences, and incremental cost-effectiveness ratios (ICER) were calculated for PHF-W vs standard cow’s milk based infant formula (SF), and, in a secondary analysis, vs extensively hydrolyzed infant formula (EHF-Whey), when the latter was used for the prevention of AD.

Results:

From a representative starting cohort of 87,724 ‘at risk’ newborns in Australia in 2009, the expected ICERs for PHF-W vs SF were AU$496 from the perspective of the DHA and savings of AUD1739 and AU$1243 from the family and societal perspectives, respectively. When compared to EHF-Whey, PHF-W was associated with savings for the cohort of AU$5,183,474 and AU$6,736,513 from the DHA and societal perspectives.

Limitations:

The generalizability and transferability of results to other settings, populations, or brands of infant formula should be made with caution. Whenever possible, a conservative approach directing bias against PHF-W rather than its comparators was applied in the base case analysis. Assumptions were verified in one-way and probabilistic sensitivity analyses, which confirmed the robustness of the model.

Conclusions:

PHF-W appears to be cost-effective when compared to SF from the DHA perspective, dominant over SF from the other perspectives, and dominant over EHF-Whey from all perspectives, in the prevention of AD in ‘at risk’ infants not exclusively breastfed, in Australia.     

Prevalence and healthcare costs of obesity-related comorbidities: evidence from an electronic medical records system in the United States

Abstract

Objective:

This study estimated the economic burden of obesity-related comorbidities (ORCs) in the US, at both the person and population levels.     

The Needham puzzle,the Weber question,and China's miracle: Long-term performance since the Sung dynasty

This paper attempts a brief overview of China's economic performance since the Sung dynasty. It discusses Chinese long economic stagnation since the Sung dynasty and explores the reasons why it was quickly lagging behind western countries from the 1800s. It explains why the industrialization and modernization led by Chinese government from 1949 to 1978 failed in narrowing the gap between China and the developed countries. It examines Chinese rapid economic growth during its reform and opening up period.     

The ECFA and its expected effect on cross-strait trade and investment: a Taiwanese perspective

To come to terms with the realization of ASEAN+1, Taiwan had concluded with mainland China a special free trade agreement (FTA), the Economic Cooperation Framework Agreement (ECFA) in June 2010. This framework agreement provides an early harvest agreement of near-term tariff elimination, including detailed product schedules for goods and services from each side, with the final shape of fuller trade liberalization in goods and services taking years to negotiate and realize. The conclusion of the ECFA has been considered as a major breakthrough in cross-strait talks and economic relationships, even though it is by no means free from controversies inside Taiwan. The authors are therefore motivated by hot debates in Taiwan to reflect on the expected trade effect of the ECFA by taking into account the factor of cross-strait global production networks. In particular, we examine with a proposed model and statistical robustness, the trend of Taiwan-based firms' localization in mainland China, driven in part by constant movements in global production networks, which generates complicated and dynamic relationships between Taiwan's investment-induced trade and structural shift in Taiwan's exports to mainland China. Based on our empirical findings, we reflect on the conventional views on the trade effect of the free trade agreement. The results of our analyses tend to support a cautious view about the trade effect of the ECFA. Without denying the significance of the ECFA and deepening cross-strait economic relationships, we argue that the impact of the ECFA should be interpreted in a wider context than just the trade perspective, as the conventional wisdom and the existing evaluations suggested.     

公共行政中的人性假设：事实与价值的论辩

“公共行政中的人是什么”是自公共行政创立以来所要回答的首要问题。在事实层面,行政人员有着个人的利益诉求,以“经济人”的方式生活,但在价值层面,公共行政组织的规范目的应当是追求和实现公共利益,行政人员必须坚持以“公共人”为价值取向,这也是现代社会公共行政的发展的必然要求。欲使行政人员成为真正的“公共人”,制度建设和道德建设都很重要,只有双管齐下,行政人员才有可能自觉接受公共精神准则的制约,切实维护公共利益。     

体面劳动问题研究的新进展与未来研究展望

全球化加剧了劳资关系的不平衡状态,强资本弱劳工的局面得以维护并日益加强,资方为追求利益最大化而忽视劳动者利益的事情屡屡发生。随着转型时期经济社会改革的深入推进,劳资关系问题也越来越引起人们的关注并成为社会的焦点问题之一,全面实现体面劳动成为各级政府的重要方针,企业、各类劳动组织以及劳动者都对实现体面劳动发出了强烈的呼声。金融危机后体面劳动研究有了新进展,未来体面劳动问题研究也大有可为。     

环京津生态抑制型贫困带的现状、成因及对策建议

环京津生态抑制型贫困带自然环境恶劣、生态脆弱、区域内贫困人口集中.但这些地区是京津地区重要的水源地和资源环境保障基地,在京津都市区的自然生态系统中具有重要屏障作用和战略地位,对区域内社会经济持续发展有重要影响.文章详细分析了环京津贫困带的现状和形成原因,并从建立生态经济发展特区、生态补偿机制构建、加强首都经济圈产业对接与合作、创新生态旅游扶贫等方面提出具体对策建议,以期改善环京津贫困带的贫困现状.     

经济结构约束下中小保险公司发展对经济增长的影响

大量研究发现保险业活动可以影响经济增长,但对于保险业的结构特征和区域差异对经济增长是否有作用却鲜有涉及。本文运用中国31个省份（直辖市）在1999-2008年间的面板数据,利用固定效应模型和系统广义矩方法进行了计量分析。我们发现保险业活动、结构以及保险业结构与经济结构的匹配对经济发展具有显著的影响：中小保险公司市场份额的提高有利于经济增长;保险业结构与经济结构匹配时会促进经济增长,反之则会抑制经济增长。本文还构建了相对保险深度指标对全国样本进行分类,发现不同区域保险业结构与经济结构的协同效应对经济增长的影响规律存在一定的差异。     

金融创新是促进还是阻碍了经济增长——基于技术进步视角的面板分析

金融创新对经济增长的作用方向一直是不明确的,本文旨在解释清楚金融创新影响经济增长的内部机制,并对其进行验证。包括金融创新对微观技术的支持,以及进一步扩展到对宏观经济的影响。通过应用工具变量法对全球的面板数据进行处理,建立以内生经济增长理论模型为基础的计量模型进行实证研究,研究结果表明：在考虑金融创新在经济增长模型中存在内生性的情况下：与金融发展不同,金融创新单独对经济增长的作用方向是不确定的,甚至可能存在显著的抑制作用;而金融创新通过技术进步对经济增长的促进作用是显著的,并且这种作用更多地通过企业的技术进步来体现。