Cost-effectiveness analysis of secukinumab in ankylosing spondylitis from the Canadian perspective

Aim: To assess the cost-effectiveness of interleukin (IL)-17A inhibitor secukinumab vs the currently licensed biologic therapies in ankylosing spondylitis (AS) patients from a Canadian healthcare system perspective.

Methods: A decision analytic model (semi-Markov) evaluated the cost-effectiveness of secukinumab 150?mg compared to certolizumab pegol, adalimumab, golimumab, etanercept and etanercept biosimilar, and infliximab and infliximab biosimilar in a biologic-naïve population, over 60 years of time horizon (lifetime). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI 50) response rate was used to assess treatment response at week 12. Non-responders or patients discontinuing initial-line of biologic therapy were allowed to switch to subsequent-line biologics. Model input parameters (short-term and long-term changes in BASDAI and Bath Ankylosing Spondylitis Functional Index [BASFI], withdrawal rates, adverse events, costs, resource use, utilities, and disutilities) were obtained from clinical trials, published literature, and other Canadian sources. Benefits were expressed as quality-adjusted life years (QALYs). Cost and benefits were discounted with an annual discount rate of 1.5% for all treatments.

Results: In the biologic-naïve population, secukinumab 150?mg dominated all comparators, as patients treated with secukinumab 150?mg achieved the highest QALYs (16.46) at the lowest cost (CAD 533,010) over a lifetime horizon vs comparators. In the deterministic sensitivity analysis, results were most sensitive to changes in baseline BASFI non-responders, BASDAI 50 at 3 months and discount rates. Probabilistic sensitivity analysis showed that secukinumab 150?mg demonstrated higher probability of achieving maximum net monetary benefit vs all comparators at various cost thresholds.

Conclusions: This analysis demonstrates that secukinumab 150?mg is the most cost-effective treatment option for biologic-naïve AS patients compared to certolizumab pegol, adalimumab, golimumab, etanercept and etanercept biosimilar, and infliximab and infliximab biosimilar for a lifetime horizon in Canada. Treatment with secukinumab translates into substantial benefits for patients and the healthcare system.     

基于生命周期理论的无锡市锡山区棕(褐)地再利用环境风险综合评价

研究目的:以生命周期理论为基础,建立定量评价棕(褐)地再利用环境风险的评价体系与方法,并以无锡市锡山区为例验证其有效性。研究方法:系统分析法、层次分析法和灰色评价法。研究结果:(1)棕(褐)地再利用全生命周期可划分为确认准备、控制治理、维护监管三大阶段,各阶段包含政策法律风险、经济风险、组织风险、污染风险等8个要素;(2)锡山区棕(褐)地再利用环境风险处于中等水平,由于棕(褐)地的污染性、复杂性,仍应对棕(褐)地环境风险进行必要的控制。研究结论:运用层次分析法和灰色评价法对棕(褐)地再利用进行环境风险综合评价具有一定的价值与可操作性。     

生命周期视角下茅洲河流域水环境综合治理

基于生命周期理论和利益相关者理论,对茅洲河流域水环境综合治理工程中的决策阶段、设计阶段、实施阶段、竣工验收阶段和运营维护阶段进行全生命周期管控,根据不同阶段的侧重点采取不同的应对措施。总结出生命周期视角下的水环境治理经验,包括开创性的治理模式,水资源、水安全、水环境、水生态、水文化 “五位一体”的城市河流健康治理理念,先进的治水科技和智慧水务以及多方协同的治理格局等,可为相关流域水环境综合治理提供参考。     

我国中小企业三维差异化特征比较研究

作为推动国民经济增长和促进社会稳定的基础力量,中小企业在市场中扮演着最活跃的经济主体。与大企业相比,中小企业有其鲜明的成长特征,从动态演进视角选取体量规模、生命周期、要素需求三个维度,系统探讨了中小企业的差异化特征。结论显示:体量规模特征反映在个体与群体以及经济板块之间;生命周期特征体现在死亡陷阱和空间格局演变上;要素需求特征会根据阶段创新内容的不同做出适时调整。     

电气自动化仪器检测原理及技术性能

本文对常用电气测量设备在生活、生产、工业等方面的应用进行了分析和研究。分别介绍了电流电压的测量、功率的测量及其它常用电子测量仪表的原理和技术性能,旨在让读者了解常用测量仪表原理及性能。     

Compensating Wage Differentials with Unemployment: Evidence from China

We estimate the economic value of mortality risk in China using the compensating-wage-differential method. We find a positive and statistically significant correlation between wages and occupational fatality risk. The estimated effect is largest for unskilled workers. Unemployment reduces compensation for risk, which suggests that some of the assumptions under which compensating wage differentials can be interpreted as measures of workers’ preferences for risk and income are invalid when unemployment is high. Workers may be unwilling to quit high-risk jobs when alternative employment is difficult to obtain, violating the assumption of perfect mobility, or some workers (e.g., new migrants) may be poorly informed about between-job differences in risk, violating the assumption of perfect information. These factors suggest our estimates of the value per statistical life (VSL) in China, which range from approximately US$30,000 to US$100,000, may be biased downward. Alternative estimates adjust for heterogeneity of risk within industry by assuming that risk is concentrated among low-skill workers. These estimates, which are likely to be biased downward, range from US$7,000 to US$20,000.      

Promoting quality-of-life and well-being research in hospitality and tourism

There is an increasing interest in quality-of-life/well-being research in hospitality and tourism. The goal of this paper is to further promote the development and use of quality-of-life/well-being concepts in the discipline by reviewing seven major theories of quality of life and well-being (and their application in hospitality and tourism based on the research that I and my colleagues have conducted over the years) and suggesting future avenues of research. The theories discussed are self-congruity theory, self-expressiveness theory, bottom-up spillover theory, leisure benefits theory, goal theory, need hierarchy theory, and broaden-and-build theory.     

Progression,Stability, or Decline? Sociological Mechanisms Underlying Change in Specialization Among Birdwatchers

Using a panel of American birdwatchers collected in 1997 and 2002, we tested the extent to which birdwatchers progressed over a five-year period. The impact different career contingencies and life course events had on predicting change in birdwatchers' behavior, skill, and commitment was also examined. Findings indicated that although progression characterized some birdwatchers' participation, involvement by others was better characterized by stability or decline, which was true for each of the indicators used to measure specialization. Career contingencies and life course changes had only a moderate influence on predicting change in the specialization indicators over time. Support from family members and retirement were the best predictors of change in specialization.     

Cultural Consonance in Leisure,Leisure Satisfaction,Life Satisfaction,and Self-Rated Health in Urban Taiwan

The purpose of this study threefold: to determine whether a shared cultural model of the importance of a set of leisure activities to a good leisure life existed in urban Taiwan, the degree to which cultural consonance in leisure mediates the relationship between leisure constraints and leisure satisfaction, and the degree to which leisure satisfaction affects life satisfaction and self-rated health. Results indicate that a cultural model of the importance of leisure activities to a good leisure life existed among sample members. Second, higher levels of self-reported participation in leisure activities that are culturally agreed upon as more important for a good leisure life are more strongly associated with leisure satisfaction than are activities culturally agreed upon as less important. Finally, leisure satisfaction strongly predicts both life satisfaction and self-rated health.     

Perception of tourism development and subjective happiness of residents in Mashhad,Iran

Tourism development affects various aspects of a populace’s life, such as environmental, social, economic, and other areas. This study examines the effect of perceived tourism development on subjective happiness and quality of life among residents of Mashhad City, Iran. A sample size of 384 residents completed a survey. Data analysis was performed using WarpPLS. Results indicated that tourism development had an effect on the residents’ subjective happiness and quality of life (QOL) and the effects of social and micro economic factors on the residents’ subjective happiness and the effects of cultural, environmental, and macroeconomic factors on the resident’s QOL.