A cost-effectiveness analysis of revaccination and catch-up strategies with the 23-valent pneumococcal polysaccharide vaccine (PPV23) in older adults in Japan

Objective: In Japan, the National Immunization Program (NIP) includes PPV23 as the primary vaccination for adults and catch-up cohorts. The Japanese Association for Infectious Diseases recommends revaccination for older adults who received primary vaccination ≥5 years earlier. The cost-effectiveness of adding revaccination and/or continuing catch-up vaccination in the NIP was evaluated from the public payer perspective in Japan.

Methods: The Markov model included five health states: no pneumococcal disease, invasive pneumococcal diseases (IPD), non-bacteremic pneumococcal pneumonia (NBPP), post-meningitis sequelae, and death. Cohorts of adults aged 65–95 were followed until age 100 or death: 2014 cohort (aged 65–95, vaccinated: 2014); 2019 cohort (aged 65: 2019); and 2019 catch-up cohort (aged 70–100: 2019, unvaccinated: 2014). Strategies included: (1) vaccinate 2014 and 2019 cohorts; (2) vaccinate 2014 and 2019 cohorts and revaccinate both; (3) strategy 1 and vaccinate 2019 catch-up cohort; (4) strategy 2 and vaccinate 2019 catch-up cohort; and (5) strategy 4 and revaccinate 2019 catch-up cohort. Parameters were retrieved from global and Japanese sources, costs and QALYs discounted at 2%, and incremental cost-effectiveness ratios (ICERs) estimated.

Results: Strategy 1 had the highest number of IPD and NBPP cases, and strategy 5 the lowest. Strategies 3–5 dominated strategy 1 and strategy 2 was cost-effective compared to strategy 1 (ICER: ¥1,622,153 per QALY gained). At a willingness-to-pay threshold of ¥5 million per QALY gained, strategy 2 was cost-effective and strategies 3–5 were cost-saving compared to strategy 1.

Conclusions: Strategies including revaccination, catch-up, or both were cost-effective or cost-saving in comparison to no revaccination and no catch-up. Results can inform future vaccine policies and programs in Japan.     

新冠肺炎疫情对中小微外贸企业的影响及对策

突如其来的新冠肺炎对全球经济造成了很大的影响,我国对外贸易当然更是无法幸免。但总体而言,笔者认为,短期影响虽然十分严重,但正在逐步消弭;中期影响需要认真对待,损失基本可控;长期影响更加深刻,但是依然可以化解——我国以及我省对外经济贸易总体向好的态势有望保持。然而,面广量大的中小微外贸企业原本就身体单薄,这场突如其来的疫情,无疑又是雪上加霜,日子更加艰难,亟待关注与帮扶。     

疫情背景下的中小微企业金融纾困模式

针对新冠病毒肺炎疫情,本课题组对中小微企业的生存压力进行调研,发现85%中小微企业现金流不足支持3个月;各级政府、金融机构的救助政策反应迅速、积极,但惠及效率有待提高;企业现金流救助需要发挥政府平台和产业链群形成的产业平台的作用,助推金融精准纾困中小微企业。建议政府部门短期积极利用两大平台资源,优化中央、地方政府专项纾困基金和支持性贷款、金融扶持资金和优惠贷款的管理模式;中期建立专项中小微企业发展的扶持基金和就业援助计划,推动中小微企业转型升级。     

Economic assessment of doripenem versus imipenem in the treatment of ventilator-associated pneumonia

Abstract

Background: Ventilator-associated pneumonia (VAP), the most common nosocomial infection in critically ill patients, is associated with significantly longer duration of mechanical ventilation, and increased mortality, hospital days, and health-care costs. A previously published prospective, randomized study established the noninferiority of intravenous (IV) doripenem versus IV imipenem/cilastatin (‘imipenem‘) for VAP. This study compares the economic outcomes of IV therapy with doripenem versus imipenem as first-line treatment for VAP.

Methods: A decision-analytic model of inpatient care and outcomes for VAP was used to estimate costs associated with VAP treatment. The model calculates total hospital costs, comprising costs of initial and concomitant therapy, and costs associated with mechanical ventilation, intensive care unit stays, and total days in hospital.

Results: Total treatment costs for doripenem were $10,630 lower than for imipenem ($71,259 vs. 81,889), driven primarily by differences in costs of mechanical ventilation ($45,224 for doripenem, $57,348 for imipenem). Probabilistic sensitivity analyses found doripenem consistently cost saving versus imipenem in 1,000 simulations. Study limitations include use of a simple model to represent a complex disease process and reliance on trial data that may not reflect real-world care and outcomes.

Conclusions: Doripenem is a cost saving first-line treatment for VAP versus imipenem while providing an equivalent rate of cure.     

新冠肺炎疫情对线上商品价格变化的影响

文章运用电商高频价格大数据,分析了新冠肺炎疫情对商品价格变化的影响。研究发现：根据公平定价理论,在突发疫情下商家会加入消费者情绪制定价格策略,商品价格经过调整后趋于稳定;并且,商品价格表现出较低的价格黏性,对称的交错调价使得新冠肺炎疫情对商品价格的冲击有限。因此,政府部门可利用线上商品价格编制大数据物价指标,及时反映市场供求变化,促进资源优化配置,为宏观政策制定提供依据;同时,加快推进消费数字化转型,优化线上交易环境,建立预警机制来应对突发情况。     

新冠肺炎疫情冲击下企业现金持有的预防价值研究

最近爆发的新冠肺炎疫情牵动着亿万民众的心,面对突如其来的疫情,企业资金面临着巨大压力。企业持有现金主要源于预防和交易动机,然而预防动机的特性决定了其在企业正常经营状态下难以直观体现,因而目前鲜有研究对企业现金持有的预防价值进行直接检验。本文以新冠肺炎疫情事件的冲击为研究切入点,通过考察不同现金持有水平的企业在面临危机冲击的市场反应,发现企业现金持有水平与事件窗口期内的累计超额收益率呈显著正相关关系,从而为现金持有的预防价值提供了更为直接的经验证据。而且,当公司受疫情冲击程度越大时,二者之间正相关关系越强。进一步发现,企业现金持有的预防价值在企业现金流压力大以及外部融资环境较差时更加凸显。本研究丰富了已有关于现金持有预防价值的相关文献,并对政府与企业应采取何种举措以应对突发事件具有一定的启示。     

新冠肺炎疫情对我国农业发展的影响与应对举措

新冠肺炎疫情的爆发对粮食种植业、畜牧养殖业、种业、休闲农业、农产品加工业、蔬菜业、水果业、花卉业等产业发展,都会带来一定的负面影响。为减少新冠肺炎疫情的负面影响,推动农业健康发展,应保障粮食和重要农产品供给,抓好春耕春播工作,保障乡村道路运输通畅,在南方地区推广稻田综合种养模式,发展生态高值农业和"康养业+富硒+农业",尽快推进饲料企业和屠宰加工企业复工复产,加大对农业产业的金融支持力度,降低农业经营成本,鼓励发展以村为单位的农业社会化服务组织,大力培育农产品销售新业态,建立政府、企业和市场互动的农业灾害救助体系。     

A retrospective study to assess the epidemiological and economic burden of pneumococcal diseases in adults aged 50 years and older in Taiwan

Objective:

Invasive pneumococcal disease (IPD) and pneumococcal pneumonia cause substantial morbidity and mortality worldwide. This retrospective study was conducted to estimate the disease burden from pneumococcal disease in older adults in Taiwan from a health insurer’s perspective.

Methods:

Data for the years 2002–2009 from patients aged ≥50 years with insurance records indicating pneumococcal meningitis, pneumococcal bacteremia, or hospitalized or outpatient pneumonia were obtained from the National Health Insurance Research Database in Taiwan. Admission data for inpatients, visit data for outpatients, and associated costs were extracted from the database to estimate the incidence, case fatality rates, and direct and indirect costs of pneumococcal disease episodes. These data were applied to the estimated population of Taiwan in 2010 to provide an estimated disease burden for a single year from the payer perspective.

Results:

The average incidence per 100,000 person years was 2.4 for IPD, 278.8 for hospitalized pneumococcal pneumonia, and 1376.4 for outpatient pneumococcal pneumonia. The average case fatality rate was 12.3% for IPD and 10.0% for hospitalized pneumonia. Hospitalized pneumonia accounted for over 90% of direct medical costs. The incidence of hospitalized pneumococcal pneumonia per 100,000 person years was 84.4 for adults of 50–64 years, 313.1 for adults of 65–74 years, 820.3 for adults of 75–84 years, and 1650.9 for adults of 85+ year of age. In 2010, it was estimated there were over 113,000 episodes of pneumococcal disease, causing almost 2000 deaths, with direct medical costs of more than NT$3.4 billion annually.

Conclusions:

Pneumococcal disease is a significant cause of mortality and excess healthcare expense among the elderly in Taiwan. Disease burden in older adults increases with advancing age.     

分析新生儿感染性肺炎的诊断与治疗

目的探讨分析新生儿感染性肺炎的诊断和有效治疗方法。方法对我院在2009年3月-2011年3月间收治的102例新生儿感染性肺炎患者临床资料进行回顾性分析,总结分析新生儿感染性肺炎的诊断和治疗方法。结果经过治疗后102例患者中有显效71例,有效23例,无效为8例,总有效率达到92.2%。结论新生儿感染性肺炎临床表现多样,经过以抗感染为主的治疗后,临床疗效明显,值得在临床上推广。     

基于新冠肺炎疫情后三亚旅游业高质量发展的研究

随着新型冠状肺炎疫情在全国各地蔓延,给国内的旅游业造成巨大的冲击.借此,文章从新冠肺炎疫情对三亚旅游业产生的影响进行研究,依据《三亚市有效应对疫情支持旅游企业发展十条政策措施》(三府办〔2020〕19号)的通知,同时,借鉴2003年非典时期,张家界应对疫情成功有效的措施,有针对性地提出发挥以政府为主导的策略和以涉旅企业...