Should health authorities offer risk-sharing contracts to pharmaceutical firms? A theoretical approach

2011 ◽  
Vol 6 (3) ◽  
pp. 391-403 ◽  
Author(s):  
Fernando Antonanzas ◽  
Carmelo Juarez-Castello ◽  
Roberto Rodriguez-Ibeas
Keyword(s):  
Health Authority ◽  
Risk Sharing ◽  
Treated Patient ◽  
Low Cost ◽  
Regulatory Decision ◽  
Pharmaceutical Firms ◽  
Health Authorities ◽  
Monitoring Costs ◽  
Pricing And Reimbursement ◽  
The One

AbstractIn this paper, we characterise the risk-sharing contracts that health authorities can design when they face a regulatory decision on drug pricing and reimbursement in a context of uncertainty. We focus on two types of contracts. On the one hand, the health authority can reimburse the firm for each treated patient regardless of health outcomes (non risk-sharing). Alternatively, the health authority can pay for the drug only when the patient is cured (risk-sharing contract). The optimal contract depends on the trade-off between the monitoring costs, the marginal production cost and the utility derived from treatment. A non-risk-sharing agreement will be preferred by the health authority, if patients who should not be treated impose a relatively low cost to the health system. When this cost is high, the health authority would prefer a risk-sharing agreement for relatively low monitoring costs.

scholarly journals PP022 New Models Are Needed To Optimize The Management Of New Medicines

2017 ◽  
Vol 33 (S1) ◽  
pp. 79-80
Author(s):  
Brian Godman ◽  
Eduardo Diogene ◽  
Jurij Fürst ◽  
Kristina Garuoliene ◽  
Augusto Guerra ◽  
...  
Keyword(s):  
Risk Sharing ◽  
Clinical Care ◽  
Cost Effective ◽  
Extensive Literature ◽  
Health Authorities ◽  
Horizon Scanning ◽  
Level Data ◽  
Long Term Follow Up ◽  
Working Together ◽  
Pricing And Reimbursement

INTRODUCTION:Countries are struggling to fund new premium priced medicines with ever increasing prices. In addition, there are substantial savings as medicines lose their patents. This requires coordinated approaches. Models are being developed centering on three pillars: pre-launch including horizon scanning; peri-launch including pricing and reimbursement (P & R)/ risk sharing; and post-launch including assessing effectiveness (1,2). This will continue to enable access to safe, effective and affordable medicines.METHODS:Desk research of regulatory and other relevant policy documents as well as a thorough and extensive literature search in peer-reviewed databases were conducted.RESULTS:Models to optimize the use of new medicines are being developed. These center on three pillars: pre-launch activities including horizon scanning with a specific focus on unmet needs, drugs expected place in therapy, drugs preliminary budget impact and forecasting (including medicines likely to lose their patents); peri-launch activities including P & R assessment and assessments of risk sharing arrangements; and post-launch activities include assessing the effectiveness and safety of new medicines in routine clinical care (1,2). Pre-launch activities to agree the number of potential patients for new cancer medicines resulted in hospitals staying within budget (3); and health authorities that had instigated activities pre-launch saw limited excess bleeding with dabigatran (3). Risk-sharing arrangements have increased access to new medicines; however, concerns with their confidential nature and administrative burden (2,3). Qualitative and/or quantitative approaches are also being developed to better value (new) medicines. There is also growing use of patient level data post launch, for example, studies highlighted concerns with dabigatran prescribing in Spain and anti-obesity medicines in Sweden. Long-term follow-up studies have shown greater effectiveness of ciclosporin versus tacrolimus for transplants despite the rhetoric.CONCLUSIONS:Stakeholders in the healthcare field are working together and developing methods to increase funding for new valued medicines whilst restricting their use where there are concerns to optimize resource use. This will (need to) continue to enable access to safe, (cost-) effective and affordable medicines.

scholarly journals Risk-Sharing Agreements in Pharmaceutical Markets

2020 ◽  
Vol 31 (2) ◽  
pp. 359
Author(s):  
Fernando Antoñanzas ◽  
Carmelo Juárez-Castelló ◽  
Roberto Rodríguez-Ibeas
Keyword(s):  
Clinical Trial ◽  
Health Authority ◽  
Risk Sharing ◽  
Unit Price ◽  
Pharmaceutical Markets ◽  
Marginal Costs ◽  
Marginal Production ◽  
Ex Post ◽  
The One ◽  
The Relationship

In this article, we model the relationship between a health authority and a pharmaceutical firm when the real efficacy of the drug manufactured by the firm is uncertain. The ex-ante information on the efficacy of the new drug is provided by the outcomes of a clinical trial. We focus on two types of contracts. On the one hand, the health authority can set a unit price regardless of the ex-post real effectiveness of the drug (traditional contract, i.e. no risk sharing). Alternatively, the health authority can make the payments contingent upon the observed ex-post effectiveness (risksharing contract). The optimal contract depends on the trade-off between the monitoring costs, the marginal production cost and the health cost derived from treatment failure. When the efficacy of the drug in the clinical trial is relatively high, a traditional contract is optimal for relatively low marginal costs. When the efficacy in the clinical trial is relatively low, the health authority always prefers to condition the payments upon the effectiveness outcomes.

Drug Target Group Prediction with Multiple Drug Networks

2020 ◽  
Vol 23 (4) ◽  
pp. 274-284 ◽  
Author(s):  
Jingang Che ◽  
Lei Chen ◽  
Zi-Han Guo ◽  
Shuaiqun Wang ◽  
Aorigele
Keyword(s):  
Drug Target ◽  
Low Cost ◽  
Machine Learning Algorithms ◽  
Classification Model ◽  
Support Vector ◽  
Multiple Drug ◽  
Property A ◽  
Multiple Networks ◽  
Proposed Model ◽  
The One

Background: Identification of drug-target interaction is essential in drug discovery. It is beneficial to predict unexpected therapeutic or adverse side effects of drugs. To date, several computational methods have been proposed to predict drug-target interactions because they are prompt and low-cost compared with traditional wet experiments. Methods: In this study, we investigated this problem in a different way. According to KEGG, drugs were classified into several groups based on their target proteins. A multi-label classification model was presented to assign drugs into correct target groups. To make full use of the known drug properties, five networks were constructed, each of which represented drug associations in one property. A powerful network embedding method, Mashup, was adopted to extract drug features from above-mentioned networks, based on which several machine learning algorithms, including RAndom k-labELsets (RAKEL) algorithm, Label Powerset (LP) algorithm and Support Vector Machine (SVM), were used to build the classification model. Results and Conclusion: Tenfold cross-validation yielded the accuracy of 0.839, exact match of 0.816 and hamming loss of 0.037, indicating good performance of the model. The contribution of each network was also analyzed. Furthermore, the network model with multiple networks was found to be superior to the one with a single network and classic model, indicating the superiority of the proposed model.

Preparedness and response in Portuguese emergency plans - Interaction with public health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Leiras ◽  
A Martins
Keyword(s):  
Public Health ◽  
Health Authority ◽  
Civil Protection ◽  
Emergency Plans ◽  
Emergency Situations ◽  
Health Measures ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Protection Authority

Abstract Background Articulation between Civil Protection and Public Health authorities is of paramount importance to control, reduce and prevent threats to the health of the population in situations of crisis or catastrophes. National Civil Protection Authority produces Emergency Plans which describe the role of every stakeholder in emergency situations. Role and importance of Public Health and Public Health Authorities is not always present or well described and known amongst stakeholders. Methods Data was collected from all Districtal Emergency Plans (n = 18). Each document was analysed considering time frame, refences to Public Health and Health Authorities, definition of roles, communication channels, coordination and inclusion of intersectoral communication flow. Quantitative analysis included absolute and relative frequencies and qualitative analysis to all parts related to the terms “Public Health” and “Health Authority”. Each document was reviewed by 2 independent researchers. Results From 18 Districtal Emergency Plans (DEP) analysed, 94,4% (n = 17) had references to Public Health, but none referred the role of Public Health Officers. Only 16,7% referred to Health Authorities, although 94,4% mentioned the law 135/2013, defining the role and attributes of Health Authority. In 72,2%, coordination of Public Health Measures was attributed to the National Medical Emergency Institute. Epidemiological surveillance and Public Health Emergencies were referred in 55,6%, and attributed to the Regional Administration of Health. Conclusions Public Health Authorities and Public Health Medical Officers role in articulation with National Civil Protection Authority in emergency situations lacks severely, with this role being replaced by other entities. This is of great concern regarding management and control of diseases, particularly communicable diseases. Key messages Public Health Authorities lack the necessary involvement in Emergency Plans and emergency situations. Public health measures are coordinated by other entities rather than Public Health Authorities.

Rapid and Green One-Pot Synthesis of Novel 2-(4-Hydroxy-2-oxo-2H-chromen-3-yl)-2-(arylamino)-1H-indene-1,3(2H)-diones

2021 ◽  
Vol 18 ◽  
Author(s):  
Abolfazl Olyaei ◽  
Zahra Ghahremany ◽  
Madieh Sadeghpour
Keyword(s):  
Aromatic Amines ◽  
Low Cost ◽  
Guanidine Hydrochloride ◽  
Reaction Times ◽  
Solvent Free ◽  
One Pot ◽  
Solvent Free Conditions ◽  
The One ◽  
High Yields ◽  
Work Up

: A green and efficient protocol was developed for the one-pot three-component synthesis of novel 2-(4-hydroxy-2-oxo-2H-chromen-3-yl)-2-(arylamino)-1H-indene-1,3(2H)-dione derivatives by the reaction of 4-hydroxycoumarin, ninhydrin and aromatic amines in the presence of guanidine hydrochloride as an organocatalyst under solvent-free conditions. The present approach offers several advantages such as low cost, simple work-up, short reaction times, chromatography-free purification, high yields and greener conditions.

Design of a Directional Olfactory Display to Study the Integration of Vision and Olfaction

2018 ◽  
Author(s):  
Lorenzo Micaroni ◽  
Marina Carulli ◽  
Francesco Ferrise ◽  
Monica Bordegoni ◽  
Alberto Gallace
Keyword(s):  
Virtual Reality ◽  
Low Cost ◽  
Olfactory Cues ◽  
Input Device ◽  
Experimental Setup ◽  
Initial Testing ◽  
Head Mounted Display ◽  
Innovative System ◽  
The One ◽  
Olfactory Display

This research aims to design and develop an innovative system, based on an olfactory display, to be used for investigating the directionality of the sense of olfaction. In particular, the design of an experimental setup to understand and determine to what extent the sense of olfaction is directional and whether there is prevalence of the sense of vision over the one of smell when determining the direction of an odor, is described. The experimental setup is based on low cost Virtual Reality (VR) technologies. In particular, the system is based on a custom directional olfactory display, an Oculus Rift Head Mounted Display (HMD) to deliver both visual and olfactory cues and an input device to register subjects’ answers. The VR environment is developed in Unity3D. The paper describes the design of the olfactory interface as well as its integration with the overall system. Finally the results of the initial testing are reported in the paper.

scholarly journals Teaching and Learning Physics with Smartphones

2015 ◽  
Vol 17 (1) ◽  
pp. 31-50 ◽  
Author(s):  
M. Á. González ◽  
Manuel Á. González ◽  
M. Esther Martín ◽  
César Llamas ◽  
Óscar Martínez ◽  
...  
Keyword(s):  
Mobile Applications ◽  
Teaching And Learning ◽  
Low Cost ◽  
Positive Influence ◽  
Mobile Technologies ◽  
Traditional Learning ◽  
Know How ◽  
Measurement Devices ◽  
The One ◽  
Physics Experiments

The use of mobile technologies is reshaping how to teach and learn. In this paper the authors describe their research on the use of these technologies to teach physics. On the one hand they develop mobile applications to complement the traditional learning and to help students learn anytime and anywhere. The use of this applications has proved to have very positive influence on the students' engagement. On the other hand, they use smartphones as measurement devices in physics experiments. This opens the possibility of designing and developing low cost laboratories where expensive material can be substituted by smartphones. The smartphones' sensors are reliable and accurate enough to permit good measurements. However, as it is shown with some examples, special care must be taken here if one does not know how these apps used to access the sensors' data are programmed.

Identification of suitable nontraditional tropical and residual paving materials in relation to the environment

1987 ◽  
Vol 24 (1) ◽  
pp. 58-71 ◽  
Author(s):  
M. D. Gidigasu ◽  
S. P. K. Asante ◽  
E. Dougan
Keyword(s):  
Performance Studies ◽  
Low Cost ◽  
Index Properties ◽  
Moisture Index ◽  
Fines Content ◽  
Geotechnical Characteristics ◽  
Pavement Construction ◽  
The One ◽  
Identification And Characterization

Results of laboratory and field construction and pavement performance studies have revealed that some apparently substandard or borderline—by temperature zone standards—tropical gravel materials can be used successfully for the construction of low-cost pavements in subhumid climatic zones.The geotechnical characteristics of suitable paving materials have been defined from results of studies carried out on satisfactory and poor road sections over a period of 5–6 years.Important correlations were found between the bearing strength (CBR) on the one hand and some moisture index properties as well as the products of the fines content and these index properties on the other.It is shown that the product of the fines content and some moisture index properties form a useful basis for identifying suitable materials for pavement construction in the moist subhumid climatic zone of Ghana.The paper is a contribution to the identification and characterization of nontraditional tropical and residual paving materials in relation to the environment. Key words: pavements, California bearing ratio (CBR), index properties, fines content, subhumid climate.

scholarly journals Photocatalytic Degradation of Organic, Inorganic and Microbial Pollutants Present in Water by Novel Materials: A Critical Review and Present Update

2021 ◽  
Vol 33 (10) ◽  
pp. 2251-2259
Author(s):  
Elizabeth Kuruvilla ◽  
C. Freeda Christy ◽  
A. Samson Nesaraj
Keyword(s):  
Water Pollution ◽  
Photocatalytic Degradation ◽  
Low Cost ◽  
Good Method ◽  
Capacitive Deionization ◽  
Aquatic Life ◽  
Environmental Friendliness ◽  
Living Things ◽  
The World ◽  
The One

Presently water pollution is the one of the major threats faced by living things all over the world. The main cause of water pollution is its effect on the life of aquatic animals. Organic, inorganic, microbial and other pollutants often mix with water bodies mainly due to human activities. Because of the presence of pollutants in water, the amount of dissolved oxygen level can be decreased which in turn affect the survival of aquatic life. The pollutant water may enter the agriculture fields and damage the plants extensively. The methods, such as, coagulation, adsorption, foam floating, electrodialysis, capacitive deionization, etc. are presently employed to treat the waste water. Among these methods, heterogeneous photocatalytic degradation is considered to be a good method because of its low cost and environmental friendliness. In this review, the decontamination of different kinds of organic, inorganic and microbial contaminants in water with different photocatalysts process is presented.

APPLICATION OF A ONE-DIMENSIONAL POSITION SENSITIVE CHAMBER ON SYNCHROTRON RADIATION

2014 ◽  
Vol 27 ◽  
pp. 1460142
Author(s):  
HUIRONG QI ◽  
MEI LIU
Keyword(s):  
Synchrotron Radiation ◽  
Low Cost ◽  
Large Area ◽  
Position Resolution ◽  
One Dimensional ◽  
X Ray ◽  
High Position ◽  
Standard Data ◽  
Wire Chamber ◽  
The One

In the last few years, wire chambers have been frequently used for X-ray detection because of their low cost, large area and reliability. X-ray diffraction is an irreplaceable method for powder crystal lattice measurements. A one-dimensional single-wire chamber has been developed in our lab to provide high position resolution for powder diffraction experiments using synchrotron radiation. There are 200 readout strips of 0.5 mm width with a pitch of 1.0 mm in the X direction, and the working gas is a mixture of Ar and CO2 (90/10). The one-dimensional position of the original ionization point is determined by the adjacent strip's distribution information using the center of gravity method. Recently, a study of the detector's performance and diffraction image was completed at the 1W1B laboratory of the Beijing Synchrotron Radiation Facility (BSRF) using a sample of SiO2. Most of the relative errors between the measured values of diffraction angles and existing data were less than 1%. The best position resolution achieved for the detector in the test was 71 μm (σ value) with a 20 μm slit collimator. Finally, by changing the detector height in incremental distances from the center of the sample, the one-dimensional detector achieved a two-dimensional diffraction imaging function, and the results are in good agreement with standard data.

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