scholarly journals Variation in the prices of oncology medicines across Europe and the implications for the future

2021 ◽  
Vol 10 (2) ◽  
pp. 72-82
Author(s):  
Brian Godman ◽  
Steven Simoens ◽  
Amanj Kurdi ◽  
Gisbert Selke ◽  
John Yfantopoulos ◽  
...  

Introduction/Objectives: Health authorities are facing increasing challenges to the sustainability of their healthcare systems because of the growing expenditures on medicines, including new, high-priced oncology medicines, and changes in disease prevalence in their ageing populations. Medicine prices in European countries are greatly affected by the ability to negotiate reasonable prices. Concerns have been expressed that prices of patented medicines do not fall sufficiently after the introduction of lower-cost generic oncology medicines. The objective of this study was to examine the associations over time in selected European countries between the prices of oral oncology medicines, population size, and gross domestic product (GDP) before and after the introduction of generic versions. Evidence of periodic reassessments of the price, value, and place in treatment of these medicines was also looked for. The goal of this review was to stimulate debate about possible improvements in approaches to reimbursement negotiations. Methodology: Analysis was performed of reimbursed prices of three oral oncology medicines (imatinib, erlotinib and fludarabine) between 2013 and 2017 across Europe. Correlations were explored between GDP, population size, and prices. Findings were compared with previous research regarding prices of generic oral oncology medicines. Results: The prices of imatinib, erlotinib and fludarabine varied among European countries, and there was limited price erosion over time in the absence of generics. There appeared to be no correlation between population size and price, but higher prices of on-patent oral cancer medicines were seen among countries with higher GDP per capita. Conclusion: Limited price erosion for patented medicines contributed to increases in oncology medicine budgets across the region. There was also a concerning lack of evidence re-assessments of the price, value, and place in treatment of patented oncology medicines following the loss of patent protection of standard medicines. The use of such proactive re-assessments in negotiating tactics might positively impact global expenditures for oncology medicines.

2021 ◽  
Author(s):  
Igor Nesteruk ◽  
Oleksii Rodionov

The accumulated number of COVID-19 cases per capita is an important characteristic of the pandemic dynamics that may also indicate the effectiveness of quarantine, testing and vaccination. As this value increases monotonically over time, the end of June 2021 was chosen, when the growth rate in Ukraine and the vast majority of European countries was small. This allowed us to draw some intermediate conclusions about the influence of the volume of population, its density, and the level of urbanization on the accumulated number of laboratory-confirmed cases per capita in European countries and regions of Ukraine. A simple analysis showed that the number of cases per capita does not depend on these demographic factors, although it may differ by about 4 times for different regions of Ukraine and more than 9 times for different European countries. The number of COVID-19 per capita registered in Ukraine is comparable with the same characteristic in other European countries but much higher than in China, South Korea and Japan.


1998 ◽  
Vol 3 (4) ◽  
pp. 271-280 ◽  
Author(s):  
Hannah Steinberg ◽  
Briony R. Nicholls ◽  
Elizabeth A. Sykes ◽  
N. LeBoutillier ◽  
Nerina Ramlakhan ◽  
...  

Mood improvement immediately after a single bout of exercise is well documented, but less is known about successive and longer term effects. In a “real-life” field investigation, four kinds of exercise class (Beginners, Advanced, Body Funk and Callanetics) met once a week for up to 7 weeks. Before and after each class the members assessed how they felt by completing a questionnaire listing equal numbers of “positive” and “negative” mood words. Subjects who had attended at least five times were included in the analysis, which led to groups consisting of 18, 20, 16, and 16 subjects, respectively. All four kinds of exercise significantly increased positive and decreased negative feelings, and this result was surprisingly consistent in successive weeks. However, exercise seemed to have a much greater effect on positive than on negative moods. The favorable moods induced by each class seemed to have worn off by the following week, to be reinstated by the class itself. In the Callanetics class, positive mood also improved significantly over time. The Callanetics class involved “slower,” more demanding exercises, not always done to music. The Callanetics and Advanced classes also showed significantly greater preexercise negative moods in the first three sessions. However, these differences disappeared following exercise. Possibly, these two groups had become more “tolerant” to the mood-enhancing effects of physical exercise; this may be in part have been due to “exercise addiction.”


Author(s):  
Christopher Hood ◽  
Rozana Himaz

This chapter draws on historical statistics reporting financial outcomes for spending, taxation, debt, and deficit for the UK over a century to (a) identify quantitatively and compare the main fiscal squeeze episodes (i.e. major revenue increases, spending cuts, or both) in terms of type (soft squeezes and hard squeezes, spending squeezes, and revenue squeezes), depth, and length; (b) compare these periods of austerity against measures of fiscal consolidation in terms of deficit reduction; and (c) identify economic and financial conditions before and after the various squeezes. It explores the extent to which the identification of squeeze episodes and their classification is sensitive to which thresholds are set and what data sources are used. The chapter identifies major changes over time that emerge from this analysis over the changing depth and types of squeeze.


Author(s):  
Anneli Lofstedt ◽  
Baukje de Roos ◽  
Paul G. Fernandes

Abstract Purpose To review the seafood dietary recommendations of European countries and compare them to national seafood supplies. Methods Current seafood dietary recommendations were collated from national health authorities across Europe. Food balance sheets were downloaded from the FAO, and appropriate conversion factors were applied to each seafood commodity. Average net per capita seafood supplies from 2007 to 2017 were derived from data on imports and production for food from both capture fisheries and aquaculture, accounting for exports. Results Both national dietary recommendations and seafood supplies varied considerably throughout Europe. At a national level, on a per capita basis, only 13 out of the 31 of European dietary recommendations for fish consumption were satisfied by national seafood supplies. Most of the countries with coastal access, as well as those with traditional fish-eating cultures, such as France and countries in Northern Europe, had adequate seafood supplies to meet their recommendations. The landlocked countries of Central and Eastern Europe did not have enough seafood supplies to satisfy their recommendations. Conclusions Our findings emphasise the need to not only consider consumer health outcomes when developing and advocating dietary recommendations, but also the sustainability of food production systems. As many foods are not necessarily locally sourced but traded as part of global production and distribution systems, it is important to consider greater consistency between national dietary recommendations to facilitate more sustainable marine food systems.


2021 ◽  
Vol 19 (1) ◽  
pp. 63-73
Author(s):  
Aimable Nsabimana ◽  
Fidele Niyitanga ◽  
Dave D. Weatherspoon ◽  
Anwar Naseem

Abstract Rwanda’s “Crop Intensification Program (CIP)” is primarily a land consolidation program aimed at improving agricultural productivity and food security. The program, which began in 2007, focuses on monocropping and commercialization of six priority crops: maize, wheat, rice, white potato, beans, and cassava. CIP has facilitated easy access to improved seed stocks, fertilizer, extension services, and postharvest handling and storage services. Although studies have documented the impact of CIP on changes in farm yield, incomes, and productivity, less is known about its impact on food prices. In this study, we examine the crop-food price differences in intensive monocropped CIP and non-intensive monocropped CIP zones in Rwanda. Specifically, the study evaluates price variations of beans and maize along with complementary food crops in intensive and non-intensive monocropped zones before and after the introduction of the CIP policy. We find that the CIP policy is not associated with differences in CIP crop prices between the intensive and non-intensive monocropped zones. Over time, prices increased for CIP crops but generally, the crop prices in the two zones were cointegrated. Prices for non-CIP crops in the two different zones did show price differentials prior to the implementation of CIP, with the prices in intensive monocropped zones being greater than in the non-intensive monocropped zones. Moreover, the prices in intensive areas are cointegrated with prices in non-intensive areas for maize and beans and these prices are converging. This indicates that farmers who intensively produced one CIP crop were able to go to the market and purchase other food crops and that price differences between zones have decreased over time, potentially making the CIP intensive farmers better off.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Miguel A. Bedoya-Pérez ◽  
Michael P. Ward ◽  
Max Loomes ◽  
Iain S. McGregor ◽  
Mathew S. Crowther

AbstractShortly after the enactment of restrictions aimed at limiting the spread of COVID-19, various local government and public health authorities around the world reported an increased sighting of rats. Such reports have yet to be empirically validated. Here we combined data from multi-catch rodent stations (providing data on rodent captures), rodent bait stations (providing data on rodent activity) and residents’ complaints to explore the effects of a six week lockdown period on rodent populations within the City of Sydney, Australia. The sampling interval encompassed October 2019 to July 2020 with lockdown defined as the interval from April 1st to May 15th, 2020. Rodent captures and activity (visits to bait stations) were stable prior to lockdown. Captures showed a rapid increase and then decline during the lockdown, while rodent visits to bait stations declined throughout this period. There were no changes in the frequency of complaints during lockdown relative to before and after lockdown. There was a non-directional change in the geographical distribution of indices of rodent abundance suggesting that rodents redistributed in response to resource scarcity. We hypothesize that lockdown measures initially resulted in increased rodent captures due to sudden shortage of human-derived food resources. Rodent visits to bait stations might not show this pattern due to the nature of the binary data collected, namely the presence or absence of a visit. Relocation of bait stations driven by pest management goals may also have affected the detection of any directional spatial effect. We conclude that the onset of COVID-19 may have disrupted commensal rodent populations, with possible implications for the future management of these ubiquitous urban indicator species.


2021 ◽  
pp. 095679762097056
Author(s):  
Morgana Lizzio-Wilson ◽  
Emma F. Thomas ◽  
Winnifred R. Louis ◽  
Brittany Wilcockson ◽  
Catherine E. Amiot ◽  
...  

Extensive research has identified factors influencing collective-action participation. However, less is known about how collective-action outcomes (i.e., success and failure) shape engagement in social movements over time. Using data collected before and after the 2017 marriage-equality debate in Australia, we conducted a latent profile analysis that indicated that success unified supporters of change ( n = 420), whereas failure created subgroups among opponents ( n = 419), reflecting four divergent responses: disengagement (resigned acceptors), moderate disengagement and continued investment (moderates), and renewed commitment to the cause using similar strategies (stay-the-course opponents) or new strategies (innovators). Resigned acceptors were least inclined to act following failure, whereas innovators were generally more likely to engage in conventional action and justify using radical action relative to the other profiles. These divergent reactions were predicted by differing baseline levels of social identification, group efficacy, and anger. Collective-action outcomes dynamically shape participation in social movements; this is an important direction for future research.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A141-A141
Author(s):  
Hrishikesh Kale ◽  
Rezaul Khandker ◽  
Ruchit Shah ◽  
Marc Botteman ◽  
Weilin Meng ◽  
...  

Abstract Introduction Use of benzodiazepines to treat insomnia has been associated with serious side effects and abuse potential. Insomnia patients are at high risk of opioid abuse and better sleep patterns may help to reduce opioid use. This study examined the trend in the use of benzodiazepines and prescription opioids before and after initiation of suvorexant in insomnia patients. Methods The study analyzed 2015–2019, Optum Clinformatics Data Mart. Insomnia patients, identified using ICD-9/10 codes and prescribed suvorexant were included. The study included incident (newly diagnosed) and prevalent cohorts of insomnia patients. The proportion of patients on benzodiazepines or prescription opioids were calculated for 12 monthly intervals before (pre-period) and after initiation of suvorexant (post-period). Interrupted time series (ITS) analysis was conducted to assess trends for use of benzodiazepine or prescription opioids over time. Results A total of 5,939 patients from the incident insomnia cohort and 18,920 from the prevalent cohort were included. For the incident cohort, mean age was 64.47 (SD: 15.48), 63% were females, 71% had Medicare Advantage coverage, 59% had Charlson comorbidity index score (CCI) ≥ 1, 27% had an anxiety disorder and 16% had substance abuse disorder. Prevalent insomnia cohort was similar but had higher CCI. Results from ITS suggested that at the beginning of the pre-period, 28% of incident insomnia patients used either opioids or benzodiazepines with the rate of use in the pre-period increasing by 0.11% per month. In the post-period, the rate of use decreased by 0.33% per month. About 26% patients used benzodiazepines or opioids at 12-month after suvorexant initiation. In the absence of suvorexant, this proportion would have been 31%. Similar findings were observed for the prevalent insomnia cohort. A larger decrease was observed for opioid use than benzodiazepines. Conclusion The rate of benzodiazepines or prescription opioid use decreased over time after the initiation of suvorexant. Suvorexant has the potential to reduce the use of opioids and benzodiazepines among insomnia patients. Further research is needed to confirm these findings. Support (if any) This study was sponsored by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.


BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Kirsten E. Wiens ◽  
Lauren E. Schaeffer ◽  
Samba O. Sow ◽  
Babacar Ndoye ◽  
Carrie Jo Cain ◽  
...  

Abstract Background Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes. Methods We used a Bayesian geostatistical model and data from household surveys to map the percentage of children with diarrhea that received (1) any ORS, (2) only RHF, or (3) no oral rehydration treatment between 2000 and 2018. This approach allowed examination of whether RHF was replaced with ORS before and after interventions, policies, and external events that may have impacted healthcare access. Results We found that RHF was replaced with ORS in most Sierra Leone districts, except those most impacted by the Ebola outbreak. In addition, RHF was replaced in northern but not in southern Mali, and RHF was not replaced anywhere in Senegal. In Senegal, there was no statistical evidence that a national policy promoting ORS use was associated with increases in coverage. In Sierra Leone, ORS coverage increased following a national policy change that abolished health costs for children. Conclusions Children in parts of Mali and Senegal have been left behind during ORS scale-up. Improved messaging on effective diarrhea treatment and/or increased ORS access such as through reducing treatment costs may be needed to prevent child deaths in these areas.


2020 ◽  
Vol 8 (3) ◽  
pp. 44
Author(s):  
Alexander Baranovsky ◽  
Nataliia Tkachenko ◽  
Vladimer Glonti ◽  
Valentyna Levchenko ◽  
Kateryna Bogatyrova ◽  
...  

Traditionally, public procurement has been associated with the measurement of achieving savings. However, recent research shows that the economic impact of public procurement is not limited only to savings, but by measuring the impact of four capitals—natural, human, social, and economic—on sustainable well-being over time. Ukraine is a country with a very low gross domestic product (GDP) per capita, which exacerbates the problem of the impact of public procurement results on the population’s welfare. Ukrainian public procurement legislation allows customers to apply non-price criteria (the share of non-price criteria cannot be more than 70%), which, together, are taken into account in the formula of the quoted price. The studies show that the effect of the use of non-price criteria depends on the relevance of the method of the evaluation of non-price criteria. The most important non-price criteria for Ukrainian customers by product categories and the methods of their evaluation are analyzed according to the Bi.prozorro.org analytics module. Therefore, it is concluded that the quoted price method, which is used in Ukrainian practice, is not relevant in comparison with the method used in the EU. A survey of the government buyers on the practice of applying non-price criteria was conducted, and the areas of their use were identified.


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