Economic burden of multiple sclerosis: a cross-sectional study in Iran

Background Multiple Sclerosis (MS) is a chronic debilitating disease that imposes a heavy socioeconomic burden on societies. This study aimed to determine the economic burden of MS on patients using the first (CinnoVex and ReciGen) and second (Fingolimod and Natalizumab) drug therapy lines. Methods This cost of illness study was an economic evaluation carried out as cross-sectional research in 2019 in southern Iran. A total of 259 patients were enrolled in two lines of drug therapy (178 patients in the first line and 81 ones in the second). The prevalence-based approach and the bottom-up approach were used to collect cost information and to calculate the costs from the societal perspective, respectively. The human capital approach was applied to calculate indirect costs. To collect the required data a researcher-made data collection form was utilized. The data were obtained using the information available in the patients’ medical records and insurance invoices as well as their self-reports or that of their companions. Results The results showed that the annual costs of MS in the first and second lines of drug therapy per patient were $ 1919 and $ 4082 purchasing power parity (PPP), respectively, and in total, $ 2721 PPP in 2019. The highest mean costs in both lines were those of direct medical costs, of which purchasing the main medicines in both lines accounted for the highest. Conclusion Considering the findings of this study and in order to reduce the burden of the disease, the following suggestions are presented: providing necessary facilities for the production of MS drugs in the country; proper and equitable distribution of neurologists; expanding the provision of home care services; and using the technologies related to the Internet, including WhatsApp, to follow up the MS patients’ treatment.

Experience in Supporting Industry Development in Japan and Lessons for Viet Nam

Japan is the world's 3rd largest economy with a nominal GDP of USD 5380 billion. Japan's economy has a rapid industrial development process after its defeat in World War II. Vietnam's economy in 2020 will achieve GDP growth of 2.9%, nominal GDP of 300 billion dollars, per capita income reached $2786, if calculated according to purchasing power parity (PPP), the average income of Vietnamese people is about $ 8,500. In 2020, Vietnam has a trade surplus of 19.1 billion USD (an important contribution to this result is the total two-way turnover of 39.6 billion USD, a trade deficit of 1.1 billion USD from Japan. No small contribution to the economic success of Vietnam as a strategic partner of Japan - the third largest economy in the world. Japan is the first country in the G7 group to recognize Vietnam as a market economy and partner, the largest ODA sponsor for Vietnam, the number 1 investor in Vietnam and the 3rd largest trading partner of Vietnam. This paper also refers the lessons learned for Vietnam.

Comparative analysis of the government investments and revenue from different sectors in Bangladesh and its impact on the development of HRM sectors: A 20 years of study

Human resource management divisions are such critical areas of both the public and private sectors that can regulate a country's socio-economic and financial status via generating and manipulating skilled workforces for all possible revenue sectors. Nominal GDP with purchasing power parity (PPP) of a nation is directly interlinked with the human resource policies. For such a developing country as Bangladesh, human resource development and management issues are often very challenging, when the government has to face the demands of a vast population with the least amount of resources. In this research, different highest to the lowest revenue sectors of our country have analyzed depending on the opinions of the HRM experts and the data records of the government, where a correlative study have preferred with the government invest to revenue scale for sector wise human resource development over twenty years. In all aspects, the correlation was significant, because only the highest emphasized sectors of the Govt. could ensure better subsidiaries, higher investments and phenomenal human resource management such as- agriculture and textiles than the inferior looking sectors namely- healthcare and socio-economic. Comprehensive factorial analysis has taken place in this research which can help to figure out the concerns and prospects of the HRM sectors means skilful training facility, health insurance, gender discrimination, education level, corruption, public private partnerships, government policies and so on. A business friendly environment and job sector comparative education and training systems can ensure sound HRM in Bangladesh with proper and cutting edge integrative policies.

Effectiveness of Globalization and Human Capital on Market & Net Income Inequality in NEXT11 Countries: A Panel Data Analysis

This study scrutinizes the impact of defacto and dejure GLOB (KOF GLOB index 2018) on Income inequality on economically emerging countries; NEXT11 countries. The defacto GLOB indicates the estimate of GLOB including variables representing activities and flows; de jure estimate includes variables which show policies representing enable flows and activities. Our analysis separates the impact of globalization on net and market income inequalities. Pretax/transfer and the post-tax/transfer GINI indices were employed as the measures of income inequality. This analysis used balanced panel for NEXT11 countries for the period 1990-2015. Economic globalization both defacto and dejure showed positive sign that depicts a significant relationship with dependent variable. It explains that defacto political has positive sign and dejure political globalization decreases inequality while economic globalizations in both divisions have positive sign and significant impact on inequality. Interestingly, defacto social globalization has positive sign but dejure social has positive sign. Moreover, the purchasing power parity and age dependency both have negative sign and significant influence on inequality. These conclusions point out that social and political globalization may be a hindering factor for governance in these countries.

MACROECONOMIC BUSINESS ENVIRONMENT AND THE DEVELOPMENT OF SMALL AND MEDIUM ENTERPRISES IN NIGERIA

The study evaluates the effect of the global macro-economic business environment on the development of Small-Scale and Medium-Sized Enterprises (SMEs) in Nigeria. Secondary data on the global macro-economic index of SMEs businesses were selected over 35 years (1985–2019). The data collected were analysed using descriptive statistics and multiple regression analysis techniques. The study revealed the positive coefficient value of 354 836.6525 and 24 141 873.6 for the gross domestic product (GDP) on Purchasing Power Parity (PPP) and Budget variables. A negative coefficient value of –16347085.61 and –232997.0657 was obtained for the inflation rate and the exchange rate, respectively. The coefficient values show the level at which the development of SMEs businesses was affected through the global environmental factors. The study concluded that the global macro-economic business environment directly affects the development of SMEs businesses. The study recommends a policy strategy that will face out the global macro-economic constraints affecting SMEs businesses.

EUROPEAN INTEGRATION: ADVANTAGES AND THREATS TO UKRAINE’S FOREIGN TRADE

Background. In terms of unfavorable external conditions and a significant deterioration of the socio-economic situation, the Ukrainian market has stagnated. Russia’s actions, including its unilateral suspension of the Free Trade Agreement, have led to a reduction in Ukraine's bilateral foreign trade operations. The processes of globalization and integration issue new challenges to the economy of any country, in particular, the questions of evaluation and stimulation of foreign trade of enterprises emerge in the conditions of constant transformation. Therefore, the aim of this study is to identifytrends and features of Ukraine’s foreign trade in the context of globalization and integration. Materials and methods. The article is based on a synthesis of research results of domestic and foreign scientists to determine the main influencing factors of cooperation with the EU on the state of development of Ukraine’s foreign trade. Research on this issue was conducted using the methods of theoretical generalization, analysis and synthesis. Results. Ukraine’s position in world trade is determined by the main factors: the dynamics of GDP, rating and index of economic freedom. The peculiarities of Ukraine's foreign trade over the last decade have been studied, the main partner countries; the main challenges that arise in our foreign trade as a result of European integration processes have been identified. It is proved that in the analysis of GDP it is expedient to use the indicator of GDP calculated on purchasing power parity. It is established that in the conditions of the world crisis, the war in the east caused the greatest damage to the economy of Ukraine. It was clarified that Ukraine needs to expand the geography of foreign trade relations, at the same time there is a significant unrealized potential for the development of bilateral relations with EU countries. Conclusion. Ukraine must follow the chosen course of European integration, but at the same must also develop other partnerships with countries on other continents. Unfortunately, Ukraine exports more raw materials and goods with low added value. Therefore, there is a need: to change the content of exports, to introduce tax and customs instruments to support exports, to amend the Association Agreement in terms of international trade. The structure of foreign trade does not stimulate Ukraine's economy to innovative development, so there is an urgent need for domestic policy reforms and changes in external priorities.

Nonlinear Cointegration and Asymmetric Adjustment in Purchasing Power Parity of the USA, Germany, and Pakistan

The current study explores nonlinear cointegration as well as asymmetric adjustment to investigate the long-run purchasing power parity in three major trading partners of Pakistan. The ESTAR and LSTAR models were used to investigate the behavior of the nominal exchange rates. The findings declared that series follows the nonlinear exchange rate. The asymmetric behavior of the exchange rate allows the threshold cointegration model to be implemented. In the case of Pakistan-China, the result suggests that long-run PPP holds. As a result, trading will be more profitable if the exchange rate is varied in relation to major trading partners rather than just the US dollar.

Estimating the Financial Incentive for Caribbean Teachers to Migrate: An Analysis of Salary Differentials using Purchasing Power Parity (PPP)

The teaching stock within the Caribbean region has been eroded by migration to developed countries. Higher potential earnings are one of the motivating factors to move abroad, but little is known about the extent of the income disparity between countries in the Caribbean and popular destination countries. Teacher salary comparisons are undertaken between selected countries in the Caribbean; Suriname, Trinidad and Tobago, St. Lucia, and Jamaica and popular destination countries, namely; United Kingdom, United States, and Canada using a purchasing power parity (PPP) exchange rate. Results show that newly qualified teachers can earn substantially more abroad, with Canada paying over twice the PPP adjusted salary compared to that offered in Jamaica (133.1%) and Suriname (110.6%). The United States offers the highest earning increases for mid- and late career teachers at over three times that offered in Jamaica (214.5%) and Suriname (223.4%). Canada is a close second across all Caribbean countries, whilst the United Kingdom offers the smallest salary differentials at 153.6% for Jamaica and 64.8% for St. Lucia. The study further reveals that there are salary disparities within the Caribbean, which may be a motivating factor for intra-regional migration.

Οικονομική αξιολόγηση της δοκιμασίας HPV DNA ως πρωταρχικής μεθόδου προσυμπτωματικού ελέγχου για καρκίνο τραχήλου της μήτρας στην Ελλάδα

Ο καρκίνος του τραχήλου της μήτρας αποτελεί την 7η συχνότερη μορφή καρκίνου στις γυναίκες στην Ελλάδα. Η αποτελεσματική διαχείριση της νόσου βασίζεται στην πρόληψη και δει στον προσυμπτωματικό έλεγχο ο οποίος έως πρόσφατα βασιζόταν στην κυτταρολογική εξέταση. Η σύνδεση του καρκίνου του τραχήλου της μήτρας με τον ιό των ανθρωπίνων θηλωμάτων οδήγησε στην ανάπτυξη της δοκιμασίας HPV DNA, η κλινική αποτελεσματικότητα της οποίας αποδεικνύεται πως υπερέχει της καθιερωμένης πρακτικής της κυτταρολογικής εξέτασης. Παρά την κλινική του υπεροχή η εισαγωγή του σε εθνικά προγράμματα προσυμπτωματικού ελέγχου απαιτεί τον έλεγχο της οικονομικής του αποδοτικότητα καθώς υπό τον περιορισμό των σπανίων πόρων η χρηματοδότησή του οφείλει να μεγιστοποιεί την αξία της επένδυσης. Στο πλαίσιο αυτό, σκοπό της παρούσας διατριβής αποτελεί η διερεύνηση της οικονομικής αποδοτικότητας εναλλακτικών στρατηγικών προσυμπτωματικού. Η προσέγγιση της υπόθεσης εργασίας επιτευχθεί με την ανάπτυξη μαρκοβιανών υποδειγμάτων τα οποία εξέτασαν την αποτελεσματικότητα και το κόστος εννέα εναλλακτικών στρατηγικών προσυμπτωματικού ελέγχου στην Ελλάδα. Οι στρατηγικές ελέγχθηκαν με ενναλακτικές προσεγγίσεις των βασικών παραμέτρων τους όπως η πρωταρχική μέθοδος, το διάστημα επανελέγχου, τα ηλικιακά όρια του πληθυσμού-στόχου και το επίπεδο συμμόρφωσης. Οι αναλύσεις διεξήχθησαν υπό την οπτική του συστήματος υγείας και βασίστηκαν ως επί το πλείστων στην κλινική μελέτη HERMES (HEllenic Real life Multicentric cErvical Screening), για τις κλινικές και επιδημιολογικές παραμέτρους των υποδειγμάτων και σε δεδομένα της κοινωνικής ασφάλισης για τις τιμές των παρεμβάσεων υγείας και των ιατρικών πράξεων. Δεδομένης της απουσίας δεδομένων σχετικά με το κόστος διαχείρισης της νόσου χρησιμοποιήθηκαν ευρωπαϊκά δεδομένα τα οποία μετατράπηκαν σε ελληνικές σχετικές τιμές με την χρήση των Δεικτών Τιμών Καταναλωτή (Consumer Price Index, CPI) ιατροτεχνολογικών υπηρεσιών και προϊόντων και των δεικτών Ισοτιμίας Αγοραστικής Δύναμης (Purchasing Power Parity, PPP). Τέλος, για τον έλεγχο της αξιοπιστίας των αποτελεσμάτων διεξήχθη μια σειρά από ντερμινιστικές (one way sensitivity analyses) και πιθανολογικές αναλύσεις ευαισθησίας (probabilistic sensitivity analyses). Η αποτελεσματικότητα των στρατηγικών προέκυψε ότι μεγιστοποιείται με τις 4 στρατηγικές (HPV test ταυτόχρονη γονοτύπηση, HPV test μετέπειτα γονοτύπηση, συνδυασμός κυτταρολογικής εξέτασης & HPV test μετέπειτα γονοτύπηση, συνδυασμός κυτταρολογικής εξέτασης & HPV test ταυτόχρονη γονοτύπηση,) οι οποίες προσφέρουν HPV test με γονοτύπηση ανά 3 έτη και απευθύνονται σε γυναίκες 25-69 με πλήρη συμμόρφωση στον έλεγχο (100%). Οι στρατηγικές αυτές δύνανται να μειώσουν την επίπτωση της νόσου σε γυναίκες 25-85 ετών κατά 24,5% σε σχέση με την τρέχουσα πρακτική (7,64 περιστατικά/100.000 γυναίκες, 95% CI 7,56 – 7,69 έναντι 10,12, 95% CI 9,99 – 10,26) και κατά 34,9% σε σχέση με της χαμηλότερης αποτελεσματικότητας στρατηγικής HPV test χωρίς γονοτύπηση ανά 5 έτη (11,47, 95% CI 11,30 – 11,61). Ο λόγος κόστους-χρησιμότητας της στρατηγικής με HPV test και ταυτόχρονη γονοτύπηση ανά 3 ή 5 έτη σε σχέση με την τρέχουσα πρακτική εκτιμήθηκε στα 3.918€/QALY και στα –162.843€/QALY, αντίστοιχα, αρκετά χαμηλότερα από το συμβατικό όριο των 52.437€/QALY. Η υιοθέτηση ενός προγράμματος προσυμπτωματικού ελέγχου με HPV test και ταυτόχρονη γονοτύπηση ανά 3 ή 5 έτη για γυναίκες 25-69 ετών αποτελεί μια οικονομικά αποδοτική επιλογή η οποία βελτιώνει τις εκβάσεις υγείας των γυναικών και βελτιστοποιεί την κατανομή των πόρων που επενδύονται στην πρόληψη του καρκίνου του τραχήλου της μήτρας στην Ελλάδα.