Research on the impact of China's reform to delegate power, streamline administration, and optimize government services on the technology innovation efficiency of the pharmaceutical manufacturing industry.

Objective: The government has recently implemented reforms aimed at delegating power, streamlining administration, and optimizing government services. This reform has eliminated barriers that impede the growth of various industries, thereby unleashing innovative potential. Additionally, there have been several medical policies, including changes to medical insurance and centralized volume-based procurement. China's pharmaceutical market has undergone significant changes, leading to increased demands for innovation technology efficiency in pharmaceutical manufacturing. Methods: The three-stage BCC theory was employed to assess the effectiveness of technology innovation in the industry under this reform. Calculate precise comprehensive technical efficiency values, pure technical efficiency values, and scale efficiency values for technological innovation in the pharmaceutical industry across 30 provinces from 2018 to 2020, after removing environmental factors. Results: In 2020, Jiangsu and Shandong and nine other provinces reached the comprehensive technical efficiency frontier surface, joining Tianjin, Zhejiang, and Guangdong provinces. However, Gansu, Qinghai, Ningxia, and Xinjiang still need to catch up due to their smaller industrial scale and lack of technology. Discussion: To ensure the effectiveness of reforms, it is crucial to fully consider provincial differences. Articulating national and provincial policies is necessary to allow efficient provinces to continue and allocate resources toward less efficient provinces to improve overall efficiency.

Does China improve social welfare after implementing the national volume-based procurement?

Objective: To explore the changes in social welfare before and after the implementation of the national volume-based procurement (NVBP). Explore whether the NVBP promotes the healthy development of manufacturers under the premise of benefiting patients. Then put forward relevant suggestions on how to effectively intervene the government in the pharmaceutical market. Methods: Starting with consumer surplus and producer surplus, social welfare was studied from the three perspectives of price, supply, and demand. Results: Consumer surplus was significantly increased, and the drug welfare of patients was significantly improved. The profits of the whole pharmaceutical industry have decreased but will increase in the future. The welfare of individual pharmaceutical enterprises varies. Overall social welfare has been significantly improved. Conclusion: The core purpose of the NVBP is to improve the medication welfare of patients, and through the increase of consumer surplus, it can affect the increase of producer surplus. Under such a linkage mechanism, the diversified linkage system of "price, demand, and supply" will achieve the effect of "1 + 1+1 > 3".

Disease burden of primary gallbladder and biliary tract cancers associated with body mass index in 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017.

OBJECTIVE: To investigate the incidence of primary gallbladder and biliary tract cancer, mortality and disability-adjusted life years (DALY) of the global burden from 1990 to 2017. METHODS: Data of 195 countries and territories from 1990 to 2017 were extracted from the Global Health Data Exchange. The age-standardized incidence rate (ASIR) and estimated annual percentage change (EAPC) were employed to quantify trends in the incidence of primary gallbladder and biliary tract cancer. The age-standardized death rate (ASDR), age-standardized DALY and their corresponding EAPC were used to evaluate mortality trends. RESULTS: The global incidence of primary gallbladder and biliary tract cancer rose by 75.9% from 119 900 cases in 1990 to 210 900 cases in 2017. The highest ASIR was observed in Chile (10.8 per 100 000 in 2017), followed by Japan and South Korea. Regions with the highest social development index (SDI) quintile also had the highest death cases associated with primary gallbladder and biliary tract cancer in 2017 (60 100, 95% UI 55 800-62 700). A high body mass index (BMI) was found to be closely related to age-standardized deaths and age-standardized DALY in most of the regions analyzed. CONCLUSIONS: Primary gallbladder and biliary tract cancer remains a serious threat to global public health, especially in high-SDI countries. The ASDR and age-standardized DALY decreased from 1990 to 2017. A high BMI may be associated with this cancer burden.

Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study.

BACKGROUND: To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. METHODS: We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0-14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. RESULTS: A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. CONCLUSIONS: The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

Cost-Effectiveness Analysis Of Pembrolizumab In The Treatment Of Advanced Recurrent Metastatic Head And Neck Squamous Cell Carcinoma In China And The United States.

BACKGROUND: Pembrolizumab, a programmed cell death-1 (PD-1) inhibitor, has recently gained prominence as a second-line treatment for recurrent and/or metastatic head and neck squamous cell cancer (R/M HNSCC). This study compares the acceptance and different influencing factors of pembrolizumab in the treatment of R/M HNSCC in developed (i.e., the United States) and developing (i.e., China) countries through cost-effectiveness analysis and provides valuable suggestions for clinical decision making. METHODS: A Markov model was constructed using TreeAge Pro 2015 software to evaluate the economic value of four treatment strategies. Quality-adjusted life years (QALY) and incremental cost-effectiveness ratio (ICER) were used as economic indicators for incremental cost-effectiveness analysis. The stability of the model was evaluated by one-way sensitivity and probability sensitivity analyses. RESULTS: The ICERs for the pembrolizumab group versus PD-L1 CPS treatment in China and the US were $7892/QALY and $11,900/QALY, respectively. All ICERs were less than the threshold of $29,306 in China and $50,000 in the US; thus, pembrolizumab is cost effective. Sensitivity analysis confirmed a stable economic advantage in the single-drug regimen of pembrolizumab in China and the US. CONCLUSION: Pembrolizumab monotherapy as a second-line treatment for R/M HNSCC presents more health benefits in comparison with the standard, PD-L1 TPS and PD-L1 CPS groups in China and the US.

Contextual Cueing Effect in Spatial Layout Defined by Binocular Disparity.

Repeated visual context induces higher search efficiency, revealing a contextual cueing effect, which depends on the association between the target and its visual context. In this study, participants performed a visual search task where search items were presented with depth information defined by binocular disparity. When the 3-dimensional (3D) configurations were repeated over blocks, the contextual cueing effect was obtained (Experiment 1). When depth information was in chaos over repeated configurations, visual search was not facilitated and the contextual cueing effect largely crippled (Experiment 2). However, when we made the search items within a tiny random displacement in the 2-dimentional (2D) plane but maintained the depth information constant, the contextual cueing was preserved (Experiment 3). We concluded that the contextual cueing effect was robust in the context provided by 3D space with stereoscopic information, and more importantly, the visual system prioritized stereoscopic information in learning of spatial information when depth information was available.