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1.
PLoS One ; 19(5): e0298897, 2024.
Article En | MEDLINE | ID: mdl-38722980

To estimate the economic and financial viability of a pig farm in central sub-tropical Mexico within a 5-year planning horizon, a Monte Carlo simulation model was utilized. Net returns were projected using simulated values for the distribution of input and product processes, establishing 2021 as base scenario. A stochastic modelling approach was employed to determine the economic and financial outlook. The findings reveal a panorama of economic and financial viability. Net income increased by 555%, return on assets rose from 3.36% in 2022 to 11.34% in 2026, and the probability of decapitalization dropped from 58% to 13%, respectively in the aforesaid periods. Similarly, the probability of obtaining negative net income decreased from 40% in 2022 to 18% in 2026. The technological, productive, and economic management of the production unit allowed for a favorable scenario within the planning horizon. There is a growing interest in predicting the economic sectors worth investing in and supporting, considering their economic and development performance. This research offers both methodological and scientific evidence to demonstrate the feasibility of establishing a planning schedule and validating the suitability of the pork sector for public investment and support.


Farms , Mexico , Animals , Swine , Farms/economics , Models, Economic , Animal Husbandry/economics , Monte Carlo Method , Prospective Studies , Income
2.
PLoS One ; 19(5): e0302931, 2024.
Article En | MEDLINE | ID: mdl-38723015

In the face of the new economic environment, enterprises must continuously enhance their capabilities to achieve long-term development. In the current market scenario, business management relies on economic principles and legal accounting. Considering the current market situation, the article analyzed enterprises system reform and production planning, proposing corresponding countermeasures. Therefore, in order to achieve rapid development, it was necessary to strengthen the management of enterprises. In this paper, the current problems faced by enterprises, solutions and the significance of enterprises needed to improve their management level were explained, and the situation of enterprises was analyzed through the enterprise strategic management model. Comparing with the traditional management model in terms of the complexity of enterprise management processes, efficiency, management level score, and quarterly profit,findings reveal that the management model in the new economic environment has reduced the complexity of the enterprise process by 0.17 points. The management efficiency has increased by 0.15 points, the management score has increased by 14 points, and the quarterly profit of the company has increased by 30,000 yuan. Furthermore, it is elucidated that, in the new economy, enhancing the management level is essential for enabling enterprises to attain long-term development.


Commerce , Commerce/economics , Models, Economic , Humans
3.
PLoS One ; 19(5): e0296654, 2024.
Article En | MEDLINE | ID: mdl-38728313

In the era of the rapid development of e-commerce, many retailers choose to launch promotional activities to become consumers' first choice for shopping. Since price discounts can greatly attract consumers, the e-commerce platforms have also begun to implement discount pricing. It is urgent for e-commerce platforms and retailers to formulate reasonable discount strategies to achieve sustainable business. In this paper, we construct a dynamic game model for implementing discount pricing on an e-commerce platform and two retailers, we study the market equilibrium between the two retailers and the e-commerce platform under various scenarios that considering consumers' strategic waiting behavior and competition between the two retailers, we further discuss the effectiveness of retailer discount pricing and the double discount pricing of the platform and retailers. We show that the optimal pricing decreases as the difference in product quality narrows under both pricing strategies. Low-quality retailers implementing a double discount pricing strategy are in relatively higher demand only when the difference in product quality is small. High-quality retailers implementing the retailer discount pricing strategy are in relatively higher demand only when the product quality difference is large. Double discount pricing is desirable for both e-commerce platforms and retailers and can be used to effectively achieve Pareto improvement in the market by increasing their expected profit. Our results emphasize the role of product quality and the value of the double discount pricing strategy. The double discount pricing strategy weakens the profit advantage that retailers and platforms gain from it as the rebate intensity and rebate redemption rates increase.


Commerce , Consumer Behavior , Commerce/economics , Consumer Behavior/economics , Humans , Costs and Cost Analysis , Models, Economic
4.
PLoS One ; 19(5): e0301764, 2024.
Article En | MEDLINE | ID: mdl-38728326

The current research project investigates the correlation between economic growth, government spending, and public revenue in seventeen Indian states spanning the years 1990 to 2020. An analysis of the relationship between key fiscal policy variables and economic growth was conducted utilising a panel data approach, the Generalised Method of Moments (GMM), and fully modified Ordinary Least Squares (FMOLS & DOLS) estimation. In our investigation, we assessed the impacts of non-tax revenue, development plan expenditure, tax revenue, and development non-plan expenditure on (i) the net state domestic product (NSDP) and (ii) the NSDP per capita. The findings indicate that the selected fiscal variables are significantly related. The results indicate that expeditious expansion of the fiscal sector is obligatory to stimulate economic growth in India and advance the actual development of the economies of these states.


Economic Development , India , Humans , Sustainable Development/economics , Government , Gross Domestic Product , Models, Economic , Public Expenditures
5.
Sci Rep ; 14(1): 10994, 2024 05 14.
Article En | MEDLINE | ID: mdl-38744832

In this paper, we propose a novel pricing model for delivery insurance in a food delivery company in Latin America, with the aim of reducing the high costs associated with the premium paid to the insurer. To achieve this goal, a thorough analysis was conducted to estimate the probability of losses based on delivery routes, transportation modes, and delivery drivers' profiles. A large amount of data was collected and used as a database, and various statistical models and machine learning techniques were employed to construct a comprehensive risk profile and perform risk classification. Based on the risk classification and the estimated probability associated with it, a new pricing model for delivery insurance was developed using advanced mathematical algorithms and machine learning techniques. This new pricing model took into account the pattern of loss occurrence and high and low-risk behaviors, resulting in a significant reduction of insurance costs for both the contracting company and the insurer. The proposed pricing model also allowed for greater flexibility in insurance contracting, making it more accessible and appealing to delivery drivers. The use of estimated loss probabilities and a risk score for the pricing of delivery insurance proved to be a highly effective and efficient alternative for reducing the high costs associated with insurance, while also improving the profitability and competitiveness of the food delivery company in Latin America.


Costs and Cost Analysis , Humans , Latin America , Algorithms , Machine Learning , Insurance/economics , Models, Economic
6.
PLoS One ; 19(5): e0303572, 2024.
Article En | MEDLINE | ID: mdl-38739613

OBJECTIVES: The development of the digital economy constitutes a key component of China's endeavors to advance towards "Digital China." The sports industry functions as a new catalyst for high-quality economic growth. This study systematically evaluated the integration between these two sectors. METHODS: First, we conducted two levels of grey relational analysis to assess their integration between 2016 and 2021. Second, we conducted a VAR analysis to determine whether their integration between 2009 and 2021 represents a causal relationship. RESULTS: At the macro level, the grey relational analysis reveals that the sports industry (grade = 0.770) ranked second among China's eight key economic sectors in terms of digital economy integration. At the meso level, a wide variation (ranging from 0.606 to 0.789) existed in the grade of integration between the digital economy and the sub-sectors of the sports industry. According to the VAR model, the digital economy does not Granger cause (p = 0.344) the growth of the sports industry. CONCLUSIONS: This study yielded two added values to the existing literature: First, there exists a sectoral imbalance in the digitization process; second, the explosive growth of the sports industry was not primarily caused by the digital economy. Accordingly, the "sports + digital" complex is still in the first wave of technological integration. We propose three policy recommendations, namely, sectoral synergistic development, overtaking via esports IP, and new economy and new regulation. Collectively, these findings provide updated insights for the digital transformation towards "building a leading sports nation" and "Digital China."


Sports , China , Humans , Economic Development , Industry/economics , Models, Economic
7.
PLoS One ; 19(5): e0302561, 2024.
Article En | MEDLINE | ID: mdl-38718054

This paper uses the difference-in-differences model to research how the "piercing the corporate veil" system marked by the 2005 Company Law amendment affects the level of corporate creditor protection. The research results show that private enterprises and local state-owned enterprises are sensitive and significant to this legal amendment. In contrast, local state-owned enterprises are more sensitive and have a stronger motivation to protect the interests of creditors. The motivation of companies with weaker profitability for creditor protection lasts not only for the year of law revision but also extends to the year of implementation. With the law's implementation, the growth effect of creditor protection for local state-owned enterprises has become more significant. Further analysis shows that the main findings of this article are more significant in companies with larger debt scales, companies with a higher year-on-year growth rate of operating income, companies with controlling shareholders, and companies with higher stock market capitalization. From an empirical research view, this paper explains the economic effect and mechanism of the whole corporate personality under the complete system and adds economic evidence for how the law acts on the capital market.


Investments , Investments/legislation & jurisprudence , Investments/economics , Humans , Models, Economic , Private Sector/economics , Private Sector/legislation & jurisprudence , Industry/economics , Industry/legislation & jurisprudence , Commerce/legislation & jurisprudence , Commerce/economics
8.
BMC Health Serv Res ; 24(1): 577, 2024 May 03.
Article En | MEDLINE | ID: mdl-38702650

BACKGROUND: Tuberculosis is the second most deadly infectious disease after COVID-19 and the 13th leading cause of death worldwide. Among the 30 countries with a high burden of TB, China ranks third in the estimated number of TB cases. China is in the top four of 75 countries with a deficit in funding for TB strategic plans. To reduce costs and improve the effectiveness of TB treatment in China, the NHSA developed an innovative BP method. This study aimed to simulate the effects of this payment approach on different stakeholders, reduce the economic burden on TB patients, improve the quality of medical services, facilitate policy optimization, and offer a model for health care payment reforms that can be referenced by other regions throughout the world. METHODS: We developed a simulation model based on a decision tree analysis to project the expected effects of the payment method on the potential financial impacts on different stakeholders. Our analysis mainly focused on comparing changes in health care costs before and after receiving BPs for TB patients with Medicare in the pilot areas. The data that were used for the analysis included the TB service claim records for 2019-2021 from the health insurance agency, TB prevalence data from the local Centre for Disease Control, and health care facilities' revenue and expenditure data from the Statistic Yearbook. A Monte Carlo randomized simulation model was used to estimate the results. RESULTS: After adopting the innovative BP method, for each TB patient per year, the total annual expenditure was estimated to decrease from $2,523.28 to $2,088.89, which is a reduction of $434.39 (17.22%). The TB patient out-of-pocket expenditure was expected to decrease from $1,249.02 to $1,034.00, which is a reduction of $215.02 (17.22%). The health care provider's revenue decreased from $2,523.28 to $2,308.26, but the health care provider/institution's revenue-expenditure ratio increased from -6.09% to 9.50%. CONCLUSIONS: This study highlights the potential of BPs to improve medical outcomes and control the costs associated with TB treatment. It demonstrates its feasibility and advantages in enhancing the coordination and sustainability of medical services, thus offering valuable insights for global health care payment reform.


Tuberculosis , Humans , China/epidemiology , Tuberculosis/economics , Tuberculosis/therapy , Health Care Costs/statistics & numerical data , COVID-19/economics , COVID-19/epidemiology , Health Expenditures/statistics & numerical data , Models, Economic , Computer Simulation , Health Personnel/economics
9.
Behav Brain Sci ; 47: e82, 2024 May 13.
Article En | MEDLINE | ID: mdl-38738369

Utilitarian characterizations of economic decision making fail to capture the complex, conditional, and heterogeneous motivations underlying human behavior as shaped by the predictive, multicriterial drivers of biological regulation. Unless economic models start to acknowledge that humans have bodies and a biology with its own adaptive logic and tradeoffs, economic policies will be systematically exposed to, and systematic generators of, proxy failures.


Decision Making , Humans , Decision Making/physiology , Motivation , Models, Economic
10.
Pharmacoeconomics ; 42(5): 487-506, 2024 May.
Article En | MEDLINE | ID: mdl-38558212

With an ever-increasing number of treatment options, the assessment of treatment sequences has become crucial in health technology assessment (HTA). This review systematically explores the multifaceted challenges inherent in evaluating sequences, delving into their interplay and nuances that go beyond economic model structures. We synthesised a 'roadmap' of literature from key methodological studies, highlighting the evolution of recent advances and emerging research themes. These insights were compared against HTA guidelines to identify potential avenues for future research. Our findings reveal a spectrum of challenges in sequence evaluation, encompassing selecting appropriate decision-analytic modelling approaches and comparators, deriving appropriate clinical effectiveness evidence in the face of data scarcity, scrutinising effectiveness assumptions and statistical adjustments, considering treatment displacement, and optimising model computations. Integrating methodologies from diverse disciplines-statistics, epidemiology, causal inference, operational research and computer science-has demonstrated promise in addressing these challenges. An updated review of application studies is warranted to provide detailed insights into the extent and manner in which these methodologies have been implemented. Data scarcity on the effectiveness of treatment sequences emerged as a dominant concern, especially because treatment sequences are rarely compared in clinical trials. Real-world data (RWD) provide an alternative means for capturing evidence on effectiveness and future research should prioritise harnessing causal inference methods, particularly Target Trial Emulation, to evaluate treatment sequence effectiveness using RWD. This approach is also adaptable for analysing trials harbouring sequencing information and adjusting indirect comparisons when collating evidence from heterogeneous sources. Such investigative efforts could lend support to reviews of HTA recommendations and contribute to synthesising external control arms involving treatment sequences.


Interdisciplinary Research , Technology Assessment, Biomedical , Humans , Decision Support Techniques , Models, Economic , Research Design , Technology Assessment, Biomedical/methods , Systematic Reviews as Topic , Clinical Trials as Topic
11.
J Affect Disord ; 356: 639-646, 2024 Jul 01.
Article En | MEDLINE | ID: mdl-38657770

OBJECTIVE: To evaluate the cost-effectiveness of repetitive transcranial magnetic stimulation (rTMS) as an adjunct to standard care from an Australian health sector perspective, compared to standard care alone for adults with treatment-resistant bipolar depression (TRBD). METHODS: An economic model was developed to estimate the cost per disability-adjusted life-year (DALY) averted and quality-adjusted life-year (QALY) gained for rTMS added to standard care compared to standard care alone, for adults with TRBD. The model simulated the time in three health states (mania, depression, residual) over one year. Response to rTMS was sourced from a meta-analysis, converted to a relative risk and used to modify the time in the depressed state. Uncertainty and sensitivity tested the robustness of results. RESULTS: Base-case incremental cost-effectiveness ratios (ICERs) were $72,299 per DALY averted (95 % Uncertainty Interval (UI): $60,915 to $86,668) and $46,623 per QALY gained (95 % UI: $39,676 - $55,161). At a willingness to pay (WTP) threshold of $96,000 per DALY averted, the base-case had a 100 % probability of being marginally cost-effective. At a WTP threshold of $64,000 per QALY gained, the base-case had a 100 % probability of being cost-effective. Sensitivity analyses decreasing the number of sessions provided, increasing the disability weight or the time spent in the depression state for standard care improved the ICERs for rTMS. CONCLUSIONS: Dependent on the outcome measure utilised and assumptions, rTMS would be considered a very cost-effective or marginally cost-effective adjunct to standard care for TRBD compared to standard care alone.


Bipolar Disorder , Cost-Benefit Analysis , Depressive Disorder, Treatment-Resistant , Quality-Adjusted Life Years , Transcranial Magnetic Stimulation , Humans , Transcranial Magnetic Stimulation/economics , Transcranial Magnetic Stimulation/methods , Bipolar Disorder/therapy , Bipolar Disorder/economics , Depressive Disorder, Treatment-Resistant/therapy , Depressive Disorder, Treatment-Resistant/economics , Australia , Adult , Models, Economic , Combined Modality Therapy , Female
12.
Pharmacoeconomics ; 42(5): 479-486, 2024 May.
Article En | MEDLINE | ID: mdl-38583100

Value of Information (VOI) analyses calculate the economic value that could be generated by obtaining further information to reduce uncertainty in a health economic decision model. VOI has been suggested as a tool for research prioritisation and trial design as it can highlight economically valuable avenues for future research. Recent methodological advances have made it increasingly feasible to use VOI in practice for research; however, there are critical differences between the VOI approach and the standard methods used to design research studies such as clinical trials. We aimed to highlight key differences between the research design approach based on VOI and standard clinical trial design methods, in particular the importance of considering the full decision context. We present two hypothetical examples to demonstrate that VOI methods are only accurate when (1) all feasible comparators are included in the decision model when designing research, and (2) all comparators are retained in the decision model once the data have been collected and a final treatment recommendation is made. Omitting comparators from either the design or analysis phase of research when using VOI methods can lead to incorrect trial designs and/or treatment recommendations. Overall, we conclude that incorrectly specifying the health economic model by ignoring potential comparators can lead to misleading VOI results and potentially waste scarce research resources.


Clinical Trials as Topic , Decision Support Techniques , Models, Economic , Research Design , Humans , Clinical Trials as Topic/economics , Clinical Trials as Topic/methods , Cost-Benefit Analysis , Uncertainty , Decision Making
14.
PLoS One ; 19(4): e0301141, 2024.
Article En | MEDLINE | ID: mdl-38557590

Recent advances in the field of machine learning have yielded novel research perspectives in behavioural economics and financial markets microstructure studies. In this paper we study the impact of individual trader leaning characteristics on markets using a stock market simulator designed with a multi-agent architecture. Each agent, representing an autonomous investor, trades stocks through reinforcement learning, using a centralized double-auction limit order book. This approach allows us to study the impact of individual trader traits on the whole stock market at the mesoscale in a bottom-up approach. We chose to test three trader trait aspects: agent learning rate increases, herding behaviour and random trading. As hypothesized, we find that larger learning rates significantly increase the number of crashes. We also find that herding behaviour undermines market stability, while random trading tends to preserve it.


Investments , Models, Economic , Machine Learning , Phenotype
15.
PLoS One ; 19(4): e0299699, 2024.
Article En | MEDLINE | ID: mdl-38648229

Portfolio optimization involves finding the ideal combination of securities and shares to reduce risk and increase profit in an investment. To assess the impact of risk in portfolio optimization, we utilize a significant volatility risk measure series. Behavioral finance biases play a critical role in portfolio optimization and the efficient allocation of stocks. Regret, within the realm of behavioral finance, is the feeling of remorse that causes hesitation in making significant decisions and avoiding actions that could lead to poor investment choices. This behavior often leads investors to hold onto losing investments for extended periods, refusing to acknowledge mistakes and accept losses. Ironically, by evading regret, investors may miss out on potential opportunities. in this paper, our purpose is to compare investment scenarios in the decision-making process and calculate the amount of regret obtained in each scenario. To accomplish this, we consider volatility risk metrics and utilize stochastic optimization to identify the most suitable scenario that not only maximizes yield in the investment portfolio and minimizes risk, but also minimizes resulting regret. To convert each multi-objective model into a single objective, we employ the augmented epsilon constraint (AEC) method to establish the Pareto efficiency frontier. As a means of validating the solution of this method, we analyze data spanning 20, 50, and 100 weeks from 150 selected stocks in the New York market based on fundamental analysis. The results show that the selection of the mad risk measure in the time horizon of 100 weeks with a regret rate of 0.104 is the most appropriate research scenario. this article recommended that investors diversify their portfolios by investing in a variety of assets. This can help reduce risk and increase overall returns and improve financial literacy among investors.


Investments , New York , Humans , Stochastic Processes , Models, Economic , Decision Making , Emotions , Risk
16.
PLoS One ; 19(4): e0302197, 2024.
Article En | MEDLINE | ID: mdl-38662755

Our study aims to investigate the interdependence between international stock markets and sentiments from financial news in stock forecasting. We adopt the Temporal Fusion Transformers (TFT) to incorporate intra and inter-market correlations and the interaction between the information flow, i.e. causality, of financial news sentiment and the dynamics of the stock market. The current study distinguishes itself from existing research by adopting Dynamic Transfer Entropy (DTE) to establish an accurate information flow propagation between stock and sentiments. DTE has the advantage of providing time series that mine information flow propagation paths between certain parts of the time series, highlighting marginal events such as spikes or sudden jumps, which are crucial in financial time series. The proposed methodological approach involves the following elements: a FinBERT-based textual analysis of financial news articles to extract sentiment time series, the use of the Transfer Entropy and corresponding heat maps to analyze the net information flows, the calculation of the DTE time series, which are considered as co-occurring covariates of stock Price, and TFT-based stock forecasting. The Dow Jones Industrial Average index of 13 countries, along with daily financial news data obtained through the New York Times API, are used to demonstrate the validity and superiority of the proposed DTE-based causality method along with TFT for accurate stock Price and Return forecasting compared to state-of-the-art time series forecasting methods.


Forecasting , Investments , Investments/economics , Forecasting/methods , Humans , Entropy , Models, Economic , Commerce/trends
17.
PLoS One ; 19(4): e0302131, 2024.
Article En | MEDLINE | ID: mdl-38662759

This study investigates the impact of oil market uncertainty on the volatility of Chinese sector indexes. We utilize commonly used realized volatility of WTI and Brent oil price along with the CBOE crude oil volatility index (OVX) to embody the oil market uncertainty. Based on the sample span from Mar 16, 2011 to Dec 31, 2019, this study utilizes vector autoregression (VAR) model to derive the impacts of the three different uncertainty indicators on Chinese stock volatilities. The empirical results show, for all sectors, the impact of OVX on sectors volatilities are more economically and statistically significant than that of realized volatility of both WTI and Brent oil prices, especially after the Chinese refined oil pricing reform of March 27, 2013. That implies OVX is more informative than traditional WTI and Brent oil prices with respect to volatility spillover from oil market to Chinese stock market. This study could provide some important implications for the participants in Chinese stock market.


Commerce , Petroleum , China , Petroleum/economics , Commerce/economics , Volatilization , Investments/economics , Uncertainty , Models, Economic , Humans , East Asian People
18.
PLoS One ; 19(4): e0298894, 2024.
Article En | MEDLINE | ID: mdl-38598503

Limited resident's participation in the stock market has become a key constraint to the capital market development. Utilizing the 2019 China Household Financial Survey (CHFS) data, our paper designs probit models to examine the peer effects of residents' stock market participation and explore the intermediary mechanisms with a multiple intermediary model. We find that: (1) Resident involvement in stock market decision-making exhibits significant peer effects. (2) Heterogeneity analysis reveals that males and rural residents display more pronounced peer effects than females and urban residents. Additionally, middle-aged residents demonstrate more potent peer effects than their younger and older counterparts, with the intensity of peer effects correlating with education levels. (3)We observe that the peer effects of market participation operate by altering economic expectations and enhancing residents' financial literacy. (4) Further investigation establishes that individuals engaging in stock market investments manifest peer effects when deciding whether to diversify their stock portfolio. This study holds reference value for analyzing the impact of social interaction on financial behaviors and regulating individuals' financial conduct.


Investments , Models, Economic , Humans , Middle Aged , Educational Status , China
19.
Pharmacoeconomics ; 42(5): 527-568, 2024 May.
Article En | MEDLINE | ID: mdl-38489077

BACKGROUND: Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, with up to 32% of patients with NSCLC harboring an epidermal growth factor receptor (EGFR) mutation. NSCLC harboring an EGFR mutation has a dedicated treatment pathway, with EGFR tyrosine kinase inhibitors and platinum-based chemotherapy often being the therapy of choice. OBJECTIVE: The aim of this study was to systemically review and summarize economic models of first-line treatments used for locally advanced or metastatic NSCLC harboring EGFR mutations, as well as to identify areas for improvement for future models. METHODS: Literature searches were conducted via Ovid in PubMed, MEDLINE, MEDLINE In-Process, Embase, Evidence-Based Medicine Reviews: Health Technology Assessment, Evidence-Based Medicine Reviews: National Health Service Economic Evaluation Database, and EconLit. An initial search was conducted on 19 December 2022 and updated on 11 April 2023. Studies were selected according to predefined criteria using the Population, Intervention, Comparator, Outcome and Study design (PICOS) framework. RESULTS: Sixty-seven articles were included in the review, representing 59 unique studies. The majority of included models were cost-utility analyses (n = 52), with the remaining studies being cost-effectiveness analyses (n = 4) and a cost-minimization analysis (n = 1). Two studies incorporated both a cost-utility and cost-minimization analysis. Although the model structure across studies was consistently reported, justification for this choice was often lacking. CONCLUSIONS: Although the reporting of economic models in NSCLC harboring EGFR mutations is generally good, many of these studies lacked sufficient reporting of justification for structural choices, performing extensive sensitivity analyses and validation in economic evaluations. In resolving such gaps, the validity of future models can be increased to guide healthcare decision making in rare indications.


Carcinoma, Non-Small-Cell Lung , Cost-Benefit Analysis , ErbB Receptors , Lung Neoplasms , Models, Economic , Humans , Antineoplastic Agents/economics , Antineoplastic Agents/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/economics , ErbB Receptors/genetics , Lung Neoplasms/drug therapy , Lung Neoplasms/economics , Lung Neoplasms/genetics , Mutation , Protein Kinase Inhibitors/economics , Protein Kinase Inhibitors/therapeutic use
20.
Clin Exp Rheumatol ; 42(4): 782-785, 2024 Apr.
Article En | MEDLINE | ID: mdl-38526008

OBJECTIVES: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of severe and chronic autoimmune diseases. Patients undergo two treatment phases: inducing remission and maintaining remission to prevent organ damage. Immunosuppressants, including glucocorticoids (GCs) are used as first-line treatment, but long-term GC use is associated with toxic effects. Novel treatments reduce or replace the need for long-term GC, and therefore can reduce GC-related toxicity. The evolving treatment landscape has presented new challenges for health technology assessment (HTA) of new treatments in AAV and long-term modelling of costs and outcomes in this disease. METHODS: Using the appraisal of avacopan in England (NICE) as a case study, this paper aims to identify the key challenges involved in the economic evaluation of new treatments for AAV, with a particular focus on the long-term modelling of the treatment costs and benefits for the purpose of HTA. The outcome of this study is a set of recommendations for modelling the cost-effectiveness of new treatments for AAV from the HTA perspective. RESULTS: The discussion focuses on the appropriate model structure, approach to modelling end-stage renal disease (ESRD) as a key determinant of costeffectiveness, capturing the impact of GC-related adverse events, and estimation of short and long-term costs of AAV. CONCLUSIONS: Economic evaluation of new treatments for AAV needs to capture all relevant downstream effects. ESRD is a key driver of cost-effectiveness but is associated with major uncertainty. Future observational studies need to offer sufficient detail to allow for differentiation in event rates across treatment options.


Aniline Compounds , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis , Cost-Benefit Analysis , Drug Costs , Immunosuppressive Agents , Models, Economic , Nipecotic Acids , Humans , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/economics , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/therapy , Antibodies, Monoclonal, Humanized/economics , Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Monoclonal, Humanized/adverse effects , Glucocorticoids/economics , Glucocorticoids/therapeutic use , Glucocorticoids/adverse effects , Immunosuppressive Agents/economics , Immunosuppressive Agents/therapeutic use , Immunosuppressive Agents/adverse effects , Kidney Failure, Chronic/economics , Kidney Failure, Chronic/therapy , Remission Induction , Technology Assessment, Biomedical , Time Factors , Treatment Outcome
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