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1.
Value Health ; 24(5): 625-631, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33933230

RESUMEN

The potential health and economic value of a vaccine for coronavirus disease (COVID-19) is self-evident given nearly 2 million deaths, "collateral" loss of life as other conditions go untreated, and massive economic damage. Results from the first licensed products are very encouraging; however, there are important reasons why we will likely need second and third generation vaccines. Dedicated incentives and funding focused explicitly on nurturing and advancing competing second and third generation vaccines are essential. This article proposes a collaborative, market-based financing mechanism for the world to incentivize and pay for the development of, and provide equitable access to, second and third generation COVID-19 vaccines. Specifically, we propose consideration of a Benefit-Based Advance Market Commitment (BBAMC). The BBAMC uses health technology assessment to determine value-based prices to guarantee overall market revenues, not revenue for any specific product or company. The poorest countries would not pay a value-based price but a discounted "tail-price." Innovators must agree to supply them at this tail price or to facilitate technology transfer to local licensees at low or zero cost to enable them to supply at this price. We expect these purchases to be paid for in full or large part by global donors. The BBAMC therefore sets prices in relation to value, protects intellectual property rights, encourages competition, and ensures all populations get access to vaccines, subject to agreed priority allocation rules.


Asunto(s)
/prevención & control , Salud Global/economía , Programas de Inmunización/economía , /tratamiento farmacológico , /economía , Defensa Civil/métodos , Defensa Civil/tendencias , Competencia Económica/normas , Competencia Económica/tendencias , Salud Global/tendencias , Humanos , Programas de Inmunización/métodos
5.
Value Health ; 24(2): 182-187, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33518024

RESUMEN

OBJECTIVE: Buprenorphine is an essential medication for the treatment of opioid use disorder (OUD), but studies show it has been underused over the last 2 decades. We sought to evaluate utilization of and spending on buprenorphine formulations in Medicaid and to evaluate the impact of key market and regulatory factors affecting availability of different formulations and generic versions. METHODS: We first identified all buprenorphine formulations approved by the Food and Drug Administration for OUD using Drugs@FDA. We then used National Drug Codes to identify each drug in the Medicaid State Drug Utilization Data and extracted annual utilization rates and spending between 2002 and 2018 by drug and according to whether a brand-name or generic version was dispensed. We compared these trends to market and regulatory factors that affected competition, which we identified through searching the Federal Register, Westlaw, PubMed, and Google News. RESULTS: Brand-name buprenorphine-naloxone sublingual tablet and film formulations (Suboxone) were dispensed 2.7 times more (n = 634 213 140) and reimbursed 4.4 times more (n = $4 440 556 473) than all other formulations combined (n = 237 769 689; $1 018 988 133). We identified numerous market and regulatory factors that contributed to an estimated 9-year delay in generic versions of the tablet formulation and 6-year delay for generic versions of the film formulation. CONCLUSIONS: Brand-name buprenorphine formulations have been widely used in Medicaid, leading to substantial costs, in part because generic versions were delayed by multiple years owing to market and regulatory factors. Timely availability of low-cost generics could have helped encourage OUD treatment with buprenorphine during the height of the opioid crisis.


Asunto(s)
Buprenorfina/economía , Buprenorfina/uso terapéutico , Medicaid/economía , Antagonistas de Narcóticos/economía , Antagonistas de Narcóticos/uso terapéutico , Trastornos Relacionados con Opioides/tratamiento farmacológico , Buprenorfina/administración & dosificación , Combinación Buprenorfina y Naloxona/economía , Combinación Buprenorfina y Naloxona/uso terapéutico , Utilización de Medicamentos , Medicamentos Genéricos/economía , Medicamentos Genéricos/uso terapéutico , Competencia Económica , Humanos , Antagonistas de Narcóticos/administración & dosificación , Tratamiento de Sustitución de Opiáceos/economía , Tratamiento de Sustitución de Opiáceos/métodos , Patentes como Asunto , Estados Unidos
9.
Artículo en Inglés | MEDLINE | ID: mdl-33316957

RESUMEN

After the economy enters a "new normal" era in China, resource-based cities are under pressure in terms of transformation, upgrading and sustainable development. This paper uses the panel data of 33 resource-based cities from 2008 to 2018 to empirically analyze the impact of environmental regulation and innovation compensation on scientific and technological competitiveness. The results show that there is a positive U-shaped relation between environmental regulation and scientific and technological competitiveness. This means that when environmental regulations exceed a certain level, continuing to increase regulations will significantly enhance technological competitiveness, but most samples are still on the left side of the turning point. At the same time, the labor productivity and fiscal capacity of non-agricultural industries in the region may have a strong regulatory effect. In a region with higher labor productivity in non-agricultural industries or stronger local fiscal capacity, environmental regulation is more likely to reflect the attribute of "innovation compensation" and advance scientific and technological competitiveness. At this stage, we should optimize the trans-regional compensation mechanism for resource-rich regions, increase investment in pollution management and ecological protection and impose stricter admission standards on industrial projects. Besides, skilled laborers should be cultivated and innovation and entrepreneurship be supported to realize the green and sustainable development of resource-based cities in the new era.


Asunto(s)
Competencia Económica , Contaminación Ambiental , Industrias , Tecnología , China , Ciudades , Competencia Económica/estadística & datos numéricos , Contaminación Ambiental/legislación & jurisprudencia , Regulación Gubernamental , Industrias/economía , Industrias/legislación & jurisprudencia , Tecnología/economía , Tecnología/legislación & jurisprudencia
11.
PLoS One ; 15(10): e0239972, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33017407

RESUMEN

In the platform-based innovation ecosystem, the symbiotic evolution and interaction between the participating entities have drawn extensive attention. However, there is a lack of understanding of the co-specialization and co-innovation among members of the innovation ecosystem. This paper addresses this gap. In this paper, the collaborative innovation between a platform firm and different kinds of complementors, and its effects on the performance of the innovation ecosystem are simulated through an improved NK model. The result shows that the co-innovation performance between generalist complementors and the platform firm is generally outperformed than that between the specialist complementors and the platform firm. As the interdependencies between the complementary components get stronger, the innovation performance of the innovation ecosystem influenced by the interaction between different types of complementors and platform firms tend to be an inverted U-shape.


Asunto(s)
Ecosistema , Modelos Teóricos , Comercio , Competencia Económica
13.
Pharmazie ; 75(8): 407-410, 2020 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-32758342

RESUMEN

New drugs against the in COVID-19 pandemic are urgently needed. Gilead Science's remdesivir has been introduced to China through special approval procedures, and was directly conducting the Phase III clinical trial. As expected, the marketing authorization process was completed soon. The drug brought hope to patients as well as business opportunities to companies. However, we must pay attention to the patent competition, generic drug competition and other unfair competition that remdesivir may face in China. China also needs to strengthen the innovation ability and international cooperation ability of local pharmaceutical companies by taking advantages of the opportunity to introduce remdesivir.


Asunto(s)
Adenosina Monofosfato/análogos & derivados , Alanina/análogos & derivados , Antivirales/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Adenosina Monofosfato/administración & dosificación , Adenosina Monofosfato/economía , Alanina/administración & dosificación , Alanina/economía , Antivirales/economía , China , Ensayos Clínicos como Asunto , Infecciones por Coronavirus/epidemiología , Aprobación de Drogas , Industria Farmacéutica/economía , Medicamentos Genéricos/administración & dosificación , Medicamentos Genéricos/economía , Competencia Económica , Humanos , Pandemias , Neumonía Viral/epidemiología
16.
S Afr Med J ; 110(2): 88-91, 2020 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-32657675

RESUMEN

The Competition Commission's Health Market Inquiry (HMI) is the most systematic and comprehensive investigation carried out into the South African private health sector. The recommendations as set out in the HMI Final Report merit extensive discussion and debate, as they could - if implemented - have far-reaching consequences for the future of the healthcare system. The objective of this article is to contribute to this discussion by providing an overview of the key findings and recommendations of the HMI and highlighting the resultant key imperatives at this critical juncture of policy development.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Competencia Económica , Sector de Atención de Salud/organización & administración , Sector Privado/organización & administración , Prestación de Atención de Salud/economía , Sector de Atención de Salud/economía , Política de Salud , Humanos , Sector Privado/economía , Sudáfrica
18.
PLoS One ; 15(6): e0234463, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32525965

RESUMEN

The affordability of pharmaceuticals has been a major challenge in US health care. Generic substitution has been proposed as an important tool to reduce the costs, yet little is known how the prices of more expensive brand-name drugs would be affected by an increased utilization of generics. We aimed to examine the trend of overall utilization and the total costs of brand-name oral contraceptive pills (OCPs), the most widely used form of contraception, and its association with the pharmaceutical market concentration among the OCPs. Data from the Medical Expenditure Panel Survey (MEPS) 2011-2014, a nationally representative survey of healthcare utilization, were extracted on the utilization of generic and brand-name OCPs. A multiple logit regression analysis was conducted to assess the trend in utilization of brand-name OCPs over time. Total costs, including the costs to the payers and consumers, were synthesized. The Herfindahl-Hirschman Index (HHI), an index describing market concentration, was constructed, and a multiple regression analysis was conducted to evaluate the association between the brand-name OCP prices and the market share of individual brand-name drugs. The odds of utilizing brand-name drugs decreased steadily in 2012, 2013, and 2014 compared to 2012 (AOR 0.87, 0.73, 0.55, respectively, p<0.05) controlling for patient mix. Despite significant decline in total utilization, there was a 90% increase in the price of brand-name OCPs, resulting an 18% increase in revenue from 2011 to 2014 for the industry. During this time, pharmaceutical market concentration for OCPs increased (HHI increased from 1105 in 2011 to 2415 in 2014). Each percentage point increase in the market share by a brand-name OCPs was associated with a $3.12 increase in its price. Market mechanisms matter. Practitioners and policy makers need to take market mechanisms into account in order to realize the benefits of generic substitutions.


Asunto(s)
Anticonceptivos Orales Combinados/economía , Costos de los Medicamentos/tendencias , Industria Farmacéutica/tendencias , Utilización de Medicamentos/tendencias , Gastos en Salud/tendencias , Adulto , Anticoncepción/economía , Anticoncepción/métodos , Anticoncepción/estadística & datos numéricos , Anticoncepción/tendencias , Conducta Anticonceptiva/estadística & datos numéricos , Costos de los Medicamentos/estadística & datos numéricos , Industria Farmacéutica/economía , Industria Farmacéutica/estadística & datos numéricos , Utilización de Medicamentos/economía , Utilización de Medicamentos/estadística & datos numéricos , Medicamentos Genéricos/economía , Competencia Económica/estadística & datos numéricos , Competencia Económica/tendencias , Femenino , Costos de la Atención en Salud/estadística & datos numéricos , Costos de la Atención en Salud/tendencias , Gastos en Salud/estadística & datos numéricos , Humanos , Encuestas y Cuestionarios/estadística & datos numéricos , Estados Unidos , Adulto Joven
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