The role of health economics within health technology assessment: past, present, and future - an Austrian perspective.

In many countries, the economics domain forms a routine part of health technology assessments (HTA) next to analyzing the comparative effectiveness and safety of a technology. The method applied most often is economic evaluation, such as cost-effectiveness analysis, which is supposed to support the efficient use of resources. In Austria, economic evaluation has played a negligible role in HTA and reimbursement decisions, even though the country faces the same public healthcare sustainability challenges as others. In this commentary, we argue that while health economics will need to play a more active role in HTA-related decision support to deal with those challenges, current approaches in other countries may have to be broadened to fit the Austrian context. We are outlining four arguments to underpin this perspective: First, economic evaluations (in their current form) are of limited benefit for supporting reimbursement decisions of new high-priced technologies. Second, a broader variety of health economic methods is needed to address the scope of technologies. Third, applying health economic methods requires a reflection on their underlying values. Finally, health economics within HTA needs to go beyond microeconomic analysis of interventions. We are suggesting several alternative methods and approaches, encouraging out-of-the-box thinking and experimenting with methods developed in the academic context but rarely applied in routine HTA. Although some of our topics are unique to Austria, others may equally apply to other healthcare systems. With our thoughts, we aim to stimulate discussions for further developing health economics within HTA in Austria and internationally.

Political Economy of Maternal Child Malnutrition: Experiences about Water, Food, and Nutrition Policies in Pakistan.

This study examined access to water, food, and nutrition programs among marginalized communities in Southern Punjab, Pakistan, and their effects on nutrition. Both qualitative and quantitative data were used in this study. We held two focus group discussions (one with 10 males and one with 10 females) and conducted in-depth interviews with 15 key stakeholders, including 20 mothers and 10 healthcare providers. A survey of 235 households was carried out to evaluate water and food insecurity, with the data analyzed using Wilcoxon's rank-sum test, t-test, and Pearson's chi-square test. The results revealed that 90% of households experienced moderate-to-severe water insecurity, and 73% faced moderate-to-severe food insecurity. Household water and food insecurity were positively correlated with each other (correlation coefficient = 0.205; p = 0.004). Greater household water (p = 0.028) and food insecurity (p < 0.001) were both associated with higher perceived stress. Furthermore, lower socioeconomic status was strongly related to higher levels of water (p < 0.001) and food insecurity (p < 0.001). Qualitative findings highlight the impact of colonial and post-colonial policies, which have resulted in water injustice, supply issues, and corruption in water administration. Women face significant challenges in fetching water, including stigma, harassment, and gender vulnerabilities, leading to conflicts and injuries. Water scarcity and poor quality adversely affect sanitation, hygiene, and breastfeeding practices among lactating mothers. Structural adjustment policies have exacerbated inflation and reduced purchasing power. Respondents reported a widespread lack of dietary diversity and food quality. Nutrition programs face obstacles such as the exclusion of people with low social and cultural capital, underfunding, weak monitoring, health sector corruption, and the influence of formula milk companies allied with the medical community and bureaucracy. This study concludes that addressing the macro-political and economic causes of undernutrition should be prioritized to improve nutrition security in Pakistan.

Uma visão dos trópicos de Heinrich Gerber, 1850-1860: ciência e pensamento econômico de um engenheiro politécnico alemão no Império do Brasil / Heinrich Gerber's vision of the tropics, 1850-1860: the scientific and economic thinking of a German polytechnic engineer in the Empire of Brazil

Resumo Analisa o pensamento científico do engenheiro politécnico Heinrich August Anton Gerber, contratado pelo governo da província de Minas Gerais de 1858 a 1867. O artigo explora o significado cultural e intelectual das atividades do engenheiro, especialmente a ideia de criação de empresa privada no setor da infraestrutura viária, bem como a mediação para importação de instrumentos científicos e livros. Os resultados também indicam que Gerber participa do envio de brasileiros para estudar engenharia em Paris. Este texto investiga as trocas culturais entre Brasil e Europa, a aplicação do conhecimento científico e o encontro com problemas práticos de ordem econômica e social pelo engenheiro no interior do Império do Brasil.

Abstract This article analyzes the scientific thinking of the German polytechnic engineer Heinrich August Anton Gerber, who was employed by Minas Gerais province from 1858 to 1867. We explore the cultural and intellectual significance of his activities, particularly the idea of creating a private company within the roadway infrastructure sector and his mediating role in the importation of scientific instruments and books. Gerber also appears to have been part of efforts to send Brazilians to study engineering in Paris. Cultural exchanges between Brazil and Europe are investigated, along with the application of scientific knowledge and his encounters with practical economic and social challenges in the interior of the Empire of Brazil.

Uma contribuição para compreender a indústria farmacêutica na dinâmica capitalista financeirizada / A contribution to understand the pharmaceutical industry in the financialized capitalist dynamics

Resumo A dominância financeira é um novo padrão sistêmico da riqueza que estabelece novas maneiras de definir, gerir e realizar a riqueza. As corporações não financeiras têm-se transformado em consonância com a dominância financeira, o que pode ocasionar desdobramentos na dinâmica produtiva e de inovação, assim como nas economias nacionais. Em meio à pandemia do coronavírus, a extrema necessidade do desenvolvimento tecnológico imputa a importância de um olhar retrospectivo para o setor farmacêutico. O objetivo do artigo é discutir as mudanças produzidas pela financeirização no âmbito da indústria farmacêutica. Para tanto, realizou-se revisão da literatura científica por busca e seleção sistematizadas. Os artigos, na maioria sobre empresas sediadas no RU e EUA, evidenciaram a dominância financeira pela concepção da empresa como ativo, participação dos fundos de alto risco, protagonismo dos ativos intangíveis, maximização do valor dos acionistas, desintegração vertical das atividades, intensificação de fusões e aquisições e encurtamento do horizonte de planejamento. Esses elementos não foram homogêneos em todos estudos demandando análises específicas por países e estudos de caso. A presente revisão contribuiu para a discussão do avanço tecnológico e aponta lacunas na produção cientifica no contexto de economias periféricas e articulada às políticas públicas e sistemas de saúde.

Abstract Financial dominance is a new systemic pattern of wealth that establishes new ways to define, manage and realize wealth. Non-financial corporations have transformed themselves in line with financial dominance, which can cause developments in the productive and innovation dynamics, as well as in national economies. During the coronavirus pandemic, Covid-19, the extreme need for technological development imputes the importance of a retrospective look to the pharmaceutical sector. The article discusses the changes brought about by financialization in the scope of the pharmaceutical industry. To this end, a review of the scientific literature was carried out by systematic search and selection. The articles, mostly about companies based in the UK and the USA, showed financial dominance due to the company's conception as an asset, participation of high-risk funds, the role of intangible assets, maximization of shareholder value, vertical disintegration of activities, intensification of mergers and acquisitions and shortening the planning horizon. These elements were not homogeneous in all studies, requiring country-specific analyzes and case studies. This review contributed to the discussion of technological advances and points out gaps in scientific production in the context of peripheral economies and linked to public policies and health systems.

Wealth inhomogeneity applied to crash rate theory.

A crash rate theory based on corporate economic utility maximization is applied to individual behavior in U.S. and German motorway death rates, by using wealth inhomogeneity data in ten-percentile bins to account for variations of utility maximization in the population. Germany and the U.S. have similar median wealth figures, a well-known indicator of accident risk, but different motorway death rates. It is found that inhomogeneity in roughly the 10(th) to 30(th) percentile, not revealed by popular measures such as the Gini index which focus on differences at the higher percentiles, provides a satisfactory explanation of the data. The inhomogeneity analysis reduces data disparity from a factor of 2.88 to 1.75 as compared with median wealth assumed homogeneity, and further to 1.09 with average wealth assumed homogeneity. The first reduction from 2.88 to 1.75 is attributable to inequality at lower percentiles and suggests it may be as important in indicating socioeconomic risk as extremes in the upper percentile ranges, and that therefore the U.S. socioeconomic risk may be higher than generally realized.

Exploration on the Teaching Reform of Marxist Political Economics Teaching / 中华医学教育探索杂志

The key to the reform deepening of Marxist political economics teaching lies in two factors: substantially reforming teaching contents and improving teaching methods.During the process of the former we must adhere to three combinations,meanwhile,in the process of the latter we should improve teaching art and teaching quality.