Trading between perceived risks and benefits related to biosimilar biological treatment in Crohn’s disease; discrete choice experiment among gastroenterologists

Objective: The objective of the study is to explore preferences of gastroenterologists for biosimilar drugs in Crohn’s Disease and reveal trade-offs between the perceived risks and benefits related to biosimilar drugs. Method: Discrete choice experiment was carried out involving 51 Hungarian gastroenterologists in May, 2014. The following attributes were used to describe hypothetical choice sets: 1) type of the treatment (biosimilar/originator) 2) severity of disease 3) availability of continuous medicine supply 4) frequency of the efficacy check-ups. Multinomial logit model was used to differentiate between three attitude types: 1) always opting for the originator 2) willing to consider biosimilar for biological-naïve patients only 3) willing to consider biosimilar treatment for both types of patients. Conditional logit model was used to estimate the probabilities of choosing a given profile. Results: Men, senior consultants, working in IBD center and treating more patients are more likely to willing to consider biosimilar for biological-naïve patients only. Treatment type (originator/biosimilar) was the most important determinant of choice for patients already treated with biologicals, and the availability of continuous medicine supply in the case biological-naïve patients. The probabilities of choosing the biosimilar with all the benefits offered over the originator under current reimbursement conditions are 89% vs 11% for new patients, and 44% vs 56% for patients already treated with biological. Conclusions: Gastroenterologists were willing to trade between perceived risks and benefits of biosimilars. The continuous medical supply would be one of the major benefits of biosimilars. However, benefits offered in the scenarios do not compensate for the change from the originator to the biosimilar treatment of patients already treated with biologicals.

Country-specific determinants of horizontal and vertical intra-industry agri-food trade: the case of Bulgaria and Romania

The article analyses patterns and country-specific determinants of agri-food trade of Bulgaria and Romania with the European Union. As literature focusing on agricultural aspects of the topic is limited, the paper seeks to contribute to the literature by providing up to date results and suggestions as well as by identifying the determinants of horizontal and vertical intra-industry trade of the Bulgaria and Romania after EU accession. Results suggest that intra-industry agri-food trade is mainly of vertical nature, referring to trade of different quality products. Results verify that determinants of horizontal and vertical IIT are similar and suggest that economic size and FDI are positively, while factor endowments and distance are negatively related to both sides of IIT. Results are mainly in line with the majority of empirical literature in the field.

The European Patterns of "Homo Academicus“ and The Chances of Its Evolution In Current Hungarian Higher Education

In the recent four or five years, there have been abrupt and radical changes in the governance of Hungarian higher education. It can then be interesting to assess the state of “homo academicus“ as it looks currently in Hungary. The notion of “homo academicus“ is obvious: it concerns participants in the system of a country’s higher education. The paper as follows still comes back to the definition of “homo academicus“ by referring first to it as occupation, or rather as a profession that can be interpreted in terms of sociology. Secondly, some historic patterns can also be mobilised, based on the assumption that university is a very European institutions that is even rooted in the tradition of the Middle Ages. The elbow-room of seeking for identity and the role to be filled by academics are limited by the effective system of the governance of higher education. It is a key to the chances of academics of meeting the historically corroborated professional standards that they exercise academic freedom. As it cannot be done individually, but in cooperation (through a collegial system), academic freedom is always combined with collective action. The field where this freedom can be exercised can be specified through university autonomy, the lack of which makes a serious barrier to the full development of a character of “homo academicus“. This is now the case in Hungary, the paper suggests. The paper seeks to gain deeper understanding of the character of academics, their vocation and professional roles, and the governance of higher education, serving as the environment for academic activity, by creating a conceptual framework. The paper is established on the results of sociological research and the experience of legal management, although it remains to be of theoretical nature. It criticises the current Hungarian situation of the governance of higher education, arguing for the reconstruction of university autonomy and financial stability. It also emphasises the importance of predictable regulations.