Visszatérhet-e a "nagy elmélet" a közgazdaságtanban? Megjegyzések a rendszerparadigma elmélettörténetéhez (Can the "grand theory" return to economics? Notes on the theoretical history of the system paradigm)

Kornai János rendszerparadigma-fogalmából és az ott felsorolt közgazdászok névsorából kiindulva, a tanulmány kiemel néhány mozzanatot ennek eszmetörténeti előzményeiből. A hatvanas évek szociológiai irodalmában időszerűtlennek tartották a nagy elmélet létrehozását, a nyolcvanas évek társadalomtudományában viszont már a hagyományos nagy rendszeralkotás és elbeszélésmód visszatérését méltatták. Adam Smith közgazdaságtanát a társadalmi érintkezés átfogó elmélete részének szánta, amely tartalmazza a jog, politika és erkölcs elveit és történetét. Ezt szemlélteti a kereskedelmi társadalom paradoxonának elemzése és annak bemutatása, hogyan vezetett a fényűzés a szabadság helyreállításához és a rendszeres kormányzat létrejöttéhez. Marx és a német történeti iskola egyaránt törekedett a társadalom történeti fejlődéstörvényeinek feltárására, noha kölcsönösen elutasították egymás felfogásának többi elemét. Schumpeter életművét az a törekvés határozta meg, hogy összekapcsolja az elméleti analízist és a történeti leírást, hogy a gazdasági fejlődés elemzéséből kiindulva megalkossa a társadalmi élet különböző területeinek interdependenciáját bemutató elméletet. / === / The study starts from János Kornai's concept of a system paradigm and the list of economists there to lift certain elements from its antecedents in intellectual history. The sociological writers of the 1960s thought it was inopportune to create a grand theory, while the social scientists of the 1980s were busy celebrating the return of the great traditional system-creating process and its mode of narration. Adam Smith presented his economics as part of a comprehensive theory of social organization that would cover the principles and history of law, politics and morality. This is illustrated by his analysis of the paradox of commercial society and his demonstration of how wealth led to the restoration of liberty and the establishment of regular governance. Marx and the German historical school both strove to identify laws of the historical development of society, although they each rejected the other elements of the other's concept. Schumpeter's oeuvre was marked by an effort to combine theoretical analysis with historical description, so that from an analysis of economic development he could arrive at a theory presenting the interdependence of the various areas of social activity.

Comparative efficacy and safety of biosimilar infliximab and other biological treatments in ankylosing spondylitis: systematic literature review and meta-analysis.

OBJECTIVES: To compare the efficacy and safety of infliximab-biosimilar with other biological drugs for the treatment of active ankylosing spondylitis (AS). METHODS: Systematic literature review for randomized controlled trials (RCTs) with adalimumab, etanercept, golimumab, infliximab and infliximab-biosimilar in AS was performed and indirect meta-analysis (Bayesian mixed treatment comparison) was carried out. The proportion of patients reaching 20 % improvement by the assessment of Spondyloarthritis International Society response criteria (ASAS20) at weeks 12 and 24 was used as efficacy endpoints, and the occurrence of serious adverse events at week 24 was applied to compare the safety of the biologicals. RESULTS: Altogether, 13 RCTs, identified by the systematic literature search, were included in the analysis. Results on the ASAS20 efficacy endpoint were reported for week 12 in 12 RCTs involving 2,395 patients, and for week 24 in 5 RCTs comprising 1,337 patients. All the five biological agents proved to be significantly superior to placebo. Infliximab showed the highest odds ratio (OR) of 7.2 (95 % CI 3.68-13.19) compared to placebo, followed by infliximab-biosimilar with OR 6.25 (95 % CI 2.55-13.14), both assessed at week 24. No significant difference was found between infliximab-biosimilar and other biological treatments regarding their efficacy and safety. CONCLUSIONS: This is the first study which includes a biosimilar drug in the meta-analysis of biological treatments in AS. The results have proven the similar efficacy and safety profile of infliximab-biosimilar treatment compared to other biologicals.

Efficacy and safety of infliximab-biosimilar compared to other biological drugs in rheumatoid arthritis: a mixed treatment comparison.

OBJECTIVE: The aim of this meta-analysis was to compare the efficacy and safety of infliximab-biosimilar and other available biologicals for the treatment of rheumatoid arthritis (RA), namely abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab and tocilizumab. METHODS: A systematic literature review of MEDLINE database until August 2013 was carried out to identify relevant randomized controlled trials (RCTs). Bayesian mixed treatment comparison method was applied for the pairwise comparison of treatments. Improvement rates by the American College of Rheumatology criteria (ACR20 and ACR50) at week 24 were used as efficacy endpoints, and the occurrence of serious adverse events was considered to assess the safety of the biologicals. RESULTS: Thirty-six RCTs were included in the meta-analysis. All the biological agents proved to be superior to placebo. For ACR20 response, certolizumab pegol showed the highest odds ratio (OR) compared to placebo, OR 7.69 [95 % CI 3.69-14.26], followed by abatacept OR 3.7 [95 % CI 2.17-6.06], tocilizumab OR 3.69 [95 % CI 1.87-6.62] and infliximab-biosimilar OR 3.47 [95 % CI 0.85-9.7]. For ACR50 response, certolizumab pegol showed the highest OR compared to placebo OR 8.46 [3.74-16.82], followed by tocilizumab OR 5.57 [95 % CI 2.77-10.09], and infliximab-biosimilar OR 4.06 [95 % CI 1.01-11.54]. Regarding the occurrence of serious adverse events, the results show no statistically significant difference between infliximab-biosimilar and placebo, OR 1.87 [95 % CI 0.74-3.84]. No significant difference regarding efficacy and safety was found between infliximab-biosimilar and the other biological treatments. CONCLUSION: This is the first indirect meta-analysis in RA that compares the efficacy and safety of biosimilar-infliximab to the other biologicals indicated in RA. We found no significant difference between infliximab-biosimilar and other biological agents in terms of clinical efficacy and safety.

The impact of the recession on health care expenditure — How does the Czech Republic, Hungary, Poland and Slovakia compare to other OECD countries?

In the past few years, several papers have been published in the international literature on the impact of the economic crisis on health and health care. However, there is limited knowledge on this topic regarding the Central and Eastern European (CEE) countries. The main aims of this study are to examine the effect of the financial crisis on health care spending in four CEE countries (the Czech Republic, Hungary, Poland and Slovakia) in comparison with the OECD countries. In this paper we also revised the literature for economic crisis related impact on health and health care system in these countries. OECD data released in 2012 were used to examine the differences in growth rates before and after the financial crisis. We examined the ratio of the average yearly growth rates of health expenditure expressed in USD (PPP) between 2008–2010 and 2000–2008. The classification of the OECD countries regarding “development” and “relative growth” resulted in four clusters. A large diversity of “relative growth” was observed across the countries in austerity conditions, however the changes significantly correlate with the average drop of GDP from 2008 to 2010. To conclude, it is difficult to capture visible evidence regarding the impact of the recession on the health and health care systems in the CEE countries due to the absence of the necessary data. For the same reason, governments in this region might have a limited capability to minimize the possible negative effects of the recession on health and health care systems.