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.

A diszkrét kiválasztási modell becslése Cox-regresszióval (Parameter estimation for multinomial discrete choice model using Cox-regression)

Considering the so-called "multinomial discrete choice" model the focus of this paper is on the estimation problem of the parameters. Especially, the basic question arises how to carry out the point and interval estimation of the parameters when the model is mixed i.e. includes both individual and choice-specific explanatory variables while a standard MDC computer program is not available for use. The basic idea behind the solution is the use of the Cox-proportional hazards method of survival analysis which is available in any standard statistical package and provided a data structure satisfying certain special requirements it yields the MDC solutions desired. The paper describes the features of the data set to be analysed.

Magyarország hét régiójának új gazdaságföldrajzi modellje – paraméterbecslés (The new economic-geography model of Hungary's seven regions - a parameter estimate)

Az új gazdaságföldrajz – amely napjaink egy igen népszerű közgazdaságtani tudományága – modelljének majdnem minden paramétere előállítható közvetlenül külső adatok segítségével. A helyettesítési rugalmassághoz azonban más módszerre van szükség. Puga [1999] által felvázolt új gazdaságföldrajzi modellt követve, egy regressziós egyenlettel megbecsülhetővé válik a kívánt paraméter, amit Magyarország hét régiójára vonatkozó béregyenlet becsléséből nyertünk. A helyettesítési rugalmasság értéke eltér a szakirodalomhoz képest, aminek magyarázata Magyarország fejlettségi szintjével állhat összefüggésben. ____ The model of the new economic geography - very popular material for economic study these days - allows almost every parameter to be presented directly with the aid of outside data. However, another method is required for substitution flexibility. With the new economic-geography model devised by Puga [1999], a regression equation allows an estimate to be made for the desired parameter, which yielded the wage equation for the six regions of Hungary. The value for substitution flexibility differs from that of the literature, the explanation for which may lie in Hungary's level of development.