Systematic review and analysis of evidences on clinical efficacy and cost-effectiveness of biological drugs for the treatment of Ankylosing Spondylitis

Technology: Infliximab and comparator biological such as adalimumab, etanercept, golimumab. Conditions: Ankylosing spondylitis (AS) Issue: Infliximab is registered to be used in patients with AS. The aim of the Report is to evaluate the clinical efficacy and safety of infliximab and comparator biologicals for the treatment of adult AS. Methods: Systematic literature review and analysis as well as meta-analysis (direct and indirect comparison) of published randomised controlled clinical trials (RCT) were performed, all relevant health economics literature were identified ad analysed. Results: Clinical efficacy of biological therapies is based on good clinical evidences regarding to all clinical efficacy endpoints (ASAS20, ASAS40, ASAS 5/6, and BASDAI 50% response). Altogether, 22 trials are included in our meta-analysis, 12 infliximab, 3 adalimumab studies, 6 etanercept and 1 golimumab. Efficacy of biological treatments for the treatment of AS has been established by clinical scientific evidences, significant improvement at all outcomes considered was confirmed. According to the results of indirect comparison, there were no significant difference between biological treatments and placebo in terms of safety and tolerability endpoints. We found no significant difference between the clinical efficacy and safety of infliximab, adalimumab, etanercept and golimumab therapies. Cost-utility analysis of adalimumab and/or infliximab, etanercept and golimumab treatment for AS were performed in the UK, Canada, The Netherlands, Germany, Spain and France. There are no cost-utility studies from Eastern Central Europe. Implications for decision making: Efficacy of infliximab and comparator biologicals for the treatment of Ankylosing Spondylitis (AS) was proved by clinical evidence, significant improvement at all outcomes considered was confirmed. We found no significant differences in efficacy and safety of different biological treatments. Health economics results suggest that biological therapies are cost-effective alternatives for the treatment of AS in group of developed high income countries. There is a lack of health economics results in Central-Eastern European countries however these data are more and more required by governments and funders as part of the company economic dossiers.

Cost-benefit analysis of climate change – A methodological overview of recent studies

Global warming16 has already begun. Climate change has become a self-propelling and self-reinforcing process as a result of the externality associated with greenhouse- gas (GHG) emissions. Although it is an externality related to humankind, according to a number of unique features we should distinguish it from other externalities. Climate change is a global phenomenon in its causes and consequences. The long-term and persistent impacts of climate change will likely continue over centuries without further anthropogenic mechanism. The preindustrial (equilibrium) level of GHG concentration in the atmosphere cannot be restored since it is irreversible, but if we do not stabilise the actual level of atmospheric concentration, the situation will become much worse than it is now. Assessing the impacts of climate change requires careful considerations because of the pervasive uncertainties and risks associated with it.

Cost-Benefit Analysis of Climate Change (a Methodological Overview of Recent Studies)

This paper examines the methodological aspect of climate change, particularly the aggregation of costs and benefits induced by climate change on individuals, societies, economies and on the whole ecosystem. Assessing the total and/or marginal costs of environmental change is difficult because of wide range of factors that have to be involved. The subsequent study tries to capture the complexity of cost assessment on climate change therefore includes several critical factors such as scenarios and modeling, valuation and estimation, equity and discounting.

Aranyszabály helyett adósságfék - a német példa = Debt-brake instead of the golden rule - the case of Germany

Az Európai Unió megújuló gazdasági kormányzási rendszerének egyik meghatározó pillére a diszkrecionális gazdaságpolitikával szemben megfogalmazott szabályalapúság lesz. A minden korábbinál erősebb és vélhetően hatékonyabb szabályok bevezetésének legelkötelezettebb híve Németország. Az elmúlt évtizedekben a folyó költségvetési kiadások hiányból történő finanszírozásának tilalmát előíró aranyszabályt inkább kevesebb, mint több sikerrel alkalmazó Németország most arra vállalkozott, hogy nem csak saját hatáskörben vezeti be az ún. adósságféket, hanem követendő példaként állítja azt a többi tagország elé is. Írásunkban az aranyszabály, illetve az adósságfék előnyeit és hátrányait vesszük számba a német tapasztalatok felhasználásával. / === / The need to strengthen rules-based fiscal policy has emerged as a widely shared consensus amongst policy-makers in the recent economic and financial crisis. Germany has become the most devoted advocator of the new regime, where more innovative and effective fiscal rules are supposed to play an even bigger role than before. Germany supports such a move however not only in rhetoric but also in practice. It decided to abandon its several decade old golden rule and to adopt a more sophisticated one, the so-called debt-brake. This article provides a cost-benefit analysis of both the previous and the new fiscal rule.

"I would like to see that one is able to say I'm proud of being a citizen of the EU…" – the way Hungarian people see Europe and the European Union

This paper explores the concepts of Europe, Europeanism and European Union, their meaning to Hungarians, how people define them and how they relate to these concepts through the analysis of qualitative in-depth interviews. The main question is whether the discourse, expressing attitudes towards Europe and the European Union, are of symbolic or utilitarian character. The symbolic way to relate to the EU is based on principles, an ideological or an emotional approach of the subject, while the pragmatic or utilitarian logic is based on rational cost-benefit analysis. The main argument of this current paper is that the way Hungarians tend to relate to the EU is rather utilitarian and it is the utilitarian logic that represents the relevant frame to understand people’s attitudes on the subject.

Mitigation and adaptation to climate change

Climate change produces significant social and economic impacts in most parts of the world, thus global action is needed to address climate change. In this chapter, the different possibilities of mitigation are explored from different points of view, and analyse the possibilities of adaptation to climate change. First, substantial reduction of GHG emission is needed, on the other hand adaptation action must deal with the inevitable impacts. According to the assessment of the chapter, it is essential that coordinated actions be taken at an EU level. In our argumentation, a macroeconomic model is used for the cost- benefit analysis of GHG gas emissions reduction. The GHG emission structure is analysed on European and global level. Even in the case of a successful mitigation strategy there rest the long-term effects of climate change which will need a coherent adaptation strategy to be dealt with. Although certain adaptation measures already have been taken, these initiatives are still very modest, and insufficient to deal with the economic effects of climate change properly.

Mennyit ér a zajterhelés csökkenése? Zajvédelmi intézkedések értékelése a haszonértékelések átvitelével (The value of silence. An application of benefit-transfer methodology for evaluating noise-control actions)

Mind ez ideig a gyakorlatban kevéssé aknázták ki azt a lehetőséget, hogy a természeti tőke pénzbeli értékelése számszerű, egzakt információt nyújthat a döntéshozóknak. A szerzők a zajvédelmi intézkedések példáján keresztül tekintik át a természeti tőkejavak közgazdasági értékelésében rejlő lehetőségeket. Ismertetik a költség-haszon elemzés környezeti javakkal bővített formájának előnyeit, majd az általában elhanyagolt, a nem piaci javak által nyújtott haszon közgazdasági értékelésére alkalmas eljárásokat, külön kitérve a zajterhelés területére. Nagy hangsúlyt helyeznek a haszonfelmérések átvitelének széles körben alkalmazható módszereire. Bemutatják az általuk gyakorlatban végzett kutatás során szerzett tapasztalatokat, különös tekintettel arra, hogy a haszonértékelések átvitele hogyan járulhat hozzá a természeti tőkejavakkal kapcsolatos döntések során a társadalmi haszon maximalizálásához. _____ The paper offers an overview of the economic valuation of transportation-induced noise and cost-benefit analysis of noise-control measures and actions. Although economic valuation can provide hard, monetized data for decision-makers, it is relatively underused in practice. The study focuses on benefit-transfer methodology, where values obtained in previous cases are used as the basis for current evaluation. A specific application of benefit transfer is presented by a recent pilot project in Hungary, whereby a tool was developed for LGOs, enabling them to make preliminary assessments of the benefits of potential noise-control measures and rank possible options. This can help to optimize the benefits to society using limited resources.

Cooperation in supply chains: A cooperative game theoretic analysis = Együttműködés ellátási láncokban: Egy kooperatív játékelméleti elemzés

A cikkben a kooperatív játékelmélet fogalmait alkalmazzuk egy ellátási lánc esetében. Az ostorcsapás-hatás elemeit egy beszállító-termelő ellátási láncban ragadjuk meg egy Arrow-Karlin típusú modellben lineáris készletezési és konvex termelési költség mellett. Feltételezzük, hogy mindkét vállalat minimalizálja a fontosabb költségeit. Két működési rendszert hasonlítunk össze: egy hierarchikus döntéshozatali rendszert, amikor először a termelő, majd a beszállító optimalizálja helyzetét, majd egy centralizált (kooperatív) modellt, amikor a vállalatok az együttes költségüket minimalizálják. A kérdés úgy merül fel, hogy a csökkentett ostorcsapás-hatás esetén hogyan osszák meg a részvevők ebben a transzferálható hasznosságú kooperatív játékban. = In this paper we apply cooperative game theory concepts to analyze supply chains. The bullwhip effect in a two-stage supply chain (supplier-manufacturer) in the framework of the Arrow-Karlin model with linear-convex cost functions is considered. It is assumed that both firms minimize their relevant costs, and two cases are examined: the supplier and the manufacturer minimize their relevant costs in a decentralized and in a centralized (cooperative) way. The question of how to share the savings of the decreased bullwhip effect in the centralized (cooperative) model is answered by transferable utility cooperative game theory tools.