Are prescribing doctors sensitive to the price that their patients have to pay in the Spanish National Health System?

[EN] Background This study aims to design an empirical test on the sensitivity of the prescribing doctors to the price afforded for the patient, and to apply it to the population data of primary care dispensations for cardiovascular disease and mental illness in the Spanish National Health System (NHS). Implications for drug policies are discussed. Methods We used population data of 17 therapeutic groups of cardiovascular and mental illness drugs aggregated by health areas to obtain 1424 observations ((8 cardiovascular groups * 70 areas) + (9 psychotropics groups * 96 areas)). All drugs are free for pensioners. For non-pensioner patients 10 of the 17 therapeutic groups have a reduced copayment (RC) status of only 10% of the price with a ceiling of €2.64 per pack, while the remaining 7 groups have a full copayment (FC) rate of 40%. Differences in the average price among dispensations for pensioners and non-pensioners were modelled with multilevel regression models to test the following hypothesis: 1) in FC drugs there is a significant positive difference between the average prices of drugs prescribed to pensioners and non-pensioners; 2) in RC drugs there is no significant price differential between pensioner and non-pensioner patients; 3) the price differential of FC drugs prescribed to pensioners and non-pensioners is greater the higher the price of the drugs. Results The average monthly price of dispensations to pensioners and non-pensioners does not differ for RC drugs, but for FC drugs pensioners get more expensive dispensations than non-pensioners (estimated difference of €9.74 by DDD and month). There is a positive and significant effect of the drug price on the differential price between pensioners and non-pensioners. For FC drugs, each additional euro of the drug price increases the differential by nearly half a euro (0.492). We did not find any significant differences in the intensity of the price effect among FC therapeutic groups. Conclusions Doctors working in the Spanish NHS seem to be sensitive to the price that can be afforded by patients when they fill in prescriptions, although alternative hypothesis could also explain the results found.

Impact of introducing longer and heavier vehicles on regional consumer price index and Spanish road freight transport system

This paper applies an integrated modeling approach to the case of Spain; the approach is based on a random utility-based multiregional input-output model and a road transport network model for assessing the effect of introducing longer and heavier vehicles (LHVs) on the regional consumer price index (CPI) and on the transportation system. The approach strongly supports the concept that changes in transport costs derived from the LHV allowance as well as the economic structure of regions have direct and indirect effects on the economy and on the transportation system. Results show that the introduction of LHVs might reduce prices paid by consumers for a representative basket of goods and services in the regions of Spain and would also lead to a reduction in the regional CPI. In addition, the magnitude and extent of changes in the transportation system are estimated by using the commodity-based structure of the approach to identify the effect of traffic changes on traffic flows and on pollutant emissions over the whole network.

On a parabolic-elliptic chemotactic system with non-constant chemotactic sensitivity

We study a parabolic–elliptic chemotactic system describing the evolution of a population’s density “u” and a chemoattractant’s concentration “v”. The system considers a non-constant chemotactic sensitivity given by “χ(N−u)”, for N≥0, and a source term of logistic type “λu(1−u)”. The existence of global bounded classical solutions is proved for any χ>0, N≥0 and λ≥0. By using a comparison argument we analyze the stability of the constant steady state u=1, v=1, for a range of parameters. – For N>1 and Nλ>2χ, any positive and bounded solution converges to the steady state. – For N≤1 the steady state is locally asymptotically stable and for χN<λ, the steady state is globally asymptotically stable.

Dynamical Equations For The Period Vectors In A Periodic System Under Constant External Stress

The purpose of this paper is to derive the dynamical equations for the period vectors of a periodic system under constant external stress. The explicit starting point is Newton’s second law applied to halves of the system. Later statistics over indistinguishable translated states and forces associated with transport of momentum are applied to the resulting dynamical equations. In the final expressions, the period vectors are driven by the imbalance between internal and external stresses. The internal stress is shown to have both full interaction and kinetic-energy terms.

The engineers and the price system /

Mode of access: Internet.

Social economy and the price system; an essay in welfare economics.

Mode of access: Internet.

The Federal reserve system; the course of the Federal reserve banks before and during the price crisis and readjustment: address ... before the North Carolina bankers' convention at Pinehurst, April 26-28, 1922.

Mode of access: Internet.