26 de desembre 2021

Behavioral Insights (2)

 Behavioral Insights

Key message,

Over the past ten years, there has been increasing interest in the idea of behavioral insights. However, at some point, this interest may start to end and attention may go elsewhere. Other ideas may come along, with their own compelling claims. People may stop deciding to “bring in” behavioral experts, as Rory was for autonomous vehicles. If this is true, then the immediate priority should be to integrate behavioral insights into the standard way that policy is made or organizations are run. That would mean that the practices are resilient to people no longer asking for “behavioral” solutions.

In fact, you could argue that this is the ultimate goal of the behavioral insights approach. The idea of a “behavioral” solution or approach should become meaningless, since the principles will have become absorbed into standard ways of working. Since, as we said in chapter 1, most policies or services concern behavior, then this is just about improving the way that central function is performed—it is not some kind of optional extra. Rather than talking about “behavioral public policy,” we would just refer to public policy (or corporate strategy) done better. In a sense, stopping talking about behavioral insights may actually be a sign that its true promise has been fulfilled. Until then, there is more to do.

The idea of a “behavioral” solution or approach should become meaningless, since the principles will have become absorbed into standard ways of working.




25 de desembre 2021

Risk-sharing agreements for drugs (3)

 Characterization of the Pharmaceutical Risk‑Sharing Arrangement Process in Catalonia


Table 1

Uncertainty type, scope, and considered variables for drug assessment

Uncertainty typeUncertainty scopeConsidered variables
ClinicalEfficacy, effectiveness, and safetyTime frame
Clinical trial phase
Patient characteristics
Primary endpoint
Surrogate endpoints
Active comparator
Sensitivity analysis
Statistical analysis
Patient subgroup analyses
Time frames for treatment follow-up
FinancialBI and CEIndication extension and concretion
Treatment regimen
Potentially replaceable treatments
Net financial impact of treatment inclusion/replacement
Potential use extensions
Other modifications in use of resources linked to new treatment
Availability of CE or CU studies

Adapted from []



20 de desembre 2021

Sick individuals and sick populations

Sick individuals and sick populations

 Individus malalts i poblacions malaltes

Una crítica de l’estratègia poblacional de Geoffrey Rose en la medicina preventiva

Rose's Strategy of Preventive Medicine

És part integral de la bona medicina preguntar no tan sols “Quin és el diagnòstic i quin és el tractament?” sinó també “Per què ha succeït això?” i “Es podia haver previngut?”. Aquesta manera de pensar és la que orienta pràcticament tota la recerca clínica i de laboratori sobre les causes i els mecanismes de la malaltia.

Geoffrey Rose 





15 de desembre 2021

The economist's view

 The Economist’s View of the World And the Quest for Well-Being

Table of Contents

Introduction

Part I. Useful Concepts:

1. Opportunity Cost

2. Marginalism

3. Economic Incentives

Part II. Government and Markets, Efficiency and Equity:

4. Government and the Economy

5. Economists and Equity

6. Externalities and the Government Agenda

Part III. The Limits of Economics:

7. The Economist's Consumer and Individual Well-Being

8. Representatives, Deliberation, and Political Leadership

9. Conclusion.




14 de desembre 2021

The five essential healthcare suppliers

 Taking access to the next level: mobilising five essential healthcare sectors

There are five groups that are crucial: Big Pharma, generic medicine manufacturers, vaccine manufacturers, diagnostics companies and medical gas companies. 

In all cases, there are a few dominant players that have a big impact on healthcare



12 de desembre 2021

The value of direct-to-consumer tests

 Direct-to-Consumer Tests on the Market Today. Identifying Valuable Tests from Those with Limited Utility

For health care professionals, the analytical validity of DTC tests is a primary concern. Analytical validity of DTC genetic testing can be defined by analytical sensitivity and specificity whereby analytical sensitivity is defined as how often a test is positive when the genetic variant of interest is present in the tested sample, and the analytical specificity is defined as how often a test result is negative when the tested sample does not contain the genetic variant of interest.18 A recent study by Tandy-Connor and colleagues19 “indicated that 40% of variants in a variety of genes reported in DTC raw data were false positives” when compared with clinical confirmatory testing. This study highlights the need to scrutinize the analytical validity of DTC genetic testing and consider confirmatory testing in a clinical diagnostic genetics laboratory. 

Per the American Society of Human Genetics, “companies offering DTC genetic testing should disclose the sensitivity, specificity and predictive value of the test, and the populations for the information is known, in a readily understandable and accessible fashion.”

Unfortunately, nobody cares about it, and the regulator is still on vacation.



10 de desembre 2021

The pandemic's true death toll

 Quantifying impacts of the COVID-19 pandemic through life-expectancy losses: a population-level study of 29 countries






Contributions (in years) to changes in life expectancy at birth from 2019 to 2020 attributable to official COVID-19 deaths and remaining causes of death. Countries are sorted from largest to smallest losses. The sum of both components adds to the total change from 2019 to 2020 in a given country. All data points are provided in a table in Supplementary File 3, available as Supplementary data at IJE online .