Economic Implications Research Articles

Cost-effective analysis of enalapril, amlodipine, and enalapril plus amlodipine combination in newly diagnosed patients of hypertension: A pharmacoeconomic comparison of the antihypertensive efficacy of drugs

Hypertension (HTN) is a chronic condition with severe complications, so early detection and effective management are essential to prevent cardiovascular events and reduce the associated economic burden. This study aims to compare the cost-effectiveness of enalapril, amlodipine, and their combination in terms of blood pressure reduction, considering overall efficacy and economic implications. A prospective, observational cost-effectiveness analysis was conducted in 150 newly diagnosed hypertensive patients who were prescribed either enalapril (5 mg), amlodipine (5 mg), or enalapril plus amlodipine (2.5 mg each). The primary outcome was the difference in systolic and diastolic blood pressure between baseline and follow-up, as well as the evaluation of overall efficacy and cost. Based on the data, statistical analysis was carried out using ANOVA and post hoc Tukey tests for drug efficacy, and cost-effectiveness was compared using MS Excel. After 30 days, all treatments significantly reduced systolic and diastolic blood pressure (p = 0.0001). The combination therapy with a lower dose showed superior efficacy in blood pressure reduction and was most cost-effective, requiring less expense for a 1 mmHg reduction in blood pressure compared to individual drugs with a higher dose. Quality of life assessment favored low-dose combination therapy, with fewer reported adverse effects. The combinationof amlodipine and enalapril at a lower dose demonstrated superior cost-effectiveness, efficacy in blood pressure reduction, and a favorable impact on patients' quality of life compared to individual drugs at a higher dose. This suggests that combination therapy may be a preferred option in the management of hypertension, emphasizing the importance of considering both clinical and economic factors in treatment decisions.

Optimization of treatment workflow for 0.35T MR-Linac system.

This study presents a novel and comprehensive framework for evaluating magnetic resonance guided radiotherapy (MRgRT) workflow by integrating the Failure Modes and Effects Analysis (FMEA) approach with Time-Driven Activity-Based Costing (TDABC). We assess the workflow for safety, quality, and economic implications, providing a holistic understanding of the MRgRT implementation. The aim is to offer valuable insights to healthcare practitioners and administrators, facilitating informed decision-making regarding the 0.35T MRIdian MR-Linac system's clinical workflow. For FMEA, a multidisciplinary team followed the TG-100 methodology to assess the MRgRT workflow's potential failure modes. Following the mitigation of primary failure modes and workflow optimization, a treatment process was established for TDABC analysis. The TDABC was applied to both MRgRT and computed tomography guided RT (CTgRT) for typical five-fraction stereotactic body RT (SBRT) treatments, assessing total workflow and costs associated between the two treatment workflows. A total of 279 failure modes were identified, with 31 categorized as high-risk, 55 as medium-risk, and the rest as low-risk. The top 20% risk priority numbers (RPN) were determined for each radiation oncology care team member. Total MRgRT and CTgRT costs were assessed. Implementing technological advancements, such as real-time multi leaf collimator (MLC) tracking with volumetric modulated arc therapy (VMAT), auto-segmentation, and increasing the Linac dose rate, led to significant cost savings for MRgRT. In this study, we integrated FMEA with TDABC to comprehensively evaluate the workflow and the associated costs of MRgRT compared to conventional CTgRT for five-fraction SBRT treatments. FMEA analysis identified critical failure modes, offering insights to enhance patient safety. TDABC analysis revealed that while MRgRT provides unique advantages, it may involve higher costs. Our findings underscore the importance of exploring cost-effective strategies and key technological advancements to ensure the widespread adoption and financial sustainability of MRgRT in clinical practice.

An Economic Analysis of Adverse Possession Statutes -- The Case of China and Germany

Adverse possession, a doctrine whereby a possessor of land who is not the true owner acquires title to the land without the consent or compensation of the "true" owner, while simultaneously appearing to be a trespasser's possession of the land adverse to the owner's interests from an economic perspective. This paper explores the economic implications of adverse possession statutes, focusing on China and Germany. It provides an overview of adverse possession, comparing relevant national laws, particularly those of Germany. Despite its economic efficiency, China has not established an adverse possession system. The analysis examines the current legislative status in China and explores inherent reasons for its absence. Evaluating the necessity for China to adopt such a system, potential problems are identified, including issues related to homeless individuals seizing property and challenges in replacing existing systems. However, the study highlights the economic benefits, such as enhancing transaction certainty reducing costs, and preventing errors through adverse possession.

Connecting the dots: A systematic review of corporate social responsibility, information asymmetry, and economic implications

AbstractThis paper conducts a comprehensive review of the theoretical and empirical connections between Corporate Social Responsibility (CSR), Information Asymmetry (IA), and their economic consequences. It employs a bibliometric analysis on 73 Web of Science manuscripts using VOSviewer1.6.18 software, combining this analysis with a literature review. The results reveal four thematic areas categorized into three clusters: CSR and IA, the impact of CSR and IA on internal risk control and corporate performance, and the broader effects of CSR and IA. The systematic literature review finds a prevailing consensus that CSR can alleviate IA issues, leading to positive economic outcomes like increased stock liquidity, enhanced investment efficiency, and reduced cost of capital. This study's uniqueness lies in its integration of bibliometric analysis and systematic literature review to provide a holistic summary of both theoretical frameworks and the economic implications of the CSR‐IA relationship. It offers valuable insights and recommendations for future research in this field.

Exploring unmet needs and preferences of young adult stroke patients for post-stroke care through PROMs and gender differences

BackgroundStroke incidence among young adults of working age (under 65 years of age) has significantly increased in the past decade, with major individual, social, and economic implications. There is a paucity of research exploring the needs of this patient population. This study assessed: (1) young adult stroke patients' physical, psychological, and occupational functioning and health-related quality of life (HRQoL); and (2) post-stroke care preferences using patient-reported outcome measures (PROMs), with attention to gender differences.MethodsA cross-sectional pilot study was conducted. Sociodemographic and clinical characteristics were collected through chart review and data on occupational function, physical, psychological, and social wellbeing >90 days post-stroke through a self-reported survey. Descriptive statistics, gender-based, and regression analyses were conducted.ResultsThe sample included 85 participants. Participants reported impairments in both, occupational functioning, with 58.7% not returned to work (RTW), and HRQoL, specifically with social activities (37%), anxiety (34%), and cognitive function (34%). Women had significantly (p < 0.05) worse physical symptoms (sleep disturbance and fatigue), emotional health (depression, stigma, emotional dyscontrol) scores, and sense of self-identify post-stroke. Over 70% of participants preferred in-person post-stroke care led by health care providers and felt they would have benefited from receiving information on physical health (71.4%), emotional and psychological health (56.0%), RTW (38.1%), and self-identity (26.2%) post-stroke. Women preferred cognitive behavioral therapy (p = 0.018) and mindfulness-based stress reduction therapy (p = 0.016), while men preferred pharmacotherapy (p = 0.02) for psychological symptoms.ConclusionThis is the first study to report impaired HRQoL, psychological and occupational functioning using PROMs, with significant gender differences and preferences for post-stroke care delivery among young adult stroke patients at >90 days after stroke. The findings highlight the importance of needs, gender, and age-specific post-stroke education and interventions.

Saponin monomers: Potential candidates for the treatment of type 2 diabetes mellitus and its complications.

Type 2 diabetes mellitus (T2DM), a metabolic disease with persistent hyperglycemia primarily caused by insulin resistance (IR), has become one of the most serious health challenges of the 21st century, with considerable economic and societal implications worldwide. Considering the inevitable side effects of conventional antidiabetic drugs, natural ingredients exhibit promising therapeutic efficacy and can serve as safer and more cost-effective alternatives for the management of T2DM. Saponins are a structurally diverse class of amphiphilic compounds widely distributed in many popular herbal medicinal plants, some animals, and marine organisms. There are many saponin monomers, such as ginsenoside compound K, ginsenoside Rb1, ginsenoside Rg1, astragaloside IV, glycyrrhizin, and diosgenin, showing great efficacy in the treatment of T2DM and its complications in vivo and in vitro. However, although the mechanisms of action of saponin monomers at the animal and cell levels have been gradually elucidated, there is a lack of clinical data, which hinders the development of saponin-based antidiabetic drugs. Herein, the main factors/pathways associated with T2DM and the comprehensive underlying mechanisms and potential applications of these saponin monomers in the management of T2DM and its complications are reviewed and discussed, aiming to provide fundamental data for future high-quality clinical studies and trials.

Sub-fertility and life style factors which affecting sub-fertility among women in Regional Director of Health Service area, Colombo

Sub-fertility and life style factors which affecting sub-fertility among women in Regional Director of Health Service area, Colombo

Exploring remanufacturing conveniency: An economic and energetic assessment for a closed-loop supply chain of a mechanical component

The concept of sustainability has become pervasive in society, compelling industries to embrace circular economy principles supported by institutions, such as the European Commission. The circular economy promotes recovery, sharing, and recycling, which poses challenges in transitioning from linear to circular models. Remanufacturing is a key strategy in this framework by enabling the recycling of discarded products, improving resource efficiency, and reducing waste. Therefore, this study investigates the key factors influencing decision-making in remanufacturing processes within the supply chains of mechanical components, identifying scenarios where remanufacturing proves to be more effective than purchasing new products. This research provides valuable insights for businesses considering the adoption of remanufacturing in their supply chains. While previous studies on remanufacturing have predominantly focused on economic aspects, this research addresses both economic and energy-related implications. The study proposes a three-stage methodology to compare three scenarios and select the optimal one: a traditional supply chain for mechanical components without remanufacturing (Scenario 1), a supply chain with remanufacturing and direct customer-manufacturer interaction (Scenario 2), and a supply chain with remanufacturing and indirect customer-manufacturer interaction facilitated by a distribution center (Scenario 3). This methodology was applied to components made of steel, aluminum, and titanium. The results reveal that the remanufacturing volume and the percentage of material preserved by conventional manufacturing process are the most critical variables to consider when evaluating the introduction of remanufacturing in supply chains. Specifically, the lower the former values the more remanufacturing tends to be preferred. Furthermore, remanufacturing is usually favored by the energetic analysis, while the economic analysis shows mixed results. The developed models and the obtained findings could assist organizations in making strategic decisions regarding end-of-life strategies and assessing the economic and energy viability of integrating remanufacturing processes into their supply chains, as opposed to favoring new component production.

Comparative Analysis of Profitability, Water and Energy Productivity in Curry Leaf Cultivation: Drip vs. Conventional Production Systems in Coimbatore district, India

The aim is to analyze the cost and returns of curry leaf production under different irrigation methods, assess water and energy productivity and draw conclusions regarding the sustainability and profitability of drip irrigation. The study utilizes a sample of 60 respondents from two blocks in Coimbatore district, employing a multi-stage random sampling technique. Primary data was collected through structured questionnaires administered via personal interviews between June and September 2023. Cost concepts were employed to calculate cultivation costs, while water and energy consumption were assessed to determine productivity. This study investigates the economic and environmental implications of adopting drip irrigation over conventional furrow irrigation for curry leaf cultivation in the Coimbatore district of Tamil Nadu, India. The results demonstrate that drip irrigation significantly reduces operational costs and improves yields compared to furrow irrigation. Gross and net incomes are substantially higher with drip irrigation, highlighting its economic advantages. Moreover, drip irrigation shows higher water and energy productivity, indicating its potential for resource conservation and sustainability. The results emphasize the importance of governmental support in promoting drip irrigation adoption to enhance water efficiency and facilitate value-added product export. In conclusion, this study highlights the significance of drip irrigation in enhancing profitability, conserving resources and promoting agricultural sustainability in curry leaf cultivation within the Coimbatore region.

Polyurethane Recycling Through Acidolysis: Current Status and Prospects for the Future

AbstractPolyurethane (PU) stands out as a crucial category of polymers which have become indispensable in improving our quality of life, revolutionizing various aspects of human existence. However, this convenience comes with a dark side – the environmental impact associated with its disposal. Nevertheless, recycling presents a promising solution, aligning with the principles of a circular economy by transforming polymer waste into new materials. A notable focus within this realm is the utilization of dicarboxylic acids (DA) as depolymerization agents, achieved through a process known as acidolysis. This method has proven to be an exceptional solution, primarily explored for recycling PU foams and subsequently employed in the production of new foams. The resulting recycled polyol finds successful applications in various PU products, including rigid and flexible foams, adhesives, and coatings. Analyzing the impact of recycled polyol on the properties of new PU products reveals interesting insights. While it slightly affects the morphology and color of foams, there is no significant impact on density or thermal conductivity. Notably, flexible foams exhibit increased stiffness when produced using recycled polyol. Additionally, the strength of PU adhesives and the surface hardness of PU coatings are enhanced with the incorporation of recycled polyol, albeit with a reduction in gloss. The recycled PU coatings also display a more hydrophobic surface. Considering both environmental and economic benefits, the advantages of this approach are evident. With the aim of catering to the needs of both the academic and industrial sectors, this review delves into the subject of PU recycling via acidolysis, subsequently exploring the utilization of recycled materials in the creation of new PU products. The review offers an in-depth explanation of the acidolysis process and thoroughly examines the degradation mechanisms involved. Additionally, it scrutinizes the impact of reaction conditions on the properties of the recycled materials and investigates their applicability in the production of novel materials. Moreover, the review presents an analysis of the environmental and economic implications associated with these processes. In summary, this review overviews the current status of acidolysis of PU and prospects for its future.

Charting the Sustainable Course: Navigating the Saudi Arabia Medical and Wellness Tourism Roadmap with Business Model Canvas (BMC)

Medical and wellness tourism has emerged as a pivotal sector with significant economic implications globally, especially after the COVID-19 pandemic. This study delves into the landscape of Saudi Arabia’s medical and wellness tourism, recognizing its importance as a key player in the tourism industry. The study aims to elevate this sector to new heights on the global stage by employing the Business Model Canvas (BMC) as a strategic tool. BMC allows for a comprehensive analysis of the medical tourism industry in Saudi Arabia, breaking down key elements across its nine blocks: key partners, key activities, key resources, value propositions, customer segments, channels, customer relationships, cost structure, and revenue streams. The results of this study shed light on the unique selling proposition (USP) as a crucial strategic step for Saudi Arabia to distinguish itself and enhance its position in the international medical tourism arena. By identifying and maximizing the unique aspects within each BMC block, the study presents a roadmap for Saudi Arabia, navigating the challenges and capitalizing on the potential of the medical and wellness tourism sector. This research serves as a guide, emphasizing the strategic importance of a well-defined business model to shape the future of medical and wellness tourism in Saudi Arabia and establish a prominent global presence.

A Highly Homogeneous Airborne Fungal Community around a Copper Open Pit Mine Reveals the Poor Contribution Made by the Local Aerosolization of Particles

Fungi are ubiquitous and metabolically versatile. Their dispersion has important scientific, environmental, health, and economic implications. They can be dispersed through the air by the aerosolization of near surfaces or transported from distant sources. Here, we tested the contribution of local (scale of meters) versus regional (kilometers) sources by analyzing an airborne fungal community by ITS sequencing around a copper mine in the North of Chile. The mine was the regional source, whereas the soil and vegetal detritus were the local sources at each point. The airborne community was highly homogeneous at ca. 2000 km2, impeding the detection of regional or local contributions. Ascomycota was the dominant phylum in the three communities. Soil and vegetal detritus communities had lower alpha diversity, but some taxa had abundance patterns related to the distance from the mine and altitude. On the contrary, the air was compositionally even and unrelated to environmental or spatial factors, except for altitude. The presence of plant pathogens in the air suggests that other distant sources contribute to this region’s airborne fungal community and reinforces the complexity of tracking the sources of air microbial communities in a real world where several natural and human activities coexist.

304 What does Prop 12 mean for the swine industry

Abstract California’s Proposition 12, also known as the Farm Animal Confinement Initiative, has been fully implemented as of January 1st, 2024. This measure regulates the minimum space requirements for egg-laying hens, dairy calves raised for veal, and breeding pigs in order for the associated products to be sold within the state of California. Suppliers of these covered products need to be accredited by specific, third-party certifying agents to be certified as ‘Prop 12 compliant’. For the swine industry, the spotlight is on the housing of any female breeding pig over the age of 6 mo. These animals must be in an enclosure that allows them to lie down, stand up, turn around, and fully extend their limbs without touching the sides of their stalls or another animal (24 square feet of floor space per animal). These regulations also limit the duration of time producers can house animals in closed crates before farrowing to 5 d. While these housing regulations do not apply during the nursing phase, research contexts, during veterinary treatment or immediately before slaughter, they do apply in the post-weaning phase. This means that the animals cannot be confined for heat-checking or breeding to be considered ‘Prop 12 compliant’. These housing standards have no minimum herd size and apply to those in commercial or private farms if there will be products produced and sold. With any change to the standard operating procedures of animal husbandry, there will be some growing pains. These issues can be addressed when considerations are given to the group composition (age and size of sows), pen mixing practices (pre or post breeding), feeding schedule [collective (trough, floor fed) or individual (electronic sow feeding, free access stalls)], and, pen structural quality (flooring, enrichment). This measure will have considerable economic and ethical implications related to barn renovations, animal care staff training, and husbandry practices for the swine industry.

The role of AI-Driven predictive analytics in optimizing IT industry supply chains

This review paper examines the pivotal role of AI-driven predictive analytics in optimizing supply chain operations within the IT industry. By leveraging machine learning, deep learning, and neural networks, predictive analytics can significantly enhance demand forecasting, inventory management, supplier selection, and risk management. Despite its potential to revolutionize supply chains, the integration of AI faces challenges, including data quality, the need for skilled personnel, and organizational resistance. Strategic implementation approaches are discussed, emphasizing robust data infrastructure, stakeholder engagement, and continuous innovation. This paper contributes to the academic discourse by highlighting AI's economic and social implications in supply chains and suggesting directions for future research. It is a comprehensive guide for practitioners and academics navigating the complexities of AI-driven predictive analytics in supply chain optimization. Keywords:  AI-driven Predictive Analytics, Supply Chain Optimization, IT Industry, Machine Learning, Strategic Implementation.

The impact of brain cancer care coordinators on healthcare utilization and outcomes in patients with glioblastoma

Abstract Background Cancer care coordinators (CCCs) are recognized as having an important role in patients’ and carers’ cancer journey. However, there are no studies investigating the impact of CCCs on quantitative outcomes. We performed a retrospective cohort study investigating the impact of brain cancer care coordinators (BCCCs) on health service resource use and survival in patients with glioblastoma. Methods All patients diagnosed with glioblastoma between 2012 and 2019 in Hunter New England Local Health District, Australia (HNELHD) were included and the patients were divided into 2 cohorts: before and after the introduction of the BCCC. Any patient diagnosed in 2016, during the introduction of the BCCC, were excluded. The main outcomes assessed were overall survival, health service resource use, odds of being admitted to hospital after the emergency presentation, and cost-offset analysis to examine the economic implications of BCCCs. Results A total of 187 patients were included. There were no significant differences in overall survival between the 2 groups (mOS 12.0 vs 11.16 months, HR 0.95). However, there was a reduction in the number of ED presentations and admissions. This was associated with a 24% reduction in aggregate length of stay with the BCCC. There was no statistically significant difference in mean patient costs, however our hospital may have saved over AUD$500 000 with BCCCs. Conclusions The introduction of BCCC did not improve survival but appeared to be associated with reduced health resource utilization. This study provides economic justification, in addition to the established quality of life improvements, to support the presence of BCCCs.

Economic evaluation of Be a Mom, a web-based intervention to prevent postpartum depression in high-risk women alongside a randomized controlled trial

BackgroundPostpartum depression (PPD) poses significant challenges, affecting both mothers and children, with substantial societal and economic implications. Internet-based cognitive behavioral therapy interventions (iCBT) offer promise in addressing PPD, but their economic impact remains unexplored. This study aimed to evaluate the cost-utility of Be a Mom, a self-guided iCBT intervention, compared with a waiting-list control among postpartum women at high risk of PPD. MethodsThis economic evaluation was conducted alongside a 14-month randomized controlled trial adopting a societal perspective. Participants were randomized to Be a Mom (n = 542) or a waitlisted control group (n = 511). Self-report data on healthcare utilization, productivity losses, and quality-adjusted life years (QALYs) were collected at baseline, post-intervention, and 4 and 12 months post-intervention. Incremental cost-effectiveness ratios (ICERs) were calculated, and cost-effectiveness acceptability curves were generated using nonparametric bootstrapping. Sensitivity analyses were conducted to assess result robustness. ResultsOver 14 months, Be a Mom generated a QALY gain of 0.0184 (0.0022, 0.0346), and cost savings of EUR 34.06 (−176.16, 108.04) compared to the control group. At a willingness to pay of EUR 20,000, Be a Mom had a 97.6 % probability of cost-effectiveness. LimitationsResults have limitations due to self-selected sample, potential recall bias in self-reporting, missing data, limited follow-up, and the use of a waiting-list control group. ConclusionsThis study addresses a critical gap by providing evidence on the cost-utility of an iCBT intervention tailored for PPD prevention. Further research is essential to identify scalable and cost-effective interventions for reducing the burden of PPD.

Epidemiological and health economic implications of symptom propagation in respiratory pathogens: A mathematical modelling investigation.

Respiratory pathogens inflict a substantial burden on public health and the economy. Although the severity of symptoms caused by these pathogens can vary from asymptomatic to fatal, the factors that determine symptom severity are not fully understood. Correlations in symptoms between infector-infectee pairs, for which evidence is accumulating, can generate large-scale clusters of severe infections that could be devastating to those most at risk, whilst also conceivably leading to chains of mild or asymptomatic infections that generate widespread immunity with minimal cost to public health. Although this effect could be harnessed to amplify the impact of interventions that reduce symptom severity, the mechanistic representation of symptom propagation within mathematical and health economic modelling of respiratory diseases is understudied. We propose a novel framework for incorporating different levels of symptom propagation into models of infectious disease transmission via a single parameter, α. Varying α tunes the model from having no symptom propagation (α = 0, as typically assumed) to one where symptoms always propagate (α = 1). For parameters corresponding to three respiratory pathogens-seasonal influenza, pandemic influenza and SARS-CoV-2-we explored how symptom propagation impacted the relative epidemiological and health-economic performance of three interventions, conceptualised as vaccines with different actions: symptom-attenuating (labelled SA), infection-blocking (IB) and infection-blocking admitting only mild breakthrough infections (IB_MB). In the absence of interventions, with fixed underlying epidemiological parameters, stronger symptom propagation increased the proportion of cases that were severe. For SA and IB_MB, interventions were more effective at reducing prevalence (all infections and severe cases) for higher strengths of symptom propagation. For IB, symptom propagation had no impact on effectiveness, and for seasonal influenza this intervention type was more effective than SA at reducing severe infections for all strengths of symptom propagation. For pandemic influenza and SARS-CoV-2, at low intervention uptake, SA was more effective than IB for all levels of symptom propagation; for high uptake, SA only became more effective under strong symptom propagation. Health economic assessments found that, for SA-type interventions, the amount one could spend on control whilst maintaining a cost-effective intervention (termed threshold unit intervention cost) was very sensitive to the strength of symptom propagation. Overall, the preferred intervention type depended on the combination of the strength of symptom propagation and uptake. Given the importance of determining robust public health responses, we highlight the need to gather further data on symptom propagation, with our modelling framework acting as a template for future analysis.

Clinical and economic implications of using daratumubab with lenalidomide in the 1st and 2nd lines of therapy for multiple myeloma patients

Objective: to assess clinical and economic implications of adding daratumumab (Dara) to the “lenalidomide + dexamethasone” (Rd) treatment program in early lines of therapy for patients with multiple myeloma (MM) ineligible for high-dose chemotherapy (HDCT) with subsequent autologous hematopoietic stem cell transplantation (autoHPSCT).Material and methods. Partitioned survival model was developed to compare overall survival in the treatment programs of MM patients in the 1st to 3rd lines of therapy. The following treatment options were included in the analysis: 1st line – Dara+Rd; 2nd line – “carfilzomib + lenalidomide” (K+Rd) or “ixazomib + lenalidomide” (Ixa+Rd) triplets; 3rd line – pomalidomide (Pom+dex) and Rd+(Dara+Rd)+(Pom+dex) versus Rd+(K/Ixa+Rd)+(Pom+dex/Dara). Probabilities of transition between health states (progression-free, progressed disease, and death) were based on published clinical data. Lifetime direct healthcare costs and incremental cost-effectiveness ratios (ICERs) per 1 life year gained were calculated from a Russian health care perspective. The indicator of the difference in costs between current and expected practice was used in budget impact analysis.Results. Dara+Rd combination increased life expectancy by 1.04 years (+16.05%) and 0.95 years (+14.57%) per patient, and in the target population (n=955) by 995.48 and 903.40 years for (Dara+Rd)+(K+Rd)+(Pom+dex) and (Dara+Rd)+(Ixa+Rd)+(Pom+dex) treatment programs, respectively, compared to Rd use in the 1st line. The ICER per 1 life year gained for Dara+Rd in 1st line therapy was 8.95 mln rubles for (Dara+Rd)+(K+Rd)+(Pom+dex) and 8.41 mln rubles for (Dara+Rd)+(Ixa+Rd)+(Pom+dex). It's lower than the median ICER of 13.64 million per 1 life year gained for antitumor drugs used to treat cancer of lymphatic and hematopoietic tissues (reference ICER). Dara+Rd triplet is used in 2nd line therapy after Rd, the number of life years gained in the target population due to greater efficacy is higher by 291.50 years compared with K+Rd and by 203.93 years compared with Ixa+Rd. The ICER per 1 life year gained for Dara+Rd is also lower than the ICER reference value: 9.25 mln rubles versus 13.64 mln rubles. The budget impact analysis showed that using Dara in early stages of MM therapy does not increase drug provision costs in the target population.Conclusion. The obtained results allowed to conclude that it is economically feasible to add Dara to the 1st and 2nd lines of therapy in lenalidomide treatment programs for MM patients who are not candidates for HDCT with autoHPSCT.

IMPACT OF ARTIFICIAL INTELLIGENCE ON SOCIETY: RISK AND CHALLENGES

Artificial Intelligence (AI) refers to the simulation of human intelligence in machines that are programmed to think and act like humans. These machines are designed to perform tasks that typically require human intelligence, such as visual perception, speech recognition, decision-making, and language translation. AI technologies include machine learning, which enables computers to learn from experience and improve their performance over time without being explicitly programmed, and deep learning, which uses neural networks to process complex patterns and data. AI has applications in various fields, including healthcare, defence, transportation, education, and labour market, and its development has raised ethical, social, educational, and economic implications. The main objective of the study is to explore the literature on the artificial intelligence, its impact on society as well as challenges and risks posed by AI. Recently AI has been utilized in various fields. To cover various societal aspects, literature has been reviewed from various disciplines where AI is applied. These areas include healthcare, automobiles, education, labour market, defence, entertainment, computation, and security. These articles are retrieved from peer-reviewed sources based on the keywords suggesting the role of AI, forecasting & assessment of impact, behavioural & ecological aspects of AI, and AI's relation to employment. In this study it has been concluded that application of Artificial Intelligence has transformed the conventional ways of almost every area of modern society by bringing the significant changes in the industry, commerce, defence, education, labour market and healthcare services. But it has raised certain concerns also such as automation leads to job displacement and economic inequality concentrating revenue among fewer individuals. AI supported Autonomous Weapons to kill could cause mass casualties if misused. Hence the idea is both devastating and exciting and the application of AI should be carefully monitored. 

Protecting Patients And Society In An Era Of Private Equity Provider Ownership: Challenges And Opportunities For Policy.

Private equity (PE) acquisitions in health care delivery nearly tripled from 2010 to 2020. Despite concerns around clinical and economic implications, policy responses have remained limited. We discuss the US policy landscape around PE ownership, using policies in the European Union for comparison. We present four domains in which policy can be strengthened. First, to improve oversight of acquisitions, policy makers should lower reporting thresholds, review sequential acquisitions that together affect market power, automate reviews with potential denials based on market concentration effects, consider new regulatory mechanisms such as attorney general veto, and increase funding for this work. Second, policy makers should increase the longer-run transparency of PE ownership, including the health care prices garnered by acquired entities. Third, policy makers should protect patients and providers by establishing minimum staffing ratios, spending floors for direct patient care, and limits on layoffs and the sale of real estate after acquisition (forms of "asset stripping"). Finally, policy makers should mitigate risky financial behavior by limiting the amount or proportion of debt used to finance PE acquisitions in health care.