Official National Sources Research Articles

Improving the Legislation on Public-Private Partnerships in Environmental Protection in the BRICS Countries

The Concept of Sustainable Development is one of the basic principles of the modern world. An increasing number of fields are coming under regulation governed by this concept. Recent updates to the environmental agenda have resulted in growing demands for increased environmental responsibility on the part of states and businesses. The global nature of environmental problems, their diversity and scale, and, at times, the irreversibility of the consequences of the negative environmental impact of the economy often provide for the consolidation of efforts by the state and business, particularly, through the implementation of public-private partnership (PPP) mechanisms. This article focuses on the pros and cons of legislation in the BRICS countries in the area of PPP practice in general and in environmental protection in particular. The data and PPP practices have been collected from the World Bank, UNCITRAL, and other official national sources related to PPP. An analysis of the legislation on PPPs in the BRICS countries indicates a lack of uniformity in the legal regulation of the relationships arising from this partnership, as well as a lack of specific legislation on PPPs specifically addressing environmental protection. The analysis shows that only those BRICS countries using the common law system (South Africa and India) have the instruments available to allow potential investors to fully assess the PPP model as it currently exists in a particular country. This practice developed as a result of a more flexible approach to the regulation of public relations. Undoubtedly, one of the many advantages of this approach is the ability to adjust the PPP system and model all of the known forms and types of PPPs in accordance with the specific needs of society and the state. The lack of flexibility, for example, of the Russian legislation on PPP regulation, has led to the limited forms or types and objects of PPPs, which is inconsistent with the modern needs of society and the state to achieve the UN Sustainable Development Goals.

Small-Scale Socio-Economic Conditions and Residential Segregation: Evidence from the Municipalities Across the Metropolitan Region of Attica

Residential segregation gained a new momentum after the turn of the new century. The pace of urbanization that has been observed over the last two decades has been proceeding hand in hand with the increasing residential segregation in large cities and metropolitan areas. The international literature is flourishing with studies on residential segregation. This paper investigates residential segregation trends in the Metropolitan Region of Attica during the period 2004-2019. The analysis is based on a database combining individual household data from the EU-SILC, as well as data from official national sources. The paper applies the Dissimilarity Index for measuring residential segregation trends based on occupation, education and living conditions, before, during and after the economic crisis. We also use the Gini index for comparing income inequality with residential segregation trends. Our analysis shows that between 2004 and 2019, residential segregation intensified between the top and bottom socio-economic groups, whilst an inclusive trend has been recorded between middle-class groups and the other two categories. The results do not suggest any similar patterns between residential segregation and income inequality. The evidence derived from this study is relevant to public policy, inclusive growth and development.

COST-EFFECTIVENESS OF TOFACITINIB FOR THE TREATMENT OF MODERATE TO SEVERE ACTIVE ULCERATIVE COLITIS IN COLOMBIA

Abstract OBJECTIVE To evaluate the cost-effectiveness of tofacitinib versus other treatment options currently available in Colombia for the management of adult patients with moderate-to-severe ulcerative colitis in naïve to biologics (first line) and exposed to biologics (second line). METHODS A Markov model was constructed with 8 weeks cycles. It simulates a cohort of patients with moderate-to-severe ulcerative colitis from a payer perspective in a 5-year horizon. The health states include remission, treatment response (without remission), active UC, and colectomy. The transition probabilities for the induction and maintenance phase were obtained from a network meta-analysis. Effectiveness was measured from quality-adjusted life-year (QALY) and the utilities were obtained from the literature. Unit costs were derived from official national sources, and these were expressed in US dollars 2021 at the average exchange rate of $3 693 COP/US. Probabilistic and deterministic sensitivity analyses were conducted. The threshold was defined as one gross domestic product ($5 391) per capita. RESULTS For first line, the incremental cost-effectiveness ratio (ICER) per QALY was for tofacitinib $2 611 and for infliximab $7 652 compared to adalimumab. Sensitivity analysis showed that tofacitinib is shown as cost-effective in 52% of the iterations, followed by adalimumab 25% and infliximab 23% patients. Meanwhile, adalimumab was $27 527 compared to tofacitinib in second line. Tofacitinib was cost-effective 72% of the iterations, followed by adalimumab 28% in the sensitivity analysis. Infliximab and golimumab were not included due to data limitation in network metanalysis in second line. For both lines vedolizumab was not a cost-effective alternative under the threshold assessed. CONCLUSION The analysis suggests that, in Colombia, the treatment with tofacitinib for moderate-to-severe UC patients is a cost-effective option in both lines, compare with other treatment options available.

Awareness, knowledge and trust in the Greek authorities towards COVID-19 pandemic: results from the Epirus Health Study cohort

BackgroundTo assess the level of knowledge and trust in the policy decisions taken regarding the coronavirus disease (COVID-19) pandemic among Epirus Health Study (EHS) participants.MethodsThe EHS is an ongoing and deeply-phenotyped prospective cohort study that has recruited 667 participants in northwest Greece until August 31st, 2020. Level of knowledge on coronavirus (SARS-CoV-2) transmission and COVID-19 severity was labeled as poor, moderate or good. Variables assessing knowledge and beliefs towards the pandemic were summarized overall and by sex, age group (25–39, 40–49, 50–59, ≥60 years) and period of report (before the lifting of lockdown measures in Greece: March 30th to May 3rd, and two post-lockdown time periods: May 4th to June 31st, July 1st to August 31st). A hypothesis generating exposure-wide association analysis was conducted to evaluate the associations between 153 agnostically-selected explanatory variables and participants’ knowledge. Correction for multiple comparisons was applied using a false discovery rate (FDR) threshold of 5%.ResultsA total of 563 participants (49 years mean age; 60% women) had available information on the standard EHS questionnaire, the clinical and biochemical measurements, and the COVID-19-related questionnaire. Percentages of poor, moderate and good knowledge status regarding COVID-19 were 4.5, 10.0 and 85.6%, respectively. The majority of participants showed absolute or moderate trust in the Greek health authorities for the management of the epidemic (90.1%), as well as in the Greek Government (84.7%) and the official national sources of information (87.4%). Trust in the authorities was weaker in younger participants and those who joined the study after the lifting of lockdown measures (p-value≤0.001). None of the factors examined was associated with participants’ level of knowledge after correction for multiple testing.ConclusionsHigh level of knowledge about the COVID-19 pandemic and trust in the Greek authorities was observed, possibly due to the plethora of good quality publicly available information and the timely management of the pandemic at its early stages in Greece. Information campaigns for the COVID-19 pandemic should be encouraged even after the lifting of lockdown measures to increase public awareness.

PIN13 Cost-Minimization Analysis of Introducing Hexaxim® into Korean National Immunization Program

Multivalent vaccines have brought public health and economic benefits by covering new antigens without increasing the number of injections. A fully liquid hexavalent vaccine, Hexaxim® (DTaP-IPV-Hib-HepB) has been approved in Korea with proven immunogenicity and safety compared to pentavalent DTaP-IPV/Hib co-administered with standalone Hep B vaccine. This research aims to evaluate the socio-economic impact of introducing Hexaxim® in Korean national immunization program (NIP). A cost-minimization analysis was performed with a societal perspective over a 1-year time horizon. Vaccines acquisition, administration, immunization error related costs, parents’ transportation and time costs were considered in the model. The probabilities of immunization error were obtained from Time and Motion study, which showed that a fully liquid vaccine significantly reduced the preparation time and resulted in fewer immunization errors. Data on birth cohort, vaccine coverage rate, transportation cost and hourly gross wage were collected from official national sources. In order to obtain the number of hospital visits for inoculation, a nationwide online market research (N=400) was carried out in August 2020. Parents’ time costs were estimated by Opportunity Cost Methods, but different approaches also explored in the sensitivity analysis. If Korea switches from the current pentavalent DTaP-IPV/Hib plus HepB to Hexaxim® for NIP, it will provide 33.2 billion KRW (=29 million USD) substantial cost-savings over the coming year. This was mainly attributable to parents’ time savings by reducing hospital visits. Reducing transportation, inoculation fee and immunization errors were also contributing factors. Sensitivity analyses indicated that results were robust to the different valuation approaches. Our research demonstrates the socio-economic value of Hexaxim® beyond clinical evidences. Additional practical benefits of Hexaxim® such as reducing storage, distribution and preparation steps, which were not fully captured in this analysis, could be considered from HCP’s perspectives. These results would support evidence-based decision-making on the introduction of Hexaxim® in Korea NIP.

Analysis on the COVID-19 Impact on the Deaths Tendency in Italy and Europe

Due to the arrival of COVID-19 in Italy and Europe, there has been a significant increase in deaths recorder in the year 2020, this increase is not justified by the number of deaths recorded for COVID-19. The hypothesis in that the deaths recorded for COVID-19 are underestimated. This study aims to estimate the possible number of unrecorded COVID-19 deaths using a predictive model built based on historical deaths recorded from 2015 to 2019. The estimate was calculated by comparing the number of deaths expected, according to the prediction for the year 2020 under normal conditions, with the deaths recorded during the pandemic in the same period which runs from March to September 2020. Through the comparison it was possible to obtain an estimate of the number of excess deaths which represent how much the arrival of the Coronavirus had affected the increase in death recorded. From the excess deaths, the number of COVID-19 deaths advertised and documented by official national sources was subtracted to obtain an estimate of the possible number of unrecorded COVID-19 deaths. Doi: 10.28991/HEF-2021-02-01-01 Full Text: PDF

Cost-effectiveness of tofacitinib for the treatment of moderate to severe active ulcerative colitis in Greece.

To evaluate the cost-effectiveness of tofacitinib versus other treatment options currently available for the management of adult patients with moderate-to-severe ulcerative colitis, who have had an inadequate response, loss of response, or were intolerant to conventional therapy or a biologic agent, in Greece. A Markov model was adapted for projecting lifetime costs and outcomes, for a cohort of patients with moderate-to-severe ulcerative colitis from a Greek payer perspective. Patients entered the model in the active ulcerative colitis state and transitioned to a remission or response state or they underwent colectomy. Following an initial 8-week induction treatment period, patients received maintenance therapy until loss of response. Nonresponders could switch to up to two subsequent biologic lines. Clinical efficacy, adverse event rates and utilities derived from OCTAVE trials and a network-meta-analysis (NMA), while adverse event-related disutilities were obtained from the literature. Information on treatment pathways and resource use was provided by an advisory board due to a lack of local data. Unit costs derived from official national sources (€, 2018). Over a life-time horizon, treating moderate-to-severe active ulcerative colitis with tofacitinib resulted in additional quality-adjusted life-years (QALYs) and lower total costs compared to vedolizumab (0.018; €6408), infliximab (biosimilar) (0.009; €3031), golimumab (0.042; €1988) and infliximab (originator) (0.009; €6724). Hence, tofacitinib was estimated to be dominant over all comparators. The results of the analysis suggest that in the Greek setting, tofacitinib could be considered a cost-effective (dominant) treatment option for the treatment of patients with moderate-to-severe active ulcerative colitis.

Safe mobility, socioeconomic inequalities, and aging: A 12-year multilevel interrupted time-series analysis of road traffic death rates in a Latin American country.

As the resources for road safety in developing countries are scarce and unevenly distributed, vulnerable road users -such as the elderly- may be particularly at risk of road traffic deaths. To date, the impact of road safety measures over the rate of road traffic deaths in older adults (60 years or older), considering the within-country socioeconomic inequalities, has not been explored in developing nations. This study takes the Chilean case as an example -with its 2005 traffic law reform as one of the road safety measures investigated-, in which open data available from official national sources for all its 13 regions over the 2002–2013 period were used for a multilevel interrupted time-series analysis. A statistically significant secular reduction of the rates of road traffic deaths in the elderly population was found (incidence rate ratio [IRR] 0.95, 95% confidence interval [CI] 0.91 to 0.99), but no evidence for a significant intercept or slope change after the traffic law reform was observed. Regions with the highest number of traffic offenses prosecuted in local police courts had lower rates of road traffic deaths in older adults (IRR 0.95, 95% CI 0.90 to 1.00), and those regions in the third (IRR 1.61, 95% CI 1.16 to 2.25) and the fifth (IRR 1.66, 95% CI 1.08 to 2.54) quintiles of socioeconomic deprivation had higher rates of road traffic deaths in the elderly. Such findings strongly support the conceptualization of the road safety of seniors in developing countries as a social equity issue, with implications for the design of traffic regulations and road environments.

Connecting users to trusted geospatial information for Europe

Abstract. In recent years, we have seen an explosion in location-based services. Whether it is maps, cadastral data or land registration, geospatial information is driving applications to realise social, economic and environmental benefits for us all. Yet in the age of ‘Big Data’ and the ‘Internet of Things’, how can we know which data sources are reliable and how easy is it to find accurate, high-quality and detailed information that we can trust? Knowing that reliable sources exist, and where to obtain them, is essential for governments and those making critical decisions that affect all our lives. As the official bodies responsible for national cadastre, land registration, geodetic surveying and mapping activities in Europe, European national mapping and cadastral agencies (NMCAs) fulfil an essential role providing definitive and detailed geospatial information. In an ever-changing world, NMCAs play an important and often critical role in helping to address the key global and regional issues that affect society, such as climate change, sustainable development, a digital economy, migration, security and health. With these challenges extending beyond national borders, society now expects a borderless digital economy and property market, as well as fully connected national databases for stronger cross-border emergency planning and environmental monitoring. As their membership association, EuroGeographics is committed to supporting European NMCAs as they improve access to their rich source of trusted, authoritative geospatial information. EuroGeographics is an independent international not-for-profit organisation representing Europe’s National Mapping, Cadastral and Land Registration Authorities. We believe in a society empowered by the use of trusted geospatial services from these official national sources. EuroGeographics strength lies in our extensive membership and we are proud to represent more than 60 organisations from 46 countries covering the whole of geographical Europe. We deliver benefits for each regardless of the geographical, technical, political, organisational, linguistic and business parameters in which they work. We support the public good by representing our members’ interests, maintaining networks that help our members improve their capabilities and role, and by facilitating access to and use of our members’ geospatial data and services. EuroGeographics’ has the strategic objective of facilitating access to our members’ authoritative data for international users of harmonised, pan-European, geospatial information and services. It coordinates the compilation and production of pan-European datasets, and has been active in exploring the development of online services. The Open European Location Services (Open ELS) project has developed services to demonstrate and test the level of interest in pan-European authoritative geospatial information. EuroGeographics has coordinated this two-year project which was co-financed by the European Union’s Connecting Europe Facility working with partners from member organisations in Finland, Germany, Great Britain, Norway, Poland, Spain, Sweden and The Netherlands. The Project has focused on facilitating access to, and encouraging the take up and use of this information, and is strongly user orientated with a programme of activities to support the digital economy. As well as test services, an Open ELS data policy has been developed which applies only to the geospatial pan-European data and services developed and maintained by EuroGeographics and its members through the Open ELS Project. The Policy was drafted using research which revealed the scope of open geospatial data from official national sources across Europe, and revealed the diversity of policy, business and legal approaches across Europe to what is ‘open’ data. Additional research, carried out by Deloitte and EuroGeographics, found that small and medium sized enterprises (SMEs) in Europe have a strong appetite for more cross-border authoritative data which could help them improve their product and service offerings, save money and become more competitive. The research highlighted four potential benefits from providing harmonised single access to pan-European geospatial information: The possibility to improve existing products and services offering; the possibility to develop new products and services; the reduced time and costs of dealing with different national mapping and cadastral agencies; and the reduced time and costs for acquiring and accessing data. Key findings from these research activities will be presented, along with an outline of the project, and what it has achieved.

How much money is spent on vaccines across Western European countries?

ABSTRACTPrevention programs, particularly vaccinations, remain highly vulnerable to budget cuts because their benefits may not be immediately identifiable. Seven Western European countries were selected (Germany, England, France, Italy, Spain, Sweden and Portugal) constituting a good mix of vaccine procurement modalities, with the objective to document the proportion of healthcare spending devoted to vaccines and its evolution. A data search was performed using the OECD online databases and official national sources from 2008 (2006 for England). No country spent more than 0.5% of its healthcare budget on vaccines. The proportion ranged from 0.25% in Spain (2012) and France (2013) to 0.47% in Germany (2014). Whereas healthcare spending increased in all countries but Spain (with increases ranging from +2.6% per year in France between 2008 and 2013 to +8.1% per year in England between 2006/07 and 2009/10), vaccine spending diminished markedly in Germany (−6.2% per year from 2008 to 2014), Spain (−6.7% per year from 2008 to 2012) and France (−4.2% per year from 2008 to 2013). Only Sweden (+5.9% per year from 2011 to 2013) and England (+18.9% per year from 2006/07 to 2009/10) increased their spending on vaccines. Vaccination involves relatively low levels of healthcare investment in Western Europe relative to the far-reaching public health benefits that it provides. We found a net trend toward a decrease in such spending in recent years, with the exception of Sweden and England. Vaccination budgets should be preserved or even increased to sustain a life-course approach to immunization with sufficient coverage rates.