A multi-stakeholder multicriteria decision analysis for the reimbursement of orphan drugs (FinMHU-MCDA study)

Background: Patient access to orphan medicinal products (OMPs) is limited and varies between countries, reimbursement decisions on OMPs are complex, and there is a need for more transparent processes to know which criteria should be considered to inform these decisions. This study aimed to determine the most relevant criteria for the reimbursement of OMPs in Spain, from a multi-stakeholder perspective, and using multicriteria decision analysis (MCDA). Methods: An MCDA was developed in 3 phases and included 28 stakeholders closely related to the field of rare diseases (6 physicians, 5 hospital pharmacists, 7 health economists, 4 patient representatives and 6 members from national and regional health authorities). Initially [phase A], a bibliographic review was conducted to identify the potential reimbursement criteria. Then, a reduced advisory board (8 members) proposed, selected, and defined the final list of criteria that could be relevant for reimbursement. A discrete choice experiment (DCE) [phase B] was developed to determine the relevance and relative importance weight of such criteria according to the stakeholders’ preferences by choosing between pairs of hypothetical financing scenarios. A multinomial logit model was fitted to analyze the DCE responses. Finally [phase C], the advisory board review the results using a deliberative process. Results: Thirteen criteria were selected, related to 4 dimensions: patient population, disease, treatment, and economic evaluation. Nine criteria were deemed relevant for decision-making and associated with a higher relative importance: Health-related quality of life (HRQL) (23.53%), treatment efficacy (14.64%), availability of treatment alternatives (13.51%), disease severity (12.62%), avoided costs (11.21%), age of target population (7.75%), safety (seriousness of adverse events) (4.72%), quality of evidence (3.82%) and size of target population (3.12%). The remaining criteria had a < 3% relative importance: economic burden of disease (2.50%), cost of treatment (1.73%), cost-effectiveness (0.83%) and safety (frequency of adverse events) (0.03%). Conclusion: The reimbursement of OMPs in Spain should be determined by its effect on patient’s HRQL, the extent of its therapeutic benefit from efficacy and the availability of other therapeutic options. Furthermore, the severity of the rare disease should also influence the decision along with the potential of the treatment to avoid associated costs

University quality measurement model based on balanced scorecard

A Higher Education Institution (HEI) has the responsibility to track the processes through indicators that guarantee the measurement of the results in almost real time. This article presents the design of a management and quality model of the processes in a university, through the integration of a Balance Scorecard (BSC) and the implementation of an information system. For which it was required: a review of existing tracing and monitoring systems in the academic sector, definition of the requirements of the proposed technological, a diagnosis of the current measurement system of the HEI analyzed, identify measurement indicators and develop a technological tool. The designed model presents a precise and clear methodological guide that can be replicated in any HEI to monitor its processes

Isoenzimas no monitoramento da deterioração de sementes de Euterpe espiritosantensis Fernandes

As sementes de Euterpe espiritosantensis são recalcitrantes, pois apresentam redução da germinação com a desidratação e curta longevidade. O objetivo deste trabalho foi identificar sistemas enzimáticos eficientes no monitoramento da deterioração e perda da capacidade germinativa de sementes de palmiteiro-vermelho. As sementes foram colocadas para secar por 0, 20 e 40 h (teor de água de 46, 40 e 36%, respectivamente) e armazenadas a 15 ºC em sacos plásticos fechados durante 54 semanas. Em intervalos de tempo de seis semanas, a qualidade das sementes foi avaliada quanto à germinação e atividade das enzimas glucose-6-fosfato desidrogenase, glutamato desidrogenase, fosfoglucomutase, fosfoglucose isomerase e peroxidase utilizando eletroforese em géis de poliacrilamida. A enzima peroxidase foi a única eficiente no monitoramento da deterioração e perda da capacidade germinativa de sementes de palmiteiro-vermelho

Socialização econômica: conhecendo o mundo econômico das crianças Economic Socialization: knowing the children's economic world

O aprendizado de conceitos econômicos e os comportamentos econômicos de crianças são objetos de estudo da Socialização Econômica, uma área que tem atraído a atenção de pesquisadores, tanto da Psicologia do Desenvolvimento quanto da Psicologia Econômica. Os estudos têm aumentado significativamente nos últimos anos em outros países, mas no Brasil poucas pesquisas têm sido desenvolvidas. Este artigo objetiva apresentar a socialização econômica como uma área de pesquisa promissora e em franco desenvolvimento, mediante a discussão de três questões fundamentais inerentes à área: 1) As fases de desenvolvimento do pensamento econômico, 2) Variáveis que interferem na socialização econômica e 3) Comportamentos econômicos de crianças. No decorrer do artigo são evidenciados os principais resultados que pretendem responder às questões citadas e são mencionadas as lacunas a preencher, como possibilidades de pesquisas a realizar. Finaliza-se com sugestões para uma agenda brasileira de pesquisas.<br>The child's learning of economic concepts and economic' behaviors are subjects of economic socialization. The research in this area is increasing in the recent years but in Brazil there are a few studies only. This article aims to introduce economic socialization as a promising research area, through discussion of three questions: 1) stages of economic reasoning development, 2) variables that interfere in economic socialization and 3) children's economic behaviors. The article shows the most important results that try to answer those questions, points out some lacks to filled in and future investigations. Finally suggestions are presented for a Brazilian research agenda