Расчетная модель общего равновесия для оценки экономического эффекта ранней диагностики болезни Паркинсона

This paper presents a new CGE model of the Russian economy with a health block. We estimate effects of Parkinson's disease (PD) on the Russian economy and population. We distinguish two mechanisms transmitting effects of the PD: a change in the quality of life of a representative household and a decrease in labor supply due to early retirement caused by PD. Our main focus is on effects of early diagnosis of PD coupled with the use of neuroprotective therapy at the prodromal stage of PD. Calculations showed that the cumulative economic effect of PD on the Russian economy, taking into account the forecast of an increase in the incidence of PD over 30 years, can lead to a loss of real GDP in the amount of -0.86%, and a decrease in the utility of households over the same period in the amount of -1.11% of the consumption level of the base year. The high efficiency of early diagnosis in combination with neuroprotective therapy was shown: the cumulative effect, taking into account the prognosis of an increase in the incidence of PD over 30 years of using this method, can give a gain of about 0.68% of the base year GDP, which is accompanied by an increase in the welfare of a representative consumer in the amount of 0.88 % of the baseline consumption. We show that the prevailing channel of influence of PD on macroeconomic parameters is the effect of a reduction in the supply of labor due to an increase in the disability of patients with PD

Расчетная модель общего равновесия для оценки экономического эффекта ранней диагностики болезни Паркинсона

This paper presents a new CGE model of the Russian economy with a health block. We estimate effects of Parkinson's disease (PD) on the Russian economy and population. We distinguish two mechanisms transmitting effects of the PD: a change in the quality of life of a representative household and a decrease in labor supply due to early retirement caused by PD. Our main focus is on effects of early diagnosis of PD coupled with the use of neuroprotective therapy at the prodromal stage of PD. Calculations showed that the cumulative economic effect of PD on the Russian economy, taking into account the forecast of an increase in the incidence of PD over 30 years, can lead to a loss of real GDP in the amount of -0.86%, and a decrease in the utility of households over the same period in the amount of -1.11% of the consumption level of the base year. The high efficiency of early diagnosis in combination with neuroprotective therapy was shown: the cumulative effect, taking into account the prognosis of an increase in the incidence of PD over 30 years of using this method, can give a gain of about 0.68% of the base year GDP, which is accompanied by an increase in the welfare of a representative consumer in the amount of 0.88 % of the baseline consumption. We show that the prevailing channel of influence of PD on macroeconomic parameters is the effect of a reduction in the supply of labor due to an increase in the disability of patients with PD

Социально-экономические детерминанты болезни Паркинсона для развитых и развивающихся стран

We set and solved the problem of identifying socio-economic determinants of Parkinson's disease (PD) by comparing the characteristics of different countries. Econometric analysis of panel data on 117 countries for 2010-2013 showed that the nature of the impact of a number of factors depends on whether a country belongs to the set of developed or developing economies. For both groups, the incidence of Parkinson's disease increases with life expectancy and decreases with the share of smokers. In addition, for developed countries, the incidence drops with increasing per capita consumption of fish and seafood and increases with amounts of fertilizer applied to the soil per hectare of arable land. For developing countries, the share of rural populations and per capita consumption of alcohol and vegetables are significant factors, with the incidence of PD decreasing with the first factor and increases with the last two. There is also reason to believe that in developing countries, the incidence of PD increases with the level of education; this is due to a decrease in physical activity of the representatives of the professions concerned. The findings are compared with the known results based on the study of patient samples for individual countries, and allow improving them. The results of this work can be used in patient selection procedures for early diagnostics of PD and are particularly important for developing countries where evidence-based recommendations has not yet been available

Оценка эффективности доклинической диагностики болезни Паркинсона методом "затраты-полезность"

Neurodegenerative diseases, Parkinson disease being an example, set challenges to modern societies both in terms of premature deaths and resources spent on treatment of the diseases. Prevention and early diagnostics in particular, are potential directions towards higher economic efficiency of healthcare interventions in this area. We suggest a way to modify the cost-utility approach to evaluation of economic efficiency of an early diagnostics method of Parkinson disease (PD) at the laboratory stage of the diagnostics method. The lack of detailed understanding of the early testing group selection and composition are the major challenges to economic evaluation here. In particular, we consider the approach to diagnose PD at the prodromal stage suggested by Ugrumov 2020. The early diagnostics at the prodromal stage, accompanied by neuroprotective therapy of those identified at high risk of PD, allows postponing PD development for later years. The innovative approach implies saving both direct and indirect costs of PD treatment in comparison with traditional approach but adds costs of testing for the high risk of PD. The latter component may be non-trivial depending on the rules of selection into the group of tested. We suggest a way to modify the cost-utility evaluation procedure so that to take this uncertainty into account. We formulate the economic efficiency condition of the early diagnostics method in terms of the minimal probability of PD in the tested group and estimate the probability based on the Russian data. The latter sets the important threshold for innovative technology when moving from the laboratory into the clinical stage

Экономическая эффективность доклинической диагностики болезни Паркинсона: марковская модель

This article contains a pharmacoeconomic analysis of early (preclinical) diagnosis of Parkinson's disease in Russia. Previous works show that using a combination of socio-economic determinants and a panel of blood biomarkers one may distinguish a Parkinsonism-related “risk group” among the entire population. This group consists of people who are most vulnerable to parkinsonism or are already ill, but at the preclinical stage. Together with the approach traditionally used in the pharmacoeconomics of chronic and long-term diseases, based on the representation of the dynamics of the development of the disease using Markov chains - discrete random processes without memory - this makes it possible to analyze the economic effects of early detection of cases and conducting preventive preclinical therapy. The work investigates the Markov model of Parkinson's disease, consisting of nine states - five states corresponding to the stages HY1-HY5, two preclinical states ("risk group", "prodromal state"). We use as the initial data for the model the probability of transition between states and health-adjusted quality of life (HRQoL) estimates, published in a number of works of researchers affiliated with AbbVie Corporation, and calculate the cost of therapy based on open data on the cost of drugs and procedures in Russian market. Moreover, we show that due to the introduction of preclinical diagnostics and preventive treatment at preclinical stages, identified patients can significantly increase the average survival time (in quality-adjusted life-years) compared to standard therapy, and the average cost per patient until the end of life can be significantly reduced

Influence of gas turbine unit working medium properties on combined cycle thermodynamic effectiveness

The use of different fuels in the gas-turbine unit alters the combustion products composition, in particular the ratio between the amounts of diatomic and triatomic gases. In turn this fact leads to a change in heat capacity, adiabatic index and specific costs of working medium compression and expansion and the recovery boiler thermal capacity. The article analyzes the impact of working medium properties changes with different fuels - methane, carbon monoxide and hydrogen, which leads to different triatomic gases content in the combustion products. We also consider the costs and the working fluid properties changes, with additional cyclic air heating before the combustion chamber of gas turbine unit. The purpose of this paper is a comparative analysis of the gas turbines cycle thermodynamic efficiency with different contents of triatomic gases in the combustion products, the amount of which depends on the used fuel properties, as well as on additional cyclic air heating before the combustion chamber. The studies were performed by the calculation method with the model, which takes into account the dependence of the specific heats and the performance adiabatic compression of air and fuel in the compressor and the expansion of the combustion products in the turbine on temperature. Besides there is an additional air heating in the air heater, but the air flow after the compressor for the first turbine stage cooling is not included. Found that the air pre-heating in the air heater decreases the thermal efficiency of the combined cycle power plant, regardless of the usage pattern of the air heater flue gas. Moreover, the exhaust gases use for heating the combustion air of air heater increases cost and capacity of the air compressor and the turbine, but not as much impact on efficiency CCP reducing as flue gas heat input to the working fluid of steam turbine cycle

Influence of gas turbine unit working medium properties on combined cycle thermodynamic effectiveness

The use of different fuels in the gas-turbine unit alters the combustion products composition, in particular the ratio between the amounts of diatomic and triatomic gases. In turn this fact leads to a change in heat capacity, adiabatic index and specific costs of working medium compression and expansion and the recovery boiler thermal capacity. The article analyzes the impact of working medium properties changes with different fuels - methane, carbon monoxide and hydrogen, which leads to different triatomic gases content in the combustion products. We also consider the costs and the working fluid properties changes, with additional cyclic air heating before the combustion chamber of gas turbine unit. The purpose of this paper is a comparative analysis of the gas turbines cycle thermodynamic efficiency with different contents of triatomic gases in the combustion products, the amount of which depends on the used fuel properties, as well as on additional cyclic air heating before the combustion chamber. The studies were performed by the calculation method with the model, which takes into account the dependence of the specific heats and the performance adiabatic compression of air and fuel in the compressor and the expansion of the combustion products in the turbine on temperature. Besides there is an additional air heating in the air heater, but the air flow after the compressor for the first turbine stage cooling is not included. Found that the air pre-heating in the air heater decreases the thermal efficiency of the combined cycle power plant, regardless of the usage pattern of the air heater flue gas. Moreover, the exhaust gases use for heating the combustion air of air heater increases cost and capacity of the air compressor and the turbine, but not as much impact on efficiency CCP reducing as flue gas heat input to the working fluid of steam turbine cycle

A Spatially Detailed Projection of Environmental Conditions in the Arctic Initiated by Climate Change

The environmental conditions of the Arctic are vulnerable to the effects of climate change. We focus on the territory of the Yamalo-Nenets Autonomous Okrug (YaNAO). The objective of this study is to project mid-21st century climate-driven changes in the state of climate and the natural environment in the YaNAO. For this purpose, the CMIP6 data models with the climate change scenario SSP5-8.5 were used. Climate change directly affects the statistics of extreme events and climatically driven phenomena, such as frosts and thaws, as well as avalanches and slush flows. Climate change causes changes in the Arctic environment, primarily due to permafrost degradation, leading to important modifications in events such as mudflows, cryogenic landslides, abrasion, erosion, suffusion, frost heave, solifluction, thermokarst, and others. In some cases, the intensity and area of these processes increase, such as heaving processes and thermokarst becoming more active by 2050. In other cases, the solifluction processes decrease in the south part of the YaNAO due to the discontinuous or sporadic permafrost distribution. Projected climatic changes will inevitably lead to the restructuring of the geosystems in YaNAO, creating risks for infrastructure in economically active territories