Comparative retention and effectiveness of migraine preventive treatments: A nationwide registry-based cohort study

Background and purpose Little is known about the comparative effects of migraine preventive drugs. We aimed to estimate treatment retention and effectiveness of migraine preventive drugs in a nationwide registry-based cohort study in Norway between 2010 and 2020. Methods We assessed retention, defined as the number of uninterrupted treatment days, and effectiveness, defined as the reduction in filled triptan prescriptions during four 90-day periods after the first preventive prescription, compared to a 90-day baseline period. We compared retention and efficacy for different drugs against beta blockers. Comparative retention was estimated with hazard ratios (HRs), adjusted for covariates, using Cox regression, and effectiveness as odds ratios (ORs) using logistic regression, with propensity-weighted adjustment for covariates. Results We identified 104,072 migraine patients, 81,890 of whom were female (78.69%) and whose mean (standard deviation) age was 44.60 (15.61) years. Compared to beta blockers, botulinum toxin (HR 0.43, 95% confidence interval [CI] 0.42–0.44) and calcitonin gene-related peptide pathway antibodies (CGRPabs; HR 0.63, 95% CI 0.59–0.66) were the least likely to be discontinued, while clonidine (HR 2.95, 95% CI 2.88–3.02) and topiramate (HR 1.34, 95% CI 1.31–1.37) were the most likely to be discontinued. Patients on simvastatin, CGRPabs, and amitriptyline were more likely to achieve a clinically significant reduction in triptan use during the first 90 days of treatment, with propensity score-adjusted ORs of 1.28 (95% CI 1.19–1.38), 1.23 (95% CI 0.79–1.90), and 1.13 (95% CI 1.08–1.17), respectively. Conclusions We found a favorable effect of CGRPabs, amitriptyline, and simvastatin compared with beta blockers, while topiramate and clonidine were associated with poorer outcomes.publishedVersio

Taxation of wind power in Norway : an analysis of possible effects of taxation on resource rent and environmental damages from Norwegian wind power plants

Wind power production in Norway has increased rapidly over the past decades, and so has the associated discussions related to nature conservation. The dilemmas are substantial, with the growing need of renewable energy, but also a desire to protect pristine nature and wildlife. Today, there is little profitability related to the industry, but with future expectations of both lower cost and higher electricity prices, profitability may increase, i.e., there may be a significant resource rent from wind power production. Based on the encroachment and possible resource rent, both resource rent taxation and environmental taxation may be relevant to consider for Norwegian wind power. A tax on the resource rent is already used for other nature resources in Norway. Environmental taxation related to nature encroachment is not used in Norway, but it has been proposed for several industries. An environmental tax aims to achieve a more efficient level of production and spatial allocation of wind power plants. This paper analyses potential effects of these two tax schemes for wind power in Norway. The analysis uses detailed information about projects holding a license with their respective costs and two scenarios for future electricity prices. The resource rent tax scheme for hydro power is used as a base, with a tax rate at 37%. With the data set used, a total annual resource rent at 170 million NOK would be generated in the base scenario with production at 3.4 TWh. In the high-price scenario, the annual resource rent would increase to 513 million NOK with production at 8.2 TWh. The environmental tax is divided into a CO2 tax and an encroachment tax. If a CO2 tax on emissions is introduced alone, it does not change the total amount of power produced, but it will reduce the profitability for several of the projects. With total environmental taxation, CO2 and encroachment tax, the production is reduced with 35% and 38% in the base and high-price scenario, respectively. After introduction of environmental taxation, the resource rent is reduced by about 35% in both scenarios. If a resource rent tax is combined with environmental taxation, the resource rent tax income would be reduced, but the total effect is increased tax income, compared to a situation with only resource rent taxation. The recommendations to draw from this analysis is to work towards environmental taxation on wind power in Norway. For this to be possible, more research is necessary, especially related to valuation and damages from production. A CO2 tax could be considered as a first step towards full environmental taxation. Further, the resource rent from production should be followed closely, and a tax on this should be introduced when the resource rent gets substantial