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

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

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

Overview: Recent advances in the understanding of the northern Eurasian environments and of the urban air quality in China – a Pan-Eurasian Experiment (PEEX) programme perspective

The Pan-Eurasian Experiment (PEEX) Science Plan, released in 2015, addressed a need for a holistic system understanding and outlined the most urgent research needs for the rapidly changing Arctic-boreal region. Air quality in China, together with the long-range transport of atmospheric pollutants, was also indicated as one of the most crucial topics of the research agenda. These two geographical regions, the northern Eurasian Arctic-boreal region and China, especially the megacities in China, were identified as a "PEEX region". It is also important to recognize that the PEEX geographical region is an area where science-based policy actions would have significant impacts on the global climate. This paper summarizes results obtained during the last 5 years in the northern Eurasian region, together with recent observations of the air quality in the urban environments in China, in the context of the PEEX programme. The main regions of interest are the Russian Arctic, northern Eurasian boreal forests (Siberia) and peatlands, and the megacities in China. We frame our analysis against research themes introduced in the PEEX Science Plan in 2015. We summarize recent progress towards an enhanced holistic understanding of the land-atmosphere-ocean systems feedbacks. We conclude that although the scientific knowledge in these regions has increased, the new results are in many cases insufficient, and there are still gaps in our understanding of large-scale climate-Earth surface interactions and feedbacks. This arises from limitations in research infrastructures, especially the lack of coordinated, continuous and comprehensive in situ observations of the study region as well as integrative data analyses, hindering a comprehensive system analysis. The fast-changing environment and ecosystem changes driven by climate change, socio-economic activities like the China Silk Road Initiative, and the global trends like urbanization further complicate such analyses. We recognize new topics with an increasing importance in the near future, especially "the enhancing biological sequestration capacity of greenhouse gases into forests and soils to mitigate climate change" and the "socio-economic development to tackle air quality issues".Peer reviewe

AEROSOL PROPERTIES IN MOSCOW ACCORDING TO 10 YEARS OF AERONET MEASUREMENTS AT THE METEOROLOGICAL OBSERVATORY OF MOSCOW STATE UNIVERSITY

Different microphysical, optical and radiative properties of aerosol were analyzed according to the 10 years of measurements (2001–2010) at the Meteorological Observatory of Moscow State University within the framework of international AERONET program. Volume aerosol size distribution was shown to have a bimodal character with dominating the fine mode aerosol particles at effective radius of reff-fine=0.15 µm. In smoke conditions reff-fine was shown to increase to 0.25 µm at extremely large aerosol optical thickness (AOT). Real and imaginary parts of refractive index are characterized by REFR=1.45, REFI=0.01 respectively, changing to REFR=1.49, REFI=0.006 for smoke aerosol. AOT seasonal changes are characterized by the increase towards warm period with a local minimum in June. The joint analysis of aerosol characteristics with the NOAA_NCEP_CPC_CAMS_OPI climatology shows the nature of these changes. For typical conditions aerosol single scattering albedo (SSA) is about 0.9 at 675 nm and is characterized by a distinct decrease with wavelength while in forest fires conditions it is significantly higher (SSA=0.95). The interaction between volume aerosol concentration of different aerosol fractions was obtained with a distinct decrease of variation towards large aerosol content

Impact of Cloud Condensation Nuclei Reduction on Cloud Characteristics and Solar Radiation during COVID-19 Lockdown 2020 in Moscow

We used MODIS observations to retrieve number concentration of cloud droplets (Nd) at cloud lower boundary during spring 2018–2020 for the Moscow region. Looking through the similar synoptic situations of the northern clear air advection, we obtained Nd within the limits of 200–300 cm−3. During the lockdown period, with similar northern advection conditions, the reduction of Nd on 40–50 cm−3 (or 14–16%), with the increase in droplet effective radius by 8 ± 1% and cloud optical thickness reduction by 5 ± 2%, was observed in contrast to the values in typical conditions in 2018–2019. We used these values for setting up corresponding parameters in numerical simulations with the COSMO-Ru model. According to the numerical experiments, we showed that the observed reduction in cloud droplet concentration by 50 cm−3 provides a 5–9 W/m2 (or 9–11%) increase in global irradiance at ground in overcast cloud conditions with LWP = 200–400 g/m2

Impact of Cloud Condensation Nuclei Reduction on Cloud Characteristics and Solar Radiation during COVID-19 Lockdown 2020 in Moscow

We used MODIS observations to retrieve number concentration of cloud droplets (Nd) at cloud lower boundary during spring 2018–2020 for the Moscow region. Looking through the similar synoptic situations of the northern clear air advection, we obtained Nd within the limits of 200–300 cm−3. During the lockdown period, with similar northern advection conditions, the reduction of Nd on 40–50 cm−3 (or 14–16%), with the increase in droplet effective radius by 8 ± 1% and cloud optical thickness reduction by 5 ± 2%, was observed in contrast to the values in typical conditions in 2018–2019. We used these values for setting up corresponding parameters in numerical simulations with the COSMO-Ru model. According to the numerical experiments, we showed that the observed reduction in cloud droplet concentration by 50 cm−3 provides a 5–9 W/m2 (or 9–11%) increase in global irradiance at ground in overcast cloud conditions with LWP = 200–400 g/m2