Growth in expenditure on high cost drugs in Australia

The paper provides an overview of the expenditure of high cost drugs in Australia and examines the average annual growth of these programs. The outlook for expenditure on high cost medicines and possible policy responses is also considered. Executive summary • Despite an overall slowing of growth in expenditure on the Pharmaceutical Benefits Scheme (PBS), the section 100 (s 100) program is showing rapid rates of growth. • The s 100 program provides pharmaceuticals to those living in isolated areas and for the treatment of  complex conditions that require specialist monitoring. • A number of programs make up the s 100 program.  Those with high growth rates include : • Expenditure on the Efficient Funding of Chemotherapy  is the fastest growing s 100 program with an average annual growth rate of 62.61 % from 2009–10 to 2013–14 . • The Highly Specialised Drugs Program grew at a rate of 6.38 % for the same period. • Although not part of the PBS, the Life Saving Drugs Programme provides access to a limited number of expensive drugs for rare diseases. This programme  grew at a rate of 12.68 % from 2009–10 to 2013–14 . • The s 100 and LSD P programs provide access to high cost drugs to treat a range of diseases including cancers, HIV /AIDS, Alzheimer’s diseases and a number of rare and life threatening conditions. Patients are protected  from the true cost of these drugs. • Given predictions about  the  increasing rates  of diseases such as cancer and Alzheimer’s disease, it is likely  that expenditure on these medicines is likely to continue to rise as more people require treatment.  As a general rule, new drugs are usually more expensive than existing treatments. • One of the objectives of the National Medicines Policy is timely access to medicines that Australians need,  and at cost the community and individuals can afford. Examination of  the expenditure on high cost drugs is warranted to ensure that this policy objective is met

Optimal Buffer Stocks in Neumann-- Economies under Uncertainty

There exists side-by^side substantial literatures on von Nuemann economies—especially their turnpike properties—(7, 8],—and on optimal growth theory under uncertainty (1, 2» 6]. Typically, the von Neumann models, although deterministic, have a fairly complicated product technology, while the optimal growth models rely on fairly rudimentary product technologies. The present work attempts to bring these two literatures together with the confines of a two-sector von Neumann model under uncertainty. For ease of interpretation, and as the primary application, the model is considered as one of an optimally planned economy [3, 4]

Time-lapse embryo imaging and morphokinetic profiling: towards a general characterisation of embryogenesis

In vitro fertilisation is an effective method of assisted reproductive technology in both humans and certain non-human animal species. In most species, specifically, in humans and livestock, high in vitro fertilisation success rates are achieved via the transfer of embryos with the highest implantation and subsequent developmental potential. In order to reduce the risk of multiple gestation, which could be a result of the transfer of several embryos per cycle, restrictive transfer policies and methods to improve single embryo selection have been implemented. A non-invasive alternative to standard microscopic observation of post-fertilisation embryo morphology and development is time-lapse technology; this enables continuous, uninterrupted observation of embryo development from fertilisation to transfer. Today, there are several time-lapse devices that are commercially available for clinical use, and methods in which time-lapse could be used to improve embryology are continually being assessed. Here we review the use of time-lapse technology in the characterisation of embryogenesis and its role in embryo selection. Furthermore, the prospect of using this technology to identify aneuploidy in human embryos, as well as the use of time-lapse to improve embryological procedures in agriculturally important species such as the pig and cow are discussed

Institutional Entrepreneurship and the Field of Power:The Emergence of the Global Hotel Industry

Institutional entrepreneurship as a field of academic enquiry is focused on the roles played by individual agents and agents acting in concert in promoting institutional change. From Bourdieu (1993; 1996), we infer that contests for institutional change are played out in the field of power, the integrative social domain that brings together powerful actors from different walks of life – business, politics, government agencies, media and the law – to affect changes in laws, regulations and conventions (Maclean and Harvey, 2019; Maclean, Harvey and Press, 2006). Institutional entrepreneurs pursue institutional change directly by legal or quasi-legal means by persuading others to act according to their interests through social influence or lobbying; often forming issue-based coalitions in pursuit of specific institutional goals (Wijen and Ansari, 2006). Hence we define institutional entrepreneurship as the skilful actions taken by an individual actor or coalition of actors to affect changes in the informal or formal rules governing a field for personal or collective advantage.There is little agreement on the processes commonly at work in institutional entrepreneurship and the ways in which these play out in different contexts. However, without some measure of agreement on the specific mechanisms whereby institutional entrepreneurs effect change in different arenas, it is difficult to generalize about strategy and tactics, let alone the outcomes of attempts to disrupt the status quo. The actual work of institutional entrepreneurship in its fine-grained detail is often glossed over. What is missing is research on collective endeavours, on emergent processes involving a range of actors in building momentum for institutional change (Aldrich, 2011; Maguire, Hardy and Lawrence, 2004; Lawrence and Phillips, 2004). It is in this aspect that Bourdieu’s construct of the field of power adds value to the theory of institutional entrepreneurship. Here the emphasis is on interactions between elite actors with different types and amounts of capital who combine their efforts to press for institutional change (Harvey and Maclean, 2008). In what follows, we build on Bourdieu’s ideas to identify three processes of institutional entrepreneurship – field formation, coalition building and rhetorical agency – at work in early phase globalization, when home-country firms seek to extend their operational reach into multiple host countries.<br/

Multi-temporality and the ghostly:Capturing the spirit of time past and yet to come?

The rediscovery of the importance of the past in organizational research has emerged alongside a growing interest in matters of time, history, and memory. Diverging from a tradition of analysis focused on the effects of chronological time and path-dependence histories, organization scholars have turned their attention to the social construction of the past and the temporal interplay between past, present, and future. They have explored how the past is remembered, forgotten, and used strategically in the present to build advantages for the future. In doing so, researchers have emphasized the separation between different temporal orders (past, present, and future) and the mechanisms managers use to harness past and future for present purposes. They have been less interested in analysing how those orders intersect and overlap. That is, we still lack an understanding of the multi-temporal reality of organizations – how the past, present, and future are integral to the lived experience of organizing

Institutional Biography and the Institutionalization of a New Organizational Template:Building the Global Branded Hotel Chain

This article expands understanding of how institutional biography may inform institutional change by examining Conrad Hilton’s role in building the global branded hotel chain (1946-1969). We show how an individual’s institutional biography can play a pivotal role in their development as an institutional entrepreneur and the institutionalization of a new organizational template. Biography, informed by the institutions individuals experience in their life trajectories, shapes the process by which an individual becomes an institutional entrepreneur; influencing the institutionalization of a new template by enabling entrepreneurs to acquire a more central position within their field. Hilton’s self-narrative became closely coupled with the ‘grand narrative’ of post-war U.S. capitalism. The Hilton case vividly illustrates how institutional tensions, embracing national interests, corporate interests, and individual self-interest, can become distilled into the identity, choices, and ambitions – the personal biographical narrative – of individuals who play a formative role in the institutions they build, change, or disrupt