2,999 research outputs found

    The Impact of Differential Cost Sharing of Non-Steroidal Anti-Inflammatory Agents on the Use and Costs of Analgesic Drugs

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    OBJECTIVE: To estimate the effect of differential cost sharing (DCS) schemes for non-steroidal anti-inflammatory drugs (NSAIDs) on drug subsidy program and beneficiary expenditures. DATA SOURCES/STUDY SETTING: Monthly aggregate claims data from Pharmacare, the public drug subsidy program for seniors in British Columbia, Canada over the period 1989-11 to 2001-06. STUDY DESIGN: DCS limits insurance reimbursement of a group of therapeutically similar drugs to the cost of the lowest priced drugs, with beneficiaries responsible for costs above the reimbursement limit. Pharmacare introduced two different forms of DCS, generic substitution (GS) and reference pricing (RP), in April 1994 and November 1995, respectively, to the NSAIDs. Under GS, generic and brand versions of the same NSAID are considered interchangeable, whereas under RP different NSAIDs are. We extrapolated average reimbursement per day of NSAID therapy over the months before GS and RP to estimate what expenditures would have been without the policies. These counterfactual predictions were compared to actual values to estimate the impact of the policies; the estimated impacts on reimbursement rates were multiplied by the post-policy volume of NSAIDS dispensed, which appeared unaffected by the policies, to estimate expenditure changes. DATA COLLECTION: The cleaned NSAID claims data, obtained from Pharmacare’s databases, were aggregated by month and by their reimbursement status under the GS and RP policies. PRINCIPAL FINDINGS: After RP, program expenditures declined by 22.7million,or22.7 million, or 4 million annually, cutting expenditure by half. Most savings accrued from the substitution of low cost NSAIDs for more costly alternatives. About 20% of savings represented expenditures by seniors who elected to pay for partially-reimbursed drugs. GS produced one quarter the savings of RP. CONCLUSIONS: RP of NSAIDs achieved its goal of reducing drug expenditures and was more effective than GS. The effects of RP on patient health and associated health care costs remain to be investigated.Reference pricing; generic substitution; prescription drugs; drug cost containment; NSAIDs.

    The structure of preserved information in quantum processes

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    We introduce a general operational characterization of information-preserving structures (IPS) -- encompassing noiseless subsystems, decoherence-free subspaces, pointer bases, and error-correcting codes -- by demonstrating that they are isometric to fixed points of unital quantum processes. Using this, we show that every IPS is a matrix algebra. We further establish a structure theorem for the fixed states and observables of an arbitrary process, which unifies the Schrodinger and Heisenberg pictures, places restrictions on physically allowed kinds of information, and provides an efficient algorithm for finding all noiseless and unitarily noiseless subsystems of the process

    Quantum Error Correction of Observables

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    A formalism for quantum error correction based on operator algebras was introduced in [1] via consideration of the Heisenberg picture for quantum dynamics. The resulting theory allows for the correction of hybrid quantum-classical information and does not require an encoded state to be entirely in one of the corresponding subspaces or subsystems. Here, we provide detailed proofs for the results of [1], derive a number of new results, and we elucidate key points with expanded discussions. We also present several examples and indicate how the theory can be extended to operator spaces and general positive operator-valued measures.Comment: 22 pages, 1 figure, preprint versio

    Potential effects of gas hydrate on human welfare

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    Science lives: School choices and ‘natural tendencies’

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    An analysis of 12 semi-structured interviews with university-based scientists and non-scientists illustrates their life journeys towards, or away from, science and the strengths and impact of life occurrences leading them to choose science or non-science professions. We have adopted narrative approaches and used Mezirow's transformative learning theory framework. The areas of discussion from the result have stressed on three main categories that include ‘smooth transition’, ‘incremental wavering transition' and ‘transformative transition’. The article concludes by discussing the key influences that shaped initial attitudes and direction in these people through natural inclination, environmental inspirations and perceptions of science
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