Faciliating More Efficient Negotiations for Innovative Therapies: A Value-Based Negotiation Framework

OBJECTIVES: An increasing number of innovative therapies (e.g., gene- and cell-based treatments) have been developed in the past 20 years. Despite the significant clinical potential of these therapies, access delays may arise because of differing perspectives of manufacturers and payers regarding issues such as the value of the product, clinical and financial uncertainties, and sustainability.Managed entry agreements (MEAs) can enable access to treatments that would not be reimbursed by conventional methods because of such concerns. However, although MEA typologies exist, there is currently no structured process to come to agreements on MEAs, which can be difficult to decide upon and implement.To facilitate more structured MEA negotiations, we propose a conceptual "value-based negotiation framework" with corresponding application tools. METHODS: The framework was developed based on an iterative process of scientific literature review and expert input. RESULTS: The framework aims to (i) systematically identify and prioritize manufacturer and payer concerns about a new treatment, and (ii) select a mutually acceptable combination of MEA terms that can best address priority concerns, with the lowest possible implementation burden. CONCLUSIONS: The proposed framework will be tested in practice, and is a step toward supporting payers and manufacturers to engage in more structured, transparent negotiations to balance the needs of both sides, and enabling quicker, more transparent MEA negotiations and patient access to innovative products

ANALISIS PENGENDALIAN BAHAN PROYEK PEMBANGUNAN DENGAN METODE GOAL PROGRAMMING PRIORITAS (STUDI KASUS : PROYEK PEMBANGUNAN GEDUNG SEKOLAH EBEN HAEZAR)

Dalam sebuah proyek pembangunan, dibutuhkan manajer yang dapat merencanakan atau mengambil keputusan dengan tepat, agar supaya tidak terjadi investasi yang berlebihan dalam sebuah proyek. Biaya bahan material dalam sebuah proyek adalah bagian terbesar dari proyek yang nilainya hampir mencapai setengah dari total biaya. Dengan menggunakan metode yang tepat, dapat mempermudah seorang manajer untuk mengambil sebuah keputusan yang tepat dalam sebuah perencanaan proyek pembangunan. Goal Programing adalah suatu program optimasi yang dapat membantu dalam pengambilan sebuah keputusan yang tepat. Goal Programming dapat diselesaikan dengan beberapa cara, diantaranya dapat menggunakan bantuan program komputer. Hasil perhitungan bahan proyek pembangunan dengan menggunakan Goal programing lebih efektif dan efisien Kata kunci: manajer, proyek, pembangunan, keputusan, Goal Programin

Genesis of the dusty Universe: modeling submillimetre source counts

We model the evolution of IR galaxies using a phenomenological approach to match the observed source counts at different IR wavelengths. We introduce a new algorithm for reproducing source counts based on direct integration of probability distributions rather than Monte-Carlo sampling. We construct a simple model for the evolution of the luminosity function and the colour distribution of IR galaxies which utilizes a minimum number of free parameters. Moreover we analyze how each of these parameters is constrained by observational data. The model is based on pure luminosity evolution and adopts the Dale & Helou SED templates. We find that the 850um source counts and their redshift distribution depend strongly on the shape of the luminosity evolution function, but only weakly on the details of the SEDs. We derive the best-fit evolutionary model using the 850um counts and redshift distribution as constraints. Moreover our best-fit shows a flattening of the faint end of the luminosity function towards high redshifts and requires a colour evolution which implies the typical dust temperatures of objects with the same luminosities to decrease with redshift. We compare our best-fit model to observed source counts at shorter and longer wavelengths which indicates our model reproduces the 70um and 1100um source counts remarkably well, but under-produces the counts at intermediate wavelengths. Analysis reveals that the discrepancy arises at low redshifts, indicating that revision of the adopted SED library towards lower dust temperatures (at a fixed infrared luminosity) is required. This modification is equivalent to a population of cold galaxies existing at low redshifts, as also indicated by recent Herschel results, which are underrepresented in IRAS sample. We show that the modified model successfully reproduces the source counts in a wide range of IR and submm wavelengths.Comment: 21 pages, 11 figures, 2 tables. Accepted for publication in MNRAS. Supplementary information could be found at http://www.strw.leidenuniv.nl/genesis

The 1-1000 micron SEDs of far-infrared galaxies

Galaxies selected at 170um by the ISO FIRBACK survey represent the brightest \~10% of the Cosmic Infrared Background. Examining their nature in detail is therefore crucial for constraining models of galaxy evolution. Here we combine Spitzer archival data with previous near-IR, far-IR, and sub-mm observations of a representative sample of 22 FIRBACK galaxies spanning three orders of magnitude in infrared luminosity. We fit a flexible, multi-component, empirical SED model of star-forming galaxies designed to model the entire ~1-1000um wavelength range. The fits are performed with a Markov Chain Monte Carlo (MCMC) approach, allowing for meaningful uncertainties to be derived. This approach also highlights degeneracies such as between Td and beta, which we discuss in detail. From these fits and standard relations we derive: L_IR, L_PAH, SFR, tau_V, M_star, M_dust, Td, and beta. We look at a variety of correlations between these and combinations thereof in order to examine the physical nature of these galaxies. Our conclusions are supplemented by morphological examination of the sources, and comparison with local samples. We find the bulk of our sample to be consistent with fairly standard size and mass disk galaxies with somewhat enhanced star-formation relative to local spirals, but likely not bona fide starbursts. A few higher-z LIGs and ULIGs are also present, but contrary to expectation, they are weak mid-IR emitters and overall are consistent with star-formation over an extended cold region rather than concentrated in the nuclear regions. We discuss the implications of this study for understanding populations detected at other wavelengths, such as the bright 850um SCUBA sources or the faint Spitzer 24um sources.Comment: 19 pages, 20 figures, accepted for publication in MNRA

Inter-annual decrease in pulse rate and peak frequency of Southeast Pacific blue whale song types

The decrease in the frequency of two southeast Pacific blue whale song types was examined over decades, usingacoustic data from several different sources ranging between the Equator and Chilean Patagonia. The pulse rate ofthe song units as well as their peak frequency were measured using two different methods (summed auto-correlationand Fourier transform). The sources of error associated with each measurement were assessed. There was a lineardecline in both parameters for the more common song type (southeast Pacific song type n ◦ 2). An abbreviated analysisalso showed a frequency decline in the scarcer southeast Pacific song type n ◦ 1 between 1970 to 2014, revealing thatboth song types are declining at similar rates. We discussed the use of measuring both pulse rate and peak frequencyto examine the frequency decline. Finally, a comparison of the rates of frequency decline with other song typesreported in the literature is presented.La décroissance en fréquence des deux chants de baleine bleue de l'océan pacifique sud est est examiné sur plusieurs décennies en utilisant comme source des données acoustiques de l'Equateur à la Patagonie chilienne. La fréquence de pulsation et la fréquence pic des signaux sont mesurés en utilisant deux méthodes distinctes (auto-corrélation sommée et transformée de Fourier rapide). Les sources d'erreur associées à chaque mesure sont estimées. Il y a un déclin linéaire de ces deux fréquences pour le chant le plus commun de cette zone (chant du Pacifique Sud Est n°2, SEP2). Un analyse plus rapide montre aussi une baisse linéaire, entre 1970 et 2014, de la fréquence du chant SEP1, plus rarement enregistré dans cette zone. Ces deux baisses ont des amplitudes similaires. L'intérêt de mesurer la fréquence de pulsation et la fréquence pic de façon concomitante est estimé. Enfin, une comparaison globale des déclins en fréquence de tous les types de chants de baleines bleues est fournie

A far infrared view of the Lockman Hole from ISO 95 micron observations - II. Optical identifications and insights into the nature of the far-infrared sources

We present the optical identifications of a 95 micron ISOPHOT sample in the Lockman Hole over an area of about half square degree. The catalogue (Rodighiero et al. 2003) includes 36 sources, making up a complete flux-limited sample for fluxes > 100 mJy. Reliable sources were detected, with decreasing but well-controlled completeness, down to 20 mJy. We have combined mid-IR and radio catalogues in this area to identify the potential optical counterparts of the far-IR sources. We found 14 radio and 13 15 micron associations, 10 of which have both associations. For the 11 sources with spectroscopic redshift, we have performed a spectrophotometric analysis of the observed Spectral Energy Distributions. Four of these 95 micron sources have been classified as faint IR galaxies (L_FIR<1.e11 solar luminosity), six as LIRGs and only one ULIRG. We have discussed the redshift distribution of these objects, comparing our results with evolutionary model predictions 95 and 175 micron. Given their moderate distances (the bulk of the closest spectroscopically identified objects lying at z<0.2), their luminosities and star formation rates (median value 10 solar masses/yr), the sources unveiled by ISOPHOT at 95 micron seem to correspond to the low redshift (z<0.3) FIRBACK 175 micron population, composed of dusty, star-forming galaxies with moderate star formation rates. We computed and compared different SFR estimators, and found that the SF derived from the bolometric IR luminosity is well correlated with that computed from the radio and mid-IR fluxes.Comment: Accepted for publication in MNRAS, a full resolution version can be downloaded from http://dipastro.pd.astro.it/giulia/PHOT/ME681rv.ps.g

A 50-year record of NOx and SO2 sources in precipitation in the Northern Rocky Mountains, USA

Ice-core samples from Upper Fremont Glacier (UFG), Wyoming, were used as proxy records for the chemical composition of atmospheric deposition. Results of analysis of the ice-core samples for stable isotopes of nitrogen (δ15N, ) and sulfur (δ34S, ), as well as and deposition rates from the late-1940s thru the early-1990s, were used to enhance and extend existing National Atmospheric Deposition Program/National Trends Network (NADP/NTN) data in western Wyoming. The most enriched δ34S value in the UFG ice-core samples coincided with snow deposited during the 1980 eruption of Mt. St. Helens, Washington. The remaining δ34S values were similar to the isotopic composition of coal from southern Wyoming. The δ15N values in ice-core samples representing a similar period of snow deposition were negative, ranging from -5.9 to -3.2 ‰ and all fall within the δ15N values expected from vehicle emissions. Ice-core nitrate and sulfate deposition data reflect the sharply increasing U.S. emissions data from 1950 to the mid-1970s