Identifying the effects of scientific information and recommendations on physicians’ prescribing behavior.

We investigate how the prescribing behavior of physicians reacts to scientific information and recommendations released by public authorities. Taking the example of antidepressant drugs, we use French panel data on exhaustive prescriptions made by a representative sample of general practitioners to more than 110,000 depressed patients between 2000 and 2008. New results revealing an increase in suicidal thinking among children taking selective serotonin reuptake inhibitors (SSRIs) were reported in 2004 and prompted the release of new guidelines by public health authorities. We identify the effect of this unexpected warning on physicians’ drug choices while addressing that possibility that patient heterogeneity may be correlated with unobserved physician characteristics. While the warning decreased the average probability of prescribing SSRIs, we find that physicians’ responses to the warning were very heterogeneous and larger if the physician had a higher preference for prescribing SSRIs before the warning

Identifying the effects of scientific information and recommendations on physicians’ prescribing behavior.

We investigate how the prescribing behavior of physicians reacts to scientific information and recommendations released by public authorities. Taking the example of antidepressant drugs, we use French panel data on exhaustive prescriptions made by a representative sample of general practitioners to more than 110,000 depressed patients between 2000 and 2008. New results revealing an increase in suicidal thinking among children taking selective serotonin reuptake inhibitors (SSRIs) were reported in 2004 and prompted the release of new guidelines by public health authorities. We identify the effect of this unexpected warning on physicians’ drug choices while addressing that possibility that patient heterogeneity may be correlated with unobserved physician characteristics. While the warning decreased the average probability of prescribing SSRIs, we find that physicians’ responses to the warning were very heterogeneous and larger if the physician had a higher preference for prescribing SSRIs before the warning

Should We Prevent Off-Label Drug Prescriptions? Empirical Evidence from France

After a drug obtains marketing authorization, the usage depends on the regulation of off-label pre-scriptions for unapproved indications. We investigate the impact of off-label prescription regulation on physicians’ behavior, patients’ health, treatment costs, and pharmaceutical firms’ pricing with a structural demand and supply model. Exploiting rich panel data on physicians’ activities and office visits in France over nine years, we use a model of prescription choice and health outcomes with unobserved patient-level heterogeneity. We identify the demand for on-label and off-label drugs and the effect of prescription choice on health outcomes. On the supply side, we use a Nash-in-Nash bargaining model between the government and the pharmaceutical companies that allows the partial identification of the marginal costs of drugs. Counterfactual simulations show that when we remove off-label drugs from the choice set of physicians, substitution to on-label drugs at constant prices would lead to an increase of 15% in the expenditure on prescription drugs. If we allow bargaining adjustment on drug prices under a ban on off-label prescriptions, the ban would further increase the treatment cost, by 26%, without improving health outcomes

Monetary values of increasing life expectancy: sensitivity to shifts of the survival curve

Individuals’ monetary values of decreases in mortality risk depend on the magnitude and timing of the risk reduction. We elicited stated preferences among three time paths of risk reduction yielding the same increase in life expectancy (decreasing risk for the next decade, subtracting a constant from or multiplying risk by a constant in all future years) and willingness to pay (WTP) for risk reductions differing in timing and life-expectancy gain. Respondents exhibited heterogeneous preferences over the alternative time paths, with almost 90 percent reporting transitive orderings. WTP is statistically significantly associated with life-expectancy gain (between about 7 and 28 days) and with respondents’ stated preferences over the alternative time paths. Estimated value per statistical life year (VSLY) can differ by time path and averages about $500,000, roughly consistent with conventional estimates obtained by dividing estimated value per statistical life by discounted life expectancy

Essais en Organisation Industrielle et Économie de la Santé

Le résumé en français n'a pas été communiqué par l'auteur.Le résumé en anglais n'a pas été communiqué par l'auteur

Essais en Organisation Industrielle et Économie de la Santé

Le résumé en français n'a pas été communiqué par l'auteur.Le résumé en anglais n'a pas été communiqué par l'auteur

The robust curve-fitting based method for coordinated voltage regulation with distributed generator and OLTC in distribution network

The voltage violation in distribution networks may occur frequently due to the rising integration of flexible demands and supplies. In this paper, the reactive power of the inverter-based distributed generator (DG) and OLTC tap position are adjusted for voltage regulation in coordinated manner. Firstly, the reactive power adjustment for the voltage regulation has been carried out by use of the DG reactive power capacity. Afterwards, the tap position of the OLTC has been changed to regulate the bus voltage that has a voltage violation problem in the case of insufficient reactive power capacity of the DG inverter. The value of the distributed generator reactive power output that regulates the voltage on the bus that has a voltage violation is found with proposed curve-fitting method and tested with the Grid Search, Artificial Bee Colony methods. The proposed method derives mathematical expressions between DG reactive power output and bus voltages as quadratic equations by curve-fitting technique. Moreover, addition to inherent upper and lower reactive power limits of the DG inverter, they are determined by the proposed curve-fitting based technique while considering voltage constraints on all buses. Proposed method is much faster than other two methods because of its plain structure and gives adequate accurate results

Strategic Submissions : A Cross-Country Analysis of Supplemental Drug Approvals

Off-label use regulation has the potential to change pharmaceutical rms' behavior and|consequently|affect patient welfare. We investigate the impact of two changes in off-label regulation on pharmaceutical rms' behavior in seeking formal marketing approval for supplementary uses. In 2012, a US court decision protected truthful o-label promotion, providing pharmaceutical companies more leeway to promote o- label uses of their drug. Similarly, in 2011, France passed a new system for monitoring o-label uses in anticipation of formal approval. Using a unique data set of pharma- ceutical rms' research and development projects, we exploit these regulatory changes to understand how rms react to government policies. Results demonstrate that rms esponded to the US policy providing lower incentives to submit supplemental uses for formal approval. The results do not evince any reaction to France's stringent|but poorly enforced|regulation. These results have implications not only for innovation policy but for the creation of high-quality data for certain indications

Accelerated multistep thermal stabilization of polyacrylonitrile fibers using an ethylenediamine pretreatment

The polyacrylonitrile multifilament yarn underwent a multistep heat treatment process including stabilization times ranging from 5 to 75 min following impregnation with a 30% ethylenediamine (EDA) aqueous solution. A series of measurements were employed to determine the structure and properties of thermally stabilized PAN samples. These included fiber thickness, fiber density, flame testing, tensile testing, X-ray diffraction, thermal analysis (differential scanning calorimetry and thermogravimetric analysis), and infrared spectroscopy. The results from XRD and IR spectroscopy indicated that the rate of aromatization reactions increased with longer stabilization times. A detailed examination of the XRD curves obtained through curve-fitting procedures suggested a rapid transformation of the original structure into a disordered amorphous phase containing pre-graphitic domains, evidenced by a gradual reduction in the degree of apparent crystallinity of the original PAN sample. The integration of EDA before the thermal stabilization stage significantly reduced the cyclization time of nitrile groups in the PAN polymer structure, thereby accelerating the stabilization reactions. This chemical pretreatment also improved the thermal stability of the samples by promoting oxidative cross-linking of the PAN polymer chains. After a 75 min multistep stabilization, the carbon yield at 1000 °C was 70.5%. Conversion index values, calculated using IR, XRD, and DSC methods, were 98.3%, 94.8%, and 89.5% respectively for the 75 min sample. These findings highlight the importance of EDA in accelerating the formation of an aromatic structure, which is critical for withstanding the high temperatures of subsequent carbonization stages. Graphical abstract: (Figure presented.)

A Critical Review on the Impacts of Energy Storage Systems and Demand-Side Management Strategies in the Economic Operation of Renewable-Based Distribution Network

Energy storage systems (ESSs) and demand-side management (DSM) strategies have significant potential in providing flexibility for renewable-based distribution networks. Therefore, combining ESSs and DSM strategies with renewable energy sources (RESs) to solve economic, operational, environmental, and power-related political issues has received special attention from power system planners around the world. In this regard, developed countries, which are pioneers in renewable technologies, have proposed various supportive policies and practices for the widespread use of ESSs and DSM strategies in the context of distribution networks. Hence, this paper performs a comprehensive review of the most recent actions taken to build the infrastructure necessary to achieve 100% renewable energy. On this basis, this paper firstly surveys the necessity of using ESSs and DSM strategies in renewable-based distribution networks. Then, the existing policies and incentive programs implemented in different countries for the development of RESs in optimal coordination with ESSs and DSM strategies are presented. The impacts of utilizing ESSs and DSM strategies in improving the economic performance of the renewable-based distribution networks are also investigated. Finally, prevalent energy management strategies, which are proposed to optimize utilization of ESSs and DSM strategies in renewable-based distribution networks, are investigated from the perspective of optimization approaches