Pharmaceutical industry, drug quality and regulation: evidence from US and Italy

This paper examines the relationship between drug price and drug quality and how it varies across two of the most common regulatory regimes in the pharmaceu-tical market: Minimum Efficacy Standards (MES) and a mix of Minimum Efficacy Standards and Price Controls mechanisms (MES+PC). Through a simple model of adverse selection we model the interaction between firm heterogenous buyers and the regulator. Buyers ’ heterogeneity stems from differences in the willingness-to-pay for drug quality, measured through ex-post efficacy. The theoretical analysis provides two main results. First, MES regime provides higher incentive to produce high quality drugs. Second, the regulatory MES+PC mix reduces the difference in terms of high-low quality drug prices and that. The empirical analysis based on Italian and US data corroborates these results

Wages and weight in Europe: evidence using quantile regression model

The aim of this research is to investigate the relationship between obesity and wages, using data for nine countries from the European Community Household Panel (ECHP) over the period 1998-2001. We improve upon the existing literature by adopting a Quantile Regression approach to characterize the heterogenous impact of obesity at different points of the wage distribution. Our results show that i) the evidence obtained from mean regression and pooled analysis hides a significant amount of heterogeneity as the relationship between obesity and wages differs across countries and wages quantiles and ii) cultural, environmental or institutional settings do not seem to be able to explain differences among countries, leaving room for a pure discriminatory effect hypothesis

The Chinese health care system reforms and household saving patterns: some stylized facts.

This chapter aims to evaluate the relationship between one of the recent healthcare reforms in the People’s Republic of China and household decisions both in terms of out-of-pocket expenditure and saving. Evidence on the results achieved by reforms of the health insurance sector in terms of reducing out-of-pocket medical expenditure is still uncertain and contradictory, and very little is known about the effect of these measures on the consumption and saving behaviour of the Chinese population. To shed light on this issue we use data collected by Chinese Household Income Project surveys (CHIPs), through a series of questionnaire-based interviews conducted in urban areas in 1995 and 2002. Our descriptive analysis suggests that there is a positive relationship between public health insurance coverage and household saving. This empirical evidence suggests that public insurance coverage is ineffective as a source of protection against income losses and might induce households to save more

Can differences in medical drug compliance between European countries be explained by social factors: analyses based on data from the European Social Survey, round 2

<p>Abstract</p> <p>Background</p> <p>Non-compliance with medication is a major health problem. Cultural differences may explain different compliance patterns. The size of the compliance burden and the impact of socio-demographic and socio-economic status within and across countries in Europe have, however, never been analysed in one survey. The aim of this study was to analyse 1) medical drug compliance in different European countries with respect to socio-demographic and socio-economic factors, and to examine 2) whether cross-national differences could be explained by these factors.</p> <p>Methods</p> <p>A multi-country interview survey <it>European Social Survey, Round 2 </it>was conducted in 2004/05 comprising questions about compliance with last prescribed drug. Non-compliance was classified as primary and secondary, depending whether the drug was purchased or not. Statistical weighting allowed for adjustment for national differences in sample mechanisms. A multiple imputation strategy was used to compensate for missing values. The analytical approach included multivariate and multilevel analyses.</p> <p>Results</p> <p>The survey comprised 45,678 participants. Response rate was 62.5% (range 43.6–79.1%). Reported compliance was generally high (82%) but the pattern of non-compliance showed large variation between countries. Some 3.2% did not purchase the most recently prescribed medicine, and 13.6% did not take the medicine as prescribed. Multiple regression analyses showed that each variable had very different and in some cases opposite impact on compliance within countries. The multilevel analysis showed that the variation between countries did not change significantly when adjusted for increasing numbers of covariates.</p> <p>Conclusion</p> <p>Reported compliance was generally high but showed wide variation between countries. Cross-national differences could, however, not be explained by the socio-demographic and socio-economic variables measured.</p

Apolipophorin-III Mediates Antiplasmodial Epithelial Responses in Anopheles gambiae (G3) Mosquitoes

Apolipophorin-III (ApoLp-III) is known to play an important role in lipid transport and innate immunity in lepidopteran insects. However, there is no evidence of involvement of ApoLp-IIIs in the immune responses of dipteran insects such as Drosophila and mosquitoes.We report the molecular and functional characterization of An. gambiae apolipophorin-III (AgApoLp-III). Mosquito ApoLp-IIIs have diverged extensively from those of lepidopteran insects; however, the predicted tertiary structure of AgApoLp-III is similar to that of Manduca sexta (tobacco hornworm). We found that AgApoLp-III mRNA expression is strongly induced in the midgut of An. gambiae (G3 strain) mosquitoes in response to Plasmodium berghei infection. Furthermore, immunofluorescence stainings revealed that high levels of AgApoLp-III protein accumulate in the cytoplasm of Plasmodium-invaded cells and AgApoLp-III silencing increases the intensity of P. berghei infection by five fold.There are broad differences in the midgut epithelial responses to Plasmodium invasion between An. gambiae strains. In the G3 strain of An. gambiae AgApoLp-III participates in midgut epithelial defense responses that limit Plasmodium infection