Issues for countries considering introducing the "fourth hurdle": The case of Hungary

Objectives: This study outlines the needs and current development of the "fourth hurdle" (i.e., requirement of effectiveness and cost-effectiveness data for drug coverage policy decisions) in Hungary, describes the legal background and seeks to address some of the most important questions in this field. Methods: The study draws on international experiences and discusses five issues that a given jurisdiction needs to consider before introducing the "fourth hurdle" for pharmaceuticals. Results: The "fourth hurdle" is very relevant in Hungary because many existing drugs are unevaluated and many new, expensive drugs are becoming available. On the other hand, the existing resources for health technology assessment, including economic evaluation, are quite limited. All the five issues are relevant in the Hungarian setting and were helpful in determining exactly how the "fourth hurdle" should be applied. Conclusions: The most important issue seems to be that the implementation of the "fourth hurdle" needs to be achieved in a way consistent with the limited resources for HTA in Hungary. Specifically this means that, in setting priorities for drugs to evaluate, additional criteria need to be applied. In particular, priority should be given to assessing drugs that have been evaluated in other countries, because this affords the opportunity to adapt existing studies or models to the Hungarian situation

DMRG and the Two Dimensional t-J Model

We describe in detail the application of the recent non-Abelian Density Matrix Renormalization Group (DMRG) algorithm to the two dimensional t-J model. This extension of the DMRG algorithm allows us to keep the equivalent of twice as many basis states as the conventional DMRG algorithm for the same amount of computational effort, which permits a deeper understanding of the nature of the ground state.Comment: 16 pages, 3 figures. Contributed to the 2nd International Summer School on Strongly Correlated Systems, Debrecen, Hungary, Sept. 200

Incomplete Protection of the Surface Weyl Cones of the Kondo Insulator SmB6_6: Spin Exciton Scattering

The compound SmB$_6$ is a Kondo Insulator, where the lowest-energy bulk electronic excitations are spin excitons. It also has surface states that are subjected to strong spin-orbit coupling. It has been suggested that SmB$_6$ is also a topological insulator. Here we show that, despite the absence of time-reversal symmetry breaking and the presence of strong spin-orbit coupling, the chiral spin texture of the Weyl cone is not completely protected. In particular, we show that the spin-exciton mediated scattering produces features in the surface electronic spectrum at energies separated from the surface Fermi energy by the spin-exciton energy. Despite the features being far removed from the surface Fermi energy, they are extremely temperature dependent. The temperature variation occurs over a characteristic scale determined by the dispersion of the spin exciton. The structures may be observed by electron spectroscopy at low temperatures.Comment: 7 pages, 5 figure

Low-temperature synthesis of SmFeAsO0.7F0.3 wires with high transport critical current density

Ag-sheathed SmFeAsO0.7F0.3 (Sm-1111) superconducting wires were prepared by a one-step solid state reaction at temperatures as low as 850~900C, instead of commonly used temperatures of 1150~1250C. The X-ray diffraction pattern of the as-sintered samples is well indexed on the basis of tetragonal ZrCuSiAs-type structure. We characterized transport critical current density Jc of the SmFeAsO0.7F0.3 wires in increasing and subsequently decreasing fields, by a resistive four-probe method. A transport Jc as high as ~1300 A/cm^2 at 4.2 K and self field has been observed for the first time in Sm-1111 type polycrystalline superconductors. The Jc also shows a rapid depression in small applied fields as well as a magnetic-history dependence, indicating weak-linked grain boundaries. The low-temperature synthesis method can be very beneficial to fabricating the RE-1111 iron oxynictides in a convenient and safe way.Comment: 12 pages, 3 figure

Intermittency in Dynamics of Two-Dimensional Vortex-like Defects

We examine high-order dynamical correlations of defects (vortices, disclinations etc) in thin films starting from the Langevin equation for the defect motion. We demonstrate that dynamical correlation functions $F_{2n}$ of vorticity and disclinicity behave as $F_{2n}\sim y^2/r^{4n}$ where $r$ is the characteristic scale and $y$ is the fugacity. As a consequence, below the Berezinskii-Kosterlitz-Thouless transition temperature $F_{2n}$ are characterized by anomalous scaling exponents. The behavior strongly differs from the normal law $F_{2n}\sim F_2^n$ occurring for simultaneous correlation functions, the non-simultaneous correlation functions appear to be much larger. The phenomenon resembles intermittency in turbulence.Comment: 30 pages, 11 figure

Development of Population Tariffs for the CarerQol Instrument for Hungary, Poland and Slovenia

__Background:__ The CarerQol instrument can be used in economic evaluations to measure the care-related quality of life of informal caregivers. Tariff sets are available for Australia, Germany, Sweden, the Netherlands, the UK, and the USA. __Objective:__ Our objective was to develop tariff sets for the CarerQol instrument for Hungary, Poland and Slovenia and to compare these with the existing value sets. __Methods:__ Discrete-choice experiments were carried out in Hungary, Poland and Slovenia. Data were collected through an online survey between November 2018 and January 2019, using representative samples of 1000 respondents per country. Tariffs were calculated from coefficient estimates from panel mixed multinomial logit models with random parameters. __Results:__ All seven CarerQol domains contributed significantly to the utility associated with different caregiving situations. Attributes valued highest were ‘physical health