Leveraging Pharma to Lower Premiums: Medical Loss Ratio Regulation in the Pharmaceutical Industry

Many recognize escalating drug prices as a significant dilemma related to America’s rising healthcare costs. Yet few can agree on what to do about them. Unaffordable drug prices are a result of many complex forces. One theory to address this problem is to reduce all government intervention and let normal market forces act as they usually do to bring the goods’ prices down to consumer-friendly ranges. However, the prescription drug market is not, and perhaps never can be, a normal market. Reasons for this include (1) a lack of price transparency, (2) information and control asymmetries between patients and physicians, (3) third-party payors, (4) demand that remains constant irrespective of any exorbitant price increases (i.e., market inelasticity), and (5) patent-ensured monopolies. These factors disrupt the normal market forces that usually maintain prices at levels amenable to the general public (i.e., price equilibrium). Left unchecked, Big Pharma increase their prices partly to pay for elevated marketing and other expenses and partly to recoup greater earnings. Consequently, they rake in substantial profits—at an average greater than any other industry. Thus, rising drug prices burden not only those who need them but also those who are expected to help pay for them. To right this abnormal market, this Note suggests an alternative theory: that Congress should apply a medical loss ratio framework to the pharmaceutical drug industry, similar to the ratio framework applied to reform the health insurance industry. This framework seeks to balance corporate profits with consumer benefits by separating profits and “other” less value-adding expenses from those that add greater value to the consumer (i.e., “medical loss”). In the health insurance industry’s 80:20 ratio framework, if the less value-adding expenses (e.g., profits, sales and marketing) cross the ratio threshold (20%), then the companies must reimburse the excess back to the consumer. This measure has eased some insurance premium increases. Similar reform is needed in the pharmaceutical industry, as currently the industry averages 21% profit— significantly above that of other industries—while also spending around 23% on sales and marketing and around 30% on manufacturing.Therefore, the average medical loss ratio is roughly 30:70 (30% on medical loss and 70% on less value-adding areas). Imposing a stricter ratio threshold, such as 40:60, would provide some much-needed incentives for drug companies to reduce their lesser-value-adding expenses and, as a result, reduce drug prices. If Big Pharma failed to meet the 40% threshold, then the excess would be returned to the consumer. Imposing a medical loss ratio regulation in the pharmaceutical industry is a promising solution to one of our nation’s greatest healthcare cost concerns

Large Interstellar Polarisation Survey, II : UV/optical study of cloud-to-cloud variations of dust in the diffuse ISM

It is well known that the dust properties of the diffuse interstellar medium exhibit variations towards different sight-lines on a large scale. We have investigated the variability of the dust characteristics on a small scale, and from cloud-to-cloud. We use low-resolution spectro-polarimetric data obtained in the context of the Large Interstellar Polarisation Survey (LIPS) towards 59 sight-lines in the Southern Hemisphere, and we fit these data using a dust model composed of silicate and carbon particles with sizes from the molecular to the sub-micrometre domain. Large (>= 6 nm) silicates of prolate shape account for the observed polarisation. For 32 sight-lines we complement our data set with UVES archive high-resolution spectra, which enable us to establish the presence of single-cloud or multiple-clouds towards individual sight-lines. We find that the majority of these 35 sight-lines intersect two or more clouds, while eight of them are dominated by a single absorbing cloud. We confirm several correlations between extinction and parameters of the Serkowski law with dust parameters, but we also find previously undetected correlations between these parameters that are valid only in single-cloud sight-lines. We find that interstellar polarisation from multiple-clouds is smaller than from single-cloud sight-lines, showing that the presence of a second or more clouds depolarises the incoming radiation. We find large variations of the dust characteristics from cloud-to-cloud. However, when we average a sufficiently large number of clouds in single-cloud or multiple-cloud sight-lines, we always retrieve similar mean dust parameters. The typical dust abundances of the single-cloud cases are [C]/[H] = 92 ppm and [Si]/[H] = 20 ppm

Large Interstellar Polarisation Survey II. UV/optical study of cloud-to-cloud variations of dust in the diffuse ISM

It is well known that the dust properties of the diffuse interstellar medium exhibit variations towards different sight-lines on a large scale. We have investigated the variability of the dust characteristics on a small scale, and from cloud-to-cloud. We use low-resolution spectro-polarimetric data obtained in the context of the Large Interstellar Polarisation Survey (LIPS) towards 59 sight-lines in the Southern Hemisphere, and we fit these data using a dust model composed of silicate and carbon particles with sizes from the molecular to the sub-micrometre domain. Large (> 6 nm) silicates of prolate shape account for the observed polarisation. For 32 sight-lines we complement our data set with UVES archive high-resolution spectra, which enable us to establish the presence of single-cloud or multiple-clouds towards individual sight-lines. We find that the majority of these 35 sight-lines intersect two or more clouds, while eight of them are dominated by a single absorbing cloud. We confirm several correlations between extinction and parameters of the Serkowski law with dust parameters, but we also find previously undetected correlations between these parameters that are valid only in single-cloud sight-lines. We find that interstellar polarisation from multiple-clouds is smaller than from single-cloud sight-lines, showing that the presence of a second or more clouds depolarises the incoming radiation. We find large variations of the dust characteristics from cloud-to-cloud. However, when we average a sufficiently large number of clouds in single-cloud or multiple-cloud sight-lines, we always retrieve similar mean dust parameters. The typical dust abundances of the single-cloud cases are [C]/[H] = 92 ppm and [Si]/[H] = 20 ppm.Comment: A&A accepte

Large Interstellar Polarisation Survey. LIPS I: FORS2 spectropolarimetry in the Southern Hemisphere

Polarimetric studies of light transmitted through interstellar clouds may give constraints on the properties of the interstellar dust grains. Traditionally, broadband linear polarisation (BBLP) measurements have been considered an important diagnostic tool for the study of the interstellar dust, while comparatively less attention has been paid to spectropolarimetric measurements. However, spectropolarimetry may offer stronger constraints than BBLP, for example by revealing narrowband features, and by allowing us to distinguish the contribution of dust from the contribution of interstellar gas. Therefore, we have decided to carry out a Large Interstellar Polarisation Survey (LIPS) using spectropolarimetric facilities in both hemispheres. Here we present the results obtained in the Southern Hemisphere with the FORS2 instrument of the ESO Very Large Telescope. Our spectra cover the wavelength range 380--950\,nm at a spectral resolving power of about 880. We have produced a publicly available catalogue of 127 linear polarisation spectra of 101 targets. We also provide the Serkowski-curve parameters, as well as the wavelength gradient of the polarisation position angle for the interstellar polarisation along 76 different lines of sight. In agreement with previous literature, we found that the best-fit parameters of the Serkowski-curve are not independent of each other. However, the relationships that we obtained are not always consistent with what was found in previous studies.Comment: Accepted by A&A (replaced on 12 October 2017 simply to correct a Metadata error

Velvet Longhorned Beetle (Trichoferus campestris (Faldermann)

The velvet longhorned beetle is an invasive wood-boring pest that is native to Asia and Russia. It infests fruit, forest, and ornamental trees, as well as green and dry wood, such as timber and lumber. This fact sheet provides a description, and information on life history, plant hosts, injury symptoms, monitoring, and management

Spotted Wing Drosophila [Drosophila suzukii]

This fact sheet describes spotted wing drosophila, an invasive vinegar fly that infests soft fruits and vegetables. It includes information on how to identify, plant hosts, injury symptoms, monitoring, non-chemical control, and chemical control

The Detection of Crystalline Silicates in Ultra-Luminous Infrared Galaxies

Silicates are an important component of interstellar dust and the structure of these grains -- amorphous versus crystalline -- is sensitive to the local physical conditions. We have studied the infrared spectra of a sample of ultra-luminous infrared galaxies. Here, we report the discovery of weak, narrow absorption features at 11, 16, 19, 23, and 28 microns, characteristic of crystalline silicates, superimposed on the broad absorption bands at 10 and 18 microns due to amorphous silicates in a subset of this sample. These features betray the presence of forsterite (Mg_2SiO_4), the magnesium-rich end member of the olivines. Previously, crystalline silicates have only been observed in circumstellar environments. The derived fraction of forsterite to amorphous silicates is typically 0.1 in these ULIRGs. This is much larger than the upper limit for this ratio in the interstellar medium of the Milky Way, 0.01. These results suggest that the timescale for injection of crystalline silicates into the ISM is short in a merger-driven starburst environment (e.g., as compared to the total time to dissipate the gas), pointing towards massive stars as a prominent source of crystalline silicates. Furthermore, amorphization due to cosmic rays, which is thought to be of prime importance for the local ISM, lags in vigorous starburst environments.Comment: 7 pages, 5 figures, accepted for publication in Ap

A southern hemisphere survey of the 5780 and 6284 {\AA} diffuse interstellar bands: correlation with the extinction

We present a new database of 5780.5 and 6283.8 {\AA} DIB measurements and also study their correlation with the reddening. The database is based on high-resolution, high-quality spectra of early-type nearby stars located in the southern hemisphere at an average distance of 300 pc. Equivalent widths of the two DIBs were determined by means of a realistic continuum fitting and synthetic atmospheric transmissions. For all stars that possess a precise measurement of their color excess, we compare the DIBs and the extinction. We find average linear relationships of the DIBS and the color excess that agree well with those of a previous survey of northern hemisphere stars closer than 550 pc. This similarity shows that there is no significant spatial dependence of the average relationship in the solar neighborhood within $\simeq$ 600 pc. A noticeably different result is our higher degree of correlation of the two DIBs with the extinction. We demonstrate that it is simply due to the lower temperature and intrinsic luminosity of our targets. Using cooler target stars reduces the number of outliers, especially for nearby stars, confirming that the radiation field of UV bright stars has a significant influence on the DIB strength. We have used the cleanest data to compute updated DIB shapes.Comment: Astronomy & Astrophysics (in press