Jörg Mahlich | University of Vienna (original) (raw)
Books by Jörg Mahlich
OBJECTIVES: The present study on people living with HIV/AIDS (PLWHA) identifies socio-demographic... more OBJECTIVES:
The present study on people living with HIV/AIDS (PLWHA) identifies socio-demographic and health-related factors corresponding with their labour market participation.
METHODS:
The study sample bases on a German observational sub-study of 527 male PLWHA. The present analysis is restricted to male PLWHA in working age. By means of a multivariate regression, we identify factors that contribute to unemployment and job loss.
RESULTS:
The probability to be unemployed is significantly negatively correlated with age above 40 years and graduation from university and positively correlated with problems with daily activities (frailty) and disease severity (CDC stage C). The probability of employment loss during the 2-year observation period is significantly negatively correlated with the educational level, whereas frailty and hepatitis C (HCV) co-infection increase the odds of employment loss.
CONCLUSIONS:
As problems to manage daily activities and disease progression are associated with unemployment, an effective HIV treatment is an important cornerstone for employment. This is also true for the management of comorbidities, such as HCV co-infection, which also negatively affects employment status in our study.
Deutschland, Österreich und die Schweiz sind nicht nur Nachbarländer im Herzen Europas, in denen ... more Deutschland, Österreich und die Schweiz sind nicht nur Nachbarländer im Herzen Europas, in denen die gleiche Sprache gesprochen wird. Die Globalisierung und EU-Osterweiterung, die Alterung der Gesellschaft, die Tertiarisierung und Deindustrialisierung, die zunehmende Individualisierung sowie der Übergang zur Wissensgesellschaft bedeuten für die drei Länder gleichermaßen Chance und Herausforderung. Diese Megatrends beeinflussen nicht nur die Lebensverhältnisse der Menschen, sondern verlangen eine kontinuierliche Überprüfung und Änderung der gesellschaftlichen und wirtschaftlichen Rahmenbedingungen. Aber auch hausgemachte Probleme erfordern von der Politik Lösungen, welche die rechtlichen und institutionellen Voraussetzungen für Beschäftigung und Wachstum verbessern und dadurch den hohen Wohlstand dieser Länder sichern helfen. Vor diesem Hintergrund wird die Reformpolitik in den drei Nachbarstaaten analysiert. Der Untersuchungszeitraum erstreckt sich von September 2002 bis September 2006.
Only inadequately perceived by the Western public, Korea has transformed into an economic heavy w... more Only inadequately perceived by the Western public, Korea has transformed into an economic heavy weight during recent decades. The Korean government believes it can turn it into one of the top 10 competitive economies until 2010. This goal does not sound overambitious as Korea has undergone tremendous efforts in order to forge ahead in the field of research and development. In some high tech industries, Korean firms have advanced into leading players in the global market place and are increasingly challenging their international competitors. Against this background, the volume offers an in-depth analysis of the Korean innovation system and shows how its science and technology policies actually work. As Korea’s economy is now reaching the status of a newly advanced economy, the book also takes a close look on ongoing structural changes in the course of economic globalization.
South Korea has attained spectacular economic success in recent decades. It has reached the statu... more South Korea has attained spectacular economic success in recent decades. It has reached the status of a Newly Advanced Economy, with challenges increasingly mirroring those faced by other advanced economies. These include the necessary upgrading of the labor force, the frictions of switching to a national system of innovation adapted to leadership in R&D, market-based economic policies that reflect the government’s difficulties in foreseeing future technological developments, and the consequences of social change for the innovation system and policy-making. In the forthcoming book the parallel challenges for innovation and technology for the Republic of Korea and other advanced economies will be analyzed more thoroughly with an international perspective in mind. This comparison and international benchmarking will allow policy makers and scholars to better appreciate how much the country has already moved into the circle of globally leading economies and what can be done to consolidate and strengthen its position
Papers by Jörg Mahlich
International Journal of Technology Assessment in Health Care, 2017
Japanese authorities have announced a plan to introduce a health technology assessment (HTA) syst... more Japanese authorities have announced a plan to introduce a health technology assessment (HTA) system in 2016. This study assessed the potential impact of such a policy on the price of the antivirologic drug simeprevir. Taking the antivirologic drug simeprevir as an example, we compared the current Japanese price with hypothetical prices that might result if a U.K. (cost-utility) or German (efficiency frontier) style HTA assessment was in place. The simeprevir unit price under the current Japanese pricing scheme is 13,122 Japanese yen (equivalent to 109.35 U.S. dollars as of April 2015). Depending on the selection of comparators and the pricing method, and assuming that HTA will be used as a basis for price setting, the estimated prices of simeprevir vary up to four times higher than under the current Japanese pricing scheme. Although the analysis is based on only one drug, it cannot be taken for granted that a new HTA system would reduce public healthcare expenditure in Japan.
Der Artikel beschreibt den moglichen Einsatz von Daten, die nicht aus klinischen Studien stammen,... more Der Artikel beschreibt den moglichen Einsatz von Daten, die nicht aus klinischen Studien stammen, fur die Zulassung und die Preisermittlung bei Marktzugang. Hierbei wird zwischen strukturierten Daten aus der Versorgung, sogenannte Real-World-Daten, wie z. B. Abrechnungsdaten, und grosen unstrukturierten Daten von Personen, sogenannte Big Data, wie z. B. Daten aus Genomanalysen und von mobilen Geraten, unterschieden. Fur den Einsatz von Real-World-Daten werden Datenquellen gelistet und Beispiele fur deren Einsatz in den grosen Markten der pharmazeutischen Industrie genannt. Fur den Einsatz von Big Data werden die Besonderheiten fur einen Einsatz bei der Zulassung und dem Marktzugang diskutiert und es wird uber die Aktivitaten sowohl der Zulassungs- als auch der Bewertungsinstitute berichtet. Am Ende wird die Frage diskutiert, mit welchen Methoden diese Daten analysiert werden konnen, um die fur beide Behorden notwendige Sicherheit zu erlangen, die fur eine Zulassung oder den Marktzug...
Journal of Cancer Research and Clinical Oncology
Journal of Medical Economics, 2020
Aim: To describe the characteristics and medication treatment patterns, healthcare resource utili... more Aim: To describe the characteristics and medication treatment patterns, healthcare resource utilization (HRU), and associated costs in Japanese patients with systemic lupus erythematosus (SLE). Methods: Claims data from the Japan Medical Data Center (JMDC) database were used to identify patients with SLE-related claims from 2010 to 2017. Algorithms were developed to retrospectively categorize patients by disease severity, treatment experience, and SLE-related manifestations such as lupus nephritis and central nervous system lupus. Descriptive and multivariate analyses were used to describe treatment pattern and estimate HRU and associated costs for the SLE cohort overall and by disease severity and complications. Results: Among 4,733 eligible patients, 2,072 (43.8%) were treatment naïve, 2,214 (46.8%) were previously treated for SLE, and 447 (9.4%) did not receive any treatment. Mean (SD) age of the total SLE cohort was 45.2 (13.1) years and mean (SD) follow-up duration was 1,137.3 (758.0) d. Based on disease severity, 1,383 (29.2%) patients had mild, 2,619 (55.3%) patients had moderate, and 731 (15.4%) patients had severe SLE. Patients on glucocorticoids (both oral and parenteral) received add-on medications the most (35.5%, p < .001). Mean annual cost per SLE patient in the post-index period, inclusive of hospitalizations, outpatient visits, and pharmacy was ¥436,836; ¥1,010,772; and ¥2,136,780 for patients with mild, moderate, and severe SLE, respectively. Limitations: The database only captured information on patients up to 75 years of age. Due to the nature of the database, biases regarding conditions that attribute to the spectrum of SLE severity, flare incidences, or individual physical status cannot be ruled out. Conclusions: This study describes the treatment patterns and economic burden experienced by Japanese patients with SLE. The results highlight an unmet need to derive better treatment strategies for patients with SLE to effectively address the disease burden in Japan.
Inhaltsverzeichnis 1 Einleitung 3 2 Was sind Business Angel (Netzwerke)? 4 2.1 Business Angel als... more Inhaltsverzeichnis 1 Einleitung 3 2 Was sind Business Angel (Netzwerke)? 4 2.1 Business Angel als Finanzierungsquelle 2.2 Business Angel Netzwerke 3 Evaluierung: Woran ist der Erfolg von i2 zu messen? 12 4 i2: Aufgabenstellung, Leistungsprofil und Organisation 14 4.1 Wie funktioniert i2: Ziele und Aufgabenstellung 4.2 Leistungsprofil von i2 4
Current Medical Research and Opinion, 2016
Objective: To describe the usage of different biologic agents for rheumatoid arthritis (RA) in Ja... more Objective: To describe the usage of different biologic agents for rheumatoid arthritis (RA) in Japan over time and to identify factors that affects the decision to initiate treatment with biologic agents. Determinants of a switch to another biologic agent for patients who are already on biologic treatment were also analyzed. Research design and methods: We utilized a hospital claims database containing 36,504 Japanese patients with a confirmed RA diagnosis. To analyze the determinants of treatment choices, we applied logistic regression analysis taking into account socio-demographic and medical factors. Results: Analyses determined that 11.8% of diagnoses and 25.4% of treated patients in Japan receive a biologic agent. Significant factors associated with biologic treatment initiation include younger age, female sex, and a higher comorbidity index. The route of administration plays a major role when it comes to a switch between different biologic agents. Conclusions: The lower likelihood of elderly patients to be initiated on biologic treatment might be explained by the risk aversion of Japanese physicians' and patients who are afraid of the potential side effects of biologics. This finding is also consistent with the notion of an age bias that impedes elderly patients from optimal access to biologic treatment. Because claims data does not contain clinical parameters such as disease activity the results should be validated in a clinical context.
Value in Health
Background: The business model of the pharmaceutical industry is changing and a higher emphasize ... more Background: The business model of the pharmaceutical industry is changing and a higher emphasize is placed on health economic expertise in order to demonstrate not only clinical but also economic value of new products. While many studies evaluate work preferences of physicians, we have not come across a study on health economists, although their importance is increasing. To fill this gap, we surveyed health economics students and experienced health economists about their job expectations and job preferences. Methods: From the management literature we have identified four relevant factors that affect job satisfaction: Corporate culture, employer’s reputation, financial remuneration, and scientific way of working. By means of an online survey we have asked 54 health economics students and experienced health economists about the importance of those factors. The respondents also had to assess the expression of the factors within industry, academia, insurances, hospitals, and association...
![Research paper thumbnail of [Medication adherence in asthma therapy--a structured review]](https://attachments.academia-assets.com/100363443/thumbnails/1.jpg)
](Pneumologie (Stuttgart, Germany), 2013
The adherence level of Asthma therapy is low. We provide a literature overview about the determin... more The adherence level of Asthma therapy is low. We provide a literature overview about the determinants of adherence in asthma therapy, and potential options that lead to an improvement of adherence. We also discuss cost issues of poor adherence. A systematic literature search was conducted and 53 articles were identified. The most prominent driving factors of adherence are patient beliefs, comorbidities, physician-patient relationship, and medication regimen. The cost effectiveness of adherence improving measures has yet to be shown. As asthma control is primarily depended on adherence, cost effective adherence programs need to be developed that respond to patients' individual needs.
Journal of Business Economics
"In dem Beitrag wird der Einfluss von keiretsu-Strukturen auf das Investitionsverhalten von ... more "In dem Beitrag wird der Einfluss von keiretsu-Strukturen auf das Investitionsverhalten von japanischen Strukturen im Rahmen einer empirischen Untersuchung untersucht. Theoretischen Überlegungen zufolge sollten keiretsu-Unternehmen in ihrem Investitionsverhalten aufgrund von geringeren Informationskosten weniger stark vom eigenen Cash-flow abhängig sein als unabhängige Unternehmen. Unsere Stichprobe umfasst 1.200 börsennotierte japanische Unternehmen von 1985 bis 2004. Wir finden, dass der Cash-flow der Unternehmen ein wichtiger Erklärungsfaktor für Investitionen sowohl in Sachanlagen als auch in Forschung und Entwicklung ist. Im Gegensatz zu älteren Studien wie der von Hoshi et al. (1991) stellen wir fest, dass sich das Investitionsverhalten von Unternehmen, die einem keiretsu angehören, nicht signifikant von unabhängigen Unternehmen unterscheidet. We analyze the determinants of capital expenditures and R&D outlays in a large sample of listed Japanese companies over the 1985-2004 period. We provide empirical evidence for the role of cash flow as a determinant of both types of investment. In contrast to earlier studies such as Hoshi et al. (1991), our findings suggest that the investment behavior of Keiretsu members is not different from unaffiliated companies."
Journal of Public Health Policy
Using a cross-sectional sample of 50 countries we investigate the influence of Hofstede's six-dim... more Using a cross-sectional sample of 50 countries we investigate the influence of Hofstede's six-dimensions of culture on COVID-19 related mortality. A multivariable regression model was fitted that controls for health-related, economic-and policyrelated variables that have been found to be associated with mortality. We included the percentage of population aged 65 and above, the prevalence of relevant comorbidities, and tobacco use as health-related variables. Economic variables were GDP, and the connectedness of a country. As policy variables, the Oxford Stringency Index as well as stringency speed, and the Global Health Security Index were used. We also describe the importance of the variables by means of a random forest model. The results suggest that individualistic societies are associated with lower COVID-19-related mortality rates. This finding contradicts previous studies that supported the popular narrative that collectivistic societies with an obedient population are better positioned to manage the pandemic.
Drugs - Real World Outcomes
Background Although chronic graft-versus-host-disease (cGvHD) is an important long-term complicat... more Background Although chronic graft-versus-host-disease (cGvHD) is an important long-term complication after allogenic hematopoietic cell transplantation (allo-HCT) and is associated with increased healthcare resource utilization, real-world evidence is scarce. Objectives The aim of the study was to evaluate survival of patients with cGvHD in Germany and to analyze hospitalization and treatment patterns. Patients and Methods Based on a German claims database with 4.9 million enrollees, a retrospective longitudinal analysis covering a 6-year period between 2013 and 2018 was conducted. Patients with allo-HCT in 2014 or 2015 (index date) and no record of transplantation or documentation of GvHD 365 days prior to index were included. Patients who subsequently developed a cGVHD were compared with those who did not develop a cGVHD within 3 years after index date. cGVHD cases were identified based on documented International Classification of Diseases, Tenth Revision (ICD-10) diagnosis and treatment algorithms. Since the onset of cGvHD is defined at 100 days after allo-HCT, only those alive beyond day 100 were considered in the survival analysis. Patients who did not survive the first 100 days after allo-HCT were censored to prevent a selection bias due to early mortality within patients without GvHD. Survival rates were plotted using the Kaplan-Meier estimator. The number of hospitalizations and average lengths of stay as well as treatment patterns were descriptively examined. Results Overall, 165 cGvHD patients were identified and compared with 43 patients without cGVHD. Short-term survival rates were better for patients with cGvHD; the 6-month survival probability was 95.8% for patients with cGVHD and 83.7% for patients without cGVHD. However, long-term survival was better in patients without GvHD; The 30-month survival probability was 65.5% for patients with cGVHD and 76.7% for patients without cGVHD. While overall 90% of cGvHD patients were hospitalized at least once, the share was only half for patients without GvHD (44%). 78.2% of patients with cGVHD received corticosteroids in combination with other predefined immunosuppressants. Conclusion Findings from this study reveal a high disease burden associated with cGvHD. This underlines the high medical need for new interventional strategies to improve survival and morbidity after allo-HCT.
Introduction Graft-versus-host disease (GvHD) can occur as an immunological response after an all... more Introduction Graft-versus-host disease (GvHD) can occur as an immunological response after an allogeneic hematopoietic cell transplantation (allo-HCT). Due to the rarity of the disease German epidemiological data are scarce. Moreover, not all cases of GvHD are properly documented in daily practice. Against this background, this study aims at providing new estimates on the incidence of GvHD in Germany. Methods Based on a large German claims database, a retrospective longitudinal analysis was conducted over a six-year period. Patients were selected that received allo- HCT between 2014 and 2015. Follow up period was three years. To adjust the incidence for undocumented cases, steroid prescriptions after an allo-HCT was used as an approximation. Based on both documented and undocumented GvHD patients, incidence rates were calculated. Results Among 3,737,317 eligible database enrollees, we identified 297 patients who received an allo-HCT between 2014 and 2015. Depending on the extrapolat...
Die Unternehmung, 2011
Produktdifferenzierungsvorteile-Preisabsprachen und Kollusion erleichtern und daher Unternehmen i... more Produktdifferenzierungsvorteile-Preisabsprachen und Kollusion erleichtern und daher Unternehmen in stark konzentrierten Märkten eine höhere Rentabilität aufweisen. Empirische Arbeiten finden jedoch nur einen kleinen Effekt der Marktkonzentration auf die Rentabilität, der im Zeitverlauf sogar noch abgenommen haben dürfte (Schmalensee 1989; Domowitz et al. 1986). In Deutschland und vielen anderen Ländern gilt daher auch das "weite Oligopol" als wettbewerbspolitisches Leitbild, und Monopolgewinne dürften nur in wenigen Branchen-meist handelt es sich um die ehemals staatlichen Netzwerkindustrien wie Energieversorgung oder Telekom-eine Rolle gespielt haben. 2. Risiko: Eine weitere Erklärungsmöglichkeit für die hohe Rentabilität der Pharmaunternehmen ist das mit pharmazeutischen Forschungs-und Entwicklungsinvestitionen (F&E-Investitionen) verbundene hohe Risiko, welches durch eine höhere erwartete Rendite ausgeglichen werden muss. Wie Grabowski/Vernon (1990, 2003) zeigen, erwirtschaftet lediglich ein Drittel aller neu auf den Markt kommenden Medikamente die entsprechenden F&E-Investitionen. Die F&E-Investitionen für ein neues Medikament betragen Schätzungen zufolge zwischen 500 Mio. USD und 800 Mio. USD (Adams/Brantner 2006; DiMasi/Hansen/ Grabowski 2003). Von positiven Spillover-Effekten zwischen firmeninternen Forschungsprojekten abgesehen (Cockburn/Henderson 2001; Henderson/Cockburn 1996), sind die Möglichkeiten, diese Risiken zu diversifizieren, begrenzt. Dementsprechend ist auch das aus dem CAPM Modell abgeleitete und durch das Beta ausgedrückte Marktrisiko für die Pharmaindustrie grösser als Eins. Für wachstumsstarke Unternehmen, deren Produkte sich noch im F&E-Stadium befinden, ist das Beta sogar erheblich höher (Bernardo et al. 2007). Die vielen Marktaustritte in Form von Fusionen und Übernahmen in dieser Branche können vor diesem Hintergrund als Folge der mit der pharmazeutischen Forschung verbundenen Marktrisiken interpretiert werden. 1 In der Studie von Danzon et al. (2007) wird dementsprechend gezeigt, dass eher Firmen mit schlecht gefüllten Produktpipelines übernommen 1 Die meisten Pharmaunternehmen sind an M&A-Aktivitäten beteiligt und lediglich drei der "Big Pharma"-Unternehmen in den USA waren in keine M&A-Transaktion in den letzten 15 Jahren involviert (Danzon et al. 2004). Einige wichtige Fusionen und Übernahmen in der letzten Zeit waren Sanofi und Aventis, Glaxo,
Rheumatology and Therapy, 2021
Introduction: To investigate drug survival for biologic disease-modifying antirheumatic drugs (bD... more Introduction: To investigate drug survival for biologic disease-modifying antirheumatic drugs (bDMARDs) in a real-world cohort of German adult biologic-naïve patients with psoriatic arthritis (PsA). Methods: Claims data for patients with a diagnosis of PsA, a bDMARD claims record (index date) between 1 January 2014 and 31 December 2017, and no bDMARD prescription for 365 days before the index date were retrospectively analyzed. The primary outcomes were the overall and individual bDMARD persistence rates over 12 months. Nonpersistence was defined as a treatment gap exceeding the days of supply plus 60 days or switching to a bDMARD other than the index therapy. Sensitivity analysis was performed, wherein the treatment gap was found to vary depending on the bDMARD regimen. Kaplan-Meier curves were plotted to determine persistence; the log-rank test was used to evaluate differences in the persistence rate. Factors associated with treatment discontinuation were evaluated using Cox regression analysis. Results: Among 10,954 patients with a PsA diagnosis, 348 were eligible. The overall bDMARD persistence rate was 57.5%; individual bDMARD persistence rates were 81.3% for ustekinumab, 66.7% for infliximab, and 60.0% for golimumab. The mean (SD) overall persistence with bDMARDs was 289 (103) days; the mean persistence was 334 (72) days for ustekinumab, 309 (82) days for golimumab, and 305 (92) days for infliximab. The main reasons for nonpersistence were switching to another bDMARD (15.8%) and treatment discontinuation (26.7%). Male gender was significantly associated with a lower risk of treatment discontinuation (hazard ratio 0.54, 95% confidence interval 0.39-0.77; P \ 0.001). The sensitivity analysis yielded similar results. Conclusion: The one-year persistence rate for bDMARDs in German PsA patients is modest, although the persistence rate depends on the bDMARD considered.
PloS one, 2018
Limited availability of real-world data that describe treatment patterns of Japanese prostate can... more Limited availability of real-world data that describe treatment patterns of Japanese prostate cancer (PCA) patients. A biweekly transition analysis of PCA treatment was performed for patients with PCA diagnosis and a specific treatment between 2010 and 2015. To account for different cancer stages, two patient populations were analyzed. The first group consisted of patients on medication for hormone-sensitive prostate cancer (HSPC). The second group is comprised of patients who ended up receiving specific therapy for castration-resistant prostate cancer (CRPC). For each treatment, the average of treatment duration and the portion of patients transitioning to a consecutive treatment was calculated. We identified 59,626 patients from the Japanese administrative database with a PCA diagnosis and specific treatment. In the first year of our observational study 786 patients commenced a HSPC treatment and 695 received a CRPC specific therapy Among the HSPC group, we found that combination ...
Clinical therapeutics, 2018
With the progress being made in the treatment of multiple myeloma and other complex cancers, a va... more With the progress being made in the treatment of multiple myeloma and other complex cancers, a variety of clinical research and treatment options are being pursued. This study uses a discrete choice experiment (DCE) to estimate treatment characteristic preferences of hematologists in Japan. A 2-stage process was applied within this study. The first stage is an attribute-rating exercise in which each of the full list of 21 attributes is rated on its importance by the clinicians when selecting a first-line therapy. The top 8 rated attributes from a stepwise logistic regression model are then used to develop a DCE to estimate hematologists' willingness to trade-off characteristics of the treatment options in their recommendation of a first-line treatment. A logit model was used to identify the attribute levels that were the strongest determinants of the physicians' treatment preferences. From among the potential treatment attributes presented, improved overall survival had the ...
OBJECTIVES: The present study on people living with HIV/AIDS (PLWHA) identifies socio-demographic... more OBJECTIVES:
The present study on people living with HIV/AIDS (PLWHA) identifies socio-demographic and health-related factors corresponding with their labour market participation.
METHODS:
The study sample bases on a German observational sub-study of 527 male PLWHA. The present analysis is restricted to male PLWHA in working age. By means of a multivariate regression, we identify factors that contribute to unemployment and job loss.
RESULTS:
The probability to be unemployed is significantly negatively correlated with age above 40 years and graduation from university and positively correlated with problems with daily activities (frailty) and disease severity (CDC stage C). The probability of employment loss during the 2-year observation period is significantly negatively correlated with the educational level, whereas frailty and hepatitis C (HCV) co-infection increase the odds of employment loss.
CONCLUSIONS:
As problems to manage daily activities and disease progression are associated with unemployment, an effective HIV treatment is an important cornerstone for employment. This is also true for the management of comorbidities, such as HCV co-infection, which also negatively affects employment status in our study.
Deutschland, Österreich und die Schweiz sind nicht nur Nachbarländer im Herzen Europas, in denen ... more Deutschland, Österreich und die Schweiz sind nicht nur Nachbarländer im Herzen Europas, in denen die gleiche Sprache gesprochen wird. Die Globalisierung und EU-Osterweiterung, die Alterung der Gesellschaft, die Tertiarisierung und Deindustrialisierung, die zunehmende Individualisierung sowie der Übergang zur Wissensgesellschaft bedeuten für die drei Länder gleichermaßen Chance und Herausforderung. Diese Megatrends beeinflussen nicht nur die Lebensverhältnisse der Menschen, sondern verlangen eine kontinuierliche Überprüfung und Änderung der gesellschaftlichen und wirtschaftlichen Rahmenbedingungen. Aber auch hausgemachte Probleme erfordern von der Politik Lösungen, welche die rechtlichen und institutionellen Voraussetzungen für Beschäftigung und Wachstum verbessern und dadurch den hohen Wohlstand dieser Länder sichern helfen. Vor diesem Hintergrund wird die Reformpolitik in den drei Nachbarstaaten analysiert. Der Untersuchungszeitraum erstreckt sich von September 2002 bis September 2006.
Only inadequately perceived by the Western public, Korea has transformed into an economic heavy w... more Only inadequately perceived by the Western public, Korea has transformed into an economic heavy weight during recent decades. The Korean government believes it can turn it into one of the top 10 competitive economies until 2010. This goal does not sound overambitious as Korea has undergone tremendous efforts in order to forge ahead in the field of research and development. In some high tech industries, Korean firms have advanced into leading players in the global market place and are increasingly challenging their international competitors. Against this background, the volume offers an in-depth analysis of the Korean innovation system and shows how its science and technology policies actually work. As Korea’s economy is now reaching the status of a newly advanced economy, the book also takes a close look on ongoing structural changes in the course of economic globalization.
South Korea has attained spectacular economic success in recent decades. It has reached the statu... more South Korea has attained spectacular economic success in recent decades. It has reached the status of a Newly Advanced Economy, with challenges increasingly mirroring those faced by other advanced economies. These include the necessary upgrading of the labor force, the frictions of switching to a national system of innovation adapted to leadership in R&D, market-based economic policies that reflect the government’s difficulties in foreseeing future technological developments, and the consequences of social change for the innovation system and policy-making. In the forthcoming book the parallel challenges for innovation and technology for the Republic of Korea and other advanced economies will be analyzed more thoroughly with an international perspective in mind. This comparison and international benchmarking will allow policy makers and scholars to better appreciate how much the country has already moved into the circle of globally leading economies and what can be done to consolidate and strengthen its position
International Journal of Technology Assessment in Health Care, 2017
Japanese authorities have announced a plan to introduce a health technology assessment (HTA) syst... more Japanese authorities have announced a plan to introduce a health technology assessment (HTA) system in 2016. This study assessed the potential impact of such a policy on the price of the antivirologic drug simeprevir. Taking the antivirologic drug simeprevir as an example, we compared the current Japanese price with hypothetical prices that might result if a U.K. (cost-utility) or German (efficiency frontier) style HTA assessment was in place. The simeprevir unit price under the current Japanese pricing scheme is 13,122 Japanese yen (equivalent to 109.35 U.S. dollars as of April 2015). Depending on the selection of comparators and the pricing method, and assuming that HTA will be used as a basis for price setting, the estimated prices of simeprevir vary up to four times higher than under the current Japanese pricing scheme. Although the analysis is based on only one drug, it cannot be taken for granted that a new HTA system would reduce public healthcare expenditure in Japan.
Der Artikel beschreibt den moglichen Einsatz von Daten, die nicht aus klinischen Studien stammen,... more Der Artikel beschreibt den moglichen Einsatz von Daten, die nicht aus klinischen Studien stammen, fur die Zulassung und die Preisermittlung bei Marktzugang. Hierbei wird zwischen strukturierten Daten aus der Versorgung, sogenannte Real-World-Daten, wie z. B. Abrechnungsdaten, und grosen unstrukturierten Daten von Personen, sogenannte Big Data, wie z. B. Daten aus Genomanalysen und von mobilen Geraten, unterschieden. Fur den Einsatz von Real-World-Daten werden Datenquellen gelistet und Beispiele fur deren Einsatz in den grosen Markten der pharmazeutischen Industrie genannt. Fur den Einsatz von Big Data werden die Besonderheiten fur einen Einsatz bei der Zulassung und dem Marktzugang diskutiert und es wird uber die Aktivitaten sowohl der Zulassungs- als auch der Bewertungsinstitute berichtet. Am Ende wird die Frage diskutiert, mit welchen Methoden diese Daten analysiert werden konnen, um die fur beide Behorden notwendige Sicherheit zu erlangen, die fur eine Zulassung oder den Marktzug...
Journal of Cancer Research and Clinical Oncology
Journal of Medical Economics, 2020
Aim: To describe the characteristics and medication treatment patterns, healthcare resource utili... more Aim: To describe the characteristics and medication treatment patterns, healthcare resource utilization (HRU), and associated costs in Japanese patients with systemic lupus erythematosus (SLE). Methods: Claims data from the Japan Medical Data Center (JMDC) database were used to identify patients with SLE-related claims from 2010 to 2017. Algorithms were developed to retrospectively categorize patients by disease severity, treatment experience, and SLE-related manifestations such as lupus nephritis and central nervous system lupus. Descriptive and multivariate analyses were used to describe treatment pattern and estimate HRU and associated costs for the SLE cohort overall and by disease severity and complications. Results: Among 4,733 eligible patients, 2,072 (43.8%) were treatment naïve, 2,214 (46.8%) were previously treated for SLE, and 447 (9.4%) did not receive any treatment. Mean (SD) age of the total SLE cohort was 45.2 (13.1) years and mean (SD) follow-up duration was 1,137.3 (758.0) d. Based on disease severity, 1,383 (29.2%) patients had mild, 2,619 (55.3%) patients had moderate, and 731 (15.4%) patients had severe SLE. Patients on glucocorticoids (both oral and parenteral) received add-on medications the most (35.5%, p < .001). Mean annual cost per SLE patient in the post-index period, inclusive of hospitalizations, outpatient visits, and pharmacy was ¥436,836; ¥1,010,772; and ¥2,136,780 for patients with mild, moderate, and severe SLE, respectively. Limitations: The database only captured information on patients up to 75 years of age. Due to the nature of the database, biases regarding conditions that attribute to the spectrum of SLE severity, flare incidences, or individual physical status cannot be ruled out. Conclusions: This study describes the treatment patterns and economic burden experienced by Japanese patients with SLE. The results highlight an unmet need to derive better treatment strategies for patients with SLE to effectively address the disease burden in Japan.
Inhaltsverzeichnis 1 Einleitung 3 2 Was sind Business Angel (Netzwerke)? 4 2.1 Business Angel als... more Inhaltsverzeichnis 1 Einleitung 3 2 Was sind Business Angel (Netzwerke)? 4 2.1 Business Angel als Finanzierungsquelle 2.2 Business Angel Netzwerke 3 Evaluierung: Woran ist der Erfolg von i2 zu messen? 12 4 i2: Aufgabenstellung, Leistungsprofil und Organisation 14 4.1 Wie funktioniert i2: Ziele und Aufgabenstellung 4.2 Leistungsprofil von i2 4
Current Medical Research and Opinion, 2016
Objective: To describe the usage of different biologic agents for rheumatoid arthritis (RA) in Ja... more Objective: To describe the usage of different biologic agents for rheumatoid arthritis (RA) in Japan over time and to identify factors that affects the decision to initiate treatment with biologic agents. Determinants of a switch to another biologic agent for patients who are already on biologic treatment were also analyzed. Research design and methods: We utilized a hospital claims database containing 36,504 Japanese patients with a confirmed RA diagnosis. To analyze the determinants of treatment choices, we applied logistic regression analysis taking into account socio-demographic and medical factors. Results: Analyses determined that 11.8% of diagnoses and 25.4% of treated patients in Japan receive a biologic agent. Significant factors associated with biologic treatment initiation include younger age, female sex, and a higher comorbidity index. The route of administration plays a major role when it comes to a switch between different biologic agents. Conclusions: The lower likelihood of elderly patients to be initiated on biologic treatment might be explained by the risk aversion of Japanese physicians' and patients who are afraid of the potential side effects of biologics. This finding is also consistent with the notion of an age bias that impedes elderly patients from optimal access to biologic treatment. Because claims data does not contain clinical parameters such as disease activity the results should be validated in a clinical context.
Value in Health
Background: The business model of the pharmaceutical industry is changing and a higher emphasize ... more Background: The business model of the pharmaceutical industry is changing and a higher emphasize is placed on health economic expertise in order to demonstrate not only clinical but also economic value of new products. While many studies evaluate work preferences of physicians, we have not come across a study on health economists, although their importance is increasing. To fill this gap, we surveyed health economics students and experienced health economists about their job expectations and job preferences. Methods: From the management literature we have identified four relevant factors that affect job satisfaction: Corporate culture, employer’s reputation, financial remuneration, and scientific way of working. By means of an online survey we have asked 54 health economics students and experienced health economists about the importance of those factors. The respondents also had to assess the expression of the factors within industry, academia, insurances, hospitals, and association...
Pneumologie (Stuttgart, Germany), 2013
The adherence level of Asthma therapy is low. We provide a literature overview about the determin... more The adherence level of Asthma therapy is low. We provide a literature overview about the determinants of adherence in asthma therapy, and potential options that lead to an improvement of adherence. We also discuss cost issues of poor adherence. A systematic literature search was conducted and 53 articles were identified. The most prominent driving factors of adherence are patient beliefs, comorbidities, physician-patient relationship, and medication regimen. The cost effectiveness of adherence improving measures has yet to be shown. As asthma control is primarily depended on adherence, cost effective adherence programs need to be developed that respond to patients' individual needs.
Journal of Business Economics
"In dem Beitrag wird der Einfluss von keiretsu-Strukturen auf das Investitionsverhalten von ... more "In dem Beitrag wird der Einfluss von keiretsu-Strukturen auf das Investitionsverhalten von japanischen Strukturen im Rahmen einer empirischen Untersuchung untersucht. Theoretischen Überlegungen zufolge sollten keiretsu-Unternehmen in ihrem Investitionsverhalten aufgrund von geringeren Informationskosten weniger stark vom eigenen Cash-flow abhängig sein als unabhängige Unternehmen. Unsere Stichprobe umfasst 1.200 börsennotierte japanische Unternehmen von 1985 bis 2004. Wir finden, dass der Cash-flow der Unternehmen ein wichtiger Erklärungsfaktor für Investitionen sowohl in Sachanlagen als auch in Forschung und Entwicklung ist. Im Gegensatz zu älteren Studien wie der von Hoshi et al. (1991) stellen wir fest, dass sich das Investitionsverhalten von Unternehmen, die einem keiretsu angehören, nicht signifikant von unabhängigen Unternehmen unterscheidet. We analyze the determinants of capital expenditures and R&D outlays in a large sample of listed Japanese companies over the 1985-2004 period. We provide empirical evidence for the role of cash flow as a determinant of both types of investment. In contrast to earlier studies such as Hoshi et al. (1991), our findings suggest that the investment behavior of Keiretsu members is not different from unaffiliated companies."
Journal of Public Health Policy
Using a cross-sectional sample of 50 countries we investigate the influence of Hofstede's six-dim... more Using a cross-sectional sample of 50 countries we investigate the influence of Hofstede's six-dimensions of culture on COVID-19 related mortality. A multivariable regression model was fitted that controls for health-related, economic-and policyrelated variables that have been found to be associated with mortality. We included the percentage of population aged 65 and above, the prevalence of relevant comorbidities, and tobacco use as health-related variables. Economic variables were GDP, and the connectedness of a country. As policy variables, the Oxford Stringency Index as well as stringency speed, and the Global Health Security Index were used. We also describe the importance of the variables by means of a random forest model. The results suggest that individualistic societies are associated with lower COVID-19-related mortality rates. This finding contradicts previous studies that supported the popular narrative that collectivistic societies with an obedient population are better positioned to manage the pandemic.
Drugs - Real World Outcomes
Background Although chronic graft-versus-host-disease (cGvHD) is an important long-term complicat... more Background Although chronic graft-versus-host-disease (cGvHD) is an important long-term complication after allogenic hematopoietic cell transplantation (allo-HCT) and is associated with increased healthcare resource utilization, real-world evidence is scarce. Objectives The aim of the study was to evaluate survival of patients with cGvHD in Germany and to analyze hospitalization and treatment patterns. Patients and Methods Based on a German claims database with 4.9 million enrollees, a retrospective longitudinal analysis covering a 6-year period between 2013 and 2018 was conducted. Patients with allo-HCT in 2014 or 2015 (index date) and no record of transplantation or documentation of GvHD 365 days prior to index were included. Patients who subsequently developed a cGVHD were compared with those who did not develop a cGVHD within 3 years after index date. cGVHD cases were identified based on documented International Classification of Diseases, Tenth Revision (ICD-10) diagnosis and treatment algorithms. Since the onset of cGvHD is defined at 100 days after allo-HCT, only those alive beyond day 100 were considered in the survival analysis. Patients who did not survive the first 100 days after allo-HCT were censored to prevent a selection bias due to early mortality within patients without GvHD. Survival rates were plotted using the Kaplan-Meier estimator. The number of hospitalizations and average lengths of stay as well as treatment patterns were descriptively examined. Results Overall, 165 cGvHD patients were identified and compared with 43 patients without cGVHD. Short-term survival rates were better for patients with cGvHD; the 6-month survival probability was 95.8% for patients with cGVHD and 83.7% for patients without cGVHD. However, long-term survival was better in patients without GvHD; The 30-month survival probability was 65.5% for patients with cGVHD and 76.7% for patients without cGVHD. While overall 90% of cGvHD patients were hospitalized at least once, the share was only half for patients without GvHD (44%). 78.2% of patients with cGVHD received corticosteroids in combination with other predefined immunosuppressants. Conclusion Findings from this study reveal a high disease burden associated with cGvHD. This underlines the high medical need for new interventional strategies to improve survival and morbidity after allo-HCT.
Introduction Graft-versus-host disease (GvHD) can occur as an immunological response after an all... more Introduction Graft-versus-host disease (GvHD) can occur as an immunological response after an allogeneic hematopoietic cell transplantation (allo-HCT). Due to the rarity of the disease German epidemiological data are scarce. Moreover, not all cases of GvHD are properly documented in daily practice. Against this background, this study aims at providing new estimates on the incidence of GvHD in Germany. Methods Based on a large German claims database, a retrospective longitudinal analysis was conducted over a six-year period. Patients were selected that received allo- HCT between 2014 and 2015. Follow up period was three years. To adjust the incidence for undocumented cases, steroid prescriptions after an allo-HCT was used as an approximation. Based on both documented and undocumented GvHD patients, incidence rates were calculated. Results Among 3,737,317 eligible database enrollees, we identified 297 patients who received an allo-HCT between 2014 and 2015. Depending on the extrapolat...
Die Unternehmung, 2011
Produktdifferenzierungsvorteile-Preisabsprachen und Kollusion erleichtern und daher Unternehmen i... more Produktdifferenzierungsvorteile-Preisabsprachen und Kollusion erleichtern und daher Unternehmen in stark konzentrierten Märkten eine höhere Rentabilität aufweisen. Empirische Arbeiten finden jedoch nur einen kleinen Effekt der Marktkonzentration auf die Rentabilität, der im Zeitverlauf sogar noch abgenommen haben dürfte (Schmalensee 1989; Domowitz et al. 1986). In Deutschland und vielen anderen Ländern gilt daher auch das "weite Oligopol" als wettbewerbspolitisches Leitbild, und Monopolgewinne dürften nur in wenigen Branchen-meist handelt es sich um die ehemals staatlichen Netzwerkindustrien wie Energieversorgung oder Telekom-eine Rolle gespielt haben. 2. Risiko: Eine weitere Erklärungsmöglichkeit für die hohe Rentabilität der Pharmaunternehmen ist das mit pharmazeutischen Forschungs-und Entwicklungsinvestitionen (F&E-Investitionen) verbundene hohe Risiko, welches durch eine höhere erwartete Rendite ausgeglichen werden muss. Wie Grabowski/Vernon (1990, 2003) zeigen, erwirtschaftet lediglich ein Drittel aller neu auf den Markt kommenden Medikamente die entsprechenden F&E-Investitionen. Die F&E-Investitionen für ein neues Medikament betragen Schätzungen zufolge zwischen 500 Mio. USD und 800 Mio. USD (Adams/Brantner 2006; DiMasi/Hansen/ Grabowski 2003). Von positiven Spillover-Effekten zwischen firmeninternen Forschungsprojekten abgesehen (Cockburn/Henderson 2001; Henderson/Cockburn 1996), sind die Möglichkeiten, diese Risiken zu diversifizieren, begrenzt. Dementsprechend ist auch das aus dem CAPM Modell abgeleitete und durch das Beta ausgedrückte Marktrisiko für die Pharmaindustrie grösser als Eins. Für wachstumsstarke Unternehmen, deren Produkte sich noch im F&E-Stadium befinden, ist das Beta sogar erheblich höher (Bernardo et al. 2007). Die vielen Marktaustritte in Form von Fusionen und Übernahmen in dieser Branche können vor diesem Hintergrund als Folge der mit der pharmazeutischen Forschung verbundenen Marktrisiken interpretiert werden. 1 In der Studie von Danzon et al. (2007) wird dementsprechend gezeigt, dass eher Firmen mit schlecht gefüllten Produktpipelines übernommen 1 Die meisten Pharmaunternehmen sind an M&A-Aktivitäten beteiligt und lediglich drei der "Big Pharma"-Unternehmen in den USA waren in keine M&A-Transaktion in den letzten 15 Jahren involviert (Danzon et al. 2004). Einige wichtige Fusionen und Übernahmen in der letzten Zeit waren Sanofi und Aventis, Glaxo,
Rheumatology and Therapy, 2021
Introduction: To investigate drug survival for biologic disease-modifying antirheumatic drugs (bD... more Introduction: To investigate drug survival for biologic disease-modifying antirheumatic drugs (bDMARDs) in a real-world cohort of German adult biologic-naïve patients with psoriatic arthritis (PsA). Methods: Claims data for patients with a diagnosis of PsA, a bDMARD claims record (index date) between 1 January 2014 and 31 December 2017, and no bDMARD prescription for 365 days before the index date were retrospectively analyzed. The primary outcomes were the overall and individual bDMARD persistence rates over 12 months. Nonpersistence was defined as a treatment gap exceeding the days of supply plus 60 days or switching to a bDMARD other than the index therapy. Sensitivity analysis was performed, wherein the treatment gap was found to vary depending on the bDMARD regimen. Kaplan-Meier curves were plotted to determine persistence; the log-rank test was used to evaluate differences in the persistence rate. Factors associated with treatment discontinuation were evaluated using Cox regression analysis. Results: Among 10,954 patients with a PsA diagnosis, 348 were eligible. The overall bDMARD persistence rate was 57.5%; individual bDMARD persistence rates were 81.3% for ustekinumab, 66.7% for infliximab, and 60.0% for golimumab. The mean (SD) overall persistence with bDMARDs was 289 (103) days; the mean persistence was 334 (72) days for ustekinumab, 309 (82) days for golimumab, and 305 (92) days for infliximab. The main reasons for nonpersistence were switching to another bDMARD (15.8%) and treatment discontinuation (26.7%). Male gender was significantly associated with a lower risk of treatment discontinuation (hazard ratio 0.54, 95% confidence interval 0.39-0.77; P \ 0.001). The sensitivity analysis yielded similar results. Conclusion: The one-year persistence rate for bDMARDs in German PsA patients is modest, although the persistence rate depends on the bDMARD considered.
PloS one, 2018
Limited availability of real-world data that describe treatment patterns of Japanese prostate can... more Limited availability of real-world data that describe treatment patterns of Japanese prostate cancer (PCA) patients. A biweekly transition analysis of PCA treatment was performed for patients with PCA diagnosis and a specific treatment between 2010 and 2015. To account for different cancer stages, two patient populations were analyzed. The first group consisted of patients on medication for hormone-sensitive prostate cancer (HSPC). The second group is comprised of patients who ended up receiving specific therapy for castration-resistant prostate cancer (CRPC). For each treatment, the average of treatment duration and the portion of patients transitioning to a consecutive treatment was calculated. We identified 59,626 patients from the Japanese administrative database with a PCA diagnosis and specific treatment. In the first year of our observational study 786 patients commenced a HSPC treatment and 695 received a CRPC specific therapy Among the HSPC group, we found that combination ...
Clinical therapeutics, 2018
With the progress being made in the treatment of multiple myeloma and other complex cancers, a va... more With the progress being made in the treatment of multiple myeloma and other complex cancers, a variety of clinical research and treatment options are being pursued. This study uses a discrete choice experiment (DCE) to estimate treatment characteristic preferences of hematologists in Japan. A 2-stage process was applied within this study. The first stage is an attribute-rating exercise in which each of the full list of 21 attributes is rated on its importance by the clinicians when selecting a first-line therapy. The top 8 rated attributes from a stepwise logistic regression model are then used to develop a DCE to estimate hematologists' willingness to trade-off characteristics of the treatment options in their recommendation of a first-line treatment. A logit model was used to identify the attribute levels that were the strongest determinants of the physicians' treatment preferences. From among the potential treatment attributes presented, improved overall survival had the ...
The International journal of health planning and management, Jan 11, 2015
The objective of this study is to analyse determinants of physician office visits and potential e... more The objective of this study is to analyse determinants of physician office visits and potential effects of co-payments in Austria. Based on survey data, the number of annual physician office visits is regressed on a set of explanatory variable such as income, communication behaviour in waiting room, travel time, gender, age, presence of chronic diseases and connectedness to family members. It was then examined how those determinants are affected by hypothetical co-payments in the range of €5 to €200. Our results suggest a negative impact of income and family connectedness on doctor's visits. On the other hand, age, morbidity and active communication behaviour in the waiting room are positively associated with office visits. The significant impact of both income and active communication behaviour on the number of doctor's visits disappears when significant co-payments greater than €50 are introduced. Higher co-payments would reduce healthcare service utilization in Austria ma...
WiSt - Wirtschaftswissenschaftliches Studium, 2006
Um die Kosten des Gesundheitswesens in den Griff zu bekommen, ist die Pharmaindustrie verstärkt Z... more Um die Kosten des Gesundheitswesens in den Griff zu bekommen, ist die Pharmaindustrie verstärkt Ziel von Kostendämpfungsmaßnahmen, nicht zuletzt da viele Gesundheitspolitiker der Annahme sind, dass Pharmafirmen außerordentlich gut verdienen. Der Beitrag versucht aufzuzeigen, dass die Profitabilität von Pharmafirmen deutlich niedriger ist, als ein flüchtiger Blick in die Bilanzen glauben machen könnte. So werden Bilanzgewinne durch die Vernachlässigung des intangiblen Kapitalstocks um fast die Hälfte überschätzt. Bei alternativen Möglichkeiten der Gewinnermittlung schneiden Pharmafirmen nicht mehr außergewöhnlich gut ab.
Journal of medical economics, Jan 31, 2015
Simeprevir (SMV), a protease inhibitor, recently became available for the treatment of chronic he... more Simeprevir (SMV), a protease inhibitor, recently became available for the treatment of chronic hepatitis C (HCV) genotype 1 patients in Japan. The introduction of triple therapy using SMV in combination with peginterferon and ribavirin (PR) significantly improves the cure rate. The aim was to assess the cost-effectiveness of SMV with PR (SMV/PR) compared to telaprevir with PR (TVR/PR), PR alone, or no treatment in treatment-naïve patients in Japan. A Markov model was developed to reflect the natural disease progression of HCV and to estimate the average life years and lifetime healthcare costs per patient. Sustained virologic response rates were obtained from a network meta-analysis including randomized clinical trials conducted in Japan. Patient baseline characteristics, HCV progression rates, mortality, medical resource utilization, and unit costs were obtained from Japanese sources. Outcomes were reported as incremental cost-effectiveness ratios as well as incremental cost and li...
Background: With the introduction of highly active combined antiretroviral therapy (c-ART) mortal... more Background: With the introduction of highly active combined antiretroviral therapy (c-ART) mortality and morbidity of HIV patients declined substantially. Earlier studies reported that c-ART was able to save health-care costs due to a reduction of other direct medical costs, particularly for inpatient treatments and concomitant medication. To date, analyses of costs and health-related quality of life (HRQOL) of patients under c-ART are lacking in Germany. Hence, this study aims to estimate the current cost of illness and HRQOL of HIV-patients under c-ART in different treatment lines. Methods: A multicenter, prospective observational study was carried out in 12 specialised German centres for infectious diseases: 8 private practices/outpatient centres and 4 specialised hospitals offering both inpatient and outpatient services. Demographic, clinical and medication data were derived from patient records. Resource utilisation, information on productivity, out of pocket costs and HRQOL (E...