Role of budget impact in drug reimbursement decisions

There are three known criteria that underlie drug reimbursement decisions: therapeutic value, cost-effectiveness, and burden of disease. However, evidence from recent reimbursement decisions in several jurisdictions points to residual, unexplained variables, among which is budget impact. Budget impact refers to the total costs that drug reimbursement and use entail with respect to one part of the health care system, pharmaceutical care, or to the entire health care system, taking into account the possible reallocation of resources across budgets or sectors of the health care system. The economic and equity rationale for carrying out budget impact analyses is opportunity cost, or benefits forgone, measured in terms of utility or equitable distribution, by using resources in one way rather than another. In other words, by choosing to draw down the budget in one way, decision makers forgo other opportunities to use the same resources. Under a set of unrealistic assumptions, cost-effectiveness analysis accounts for opportunity cost while conveying to the decision maker the price of maximizing health gains, subject to a budget or resource constraint. However, the underlying assumptions are implausible, particularly in the context of pharmaceutical care. Moreover, budget impact analysis is more useful to the decision maker than cost-effectiveness analysis if the objective is not to maximize health gains subject to a budget or resource constraint, but to reduce variance in health gains. With respect to equitable distribution, budget impact analyses lay bare the individuals or groups who lose out - those who bear the opportunity cost of spending resources in accordance with one decision rule rather than another.     

Dual fingerprint reagents with enhanced sensitivity: 5-methoxy- and 5-methylthioninhydrin

"Dual fingerprint reagents" are chemical formulations which produce with latent fingerprints in a single step, impressions that are both colored and fluorescent. Pre-mixed solutions of the two commercially available ninhydrin analogues, 5-methoxyninhydrin (MN) and 5-methylthioninhydrin (MTN) with zinc or cadmium salts, are true dual reagents. They are much more sensitive than the parent dual reagent, ninhydrin/ZnCl(2). The main advantage of the new formulations is that they can be used at room temperature, with no need to cool the sample to liquid nitrogen temperature. At 0.05% concentration, which is 10-fold lower than the common ninhydrin working solution, MTN/ZnCl(2) is as sensitive as DFO in the fluorescence mode and considerably more sensitive in the color mode. MTN is also slightly cheaper than DFO.     

Mitochondrial DNA control region variation in a population sample from Hong Kong, China

Entire mitochondrial control region sequences were generated from 377 unrelated individuals from urban Hong Kong. In line with other control region datasets from China, the sample from Hong Kong exhibited significant genetic diversity that was reflected in a random match probability of 0.19% and a mean pairwise difference of 13.14. A total of 305 haplotypes were identified, of which 262 were unique. These sequences will be made publicly available to serve as forensic mtDNA reference data for China.     

Increasing Family Reunification for Substance‐Abusing Mothers and Their Children: Comparing Two Drug Court Interventions in Miami

This study provides a quasi‐experimental test of 80 consecutive enrollments in the Miami‐Dade (Florida) Dependency Drug Court in order to examine the impact of a family‐based and gender specific intervention, Engaging Moms Program (EMP), on drug court graduation and family reunification. We compared EMP with case management services (CMS). Results indicated that 72% of mothers in the EMP graduated from drug court, and 70% were reunified with their children. In contrast, 38% of mothers receiving CMS graduated from drug court, and 40% were reunited with their children. EMP, then, appears to be a promising family drug court intervention.     

New Evidence on the Monetary Value of Saving a High Risk Youth

There is growing interest in crime prevention through early youth interventions; yet, the standard United States response to the crime problem, particularly among juveniles, has been to increase the use and resource allocation allotted toward punishment and incapacitation and away from prevention and treatment. At the same time, longitudinal studies of delinquency and crime have repeatedly documented a strong link between past and future behavior and have identified a small subset of offenders who commit a large share of criminal offenses. These findings suggest that if these offenders can be identified early and correctly and provided with prevention and treatment resources early in the life course, their criminal activity may be curtailed. While researchers have studied these offenders in great detail, little attention has been paid to the costs they exert on society. This paper provides estimates of the cost of crime imposed on society by high risk youth. Our approach follows and builds upon the early framework and basic methodology developed by Cohen (J Quant Criminol 14: 5–33, 1998), by using new estimates of the costs of individual crimes, ones that are more comprehensive and that significantly increased the monetary cost per crime. We also use new estimates on the underlying offending rate for high risk juvenile offenders. We estimate the present value of saving a 14-year-old high risk juvenile from a life of crime to range from $2.6 to $5.3 million. Similarly, saving a high risk youth at birth would save society between $2.6 and $4.4 million.

Correction to: (Sex) Crime and Punishment in the #MeToo Era: How the Public Views Rape

Political Behavior - The original version of this article mistakenly listed “the Foundations of Human Behavior Initiative at Harvard University” in Acknowledgements section. The proper...     

The effects of outlier presence,plaintiff population size,and aggregation of plaintiffs on simulated civil jury decisions

An experiment was performed to determine the effects of the size of the plaintiff population, the presence or absence of an outlier, defined as a plaintiff whose injuries were significantly more severe than other plaintiffs, and whether plaintiffs were tried individually or were aggregated in a group. Sixty-six person juries were assigned to one of eleven experimental conditions, listened to a 4-h toxic tort tria, and after deliberating, delivered verdicts on liability, and damage awards. The verdicts were increased significantly by the presence of an outlier and by an increase in the plaintiff population. While the punitive awards were higher in the outlier condition, there was also a tendency for juries to find the company not liable.The meaning of the above findings, as well as the fact that juries exhibited great variability in their verdicts was discussed. Evidence as to the decision-making process of the juries was also gathered and discussed.This research was supported by National Science Foundation Grant SES 860 9892 and by a University of Toledo College of Arts and Sciences Faculty Development Grant. Special thanks to members of the Toledo Repertoire Theatre and University of Toledo Theatre Department for their assistance in preparing the materials for this study.     

Genetic variation for 15 autosomal STR loci (PowerPlex 16) in a population sample from northern Greece

Fifteen autosomal STR loci were typed in a population sample of 318 unrelated individuals from northern Greece. Allele frequencies were determined, and Hardy-Weinberg equilibrium tested, for the following loci: D5S818, D7S820, TH01, TPOX, vWA, CSF1PO, D16S539, D13S317, D8S1179, D3S1358, FGA, PENTA D, PENTA E, D21S11, D18S51.