Suchergebnisse

BACKGROUND: Since the introduction of the orphan drugs legislation in Europe, it has been suggested that the general method of assessing drugs for reimbursement is not necessarily suitable for orphan drugs. The National Institute for Health and Clinical Excellence indicated that several criteria other than cost and efficacy could be considered in reimbursement decisions for orphan drugs. This study sought to explore the multi-criteria decision analysis (MCDA) framework proposed by (Orphanet J Rare Dis 7:74, 2012) to a range of orphan drugs, with a view to comparing the aggregate scores to the average annual cost per patient for each product, and thus establishing the merit of MCDA as a tool for assessing the value of orphan drugs in relation to their pricings. METHODS: An MCDA framework was developed using the nine criteria proposed by (Orphanet J Rare Dis 7:74, 2012) for the evaluation of orphan drugs, using the suggested numerical scoring system on a scale of 1 to 3 for each criterion. Correlations between the average annual cost of the drugs and aggregate MCDA scores were tested and plotted graphically. Different weightings for each of the attributes were also tested. A further analysis was conducted to test the impact of including the drug cost as an attribute in the aggregate index scores. RESULTS: In the drugs studied, the R (2), that statistically measures how close the data are to the fitted regression line was 0.79 suggesting a strong correlation between the drug scores and the average annual cost per patient. CONCLUSION: Despite several limitations of the proposed model, this quantitative study provided insight into using MCDA and its relationship to the average annual costs of the products.

Combined with measurements made by very-long-baseline interferometry, the observations of fast TeV gamma-ray flares probe the structure and emission mechanism of blazar jets. However, only a handful of such flares have been detected to date, and only within the last few years have these flares been observed from lower-frequency-peaked BL Lac objects and flat-spectrum radio quasars. We report on a fast TeV gamma-ray flare from the blazar BL Lacertae observed by the Very Energetic Radiation Imaging Telescope Array System (VERITAS). with a rise time of ∼2.3 hr and a decay time of ∼36 min. The peak flux above 200 GeV is (4.2 ± 0.6) ×10 photon m s measured with a 4-minute-binned light curve, corresponding to ∼180% of the flux that is observed from the Crab Nebula above the same energy threshold. Variability contemporaneous with the TeV gamma-ray flare was observed in GeV gamma-ray, X-ray, and optical flux, as well as in optical and radio polarization. Additionally, a possible moving emission feature with superluminal apparent velocity was identified in Very Long Baseline Array observations at 43 GHz, potentially passing the radio core of the jet around the time of the gamma-ray flare. We discuss the constraints on the size, Lorentz factor, and location of the emitting region of the flare, and the interpretations with several theoretical models that invoke relativistic plasma passing stationary shocks.© 2018. The American Astronomical Society. All rights reserved. ; VERITAS is supported by grants from the U.S. Department of Energy Office of Science, the U.S. National Science Foundation and the Smithsonian Institution, and by NSERC in Canada. We acknowledge the excellent work of the technical support staff at the Fred Lawrence Whipple Observatory and at the collaborating institutions in the construction and operation of the instrument. The research at Boston University was supported in part by NASA Fermi Guest Investigator Program grant 80NSSC17K 0694. The VLBA is an instrument of the Long Baseline Observatory (LBO). The LBO is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc. This research has made use of data from the MOJAVE database that is maintained by the MOJAVE team (Lister et al. 2009) and supported by NASA Fermi grant NNX15AU76G. This work made use of the Swinburne University of Technology software correlator (Deller et al. 2011), developed as part of the Australian Major National Research Facilities Programme and operated under licence. Y.Y.K. and A.B.P. are partly supported by the Russian Foundation for Basic Research (project 17-02-00197), the government of the Russian Federation (agreement 05.Y09.21.0018), and the Alexander von Humboldt Foundation. T.S. was funded by the Academy of Finland projects 274477 and 284495. This research has made use of data from the OVRO 40 m monitoring program (Richards et al. 2011) which is supported in part by NASA grants NNX08AW31G, NNX11A043G, and NNX14AQ89G and NSF grants AST-0808050 and AST-1109911. The monitoring of BL. Lacertae and other blazars at the Steward Observatory is supported through NASA Fermi Guest Investigator grant NNX15AU81G. I.A. acknowledges support by a Ramon y Cajal grant of the Ministerio de Economia y Competitividad (MINECO) of Spain. Acquisition and reduction of the MAPCAT data was supported in part by MINECO through grants AYA2010-14844, AYA2013-40825-P, and AYA2016-80889-P, and by the Regional Government of Andalucia through grant P09-FQM-4784. The MAPCAT observations were carried out at the German-Spanish Calar Alto Observatory, which is jointly operated by the Max-Planck-Institut fur Astronomie and the Instituto de Astrofisica de Andalucia-CSIC. The St. Petersburg University team acknowledges support from Russian Science Foundation grant 17-12-01029.