Despite a multitude of theoretical discussions on China's mixed ownership reform, very few studies have addressed realistic questions concerning the implementation of the reform. The Resolutions of the Third Plenu...Despite a multitude of theoretical discussions on China's mixed ownership reform, very few studies have addressed realistic questions concerning the implementation of the reform. The Resolutions of the Third Plenum of the 18 th CPC Central Committee and other reform strategies have outlined the reform of sectors with natural monopoly, including urban public utility sectors. The question is how mixed ownership reform should be carried out in sectors of natural monopoly, or which public utilities sectors should enjoy priority of mixed ownership reform. To answer this question, this paper employs data of large public utility enterprises in China from 1998 to 2008, and estimates the natural monopoly attribute at the industry level and corporate total factor productivity(TFP) using cost function analysis method excluding the impact of product price factor. Based on the difference-indifferences-in-differences(DDD) method of natural experiment, an empirical test is carried out for the relationship among natural monopoly, mixed ownership reform and corporate productivity. Our results suggest that:(1) Statistically, mixed ownership reform cannot significantly increase corporate TFP in sectors with natural monopoly;(2) mixed ownership reform should not be carried out indiscriminately on a nationwide basis and for all public utilities sectors. Such an attempt of reform without distinguishing natural monopoly and the level of competitiveness is fraught with policy uncertainties;(3) relative to sectors with natural monopoly, corporate productivity in competitive sectors after mixed ownership reform will improve more significantly and enjoy greater "policy dividends" of institutional reform. Therefore, mixed ownership reform should be carried out first in competitive sectors.展开更多
Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical...Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical trial conducted in Asia. Methods: We applied a Markov model to estimate the quality-adjusted life years, medical cost and incidence of diabetes-related complications for patients receiving the Liraglutide as an add-on to the metformin treatment. Baseline characteristics were taken from a China’s study while the treatment effect is from an Asian study. The related medical cost and utility score were obtained from a local study in China. Having set 30 years’ simulations, the incremental cost-effectiveness ratio was calculated comparing with glimepiride treatment. The ratio would be compared with the willingness to pay for a quality-adjusted-life-year (QALY) which is three times of the GDP per capita in Beijing. Sensitivity analysis was also performed. Result: During a period of 30 years, the base-case analysis which takes discount rate at 3% shows that Liraglutide 1.8 mg results in an average incremental cost of CNY 82,671.49, an improvement in 0.12 QALYs and a reduction of incidence of diabetes-related complications comparing to glimepiride. The associated incremental cost-effectiveness ratio is CNY 688,929.08. Conclusion: Long-term project shows that taking Liraglutide as an add-on to the metformin treatment will lead to increasing quality-adjusted life years and reduction of incidence of diabetes-related complications. When the price of Liraglutide is reduced by 43 percent in China’s yuan, Liraglutide will be cost-effective in China from the healthcare system perspective taking three times of GDP per capita as our WTP threshold.展开更多
文摘Despite a multitude of theoretical discussions on China's mixed ownership reform, very few studies have addressed realistic questions concerning the implementation of the reform. The Resolutions of the Third Plenum of the 18 th CPC Central Committee and other reform strategies have outlined the reform of sectors with natural monopoly, including urban public utility sectors. The question is how mixed ownership reform should be carried out in sectors of natural monopoly, or which public utilities sectors should enjoy priority of mixed ownership reform. To answer this question, this paper employs data of large public utility enterprises in China from 1998 to 2008, and estimates the natural monopoly attribute at the industry level and corporate total factor productivity(TFP) using cost function analysis method excluding the impact of product price factor. Based on the difference-indifferences-in-differences(DDD) method of natural experiment, an empirical test is carried out for the relationship among natural monopoly, mixed ownership reform and corporate productivity. Our results suggest that:(1) Statistically, mixed ownership reform cannot significantly increase corporate TFP in sectors with natural monopoly;(2) mixed ownership reform should not be carried out indiscriminately on a nationwide basis and for all public utilities sectors. Such an attempt of reform without distinguishing natural monopoly and the level of competitiveness is fraught with policy uncertainties;(3) relative to sectors with natural monopoly, corporate productivity in competitive sectors after mixed ownership reform will improve more significantly and enjoy greater "policy dividends" of institutional reform. Therefore, mixed ownership reform should be carried out first in competitive sectors.
文摘Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical trial conducted in Asia. Methods: We applied a Markov model to estimate the quality-adjusted life years, medical cost and incidence of diabetes-related complications for patients receiving the Liraglutide as an add-on to the metformin treatment. Baseline characteristics were taken from a China’s study while the treatment effect is from an Asian study. The related medical cost and utility score were obtained from a local study in China. Having set 30 years’ simulations, the incremental cost-effectiveness ratio was calculated comparing with glimepiride treatment. The ratio would be compared with the willingness to pay for a quality-adjusted-life-year (QALY) which is three times of the GDP per capita in Beijing. Sensitivity analysis was also performed. Result: During a period of 30 years, the base-case analysis which takes discount rate at 3% shows that Liraglutide 1.8 mg results in an average incremental cost of CNY 82,671.49, an improvement in 0.12 QALYs and a reduction of incidence of diabetes-related complications comparing to glimepiride. The associated incremental cost-effectiveness ratio is CNY 688,929.08. Conclusion: Long-term project shows that taking Liraglutide as an add-on to the metformin treatment will lead to increasing quality-adjusted life years and reduction of incidence of diabetes-related complications. When the price of Liraglutide is reduced by 43 percent in China’s yuan, Liraglutide will be cost-effective in China from the healthcare system perspective taking three times of GDP per capita as our WTP threshold.
