Canasta alimentaria normativa: perspectivas actuales e implicaciones para la salud pública en Venezuela / Normative Food Basket current perspectives and implications for public health in Venezuela

La Canasta Alimentaria Normativa (CAN) es un instrumento estratégico de planificación y seguimiento, que impacta el ámbito económico (fijación del salario mínimo SM y del umbral de la pobreza relativa), la seguridad alimentaria y la salud pública. El objetivo fue describir la evolución histórica de la CAN en Venezuela, contrastando su valoración económica respecto al SM durante el período 1990 ­ 2023. Tipo de estudio: Descriptivo. Se empleó la CAN del Instituto Nacional de Estadísticas/Instituto Nacional de Nutrición (INE/INN) y su comparación con la canasta del Centro de Documentación y Análisis Social de la Federación Venezolana de Maestros(CENDAS ­ FVM). Los valores mensuales de la CAN y del SM se recalcularon a dólares USA, de acuerdo a la tasa de cambio oficial. No se incluyó evaluación de la estructura interna, ni sus expresiones en términos de aporte de energía y nutrientes. Resultados: Desde 1990 hasta el año 2015, se requirieron entre1,0 y 1,8 SM y entre 0,6 y 1,7 Ingresos Mínimos Legales (IML)para acceder a la CAN. Para el año 2023 se requirieron hasta 78,3SM y 51,6 IML. El valor promedio de la canasta del CENDAS-FVM fue superior al valor de la CAN INE/INN, en una proporción de 1,7: 1. Conclusiones: la CAN resultó sensible en identificar los cambios y tendencias de su estimación económica, en el ambiente inflacionario venezolano. El uso de sus resultados está sujeta a cierto grado de discrecionalidad política. El costo de la CAN, expresa una contracción del poder de compra de los hogares venezolanos con potenciales impactos sobre la nutrición y la salud física y mental a corto y largo plazo.

The Normative Food Basket (NFB) represents astrategic planning and monitoring instrument, which impactsthe economic sphere (setting of the minimum wage (MW) andthe relative poverty threshold), food security and public health.The objective was to describe the historical evolution of the NFB in Venezuela, contrasting its economic valuation with respect to the MW during the period 1990 ­ 2023. Type of study: Descriptive. The NFB of the National Institute of Statistics/National Institute of Nutrition (NIS/NIN) was used and itscomparison with the basket of the Center for Documentationand Social Analysis of the Venezuelan Federation of Teachers (CENDAS ­ FVM). The monthly values of the NFB and theMW were recalculated into dollars (US$), according to theofficial exchange rate. No evaluation of the internal structurewas included, nor its expressions in terms of energy and nutrientcontribution. Results: From 1990 to 2015, between 1.0 and1.8 MW and between 0.6 and 1.7 Minimum Legal Income(MLI) were required to access the NFB. By 2023, up to 78.3MW and 51.6 MLI were required. The average value of the CENDAS-FVM basket was higher than the value of the NFBNIS/NIN, in a proportion of 1.7: 1. Conclusions: As a statistical operation, the NFB was sensitive in identifying changes andtrends in its estimate economic, in the Venezuelan inflationaryenvironment. The use of its results is subject to a certain degree ofpolitical discretion. The cost of CAN expresses a contraction inthe purchasing power of Venezuelan households with potentialimpacts on nutrition and physical/mental health in the shortand long term.

Analysis of practical prices in the acquisition of medicines by the health consortia compared to municipal institutions in the period from 2017 to 2018

Objective: To identify whether the drug purchases made by the Health Consortia were more efficient, in economic terms, than the purchases made individually by the Municipal Institutions, for the years 2017 and 2018. Methods: Descriptive analysis of the sample, using the trend measures central, economic analysis and calculation of the economic percentage. Results: The values obtained showed efficiency in consortium purchases, reflected in the greater quantity acquired and the lower price practiced, for most of the items analyzed in the reference period. Conclusions: Purchases by Health Consortia provided more savings compared to purchases made by Municipal Institutions, proving to be an option to obtain economic resources for health.

Análise de preços praticados nas aquisições de medicamentos pelos consórcios de saúde em comparação com as instituições municipais para o período de 2017 a 2018 / Analysis of practical prices in the acquisition of medicines by the health consortia compared to municipal institutions in the period from 2017 to 2018

Objetivo: Identificar se as aquisições de medicamentos realizadas pelos Consórcios de Saúde foram mais eficientes, em termos econômicos, que as compras realizadas individualmente pelas Instituições Municipais, para os anos de 2017 e 2018. Métodos: Análise descritiva da amostra, empregando as medidas de tendência central, análise econômica e cálculo do percentual econômico. Resultados: Os valores obtidos mostraram eficiência nas compras dos consórcios, refletidos na maior quantidade adquirida e no menor preço praticado, para a maioria dos itens analisados no período de referência. Conclusão: As compras pelos Consórcios de Saúde proporcionaram mais economia em comparação com as compras realizadas pelas Instituições Municipais, mostrando-se como uma opção para obter economicidade dos recursos destinados à saúde.

Objective: To identify whether the drug purchases made by the Health Consortia were more efficient, in economic terms, than the purchases made individually by the Municipal Institutions, for the years 2017 and 2018. Methods: Descriptive analysis of the sample, using the trend measures central, economic analysis and calculation of the economic percentage. Results: The values obtained showed efficiency in consortium purchases, reflected in the greater quantity acquired and the lower price practiced, for most of the items analyzed in the reference period. Conclusion: Purchases by Health Consortia provided more savings compared to purchases made by Municipal Institutions, proving to be an option to obtain economic resources for health.

Reasons and enlightenment of the formation of high drug prices in the United States / 中华医院管理杂志

Optimizing the drug price management mechanism and improving the availability and affordability of drugs are important in deepening the medical and health reform. The price of drugs in the United States has always been higher than the world average. The price of drugs, the total expenditure on drugs and the personal burden of patients have shown an increasing trend. By exploring the causes of high drug prices in the United States, the author found that there were four main reasons for the current situation of drug prices in the United States, including the interests of enterprises, the limited competition mechanism of the US drug market, relatively insufficient market bargaining power of the US payers, and opaque mechanism of price formation.Firstly, pharmaceutical companies try to achieve their interests by raising drug prices. Secondly, the price formation mechanism of the United States drug market is affected by the price strategy of pharmaceutical companies, and government policies also indirectly affect the role of the market. Thirdly, the payers in the United States are relatively scattered, so that the market bargaining power is relatively insufficient.Fourthly, due to the numerous drug circulation links and stakeholders, the drug price formation mechanism is opaque and lacks supervision. Therefore, when strengthening drug price management in China, we should build a coordination mechanism between the government and the market on the basis of the existing basic economic system and drug management mechanism, establish the strategic purchase and negotiation position of medical insurance for drugs, enhance the transparency of drug circulation and trading, and establish a scientific pricing system. It is also important to promote drug innovation and ensure drug quality.

Transmission of exchange rate variation to Brazilian pulp export prices / Transmissão da variação da taxa de câmbio para os preços brasileiros de exportação da celulose

ABSTRACT: The aim of this research was to examine the relationship between exchange rate variations and Brazilian export prices for cellulose, which is defined as the exchange rate pass-through, taking the period from January 2000 to March 2019 as a reference. The data were collected on the websites of the Ministry of Development, Industry and Foreign Trade - MDIC, the Institute of Applied Economics - IPEA and the Federal Reserve Bank of St. Louis - FRED. Thus, time series instruments were used, especially the Error Correction Vector Model. Results provided indications that the pass-through degree of exchange rate for cellulose export prices occurred incompletely in the total period and in the second sub-period, and was null in the first sub-period, representing that depreciation of rate exchange rates did not translate into significant competitiveness gains, as they did not significantly reduced export prices.

RESUMO: O objetivo deste trabalho consistiu no exame da relação entre as variações cambiais e os preços de exportação brasileiros da celulose, relação definida como o pass-throughda taxa de câmbio, tendo como referência o período de janeiro de 2000 a março de 2019. Os dados foram coletados nos sites do Ministério do Desenvolvimento, Indústria e Comércio Exterior - MDIC, no Instituto de Economia Aplicada - IPEA e no Federal Reserve Bank of St. Louis - FRED. Neste sentido, fez-se uso dos instrumentais de séries temporais, especialmente do Modelo Vetor de Correção de Erros. Os resultados encontrados forneceram indicações de que o grau de pass-throughda taxa de câmbio para os preços de exportação da celulose ocorreram de forma incompleta no período total e no segundo sub-período, e nula no primeiro sub-período, representando que depreciações da taxa de câmbio não se traduzem em ganhos significativos de competitividade, dado que não reduzem expressivamente os preços de exportação.

Preço dos alimentos, consumo de bebidas adoçadas e obesidade no Brasil / Food prices, consumption of sweetened beverages and obesity in Brazil

Introdução: Sabe-se que o cenário global de preço dos alimentos contribui para a epidemia de obesidade por meio do incentivo ao consumo de alimentos não saudáveis. No entanto, a real magnitude da influência do preço de alimentos sobre o estado nutricional e o consumo alimentar no Brasil permanece incerta. Objetivos: Analisar a associação entre o preço dos alimentos, o consumo de bebidas adoçadas e o estado nutricional da população brasileira. Métodos (Manuscrito 1): Estudo em painel envolvendo dados ecológicos de 10 capitais brasileiras e do Distrito Federal para o período entre 2007 e 2018. Dados da Pesquisa de Orçamentos Familiares de 2008/9 foram usados para calcular o preço dos grupos de alimentos que, acrescidos de dados do Sistema Nacional de Índices de Preços ao Consumidor, resultaram em uma série de preços por cidade para cada um dos anos. A prevalência de indicadores de consumo de bebidas adoçadas em cada cidade, por ano, foi obtida no VIGITEL. A relação entre preço e consumo foi estudada a partir de modelos de regressão de efeito fixo para dados em painel. (Manuscrito 2): Estudo transversal com dados da Pesquisa de Orçamentos Familiares de 2008/9. Foram utilizadas informações aferidas de peso e altura de todos os indivíduos, assim como de preço dos alimentos adquiridos para consumo domiciliar. Modelos de regressão multivariada (log-log) foram utilizados para estimar a elasticidade-preço da prevalência de excesso de peso e obesidade para toda a população e para dois estratos de renda do país. (Manuscrito 3): A base de dados desenvolvida para o primeiro artigo foi utilizada, assumindo-se como desfecho o IMC médio nas localidades estudadas (com base nas informações autorreferidas de peso e altura disponíveis no VIGITEL). O preço relativo dos alimentos saudáveis (em relação aos ultraprocessados) foi estimado para cada localidade em cada ano. Modelos de regressão de efeito fixo para dados em painel foram estimados para analisar a relação entre o preço dos alimentos e o IMC médio da população. O estudo foi aprovado pelo Comitê de Ética em Pesquisa envolvendo Seres Humanos da Universidade Federal de Minas Gerais (COEP/UFMG) (CAAE nº 88465018.1.0000.5149). Resultados: O preço das bebidas adoçadas esteve inversamente associado ao seu consumo. Estimamos que um aumento de 1,00% no preço das bebidas adoçadas diminuiria 1,25% a prevalência do seu consumo regular entre as mulheres e 1,57% entre os homens. Encontrou-se também uma associação inversa entre preço de alimentos ultraprocessados e prevalência de sobrepeso e obesidade no Brasil. Observamos que o aumento de 1,00% no preço dos alimentos ultraprocessados levaria a uma diminuição na prevalência de excesso de peso e obesidade de 0,33% e 0,59%, respectivamente. Para o grupo de menor renda, o efeito do preço dos alimentos ultraprocessados foi maior. Por fim, o preço relativo dos alimentos saudáveis associou-se positivamente ao IMC da população. Observamos que um aumento de 10,0% no preço relativo de alimentos saudáveis (não ultraprocessados) levaria a um aumento de 0,3% no IMC médio (0,4% para mulheres e 0,2% para homens). Conclusões: Concluímos que existe uma relação entre o preço dos alimentos, o consumo de bebidas adoçadas e a obesidade no Brasil. A adoção de medidas fiscais, como a tributação de alimentos ultraprocessados, desponta como ferramenta proeminente no controle de obesidade e outros resultados negativos para a saúde.

Introduction: It is known that the global food prices scenario contributes to the obesity epidemic by encouraging the consumption of unhealthy foods. However, the real magnitude of the influence of food prices on nutritional status and food consumption in Brazil remains uncertain. Objective: To analyze the association between food prices, consumption of sweetened beverages and nutritional status of the Brazilian population. Methods (Manuscript 1): Panel study involving ecological data from 10 Brazilian capitals and the Federal District for the period between 2007 and 2018. Data from the Household Budget Survey (HBS 2008/9) were used to calculate the price of food groups that, added data from the National Consumer Price Index System resulted in a series of prices per city for each year. The prevalence indicators of sweetened beverages consumption in each city per year were obtained from VIGITEL. The relationship between price and consumption was studied using fixed-effect regression models for panel data. (Manuscript 2): Cross-sectional study with data from the Household Budget Survey (HBS 2008/9). Information on the weight and height of all individuals was used, as well as the price of food purchased for household consumption. Multivariate regression models (log-log) were used to estimate the price elasticity of the prevalence of overweight and obesity for the entire population and for two income strata in the country. (Manuscript 3): The database developed for the first article was used, assuming the mean BMI in the studied locations as an outcome (based on self-reported weight and height information available at VIGITEL). The relative price of healthy foods (in relation to ultra-processed foods) was estimated for each location in each year. Fixed-effect regression models for panel data were estimated to analyze the relationship between the food prices and the mean BMI of the population. The study was approved by the Research Ethics Committee involving Human Beings at the Federal University of Minas Gerais (COEP / UFMG) (CAAE nº 88465018.1.0000.5149). Results: The sweetened beverages price was inversely associated with their consumption. We estimate that a 1.00% increase in the sweetened beverages price would decrease 1.25% the prevalence of sweetened beverages regular consumption among women and 1.57% among men. An inverse association was also found between the price of ultra-processed foods and the prevalence of overweight and obesity in Brazil. We observed that the 1.00% increase in the price of ultra-processed foods would lead to a decrease in the prevalence of overweight and obesity of 0.33% and 0.59%, respectively. For the lower income group, the effect of the price of ultra-processed foods was greater. Finally, the relative price of healthy foods (non-ultra-processed foods) was positively associated with the population's BMI. We observed that a 10.0% increase in the relative price of non-ultra-processed foods would lead to a 0.3% increase in the average BMI (0.4% for women and 0.2% for men). Conclusions: We conclude that there is an association between the food prices, sweetened beverages consumption and nutritional status in Brazil. The adoption of fiscal measures, such as the taxation of ultra-processed foods, emerges as a prominent tool in the control of obesity and other negative health outcomes

El acceso a medicamentos en Latinoamérica, una mirada al caso de Costa Rica / Access to medicines in Costa Rica and the rest of Latin America

Introducción: La Organización Mundial de la Salud recomendó, a los Estados miembros, la implementación de diversas medidas con la intención de garantizar el acceso efectivo y equitativo a los medicamentos, así como su uso racional en armonía con el ambiente. Sin embargo, en Latinoamérica el acceso a los servicios de salud y a los medicamentos tiene una tendencia mercantilista, donde la comercialización se realiza con matices de lucro, lo que transgrede los derechos de las personas que aspiran a un mejor bienestar. Objetivo: Describir el acceso a los medicamentos en Latinoamérica particularizando en el caso de Costa Rica. Métodos: Este es un trabajo de investigación documental, con enfoque cualitativo, que se basó en la búsqueda y selección de materiales en bases de datos de publicaciones científicas, con el uso de palabras clave. Se organizó la búsqueda en dos secciones: acceso a medicamentos en Latinoamérica y acceso a medicamentos en Costa Rica. Conclusiones: Los esfuerzos realizados no son suficientes para lograr el acceso equitativo de los medicamentos, todavía existen diversas causas que generan desigualdades evitables para poder alcanzar los recursos limitados y los medicamentos de mayor costo. Costa Rica, refleja idénticas dificultades que el resto de los países del área. Por lo que debe tener en cuenta los comportamientos desiguales e inadecuados de algunos sectores de la población y trazar estrategias educativas adecuadas para su uso racional, además, de establecer políticas y controles apropiados en contra de los altos precios de los medicamentos(AU)

Introduction: The World Health Organization recommended to Member States the implementation of various measures with the intention of ensuring the effective and equitable access to medicines, as well as its rational use in harmony with the environment. However, in Latin America access to health services and medicines has a mercantilist tendency, where marketing is done with nuances of profit which transgresses the rights of people who aspire to an improvement in that regard. Objective: To describe the access to medicines in Latin America and, specifically, in Costa Rica. Methods: This is a work of documentary research, with a qualitative approach, which was based on the search and selection of materials in databases of scientific publications, with the use of keywords. The search was organized in two sections: access to medicines in Latin America and access to medicines in Costa Rica. Conclusions: The efforts made are not enough to achieve the equitable access to medicines. There are still diverse causes that generate avoidable inequalities in order to reach the limited resources and higher cost´s drugs. Costa Rica reflects the same difficulties that the rest of the countries of the area. So, it must be taken into account the unequal and inadequate behaviours of some sectors of the population and create adequate educational strategies for their rational use; and to establish policies and appropriate controls against high prices of medicines(AU)

Measuring Availability, Prices and Affordability of Ischaemic Heart Disease Medicines in Bangi, Selangor, Malaysia

@#Background: This study is aimed to analyse the availability, prices and affordability of medicines for ischaemic heart disease (IHD) in Bangi, Selangor, Malaysia. Methods: A quantitative research was carried out using the methodology developed by the World Health Organization and Health Action International (WHO/HAI). The prices were compared with international reference prices (IRPs) to obtain a median price ratio. The daily wage of the lowest paid unskilled government worker was used as the standard of the affordability for the medicines. In this study, ten medicines of the IHD were included. The data were collected from 10 private medicine outlets for both originator brand (OB) and lowest-priced generic brand (LPG) in Bangi, Selangor. Results: From the results, the mean availability of OB and LPG were 30% and 42%, respectively. Final patient prices for LPG and OB were about 10.77 and 24.09 times their IRPs, respectively. Medicines that consumes more than a day’s wage are considered unaffordable. Almost half of the IHD medications cost more than one day’s wage. For example, the lowest paid unskilled government worker would need 1.4 days’ wage for captopril, while 1.2 days’ wage to purchase enalapril for LPG. Meanwhile, for OB, the costs rise to 3.4 days’ wage for amlodipine and 3.3 days’ wage for simvastatin. Conclusion: The findings of this study emphasise the need of focusing and financing, particularly in the private sector, on making chronic disease medicines accessible. This requires multi-faceted interventions, as well as the review of policies and regulations.

Un análisis de la crisis económica de Venezuela desde los postulados de la Escuela Austríaca de Economía / An analysis of the economic crisis in Venezuela from the postulates of the Austrian School of Economics / Uma análise da crise econômica na Venezuela desde os postulados da Escola Austríaca de Economia

Resumen Introducción: En este artículo se analiza la crisis económica de Venezuela desde la perspectiva de la Escuela Austríaca de Economía, la cual proporciona un instrumental analítico de gran valor para comprender las consecuencias del intervencionismo fiscal y monetario y desde hace tiempo ha planteado la imposibilidad de organizar de forma centralizada la economía. La situación actual de Venezuela hace necesario un estudio de las causas que han generado la profunda crisis política, económica y social por lo que se analizará la estructura productiva, la política monetaria, la fijación de precios máximos, el control de cambios y el endeudamiento externo. Objetivo: Explicar los efectos de la política económica que los sucesivos gobiernos de Venezuela han desarrollado para detectar las causas de la actual crisis económica y plantear propuestas de reforma que permitan revertir la situación en la medida de lo posible. Materiales y métodos: Se basa en el estudio de fuentes primarias como son la información macroeconómica de distintos centros de investigación y el análisis de los artículos y libros académicos más relevantes. Resultados: El socialismo real se desmoronó en Europa del este y Asia debido a la falta de productividad del sistema y la Escuela Austríaca de Economía advirtió en los años de entreguerra de la insostenibilidad de este modelo desde una perspectiva teórica. Conclusiones: Nuestro análisis muestra que el Socialismo del siglo XXI, del cual Venezuela es el máximo exponente, camina en la misma dirección y que el libre mercado es el único camino hacia la prosperidad económica.

Abstract Introduction: This article analyzes the economic crisis of Venezuela from the perspective of the Austrian School of Economics, which provides an analytical tool of great value to understand the consequences of fiscal and monetary interventionism and has long posed the impossibility of organizing Centralized way the economy. The current situation in Venezuela makes it necessary to study the causes that have generated the deep political, economic and social crisis, which will analyze the productive structure, monetary policy, the setting of maximum prices, exchange control and external indebtedness. Objective: Explain the effects of the economic policy that the successive governments of Venezuela have developed to detect the causes of the current economic crisis and propose reform proposals that allow the situation to be reversed as much as possible. Materials and methods: It is based on the study of primary sources such as the macroeconomic information of different research centers and the analysis of the most relevant academic articles and books. Results: Real socialism collapsed in Eastern Europe and Asia due to the lack of productivity of the system and the Austrian School of Economics warned in the interwar years of the unsustainability of this model from a theoretical perspective. Conclusions: Our analysis shows that the Socialism of the 21st century, of which Venezuela is the maximum exponent, walks in the same direction and that the free market is the only way to economic prosperity.

Resumo Introdução: Este artigo descreve a crise econômica na Venezuela é analisado do ponto de vista da Escola Austríaca de Economia, que fornece ferramentas analíticas de grande valor para compreender as consequências de intervencionismo fiscal e monetária e há muito tempo levantou a incapacidade de organizar Forma centralizada da economia. A situação atual na Venezuela torna necessário estudar as causas que geraram a profunda crise política, econômica e social, que analisaram a estrutura produtiva, a política monetária, a fixação de preços máximos, o controle cambial e o endividamento externo. Objetivo: Explique os efeitos da política econômica que os sucessivos governos da Venezuela desenvolveram para detectar as causas da atual crise econômica e propor propostas de reforma que permitam que a situação seja revertida o máximo possível. Materiais e métodos: Baseia-se no estudo de fontes primárias, como a informação macroeconômica de diferentes centros de pesquisa e a análise dos artigos acadêmicos e livros mais relevantes. Resultados: O real socialismo entrou em colapso na Europa Oriental e Ásia devido à falta de produtividade do sistema e a Escola Austríaca de Economia alertou nos anos entre guerras da insustentabilidade deste modelo de uma perspectiva teórica. Conclusões: Nossa análise mostra que o socialismo do século XXI, do qual a Venezuela é o maior expoente, anda na mesma direção e que o livre mercado é o único caminho para a prosperidade econômica.

The analysis and countermeasures of the overcharge problem of highly valued medical consumables in China / 中国卫生政策研究

Nowadays, the overcharge problem of some highly valued medical consumables is getting worse in China, leading its relevant treatment cost to be very high, which greatly increases the burden of medical expenses for the patients' treatment and forms a terrific reason of catastrophic health expenditure. It is advisable for the government attaching great importance to and take comprehensive measures to curb the overcharge for highly valued medical consumables. To solve this problem, it is suggested to cure the standard, cultivate national brands to break the monopoly of import products, improve the comprehensive regulatory mechanism of circulation and use to prevent some highly valued medical consumables being overpriced, strengthening oversight in the stage of use to restrain clinical abused behaviors, packaging pricing for these highly valued medical consumables to promote producers and operators to significantly reduce prices, and guiding the doctors in the choice of cost-effective medical supplies.

7．Health Technology Assessment from the Viewpoint of Patients and Patient Groups / 薬剤疫学

Patients can receive advanced medical care at a relatively low burden with the support of the system of the public health insurance for the whole nation and high-cost medical expense benefit in Japan. Despite these systems, some patients feel that they have many economic burden of medical care and cancer patient groups have demanded the reduction of economic burden. On the other hand some claim that the application of insurance to new drugs should be revised as the prices of new drugs are highly rising. As for health technology assessment cost-effectiveness evaluation is now being introduced from the point of cutting costs and patients now do not participate in the process of appraisal.

Study on Drug Pricing and Price-adjusting Mechanism Based on Drug Value / 中国卫生经济

It put forward the mechanism of drug pricing and price-adjusting based on classification of drug value.It can set different prices according to different value The higher the value is,the higher the price will be.It could embody the principle of good quality,good price so as to and ensure the unity of price and value.

Land use changes after the period commodities rising price in the Rio Grande do Sul State, Brazil / Mudanças no uso da terra depois do período de aumento de preço das commodities no Rio Grande do Sul, Brasil

ABSTRACT: At the end of the 20th and early 21st century, agricultural systems incorporated definitively a new mission: to generate goods for a world population that continues to grow and whose way of life demand food with low environmental impact. Soybean is the main raw material for the production of biodiesel in Brazil, accountably responsible for 82.4% of the total produced between 2006 and 2013. The Brazilian state of Rio Grande do Sul (RS), which is formed by the Pampa and the Atlantic forest biomes, was responsible for 35.7% of the country's biodiesel production in the referred period. The aim of this paper was to verify the impact of the increased area of soybean cultivation in land use in Rio Grande do Sul State, in the period between 1990 and 2015, considering separately its two biomes (Pampa and Atlantic Forest) original areas, using both census dataset and satellite images. We used the period from 1990 to 2000 as before commodity rising price (BCRP) and the period from 2000 to 2013 as commodity rising price (CRP). The 505,162 ha from Atlantic Forest biome and 1,192,115ha from Pampa biome were added to soybean production in the CRP period. In the Atlantic Forest, this enlargement occurred in the border of the main production area, while in Pampa biome conversion of natural grassland to crop land was the main reason for the large increment in the cultivated area.

RESUMO: No final do século XX e início do século XXI, os sistemas agrícolas incorporaram definitivamente uma nova missão: gerar energia para uma população mundial que continua a crescer e que demanda por seu modo de vida, não só alimentos, mas também, cada vez mais energia, principalmente, energia com baixo impacto ambiental. A soja permaneceu a principal matéria-prima para a produção de biodiesel no Brasil, no período de 2006 a 2013, em que foi responsável por 82,4%, sendo o estado do RS responsável por 35,7% do total da produção brasileira de biodiesel. O objetivo deste trabalho é verificar o impacto do aumento da área de cultivo de soja no uso da terra no Rio Grande do Sul, no período entre 1990 e 2015. Considera-se, separadamente, as áreas originais de seus dois biomas (Pampa e Mata Atlântica), usando o conjunto de dados do IBGE e imagens de satélite. Utilizou-se o período de 1990 a 2000 como o período anterior ao da suba de preços de commodities (BCRP) e, o período de 2000 a 2013 como período de aumento do preço das commodities (CRP). Um total de 505.162ha do bioma Mata Atlântica e de 1.192.115ha do bioma Pampa foram incorporados à produção de soja no período CRP. No bioma Mata Atlântica, o aumento ocorreu nos limites da área cultivada, enquanto que no bioma Pampa através da conversão da área com pastagem nativa.

Internet y su potencial en el marketing estratégico de precios: Una aproximación teórica y empírica

La dinámica de los procesos de desarrollo tecnológico digital se dio por la convergencia de las tecnologías de la información y la comunicación, en lo que hoy se denomina Internet. Señalándose a ésta como una eficaz herramienta estratégica de ventaja competitiva en las empresas, que logró interrelacionar y ampliar e internacionalizar los mercados en una red digital, mejorando de manera apreciable las relaciones con los clientes. El propósito del trabajo fue realizar un análisis bibliográfico del potencial del marketing digital estratégico desde la perspectiva de los precios y verificar el avance de la infraestructura tecnológica digital existente, de manera comparada. El trabajo se abordó en un análisis descriptivo de los trabajos precedentes, y cuantitativo desde los hechos reales del mercado internacional, en los periodos analizados, considerando la infraestructura tecnológica digital existente. Los resultados mostraron los avances del estado de la cuestión y los empíricos de las compras por Internet en el mundo por regiones. El artículo concluyó que los precios por Internet no indujeron la tendencia a la baja ni a la hipótesis del mercado perfecto. A la par los países desarrollados y Asia-Pacífico lideraron el mercado digital, mientras América Latina señaló prudencia comercial.

The dynamics of the processes of digital technology development was gave by the convergence of the information and communications technology in which today is called Internet.The prior has been pointed as an effective strategic tool for competitive advantage in business, which managed to interrelate, expand, and internationalize the markets in a digital network, improving the relationship with customers. The purpose of this study was to perform of international literature review of potential strategic digital marketing, from the perspective of prices and review the progress of the digital technology infrastructure, in a comparative way The work was addressed in a descriptive analysis of previous work and quantitative facts from the international market, in the periods analyzed, considering the digital infrastructure. The results showed the progress of international literature and the empirical advances in online shopping in the world by region. The article concluded that prices on the Internet did not induce downward trend or the perfect market hypothesis. Likewise, the developed countries and Asia-Pacific led the digital market, while Latin America showed commercial prudence.

A dinâmica dos processos de desenvolvimento de tecnologia digital deu a convergência das tecnologias de informação e comunicações, no que hoje é chamado de Internet. Apontando para ele como uma ferramenta estratégica eficaz para a vantagem competitiva nas empresas, que conseguiu se inter-relacionam e expandir e internacionalizar os mercados de uma rede digital, melhorando sensivelmente as relações com os clientes. O objetivo do estudo foi realizar uma revisão da literatura sobre o potencial de marketing digital estratégica dos preços perspectiva e verificar o progresso da infra-estrutura da tecnologia digital, forma comparativa. O trabalho foi abordada em uma análise descritiva dos trabalhos anteriores, e quantitativamente a partir dos fatos reais do mercado internacional, nos períodos analisados, considerando a infra-estrutura de tecnologia digital. Os resultados mostraram o progresso do estado de coisas e lojas empírica on-line no mundo por região. O artigo concluiu que os preços para o Internet não induziu tendência de queda ou a hipótese de mercado perfeito. Ao mesmo tempo, os países desenvolvidos e Ásia-Pacífico liderou o mercado digital, enquanto a América Latina disse prudência comercial.

Discussion on the Causes and Treatment Strategies of Artificially High Drug Prices / 中国药房

OBJECTIVE:To discuss the causes and related treatment strategies of artificially high drug prices. METHODS:The causes of artificially high drug prices were analyzed from drug price formation,distribution and trading,drug use in medical institutions and other aspects,in order to sort out the overall plan and treatment strategies of artificially high drug prices. RESULTS& CONCLUSIONS:Artificially high drug prices are resulted from not sound pricing mechanism,numerous circulation links,im-perfect procurement system,“drug maintaining medicine”mechanism of medical institutions and other factors. It is suggested to solve artificially high drug prices from perfecting drug market price formation mechanism,promoting circulation reform,improving centralized purchasing trading mechanism;at the same time,accelerating the reform of medicare payment system,deepening the re-form of public medical institutions operating mechanism and perfecting supervision laws and regulations so as to gradually improve the drug price administration system and realize reasonable drug pricing.

Dinâmica de produção e comercialização da erva-mate no Rio Grande do Sul, Brasil / Dynamics of production and commercialization of yerba mate in Rio Grande do Sul, Brazil

A produção de erva-mate é uma das atividades não madeireiras que compõe o mercado agroflorestal brasileiro. No Rio Grande do Sul, este segmento é impulsionado pela tradição do consumo do chimarrão. Entretanto, nos últimos anos, observa-se que o estado gaúcho vem perdendo parcela significativa do mercado nacional, principalmente para o estado do Paraná. Nesse sentido, o presente estudo objetiva compreender a dinâmica produtiva e de comercialização deste produto, a partir da análise do comportamento dos preços pagos aos produtores rurais de erva-mate no Rio Grande do Sul, os preços diretos aos consumidores da erva-mate para chimarrão, além de dados estatísticos relacionados à produção de erva-mate. Evidencia-se que o modelo econométrico realizado para estimar o valor da erva-mate, embora indique a existência de associação linear positiva entre as variáveis dependente e independente, é considerado estatisticamente frágil. Ainda, cerca de 80% das variações no preço do quilograma da erva-mate no varejo de Porto Alegre são explicadas pelas variações no preço da arroba da erva-mate paga aos produtores rurais. Assim, reitera-se a necessidade de análises adicionais para identificar quais fatores exercem maior influência sobre o mercado da erva-mate, no contexto de expansão da demanda nacional e internacional.

The production of yerba mate is one of the non-lumberman forest activities that compose the Brazilian agroforestry market. In Rio Grande do Sul, this segment is propelled by tradition of mate consumption. However, in recent years, it is observed that Rio Grande do Sul state has been losing significant share of the domestic market, mainly to the state of Paraná. In this sense, this study aims to understand the dynamics of production and marketing of this product, from the analysis of the behavior of prices received by farmers of yerba mate in Rio Grande do Sul, prices direct to consumers of yerba mate as well as statistical data related to production of yerba mate. It is evident that the econometric model conducted to estimate the value of yerba mate, while indicating the existence of positive linear association between the dependent and independent variables, is considered statistically frail. Moreover, about 80% of the variations in the price of the kilogram of yerba mate in retail Porto Alegre are explained by variations in the price of the bushel of yerba mate paid to Rio Grande do Sul farmers. Thus, is reiterated the need for additional analyzes to identify the factors that have an influence on the market for yerba mate in the context of expansion of national and international demand.

A cross-sectional survey of the models in Bihar and Tamil Nadu, India for pooled procurement of medicines.

Background: In India, access to medicine in the public sector is significantly affected by the efficiency of the drug procurement system and allied processes and policies. This study was conducted in two socioeconomically different states: Bihar and Tamil Nadu. Both have a pooled procurement system for drugs but follow different models. In Bihar, the volumes of medicines required are pooled at the state level and rate contracted (an open tender process invites bidders to quote for the lowest rate for the list of medicines), while actual invoicing and payment are done at district level. In Tamil Nadu, medicine quantities are also pooled at state level but payments are also processed at state level upon receipt of laboratory quality-assurance reports on the medicines. Methods: In this cross-sectional survey, a range of financial and non-financial data related to procurement and distribution of medicine, such as budget documents, annual reports, tender documents, details of orders issued, passbook details and policy and guidelines for procurement were analysed. In addition, a so-called ABC analysis of the procurement data was done to to identify high-value medicines. Results: It was observed that Tamil Nadu had suppliers for 100% of the drugs on their procurement list at the end of the procurement processes in 2006, 2007 and 2008, whereas Bihar’s procurement agency was only able to get suppliers for 56%, 59% and 38% of drugs during the same period. Further, it was observed that Bihar’s system was fuelling irrational procurement; for example, fluconazole (antifungal) alone was consuming 23.4% of the state’s drug budget and was being procured by around 34% of the districts during 2008–2009. Also, the ratios of procurement prices for Bihar compared with Tamil Nadu were in the range of 1.01 to 22.50. For 50% of the analysed drugs, the price ratio was more than 2, that is, Bihar’s procurement system was procuring the same medicines at more than twice the prices paid by Tamil Nadu. Conclusion: Centralized, automated pooled procurement models like that of Tamil Nadu are key to achieving the best procurement prices and highest possible access to medicines.

Problems and outlook of quality evaluation of Chinese materia medica under guidance of modern scientific thinking / 中草药

The treatment and prevention effects of traditional Chinese medicine (TCM) depend primarily on the quality of resources and decoction pieces, and the quality of Chinese crude drugs is mainly reflected in the genuineness, wildness, growing time, and product compliance. Now the quality of Chinese materia medica resources is evaluated by chemical index components identification in Chinese Pharmacopoeia, to some extent, evaluation criteria were standardized. However, the market with imperfect mechanism gave criminals an opportunity to manufacture counterfeit products. Remedy traditional methods should be combined with modern technology in order to promote the sound development of TCM health industry.

Impacto en el acceso a medicamentos en la población colombiana después de la actualización del plan de beneficios en el 2012 / Impact on the Access to Medication in Colombian Population after the Benefit Plan Update in 2012 / Impacto no acesso a remédios na populagáo colombiana após a atualizagáo do plano de beneficios no 2012

Objetivo: evaluar los cambios en la demanda de servicios en salud, luego de la actualización del plan de beneficios de Colombia, entre los años 2010 y 2012. Métodos: estudio tipo descriptivo y explicativo, donde se evalúa el uso de tecnologías sanitarias antes y después de la actualización del Plan Obligatorio de Salud. Se tomaron las dispensaciones de medicamentos entre el 2010 y el 2012 del Sistema de Información de Precios de Medicamentos. Para valorar los cambios se construyó una escala de valoración de cambios porcentuales. Resultados: se evidenciaron cambios en el comportamiento de la demanda de servicios. Como se esperaba, la actualización del Plan de Beneficios representa para los pacientes mayor acceso a las nuevas tecnologías, medido a través del mayor uso de tecnologías nuevas. Conclusión: la actualización del plan de beneficios mejoró el acceso de los pacientes a una gran parte de los servicios de salud.

Objective: Assessing the changes in the demand of health services after the update of the benefit plan in Colombia, during 2010 and 2012. Methods: Descriptive and Explanatory type study, where the use of healthcare technologies before and after the update of the Compulsory Health Plan is assessed. We took the drug dispensations between 2010 and 2012 from the Drug Price Information System. To assess the changes, we made an evaluation scale of percentage changes. Results: We found evidence of changes in the behavior of the demand of services. As expected, the update of the Benefits Plan represents greater access to new technologies, measured through a greater use of new technologies. Conclusion: The update of the Benefits Plan improved access for patients to a large part of the health services.

Objetivo: avaliar as mudancas na demanda de servicos em saúde, após atualizacao do plano de beneficios da Colombia, entre os anos 2010 e 2012. Métodos: estudo tipo descritivo e explicativo, onde avalia-se o uso de tecnologias sanitarias antes e depois da atualizacao do Plano Obrigatório de Saúde. Tomaram-se as dispensares de medicamentos entre o 2010 e 2012 do Sistema de Informacao de Precos de Medicamentos. Para avaliar as mudancas foi construída uma escala de valoracao de mudancas porcentuais. Resultados: evidenciaram-se mudancas no comportamento da demanda de servicos. Como esperado, a atualizacao do Plano de Beneficios representa para os pacientes maior acesso as novas tecnologias, medido a través do maior uso de tecnologia nova. Conclusao: a atualizacao do plano de beneficios melhorou o acesso dos pacientes a uma grande parte dos servicos de saúde.

A Micro-costing Model of Neonatal Intensive Care from a Tertiary Indian Unit: Feasibility and Implications for Insurance.

Objective: To calculate and compare costs of neonatal intensive care by micro-costing and gross-costing methods. Methods: The costs of resources of a tertiary care neonatal intensive care unit were estimated by the two methods to arrive at specific costs per diagnosis related categories for 33 neonates followed-up prospectively. Results: Grosscosting as compared to micro-costing resulted in higher cost per bed (Rs 6315 vs. Rs 4969) and wide variations of costs (-34.8% to +13.4%). Intensity of interventions, relative stay in neonatal intensive care unit compared to the step-down nursery, and total length of hospital admission accounted for these variations. Conclusions: Estimates based on micro-costing arrived in this study may be used as a starting point in developing assumptions for insurance models covering neonatal intensive care.