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Drugs anticipated to be selected for Medicare price negotiation in 2026 for implementation in 2028
No full textBACKGROUND: The 2028 incorporation of Part B drugs into the Medicare Drug Price Negotiation Program, established by the Inflation Reduction Act (IRA), introduces several unique challenges. The Centers for Medicare & Medicaid Services (CMS) final guidance for Initial Price Applicability Year (IPAY) 2028 indicates that both traditional fee-for-service Medicare and Medicare Advantage encounter data will be used to identify eligible Part B drugs. Furthermore, the newly enacted One Big Beautiful Bill Act of 2025 (OBBBA) also has implications for which drugs are selected because of its expanded “Orphan Drug Exclusion” criteria. OBJECTIVE: To predict 15 drugs likely to be selected for IPAY 2028. METHODS: Using CMS’s 2020-2023 Part D and Part B Spending by Drug datasets and 2024 Average Sales Price Pricing Files, we projected 2024 expenditures for Part D and B drugs separately via regression models for utilization and pricing trends. Utilization and pricing were multiplied to estimate 2024 gross expenditures. Exclusion criteria were then applied, consistent with the IRA, OBBBA, and final CMS guidance, to arrive at 50 Part B and 50 Part D negotiation-eligible products. We selected 15 IPAY 2028 products based on their ranked combined Parts B and D 2024 projected gross expenditures. RESULTS: The 15 selected drugs had projected 2024 expenditures above $800M, with 8 biologics and 7 small molecule drugs, and 7 Part B and D products and 8 exclusively Part D products. OBBBA significantly alters eligibility, delaying eligibility for 5 products and excluding at least 3 products from future negotiations. CONCLUSIONS: Part B drugs will be negotiated for the first time in IPAY 2028. Policy changes, such as the OBBBA, exclude several high-cost products from negotiation. These policy decisions have major implications for how the Drug Price Negotiation Program targets high-spend drugs and achieves meaningful savings for the Medicare program
Implementation science in Africa-whose epistemology counts?
Get PDFImplementation science, although promising to bridge the know-do gap in global health, has inadvertently created new forms of epistemic exclusion in African health systems. In this Viewpoint, we present an empirical critique of how widely used implementation frameworks, rooted in Eurocentric and North American epistemologies, systematically fail to recognise the mechanisms through which successful implementation occurs in African contexts. Drawing on case studies across diverse African settings, we reveal how this epistemological mismatch undermines both the science and practice of implementation in African health systems. Using epistemic injustice theory, we show how frameworks operationalise constructs in ways that treat traditional governance, community legitimacy, and relational authority as peripheral variables rather than generative mechanisms of change. We propose concrete transformations to implementation science that centre African epistemological traditions and require genuine power-sharing in knowledge production to support health system improvement across all contexts
Humanitarian concerns and acceptance of Syrian refugees in Turkey
Get PDFDo humanitarian concerns increase support for hosting refugees? Evidence from Western democracies suggests they do, but do they matter elsewhere? We theorize that humanitarian motivations—concern for torture victims—make host societies more willing to welcome refugees regardless of background. Based on a conjoint experiment in Turkey (N = 2,362), Syrian refugee profiles indicating torture receive higher support than otherwise-similar profiles without torture. This effect is modest compared to other drivers and Western findings, yet increases support uniformly across torture victims regardless of ethnicity, religion, education, or civil war involvement. The effect extends across neighborhood residence, work permits, and citizenship, resonating broadly across respondents. Gender is the sole significant moderator, with information about torture having a stronger effect on female respondents. These findings demonstrate that humanitarian concerns persist even in contexts of mass displacement and economic strain, though their influence remains limited relative to ethnic and religious considerations
Markets and new industrial policy: systemic directionality or polycentric evolutionism?
Get PDFProponents of “new industrial policy” claim that systemic directionality can be imparted to market economies in ways recognising the epistemic challenges of complexity and uncertainty. This paper evaluates these efforts to reformulate industrial policy on a more epistemically modest, evolutionary footing and argues that they fail. We contend that the focus on “systemic directionality” undercuts the emphasis placed on evolutionary learning and the epistemic limitations of centralised authority. Proper attention to these problems implies neither a laissez-faire/market fundamentalist position nor one that favours “systemic directionality.” Rather, it points towards a largely directionless environment where market-state entanglements arise through a polycentric evolutionism at multiple different scales
Multivariate kernel regression in vector and product metric spaces
Get PDFThis paper derives limit properties of nonparametric kernel regression estimators without requiring existence of density for regressors in R q. In functional regression limit properties are established for multivariate functional regression. The rate and asymptotic normality for the Nadaraya–Watson (NW) estimator is established for distributions of regressors in R q that allow for mass points, factor structure, multicollinearity and nonlinear dependence, as well as fractal distribution; when bounded density exists we provide statistical guarantees for the standard rate and the asymptotic normality without requiring smoothness. We demonstrate faster convergence associated with dimension reducing types of singularity, such as a fractal distribution or a factor structure in the regressors. The paper extends asymptotic normality of kernel functional regression to multivariate regression over a product of any number of metric spaces. Finite sample evidence confirms rate improvement due to singularity in regression over R q. For functional regression the simulations underline the importance of accounting for multiple functional regressors. We demonstrate the applicability and advantages of the NW estimator in our empirical study, which reexamines the job training program evaluation based on the LaLonde data
Routledge handbook of Punjab studies
No full textThe Routledge Handbook of Punjab Studies offers a comprehensive introduction to the field of Punjab studies. Chapters cover the history, politics, economics, culture, religion and society as well as the Punjab diaspora, and the Handbook is structured into six parts: Punjab, Partition and Beyond; Economic Development: Labour, Resources and Challenges; Political Contestations and Movements; Cultural Repositioning: Language, Literature and the Arts; Religion, Caste and Gender; and Diasporic Dilemmas. Topics explored include migration, memory, anti-colonialism, industrialisation, federalism, river water disputes, agriculture, ecology, communism, conflict, militancy, counter-insurgency, poetry, cinema, plays, music, theology, sexuality, inequality, tribal marginalisation, multiculturalism, diasporic homeland connections and gender-based violence. Providing an interdisciplinary analysis by a set of international contributors, this Handbook will be an indispensable resource for researchers and students in the field of South Asian studies in general and Sikh and Punjab studies in particular
Beyond manoeuvre theory for European defence
Get PDFThis article contributes to the debate about European defence in the light of the Russo‐Ukraine war and growing doubts about US commitment to Europe. It argues that Europeans need to fundamentally relearn the ability to imagine military strategy from a European viewpoint. In a first step, we investigate the influence of manoeuvre theory in NATO thinking. In a second step, we engage with the growing manoeuvre‐critical literature and come to the conclusion that manoeuvre theory does not hold the answer for European strategic challenges vis‐à‐vis Russia. In a third step, we reappraise alternative defence concepts mainly developed in West Germany during the 1980s as a source for rethinking European conventional defence and deterrence in the nuclear age. We argue that, even though concepts such as ‘spider‐in‐the‐web’ do not offer ready‐made blueprints, they do provide conceptual impulses to (re)think positional defence in the nuclear age. Finally, we point out avenues for future research
How do you identify a good manager?
No full textWe introduce and validate a novel approach to identifying good managers. In a preregistered lab experiment, we causally identify managerial contributions by randomly assigning managers to teams and controlling for individual skill. We find that manager contributions are crucial for team success, and that people who self-select into management roles perform worse than randomly assigned managers. Managerial performance is strongly predicted by economic decision-making skill but not by demographic characteristics. Two validation studies support our experimental results. Participants who succeed in the lab receive more real-world promotions and, in a separate study of retail store managers, skill measures strongly predict store sales. A one standard deviation increase in manager quality increases annual per store sales by US$4.1 million (25% increase). Selecting managers on skills rather than demographic characteristics or the desire to lead could substantially improve organizational performance
Analyzing parliamentary voting dynamics using multiple aspects trajectory clustering approach
No full textMultiple aspects trajectory (MAT) is a relevant concept that enables mining useful patterns and behaviors of moving objects for different applications. As a new way of looking at trajectories, MAT includes a semantic dimension, and thus presents the notion of aspects that are relevant facts of the real world that add more meaning to spatio-temporal data. Considering the possibilities of this new algorithmic paradigm, we decided to test it on political data. More specifically, we look at legislative voting behavior to understand political alignment, coalition dynamics, and governance patterns. Traditional data mining approaches do not capture the temporal motifs of parliamentary voting patterns. We address this gap by employing the MAT-Tree algorithm, a hierarchical clustering method for multiple aspects trajectories, to analyze twenty years of voting data of the Brazilian Chamber of Deputies. We aim to reveal hidden patterns, such as voting similarities and alignments, by analyzing the data from the perspective of multiple aspects, thereby enabling a multidimensional analysis of voting patterns. The experimental results demonstrate that MAT-Tree identifies cohesive voting blocks, shifts in legislative support, and outlier behaviors across different political periods. Furthermore, the analysis reveals critical patterns, including increased polarization in post-impeachment periods and evolving dynamics between government and opposition. Thus, these findings highlight the potential of MAT clustering with MAT-Tree as a robust tool for political analysis, providing a scalable framework for exploring multidimensional datasets that go beyond mobility data
Notes on campist internationalism
No full textAyça Çubukçu offers a sharp critique of "campist" left politics and discusses the potential for an internationalism from below