A high prevalence of C-shaped canals and a low incidence of three-rooted molars were observed in the mandibular second molars of the Korean subpopulation studied.

Objective To compare the market dynamics of biosimilar infliximab among four Organization for Economic Cooperation and Development (OECD) countries (UK, France, Japan, and Korea) where supply-side and demand-side policies varied greatly, given high and growing expenditure on biological medicines to treat immunological diseases across countries. Methods A quarterly dataset covering October 2012 to March 2018 was constructed from the MIDAS-IQVIA International database. The sales value (in USD) and volume (in standard units) of originator infliximab and biosimilar products and their relative price in each country were compared. Results With the introduction of biosimilars, the sales value of infliximab increased approximately 2.5 times in Korea, whereas it only slightly increased (1.2 times for France and the UK) or decreased (0.9 for Japan) in other countries. While stable market size dynamics were observed in the other countries, an escalating market size, attributable to the increase in originator infliximab, was observed in Korea. In the UK and France, which have implemented demand-side policies, the sales volume of originator infliximab appreciably decreased after the entry of biosimilar infliximab while that of biosimilars increased; however, in Korea, which has supply-side policies based on price-linking with few demand-side policies, the volume of originator infliximab actually increased by 70% alongside a very limited increase in biosimilar infliximab. The lowest price ratio between biosimilar and originator infliximab was found in Japan, at 68%. In France and Korea, the ex-factory prices of biosimilar infliximab were 99 and 95%, respectively, of the originator infliximab price. In the UK, the ex-factory price of biosimilar infliximab started at 87% of that of originator infliximab and then decreased to 80% as the market matured. However, actual price differences might differ. Conclusion The uptake of biosimilar infliximab varied greatly, and in contrast to the UK, France, and Japan, the introduction of biosimilar infliximab resulted in market expansion in Korea, which might be explained by a lack of demand-side policies in Korea. Both supply- and demand-side measures are necessary for health authorities to achieve desired savings from the availability of biosimilars.

After deesterification of commercial pectins with a pectin methyl esterase (PME), their gelling properties were characterized using instrumental texture analysis. The final degree of esterification (DE) of the high- and low-methoxy pectins reached approximately 6% after the PME treatment, while deesterification of low-methoxy amidated pectin stopped at 18% DE. Furthermore, DE of high-methoxy pectin was tailored to be 40%, which is equivalent to the DE of commercial low-methoxy pectin. As a result, significant changes in molecular weight (Mw) distribution were observed in the PME-treated pectins. The texture profile analysis showed that PME modification drastically increased hardness, gumminess, and chewiness, while decreasing cohesiveness and adhesiveness of the pectin gels (P < 0.05). The pectin gel with relatively high peak molecular weight (Mp, 3.5 x 10(5)) and low DE (6), which was produced from high-methoxy pectin, exhibited the greatest hardness, gumminess, chewiness, and resilience. The hardness of low-methoxy amidated pectin increased over 300% after PME deesterification, suggesting that the effects of amide substitution could be reinforced when DE is even lower. The partial least square regression analysis indicated that the Mw and DE of the pectin molecule are the most crucial factors for hardness, chewiness, gumminess, and resilience of gel matrix.

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of new innovation in this evolving environment. Methods: A retrospective analysis was conducted across a convenience sample of studies (n=24) reported in the public domain since January 2016 involving the pricing in selected European markets of new innovative biologics (JAK inhibitors and Interleukins) in inflammatory disease areas, including RA and Psoriasis, where biosimilar TNF entry has occurred. The studies involved secondary and primary research, system dynamics modelling, and war gaming (competitive simulation). Results: The study identified the drivers of pricing decisions, including the extent to which incremental clinical value was incorporated into pricing decisions; and the extent to which multi-criteria decisionmaking (involving factors other than price) was incorporated into procurement decisions. The analysis further identified 3 distinct forms of price referencing that impacted new innovation and the different roles that the list and net prices played in these. In some countries the pricing of new innovation appeared to be entirely driven by reference pricing. Whilst list prices may appear to be stable, all players appeared to regularly adjust their effective net prices in order to win, whilst indirectly attempting to slow down the shift to price commoditisation where all parties, including the innovators, lose. Conclusions: A critical success factor for any company playing in this dynamic market will be the ability to track both net price and therapy choice, and to use this insight to determine the real-time pricing decisions that maximize opportunity and minimize risk.