Journal of Medical Economics最新文献

{"title":"Health and economic impact of the 21-valent pneumococcal conjugate vaccine (V116) for adults in Japan: a delta price approach.","authors":"Peter P Mueller, Atsushi Tajima, Kelsie Cassell, Taizo Matsuki, Nicole Cossrow, Zinan Yi, Kelly D Johnson, Kwame Owusu-Edusei","doi":"10.1080/13696998.2024.2445429","DOIUrl":"10.1080/13696998.2024.2445429","url":null,"abstract":"<p><strong>Introduction: </strong>This study analyzed the health and economic impact of the 21-valent pneumococcal conjugate vaccine (V116) and the 20-valent pneumococcal conjugate vaccine (PCV20), as well as their relative cost-effectiveness, in Japanese adults aged 65 years using a delta pricing approach.</p><p><strong>Methods: </strong>A Markov model was employed to simulate the movement of the Japanese population among four health states: healthy, pneumococcal disease (consisting of invasive pneumococcal disease [IPD] with or without meningitis and non-bacteremic pneumococcal pneumonia [NBPP]), post-meningitis sequelae, and death. The model was populated with publicly available demographic and epidemiologic data, stratified by risk level. Pneumococcal serotype distribution and vaccine effectiveness, as well as direct and indirect treatment costs and health-related utilities, were derived from published sources. The model used a lifetime horizon and 2% discounting of costs and life-years. Costs were adjusted to 2023 values in Japanese yen (¥). Outcomes were cases and deaths, life-years and quality-adjusted life-years (QALYs), vaccination and treatment costs, and incremental cost-effectiveness ratios. The range over which V116 was cost-saving and cost-effective was determined.</p><p><strong>Results: </strong>Compared to PCV20, V116 averted an additional 28 cases of IPD, 918 cases of NBPP, 5 deaths from IPD, and 51 deaths from NBPP over the lifetime of a single age 65 cohort. Life-years and QALYs gained were 1,019 and 642, respectively, relative to PCV20; V116 saved ¥733 million in direct medical costs and ¥557 million in indirect costs, compared to PCV20. V116 was found to be cost-saving at price premiums up to ¥1,322 (payer perspective) or ¥2,327 (societal perspective) and remained below a willingness-to-pay threshold of ¥5 million/QALY for premiums up to ¥7,113 (payer perspective) or ¥8,117 (societal perspective).</p><p><strong>Conclusions: </strong>V116 is projected to provide more population health benefits in Japan than PCV20, and to be cost-effective at a variety of price premiums.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"136-145"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Budget impact of introducing glofitamab for treatment of relapsed or refractory diffuse large B-cell lymphoma after two or more lines of systemic therapy in the United States.","authors":"Zahra Mahmoudjafari, Jia Li, Eric Bercaw, Hélène Parisé, Katalin Bognar, Si-Tien Wang, Anthony Masaquel","doi":"10.1080/13696998.2025.2486839","DOIUrl":"10.1080/13696998.2025.2486839","url":null,"abstract":"<p><strong>Background: </strong>Glofitamab is a T-cell engaging bispecific monoclonal antibody that was granted accelerated approval from the United States Food and Drug Administration for adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified or large B-cell lymphoma arising from follicular lymphoma, after ≥2 lines of systemic therapy (3L+).</p><p><strong>Methods: </strong>A budget impact model was developed for a hypothetical blended commercial/Medicare health plan with 1,000,000 members. Comparators were axicabtagene ciloleucel (Axi-cel), lisocabtagene maraleucel (Liso-cel), tisagenlecleucel (Tisa-cel), loncastuximab tesirine, polatuzumab vedotin + bendamustine + rituximab, rituximab + gemcitabine + oxaliplatin, tafasitamab + lenalidomide, and epcoritamab (Epcor). Total costs included those for drugs, wastage, administration, grade ≥3 adverse reactions, and all-grade cytokine release syndrome) and routine care. Market shares were based on internal projections and expert opinions. Total and per-member per-month (PMPM) net budget impacts over 3 years were calculated.</p><p><strong>Results: </strong>Approximately nine patients were projected to be eligible for 3L + DLBCL treatment in a health plan of 1,000,000 members. The introduction of glofitamab as a treatment option resulted in estimated total and PMPM cost savings of $728,697 and -$0.0202, respectively, over 3 years. Costs were reduced across all cost categories but particularly in drug costs. Among the newer therapies, total 3-year cost per treated patient was lowest for glofitamab: $226,658 versus Tisa-cel = $564,113; Axi-cel = $540,002; Liso-cel = $516,272; and Epcor = $335,293. Across all sensitivity analyses, the inclusion of glofitamab had minimal PMPM budget impact, ranging from -$0.0256 to -$0.0108.</p><p><strong>Conclusions: </strong>With the lowest 3-year total cost per treated patient among the newer therapies, glofitamab being an available option in the 3L + DLBCL market is estimated to save a hypothetical 1,000,000-member health plan $728,697 in cumulative total costs and $0.0202 in PMPM costs over 3 years.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"595-604"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The multiple criteria qualitative value-based pricing framework \"MARIE\" for new clinical status.","authors":"Akina Takami, Naotaka Sakashita, Tatsuhiro Uenishi, Ayako Shoji, Ataru Igarashi","doi":"10.1080/13696998.2025.2492478","DOIUrl":"https://doi.org/10.1080/13696998.2025.2492478","url":null,"abstract":"<p><strong>Background: </strong>Adjustment of drug prices after the change of their clinical status in the current drug pricing system in Japan functions as an appropriate allocation mechanism for drug expenditures under the universal health insurance system. However, the failure to incorporate a drug's value when determining its price decreases pharmaceutical companies' motivation to develop and launch novel drugs in Japan.</p><p><strong>Methods: </strong>In this study, we applied the value-based pricing framework MARIE to drugs with new clinical status. We estimated drug prices at the time of approval for the initial indication and new clinical status, with a total of 32 drugs by using MARIE. To estimate maximum number of patients for the new clinical status, we referred to the market expansion rate and calculated it backwards.</p><p><strong>Results: </strong>As a result, the median change of MARIE-estimated price under new clinical status against those under initial indication was -50.24% (range, -80.36% to 16.39%). For the initial indication, the median ratio of the drug price estimated with MARIE to the initial list price was 122.12% (range, 15.57% to 2237.38%); the median ratio of actual to estimated drug price were similar to those in our previous study (125.65%).</p><p><strong>Conclusions: </strong>We proposed the versatile, practical, convenient, multiple criteria, qualitative VBP framework MARIE for the new clinical status. Under the MARIE system, price would only be changed when the \"box\" (category of the maximum number of patients) in the conversion table of the maximum number of the patients changes as the environment changes.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"606-614"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axicabtagene ciloleucel compared to standard of care in Canadian patients with relapsed or refractory large B-cell lymphoma: a cost-effectiveness analysis of the ZUMA-7 trial.","authors":"John Kuruvilla, Laurie H Sehn, Sydney Whitney, Anik R Patel, Heather Cameron, Geoffrey G J Reid","doi":"10.1080/13696998.2025.2498853","DOIUrl":"https://doi.org/10.1080/13696998.2025.2498853","url":null,"abstract":"<p><strong>Aims and background: </strong>In the pivotal ZUMA-7 trial, second-line (2L) treatment with axicabtagene ciloleucel (axi-cel) had superior clinical outcomes compared to standard of care (SOC; salvage chemoimmunotherapy followed by high-dose therapy and autologous stem cell transplant in responders) in patients with large B-cell lymphoma (LBCL) who were refractory or relapsed (r/r) within 12 months of completion of frontline therapy. The aim of this analysis was to evaluate the cost-effectiveness of axi-cel compared to SOC for 2L LBCL in Canada.</p><p><strong>Methods: </strong>A 3-health state partitioned-survival model was used to estimate the cost-effectiveness of axi-cel vs. SOC from a Canadian healthcare system perspective. Clinical outcomes were informed by ZUMA-7. The model calculated expected quality-adjusted life years (QALYs), total costs, and the incremental cost-effectiveness ratio (ICER).</p><p><strong>Results: </strong>Over a lifetime horizon, the model estimated a total of 9.48 and 7.25 QALYs, and total costs of $569,168 and $337,906 for axi-cel and SOC, respectively, resulting in an ICER of $103,810/QALY. When adjusting for the substantial proportion of patients in the SOC arm who received cellular therapy as subsequent treatment, the ICER was reduced to $78,555/QALY.</p><p><strong>Conclusions: </strong>Treatment with axi-cel in 2L is a cost-effective option that addresses an important unmet clinical need for Canadian patients with r/r LBCL.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"688-695"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addendum.","authors":"","doi":"10.1080/13696998.2025.2524268","DOIUrl":"https://doi.org/10.1080/13696998.2025.2524268","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"986"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of population-based and cohort-based models in cost-effectiveness analysis: a case study of pneumococcal conjugate vaccines in infants in Germany.","authors":"Johnna Perdrizet, Dominik Schröder, Felicitas Kühne, Julia Schiffner-Rohe, Maren Laurenz, Christian Theilacker, Aleksandar Ilic, An Ta, Christof von Eiff","doi":"10.1080/13696998.2025.2536430","DOIUrl":"10.1080/13696998.2025.2536430","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this analysis is to evaluate the impact of model choice (closed single-cohort versus population-based) in cost-effectiveness analysis (CEA) using pneumococcal conjugate vaccines (PCVs) in infants in Germany as a case study.</p><p><strong>Methods: </strong>Two Markov models were developed: one with a closed single-cohort model and one with a population-based model. Except for the design of the modelled population/cohort, all other inputs and characteristics were kept identical between the models. Comparators included PCV20 under a 3 + 1 vaccination schedule versus PCV13 and PCV15 under a 2 + 1 vaccination schedule. Health and economic outcomes were compared between the two models.</p><p><strong>Results: </strong>The population-based model demonstrated that PCV20 was cost-saving and provided better health outcomes compared to both PCV13 and PCV15, indicating PCV20 as the dominant strategy with negative ICERs per QALY. In contrast, the closed single-cohort model showed PCV20 was associated with higher total costs compared to PCV13 and PCV15.</p><p><strong>Conclusion: </strong>This analysis highlights the importance of accurately identifying the relevant population when conducting CEAs of vaccines. This is particularly crucial when a vaccine produces indirect effects in individuals who are not directly vaccinated, as this otherwise leads to an underestimation of cost-effectiveness.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1191-1197"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delay in receiving lab test results increases the costs of treating an episode of care for treating urinary tract infections.","authors":"Kenneth E Thorpe, Peter J Joski","doi":"10.1080/13696998.2025.2527509","DOIUrl":"10.1080/13696998.2025.2527509","url":null,"abstract":"<p><strong>Aims: </strong>To provide the first national study examining the impact on the health care costs of treating an episode of urinary tract infection as a function of the time delay in receiving antimicrobial susceptibility test results.</p><p><strong>Methods: </strong>We used a nationally representative data set of privately insured adults and dependents. Our retrospective analysis included those receiving a urine bacteria test and susceptibility testing and ultimately diagnosed with a urinary tract infection. Using regression analysis, we estimate episode of care-based treatment costs associated with each day of delay in receiving susceptibility test results controlling for patient age, gender, and number of comorbid conditions.</p><p><strong>Results: </strong>Delays in receiving test results that allow for filling a prescription or a diagnosis increase health plan treatment costs. The analysis looked at patients with a susceptibility test and an ultimate diagnosis of urinary tract infection. We examined the days between the test and two outcomes, the diagnosis and the prescription filled. Even 1 day of delay added over $1,600 (2022 US dollars) in health plan spending to treat the condition. These additional costs were traced to increased hospitalizations for the condition for each day of delay. Delays in prescriptions filled added the most to treatment costs. Receiving test results on the day of test could reduce treatment costs by 40%.</p><p><strong>Limitations: </strong>There are a whole range of bacterial tests. The analysis focused on only one - a urine bacterial and susceptibility culture test - and was limited to patients ultimately diagnosed with urinary tract infection.</p><p><strong>Conclusions: </strong>The analysis provides the first national estimates of the increased costs of treating urinary tract infections due to delays in receiving test results. Slow turnaround times in receiving test results for bacterial infections increase hospitalizations and health plan and employer spending for treating infections. We need new technologies that allow for rapid results for these tests.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1037-1044"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of semaglutide 2.4 mg on healthcare resource utilization and medical costs in patients with atherosclerotic cardiovascular disease in the United States (SHINE-ASCVD).","authors":"Wojciech Michalak, Zhenxiang Zhao, Mads Faurby, Sara Alvarez, Angela Fitch","doi":"10.1080/13696998.2025.2526282","DOIUrl":"10.1080/13696998.2025.2526282","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality. Semaglutide 2.4 mg (Wegovy) has demonstrated improved outcomes in patients with overweight or obesity (ov/ob) and ASCVD, but its impact on medical costs and healthcare resource utilization (HCRU) remains unknown.</p><p><strong>Aims: </strong>To compare all-cause medical costs and HCRU among patients with ov/ob and ASCVD treated with semaglutide 2.4 mg versus semaglutide-untreated controls.</p><p><strong>Materials and methods: </strong>This observational cohort study utilized Komodo's Healthcare Map and included patients with ov/ob and ≥1 diagnosis of ASCVD during the baseline period with ≥12 months of insurance coverage before and after the index date. Patients in the semaglutide 2.4 mg cohort initiated treatment after 4 June 2021 and stayed adherent. Semaglutide-untreated controls were randomly selected and 1:4 propensity score matched based on baseline demographics, clinical characteristics, medical costs, and HCRU. Medical costs and HCRU were compared using generalized linear models.</p><p><strong>Results: </strong>770 semaglutide 2.4 mg-treated patients and 3,080 controls were included. In the year following treatment initiation, semaglutide 2.4 mg was associated with 22% lower mean medical costs versus controls (-$4,639 per patient per year [PPPY]; cost ratio = 0.78, 95% confidence interval [CI] 0.67, 0.89). This difference is mainly due to lower inpatient costs with semaglutide 2.4 mg, which were 65% lower than controls (-$3,593; cost ratio = 0.35 [95% CI 0.21, 0.49]), along with a 48% lower inpatient visit rate (0.08 vs. 0.15; rate ratio = 0.52 [95% CI 0.34, 0.70]).</p><p><strong>Limitations: </strong>Limitations inherent to retrospective claims analyses apply to this study.</p><p><strong>Conclusions: </strong>This real-world analysis shows significantly lower annual medical costs and HCRU with semaglutide 2.4 mg versus no semaglutide 2.4 mg treatment in patients with ov/ob and ASCVD. Improving outcomes with semaglutide 2.4 mg combined with lower costs and HCRU may help slow the growing burden of ASCVD in this population.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1075-1085"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/13696998.2025.2477381","DOIUrl":"https://doi.org/10.1080/13696998.2025.2477381","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"363"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of bispecific antibody faricimab for treatment of neovascular age-related macular degeneration and diabetic macular edema in Japan.","authors":"Yasuo Yanagi, Jun Tsujimura, Shinya Ohno, Kentaro Higashi, Naotaka Sakashita, Ayako Shoji, Ataru Igarashi","doi":"10.1080/13696998.2025.2478755","DOIUrl":"10.1080/13696998.2025.2478755","url":null,"abstract":"<p><strong>Objective: </strong>To assess the cost-effectiveness of faricimab <i>vs.</i> other anti-vascular endothelial growth factor (anti-VEGF) drugs for treatment of neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) in Japan, while considering societal burden associated with treatment.</p><p><strong>Methods: </strong>A Markov model for cost-effectiveness analysis of anti-VEGF treatment in patients with nAMD and DME was applied based on cost and utility value data from Japan. Faricimab administered through a treat-and-extend (T&E) regimen was compared with ranibizumab administered pro re nata (PRN) and T&E, aflibercept T&E, brolucizumab T&E, and best supportive care (BSC). Further to treatment costs (public payer perspective), the societal burden (societal perspective), including costs of travel, informal care, and productivity, was assessed.</p><p><strong>Results: </strong>In treatment of nAMD, lifetime quality-adjusted life years (QALYs) gained were highest with faricimab (faricimab T&E: 6.92, ranibizumab PRN: 6.88, ranibizumab T&E: 6.91, aflibercept T&E: 6.89, brolucizumab T&E: 6.89, BSC: 5.99). From the public payer perspective, the lifetime total cost for faricimab T&E was lower than those for ranibizumab (PRN, T&E) and brolucizumab (T&E), comparable to aflibercept T&E, and higher than BSC (incremental costs: 158,385 and 6,475,511 JPY, respectively). As a result, faricimab was cost-effective or dominant in the treatment of nAMD, excluding BSC. From the societal perspective, faricimab was dominant against all comparators in nAMD. In treatment of DME, QALYs gained were highest with faricimab (faricimab T&E: 8.51, ranibizumab PRN: 8.17, aflibercept PRN: 8.36, ranibizumab T&E: 8.13, BSC: 5.16). From both the public payer and societal perspectives, faricimab was dominant against all comparators in DME.</p><p><strong>Conclusions: </strong>When societal burdens were considered, faricimab was dominant in both nAMD and DME against all comparators, suggesting that the extended dosing interval associated with faricimab treatment may alleviate societal burdens and consequently improve patient outcomes.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"448-459"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}