Цель диссертации – аналитически обеспечить разработку системы взаимопомощи и социализации для лиц с ограниченными возможностями здоровья на базе существующей версии локальной платежной системы. Актуальность обусловлена огромными масштабами сообщества инвалидов в России. Проблема инвалидности остается болезненной, как с точки зрения медицины, так и с социально-экономической стороны. В работе решаются задачи: анализ предметной области, изучение альтернативных расчетных средств, электронных платежных системы. Изучены результаты исследований прошлых лет, а также модели и методики разработки продукта. Проведена полная аналитика системы, посчитаны все затраты, подготовлен проект внедрения, а также создан прототип системы для проведения деловых игр. Объектом исследования являются методы и инструменты изучения рынка ИКТ и разработки инновационного продукта. Предмет – аналитическое обоснование вывода на рынок и разработки инновационного продукта для лиц с ОВЗ. Научная новизна заключается в том, что в работе с помощью современных моделей и методик обоснована необходимость создания системы взаимодействия инвалидов, которая объединяла бы в себе функции интернет-магазина и ведение балансов счетов участников. Система уникальна и не имеет конкурентов. Практическая значимость заключается в создании аналитической базы сообщества инвалидов России и подготовке материалов для введения ЛПС в жизнь сообществ. / The purpose of the dissertation is to analytically ensure the development of a system of mutual assistance and socialization for people with disabilities based on the existing version of the local payment system. The relevance is due to the huge scale of the disabled community in Russia. The problem of disability remains painful, both from the point of view of medicine and from the socio-economic side. The paper solves the following tasks: analysis of the subject area, study of alternative means of payment, electronic payment systems. The results of previous years' research, as well as models and methods of product development are studied. A complete analysis of the system was carried out, all costs were calculated, an implementation project was prepared, and a prototype of the system for conducting business games was created. The object of the research is methods and tools for studying the ICT market and developing an innovative product. The subject is an analytical justification for launching and developing an innovative product for people with disabilities. The scientific novelty lies in the fact that the work with the help of modern models and techniques justifies the need to create a system of interaction of disabled people, which would combine the functions of an online store and maintaining the balance of accounts of participants. The system is unique and has no competitors. The practical significance lies in the creation of an analytical base of the Russian disabled community and the preparation of materials for the introduction of LPS into the life of communities.

Det var ett decennium sedan det mobila betalningssystemet utvecklades. Innan dess var det fysiska betalningssystemet som präglade det svenska samhället. Bankerna lyfter ständigt hur det mobila betalningssystemet är bekvämt och smidigt att använda medans riskerna göms i skymundan. Den här studiens syfte är att undersöka vilka säkerhetsåtgärder som vidtas vid risker samt hur dessa risker påverkar kundernas förtroende kring det mobila och fysiska betalningssystemet. De risker som undersöktes var olika typer av IT-risker samt rånrisken. Studien är använder sig av en kvalitativ metod med en abduktiv ansats tillsammans med semistrukturerade intervjuer. Dessa intervjuer utfördes på fyra kundtjänstmedarbetare, två från Swedbank och två från Handelsbanken som arbetar med frågor gällande mobila och fysiska betalningssystem. Den tidigare forskningen har lagt ett underlag för studiens resultat. Den tidigare forskning tog upp bland annat hur det mobila betalningssystemet är ett bekvämare betalningssystem men mer riskabelt jämfört det fysiska. Analysen och diskussionskapitlet av studien har dragit paralleller mellan teori och datainsamling. Studien drog en slutsats om att risker sker i mindre omfång på grund av bankernas starka och utvecklade säkerhetsåtgärder. Förtroendet för bankerna sjunker när risker inträffar. En kombination av det mobila och fysiska betalningssystemen är att föredra. Studiens resterande delar är skrivna på svenska. / It has been a decade since the mobile payment system was developed. Before that, it was the physical payment system that embossed Swedish society. Banks are constantly highlighting how the mobile payment system is convenient and easy to use while the risks are hidden. The purpose of this study is to investigate what security measures are taken in the event of risks and how these risks affect the customers trust in the mobile and physical payment system. The study was conducted using a qualitative method with an abductive approach together with semi-structured interviews. These interviews were conducted with four customer service employees, two from Swedbank and two from Handelsbanken who work with questions regarding the two payment systems. The previous research addressed, among other things, how the mobile payment system is a convenient payment system but has more risks compared to the physical one. The analysis and discussion chapter of this study have drawn parallels between theory and data collection. This study concluded that risks occur to a lesser extent due to the banks’ strong and developed security measures. The study also concludes that trust in banks decreases when the payment systems are at risk. A combination of the two payment systems is preferred. The remaining parts of this study are written in Swedish.

The Swedish car fleet is currently amidst a transition of electrification. This increases the need for an extensive charging infrastructure, and thereby smoothly functioning payment methods for charging. At the time being, there are many charging operators in the market that provide their own payment solutions for charging Battery Electric Vehicles (BEV) and Plug-­in Hybrid Electric Vehicles (PHEV), as the market has developed without any regulations. In consideration of this problem definition, the possibilities and challenges for developing a common payment system was analyzed. With this aim, three key areas were studied: Firstly, the prerequisites for a common payment system in the market was investigated through the historical evolution of such a system in the banking industry. From this, parallels could be drawn to the current market situation of the BEV and PHEV charging industry. Secondly, the problematization was further researched in regard to the customer perspective of the current payment processes. Finally, the prerequisites for a common payment system was analyzed in regard to a company perspective. The three areas were researched through the following three methods: a literary analysis, a questionnaire and a field study at a company. The results show that a need for a unification of payments is present in heterogeneous markets. Therefore, the BEV and PHEV charging market has adequate preconditions for the development of a common payment system considering the innumerable amount of charging operators that currently exist in the market. Furthermore, the results from the questionnaire showed that a majority of BEV and PHEV users are unsatisfied with the current conformation of the payment processes. Lastly, the results show that in regard to the company perspective, there is a satisfactory market climate for entry of a common payment solution considering the business model and technological solution of the analyzed company as well as the customer need. / I takt med att Sveriges bilflotta elektrifieras ökar även behovet av en utbredd laddinfrastruktur och med det ett smidigt sätt att betala för laddningen. I dagsläget tillhandahåller många laddoperatörer egna betalningslösningar för laddning av el­ och laddhybridbilar då marknadens framväxt skett utan reglering. Utifrån denna problemformulering undersöktes möjligheter och utmaningar för ett gemensamt betalningssystem. Under studiens gång undersöktes i detta syfte tre områden: För det första utforskades förutsättningar för ett gemensamt betalningssystem genom att dra historiska paralleller från utvecklingen av ett sådant system inom bankindustrin. För det andra undersöktes problematiseringen utifrån ett kundperspektiv kring dagens betalningslösningar. Slutligen analyserades förutsättningarna för ett gemensamt betalningssystem ur ett företagsperspektiv. Områdena undersöktes genom följande tre metoder; en litteraturstudie, en enkätstudie och en fältstudie på ett företag. Resultaten visar att ett behov av enhetliga betalningar uppstår i samband med heterogena marknader. Därmed har marknaden för laddning av el­ och laddhybridbilar idag goda förutsättningar för ett gemensamt betalningssystem utifrån den variation av laddoperatörer på dagens marknad. Vidare visade enkätresultaten att en majoritet av el­ och laddhybridbilsägare är missnöjda gällande utformningen av dagens betalningsprocesser. Slutligen visade resultaten ur ett företagsperspektiv att det finns goda förutsättningar för introducering av en gemensam betalningslösning utifrån analys av affärsmodell, teknologisk lösning och kundbehov.

Text in Afrikaans, abstract in Afrikaans and English / The development of sophisticated computer technology and the consequent computerisation of the payment system has had a far-reaching effect on fund transfer systems all over the world. The most important purpose of this thesis is to indicate the nature of an electronic fund transfer; to set out the relationships of the parties involved in an electronic funds transfer and to show by comparison with other legal systems where our law may be deficient in the regulation of the computerised payment system. At the outset, the nature and functions of money are compared to electronic fund transfers and a distinction drawn between paper-based transactions and electronic fund transfers. In this regard, electronic fund transfers as method of payment is also discussed. Automatic computer processing also gave rise to a variety of new kinds of financial services. A distinction is made between customer-initiated systems (A TM' s, EFTPOS and home-banking services) and systems used by the banks to effect electronic funds transfers between banks and to send financial messages. In this regard, the settlement function of clearing houses and the legal nature thereof are examined. A description of a local clearing house, the ACB, is included as well as a discussion of the clearing of cheques, the moment of payment of cheques and the status of the ACB. Other relevant legal aspects of the computerisation of the payment system which are examined and discussed are the following: the use of the so-called electronic signature; the regulation of risks in electronic payments and the creation of sufficient security measures; the criminal liability of an accused in the case of an unauthorised withdrawal or transfer; questions and problems surrounding evidential matters; the putting into operation of procedures to correct errors and the creation of an ombudsman to settle and resolve disputes; cheque truncation and the right of an individual to privacy in the milieu of electronic payments. Finally, the legal relationships between the parties involved in a credit transfer and the moment of payment is examined. Regulation in this regard is also considered. / Die ontwikkeling van gesofistikeerde rekenaartegnologie en die gevolglike rekenarisering van die betalingstelsel het 'n verreikende effek op die fondsoordragstelsels van banke regoor die wereld gehad. Die belangrikste doelstellings van hierdie proefskrif is gevolglik om die aard van 'n elektroniese fondsoordrag aan te dui; om die verhoudinge tussen die partye betrokke by 'n elektroniese fondsoordrag nader te omskryf en om by wyse van 'n regsvergelykende ondersoek aan te toon waar daar leemtes in ons reg ten opsigte van die regulering van die gerekenariseerde betalingstelsel bestaan. Die aard en funksies van geld is ter aanvang met elektroniese fondsoordrag vergelyk en 'n onderskeid is tussen papierbasistransaksies en elektroniese fondsoordragte getref. In hierdie verband is elektroniese fondsoordrag as betalingsmetode ook bespreek. Outomatiese rekenaarverwerking het ook tot 'n verskeidenheid van nuwe soorte finansiele dienste aanleiding gegee. Daar is onderskei tussen klient-geaktiveerde stelsels (OTM'e, EFTPOS en tuisbankdienste) en fondsoordragstelsels wat deur die banke aangewend word om elektroniese fondsoordragte tussen banke te bewerkstellig en om finansiele boodskappe te versend. In die verband is die verrekeningsfunksie van klaringshuise en die regsaard daarvan ondersoek. 'n Beskrywing van die werksaamhede van die ACB, as plaaslike klaringshuis, is hierby ingesluit asook 'n bespreking van die verrekening van tjeks, die tydstip van betaling van tjeks en die status van die ACB. Ander relevante regsaspekte van die rekenarisering van die betalingstelsel wat ondersoek en bespreek is, is die gebruik van die sogenaamde elektroniese handtekening; die risikoreeling in die elektroniese betalingsverkeer en die daarstelling van voldoende sekuriteitsprosedures; die strafregtelike aanspreeklikheid van 'n beskuldigde in die geval van 'n ongemagtigde onttrekking of oordrag; vrae en probleme rondom bewysregtelike aangeleenthede; die inwerkingstelling van foutoplossingsprosedures en die daarstelling van 'n ombudsman om geskille te voorkom en te besleg; tjekretensie en die reg van die individu op sy privaatheid in die milieu van die elektroniese betalingsverkeer. Laastens is die regsverhoudinge tussen die deelnemende partye en die tydstip van betaling in die geval van 'n kredietoordrag ondersoek, en oorweging is aan regulering in die verband geskenk. / Private law / LL. D.

Syftet med denna studie var att undersöka framtidsutsikter och utmaningar för kontaktlös betalningsmetod som är NFC-baserad. Detta mynnade ut i frågor som undersökte kring varför enbart ett fåtal banker valt att satsa på kontaktlösa betalkort, vilka utmaningar som NFC-baserade betalningar står inför i den svenska marknaden och även vilka framtidsutsikter den kontaktlösa betalningsmetoden har i den svenska betalningsbranschen. För att svara på dessa frågor, tillämpades en kvalitativ fallstudie med semistrukturerade intervjuer. Två respondenter från varsin bank som infört kontaktlös betalningsmetod i Sverige intervjuades, likaså en respondent från en bank som inte hade infört kontaktlös betalningsmetod i Sverige och ytterligare två respondenter från en annan bank som inte infört kontaktlösa betalningsmetoder i Sverige. Utöver detta, intervjuades även en forskare från Sveriges riksbank och en konsult som arbetar inom ett forum för kontaktlös betalningsmetod. Studien påvisade att anledningen till att ett fåtal banker erbjudit kontaktlös betalningsmetod till sina kunder var till följd av att Sverige varit relativt sena med att byta från magnetremsa som betalningsmetod till chip och PIN, vilket gjort att man ogärna investerade i kontaktlös betalningsmetod. Utmaningar som kontaktlös betalningsmetod står inför är att se till att infrastrukturen utökas i Sverige samt informera kunder om kontaktlös betalningsmetod. Framtidsutsikterna för kontaktlös betalningsmetod är positiva och tanken bland flera aktörer är att kontaktlös betalningsmetod ska vara väldigt utbrett i Sverige år 2020. / The purpose of this research was to investigate future prospects and challenges regarding contactless payment method which is based on NFC. These lead to the formulation of questions which researched why only a few banks had chosen to employ contactless payment cards, which challenges that NFC-based payments are facing in the Swedish market, and also which future prospects the contactless payment method has in the Swedish payment market. In order to answer these questions, a qualitative case study with semi-structured interviews was utilized. Interviews were conducted with two respondents from respective banks which had introduced contactless payment in Sweden while additional interviews were conducted with one respondent from a bank which had not introduced contactless payment in Sweden and two respondents from another bank which had not introduced contactless payment methods in Sweden. In addition to this, one respondent from the central bank of Sweden and one consultant working within a forum regarding contactless payment have been interviewed. The study showed that the reason to why few banks have offered contactless payment method to their customers was due to that Sweden had been relatively late in regards to changing from magnetic strip as a payment method to chip and PIN, which resulted in that the market participants did not wish to invest in the contactless payment method. Challenges which the contactless payment method is facing, is to make sure that the infrastructure will be increased in Sweden, and inform customers about the contactless payment method. The future prospects for the contactless payment methods are positive and the intention among several market participants is that the contactless payment method will be very widespread in Sweden 2020.

Les informations relatives aux cryptomonnaies sont susceptibles de changer à l'avenir tant cette matière est nouvelle et encore peu ancrée dans le droit. Ce mémoire est une réflexion sur l'essor du Bitcoin et des cryptomonnaies à leurs débuts, alors même que le droit cherche à s'accaparer ces nouvelles technologies, à les intégrer dans son système préexistant. / Les cryptomonnaies sont des monnaies numériques, qui se sont développées hors de tout contrôle étatique et qui fonctionnent de manière décentralisée. Bien qu’étant encore à leurs balbutiements, ces cryptomonnaies, à l’instar du Bitcoin, soulèvent de nombreuses questions juridiques. Dans ce mémoire, seront analysées les différentes définitions qui pourraient inclure la cryptomonnaie, avant de nous concentrer sur la définition de la monnaie numérique. Ensuite, seront étudiés, les aspects criminogènes des cryptomonnaies et la volonté des États d’avoir un certain contrôle sur celles-ci. Puis après nous être concentré sur la fiscalité applicable aux monnaies numériques, il sera nécessaire d’examiner l’étendue de la protection des consommateurs, dans leurs rapports aux cryptomonnaies. Pour ce faire nous nous appuierons, entre autre, sur les lois canadiennes, françaises et américaines. Toutefois vous vous en rendrez-compte, les cryptomonnaies n’ont pas encore été totalement englobés dans les systèmes juridiques des trois pays étudiés, et les tribunaux n’ont été saisis que dans très peu d’affaires relatives aux monnaies numériques, ce qui implique que de nombreuses incertitudes juridiques persistent à l’heure actuelle. / Cryptocurrencies are digital currencies which developped outside of state control. They function in a purely decentralized manner. Although they are only at an early stage, those cryptocurrencies, like Bitcoin, raise many legal issues. In this article we will analyze different definitions which might include cryptocurrencies, before focusing on the definition of digital currencies. Therefore we will study the criminal aspects of cryptocurrencies and the willingness of the states to gain a certain control over them. Then, after focusing on the taxes applying to digital currencies, it is necessary to examine the extent of the consumer’s protection while dealing with cryptocurrencies. In order to do this, we will rely, among others, on Canadian, French and American laws. As you will notice by yourselves the cryptocurrencies have not yet been fully encompassed within the legal systems of those three countries, and as the courts have only been seized in very few cases relating to digital currencies, you will find that many legal uncertainties currently persist.

O estudo jurídico do sistema de pagamentos sob o enfoque do direito obrigacional requer exame prévio do fenômeno socioeconômico representado pela moeda, enquanto elemento fundamental da relação obrigacional de compra e venda, determinante do preço e objeto do pagamento. Antes, porém, da análise do pagamento e de seus instrumentos jurídicos, ou seja, da moeda (em sentido largo) como efeito jurídico, tem-se de perquirir sobre sua natureza com o auxílio dos conceitos elaborados sobretudo pela ciência econômica, mas também pela sociologia e pela história social. O exame da realidade socioeconômica sob o prisma da essência dos fatos, não apenas de sua aparência, busca na materialidade do fenômeno monetário o suporte teórico para o encaminhamento da análise jurídica desse mesmo fenômeno e seus correlatos, tanto sob o enfoque positivista (dogmático) quanto sob o interativo, ou seja, enquanto relação entre o mundo jurídico positivo e a globalidade social por meio da interpretação ou aplicação das normas. A partir desse quadro analítico, procura o presente trabalho apresentar, primeiramente, um panorama do sistema monetário, situando o problema da moeda no contexto econômico e jurídico. Na segunda parte são expostos os fundamentos analíticos da economia em sua forma monetária (análise econômica da moeda). A terceira seção abrange o efetivo funcionamento do sistema monetário, particularmente examinando as funções do dinheiro numa economia monetária. A quarta e última parte apresenta o Sistema de Pagamentos Brasileiro (SPB) em seus moldes institucionais, situando-o no arcabouço do ordenamento jurídico nacional. A partir de seus fundamentos jurídicos, procede-se ao exame das matérias específicas do Direito obrigacional, em particular do pagamento e de suas garantias institucionais. / The legal study of the system of payments under the focus given by law requires prior examination of the economic phenomenon represented by currency as a key element of the obligational relationship given by purchase agreement, as by establishing the price and also as an object of payment. However, previously to the analysis of the payment and its legal instruments, i.e. the currency (in broad sense) as a legal effect, one should assess his nature with the aid of concepts specially developed by economic science, but also by sociology and social history. The examination of the socio-economic reality lit by the essence of the facts, not just by their appearance, search through the materiality of monetary phenomenon for the theoretical support for legally dealing with such a phenomenon and the correlated ones, both under the positivist approach (dogmatic) as under the interactive one, that is, as a relationship between the effective legal world and the social universe as a result of the interpretation or application of law. From this analytical framework, the ongoing writing seeks firstly to show a panorama of the monetary system by focusing the currency problem in the economic and legal context. The second part deals with the analytical foundations of the economy in its monetary form (economic analysis of currency). The third section covers the effective functioning of the monetary system, particularly by assessing the functions of money in the context of a monetary economy. The fourth and last part deals with the Brazilian Payment System (SPB) in its institutional patterns, by placing it in the framework of the national legal system. From their legal grounds, one assesses the specific matters concerning the Law of obligations, in particular the payment and its institutional collaterals.

Submitted by Mariana Dornelles Vargas (marianadv) on 2015-03-25T13:57:02Z No. of bitstreams: 1 4iPay.pdf: 3380679 bytes, checksum: 49edaff25098492ab3c46fcf4aad082b (MD5) / Made available in DSpace on 2015-03-25T13:57:02Z (GMT). No. of bitstreams: 1 4iPay.pdf: 3380679 bytes, checksum: 49edaff25098492ab3c46fcf4aad082b (MD5) Previous issue date: 2012 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Este trabalho tem por objetivo apresentar um modelo de arquitetura e usabilidade para um sistema de pagamento móvel (Mobile Payment System), considerando as premissas de independência de dispositivo, de localização, de operadora de telefonia móvel e de administradora financeira para suprir as necessidades de efetivar pagamentos e recebimentos de qualquer natureza em ambientes de comércio ubíquo (Ubiquitous Commerce). O trabalho inicialmente descreve a motivação, os objetivos e os conceitos fundamentais sobre os quais se baseia a proposta do modelo. A seguir são elencados os principais trabalhos relacionados e uma análise comparativa detalhada é realizada, derivando as características mais importantes a serem consideradas no modelo proposto. Em seguida, é proposto um modelo de pagamento móvel, denominado 4iPay, onde são detalhados os objetivos, arquitetura, recursos e a proposta técnico-científica de comércio eletrônico em ambientes ubíquos. Na proposição do modelo foi considerada a convergência dos trabalhos relacionados analisados no que tange à ubiquidade, unicidade, universalidade e unissonância. Assim, o modelo 4iPay pretende reunir as melhores características, inovando e melhorando em alguns aspectos relevantes ao comércio ubíquo de fato. O modelo proposto visa propor uma solução diferenciada em termos de arquitetura, modelo de negócio, usabilidade, baixo consumo de banda e alto desempenho nas transações de pagamento e recebimento, em relação às propostas atuais, levando em consideração, nas transações comerciais eletrônicas móveis, questões como independência de dispositivo, localização física, segurança e confiabilidade, além de outras características expostas ao longo do trabalho, como otimização no uso de protocolos de comunicação e flexibilidade na utilização de conexões locais ou remotas. Também são descritos cenários efetivos de uso de onde e como o modelo 4iPay pode ser aplicado. Para tanto é apresentado o protótipo desenvolvido para avaliar o modelo. Por fim, são apresentados os resultados obtidos na avaliação dos cenários, nas avaliações de desempenho da aplicação e na pesquisa de campo de aceitação do modelo proposto. / This work aims at presenting a usability and architectural model for a mobile payment system. In our model, we assume independence of devices, of location, of mobile operator, and of administrator, to allow all kinds of payment in ubiquitous environments (Ubiquitous Commerce). In this work, we begin describing motivation, goals, and fundamental concepts, in which the proposed model is based. Next, we present related works and a detailed comparative analysis of those projects, deriving the most important features. Later, we propose a model of mobile payment, called 4iPay, based on those features. We detail the 4iPay model, architecture, features, and the technical-scientific proposal of an electronic commerce system in ubiquitous environments. We consider, in the proposed model, the convergence of various related works in terms of ubiquity, unity, universality, and unison. Thus, 4iPay aims at bringing together the best features, innovating and improving in some aspects. In the model, we propose a distinguished solution in terms of architecture, business model, usability, low bandwidth consumption and high performance in payment and receipt transactions. We also consider issues such as device independence, physical location, security and reliability, and other features related to mobile electronic commerce transactions, such as optimizing communications protocols usage and flexibility in local or remote connections. We also present the effective use in scenarios of where and how 4iPay can be applied. For this purpose we present the prototype developed to evaluate the model. Finally, we present the scenarios assessment results, the application performance evaluation and the proposed model acceptance survey.

Depuis le début des années 2000, les traitements anticancéreux oraux (TAO) sont en développement croissant, notamment dans le cancer du sein. Ils permettent aux patients la prise de comprimés par voie orale à domicile améliorant la qualité de vie. On estime que 10 à 34% des tumeurs du sein sur-expriment la protéine HER2 (HER2+) qui augmente le risque de métastases. Deux thérapies ciblées anti-HER2 sont actuellement disponibles : le trastuzumab, anticorps monoclonal administré par voie intraveineuse et le lapatinib, inhibiteur de tyrosine kinase administré par voie orale. D’après les recommandations de l’Agence Nationale d’Accréditation et d’Evaluation en Santé (ANAES, 2003), les TAO devraient être privilégiées par rapport aux formes intraveineuses prises à l’hôpital lorsque leur efficacité est équivalente. Dans la pratique courante des oncologues, les TAO semblent néanmoins sous-utilisées dans certains cas. En plus des freins médicaux connus (adhésion thérapeutique, gestion des effets indésirables), les TAO induisent une consommation de ressources hopitalières supplémentaires qui n’est pas valorisée dans le modèle de tarification à l’activité (T2A) des établissements hospitaliers, lequel repose sur la nature et la quantité d’activité médicale réalisée. Nous supposons que le modèle de T2A représente un frein économique à l’utilisation des TAO entrainant une disparité d’accès entre les traitements anticancéreux oraux et intraveineux. L’objectif de ce travail de thèse était donc de déterminer le rôle de la T2A dans l’accès des patients aux TAO au moyen d’une évaluation médico- économique de l’impact économique et organisationnel des TAO sur le système de soins. Une revue de littérature a permis de mettre en évidence le rôle du mode de financement des soins sur l’accès aux TAO en France et aux Etats-Unis. L’analyse des bases de données nationales hospitalières du Programme Médicalisé des Systèmes d’Information (PMSI) a permis de quantifier l’enjeu économique de la chimiothérapie pour les établissements de soins et qui représente la deuxième activité des hôpitaux en volume après l’hémodialyse. Le bénéfice lié aux séances de chimiothérapie a ainsi été estimé à 108 millions d’Euros en 2010 pour l’ensemble des établissements publics et privés en France. L’analyse a également permis de simuler le transfert d’allocation de ressources de l’hôpital vers les soins de ville induit par la substitution des séances de chimiothérapie par l’utilisation des TAO. Un modèle comparant le coût du traitement intraveineux (trastuzumab) aux TAO (lapatinib et capécitabine) dans le cancer du sein métastatique HER2+ a confirmé des coûts moindres pour les TAO (17 165€ versus 36 077€ par an et par patient) liés à une économie sur les transports médicalisés mais surtout sur les consommations hospitalières et ce, malgré un coût d’acquisition plus élevé des TAO. Malgré cet impact budgétaire négatif pour les hôpitaux, une étude de préférences (Méthode des Choix Discrets) conduite auprès d’un échantillon de 203 médecins hospitaliers et libéraux a montré que l’efficacité d’un traitement anticancéreux restait le déterminant principal de la décision thérapeutique (β=2,214, p<0,0001). L’étude a toutefois révélé que, aux stades avancés du cancer, la voie d’administration et son coût étaient également associés au choix du traitement (β=0,612, p=0,035 ;β=0,506, p<0,0001). Les résultats montrent donc que le modèle de financement de l’activité hospitalière influence le choix des modalités de traitement même si les critères d’ordre médicaux et environnementaux du patient demeurent des déterminants essentiels dans le choix du recours aux TAO (profil clinique du patient, adhésion thérapeutique, préférences du patient, environnement familial et socio-économique, conditions d’accès à l’offre de soins) / Since the early 2000’s, oral anticancer drugs (OADs) are increasingly available especially for the treatment of breast cancer. This route of chemotherapy administration allows patients to take oral tablets at home improving their quality-of-life. We estimate that 10 to 34% of breast tumors over-express the HER2 protein (HER2+) that increases the risk of developing metastasis. Two anti-HER2 targeted therapies are currently available: trastuzumab, a monoclonal antibody administered intravenously and lapatinib, a tyrosine kinase inhibitor administered orally. According to the recommendations of the National Agency for Accreditation and Evaluation in Health (ANAES, 2003), OADs should be administered when their efficacy is equivalent to the one of intravenous forms taken at hospital. In the current practice of oncologists, OADs seem to be underused in some cases. The medical brakes to the use of OADs (i.e. adherence, management of side effects) are well known. Nonetheless, OADs induce additional hospital healthcare resources which are not taken into account in the hospital payment system that is based on the nature and the quantity of medical activities performed (i.e. per-case payment system (PPS)). We assume that the current model of PPS represents an economic barrier to the use of OADs and which induces a disparity of access between oral and intravenous cancer treatments. The objective of this thesis was to determine the role of the PPS on the patient access to OADs based on a medico-economic evaluation of the economical and organizational impacts of OADs on the health care system. A literature review has highlighted the role of the funding of care on the access to OADs in the French and US healthcare systems. From an analysis of the national hospital database (PMSI database), we have quantified the economic implications of chemotherapy administration that is the second hospital activity in volume after hemodialysis. Earnings associated with chemotherapy sessions have been estimated at 108 million Euros in 2010 for all private and public institutions in France. This analysis also allowed us to simulate the transfer of resources allocation from hospital to community setting induced by the substitution of chemotherapy sessions by the use of OADs. A model comparing the cost of intravenous anticancer drug (trastuzumab) to OADs (lapatinib and capecitabine) in the treatment of HER2+ metastatic breast cancer confirmed the lower costs for OADs (€ 17,165 versus € 36,077 per year per patient). The higher acquisition cost of OADs was offset by the cost savings in terms of medical transportation and hospital resources. Despite this negative budget impact for hospitals, a preference study (Discrete Choice Experiment) conducted among 203 physicians showed that the efficacy of cancer treatment remained the main determinant of the therapeutic decision (β=2.214, p<0.0001). The study has also revealed that, in the advanced stages of cancer, the route of administration and its associated cost was also associated with the treatment choice (β=0.612, p= 0.035; =β0.506, p<0.0001). Overall, the results show that the hospital payment system influences the choice of treatment modalities. Nonetheless, medical criterions related to the patient remain essential in the choice of using OADs (clinical profile of the patient, adherence, patient preferences, familial and socio-economic environment, and conditions of access to health care)

The diploma thesis deals with the new legal legislation on the field of protection of the bank client as a consumer in the legal system of Czech Republic and evaluation of the level set by regulation. The theses itself provides a complex view on particular areas of the protection of the consumer on the field of commercial banking, which has undergone major amendments during last years, such as consumer loans, payments, insurance claims from deposits and financial arbiter. Particular areas of the protection of the consumer are amended by the results of the researches concentrated on financial literacy of consumers, evaluation of the possible impacts on the consumer and banking institution and moreover there is outlined possible development in the stated area.