4.4 A Policy for Encouraging the Effective Use of Computers in Animal Production Development

1981 ◽  
Vol 5 ◽  
pp. 137-140
Author(s):  
C. T. Whittemore
Keyword(s):  
Cost Effectiveness ◽  
Real Life ◽  
Simulation Models ◽  
Agricultural Industry ◽  
Flat Rate ◽  
Wide Range ◽  
Business Forecasting ◽  
Development Workers ◽  
Effective Use ◽  
The Cost

In addition to data and record handling and the completion of complex and arduous mathematical calculations, the computer may serve a wide range of purposes for the agricultural industry; these include the provision of day-to-day management information, the mechanical enactment of management decisions, business forecasting, interpretation of real life and prediction of future response by use of simulation models, analysis of cost effectiveness of various tactics and stratagems, the transfer of information, scrutinization of existing knowledge and the formulation of experimental programmes. The computer is seen as a major linking medium between research, development and production practice; being both the preferred route for information flow and an ideal way of packaging dispersed pieces of knowledge into practical, usable, systems advice.The concern of practical producers is not with discrete little problems but with systems. To help, the extension worker must bring forward systems solutions. Often research and development workers try to get across to producers potential benefits in small bits (3 times daily milking gives a yield lift of 15%; flat rate feeding gives better margins over concentrates; high density diets improve feed efficiency), whereas producer benefits come from the cost effectiveness of whole integrated systems.

scholarly journals Cost-Effectiveness Analysis Comparing Two Approaches for Empirical Antifungal Therapy in Hematological Patients with Persistent Febrile Neutropenia

2013 ◽  
Vol 57 (10) ◽  
pp. 4664-4672 ◽  
Author(s):  
Almudena Martín-Peña ◽  
M. Victoria Gil-Navarro ◽  
Manuela Aguilar-Guisado ◽  
Ildefonso Espigado ◽  
Maite Ruiz Pérez de Pipaón ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Febrile Neutropenia ◽  
Antifungal Therapy ◽  
Standard Approach ◽  
Sensitivity Analyses ◽  
Treatment Pathways ◽  
Hematological Patients ◽  
Wide Range ◽  
Empirical Antifungal Therapy ◽  
The Cost

ABSTRACTNew approaches of empirical antifungal therapy (EAT) in selected hematological patients with persistent febrile neutropenia (PFN) have been proposed in recent years, but their cost-effectiveness has not been studied. The aim of this study was to compare the cost-effectiveness of two different approaches of EAT in hematological patients with PFN: the diagnosis-driven antifungal therapy (DDAT) approach versus the standard approach of EAT. A decision tree to assess the cost-effectiveness of both approaches was developed. Outcome probabilities and treatment pathways were extrapolated from two studies: a prospective cohort study following the DDAT approach and a randomized clinical trial following the standard approach. Uncertainty was undertaken through sensitivity analyses and Monte Carlo simulation. The average effectiveness and economic advantages in the DDAT approach compared to the standard approach were 2.6% and €5,879 (33%) per PFN episode, respectively. The DDAT was the dominant approach in the 99.5% of the simulations performed with average cost-effectiveness per PFN episode of €32,671 versus €52,479 in the EAT approach. The results were robust over a wide range of variables. The DDAT approach is more cost-effective than the EAT approach in the management of PFN in hematological patients.

scholarly journals The cost-effectiveness of hypertension management in low-income and middle-income countries: a review

2020 ◽  
Vol 5 (9) ◽  
pp. e002213
Author(s):  
Deliana Kostova ◽  
Garrison Spencer ◽  
Andrew E Moran ◽  
Laura K Cobb ◽  
Muhammad Jami Husain ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Disease Risk ◽  
National Income ◽  
Economic Evaluations ◽  
Health Improvement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
The Cost

Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertension interventions in LMICs is varied across geographical, clinical and evaluation contexts. We conducted a comprehensive search for published economic evaluations of hypertension treatment programmes in LMICs. The search identified 71 articles assessing a wide range of hypertension intervention designs and cost components, of which 42 studies across 15 countries reported estimates of cost-effectiveness. Although comparability of results was limited due to heterogeneity in the interventions assessed, populations studied, costs and study quality score, most interventions that reported cost per averted disability-adjusted life-year (DALY) were cost-effective, with costs per averted DALY not exceeding national income thresholds. Programme elements that may reduce cost-effectiveness included screening for hypertension at younger ages, addressing prehypertension, or treating patients at lower cardiovascular disease risk. Cost-effectiveness analysis could provide the evidence base to guide the initiation and development of hypertension programmes.

scholarly journals Cost Effectiveness of First-Line Treatment with Doxorubicin/Ifosfamide Compared to Trabectedin Monotherapy in the Management of Advanced Soft Tissue Sarcoma in Italy, Spain, and Sweden

Sarcoma ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-19 ◽  
Author(s):  
Julian F. Guest ◽  
Monica Panca ◽  
Erikas Sladkevicius ◽  
Nicholas Gough ◽  
Mark Linch
Keyword(s):  
Cost Effectiveness ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Cost Effective ◽  
Line Treatment ◽  
First Line ◽  
Advanced Soft Tissue Sarcoma ◽  
Effective Use ◽  
The Cost ◽  
First Line Treatment

Background. Doxorubicin/ifosfamide is a first-line systemic chemotherapy for the majority of advanced soft tissue sarcoma (ASTS) subtypes. Trabectedin is indicated for the treatment of ASTS after failure of anthracyclines and/or ifosfamide; however it is being increasingly used off-label as a first-line treatment. This study estimated the cost effectiveness of these two treatments in the first-line management of ASTS in Italy, Spain, and Sweden.Methods. A Markov model was constructed to estimate the cost effectiveness of doxorubicin/ifosfamide compared to trabectedin monotherapy, defined as the cost per QALY gained, in each country.Results. First-line treatment with doxorubicin/ifosfamide resulted in lower two-year healthcare costs and more QALYs than first-line treatment with trabectedin monotherapy in all three countries. Probabilistic sensitivity analysis showed that at a cost per QALY threshold of €35,000, >90% of a cohort would be cost effectively treated with doxorubicin/ifosfamide compared to trabectedin monotherapy in all three countries.Conclusion. Within the model’s limitations, first-line treatment of patients with ASTS with doxorubicin/ifosfamide instead of trabectedin monotherapy affords a cost-effective use of publicly funded healthcare resources in Italy, Spain, and Sweden and is therefore the preferred treatment in all three countries. These findings support the recommendation that trabectedin should remain a second-line treatment.

Cost-effectiveness of targeting chemotherapy with the 70-gene prognostic signature in early-stage breast cancer (ESBC) patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6570-6570
Author(s):  
K. B. Tong ◽  
E. Chen ◽  
G. Brink ◽  
R. Bender ◽  
F. de Snoo ◽  
...  
Keyword(s):  
Lymph Node ◽  
Cost Effectiveness ◽  
Adjuvant Chemotherapy ◽  
Cost Effective ◽  
Gene Signature ◽  
Risk Classification ◽  
Node Negative ◽  
Life Years ◽  
Wide Range ◽  
The Cost

6570 Background: The 70-gene microarray test (MammaPrint) has been shown to provide additional prognostic information to clinicopathologic risk assessment for women ESBC; however, the cost-effectiveness of this strategy is not well understood. Methods: The objective of this analysis was to estimate the incremental benefits, costs, and cost-effectiveness of the treatments guided by the 70-gene signature versus Adjuvant! Software (AS) to decide on the use of adjuvant chemotherapy for women ≤61 years with lymph node negative, HER-2 negative ESBC with estrogen receptor (ER) positive or negative disease. A Markov model with a lifetime horizon and three health states (alive without recurrence, death from cancer and death from other causes) was constructed using TreeAge Pro software. Risk classification and patient outcomes data were based on a multi-center 70-gene signature validation study. Efficacy of chemotherapy derived from published meta-analysis of clinical trials. Costs and health utilities were obtained from the literature. Costs and benefits were discounted 3%/year. Results: Compared to AS, the 70-gene signature strategy resulted in 35% of patients being reassigned to a different risk classification and avoided chemotherapy in 9% of patients. In the base case, the 70-gene signature strategy was cost neutral (lifetime costs per patient: $178,811 versus $178,893 for the 70-gene signature and AS strategy). Moreover the 70-gene signature strategy was associated with an increase of 0.13 life years (LYs) and 0.16 quality adjusted life years (QALYs). The model results were sensitive to the cost of 70-gene signature test, cost of adjuvant chemotherapy, and relative risk reduction associated with chemotherapy; however, the 70-gene strategy remained cost-effective across a wide range of assumptions. Conclusions: In this analysis, the 70-gene signature was associated with a reduction in chemotherapy use and an increase in life expectancy. The 70-gene signature appears to be a cost-effective strategy for obtaining additional information to guide the decision to use adjuvant chemotherapy in patients with lymph node negative ESBC. [Table: see text]

The cost-effectiveness of patient-applied treatments for anogenital warts

2003 ◽  
Vol 14 (4) ◽  
pp. 228-234 ◽  
Author(s):  
Paul Williams ◽  
Geo von Krogh
Keyword(s):  
Cost Effectiveness ◽  
Health Service ◽  
Drug Acquisition ◽  
Sensitivity Analyses ◽  
Controlled Trials ◽  
Anogenital Warts ◽  
Health Service Provider ◽  
Wide Range ◽  
The Cost ◽  
The Impact

A model was developed to estimate the cost-effectiveness of podophyllotoxin and imiquimod for self-treatment of anogenital warts. The effectiveness endpoint was sustained clearance after treatment and a subsequent follow-up period of approximately 12 weeks. Effectiveness of podophyllotoxin was estimated from a quantitative summary of nine placebo-controlled trials, while effectiveness of imiquimod was based on a quantitative summary of six placebo-controlled trials. Costs were considered from a UK health service provider perspective; drug acquisition costs were obtained from the British National Formulary and health service costs of clinic attendance were based on a recent survey of GUM clinics. The impact of uncertainty was explored in a wide range of one-way and probabilistic (multi-way) sensitivity analyses. The cost per sustained clearance was 313 for podophyllotoxin and 606 for imiquimod. The modest and statistically insignificant incremental effectiveness of imiquimod was purchased at high cost—2476 per additional sustained clearance. Sensitivity analyses showed the economic superiority of podophyllotoxin to be robust and statistically very significant.

scholarly journals Cost-Effectiveness of Multiple Sclerosis Disease-Modifying Therapies: A Systematic Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
David Yamamoto ◽  
Jonathan D. Campbell
Keyword(s):  
Cost Effectiveness ◽  
Simulation Models ◽  
Primary Outcome Measure ◽  
Multiple Sclerosis Disease ◽  
Life Years ◽  
Quality Category ◽  
The Cost ◽  
Effectiveness Studies

Objective. To provide a current and comprehensive understanding of the cost-effectiveness of DMTs for the treatment of MS by quantitatively evaluating the quality of recent cost-effectiveness studies and exploring how the field has progressed from past recommendations.Methods. We assessed the quality of studies that met our systematic literature search criteria using the Quality of Health Economic Studies validated instrument.Results. Of the 82 studies that met our initial search criteria, we included 22 in this review. Four studies (18%) achieved quality category 2, three studies (14%) achieved quality category 3, and 15 studies (68%) achieved the highest quality category 4. 91% of studies were simulation models. 13 studies (59%) had quality-adjusted life years (QALYs) as the primary outcome measure, included a societal perspective in the analysis, and utilized time horizons of 10 years to lifetime.Conclusions. To continue to improve the cost-effectiveness evidence of DMTs, we recommend: lifetime horizons, societal perspectives, and QALYs; supplemental evidence with shorter horizons, payer perspectives, and clinical outcomes to inform multiple decision makers; development of modeling and input standards for comparability; head-to-head RCTs between DMTs and long-term prospective studies; and comprehensive cost-effectiveness studies that compare all appropriate DMTs.

scholarly journals Sustainable life support on Mars – the potential roles of cyanobacteria

2015 ◽  
Vol 15 (1) ◽  
pp. 65-92 ◽  
Author(s):  
Cyprien Verseux ◽  
Mickael Baqué ◽  
Kirsi Lehto ◽  
Jean-Pierre P. de Vera ◽  
Lynn J. Rothschild ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Resource Utilization ◽  
Life Support ◽  
Biological Processes ◽  
Nitrogen Fixing ◽  
Local Resources ◽  
Technological Advances ◽  
Wide Range ◽  
The Cost

AbstractEven though technological advances could allow humans to reach Mars in the coming decades, launch costs prohibit the establishment of permanent manned outposts for which most consumables would be sent from Earth. This issue can be addressed byin situresource utilization: producing part or all of these consumables on Mars, from local resources. Biological components are needed, among other reasons because various resources could be efficiently produced only by the use of biological systems. But most plants and microorganisms are unable to exploit Martian resources, and sending substrates from Earth to support their metabolism would strongly limit the cost-effectiveness and sustainability of their cultivation. However, resources needed to grow specific cyanobacteria are available on Mars due to their photosynthetic abilities, nitrogen-fixing activities and lithotrophic lifestyles. They could be used directly for various applications, including the production of food, fuel and oxygen, but also indirectly: products from their culture could support the growth of other organisms, opening the way to a wide range of life-support biological processes based on Martian resources. Here we give insights into how and why cyanobacteria could play a role in the development of self-sustainable manned outposts on Mars.

scholarly journals THE ANALYSIS AND ESTIMATION OF ECONOMIC EFFICIENCY OF RISK MANAGEMENT

2015 ◽  
pp. 72-83 ◽  
Author(s):  
V. A. Makarova
Keyword(s):  
Risk Management ◽  
Cost Effectiveness ◽  
Economic Impact ◽  
Economic Efficiency ◽  
Wide Range ◽  
The Cost ◽  
Corporate Government

Enterprise-wide risk management is a relatively new scientific and practical area of a corporate government, which has a special mission to deal with corporate risks and exposures and to achieve beneficial risk management outcomes. Risk management has a wide range of methods, techniques and tools, but quite expensive, but in the case of a successful application, can stimulate an increase in the company's value. Nevertheless, despite its relevance, risk management reluctantly introduced to the company, this is due, primarily, to the inability to pre-determine the economic impact of existing activities. Most methods for assessing the cost-effectiveness of risk management, as a rule, designed to assess the economic impact after the fact, in this article, the author has provided the tools for assessing the financial and economic impact of the implementation of risk management in advance.

Cost-effectiveness of a home telemonitoring system and a diagnostic algorithm in the management of heart failure in the Netherlands (Preprint)

2021 ◽  
Author(s):  
Fernando Albuquerque de Almeida ◽  
Isaac Corro Ramos ◽  
Maiwenn Al ◽  
Maureen Rutten-van Mölken
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
The Netherlands ◽  
Nyha Class ◽  
Cost Effective ◽  
Health Concern ◽  
Base Case ◽  
Home Telemonitoring ◽  
Wide Range ◽  
The Cost

BACKGROUND Heart failure (HF) is a major health concern associated with significant morbidity, mortality, and reduced quality of life for patients. Home telemonitoring (HTM) facilitates frequent or continuous assessment of disease signs and symptoms, while it has been shown to improve compliance by involving patients in their own care and to prevent emergency admissions by facilitating early detection of clinically significant changes. Diagnostic algorithms (DAs) are predictive mathematical relationships that make use of a wide range of collected data for calculating the likelihood of a particular event happening and utilise this output for prioritising patients with regards to their treatment. OBJECTIVE Assessing the cost-effectiveness of HTM and a DA in the management of heart failure in the Netherlands. Three interventions were analysed: usual care (UC), HTM, and HTM+DA. METHODS A previously published discrete event simulation model was used. The base-case analysis was performed according to the Dutch guidelines for economic evaluation. Sensitivity, scenario, and value of information analyses were performed. Particular attention was given to the cost-effectiveness of the DA at various levels of diagnostic accuracy of event prediction and to different patient subgroups. RESULTS HTM+DA extendedly dominates HTM and it has a deterministic incremental cost-effectiveness ratio versus UC of €27,712 per quality-adjusted life year (QALY). The model showed robustness in the sensitivity and scenario analyses. HTM+DA had a 96.0% probability of being cost-effective at a €80,000/QALY threshold. An optimal point for the threshold value for the alarm of the DA in terms of its cost-effectiveness was estimated. NYHA class IV patients were the subgroup with the worst cost-effectiveness results versus UC, while HTM+DA was found to be the most cost-effective for patients <65 years-old and for patients in NYHA class I. CONCLUSIONS Although increased costs of adopting HTM and DA in the management of HF may seemingly be an additional strain on scarce health care resources, the results of this study demonstrate that, by increasing patient life expectancy by 1.28 years and reducing their hospitalisation rate by 23% when compared to UC, the use of these technologies may be seen as an investment, as HTM+DA extendedly dominates HTM and is cost-effective versus UC at normally accepted thresholds in the Netherlands.

Cost effectiveness of maintenance bevacizumab in patients with metastatic colorectal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 718-718
Author(s):  
Joel Lange ◽  
Rahul Rajeev ◽  
T. Clark Gamblin ◽  
Kiran Turaga
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Metastatic Colorectal Cancer ◽  
Sensitivity Analyses ◽  
Drug Pricing ◽  
Wide Range ◽  
Quality Of Life Scale ◽  
Global Quality Of Life ◽  
The Cost ◽  
Quality Adjusted Life

718 Background: Observation alone after initial treatment of unresectable metastatic colorectal cancer is often anxiety provoking for physician and patient alike. The CAIRO 3 trial suggested the efficacy of maintenance capecitabine and bevacizumab in improving overall survival for such patients. We hypothesized that the cost effectiveness for maintenance capecitabine and bevacizumab would be worse than accepted population thresholds. Methods: Data from the CAIRO-3 trial was used to populate a semi-markov model, in which patients transitioned between different disease and complication based states. Transition probabilities were extratcted from the trial. Costs were determined from a thirs payer persective from the Medicare part B ASP drug pricing file. Utility was converted from the global quality of life scale. Incremental cost effectiveness ratios were calculated. Results: Cost of the maintenance arm after 10 cycles was $108,848 with a gain in 14.93 quality adjusted life months, while the quality adjusted life months gained at no cost in the observation arm was 13.67. This yielded an ICER of $1,036,648/QALY. Two way sensitivity analyses demonstrated dominance of observation across a wide range of parameters unless the cost per cycle was < $6250. Conclusions: Maintenance capecitabine and bevacizumab is not cost effective and is higher than the willingness to pay threshold for any developed nation. Reducing drug pricing is the only way to financially support the argument for this treatment strategy.

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