scholarly journals Cost reduction of the new NZEB Wooden building – case study of the kindergarten in Estonia

2020 ◽  
Vol 172 ◽  
pp. 13002
Author(s):  
Endrik Arumägi ◽  
Targo Kalamees
Keyword(s):  
Energy Efficiency ◽  
Cost Effectiveness ◽  
Cost Reduction ◽  
Energy Demand ◽  
Energy Levels ◽  
Building Envelope ◽  
Base Case ◽  
Optimal Point ◽  
Class B ◽  
The Cost

In this study the cost changes caused by the implementation of the nZEB solutions are calculated. The energy demand of a building was calculated according to the methodology for calculating the energy efficiency of buildings, using dynamic energy simulations. The financial calculations are based on the methodology described in Delegated Regulation (EU) No 244/2012 of the European Commission. The simulations and calculations for assessing the cost-effectiveness of technical solutions are based on the selected sample building. The energy efficiency solutions are derived by increasing/decreasing the insulation value of the building envelope in subsequent steps. Financial calculations were based on the investment needed to achieve the nearly zero-energy levels. The results for different combinations vary to a large degree. According to regulations new building must fulfill the low energy building (EPI class “B”) requirement without local production. The EPI value to fulfill the requirement in the cost-even range is reached in case of the GSHP and efficient DH. In case of the GSHP and efficient DH also the cost-optimal point is in the EPI class “B”. Overall the minimum ΔNPV values stay below the zero line in all the cases offering a range of opportunities to choose combinations to reach lover EPI compared to base case. The results of cost-effectiveness calculations for selected building with different combinations of structural solutions and heat sources show the possible different scenarios to reach nZEB level and the possible cost reduction.

scholarly journals Cost and Energy Reduction of a New nZEB Wooden Building

Energies ◽  
2020 ◽  
Vol 13 (14) ◽  
pp. 3570
Author(s):  
Endrik Arumägi ◽  
Targo Kalamees
Keyword(s):  
Energy Efficiency ◽  
Energy Use ◽  
Net Present Value ◽  
Performance Indicator ◽  
Energy Levels ◽  
Energy Performance ◽  
Building Envelope ◽  
Zero Energy ◽  
Construction Costs ◽  
The Cost

The current study demonstrates the possibilities of reducing energy use and construction costs and provides evidence that wooden nearly-zero-energy buildings (nZEB) are technically possible at affordable construction costs by using novel design processes and procurement models that enable scalable and modular production. The energy efficiency solutions were derived by increasing/decreasing the insulation value of the building envelope in successive steps. Financial calculations were based on the investment needed to achieve the nearly-zero-energy levels. Overall, many opportunities exist to decrease the cost and energy use compared to the current (pre-nZEB) practice because the net present value can change up to 150 €/m² on the same energy performance indicator (EPI) level. The EPI in the cost-even range was reached by combining a ground-source heat pump (between 115 and 128 kWh/(m2·a)) and efficient district heating (between 106 and 124 kWh/(m2·a)). As energy efficiency decreases, improving energy efficiency becomes more expensive by insulation measures. Throughout the EPI range the most cost efficient was investment in the improvement of the thermal transmittance of windows (3–13 €/(kWh/(m2·a))) while investments in other building envelope parts were less effective (4–80 €/(kWh/(m2·a))). If these were possible to install, photovoltaic (PV) panels installed to the roof would be the cheapest solution to improve the energy performance. Integrated project delivery procurement (design and construction together) and the use of prefabricated wooden structures reduced the constructing cost by half (from ~2700 €/net m2 to 1390 €/net m2) and helped to keep the budget within limits.

scholarly journals Impact of Passive Energy Efficiency Measures on Cooling Energy Demand in an Architectural Campus Building in Karachi, Pakistan

2021 ◽  
Vol 13 (13) ◽  
pp. 7251
Author(s):  
Mushk Bughio ◽  
Muhammad Shoaib Khan ◽  
Waqas Ahmed Mahar ◽  
Thorsten Schuetze
Keyword(s):  
Energy Efficiency ◽  
Energy Demand ◽  
Electricity Consumption ◽  
Information Modeling ◽  
Base Case ◽  
Energy Efficiency Measures ◽  
Efficiency Measures ◽  
The Impact ◽  
Cooling Energy Demand ◽  
Campus Building

Electric appliances for cooling and lighting are responsible for most of the increase in electricity consumption in Karachi, Pakistan. This study aims to investigate the impact of passive energy efficiency measures (PEEMs) on the potential reduction of indoor temperature and cooling energy demand of an architectural campus building (ACB) in Karachi, Pakistan. PEEMs focus on the building envelope’s design and construction, which is a key factor of influence on a building’s cooling energy demand. The existing architectural campus building was modeled using the building information modeling (BIM) software Autodesk Revit. Data related to the electricity consumption for cooling, building masses, occupancy conditions, utility bills, energy use intensity, as well as space types, were collected and analyzed to develop a virtual ACB model. The utility bill data were used to calibrate the DesignBuilder and EnergyPlus base case models of the existing ACB. The cooling energy demand was compared with different alternative building envelope compositions applied as PEEMs in the renovation of the existing exemplary ACB. Finally, cooling energy demand reduction potentials and the related potential electricity demand savings were determined. The quantification of the cooling energy demand facilitates the definition of the building’s electricity consumption benchmarks for cooling with specific technologies.

Modeling the cost-effectiveness of a new treatment for MS (natalizumab) compared with current standard practice in Sweden

2008 ◽  
Vol 14 (5) ◽  
pp. 679-690 ◽  
Author(s):  
G Kobelt ◽  
J Berg ◽  
P Lindgren ◽  
B Jonsson ◽  
L Stawiarz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cost Effectiveness ◽  
Societal Perspective ◽  
Functional Disability ◽  
Health Benefit ◽  
Base Case ◽  
Current Standard ◽  
Disease Modifying Drugs ◽  
New Treatment ◽  
The Cost

Objective To estimate the cost-effectiveness of a new treatment (natalizumab) for multiple sclerosis (MS) compared with current standard therapy with disease-modifying drugs (DMDs) in Sweden. Methods A Markov model was constructed to illustrate disease progression based on functional disability (the Expanded Disability Status Scale (EDSS)). The effectiveness of natalizumab was based on a 2-year clinical trial in 942 patients (AFFIRM). The effectiveness of current DMDs was estimated from a matched sample of 512 patients in the Stockholm MS registry. Patients withdrawing from treatment were assumed to follow the disease course of 824 patients with relapsing–remitting disease at onset in the Ontario natural history cohort. Costs and utilities are based on a recent observational study in 1339 patients. All data sets were available at the patient level. Main results are presented from the societal perspective, over a 20-year time frame, in 2005 Euros (€1 = 9.25 SEK). Results In the base case, treatment with natalizumab was less expensive and more effective than treatment with current DMDs. When only healthcare costs were considered, the cost per quality-adjusted life year gained with natalizumab was €38 145. Results are sensitive only to the time horizon of the analysis and assumptions about effectiveness of natalizumab beyond the trial. Conclusions This cost-effectiveness analysis used registry data, cohort and observational studies to extrapolate the efficacy findings of natalizumab from the AFFIRM clinical trial to measure effectiveness in clinical practice. The analysis results suggest that for the population considered, natalizumab provides an additional health benefit at a similar cost to current DMDs from a societal perspective.

scholarly journals Comfort within Budget: Assessing the Cost-Effectiveness of Envelope Improvements in Single-Family Affordable Housing

2021 ◽  
Vol 13 (6) ◽  
pp. 3054
Author(s):  
Renata Tubelo ◽  
Lucelia Rodrigues ◽  
Mark Gillott ◽  
May Zune
Keyword(s):  
Cost Effectiveness ◽  
Affordable Housing ◽  
Energy Use ◽  
Thermal Conditions ◽  
Building Envelope ◽  
Single Family ◽  
Design Strategies ◽  
Housing Type ◽  
The Cost ◽  
The Impact

In Brazil, the delivery of homes for low-inc ome households is dictated by costs rather than performance. Issues such as the impact of climate change, affordability of operational energy use, and lack of energy security are not taken into account, even though they can severely impact the occupants. In this work, the authors evaluated the thermal performance of two affordable houses as-built and after the integration of envelope improvements. A new replicable method to evaluate the cost-effectiveness of these improvements was proposed. The case study houses comprise the most common affordable housing type delivered widely across Brazil and a proposition of a better affordable housing solution, built in Porto Alegre, southern Brazil, integrating passive design strategies to increase thermal comfort. The findings reveal a potential for improving indoor thermal conditions by up to 76% and 73%, respectively, if costs are not a concern, and 40% and 45% with a cost increase of 12% and 9% if a comfort criterion of 20–25 °C was considered. Equations to estimate costs of improvements in affordable housing were developed. The authors concluded that there is a great scope for building envelope optimisation, and that this is still possible without significant impact on budget.

scholarly journals Cytomegalovirus Screening in Pregnancy: A Cost-Effectiveness and Threshold Analysis

2018 ◽  
Vol 36 (07) ◽  
pp. 678-687 ◽  
Author(s):  
Catherine M. Albright ◽  
Erika F. Werner ◽  
Brenna L. Hughes
Keyword(s):  
Cost Effectiveness ◽  
Behavioral Intervention ◽  
Universal Screening ◽  
Cost Effective ◽  
Base Case ◽  
Design Decision ◽  
Intervention Effectiveness ◽  
Behavioral Counseling ◽  
The Cost ◽  
In Pregnancy

Objective To determine threshold cytomegalovirus (CMV) infectious rates and treatment effectiveness to make universal prenatal CMV screening cost-effective. Study Design Decision analysis comparing cost-effectiveness of two strategies for the prevention and treatment of congenital CMV: universal prenatal serum screening and routine, risk-based screening. The base case assumptions were a probability of primary CMV of 1% in seronegative women, hyperimmune globulin (HIG) effectiveness of 0%, and behavioral intervention effectiveness of 85%. Screen-positive women received monthly HIG and screen-negative women received behavioral counseling to decrease CMV seroconversion. The primary outcome was the cost per maternal quality-adjusted life year (QALY) gained with a willingness to pay of $100,000 per QALY. Results In the base case, universal screening is cost-effective, costing $84,773 per maternal QALY gained. In sensitivity analyses, universal screening is cost-effective only at a primary CMV incidence of more than 0.89% and behavioral intervention effectiveness of more than 75%. If HIG is 30% effective, primary CMV incidence can be 0.82% for universal screening to be cost-effective. Conclusion The cost-effectiveness of universal maternal screening for CMV is highly dependent on the incidence of primary CMV in pregnancy. If efficacious, HIG and behavioral counseling allow universal screening to be cost-effective at lower primary CMV rates.

scholarly journals Cost-effectiveness of Triple Therapy with Telaprevir for Chronic Hepatitis C Virus Patients in Germany

10.36469/9870 ◽  
2013 ◽  
Vol 1 (3) ◽  
pp. 239-253 ◽  
Author(s):  
Jona T. Stahmeyer ◽  
Svenja Schauer ◽  
Siegbert Rossol ◽  
Hans Heinrich Wedemeyer ◽  
Daniel Wirth ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hepatitis C ◽  
Triple Therapy ◽  
Sensitivity Analyses ◽  
Healthcare Sector ◽  
Base Case ◽  
Life Years ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
The Cost

Background: About 400,000-500,000 people are infected with hepatitis C in Germany. Long-term consequences are the development of liver cirrhosis and hepatocellular carcinoma. The introduction of first generation protease inhibitors has significantly improved the treatment of hepatitis C genotype 1 patients. The aim of the study was to assess the cost-effectiveness of triple therapy with telaprevir in Germany. Methods: We used a Markov model on disease progression and natural history to assess the cost-effectiveness of triple therapy with telaprevir compared to standard treatment with pegylated interferon and ribavirin. Model structure and inputs were discussed with clinical experts. Deterministic and probabilistic sensitivity analyses were performed to verify the robustness of results. Results: The base-case analyses shows that triple therapy results in higher costs (untreated patients: €48,446 vs. €30,691; previously treated patients: €63,228 vs. €48,603) and better outcomes (untreated patients: 16.85 qualily of life years [QALYs] vs. 15.97 QALYs; previously treated patients: 14.16 QALYs vs. 12.89 QALYs). The incremental cost-effectiveness ratio (ICER) was €20,131 per QALY and €30,567 per life year gained (LYG) for previously untreated patients. ICER in treatment experienced patients was €7,664 per QALY for relapse patients, €12,506 per QALY for partial responders and €28,429 per QALY for null responders. Results were robust in sensitivity analyses. Conclusion: Although triple therapy with telaprevir leads to additional costs, there is a high probability of being cost-effective for different thresholds. This health economic analysis makes an important contribution to current debates on cost savings and efficient resource allocation in the German healthcare sector.

scholarly journals Lenvatinib and sorafenib for differentiated thyroid cancer after radioactive iodine: a systematic review and economic evaluation

2020 ◽  
Vol 24 (2) ◽  
pp. 1-180 ◽  
Author(s):  
Nigel Fleeman ◽  
Rachel Houten ◽  
Adrian Bagust ◽  
Marty Richardson ◽  
Sophie Beale ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cost Effectiveness ◽  
Systematic Reviews ◽  
Observational Studies ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Clinical Effectiveness ◽  
Economic Evaluations ◽  
Base Case ◽  
The Cost

Background Thyroid cancer is a rare cancer, accounting for only 1% of all malignancies in England and Wales. Differentiated thyroid cancer (DTC) accounts for ≈94% of all thyroid cancers. Patients with DTC often require treatment with radioactive iodine. Treatment for DTC that is refractory to radioactive iodine [radioactive iodine-refractory DTC (RR-DTC)] is often limited to best supportive care (BSC). Objectives We aimed to assess the clinical effectiveness and cost-effectiveness of lenvatinib (Lenvima®; Eisai Ltd, Hertfordshire, UK) and sorafenib (Nexar®; Bayer HealthCare, Leverkusen, Germany) for the treatment of patients with RR-DTC. Data sources EMBASE, MEDLINE, PubMed, The Cochrane Library and EconLit were searched (date range 1999 to 10 January 2017; searched on 10 January 2017). The bibliographies of retrieved citations were also examined. Review methods We searched for randomised controlled trials (RCTs), systematic reviews, prospective observational studies and economic evaluations of lenvatinib or sorafenib. In the absence of relevant economic evaluations, we constructed a de novo economic model to compare the cost-effectiveness of lenvatinib and sorafenib with that of BSC. Results Two RCTs were identified: SELECT (Study of [E7080] LEnvatinib in 131I-refractory differentiated Cancer of the Thyroid) and DECISION (StuDy of sorafEnib in loCally advanced or metastatIc patientS with radioactive Iodine-refractory thyrOid caNcer). Lenvatinib and sorafenib were both reported to improve median progression-free survival (PFS) compared with placebo: 18.3 months (lenvatinib) vs. 3.6 months (placebo) and 10.8 months (sorafenib) vs. 5.8 months (placebo). Patient crossover was high (≥ 75%) in both trials, confounding estimates of overall survival (OS). Using OS data adjusted for crossover, trial authors reported a statistically significant improvement in OS for patients treated with lenvatinib compared with those given placebo (SELECT) but not for patients treated with sorafenib compared with those given placebo (DECISION). Both lenvatinib and sorafenib increased the incidence of adverse events (AEs), and dose reductions were required (for > 60% of patients). The results from nine prospective observational studies and 13 systematic reviews of lenvatinib or sorafenib were broadly comparable to those from the RCTs. Health-related quality-of-life (HRQoL) data were collected only in DECISION. We considered the feasibility of comparing lenvatinib with sorafenib via an indirect comparison but concluded that this would not be appropriate because of differences in trial and participant characteristics, risk profiles of the participants in the placebo arms and because the proportional hazard assumption was violated for five of the six survival outcomes available from the trials. In the base-case economic analysis, using list prices only, the cost-effectiveness comparison of lenvatinib versus BSC yields an incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained of £65,872, and the comparison of sorafenib versus BSC yields an ICER of £85,644 per QALY gained. The deterministic sensitivity analyses show that none of the variations lowered the base-case ICERs to < £50,000 per QALY gained. Limitations We consider that it is not possible to compare the clinical effectiveness or cost-effectiveness of lenvatinib and sorafenib. Conclusions Compared with placebo/BSC, treatment with lenvatinib or sorafenib results in an improvement in PFS, objective tumour response rate and possibly OS, but dose modifications were required to treat AEs. Both treatments exhibit estimated ICERs of > £50,000 per QALY gained. Further research should include examination of the effects of lenvatinib, sorafenib and BSC (including HRQoL) for both symptomatic and asymptomatic patients, and the positioning of treatments in the treatment pathway. Study registration This study is registered as PROSPERO CRD42017055516. Funding The National Institute for Health Research Health Technology Assessment programme.

scholarly journals Multi-Objective Techno-Economic Optimization of Design Parameters for Residential Buildings in Different Climate Zones

2021 ◽  
Vol 14 (1) ◽  
pp. 65
Author(s):  
Muhammad Usman ◽  
Georg Frey
Keyword(s):  
Thermal Load ◽  
Energy Demand ◽  
Residential Buildings ◽  
Optimal Solution ◽  
Building Envelope ◽  
Design Parameters ◽  
Base Case ◽  
Economic Optimization ◽  
Single Family ◽  
Climate Zones

The comprehensive approach for a building envelope design involves building performance simulations, which are time-consuming and require knowledge of complicated processes. In addition, climate variation makes the selection of these parameters more complex. The paper aims to establish guidelines for determining a single-family household’s unique optimal passive design in various climate zones worldwide. For this purpose, a bi-objective optimization is performed for twenty-four locations in twenty climates by coupling TRNSYS and a non-dominated sorting genetic algorithm (NSGA-III) using the Python program. The optimization process generates Pareto fronts of thermal load and investment cost to identify the optimum design options for the insulation level of the envelope, window aperture for passive cooling, window-to-wall ratio (WWR), shading fraction, radiation-based shading control, and building orientation. The goal is to find a feasible trade-off between thermal energy demand and the cost of thermal insulation. This is achieved using multi-criteria decision making (MCDM) through criteria importance using intercriteria correlation (CRITIC) and the technique for order preference by similarity to ideal solution (TOPSIS). The results demonstrate that an optimal envelope design remarkably improves the thermal load compared to the base case of previous envelope design practices. However, the weather conditions strongly influence the design parameters. The research findings set a benchmark for energy-efficient household envelopes in the investigated climates. The optimal solution sets also provide a criterion for selecting the ranges of envelope design parameters according to the space heating and cooling demands of the climate zone.

Abstract 200: Cost-Effectiveness of Newer Anticoagulants for Stroke Prevention in Atrial Fibrillation

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Brendan L Limone ◽  
William L Baker ◽  
Craig I Coleman
Keyword(s):  
Atrial Fibrillation ◽  
Cost Effectiveness ◽  
Stroke Prevention ◽  
Indirect Comparison ◽  
Cost Effective ◽  
The United States ◽  
Base Case ◽  
Treatment Comparison ◽  
Newer Anticoagulants ◽  
The Cost

Background: A number of new anticoagulants for stroke prevention in atrial fibrillation (SPAF) have gained regulatory approval or are in late-stage development. We sought to conduct a systematic review of economic models of dabigatran, rivaroxaban and apixaban for SPAF. Methods: We searched the Medline, Embase, National Health Service Economic Evaluation Database and Health Technology Assessment database along with the Tuft’s Registry through October 10, 2012. Included models assessed the cost-effectiveness of dabigatran (150mg, 110mg, sequential), rivaroxaban or apixaban for SPAF using a Markov model or discrete event simulation and were published in English. Results: Eighteen models were identified. All models utilized a lone randomized trial (or an indirect comparison utilizing a single study for any given direct comparison), and these trials were clinically and methodologically heterogeneous. Dabigatran 150mg was assessed in 9 of models, dabigatran 110mg in 8, sequential dabigatran in 9, rivaroxaban in 4 and apixaban in 4. Adjusted-dose warfarin (either trial-like, real-world prescribing or genotype-dosed) was a potential first-line therapy in 94% of models. Models were conducted from the perspective of the United States (44%), European countries (39%) and Canada (17%). In base-case analyses, patients typically were at moderate-risk of ischemic stroke, initiated anticoagulation between 65 and 73 years of age, and were followed for or near a lifetime. All models reported cost/quality-adjusted life-year (QALY) gained, and while 22% of models reported using a societal perspective, no model included costs of lost productivity. Four models reported an incremental cost-effectiveness ratio (ICER) for a newer anticoagulant (dabigatran 110mg (n=4)/150mg (n=2); rivaroxaban (n=1)) vs. warfarin above commonly reported willingness-to-pay thresholds. ICERs (in 2012US$) vs. warfarin ranged from $3,547-$86,000 for dabigatran 150mg, $20,713-$150,000 for dabigatran 110mg, $4,084-$21,466 for sequentially-dosed dabigatran and $23,065-$57,470 for rivaroxaban. In addition, apixaban was demonstrated to be an economically dominant strategy compared to aspirin and to be dominant or cost-effective ($11,400-$25,059) vs. warfarin. Based on separate indirect treatment comparison meta-analyses, 3 models compared the cost-effectiveness of these new agents and reported conflicting results. Conclusions: Cost-effectiveness models of newer anticoagulants for SPAF have been extensively published. Models have frequently found newer anticoagulants to be cost-effective, but due to the lack of head-to-head trial comparisons and heterogeneity in clinical characteristic of underlying trials and modeling methods, it is currently unclear which of these newer agents is most cost-effective.

The Implementation of Nearly Zero Energy Buildings (nZEB) in Spain

2019 ◽  
pp. 364-386
Author(s):  
Elisa Peñalvo-López ◽  
Javier Cárcel-Carrasco ◽  
Manuel Valcuende-Paya ◽  
María Carmen Carnero-Moya
Keyword(s):  
Energy Efficiency ◽  
Energy Demand ◽  
Energy Levels ◽  
Minimum Energy ◽  
Value Added ◽  
Economic Sector ◽  
Zero Energy ◽  
Demand Reduction ◽  
New Buildings ◽  
Zero Energy Buildings

The construction segment is an important economic sector in Europe, representing 9% of European gross domestic product (GDP) and providing approximately 18 million direct jobs. Construction activities that include renovation work and energy retrofits add almost twice as much value as the construction of new buildings, and small and medium-sized enterprises (SMEs) contribute more than 70% of the value added in the EU building sector. Furthermore, European legislation obliges member states to establish minimum energy efficiency requirements for buildings to achieve optimum levels of costs versus energy demand reduction. These requirements are reviewed every five years and represent categories of buildings based on their energy levels (demand and generation). This chapter analyzes the legislation associated to nearly zero energy buildings (nZEB) in Spain in order to identify the factors that will leverage their massive implementation.

Sign in / Sign up

Export Citation Format

Share Document