Health economic impacts and cost-effectiveness of aflatoxin-reduction strategies in Africa: case studies in biocontrol and post-harvest interventions

BackgroundReducing dietary sodium (salt) intake has been proposed as a population-wide strategy to reduce blood pressure and cardiovascular disease (CVD). The cost-effectiveness of such strategies has hitherto not been investigated in Cameroon.MethodsA multicohort multistate life table Markov model was used to evaluate the cost-effectiveness of three population salt reduction strategies: mass media campaign, school-based salt education programme and low-sodium salt substitute. A healthcare system perspective was considered and adults alive in 2016 were simulated over the life course. Outcomes were changes in disease incidence, mortality, health-adjusted life years (HALYs), healthcare costs and incremental cost-effectiveness ratios (ICERs) over the lifetime. Probabilistic sensitivity analysis was used to quantify uncertainty.ResultsOver the life span of the cohort of adults alive in Cameroon in 2016, substantial numbers of new CVD events could be prevented, with over 10 000, 79 000 and 84 000 CVD deaths that could be averted from mass media, school education programme and salt substitute interventions, respectively. Population health gains over the lifetime were 46 700 HALYs, 348 800 HALYs and 368 400 HALYs for the mass media, school education programme and salt substitute interventions, respectively. ICERs showed that all interventions were dominant, with probabilities of being cost-saving of 84% for the school education programme, 89% for the mass media campaign and 99% for the low sodium salt substitute. Results were largely robust in sensitivity analysis.ConclusionAll the salt reduction strategies evaluated were highly cost-effective with very high probabilities of being cost-saving. Salt reduction in Cameroon has the potential to save many lives and offers good value for money.

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Cost-effectiveness of zoledronic acid compared with sequential denosumab/alendronate for older osteoporotic women in Japan

Archives of Osteoporosis ◽

10.1007/s11657-021-00956-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Takahiro Mori ◽

Carolyn J. Crandall ◽

Tomoko Fujii ◽

David A. Ganz

Keyword(s):

Health Economic ◽

Cost Effectiveness ◽

Zoledronic Acid ◽

Cost Saving ◽

Fragility Fracture ◽

Community Dwelling ◽

Sensitivity Analyses ◽

Term Care ◽

Lifetime Horizon ◽

The Cost

Abstract Summary Among hypothetical cohorts of older osteoporotic women without prior fragility fracture in Japan, we evaluated the cost-effectiveness of two treatment strategies using a simulation model. Annual intravenous zoledronic acid for 3 years was cost-saving compared with biannual subcutaneous denosumab for 3 years followed by weekly oral alendronate for 3 years. Purpose Osteoporosis constitutes a major medical and health economic burden to society worldwide. Injectable treatments for osteoporosis require less frequent administration than oral treatments and therefore have higher persistence and adherence with treatment, which could explain better efficacy for fracture prevention. Although annual intravenous zoledronic acid and biannual subcutaneous denosumab are available, it remains unclear which treatment strategy represents a better value from a health economic perspective. Accordingly, we examined the cost-effectiveness of zoledronic acid for 3 years compared with sequential denosumab/alendronate (i.e., denosumab for 3 years followed by oral weekly alendronate for 3 years, making the total treatment duration 6 years) among hypothetical cohorts of community-dwelling osteoporotic women without prior fragility fracture in Japan at ages 65, 70, 75, or 80 years. Methods Using a previously validated and updated Markov microsimulation model, we obtained incremental cost-effectiveness ratios (Japanese yen [¥] (or US dollars [$]) per quality-adjusted life-year [QALY]) from the public healthcare and long-term care payer’s perspective over a lifetime horizon with a willingness-to-pay of ¥5 million (or $47,500) per QALY. Results In the base case, zoledronic acid was cost-saving (i.e., more effective and less expensive) compared with sequential denosumab/alendronate. In deterministic sensitivity analyses, results were sensitive to changes in the efficacy of zoledronic acid or the cumulative persistence rate with zoledronic acid or denosumab. In probabilistic sensitivity analyses, the probabilities of zoledronic acid being cost-effective were 98–100%. Conclusions Among older osteoporotic women without prior fragility fracture in Japan, zoledronic acid was cost-saving compared with sequential denosumab/alendronate.

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Time to Cost-Effectiveness Following Stroke Reduction Strategies in AF

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2015.09.084 ◽

2015 ◽

Vol 66 (24) ◽

pp. 2728-2739 ◽

Cited By ~ 54

Author(s):

Vivek Y. Reddy ◽

Ronald L. Akehurst ◽

Shannon O. Armstrong ◽

Stacey L. Amorosi ◽

Stephen M. Beard ◽

...

Keyword(s):

Cost Effectiveness ◽

Reduction Strategies

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Public and Private Ownership in the Iranian Constitution: Principle 44, A Barrier for Development

Journal of Politics and Law ◽

10.5539/jpl.v10n4p73 ◽

2017 ◽

Vol 10 (4) ◽

pp. 73

Author(s):

Ahmad Torabi

Keyword(s):

Case Studies ◽

Economic Impacts ◽

Private Ownership ◽

Public Ownership ◽

Public And Private ◽

The Third ◽

Public Property ◽

Legal Challenges ◽

The Law ◽

The Government

The Iranian legislator has sought to protect public property and public ownership in the Iranian Constitution in accordance with Islamic principles, terms and procedures. There are a number of principles that have been directly applied to this purpose; however, one principle has had a very significant impact on government domination of the economy of Iran: principle 44. This principle does not directly describe public property; rather, it aims to determine the areas that are under public ownership and are administered by the government. However, the principle has some contradictions and legal challenges in itself. In addition, the supplementary law that has been enacted to provide the areas for the enforcement of principle 44 fails to secure the aims of the legislator. Therefore, this paper analyses legal challenges of the principle, as well as its supplementary law, and gives suggestions to solve the challenges.This paper is divided into four sections. The first section provides an analysis of the principle itself, and its relationship and consistency with other principles of the constitution. In the second section, the Law of Implementation of Principle 44 and the legal challenges that arise from it will be discussed. The third section focuses on the negative economic impacts of this law, as well as case studies of it. Lastly, the paper provides a summary of suggestions to amend this law.

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Cost-Effectiveness Analysis of Risk- Reduction Strategies

Blood Safety and Surveillance ◽

10.1201/9780203908242.ch23 ◽

2001 ◽

Author(s):

James AuBuchon

Keyword(s):

Cost Effectiveness ◽

Risk Reduction ◽

Cost Effectiveness Analysis ◽

Effectiveness Analysis ◽

Reduction Strategies ◽

Risk Reduction Strategies

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Cost-Effectiveness Analysis of Risk-Reduction Strategies

Blood Safety and Surveillance ◽

10.1201/b13998-24 ◽

2001 ◽

pp. 521-542

Author(s):

James AuBuchon

Keyword(s):

Cost Effectiveness ◽

Risk Reduction ◽

Cost Effectiveness Analysis ◽

Effectiveness Analysis ◽

Reduction Strategies ◽

Risk Reduction Strategies

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The Possible Use of Akerlof and Kranton’s Utility Model in Higher Education

Business Systems Research Journal ◽

10.2478/bsrj-2018-0011 ◽

2018 ◽

Vol 9 (1) ◽

pp. 138-150

Author(s):

Nikolett Mihaly

Keyword(s):

Higher Education ◽

Case Studies ◽

Significant Role ◽

Economic Impacts ◽

Institutional Policy ◽

Utility Model ◽

Scientific Results ◽

Identity Changes ◽

The Relationship

Abstract Background: The identity and utility research carries significant role in the modern economics. There are financial outputs, if we can moderate appropriate the student’s and worker’s identities. Objectives: The paper examines the possible use of the utility model and theoretical principles of Akerlof and Kranton (2000, 2002) in higher education. The examined aspects are utility, identity and role. Methods/Approach: The paper aims at employing the model of Akerlof in higher education and how the terms identity and utility can be interpreted in this environment. Results: To sum up, we can say that while case studies and certain experiments seem to justify the model of Akerlof and Kranton, there are few scientific results in higher education to rely on that prove the relationship between identity and utility. Conclusions: It can be deduced that the identity of students has some economic impacts. Institutional policy can increase not only the success of its students but also their income through identity changes.

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