scholarly journals Enumerating the Economic Cost of Antimicrobial Resistance Per Antibiotic Consumed to Inform the Evaluation of Interventions Affecting their Use

2017 ◽  
Author(s):  
Poojan Shrestha ◽  
Ben S Cooper ◽  
Joanna Coast ◽  
Raymond Oppong ◽  
Nga T. T. Do ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Broad Spectrum ◽  
Correlation Coefficients ◽  
Economic Cost ◽  
The United States ◽  
Economic Evaluations ◽  
Policy Recommendations ◽  
Economic Costs ◽  
The Us ◽  
The Cost

AbstractBackground– Antimicrobial resistance (AMR) poses a colossal threat to global health and incurs high economic costs to society. Economic evaluations of antimicrobials and interventions such as diagnostics and vaccines that affect their consumption rarely include the costs of AMR, resulting in sub-optimal policy recommendations. We estimate the economic cost of AMR per antibiotic consumed, stratified by drug class and national income level.Methods– The model is comprised of three components: correlation coefficients between human antibiotic consumption and subsequent resistance; the economic costs of AMR for five key pathogens; and consumption data for antibiotic classes driving resistance in these organisms. These were used to calculate the economic cost of AMR per antibiotic consumed for different drug classes, using data from Thailand and the United States (US) to represent low/middle and high-income countries.Results– The correlation coefficients between consumption of antibiotics that drive resistance in S. aureus, E. coli, K. pneumoniae, A. baumanii, and P. aeruginosa and resistance rates were 0.37, 0.27, 0.35, 0.45, and 0.52, respectively. The total economic cost of AMR due to resistance in these five pathogens was $0.5 billion and $2.8 billion in Thailand and the US, respectively. The cost of AMR associated with the consumption of one standard unit (SU) of antibiotics ranged from $0.1 for macrolides to $0.7 for quinolones, cephalosporins and broad-spectrum penicillins in the Thai context. In the US context, the cost of AMR per SU of antibiotic consumed ranged from $0.1 for carbapenems to $0.6 for quinolones, cephalosporins and broad spectrum penicillins.Conclusion– The economic costs of AMR per antibiotic consumed were considerable, often exceeding their purchase cost. Differences between Thailand and the US were apparent, corresponding with variation in the overall burden of AMR and relative prevalence of different pathogens. Notwithstanding their limitations, use of these estimates in economic evaluations can make better-informed policy recommendations regarding interventions that affect antimicrobial consumption and those aimed specifically at reducing the burden of AMR.

scholarly journals The cost of music

Popular Music ◽  
2020 ◽  
Vol 39 (1) ◽  
pp. 43-65 ◽  
Author(s):  
Matt Brennan ◽  
Kyle Devine
Keyword(s):  
Economic Cost ◽  
The United States ◽  
Environmental Cost ◽  
Recording Industry ◽  
Recorded Music ◽  
The Us ◽  
Human Costs ◽  
Audio Files ◽  
The One ◽  
The Cost

AbstractWhat is the cost of music in the so-called Anthropocene? We approach this question by focusing on the case of sound-recording formats. We consider the cost of recorded music through two overlapping lenses: economic cost, on the one hand, and environmental cost, on the other. The article begins by discussing how the price of records has changed from the late 19th to the 21st century and across the seven most economically significant playback formats: phonograph cylinder, gramophone disc, vinyl LP, cassette tape, compact disc, digital audio files on hard drive, and streaming from the cloud. Our case study territory is the United States, and we chart the gradual decline in the price of recorded music up to the present. We then examine the environmental and human costs of music by looking at what recordings are made out of, where those materials come from, and what happens to them when they are disposed of. Despite what rhetorics of digital dematerialisation tell us, we show that the labour conditions in the digital electronics and IT industries are as inhumane as ever, while the amount of greenhouse gases released by the US recording industry could actually be higher today than at the height of any previous format. We conclude by asking the obvious (but by no means straightforward) question: what are musicians and fans to do?

scholarly journals Patterns of dental antibiotic prescribing in 2017: Australia, England, United States, and British Columbia (Canada)

2021 ◽  
pp. 1-8
Author(s):  
Wendy Thompson ◽  
Leanne Teoh ◽  
Colin C. Hubbard ◽  
Fawziah Marra ◽  
David M. Patrick ◽  
...  
Keyword(s):  
United States ◽  
British Columbia ◽  
Broad Spectrum ◽  
Antibiotic Prescription ◽  
Population Level ◽  
The United States ◽  
Antibiotic Prescribing ◽  
Prescribing Behavior ◽  
The Us ◽  
Amoxicillin Clavulanic Acid

Abstract Objective: Our objective was to compare patterns of dental antibiotic prescribing in Australia, England, and North America (United States and British Columbia, Canada). Design: Population-level analysis of antibiotic prescription. Setting: Outpatient prescribing by dentists in 2017. Participants: Patients receiving an antibiotic dispensed by an outpatient pharmacy. Methods: Prescription-based rates adjusted by population were compared overall and by antibiotic class. Contingency tables assessed differences in the proportion of antibiotic class by country. Results: In 2017, dentists in the United States had the highest antibiotic prescribing rate per 1,000 population and Australia had the lowest rate. The penicillin class, particularly amoxicillin, was the most frequently prescribed for all countries. The second most common agents prescribed were clindamycin in the United States and British Columbia (Canada) and metronidazole in Australia and England. Broad-spectrum agents, amoxicillin-clavulanic acid, and azithromycin were the highest in Australia and the United States, respectively. Conclusion: Extreme differences exist in antibiotics prescribed by dentists in Australia, England, the United States, and British Columbia. The United States had twice the antibiotic prescription rate of Australia and the most frequently prescribed antibiotic in the US was clindamycin. Significant opportunities exist for the global dental community to update their prescribing behavior relating to second-line agents for penicillin allergic patients and to contribute to international efforts addressing antibiotic resistance. Patient safety improvements will result from optimizing dental antibiotic prescribing, especially for antibiotics associated with resistance (broad-spectrum agents) or C. difficile (clindamycin). Dental antibiotic stewardship programs are urgently needed worldwide.

scholarly journals The comparison of vaccine hesitancy of COVID-19 vaccination in China and the United States

2021 ◽  
Author(s):  
Taoran Liu ◽  
Zonglin He ◽  
Jian Huang ◽  
Ni Yan ◽  
Qian Chen ◽  
...  
Keyword(s):  
United States ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Discrete Choice ◽  
Choice Experiments ◽  
The United States ◽  
Discrete Choice Experiments ◽  
Vaccine Hesitancy ◽  
The Us ◽  
The Cost

AbstractObjectivesTo investigate the differences in vaccine hesitancy and preference of the currently available COVID-19 vaccines between two countries, viz. China and the United States (US).MethodA cross-national survey was conducted in both China and the US, and discrete choice experiments as well as Likert scales were utilized to assess vaccine preference and the underlying factors contributing to the vaccination acceptance. A propensity score matching (PSM) was performed to enable a direct comparison between the two countries.ResultsA total of 9,077 (5,375 and 3,702, respectively, from China and the US) respondents have completed the survey. After propensity score matching, over 82.0% respondents from China positively accept the COVID-19 vaccination, while 72.2% respondents form the US positively accept it. Specifically, only 31.9% of Chinese respondents were recommended by a doctor to have COVID-19 vaccination, while more than half of the US respondents were recommended by a doctor (50.2%), local health board (59.4%), or friends and families (64.8%). The discrete choice experiments revealed that respondents from the US attached the greatest importance to the efficacy of COVID-19 vaccines (44.41%), followed by the cost of vaccination (29.57%), whereas those from China held a different viewpoint that the cost of vaccination covers the largest proportion in their trade-off (30.66%), and efficacy ranked as the second most important attribute (26.34%). Also, respondents from China tend to concerned much more about the adverse effect of vaccination (19.68% vs 6.12%) and have lower perceived severity of being infected with COVID-19.ConclusionWhile the overall acceptance and hesitancy of COVID-19 vaccination in both countries are high, underpinned distinctions between countries are observed. Owing to the differences in COVID-19 incidence rates, cultural backgrounds, and the availability of specific COVID-19 vaccines in two countries, the vaccine rollout strategies should be nation-dependent.

scholarly journals On the ethics of doctors in capitalist countries

1981 ◽  
Vol 62 (5) ◽  
pp. 80-83
Author(s):  
S. Ya. Chikin
Keyword(s):  
United States ◽  
Surgical Intervention ◽  
The United States ◽  
For Profit ◽  
Us Congress ◽  
The Us ◽  
The Cost

In 1977, the US Congress published statistics on the operation of surgical clinics in many cities in the country. These materials cannot be read without a shudder. They once again proved that American doctors are no different from businessmen in their passion for profit. The report's conclusion was very sad. He testified that up to three million unjustified surgeries are performed annually in the United States. Naturally, they are not undertaken for the sake of the patient's health, but in order to present a more weighty bill to the patient, because the cost of the simplest surgical intervention is now estimated at at least $ 1000.

scholarly journals Is It Time for the Beaver to Hop off the Eagle? A Case for Canada to Reconsider Its Geopolitical Alignment with the United States

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Kevin Zhou
Keyword(s):  
United States ◽  
Cold War ◽  
International System ◽  
Economic Cost ◽  
The United States ◽  
Islamic State ◽  
Post Cold War ◽  
The Us ◽  
The Korean War ◽  
International Diplomacy

Canada is known for its close relations with the United States in the domains of economic affairs, defence and international diplomacy. This arrangement, however, was a product of the great changes brought about by the Second World War. The combination of British decline, Ottawa’s desire to achieve full independence from London, and the looming Soviet threat during the Cold War created a political environment in which Canada had to become closely integrated with the United States both militarily and economically. Canada did so to ensure its survival in the international system. With the exception of a few controversial issues like US involvement in Vietnam (1955) and Iraq (2003) as well as Ballistic Missile Defence (BMD), Ottawa has been Washington’s closest ally since 1945. On numerous occasions like the Korean War, the Cuban Missile Crisis, and as recently as the War in Afghanistan and the War Against IS (Islamic State), Canada had provided staunch military and diplomatic support to Washington in its engagements around the globe. In an era of relative peace, stability, and certainty, particularly during the Post-Cold War period and the height of American power from 1991 to 2008, this geopolitical arrangement of continental integration had greatly benefited Canada. This era of benefits, however, is arguably drawing to a close. The Great Recession of 2007-09, the situations in Iraq and Afghanistan, and the insistence on pursuing a foreign policy of global primacy despite its significant economic cost, are sending the US down an uncertain path. Due to its close relations and geographical proximity with the US, Canada now faces a hostile international environment that is filled with uncertainty as a result of superpower decline, great power rivalries, environmental degradation, and failed US interventions.

Abstract 18272: The Increasing Proportion of Acute Myocardial Infarction Represented by the Uninsured: a Growing Financial Burden in the United States

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bethany Doran ◽  
Yu Guo ◽  
Jinfeng Xu ◽  
Sripal Bangalore
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Insurance ◽  
Financial Burden ◽  
Insurance Coverage ◽  
The United States ◽  
The Us ◽  
Hospital Stays ◽  
Nationally Representative ◽  
The Cost

Introduction: Under the provisions of the Affordable Care Act, insurance coverage will markedly increase with the Congressional Budgetary Office estimating the number of insured to increase by approximately 13 million in 2014 and 25 million in 2016. However, approximately 31 million non-elderly US citizens are expected to remain without health insurance in 2016. Acute myocardial infarction (AMI) remains a source of significant morbidity and mortality, as well as cost to society. No prior studies have examined temporal rates of uninsured among patients presenting with an AMI using a nationally representative database. Hypothesis: We tested the hypothesis that the proportion of uninsured individuals with AMI and cost of uninsured to society will vary by year. Methods: We used the Nationwide Inpatient Sample (NIS), which contains estimates from approximately 8 million hospital visits and information related to number of discharges, aggregate charges, and principal diagnoses of all patients discharged in the US. We calculated the percentage of acute myocardial infarction by insurance status, and the sum of all charges of hospital stays in the US adjusted for inflation. Results: The cost to society due to acute myocardial infarction in the uninsured increased substantially from 1997 to 2012, with total cost in 1997 of $852,596,272 and $3,446,893,954 in 2012 after adjustment for inflation. In addition, although rates of AMI decreased in the general population (from 268.6/100,000 individuals in 1997 to 193.8/100,000 individuals in 2012), the proportion of individuals with AMI who were uninsured increased (from 3.83% in 1997 to 7.37% in 2012). Conclusions: The proportion of those experiencing AMI who are uninsured is rising, as is cost to society. It remains to be seen what the effects of expanding health insurance will have on the rate of AMI as well as proportion of AMI represented by the uninsured.

PD04 Cost-Utility Of Quetiapine For Schizophrenia: A Systematic Review

2018 ◽  
Vol 34 (S1) ◽  
pp. 133-134
Author(s):  
André Santos ◽  
Cristina Ruas
Keyword(s):  
Antipsychotic Drugs ◽  
The United States ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Discontinuation Of Treatment ◽  
The Cochrane Library ◽  
The Cost ◽  
And Behavior

Introduction:Schizophrenia is a chronic debilitating condition characterized by disorders in thought, affect and behavior. The worldwide prevalence is around 0.3 to 1 percent. The pharmacological treatment is based on antipsychotic drugs, but their efficacy is limited, culminating in discontinuation of treatment, relapses, and readmissions to health services. Quetiapine was initially approved for use in the United States of America in 1997. The drug has moderate affinity for D2 and 5-HT2A receptors and high affinity for H1 receptors. This study aimed to conduct an assessment of the cost-utility of quetiapine for schizophrenia around the world.Methods:Cost-utility studies of head-to-head comparisons of quetiapine against other antipsychotic drugs for the treatment of patients with schizophrenia and related disorders were included, irrespective of the diagnostic criteria used. An electronic search on Medline, Lilacs, Center for Reviews and Dissemination, The Cochrane Library and PsycINFO was conducted and complemented by references of included studies, Google Scholar and conference abstracts. Monetary values were converted to PPP-USD for the same base-year of the study.Results:Six economic evaluations were included, representing four countries and a multicentric analysis. Comparisons between quetiapine and twelve other antipsychotic drugs were identified. Three studies found quetiapine to be dominated by risperidone and the remaining three found it to be more expensive and more effective with incremental cost-effectiveness ratio (ICER) values of USD 36,535, 8,786 and USD 127,600 per quality-adjusted life-year (QALY). Three studies found quetiapine, in comparison to olanzapine, to be inferior, one found it to be superior and two studies found it to be more expensive and more effective with ICER values of USD 139,699 and USD 224,000 per QALY. The reports were considered to be of reasonable quality. Yet the mixture of contexts might influence the results.Conclusions:In general, there seems to be a trend favoring olanzapine and risperidone over quetiapine. None of the studies favored quetiapine over all the other drugs.

Recognizing barriers to entry of biosimilars in the United States market and highlighting the solutions

2020 ◽  
pp. 174113432097215
Author(s):  
Arpit Bana ◽  
Priti J Mehta
Keyword(s):  
Patent Protection ◽  
Reference Product ◽  
Market Competition ◽  
The United States ◽  
Living Cells ◽  
Barriers To Entry ◽  
The Us ◽  
The Government ◽  
The Cost ◽  
The U.S

Drugs that are procured from living cells and are used to treat acute and chronic diseases are called biologics, whereas biosimilars are the drugs which are highly similar but not identical to the original reference product. The main advantage of these drugs is that they are highly targeted with great therapeutic activity and can be used for multiple indications. Despite all the advantages biologics are still extremely costly. The main purpose of developing and introducing biosimilars was and is to increase market competition leading to a decrease in the cost of the biologics. However, until now the cost of the treatment has not decreased in the US market because there are many barriers to the entry of biosimilar in the US market which are discussed in this article. In this article, we argue that the barrier or hurdle in the US market entry of the biosimilars is not only limited to patent protection or exclusivity but other less discussed barriers are also there which are to be discussed. Due to these barriers till June 10, 2020, only 9 biosimilars are available commercially in the US market out of the 27 biosimilars approved for marketing by the U.S. Food and Drug Administration (FDA). We argue that the introduction of these biosimilars in the US market is essential for increasing market competition and thus decreasing the overall treatment cost for both the government and the payers. In this article, we are also providing perspective on the possible solutions to reduce these barriers and to encourage the entry of biosimilar in the US market.

scholarly journals Occupational Stress and Its Economic Cost in Hong Kong: The Role of Positive Emotions

2020 ◽  
Vol 17 (22) ◽  
pp. 8601
Author(s):  
Oi Ling Siu ◽  
Cary L. Cooper ◽  
Lara C. Roll ◽  
Carol Lo
Keyword(s):  
Hong Kong ◽  
Occupational Stress ◽  
Positive Emotions ◽  
Job Insecurity ◽  
Economic Cost ◽  
Economic Costs ◽  
Job Stressors ◽  
Organizational Constraints ◽  
The Cost

There has been less research on the costs of occupational stress attributed to certain job stressors in Chinese contexts. This study identified and validated common job stressors and estimated the economic cost in Hong Kong. The role of positive emotions in alleviating the economic costs of job stressors was also examined. Both qualitative and quantitative approaches were adopted. The findings obtained from five focus group discussions and a survey validated five common job stressors: Job insecurity; quantitative workload; organizational constraints; interpersonal conflicts; and work/home interface. A total of 2511 employees were surveyed, with 2032 valid questionnaires returned (925 males, 1104 females, and 3 unidentified, whose ages ranged from 18 to 70 years). The economic costs were estimated by combining the costs of absenteeism, presenteeism, and medical expenses. Absenteeism mainly caused by job stressors of the work/home interface, job insecurity, and quantitative workload accounted for an annual economic cost of HK$550 million to HK$860 million. The annual economic cost due to presenteeism mainly caused by job stressors of job insecurity, interpersonal conflict, quantitative workload, and organizational constraints ranged from HK$1.373 billion to HK$2.146 billion. The cost of medical treatments associated with occupational stress was HK$2.889 billion to HK$4.083 billion. Therefore, the total annual economic cost of occupational stress was approximately HK$4.81 billion to HK$7.09 billion. Positive emotions, representing a less explored individual factor in the cost of occupational stress studies, was found to be negatively correlated with presenteeism and buffered the negative impact of job stressors on absenteeism. The theoretical contributions and practical implications of findings are discussed.

Power and Military Impotence

Worldview ◽  
1973 ◽  
Vol 16 (10) ◽  
pp. 31-36
Author(s):  
Seymour Melman
Keyword(s):  
Soviet Union ◽  
Economic Cost ◽  
The United States ◽  
Arms Race ◽  
Military Power ◽  
The Soviet Union ◽  
Military Security ◽  
Special Force ◽  
The Cost ◽  
The Military

After twenty-five years of a nuclear-military arms race, it is possible to define significant limits of military power for national security. These limits apply with special force to the nuclear superpowers. These same limits of military power also define new requirements for a disarmament process.Underlying the long discussion of disarmament among nations has been the understanding that lowered levels of armaments produce mutual advantage: the prospect of physical destruction is reduced; and the cost of armaments can be applied to constructive uses. The arms race from 1946 to 1971 between the United States and the Soviet Union has not improved the military security of either nation, and the economic cost to these two countries has exceeded $1,500 billion.

Sign in / Sign up

Export Citation Format

Share Document