A Brief of the Economics of ADAS for Full Size Light Duty Pickup Trucks: Relating Effectiveness to Cost

Author(s):  
Francis Fish ◽  
Bert Bras

Abstract Advanced Driver Assistance Systems (ADAS) have become increasingly common in vehicles in the last decade. The majority of studies have focused on smaller vehicles with gross vehicle weight rating (GVWR) under 5,000lbs, predominantly sedans, for their ADAS evaluations. While it is sensible to use this style of vehicle because it is ubiquitous worldwide for a typical vehicle body style, these studies neglect full-size light-duty pickup trucks, GVWR 5,000 – 10,000lbs, which are abundant on the roads in the United States. The increase in mass, higher center of gravity, and utilitarianism of the vehicles allows for unique conditions for studying the effects of ADAS. This work evaluates the effectiveness of ADAS in full-size light-duty pickup trucks across brands, representing 18% of registered vehicles in the US, at reducing severity of injury for occupants during accidents involving fatalities relative to expense of the ADAS technology. This work will illustrate the cost benefit of ADAS at reducing the severity of injuries for occupants of full-size light-duty pickup trucks for multiple different brands.

2021 ◽  
Author(s):  
Francis Fish ◽  
Bert Bras

Abstract Advanced Driver Assistance Systems (ADAS) have become increasingly common in vehicles in the last decade. The majority of studies has focused on smaller vehicles with gross vehicle weight rating (GVWR) under 5,000lbs, predominantly sedans, for their ADAS evaluations. While it is sensible to use this style of vehicle because it is ubiquitous worldwide for a typical vehicle body style, these studies neglect full-size light-duty pickup trucks (FSLDPTs), GVWR 5,000 – 10,000lbs, which are abundant on the roads in the United States, 18% of vehicles. The increase in mass, higher center of gravity, and utilitarianism of the vehicles allows for unique conditions for studying the effects of ADAS. This work determines the best and worst location to be hit in a full-size light-duty pickup truck based on data for the industry sales leader in this class of vehicles. The objective is to use these results for future designs of ADAS technologies and their placement on the FSLDPT. While these methods could be applied to any vehicle, the FSLDPT sales leader will be investigated as it represents about 9% of registered vehicles in the United States. The results will be optimized with respect to cost in terms of initial up-front purchasing cost and post-accident vehicle repair cost.


2018 ◽  
Vol 6 (4) ◽  
pp. 38
Author(s):  
Sonia Paone

The article analyses the transformations of the use of eminent domain in the United States in the context of urban redevelopment programs. In the past the private property has been expropriated for public use only. Recently it is possible to forcibly transfer property, from a private subject to private developers, on the basis of a cost-benefit analysis that demonstrates that the new use is more efficient than the previous one. This profound change has been possible thanks to a progressive modification of the concept of public use. Traditionally, public use coincided with the construction of infrastructures and public utility, such as highways and railroads. Over the time, it has come to include other aims: firstly, projects of urban renewal and economic development carried forth by private developers. Essentially, it has resulted in the use of expropriation to assemble lands which are then granted to subjects who intervene in the reconfiguration of the city for private purposes. Starting from some important examples of urban development, the main phases of this process are reconstructed, also taking into account the most important decisions of the US Supreme Court that contributed to the change of doctrine, invalidating the postulate of public use as justification for expropriation.


2021 ◽  
Author(s):  
Taoran Liu ◽  
Zonglin He ◽  
Jian Huang ◽  
Ni Yan ◽  
Qian Chen ◽  
...  

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.


1981 ◽  
Vol 62 (5) ◽  
pp. 80-83
Author(s):  
S. Ya. Chikin

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.


2011 ◽  
Vol 16 (2) ◽  
pp. 77-86
Author(s):  
William A. Prescott ◽  
David J. Hutchinson

ABSTRACT Respiratory syncytial virus (RSV) bronchiolitis is the leading cause of infant hospitalization in the United States. Prophylaxis with palivizumab is effective in reducing RSV hospitalizations in premature infants and in infants or children with chronic lung disease or congenital heart disease. Patients with CF or those who are immunocompromised may be at increased risk for RSV infection–related complications; hence, prophylaxis may prove beneficial to these populations. The extent of palivizumab use in the CF and immunocompromised populations is variable. Palivizumab appears to be safe and may be effective in infants and young children with CF and immunocompromise. However, well-designed, randomized, controlled trials published in peer-reviewed journals are lacking, and its routine use can therefore not be recommended at this time. If used in patients with CF or those who are immunocompromised, RSV prophylaxis should be restricted to peak outbreak months in order to optimize the cost benefit of palivizumab.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bethany Doran ◽  
Yu Guo ◽  
Jinfeng Xu ◽  
Sripal Bangalore

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.


Author(s):  
Arpit Bana ◽  
Priti J Mehta

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.


2013 ◽  
Vol 4 (2) ◽  
pp. 281-286 ◽  
Author(s):  
Susan Rose–Ackerman

The Politics of Precaution by David Vogel, and the edited volume, The Reality of Precaution each compare the United States with Europe over a range of regulatory areas. Vogel claims that the US and Europe changed places in recent years with Europe becoming more precautionary than the US. The edited volume covers a wider range of topics and finds that the results are mixed. The evidence of diversity in the edited volume appears convincing, but this essay argues that both volumes too narrowly focus on the precautionary principle. Rather it argues for a broader context that confronts precaution both with the proportionality principle, which is a mainstay of European Union law, and with the limitations of cost/benefit analysis and Impact Assessment. It unpacks the normative underpinnings of these concepts to suggest a broader frame for policy analysis.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15601-e15601
Author(s):  
Ipek Özer-Stillman ◽  
Apoorva Ambavane ◽  
Paul Cislo

e15601 Background: Cytokines are a first-line treatment option for a subset of advanced RCC patients in the US. After progression on cytokines, NCCN guidelines recommend targeted agents, such as axitinib and sorafenib. Subgroup analysis of post-cytokine patients in the phase III AXIS trial found that axitinib increased median progression free survival (PFS) compared with sorafenib (12.0 vs. 6.6 months, p<0.0001), while overall survival (OS) showed no difference (29.4 vs. 27.8 months, p=0.144). An economic analysis for this subgroup was conducted from a US healthcare payer perspective. Methods: A cohort partition model with monthly cycles was constructed to estimate direct medical costs and health outcomes, discounted at 3.0% per annum, over cohort lifetime. Patients were apportioned into 3 health states (progression-free, progressed and dead) based on OS and PFS Kaplan-Meier curves for the post-cytokine subgroup in the AXIS trial. Active treatment was applied until progression, followed by best supportive care (BSC) alone thereafter. The wholesale acquisition costs were based from RedBook. Adverse event (AE) management costs were obtained from published studies. AE rates and utility values were informed by the AXIS trial. Administrative claims data from MarketScan Database were analyzed to estimate costs for BSC and routine care of second-line advanced RCC patients. Results: The total per-patient lifetime costs were estimated to be $242,750 for axitinib and $168,880 for sorafenib and most of the cost difference (84%) was due to the higher total medication cost of axitinib. The cost difference was sensitive to dose intensity and length of treatment. The difference in quality-adjusted life-years (QALY) for axitinib versus sorafenib was minor (1.3 versus 1.2) and the incremental cost-effectiveness ratio (ICER) for axitinib compared with sorafenib was $683,209/QALY. Conclusions: For cytokine-refractory advanced RCC patients, axitinib resulted in an ICER > $650,000/QALY versus sorafenib due to high drug costs and lack of OS benefit, indicating that axitinib may not present good value for money as 2nd line treatment when compared to sorafenib in the US.


2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 283-283
Author(s):  
Mark Christopher Markowski ◽  
Kevin D. Frick ◽  
James R. Eshleman ◽  
Jun Luo ◽  
Emmanuel S. Antonarakis

283 Background: The rising cost of oncology care in the US is an ongoing societal challenge, and identifying biomarkers that inform clinical decisions and reduce the use of ineffective therapies remains elusive. A splice variant of the androgen receptor, AR-V7, was found to confer resistance to Abi and Enza in men with mCRPC, but did not negatively affect responses to taxanes, suggesting that early use of chemotherapy may be a more effective option for AR-V7(+) pts. With the recent development of a CLIA-certified clinical assay for AR-V7 at Johns Hopkins, we hypothesized that AR-V7 testing in mCRPC pts may result in cost savings by avoiding futile treatment with Abi/Enza in men with AR-V7(+) disease. Methods: We calculated the cost savings of performing AR-V7 testing in mCRPC pts prior to starting Abi/Enza (and avoiding these drugs in AR-V7(+) men) versus treating all mCRPC pts with Abi/Enza (without use of the biomarker). We have set the cost of the AR-V7 assay at $1000. The cost of 3 months of Abi/Enza (the minimum time it would take to determine resistance, clinically) was approximated at $20,000. We estimated that 30,000 mCRPC pts per year are eligible for Abi/Enza in the US. Results: In our prior studies, about 30% of mCRPC pts previously treated with Abi/Enza had detectable AR-V7 in CTCs. Assuming an AR-V7 prevalence of 30%, about 9,000 AR-V7(+) mCRPC pts per year would receive ineffective treatment with Abi/Enza, at an estimated cost of $180 Million. The upfront cost of testing all mCRPC pts who are Abi/Enza-eligible for AR-V7 is $30 Million, resulting in a net cost savings of $150 Million. When performing a continuous cost-benefit analysis after assuming other prevalences of AR-V7 (ranging from 4% to 50%) and a range of costs for Abi/Enza ($2000 to $24,000 per 3 months), we determined that AR-V7 testing would result in a cost savings as long as the prevalence of AR-V7 is > 5% (if the cost of 3 months of Abi/Enza remains at $20,000). Conclusions: AR-V7 testing in mCRPC pts (at $1000/test) is cost-beneficial when considering the current price of Abi/Enza, and may reduce the ineffective use of Abi/Enza leading to a net cost savings to the healthcare system.


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