scholarly journals Cost-effective implementation of the Paris Agreement using flexible greenhouse gas metrics

2021 ◽  
Vol 7 (22) ◽  
pp. eabf9020
Author(s):  
Katsumasa Tanaka ◽  
Olivier Boucher ◽  
Philippe Ciais ◽  
Daniel J. A. Johansson ◽  
Johannes Morfeldt
Keyword(s):  
Cost Effectiveness ◽  
Greenhouse Gas ◽  
Economic Cost ◽  
Cost Effective ◽  
Paris Agreement ◽  
Effective Implementation ◽  
Global Cost ◽  
Common Scale ◽  
Mitigation Costs ◽  
Global Stocktake

Greenhouse gas (GHG) metrics, that is, conversion factors to evaluate the emissions of non-CO2 GHGs on a common scale with CO2, serve crucial functions in the implementation of the Paris Agreement. While different metrics have been proposed, their economic cost-effectiveness has not been investigated under a range of pathways, including those substantially overshooting the temperature targets. Here, we show that cost-effective metrics for methane that minimize the overall mitigation costs are time-dependent, primarily determined by the pathway, and strongly influenced by temperature overshoot. Parties to the Paris Agreement have already adopted the conventional GWP100 (100-year global warming potential), which is shown to be a good approximation of cost-effective metrics for the coming decades. In the longer term, however, we suggest that parties consider adapting the choice of common metrics to the future pathway as it unfolds, as part of the recurring global stocktake, if global cost-effectiveness is a key consideration.

scholarly journals Cost-effective implementation of the Paris Agreement using flexible greenhouse gas metrics

2021 ◽  
Author(s):  
Katsumasa Tanaka ◽  
Olivier Boucher ◽  
Philippe Ciais ◽  
Daniel Johansson ◽  
Johannes Morfeldt
Keyword(s):  
Cost Effectiveness ◽  
Greenhouse Gas ◽  
Economic Cost ◽  
Cost Effective ◽  
Paris Agreement ◽  
Time Dependent ◽  
Climate Mitigation ◽  
Effective Implementation ◽  
Common Scale ◽  
Global Stocktake

<p>Greenhouse gas (GHG) metrics, that is, conversion factors to evaluate the emissions of non-CO<sub>2</sub> climate forcers on a common scale with CO<sub>2</sub>, serve crucial functions upon the implementation of the Paris Agreement. While different metrics have been proposed, their economic cost-effectiveness has not been investigated under a range of pathways, including those temporarily missing or significantly overshooting the temperature targets of the Paris Agreement. Here we show that cost-effective metrics for methane that minimize the overall cost of climate mitigation are time-dependent, primarily determined by the pathway, and strongly influenced by temperature overshoot. The Paris Agreement will implement the conventional 100-year Global Warming Potential (GWP100), a good approximation of cost-effective metrics for the coming decades. In the longer term, however, we suggest that parties consider adapting the choice of common metrics to the future pathway as it unfolds, as part of the global stocktake, if cost-effectiveness is a key consideration.</p>

scholarly journals Cost-effective implementation of the Paris Agreement using flexible greenhouse gas metrics

2020 ◽  
Author(s):  
Katsumasa Tanaka ◽  
Olivier Boucher ◽  
Philippe Ciais ◽  
Daniel Johansson
Keyword(s):  
Greenhouse Gas ◽  
Cost Effective ◽  
Paris Agreement ◽  
Effective Implementation

scholarly journals Cost-effective implementation of the Paris Agreement using flexible greenhouse gas metrics

2020 ◽  
Author(s):  
Katsumasa Tanaka ◽  
Olivier Boucher ◽  
Philippe Ciais ◽  
Daniel Johansson ◽  
Johannes Morfeldt
Keyword(s):  
Greenhouse Gas ◽  
Cost Effective ◽  
Paris Agreement ◽  
Effective Implementation

scholarly journals Cost-effective implementation of the Paris Agreement using flexible greenhouse gas metrics

2020 ◽  
Author(s):  
Katsumasa Tanaka ◽  
Olivier Boucher ◽  
Philippe Ciais ◽  
Daniel Johansson ◽  
Johannes Morfeldt
Keyword(s):  
Greenhouse Gas ◽  
Cost Effective ◽  
Paris Agreement ◽  
Effective Implementation

An economic analysis of implementing the SIGN third molar guideline: implications for the design and analysis of implementation studies

2005 ◽  
Vol 10 (3) ◽  
pp. 143-149 ◽  
Author(s):  
Colin Tilley ◽  
Emma McIntosh ◽  
Maryam Bahrami ◽  
Jan Clarkson ◽  
Chris Deery ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Guideline Implementation ◽  
Third Molar ◽  
Implementation Strategies ◽  
Cost Effective ◽  
Effective Implementation ◽  
Dental Practitioners ◽  
Implementation Studies ◽  
Dental Practices ◽  
The Cost

Objectives: To compare the cost-effectiveness of four third molar guideline implementation strategies. Methods: Fifty-one dental practices in Scotland were randomized to one of four implementation strategies. The effectiveness of the strategies was measured by general dental practitioners' compliance with the guideline. Results: The effectiveness of the guideline depended crucially upon the type of patient treated. In particular, for a minority of patients (14%) with no clinical signals of their 'type', the implementation strategies generate potentially large gains in evidence-based practice. However, the cost per patient of achieving these gains is large given that the costs are incurred for all patients, but benefits accrue only to a minority. Discussion: The results show that the type of patient presenting for treatment can influence the effectiveness, cost-effectiveness and therefore policy conclusions. Consequently, the design and analysis of studies need to be sufficiently sensitive to detect subtle interaction effects. This may explain the dearth of guideline implementation trials with significant findings. The results also suggest that a more cost-effective implementation method in primary care dentistry may be to subsidize treatment conditional upon patient type.

scholarly journals Clinical trial to compare between different dressing methods on split thickness graft donor site (conventional method VS Ca alginate Vs Hydrocolloid sheet)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H S Tantawy ◽  
M O Kotb ◽  
W B Gerges ◽  
M M A Shihata
Keyword(s):  
Cost Effectiveness ◽  
Conventional Method ◽  
Healing Rate ◽  
Direct Method ◽  
Donor Site ◽  
Cost Effective ◽  
Standard Of Care ◽  
Wound Dressings ◽  
Global Cost ◽  
Ca Alginate

Abstract Background According WHO Egypt has high incidence in RTA and burn. Controversy between studies and reviews on the best dressing on donor site, while evidence support the use of moist wound dressings other centers believe that the impregnated gauze is cost effective. Objective Comparison between 3 types of dressings: The Conventional method (Vaseline gauze), Calcium alginate and Hydrocolloid sheets to determine which donor-site dressings are associated with the best outcomes for faster healing rate, less Pain, decreased Infection rate, healing quality and cost-effectiveness. Patients and Methods This study was conducted on 60 patients 35 males (58.33%) and 25 females (41.67%) in Ahmed Maher Teaching hospital divided into 20 patients in each, the conventional by Vaseline gauze group, the hydrocolloid using group and the Ca alginate group. Results The hydrocolloid showed highly significant overall results in faster epithilization and healing rate with mean 9.35 days ± 1.8 days and significant pain reduction post operatively and comfort during dressings and it was satisfactory in the reduction in change frequency as most patients healed between 7 – 10 days and in most cases the requirement for dressing change was every 5 days. Conclusion Modern wound dressings should become the standard of care in Egyptian burn centers and hydrocolloid is advised when multiple reharvesting for huge skin defects and increase satisfaction with considerable cost effectiveness. Vaseline gauze showed the worst results, but cost effectiveness by direct method is doubted if compared by the indirect and global cost of analgesics, hospital stay and medical stuff burden of dressing frequency.

scholarly journals Cost-effectiveness of the Adaptive Implementation of Effective Programs Trial (Adept): Approaches to Adopting Implementation Strategies

2020 ◽  
Author(s):  
Andria B Eisman ◽  
David Hutton ◽  
Lisa Prosser ◽  
Shawna Smith ◽  
Amy Kilbourne
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Implementation Strategies ◽  
Cost Effective ◽  
Life Goals ◽  
Sensitivity Analyses ◽  
Implementation Support ◽  
Effective Implementation ◽  
Life Years ◽  
Effective Programs

Abstract Background Theory-based methods to support clinician uptake of evidence-based practices (EBPs) are critical to improving mental health outcomes. Costs associated with effective implementation strategies can be substantial, and few have been rigorously evaluated. The purpose of this study is to conduct a cost-effectiveness analysis to identify the most cost-effective approach to deploying implementation strategies to enhance the uptake of Life Goals, a mental health EBP. Methods We used data from a previously conducted randomized trial to compare the cost-effectiveness of different augmentations to Replicating Effective Programs (REP) combined with external and/or internal facilitation to enhance uptake of Life Goals. REP is a low-level strategy that includes EBP packaging, training, and technical assistance. External facilitation (EF) involves external expert support, and internal facilitation (IF) augments EF with protected time for internal staff to support EBP implementation. We developed a decision tree to assess 1-year costs and outcomes for four implementation strategies: 1) REP only, 2) REP + EF 3) REP + EF add IF if necessary, 4) REP + EF/IF. The analyses used a 1-year time horizon and assumes a health payer perspective. Our outcome was quality-adjusted life years (QALYs). The economic outcome was the incremental cost-effectiveness ratio (ICER). We conducted deterministic and probabilistic sensitivity analysis (PSA). Results Our results indicate that REP + EF add IF is the most cost-effective option with an ICER of $593/QALY. The REP + EF/IF and REP + EF only conditions are dominated. One-way sensitivity analyses indicate that results are sensitive to utilities for REP + EF and REP + EF add IF. The PSA results indicate that REP + EF, add IF is the optimal strategy in 30% of iterations at the threshold of $100,000/QALY. Conclusions Our results suggest that the most cost-effective implementation support begins with a less intensive, less costly strategy initially and increases as needed to enhance EBP uptake. Using this approach, implementation support resources can be judiciously allocated to those clinics that would most benefit. Our results were not robust to changes in the utility measure. Further research is needed that incorporates robust and relevant utilities in implementation research to identify the most cost-effective strategies. This research advances economic evaluation of implementation by assessing costs and utilities across multiple implementation strategy combinations. Trial registration: ClinicalTrials.gov Identifier: NCT02151331, 05/30/2014

Abstract 02: Population Strategies to Decrease Sodium Intake: A Global Cost-Effectiveness Analysis

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Michael Webb ◽  
Saman Fahimi ◽  
Gitanjali M Singh ◽  
Shahab Khatibzadeh ◽  
Renata Micha ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Sodium Intake ◽  
Cost Effective ◽  
Dietary Sodium ◽  
Gdp Per Capita ◽  
Sodium Reduction ◽  
National Education ◽  
Life Years ◽  
Global Cost ◽  
Per Capita

Background: Excess sodium intake is a major risk factor for CVD globally. Yet, the cost-effectiveness of policy interventions to reduce sodium consumption in every country has not been quantified. Methods: We characterized global sodium intakes, blood pressure (BP) levels, effects of sodium on BP, and CVD rates, each by age and sex in 187 countries based on the 2010 Global Burden of Diseases study. Nation-specific costs of a policy that combined education with targeted industry agreements to reduce sodium were estimated using the WHO NCD Costing Tool. Nation-specific impacts on mortality and disability-adjusted life years (DALYs) were modeled using comparative risk assessment, based on various scenarios including 10%, 30%, 1 g/d, and 3 g/d achieved sodium reductions over 10 yrs. Cost-effectiveness (CE) was evaluated as PPP-adjusted international $ per DALY saved over 10 yrs. Results: Worldwide, a 10% sodium reduction within each country was projected to avert an average of 5,655,000 CVD-related DALYs/year, at an average cost of 1.11 international dollars per capita over the 10 yr intervention. The average CE ratio was I$207/DALY. Across 21 world regions, sodium reduction would be most CE in South Asia and East/Southeast Asia (each I$120/DALY); across 187 countries, the most CE were Moldova (I$9.89/DALY), Azerbaijan (I$12.82/DALY), and Uzbekistan (I$12.85/DALY). The least CE region was Australia/New Zealand (I$922/DALY), although this CE was still substantially below the usual threshold to define an intervention as CE (3.0 GDP per capita). 99% of the world's population live in countries in which the intervention had a CE ratio < 1.0 GDP per capita, and 95% in countries with a CE ratio < 0.1 GDP per capita - far below standard acceptable CE ratios of 3.0 GDP per capita. Conclusions: National education and industry-agreement strategies to reduce dietary sodium would have substantial impacts on CVD and be extremely cost-effective in nearly every country worldwide. CE of 10% reduction intervention: GDP/capita per DALY

Within trial cost-effectiveness of a structured lifestyle intervention in adults with overweight/obesity and type 2 diabetes: Results from the Action for Health in Diabetes (Look AHEAD) Study

2020 ◽  
Author(s):  
Ping Zhang ◽  
Karen M. Atkinson ◽  
George Bray ◽  
Haiying Chen ◽  
Jeanne M. Clark ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Lifestyle Intervention ◽  
Health Utility Index ◽  
Health Benefit ◽  
Cost Effective ◽  
Health Utility ◽  
Health Care Expenditures ◽  
Quality Adjusted Life Year

<b>OBJECTIVE </b>To assess the cost-effectiveness (CE) of an intensive lifestyle intervention (ILI) compared to standard diabetes support and education (DSE) in adults with overweight/obesity and type 2 diabetes, as implemented in the Action for Health in Diabetes study. <p><b>RESEARCH DESIGN AND METHODS</b> Data were from 4,827 participants during the first 9 years of the study from 2001 to 2012. Information on Health Utility Index-2 and -3, SF-6D, and Feeling Thermometer [FT]), cost of delivering the interventions, and health expenditures were collected during the study. CE was measured by incremental cost-effectiveness ratios (ICERs) in costs per quality-adjusted life year (QALY). Future costs and QALYs were discounted at 3% annually. Costs were in 2012 US dollars. </p> <p><b>RESULTS </b><a>Over the </a>9 years studied, the mean cumulative intervention costs and mean cumulative health care expenditures were $11,275 and $64,453 per person for ILI and $887 and $68,174 for DSE. Thus, ILI cost $6,666 more per person than DSE. Additional QALYs gained by ILI were not statistically significant measured by the HUIs and were 0.17 and 0.16, respectively, measured by SF-6D and FT. The ICERs ranged from no health benefit with a higher cost based on HUIs, to $96,458/QALY and $43,169/QALY, respectively, based on SF-6D and FT. </p> <p><b>Conclusions </b>Whether<b> </b>ILI was cost-effective over the 9-year period is unclear because different health utility measures led to different conclusions. </p>

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