scholarly journals Estimating the impact of tax policy interventions on the projected number and prevalence of adults with type 2 diabetes in Germany between 2020 and 2040

2021 ◽  
Vol 9 (1) ◽  
pp. e001813
Author(s):  
Thaddäus Tönnies ◽  
Christin Heidemann ◽  
Rebecca Paprott ◽  
Esther Seidel-Jacobs ◽  
Christa Scheidt-Nave ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Tax Policy ◽  
Base Case ◽  
Case Scenario ◽  
Base Case Scenario ◽  
Sweetened Beverages ◽  
Policy Interventions ◽  
The Impact ◽  
Intervention Scenario

IntroductionAs a population-wide intervention, it has been proposed to raise taxes on unhealthy products to prevent diseases such as type 2 diabetes. In this study, we aimed to estimate the effect of tax policy interventions in 2020 on the projected prevalence and number of people with type 2 diabetes in the German adult population in 2040.Research design and methodsWe applied an illness-death model and the German Diabetes Risk Score (GDRS) to project the prevalence and number of adults with type 2 diabetes in Germany under a base case scenario and under a tax policy intervention scenario. For the base case scenario, we assumed constant age-specific incidence rates between 2020 and 2040. For the intervention scenario, we assumed a 50% price increase for sugar-sweetened beverages, tobacco and red meat products in the year 2020. Based on price elasticities, we estimated the impact on these risk factors alone and in combination, and calculated subsequent reductions in the age-specific and sex-specific GDRS. These reductions were used to determine reductions in the incidence rate and prevalence using a partial differential equation.ResultsCompared with the base case scenario, combined tax interventions in 2020 resulted in a 0.95 percentage point decrease in the prevalence of type 2 diabetes (16.2% vs 17.1%), which corresponds to 640 000 fewer prevalent cases of type 2 diabetes and a relative reduction by 6%.ConclusionsTaxation of sugar-sweetened beverages, tobacco products and red meat by 50% modestly lowered the projected number and prevalence of adults with type 2 diabetes in Germany in 2040. Raising taxes on unhealthy products as a stand-alone measure may not be enough to attenuate the future rise of type 2 diabetes.

scholarly journals Economic evaluation of the use of saxagliptin in the treatment of type 2 diabetes in Italy

2010 ◽  
Vol 11 (2) ◽  
pp. 103-115 ◽  
Author(s):  
Marco Cristiani ◽  
Anna Citarella ◽  
Andrea Belisari ◽  
Guido Didoni ◽  
Lorenzo Giovanni Mantovani ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Treatment Strategies ◽  
Base Case ◽  
Case Scenario ◽  
Base Case Scenario ◽  
Utility Decrement ◽  
The Cost

In this study we compare the cost-effectiveness of saxagliptin (Onglyza®) in combination with metformin to that of either sulphonylurea (SU) plus metformin or a thiazolidinedione  (TZD) plus metformin, in type 2 diabetes mellitus patients who are not well-controlled on metformin alone. By using decision-analytic modeling, long-term costs and health outcomes associated with the investigated treatment strategies are estimated. This is achieved by modeling the risk of experiencing diabetes-related events (e.g. myocardial infarction) or side-effects such as hypoglycemia and weight gain. The risk of these events  depends on baseline characteristics as well as risk factors (which can be altered by the treatment strategies). Ultimately, costs (NHS perspective) and quality-adjusted life years (QALYs) for each treatment strategy are based on the occurrence of these events. Based on these estimates incremental cost-effectiveness ratios (cost per QALYs) are calculated. In the analysis comparing saxagliptin + metformin with SU + metformin in 1,000 patients in a 40 years time horizon, the total QALY gain with saxagliptin + metformin is 111. The incremental cost with saxagliptin + metformin is € 1,300,000, resulting in a total cost per QALY gained with saxagliptin + metformin of € 11,800 in the base case scenario. Similarly, the comparison with TZD + metformin resulted in a total  QALY gain with saxagliptin + metformin of 127, with an incremental cost of € 144,000, resulting in a total cost per QALY gained with saxagliptin + metformin of € 1,100 in the base case scenario. The results are mainly driven by differences in hypoglycemias (associated with a utility decrement and a monetary cost) and weight gain (which is associated with a utility decrement and also increases the risk for diabetes-related events). Saxagliptin + metformin is associated with small difference in macrovascular events such as myocardial infarction, congestive heart failure compared to SU or TZD plus metformin strategies, probably due to the difference of action on net weight. Since the treatment cost is higher with saxagliptin + metformin, total costs are also higher for the Onglyza®-based strategy although the higher drug cost is partially offset by the lower rate of macrovascular costs and reduced cost of severe hypoglycemias. The present analysis suggests that saxagliptin, when added to metformin, is a cost-effective treatment alternative for type 2 diabetes mellitus patients in Italy who are not well-controlled on metformin alone. Both compared to SU + metformin and TZD + metformin, the cost-effectiveness results of saxagliptin + metformin are robust to various assumptions concerning input variables. Hence, the favorable safety profile for saxagliptin, with a risk of hypoglycemia and impact on weight similar to placebo, makes it possible to increase the utility for patients since it is not reducing risk of diabetes-related events per se.

scholarly journals Influence of aquifer and streambed heterogeneity on the distribution of groundwater discharge

2009 ◽  
Vol 13 (1) ◽  
pp. 69-77 ◽  
Author(s):  
E. Kalbus ◽  
C. Schmidt ◽  
J. W. Molson ◽  
F. Reinstorf ◽  
M. Schirmer
Keyword(s):  
Groundwater Flow ◽  
Transport Model ◽  
Regional Scale ◽  
Base Case ◽  
Case Scenario ◽  
Base Case Scenario ◽  
Heterogeneous Distribution ◽  
Heterogeneous Aquifer ◽  
The Impact ◽  
Low K

Abstract. The spatial distribution of groundwater fluxes through a streambed can be highly variable, most often resulting from a heterogeneous distribution of aquifer and streambed permeabilities along the flow pathways. Using a groundwater flow and heat transport model, we defined four scenarios of aquifer and streambed permeability distributions to simulate and assess the impact of subsurface heterogeneity on the distribution of groundwater fluxes through the streambed: (a) a homogeneous low-K streambed within a heterogeneous aquifer; (b) a heterogeneous streambed within a homogeneous aquifer; (c) a well connected heterogeneous low-K streambed within a heterogeneous aquifer; and (d) a poorly connected heterogeneous low-K streambed within a heterogeneous aquifer. The simulation results were compared with a base case scenario, in which the streambed had the same properties as the aquifer, and with observed data. The results indicated that the aquifer has a stronger influence on the distribution of groundwater fluxes through the streambed than the streambed itself. However, a homogeneous low-K streambed, a case often implemented in regional-scale groundwater flow models, resulted in a strong homogenization of fluxes, which may have important implications for the estimation of peak mass flows. The flux distributions simulated with heterogeneous low-K streambeds were similar to the flux distributions of the base case scenario, despite the lower permeability. The representation of heterogeneous distributions of aquifer and streambed properties in the model has been proven to be beneficial for the accuracy of flow simulations.

scholarly journals The effectiveness of social bubbles as part of a Covid-19 lockdown exit strategy, a modelling study

2020 ◽  
Author(s):  
Trystan Leng ◽  
Connor White ◽  
Joe Hilton ◽  
Adam Kucharski ◽  
Lorenzo Pellis ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Base Case ◽  
Exit Strategy ◽  
Epidemic Threshold ◽  
Case Scenario ◽  
Base Case Scenario ◽  
The Social ◽  
The Uk ◽  
The Impact ◽  
Epidemic Risk

AbstractBackgroundDuring the Covid-19 lockdown, contact clustering in social bubbles may allow extending contacts beyond the household at minimal additional risk and hence has been considered as part of modified lockdown policy or a gradual lockdown exit strategy. We estimated the impact of such strategies on epidemic and mortality risk using the UK as a case study.MethodsWe used an individual based model for a synthetic population similar to the UK, that is stratified into transmission risks from the community, within the household and from other households in the same social bubble. The base case considers a situation where non-essential shops and schools are closed, the secondary household attack rate is 20% and the initial reproduction number is 0.8. We simulate a number of strategies including variations of social bubbles, i.e. the forming of exclusive pairs of households, for particular subsets of households (households including children and single occupancy households), as well as for all households. We test the sensitivity of the results to a range of alternative model assumptions and parameters.ResultsClustering contacts outside the household into exclusive social bubbles is an effective strategy of increasing contacts while limiting some of the associated increase in epidemic risk. In the base case scenario social bubbles reduced cases and fatalities by 17% compared to an unclustered increase of contacts. We find that if all households were to form social bubbles the reproduction number would likely increase to 1.1 and therefore beyond the epidemic threshold of one. However, strategies that allow households with young children or single occupancy households to form social bubbles only increased the reproduction number by less than 10%. The corresponding increase in morbidity and mortality is proportional to the increase in the epidemic risk but is largely focussed in older adults independently of whether these are included in the social bubbles.ConclusionsSocial bubbles can be an effective way of extending contacts beyond the household limiting the increase in epidemic risk, if managed appropriately.

scholarly journals Agricultural Supply Chain Risk Management Under Price and Demand Uncertainty

2021 ◽  
Vol 10 (2) ◽  
pp. 17-32
Author(s):  
Pritee Ray
Keyword(s):  
Risk Management ◽  
Supply Chain ◽  
Management Strategy ◽  
Expected Profit ◽  
Base Case ◽  
Risk Management Strategy ◽  
Case Scenario ◽  
Base Case Scenario ◽  
The Impact ◽  
Agricultural Supply

Agricultural supply chain (ASC) plays a vital role for sustainability as it is the main source of food supply. ASC encounters more sources of risk due to seasonality, perishability, and weather conditions, which makes the global food security system complex. This paper develops an optimization model for a perishable product supply chain to decide the optimal risk management strategy that maximizes the decision maker's expected profit under demand and price uncertainty. A base-case scenario is considered to show the impact of risk management strategy on performance improvement. The expected profit of the decision maker is obtained for different combination of strategies, and sensitivity analysis is performed to show the impact of perishability on the percentage of improvement from the base case scenario. The results show that backup supplier strategy is very effective during the yield disruption, but it is not as effective during harvest disruption. Hence, a single approach is inadequate to provide solution in all types of risk scenarios; thus, the combination of approaches is most effective.

scholarly journals Developing migrants prototypes performance through bottom-up construction method

2021 ◽  
Author(s):  
Rojhat Ibrahim ◽  
Bálint Baranyai
Keyword(s):  
Thermal Comfort ◽  
Construction Method ◽  
Base Case ◽  
Simulation Tool ◽  
Indoor Climate ◽  
Case Scenario ◽  
Base Case Scenario ◽  
Bottom Up ◽  
The World ◽  
The Impact

AbstractNatural and man-made disasters are vital issues that led to the increasing number of migrants, many of them stayed displaced for decades this requires more permanent dwellings. The main aim of the study is to investigate the impact of the bottom-up construction method on developing migrant’s shelters energy and thermal comfort performance. Dynamic simulation tool Indoor Climate and Energy (IDA ICE 4.8) has been used to assess nine different scenarios. The results quantified that the annually delivered energy and thermal comfort accepted hours of proposed scenario nine (S9) is better compared to base-case scenario one (S1) by 63% kWh and 4,215 h respectively. Methodologies and results of this paper can be adopted and applied for various places of the world affected by migration issue.

scholarly journals Improving vaccination coverage and offering vaccine to all school-age children will allow uninterrupted in-person schooling in King County, WA: Modeling analysis

2021 ◽  
Author(s):  
Chloe Bracis ◽  
Mia Moore ◽  
David A Swan ◽  
Laura Matrajt ◽  
Larissa Anderson ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Mitigation Measures ◽  
School Age Children ◽  
Base Case ◽  
King County ◽  
Case Scenario ◽  
Base Case Scenario ◽  
Social Distancing ◽  
School Year ◽  
The Impact

Background: The mass rollout of COVID vaccination in early 2021 allowed local and state authorities to relax mobility and social interaction regulations in spring 2021 including lifting all restrictions for vaccinated people and restoring in-person schooling. However, the emergence and rapid spread of highly transmissible variants combined with slowing down the pace of vaccination created uncertainty around the future trajectory of the epidemic. In this study we analyze the expected benefits of offering vaccination to children age 5-11 under differing conditions for in-person schooling. Methods: We adapted a mathematical model of SARS-CoV-2 transmission, calibrated to data from King County, Washington, to handle multiple variants with increased transmissibility and virulence as well as differential vaccine efficacies against each variant. Reactive social distancing is implemented driven by fluctuations in the number of hospitalizations in the county. We simulate scenarios offering vaccination to children aged 5-11 with different starting dates and different proportions of physical interactions (PPI) in schools being restored. The impact of improving overall vaccination coverage among the eligible population is also explored. Cumulative hospitalizations, percentage reduction of hospitalizations and proportion of time at maximum social distancing over the 2021-2022 school year are reported. Findings: In the base-case scenario with 85% vaccination coverage of 12+ year-olds, our model projects 4945 (median, IQR 4622-5341) total COVID-19 hospitalizations and 325 (median, IQR 264-400) pediatric hospitalizations if physical contacts at schools are fully restored (100% PPI) for the entire school year compared to 3675 (median, IQR 2311-4725) and 163 (median, IQR 95-226) if schools remained closed. Reducing contacts in schools to 75% PPI or 50% PPI through masking, ventilation and distancing is expected to decrease the overall cumulative hospitalizations by 2% and 4% respectively and youth hospitalizations by 8% and 23% respectively. Offering early vaccination to children aged 5-11 with 75% PPI is expected to prevent 756 (median, IQR 301-1434) hospitalizations and cut hospitalizations in the youngest age group in half compared to no vaccination. It will largely reduce the need of additional social distancing over the school year. If, in addition, 90% overall vaccination coverage is reached, 60% of remaining hospitalizations will be averted and the need of extra mitigation measures almost certainly avoided. Conclusions: Our work highlights that in-person schooling is possible if reasonable precaution measures are taken at schools to reduced infectious contacts. Rapid vaccination of all school-aged children will provide meaningful reduction of the COVID health burden over this school year but only if implemented early. Finally, it remains critical to vaccinate as many people as possible to limit the morbidity and mortality associated with the current surge in Delta variant cases.

scholarly journals Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages

PLoS ONE ◽  
2015 ◽  
Vol 10 (11) ◽  
pp. e0143050 ◽  
Author(s):  
Mercy Manyema ◽  
J. Lennert Veerman ◽  
Lumbwe Chola ◽  
Aviva Tugendhaft ◽  
Demetre Labadarios ◽  
...  
Keyword(s):  
South Africa ◽  
Type 2 Diabetes ◽  
Sugar Sweetened Beverages ◽  
Sweetened Beverages ◽  
The Impact

scholarly journals Evaluating the Impact of the Registered Provisional Immigrant Program: A Cost-Benefit Analysis

2016 ◽  
Vol 23 ◽  
pp. 20
Author(s):  
Odia Bintou Cissé
Keyword(s):  
Undocumented Immigrants ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
The United States ◽  
Base Case ◽  
Benefit Analysis ◽  
Case Scenario ◽  
Base Case Scenario ◽  
Worst Case ◽  
The Impact

On June 27, 2013, the Senate passed the Border Security, Economic Opportunity, and Immigration Modernization Act of 2013 (referred to as S.744). The bill addresses key elements of the immigration process through five sections. This analysis serves as an ex-ante Cost-Benefit Analysis (CBA) of the proposed Registered Provisional Immigrant (RPI) program under Section II of S.744, which would allow undocumented immigrants in the US to obtain legal status. The CBA looks at a 10-year timeframe from 2015 through 2025 and estimates the costs and benefits to four groups: undocumented immigrants, US taxpayers, employers of undocumented immigrants, and the United States Citizenship and Immigration Services (USCIS) under a base case scenario, a distributional weight scenario, and a worst-case scenario. Given the positive net benefits observed under the three scenarios, significant evidence recommends the implementation of the RPI program.

scholarly journals Optimizing the use of the Men-ACWY conjugated vaccine to control the developing meningococcal W disease outbreak in the Netherlands, a rapid analysis

2018 ◽  
Author(s):  
Albert Jan van Hoek ◽  
Mirjam Knol ◽  
Hester de Melker ◽  
Jacco Wallinga
Keyword(s):  
Cost Effectiveness ◽  
The Netherlands ◽  
Vaccination Campaign ◽  
Cost Effective ◽  
Reproductive Number ◽  
Base Case ◽  
Case Scenario ◽  
Base Case Scenario ◽  
Catch Up ◽  
The Impact

AbstractBackgroundThere is a developing outbreak of Neisseria meningitidis serotype W (MenW) in the Netherlands. In response, those aged 14 months and 14 years are vaccinated with the conjugated MenACWY vaccine. In the spring of 2018 we aimed to explore the impact of adding a one-off catch-up campaign targeting those aged 15-18 years on the transmission of MenW and the cost-effectiveness of such a campaign.MethodsWe estimated the growth rate of the MenW outbreak and quantified the impact of various targeted vaccination strategies on the reproductive number, and subsequently projected the future incidence with and without vaccination. Future cases were expressed in costs and QALYS and the incremental cost-effectiveness ratio was obtained.ResultsWe estimate a reproductive number of around 1.4 (95%CI 1.2-1.7) over the period February 2016-February 2018. Adding the catch-up campaign reduces the reproductive number five years earlier than without a catch-up campaign, to a level around 1.2. The vaccination campaign, including the catch-up, will prevent around 100 cases per year in our base case scenario. Given the projected impact and realistic assumptions on costs and QALYs, adding the catch-up can be considered cost-effective using a threshold of €20,000 per QALY.ConclusionAdding the catch-up campaign targeting those aged 15-18 brings the impact of vaccination on reducing transmission five years forward and directly prevents a high-incidence age group from carriage and disease. Such a campaign can be considered cost-effective. Our study did underpin the decision to introduce a catch-up campaign in spring 2019. Furthermore, our applied method can be of interest for anyone solving vaccine allocation questions in a developing outbreak.

scholarly journals Quantifying the Impact of Traffic on Electric Vehicle Efficiency

2022 ◽  
Vol 13 (1) ◽  
pp. 15
Author(s):  
Tim Jonas ◽  
Christopher D. Hunter ◽  
Gretchen A. Macht
Keyword(s):  
Electric Vehicle ◽  
Traffic Congestion ◽  
Base Case ◽  
Traffic Intensity ◽  
Case Scenario ◽  
Base Case Scenario ◽  
Traffic Conditions ◽  
Traffic Scenario ◽  
Morning Commute ◽  
The Impact

While the influence of several factors on battery electric vehicle (BEV) efficiency has been investigated in the past, their impact on traffic is not yet fully understood, especially when driving in a natural environment. This paper investigates the influence of driving in intense traffic conditions while considering the ambient temperature and driving behavior on BEV energy efficiency in a field study. A total of 30 BEV inexperienced drivers test drove a 2017 Volkswagen eGolf on a route with various road types in two different traffic intensity scenarios: During morning commute hours with higher traffic congestion and lower congestion hours throughout the middle of the day. Results support the hypothesis that traffic conditions significantly impact the vehicle’s efficiency, with additional consumption of approximately 4–5% in the high traffic scenario. By creating and comparing driving in traffic to an underlying base case scenario, the additional range potential by avoiding traffic for this particular vehicle can be quantified as up to seven miles. New patterns of BEV efficiencies emerged, which can help stakeholders understand how eco-driving can be strategically improved by selecting trip times and routes that avoid high traffic intensity.

Sign in / Sign up

Export Citation Format

Share Document