Anticancer drug waste minimization and cost-saving study by using a closed-system transfer device for chemotherapy compounding

2021 ◽  
pp. 107815522110085
Author(s):  
Casimir adade adade ◽  
Boubacar BF Diop ◽  
Houda Attjioui ◽  
Amine cheikh ◽  
Hafid Mefetah ◽  
...  
Keyword(s):  
Cost Saving ◽  
Closed System ◽  
Waste Minimization ◽  
Cancer Drug ◽  
Period 2 ◽  
Before And After ◽  
Cost Of Drugs ◽  
Drug Waste ◽  
The Cost ◽  
Conventional Systems

Introduction There is a need for an economic evaluation of the use of closed system (CSTD) in chemotherapy compounding, especially in resource-constrained settings. Objective The objective of this study was to assess the cost saving of the management of cancer drug leftovers before and after introduction of CSTD associated with an extension of the beyond-use date (BUD) of cancer vials. A secondary objective was to estimate the level of minimization of drug wastage. Materials and methods This was a prospective, single-center study with two periods of two months each. The cost of drugs saved by using conventional systems (syringe and needle) without a closed system in the first period was compared to the cost of drugs saved by using the CSTD Chemoclave® system in the second period. The drug waste minimization rate compared actual drug waste to potential waste in Period 2. Results In Period 1, the amount of drug saved accounted for an average of 10.3% of the amount used in milligrams and the amount of drug wasted accounted for an average of 18.7%. In period 2, these proportions were 15.2% and 6.4% respectively. The CSTD generated an extra cost of 11,962.5 USD compared to the conventional system. The drug saved cost related only to the CSTD and the acquisition cost of the CSTD was a deficit of -7,444.95 USD and the cost saved from the compounding (CSTD and syringes) was a gain of 1,722.01 USD. The waste minimization represented an average of 72.5% ± 24.4% of potential waste. Conclusion The use of CSTD to extend the BUD allowed to reduce waste due to microbiological instability without adding an economic profit.

Reducing costs while maintaining quality in endovascular neurosurgical procedures

2014 ◽  
Vol 121 (5) ◽  
pp. 1071-1076 ◽  
Author(s):  
Osama N. Kashlan ◽  
Thomas J. Wilson ◽  
Neeraj Chaudhary ◽  
Joseph J. Gemmete ◽  
William R. Stetler ◽  
...  
Keyword(s):  
Cost Saving ◽  
Contrast Agent ◽  
Policy Change ◽  
Economies Of Scale ◽  
Feedback System ◽  
Neurosurgical Procedures ◽  
Policy Changes ◽  
Before And After ◽  
The Cost ◽  
Neurointerventional Procedures

Object As medical costs continue to rise during a time of increasing medical resource utilization, both hospitals and physicians must attempt to limit superfluous health care expenses. Neurointerventional treatment has been shown to be costly, but it is often the best treatment available for certain neuropathologies. The authors studied the effects of 3 policy changes designed to limit the costs of performing neurointerventional procedures at the University of Michigan. Methods The authors retrospectively analyzed the costs of performing neurointerventional procedures during the 6-month periods before and after the implementation of 3 cost-saving policies: 1) the use of an alternative, more economical contrast agent, 2) standardization of coil prices through negotiation with industry representatives to receive economies of scale, and 3) institution of a feedback method to show practitioners the costs of unused products per patient procedure. The costs during the 6-month time intervals before and after implementation were also compared with costs during the most recent 6-month time period. Results The policy requiring use of a more economical contrast agent led to a decrease in the cost of contrast usage of $42.79 per procedure for the first 6 months after implementation, and $137.09 per procedure for the most current 6-month period, resulting in an estimated total savings of $62,924.31 for the most recent 6-month period. The standardized coil pricing system led to savings of $159.21 per coil after the policy change, and $188.07 per coil in the most recent 6-month period. This yielded total estimated savings of $76,732.56 during the most recent 6-month period. The feedback system for unused items decreased the cost of wasted products by approximately $44.36 per procedure in the 6 months directly after the policy change and by $48.20 per procedure in the most recent 6-month period, leading to total estimated savings of $22,123.80 during the most recent 6-month period. According to extrapolation over a 1-year period, the 3 policy changes decreased costs by an estimated $323,561.34. Conclusions Simple cost-saving policies can lead to substantial reductions in costs of neurointerventional procedures while maintaining high levels of quality and growth of services.

Print Media and the Political Reform in Ethiopia

2019 ◽  
Vol 14 ◽  
pp. 3356-3371
Author(s):  
Negesse Gessese
Keyword(s):  
Social Changes ◽  
Analysis Method ◽  
Sources Of Information ◽  
Attribution Of Responsibility ◽  
Societal Issues ◽  
Content Selection ◽  
Period 2 ◽  
Content Analysis Method ◽  
Before And After ◽  
Issue Frames

This research examines the agenda and frames used by the Reporter newspaper editorial coverage of issues and actors before and after the reform in Ethiopia. The study applies a quantitative content analysis method and examined 99 (Period 1 = 57 and Period 2 = 42) editorials in all periods. The source of data and the period of data collection were purposely selected. The results indicated that societal issues, government, and party issues were frequent in both periods. The professional journalist was the only Author in both periods. More government criticism and more reforms were mentioned before the reform. Compared with editorials published before and after the reform, noticeable changes were observed in government critique, attribution of responsibility frames, human interest frames and economic issue frames. However, content selection, sources of information, mentioned reforms, conflict relationship frames, and ideological frames didn’t have relationship with the date of publication. Finally, the Reporter editorials coverage did change significantly in many respects, although it is difficult to determine the causes of the changes—economic factors, reduced political control, social changes or globalization forces.

Waste minimization program in Shuaiba Industrial Area

1999 ◽  
Vol 39 (10-11) ◽  
pp. 289-295
Author(s):  
Saleh Al-Muzaini
Keyword(s):  
Solid Waste ◽  
Power Plants ◽  
Large Scale ◽  
Industrial Area ◽  
Waste Minimization ◽  
Regulatory Body ◽  
Eastern Sector ◽  
Western Sector ◽  
Petroleum Companies ◽  
The Cost

The Shuaiba Industrial Area (SIA) is located about 50 km south of Kuwait City. It accommodates most of the large-scale industries in Kuwait. The total area of the SIA (both eastern and western sectors) is about 22.98 million m2. Fifteen plants are located in the eastern sector and 23 in the western sector, including two petrochemical companies, three refineries, two power plants, a melamine company, an industrial gas corporation, a paper products company and, two steam electricity generating stations, in addition to several other industries. Therefore, only 30 percent of the land in the SIA's eastern sector and 70 percent of land in the SIA's western sector is available for future expansion. Presently, industries in the SIA generate approximately 204,000 t of solid waste. With future development in the industries in the SIA, the estimated quantities will reach 240,000 t. The Shuaiba Area Authority (SAA), a governmental regulatory body responsible for planning and development in the SIA, has recognized the problem of solid waste and has developed an industrial waste minimization program. This program would help to reduce the quantity of waste generated within the SIA and thereby reduce the cost of waste management. This paper presents a description of the waste minimization program and how it is to be implemented by major petroleum companies. The protocols employed in the waste minimization program are detailed.

scholarly journals An Outreach Rehabilitation Program for Nursing Home Residents After Hip Fracture May Be Cost-Saving

2020 ◽  
Vol 75 (10) ◽  
pp. e159-e165
Author(s):  
Lauren A Beaupre ◽  
Doug Lier ◽  
Jay S Magaziner ◽  
C Allyson Jones ◽  
D William C Johnston ◽  
...  
Keyword(s):  
Nursing Home ◽  
Hip Fracture ◽  
Cost Saving ◽  
Incremental Cost ◽  
Usual Care ◽  
Nursing Home Residents ◽  
Rehabilitation Program ◽  
Study Entry ◽  
Rehabilitation Intervention ◽  
The Cost

Abstract Background We compared the cost-effectiveness of 10 weeks of outreach rehabilitation (intervention) versus usual care (control) for ambulatory nursing home residents after hip fracture. Methods Enrollment occurred February 2011 through June 2015 in a Canadian metropolitan region. Seventy-seven participants were allocated in a 2:1 ratio to receive a 10-week rehabilitation program (intervention) or usual care (control) (46 intervention; 31 control). Using a payer perspective, we performed main and sensitivity analyses. Health outcome was measured by quality-adjusted life years (QALYs), using the EQ5D, completed at study entry, 3-, 6-, and 12-months. We obtained patient-specific data for outpatient visits, physician claims, and inpatient readmissions; the trial provided rehabilitation utilization/cost data. We estimated incremental cost and incremental effectiveness. Results Groups were similar at study entry; the mean age was 87.9 ± 6.6 years, 54 (71%) were female and 58 (75%) had severe cognitive impairment. EQ5D QALYs scores were nonsignificantly higher for intervention participants. Inpatient readmissions were two times higher among controls, with a cost difference of −$3,350/patient for intervention participants, offsetting the cost/intervention participant of $2,300 for the outreach rehabilitation. The adjusted incremental QALYs/patient difference was 0.024 favoring the intervention, with an incremental cost/patient of −$621 for intervention participants; these values were not statistically significant. A sensitivity analysis reinforced these findings, suggesting that the intervention was likely dominant. Conclusion A 10-week outreach rehabilitation intervention for nursing home residents who sustain a hip fracture may be cost-saving, through reduced postfracture hospital readmissions. These results support further work to evaluate postfracture rehabilitation for nursing home residents.

The cost implication of primary prevention in the HOPE 3 trial

2019 ◽  
Vol 5 (3) ◽  
pp. 266-271
Author(s):  
Andre Lamy ◽  
Eva Lonn ◽  
Wesley Tong ◽  
Balakumar Swaminathan ◽  
Hyejung Jung ◽  
...  
Keyword(s):  
Developing Countries ◽  
Primary Prevention ◽  
Cost Saving ◽  
Developed Countries ◽  
Sensitivity Analyses ◽  
Clinical Trial Registration ◽  
Pressure Lowering ◽  
The Cost ◽  
Care Costs ◽  
Country Specific

Abstract Aims The Heart Outcomes Prevention Evaluation-3 (HOPE-3) found that rosuvastatin alone or with candesartan and hydrochlorothiazide (HCT) (in a subgroup with hypertension) significantly lowered cardiovascular events compared with placebo in 12 705 individuals from 21 countries at intermediate risk and without cardiovascular disease. We assessed the costs implications of implementation in primary prevention in countries at different economic levels. Methods and results Hospitalizations, procedures, study and non-study medications were documented. We applied country-specific costs to the healthcare resources consumed for each patient. We calculated the average cost per patient in US dollars for the duration of the study (5.6 years). Sensitivity analyses were also performed with cheapest equivalent substitutes. The combination of rosuvastatin with candesartan/HCT reduced total costs and was a cost-saving strategy in United States, Canada, Europe, and Australia. In contrast, the treatments were more expensive in developing countries even when cheapest equivalent substitutes were used. After adjustment for gross domestic product (GDP), the costs of cheapest equivalent substitutes in proportion to the health care costs were higher in developing countries in comparison to developed countries. Conclusion Rosuvastatin and candesartan/HCT in primary prevention is a cost-saving approach in developed countries, but not in developing countries as both drugs and their cheapest equivalent substitutes are relatively more expensive despite adjustment by GDP. Reductions in costs of these drugs in developing countries are essential to make statins and blood pressure lowering drugs affordable and ensure their use. Clinical trial registration HOPE-3 ClinicalTrials.gov number, NCT00468923.

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

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.

scholarly journals Paediatric attendances of the emergency department in a major Irish tertiary referral centre before and after expansion of free GP care to children under 6: a retrospective observational study

2021 ◽  
Vol 5 (1) ◽  
pp. e000862
Author(s):  
Irina Korotchikova ◽  
Sukainah Al Khalaf ◽  
Ewa Sheridan ◽  
Rory O'Brien ◽  
Colin P Bradley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Observational Study ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Period 2 ◽  
Time Period ◽  
Before And After ◽  
Gp Care

ObjectivesTo examine the characteristics of paediatric attendances to the emergency department (ED) in Cork University Hospital (CUH) before and after the expansion of free general practitioner (GP) care to children under the age of 6 years.DesignThis is a retrospective observational study that used a large administrative dataset.SettingThe study was conducted in major Irish tertiary referral centre that serves a total population of over 1.1 million. It is a public hospital, owned and managed by the health service executive.ParticipantsChildren aged 0–15 years who attended CUH ED during the study period of 6 years (2012–2018) were included in this study (n=76 831).InterventionsFree GP care was expanded to all children aged 0–5 years in July 2015.Main outcome measuresPaediatric attendances to CUH ED were examined before (Time Period 1: July 2012–June 2015) and after (Time Period 2: July 2015–June 2018) the expansion of free GP care to children under 6. Changes in GP referral rates and inpatient hospital admissions were investigated.ResultsPaediatric presentations to CUH ED increased from 35 819 during the Time Period 1 to 41 012 during the Time Period 2 (14.5%). The proportion of the CUH ED attendances through GP referrals by children under 6 increased by over 8% in the Time Period 2 (from 10 148 to 14 028). Although the number of all children who attended CUH ED and were admitted to hospital increased in Time Period 2 (from 8704 to 9320); the proportion of children in the 0–5 years group who attended the CUH ED through GP referral and were subsequently admitted to hospital, decreased by over 3%.ConclusionThe expansion of free GP care has upstream health service utilisation implications, such as increased attendances at ED, and should be considered and costed by policy-makers.

scholarly journals Cost Analysis of Methylprednisolone Treatment of Multiple Sclerosis Patients

1998 ◽  
Vol 25 (3) ◽  
pp. 222-229 ◽  
Author(s):  
Lynda S. Robson ◽  
Charlene Bain ◽  
Shann Beck ◽  
Suzanne Guthrie ◽  
Peter C. Coyte ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cost Saving ◽  
Cost Analysis ◽  
Home Care ◽  
Care Program ◽  
Sensitivity Analyses ◽  
Patient Treatment ◽  
Fiscal Year ◽  
Multiple Sclerosis Patients ◽  
The Cost

ABSTRACT:Background:Intravenous methylprednisolone (IVMP) is the treatment of choice for multiple sclerosis (MS) patients undergoing acute exacerbation of disease symptoms and yet its cost has not been accurately determined. Determination of this cost in different settings is also pertinent to consideration of cost-saving alternatives to in-patient treatment.Methods:Cost analysis from the point of view of the health care system of IVMP treatment of MS patients receiving treatment in association with a selected Toronto teaching hospital in fiscal year 1994/95 was carried out. Costs of any concurrent treatments were excluded.Results:Total cost for 92 patients, based on a 4 dose regime, was estimated to be $78,527. The the cost per patient was $1,1181.84 for in-patients (IP), $714.64 for out-patients of the MS Clinic (OP) and $774.21 for patients whose treatment was initiated in the Clinic, but completed in the home (HC). Sensitivity analyses indicated: 1) IP treatment was in all cases more expensive than that of OP or HC; 2) the cost savings of OP vs. HC was sensitive to assumptions made regarding Clinic overhead, Clinic nursing costs and Home Care Program overhead.Conclusion:Alternatives to in-patient care must be considered carefully. In this study, both out-patient and in-home treatment were cost-saving alternatives to in-patient treatment, but large differences in the cost of hospital out-patient vs. in-home care could not be demonstrated.

Prescribing costs

1993 ◽  
Vol 31 (22) ◽  
pp. 87-87
Keyword(s):  
General Practitioners ◽  
Average Cost ◽  
Department Of Health ◽  
Cost Of Drugs ◽  
The Cost

The cost of drugs prescribed by general practitioners in England rose by 13.4% between 1991 and 1992, bringing the total amount spent on medicines prescribed in the community last year to £2858 million. In the same period the number of items dispensed rose by 4.6%, or 4.2% per head of population, and the average cost per item increased by 8.5%, from £6.20 to £6.72. These figures are contained in the latest issue of the Statistical Bulletin,1 published annually by the Department of Health.

Physicians' Interactions with Pharmaceutical Companies

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 281-282
Author(s):  
LEWIS H. MARGOLIS
Keyword(s):  
Medical Care ◽  
Cost Of Care ◽  
Pharmaceutical Companies ◽  
Cost Of Drugs ◽  
The Cost

In Reply.— In my essay1 I suggested that the acceptance of gifts from pharmaceutical companies violates a duty of justice because gifts represent resources inappropriately taken from patients through the added costs of the drugs that they buy. Dr Procopio raises the larger question of how other types of promotional activities increase the cost of drugs in particular and medical care in general. His letter makes clear, however, that the contribution of an activity such as the distribution of samples to the cost of care is difficult to determine because several different purposes are served.

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