scholarly journals Cost savings of paper analytical devices (PADs) to detect substandard and falsified antibiotics: Kenya case study

2021 ◽  
Vol 5 ◽  
pp. 239920262098030
Author(s):  
Hui-Han Chen ◽  
Colleen Higgins ◽  
Sarah K. Laing ◽  
Sarah L. Bliese ◽  
Marya Lieberman ◽  
...  

Background: Over 10% of antibiotics in low- and middle-income countries (LMICs) are substandard or falsified. Detection of poor-quality antibiotics via the gold standard method, high-performance liquid chromatography (HPLC), is slow and costly. Paper analytical devices (PADs) and antibiotic paper analytical devices (aPADs) have been developed as an inexpensive way to estimate antibiotic quality in LMICs. Aim: To model the impact of using a rapid screening tools, PADs/aPADs, to improve the quality of amoxicillin used for treatment of childhood pneumonia in Kenya. Methods: We developed an agent-based model, ESTEEM (Examining Screening Technologies with Economic Evaluations for Medicines), to estimate the effectiveness and cost savings of incorporating PADs and aPADs in amoxicillin quality surveillance in Kenya. We compared the current testing scenario (batches of entire samples tested by HPLC) with an expedited HPLC scenario (testing smaller batches at a time), as well as a screening scenario using PADs/aPADs to identify poor-quality amoxicillin followed by confirmatory analysis with HPLC. Results: Scenarios using PADs/aPADs or expedited HPLC yielded greater incremental benefits than the current testing scenario by annually averting 586 (90% uncertainty range (UR) 364–874) and 221 (90% UR 126–332) child pneumonia deaths, respectively. The PADs/aPADs screening scenario identified and removed poor-quality antibiotics faster than the expedited or regular HPLC scenarios, and reduced costs significantly. The PADs/aPADs scenario resulted in an incremental return of $14.9 million annually compared with the reference scenario of only using HPLC. Conclusion: This analysis shows the significant value of PADs/aPADs as a medicine quality screening and testing tool in LMICs with limited resources.

2016 ◽  
Vol 24 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Sung-Pa Park

Summary Introduction. People with epilepsy (PWE) have a higher risk of developing depression and anxiety than people without epilepsy. However, understanding and management of that issue remain under-recognized. Aim. To emphesize: a) the relationship between depression, anxiety, and epilepsy, and b) to suggest practical strategies for their identification by clinicians. Methods. The current literatures was reviewed investigating the impact of depression and anxiety in PWE and those examining the validity of simple screening tools for the detection of depression and anxiety. Review. Approximately one quarter of PWE have been known to be suffered from depression. The frequency of depression and anxiety was closely related to poor seizure control. Depression and anxiety have been reported to have a bidirectional relationship with epilepsy. The higher degree of depression and anxiety was more likely to elicit the suicidal ideation and attempt, adverse events and poor compliance of antiepileptic drugs, poor surgical outcome, and eventually, poor quality of life. Furthermore, depression and anxiety were closely associated with perceived stigma, obsessive-compulsive symptom, aggression, fatigue, and perceived stress. Conclusions. Clinicians who take care of PWE in a busy clinical setting should identify their psychiatric problems by brief screening tools and treat them instantly to minimize their negative impacts.


Author(s):  
Vy Bui ◽  
Colleen R. Higgins ◽  
Sarah Laing ◽  
Sachiko Ozawa

Substandard and falsified antimalarials contribute to the global malaria burden by increasing the risk of treatment failures, adverse events, unnecessary health expenditures, and avertable deaths, yet no study has examined this impact in western francophone Africa to date. In Benin, where malaria remains endemic and is the leading cause of mortality among children younger than 5 years, there is a lack of robust data to combat the issue effectively and inform policy decisions. We adapted the Substandard and Falsified Antimalarial Research Impact model to assess the health and economic impact of poor-quality antimalarials in this population. The model simulates population characteristics, malaria infection, care-seeking behavior, disease progression, treatment outcomes, and associated costs of malaria. We estimated approximately 1.8 million cases of malaria in Benin among children younger than 5 years, which cost $193 million (95% CI, $192–$193 million) in treatment costs and productivity losses annually. Substandard and falsified antimalarials were responsible for 11% (n = 693) of deaths and nearly $20.8 million in annual costs. Moreover, we found that replacing all antimalarials with quality-ensured artemisinin combination therapies (ACTs) could result in $29.6 million in cost savings and prevent 1,038 deaths per year. These results highlight the value of improving access to quality-ensured artemisinin combination therapies for malaria treatment and increasing care-seeking in Benin. Policymakers and key stakeholders should use these findings to advocate for increased access to quality-ensured antimalarials, inform policies and interventions to improve health-care access and quality, and reduce the burden of malaria.


Methodology ◽  
2015 ◽  
Vol 11 (3) ◽  
pp. 89-99 ◽  
Author(s):  
Leslie Rutkowski ◽  
Yan Zhou

Abstract. Given a consistent interest in comparing achievement across sub-populations in international assessments such as TIMSS, PIRLS, and PISA, it is critical that sub-population achievement is estimated reliably and with sufficient precision. As such, we systematically examine the limitations to current estimation methods used by these programs. Using a simulation study along with empirical results from the 2007 cycle of TIMSS, we show that a combination of missing and misclassified data in the conditioning model induces biases in sub-population achievement estimates, the magnitude and degree to which can be readily explained by data quality. Importantly, estimated biases in sub-population achievement are limited to the conditioning variable with poor-quality data while other sub-population achievement estimates are unaffected. Findings are generally in line with theory on missing and error-prone covariates. The current research adds to a small body of literature that has noted some of the limitations to sub-population estimation.


Author(s):  
A. Seetharaman ◽  
Nitin Patwa ◽  
Simon Lai Koek Wai ◽  
Ahammed Shamir

The evolution of the Internet has revolutionised the sourcing and procurement processes in organisations in every industry. The focus of this paper is to analyse the perception of business users on the factors which impact the usage of eprocurement systems in the biomedical industry. There are four factors identified in this research: i.e. control and compliance, cost savings, process automation, and improvements and transparency. The benefit of achieving process automation is the first biggest factor, followed by the need for control and compliance, and transparency, being the second and third factors respectively. The fourth factor, cost savings, is ignored because the users perceived that cost savings will not be realised in the short term, and the returns from the investment could be a couple of years after the eprocurement system has been fully operational. The research also concludes that the ability to perform business analytics and to strengthen the supply chain are the most important factors in measuring the success in the adoption of e-procurement systems


10.37512/700 ◽  
2020 ◽  

Poor quality complementary foods contribute to undernutrition in children aged 6-23 months. Therefore, there is need to explore foods that will provide adequate nutrients for this age group. This study aimed at determining the impact of a sorghum-amaranth composite flour porridge on nutrient intake of children aged 6-23 months. A randomized controlled trial was conducted at Kiandutu slum, Thika, Kenya. Children in the control group (CG), received a maize-sorghum flour while those in the treatment group (TG) received an amaranth-sorghum flour. The sample size per study group was 73 mother-child pairs. The children in the TG received Kcal 1000 worth of porridge/day while those in the CG received Kcal 266.8/day. Mothers of children in both groups were given nutrition education at baseline, and monthly, for six months. Food intake data was taken at baseline, then monthly for six months. Descriptive statistics were used to describe nutrient intake. Chi square and Mann Whitney U test were was used to compare the baseline characteristics of the two groups and their nutrient intake, respectively. At baseline characteristics of the two groups were similar. On a monthly basis, nutrient intake in the TG was significantly higher for a majority of the nutrients than in the CG. The product can contribute to preventing under-nutrition in children aged 6-23 months.


Author(s):  
Ipseeta Satpathy ◽  
B. Chandra Mohan Patnaik ◽  
Chandrabhanu Das

The existence of Yoga dates back to more than ten thousand years around India and all nations. The Hindu Mythology considers the genesis of Yoga by incorporating Lord Shiva as Guru and Goddess Parvati as Shishya. Gradually with the development of civilization mankind assessed the benefits of this spiritual discipline and different leaders propagated the Yoga in different ways.In this era of 21st century Baba Ramdev propagated the yoga sutras with simple and effective techniques. The Pranayam and Suryanamaskar are the popular routines practiced by many followers of Baba Ramdev. Today Yoga is practiced as a way of Living to prevent Lifestyle diseases, combat stress and rejuvenate self. Yoga has gained immense popularity over the years with July 21st being celebrated as International Yoga Day. Corporate are also now introducing Yoga for employees as a means to relieve their stress and improve productivity. Long Hours of sitting, standing and excessive use of electronic gadgets puts pressure on bones, joints and responsible for Lifestyle diseases. Yoga is now increasingly used as a wellness solution replacing high cost antibiotic drugs. Employee well-being leads to Cost Savings in terms of personnel by reduced payment of Insurance and Medical Bills. The paper studies the Impact of Yoga to Financial benefits in MSME Organizations in Odisha in light of three different perspectives of Internal Control, Inventory management and Cash Flow. The primary data was collected from a sample of 155 high profile finance executives working in the MSME sector. Ranking Table and Regression Analysis Methodology was used to derive meaningful conclusions. The research takes initiative to transform the effectiveness of Yoga into improved financial health for the Organization. The observation from the study interprets a positive impact of Yoga on good financial health of Organization.


2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch

Current estimates of obesity costs ignore the impact of future weight loss and gain, and may either over or underestimate economic consequences of weight loss. In light of this, I construct static and dynamic measures of medical costs associated with body mass index (BMI), to be balanced against the cost of one-time interventions. This study finds that ignoring the implications of weight loss and gain over time overstates the medical-cost savings of such interventions by an order of magnitude. When the relationship between spending and age is allowed to vary, weight-loss attempts appear to be cost-effective starting and ending with middle age. Some interventions recently proven to decrease weight may also be cost-effective.


2020 ◽  
pp. 003464462097393
Author(s):  
Colin Cannonier ◽  
Monica Galloway Burke ◽  
Ed Mitchell

In this article, we explore the impact of a reentry and aftercare service program on the likelihood of returning to prison by ex-offenders. Using administrative data within a difference-in-differences design, we find that this social program is associated with a reduction in recidivism rates. Benchmark estimates show that the program was associated with estimated reductions in the probability of recidivating of 6.0 to 8.7 percentage points. The estimate appears to be economically significant as it implies an estimated treated effect in the 15.8% to 19.2% range. We consider the heterogeneous effects of the program on reducing recidivism according to race, age group, and program type. The program helped to reduce recidivism among Whites but not Blacks; older participants were the main beneficiaries while the effectiveness of the program was observed among older participants. Back-of-the-envelope cost-savings analysis is incorporated to estimate the potential savings to the state arising from the reduction in recidivism rates likely attributable to the program. The findings are robust to sample selection bias, alternative specifications, and estimation techniques. Our results offer some implications for the role of faith-based social programs within the context of criminal justice reform to combat reentry of former inmates. They also provide a cautionary tale about the need to evaluate programs not just based on their overall effect.


Pharmaceutics ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 905
Author(s):  
Sangeeta Kumari ◽  
Madhuri Dandamudi ◽  
Sweta Rani ◽  
Elke Behaeghel ◽  
Gautam Behl ◽  
...  

Dry eye disease (DED) or keratoconjunctivitis sicca is a chronic multifactorial disorder of the ocular surface caused by tear film dysfunction. Symptoms include dryness, irritation, discomfort and visual disturbance, and standard treatment includes the use of lubricants and topical steroids. Secondary inflammation plays a prominent role in the development and propagation of this debilitating condition. To address this we have investigated the pilot scale development of an innovative drug delivery system using a dexamethasone-encapsulated cholesterol-Labrafac™ lipophile nanostructured lipid carrier (NLC)-based ophthalmic formulation, which could be developed as an eye drop to treat DED and any associated acute exacerbations. After rapid screening of a range of laboratory scale pre-formulations, the chosen formulation was prepared at pilot scale with a particle size of 19.51 ± 0.5 nm, an encapsulation efficiency of 99.6 ± 0.5%, a PDI of 0.08, and an extended stability of 6 months at 4 °C. This potential ophthalmic formulation was observed to have high tolerability and internalization capacity for human corneal epithelial cells, with similar behavior demonstrated on ex vivo porcine cornea studies, suggesting suitable distribution on the ocular surface. Further, ELISA was used to study the impact of the pilot scale formulation on a range of inflammatory biomarkers. The most successful dexamethasone-loaded NLC showed a 5-fold reduction of TNF-α production over dexamethasone solution alone, with comparable results for MMP-9 and IL-6. The ease of formulation, scalability, performance and biomarker assays suggest that this NLC formulation could be a viable option for the topical treatment of DED.


Author(s):  
Nadine T. Hillock ◽  
Tracy L. Merlin ◽  
Jonathan Karnon ◽  
John Turnidge ◽  
Jaklin Eliott

Abstract Background The frameworks used by Health Technology Assessment (HTA) agencies for value assessment of medicines aim to optimize healthcare resource allocation. However, they may not be effective at capturing the value of antimicrobial drugs. Objectives To analyze stakeholder perceptions regarding how antimicrobials are assessed for value for reimbursement purposes and how the Australian HTA framework accommodates the unique attributes of antimicrobials in cost-effectiveness evaluation. Methods Eighteen individuals representing the pharmaceutical industry or policy-makers were interviewed. Interviews were transcribed verbatim, coded, and thematically analyzed. Results Key emergent themes were that reimbursement decision-making should consider the antibiotic spectrum when assessing value, risk of shortages, the impact of procurement processes on low-priced comparators, and the need for methodological transparency when antimicrobials are incorporated into the economic evaluation of other treatments. Conclusions Participants agreed that the current HTA framework for antimicrobial value assessment is inadequate to properly inform funding decisions, as the contemporary definition of cost-effectiveness fails to explicitly incorporate the risk of future resistance. Policy-makers were uncertain about how to incorporate future resistance into economic evaluations without a systematic method to capture costs avoided due to good stewardship. Lacking financial reward for the benefits of narrower-spectrum antimicrobials, companies will likely focus on developing broad-spectrum agents with wider potential use. The perceived risks of shortages have influenced the funding of generic antimicrobials in Australia, with policy-makers suggesting a willingness to pay more for assured supply. Although antibiotics often underpin the effectiveness of other medicines, it is unclear how this is incorporated into economic models.


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