Plastic Liners for Offshore Production Lines: A Cost Effective Alternative Solution to Corrosion Resistant Alloys?

2021 ◽  
Author(s):  
Thomas Delaplace ◽  
Morgan Gouriou ◽  
Denis Melot
Keyword(s):  
Cost Savings ◽  
Cost Effective ◽  
Sensitivity Study ◽  
Cost Comparison ◽  
Production Lines ◽  
Potential Cost ◽  
Corrosion Resistant ◽  
Offshore Production ◽  
Design Requirements ◽  
The Cost

Abstract This paper presents the investigations performed by TotalEnergies and Saipem on the cost effectiveness potential of internal plastic lining for corrosion protection of offshore production lines. Objective was to better understand for a complete EPCI cost comparison the various parameters that could have a significant impact on the potential savings associated with the use of plastic lining instead of CRAs (Corrosion Resistant Alloys) for very corrosive production fluids such as sour gases. An extensive cost comparison study between CRA lining and plastic lining for offshore production lines was performed considering sensitivity on several parameters: 3 pipe diameters, S-Lay, Reel-Lay and J-Lay installation, sensitivity to external thermal insulation requirements, mechanical and design requirements, to pipe length and fixed costs (technologies and vessels). A dedicated calculation tool for system design and cost assessment was built on purpose for this sensitivity study. Costs were assessed for the various cases, starting from pipe design, then assessing procurement costs, fabrication costs then installation costs with preliminary cycle time assessment. Project management and engineering costs have been considered to obtain comparative EPCI (as installed) cost assessments for the various study cases. Plastic lining appears to be a cost-effective solution installed in J-Lay or S-Lay in addition to reeling (up to 45% of potential cost savings on installed line compared to CRA lining). The main driver for the cost savings is associated to the procurement of the pipes and associated lining, including pipe manufacturing. Some smaller savings can also be obtained from the offshore cycle times in J-Lay and S-Lay as the CRA welding add a significant operation time in comparison with standard CS welds. The fixed additional costs associated to the plastic lining (specific tooling for example) can be quickly amortized after a few kilometers thanks to the material cost savings. Integrating them as a company investment allows to unlock costs savings even for shorter lines. The thermal contribution of the plastic liner is also interesting regarding the overall pipe insulation design. This study completes the works already performed by the industry on the offshore costs of plastic lining as it considers the whole EPCI CAPEX costs from the Contractor and Operator points of view and offshore experience. The study integrates the S-Lay and J-Lay installation methods (while previous studies mainly focused on Reel-Lay) and includes an extensive sensitivity study with various key parameters such as pipe sizes, pipe design requirements, material costs and offshore operation times to get a general overview of potential benefits associated with plastic linings for offshore production lines transporting corrosive fluids such as sour gases.

scholarly journals 2694. Incidence of Pneumocytis jiroveci (PJP) Infection with 3-Month Prophylaxis of Aerosolized Pentamidine (AP) in Autologous Hematopoietic Stem Cell Transplantation (HSCT)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S947-S947
Author(s):  
Sarah Perreault ◽  
Dayna McManus ◽  
Rebecca Pulk ◽  
Jeffrey E Topal ◽  
Francine Foss ◽  
...  
Keyword(s):  
Cost Savings ◽  
Cost Comparison ◽  
High Dose ◽  
Potential Cost ◽  
Hematopoietic Stem ◽  
Increased Risk ◽  
One Year ◽  
Relapsed Disease ◽  
The Cost ◽  
Autologous Hsct

Abstract Background HSCT patients are at an increased risk of developing PJP after transplant due to treatment induced immunosuppression. Given the risk of cytopenias with co-trimoxazole, AP is utilized as an alternative for PJP prophylaxis. A prior study revealed a 0% (0/19 patients) incidence when AP prophylaxis was given for one year post autologous HSCT. Current guidelines recommend a duration of 3 – 6 months for PJP prophylaxis in autologous HSCT. The primary endpoint of this study was to assess the incidence of PJP infection within one year post autologous HSCT in patients who received 3 months of AP. Secondary endpoint was a cost comparison of 3 months compared with 6 months of AP. Methods A single-center, retrospective study of adult autologous HSCT patients at Yale New Haven Hospital between February 2013 and December 2017 was performed. Patients were excluded if: <18 years of age, received < or >3 months of AP, changed to alternative PJP prophylactic agent or received no PJP prophylaxis, received tandem HSCT, deceased prior to one year post-transplant from a non PJP-related infection, HIV positive, or lost to follow-up. Pentamidine was given as a 300 mg inhalation monthly for 3 months starting Day +15 after autologous HSCT. Results A total of 288 patients were analyzed, no PJP infections occurred within one year post HSCT. Additionally, 187 (65%) patients received treatment post HSCT with 135/215 (63%) receiving maintenance immunomodulatory drugs for myeloma and 40/288 (14%) patients developing relapsed disease. 43% of the chemotherapy regimens for relapsed disease included high dose corticosteroids. The cost difference of using 3 months vs. 6 months of AP is $790, reflecting the cost of drug and its administration. Applying our incidence of 0%, potential cost savings of 3 months vs. 6 months of AP would be $330,000 over 5 years or $66,000 per year. Conclusion Three months of AP for PJP prophylaxis in autologous HSCT patients is safe and effective as well as cost-effective compared with a 6 month regimen. Disclosures All authors: No reported disclosures.

scholarly journals Cost Comparison of Atypical Antipsychotics: Paliperidone ER and Risperidone

2018 ◽  
Vol 54 (6) ◽  
pp. 389-392
Author(s):  
Kiranjit Luther ◽  
Guang Mei Fung ◽  
Farah Khorassani
Keyword(s):  
Drug Utilization ◽  
Atypical Antipsychotics ◽  
Cost Savings ◽  
Cost Comparison ◽  
Prescribing Patterns ◽  
Utilization Review ◽  
Drug Utilization Review ◽  
Potential Cost ◽  
Therapy Cost ◽  
The Cost

Purpose: Paliperidone and risperidone are atypical antipsychotics that are structurally and therapeutically similar. Risperidone is metabolized by the liver via cytochrome (CYP) 2D6 to an active metabolite, 9-hydroxyrisperidone. The atypical antipsychotic paliperidone is 9-hydroxyrisperidone formulated separately as an extended-release (ER) tablet and is considerably more expensive than risperidone. The purpose of this retrospective drug utilization review is to evaluate the prescribing patterns of paliperidone ER and evaluate potential cost savings by converting paliperidone ER orders to risperidone at an inpatient psychiatric hospital’s formulary. Methods: This retrospective drug utilization review includes 100 patients, older than 18 years old, who were prescribed oral paliperidone ER at an inpatient, psychiatric hospital between January 1, 2017, and June 2, 2017. The data were collected through the electronic medical records. Patients who were prescribed oral paliperidone ER and refused to take paliperidone ER were excluded from the study population. The cost of each patient’s oral paliperidone ER pharmacotherapy was calculated using average wholesale prices. An equivalent total dose of risperidone therapy was calculated using a 2:3 paliperidone ER to risperidone conversion. The cost savings were then analyzed by comparing the total costs of paliperidone ER with risperidone therapy. Results: The results indicate that from January through June 2017, approximately 68% of all paliperidone ER utilization was for its approved indication of schizophrenia and schizoaffective disorder. The other 32% of utilization was either off-label or for approved indications of risperidone. The total paliperidone ER therapy cost for 100 patients was approximately $17 000, while the cost of risperidone therapy would be approximately $400 for the same patients over 6 months. Overall, this would provide an estimated cost savings of over $33 000 per year or about $169 in savings per patient. Conclusion: The study analysis demonstrates that there are opportunities for cost savings through therapeutic interchange of paliperidone ER to risperidone.

scholarly journals Reducing the Cost of the Diagnostic Odyssey in Early Onset Epileptic Encephalopathies

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Charuta Joshi ◽  
Diana L. Kolbe ◽  
M. Adela Mansilla ◽  
Sara O. Mason ◽  
Richard J. H. Smith ◽  
...  
Keyword(s):  
Early Onset ◽  
Cost Savings ◽  
Cost Effective ◽  
Potential Cost ◽  
Epileptic Encephalopathies ◽  
Diagnostic Odyssey ◽  
Insurance Reimbursement ◽  
Insurance Carrier ◽  
The Cost ◽  
Patients With Epilepsy

Whole exome sequencing (WES) has revolutionized the way we think about and diagnose epileptic encephalopathies. Multiple recent review articles discuss the benefits of WES and suggest various algorithms to follow for determining the etiology of epileptic encephalopathies. Incorporation of WES in these algorithms is leading to the discovery of new genetic diagnoses of early onset epileptic encephalopathies (EOEEs) at a rapid rate; however, WES is not yet a universally utilized diagnostic tool. Clinical WES may be underutilized due to provider discomfort in ordering the test or perceived costliness. At our hospital WES is not routinely performed for patients with EOEE due to limited insurance reimbursement. In fact for any patient with noncommercial insurance (Medicaid) the institution does not allow sending out WES as this is not “established”/“proven to be highly useful and cost effective”/“approved test” in patients with epilepsy. Recently, we performed WES on four patients from three families and identified novel mutations in known epilepsy genes in all four cases. These patients had State Medicaid as their insurance carrier and were followed up for several years for EOEE while being worked up using the traditional/approved testing methods. Following a recently proposed diagnostic pathway, we analyzed the cost savings (US dollars) that could be accrued if WES was performed earlier in the diagnostic odyssey. This is the first publication that addresses the dollar cost of traditional testing in EOEE as performed in these four cases versus WES and the potential cost savings.

Cost Comparison of Fan-out Wafer-Level Packaging to Fan-out Panel-Based Packaging

2016 ◽  
Vol 2016 (1) ◽  
pp. 000180-000184 ◽  
Author(s):  
Chet Palesko ◽  
Amy Lujan
Keyword(s):  
Surface Area ◽  
Cost Savings ◽  
Cost Comparison ◽  
Wafer Level ◽  
Potential Cost ◽  
Total Potential ◽  
Wafer Level Packaging ◽  
Cost Impact ◽  
Manufacturing Activity ◽  
The Cost

Abstract Fan-out wafer-level packaging (FOWLP) offers many significant benefits over other packaging technologies. It is one of the smallest packaging options, but unlike fan-in wafer-level packaging, the IO count of FOWLP is not limited to the area of the die. Given these advantages, FOWLP continues to grow in popularity. While the cost of FOWLP is usually reasonable, there are still opportunities for future cost reduction. Many FOWLP suppliers are exploring panel-based manufacturing instead of the current wafer-based approach. Since many more packages can fit on a large panel than on a wafer, the cost per package can be reduced. The surface area of a 370mm × 470mm panel is 1,739 sq.cm. compared to 706 sq.cm. for a 300mm wafer. This means more than twice as many packages can be manufactured on a single panel. However, this does not mean that the cost per package will be cut in half. Many of the costly manufacturing activities do not depend on the surface area of the panel or wafer and they will not be affected by a larger panel. This paper analyzes the current cost of FOWLP activities and highlights which activities will benefit from a move to panels. An analysis of each manufacturing activity is presented comparing the cost impact of panel versus wafer. The total potential cost savings is also presented.

Analytical decision model for the cost-effective management of solitary pulmonary nodules.

1998 ◽  
Vol 16 (6) ◽  
pp. 2113-2125 ◽  
Author(s):  
S S Gambhir ◽  
J E Shepherd ◽  
B D Shah ◽  
E Hart ◽  
C K Hoh ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Decision Analysis ◽  
Cost Savings ◽  
Pulmonary Nodules ◽  
Cost Effective ◽  
Solitary Pulmonary Nodules ◽  
Potential Cost ◽  
Positron Emission ◽  
The Cost ◽  
Analysis Models

PURPOSE AND METHODS Multiple strategies are currently being used to manage patients who present with indeterminate solitary pulmonary nodules (SPN). We have used decision-analysis models to assess the cost-effectiveness of various strategies for the diagnosis and management of SPN. Four decision strategies were compared: a wait and watch strategy, a surgery strategy, a computed tomography (CT)-based strategy, and a CT-plus-positron emission tomography (PET) strategy. An incremental cost-effectiveness ratio (ICER) was used to compare all strategies to the wait and watch strategy. RESULTS A CT-plus-PET strategy was the most cost-effective over a large pretest likelihood (probability of having a malignant nodule), with a range of 0.12 to 0.69. Furthermore, within this likelihood range, the potential cost savings of using the CT-plus-PET strategy over the CT strategy ranged from $91 to $2,200 per patient. This translates to a yearly national savings of approximately $62.7 million. CONCLUSION Decision-analysis modeling indicates the potential cost-effectiveness of [18F]2-fluoro-2-deoxy-D-glucose (FDG)-PET in the management of SPN. Furthermore, the decision trees developed can be used to model various features of the management of SPN, including modeling the cost-effectiveness of other newly emerging technologies.

scholarly journals Potential and Realized Cost Savings with the Use of the Biosimilar Grastofil Vs Neupogen

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2126-2126
Author(s):  
Hishaam Bhimji ◽  
Dean Eurich ◽  
Kerry Mansell ◽  
Holly Mansell
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Cost Savings ◽  
Cost Effective ◽  
Potential Cost ◽  
Significant Cost ◽  
Term Care ◽  
Time Period ◽  
The Cost ◽  
Care System

Background: Filgrastim was first introduced to the Canadian marketplace as Neupogen® in 1992 to treat neutropenia caused by chemotherapy regimens. In 2009, the first biosimilar drug was approved for use in Canada, and in March 2016, a biosimilar for filgrastim (Grastofil®) became available. Biosimilars represent safe, effective, and cost effective alternatives to originator biologic medications. However, although biosimilar medications present opportunities for significant cost savings to the health care system, overall uptake and use of biosimilar medications in North America has been low. The aim of this study was to describe the overall use of the filgrastim products Grastofil® and Neupogen® in Canada. Methods: A retrospective analysis of Canadian drug purchases between July 2016 and June 2018 was performed for the drug filgrastim (Neupogen®, Grastofil®). The data used to estimate drug purchases were obtained from IQVIA™, a multi-national healthcare analytics company. Samples from the IQVIA™ Canadian Drugstore and Hospital Purchases (CDH) audit covered greater than 88% of the hospital market and one-third of the retail market. Samples were stratified by region, market size, and type of outlet (e.g. cancer centers, long-term care). For each drug, the total purchase dollar amounts were provided by province on a month by month basis. Potential cost-savings were calculated as a product between the units of each product purchased and the cost difference between Neupogen® and the biosimilar Grastofil® on a quarterly basis for each province. Results: Between July 1st, 2016 and June 30th, 2018, Grastofil® accounted for 27.0% (382,254/1,415,762 units) of filgrastim purchases. During this time period, $62,061,576 was spent on Grastofil® purchases and $204,152,590 was spent on Neupogen® purchases. Through use of the biosimilar Grastofil®, $13,443,873 (37.0%) in savings were realized. Had there been 100% use of the biosimilar Grastofil®, it would have resulted in $36,348,476 in cost savings. In the first quarter (July to September 2016) Grastofil® accounted for 1.5% of filgrastim purchases, whereas in the April to June 2018 quarter it increased to 43.6% of filgrastim purchases. The overall percentage of filgrastim units purchased by Canadian province varied substantially. The market share captured by Grastofil® ranged from a low of 0.08% ($4007/$5,189,623) in the province of Nova Scotia, to a high of 81.62% ($932,864/$1,142,905) in the province of Saskatchewan. Canada's largest province, Ontario, saw Grastofil® account for 44.7% ($9,047,489/$20,229,421) of purchases during this time period. Discussion: Although the biosimilar Grastofil® only accounted for 27% of filgrastim purchases between 2016 and 2018, there was substantial growth over this time period. By the end of June 2018, Grastofil® accounted for approximately 44% of filgrastim purchases, which is substantially higher than other biosimilar medications currently available in Canada. There are also stark differences between each province, whereas some had little to no use of the biosimilar, whereby in other provinces the purchases of Grastofil® outnumbered the purchases of Neupogen®. Had there been exclusive use of the biosimilar, an additional $23 million dollars in savings could have been realized. Conclusions: The use of biosimilars represents an opportunity for cost savings to be realized in an over-extended health care system. Although there appears to be acceptance for the use of Grastofil® as the overall purchases trended up from 2016 to 2018, there are still significant cost savings that could be realized by greater use of biosimilar drugs. Disclosures Mansell: Apobiologix: Research Funding.

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

Pound Wise and Penny Foolish? Weight Loss and The Dynamics of Health Care Spending

2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch
Keyword(s):  
Weight Loss ◽  
Cost Savings ◽  
Cost Effective ◽  
Economic Consequences ◽  
Health Care Spending ◽  
Order Of Magnitude ◽  
Dynamic Measures ◽  
The Cost ◽  
The Impact ◽  
The Relationship

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.

scholarly journals Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar

2021 ◽  
Vol 6 (1) ◽  
pp. e000561
Author(s):  
Ving Fai Chan ◽  
Fatma Omar ◽  
Elodie Yard ◽  
Eden Mashayo ◽  
Damaris Mulewa ◽  
...  
Keyword(s):  
Implementation Research ◽  
Cost Savings ◽  
Cost Effective ◽  
Integrated Model ◽  
Health Screening ◽  
High Coverage ◽  
Health Delivery ◽  
Screening Cost ◽  
Eye Health ◽  
The Cost

ObjectiveTo review and compare the cost-effectiveness of the integrated model (IM) and vertical model (VM) of school eye health programme in Zanzibar.Methods and analysisThis 6-month implementation research was conducted in four districts in Zanzibar. Nine and ten schools were recruited into the IM and VM, respectively. In the VM, teachers conducted eye health screening and education only while these eye health components were added to the existing school feeding programme (IM). The number of children aged 6–13 years old screened and identified was collected monthly. A review of project account records was conducted with 19 key informants. The actual costs were calculated for each cost categories, and costs per child screened and cost per child identified were compared between the two models.ResultsScreening coverage was 96% and 90% in the IM and VM with 297 children (69.5%) from the IM and 130 children (30.5%) from VM failed eye health screening. The 6-month eye health screening cost for VM and IM was US$6 728 and US$7 355. The cost per child screened for IM and VM was US$1.23 and US$1.31, and the cost per child identified was US$24.76 and US$51.75, respectively.ConclusionBoth models achieved high coverage of eye health screening with the IM being a more cost-effective school eye health delivery screening compared with VM with great opportunities for cost savings.

scholarly journals Self-fill oxygen technology: benefits for patients, healthcare providers and the environment

Breathe ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Phyllis Murphie ◽  
Nick Hex ◽  
Jo Setters ◽  
Stuart Little
Keyword(s):  
Positive Impact ◽  
Healthcare Providers ◽  
Cost Savings ◽  
Cost Effective ◽  
Evidence Base ◽  
Environmental Benefits ◽  
List Type ◽  
Potential Cost ◽  
Unlimited Supply ◽  
Technology Benefits

“Non-delivery” home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers.Educational aimsProvide update for oxygen prescribers on options for home oxygen provision.Provide update on the evidence base for available self-fill oxygen technologies.Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems.

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