scholarly journals Impact of changes in the methodology of external price referencing on medicine prices: discrete-event simulation

2020 ◽  
Author(s):  
Sabine Vogler ◽  
Peter Schneider ◽  
Lena Lepuschütz
Keyword(s):  
Cost Containment ◽  
Discrete Event ◽  
Real Life ◽  
Base Case ◽  
Medicine Price ◽  
The Real ◽  
Discrete Event Simulations ◽  
Methodological Choices ◽  
Event Simulation ◽  
Medicine Prices

Abstract Background: Several governments apply the policy of external price referencing (EPR), which considers the prices of a medicine in one or more other countries for the purpose of setting the price in the own country. Different methodological choices can be taken to design the EPR policy. The study aimed to analyse whether, or not, and how changes in the methodology of EPR can impact medicine prices.Methods: The real-life EPR methodology as of Q1/2015 was surveyed in all European Union Member States, Iceland, Norway and Switzerland through a questionnaire responded by national pricing authorities. Different scenarios were developed related to the parameters of the EPR methodology. Discrete-event simulations of fictitious prices in the 28 countries of the study that had EPR in place were run for a period of 10 years. The continuation of the real-life EPR methodology in the countries as surveyed in 2015, without any change, served as base case.Results: Consideration of discounts (an assumed 20% discount in five large economies and the mandatory discount in Germany, Greece and Ireland) and determining the reference price based on the lowest price in the country basket would result in higher price reductions (on average -47.2% and -34.2% compared to the base case). An adjustment of medicine price data of the reference countries by purchasing power parities would lead to higher prices in some more affluent countries (e.g. Switzerland, Norway) and lower prices in lower-income economies (Bulgaria, Romania, Hungary, Poland). Regular price revisions and changes in the basket of reference countries would also impact medicine prices, however to a lesser extent.Conclusions: EPR has some potential for cost-containment. Medicine prices could be decreased further if certain parameters of the EPR methodology were changed. If public payers aim to apply EPR to keep medicine prices at more affordable levels, they are encouraged to explore the cost-containment potential of this policy and to take appropriate methodological choices in the design of EPR.

scholarly journals Impact of changes in the methodology of external price referencing on medicine prices: discrete-event simulation

2020 ◽  
Author(s):  
Sabine Vogler ◽  
Peter Schneider ◽  
Lena Lepuschütz
Keyword(s):  
Cost Containment ◽  
Discrete Event ◽  
Real Life ◽  
Base Case ◽  
Case Scenario ◽  
Medicine Price ◽  
Base Case Scenario ◽  
The Real ◽  
Methodological Choices ◽  
Medicine Prices

Abstract Background: Several governments apply the policy of external price referencing (EPR), which considers the prices of a medicine in one or more other countries for the purpose of setting the price in the own country. Different methodological choices can be taken to design EPR. The study aimed to analyse whether, or not, and how changes in the methodology of EPR can impact medicine prices.Methods: The real-life EPR methodology as of Q1/2015 was surveyed in all European Union Member States (where applicable), Iceland, Norway and Switzerland through a questionnaire responded by national pricing authorities. Different scenarios were developed related to the parameters of the EPR methodology. Discrete-event simulations of fictitious prices in the 28 countries of the study that had EPR were run over 10 years. The continuation of the real-life EPR methodology in the countries as surveyed in 2015, without any change, served as base case.Results: In most scenarios, after ten years, medicine prices in all or most surveyed countries were – sometimes considerably – lower than in the base case scenario. But in a few scenarios medicine prices increased in some countries. Consideration of discounts (an assumed 20% discount in five large economies and the mandatory discount in Germany, Greece and Ireland) and determining the reference price based on the lowest price in the country basket would result in higher price reductions (on average -47.2% and -34.2% compared to the base case). An adjustment of medicine price data of the reference countries by purchasing power parities would lead to higher prices in some more affluent countries (e.g. Switzerland, Norway) and lower prices in lower-income economies (Bulgaria, Romania, Hungary, Poland). Regular price revisions and changes in the basket of reference countries would also impact medicine prices, however to a lesser extent.Conclusions: EPR has some potential for cost-containment. Medicine prices could be decreased if certain parameters of the EPR methodology were changed. If public payers aim to apply EPR to keep medicine prices at more affordable levels, they are encouraged to explore the cost-containment potential of this policy by taking appropriate methodological choices in the EPR design.

scholarly journals Impact of changes in the methodology of external price referencing on medicine prices: discrete-event simulation

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sabine Vogler ◽  
Peter Schneider ◽  
Lena Lepuschütz
Keyword(s):  
Cost Containment ◽  
Discrete Event ◽  
Real Life ◽  
Base Case ◽  
Case Scenario ◽  
Medicine Price ◽  
Base Case Scenario ◽  
The Real ◽  
Methodological Choices ◽  
Medicine Prices

Abstract Background Several governments apply the policy of external price referencing (EPR), which considers the prices of a medicine in one or more other countries for the purpose of setting the price in the own country. Different methodological choices can be taken to design EPR. The study aimed to analyse whether, or not, and how changes in the methodology of EPR can impact medicine prices. Methods The real-life EPR methodology as of Q1/2015 was surveyed in all European Union Member States (where applicable), Iceland, Norway and Switzerland through a questionnaire responded by national pricing authorities. Different scenarios were developed related to the parameters of the EPR methodology. Discrete-event simulations of fictitious prices in the 28 countries of the study that had EPR were run over 10 years. The continuation of the real-life EPR methodology in the countries as surveyed in 2015, without any change, served as base case. Results In most scenarios, after 10 years, medicine prices in all or most surveyed countries were—sometimes considerably—lower than in the base case scenario. But in a few scenarios medicine prices increased in some countries. Consideration of discounts (an assumed 20% discount in five large economies and the mandatory discount in Germany, Greece and Ireland) and determining the reference price based on the lowest price in the country basket would result in higher price reductions (on average − 47.2% and − 34.2% compared to the base case). An adjustment of medicine price data of the reference countries by purchasing power parities would lead to higher prices in some more affluent countries (e.g. Switzerland, Norway) and lower prices in lower-income economies (Bulgaria, Romania, Hungary, Poland). Regular price revisions and changes in the basket of reference countries would also impact medicine prices, however to a lesser extent. Conclusions EPR has some potential for cost-containment. Medicine prices could be decreased if certain parameters of the EPR methodology were changed. If public payers aim to apply EPR to keep medicine prices at more affordable levels, they are encouraged to explore the cost-containment potential of this policy by taking appropriate methodological choices in the EPR design.

Evaluation of postponement strategy in the production of table wine in Brazil: a discrete event simulation approach

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Carolina Reis Gualberto ◽  
Lásara Fabrícia Rodrigues ◽  
Karine Araújo Ferreira
Keyword(s):  
Discrete Event Simulation ◽  
Discrete Event ◽  
Real Life ◽  
Minas Gerais ◽  
Future Research ◽  
Lost Sales ◽  
Wine Production ◽  
Content Type ◽  
Event Simulation ◽  
Postponement Strategy

Purpose The purpose of this paper is to develop an approach to evaluate the partial postponement strategy and compare it with postponement and make-to-stock (MTS) strategies in the production of table wine in wineries in the state of Minas Gerais (south-eastern Brazil). Design/methodology/approach An approach based on discrete event simulation was developed to support decision-making in the wine sector. Simulation models were used to analyse partial postponement, postponement and MTS strategies in wine production. These models were inspired by a typical table wine producer selected from an exploratory study conducted in 12 wineries of Minas Gerais state in Brazil. Findings Hybrid strategies, such as partial postponement, favour the advantages of postponement and MTS depending on the portion of semi-finished and finished goods adopted. Wine production characteristics favour postponement and partial postponement with high semi-finished product levels (customer order-driven product) because this allows companies to reduce their inventory of bottles, despite possible increases in lost sales and costs. MTS and partial postponement with high finished product levels (forecast-driven product) present higher costs with bottled wine storage; however, these strategies reduce lost sales and improve agility and reliability in deliveries. Research limitations/implications Future research should analyse the production of table wines in other regions of the country and the production of fine wines. Practical implications The findings suggest promising perspectives for real-life applications in wineries in Brazil and other countries. Originality/value Simulation techniques allow the analysis of production strategies in little-known industries, such as table wine production in Brazil. The approach developed is flexible enough to support decisions and to be adapted to companies’ and markets’ characteristics and to test specific strategies.

Discrete Event Simulation Of The COVID-19 Sample Collection Point Operation

2021 ◽  
Author(s):  
Martina Kuncova ◽  
Katerina Svitkova ◽  
Alena Vackova ◽  
Milena Vankova
Keyword(s):  
Discrete Event Simulation ◽  
Waiting Times ◽  
Discrete Event ◽  
Real Data ◽  
Simulation Software ◽  
Sample Collection ◽  
The Real ◽  
Event Simulation ◽  
Collection Process ◽  
Collection Point

The year 2020 was very challenging for everyone due to the COVID-19 pandemic. Many people turn their lives upside down from day to day. Politicians had to impose completely unprecedented measures, and doctors immediately had to adapt to the huge influx of patients and the massive demand for testing. Of course, not all processes could be planned completely efficiently, given that the situation literally changes from minute to minute, but sometimes better planning could improve the real processes. This contribution deals with the application of simulation software SIMUL8 to the analysis of the COVID-19 sample collection process in a drive-in point in a hospital. The main aim is to create a model based on the real data and then to find out the suitable number of other staff (medics) helping a doctor during the process to decrease the number of unattended patients and their waiting times.

scholarly journals Going Through Rough Times: from Non-Equilibrium Surface Growth to Algorithmic Scalability

2001 ◽  
Vol 701 ◽  
Author(s):  
G. Korniss ◽  
M.A. Novotny ◽  
P.A. Rikvold ◽  
H. Guclu ◽  
Z. Toroczkai
Keyword(s):  
Time Horizon ◽  
Discrete Event ◽  
Parallel Discrete Event Simulation ◽  
Discrete Event Simulations ◽  
Kinetic Roughening ◽  
Event Simulation ◽  
Evolving System ◽  
Progress Rate ◽  
Parallel Discrete Event ◽  
Synchronization Scheme

ABSTRACTEfficient and faithful parallel simulation of large asynchronous systems is a challenging computational problem. It requires using the concept of local simulated times and a synchronization scheme. We study the scalability of massively parallel algorithms for discrete-event simulations which employ conservative synchronization to enforce causality. We do this by looking at the simulated time horizon as a complex evolving system, and we identify its universal characteristics. We find that the time horizon for the conservative parallel discrete-event simulation scheme exhibits Kardar-Parisi-Zhang-like kinetic roughening. This implies that the algorithm is asymptotically scalable in the sense that the average progress rate of the simulation approaches a non-zero constant. It also implies, however, that there are diverging memory requirements associated with such schemes.

scholarly journals Improving the Installation of Offshore Wind Farms by the use of Discrete Event Simulation

2015 ◽  
Author(s):  
Yohannes T. Muhabie ◽  
Jean-David Caprace ◽  
Cristian Petcu ◽  
Philippe Rigo
Keyword(s):  
Discrete Event Simulation ◽  
Wind Farm ◽  
Discrete Event ◽  
Probabilistic Approach ◽  
Wind Farms ◽  
Distance Matrix ◽  
Offshore Wind ◽  
Weather Data ◽  
The Real ◽  
Event Simulation

The offshore wind energy development is highly affected by the condition of the weather at sea. Hence, it demands a well-organized planning of the overall process starting from the producers’ sites until the offshore site where the turbines will finally be installed. The planning phase can be supported with the help of Discrete Event Simulation (DES) where weather restrictions, distance matrix, vessel characteristics and assembly scenarios are taken into account. The purpose of this paper is to simulate the overall transport, assembly and installation of the wind turbine components at sea. The analysis is carried out through DES considering both the real historical weather data (wind speed and wave height) and probabilistic approach. Results of the study, applied to the real Offshore Wind Farm (OWF) configuration, are showing a good agreement between the two proposed models. The results point out that the probabilistic\ approach is highly affected by the semi-random numbers used to model the stochastic behavior of the input variable so that several iterations (200 to 400) are required to reach the convergence of the simulation outputs. We suggest that seasonality of the outputs of both models are preserved, i.e. the variation of the results depending on the variation of the weather along the year. These findings provide a new framework to address risks and uncertainties in OWF installations.

Using Discrete Event Simulation Software in a MET Program

2001 ◽  
Author(s):  
Alok K. Verma
Keyword(s):  
Discrete Event Simulation ◽  
Manufacturing Systems ◽  
Discrete Event ◽  
Real Life ◽  
Simulation Software ◽  
Computer Integrated Manufacturing ◽  
Student Interest ◽  
Technology Program ◽  
Event Simulation ◽  
Life Problems

Abstract Discrete event simulation software can be an effective tool for teaching comparative analysis of manufacturing systems for improving performance. ProModel software is used in a computer integrated manufacturing course in the Mechanical Engineering Technology Program for this purpose. Use of this tool allows an instructor to demonstrate the pros and cons of various manufacturing scenarios and recommend a solution. Student interest is enhanced by assigning simulation of real life problems from local industries.

scholarly journals Discrete event simulation applied to single queue management: a case study at a bank agency

2021 ◽  
Vol 12 (9) ◽  
pp. s831-s842
Author(s):  
Marcos Aurélio da Rocha Nascimento ◽  
Lilian Mendes dos Santos ◽  
Adriano Maniçoba da Silva ◽  
Regis Cortez Bueno ◽  
Sivanilza Teixeira Machado ◽  
...  
Keyword(s):  
Discrete Event Simulation ◽  
Discrete Event ◽  
Real Life ◽  
Service Rate ◽  
Queue Management ◽  
Discrete Events ◽  
Services Research ◽  
Event Simulation ◽  
Labor Requirements

Capacity and queue management are currently used in financial institutions. With decreasing bank units due to internet services, research in this field has focused on improving to utilize their employees efficiently and achieve service excellence. In developing countries like Brazil, the customer has become more bank-accounted due to government and labor requirements, such as the wage credit became mandatory in the wage account. The paper's aim is motivated by a real-life case study to simulate discrete events to improve queue management at a Brazilian bank branch with the Arena software simulation environment. The simulation model was designed, tested, and applied considering the Discrete Event Simulation (DES) replication for queuing strategies on a real-world banking scenario. The arrival and service times were collected from 115 customers in Ferraz de Vasconcelos/SP city. It was performed in version 15.10 (2018) of the Arena software, with processor Intel core i3 CPU dual-core 3.07 GHz and 8GB of RAM. The results indicate that the bank agency should consider providing 9 to 11 operators to attend customers considering the arrival and service rate.

scholarly journals Integrating Simulation-Based Optimization for Lean Logistics: A Case Study

2018 ◽  
Vol 8 (12) ◽  
pp. 2448 ◽  
Author(s):  
Jorge González-Reséndiz ◽  
Karina Cecilia Arredondo-Soto ◽  
Arturo Realyvásquez-Vargas ◽  
Humberto Híjar-Rivera ◽  
Teresa Carrillo-Gutiérrez
Keyword(s):  
Simulation Model ◽  
Information And Communication Technologies ◽  
Discrete Event ◽  
Real Life ◽  
Inventory Level ◽  
Event Simulation ◽  
Lean Logistics ◽  
Information And Communication ◽  
Logistics Process

The present work aims at the comprehensive application of stochastic and optimization tools with the support of Information and Communication Technologies (ICT) through a case study in a logistics process for electronic goods; simulation and Response Surface Methodology (RSM) are applied for this purpose. The problem to be evaluated is to define an optimal distribution cost for products shipped to wholesale customers located in different cities in Mexico from a manufacturing plant in Tijuana, Mexico. The factors under study are the product allocation for each distribution center, finished good inventory level and on time deliveries, which are supposed to be significant to get the objective. The methodology applied for this problem considers the design of a discrete event simulation model to represent virtually the real life of logistics process, which is considered a complex system due to different activities are interrelated to carry it out. This model is used to execute the different experiments proposed by the RSM. The results obtained from simulation model were analyzed with the RSM to define the mathematical model that allows identifying the parameters of the factors in order to optimize the process. The findings prove how the ICT facilitate the application of stochastic tools with the purpose of process optimization.

scholarly journals Measuring the Realtime Capability of Parallel-Discrete-Event-Simulations

Electronics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 636
Author(s):  
Christina Obermaier ◽  
Raphael Riebl ◽  
Ali H. Al-Bayatti ◽  
Sarmadullah Khan ◽  
Christian Facchi
Keyword(s):  
Real Time ◽  
Discrete Event ◽  
Research Field ◽  
Soft Or ◽  
Real Time Simulation ◽  
The Real ◽  
Discrete Event Simulations ◽  
Time Simulation ◽  
Parallel Discrete Event ◽  
Event Simulations

Speeding up Discrete Event Simulations (DESs) is a broad research field. Promising Parallel Discrete Event Simulation (PDES) approaches with optimistic and conservative synchronisation schemes have emerged throughout the years. However, in the area of real-time simulation, PDESs are rarely considered. This is caused by the complex problem of fitting parallel executed DES models to a real-time clock. Hence, this paper gives an extensive review of existing conservative and optimistic synchronisation schemes for PDESs. It introduces a metric to compare their real-time capabilities to determine whether they can be used for soft or firm real-time simulation. Examples are given on how to apply this metric to evaluate PDESs using synthetic and real-world examples. The results of the investigation reveal that no final answer can be given if PDESs can be used for soft or firm real-time simulation as they are. However, boundary conditions were defined, which allow a use-case specific evaluation of the real-time capabilities of a certain parallel executed DES. Using this in-depth knowledge and can lead to predictability of the real-time behaviour of a simulation run.

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