scholarly journals Cost–effectiveness and cost-benefit analysis of oliceridine in the treatment of acute pain

2021 ◽  
Author(s):  
Kit N Simpson ◽  
Michael J Fossler ◽  
Linda Wase ◽  
Mark A Demitrack
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Cost Effective ◽  
Adverse Outcomes ◽  
Protein Signaling ◽  
Opioid Receptor Agonist ◽  
Cost Effective Alternative ◽  
Μ Opioid Receptor ◽  
The Cost

Aim: Oliceridine, a new class of μ-opioid receptor agonist, is selective for G-protein signaling (analgesia) with limited recruitment of β-arrestin (associated with adverse outcomes) and may provide a cost-effective alternative versus conventional opioid morphine for postoperative pain. Patients & methods: Using a decision tree with a 24-h time horizon, we calculated costs for medication and management of three most common adverse events (AEs; oxygen saturation <90%, vomiting and somnolence) following postoperative oliceridine or morphine use. Results: Using oliceridine, the cost for managing AEs was US$528,424 versus $852,429 for morphine, with a net cost savings of $324,005. Conclusion: Oliceridine has a favorable overall impact on the total cost of postoperative care compared with the use of the conventional opioid morphine.

Medical readiness: evaluating the robustness of medical clinic staffing solutions

2016 ◽  
Vol 14 (4) ◽  
pp. 407-419
Author(s):  
Michael Q Corpuz ◽  
Christina F Rusnock ◽  
Vhance V Valencia ◽  
Kyle Oyama
Keyword(s):  
Negative Impact ◽  
Cost Benefit Analysis ◽  
Relative Effectiveness ◽  
Discrete Event ◽  
Cost Savings ◽  
Cost Benefit ◽  
Wait Time ◽  
Cost Effective ◽  
Wait Times ◽  
Staffing Mix

Medical readiness requires Department of Defense medical clinics to be robust to changes in patient demand. Minor fluctuations in patient demand occur on a regular basis, but major increases can also occur. Major demand increases can result from a number of occurrences, including mass military deployments, medical incidents, outbreaks, and overflow from Veterans’ Affairs clinics. This research evaluates a system of clinics at Wright-Patterson Air Force Base in order to determine its ability to handle a 200% surge in patient demand. In addition, this study evaluates the relative effectiveness of six different staffing mix options to minimize patient wait times, also under the surge demand conditions. This evaluation is conducted using discrete-event simulation to estimate patient wait times and includes a sensitivity analysis of the increased patient demand, as well as a cost–benefit analysis to determine the most cost-effective alternative scenario. The study finds that adjustments to staffing mix enable cost savings while meeting current demands. In addition, the study finds that adjusting the staffing mix will not have a negative impact on patient wait time in the surge conditions, relative to the current staffing mix.

Cost benefit analysis of measures to reduce industrial effluent discharges

2010 ◽  
Vol 62 (7) ◽  
pp. 1623-1628
Author(s):  
Åsa Sivard ◽  
Tomas Ericsson ◽  
Nippe Hylander ◽  
Magnus Karlsson ◽  
Mikael Malmaeus
Keyword(s):  
Organic Material ◽  
Cost Benefit Analysis ◽  
Industrial Effluent ◽  
Oxygen Demand ◽  
Cost Benefit ◽  
Cost Effective ◽  
Paper Mill ◽  
Pulp And Paper Mill ◽  
Cost Efficient ◽  
The Cost

In an environmentally harmonized society the most cost effective measures to reduce the total effluent discharges should be taken into account. Generalised discharge values are presented for organic material and nutrients in this paper. Depending on conditions in the receiving water any of these parameters can be the determining factor for the eutrophication and oxygen demand. These parameters can be generalized into equivalent loads of TOC, nitrogen or phosphorus by recalculation according to the Redfield ratio. The cost for reduction of organic material and nutrients from a pulp and paper mill is calculated as a cost per unit pollutant (cost equivalent). This cost equivalent is compared with alternative costs, expressed in the same way, for reduction of organic material and nutrients in adjacent industries, municipal treatment plants, impact from transportation, farming, air deposits etc. In order to find where the most cost efficient measures for the society should be taken the cost equivalent for the mill is compared with the alternative measures and their equivalent costs.

Cost-benefit analysis of AR-V7 testing in patients (Pts) with metastatic castration resistant prostate cancer (mCRPC) eligible for abiraterone (Abi) or enzalutamide (Enza).

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 283-283
Author(s):  
Mark Christopher Markowski ◽  
Kevin D. Frick ◽  
James R. Eshleman ◽  
Jun Luo ◽  
Emmanuel S. Antonarakis
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Castration Resistant Prostate Cancer ◽  
The Us ◽  
Effective Option ◽  
Current Price ◽  
Societal Challenge ◽  
The Cost

283 Background: The rising cost of oncology care in the US is an ongoing societal challenge, and identifying biomarkers that inform clinical decisions and reduce the use of ineffective therapies remains elusive. A splice variant of the androgen receptor, AR-V7, was found to confer resistance to Abi and Enza in men with mCRPC, but did not negatively affect responses to taxanes, suggesting that early use of chemotherapy may be a more effective option for AR-V7(+) pts. With the recent development of a CLIA-certified clinical assay for AR-V7 at Johns Hopkins, we hypothesized that AR-V7 testing in mCRPC pts may result in cost savings by avoiding futile treatment with Abi/Enza in men with AR-V7(+) disease. Methods: We calculated the cost savings of performing AR-V7 testing in mCRPC pts prior to starting Abi/Enza (and avoiding these drugs in AR-V7(+) men) versus treating all mCRPC pts with Abi/Enza (without use of the biomarker). We have set the cost of the AR-V7 assay at $1000. The cost of 3 months of Abi/Enza (the minimum time it would take to determine resistance, clinically) was approximated at $20,000. We estimated that 30,000 mCRPC pts per year are eligible for Abi/Enza in the US. Results: In our prior studies, about 30% of mCRPC pts previously treated with Abi/Enza had detectable AR-V7 in CTCs. Assuming an AR-V7 prevalence of 30%, about 9,000 AR-V7(+) mCRPC pts per year would receive ineffective treatment with Abi/Enza, at an estimated cost of $180 Million. The upfront cost of testing all mCRPC pts who are Abi/Enza-eligible for AR-V7 is $30 Million, resulting in a net cost savings of $150 Million. When performing a continuous cost-benefit analysis after assuming other prevalences of AR-V7 (ranging from 4% to 50%) and a range of costs for Abi/Enza ($2000 to $24,000 per 3 months), we determined that AR-V7 testing would result in a cost savings as long as the prevalence of AR-V7 is > 5% (if the cost of 3 months of Abi/Enza remains at $20,000). Conclusions: AR-V7 testing in mCRPC pts (at $1000/test) is cost-beneficial when considering the current price of Abi/Enza, and may reduce the ineffective use of Abi/Enza leading to a net cost savings to the healthcare system.

The Cost-Benefit Analysis for the Evaluation of Public Infrastructure Projects - The Case of the Subway of Potenza

2014 ◽  
Vol 1073-1076 ◽  
pp. 1362-1367
Author(s):  
Benedetto Manganelli
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Economic Feasibility ◽  
Transport Infrastructure ◽  
Benefit Analysis ◽  
Public Infrastructure ◽  
New Public ◽  
The Cost ◽  
The City

In the present work the economic feasibility of a project of public infrastructure, the expansion of the subway of the city Potenza, is estimated. The assessment has been developed through the application of the Cost-Benefit Analysis. As is known the advantage of this technique is the ability to express in monetary terms the externalities (positive and negative) generated by the project. In this case, the external cost savings related to the improvement of the mobility in the city have been internalized. The research has shown that the valuation of the externalities can be an effective way to manage the planning of new public transport infrastructure.

scholarly journals Investigation of a Magnetic-Type Waterproof Oil Spill Stop Device for Ships

2020 ◽  
Vol 8 (9) ◽  
pp. 636
Author(s):  
Chong-Ju Chae
Keyword(s):  
Oil Spills ◽  
Marine Pollution ◽  
Cost Benefit Analysis ◽  
Water Pressure ◽  
Cost Benefit ◽  
Cost Effective ◽  
Minimum Diameter ◽  
Formal Safety Assessment ◽  
Magnetic Type ◽  
The Cost

If a ship’s hull or tank breaks, the ship may sink, or oil spills can cause enormous damage to the environment. If the ship is equipped with a capable, cost-effective oil or liquid flow stop emergency device, casualties and marine pollution could be reduced. Many magnetic-type liquid spill stop emergency devices developed since 1904 have limitations, such as difficulties with installation and impossibility of use during sailing. This study demonstrated the applicability of a magnetic-type liquid spill stop emergency device through tests for water pressure and leakage, attachment, magnetic fields, and the generation of sparks. Results showed that the device can be applied to the ship’s side hull and bottom with a specified minimum diameter at a pressure depth of 1.0 kg/cm2 while sailing at a speed of 18 kts (9.26 m/s). If the distance from the device was at least approximately 750 mm, the magnetic field had no effect, and there was no risk of explosion due to sparks. A cost–benefit analysis based on the International Maritime Organization-approved guidelines for formal safety assessment confirmed the cost effectiveness of the device. This experimental study confirmed that the magnetic liquid stop emergency device is generally applicable to a ship’s hull.

scholarly journals Integrating cost–benefit analysis into the NIST Cybersecurity Framework via the Gordon–Loeb Model

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Lawrence A Gordon ◽  
Martin P Loeb ◽  
Lei Zhou
Keyword(s):  
Risk Management ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
Benefit Analysis ◽  
Logical Approach ◽  
Explicit Recognition ◽  
Effective Level ◽  
The Cost

Abstract The National Institute for Standards and Technology (NIST) Cybersecurity Framework has rapidly become a widely accepted approach to facilitating cybersecurity risk management within organizations. An insightful aspect of the NIST Cybersecurity Framework is its explicit recognition that the activities associated with managing cybersecurity risk are organization specific. The NIST Framework also recognizes that organizations should evaluate their cybersecurity risk management on a cost–benefit basis. The NIST Framework, however, does not provide guidance on how to carry out such a cost–benefit analysis. This article provides an approach for integrating cost–benefit analysis into the NIST Cybersecurity Framework. The Gordon–Loeb (GL) Model for cybersecurity investments is proposed as a basis for deriving a cost-effective level of spending on cybersecurity activities and for selecting the appropriate NIST Implementation Tier level. The analysis shows that the GL Model provides a logical approach to use when considering the cost–benefit aspects of cybersecurity investments during an organization’s process of selecting the most appropriate NIST Implementation Tier level. In addition, the cost–benefit approach provided in this article helps to identify conditions under which there is an incentive to move to a higher NIST Implementation Tier.

scholarly journals Analysis of the Cost Effectiveness of a Suicide Barrier on the Golden Gate Bridge

Crisis ◽  
2013 ◽  
Vol 34 (2) ◽  
pp. 98-106 ◽  
Author(s):  
Dayna Atkins Whitmer ◽  
David Lauren Woods
Keyword(s):  
Cost Effectiveness ◽  
San Francisco ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
Alternative Methods ◽  
Suicide Mortality ◽  
Golden Gate ◽  
Golden Gate Bridge ◽  
The Cost

Background: The Golden Gate Bridge (GGB) is a well-known “suicide magnet” and the site of approximately 30 suicides per year. Recently, a suicide barrier was approved to prevent further suicides. Aims: To estimate the cost-effectiveness of the proposed suicide barrier, we compared the proposed costs of the barrier over a 20-year period ($51.6 million) to estimated reductions in mortality. Method: We reviewed San Francisco and Golden Gate Bridge suicides over a 70-year period (1936–2006). We assumed that all suicides prevented by the barrier would attempt suicide with alternative methods and estimated the mortality reduction based on the difference in lethality between GGB jumps and other suicide methods. Cost/benefit analyses utilized estimates of value of statistical life (VSL) used in highway projects. Results: GGB suicides occur at a rate of approximately 30 per year, with a lethality of 98%. Jumping from other structures has an average lethality of 47%. Assuming that unsuccessful suicides eventually committed suicide at previously reported (12–13%) rates, approximately 286 lives would be saved over a 20-year period at an average cost/life of approximately $180,419 i.e., roughly 6% of US Department of Transportation minimal VSL estimate ($3.2 million). Conclusions: Cost-benefit analysis suggests that a suicide barrier on the GGB would result in a highly cost-effective reduction in suicide mortality in the San Francisco Bay Area.

Water systems and risk analysis

2005 ◽  
Vol 51 (5) ◽  
pp. 105-112 ◽  
Author(s):  
O.A.C. Hoes ◽  
W. Schuurmans ◽  
J. Strijker
Keyword(s):  
The Netherlands ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
Water Systems ◽  
Small Scale ◽  
Design Standards ◽  
Starting Point ◽  
Significant Damage ◽  
The Cost

Worldwide the water management sector is about to review the design standards for water systems, as expected climate changes may possibly increase the frequency of flood events. This paper reviews new flood standards for surface water systems in The Netherlands, also presenting a cost-benefit analysis. Flood standards were formulated after several serious incidents in 1998 and 2001 to inform residents about the level of protection that they may expect to receive. At this moment all water boards are about to evaluate their water systems using these standards. The cost-benefit approach has been applied to determine whether the necessary measures to comply with such standards were cost-effective. We found that the standards make too much a simplification of the variety of water systems, and lead to costly measures without being beneficial while many small-scale floods in The Netherlands do not cause any significant damage. A better starting point to anticipate on climate change is to prevent damage, instead of the prevention of flooding.

Electricity conservation opportunities within private university campuses in Bangladesh

2019 ◽  
Vol 31 (2) ◽  
pp. 256-274 ◽  
Author(s):  
Muntasir Murshed
Keyword(s):  
Developing Economies ◽  
Cost Benefit Analysis ◽  
Electricity Consumption ◽  
Cost Benefit ◽  
Cost Effective ◽  
Private University ◽  
University Campuses ◽  
The North ◽  
Electricity Conservation ◽  
The Cost

The mushroom growth of universities in the developing economies, in particular, is believed to be a key contributor to the relentless aggravation in the overall demand for electricity. Moreover, the large university campuses are often compared to cities whereby the associated electricity-consumption within these campuses are also referred to account for a bulk of the total urban electricity consumption. Thus, conservation of electricity within the campus has become a core agenda of universities in quest of ensuring respective campus sustainability. Against this backdrop, this paper aims to highlight and recommend the cost-effective and best-practiced techniques applied to conserve electricity within the private universities in Bangladesh. As part of the methodology, a cost–benefit analysis of electricity conservation is put forward in the context of a case study of the North South University, the largest private university in Bangladesh. The results from the analyses imply that proper implementation of the electricity conservation and efficiency enhancement techniques within the campus can effectively cut down the total electricity bills by almost one-third and simultaneously account for a 5% reduction in the total electricity demand within the campus.

A Cost-Benefit Analysis of Reducing Surgical Site Infections

2018 ◽  
Vol 84 (2) ◽  
pp. 254-261
Author(s):  
Alexander Rosemurgy ◽  
Jacqueline Whitaker ◽  
Kenneth Luberice ◽  
Christian Rodriguez ◽  
Darrell Downs ◽  
...  
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Surgical Site Infections ◽  
Potential Cost ◽  
Pancreatic Resections ◽  
Before And After ◽  
Abdominal Operations ◽  
The Cost ◽  
The Impact

Surgical Site Infections (SSI) represent an onerous burden on our health-care system. This study was undertaken to determine the impact of a protocol aimed at reducing SSIs on the frequency and cost of SSIs after abdominal surgery. Beginning in 2013, 811 patients undergoing gastrointestinal operations were prospectively followed. In 2014, we initiated a protocol to reduce SSIs. SSIs were monitored before and after protocol implementation, and differences in SSI incidence and associated costs were determined. Before protocol initiation, standardized operative preparation cost was $40.85 to $126.94 per patient depending on the results of methicillin-resistant Staphylococcus aureus screen; after protocol initiation, the cost was $43.85 per patient, saving up to $83.09 per patient. With the protocol in place, SSI rate was reduced from 4.9 to 3.4 per cent (13 of 379) representing a potential prevention of eight infections that would have cost payers $166,280 ($20,785 per infection). Notably, the SSI rate after pancreatectomy was reduced by 63 per cent ( P = 0.04). With preparation and diligence, SSI rate can be meaningfully reduced and potential cost savings can be achieved. In particular, SSI rate reduction for major abdominal operations and especially pancreatic resections can be achieved. A protocol to reduce SSI is a “win-win” for all stakeholders and should be encouraged with thoughtful and active participation from all hospital disciplines.

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