Potensi Ekonomi dan Kelayakan Budidaya Tanaman Lada (Piper nigrum) di Kecamatan Purehu Kabupaten Kolaka Utara

This study examined pepper cultivation's economic potential and feasibility in Purehu Village, Purehu District, North Kolaka Regency, Southeast Sulawesi. The research was conducted from January until February 2021. The research approach used by the author is qualitative with descriptive methods. Data collection in this study was carried out through in-depth interviews with informants, observation, and documentation. The informant or subject of this research is the head of a farmer's family in Purehu Village. The variable of this research was the economic potential and feasibility cultivation of pepper—analysis of data using income cost difference (R-C) and Revenue Cost Ratio (R/C). The results showed that pepper cultivation (P. nigrum) in Purehu Village, Purehu District, could generate an average profit of IDR84.000.000 for the first harvest, and pepper cultivation in that area is very worth continuing based on the R/C ratio. The study concludes that pepper cultivation in Purehu Village has very high economic potential (good) because the farmers' profits are quite large each year, and pepper cultivation in that place is very feasible to continue.

Cerebrospinal fluid leakage costs after craniotomy and health economic assessment of incidence reduction from a hospital perspective in the Netherlands

ObjectivesWe aim to quantify the cost difference between patients with incisional cerebrospinal fluid (iCSF) leakage and those without after intradural cranial surgery. Second, the potential cost savings per patient when a decrease in iCSF leakage rate would be achieved with and without added costs for preventative measures of various price and efficacy are modelled.DesignHealth economic assessment from a hospital perspective based on a retrospective cohort study.SettingDutch tertiary referral centre.ParticipantsWe included 616 consecutive patients who underwent intradural cranial surgery between 1 September 2017 and 1 September 2018. Patients undergoing burr hole surgery or transsphenoidal surgery, or who died within 1 month after surgery or were lost to follow-up were excluded.Primary and secondary outcome measuresOutcomes of the cost analysis include a detailed breakdown of mean costs per patient for patients with postoperative iCSF leakage and patients without, and the mean cost difference. For the scenario analyses the outcomes are the potential cost savings per 1000 patients when a decrease in iCSF leakage would be achieved.ResultsMean cost difference between patients with and without iCSF leakage was €9665 (95%CI, €5125 to €14 205). The main cost driver was hospital stay with a difference of 8.5 days. A 25% incidence reduction would result in a mean cost saving of −€94 039 (95% CI, −€218 258 to −€7077) per 1000 patients. A maximum cost reduction of −€653 025 (95% CI, −€1 204 243 to −€169 120) per 1000 patients could be achieved if iCSF leakage would be reduced with 75% in all patients, with 72 cases of iCSF leakage avoided.ConclusionsPostoperative iCSF leakage after intradural cranial surgery increases healthcare costs significantly and substantially. From a health economic perspective preventative measures to avoid iCSF leakage should be pursued.

Decision onRegional Logistics Network Based on H-S and P-P Network: Taking Tobacco Transportation Logistics as anExample

Objectives: The logistics hub construction has always been the short board of logistics network planning in China. In order to improve the decision-making efficiency of logistics enterprise’s hub selection and reduce its comprehensive operation cost, this paper establishes a cost difference model for hub-and-spoke(H-S) and point-to-point(P-P) networks considering the fixed cost of hubs, transportation and route costs based on the 0-1 integer nonlinear programming. The model aims at minimizing the cost difference between the two networks, and divides the fixed cost of the hubs into three situations: full lease, lease and self-built, and fully self-built. Finally, this paper takes tobacco transportation logistics as an example, and use particle swarm algorithm to solve the model by using tobacco transportation logistics data of a logistics enterprise in Jiangsu Province. The results show that: (i) in the case of complete leasing, the total cost of the H-S network decreases with the increase of the number of hubs, and the cost change has a point of intersection with the total cost of the P-P network;(ii) when the lease and self-build are mixed, the increase is first reduced and then increased, it is U-shaped and has a minimum value, and there are two intersections with the total cost of the P-P network;(iii) the situation of completely self-built and fully leased is just the opposite. This paper takes tobacco transportation logistics as a representative, and provides a reference for logistics companies to choose the appropriate regional logistics network structure and different pivot points.

Analysis of the Fee-to-Tax Reform on Water Resources in China

The Resource Tax Law was officially implemented on September 1, 2020, in China. This law presents the “Fee-to-Tax” reform of water resources. This article compares the effects of the “Fee-to-Tax” reform under asymmetric duopoly conditions with perfect information. The mechanisms of the two policies are different when all firms simultaneously respond to water resources: the water resource fee affects output by reducing market size, while the water resource tax reduces output by amplifying the weighted cost difference effects between companies. Water resource taxes work better than fees for eliminating backward production capacity. A comparison of the situation when companies respond sequentially is also carried out. When a low-cost firm is in the leading position, the collection of fees actually reduces the output difference, whereas the tax improves it. When a high-cost firm acts as a leader, the effects depend on the cost difference. When the cost difference between firms is small, the first-move advantage of high-cost firms dominates the cost advantages of low-cost firms. Therefore, a higher tax rate yields a smaller output difference. When cost differences are relatively larger, the cost advantage of low-cost firms dominates the first-move advantage of high-cost firms. As the operational cost for reducing water consumption increases, the reduced water consumption first increases and then decreases.

A pharmacoeconomic study of different brands of commonly prescribed antihypertensive drugs

Background: The hypertension is the most common chronic disease, therefore treatment should be affordable. The antihypertensive drugs of same strength are available in market at different costs. This study was undertaken to create awareness among health care workers and patients, about cost difference among different brands of same antihypertensive drug. So that whenever possible, a cheaper effective brand can be prescribed to ensure better patient adherence.Methods: Maximum retail price (MRP) of various antihypertensive drugs of same strength, manufactured by different pharmaceutical companies was obtained from various offline and online sources. The minimum and maximum cost of 10 tablets/capsules noted. The cost ratio and percentage cost variation was calculated for single drug and fixed dose combinations. The ceiling price (as per DPCO) of essential antihypertensives (as per national list of essential medicines) was compared with their maximum cost.Results: The formulations of single antihypertensive drugs (41) and fixed dose combinations of two drugs (19) and three drugs (9) were included in the study. Among the single antihypertensives analyzed the highest cost difference was of eplerenone (50 mg) and high cost ratio and cost variation percentage was of amlodipine (5 mg). Among fixed dose combination of two drugs analyzed highest cost difference was found that of hydrochlorothazide (12.5 mg)+olmesartan (40 mg) combination and highest cost ratio and percentage cost variation was of amlodipine (5 mg)+telmisartan (40 mg).Conclusions: There was a huge price variation among the antihypertensive drugs manufactured by various companies. Some measures must be taken by the government to bring the uniformity in the price that will help to reduce the economic burden on the patients.

Cost comparisons of available brands of insulin glargine preparations

Background: The objective was to study the annual cost of each of the four important brands of insulin glargine available in India and to study the comparative annual cost of all the four brands.Methods: Four most commonly prescribed brands of insulin glargine vials were selected for cost comparisons. The daily as well as annual cost of prescription of insulin glargine vials based on once daily use was worked out directly as well as in percentages and presented in the form of table and bar diagrams.Results: After careful analysis of the data it was found that the costliest brand, brand D is more than two times costlier than the cheapest brand, brand B and thus the brand preparation selection, can lead to huge difference in annual cost burden to the patient.Conclusions: This significant cost difference between costliest and cheapest brands of insulin glargine vials assumes even further importance since majority of the diabetics need to bear the cost of multiple drugs prescribed to them, on their own. Thus it rather becomes a duty of the prescribing health care provider to prescribe those medicines which are cost effective to his/her patients.

Association of opioid use disorder with healthcare utilization and cost in a public health system

Background and objectives: To quantify the healthcare costs associated with opioid use disorder among members in a public healthcare system, and compare them to healthcare costs in the general population. Methods: Retrospective cohort study in inpatient and outpatient care settings of Israel's largest public healthcare provider (that covers 4.7 million members). Participants included 1,173 members who had a diagnosis of opioid use disorder in the years between 2013 and 2018. Each patient was matched with 10 controls based on age and sex. The main outcome was monthly healthcare costs. Results: The mean monthly healthcare cost of members with opioid use disorder was $1,102 compared to $211 among controls (5.2-fold difference; 95% confidence interval [CI]: 4.6-6.0). After excluding members with heroin related diagnoses before the index date (in order to focus on prescription opioids), this healthcare cost ratio did not substantially change (4.6-fold; 95%-CI: 3.9-5.4). Members with opioid use disorder under the age of 65 years had a cost difference of 6.1-fold (95%-CI: 5.2-7.1), while those 65 years and older experienced cost difference of 3.4-fold (95%-CI: 2.6-4.5). The category with the highest cost for members with opioid use disorder was inpatient services, which was 8.7-fold (95%-CI 7.2-10.4) greater than among controls. Conclusions: Healthcare costs among individuals with opioid use disorder in a public health system were substantially higher than among controls, at least partially attributed to prescription opioid use disorder. Differences were greater among individuals younger than 65 years, highlighting the importance of preventing and treating opioid use disorder among younger adult populations.

A systematic review of economic aspects of service interventions to increase anticoagulation use in atrial fibrillation

Objective: To systematically identify and appraise existing evidence surrounding economic aspects of anticoagulation service interventions for patients with atrial fibrillation. Methods: We searched the published and grey literature up to October 2019 to identify relevant economic evidence in any healthcare setting. A narrative synthesis approach was taken to summarise evidence by economic design and type of service intervention, with costs expressed in pound sterling and valued at 2017-2018 prices. Results: 13 studies met our inclusion criteria from 1,168 papers originally identified. Categories of interventions included anticoagulation clinics (n=4), complex interventions (n=4), decision support tools (n=3) and patient-centred approaches (n=2). Anticoagulation clinics were cost saving compared to usual care (range for mean cost difference: £188-£691 per-patient per-year) with equivalent health outcomes. Only one economic evaluation of a complex intervention was conducted; case management was more expensive than usual care (mean cost difference: £255 per-patient per-year) and the probability of its cost-effectiveness never exceeded 70%. There was limited economic evidence surrounding decision support tools or patient-centred approaches. Targeting service interventions at high-risk groups and those with suboptimal treatment was most likely to result in cost savings. Conclusion: This review revealed some evidence to support the cost-effectiveness of anticoagulation clinics. However, summative conclusions are constrained by a paucity of economic evidence, a lack of direct comparisons between interventions, and study heterogeneity in terms of intervention, comparator and study year. Further research is urgently needed to inform commissioning and service development. Data from this review can inform future economic evaluations of anticoagulation service interventions

Baseline and short-term financial burden (FB) in colorectal cancer (CRC) treated with curative intent: Early results of ECOG-ACRIN EAQ162CD.

1518 Background: Cancer therapy costs continue to rise, resulting in FB. FB in CRC treated with curative intent remains unexplored, particularly in the community oncology setting. We assess baseline FB and 3-month change, including predictors. Methods: Patients with newly diagnosed CRC treated with curative intent were enrolled through NCI Community Oncology Research Program (NCORP) Community Sites in a longitudinal study and completed the validated FACIT Comprehensive Score for Financial Toxicity (COST) instrument at baseline and 3 months. Higher COST score (range 0-44) indicates greater financial well-being. Pearson correlation compared baseline and 3-month measurements. Effects of patient demographics, clinical, self-efficacy variables (Table) and practice safety net affiliation were assessed using linear regression for baseline COST and COST difference at 3 months. F-tests identified covariates significantly predicting FB. Results: 450 and 296 participants completed the baseline and 3-month survey with a mean COST score 23.5 ± 11.9 and 24.6 ± 12.4, respectively (r=0.80, p<0.001), considered grade 1 or mild. Financial resource indicators such as income, insurance type, high-deductible insurance and savings, along with self-efficacy strongly predicted baseline FB (Table). No assessed covariates predicted COST difference. Safety-net affiliation (54/450, 12%) did not predict COST outcomes. Conclusions: Among those with CRC treated with curative intent in community settings, FB at treatment initiation and 3-month follow-up are highly correlated. Financial resources predict FB at treatment initiation. Self-efficacy to manage finances predicted FB, suggesting interventions such as financial counseling and navigation delivered early in the treatment course may minimize downstream FB. Clinical trial information: NCT03516942. [Table: see text]