Frequent Flyer Cost Estimation

The marketing activity of a modern airline is quite diverse. Under the conditions of an oligopoly, airlines develop their business in competition for a passenger.In modern conditions in Russia, the use of dumping methods of the early 1990s is very ineffective. There are no weak airlines left on the long-distance air transportation market, and in regional markets large companies lose to small regional carriers due to the high cost of performing flights on large-capacity aircrafts of the airline’s fleet.Generally, non-price methods of competition come out on top. Flexible tariff policy, advertising, and high service in servicing passengers remain leading traditional methods of competing for a passenger.This article is devoted to the study of another marketing method for attracting passengers, or rather retaining passengers on the airline’s flights, which is development of bonus programs, frequent flyer programs. PJSC Russian Airlines (Aeroflot) was chosen as the object for the study. The subject of the research is the «Aeroflot Bonus» program.The objective of the study is to study the cost of the program. For research purposes, this is the value of the frequent flyer program point. The problem proposed to be solved is to determine the amount of expenses for implementation of the bonus program of frequent flyers. When solving the problem in its staging part, the assessment is not limited to direct costs associated with the costs of marketing efforts in the form of costs for organising a special advertising department, issuing bonus cards, software, and wages. The estimation refers also to indirect costs in the form of unreceived proceeds from free bonus tickets. Besides, a rough estimate has been made of the airline’s hidden costs due to an unpaid seat on the plane. The study conclusions indicate that hidden costs will be taken into account in calculating the cost of a flight and the bonus program has a right to exist.

A prospective study of costs associated with the evaluation of allergic reactions to radiological contrast media

Background: The prevalence of hypersensitivity reactions to radiological contrast media (RCM) is increasing due to the greater performance of diagnostic and therapeutic tests that require RCMs. Objective: We carried out a year-long real-life observational study to prospectively evaluate the patients referred to the Allergy Service from Primary Care, Emergency Room, and other Services with suspected moderate to severe RCM hypersensitivity. Methods: To study the costs of RCM hypersensitivity evaluation, we systematically recorded direct and indirect costs. Results: Sixty-nine patients with previous reactions to RCM were evaluated in the Allergy Service from June 1st, 2017, to May 31st, 2018. Total direct health care costs were € 10715.84, with a mean cost per patient of € 155.30 ± 77.08. Specifically, direct non-health costs reached € 1605.42 (mean € 23.27 ± 41.14), and indirect costs were € 6490.85 (mean € 94.07 ± 110.61). In summary, the total cost was € 18812.11, which means a mean cost of € 272.64 ± 164.77. Conclusions: Our study reflects that the costs of an elective evaluation of hypersensitivity to RCM are low. This fact reaffirms that correct and safe management of these patients could be cost-effective, so our efforts should be directed to implement the necessary logistics.

Economic burden of multiple sclerosis: a cross-sectional study in Iran

Background Multiple Sclerosis (MS) is a chronic debilitating disease that imposes a heavy socioeconomic burden on societies. This study aimed to determine the economic burden of MS on patients using the first (CinnoVex and ReciGen) and second (Fingolimod and Natalizumab) drug therapy lines. Methods This cost of illness study was an economic evaluation carried out as cross-sectional research in 2019 in southern Iran. A total of 259 patients were enrolled in two lines of drug therapy (178 patients in the first line and 81 ones in the second). The prevalence-based approach and the bottom-up approach were used to collect cost information and to calculate the costs from the societal perspective, respectively. The human capital approach was applied to calculate indirect costs. To collect the required data a researcher-made data collection form was utilized. The data were obtained using the information available in the patients’ medical records and insurance invoices as well as their self-reports or that of their companions. Results The results showed that the annual costs of MS in the first and second lines of drug therapy per patient were $ 1919 and $ 4082 purchasing power parity (PPP), respectively, and in total, $ 2721 PPP in 2019. The highest mean costs in both lines were those of direct medical costs, of which purchasing the main medicines in both lines accounted for the highest. Conclusion Considering the findings of this study and in order to reduce the burden of the disease, the following suggestions are presented: providing necessary facilities for the production of MS drugs in the country; proper and equitable distribution of neurologists; expanding the provision of home care services; and using the technologies related to the Internet, including WhatsApp, to follow up the MS patients’ treatment.

Making shoulder pain simple in general practice: implementing an evidence-based guideline for shoulder pain, protocol for a hybrid design stepped-wedge cluster randomised study (EASIER study)

IntroductionResearch suggests that current care for shoulder pain is not in line with the best available evidence. This project aims to assess the effectiveness, cost-effectiveness and the implementation of an evidence-based guideline for shoulder pain in general practice in Norway.Methods and analysisA stepped-wedge, cluster-randomised trial with a hybrid design assessing clinical effectiveness, cost-effectiveness and the effect of the implementation strategy of a guideline-based intervention in general practice. We will recruit at least 36 general practitioners (GPs) and randomise the time of cross-over from treatment as usual to the implemented intervention. The intervention includes an educational outreach visit to the GPs, a computerised decision tool for GPs and a self-management application for patients. We will measure outcomes at patient and GP levels using self-report questionnaires, focus group interviews and register based data. The primary outcome measure is the patient-reported Shoulder Pain and Disability Index measured at 12 weeks. Secondary outcomes include the EuroQol Quality of Life Measure (EQ5D-5L), direct and indirect costs, patient’s global perceived effect of treatment outcome, Pain Self-Efficacy and Brief Illness Perception Questionnaire. We will evaluate the implementation process with focus on adherence to guideline treatment. We will do a cost–minimisation analysis based on direct and selected indirect costs and a cost–utility analysis based on EQ5D-5L. We will use mixed effect models to analyse primary and secondary outcomes.Ethics and disseminationEthics approval was granted by the Regional Committee for Medical and Health Research Ethics-South East Norway (ref. no: 2019/104). Trial results will be submitted for publication in a peer-reviewed medical journal in accordance with Consolidated Standards of Reporting Trials.Trial registration numberNCT04806191.

Estimating the economic burden of typhoid in children and adults in Blantyre, Malawi: a costing cohort study

BackgroundTyphoid causes preventable death and disease. The World Health Organizationrecommends Typhoid Conjugate Vaccine for endemic countries, but introductiondecisions depend on cost-effectiveness. We estimated household and healthcareeconomic burdens of typhoid in Blantyre, Malawi.MethodsIn a prospective cohort of culture-confirmed typhoid cases at two primary- and areferral-level health facility, we collected direct medical, non-medical costs (2020 U.S. dollars) to healthcare provider, plus indirect costs to households.ResultsFrom July 2019-March 2020, of 109 cases, 63 (58%) were <15 years old, 44 (40%)were inpatients. Mean hospitalization length was 7.7 days (SD 4.1). For inpatients,mean total household and provider costs were $93.85 (95%CI: 68.87-118.84) and$296.52 (95%CI: 225.79-367.25), respectively. For outpatients, these costs were$19.05 (95%CI: 4.38-33.71) and $39.65 (95%CI: 33.93-45.39), respectively.Household costs were due mainly to direct non-medical and indirect costs, medicalcare was free. Catastrophic illness cost, defined as cost >40% of non-food monthlyhousehold expenditure, occurred in 48 (44%) households.ConclusionsTyphoid can be economically catastrophic for families, despite accessible free medicalcare. Typhoid is costly for government healthcare provision. These data make aneconomic case for TCV introduction in Malawi and the region and will be used to derivevaccine cost-effectiveness.

Cost consequences analysis of hypertensive outpatients: a study in a private hospital in Yogyakarta special province

Background: Hypertension is a chronic disease that requires long-term treatment and has an impact on the cost of treatment. The costs will be greater given the loss of productivity, family burden, and social life impacted by hypertension based on patient’s perspective. Objective: The purpose of the study was to determine the costs and clinical outcome of antihypertensive therapy from the patient's perspective and to identify the discrepancies between the costs and the INA-CBGs (Indonesia Case Based Groups) tariff. Methods: The research was an observational study with a cross-sectional design. The targeted population was outpatients who had received antihypertensive therapy for at least 1 month at a private hospital in Yogyakarta. The costs included direct medical costs, direct non-medical costs, and indirect costs, while the clinical outcomes were patient’s blood pressure. The descriptive analysis was carried out to describe the characteristics of the research subjects, the clinical outcome, and the cost. Analysis of the discrepancies between the costs and the INA-CBGs tariff used the Mann-Whitney test and One-Sample t-test. Results: The results showed that the average direct medical costs, direct non-medical costs, and indirect costs from the patient’s perspective were IDR359,408.00, IDR24,617.00, and IDR 40,583.00, respectively. There was a significant difference between the real costs and the rate of INA-CBGs based on the results of statistical tests, while the cost discrepancy was IDR5,287,045.00. Conclusion: The direct non-medical costs and indirect costs of hypertensive outpatients were less than the direct medical costs. A significant difference occurred between the real costs and INA CBG’s tariff. Keywords: hypertension, cost consequences, pharmacoeconomics, patient’s perspective

Corporate Restructuring

Corporate restructuring occurs when a company makes significant changes to its financial or operational structure, for example, by changing its complement of employees or assets through downsizing or upsizing. A common set of factors drives decisions to restructure, including decisions to divest or to acquire employees, assets, or both. In order of priority, these factors comprise current and prior company performance, managerial foresight, economic conditions, political uncertainty, industry, and technology. Companies typically downsize employees to stop eroding profitability and to increase the likelihood of future profitability. The economic rationale that drives it is straightforward: companies become profitable when revenues exceed costs, an outcome obtained by increasing revenues, decreasing costs, or both. Because future revenues are less predictable and controllable than future costs, decreasing costs is compelling. Managers often do that by reducing the size of the workforce and its associated labor costs. Employee downsizing makes sense when it is a reaction to an emergency, such as the COVID-19 pandemic. Employee downsizing can also be part of a broader workforce strategy designed to adjust workforce competencies to align more closely with the overall strategy of a business. Organizations typically use one or more of four broad methods to downsize their workforces. The simplest is natural attrition. Alternatively, firms may offer buyouts—to individual employees (voluntary severance), to entire business units (corporate restructuring), even to the entire organization. A third strategy is involuntary layoffs—termination—with no choice by the departing employees. Businesses large and small that were hard hit by the pandemic had little or no choice but to use this strategy. A final strategy is early retirement offers, often part of a broader buyout scheme. From an organizational view, early retirement has the advantage of opening up promotion opportunities for younger workers. When firms downsize employees, they incur direct as well as indirect costs. While almost all the direct costs, such as severance pay and accrued vacation, are short-term (realized in the year they are incurred), indirect costs, such as decreased productivity, reduced morale, and aversion to risk among survivors, begin to accrue immediately and may continue for longer periods. When considering alternatives to downsizing employees, decision-makers must first assess if the downturn in business is permanent or temporary. If permanent, the only alternative to layoffs is to upskill, reskill, or retrain employees to develop new lines of business. If temporary, then there are numerous alternative ways to cut costs besides laying off workers. These range from reducing work hours to redeploying workers. A central issue for many stakeholders is the financial consequences of corporate restructuring. Regarding acquisitions, there is little evidence of a net beneficial effect on the performance of the acquirer, as measured by profitability. Rather, such actions often yield a lower rate of return than growth through internal investment. With respect to divestiture of assets, meta-analysis reveals a mixed picture of subsequent performance. Evidence does indicate, however, that different performance effects can be attributed to different conditions of the macroeconomy. With respect to within-company changes in employees, assets, or both, large-scale research reveals that corporate restructuring undertaken during difficult financial conditions, on average, outperforms corporate restructuring undertaken under more benign conditions. An important lesson for managers is to avoid downsizing as a quick fix to restore or enhance profitability. Layoffs are the most frequently employed method of downsizing but provide the smallest payoff. When faced with deteriorating results, it might be more prudent to be patient and to undertake the more demanding and comprehensive downsizing of employees and assets. As for upsizing employees, assets, or both, high-profitability upsizing does not automatically lead to better stock market performance. It tends to yield better results when the company’s performance needs improvement.

Effect of Buoyancy Loads on the Tsunami Fragility of Reinforced Concrete Frames Including Consideration of Blow-out Slabs

Currently available performance-based methodologies for assessing the fragility of structures subjected to tsunami neglect the effects of tsunami-induced vertical loads due to internal buoyancy. This paper adopts a generalized methodology for the performance assessment of structures that integrates the effects of buoyancy loads on slabs during a tsunami inundation. The methodology is applied in the fragility assessment of three case-study frames (low, mid and high-rise), representative of existing masonry-infilled reinforced concrete (RC) buildings typical of Mediterranean region. The paper shows the effect of modelling buoyancy loads on damage evolution, structural performance and fragility curves associated with different structural damage mechanisms for RC frames with breakaway infill walls including consideration of blow-out slabs. The outcomes attest that the predominant failure mechanism of selected case-study is the brittle shear failure of seaward columns, which is slightly affected by buoyancy loads. When brittle failure is avoided, buoyancy loads significantly affect the damage evolution during a tsunami, especially in the case of structures with blow-out slabs. The rate of occurrence of slabs uplift failure increases with the number of stories of the building but only slightly affects the fragility curves of investigated structures. However, it can significantly increase their vulnerability, affecting both direct and indirect costs deriving from the repair of the damaged interior slabs.

A methodology to assess indirect economic impacts of animal disease outbreaks

Indirect costs of animal disease outbreaks often significantly exceed the direct costs. Despite their importance, indirect costs remain poorly characterised due to their complexity. In this study, we developed a framework to assess the indirect costs of a hypothetical African Swine Fever outbreak in Switzerland. We collected data through international and national stakeholder interviews, analysis of national disease control regulations and industry data. We developed a framework to capture the resulting qualitative and quantitative data, categorise the impacts of these regulations, and rank the impacts in order of importance. We then developed a spreadsheet model to calculate the indirect costs of one category of control measure for an individual group of stakeholders. We developed a decision tree model to guide the most economically favourable implementation plan for a given control measure category, under different outbreak scenarios. Our results suggest that the most important measure/impact categories were ‘Transport logistics’, ‘Consumer demand’, ‘Prevention of wild boar and domestic pig contact’ and ‘Slaughter logistics’. In our hypothetical scenario, the greatest costs associated with ‘Prevention of wild boar and domestic pig contact’ were due to assumed partial or total depopulation of pig farms in order to reduce herd size to comply with the simulated control regulations. The model also provides suggestions on the most economically favourable strategy to reduce contact between wild boar and domestic pigs in control areas depending on the duration of the outbreak. Our approach provides a new framework to integrate qualitative and quantitative data to guide disease control strategy. This method could be useful in other countries and for other diseases, including in data- and resource-poor settings, or areas with limited experience of animal disease outbreaks.