WorldWideScience

Sample records for cost generic alternatives

  1. Impact of alternative interventions on changes in generic dispensing rates.

    Science.gov (United States)

    O'Malley, A James; Frank, Richard G; Kaddis, Atheer; Rothenberg, Barbara M; McNeil, Barbara J

    2006-10-01

    To evaluate the effectiveness of four alternative interventions (member mailings, advertising campaigns, free generic drug samples to physicians, and physician financial incentives) used by a major health insurer to encourage its members to switch to generic drugs. Using claim-level data from Blue Cross Blue Shield of Michigan, we evaluated the success of four interventions implemented during 2000-2003 designed to increase the use of generic drugs among its members. Around 13 million claims involving seven important classes of drugs were used to assess the effectiveness of the interventions. For each intervention a control group was developed that most closely resembled the corresponding intervention group. Logistic regression models with interaction effects between the treatment group (intervention versus control) and the status of the intervention (active versus not active) were used to evaluate if the interventions had an effect on the generic dispensing rate (GDR). Because the mail order pharmacy was considered more aggressive at converting prescriptions to generics, separate generic purchasing models were fitted to retail and mail order claims. In secondary analyses separate models were also fitted to claims involving a new condition and claims refilled for preexisting conditions. The interventions did not appear to increase the market penetration of generic drugs for either retail or mail order claims, or for claims involving new or preexisting conditions. In addition, we found that the ratio of copayments for brand name to generic drugs had a large positive effect on the GDR. The interventions did not appear to directly influence the GDR. Financial incentives expressed to consumers through benefit designs have a large influence on their switching to generic drugs and on the less-costly mail-order mode of purchase.

  2. Generic magnetic fusion reactor cost assessment

    International Nuclear Information System (INIS)

    Sheffield, J.

    1985-01-01

    The Fusion Energy Division of the Oak Ridge National Laboratory discusses ''generic'' magnetic fusion reactors. The author comments on DT burning magnetic fusion reactor models being possibly operational in the 21st century. Representative parameters from D-T reactor studies are given, as well as a shematic diagram of a generic fusion reactor. Values are given for winding pack current density for existing and future superconducting coils. Topics included are the variation of the cost of electricity (COE), the dependence of the COE on the net electric power of the reactor, and COE formula definitions

  3. Method for developing cost estimates for generic regulatory requirements

    International Nuclear Information System (INIS)

    1985-01-01

    The NRC has established a practice of performing regulatory analyses, reflecting costs as well as benefits, of proposed new or revised generic requirements. A method had been developed to assist the NRC in preparing the types of cost estimates required for this purpose and for assigning priorities in the resolution of generic safety issues. The cost of a generic requirement is defined as the net present value of total lifetime cost incurred by the public, industry, and government in implementing the requirement for all affected plants. The method described here is for commercial light-water-reactor power plants. Estimating the cost for a generic requirement involves several steps: (1) identifying the activities that must be carried out to fully implement the requirement, (2) defining the work packages associated with the major activities, (3) identifying the individual elements of cost for each work package, (4) estimating the magnitude of each cost element, (5) aggregating individual plant costs over the plant lifetime, and (6) aggregating all plant costs and generic costs to produce a total, national, present value of lifetime cost for the requirement. The method developed addresses all six steps. In this paper, we discuss on the first three

  4. Maximum potential cost-savings attributable to generic substitution ...

    African Journals Online (AJOL)

    D. Husselmann

    community. ... Conclusions: Potential economic benefits can be generated with generic substitution. ... Available online at www.sciencedirect.com ... supply of safe, cost-effective drugs of acceptable quality to all citizens of South Africa, and the rational use of drugs by .... different types of schizophrenic diagnosis) with a claim.

  5. Cost assessment of a generic magnetic fusion reactor

    International Nuclear Information System (INIS)

    Sheffield, J.; Dory, R.A.; Cohn, S.M.; Delene, J.G.; Parsly, L.F.; Ashby, D.E.T.F.; Reiersen, W.T.

    1986-03-01

    A generic reactor model is used to examine the economic viability of generating electricity by magnetic fusion. The simple model uses components that are representative of those used in previous reactor studies of deuterium-tritium-burning tokamaks, stellarators, bumpy tori, reversed-field pinches (RFPs), and tandem mirrors. Conservative costing assumptions are made. The generic reactor is not a tokamak; rather, it is intended to emphasize what is common to all magnetic fusion rectors. The reactor uses a superconducting toroidal coil set to produce the dominant magnetic field. To this extent, it is not as good an approximation to systems such as the RFP in which the main field is produced by a plasma current. The main output of the study is the cost of electricity as a function of the weight and size of the fusion core - blanket, shield, structure, and coils. The model shows that a 1200-MW(e) power plant with a fusion core weight of about 10,000 tonnes should be competitive in the future with fission and fossil plants. Studies of the sensitivity of the model to variations in the assumptions show that this result is not sensitively dependent on any given assumption. Of particular importance is the result that a fusion reactor of this scale may be realized with only moderate advances in physics and technology capabilities

  6. Estimated generic prices of cancer medicines deemed cost-ineffective in England: a cost estimation analysis.

    Science.gov (United States)

    Hill, Andrew; Redd, Christopher; Gotham, Dzintars; Erbacher, Isabelle; Meldrum, Jonathan; Harada, Ryo

    2017-01-20

    The aim of this study was to estimate lowest possible treatment costs for four novel cancer drugs, hypothesising that generic manufacturing could significantly reduce treatment costs. This research was carried out in a non-clinical research setting using secondary data. There were no human participants in the study. Four drugs were selected for the study: bortezomib, dasatinib, everolimus and gefitinib. These medications were selected according to their clinical importance, novel pharmaceutical actions and the availability of generic price data. Target costs for treatment were to be generated for each indication for each treatment. The primary outcome measure was the target cost according to a production cost calculation algorithm. The secondary outcome measure was the target cost as the lowest available generic price; this was necessary where export data were not available to generate an estimate from our cost calculation algorithm. Other outcomes included patent expiry dates and total eligible treatment populations. Target prices were £411 per cycle for bortezomib, £9 per month for dasatinib, £852 per month for everolimus and £10 per month for gefitinib. Compared with current list prices in England, these target prices would represent reductions of 74-99.6%. Patent expiry dates were bortezomib 2014-22, dasatinib 2020-26, everolimus 2019-25 and gefitinib 2017. The total global eligible treatment population in 1 year is 769 736. Our findings demonstrate that affordable drug treatment costs are possible for novel cancer drugs, suggesting that new therapeutic options can be made available to patients and doctors worldwide. Assessing treatment cost estimations alongside cost-effectiveness evaluations is an important area of future research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Societal value of generic medicines beyond cost-saving through reduced prices.

    Science.gov (United States)

    Dylst, Pieter; Vulto, Arnold; Simoens, Steven

    2015-01-01

    This paper aims to provide an overview of the added societal value of generic medicines beyond their cost-saving potential through reduced prices. In addition, an observational case study will document the impact of generic entry on access to pharmacotherapy in The Netherlands and an illustrative exercise was carried out to highlight the budget impact of generic entry. A narrative literature review was carried out to explore the impact of generic medicines on access to pharmacotherapy, innovation and medication adherence. Data from the Medicines and Medical Devices Information Project database in The Netherlands were used for the case study in which the impact of generic medicine entrance on the budget and the number of users was calculated as an illustrative exercise. Generic medicines have an additional societal value beyond their cost-saving potential through reduced prices. Generic medicines increase access to pharmacotherapy, provide a stimulus for innovation by both originator companies and generic companies and, under the right circumstances, have a positive impact on medication adherence. Generic medicines offer more to society than just their cost-saving potential through reduced prices. As such, governments must not focus only on the prices of generic medicines as this will threaten their long-term sustainability. Governments must therefore act appropriately and implement a coherent set of policies to increase the use of generic medicines.

  8. Potential cost savings from generic medicines – protecting the ...

    African Journals Online (AJOL)

    the difference between brand and generic medicines listed for that algorithm, and also as the median of differences between generic medicines for the same condition. Results: Three of the algorithms .... Protecting the PMBs, as a key element of the new community-rated medical schemes environment, is therefore vital.

  9. Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

    Directory of Open Access Journals (Sweden)

    Smita Nayak

    Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost

  10. Finding costs methodology - alternative approaches

    International Nuclear Information System (INIS)

    Gaddis, D.

    1992-01-01

    Though the context may vary, the topic of the day in the oil and gas industry is ''finding costs per barrel.'' First, there have been numerous articles in both the popular media and the industry press that have argued it is cheaper for companies to buy reserves that find them with the drill bit. Financial analysts have emphasized the importance of comparing relative finding costs when evaluating different companies. The success of failure of a company's management has been judged on the basis of finding costs. In discussing oil and gas prices, economists commonly refer to the relationship between the market prices of oil and gas and their finding costs, and no discussion of the U.S. petroleum industry and the development of a national energy policy is complete without reference to finding costs. (Author)

  11. Potential Cost Savings from Generic Medicines - Protecting the ...

    African Journals Online (AJOL)

    ... a pro-generic policy since the introduction of the National Drug Policy in 1996. ... Medicines provided outside of hospitals accounted for 17% of medical aid ... in the chronic disease algorithms set out by the Council for Medical Schemes ...

  12. Cost estimating for CERCLA remedial alternatives a unit cost methodology

    International Nuclear Information System (INIS)

    Brettin, R.W.; Carr, D.J.; Janke, R.J.

    1995-06-01

    The United States Environmental Protection Agency (EPA) Guidance for Conducting Remedial Investigations and Feasibility Studies Under CERCLA, Interim Final, dated October 1988 (EPA 1988) requires a detailed analysis be conducted of the most promising remedial alternatives against several evaluation criteria, including cost. To complete the detailed analysis, order-of-magnitude cost estimates (having an accuracy of +50 percent to -30 percent) must be developed for each remedial alternative. This paper presents a methodology for developing cost estimates of remedial alternatives comprised of various technology and process options with a wide range of estimated contaminated media quantities. In addition, the cost estimating methodology provides flexibility for incorporating revisions to remedial alternatives and achieves the desired range of accuracy. It is important to note that the cost estimating methodology presented here was developed as a concurrent path to the development of contaminated media quantity estimates. This methodology can be initiated before contaminated media quantities are estimated. As a result, this methodology is useful in developing cost estimates for use in screening and evaluating remedial technologies and process options. However, remedial alternative cost estimates cannot be prepared without the contaminated media quantity estimates. In the conduct of the feasibility study for Operable Unit 5 at the Fernald Environmental Management Project (FEMP), fourteen remedial alternatives were retained for detailed analysis. Each remedial alternative was composed of combinations of remedial technologies and processes which were earlier determined to be best suited for addressing the media-specific contaminants found at the FEMP site, and achieving desired remedial action objectives

  13. Validation of generic cost estimates for construction-related activities at nuclear power plants: Final report

    International Nuclear Information System (INIS)

    Simion, G.; Sciacca, F.; Claiborne, E.; Watlington, B.; Riordan, B.; McLaughlin, M.

    1988-05-01

    This report represents a validation study of the cost methodologies and quantitative factors derived in Labor Productivity Adjustment Factors and Generic Methodology for Estimating the Labor Cost Associated with the Removal of Hardware, Materials, and Structures From Nuclear Power Plants. This cost methodology was developed to support NRC analysts in determining generic estimates of removal, installation, and total labor costs for construction-related activities at nuclear generating stations. In addition to the validation discussion, this report reviews the generic cost analysis methodology employed. It also discusses each of the individual cost factors used in estimating the costs of physical modifications at nuclear power plants. The generic estimating approach presented uses the /open quotes/greenfield/close quotes/ or new plant construction installation costs compiled in the Energy Economic Data Base (EEDB) as a baseline. These baseline costs are then adjusted to account for labor productivity, radiation fields, learning curve effects, and impacts on ancillary systems or components. For comparisons of estimated vs actual labor costs, approximately four dozen actual cost data points (as reported by 14 nuclear utilities) were obtained. Detailed background information was collected on each individual data point to give the best understanding possible so that the labor productivity factors, removal factors, etc., could judiciously be chosen. This study concludes that cost estimates that are typically within 40% of the actual values can be generated by prudently using the methodologies and cost factors investigated herein

  14. A generic tool for cost estimating in aircraft design

    NARCIS (Netherlands)

    Castagne, S.; Curran, R.; Rothwell, A.; Price, M.; Benard, E.; Raghunathan, S.

    2008-01-01

    A methodology to estimate the cost implications of design decisions by integrating cost as a design parameter at an early design stage is presented. The model is developed on a hierarchical basis, the manufacturing cost of aircraft fuselage panels being analysed in this paper. The manufacturing cost

  15. Generic Database Cost Models for Hierarchical Memory Systems

    OpenAIRE

    Manegold, Stefan; Boncz, Peter; Kersten, Martin

    2002-01-01

    textabstractAccurate prediction of operator execution time is a prerequisite for database query optimization. Although extensively studied for conventional disk-based DBMSs, cost modeling in main-memory DBMSs is still an open issue. Recent database research has demonstrated that memory access is more and more becoming a significant---if not the major---cost component of database operations. If used properly, fast but small cache memories---usually organized in cascading hierarchy between CPU ...

  16. Generic Database Cost Models for Hierarchical Memory Systems

    NARCIS (Netherlands)

    S. Manegold (Stefan); P.A. Boncz (Peter); M.L. Kersten (Martin)

    2002-01-01

    textabstractAccurate prediction of operator execution time is a prerequisite for database query optimization. Although extensively studied for conventional disk-based DBMSs, cost modeling in main-memory DBMSs is still an open issue. Recent database research has demonstrated that memory access is

  17. Generic database cost models for hierarchical memory systems

    NARCIS (Netherlands)

    S. Manegold (Stefan); P.A. Boncz (Peter); M.L. Kersten (Martin)

    2002-01-01

    textabstractAccurate prediction of operator execution time is a prerequisite fordatabase query optimization. Although extensively studied for conventionaldisk-based DBMSs, cost modeling in main-memory DBMSs is still an openissue. Recent database research has demonstrated that memory access ismore

  18. Generic atorvastatin, the Belgian statin market and the cost-effectiveness of statin therapy.

    Science.gov (United States)

    Simoens, Steven; Sinnaeve, Peter R

    2013-02-01

    This study examines how the market entry of generic atorvastatin influences the Belgian statin market and the cost-effectiveness of statin therapy. Using IMS Health data, the Belgian 2000-2011 statin market was analyzed in terms of total expenditure, annual price of statin treatment, and patient numbers. A simulation analysis projected statin market shares from 2012 to 2015 following market entry of generic atorvastatin. This analysis was based on three scenarios regarding the number of patients taking specific statins. Savings associated with an atorvastatin price reduction of 50-70 % were calculated. A literature review of economic evaluations assessed the cost-effectiveness of generic atorvastatin. Statin expenditure increased from €113 million in 2000 to €285 million in 2011 due to higher expenditure on atorvastatin and rosuvastatin. Although the number of patients treated with simvastatin increased by nearly 800 %, the resulting increase in expenditure was partially offset by price reductions. Atorvastatin is projected to become the dominant product in the Belgian statin market (market share of 47-66 % by 2015). Annual savings would attain €108.6-€153.7 million for a 50 % reduction in the atorvastatin price and €152.0-€215.2 million for a 70 % price reduction. The literature suggests that generic atorvastatin is cost-effective as compared to simvastatin. The limited evidence about the cost-effectiveness of rosuvastatin as compared with generic atorvastatin is inconclusive. Generic atorvastatin is cost-effective as compared to simvastatin, is projected to become the dominant product in the Belgian statin market and is expected to generate substantial savings to health care payers.

  19. Handbook for cost estimating. A method for developing estimates of costs for generic actions for nuclear power plants

    International Nuclear Information System (INIS)

    Ball, J.R.; Cohen, S.; Ziegler, E.Z.

    1984-10-01

    This document provides overall guidance to assist the NRC in preparing the types of cost estimates required by the Regulatory Analysis Guidelines and to assist in the assignment of priorities in resolving generic safety issues. The Handbook presents an overall cost model that allows the cost analyst to develop a chronological series of activities needed to implement a specific regulatory requirement throughout all applicable commercial LWR power plants and to identify the significant cost elements for each activity. References to available cost data are provided along with rules of thumb and cost factors to assist in evaluating each cost element. A suitable code-of-accounts data base is presented to assist in organizing and aggregating costs. Rudimentary cost analysis methods are described to allow the analyst to produce a constant-dollar, lifetime cost for the requirement. A step-by-step example cost estimate is included to demonstrate the overall use of the Handbook

  20. Deregulation and Nuclear Training: Cost Effective Alternatives

    International Nuclear Information System (INIS)

    Richard P. Coe; Patricia A. Lake

    2000-01-01

    Training is crucial to the success of any organization. It is also expensive, with some estimates exceeding $50 billion annually spent on training by U.S. corporations. Nuclear training, like that of many other highly technical organizations, is both crucial and costly. It is unlikely that the amount of training can be significantly reduced. If anything, current trends indicate that training needs will probably increase as the industry and workforce ages and changes. With the advent of energy deregulation in the United States, greater pressures will surface to make the costs of energy more cost-competitive. This in turn will drive businesses to more closely examine existing costs and find ways to do things in a more cost-effective way. The commercial nuclear industry will be no exception, and nuclear training will be equally affected. It is time for nuclear training and indeed the entire nuclear industry to begin using more aggressive techniques to reduce costs. This includes the need for nuclear training to find alternatives to traditional methods for the delivery of cost-effective high-quality training that meets regulatory requirements and produces well-qualified personnel capable of working in an efficient and safe manner. Computer-based and/or Web-based training are leading emerging technologies

  1. Cost-effectiveness of hepatitis C treatment using generic direct-acting antivirals available in India.

    Directory of Open Access Journals (Sweden)

    Rakesh Aggarwal

    Full Text Available Availability of directly-acting antivirals (DAAs has changed the treatment landscape of hepatitis C virus (HCV infection. The high price of DAAs has restricted their use in several countries. However, in some countries such as India, generic DAAs are available at much cheaper price. This study examined whether generic DAAs could be cost-saving and how long it would take for the treatment to become cost-saving/effective.A previously-validated, mathematical model was adapted to the HCV-infected population in India to compare the outcomes of no treatment versus treatment with DAAs. Model parameters were estimated from published studies. Cost-effectiveness of HCV treatment using available DAAs was calculated, using a payer's perspective. We estimated quality-adjusted life years (QALYs, disability-adjusted life years (DALYs, total costs, and incremental cost-effectiveness ratio of DAAs versus no treatment. One-way and probabilistic sensitivity analyses were conducted.Compared with no treatment, the use of generic DAAs in Indian HCV patients would increase the life expectancy by 8.02 years, increase QALYs by 3.89, avert 19.07 DALYs, and reduce the lifetime healthcare costs by $1,309 per-person treated. Treatment became cost-effective within 2 years, and cost-saving within 10 years of its initiation overall and within 5 years in persons with cirrhosis. Treating 10,000 HCV-infected persons could prevent 3400-3850 decompensated cirrhosis, 1800-2500 HCC, and 4000-4550 liver-related deaths. The results were sensitive to the costs of DAAs, pre- and post-treatment diagnostic tests and management of cirrhosis, and quality of life after sustained virologic response.Treatment with generic DAAs available in India will improve patient outcomes, provide a good value for money within 2 years, and be ultimately cost-saving. Therefore, in this and similar settings, HCV treatment should be a priority from a public health as well an economic perspective.

  2. Costs of berm and causeway alternatives

    International Nuclear Information System (INIS)

    Kubo, Arthur S.

    1987-01-01

    Experiments initiated in February 1985 and still in progress have demonstrated that removal of 30 cm of topsoil brings the specific activity of Bikini Island soil down to the level of that on Eneu and reduces the external exposure rate to gamma rays from an average of 68 pr/h to 5 pr/h. The analytical data completed thus far for food crops grown in the experimental and control areas indicate a parallel response. During 1986 results became available showing that removal of topsoil would also limit productivity. However, it is now known that with adequate care the excavated plot can be as productive as the unexcavated (natural) one. The removal of 30 cm (1 foot) of topsoil at Bikini Island would produce large amounts of waste vegetable matter and approximately 719,000 cubic meters of contaminated topsoil. Three principal alternatives have been considered for the disposal of the spoil. The cost estimates for these and other rehabilitation alternatives were developed in detail by a panel of engineers, chaired by BARC member Arthur S. Kubo, which met in January 1986. The panel's report constitutes Appendix C of BARC Report No. 4

  3. Costs of berm and causeway alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Arthur S [Bikini Atoll Rehabilitation Committee, Berkeley, CA (United States); [BDM Corporation, McLean, VA (United States)

    1987-07-01

    Experiments initiated in February 1985 and still in progress have demonstrated that removal of 30 cm of topsoil brings the specific activity of Bikini Island soil down to the level of that on Eneu and reduces the external exposure rate to gamma rays from an average of 68 pr/h to 5 pr/h. The analytical data completed thus far for food crops grown in the experimental and control areas indicate a parallel response. During 1986 results became available showing that removal of topsoil would also limit productivity. However, it is now known that with adequate care the excavated plot can be as productive as the unexcavated (natural) one. The removal of 30 cm (1 foot) of topsoil at Bikini Island would produce large amounts of waste vegetable matter and approximately 719,000 cubic meters of contaminated topsoil. Three principal alternatives have been considered for the disposal of the spoil. The cost estimates for these and other rehabilitation alternatives were developed in detail by a panel of engineers, chaired by BARC member Arthur S. Kubo, which met in January 1986. The panel's report constitutes Appendix C of BARC Report No. 4.

  4. The impact of reference pricing and extension of generic substitution on the daily cost of antipsychotic medication in Finland.

    Science.gov (United States)

    Koskinen, Hanna; Ahola, Elina; Saastamoinen, Leena K; Mikkola, Hennamari; Martikainen, Jaana E

    2014-12-01

    To assess the impact of reference pricing and extension of generic substitution on the daily cost of antipsychotic drugs in Finland during the first year after its launch. Furthermore, the additional impact of reference pricing on prior implemented generic substitution is assessed. A retrospective analysis was performed between 2006 and 2010. A segmented linear regression analysis of interrupted time series was used to estimate changes in the levels and trends in the cost of one day of treatment. Of the study drugs, clozapine belonged to generic substitution already at the start of the study period while olanzapine and quetiapine were included in generic substitution alongside with reference pricing in 2009. Risperidone was included in generic substitution in 2008, before reference pricing. A substantial decrease in the daily cost of all four antipsychotic substances was seen after one year of the implementation of reference pricing and the extension of generic substitution. The impact ranged from -29.9% to -66.3%, and it was most substantial on the daily cost of olanzapine. Also in the daily cost of risperidone a substantial decrease of -43.3% was observed. However, most of these savings, -32.6%, were generated by generic substitution which had been adopted prior. Reference pricing and the extension of generic substitution produced substantial savings on antipsychotic medication costs during the first year after its launch, but the intensity of the impact differed between active substances. Furthermore, our results suggest that the additional cost savings from reference pricing after prior implemented generic substitution, are comparatively low.

  5. Benefit-cost-risk analysis of alternatives for greater-confinement disposal of radioactive waste

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Peterson, J.M.

    1983-01-01

    Seven alternatives are included in the analysis: near-surface disposal; improved waste form; below-ground engineered structure; augered shaft; shale fracturing; shallow geologic repository; and high-level waste repository. These alternatives are representative generic facilities that span the range from low-level waste disposal practice to high-level waste disposal practice, tentatively ordered according to an expected increasing cost and/or effectiveness of confinement. They have been chosen to enable an assessment of the degree of confinement that represents an appropriate balance between public health and safety requirements and costs rather than identification of a specific preferred facility design. The objective of the analysis is to provide a comparative ranking of the alternatives on the basis of benefit-cost-risk considerations

  6. Influence of generic reference pricing on medicine cost in Slovenia: a retrospective study

    Science.gov (United States)

    Marđetko, Nika; Kos, Mitja

    2018-01-01

    Aim To assess the impact of the generic reference pricing (GRP) system on the prices and cost of medicines in Slovenia approximately 8 years after its introduction in 2003 and before the implementation of the therapeutic reference pricing system. Methods A retrospective study of all medicines (N = 789) included in the GRP system on January 31, 2012 was performed. Medicine prices and cost were analyzed between January 31, 2012 and December 31, 2013 after every update (N = 11) of the maximum reimbursable price (MRP) and were compared to the price and cost on January 31, 2012 (index date). Time trends of different types of medicine prices (maximum allowed price, MRP, and actual wholesale price) were graphically analyzed, and actual wholesale price adjustments to the MRP changes and the budget impact of the GRP were assessed. Results In the 2-year study period, the long-term performance of the GRP system was associated with an approximate 45% decrease in the average MRP or an approximate 20% cost reduction. For each MRP update period, the GRP reduced the cost based on the maximum allowed price for approximately 30%. The wholesale price adjustments were mostly made for medicines priced above the MRP and reduced patients’ out-of-pocket cost. Conclusions In the long term, the GRP system effectively reduced medicine prices and the cost of reimbursed products. PMID:29740992

  7. Influence of generic reference pricing on medicine cost in Slovenia: a retrospective study.

    Science.gov (United States)

    Marđetko, Nika; Kos, Mitja

    2018-04-30

    To assess the impact of the generic reference pricing (GRP) system on the prices and cost of medicines in Slovenia approximately 8 years after its introduction in 2003 and before the implementation of the therapeutic reference pricing system. A retrospective study of all medicines (N=789) included in the GRP system on January 31, 2012 was performed. Medicine prices and cost were analyzed between January 31, 2012 and December 31, 2013 after every update (N=11) of the maximum reimbursable price (MRP) and were compared to the price and cost on January 31, 2012 (index date). Time trends of different types of medicine prices (maximum allowed price, MRP, and actual wholesale price) were graphically analyzed, and actual wholesale price adjustments to the MRP changes and the budget impact of the GRP were assessed. In the 2-year study period, the long-term performance of the GRP system was associated with an approximate 45% decrease in the average MRP or an approximate 20% cost reduction. For each MRP update period, the GRP reduced the cost based on the maximum allowed price for approximately 30%. The wholesale price adjustments were mostly made for medicines priced above the MRP and reduced patients' out-of-pocket cost. In the long term, the GRP system effectively reduced medicine prices and the cost of reimbursed products.

  8. Design and cost evaluation of generic magnetic fusion reactor using the D-D fuel cycle

    International Nuclear Information System (INIS)

    Shannon, T.E.

    1988-01-01

    A fusion reactor systems code has been developed to evaluate the economic potential of power generation from a toroidal magnetic fusion reactor using deuterium-deuterium (D-D) fuel. A method similar to that developed by J. Sheffield, of the Oak Ridge National Laboratory, for deuterium-tritium (D-T) fuel was used to model the generic aspects of magnetic fusion reactors. The results of the systems study and cost evaluation show that the cost of electricity produced by a D-D reactor is two times higher than that produced by an equivalent D-T reactor design. The significant finding of the study is that the cost ratio between the D-D and D-T systems can potentially be reduced to 1.5 by improved engineering design and even lower by better physics performance. The absolute costs for both systems at this level are close to the costs for nuclear fission and fossil fuel plants. A design for a magnet reinforced with advanced composite materials is presented as an example of an engineering improvement that could reduce the cost of electricity produced by both reactors. However, since the magnets in the D-D reactor are much larger than in the K-T reactor, the cost ratio of the two systems is significantly reduced

  9. Molecularly Imprinted Polymer Technology: A Powerful, Generic ...

    African Journals Online (AJOL)

    Molecularly Imprinted Polymer Technology: A Powerful, Generic, Facile and Cost Effective Alternative for Enantio-recognition and Separation: A Glance at Advances and Applications. ... Tanzania Journal of Science. Journal Home · ABOUT ...

  10. Cost Effectiveness of Alternative Route Special Education Teacher Preparation

    Science.gov (United States)

    Sindelar, Paul T.; Dewey, James F.; Rosenberg, Michael S.; Corbett, Nancy L.; Denslow, David; Lotfinia, Babik

    2012-01-01

    In this study, the authors estimated costs of alternative route preparation to provide states a basis for allocating training funds to maximize production. Thirty-one special education alternative route program directors were interviewed and completed cost tables. Two hundred and twenty-four program graduates were also surveyed. The authors…

  11. Cost-effectiveness of Low-dose Submicron Diclofenac Compared With Generic Diclofenac.

    Science.gov (United States)

    Mladsi, Deirdre; Ronquest, Naoko; Odom, Dawn; Miles, LaStella; Saag, Kenneth

    2016-11-01

    NSAIDs are commonly prescribed for the treatment of pain and inflammation. Despite the effectiveness of NSAIDs, concerns exist regarding their tolerability. Worldwide health authorities, including the European Medicines Agency, Health Canada, and the US Food and Drug Administration, have advised that NSAIDs be prescribed at the lowest effective dosage and for the shortest duration. Effective lowering of NSAID dosage without compromising pain relief has been demonstrated in randomized, controlled trials of the recently approved NSAID lower-dose submicron diclofenac. Building on previously published work from an independently published systematic review and meta-analysis, a linear dose-toxicity relationship between diclofenac dose and serious gastrointestinal (GI) events was recently demonstrated, indicating that reductions in adverse events (AEs) may be seen even with modest dose reductions in many patients. The objective of the present study was to estimate the potential reduction in risk for NSAID dose-related AEs, corresponding savings in health care costs, and the incremental cost-effectiveness of submicron diclofenac compared with generic diclofenac in the United States. Our decision-analytic cost-effectiveness model considered a subset of potential AEs that may be avoided by lowering NSAID dosage. To estimate the expected reductions in upper GI bleeding/perforation and major cardiovascular events with submicron diclofenac, our model used prediction equations estimated by meta-regressions using data from systematic literature reviews. Utilities, lifetime costs, and health outcomes associated with AEs were estimated using data from the literature. The face validity of the model structure and inputs was confirmed by clinical experts in the United States. Results were evaluated in 1-way and probabilistic sensitivity analyses. The model predicted that submicron diclofenac versus generic diclofenac could reduce the occurrence of modeled GI events (by 18

  12. A generic interface to reduce the efficiency-stability-cost gap of perovskite solar cells

    Science.gov (United States)

    Hou, Yi; Du, Xiaoyan; Scheiner, Simon; McMeekin, David P.; Wang, Zhiping; Li, Ning; Killian, Manuela S.; Chen, Haiwei; Richter, Moses; Levchuk, Ievgen; Schrenker, Nadine; Spiecker, Erdmann; Stubhan, Tobias; Luechinger, Norman A.; Hirsch, Andreas; Schmuki, Patrik; Steinrück, Hans-Peter; Fink, Rainer H.; Halik, Marcus; Snaith, Henry J.; Brabec, Christoph J.

    2017-12-01

    A major bottleneck delaying the further commercialization of thin-film solar cells based on hybrid organohalide lead perovskites is interface loss in state-of-the-art devices. We present a generic interface architecture that combines solution-processed, reliable, and cost-efficient hole-transporting materials without compromising efficiency, stability, or scalability of perovskite solar cells. Tantalum-doped tungsten oxide (Ta-WOx)/conjugated polymer multilayers offer a surprisingly small interface barrier and form quasi-ohmic contacts universally with various scalable conjugated polymers. In a simple device with regular planar architecture and a self-assembled monolayer, Ta-WOx-doped interface-based perovskite solar cells achieve maximum efficiencies of 21.2% and offer more than 1000 hours of light stability. By eliminating additional ionic dopants, these findings open up the entire class of organics as scalable hole-transporting materials for perovskite solar cells.

  13. The cost of ethanol production from lignocellulosic biomass -- A comparison of selected alternative processes. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Grethlein, H.E.; Dill, T.

    1993-04-30

    The purpose of this report is to compare the cost of selected alternative processes for the conversion of lignocellulosic biomass to ethanol. In turn, this information will be used by the ARS/USDA to guide the management of research and development programs in biomass conversion. The report will identify where the cost leverages are for the selected alternatives and what performance parameters need to be achieved to improve the economics. The process alternatives considered here are not exhaustive, but are selected on the basis of having a reasonable potential in improving the economics of producing ethanol from biomass. When other alternatives come under consideration, they should be evaluated by the same methodology used in this report to give fair comparisons of opportunities. A generic plant design is developed for an annual production of 25 million gallons of anhydrous ethanol using corn stover as the model substrate at $30/dry ton. Standard chemical engineering techniques are used to give first order estimates of the capital and operating costs. Following the format of the corn to ethanol plant, there are nine sections to the plant; feed preparation, pretreatment, hydrolysis, fermentation, distillation and dehydration, stillage evaporation, storage and denaturation, utilities, and enzyme production. There are three pretreatment alternatives considered: the AFEX process, the modified AFEX process (which is abbreviated as MAFEX), and the STAKETECH process. These all use enzymatic hydrolysis and so an enzyme production section is included in the plant. The STAKETECH is the only commercially available process among the alternative processes.

  14. The Development of Alternative Food Cost Indexes

    Science.gov (United States)

    1974-11-01

    this total effort were to develop a new uniform ration cost system which would be directly related to known consumer preferences and nutritional...usage by all military services. 6. Be easy to understand and use. 7. Provide a BDFA capable of meeting consumer preferences and requirements as well... consumer preferences . in addition, historical usage data cannot help but reflect certain undesirable influences that mi I itary food service has

  15. Comparative life-cycle cost analysis for low-level mixed waste remediation alternatives

    International Nuclear Information System (INIS)

    Jackson, J.A.; White, T.P.; Kloeber, J.M.; Toland, R.J.; Cain, J.P.; Buitrago, D.Y.

    1995-03-01

    The purpose of this study is two-fold: (1) to develop a generic, life-cycle cost model for evaluating low-level, mixed waste remediation alternatives, and (2) to apply the model specifically, to estimate remediation costs for a site similar to the Fernald Environmental Management Project near Cincinnati, OH. Life-cycle costs for vitrification, cementation, and dry removal process technologies are estimated. Since vitrification is in a conceptual phase, computer simulation is used to help characterize the support infrastructure of a large scale vitrification plant. Cost estimating relationships obtained from the simulation data, previous cost estimates, available process data, engineering judgment, and expert opinion all provide input to an Excel based spreadsheet for generating cash flow streams. Crystal Ball, an Excel add-on, was used for discounting cash flows for net present value analysis. The resulting LCC data was then analyzed using multi-attribute decision analysis techniques with cost and remediation time as criteria. The analytical framework presented allows alternatives to be evaluated in the context of budgetary, social, and political considerations. In general, the longer the remediation takes, the lower the net present value of the process. This is true because of the time value of money and large percentage of the costs attributed to storage or disposal

  16. Tracking costs of alternatively fueled buses in Florida : [summary].

    Science.gov (United States)

    2011-01-01

    In an effort to address rising fuel costs and environmental concerns, many transit agencies across Florida have introduced alternative fuel technologies to their traditional diesel-powered fleets. Fuel types include biodiesel, compressed natural gas,...

  17. Tracking costs of alternatively fueled buses in Florida.

    Science.gov (United States)

    2011-11-04

    The goal of the current project is to establish a recording and reporting mechanism for collecting field data on the performance and costs of alternatively fueled public transit vehicles operating in Florida in order to assist policy makers with thei...

  18. Cost-benefit analysis of alternative fuels and motive designs.

    Science.gov (United States)

    2013-04-01

    This project was funded by the Federal Railroad Administration to better understand the potential cost and benefits of using alternative fuels for U.S. freight and passenger locomotive operations. The framework for a decision model was developed by T...

  19. Investigation of an alternative generic model for predicting pharmacokinetic changes during physiological stress.

    Science.gov (United States)

    Peng, Henry T; Edginton, Andrea N; Cheung, Bob

    2013-10-01

    Physiologically based pharmacokinetic models were developed using MATLAB Simulink® and PK-Sim®. We compared the capability and usefulness of these two models by simulating pharmacokinetic changes of midazolam under exercise and heat stress to verify the usefulness of MATLAB Simulink® as a generic PBPK modeling software. Although both models show good agreement with experimental data obtained under resting condition, their predictions of pharmacokinetics changes are less accurate in the stressful conditions. However, MATLAB Simulink® may be more flexible to include physiologically based processes such as oral absorption and simulate various stress parameters such as stress intensity, duration and timing of drug administration to improve model performance. Further work will be conducted to modify algorithms in our generic model developed using MATLAB Simulink® and to investigate pharmacokinetics under other physiological stress such as trauma. © The Author(s) 2013.

  20. Emission Control Cost-Effectiveness of Alternative-Fuel Vehicles

    OpenAIRE

    Wang, Quanlu; Sperling, Daniel; Olmstead, Janis

    1993-01-01

    Although various legislation and regulations have been adopted to promote the use of alternative-fuel vehicles for curbing urban air pollution problems, there is a lack of systematic comparisons of emission control cost-effectiveness among various alternative-fuel vehicle types. In this paper, life-cycle emission reductions and life-cycle costs were estimated for passenger cars fueled with methanol, ethanol, liquified petroleum gas, compressed natural gas, and electricity. Vehicle emission es...

  1. External costs of nuclear: Greater or less than the alternatives?

    International Nuclear Information System (INIS)

    Rabl, Ari; Rabl, Veronika A.

    2013-01-01

    Since Fukushima many are calling for a shutdown of nuclear power plants. To see whether such a shutdown would reduce the risks for health and environment, the external costs of nuclear electricity are compared with alternatives that could replace it. The frequency of catastrophic nuclear accidents is based on the historical record, about one in 25 years for the plants built to date, an order of magnitude higher than the safety goals of the U.S. Nuclear Regulatory Commission. Impacts similar to Chernobyl and Fukushima are assumed to estimate the cost. A detailed comparison is presented with wind as alternative with the lowest external cost. The variability of wind necessitates augmentation by other sources, primarily fossil fuels, because storage at the required scale is in most regions too expensive. The external costs of natural gas combined cycle are taken as 0.6 €cent/kWh due to health effects of air pollution and 1.25 €cent/kWh due to greenhouse gases (at 25€/t CO 2 eq ) for the central estimate, but a wide range of different parameters is also considered, both for nuclear and for the alternatives. Although the central estimate of external costs of the wind-based alternative is higher than that of nuclear, the uncertainty ranges overlap. - Highlights: ► The external costs of nuclear electricity are compared with the alternatives. ► Frequency and cost of nuclear accidents based on Chernobyl and Fukushima. ► Detailed comparison with wind as alternative with the lowest external costs. ► High external cost of wind because of natural gas backup (storage too limited). ► External costs of wind higher than nuclear but uncertainty ranges overlap

  2. Cost allocation policy review: options and preferred alternatives

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-10-15

    This policy review of the consultation process on the electricity cost allocation issue is presented with specific cost allocation policy issues addressed herein, such as: the new microFIT rate, accounting changes and the transition to IFRS, and review of allocating costs to load displacement generation. This report gave the current situation for all these issues, previous work, issues, viable options for dealing with these issues and the preferred alternatives.

  3. Cost effectiveness methodology for evaluating Korean international communication system alternatives.

    OpenAIRE

    Hwang, Tae Kyun.

    1987-01-01

    Approved for public release; distribution in unlimited. Cost and Effectiveness models are developed by using of cost-effectiveness technique for fiber optic cable and satellite communication media. The models are applied to the Korean international communication problem. Alternative selection is required since the two medias different in cost and effectiveness. The major difficulties encountered were data gathering and measuring the effectiveness of the Korean international ...

  4. Supplementary study about the ATC generic project. Alternative storage for encapsulated fuel

    International Nuclear Information System (INIS)

    Canadas Martinez, I.

    2010-01-01

    The objective of this study is to present the alternatives for a complementary installation and facilitate the decision making on the best solution, keeping many determining factors in mind. Two are the alternatives studied: supplementary storage, similar to the Trillo Nuclear Power Plant, and outdoor storage, similar to the Asco and Jose Cabrera Nuclear Power Plants.

  5. Tracking costs of alternatively fueled buses in Florida - phase II.

    Science.gov (United States)

    2013-04-01

    The goal of this project is to continue collecting and reporting the data on the performance and costs of alternatively fueled public transit vehicles in the state in a consistent manner in order to keep the Bus Fuels Fleet Evaluation Tool (BuFFeT) c...

  6. Costs and returns analysis of improved and alternative cassava ...

    African Journals Online (AJOL)

    The specific objectives of the study was an analysis of the costs and returns of improved and alternative technologies available in the study area by farmers and their level of adoption of the new technologies. Data were collected from a random sample of 250 farmers and 30 extension Staff in the three (3) agricultural zones ...

  7. Power generation costs for alternate reactor fuel cycles

    International Nuclear Information System (INIS)

    Smolen, G.R.; Delene, J.G.

    1980-09-01

    The total electric generating costs at the power plant busbar are estimated for various nuclear reactor fuel cycles which may be considered for power generation in the future. The reactor systems include pressurized water reactors (PWR), heavy-water reactors (HWR), high-temperature gas cooled reactors (HTGR), liquid-metal fast breeder reactors (LMFBR), light-water pre-breeder and breeder reactors (LWPR, LWBR), and a fast mixed spectrum reactor (FMSR). Fuel cycles include once-through, uranium-only recycle, and full recycle of the uranium and plutonium in the spent fuel assemblies. The U 3 O 8 price for economic transition from once-through LWR fuel cycles to both PWR recycle and LMFBR systems is estimated. Electric power generation costs were determined both for a reference set of unit cost parameters and for a range of uncertainty in these parameters. In addition, cost sensitivity parameters are provided so that independent estimations can be made for alternate cost assumptions

  8. Cost effective radiation risk management in a generic nuclear plant design

    International Nuclear Information System (INIS)

    Maan, M.A.

    1982-11-01

    To determine whether any further dose reduction measures are justified, a method appropriate for cost effective radiation risk management has been developed. This new method is based on the radiation detriment optimization measures advocated in the revised (1977) ALARA concept. The methodology includes the determination of available alternatives, and the determination of the variable monetary ceiling on expenditures to reduce the radiological detriment (both occupational and public). The method used to determine the maximum justifiable expenditure for additional reduction of detriment takes into account the economic and social climate, administrative/legal exposure limits, and the actual magnitude of risk. All these factors may vary from country to country. The variable monetary ceiling, sensitive to an actual level of risk, provides a handy measure allowing designers to make a decision whether or not the modification of design is necessary and/or cost effective. This will ensure rationally and consistently that the utilities and their customers (public) get maximum benefit for their safety dollars

  9. Comparative analysis of the cost and effectiveness of generic and brand-name antibiotics: the case of uncomplicated urinary tract infection.

    Science.gov (United States)

    Lin, Yu-Shiuan; Jan, I-Shiow; Cheng, Shou-Hsia

    2017-03-01

    Generic medications used for chronic diseases are beneficial in containing healthcare costs and improving drug accessibility. However, the effects of generic drugs in acute and severe illness remain controversial. This study aims to investigate treatment costs and outcomes of generic antibiotics prescribed for adults with a urinary tract infection in outpatient settings. The data source was the Longitudinal Health Insurance Database of Taiwan. We included outpatients aged 20 years and above with a urinary tract infection who required one oral antibiotic for which brand-name and generic products were simultaneously available. Drug cost and overall healthcare expense of the index consultation, healthcare cost during a 42-day follow-up period, and treatment failure rates were the main dependent variables. Data were compared between brand-name and generic users from the entire cohort and a propensity score-matched samples. Results from the entire cohort and propensity score-matched samples were similar. Daily antibiotic cost was significantly lower among generic users than brand-name users. Significant lower total drug claims of the index consultation only existed in patients receiving the investigated antibiotics, while the drug price between brand-name and generic versions were relatively large (e.g., >50%). The overall healthcare cost of the index consultation, healthcare expenditure during a 42-day follow-up period, and treatment failure rates were similar between the two groups. Compared with those treated with brand-name antibiotics, outpatients who received generic antibiotics had equivalent treatment outcomes with lower drug costs. Generic antibiotics are effective and worthy of adoption among outpatients with simple infections indicating oral antibiotic treatment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Handbook for quick cost estimates. A method for developing quick approximate estimates of costs for generic actions for nuclear power plants

    International Nuclear Information System (INIS)

    Ball, J.R.

    1986-04-01

    This document is a supplement to a ''Handbook for Cost Estimating'' (NUREG/CR-3971) and provides specific guidance for developing ''quick'' approximate estimates of the cost of implementing generic regulatory requirements for nuclear power plants. A method is presented for relating the known construction costs for new nuclear power plants (as contained in the Energy Economic Data Base) to the cost of performing similar work, on a back-fit basis, at existing plants. Cost factors are presented to account for variations in such important cost areas as construction labor productivity, engineering and quality assurance, replacement energy, reworking of existing features, and regional variations in the cost of materials and labor. Other cost categories addressed in this handbook include those for changes in plant operating personnel and plant documents, licensee costs, NRC costs, and costs for other government agencies. Data sheets, worksheets, and appropriate cost algorithms are included to guide the user through preparation of rough estimates. A sample estimate is prepared using the method and the estimating tools provided

  11. Handbook for quick cost estimates. A method for developing quick approximate estimates of costs for generic actions for nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Ball, J.R.

    1986-04-01

    This document is a supplement to a ''Handbook for Cost Estimating'' (NUREG/CR-3971) and provides specific guidance for developing ''quick'' approximate estimates of the cost of implementing generic regulatory requirements for nuclear power plants. A method is presented for relating the known construction costs for new nuclear power plants (as contained in the Energy Economic Data Base) to the cost of performing similar work, on a back-fit basis, at existing plants. Cost factors are presented to account for variations in such important cost areas as construction labor productivity, engineering and quality assurance, replacement energy, reworking of existing features, and regional variations in the cost of materials and labor. Other cost categories addressed in this handbook include those for changes in plant operating personnel and plant documents, licensee costs, NRC costs, and costs for other government agencies. Data sheets, worksheets, and appropriate cost algorithms are included to guide the user through preparation of rough estimates. A sample estimate is prepared using the method and the estimating tools provided.

  12. Cost-effectiveness evaluation of alternatives in environmental impact statements

    International Nuclear Information System (INIS)

    Weiser, A.L.

    1977-01-01

    Although it has been Federal government officials who have been accused in courts of law with mismanagement with regard to the consideration of alternatives in the environmental impact statement, the responsibility for systematically considering all alternatives to a proposed project remains with project decisionmakers in the Federal, state, or local levels of government and in industry. By applying the techniques of system cost-effectiveness analysis to the assessment of alternatives, it is believed that management will be able to clearly demonstrate that the selection of the proposed approach was neither arbitrary nor capricious. A rational approach to the assessment of alternatives should aid in meeting the mandates of environmental legislation and EIS guidelines, and it should eliminate the merit of any plaintiff's charge of mismanagement with regard to management's consideration of alternatives. Even though many interfaces between the proposed system and the environment cannot as yet be objectively quantified, application of CE techniques will demonstrate that a rigorous exploration and objective evaluation has been applied to the consideration of alternatives with respect to project objectives, financial conditions, and adverse environmental impacts

  13. The use of generic drugs in prevention of chronic disease is far more cost-effective than thought, and may save money.

    Science.gov (United States)

    Shrank, William H; Choudhry, Niteesh K; Liberman, Joshua N; Brennan, Troyen A

    2011-07-01

    In this article we highlight the important role that medication therapy can play in preventing disease and controlling costs. Focusing on coronary artery disease, we demonstrate that prevention, with the appropriate use of generic medications, appears far more cost-effective than previously documented, and it may even save on costs. For example, an earlier study estimated that reducing blood pressure to widely established clinical guidelines in nondiabetic patients cost an estimated $52,983 per quality-adjusted life-year if a brand-name drug was used. However, we estimate that the cost is just $7,753 per quality-adjusted life-year at generic medication prices. As the nation attempts to find strategies to improve population health without adding to the unsustainably high cost of care, policy makers should focus on ensuring that patients have access to essential generic medications.

  14. Societal lifecycle costs of cars with alternative fuels/engines

    International Nuclear Information System (INIS)

    Ogden, Joan M.; Williams, Robert H.; Larson, Eric D.

    2004-01-01

    Effectively addressing concerns about air pollution (especially health impacts of small-particle air pollution), climate change, and oil supply insecurity will probably require radical changes in automotive engine/fuel technologies in directions that offer both the potential for achieving near-zero emissions of air pollutants and greenhouse gases and a diversification of the transport fuel system away from its present exclusive dependence on petroleum. The basis for comparing alternative automotive engine/fuel options in evolving toward these goals in the present analysis is the 'societal lifecycle cost' of transportation, including the vehicle first cost (assuming large-scale mass production), fuel costs (assuming a fully developed fuel infrastructure), externality costs for oil supply security, and damage costs for emissions of air pollutants and greenhouse gases calculated over the full fuel cycle. Several engine/fuel options are considered--including current gasoline internal combustion engines and a variety of advanced lightweight vehicles: internal combustion engine vehicles fueled with gasoline or hydrogen; internal combustion engine/hybrid electric vehicles fueled with gasoline, compressed natural gas, Diesel, Fischer-Tropsch liquids or hydrogen; and fuel cell vehicles fueled with gasoline, methanol or hydrogen (from natural gas, coal or wind power). To account for large uncertainties inherent in the analysis (for example in environmental damage costs, in oil supply security costs and in projected mass-produced costs of future vehicles), lifecycle costs are estimated for a range of possible future conditions. Under base-case conditions, several advanced options have roughly comparable lifecycle costs that are lower than for today's conventional gasoline internal combustion engine cars, when environmental and oil supply insecurity externalities are counted--including advanced gasoline internal combustion engine cars, internal combustion engine

  15. Buying Health: The Costs of Commercialization and an Alternative Philosophy

    Directory of Open Access Journals (Sweden)

    Larry Churchill

    2013-01-01

    Full Text Available This paper argues that commercial forces have steadily encroached into our understanding of medicine and health in modern industrial societies. The impact on the delivery of personal medical services and on common ideas about food and nutrition is profound and largely deleterious to public health. A key component of commercialization is reductionism of medical services, health products and nutritional components into small, marketable units. This reductive force makes both medical services and nutritional components more costly and is corrosive to more holistic concepts of health. We compare commercial and holistic approaches to nutrition in detail and offer an alternative philosophy. Adopting this alternative will require sound public policies that rely less on marketing as a distribution system and that enfranchise individuals to be reflective on their use of medical services, their food and nutrition choices, and their larger health needs.

  16. Cost analysis of Navy acquisition alternatives for the NAVSTAR Global Positioning System

    Science.gov (United States)

    Darcy, T. F.; Smith, G. P.

    1982-12-01

    This research analyzes the life cycle cost (LCC) of the Navy's current and two hypothetical procurement alternatives for NAVSTAR Global Positioning System (GPS) user equipment. Costs are derived by the ARINC Research Corporation ACBEN cost estimating system. Data presentation is in a comparative format describing individual alternative LCC and differential costs between alternatives. Sensitivity analysis explores the impact receiver-processor unit (RPU) first unit production cost has on individual alternative LCC, as well as cost differentials between each alternative. Several benefits are discussed that might provide sufficient cost savings and/or system effectiveness improvements to warrant a procurement strategy other than the existing proposal.

  17. Cost-Effectiveness and Cost Thresholds of Generic and Brand Drugs in a National Chronic Hepatitis B Treatment Program in China.

    Directory of Open Access Journals (Sweden)

    Mehlika Toy

    Full Text Available Chronic liver disease and liver cancer associated with chronic hepatitis B (CHB are leading causes of death among adults in China. Although newborn hepatitis B immunization has successfully reduced the prevalence of CHB in children, about 100 million Chinese adults remain chronically infected. If left unmanaged, 15-25% will die from liver cancer or liver cirrhosis. Antiviral treatment is not necessary for all patients with CHB, but when it is indicated, good response to treatment would prevent disease progression and reduce disease mortality and morbidity, and costly complications. The aim of this study is to analyze the cost-effectiveness of generic and brand antiviral drugs for CHB treatment in China, and assessing various thresholds at which a highly potent, low resistance antiviral drug would be cost-saving and/or cost-effective to introduce in a national treatment program. We developed a Markov simulation model of disease progression using effectiveness and cost data from the medical literature. We measured life-time costs, quality adjusted life years (QALYs, incremental cost-effectiveness ratios (ICERs, and clinical outcomes. The no treatment strategy incurred the highest health care costs ($12,932-$25,293 per patient, and the worst health outcomes, compared to the antiviral treatment strategies. Monotherapy with either entecavir or tenofovir yielded the most QALYs (14.10-19.02 for both HBeAg-positive and negative patients, with or without cirrhosis. Threshold analysis showed entercavir or tenofovir treatment would be cost saving if the drug price is $32-75 (195-460 RMB per month, highly cost-effective at $62-110 (379-670 RMB per month and cost-effective at $63-120 (384-734 RMB per month. This study can support policy decisions regarding the implementation of a national health program for chronic hepatitis B treatment in China at the population level.

  18. A Review of Generic Preference-Based Measures for Use in Cost-Effectiveness Models.

    Science.gov (United States)

    Brazier, John; Ara, Roberta; Rowen, Donna; Chevrou-Severac, Helene

    2017-12-01

    Generic preference-based measures (GPBMs) of health are used to obtain the quality adjustment weight required to calculate the quality-adjusted life year in health economic models. GPBMs have been developed to use across different interventions and medical conditions and typically consist of a self-complete patient questionnaire, a health state classification system, and preference weights for all states defined by the classification system. Of the six main GPBMs, the three most frequently used are the Health Utilities Index version 3, the EuroQol 5 dimensions (3 and 5 levels), and the Short Form 6 dimensions. There are considerable differences in GPBMs in terms of the content and size of descriptive systems (i.e. the numbers of dimensions of health and levels of severity within these), the methods of valuation [e.g. time trade-off (TTO), standard gamble (SG)], and the populations (e.g. general population, patients) used to value the health states within the descriptive systems. Although GPBMs are anchored at 1 (full health) and 0 (dead), they produce different health state utility values when completed by the same patient. Considerations when selecting a measure for use in a clinical trial include practicality, reliability, validity and responsiveness. Requirements of reimbursement agencies may impose additional restrictions on suitable measures for use in economic evaluations, such as the valuation technique (TTO, SG) or the source of values (general public vs. patients).

  19. Cost-Effectiveness of Single- Versus Generic Multiple-Tablet Regimens for Treatment of HIV-1 Infection in the United States.

    Directory of Open Access Journals (Sweden)

    Donna E Sweet

    Full Text Available The possibility of incorporating generics into combination antiretroviral therapy and breaking apart once-daily single-tablet regimens (STRs, may result in less efficacious medications and/or more complex regimens with the expectation of marked monetary savings. A modeling approach that assesses the merits of such policies in terms of lifelong costs and health outcomes using adherence and effectiveness data from real-world U.S. settings.A comprehensive computer-based microsimulation model was developed to assess the lifetime health (life expectancy and quality adjusted life-years--QALYs and economic outcomes in HIV-1 infected patients initiating STRs compared with multiple-table regimens including generic medications where possible (gMTRs. The STRs considered included tenofovir disoproxil fumarate/emtricitabine and efavirenz or rilpivirine or elvitegravir/cobicistat. gMTRs substitutions included each counterpart to STRs, including generic lamivudine for emtricitabine and generic versus branded efavirenz.Life expectancy is estimated to be 1.301 years higher (discounted 0.619 QALY gain in HIV-1 patients initiating a single-tablet regimen in comparison to a generic-based multiple-table regimen. STRs were associated with an average increment of $26,547.43 per patient in medication and $1,824.09 in other medical costs due to longer survival which were partially offset by higher inpatients costs ($12,035.61 with gMTRs treatment. Overall, STRs presented incremental lifetime costs of $16,335.91 compared with gMTRs, resulting in an incremental cost-effectiveness ratio of $26,383.82 per QALY gained.STRs continue to represent good value for money under contemporary cost-effectiveness thresholds despite substantial price reductions of generic medications in the U. S.

  20. Mobile liquid VR system: a cost effective alternative

    International Nuclear Information System (INIS)

    Soto, R.; Harkins, R.; HPD, Inc., Naperville, IL)

    1985-01-01

    The need for cost effective alternatives to treat large volumes of liquid radwaste has never been more evident. As part of a continuing effort to introduce such alternatives, HPD, Inc., and Chem-Nuclear Systems, Inc., have integrated two proven state-of-the-art technologies to offer a mobile liquid volume reduction system that satisfies nuclear industry requirements, with respect to liquid radwaste handling. This system optimizes proven technology by employing a crystallizer unit to concentrate the waste liquids to 50 weight percent solids, thereby reducing the volume to be solidified by factors of 40, while using only 20 percent of the energy required by conventional evaporative systems. In addition, the system employs a field proven cement solidification process which has been accepted in a Topical Report by the US NRC and which offers the highest waste to container volume ratios for stable waste forms in the industry. This volume reduction-solidification system is able to reduce over 7000 gallons of liquid waste per day to less than 30 cubic feet of 10CFR61 certified stable solidified waste for ultimate disposal or on-site storage. This document describes the GEODE System; its applicability; economics; volume reduction; scope of responsibility and experience. Major benefits include higher VR factors; assurance of continual regulatory compliance; and no capital investment

  1. A Generic Service-Oriented Cost Model for Student Admissions Registration

    Science.gov (United States)

    Pena, Philip Edward

    2017-01-01

    State support of community colleges has been reduced in recent years and is not expected to recover to previous levels, even though costs continue to rise. While many colleges have increased tuition in response to this situation, students cannot afford endless increases in tuition. While predicting the future is difficult, it is likely that…

  2. Comparative effectiveness and costs of generic and brand-name gabapentin and venlafaxine in patients with neuropathic pain or generalized anxiety disorder in Spain

    Directory of Open Access Journals (Sweden)

    Sicras-Mainar A

    2015-06-01

    Full Text Available Antoni Sicras-Mainar,1 Javier Rejas-Gutiérrez,2 Ruth Navarro-Artieda3 1Planning Directorate, Badalona Serveis Assistencials SA, Badalona, Barcelona, Spain; 2Department of Health Economics and Outcomes Research, Pfizer SLU, Alcobendas, Madrid, Spain; 3Medical Documentation, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain Objective: To explore adherence/persistence with generic gabapentin/venlafaxine versus brand-name gabapentin/venlafaxine (Neurontin®/Vandral® in peripheral neuropathic pain (pNP or generalized anxiety disorder (GAD, respectively, and whether it is translated into different costs and patient outcomes in routine medical practice. Methods: A retrospective, new-user cohort study was designed. Electronic medical records (EMR of patients included in the health plan of Badalona Serveis Assistencials SA, Barcelona, Spain were exhaustively extracted for analysis. Participants were beneficiaries aged 18+ years, followed between 2008 and 2012, with a pNP/GAD International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM code, who initiated treatment with generic or brand-name gabapentin or venlafaxine. Assessments included 1-year treatment persistence and adherence (medication possession ratio, health care costs, and reduction in severity of pain and anxiety symptoms. Results: A total of 2,210 EMR were analyzed; 1,369 on gabapentin (brand 400; generic 969 and 841 on venlafaxine (brand 370 and generic 471. Brand-name gabapentin and venlafaxine were both significantly associated with longer persistence than generic: 7.3 versus 6.3 months, P<0.001; and 8.8 versus 8.1 months, P<0.05, respectively. Brand-name was associated with higher adherence: 86.5% versus 81.3%, P<0.001; and 82.1% versus 79.0%, P<0.05, respectively. Adjusted average costs were higher with generic compared with brand: €1,277 versus €1,057 (difference of €220 per patient; P<0.001 for gabapentin; and €1,110 versus €928

  3. Health and economic costs of alternative energy sources

    International Nuclear Information System (INIS)

    Hamilton, L.D.; Manne, A.S.

    1977-01-01

    National energy policy requires realistic totaling of costs in assessing energy alternatives. The Biomedical and Environmental Assessment Division (BEAD) at Brookhaven is estimating biomedical and environmental costs of energy production and use. All forms of energy, including new technologies, are being considered. Beginning with a compilation of pollutants from the energy system, the various paths to man are traced and health effects evaluated. Excess mortality and morbidity in the U.S. attributable to a total fuel cycle to produce 6.6x10 9 kwh - about a year's production of a 1000-MWe power plant - are being estimated. Where enough information is available, estimates are quantitative. In some instances only the nature of the potential hazard can be described. This assessment aims at providing initial estimates of relative impacts to identify where the important health hazards in each fuel cycle arise, thereby identifying key areas for judging the total costs of alternative energy sources, and those areas of research likely to improve the accuracy of the estimates. It was thus estimated that the production of electric power from all sources in the U.S. in 1975 was associated with between two to nineteen thousand deaths and twenty-nine to fourty-eight thousand disabilities; this is roughly between 0.2 and 2% of total deaths in U.S. ages 1-74. The estimated health effects associated with a total fuel cycle standardized to produce 10 10 kwh electric power were: from coal estimated deaths 20-200, estimated disabilities 300-500; from oil estimated deaths 3-150, estimated disabilities 150-300; from gas estimated deaths 0.2, estimated disabilities 20; from nuclear estimated deaths 1-3, estimated disabilities 8-30. The differences in the year 2000 between health impacts of the U.S. energy system under normal growth expectations and under conditions of a nuclear moratorium were estimated. On the assumption that the nuclear moratorium would require 320 additional 1000-MWe

  4. Alternative windpower ownership structures: Financing terms and project costs

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, R.; Kahn, E.

    1996-05-01

    Most utility-scale renewable energy projects in the United States are developed and financed by private renewable energy companies. Electric output is then sold to investor-owned and public utilities under long-term contracts. Limited partnerships, sale/leaseback arrangements, and project-financing have historically been the dominant forms of finance in the windpower industry, with project-finance taking the lead more recently. Although private ownership using project-finance is still the most popular form of windpower development, alternative approaches to ownership and financing are becoming more prevalent. U.S. public and investor-owned electric utilities (IOUs) have begun to participate directly in windpower projects by owning and financing their own facilities rather than purchasing windpower from independent non-utility generators (NUGs) through power purchase agreements (PPAs). In these utility-ownership arrangements, the wind turbine equipment vendor/developer typically designs and constructs a project under a turnkey contract for the eventual project owner (the utility). The utility will also frequently sign an operations and maintenance (O&M) contract with the project developer/equipment vendor. There appear to be a number of reasons for utility involvement in recent and planned U.S. wind projects. One important claim is that utility ownership and self-finance provides substantial cost savings compared to contracting with private NUGs to supply wind-generated power. In this report, we examine that assertion.

  5. School District Program Cost Accounting: An Alternative Approach

    Science.gov (United States)

    Hentschke, Guilbert C.

    1975-01-01

    Discusses the value for school districts of a program cost accounting system and examines different approaches to generating program cost data, with particular emphasis on the "cost allocation to program system" (CAPS) and the traditional "transaction-based system." (JG)

  6. Comparative effectiveness and costs of generic and brand-name gabapentin and venlafaxine in patients with neuropathic pain or generalized anxiety disorder in Spain.

    Science.gov (United States)

    Sicras-Mainar, Antoni; Rejas-Gutiérrez, Javier; Navarro-Artieda, Ruth

    2015-01-01

    To explore adherence/persistence with generic gabapentin/venlafaxine versus brand-name gabapentin/venlafaxine (Neurontin(®)/Vandral(®)) in peripheral neuropathic pain (pNP) or generalized anxiety disorder (GAD), respectively, and whether it is translated into different costs and patient outcomes in routine medical practice. A retrospective, new-user cohort study was designed. Electronic medical records (EMR) of patients included in the health plan of Badalona Serveis Assistencials SA, Barcelona, Spain were exhaustively extracted for analysis. Participants were beneficiaries aged 18+ years, followed between 2008 and 2012, with a pNP/GAD International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code, who initiated treatment with generic or brand-name gabapentin or venlafaxine. Assessments included 1-year treatment persistence and adherence (medication possession ratio), health care costs, and reduction in severity of pain and anxiety symptoms. A total of 2,210 EMR were analyzed; 1,369 on gabapentin (brand 400; generic 969) and 841 on venlafaxine (brand 370 and generic 471). Brand-name gabapentin and venlafaxine were both significantly associated with longer persistence than generic: 7.3 versus 6.3 months, PBrand-name was associated with higher adherence: 86.5% versus 81.3%, Pbrand: €1,277 versus €1,057 (difference of €220 per patient; Pbrand-name was associated with higher reduction in pain (7.8%; Pbrand-name gabapentin or venlafaxine were more likely to adhere and persist on treatment of pNP or GAD, have lower health care costs, and show further reduction of pain and anxiety symptoms than with generic drugs in routine medical practice.

  7. Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort.

    Directory of Open Access Journals (Sweden)

    Matthias Stoll

    Full Text Available UNLABELLED: BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios. METHODS: Antiretroviral regimens (ART from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes. RESULTS: During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70. Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively. Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%. CONCLUSIONS: Analysis of the data of this nationwide study reflects disease-specific health services research

  8. Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort.

    Science.gov (United States)

    Stoll, Matthias; Kollan, Christian; Bergmann, Frank; Bogner, Johannes; Faetkenheuer, Gerd; Fritzsche, Carlos; Hoeper, Kirsten; Horst, Heinz-August; van Lunzen, Jan; Plettenberg, Andreas; Reuter, Stefan; Rockstroh, Jürgen; Stellbrink, Hans-Jürgen; Hamouda, Osamah; Bartmeyer, Barbara

    2011-01-01

    BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios. Antiretroviral regimens (ART) from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC)-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes. During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70). Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively). Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%. Analysis of the data of this nationwide study reflects disease-specific health services research and will give insights into the cost impacts of

  9. The National Shipbuilding Research Program: Producibility Cost Reductions through Alternative Materials and Processes

    National Research Council Canada - National Science Library

    Horsmon, Jr., Albert W; Johnson, Karl; Gans-Devney, Barbara

    1999-01-01

    This report describes research into the use of alternative materials and processes to reduce material and labor costs while also looking at the influence of these choices on the life cycle costs of the vessel...

  10. AX Tank Farm waste retrieval alternatives cost estimates

    International Nuclear Information System (INIS)

    Krieg, S.A.

    1998-01-01

    This report presents the estimated costs associated with retrieval of the wastes from the four tanks in AX Tank Farm. The engineering cost estimates developed for this report are based on previous cost data prepared for Project W-320 and the HTI 241-C-106 Heel Retrieval System. The costs presented in this report address only the retrieval of the wastes from the four AX Farm tanks. This includes costs for equipment procurement, fabrication, installation, and operation to retrieve the wastes. The costs to modify the existing plant equipment and systems to support the retrieval equipment are also included. The estimates do not include operational costs associated with pumping the waste out of the waste receiver tank (241-AY-102) between AX Farm retrieval campaigns or transportation, processing, and disposal of the retrieved waste

  11. Life-Cycle Costs of Alternative ICBM Second Stage Designs

    Science.gov (United States)

    1992-09-01

    of Logistics, Air Force Institute of Technology (AU), Wright-Patterson AFB OH, 1992. 34. Horngren , Charles T. and George Foster. Cost Accounting ; A...Managerial Emphasis (Sixth Edition). Englewood Cliffs NJ: Prentice-Hall, Inc., 1987. 35. Horngren , Charles T. and George Foster. Cost Accounting ; A...our research. We would also like to thank those involved with the 1991 Small ICBM Operations and Support cost estimate. Your assistance with the O& S

  12. 10 CFR 503.32 - Lack of alternate fuel supply at a cost which does not substantially exceed the cost of using...

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Lack of alternate fuel supply at a cost which does not... (CONTINUED) ALTERNATE FUELS NEW FACILITIES Permanent Exemptions for New Facilities § 503.32 Lack of alternate... alternate fuel supply at a cost which does not substantially exceed the cost of using imported petroleum. To...

  13. Comparison of response rates and cost-effectiveness for a community-based survey: postal, internet and telephone modes with generic or personalised recruitment approaches

    Science.gov (United States)

    2012-01-01

    Background Epidemiological research often requires collection of data from a representative sample of the community or recruitment of specific groups through broad community approaches. The population coverage of traditional survey methods such as mail-outs to residential addresses, and telephone contact via public directories or random-digit-dialing is declining and survey response rates are falling. There is a need to explore new sampling frames and consider multiple response modes including those offered by changes in telecommunications and internet technology. Methods We evaluated response rates and cost-effectiveness for three modes of survey administration (postal invitation/postal survey, postal invitation/internet survey and postal invitation/telephone survey) and two styles of contact approach (personalised and generic) in a community survey of greywater use. Potential respondents were contacted only once, with no follow up of non-responders. Results The telephone survey produced the highest adjusted response rate (30.2%), followed by the personalised postal survey (10.5%), generic postal survey (7.5%) and then the internet survey (4.7% for the personalised approach and 2.2% for the generic approach). There were some differences in household characteristics and greywater use rates between respondents to different survey modes, and between respondents to personalised and generic approaches. These may be attributable to the differing levels of motivations needed for a response, and varying levels of interest in the survey topic among greywater users and non-users. The generic postal survey had the lowest costs per valid survey received (Australian $22.93), followed by the personalised postal survey ($24.75). Conclusions Our findings suggest that postal surveys currently remain the most economic option for population-based studies, with similar costs for personalised and generic approaches. Internet surveys may be effective for specialised groups where email

  14. Cost-effectiveness of rosuvastatin in comparison with generic atorvastatin and simvastatin in a Swedish population at high risk of cardiovascular events

    Directory of Open Access Journals (Sweden)

    Gandhi SK

    2012-01-01

    Full Text Available Sanjay K Gandhi1, Marie M Jensen2, Kathleen M Fox3, Lee Smolen4, Anders G Olsson5, Thomas Paulsson61AstraZeneca LP, Wilmington, DE, USA; 2AstraZeneca, Lund, Sweden; 3Strategic HealthCare Solution, Monkton, MD; 4Medical Decision Modeling Inc, Indianapolis, IN, USA; 5Department of Medical and Health Sciences, Linkoping University, and Stockholm Heart Center, Stockholm; 6AstraZeneca, Sodertalje, SwedenBackground: To assess the long-term cost-effectiveness of rosuvastatin therapy compared with generic simvastatin and generic atorvastatin in reducing the incidence of cardiovascular events and mortality in a Swedish population with Framingham risk ≥20%.Methods: A probabilistic Monte Carlo simulation model based on data from JUPITER (the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin was used to estimate the long-term cost-effectiveness of rosuvastatin 20 mg daily versus simvastatin or atorvastatin 40 mg for the prevention of cardiovascular death and morbidity. The three-stage model included cardiovascular event prevention simulating the 4 years of JUPITER, initial prevention beyond the trial, and subsequent cardiovascular event prevention. A Swedish health care payer perspective (direct costs only was modeled for a lifetime horizon, with 2008/2009 as the costing period. Univariate and probabilistic sensitivity analyses were performed.Results: The incremental cost per quality-adjusted life-year (QALY gained with rosuvastatin 20 mg over simvastatin or atorvastatin 40 mg ranged from SEK88,113 (rosuvastatin 20 mg versus simvastatin 40 mg; Framingham risk ≥30%; net avoidance of 34 events/1000 patients to SEK497,542 (versus atorvastatin 40 mg: Framingham risk ≥20%; net avoidance of 11 events/1000 patients over a lifetime horizon. Probabilistic sensitivity analyses indicated that at a willingness-to-pay threshold of SEK500,000/QALY, rosuvastatin 20 mg would be cost-effective for approximately 75%–85

  15. Low-cost rural surface alternatives : literature review and recommendations.

    Science.gov (United States)

    2013-12-01

    Freezing and thawing action induces damage to unbound gravel roads in Iowa resulting in maintenance costs for secondary road departments. Some approaches currently used by County Engineers to deal with this problem include temporarily spreading rock ...

  16. The availability and cost of healthier food alternatives.

    Science.gov (United States)

    Jetter, Karen M; Cassady, Diana L

    2006-01-01

    Many people, especially low-income consumers, do not successfully follow dietary recommendations to eat more whole grains and less fat and added sugar. The food environment may have a significant impact on the choice by low-income consumers to eat healthier foods, as both the availability and price of healthier food items may limit their ability to eat a healthier diet. We investigated the cost and availability of a standard market basket of foods, and a healthier basket that included low-fat meat and dairy and whole grain products. Market-basket surveys were conducted in 25 stores in Los Angeles and Sacramento. Stores were selected from neighborhoods that were varied by income and surveyed three times from September 2003 to June 2004. The average cost of a standard market basket (based on the U.S. Department of Agriculture's Thrifty Food Plan [TFP]) and a healthier market basket was calculated from these prices and compared using a standard t-test to determine if they were significantly different from each other. The analysis was conducted in 2005. In neighborhoods served by smaller grocery stores, access to whole-grain products, low-fat cheeses, and ground meat with cost was $194, and the healthier market-basket cost was $230. The average cost of the healthier market basket was more expensive by $36 due to higher costs of whole grains, lean ground beef, and skinless poultry. The higher cost of the healthier basket is equal to about 35% to 40% of low-income consumers' food budgets of $2410 a year. The lack of availability in small grocery stores located in low-income neighborhoods, and the higher cost of the healthier market basket may be a deterrent to eating healthier among very low-income consumers. Public policies should take the food environment into account in order to develop successful strategies to encourage the consumption of healthier foods.

  17. Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States.

    Science.gov (United States)

    Padula, William V; Larson, Richard A; Dusetzina, Stacie B; Apperley, Jane F; Hehlmann, Rudiger; Baccarani, Michele; Eigendorff, Ekkehard; Guilhot, Joelle; Guilhot, Francois; Hehlmann, Rudiger; Mahon, Francois-Xavier; Martinelli, Giovanni; Mayer, Jiri; Müller, Martin C; Niederwieser, Dietger; Saussele, Susanne; Schiffer, Charles A; Silver, Richard T; Simonsson, Bengt; Conti, Rena M

    2016-07-01

    We analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib's price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness ("imatinib-first") would be cost-effective compared with the current standard of care: "physicians' choice" of initiating treatment with any one of the three TKIs. We constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician's choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models' clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven's MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study's conduct. Both strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician's choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses. When imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP. © The Author 2016. Published by Oxford University Press.

  18. A cost and operational effectiveness analysis of alternative anti-surface warfare platforms

    OpenAIRE

    Skinner, Walter Mark.

    1993-01-01

    Approved for public release; distribution is unlimited. A Cost and Operational Effectiveness Analysis (COEA) is performed for three alternative anti-surface warfare (ASUW) platforms that will conduct operations in multi-service regional scenarios. Estimated program costs, historical cost variances, and measures of operational effectiveness are determined for each COEA alternative, and service life extension effects are examined. The data is merged in a mixed-integer optimization model, MPA...

  19. Encouraging generic use can yield significant savings.

    Science.gov (United States)

    Zimmerman, Christina

    2012-11-01

    Key findings. (1) Zero copayment for generic drugs is the greatest influencer of generic statin utilization. (2) Both higher copayments for generic drugs and lower copayments for competing brands are associated with a decreased probability of using generic statins. (3) Prior authorization and step therapy requirements for brand-name statins are associated with an increased use of generic drugs. (4) Greater use of generic statins should reduce costs for patients, plans, and Medicare.

  20. Comparative Cost/Benefit of Alternative/Conventional Feedstuff in ...

    African Journals Online (AJOL)

    benefit of the use of conventional (corn/soya bean based) and alternative (less of corn and soya bean substituted with agro-allied and industrial by-products) feedstuffs. Completely randomized design was used and the experiment conducted for a ...

  1. Alternative and cost-effective bridge approach slabs.

    Science.gov (United States)

    2010-10-01

    The primary objectives of the proposed project are to investigate the causes for any bumps at the end of the bridge approach slab : and to develop remedial measures or alternative designs for a replacement. It is clear that the problem stems from geo...

  2. Supply Chain Collaboration Alternatives: Understanding the Expected Costs and Benefits.

    Science.gov (United States)

    McLaren, Tim; Head, Milena; Yuan, Yufei

    2002-01-01

    Discusses collaboration as a recent trend in supply chain management (SCM) that focuses on joint planning, coordination, and process integration between suppliers, customers, and other partners in a supply chain. Analyzes alternative information systems approaches for supporting collaborative SCM, including phone, fax, or email systems; Web-based…

  3. A method for quantifying and comparing the costs and benefits of alternative riparian zone buffer widths

    Science.gov (United States)

    Chris B. LeDoux; Ethel Wilkerson

    2008-01-01

    We developed a method that can be used to quantify the opportunity costs and ecological benefits of implementing alternative streamside management zones/buffer zone widths. The opportunity costs are computed based on the net value of the timber left behind in the buffer zone, the stump-to-mill logging costs for the logging technology that would have been used to...

  4. Low-Cost Generic Program Use by Medicare Beneficiaries: Implications for Medication Exposure Misclassification in Administrative Claims Data.

    Science.gov (United States)

    Pauly, Nathan J; Talbert, Jeffery C; Brown, Joshua

    2016-06-01

    Administrative claims data are used for a wide variety of research and quality assurance purposes; however, they are prone to medication exposure misclassification if medications are purchased without using an insurance benefit. Low-cost generic drug programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted, and the exposure may go unobserved in claims data. As heavy users of medications, Medicare beneficiaries have much to gain from the affordable medications offered through LCGPs. This use may put them at increased risk of exposure misclassification in claims data. Many high-risk medications (HRMs) and medications tracked for adherence and utilization quality metrics are available through LCGPs, and exposure misclassification of these medications may impact the quality assurance efforts reliant on administrative claims data. Presently, there is little information regarding the use of these programs among a geriatric population. To (a) quantify the prevalence of LCGP users in a nationally representative population of Medicare beneficiaries; (b) compare clinical and demographic characteristics of LCGP users and nonusers; (c) assess determinants of LCGP use and medications acquired through these programs; and (d) analyze patterns of LCGP use during the years 2007-2012. This study relied on data from the Medical Expenditure Panel Survey (MEPS) from 2007 to 2012. The first 3 objectives were completed with a cohort of individuals in the most recent MEPS panel, while the fourth objective was completed with a separate cohort composed of individuals who participated in MEPS from 2007 to 2012. Inclusion in either study cohort required that individuals were Medicare beneficiaries aged 65 years or greater, used at least 1 prescription drug during their 2-year panel period, and participated in all 5

  5. Prevalence of Low-Cost Generic Program Use in a Nationally Representative Cohort of Privately Insured Adults.

    Science.gov (United States)

    Pauly, Nathan James; Brown, Joshua David

    2015-12-01

    Administrative claims data are used for a wide variety of research and quality assurance purposes. Despite their utility, they are prone to medication exposure misclassification if medications are purchased without utilizing an insurance benefit. Low-cost generic programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. Since they were implemented in 2006, LCGPs are now available at 8 of the 10 largest pharmacy chains and include a wide variety of medication classes. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted and exposure may go unobserved in claims data. There are little data regarding the utilization of these programs, and estimates of their use can provide important insights into the potential impact LCGPs may have on exposure misclassification in claims data. To (a) quantify the prevalence of LCGP users in a privately insured adult population, (b) assess patterns of LCGP use, and (c) compare clinical and demographic characteristics associated with LCGP users and nonusers. The study cohort consisted of 19,037 privately insured adults aged 18-64 who participated in the Medical Expenditure Panel Survey (MEPS) from 2007-2011. MEPS captures medication utilization at the pharmacy level, so prescription fills can be observed irrespective of a claim being filed. Pharmaceutical utilization was assessed at the individual level for each year of the study period, and LCGP use was recorded as a binary variable for each individual. An LCGP medication fill was identified if the total cost of the drug was paid out of pocket and matched the cost of medications listed on LCGP formularies available from Target, Walmart, CVS, or other major pharmacy retailers during these years. Cohort demographics and characteristics of interest included age, gender, race, employment status, marital status, family income, education level, residence in a metropolitan

  6. Alternative ceramic circuit constructions for low cost, high reliability applications

    International Nuclear Information System (INIS)

    Modes, Ch.; O'Neil, M.

    1997-01-01

    The growth in the use of hybrid circuit technology has recently been challenged by recent advances in low cost laminate technology, as well as the continued integration of functions into IC's. Size reduction of hybrid 'packages' has turned out to be a means to extend the useful life of this technology. The suppliers of thick film materials technology have responded to this challenge by developing a number of technology options to reduce circuit size, increase density, and reduce overall cost, while maintaining or increasing reliability. This paper provides an overview of the processes that have been developed, and, in many cases are used widely to produce low cost, reliable microcircuits. Comparisons of each of these circuit fabrication processes are made with a discussion of advantages and disadvantages of each technology. (author)

  7. Cost-Effectiveness Analysis of Unsafe Abortion and Alternative First ...

    African Journals Online (AJOL)

    To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, we developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women, and comparatively assessed the cost-effectiveness of unsafe abortion and three ...

  8. Preventing the Wernicke-Korsakoff syndrome in Australia: cost-effectiveness of thiamin-supplementation alternatives.

    Science.gov (United States)

    Connelly, L; Price, J

    1996-04-01

    Alcoholic Wernicke's encephalopathy has been commonplace in Australia for many years and, as this syndrome is attributed to a deficiency in the diet, it should be preventable. This study employs conventional cost-effectiveness methodology to compare the economic efficiency of several thiamin-supplementation alternatives that have been proposed for the prevention of Wernicke's encephalopathy. A series of rankings of these measures is derived from an estimated cost per case averted for each of the alternatives studied. These rankings identify the least cost-effective thiamin-supplementation alternative as that of enriching bread-making flour with thiamin.

  9. Alternative methods of modeling wind generation using production costing models

    International Nuclear Information System (INIS)

    Milligan, M.R.; Pang, C.K.

    1996-08-01

    This paper examines the methods of incorporating wind generation in two production costing models: one is a load duration curve (LDC) based model and the other is a chronological-based model. These two models were used to evaluate the impacts of wind generation on two utility systems using actual collected wind data at two locations with high potential for wind generation. The results are sensitive to the selected wind data and the level of benefits of wind generation is sensitive to the load forecast. The total production cost over a year obtained by the chronological approach does not differ significantly from that of the LDC approach, though the chronological commitment of units is more realistic and more accurate. Chronological models provide the capability of answering important questions about wind resources which are difficult or impossible to address with LDC models

  10. Generic Advantages

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Generic Advantages. Scalability an incremental coverage. Standardization. Business Plan Flexibility. Lifecycle Flexibility. Reliability. Service Interoperability. Changed Industry dynamics.

  11. The net effect of alternative allocation ratios on recruitment time and trial cost.

    Science.gov (United States)

    Vozdolska, Ralitza; Sano, Mary; Aisen, Paul; Edland, Steven D

    2009-04-01

    Increasing the proportion of subjects allocated to the experimental treatment in controlled clinical trials is often advocated as a method of increasing recruitment rates and improving the performance of trials. The presumption is that the higher likelihood of randomization to the experimental treatment will be perceived by potential study enrollees as an added benefit of participation and will increase recruitment rates and speed the completion of trials. However, studies with alternative allocation ratios require a larger sample size to maintain statistical power, which may result in a net increase in time required to complete recruitment and a net increase in total trial cost. To describe the potential net effect of alternative allocation ratios on recruitment time and trial cost. Models of recruitment time and trial cost were developed and used to compare trials with 1:1 allocation to trials with alternative allocation ratios under a range of per subject costs, per day costs, and enrollment rates. In regard to time required to complete recruitment, alternative allocation ratios are net beneficial if the recruitment rate improves by more than about 4% for trials with a 1.5:1 allocation ratio and 12% for trials with a 2:1 allocation ratio. More substantial improvements in recruitment rate, 13 and 47% respectively for scenarios we considered, are required for alternative allocation to be net beneficial in terms of tangible monetary cost. The cost models were developed expressly for trials comparing proportions or means across treatment groups. Using alternative allocation ratio designs to improve recruitment may or may not be time and cost-effective. Using alternative allocation for this purpose should only be considered for trial contexts where there is both clear evidence that the alternative design does improve recruitment rates and the attained time or cost efficiency justifies the added study subject burden implied by a larger sample size.

  12. An Alternative Avenue to Teacher Certification: A Cost Analysis of the Pathways to Teaching Careers Program.

    Science.gov (United States)

    Rice, Jennifer King; Brent, Brian O.

    2002-01-01

    Analyzes cost effectiveness of the Pathways to Teaching Careers, a program that supports an alternative route to university-based teacher certification primarily for noncertified teachers, paraprofessionals, and Peace Corps volunteers. (PKP)

  13. COST ANALYSIS OF ALTERNATIVE COMPUTERIZED SYSTEMS FOR THE MARKETING AND DISTRIBUTION OF MULTIPLE FOOD COMMODITIES

    OpenAIRE

    Epperson, James E.; Helmreich, D.P.; Moon, Leonard C.; Carley, Dale H.; Huang, Chung L.; Fletcher, Stanley M.

    1981-01-01

    The authors make cost comparisons among alternative computerized marketing systems. The systems described could encompass any number of commodities and stages of distribution involving cash and/or futures transactions.

  14. Power shopping - practical advice and cost-saving alternatives

    International Nuclear Information System (INIS)

    Anthofer, J.

    1999-01-01

    Encore Energy Solutions is a power consulting company which operates in California, Alberta and Ontario. The company manages electricity portfolios, sells risk management instruments and works with end users to lower power costs. It also helps utilities manage the evolution to a competitive energy market. In this presentation, a series of overhead viewgraphs were used to explain the roles of different players in Ontario's electric power industry, including generators, retailers, distributors, wholesale sellers, transmitters, wholesale consumers, independent market operators (IMOs), and consultants. The challenges facing municipal electric utilities regarding the wires business and retail services were also discussed. The trends in today's evolving power market were highlighted. These included price elasticity, load dispatch, granularity, long- and short-term volatility, gas prices, day/night spread, transmission tariffs, congestion and cost of capital. A graph depicting volatility term structures for electricity, natural gas and crude oil suggests that instantaneous volatility of power is almost infinite. Issues regarding risk management in terms of shareholder's portfolio values were also discussed. 17 figs

  15. Evaluation of increased adherence and cost savings of an employer value-based benefits program targeting generic antihyperlipidemic and antidiabetic medications.

    Science.gov (United States)

    Clark, Bobby; DuChane, Janeen; Hou, John; Rubinstein, Elan; McMurray, Jennifer; Duncan, Ian

    2014-02-01

    A major employer implemented a change to its employee health benefits program to allow beneficiaries with diabetes or high cholesterol to obtain preselected generic antidiabetic or generic antihyperlipidemic medications with a zero dollar copayment. To receive this benefit, plan beneficiaries were required to participate in a contracted vendor's case management and/or wellness program.  To assess changes in medication adherence and the costs for generic antidiabetic and generic antihyperlipidemic medications resulting from participation in a zero copay (ZCP) program.   This was a retrospective pre-post comparison group study, evaluating adherence and cost. Participants using an antihyperlipidemic and/or antidiabetic medication during the study identification period and post-implementation period for the program were considered eligible for the study. Eligible beneficiaries who enrolled in the ZCP program during the post-implementation period were considered participants, while those who did not enroll during this period were considered nonparticipants. ZCP program participants and nonparticipants were matched via a 1-to-1 propensity scoring method using age, gender, comorbidity count, medication type (antihyperlipidemic, antidiabetic, or both), and baseline adherence as matching criteria. The proportion of days covered (PDC) metric expressed as a mean percentage was used to assess adherence to medication therapy, while payer cost was examined using prescription drug utilization expressed as per member per year (PMPY) and cost change per 30 days of medication expressed in dollars.   Among participants who were users of antidiabetic medications, the mean adherence rate was sustained from pre- to post-implementation (81.8% vs. 81.9%); however, it decreased in the matched nonparticipant group (81.9% vs. 73.1%). This difference in mean adherence over time between the participants and nonparticipants was statistically significant (0.1% vs. -8.8%, P  less than  0

  16. Global warming and urban smog: The cost effectiveness of CAFE standards and alternative fuels

    International Nuclear Information System (INIS)

    Krupnick, A.J.; Walls, M.A.; Collins, C.T.

    1992-01-01

    This paper evaluates alternative transportation policies for reducing greenhouse gas emissions and ozone precursors. The net cost-effectiveness -- i.e., the cost per ton of greenhouse gas reduced, adjusted for ozone reduction benefits -- of substituting methanol, compressed natural gas (CNG), and reformulated gasoline for conventional gasoline is assessed and compared with the cost-effectiveness of raising the corporate average fuel economy (CAFE) standard to 38 miles per gallon. Computing this open-quotes netclose quotes cost-effectiveness is one way of measuring the joint environmental benefits that these alternatives provide. Greenhouse gas emissions are assessed over the entire fuel cycle and include not only carbon dioxide emissions, but also methane, carbon monoxide, and nitrous oxide emissions. In computing cost-effectiveness, we account for the so-called open-quotes rebound effectclose quotes -- the impact on vehicle-miles traveled of higher or lower fuel costs. CNG is found to be the most cost-effective of these alternatives, followed by increasing the CAFE standard, substituting methanol for gasoline, and substituting reformulated for conventional gasoline. Including the ozone reduction benefits does not change the rankings of the alternatives, but does make the alternative fuels look better relative to increasing the CAFE standard. Incorporating the rebound effect greatly changes the magnitude of the estimates but does not change the rankings of the alternatives. None of the alternatives look cost-effective should a carbon tax of $35 per ton be passes (the proposal in the Stark bill, H.R. 1086), and only CNG under optimistic assumptions looks cost-effective if a tax of $100 per ton of carbon is passed

  17. An Alternative Method for Computing Unit Costs and Productivity Ratios. AIR 1984 Annual Forum Paper.

    Science.gov (United States)

    Winstead, Wayland H.; And Others

    An alternative measure for evaluating the performance of academic departments was studied. A comparison was made with the traditional manner for computing unit costs and productivity ratios: prorating the salary and effort of each faculty member to each course level based on the personal mix of course taught. The alternative method used averaging…

  18. Enforcement costs: some humanitarian alternatives to stronger patent rights.

    Science.gov (United States)

    Trotter, Andrew

    2012-01-01

    Diseases that cause comparatively few problems in developed countries kill millions of people in the Third World each year. In many cases, people die because they cannot afford the medication needed to save their lives. In others, there are simply no drugs available because there are no wealthy western patients to justify pharmaceutical companies investing in a cure. This reveals a deep-seated problem within the patent system and the pharmaceutical industry that emphasises markets and profits at the expense of health and global welfare. Global efforts have seen substantial improvements in access to medicines in isolated areas, but with international agreements driving towards stronger patent protection and the expiry date for the TRIPS grace period fast approaching, it is time to consider alternatives which will allow the patent system to work for the humanitarian cause rather than against it. This paper considers two such problems in the patent system and pharmaceutical industry - prohibitive pricing and misdirected incentives - to offer a mode of regulation and enforcement that will support both a viable pharmaceutical industry and the human right to health and medication.

  19. Study of the standard direct costs of various techniques of advanced endoscopy. Comparison with surgical alternatives.

    Science.gov (United States)

    Loras, Carme; Mayor, Vicenç; Fernández-Bañares, Fernando; Esteve, Maria

    2018-03-12

    The complexity of endoscopy has carried out an increase in cost that has a direct effect on the healthcare systems. However, few studies have analyzed the cost of advanced endoscopic procedures (AEP). To carry out a calculation of the standard direct costs of AEP, and to make a financial comparison with their surgical alternatives. Calculation of the standard direct cost in carrying out each procedure. An endoscopist detailed the time, personnel, materials, consumables, recovery room time, stents, pathology and medication used. The cost of surgical procedures was the average cost recorded in the hospital. Thirty-eight AEP were analyzed. The technique showing lowest cost was gastroscopy + APC (€116.57), while that with greatest cost was ERCP with cholangioscopy + stent placement (€5083.65). Some 34.2% of the procedures registered average costs of €1000-2000. In 57% of cases, the endoscopic alternative was 2-5 times more cost-efficient than surgery, in 31% of cases indistinguishable or up to 1.4 times more costly. Standard direct cost of the majority of AEP is reported using a methodology that enables easy application in other centers. For the most part, endoscopic procedures are more cost-efficient than the corresponding surgical procedure. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  20. Health and economic costs of alternative energy sources

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, L D [Biomedical and Environmental Assessment Division, National Center for Analysis of Energy Systems, Brookhaven National Laboratory (United States); Manne, A S [Department of Operations Research, Stanford University (United States)

    1978-08-15

    Before the United States of America can arrive at a coherent national energy policy, several ongoing debates must be resolved - on environmental hazards, health impacts, and the direct economic consequences of alternative future energy options. No one strategy is obviously correct - or uniquely ethical. Each strategy has its drawbacks, each can be blocked by one or another coalition of interest groups. The public is poorly informed by the media. A single large coal-mine accident is far more extensively reported than a long series of isolated accidents at grade crossings for coal trains, and yet the latter causes more deaths each year. Similarly, the public debate on nuclear issues is focused on low-probability, high-consequence events. It is as though national policy were being framed by a gambler whose motto is 'it's only the stakes and not the odds that matter'. The two authors of this paper come from different disciplines, yet they both believe that the odds do matter. It is essential that the public be well informed about the health risks and the economic consequences of a moratorium on the civilian uses of nuclear energy in the USA. We think that such a moratorium would adversely affect health and the economy. These impacts although small in relation, say, to the overall death rate or to the overall gross national product are not small in an absolute sense The adverse consequences of a moratorium are much more certain, and surely outweigh the impacts of any plausible accident associated with the operation of power reactors.

  1. Health and economic costs of alternative energy sources

    International Nuclear Information System (INIS)

    Hamilton, L.D.; Manne, A.S.

    1978-01-01

    Before the United States of America can arrive at a coherent national energy policy, several ongoing debates must be resolved - on environmental hazards, health impacts, and the direct economic consequences of alternative future energy options. No one strategy is obviously correct - or uniquely ethical. Each strategy has its drawbacks, each can be blocked by one or another coalition of interest groups. The public is poorly informed by the media. A single large coal-mine accident is far more extensively reported than a long series of isolated accidents at grade crossings for coal trains, and yet the latter causes more deaths each year. Similarly, the public debate on nuclear issues is focused on low-probability, high-consequence events. It is as though national policy were being framed by a gambler whose motto is 'it's only the stakes and not the odds that matter'. The two authors of this paper come from different disciplines, yet they both believe that the odds do matter. It is essential that the public be well informed about the health risks and the economic consequences of a moratorium on the civilian uses of nuclear energy in the USA. We think that such a moratorium would adversely affect health and the economy. These impacts although small in relation, say, to the overall death rate or to the overall gross national product are not small in an absolute sense The adverse consequences of a moratorium are much more certain, and surely outweigh the impacts of any plausible accident associated with the operation of power reactors

  2. Maintenance & Repair Cost Calculation and Assessment of Resale Value for Different Alternative Commercial Vehicle Powertrain Technologies

    OpenAIRE

    Kleiner, Florian; Friedrich, Horst E.

    2017-01-01

    For detailed evaluation of the Total Cost of Ownership, expenditures for Maintenance & Repair as well as the resale value are important to consider and should not be neglected. However, information on Maintenance & Repair costs as well as residual values for commercial vehicles with alternative powertrains is missing and data on this issue is rare. There is a lack of information and consolidated knowledge. In order to enable a holistic cost assessment for commercial vehicles, a comprehensive ...

  3. Life cycle cost analysis of alternative vehicles and fuels in Thailand

    International Nuclear Information System (INIS)

    Goedecke, Martin; Therdthianwong, Supaporn; Gheewala, Shabbir H.

    2007-01-01

    High crude oil prices and pollution problems have drawn attention to alternative vehicle technologies and fuels for the transportation sector. The question is: What are the benefits/costs of these technologies for society? To answer this question in a quantitative way, a web-based model (http://vehiclesandfuels.memebot.com) has been developed to calculate the societal life cycle costs, the consumer life cycle costs and the tax for different vehicle technologies. By comparing these costs it is possible to draw conclusions about the social benefit and the related tax structure. The model should help to guide decisions toward optimality, which refers to maximum social benefit. The model was applied to the case of Thailand. The life cycle cost of 13 different alternative vehicle technologies in Thailand have been calculated and the tax structure analyzed

  4. Cost-effective management alternatives for Snake River Chinook salmon: a biological-economic synthesis.

    Science.gov (United States)

    Halsing, David L; Moore, Michael R

    2008-04-01

    The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can

  5. NET 40 Generics Beginner's Guide

    CERN Document Server

    Mukherjee, Sudipta

    2012-01-01

    This is a concise, practical guide that will help you learn Generics in .NET, with lots of real world and fun-to-build examples and clear explanations. It is packed with screenshots to aid your understanding of the process. This book is aimed at beginners in Generics. It assumes some working knowledge of C# , but it isn't mandatory. The following would get the most use out of the book: Newbie C# developers struggling with Generics. Experienced C++ and Java Programmers who are migrating to C# and looking for an alternative to other generic frameworks like STL and JCF would find this book handy.

  6. The generics in transplantation and the rules on their use.

    Science.gov (United States)

    Masri, Marwan

    2003-06-01

    agents MMF and Rapamycin. Currently there are 5 FDA approved Cyclosporine generics with a 20% market share in the USA and a mere 0% in Europe. Alternatives formulations to both Rapa and for MMF would be available soon. These forms are not by definition generics and are considered by the FDA to be new brand names act on the same site as Cell Cept and Rapaimmune. Their introduction would be a great welcome and would definitely results in cost saving in transplantation cost. In conclusion, generics efficacy and safety is similar to that of the brand name and their use is cost effective.

  7. Cost benefit and risk assessment for selected tank waste process testing alternatives

    International Nuclear Information System (INIS)

    Gasper, K.A.

    1995-01-01

    The US Department of Energy has established the Tank Waste Remediation System (TWRS) program to safely manage wastes currently stored in underground tank at the Hanford Site. A TWRS testing and development strategy was recently developed to define long-range TWRS testing plans. The testing and development strategy considered four alternatives. The primary variable in the alternatives is the level of pilot-scale testing involving actual waste. This study evaluates the cost benefit and risks associated with the four alternatives. Four types of risk were evaluated: programmatic schedule risk, process mishap risk, worker risk, and public health risk. The structure of this report is as follows: Section 1 introduces the report subject; Section 2 describes the test strategy alternative evaluation; Section 3 describes the approach used in this study to assess risk and cost benefit; Section 4 describes the assessment methodologies for costs and risks; Section 5 describes the bases and assumptions used to estimate the costs and risks; Section 6 presents the detailed costs and risks; and Section 7 describes the results of the cost benefit analysis and presents conclusions

  8. Rethinking generic skills

    Directory of Open Access Journals (Sweden)

    Roy Canning

    2013-10-01

    Full Text Available The paper provides a critical analysis of the notion of generic or transversal skillscontained with European Union policy discourses. The author presents a conceptualframework that challenges the idea that generic skills are universal, transferable andautonomous. An alternative analysis is put forward that argues the case forcontextualising skills and knowledge within particular understandings and cultures thatare more collective than individualistic in nature. The arguments are framed withinwider cross-disciplinary debates in linguistics, geosemiotics and social-cultural theoryand build upon an earlier paper exploring core skills in the UK (Canning, 2007.

  9. Report on the Savannah River Site aluminum-based spent nuclear fuel alternatives cost study

    International Nuclear Information System (INIS)

    1998-12-01

    Initial estimates of costs for the interim management and disposal of aluminum-based spent nuclear fuel (SNF) were developed during preparation of the Environmental Impact Statement (EIS) on the Nuclear Weapons Nonproliferation Policy Concerning Foreign Research Reactor Spent Nuclear Fuel. The Task Team evaluated multiple alternatives, assessing programmatic, technical, and schedule risks, and generated life-cycle cost projections for each alternative. The eight technology alternatives evaluated were: direct co-disposal; melt and dilute; reprocessing; press and dilute; glass material oxidation dissolution system (GMODS); electrometallurgical treatment; dissolve and vitrify; and plasma arc. In followup to the Business Plan that was developed to look at SNF dry storage, WSRC prepared an addendum to the cost study. This addendum estimated the costs for the modification and use of an existing (105L) reactor facility versus a greenfield approach for new facilities (for the Direct Co-Disposal and Melt and Dilute alternatives). WSRC assessed the impacts of a delay in reprocessing due to the potential reservation of H-Canyon for other missions (i.e., down blending HEU for commercial use or the conversion of plutonium to either MOX fuel or an immobilized repository disposal form). This report presents the relevant results from these WSRC cost studies, consistent with the most recent project policy, technology implementation, canyon utilization, and inventory assumptions. As this is a summary report, detailed information on the technical alternatives or the cost assumptions raised in each of the above-mentioned cost studies is not provided. A comparison table that briefly describes the bases used for the WSRC analyses is included as Appendix A

  10. An Assessment Of The Life Cycle Costs And GHG Emissions For Alternative Generation Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Donnelly, C. Richard; Carias, Anibal; Ali, Mohammad; Wood, Nicholas; Morgenroth, Michael; Bridgeman, Andrew

    2010-09-15

    The best choices for supplying energy in a manner that can reduce emissions at a reasonable cost while still ensuring grid stability and reliability of supply is a matter of some debate. In this paper, a first principles analysis is performed to look at life-cycle costs and emissions as well as the amount of energy that is provided to the system from various low-emission alternatives, including wind, water, solar and nuclear power. These low-emission sources are then benchmarked against coal-fired energy production to establish a normalized assessment of the clean energy alternatives currently available.

  11. Global warming and urban smog: Cost-effectiveness of CAFE standards and alternative fuels

    International Nuclear Information System (INIS)

    Krupnick, A.J.; Walls, M.A.; Collins, C.T.

    1993-01-01

    In this paper we estimate the cost-effectiveness, in terms of reducing greenhouse gas emissions, of increasing the corporate average fuel economy (CAFE) standard to 38 miles per gallon and substituting methanol, compressed natural gas (CNG), and reformulated gasoline for conventional gasoline. Greenhouse gas emissions are assessed over the entire fuel cycle and include carbon dioxide, methane, carbon monoxide, and nitrous oxide emissions. To account for joint environmental benefits, the cost per ton of greenhouse gas reduced is adjusted for reductions in volatile organic compound (VOC) emissions, an ozone precursor. CNG is found to be the most cost-effective of these alternatives, followed by increasing the CAFE standard, substituting methanol for gasoline, and substituting reformulated for conventional gasoline. Including the VOC benefits does not change the ranking of the alternatives, but does make the alternative fuels look better relative to increasing the CAFE standard. None of the alternatives look cost-effective should a carbon tax of $35 per ton be passed, and only CNG under optimistic assumptions looks cost-effective with a tax of $100 per ton of carbon. 35 refs., 4 figs., 6 tabs

  12. Assessment of generic solar thermal systems for large power applications: analysis of electric power generating costs for systems larger than 10 MWe

    Energy Technology Data Exchange (ETDEWEB)

    Apley, W.J.; Bird, S.P.; Brown, D.R.; Drost, M.K.; Fort, J.A.; Garrett-Price, B.A.; Patton, W.P.; Williams, T.A.

    1980-11-01

    Seven generic types of collectors, together with associated subsystems for electric power generation, were considered. The collectors can be classified into three categories: (1) two-axis tracking (with compound-curvature reflecting surfaces); (2) one-axis tracking (with single-curvature reflecting surfaces); and (3) nontracking (with low-concentration reflecting surfaces). All seven collectors were analyzed in conceptual system configurations with Rankine-cycle engines. In addition, two of the collectors were analyzed with Brayton-cycle engines, and one was analyzed with a Stirling-cycle engine. With these engine options, and the consideration of both thermal and electrical storage for the Brayton-cycle central receiver, 11 systems were formulated for analysis. Conceptual designs developed for the 11 systems were based on common assumptions of available technology in the 1990 to 2000 time frame. No attempt was made to perform a detailed optimization of each conceptual design. Rather, designs best suited for a comparative evaluation of the concepts were formulated. Costs were estimated on the basis of identical assumptions, ground rules, methodologies, and unit costs of materials and labor applied uniformly to all of the concepts. The computer code SOLSTEP was used to analyze the thermodynamic performance characteristics and energy costs of the 11 concepts. Year-long simulations were performed using meteorological and insolation data for Barstow, California. Results for each concept include levelized energy costs and capacity factors for various combinations of storage capacity and collector field size.

  13. Total life-cycle cost analysis of conventional and alternative fueled vehicles

    International Nuclear Information System (INIS)

    Cardullo, M.W.

    1993-01-01

    Total Life-Cycle Cost (TLCC) Analysis can indicate whether paying higher capital costs for advanced technology with low operating and/or environmental costs is advantageous over paying lower capital costs for conventional technology with higher operating and/or environmental costs. While minimizing total life-cycle cost is an important consideration, the consumer often identifies non-cost-related benefits or drawbacks that make more expensive options appear more attractive. The consumer is also likely to heavily weigh initial capital costs while giving limited consideration to operating and/or societal costs, whereas policy-makers considering external costs, such as those resulting from environmental impacts, may reach significantly different conclusions about which technologies are most advantageous to society. This paper summarizes a TLCC model which was developed to facilitate consideration of the various factors involved in both individual and societal policy decision making. The model was developed as part of a US Department of Energy Contract and has been revised to reflect changes necessary to make the model more realistic. The model considers capital, operating, salvage, and environmental costs for cars, vans, and buses using conventional and alternative fuels. The model has been developed to operate on an IBM or compatible personal computer platform using the commercial spreadsheet program MicroSoft Excell reg-sign Version 4 for Windows reg-sign and can be easily kept current because its modular structure allows straightforward access to embedded data sets for review and update

  14. Cost Benefit and Alternatives Analysis of Distribution Systems with Energy Storage Systems: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Tom; Nagarajan, Adarsh; Baggu, Murali; Bialek, Tom

    2017-06-27

    This paper explores monetized and non-monetized benefits from storage interconnected to distribution system through use cases illustrating potential applications for energy storage in California's electric utility system. This work supports SDG&E in its efforts to quantify, summarize, and compare the cost and benefit streams related to implementation and operation of energy storage on its distribution feeders. This effort develops the cost benefit and alternatives analysis platform, integrated with QSTS feeder simulation capability, and analyzed use cases to explore the cost-benefit of implementation and operation of energy storage for feeder support and market participation.

  15. Bridge approach slabs for Missouri DOT field evaluation of alternative and cost efficient bridge approach slabs.

    Science.gov (United States)

    2013-05-01

    Based on a recent study on cost efficient alternative bridge approach slab (BAS) designs (Thiagarajan et : al. 2010) has recommended three new BAS designs for possible implementation by MoDOT namely a) 20 feet cast-inplace : slab with sleeper slab (C...

  16. Neonatal carrier: An easy to make alternative device to costly transport chambers

    Directory of Open Access Journals (Sweden)

    Joshi Milind

    2010-01-01

    Full Text Available The transport of sick neonates to the surgical centers or transportation within the center is an essential requirement of neonatal surgery. Neonatal transport incubators are costly, space occupying, and are not available at many places in the developing countries. We report here a cheap yet effective and easy to make, alternate neonatal carrier device.

  17. Corrosion and protection in reinforced concrete : Pulse cathodic protection: an improved cost-effective alternative

    NARCIS (Netherlands)

    Koleva, D.A.

    2007-01-01

    Corrosion and protection in reinforced concrete. Pulse cathodic protection: an improved cost-effective alternative. The aim of the research project was to study the possibilities for establishing a new or improved electrochemical method for corrosion prevention/protection for reinforced concrete.

  18. Estimates of Canadian fuel fabrication costs for alternative fuel cycles and systems

    International Nuclear Information System (INIS)

    Blahnik, C.

    1979-04-01

    Unit fuel fabrication costs are estimated for alternate fuel cycles and systems that may be of interest in Ontario Hydro's strategy analyses. A method is proposed for deriving the unit fuel fabrication price to be paid by a Canadian utility as a function of time (i.e. the price that reflects the changing demand/supply situation in the particular scenario considered). (auth)

  19. Family Genericity

    DEFF Research Database (Denmark)

    Ernst, Erik

    2006-01-01

    Type abstraction in object-oriented languages embody two techniques, each with its own strenghts and weaknesses. The first technique is extension, yielding abstraction mechanisms with good support for gradual specification. The prime example is inheritance. The second technique is functional abst...... the result as family genericity. The presented language design has been implemented....

  20. Final cost reduction study for the Geysers Recharge Alternative. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-11-01

    The purpose of this study is to determine whether or not cost reduction opportunities exist for the Geysers Recharge Alternative as defined in the Santa Rosa Subregional Long-Term Wastewater Project EIR/EIS. The City of Santa Rosa has been directed to have a plan for reclaimed water disposal in place by 1999 which will meet future capacity needs under all weather conditions. A Draft EIR/EIS released in July 1996 and a Final EIR certified in June 1997 examine four primary alternatives plus the No Action Alternative. Two of the primary alternatives involve agricultural irrigation with reclaimed water, either in western or southern Sonoma County. Another involves increased discharge of reclaimed water into the Russian River. The fourth involves using reclaimed water to replenish the geothermal reservoir at the Geysers. The addition of this water source would enable the Geysers operators to produce more steam from the geothermal area and thereby prolong the life and economic production level of the steamfield and the geothermal power plants supplied by the steamfield. This study provides additional refined cost estimates for new scenarios which utilize an alternative pipeline alignment and a range of reclaimed water flows, which deliver less water to the Geysers than proposed in the EIR/EIS (by distributing flow to other project components). Also, electrical power rates were revised to reflect the recent changes in costs associated with deregulation of the power industry. In addition, this report provides information on sources of potential public and private funding available and future environmental documentation required if the cost reduction scenarios were to be selected by the City as part of their preferred alternative.

  1. Cost-effectiveness of nitrogen mitigation by alternative household wastewater management technologies.

    Science.gov (United States)

    Wood, Alison; Blackhurst, Michael; Hawkins, Troy; Xue, Xiaobo; Ashbolt, Nicholas; Garland, Jay

    2015-03-01

    Household wastewater, especially from conventional septic systems, is a major contributor to nitrogen pollution. Alternative household wastewater management technologies provide similar sewerage management services but their life cycle costs and nitrogen flow implications remain uncertain. This paper addresses two key questions: (1) what are the total costs, nitrogen mitigation potential, and cost-effectiveness of a range of conventional and alternative municipal wastewater treatment technologies, and (2) what uncertainties influence these outcomes and how can we improve our understanding of these technologies? We estimate a household nitrogen mass balance for various household wastewater treatment systems and combine this mass balance with life cycle cost assessment to calculate the cost-effectiveness of nitrogen mitigation, which we define as nitrogen removed from the local watershed. We apply our methods to Falmouth, MA, where failing septic systems have caused heightened eutrophication in local receiving water bodies. We find that flushing and dry (composting) urine-diversion toilets paired with conventional septic systems for greywater management demonstrate the lowest life cycle cost and highest cost-effectiveness (dollars per kilogram of nitrogen removed from the watershed). Composting toilets are also attractive options in some cases, particularly best-case nitrogen mitigation. Innovative/advanced septic systems designed for high-level nitrogen removal are cost-competitive options for newly constructed homes, except at their most expensive. A centralized wastewater treatment plant is the most expensive and least cost-effective option in all cases. Using a greywater recycling system with any treatment technology increases the cost without adding any nitrogen removal benefits. Sensitivity analysis shows that these results are robust considering a range of cases and uncertainties. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Costs of rearing children in agricultural economies: an alternative estimation approach and findings from rural Bangladesh.

    Science.gov (United States)

    Khan, M M; Magnani, R J; Mock, N B; Saadat, Y S

    1993-03-01

    There are changes in child costs during demographic transition. This study examines household time allocation from 66 agricultural households in 3 villages in Tangail District in rural north central Bangladesh in 1984-85 (371 days). Component and total child-rearing costs are estimated in alternative ways. Conventional "opportunity wage" measures are considered overestimated. The methodological shortcomings of direct cost accounting procedures and consumer demand methods in computing time cost and monetary cost of child rearing are pointed out. In this study's alternative computation, age standardized equivalent costs are generated. Child food consumption costs were generated from a large national survey conducted in 1983. Nonfood expenditures were estimated by food to nonfood expenditure ratios taken from the aforementioned survey. For estimating breast-feeding costs, an estimate was produced based on the assumption that costs for infant food consumption were a fixed proportion of food costs for older children. Land ownership groups were set up to reflect socioeconomic status: 1) landless households, 2) marginal farm households with 1 acre or .4 hectares of land, 3) middle income households with 1-2 acres of land, 4) upper middle income households with 2-4 acres of land, and 5) upper income or rich households with over 4 acres of land. The nonmarket wage rate for hired household help was used to determine the value of cooking, fetching water, and household cleaning and repairing. The results confirm the low costs of child rearing in high fertility societies. Productive nonmarket activities are effective in subsidizing the costs of children. The addition of a child into households already with children has a low impact on time costs of children; "this economies of scale effect is estimated ... at 20%." The highest relative costs were found in the lowest income households, and the lowest costs were in the highest income households. 5% of total household income is

  3. Comparative cost analysis -- computed tomography vs. alternative diagnostic procedures, 1977-1980

    International Nuclear Information System (INIS)

    Gempel, P.A.; Harris, G.H.; Evans, R.G.

    1977-12-01

    In comparing the total national cost of utilizing computed tomography (CT) for medically indicated diagnoses with that of conventional x-ray, ultrasonography, nuclear medicine, and exploratory surgery, this investigation concludes that there was little, if any, added net cost from CT use in 1977 or will there be in 1980. Computed tomography, generally recognized as a reliable and useful diagnostic modality, has the potential to reduce net costs provided that an optimal number of units can be made available to physicians and patients to achieve projected reductions in alternative procedures. This study examines the actual cost impact of CT on both cranial and body diagnostic procedures. For abdominal and mediastinal disorders, CT scanning is just beginning to emerge as a diagnostic modality. As such, clinical experience is somewhat limited and the authors assume that no significant reduction in conventional procedures took place in 1977. It is estimated that the approximately 375,000 CT body procedures performed in 1977 represent only a 5 percent cost increase over use of other diagnostic modalities. It is projected that 2,400,000 CT body procedures will be performed in 1980 and, depending on assumptions used, total body diagnostic costs will increase only slightly or be reduced. Thirty-one tables appear throughout the text presenting cost data broken down by types of diagnostic procedures used and projections by years. Appendixes present technical cost components for diagnostic procedures, the comparative efficacy of CT as revealed in abstracts of published literature, selected medical diagnoses, and references

  4. Cost-effectiveness of alternative conservation strategies with application to the Pacific leatherback turtle.

    Science.gov (United States)

    Gjertsen, Heidi; Squires, Dale; Dutton, Peter H; Eguchi, Tomoharu

    2014-02-01

    Although holistic conservation addressing all sources of mortality for endangered species or stocks is the preferred conservation strategy, limited budgets require a criterion to prioritize conservation investments. We compared the cost-effectiveness of nesting site and at-sea conservation strategies for Pacific leatherback turtles (Dermochelys coriacea). We sought to determine which conservation strategy or mix of strategies would produce the largest increase in population growth rate per dollar. Alternative strategies included protection of nesters and their eggs at nesting beaches in Indonesia, gear changes, effort restrictions, and caps on turtle takes in the Hawaiian (U.S.A.) longline swordfish fishery, and temporal and area closures in the California (U.S.A.) drift gill net fishery. We used a population model with a biological metric to measure the effects of conservation alternatives. We normalized all effects by cost to prioritize those strategies with the greatest biological effect relative to its economic cost. We used Monte Carlo simulation to address uncertainty in the main variables and to calculate probability distributions for cost-effectiveness measures. Nesting beach protection was the most cost-effective means of achieving increases in leatherback populations. This result creates the possibility of noncompensatory bycatch mitigation, where high-bycatch fisheries invest in protecting nesting beaches. An example of this practice is U.S. processors of longline tuna and California drift gill net fishers that tax themselves to finance low-cost nesting site protection. Under certain conditions, fisheries interventions, such as technologies that reduce leatherback bycatch without substantially decreasing target species catch, can be cost-effective. Reducing bycatch in coastal areas where bycatch is high, particularly adjacent to nesting beaches, may be cost-effective, particularly, if fisheries in the area are small and of little commercial value.

  5. Economic feasibility of invesment alternatives for reducing torula yeast' production cost

    International Nuclear Information System (INIS)

    Torres Fernández, Alfredo; Díaz de los Ríos, Manuel; Saura Laria, Gustavo

    2016-01-01

    The prices of ammonium salts which are used in the torula yeast production technology are very high nowadays. In the other hand, this technology has very high energy costs which are consumed by blowers in fermentation, separators machines and in the concentration and drying of yeast. In this paper, different technical alternatives are analyzed for reducing the production cost of torula yeast, through changes in production inputs, electric motors and the replacement of a portion of the fuel used for drying by biogas. Then, the economic feasibility in both currencies is evaluated for practical application. (author)

  6. ECONOMIC FEASIBILITY OF INVESMENT ALTERNATIVES FOR REDUCING TORULA YEAST' PRODUCTION COST

    Directory of Open Access Journals (Sweden)

    Alfredo Torres Fernández

    2016-01-01

    Full Text Available The prices of ammonium salts which are used in the torula yeast production technology are very high nowadays. In the other hand, this technology has very high energy costs which are consumed by blowers in fermentation, separators machines and in the concentration and drying of yeast. In this paper, different technical alternatives are analyzed for reducing the production cost of torula yeast, through changes in production inputs, electric motors and the replacement of a portion of the fuel used for drying by biogas. Then, the economic feasibility in both currencies is evaluated for practical application.

  7. Licensing of Generic Medicines: Are There Any Challenges Left? A Pharmaceutical Regulatory Perspective.

    Science.gov (United States)

    Borg, John Joseph; Tomasi, Paolo; Pani, Luca; Aislaitner, George; Pirozynski, Michal; Leufkens, Hubert; Melchiorri, Daniela

    2014-01-01

    When an innovative product (innovator) is not covered anymore by intellectual property rights, cheaper equivalent medicinal products (generic products) may be marketed and used in clinical practice. The regulation of generic products is well-established, and is primarily based on standard rules for quality, therapeutic equivalence requirements (the latter in most instances proven through a bioequivalence study), and safety data for the innovator. The extensive experience from bringing generic products to the market over the last decades allows the conclusion that they are well-accepted and provide a useful alternative option for cost-effective pharmacotherapy. While supporting this conclusion, there are a number of issues to be considered during the assessment of a generic product application. Six scenarios are described in total, from an efficacy and a safety perspective, where potential concerns with the current regulatory standards could arise in the approval of generic products. We also propose solutions to these scenarios in order to foster debate on these issues.

  8. Generic safety documentation model

    International Nuclear Information System (INIS)

    Mahn, J.A.

    1994-04-01

    This document is intended to be a resource for preparers of safety documentation for Sandia National Laboratories, New Mexico facilities. It provides standardized discussions of some topics that are generic to most, if not all, Sandia/NM facilities safety documents. The material provides a ''core'' upon which to develop facility-specific safety documentation. The use of the information in this document will reduce the cost of safety document preparation and improve consistency of information

  9. Life Cycle Costing in Sustainability Assessment—A Case Study of Remanufactured Alternators

    Directory of Open Access Journals (Sweden)

    Annekatrin Lehmann

    2011-11-01

    Full Text Available Sustainability is on the international agenda, and is a driver for industry in international competition. Sustainability encompasses the three pillars: environment, society and economy. To prevent shifting of burden, the whole life cycle needs to be taken into account. For the environmental dimension of sustainability, life cycle assessment (LCA has been practiced for a while and is a standardized method. A life cycle approach for the social and economic pillars of sustainability needs to be further developed. This paper investigates the application of life cycle costing (LCC as part of a wider sustainability assessment where also social life cycle assessment (SLCA and LCA are combined. LCA-type LCC is applied on a case study of remanufactured alternators. Remanufacturing of automobile parts is a fast growing important business with large potential for cost and resource savings. Three design alternatives for the alternator and three locations for the remanufacturing plant are evaluated. The remanufacturer perspective and the user perspective are investigated. The results for the LCA-type LCC show that the largest cost for the remanufacturer is the new parts replacing old warn parts. However, the user cost, and therein especially, cost for fuel used for the alternator’s power production dominates and should be the focus for further improvement. In conducting the case study, it was revealed that the connection between the LCA-type LCC results and the economic dimension of sustainability needs to be further investigated and defined. For this purpose, areas of protection for life cycle sustainability assessment and LCA-type LCC in particular need further development.

  10. Comparison of Compounded, Generic, and Innovator-Formulated Itraconazole in Dogs and Cats.

    Science.gov (United States)

    Renschler, Janelle; Albers, Amanda; Sinclair-Mackling, Hanna; Wheat, Lawrence Joseph

    2018-05-14

    The triazole antifungal itraconazole may be cost prohibitive in brand name form; therefore, compounded and generic products are often used as alternatives. Itraconazole blood concentrations have not been studied in clinical patients receiving these formulations. Itraconazole bioassay was performed on serum/plasma from 95 dogs and 20 cats receiving itraconazole (compounded from bulk powder, generic pelletized, or brand name) for systemic mycosis treatment. Mean itraconazole concentration was lower in the compounded group (n = 42) as compared with the generic (n = 40) or brand name (n = 33) groups (0.5 µg/mL versus 8.3 µg/mL and 6.5 µg/mL, respectively; P 10 µg/mL; 37.5 and 24%, respectively). Compounded itraconazole should be avoided, but generic itraconazole appears to serve as a reasonable alternative to brand name itraconazole. Therapeutic drug monitoring may be beneficial in all cases.

  11. Cheese whey: A cost-effective alternative for hyaluronic acid production by Streptococcus zooepidemicus.

    Science.gov (United States)

    Amado, Isabel R; Vázquez, José A; Pastrana, Lorenzo; Teixeira, José A

    2016-05-01

    This study focuses on the optimisation of cheese whey formulated media for the production of hyaluronic acid (HA) by Streptococcus zooepidemicus. Culture media containing whey (W; 2.1g/L) or whey hydrolysate (WH; 2.4 g/L) gave the highest HA productions. Both W and WH produced high yields on protein consumed, suggesting cheese whey is a good nitrogen source for S. zooepidemicus production of HA. Polysaccharide concentrations of 4.0 g/L and 3.2g/L were produced in W and WH in a further scale-up to 5L bioreactors, confirming the suitability of the low-cost nitrogen source. Cheese whey culture media provided high molecular weight (>3000 kDa) HA products. This study revealed replacing the commercial peptone by the low-cost alternative could reduce HA production costs by up to a 70% compared to synthetic media. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Advanced Transportation System Studies. Technical Area 3: Alternate Propulsion Subsystems Concepts. Volume 3; Program Cost Estimates

    Science.gov (United States)

    Levack, Daniel J. H.

    2000-01-01

    The objective of this contract was to provide definition of alternate propulsion systems for both earth-to-orbit (ETO) and in-space vehicles (upper stages and space transfer vehicles). For such propulsion systems, technical data to describe performance, weight, dimensions, etc. was provided along with programmatic information such as cost, schedule, needed facilities, etc. Advanced technology and advanced development needs were determined and provided. This volume separately presents the various program cost estimates that were generated under three tasks: the F- IA Restart Task, the J-2S Restart Task, and the SSME Upper Stage Use Task. The conclusions, technical results , and the program cost estimates are described in more detail in Volume I - Executive Summary and in individual Final Task Reports.

  13. The Generic Data Capture Facility

    Science.gov (United States)

    Connell, Edward B.; Barnes, William P.; Stallings, William H.

    1987-01-01

    The Generic Data Capture Facility, which can provide data capture support for a variety of different types of spacecraft while enabling operations costs to be carefully controlled, is discussed. The data capture functions, data protection, isolation of users from data acquisition problems, data reconstruction, and quality and accounting are addressed. The TDM and packet data formats utilized by the system are described, and the development of generic facilities is considered.

  14. Effects of alternative promoters of growth on the performance and cost of production of broilers

    Directory of Open Access Journals (Sweden)

    Patrícia Tomazini Medeiros

    2009-09-01

    Full Text Available Probiotics and prebiotics were compared to antimicrobials as alternative growth promoters in male broilers grown from 1 to 42 days of age. Eight treatments were evaluated: a control feed without antimicrobials or alternative growth promoters, a control feed with antimicrobials, a control feed with the antimicrobials colistine and avilamicine, three rations with probiotic Bacillus subtilis in different concentrations and/or under recommended usage, one ration with probiotic Saccharomyces cerevisiae in addition to a mixture of probiotic Bacillus subtilis, Saccharomyces cerevisiae and Aspergillus oryzae, and one ration with mananoligossacarids (MOS plus betaglutanes. Antimicrobials and alternative growth promoters were added to an initial feed and to a growth feed common to all birds. Thirteen to 17 replicates of 50 birds of a Cobb line were utilized per treatment in a completely randomized design. Feed consumption, feed conversion and production costs did not significantly differ among treatments. The weights of 42-day-old birds fed on Bacillus subtilis (1,6 x 109CFU/g or the mixture of probiotics were higher or similar to the weights of birds fed on ration with antimicrobials. It was concluded that probiotics can replace antimicrobials as growth promoters for broilers up to 42 days of age without negative effects on growth performance and production cost.

  15. The Clinical and Economic Impact of Generic Locking Plate Utilization at a Level II Trauma Center.

    Science.gov (United States)

    Mcphillamy, Austin; Gurnea, Taylor P; Moody, Alastair E; Kurnik, Christopher G; Lu, Minggen

    2016-12-01

    In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula. Retrospective review. Level II Trauma center. 828 adult patients with operatively managed clavicle, proximal humerus, distal radius, proximal tibia, tibial pilon, and ankle fractures. Operative treatment with conventional or generic implants. The 414 patients treated with generic implants were compared with 414 patients treated with conventional implants. There were no significant differences in age, sex, presence of diabetes, smoking history or fracture type between the generic and conventional groups. No difference in operative time, estimated blood loss or intraoperative complication rate was observed. No increase in postoperative infection rate, hardware failure, hardware loosening, malunion, nonunion or need for hardware removal was noted. Overall, our hospital realized a 56% reduction in implant costs, an average savings of $1197 per case, and a total savings of $458,080 for the study period. Use of generic orthopaedic implants has been successful at our institution, providing equivalent clinical outcomes while significantly reducing implant expenditures. Based on our data, the use of generic implants has the potential to markedly reduce operative costs as long as quality products are used. Therapeutic Level III.

  16. Cost-effectiveness of pharmacogenetics-guided warfarin therapy vs. alternative anticoagulation in atrial fibrillation.

    Science.gov (United States)

    Pink, J; Pirmohamed, M; Lane, S; Hughes, D A

    2014-02-01

    Pharmacogenetics-guided warfarin dosing is an alternative to standard clinical algorithms and new oral anticoagulants for patients with nonvalvular atrial fibrillation. However, clinical evidence for pharmacogenetics-guided warfarin dosing is limited to intermediary outcomes, and consequently, there is a lack of information on the cost-effectiveness of anticoagulation treatment options. A clinical trial simulation of S-warfarin was used to predict times within therapeutic range for different dosing algorithms. Relative risks of clinical events, obtained from a meta-analysis of trials linking times within therapeutic range with outcomes, served as inputs to an economic analysis. Neither dabigatran nor rivaroxaban were cost-effective options. Along the cost-effectiveness frontier, in relation to clinically dosed warfarin, pharmacogenetics-guided warfarin and apixaban had incremental cost-effectiveness ratios of £13,226 and £20,671 per quality-adjusted life year gained, respectively. On the basis of our simulations, apixaban appears to be the most cost-effective treatment.

  17. A cost-benefit analysis of alternative device configurations for aviation-checked baggage security screening.

    Science.gov (United States)

    Jacobson, Sheldon H; Karnani, Tamana; Kobza, John E; Ritchie, Lynsey

    2006-04-01

    The terrorist attacks of September 11, 2001 have resulted in dramatic changes in aviation security. As of early 2003, an estimated 1,100 explosive detection systems (EDS) and 6,000 explosive trace detection machines (ETD) have been deployed to ensure 100% checked baggage screening at all commercial airports throughout the United States. The prohibitive costs associated with deploying and operating such devices is a serious issue for the Transportation Security Administration. This article evaluates the cost effectiveness of the explosive detection technologies currently deployed to screen checked baggage as well as new technologies that could be used in the future. Both single-device and two-device systems are considered. In particular, the expected annual direct cost of using these devices for 100% checked baggage screening under various scenarios is obtained and the tradeoffs between using single- and two-device strategies are studied. The expected number of successful threats under the different checked baggage screening scenarios with 100% checked baggage screening is also obtained. Lastly, a risk-based screening strategy proposed in the literature is analyzed. The results reported suggest that for the existing security setup, with current device costs and probability parameters, single-device systems are less costly and have fewer expected number of successful threats than two-device systems due to the way the second device affects the alarm or clear decision. The risk-based approach is found to have the potential to significantly improve security. The cost model introduced provides an effective tool for the execution of cost-benefit analyses of alternative device configurations for aviation-checked baggage security screening.

  18. Alternatives and costs for the decommissioning of Angra Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Carajilescov, Pedro; Moreira, Joao Manoel Losada; Maiorino, Jose Rubens, E-mail: pedro.carajilescov@ufabc.edu.br [Universidade Federal do ABC (UFABC), Santo Andre, SP (Brazil)

    2013-07-01

    The decommissioning of a nuclear reactor requires several actions involving legal basis, decommissioning strategies, planning, dismantling, packing, transport and storage of a large volume of radioactive materials, qualified personnel and financial resources. The paper discusses the several aspects of these actions for the decommissioning of Angra nuclear Power Plants, based on the international experiences. The main phases of the decommissioning process, the Brazilian regulation and cost estimations are also presented. Finally, two alternatives for the decommissioning of the plants, based on logistic aspects, are discussed. (author)

  19. Alternatives and costs for the decommissioning of Angra Nuclear Power Plants

    International Nuclear Information System (INIS)

    Carajilescov, Pedro; Moreira, Joao Manoel Losada; Maiorino, Jose Rubens

    2013-01-01

    The decommissioning of a nuclear reactor requires several actions involving legal basis, decommissioning strategies, planning, dismantling, packing, transport and storage of a large volume of radioactive materials, qualified personnel and financial resources. The paper discusses the several aspects of these actions for the decommissioning of Angra nuclear Power Plants, based on the international experiences. The main phases of the decommissioning process, the Brazilian regulation and cost estimations are also presented. Finally, two alternatives for the decommissioning of the plants, based on logistic aspects, are discussed. (author)

  20. Assessment of processes, facilities, and costs for alternative solid forms for immobilization of SRP defense waste

    International Nuclear Information System (INIS)

    Dunson, J.B. Jr.; Eisenberg, A.M.; Schuyler, R.L. III; Haight, H.G. Jr.; Mello, V.E.; Gould, T.H. Jr.; Butler, J.L.; Pickett, J.B.

    1982-03-01

    A quantitative merit evaluation which assesses the relative difficulty of remote processing of Savannah River Plant high-level wastes for seven alternative waste forms is presented. The reference borosilicate glass process is rated as the simplest, followed by FUETAP concrete. The other processes evaluated in order of increasing complexity were: glass marbles in a lead matrix, high-silica glass, crystalline ceramic (Synroc-D and tailored ceramic), and coated ceramic particles. Cost appraisals are summarized for the borosilicate glass, high-silica glass, and ceramic waste form processing facilities

  1. Iliac crest autograft versus alternative constructs for anterior cervical spine surgery: Pros, cons, and costs

    Science.gov (United States)

    Epstein, Nancy E.

    2012-01-01

    Background: Grafting choices available for performing anterior cervical diskectomy/fusion (ACDF) procedures have become a major concern for spinal surgeons, and their institutions. The “gold standard”, iliac crest autograft, may still be the best and least expensive grafting option; it deserves to be reassessed along with the pros, cons, and costs for alternative grafts/spacers. Methods: Although single or multilevel ACDF have utilized iliac crest autograft for decades, the implant industry now offers multiple alternative grafting and spacer devices; (allografts, cages, polyether-etherketone (PEEK) amongst others). While most studies have focused on fusion rates and clinical outcomes following ACDF, few have analyzed the “value-added” of these various constructs (e.g. safety/efficacy, risks/complications, costs). Results: The majority of studies document 95%-100% fusion rates when iliac crest autograft is utilized to perform single level ACDF (X-ray or CT confirmed at 6-12 postoperative months). Although many allograft studies similarly quote 90%-100% fusion rates (X-ray alone confirmed at 6-12 postoperative months), a recent “post hoc analysis of data from a prospective multicenter trial” (Riew KD et. al., CSRS Abstract Dec. 2011; unpublished) revealed a much higher delayed fusion rate using allografts at one year 55.7%, 2 years 87%, and four years 92%. Conclusion: Iliac crest autograft utilized for single or multilevel ACDF is associated with the highest fusion, lowest complication rates, and significantly lower costs compared with allograft, cages, PEEK, or other grafts. As spinal surgeons and institutions become more cost conscious, we will have to account for the “value added” of these increasingly expensive graft constructs. PMID:22905321

  2. Diesel vs. compressed natural gas for school buses: a cost-effectiveness evaluation of alternative fuels

    International Nuclear Information System (INIS)

    Cohen, J.T.

    2005-01-01

    Reducing emissions from school buses is a priority for both state and federal regulators. Two popular alternative technologies to conventional diesel (CD) are emission controlled diesel (ECD), defined here to be diesel buses equipped with continuously regenerating particle filters, and engines fueled by compressed natural gas (CNG). This paper uses a previously published model to quantify the impact of particulate matter (PM), oxides of nitrogen (NO x ), and sulfur dioxide (SO 2 ) emissions on population exposure to ozone and to primary and secondary PM, and to quantify the resulting health damages, expressed in terms of lost quality adjusted life years (QALYs). Resource costs include damages from greenhouse gas-induced climate change, vehicle procurement, infrastructure development, and operations. I find that ECD and CNG produce very similar reductions in health damages compared to CD, although CNG has a modest edge because it may have lower NO x emissions. However, ECD is far more cost effective ($400,000-900,000 cost per QALY saved) than CNG (around $4 million per QALY saved). The results are uncertain because the model used makes a series of simplifying assumptions and because emissions data and cost data for school buses are very limited

  3. Production Costs of Alternative Transportation Fuels. Influence of Crude Oil Price and Technology Maturity

    Energy Technology Data Exchange (ETDEWEB)

    Cazzola, Pierpaolo; Morrison, Geoff; Kaneko, Hiroyuki; Cuenot, Francois; Ghandi, Abbas; Fulton, Lewis

    2013-07-01

    This study examines the production costs of a range of transport fuels and energy carriers under varying crude oil price assumptions and technology market maturation levels. An engineering ''bottom-up'' approach is used to estimate the effect of the input cost of oil and of various technological assumptions on the finished price of these fuels. In total, the production costs of 20 fuels are examined for crude oil prices between USD 60 and USD 150 per barrel. Some fuel pathways can be competitive with oil as their production, transport and storage technology matures, and as oil price increases. Rising oil prices will offer new opportunities to switch to alternative fuels for transport, to diversify the energy mix of the transport sector, and to reduce the exposure of the whole system to price volatility and potential distuption of supply. In a time of uncertainty about the leading vehicle technology to decarbonize the transport sector, looking at the fuel cost brings key information to be considered to keep mobility affordable yet sustainable.

  4. Cost effectiveness of Alternative Helicobacter pylori Eradication Strategies in the Management of Duodenal Ulcer

    Directory of Open Access Journals (Sweden)

    Bernie O'Brien

    1997-01-01

    Full Text Available Published data and techniques for decision analysis were used to construct a model to estimate the cost effectiveness of nine alternative strategies for the management of patients diagnosed with uncomplicated duodenal ulcer. Two strategies of intermittent therapy with either ranitidine or omeprazole, one strategy of continuous maintenance treatment with ranitidine, and six strategies for ulcer healing and eradication of Helicobacter pylori infection were considered. Healing time curves were estimated by using published data, allowing for estimation of expected time for acute healing episodes. The expected number of weeks to heal per patient, in a one-year period, was estimated by combining healing time data with probability of ulcer recurrence. It was found that patients that underwent any of the six H pylori eradication regimens had fewer days with ulcer per year than those who underwent maintenance or intermittent ranitidine. Four eradication regimens had lower costs and better outcomes than ranitidine therapy. In comparing H pylori strategies, the two strategies of omeprazole plus one antibiotic (either amoxicillin or clarithromycin are more costly than omeprazole plus two antibiotics (specifically amoxicillin and metronidazole or clarithromycin and metronidazole and result in similar outcomes. Although omeprazole-based eradication regimens are more costly than ranitidine bismuth triple therapy, they are associated with fewer recurrences of ulcer and days of symptoms. A limitation of the analysis is that it did not incorporate issues of compliance and metronidazole resistance; however, the former concern may be less of an issue as H pylori regimens become simpler and shorter in duration.

  5. Alternatives for operational cost reduction in oil pipelines; Alternativas para reducao de custos energeticos operacionais em oleodutos

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Philipe Barroso; Carneiro, Leonardo Motta; Pires, Luis Fernando Goncalves [Pontificia Universidade Catolica do Rio de Janeiro (SIMDUT/DEM/ PUC-Rio), RJ (Brazil). Dept. de Engenharia Mecancia. Nucleo de Simulacao Termo-Hidraulica de Dutos

    2012-07-01

    This paper intends to give a brief overview of some cost reduction alternatives in oil pipelines, to optimize the pipeline operation. Four different alternatives are presented, based on previous studies made on existing pipelines, to demonstrate the response obtained with these solutions. Pipeline operation, especially on mature ones, tends to have a high operational cost, be by tradition, the aging of the installation, change of operational characteristics - such as nominal flow, product, or even flow direction - for which the pipeline wasn't originally designed. The alternatives showed allow for an increase survival time of the pipeline, without resorting to major changes, such as replacement of pipes or adding pumping stations to the system. The alternative studied varies from no implementation cost to high installation cost or operational cost increase, depending on the system and the alternative chosen. From changing the pump arrays during operation or changing the products viscosity with different blends, that represent virtually no cost to the pipeline operation, to the use of VFDs, with a high installation cost or DRA, which increase the operational cost. (author)

  6. Energy abatement in Chinese industry: Cost evaluation of regulation strategies and allocation alternatives

    International Nuclear Information System (INIS)

    Xia, X.H.; Chen, G.Q.

    2012-01-01

    For Chinese industry, the costs of different energy consumption abatement scenarios are evaluated by the method of directional distance function. These scenarios are based on the combinations of regulation strategies and allocation alternatives—the former are sectors and provinces, and the latter include the five principles of average, intensity share, absolute share, discriminatory absolute and discriminatory intensity. For all the scenarios, the quantitative impacts in terms of output potential loss are calculated and compared. Due to less output potential loss for all the allocation alternatives, the sector regulation strategy is shown to be more effective than the province regulation strategy. It is also demonstrated that, among all the scenarios considered, the sector regulation based on the intensity share principle and the province regulation based on the absolute share principle are the two optimal. The performances of energy abatement allocation of the 11th and 12th Five Year Plans of China are assessed against the simulated scenarios. - Highlights: ► The costs of different energy consumption abatement scenarios are evaluated for Chinese industry. ► The impacts on all entities under all allocation alternatives are calculated and compared. ► The optimal scenarios for the different strategies are identified. ► The performances of the 11th and 12th Five Year Plans are assessed.

  7. Efficiency versus cost of alternative fuels from renewable resources: outlining decision parameters

    International Nuclear Information System (INIS)

    Kaul, Sanjay; Edinger, Raphael

    2004-01-01

    In the discussion of traditional versus renewable energies and alternatives to conventional crude oil-based fuels in the transportation sector, efficiency calculations are but one decision making parameter. Comparing the assets and liabilities of fossil-based and renewable fuels in the transportation sector, further aspects such as centralized versus decentralized technologies, cost evaluations, taxation, and ecological/social benefits have to be taken into account. This paper outlines the driving parameters for shifting toward alternative fuels based on fossil or renewable resources and their use in innovative vehicle technologies such as advanced internal combustion and fuel cell electric drive systems. For the decision in favor or against an alternative fuel to be introduced to the mass market, automotive technologies and the energy supply system have to be examined in an integrated way. From an economic and technological perspective, some fuels may be even incompatible with the trend toward using renewable resources that have advantages in decentralized systems. Beyond efficiency calculations, political and industrial interests arise and may be influential to reshaping our currently crude oil-based mobility sector

  8. Comparison of costs for three hypothetical alternative kitchen waste management systems.

    Science.gov (United States)

    Schiettecatte, Wim; Tize, Ronald; De Wever, Heleen

    2014-11-01

    Urban water and waste management continues to be a major challenge, with the Earth's population projected to rise to 9 billion by 2050, with 70% of this population expected to live in cities. A combined treatment of wastewater and the organic fraction of municipal solid waste offers opportunities for improved environmental protection and energy recovery, but the collection and transport of organic wastes must be cost effective. This study compares three alternative kitchen waste collection and transportation systems for a virtual modern urban area with 300,000 residents and a population density of 10,000 persons per square kilometre. Door-to-door collection, being the standard practice in modern urban centres, remains the most economically advantageous at a cost of 263 euros per tonne of kitchen waste. Important drawbacks are the difficult logistics, increased city traffic, air and noise pollution. The quieter, cleaner and more hygienic vacuum transport of kitchen waste comes with a higher cost of 367 euros per tonne, mainly resulting from a higher initial investment cost for the system installation. The third option includes the well-known use of under-sink food waste disposers (often called garbage grinders) that are connected to the kitchen's wastewater piping system, with a total yearly cost of 392 euros per tonne. Important advantages with this system are the clean operation and the current availability of a city-wide sewage conveyance pipeline system. Further research is recommended, for instance the application of a life cycle assessment approach, to more fully compare the advantages and disadvantages of each option. © The Author(s) 2014.

  9. Impacts of generic competition and benefit management practices on spending for prescription drugs: evidence from Medicare's Part D benefit.

    Science.gov (United States)

    Sheingold, Steven; Nguyen, Nguyen Xuan

    2014-01-01

    This study estimates the effects of generic competition, increased cost-sharing, and benefit practices on utilization and spending for prescription drugs. We examined changes in Medicare price and utilization from 2007 to 2009 of all drugs in 28 therapeutic classes. The classes accounted for 80% of Medicare Part D spending in 2009 and included the 6 protected classes and 6 classes with practically no generic competition. All variables were constructed to measure each drug relative to its class at a specific plan sponsor. We estimated that the shift toward generic utilization had cut in half the rate of increase in the price of a prescription during 2007-2009. Specifically, the results showed that (1) rapid generic penetration had significantly held down costs per prescription, (2) copayment and other benefit practices shifted utilization to generics and favored brands, and (3) price increases were generally greater in less competitive classes of drugs. In many ways, Part D was implemented at a fortuitous time; since 2006, there have been relatively few new blockbuster drugs introduced, and many existing high-volume drugs used by beneficiaries were in therapeutic classes with multiple brands and generic alternatives. Under these conditions, our paper showed that plan sponsors have been able to contain costs by encouraging use of generics or drugs offering greater value within therapeutic classes. It is less clear what will happen to future Part D costs if a number of new and effective drugs for beneficiaries enter the market with no real competitors.

  10. Life-cycle cost and impacts: alternatives for managing KE basin sludge

    International Nuclear Information System (INIS)

    Johnson, L.M.

    1997-01-01

    This document presents the results of a life-cycle cost and impacts evaluation of alternatives for managing sludge that will be removed from the K Basins. The two basins are located in the 100-K Area of the Hanford Site. This evaluation was conducted by Fluor Daniel Hanford, Inc. (FDH) and its subcontractors to support decisions regarding the ultimate disposition of the sludge. The long-range plan for the Hanford Site calls for spent nuclear fuel (SNF), sludge, debris, and water to be removed from the K East (KE) and K West (KW) Basins. This activity will be conducted as a removal action under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). The scope of the CERCLA action will be limited to removing the SNF, sludge, debris, and water from the basins and transferring them to authorized facilities for interim storage and/or treatment and disposal. The scope includes treating the sludge and water in the 100-K Area prior to the transfer. Alternatives for the removal action are evaluated in a CERCLA engineering evaluation/cost analysis (EE/CA) and include different methods for managing sludge from the KE Basins. The scope of the removal action does not include storing, treating, or disposing of the sludge once it is transferred to the receiving facility and the EE/CA does not evaluate those downstream activities. This life-cycle evaluation goes beyond the EE/CA and considers the full life-cycle costs and impacts of dispositioning sludge

  11. A low-cost alternative to the optical experiment commercially known as “Magic Hologram – 3D Mirage”

    Directory of Open Access Journals (Sweden)

    Osmar Henrique Moura Silva

    2014-09-01

    Full Text Available This work presents a low-cost alternative to the commercialized experiment called “Magic Hologram – Mirage 3D”, which reproduces the real image of an object that is seen three-dimensionally in the air. An analysis of this alternative is carried out, indicating educational aspects of its use in the classroom in quantitative terms.

  12. An Alternative Methodological Approach for Cost-Effectiveness Analysis and Decision Making in Genomic Medicine.

    Science.gov (United States)

    Fragoulakis, Vasilios; Mitropoulou, Christina; van Schaik, Ron H; Maniadakis, Nikolaos; Patrinos, George P

    2016-05-01

    Genomic Medicine aims to improve therapeutic interventions and diagnostics, the quality of life of patients, but also to rationalize healthcare costs. To reach this goal, careful assessment and identification of evidence gaps for public health genomics priorities are required so that a more efficient healthcare environment is created. Here, we propose a public health genomics-driven approach to adjust the classical healthcare decision making process with an alternative methodological approach of cost-effectiveness analysis, which is particularly helpful for genomic medicine interventions. By combining classical cost-effectiveness analysis with budget constraints, social preferences, and patient ethics, we demonstrate the application of this model, the Genome Economics Model (GEM), based on a previously reported genome-guided intervention from a developing country environment. The model and the attendant rationale provide a practical guide by which all major healthcare stakeholders could ensure the sustainability of funding for genome-guided interventions, their adoption and coverage by health insurance funds, and prioritization of Genomic Medicine research, development, and innovation, given the restriction of budgets, particularly in developing countries and low-income healthcare settings in developed countries. The implications of the GEM for the policy makers interested in Genomic Medicine and new health technology and innovation assessment are also discussed.

  13. Needs-based sewerage prioritization: alternative to conventional cost-benefit analysis.

    Science.gov (United States)

    Rashid, Md M; Hayes, Donald F

    2011-10-01

    This paper presents an empirical approach to select and prioritize sewerage projects within set budgetary limitations. The methodology includes a model which quantifies benefits of a sewerage project as an index or dimensionless number. The index considers need and urgency of sewerage and other project goals. Benefit is defined as the difference in anticipated impact between the current condition (without the project) and the expected condition with the project. Anticipated benefits primarily include reduction in environmental pollution, reduction of human diseases and morbidity, and other tangible and intangible improvement. This approach is a powerful decision tool for sewerage prioritization and an effective alternative to conventional cost-benefit analysis. Unlike conventional analysis, this approach makes no attempt to convert project benefits and other impacts into a monetary measure. This work recognizes that the decision to provide sewerage based solely on net benefits is not practical. Instead, benefit-cost ratios (B/C) are calculated utilizing cost-effectiveness approach. Using these ratios, 16 unserviced areas of Ensenada, Mexico are ranked. The prioritization rankings produced by this method must be further scrutinized and carefully reviewed for logic, accuracy of input data, and practicality of implementation. A similar framework may also be useful for prioritizing other public works projects. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Costs and benefits of alternatives for mill-tailings management: a perspective

    International Nuclear Information System (INIS)

    Chee, P.C.; Yuan, Y.C.; Roberts, C.J.

    1983-01-01

    Past milling of uranium and thorium ore in the United States has produced tailings that are stored at numerous sites around the country. Some of these storage sites are located near towns and cities, and the local populations are exposed to radiation and radioactive materials migrating off the sites. The federal government has initiated remedial action programs (for example the Uranium Mill Tailings Remedial Action Program and the Formerly Utilized Sites Remedial Action Program) to clean up land and buildings that have become contaminated with radioactive material and thus eliminate or reduce population exposure to radiation. The degree of long-term benefit from any reduction of the population dose will be different for each remedial action, as will the cost. To gain a perspective on the cost-benefit ratios of various alternatives (remedial actions), estimates are made of the potential radiation doses to affected populations near two inactive sites and of the costs associated with (1) onsite stabilization of radioactive tailings, and (2) transportation of tailings to remote locations for stabilization. The calculations presented in this paper were based on actual conditions at an inactive uranium mill tailings site (the Vitro site in Salt Lake City, Utah) and at a former thorium-processing facility (Kerr-McGee site in West Chicago, Illinois)

  15. A cost comparison of alternative regimens for treatment-refractory partial seizure disorder: an econometric analysis.

    Science.gov (United States)

    Lee, Won Chan; Hoffmann, Marc S; Arcona, Steve; D'Souza, Joseph; Wang, Qin; Pashos, Chris L

    2005-10-01

    Partial seizure disorder is typically treated by monotherapy with antiepileptic drugs (AEDs). However, when the condition is refractory to the initial treatment regimen, patients may be switched to monotherapy with another AED or to combination therapy with the initial AED plus a second AED. The purpose of this study was to examine the economic costs associated with treatment-refractory partial seizure disorder and to compare the costs of 2 alternative approaches: a switch to oxcarbazepine (OXC) monotherapy or the addition to the regimen of another AED (AED add-on). Adult patients with a diagnosis of partial seizure disorder who received initial AED monotherapy between January 1, 2000, and March 31, 2003, were identified from the PharMetrics Patient-Centric Database, a health plan administrative claims database. The medical and pharmacy history of these patients was analyzed from 6 months before a change to either OXC monotherapy or AED add-on therapy through 12 months after the change in treatment. Total health care resource utilization and the associated costs were compared within each cohort before and after the change, as well as between cohorts, with statistical differences tested using Wilcoxon rank sum tests. Multivariate econometric analyses were performed to examine the impact of age, sex, geographic location, Charlson Comorbidity Index, and the presence of specific comorbidities. Demographic and clinical characteristics 102 were similar between the OXC monotherapy cohort (n = 259) and the AED add-on cohort (n = 795). Annual direct treatment costs increased in both groups in the period after the failure of initial monotherapy, increasing from 10,462 US dollars to 11,360 US dollars in the OXC cohort and from 10,137 US dollars to 12,201 US dollars in the AED add on cohort (P < 0.01). Increased pharmacy costs were the primary driver behind cost increases in both cohorts. Patients in the AED add-on cohort were significantly more likely to have an emergency

  16. A consumer register: an acceptable and cost-effective alternative for accessing patient populations

    Directory of Open Access Journals (Sweden)

    Jamie Bryant

    2016-10-01

    register. Use of volunteer data collectors contributed to an annual saving of $14,183, however paid data collectors achieved significantly higher consent rates. Successful enrolment onto the register was completed for 42 % of the sample. Conclusions A Consumer Register is a promising and feasible alternative to population-based registries, with the majority of participants willing to be contacted multiple times via low-resource methods such as email. There is an effectiveness/cost trade off in the use of paid versus volunteer data collectors.

  17. Potential Clinical and Economic Impact of Switching Branded Medications to Generics

    Science.gov (United States)

    Straka, Robert J.; Keohane, Denis J.; Liu, Larry Z.

    2017-01-01

    Switching branded to generic medications has become a common cost-containment measure. Although this is an important objective for health care systems worldwide, the impact of this practice on patient outcomes needs to be carefully considered. We reviewed the literature summarizing the potential clinical and economic consequences of switching from branded to generic medications on patient outcomes. A literature search of peer-reviewed articles published 2003–2013 using key words of “generic switching” or “substitution” was conducted using PubMed, OvidSP, and ScienceDirect. Of 30 articles identified and reviewed, most were related to the diseases of the central nervous system, especially epilepsy. Based on our review, potential impacts of switching fell into 3 broad categories: patient attitudes and adherence, clinical and safety outcomes, and cost and resource utilization. Although in many cases generics may represent an appropriate alternative to branded products, this may not always be the case. Specifically, several studies suggested that switching may negatively impact medication adherence, whereas other studies found that generic switching was associated with poorer clinical outcomes and more adverse events. In some instances, switching accomplished cost savings but did so at increased total cost of care because of increased physician visits or hospitalizations. Although in many cases generics may represent an appropriate alternative, mandatory generic switching may lead to unintended consequences, especially in certain therapeutic areas. Although further study is warranted, based on our review, it may be medically justifiable for physicians and patients to retain the right to request the branded product in certain cases. PMID:26099048

  18. An environmental cost-benefit analysis of alternative green roofing strategies

    Science.gov (United States)

    Richardson, M.; William, R. K.; Goodwell, A. E.; Le, P. V.; Kumar, P.; Stillwell, A. S.

    2016-12-01

    Green roofs and cool roofs are alternative roofing strategies that mitigate urban heat island effects and improve building energy performance. Green roofs consist of soil and vegetation layers that provide runoff reduction, thermal insulation, and potential natural habitat, but can require regular maintenance. Cool roofs involve a reflective layer that reflects more sunlight than traditional roofing materials, but require additional insulation during winter months. This study evaluates several roofing strategies in terms of energy performance, urban heat island mitigation, water consumption, and economic cost. We use MLCan, a multi-layer canopy model, to simulate irrigated and non-irrigated green roof cases with shallow and deep soil depths during the spring and early summer of 2012, a drought period in central Illinois. Due to the dry conditions studied, periodic irrigation is implemented in the model to evaluate its effect on evapotranspiration. We simulate traditional and cool roof scenarios by altering surface albedo and omitting vegetation and soil layers. We find that both green roofs and cool roofs significantly reduce surface temperature compared to the traditional roof simulation. Cool roof temperatures always remain below air temperature and, similar to traditional roofs, require low maintenance. Green roofs remain close to air temperature and also provide thermal insulation, runoff reduction, and carbon uptake, but might require irrigation during dry periods. Due to the longer lifetime of a green roof compared to cool and traditional roofs, we find that green roofs realize the highest long term cost savings under simulated conditions. However, using longer-life traditional roof materials (which have a higher upfront cost) can help decrease this price differential, making cool roofs the most affordable option due to the higher maintenance costs associated with green roofs

  19. Strategies for cost-effective carbon reductions: A sensitivity analysis of alternative scenarios

    International Nuclear Information System (INIS)

    Gumerman, Etan; Koomey, Jonathan G.; Brown, Marilyn

    2001-01-01

    Analyses of alternative futures often present results for a limited set of scenarios, with little if any sensitivity analysis to identify the factors affecting the scenario results. This approach creates an artificial impression of certainty associated with the scenarios considered, and inhibits understanding of the underlying forces. This paper summarizes the economic and carbon savings sensitivity analysis completed for the Scenarios for a Clean Energy Future study (IWG, 2000). Its 19 sensitivity cases provide insight into the costs and carbon-reduction impacts of a carbon permit trading system, demand-side efficiency programs, and supply-side policies. Impacts under different natural gas and oil price trajectories are also examined. The results provide compelling evidence that policy opportunities exist to reduce carbon emissions and save society money

  20. Energy and cost saving results for advanced technology systems from the Cogeneration Technology Alternatives Study (CTAS)

    Science.gov (United States)

    Sagerman, G. D.; Barna, G. J.; Burns, R. K.

    1979-01-01

    An overview of the organization and methodology of the Cogeneration Technology Alternatives Study is presented. The objectives of the study were to identify the most attractive advanced energy conversion systems for industrial cogeneration applications in the future and to assess the advantages of advanced technology systems compared to those systems commercially available today. Advanced systems studied include steam turbines, open and closed cycle gas turbines, combined cycles, diesel engines, Stirling engines, phosphoric acid and molten carbonate fuel cells and thermionics. Steam turbines, open cycle gas turbines, combined cycles, and diesel engines were also analyzed in versions typical of today's commercially available technology to provide a base against which to measure the advanced systems. Cogeneration applications in the major energy consuming manufacturing industries were considered. Results of the study in terms of plant level energy savings, annual energy cost savings and economic attractiveness are presented for the various energy conversion systems considered.

  1. The Cost-Effectiveness of Three Screening Alternatives for People with Diabetes with No or Early Diabetic Retinopathy

    Science.gov (United States)

    Rein, David B; Wittenborn, John S; Zhang, Xinzhi; Allaire, Benjamin A; Song, Michael S; Klein, Ronald; Saaddine, Jinan B

    2011-01-01

    Objective To determine whether biennial eye evaluation or telemedicine screening are cost-effective alternatives to current recommendations for the estimated 10 million people aged 30–84 with diabetes but no or minimal diabetic retinopathy. Data Sources United Kingdom Prospective Diabetes Study, National Health and Nutrition Examination Survey, American Academy of Ophthalmology Preferred Practice Patterns, Medicare Payment Schedule. Study Design Cost-effectiveness Monte Carlo simulation. Data Collection/Extraction Methods Literature review, analysis of existing surveys. Principal Findings Biennial eye evaluation was the most cost-effective treatment option when the ability to detect other eye conditions was included in the model. Telemedicine was most cost-effective when other eye conditions were not considered or when telemedicine was assumed to detect refractive error. The current annual eye evaluation recommendation was costly compared with either treatment alternative. Self-referral was most cost-effective up to a willingness to pay (WTP) of U.S.$37,600, with either biennial or annual evaluation most cost-effective at higher WTP levels. Conclusions Annual eye evaluations are costly and add little benefit compared with either plausible alternative. More research on the ability of telemedicine to detect other eye conditions is needed to determine whether it is more cost-effective than biennial eye evaluation. PMID:21492158

  2. An alternative sensor fusion method for object orientation using low-cost MEMS inertial sensors

    Science.gov (United States)

    Bouffard, Joshua L.

    This thesis develops an alternative sensor fusion approach for object orientation using low-cost MEMS inertial sensors. The alternative approach focuses on the unique challenges of small UAVs. Such challenges include the vibrational induced noise onto the accelerometer and bias offset errors of the rate gyroscope. To overcome these challenges, a sensor fusion algorithm combines the measured data from the accelerometer and rate gyroscope to achieve a single output free from vibrational noise and bias offset errors. One of the most prevalent sensor fusion algorithms used for orientation estimation is the Extended Kalman filter (EKF). The EKF filter performs the fusion process by first creating the process model using the nonlinear equations of motion and then establishing a measurement model. With the process and measurement models established, the filter operates by propagating the mean and covariance of the states through time. The success of EKF relies on the ability to establish a representative process and measurement model of the system. In most applications, the EKF measurement model utilizes the accelerometer and GPS-derived accelerations to determine an estimate of the orientation. However, if the GPS-derived accelerations are not available then the measurement model becomes less reliable when subjected to harsh vibrational environments. This situation led to the alternative approach, which focuses on the correlation between the rate gyroscope and accelerometer-derived angle. The correlation between the two sensors then determines how much the algorithm will use one sensor over the other. The result is a measurement that does not suffer from the vibrational noise or from bias offset errors.

  3. Low-Cost Alternative for the Measurement of Water Levels in Surface Water Streams

    Directory of Open Access Journals (Sweden)

    Luis E. PEÑA

    2017-11-01

    Full Text Available Flood risk management and water resources planning involve a deep knowledge of surface streams so that mitigation strategies and climate change adaptations can be implemented. Commercially, there is a wide range of technologies for the measurement of hydroclimatic variables; however, many of these technologies may not be affordable for institutions with limited budgets. This paper has two main objectives: 1 Present the design of an ultrasound-based water level measurement system, and 2 Propose a methodological alternative for the development of instruments, according to the needs of institutions conducting monitoring of surface waterbodies. To that end, the proposed methodology is based on selection processes defined according to the specific needs of each waterbody. The prototype was tested in real-world scale, with the potential to obtain accurate measurements. Lastly, we present the design of the ultrasound-based water level measurement instrument, which can be built at a low cost. Low-cost instruments can potentially contribute to the sustainable instrumental autonomy of environmental entities and help define measurement and data transmission standards based on the specific requirements of the monitoring.

  4. Cost and greenhouse gas emission tradeoffs of alternative uses of lignin for second generation ethanol

    Science.gov (United States)

    Pourhashem, Ghasideh; Adler, Paul R.; McAloon, Andrew J.; Spatari, Sabrina

    2013-06-01

    Second generation ethanol bioconversion technologies are under demonstration-scale development for the production of lignocellulosic fuels to meet the US federal Renewable Fuel Standards (RFS2). Bioconversion technology utilizes the fermentable sugars generated from the cellulosic fraction of the feedstock, and most commonly assumes that the lignin fraction may be used as a source of thermal and electrical energy. We examine the life cycle greenhouse gas (GHG) emission and techno-economic cost tradeoffs for alternative uses of the lignin fraction of agricultural residues (corn stover, and wheat and barley straw) produced within a 2000 dry metric ton per day ethanol biorefinery in three locations in the United States. We compare three scenarios in which the lignin is (1) used as a land amendment to replace soil organic carbon (SOC); (2) separated, dried and sold as a coal substitute to produce electricity; and (3) used to produce electricity onsite at the biorefinery. Results from this analysis indicate that for life cycle GHG intensity, amending the lignin to land is lowest among the three ethanol production options (-25 to -2 g CO2e MJ-1), substituting coal with lignin is second lowest (4-32 g CO2e MJ-1), and onsite power generation is highest (36-41 g CO2e MJ-1). Moreover, the onsite power generation case may not meet RFS2 cellulosic fuel requirements given the uncertainty in electricity substitution. Options that use lignin for energy do so at the expense of SOC loss. The lignin-land amendment option has the lowest capital cost among the three options due to lower equipment costs for the biorefinery’s thermal energy needs and use of biogas generated onsite. The need to purchase electricity and uncertain market value of the lignin-land amendment could raise its cost compared to onsite power generation and electricity co-production. However, assuming a market value (50-100/dry Mg) for nutrient and soil carbon replacement in agricultural soils, and potentially

  5. Cost and greenhouse gas emission tradeoffs of alternative uses of lignin for second generation ethanol

    International Nuclear Information System (INIS)

    Pourhashem, Ghasideh; Spatari, Sabrina; Adler, Paul R; McAloon, Andrew J

    2013-01-01

    Second generation ethanol bioconversion technologies are under demonstration-scale development for the production of lignocellulosic fuels to meet the US federal Renewable Fuel Standards (RFS2). Bioconversion technology utilizes the fermentable sugars generated from the cellulosic fraction of the feedstock, and most commonly assumes that the lignin fraction may be used as a source of thermal and electrical energy. We examine the life cycle greenhouse gas (GHG) emission and techno-economic cost tradeoffs for alternative uses of the lignin fraction of agricultural residues (corn stover, and wheat and barley straw) produced within a 2000 dry metric ton per day ethanol biorefinery in three locations in the United States. We compare three scenarios in which the lignin is (1) used as a land amendment to replace soil organic carbon (SOC); (2) separated, dried and sold as a coal substitute to produce electricity; and (3) used to produce electricity onsite at the biorefinery. Results from this analysis indicate that for life cycle GHG intensity, amending the lignin to land is lowest among the three ethanol production options (−25 to −2 g CO 2 e MJ −1 ), substituting coal with lignin is second lowest (4–32 g CO 2 e MJ −1 ), and onsite power generation is highest (36–41 g CO 2 e MJ −1 ). Moreover, the onsite power generation case may not meet RFS2 cellulosic fuel requirements given the uncertainty in electricity substitution. Options that use lignin for energy do so at the expense of SOC loss. The lignin–land amendment option has the lowest capital cost among the three options due to lower equipment costs for the biorefinery’s thermal energy needs and use of biogas generated onsite. The need to purchase electricity and uncertain market value of the lignin–land amendment could raise its cost compared to onsite power generation and electricity co-production. However, assuming a market value ($50–$100/dry Mg) for nutrient and soil carbon replacement in

  6. Use of complementary and alternative medicine by patients with cancer in northern Turkey: analysis of cost and satisfaction.

    Science.gov (United States)

    Aydin Avci, Ilknur; Koç, Zeliha; Sağlam, Zeynep

    2012-03-01

    The aims of this study were to determine (1) the prevalence of complementary and alternative medicine use among patients with cancer, (2) the method of use of the particular therapy, (3) the reasons for using complementary and alternative medicine therapies, (4) the benefits experienced by the use of complementary and alternative medicine, (5) the source of information about complementary and alternative medicine therapies and, (6) the satisfaction and cost of complementary and alternative medicine. Complementary and alternative medicine consists of diverse medical and healthcare systems, practices and products that are not considered at present to be a part of conventional medicine. The majority of patients who use complementary and alternative medicine use more than one method. Complementary and alternative medicine use is more common in cases of advanced disease or poor prognosis. This is a descriptive study of complementary and alternative medicine. This study was conducted in the Chemotherapy Unit at Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey, between 18 March 2008-30 June 2008. Two hundred fifty-three patients with cancer, among 281 patients who applied to the chemotherapy clinic between these dates, agreed to take part in the study with whom contact could be made were included. A questionnaire including descriptive characteristics in collecting data, characteristics about diseases and their treatments, complementary and alternative medicine information and implementation situations and a control list about complementary and alternative medicine implementations were given. The collected data were evaluated by computer using descriptive statistics, the chi-square test and Student's t-test. In this study, 94·1% of the patients were content with medical treatment, 58·9% of them used complementary and alternative medicine treatments, 41·1% did not use any complementary and alternative medicine treatments. The satisfaction level of the

  7. Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

    Science.gov (United States)

    Goldie, Sue J.; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

    2010-01-01

    Background Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Methods and Findings Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold (∼23%–35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately

  8. Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

    Directory of Open Access Journals (Sweden)

    Sue J Goldie

    2010-04-01

    Full Text Available BACKGROUND: Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. METHODS AND FINDINGS: Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35% without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC. An integrated and stepwise approach was

  9. Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

    Science.gov (United States)

    Goldie, Sue J; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

    2010-04-20

    Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately prevent four of five

  10. Determinants of generic drug substitution in Switzerland

    Directory of Open Access Journals (Sweden)

    Lufkin Thomas M

    2011-01-01

    Full Text Available Abstract Background Since generic drugs have the same therapeutic effect as the original formulation but at generally lower costs, their use should be more heavily promoted. However, a considerable number of barriers to their wider use have been observed in many countries. The present study examines the influence of patients, physicians and certain characteristics of the generics' market on generic substitution in Switzerland. Methods We used reimbursement claims' data submitted to a large health insurer by insured individuals living in one of Switzerland's three linguistic regions during 2003. All dispensed drugs studied here were substitutable. The outcome (use of a generic or not was modelled by logistic regression, adjusted for patients' characteristics (gender, age, treatment complexity, substitution groups and with several variables describing reimbursement incentives (deductible, co-payments and the generics' market (prices, packaging, co-branded original, number of available generics, etc.. Results The overall generics' substitution rate for 173,212 dispensed prescriptions was 31%, though this varied considerably across cantons. Poor health status (older patients, complex treatments was associated with lower generic use. Higher rates were associated with higher out-of-pocket costs, greater price differences between the original and the generic, and with the number of generics on the market, while reformulation and repackaging were associated with lower rates. The substitution rate was 13% lower among hospital physicians. The adoption of the prescribing practices of the canton with the highest substitution rate would increase substitution in other cantons to as much as 26%. Conclusions Patient health status explained a part of the reluctance to substitute an original formulation by a generic. Economic incentives were efficient, but with a moderate global effect. The huge interregional differences indicated that prescribing behaviours and

  11. [Generic drugs: good or bad? Physician's knowledge of generic drugs and prescribing habits].

    Science.gov (United States)

    García, A J; Martos, F; Leiva, F; Sánchez de la Cuesta, F

    2003-01-01

    In this article we analyze the responses of 1220 Spanish physicians who participated in a survery about generic drugs. A previously validated questionnaire was sent to physicians through the Spanish Medical Councils of the different provinces. Four items were analyzed: what doctors know about generic drugs (knowledge); physicians' prescribing habits concerning these drugs (attitude and professional competence); how prescription of generic drugs effects pharmaceutical costs amd, finally, what doctors believe a generic drug should be. The influence of physician-related variables (age, type of contract, specialty, workload, etc.) on prescribing of generic drugs was also analyzed. In view of the results, we believe that to rationalize expenditure through and appropriate policy on generic drugs Spanish health authorities should offer more and better training and information (clear and independent) about what generic drugs are.

  12. Life cycle benefit-cost analysis of alternatives for deployment of the transportable vitrification system

    International Nuclear Information System (INIS)

    Sexton, J.L.; Dole, L.R.

    1996-07-01

    The U.S. Department of Energy's (DOE) Oak Ridge Reservation (ORR) occupies almost 37,000 acres in and around the city of Oak Ridge, Tennessee. In the rapid effort to produce a working atomic bomb, three plants were constructed: Oak Ridge Gaseous Diffusion Plant (K-25), now the Oak Ridge K-25 Site and the Center for Environmental Technology and Waste Management; Clinton Laboratories (now the Oak Ridge National Laboratory [ORNL]); and the Oak Ridge Y-12 Plant. Following the end of the Cold War and the resulting reduction in nuclear weapons production, the DOE faced an unprecedented task of safely managing, storing, and treating legacy waste while, at the same time, cleaning up the contaminated areas within its sites in 33 states in a manner that uses the most cost-effective methods in conjunction with its responsibility to protect human health and the environment. The Transportable Vitrification system (TVS), an alternative waste treatment technology, has been developed by the DOE Office of Technology Development (EM-50). EM-50, or OTD, is the DOE program concerned with developing, demonstrating, and deploying new methods for environmental restoration and waste management and, as such, has provided the majority of the funding for the development of the TVS. This study reports the results of life cycle benefit-cost-risk analyses of the TVS for a series of use-scenarios proposed for treating mixed low-level waste (MLLW) streams on the ORR in accordance with the Office of Management and Budget (OMB) guidelines contained in OMB Circular 94. The system is designed to produce about 300 lb of glass per hour at its maximum capacity and is capable of processing wet, dry, or slurried waste. When formed into glass by the TVS, MLLW streams meet the Resource Conservation and Recovery Act (RCRA) land disposal requirements (LDR) and can potentially be disposed of as low-level wastes (LLW)

  13. The fitness cost of mis-splicing is the main determinant of alternative splicing patterns.

    Science.gov (United States)

    Saudemont, Baptiste; Popa, Alexandra; Parmley, Joanna L; Rocher, Vincent; Blugeon, Corinne; Necsulea, Anamaria; Meyer, Eric; Duret, Laurent

    2017-10-30

    Most eukaryotic genes are subject to alternative splicing (AS), which may contribute to the production of protein variants or to the regulation of gene expression via nonsense-mediated messenger RNA (mRNA) decay (NMD). However, a fraction of splice variants might correspond to spurious transcripts and the question of the relative proportion of splicing errors to functional splice variants remains highly debated. We propose a test to quantify the fraction of AS events corresponding to errors. This test is based on the fact that the fitness cost of splicing errors increases with the number of introns in a gene and with expression level. We analyzed the transcriptome of the intron-rich eukaryote Paramecium tetraurelia. We show that in both normal and in NMD-deficient cells, AS rates strongly decrease with increasing expression level and with increasing number of introns. This relationship is observed for AS events that are detectable by NMD as well as for those that are not, which invalidates the hypothesis of a link with the regulation of gene expression. Our results show that in genes with a median expression level, 92-98% of observed splice variants correspond to errors. We observed the same patterns in human transcriptomes and we further show that AS rates correlate with the fitness cost of splicing errors. These observations indicate that genes under weaker selective pressure accumulate more maladaptive substitutions and are more prone to splicing errors. Thus, to a large extent, patterns of gene expression variants simply reflect the balance between selection, mutation, and drift.

  14. Cost benefit analysis of remediation alternatives for controlling the flux of strontium-90 into the Columbia River

    International Nuclear Information System (INIS)

    Gustafson, F.W.; Todd, M.E.

    1993-09-01

    The release of large volumes of water to waste disposal cribs at the Hanford Site's 100-N Area caused contaminants, principally strontium-90, to be carried toward the Columbia River through the groundwater. Since shutdown of the N Reactor, these releases have been discontinued, although small water flows continue to be discharged to the 1325-N crib. Most of the contamination which is now transported to the river is occurring as a result of the natural groundwater movement. The contaminated groundwater at N Springs flows into the river through seeps and springs along the river's edge. An expedited response action (ERA) has been proposed to eliminate or restrict the flux of strontium-90 into the river. A cost benefit analysis of potential remedial alternatives was completed that recommends the alternative which best meets given selection criteria prescribed by the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). The methodology used for evaluation, cost analysis, and alternative recommendation is the engineering evaluation/cost analysis (EE/CA). Complete remediation of the contaminated groundwater beneath 100-N Area was not a principal objective of the analysis. The objective of the cost benefit analysis was to identify a remedial alternative that optimizes the degree of benefit produced for the costs incurred

  15. Scilab software as an alternative low-cost computing in solving the linear equations problem

    Science.gov (United States)

    Agus, Fahrul; Haviluddin

    2017-02-01

    Numerical computation packages are widely used both in teaching and research. These packages consist of license (proprietary) and open source software (non-proprietary). One of the reasons to use the package is a complexity of mathematics function (i.e., linear problems). Also, number of variables in a linear or non-linear function has been increased. The aim of this paper was to reflect on key aspects related to the method, didactics and creative praxis in the teaching of linear equations in higher education. If implemented, it could be contribute to a better learning in mathematics area (i.e., solving simultaneous linear equations) that essential for future engineers. The focus of this study was to introduce an additional numerical computation package of Scilab as an alternative low-cost computing programming. In this paper, Scilab software was proposed some activities that related to the mathematical models. In this experiment, four numerical methods such as Gaussian Elimination, Gauss-Jordan, Inverse Matrix, and Lower-Upper Decomposition (LU) have been implemented. The results of this study showed that a routine or procedure in numerical methods have been created and explored by using Scilab procedures. Then, the routine of numerical method that could be as a teaching material course has exploited.

  16. Energy and cost savings results for advanced technology systems from the Cogeneration Technology Alternatives Study /CTAS/

    Science.gov (United States)

    Sagerman, G. D.; Barna, G. J.; Burns, R. K.

    1979-01-01

    The Cogeneration Technology Alternatives Study (CTAS), a program undertaken to identify the most attractive advanced energy conversion systems for industrial cogeneration applications in the 1985-2000 time period, is described, and preliminary results are presented. Two cogeneration options are included in the analysis: a topping application, in which fuel is input to the energy conversion system which generates electricity and waste heat from the conversion system is used to provide heat to the process, and a bottoming application, in which fuel is burned to provide high temperature process heat and waste heat from the process is used as thermal input to the energy conversion system which generates energy. Steam turbines, open and closed cycle gas turbines, combined cycles, diesel engines, Stirling engines, phosphoric acid and molten carbonate fuel cells and thermionics are examined. Expected plant level energy savings, annual energy cost savings, and other results of the economic analysis are given, and the sensitivity of these results to the assumptions concerning fuel prices, price of purchased electricity and the potential effects of regional energy use characteristics is discussed.

  17. Novel low-cost alternative to THz for security and defence applications

    Science.gov (United States)

    Diamond, G. G.; Hutchins, D. A.; Pallav, P.; Green, R. J.

    2008-10-01

    A novel technique of NIR imaging is presented that gives access to most of the applications currently published as being solely suitable for Terahertz (THz) waves. The technique uses NIR beams wavelengths found in ordinary domestic remote controls (circa 850 nm) and various signal recovery techniques commonly found in astronomy. This alternative technique can be realised by very simple and inexpensive electronics and is inherently far more portable and easy to use and no special sources are required. Transmission imaging results from this technique are presented from several industrial examples and various security applications and are compared and contrasted directly with their THz-derived counterparts. It would appear possible to very cheaply and simply emulate the performance of commercial terahertz systems at a fraction of the cost and with greatly reduced processing times Another advantage is that apart from imaging, this technique affords the means to provide simultaneous in-situ chemical-bond analysis for stand-off detection of certain chemical signatures - for example, those found in drugs and explosives (both molecular and oxidiser based). Also, unlike THz, this technique can penetrate bulk water and high humidity atmospheres and be used in transmission mode on biological and medical samples. Several results are presented of non-ionising X-ray type images that even differentiate between separate types of soft tissue

  18. The costs of production of alternative jet fuel: A harmonized stochastic assessment.

    Science.gov (United States)

    Bann, Seamus J; Malina, Robert; Staples, Mark D; Suresh, Pooja; Pearlson, Matthew; Tyner, Wallace E; Hileman, James I; Barrett, Steven

    2017-03-01

    This study quantifies and compares the costs of production for six alternative jet fuel pathways using consistent financial and technical assumptions. Uncertainty was propagated through the analysis using Monte Carlo simulations. The six processes assessed were HEFA, advanced fermentation, Fischer-Tropsch, aqueous phase processing, hydrothermal liquefaction, and fast pyrolysis. The results indicate that none of the six processes would be profitable in the absence of government incentives, with HEFA using yellow grease, HEFA using tallow, and FT revealing the lowest mean jet fuel prices at $0.91/liter ($0.66/liter-$1.24/liter), $1.06/liter ($0.79/liter-$1.42/liter), and $1.15/liter ($0.95/liter-$1.39/liter), respectively. This study also quantifies plant performance in the United States with a Renewable Fuel Standard policy analysis. Results indicate that some pathways could achieve positive NPV with relatively high likelihood under existing policy supports, with HEFA and FPH revealing the highest probability of positive NPV at 94.9% and 99.7%, respectively, in the best-case scenario. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Costs for Alternatives to District Heating. A study of real costs on local heating markets; Alternativkostnad till fjaerrvaerme. En studie av verkliga kostnader paa lokala vaermemarknader

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, Annelie; Lehtmets, Marti; Andersson, Sofie

    2008-07-01

    Heating comprise the major part of the cost of supporting a building with necessities like electricity, heat, refuse collection and water and sewage. As these costs increase, it is becoming more interesting to find other solutions in order to reduce them. One alternative is to convert to another heating system. Several price analyses comparing different heating systems have been performed. Avgiftsgruppen publishes one report on a yearly basis, where the costs to support a building with necessities and how they vary between communities are listed. The latest report states that it is less expensive in 75 % of the communities in Sweden to convert from district heating to a pellets boiler or a ground-source pump. However, other studies have established that the heat market is a local market with local conditions. Therefore you need to compare alternative heating costs that are specific to the area instead of estimated average costs at a national level. The purpose of this survey is to study a local heat market in order to verify the real cost of the alternative heating systems to district heating and if these costs vary between different communities. The hypothesis is that it is not possible to generalize the heating cost on a national level. Instead, a local market should be studied to make an accurate cost comparison between heating options. Three communities are studied in order to find real and verified investment costs in pellet boilers and heat pumps. The investments that are of primary interest are those performed in buildings similar to the multi-dwelling house used in earlier price analyses. Furthermore, the building should be located within the distribution network of district heating in order to illustrate the competition between the heating alternatives. The result of the study illustrates the difficulties to find real and verified costs of completed investments in alternative heating systems in buildings that is of primary interest for this study. Contacts

  20. The generic article

    NARCIS (Netherlands)

    Farkas, D.F.; Swart, Henriëtte de

    2005-01-01

    We take a fresh look at the connection between genericity and (in)definiteness by reconsidering a long-standing puzzle concerning the relation between definiteness and genericity. We contrast English on the one hand and Romance languages and Hungarian on the other, focusing on generic sentences

  1. Use of time and materials and cost reimbursement subcontracts for remedial actions under the alternative remedial contracting strategy contracts. Directive

    International Nuclear Information System (INIS)

    1992-01-01

    The directive is intended to establish agency guidance on the use of time and materials and cost reimbursement contracts for remedial actions in general and to provide specific instruction regarding the use of these approaches in subcontracting under the Alternative Remedial Contracting Strategy (ARCS) contracts

  2. An alternative for cost-effective remediation of depleted uranium (DU) at certain environmental restoration sites.

    Science.gov (United States)

    Miller, M; Galloway, B; VanDerpoel, G; Johnson, E; Copland, J; Salazar, M

    2000-02-01

    Numerous sites in the United States and around the world are contaminated with depleted uranium (DU) in various forms. A prevalent form is fragmented DU originating from various scientific tests involving high explosives and DU during weapon development programs, at firing practice ranges, or war theaters where DU was used in armor-piercing projectiles. The contamination at these sites is typically very heterogeneous, with discreet, visually identifiable DU fragments mixed with native soil. That is, the bulk-averaged DU activity is quite low, while specific DU fragments, which are distinct from the soil matrix, have much higher specific activity. DU is best known as a dark, black metal that is nearly twice as dense as lead, but DU in the environment readily weathers (oxidizes) to a distinctive bright yellow color that is readily visible. While the specific activity (amount of radioactivity per mass of soil) of DU is relatively low and presents only a minor radiological hazard, the fact that it is radioactive and visually identifiable makes it desirable to remove the DU "contamination" from the environment. The typical approach to conducting this DU remediation is to use radiation detection instruments to identify the contaminant and separate it from the adjacent soil, packaging it for disposal as radioactive waste. This process can be performed manually or by specialized, automated equipment. Alternatively, in certain situations a more cost-effective approach might be simple mechanical or gravimetric separation of the DU fragments from the host soil matrix. At SNL/NM, both the automated and simple mechanical approaches have recently been employed. This paper discusses the pros/cons of the two approaches.

  3. A cost-benefit analysis of alternatively fueled buses with special considerations for V2G technology

    International Nuclear Information System (INIS)

    Shirazi, Yosef; Carr, Edward; Knapp, Lauren

    2015-01-01

    Motivated by climate, health and economic considerations, alternatively-fueled bus fleets have emerged worldwide. Two popular alternatives are compressed natural gas (CNG) and electric vehicles. The latter provides the opportunity to generate revenue through vehicle-to-grid (V2G) services if properly equipped. This analysis conducts a robust accounting of the costs of diesel, CNG and battery-electric powertrains for school buses. Both marginal and fleet-wide scenarios are explored. Results indicate that the marginal addition of neither a small CNG nor a small V2G-enabled electric bus is cost effective at current prices. Contrary to previous findings, a small V2G-enabled electric bus increases net present costs by $7,200/seat relative to diesel for a Philadelphia, PA school district. A small CNG bus increases costs by $1,200/seat relative to diesel. This analysis is the first to quantify and include the economic implications of cold temperature extremes on electric vehicle battery operations, and the lower V2G revenues that result. Additional costs and limitations imposed by electric vehicles performing V2G are frequently overlooked in the literature and are explored here. If a variety of technical, legal, and economic challenges are overcome, a future eBus may be economical. - Highlights: • We present a robust cost-benefit analysis of various bus technologies. • Diesel is a low-cost technology at current prices. • CNG represents slightly higher costs on a marginal bus basis. • V2G-enabled electric buses are not cost-effective at current prices. • We identify frequently overlooked costs and challenges to V2G implementation.

  4. Modeling the fiscal costs and benefits of alternative treatment strategies in the United Kingdom for chronic hepatitis C.

    Science.gov (United States)

    Connolly, Mark P; Kotsopoulos, Nikos; Ustianowski, Andrew

    2018-01-01

    Hepatitis C (HCV) infection causes substantial direct health costs, but also impacts broader societal and governmental costs, such as tax revenue and social protection benefits. This study investigated the broader fiscal costs and benefits of curative interventions for chronic Hepatitis C (CHC) that allow individuals to avoid long-term HCV attributed health conditions. A prospective cohort model, assessing the long-term fiscal consequences of policy decisions, was developed for HCV infected individuals, following the generational accounting analytic framework that combines age-specific lifetime gross taxes paid and governmental transfers received (i.e. healthcare and social support costs). The analysis assessed the burden of a theoretical cohort of untreated HCV infected patients with the alternative of treating these patients with a highly efficacious curative intervention (ledipasvir/sofosbuvir [LDV/SOF]). It also compared treating patients at all fibrosis stages (Stages F0-F4) compared to late treatment (Stage F4). Based on projected lifetime work activity and taxes paid, the treated cohort paid an additional £5,900 per patient compared to the untreated cohort. Lifetime government disability costs of £97,555 and £125,359 per patient for treated cohort vs no treatment cohort were estimated, respectively. Lifetime direct healthcare costs in the treated cohort were £32,235, compared to non-treated cohort of £26,424, with an incremental healthcare costs increase of £5,901 per patient. The benefit cost ratio (BCR) of total government benefits and savings relative to government treatment costs (including LDV/SOF) ranged from 1.8-5.6. Treating patients early resulted in 77% less disability costs, 43% lower healthcare costs, and 33% higher tax revenue. The ability to cure Hepatitis C offers considerable fiscal benefits beyond direct medical costs and savings attributed to reduced disability costs, public allowances, and improved tax revenue. Changes in parameters

  5. Alternate bidding strategies for asphalt and concrete pavement projects utilizing life cycle cost analysis (LCCA).

    Science.gov (United States)

    2012-07-01

    Recent changes in pavement materials costs have impacted the competitive environment relative to the : determination of the most cost effective pavement structure for a specific highway project. In response, State : highway agencies have renewed thei...

  6. Is Accelerated Partner Therapy (APT) a cost-effective alternative to routine patient referral partner notification in the UK? Preliminary cost-consequence analysis of an exploratory trial.

    Science.gov (United States)

    Roberts, Tracy E; Tsourapas, Angelos; Sutcliffe, Lorna; Cassell, Jackie; Estcourt, Claudia

    2012-02-01

    To undertake a cost-consequence analysis to assess two new models of partner notification (PN), known as Accelerated Partner Therapy (APT Hotline and APT Pharmacy), as compared with routine patient referral PN, for sex partners of people with chlamydia, gonorrhoea and non-gonococcal urethritis. Comparison of costs and outcomes alongside an exploratory trial involving two genitourinary medicine clinics and six community pharmacies. Index patients selected the PN method (APT Hotline, APT Pharmacy or routine PN) for their partners. Clinics and pharmacies recorded cost and resource use data including duration of consultation and uptake of treatment pack. Cost data were collected prospectively for two out of three interventions, and data were synthesised and compared in terms of effectiveness and costs. Routine PN had the lowest average cost per partner treated (approximately £46) compared with either APT Hotline (approximately £54) or APT Pharmacy (approximately £53) strategies. The cost-consequence analysis revealed that APT strategies were more costly but also more effective at treating partners compared to routine PN. The hotline strategy costs more than both the alternative PN strategies. If we accept that strategies which identify and treat partners the fastest are likely to be the most effective in reducing reinfection and onward transmission, then APT Hotline appears an effective PN strategy by treating the highest number of partners in the shortest duration. Whether the additional benefit is worth the additional cost cannot be determined in this preliminary analysis. These data will be useful for informing development of future randomised controlled trials of APT.

  7. An Analysis of Alternatives for Reducing Outpatient Military Health Care Costs for Active Duty Members and their Families: Implementing a Recommended Savings Strategy Using Defense Acquisition Principles

    National Research Council Canada - National Science Library

    Jaime, Richardo; Rupert, Joshua W

    2007-01-01

    .... In efforts to reduce or contain the costs of the military health care system, this project will propose two cost savings alternatives for providing outpatient care to active duty personnel and their dependents...

  8. Beyond free electricity: the costs of electric cooking in poor households and a market-friendly alternative

    International Nuclear Information System (INIS)

    Howells, M.; Alfstad, T.; Victor, D.G.; Elias, R.J.; Gaunt, T.

    2006-01-01

    The South African government is introducing a poverty-reduction policy that will supply households with a monthly 50 kWh free basic electricity (FBE) subsidy. We show that FBE distorts the energy choices of poor households by encouraging them to cook with electricity, whereas alternatives such as liquefied petroleum gas (LPG) can deliver a similar cooking service at a much lower cost to society. An alternative energy scheme, such as providing households with clean energy credits equivalent in value to the FBE's cost, could deliver additional energy services worth at least 6% of total household welfare (and probably much more) at no additional public cost; those benefits are so large that they would cover the entire cost of LPG fuel needed to implement the scheme. The analysis is extremely sensitive to the coincidence of electric cooking with peak power demand on the South African grid and to assumptions regarding how South Africa will meet its looming shortfall in peak power capacity. One danger of FBE is that actual peak coincidence and the costs of supplying peak power could be much less favorable than we assume, and such uncertainties expose the South African power system to potentially very high costs of service. (author)

  9. Beyond free electricity: The costs of electric cooking in poor households and a market-friendly alternative

    International Nuclear Information System (INIS)

    Howells, Mark; Victor, David G.; Gaunt, Trevor; Elias, Rebecca J.; Alfstad, Thomas

    2006-01-01

    The South African government is introducing a poverty-reduction policy that will supply households with a monthly 50 kWh free basic electricity (FBE) subsidy. We show that FBE distorts the energy choices of poor households by encouraging them to cook with electricity, whereas alternatives such as liquefied petroleum gas (LPG) can deliver a similar cooking service at a much lower cost to society. An alternative energy scheme, such as providing households with clean energy credits equivalent in value to the FBE's cost, could deliver additional energy services worth at least 6% of total household welfare (and probably much more) at no additional public cost; those benefits are so large that they would cover the entire cost of LPG fuel needed to implement the scheme. The analysis is extremely sensitive to the coincidence of electric cooking with peak power demand on the South African grid and to assumptions regarding how South Africa will meet its looming shortfall in peak power capacity. One danger of FBE is that actual peak coincidence and the costs of supplying peak power could be much less favorable than we assume, and such uncertainties expose the South African power system to potentially very high costs of service

  10. Marginal abatement cost curves for NOx incorporating both controls and alternative measures

    Science.gov (United States)

    A marginal abatement cost curve (MACC) traces out the efficient marginal abatement cost level for any aggregate emissions target when a least cost approach is implemented. In order for it to represent the efficient MAC level, all abatement opportunities across all sectors and loc...

  11. Development of a Cost Estimation Process for Human Systems Integration Practitioners During the Analysis of Alternatives

    Science.gov (United States)

    2010-12-01

    processes. Novice estimators must often use of these complicated cost estimation tools (e.g., ACEIT , SEER-H, SEER-S, PRICE-H, PRICE-S, etc.) until...However, the thesis will leverage the processes embedded in cost estimation tools such as the Automated Cost Estimating Integration Tool ( ACEIT ) and the

  12. Calculation of economic viability of alternative energy sources considering its environmental costs for small communities of Northeast Brazil

    International Nuclear Information System (INIS)

    Stecher, Luiza Chourkalo

    2014-01-01

    There has been an increasing concern about current environmental issues caused by human activity, as the world searches for development. The production of electricity is an extremely relevant factor in this scenario since it is responsible for a large portion of the emissions that cause the greenhouse effect. Due to this fact, a sustainable development with alternative energy sources, which are attractive for such purpose, must be proposed, especially in places that are not supplied by the conventional electricity grid such as many communities in the Northeast Brazil. This work aims to calculate the environmental cost for the alternative sources of energy - solar, wind and biomass - during electricity generation, and to estimate the economic feasibility of those sources in small communities of Northeast Brazil, considering the avoided costs. The externalities must be properly identified and valued so the costs or benefits can be internalized and reflect accurately the economic feasibility or infeasibility of those sources. For this, the method of avoided costs was adopted for the calculation of externalities. This variable was included in the equation developed for all considered alternative energy sources. The calculations of economic feasibility were performed taking the new configurations in consideration, and the new equation was reprogrammed in the Programa de Calculo de Custos de Energias Alternativas, Solar, Eolica e Biomassa (PEASEB). The results demonstrated that the solar photovoltaic energy in isolated systems is the most feasible and broadly applicable source for small communities of Northeast Brazil. (author)

  13. Comparison of costs for alternative mixed low-level waste treatment systems

    International Nuclear Information System (INIS)

    Schwinkendorf, W.E.; Harvego, L.; Cooley, C.R.; Biagi, C.

    1996-01-01

    Total life cycle costs (TLCCs), including disposal costs, of thermal, nonthermal and enhanced nonthermal systems were evaluated to guide future research and development programs for the treatment of mixed low-level waste (MLLW) consisting of RCRA hazardous and low-level radioactive wastes. In these studies, nonthermal systems are defined as those systems that process waste at temperatures less than 350 C. Preconceptual designs and costs were developed for thirty systems with a capacity (2,927 lbs/hr) to treat the DOE MLLW stored inventor y(approximately 236 million pounds) in 20 years in a single, centralized facility. A limited comparison of the studies' results is presented in this paper. Sensitivity of treatment costs with respect to treatment capacity, number of treatment facilities, and system availability were also determined. The major cost element is operations and maintenance (O and M), which is 50 to 60% of the TLCC for both thermal and nonthermal systems. Energy costs constitute a small fraction (< 1%) of the TLCCs. Equipment cost is only 3 to 5% of the treatment cost. Evaluation of subsystem costs demonstrate that receiving and preparation is the highest cost subsystem at about 25 to 30% of the TLCC for both thermal and nonthermal systems. These studies found no cost incentives to use nonthermal or hybrid (combined nonthermal treatment with stabilization by vitrification) systems in place of thermal systems. However, there may be other incentives including fewer air emissions and less local objection to a treatment facility. Building multiple treatment facilities to treat the same total mass of waste as a single facility would increase the total treatment cost significantly, and improved system availability decreases unit treatment costs by 17% to 30%

  14. Cost-effectiveness of alternative changes to a national blood collection service.

    Science.gov (United States)

    Willis, S; De Corte, K; Cairns, J A; Zia Sadique, M; Hawkins, N; Pennington, M; Cho, G; Roberts, D J; Miflin, G; Grieve, R

    2018-05-16

    To evaluate the cost-effectiveness of changing opening times, introducing a donor health report and reducing the minimum inter-donation interval for donors attending static centres. Evidence is required about the effect of changes to the blood collection service on costs and the frequency of donation. This study estimated the effect of changes to the blood collection service in England on the annual number of whole-blood donations by current donors. We used donors' responses to a stated preference survey, donor registry data on donation frequency and deferral rates from the INTERVAL trial. Costs measured were those anticipated to differ between strategies. We reported the cost per additional unit of blood collected for each strategy versus current practice. Strategies with a cost per additional unit of whole blood less than £30 (an estimate of the current cost of collection) were judged likely to be cost-effective. In static donor centres, extending opening times to evenings and weekends provided an additional unit of whole blood at a cost of £23 and £29, respectively. Introducing a health report cost £130 per additional unit of blood collected. Although the strategy of reducing the minimum inter-donation interval had the lowest cost per additional unit of blood collected (£10), this increased the rate of deferrals due to low haemoglobin (Hb). The introduction of a donor health report is unlikely to provide a sufficient increase in donation frequency to justify the additional costs. A more cost-effective change is to extend opening hours for blood collection at static centres. © 2018 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.

  15. The Cost-Effectiveness of Alternative Instruments for Environmental Protection in a Second-Best Setting

    OpenAIRE

    Lawrence H. Goulder; Ian W. H. Parry; Roberton C. Williams III; Dallas Burtraw

    1998-01-01

    This paper employs analytical and numerical general equilibrium models to examine the costs of achieving pollution reductions under a range of environmental policy instruments in a second-best setting with pre-existing factor taxes. We compare the costs and overall efficiency impacts of emissions taxes, emissions quotas, fuels taxes, performance standards, and mandated technologies, and explore how costs change with the magnitude of pre-existing taxes and the extent of pollution abatement. We...

  16. Assessment of costs and benefits of flexible and alternative fuel use in the US transportation sector

    Energy Technology Data Exchange (ETDEWEB)

    None

    1993-01-01

    The primary objective of this report is to provide estimates of volumes and development costs of known nonassociated gas reserves in selected, potentially important supplier nations, using a standard set of costing algorithms and conventions. Estimates of undeveloped nonassociated gas reserves and the cost of drilling development wells, production equipment, gas processing facilities, and pipeline construction are made at the individual field level. A discounted cash-flow model of production, investment, and expenses is used to estimate the present value cost of developing each field on a per-thousand-cubic-foot (Mcf) basis. These gas resource cost estimates for individual accumulations (that is, fields or groups of fields) then were aggregated into country-specific price-quantity curves. These curves represent the cost of developing and transporting natural gas to an export point suitable for tanker shipments or to a junction with a transmission line. The additional costs of LNG or methanol conversion are not included. A brief summary of the cost of conversion to methanol and transportation to the United States is contained in Appendix D: Implications of Gas Development Costs for Methanol Conversion.

  17. Comparative review of three cost-effectiveness models for rotavirus vaccines in national immunization programs; a generic approach applied to various regions in the world

    NARCIS (Netherlands)

    Postma, Maarten J.; Jit, Mark; Rozenbaum, Mark H.; Standaert, Baudouin; Tu, Hong-Anh; Hutubessy, Raymond C. W.

    2011-01-01

    Background: This study aims to critically review available cost-effectiveness models for rotavirus vaccination, compare their designs using a standardized approach and compare similarities and differences in cost-effectiveness outcomes using a uniform set of input parameters. Methods: We identified

  18. Table sugar as an alternative low cost medium component for in ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-08-04

    Aug 4, 2008 ... In view of this, the aim of this research was to evaluate alternative cheap sources of ... randomized complete block design was used to compare laboratory ..... tuberosum L.) encapsulated in calcium alginate hollow beads.

  19. Portfolio theory and the alternative decision rule of cost-effectiveness analysis: theoretical and practical considerations.

    Science.gov (United States)

    Sendi, Pedram; Al, Maiwenn J; Gafni, Amiram; Birch, Stephen

    2004-05-01

    Bridges and Terris (Soc. Sci. Med. (2004)) critique our paper on the alternative decision rule of economic evaluation in the presence of uncertainty and constrained resources within the context of a portfolio of health care programs (Sendi et al. Soc. Sci. Med. 57 (2003) 2207). They argue that by not adopting a formal portfolio theory approach we overlook the optimal solution. We show that these arguments stem from a fundamental misunderstanding of the alternative decision rule of economic evaluation. In particular, the portfolio theory approach advocated by Bridges and Terris is based on the same theoretical assumptions that the alternative decision rule set out to relax. Moreover, Bridges and Terris acknowledge that the proposed portfolio theory approach may not identify the optimal solution to resource allocation problems. Hence, it provides neither theoretical nor practical improvements to the proposed alternative decision rule.

  20. Least-cost electrical services as an alternative to the braidwood project

    International Nuclear Information System (INIS)

    Lovins, A.

    1985-01-01

    This book is a summary of testimony before the Illinois Commerce Commission. The author argues that even if it cost nothing to build the Braidwood plant, it would cost less to write it off and buy electricity-saving measures instead

  1. A new harvest operation cost model to evaluate forest harvest layout alternatives

    Science.gov (United States)

    Mark M. Clark; Russell D. Meller; Timothy P. McDonald; Chao Chi Ting

    1997-01-01

    The authors develop a new model for harvest operation costs that can be used to evaluate stands for potential harvest. The model is based on felling, extraction, and access costs, and is unique in its consideration of the interaction between harvest area shapes and access roads. The scientists illustrate the model and evaluate the impact of stand size, volume, and road...

  2. Alternative strategies to reduce cost and waste volume in HEPA filtration using metallic filter media - 59348

    International Nuclear Information System (INIS)

    Chadwick, Chris

    2012-01-01

    Document available in abstract form only. Full text of publication follows: The disposal costs of contaminated HEPA and THE filter elements have been proved to be disproportionately high compared with the cost of the elements themselves. Work published elsewhere (Moore, et el 1992; Bergman et al 1997) suggests that the cost of use of traditional, panel type, glass fibre HEPA filtration trains to the DOE was, during that period, $29.5 million, based on a five year life cycle, and including installation, testing, removal and disposal life cycle costs being based on estimates dating from 1987-1990. Within that cost estimate, $300 was the value given to the filter and $4, 450 was given to the peripheral activity. Clearly, if the $4, 450 component could be reduced, tremendous saving could ensue, in addition to the reduction of the legacy burden of waste volume. This issue exists for operators in both the US and in Europe. If HEPA filters could be cleaned to a condition where they could either be re-used or decontaminated to the extent that they could be stored as a lower cost wasteform or if HEPA/THE filter elements were available without any organic content likely to give rise to flammable or explosive decomposition gases during long term storage this would also reduce the costs and monitoring necessary in storage. (author)

  3. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Directory of Open Access Journals (Sweden)

    Lacy, Kyle

    2015-01-01

    Full Text Available Traumatic dislocations of the shoulder commonly present to emergency departments (EDs. Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. [West J Emerg Med. 2015;16(1:114–120.

  4. A multicenter experience with generic tacrolimus conversion.

    Science.gov (United States)

    McDevitt-Potter, Lisa M; Sadaka, Basma; Tichy, Eric M; Rogers, Christin C; Gabardi, Steven

    2011-09-27

    The first generic tacrolimus product gained Food and Drug Administration approval in August 2009. This prospective, observational trial sought to determine the need for dose titrations and measure drug cost savings on conversion to generic tacrolimus. Transplant recipients on stable tacrolimus doses were converted from brand to generic tacrolimus on a mg:mg basis. Data were collected at the time of generic conversion (study arm) and at a time point exactly 6 months before conversion (control arm) for all subjects. Seventy conversions from four centers are reported. Subjects were a mean of 70 months after kidney (n=37), liver (n=28), or multiorgan (n=5) transplant. In the study arm, mean tacrolimus doses were 4.4 and 4.5 mg/d and mean tacrolimus trough concentrations were 5.8 and 5.9 ng/mL before and after conversion, respectively. In the control arm, mean tacrolimus doses were 4.6 and 4.6 mg/d and mean tacrolimus trough concentrations were 6.1 and 5.9 ng/mL before and after the control time point, respectively. Dose titrations occurred in five patients (7%) in the control arm and 15 patients (21%) in the study arm (P=0.028). Mean monthly drug costs were $645 for brand, $593 for generic, and $595 for generic after dose titrations. Mean monthly patient copays were $38 for brand and $15 for generic. These cumulative data show that dose requirements and trough levels are similar between brand and generic tacrolimus and that generic substitution allows for savings. However, postconversion monitoring is prudent as patients may require dose titration.

  5. Transitional orientation: a cost-effective alternative to traditional RN residency programs.

    Science.gov (United States)

    Guthrie, Kimberly; Tyrna, Jaime; Giannuzzi, Donna

    2013-01-01

    Recruitment, orientation, and development costs, particularly for inexperienced RNs, challenge hospitals to find cost-effective methods to assure patients receive competent nursing care. Nurse leaders at the Lee Memorial Health System (LMHS) initiated a multifaceted development methodology called the Transitional Orientation Program, designed to develop and retain competent RNs. To assist in the intensive development needs required by the transitional unit interns and for other inexperienced RNs assigned initially to their unit of hire, LMHS established new clinical educator positions called intern development specialists (IDS). Results of this initiative showed a significant decrease in total orientation times and costs, and a dramatic increase in retention rates of inexperienced RNs.

  6. Alternative wind power modeling methods using chronological and load duration curve production cost models

    Energy Technology Data Exchange (ETDEWEB)

    Milligan, M R

    1996-04-01

    As an intermittent resource, capturing the temporal variation in windpower is an important issue in the context of utility production cost modeling. Many of the production cost models use a method that creates a cumulative probability distribution that is outside the time domain. The purpose of this report is to examine two production cost models that represent the two major model types: chronological and load duration cure models. This report is part of the ongoing research undertaken by the Wind Technology Division of the National Renewable Energy Laboratory in utility modeling and wind system integration.

  7. Cost-effectiveness of alternative management strategies for patients with solitary pulmonary nodules.

    Science.gov (United States)

    Gould, Michael K; Sanders, Gillian D; Barnett, Paul G; Rydzak, Chara E; Maclean, Courtney C; McClellan, Mark B; Owens, Douglas K

    2003-05-06

    Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is a potentially useful but expensive test to diagnose solitary pulmonary nodules. To evaluate the cost-effectiveness of strategies for pulmonary nodule diagnosis and to specifically compare strategies that did and did not include FDG-PET. Decision model. Accuracy and complications of diagnostic tests were estimated by using meta-analysis and literature review. Modeled survival was based on data from a large tumor registry. Cost estimates were derived from Medicare reimbursement and other sources. All adult patients with a new, noncalcified pulmonary nodule seen on chest radiograph. Patient lifetime. Societal. 40 clinically plausible combinations of 5 diagnostic interventions, including computed tomography, FDG-PET, transthoracic needle biopsy, surgery, and watchful waiting. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. The cost-effectiveness of strategies depended critically on the pretest probability of malignancy. For patients with low pretest probability (26%), strategies that used FDG-PET selectively when computed tomography results were possibly malignant cost as little as 20 000 dollars per QALY gained. For patients with high pretest probability (79%), strategies that used FDG-PET selectively when computed tomography results were benign cost as little as 16 000 dollars per QALY gained. For patients with intermediate pretest probability (55%), FDG-PET strategies cost more than 220 000 dollars per QALY gained because they were more costly but only marginally more effective than computed tomography-based strategies. The choice of strategy also depended on the risk for surgical complications, the probability of nondiagnostic needle biopsy, the sensitivity of computed tomography, and patient preferences for time spent in watchful waiting. In probabilistic sensitivity analysis, FDG-PET strategies were cost saving or cost less than 100 000 dollars per QALY

  8. Cost-Effectiveness of Alternative Blood-Screening Strategies for West Nile Virus in the United States.

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available BACKGROUND: West Nile virus (WNV is endemic in the US, varying seasonally and by geographic region. WNV can be transmitted by blood transfusion, and mandatory screening of blood for WNV was recently introduced throughout the US. Guidelines for selecting cost-effective strategies for screening blood for WNV do not exist. METHODS AND FINDINGS: We conducted a cost-effectiveness analysis for screening blood for WNV using a computer-based mathematical model, and using data from prospective studies, retrospective studies, and published literature. For three geographic areas with varying WNV-transmission intensity and length of transmission season, the model was used to estimate lifetime costs, quality-adjusted life expectancy, and incremental cost-effectiveness ratios associated with alternative screening strategies in a target population of blood-transfusion recipients. We compared the status quo (baseline screening using a donor questionnaire to several strategies which differed by nucleic acid testing of either pooled or individual samples, universal versus targeted screening of donations designated for immunocompromised patients, and seasonal versus year-long screening. In low-transmission areas with short WNV seasons, screening by questionnaire alone was the most cost-effective strategy. In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients was the most cost-effective strategy. Seasonal screening of the entire recipient pool added minimal clinical benefit, with incremental cost-effectiveness ratios exceeding US$1.7 million per quality-adjusted life-year gained. Year-round screening offered no additional benefit compared to seasonal screening in any of the transmission settings. CONCLUSIONS: In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations

  9. Cost-effectiveness of alternative blood-screening strategies for West Nile Virus in the United States.

    Directory of Open Access Journals (Sweden)

    Caroline T Korves

    2006-02-01

    Full Text Available West Nile virus (WNV is endemic in the US, varying seasonally and by geographic region. WNV can be transmitted by blood transfusion, and mandatory screening of blood for WNV was recently introduced throughout the US. Guidelines for selecting cost-effective strategies for screening blood for WNV do not exist.We conducted a cost-effectiveness analysis for screening blood for WNV using a computer-based mathematical model, and using data from prospective studies, retrospective studies, and published literature. For three geographic areas with varying WNV-transmission intensity and length of transmission season, the model was used to estimate lifetime costs, quality-adjusted life expectancy, and incremental cost-effectiveness ratios associated with alternative screening strategies in a target population of blood-transfusion recipients. We compared the status quo (baseline screening using a donor questionnaire to several strategies which differed by nucleic acid testing of either pooled or individual samples, universal versus targeted screening of donations designated for immunocompromised patients, and seasonal versus year-long screening. In low-transmission areas with short WNV seasons, screening by questionnaire alone was the most cost-effective strategy. In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients was the most cost-effective strategy. Seasonal screening of the entire recipient pool added minimal clinical benefit, with incremental cost-effectiveness ratios exceeding USD 1.7 million per quality-adjusted life-year gained. Year-round screening offered no additional benefit compared to seasonal screening in any of the transmission settings.In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients is cost

  10. Comparative review of three cost-effectiveness models for rotavirus vaccines in national immunization programs; a generic approach applied to various regions in the world

    Directory of Open Access Journals (Sweden)

    Tu Hong-Anh

    2011-07-01

    Full Text Available Abstract Background This study aims to critically review available cost-effectiveness models for rotavirus vaccination, compare their designs using a standardized approach and compare similarities and differences in cost-effectiveness outcomes using a uniform set of input parameters. Methods We identified various models used to estimate the cost-effectiveness of rotavirus vaccination. From these, results using a standardized dataset for four regions in the world could be obtained for three specific applications. Results Despite differences in the approaches and individual constituting elements including costs, QALYs Quality Adjusted Life Years and deaths, cost-effectiveness results of the models were quite similar. Differences between the models on the individual components of cost-effectiveness could be related to some specific features of the respective models. Sensitivity analysis revealed that cost-effectiveness of rotavirus vaccination is highly sensitive to vaccine prices, rotavirus-associated mortality and discount rates, in particular that for QALYs. Conclusions The comparative approach followed here is helpful in understanding the various models selected and will thus benefit (low-income countries in designing their own cost-effectiveness analyses using new or adapted existing models. Potential users of the models in low and middle income countries need to consider results from existing studies and reviews. There will be a need for contextualization including the use of country specific data inputs. However, given that the underlying biological and epidemiological mechanisms do not change between countries, users are likely to be able to adapt existing model designs rather than developing completely new approaches. Also, the communication established between the individual researchers involved in the three models is helpful in the further development of these individual models. Therefore, we recommend that this kind of comparative study

  11. Cost-benefit analysis of alternative LNG vapor-mitigation measures. Topical report, September 14, 1987-January 15, 1991

    International Nuclear Information System (INIS)

    Atallah, S.

    1992-01-01

    A generalized methodology is presented for comparing the costs and safety benefits of alternative hazard mitigation measures for a large LNG vapor release. The procedure involves the quantification of the risk to the public before and after the application of LNG vapor mitigation measures. In the study, risk was defined as the product of the annual accident frequency, estimated from a fault tree analysis, and the severity of the accident. Severity was measured in terms of the number of people who may be exposed to 2.5% or higher concentration. The ratios of the annual costs of the various mitigation measures to their safety benefits (as determined by the differences between the risk before and after mitigation measure implementation), were then used to identify the most cost-effective approaches to vapor cloud mitigation

  12. Novel, low-cost alternative technologies to tackle practical, industrial conundrums – a case study of batteries

    Directory of Open Access Journals (Sweden)

    Chan Victor K. Y.

    2016-01-01

    Full Text Available Whereas batteries in comparison with most other means of energy storage are more environmentally friendly and economical in their operation, they are beset by low energy replenishment rates, low energy storage density, high capital cost of themselves, and high capital cost of energy replenishment infrastructures. Mainly based on ergonomics, this paper proposes a novel, low-cost alternative technology to practically and industrially make these weaknesses irrelevant to some extent without calling for revolutionary technological breakthroughs in material science, batteries’ microstructures, or battery manufacturing technologies. The technology takes advantage of modularization of battery systems, prioritization of charging and discharging of battery module(s according to ease of unloading and/or loading the battery module(s and/or ease of loading replacement battery module(s of the battery module(s.

  13. A Comparison of Alternative Strategies for Cost-Effective Water Quality Management in Lakes

    Science.gov (United States)

    Kramer, Daniel Boyd; Polasky, Stephen; Starfield, Anthony; Palik, Brian; Westphal, Lynne; Snyder, Stephanie; Jakes, Pamela; Hudson, Rachel; Gustafson, Eric

    2006-09-01

    Roughly 45% of the assessed lakes in the United States are impaired for one or more reasons. Eutrophication due to excess phosphorus loading is common in many impaired lakes. Various strategies are available to lake residents for addressing declining lake water quality, including septic system upgrades and establishing riparian buffers. This study examines 25 lakes to determine whether septic upgrades or riparian buffers are a more cost-effective strategy to meet a phosphorus reduction target. We find that riparian buffers are the more cost-effective strategy in every case but one. Large transaction costs associated with the negotiation and monitoring of riparian buffers, however, may be prohibiting lake residents from implementing the most cost-effective strategy.

  14. Alternative measures of the Federal Reserve Banks' cost of equity capital

    OpenAIRE

    Barnes, Michelle L.; Lopez, Jose A.

    2005-01-01

    The Monetary Control Act of 1980 requires the Federal Reserve System to provide payment services to depository institutions through the twelve Federal Reserve Banks at prices that fully reflect the costs a private-sector provider would incur, including a cost of equity capital (COE). Although Fama and French (1997) conclude that COE estimates are “woefully” and “unavoidably” imprecise, the Reserve Banks require such an estimate every year. We examine several COE estimates based on the Capital...

  15. [Variability and opportunity costs among the surgical alternatives for breast cancer].

    Science.gov (United States)

    Angulo-Pueyo, Ester; Ridao-López, Manuel; Martínez-Lizaga, Natalia; García-Armesto, Sandra; Bernal-Delgado, Enrique

    2014-01-01

    To analyze medical practice variation in breast cancer surgery (either inpatient-based or day-case surgery), by comparing conservative surgery (CS) plus radiotherapy vs. non-conservative surgery (NCS). We also analyzed the opportunity costs associated with CS and NCS. We performed an observational study of age- and sex-standardized rates of CS and NCS, performed in 199 Spanish healthcare areas in 2008-2009. Costs were calculated by using two techniques: indirectly, by using All-Patients Diagnosis Related Groups (AP-DRG) based on hospital admissions, and directly by using full costing from the Spanish Network of Hospital Costs (SNHC) data. Standardized surgery rates for CS and NCS were 6.84 and 4.35 per 10,000 women, with variation across areas ranging from 2.95 to 3.11 per 10,000 inhabitants. In 2009, 9% of CS was performed as day-case surgery, although a third of the health care areas did not perform this type of surgery. Taking the SNHC as a reference, the cost of CS was estimated at 7,078 € and that of NCS was 6,161 €. Using AP-DRG, costs amounted to 9,036 € and 8,526 €, respectively. However, CS had lower opportunity costs than NCS when day-case surgery was performed frequently-more than 46% of cases (following SNHC estimates) or 23% of cases (following AP-DRG estimates). Day-case CS for breast cancer was found to be the best option in terms of opportunity-costs beyond a specific threshold, when both CS and NCS are elective. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  16. Cost-effectiveness analysis of treatment alternatives for beef bulls with preputial prolapse.

    Science.gov (United States)

    Kasari, T R; McGrann, J M; Hooper, R N

    1997-10-01

    To develop an economic model for comparing cost-effectiveness of medical and surgical treatment versus replacement of beef bulls with preputial prolapse. Economic analysis. Estimates determined from medical records of bulls treated for preputial prolapse at our hospital and from information about treatment of bulls published elsewhere. Annual depreciation cost for treatment (ADC(T)) and replacement (ADC(R)) were calculated. Total investment for an injured bull equaled the sum of salvage value, maintenance cost, and expected cost of the treatment option under consideration. Total investment for a replacement bull was purchase price. Net present value of cost was calculated for each year of bull use. Sensitivity analyses were constructed to determine the value that would warrant treatment of an injured bull. The decision to treat was indicated when ADC(T) was less than ADC(R). In our example, it was more cost-effective for owners to cull an injured bull. The ADC(R) was $97 less than ADC(T) for medical treatment ($365 vs $462) and $280 less than ADC(T) for surgical treatment ($365 vs $645). Likewise, net present value of cost values indicated that it was more cost-effective for owners to cull an injured bull. Sensitivity analysis indicated treatment decisions were justified on the basis of replacement value or planned number of breeding seasons remaining for the bull. The model described here can be used by practitioners to provide an objective basis to guide decision making of owners who seek advice on whether to treat or replace bulls with preputial prolapse.

  17. Efficient Generic Functional Programming

    NARCIS (Netherlands)

    Alimarine, A.; Smetsers, J.E.W.

    2005-01-01

    Generic functions are defined by induction on the structural representation of types. As a consequence, by defining just a single generic operation, one acquires this operation over any particular data type. An instance on a specific type is generated by interpretation of the type's structure. A

  18. Optimizing Generic Functions

    NARCIS (Netherlands)

    Alimarine, A.; Smetsers, J.E.W.

    2004-01-01

    Generic functions are defined by induction on the structural representation of types. As a consequence, by defining just a single generic operation, one acquires this operation over any particular type. An instance on a specific type is generated by interpretation of the type's structure. A direct

  19. Life cycle cost analysis to examine the economical feasibility of hydrogen as an alternative fuel

    International Nuclear Information System (INIS)

    Lee, Ji-Yong; Yoo, Moosang; Cha, Kyounghoon; Hur, Tak; Lim, Tae Won

    2009-01-01

    This study uses a life cycle costing (LCC) methodology to identify when hydrogen can become economically feasible compared to the conventional fuels and which energy policy is the most effective at fostering the penetration of hydrogen in the competitive fuel market. The target hydrogen pathways in this study are H 2 via natural gas steam reforming (NG SR), H 2 via naphtha steam reforming (Naphtha SR), H 2 via liquefied petroleum gas steam reforming (LPG SR), and H 2 via water electrolysis (WE). In addition, the conventional fuels (gasoline, diesel) are also included for the comparison with the H 2 pathways. The life cycle costs of the target fuels are computed and several key factors are examined to identify the economical feasibilities of the target systems: fuel cell vehicle (FCV) price, social cost of greenhouse gases (GHGs) and regulated air emissions (CO, VOC, SO x , NO x , PM), fuel efficiency of FCV, capital costs of H 2 equipments at a H 2 fueling station. The life cycle costs of a H 2 pathway also depend on the production capacity. Although, at present, all H 2 pathways are more cost efficient than the conventional fuels in the fuel utilization stage, the H 2 pathways have lack competitiveness against the conventional fuels in the life cycle (well to wheel) costs due to the high price of FCV. From future scenario analyses in 2015, all H 2 pathways are expected to have lower life cycle costs than the conventional fuels as a transportation fuel. It is evident that the FCV price is the most important factor for encouraging the hydrogen economy and FCVs. Unless the FCV price is below US $62,320, it is necessary for the institution to subsidize the FCV price by any amount over US $62,320 in order to inject H 2 into the market of transportation fuel. The incentive or taxes on GHGs and regulated air emissions are also expected to effectively encourage the diffusion of H 2 and FCV, especially for the H 2 pathway of WE with wind power (WE[Wind]). The uncertainties

  20. Levelised unit electricity cost comparison of alternate technologies for baseload generation in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Ayres, M.; McRae, M.; Stogran, M.

    2004-08-15

    This report provides a comparison of the lifetime cost of constructing, operating and decommissioning new generation suitable for supplying baseload power by early in the next decade. New baseload generation options in Ontario are nuclear, coal-fired steam turbines or combined cycle gas turbines (CCGT). Nuclear and coal-fired units are characterised by high capital costs and low operating costs. As such, they are candidates for baseload operation only. Gas-fired generation is characterised by lower capital costs and higher operating costs and thus may meet the requirements for operation as peaking and/or baseload generation. The comparison of baseload generating technologies is made by reference to the estimated levelised unit electricity cost (LUEC). The LUEC can be thought of as a 'supply cost', where the unit cost is the price needed to recover all costs over the period. It is determined by finding the price that sets the sum of all future discounted cash flows (net present value, or NPV) to zero. It can also be thought of as representing the constant real wholesale price of electricity that meets the financing cost, debt repayment, income tax and cash flow constraints associated with the construction operation and decommissioning of a generating plant. Levelised unit cost comparisons are usually made with different sets of financing assumptions. This report considers two base cases, which we describe as 'merchant' and 'public' financing. The term 'merchant plant' is used to refer to ones that are built and operated by private investors. These investors pay for their capital through debt and by raising equity, and thus pay return on equity and interest on debt throughout their lifetime. These projects include income taxes, both provincial and federal. Publicly financed projects typically are not subject to income taxes or to the same constraints on raising finance through issuing debt and equity. However, they are

  1. Levelised unit electricity cost comparison of alternate technologies for baseload generation in Ontario

    International Nuclear Information System (INIS)

    Ayres, M.; McRae, M.; Stogran, M.

    2004-08-01

    This report provides a comparison of the lifetime cost of constructing, operating and decommissioning new generation suitable for supplying baseload power by early in the next decade. New baseload generation options in Ontario are nuclear, coal-fired steam turbines or combined cycle gas turbines (CCGT). Nuclear and coal-fired units are characterised by high capital costs and low operating costs. As such, they are candidates for baseload operation only. Gas-fired generation is characterised by lower capital costs and higher operating costs and thus may meet the requirements for operation as peaking and/or baseload generation. The comparison of baseload generating technologies is made by reference to the estimated levelised unit electricity cost (LUEC). The LUEC can be thought of as a 'supply cost', where the unit cost is the price needed to recover all costs over the period. It is determined by finding the price that sets the sum of all future discounted cash flows (net present value, or NPV) to zero. It can also be thought of as representing the constant real wholesale price of electricity that meets the financing cost, debt repayment, income tax and cash flow constraints associated with the construction operation and decommissioning of a generating plant. Levelised unit cost comparisons are usually made with different sets of financing assumptions. This report considers two base cases, which we describe as 'merchant' and 'public' financing. The term 'merchant plant' is used to refer to ones that are built and operated by private investors. These investors pay for their capital through debt and by raising equity, and thus pay return on equity and interest on debt throughout their lifetime. These projects include income taxes, both provincial and federal. Publicly financed projects typically are not subject to income taxes or to the same constraints on raising finance through issuing debt and equity. However, they are constrained to provide a rate of return. The

  2. Financial and accounting alternatives for the recovery of nuclear plant decommissioning costs

    International Nuclear Information System (INIS)

    Collins, P.A.

    1980-01-01

    Compared are 12 different methods of financing the decommissioning of nuclear power plants. The basic financing alternatives are presented first in their simple version where income taxes are zero. Then the effects of the present income tax laws are added and their effect determined

  3. Technical Evaluation Report 24: Open Source Software: an alternative to costly Learning Management Systems

    Directory of Open Access Journals (Sweden)

    Jim Depow

    2003-10-01

    Full Text Available This is the first in a series of two reports discussing the use of open source software (OSS and free software (FS in online education as an alternative to expensive proprietary software. It details the steps taken in a Canadian community college to download and install the Linux Operating System in order to support an OSS/ FS learning management system (LMS.

  4. Health care costs of adults treated for attention-deficit/hyperactivity disorder who received alternative drug therapies.

    Science.gov (United States)

    Wu, Eric Q; Birnbaum, Howard G; Zhang, Huabin F; Ivanova, Jasmina I; Yang, Elaine; Mallet, David

    2007-09-01

    Many therapies exist for treating adult attention-deficit/hyperactivity disorder (ADHD), also referred to as attention-deficit disorder (ADD), but there is no research regarding cost differences associated with initiating alternative ADD/ADHD drug therapies in adults. To compare from the perspective of a large self-insured employer the risk-adjusted direct health care costs associated with 3 alternative drug therapies for ADD in newly treated patients: extended-release methylphenidate (osmotic release oral system-MPH), mixed amphetamine salts extended release (MAS-XR), or atomoxetine. We analyzed data from a US claims database of 5 million beneficiaries from 31 large self-insured employers (1999-2004). Analysis was restricted to adults aged 18 to 64 years with at least 1 diagnosis of ADD/ADHD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 314.0x--attention deficit disorder; 314.00--attention deficit disorder without hyperactivity; or 314.01--attention-deficit disorder with hyperactivity) and at least 1 pharmacy claim for OROS-MPH, MAS-XR, or atomoxetine identified using National Drug Codes. In preliminary analysis, we calculated the duration of index ADHD drug therapy as time from index therapy initiation to a minimum 60-day gap. Because the median duration of index ADHD drug therapy was found to be approximately 90 days, the primary measures were total direct medical plus drug costs and medical-only costs computed over 6 months following therapy initiation. Adults were required to have continuous eligibility 6 months before and 6 months after their latest drug therapy initiation and no ADHD therapy during the previous 6 months. Cost was measured as the payment amount made by the health plan to the provider rather than billed charges, and it excluded patient copayments and deductibles. Medical costs included costs incurred for all-cause inpatient and outpatient/other services. Costs were adjusted for inflation to

  5. The cost-effectiveness of neonatal screening for Cystic Fibrosis: an analysis of alternative scenarios using a decision model

    Directory of Open Access Journals (Sweden)

    Tu Karen

    2005-08-01

    Full Text Available Abstract Background The use of neonatal screening for cystic fibrosis is widely debated in the United Kingdom and elsewhere, but the evidence available to inform policy is limited. This paper explores the cost-effectiveness of adding screening for cystic fibrosis to an existing routine neonatal screening programme for congenital hypothyroidism and phenylketonuria, under alternative scenarios and assumptions. Methods The study is based on a decision model comparing screening to no screening in terms of a number of outcome measures, including diagnosis of cystic fibrosis, life-time treatment costs, life years and QALYs gained. The setting is a hypothetical UK health region without an existing neonatal screening programme for cystic fibrosis. Results Under initial assumptions, neonatal screening (using an immunoreactive trypsin/DNA two stage screening protocol costs £5,387 per infant diagnosed, or £1.83 per infant screened (1998 costs. Neonatal screening for cystic fibrosis produces an incremental cost-effectiveness of £6,864 per QALY gained, in our base case scenario (an assumed benefit of a 6 month delay in the emergence of symptoms. A difference of 11 months or more in the emergence of symptoms (and mean survival means neonatal screening is both less costly and produces better outcomes than no screening. Conclusion Neonatal screening is expensive as a method of diagnosis. Neonatal screening may be a cost-effective intervention if the hypothesised delays in the onset of symptoms are confirmed. Implementing both antenatal and neonatal screening would undermine potential economic benefits, since a reduction in the birth incidence of cystic fibrosis would reduce the cost-effectiveness of neonatal screening.

  6. A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations.

    Science.gov (United States)

    Achana, Felix; Petrou, Stavros; Khan, Kamran; Gaye, Amadou; Modi, Neena

    2018-01-01

    A new methodological framework for assessing agreement between cost-effectiveness endpoints generated using alternative sources of data on treatment costs and effects for trial-based economic evaluations is proposed. The framework can be used to validate cost-effectiveness endpoints generated from routine data sources when comparable data is available directly from trial case report forms or from another source. We illustrate application of the framework using data from a recent trial-based economic evaluation of the probiotic Bifidobacterium breve strain BBG administered to babies less than 31 weeks of gestation. Cost-effectiveness endpoints are compared using two sources of information; trial case report forms and data extracted from the National Neonatal Research Database (NNRD), a clinical database created through collaborative efforts of UK neonatal services. Focusing on mean incremental net benefits at £30,000 per episode of sepsis averted, the study revealed no evidence of discrepancy between the data sources (two-sided p values >0.4), low probability estimates of miscoverage (ranging from 0.039 to 0.060) and concordance correlation coefficients greater than 0.86. We conclude that the NNRD could potentially serve as a reliable source of data for future trial-based economic evaluations of neonatal interventions. We also discuss the potential implications of increasing opportunity to utilize routinely available data for the conduct of trial-based economic evaluations.

  7. The effect of alternative cost and environmental impact minimisation strategies on radioactive waste disposal strategies

    International Nuclear Information System (INIS)

    Laundy, R.S.; James, A.R.; Groom, M.S.; Dalrymple, G.J.

    1985-06-01

    The study reported here investigates the effects of different cost and environmental impact minimisation strategies for a single waste disposal scenario. Four disposal options are considered. The study examines the environmental impacts from waste storage and transport and the disposal impacts in terms of collective dose, maximum individual dose and individual dose from intrusion. The total cost of disposing of waste takes account of storage, transport and disposal costs to each of the four facilities. Two minimum cost scenarios and seven minimum impact assessments were performed. The results showed clearly that a trade-off has to be made between the environmental impacts from transport and storage of waste. A low objective risk of transport is achieved by directing waste to the engineered trench, assumed to have a central location. This waste is stored until the facility is available in 1995 thus increasing the potential impact from storage. The results also show a trade-off has to be made between minimising the maximum individual dose from disposal and collective dose. The study shows that for relatively little cost large reductions in the impacts can be obtained particularly in short and long-term collective dose and the individual dose from intrusion. (author)

  8. Low Cost Skin Segmentation Scheme in Videos Using Two Alternative Methods for Dynamic Hand Gesture Detection Method

    Directory of Open Access Journals (Sweden)

    Eman Thabet

    2017-01-01

    Full Text Available Recent years have witnessed renewed interest in developing skin segmentation approaches. Skin feature segmentation has been widely employed in different aspects of computer vision applications including face detection and hand gestures recognition systems. This is mostly due to the attractive characteristics of skin colour and its effectiveness to object segmentation. On the contrary, there are certain challenges in using human skin colour as a feature to segment dynamic hand gesture, due to various illumination conditions, complicated environment, and computation time or real-time method. These challenges have led to the insufficiency of many of the skin color segmentation approaches. Therefore, to produce simple, effective, and cost efficient skin segmentation, this paper has proposed a skin segmentation scheme. This scheme includes two procedures for calculating generic threshold ranges in Cb-Cr colour space. The first procedure uses threshold values trained online from nose pixels of the face region. Meanwhile, the second procedure known as the offline training procedure uses thresholds trained out of skin samples and weighted equation. The experimental results showed that the proposed scheme achieved good performance in terms of efficiency and computation time.

  9. A simulation model to estimate the cost and effectiveness of alternative dialysis initiation strategies.

    Science.gov (United States)

    Lee, Chris P; Chertow, Glenn M; Zenios, Stefanos A

    2006-01-01

    Patients with end-stage renal disease (ESRD) require dialysis to maintain survival. The optimal timing of dialysis initiation in terms of cost-effectiveness has not been established. We developed a simulation model of individuals progressing towards ESRD and requiring dialysis. It can be used to analyze dialysis strategies and scenarios. It was embedded in an optimization frame worked to derive improved strategies. Actual (historical) and simulated survival curves and hospitalization rates were virtually indistinguishable. The model overestimated transplantation costs (10%) but it was related to confounding by Medicare coverage. To assess the model's robustness, we examined several dialysis strategies while input parameters were perturbed. Under all 38 scenarios, relative rankings remained unchanged. An improved policy for a hypothetical patient was derived using an optimization algorithm. The model produces reliable results and is robust. It enables the cost-effectiveness analysis of dialysis strategies.

  10. Cost analysis of alternate management schemes in early stage testicular seminoma

    International Nuclear Information System (INIS)

    Sharda, Navneet N.; Kinsella, Timothy J.; Ritter, Mark A.

    1995-01-01

    Purpose: Optimal management of early stage testicular seminoma remains uncertain. Standard therapy includes inguinal orchidectomy followed by irradiation of the pelvic and para-aortic nodes. Due to the excellent survival rates (<4% seminoma specific mortality as per the Princess Margaret, Institute Goustave-Roussy experience), the option of observation following orchidectomy has been proposed, with no diminution in absolute survival noted since salvage chemotherapy is effective in the treatment of early systemic relapse. However, the intensity of follow-up required if observation is chosen will likely add an increased medical cost burden which needs to be balanced against the cost of standard treatment using radiation therapy. We have therefore performed a cost comparison between these two management strategies in order to define any differences. Methods and Materials: All costs reported are adjusted to 1994 dollars and analysis is begun immediately post-orchidectomy. The cost of observation was calculated assuming a 15% relapse rate (10%-20%) over seven years of follow-up. The follow-up schedule was assumed identical to that commonly reported in the literature (Princess Margaret, Institute Gustave-Roussy, Royal Marsden), consisting of periodic CXR, CT abd/pelvis, tumor markers and examinations. Chemotherapy costs associated with treatment of recurrences were generated from the inpatient hospital charges and physician billing of five patients who received three cycles of a standard United States regimen consisting of bleomycin, etoposide and cis-platinum in 1994. On average, four days of hospitalization were required. Radiological costs were also calculated from the actual patient billing records in 1994 and incremented at a rate of 3%/year over the length of proposed follow-up. Costs of irradiation and subsequent standard follow-up were similarly generated from the hospital charges and physician billing of five patients treated postoperatively. A 4% recurrence

  11. Environmental cost-effectiveness of bio diesel production in Greece: Current policies and alternative scenarios

    International Nuclear Information System (INIS)

    Iliopoulos, Constantine; Rozakis, Stelios

    2010-01-01

    Following European Directive 2003/30/EC, the Greek Government adapted legislation that introduces and regulates the bio diesel market. The implemented quota scheme allocates the country's annual, predetermined, tax exempt production of bio diesel to industries based on their ability to meet several criteria. A number of bio diesel supply chain stakeholders have criticized this policy for being efficiency-robbing and vague. This paper uses 2007 data from energy crop farms and three bio diesel-producing companies in order to assess these criticisms. We study the economic and environmental aspects of the currently adopted policy and compare them to three alternative scenarios. We conclude that such criticisms have a merit and that policy makers need to reconsider their alternative options regarding the promotion of bio diesel in transport. Permission of sales directly to local consumers and promotion of forward integration by farmers are efficiency enhancing and environment-friendly means of promoting the use of bio diesel in transport.

  12. Assessment of costs and benefits of flexible and alternative fuel use in the US transportation sector

    International Nuclear Information System (INIS)

    1991-10-01

    The DOE is conducting a comprehensive technical analysis of a flexible-fuel transportation system in the United States -- that is, a system that could easily switch between petroleum and another fuel, depending on price and availability. The DOE Alternative Fuels Assessment is aimed directly at questions of energy security and fuel availability, but covers a wide range of issues. This report examines environmental, health, and safety concerns associated with a switch to alternative- and flexible-fuel vehicles. Three potential alternatives to oil-based fuels in the transportation sector are considered: methanol, compressed natural gas (CNG), and electricity. The objective is to describe and discuss qualitatively potential environmental, health, and safety issues that would accompany widespread use of these three fuels. This report presents the results of exhaustive literature reviews; discussions with specialists in the vehicular and fuel-production industries and with Federal, State, and local officials; and recent information from in-use fleet tests. Each chapter deals with the end-use and process emissions of air pollutants, presenting an overview of the potential air pollution contribution of the fuel --relative to that of gasoline and diesel fuel -- in various applications. Carbon monoxide, particulate matter, ozone precursors, and carbon dioxide are emphasized. 67 refs., 6 figs. , 8 tabs

  13. A Comparison of Alternative Tax Bases

    OpenAIRE

    John Freebairn

    2005-01-01

    The revenue, efficiency, equity and operating costs properties of alternative tax bases or taxable sums are compared and contrasted. Initially the assessment is made for generic, comprehensive tax bases on income and consumption flows, wealth stocks, and on transactions. On the criteria of efficiency and equity, there are unresolved conceptual and empirical arguments in choosing between income, consumption and wealth tax bases, but general revenue raising transaction taxes are inferior. In pr...

  14. Pre-Primary Education: Needs, Alternatives and Costs, 1971-1980.

    Science.gov (United States)

    Colmen, Joseph G.; Sandoval, Corazon

    The rationale for a national investment in early childhood learning, the needs to be met, and the costs are discussed. A number of current program models, diagnostic service centers, programs for parent education, and preparent programs at the secondary and college levels are described. Research studies and findings about different early childhood…

  15. Technological Minimalism: A Cost-Effective Alternative for Course Design and Development.

    Science.gov (United States)

    Lorenzo, George

    2001-01-01

    Discusses the use of minimum levels of technology, or technological minimalism, for Web-based multimedia course content. Highlights include cost effectiveness; problems with video streaming, the use of XML for Web pages, and Flash and Java applets; listservs instead of proprietary software; and proper faculty training. (LRW)

  16. 33 CFR 241.5 - Procedures for estimating the alternative cost-share.

    Science.gov (United States)

    2010-07-01

    ... pay differential for Federal workers who purchase local retail and who use private housing, employed... in the Federal Government's cost of living pay differential for Federal workers who purchase local... replacement income factor by both b1 and b2 and subtract each from a in the equation in § 241.5(b)(5)). The...

  17. The Enforcer Aircraft Program: A Lower-Cost Alternative Weapon System.

    Science.gov (United States)

    1984-03-01

    armoured striking forces. NATO’s air forces then, sns 1.select the optimum aircraft(s) to maximize the damage to the enemy while minimizing the cost to...the reascns Congress kept the Enforcer program alive was their inclination to support the underdog , an underdog with persuasiveness and tenacity. To

  18. [Policies encouraging price competition in the generic drug market: Lessons from the European experience].

    Science.gov (United States)

    Puig-Junoy, Jaume

    2010-01-01

    To describe alternative policies aimed at encouraging price competition in generic drug markets in countries with strict price regulation, and to present some case studies drawn from the European experience. Systematic literature review of articles and technical reports published after 1999. The shortcomings in consumer price competition observed in some European generic markets, including Spain, may be reduced through three types of public reimbursement or financing reforms: policies aimed at improving the design of current maximum reimbursement level policies; policies aimed at monitoring competitive prices in order to reimburse real acquisition cost to pharmacies; and, more radical and market-oriented policies such as competitive tendering of public drug purchases. The experience of recent reforms adopted in Germany, Belgium, Holland, Norway, and Sweden offers a useful guide for highly price-regulated European countries, such as Spain, currently characterized by limited consumer price competition and the high discounts offered to pharmacy purchases. Direct price regulation and/or the generic reference pricing systems used to reduce generic drug prices in many European countries can be successfully reformed by adopting measures more closely aimed at encouraging consumer price competition in generic drug markets. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. Thin film solar modules: the low cost, high throughput and versatile alternative to Si wafers

    Energy Technology Data Exchange (ETDEWEB)

    Hegedus, S. [Delaware Univ., Inst. of Energy Conversion, Newark, DE (United States)

    2006-07-01

    Thin film solar cells (TFSC) have passed adolescence and are ready to make a substantial contribution to the world's electricity generation. They can have advantages over c-Si solar modules in ease of large area, lower cost manufacturing and in several types of applications. Factors which limit TFSC module performance relative to champion cell performance are discussed along with the importance of increased throughput and yield. The consensus of several studies is that all TFSC can achieve costs below 1 $/W if manufactured at sufficiently large scale >100 MW using parallel lines of cloned equipment with high material utilization and spray-on encapsulants. There is significant new commercial interest in TFSC from small investors and large corporations, validating the thin film approach. Unique characteristics are discussed which give TFSC an advantage over c-Si in two specific markets: small rural solar home systems and building integrated photovoltaic installations. TFSC have outperformed c-Si in annual energy production (kWhrs/kW), have demonstrated outdoor durability comparable to c-Si and are being used in MW scale installations worldwide. The merits of the thin film approach cannot be judged on the basis of efficiency alone but must also account for module performance and potential for low cost. TFSC advocates should promote their unique virtues compared to c-Si: lower cost, higher kWhr/kW output, higher battery charging current, attractive visual appearance, flexible substrates, long-term stability comparable to c-Si, and multiple pathways for deposition with room for innovation and evolutionary improvement. There is a huge market for TFSC even at today's efficiency if costs can be reduced. A brief window of opportunity exists for TFSC over the next few years due the Si shortage. The demonstrated capabilities and advantages of TFSC must be proclaimed more persistently to funding decision-makers and customers without minimizing the remaining

  20. Economic Costs and Adaptations for Alternative Regulations of California's Sacramento–San Joaquin Delta

    Directory of Open Access Journals (Sweden)

    Stacy K. Tanaka

    2011-07-01

    Full Text Available Stacy K. Tanaka, Christina R. Connell–Buck, Kaveh Madani, Josue Medellín-Azuara, Jay R. Lund, and Ellen Hanakdoi: http://dx.doi.org/10.15447/sfews.2014v9iss2art4Water exports from California’s Sacramento–San Joaquin Delta are an environmental concern because they reduce net outflows of fresh water from the Delta, and can entrain fish and disrupt flows within the Delta. If exports were no longer pumped from within the Delta, the regulatory issue becomes one of maintaining appropriate flows into and out of the Delta. This paper presents the results of two sets of hydro-economic optimization modeling runs, which were developed to represent a range of modified Delta operations and their economic and operational effects on California’s water supply system. The first set of runs represents decreasing export capacity from the Delta. The second set increases minimum net Delta outflow (MNDO requirements. The hydro-economic model seeks the least–cost statewide water management scheme for water supply, including a wide range of resources and water management options. Results show that reducing exports or increasing MNDO requirements increase annual average statewide water scarcity, scarcity costs, and operating costs (from greater use of desalination, wastewater recycling, water treatment, and pumping. Effects of reduced exports are especially concentrated in agricultural communities in the southern Central Valley because of their loss of access to overall water supply exports and their ability to transfer remaining water to southern California. Increased outflow requirements increase water scarcity and associated costs throughout California. For an equivalent amount of average Delta outflows, statewide costs increase more rapidly when exports alone are reduced than when minimum outflow requirements are increased and effects are more widely distributed statewide.

  1. Generic antibiotics in Japan.

    Science.gov (United States)

    Fujimura, Shigeru; Watanabe, Akira

    2012-08-01

    Generic drugs have been used extensively in many developed countries, although their use in Japan has been limited. Generic drugs reduce drug expenses and thereby national medical expenditure. Because generic drugs provide advantages for both public administration and consumers, it is expected that they will be more widely used in the future. However, the diffusion rate of generic drugs in Japan is quite low compared with that of other developed countries. An investigation on generic drugs conducted by the Ministry of Health, Labour and Welfare in Japan revealed that 17.2 % of doctors and 37.2 % of patients had not used generic drugs. The major reasons for this low use rate included distrust of off-patent products and lower drug price margin compared with the brand name drug. The generic drugs available in the market include external drugs such as wet packs, antihypertensive agents, analgesics, anticancer drugs, and antibiotics. Among them, antibiotics are frequently used in cases of acute infectious diseases. When the treatment of these infections is delayed, the infection might be aggravated rapidly. The pharmacokinetics-pharmacodynamics (PK-PD) theory has been adopted in recent chemotherapy, and in many cases, the most appropriate dosage and administration of antibiotics are determined for individual patients considering renal function; high-dosage antibiotics are used preferably for a short duration. Therefore, a highly detailed antimicrobial agent is necessary. However, some of the generic antibiotics have less antibacterial potency or solubility than the brand name products. We showed that the potency of the generic products of vancomycin and teicoplanin is lower than that of the branded drugs by 14.6 % and 17.3 %, respectively. Furthermore, we confirmed that a generic meropenem drug for injection required about 82 s to solubilize in saline, whereas the brand product required only about 21 s. It was thought that the cause may be the difference in size of bulk

  2. Brand loyalty, patients and limited generic medicines uptake.

    Science.gov (United States)

    Costa-Font, Joan; Rudisill, Caroline; Tan, Stefanie

    2014-06-01

    The sluggish development of European generic drug markets depends heavily on demand side factors, and more specifically, patients' and doctors' loyalty to branded products. Loyalty to originator drugs, to the point where originator prices rise upon generic entry has been described as the 'generics paradox'. Originator loyalty can emerge for a plethora of reasons; including costs, perceptions about quality and physician advice. We know very little about the behavioural underpinnings of brand loyalty from the consumer or patient standpoint. This paper attempts to test the extent to which patients are brand loyal by drawing upon Spain's 2002 Health Barometer survey as it includes questions about consumer acceptance of generics in a country with exceptionally low generic uptake and substitution at the time of the study. Our findings suggest that at least 13% of the population would not accept generics as substitutes to the originator. These results confirm evidence of brand loyalty for a minority. Alongside high levels of awareness of generics, we find that low cost-sharing levels explain consumer brand loyalty but their impact on acceptance of generic substitution is very small. Higher cost-sharing and exempting fewer patients from cost-sharing have the potential to encourage generic acceptance. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Nutritionism, Commercialization and Food; Comment on “Buying Health: The Costs of Commercialism and an Alternative Philosophy”

    Directory of Open Access Journals (Sweden)

    Anne Barnhill

    2013-01-01

    Full Text Available In “Buying Health: the Costs of Commercialization and an Alternative Philosophy”, Larry R. Churchill and Shelley C. Churchill discuss the commercialization of health and, in particular, the commercialization of nutrition. In this commentary on their article, I draw a connection between Churchill and Churchill’s account of the commercialization of nutrition and Michael Pollan’s critique of “nutritionism”. I also offer a friendly amendment to Churchill and Churchill’s account, suggesting that the commercialization of nutrition is not a monolithic experience but it is rather widely challenged.

  4. 3D printing scanning electron microscopy sample holders: A quick and cost effective alternative for custom holder fabrication.

    Directory of Open Access Journals (Sweden)

    Gabriel N Meloni

    Full Text Available A simple and cost effective alternative for fabricating custom Scanning Electron Microscope (SEM sample holders using 3D printers and conductive polylactic acid filament is presented. The flexibility of the 3D printing process allowed for the fabrication of sample holders with specific features that enable the high-resolution imaging of nanoelectrodes and nanopipettes. The precise value of the inner semi cone angle of the nanopipettes taper was extracted from the acquired images and used for calculating their radius using electrochemical methods. Because of the low electrical resistivity presented by the 3D printed holder, the imaging of non-conductive nanomaterials, such as alumina powder, was found to be possible. The fabrication time for each sample holder was under 30 minutes and the average cost was less than $0.50 per piece. Despite being quick and economical to fabricate, the sample holders were found to be sufficiently resistant, allowing for multiple uses of the same holder.

  5. Increasing the competitiveness of maintenance contract rates by using an alternative methodology for the calculation of average vehicle maintenance costs

    Directory of Open Access Journals (Sweden)

    Stephen Carstens

    2008-11-01

    Full Text Available Companies tend to outsource transport to fleet management companies to increase efficiencies if transport is a non-core activity. The provision of fleet management services on contract introduces a certain amount of financial risk to the fleet management company, specifically fixed rate maintenance contracts. The quoted rate needs to be sufficient and also competitive in the market. Currently the quoted maintenance rates are based on the maintenance specifications of the manufacturer and the risk management approach of the fleet management company. This is usually reflected in a contingency that is included in the quoted maintenance rate. An alternative methodology for calculating the average maintenance cost for a vehicle fleet is proposed based on the actual maintenance expenditures of the vehicles and accepted statistical techniques. The proposed methodology results in accurate estimates (and associated confidence limits of the true average maintenance cost and can beused as a basis for the maintenance quote.

  6. Xanthium strumarium L. seed hull as a zero cost alternative for Rhodamine B dye removal.

    Science.gov (United States)

    Khamparia, Shraddha; Jaspal, Dipika Kaur

    2017-07-15

    Treatment of polluted water has been considered as one of the most important aspects in environmental sciences. Present study explores the decolorization potential of a low cost natural adsorbent Xanthium strumarium L. seed hull for the adsorption of a toxic xanthene dye, Rhodamine B (RHB). The characterization of the adsorbent revealed the presence of high amount of carbon, when exposed to Electron Dispersive Spectroscopy (EDS). Further appreciable decolorization took place which was confirmed by Fourier Transform Infrared Spectroscopy (FTIR) analysis noticing shift in peaks. Isothermal studies indicated multilayer adsorption following Freundlich isotherm. The rate of adsorption was supported by second order kinetics directing a chemical phenomenon during the process with dominance of film diffusion as the rate governing step. Moreover paper aims at correlating the chemical arena to the mathematical aspect providing an in-depth information of the studied treatment process. For proper assessment and validation of the observed data, experimental data has been statistically treated by applying different error functions namely, Chi-square test (χ 2 ), Sum of absolute errors (EABS) and Normalized standard deviation (NSD). Further practical applicability of the low cost adsorbent was evaluated by continuous column mode studies with 72.2% of dye recovery. Xanthium strumarium L. proved to be environment friendly low cost natural adsorbent for decolorizing RHB from aquatic system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Non-Dam Alternatives for Delivering Water Services at Least Cost and Risk

    Directory of Open Access Journals (Sweden)

    Michael P. Totten

    2010-06-01

    We present evidence that a value-adding and risk-minimising water planning process can be achieved by shifting from the conventional focus on supply expansion to one that concentrates on efficiently delivering services at and near the point of use. The State of California has two decades of experience with this approach, demonstrating that market-based policy and regulatory innovations can unleash efficiency gains resulting in more utility water services and energy services delivered with less supply expansion at lower costs, while minimising climate-change risk, pollution and the social cost that accompany large infrastructural projects. Efficiency in delivered water services could be accomplished with investments in the range of US$10-25 billion annually, while obviating the need for spending hundreds of billions of dollars on more expensive hydropower and related infrastructural expansion projects. The shift to a regulatory system that encompasses cost-effective end-use efficiency improvements in delivering water and energy services could eliminate the need for an estimated half of all proposed dams globally, thus allowing for the maintenance of other ecosystem service benefits and offer the best hopes of meeting basic human needs for water at a more achievable level of investment.

  8. Linear accelerator: a reproducible, efficacious and cost effective alternative for blood irradiation.

    Science.gov (United States)

    Shastry, Shamee; Ramya, B; Ninan, Jefy; Srinidhi, G C; Bhat, Sudha S; Fernandes, Donald J

    2013-12-01

    The dedicated devices for blood irradiation are available only at a few centers in developing countries thus the irradiation remains a service with limited availability due to prohibitive cost. To implement a blood irradiation program at our center using linear accelerator. The study is performed detailing the specific operational and quality assurance measures employed in providing a blood component-irradiation service at tertiary care hospital. X-rays generated from linear accelerator were used to irradiate the blood components. To facilitate and standardize the blood component irradiation, a blood irradiator box was designed and fabricated in acrylic. Using Elekta Precise Linear Accelerator, a dose of 25 Gy was delivered at the centre of the irradiation box. Standardization was done using five units of blood obtained from healthy voluntary blood donors. Each unit was divided to two parts. One aliquot was subjected to irradiation. Biochemical and hematological parameters were analyzed on various days of storage. Cost incurred was analyzed. Progressive increase in plasma hemoglobin, potassium and lactate dehydrogenase was noted in the irradiated units but all the parameters were within the acceptable range indicating the suitability of the product for transfusion. The irradiation process was completed in less than 30 min. Validation of the radiation dose done using TLD showed less than ± 3% variation. This study shows that that the blood component irradiation is within the scope of most of the hospitals in developing countries even in the absence of dedicated blood irradiators at affordable cost. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Student peer teaching in paediatric simulation training is a feasible low-cost alternative for education.

    Science.gov (United States)

    Wagner, Michael; Mileder, Lukas P; Goeral, Katharina; Klebermass-Schrehof, Katrin; Cardona, Francesco S; Berger, Angelika; Schmölzer, Georg M; Olischar, Monika

    2017-06-01

    The World Health Organization recommends regular simulation training to prevent adverse healthcare events. We used specially trained medical students to provide paediatric simulation training to their peers and assessed feasibility, cost and confidence of students who attended the courses. Students at the Medical University of Vienna, Austria were eligible to participate. Students attended two high-fidelity simulation training sessions, delivered by peers, which were videorecorded for evaluation. The attendees then completed questionnaires before and after the training. Associated costs and potential benefits were analysed. From May 2013 to June 2015, 152 students attended the sessions and 57 (37.5%) completed both questionnaires. Satisfaction was high, with 95% stating their peer tutor was competent and 90% saying that peer tutors were well prepared. The attendees' confidence in treating critically ill children significantly improved after training (p peer tutor were six Euros per working hour, compared to 35 Euros for a physician. Using peer tutors for paediatric simulation training was a feasible and low-cost option that increased the number of medical students who could be trained and increased the self-confidence of the attendees. Satisfaction with the peer tutors was high. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  10. Compensating the opportunity cost of forest functional zoning - two alternative options for the Romanian forest policy

    Directory of Open Access Journals (Sweden)

    Marian Drăgoi,

    2010-09-01

    Full Text Available An important challenge of the environmental policy is conceivingappropriate economic instruments able to account for the positive externalities provided by forest ecosystems. This issue is extremely important for implementing the provisions of the Romanian Forest Act, which states that forest owners shall be compensated for the opportunity costs of giving up harvesting operations due to various conservation purposes. The paper presents a statistical method based on analytical assessment of the effective forgone revenues brought about by banning the harvesting operations in 96 cases, each case being a distinctive forest management plan conceived for a large forest area, i.e. a production unit. Doing so, the scale effect has been taken into account because all legal provisions referring to forest management planning systems are focused on production units, considered the basic reference elements for sustainable forest management. The multiple regression function produced by the statistical analysis was turned into a simple formula allowing for a straightforward set up of the average compensation worth being paid per year and hectare. In order to better fetch the real opportunity cost paid for each hectare of protected forest, the algorithmwas further improved in order to account for the differences in stumpage residual value. Actually, the average compensation is differentiated onto five categories of hauling distances, using the same algorithm used by the National Forest Administration for differentiating the average reservation price established at national level on the ground of full-cost method stumpage pricing system.

  11. Compensating the opportunity cost of forest functional zoning - two alternative options for the Romanian forest policy

    Directory of Open Access Journals (Sweden)

    Marian Drăgoi

    2010-06-01

    Full Text Available An important challenge of the environmental policy is conceiving appropriate economic instruments able to account for the positive externalities provided by forest ecosystems. This issue is extremely important for implementing the provisions of the Romanian Forest Act, which states that forest owners shall be compensated for the opportunity costs of giving up harvesting operations due to various conservation purposes. The paper presents a statistical method based on analytical assessment of the effective forgone revenues brought about by banning the harvesting operations in 96 cases, each case being a distinctive forest management plan conceived for a large forest area, i.e. a production unit. Doing so, the scale effect has been taken into account because all legal provisions referring to forest management planning systems are focused on production units, considered the basic reference elements for sustainable forest management. The multiple regression function produced by the statistical analysis was turned into a simple formula allowing for a straightforward set up of the average compensation worth being paid per year and hectare. In order to better fetch the real opportunity cost paid for each hectare of protected forest, the algorithm was further improved in order to account for the differences in stumpage residual value. Actually, the average compensation is differentiated onto five categories of hauling distances, using the same algorithm used by the National Forest Administration for differentiating the average reservation price established at national level on the ground of full-cost method stumpage pricing system. 

  12. Complementary and alternative medicine use and cost in functional bowel disorders: A six month prospective study in a large HMO

    Directory of Open Access Journals (Sweden)

    Drossman Douglas A

    2008-07-01

    Full Text Available Abstract Background Functional Bowel Disorders (FBD are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM used for FBDs other than Irritable Bowel Syndrome (IBS, or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain. Methods 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS, quality of life (IBS-QoL, psychological distress (BSI and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims. Results CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice. Conclusion CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.

  13. A cost and technical efficiency analysis of two alternative models for implementing the basic package of health services in Afghanistan.

    Science.gov (United States)

    Blaakman, Aaron Philip; Salehi, Ahmad Shah; Boitard, Romain

    2014-01-01

    Since 2003, the Afghan Ministry of Public Health (MoPH) and international partners have directed a contracting-out model through which non-governmental organisations (NGOs) deliver the Basic Package of Health Services (BPHS) in 31 of the 34 Afghan provinces. The MoPH also managed health service delivery in three provinces under an alternative initiative entitled Strengthening Mechanisms (SM). In 2011, under the authority of the MoPH and Delegation of the European Union to Afghanistan, EPOS Health Management conducted a cost and technical efficiency study of the contracting-out and SM mechanisms in six provinces to examine economic trade-offs in the provision of the BPHS. The study provides analyses of all resource inputs and primary outputs of the BPHS in the six provinces during 2008 and 2009. The authors examined technical efficiency using Data Envelopment Analysis (DEA) at the BPHS facility level. Cost analysis results indicate that the weighted average cost per BPHS outpatient visit totalled $3.41 in the SM provinces and $5.39 in the NGO-led provinces in 2009. Furthermore, the data envelopment analyses (DEAs) indicate that facilities in the three NGO-led provinces scored 0.168 points higher on the DEA scale (0-1) than SM facilities. The authors conclude that an approximate 60% increase in costs yielded a 16.8% increase in technical efficiency in the delivery of the BPHS during 2009 in the six provinces.

  14. Practicing the Generic (City)

    DEFF Research Database (Denmark)

    Hansen, Lone Koefoed

    2010-01-01

    Flanagan proposes that most locative media artworks neglect the particularities of spaces, their historical and political layers. Koolhaas, on the other hand, states that all urban areas are alike, that we are facing a global Generic City. The paper analyses digital media artist Esther Polak......’s NomadicMILK project in light of the generic and particular properties of space as laid out by Flanagan and Koolhaas in order to discuss the possible reconfiguring practices of locative media....

  15. Labour-based bitumen roads as cost-effective alternatives to conventional gravel wearing courses

    CSIR Research Space (South Africa)

    Paige-Green, P

    2004-09-01

    Full Text Available and streets. The potential for large-scale application of labour-based road works is therefore enormous. Delivery of a quality product is seen as key to the acceptance of labour-based road works. In Gundo Lashu it was realised early on that finding good... quality wearing course gravel in itself constituted a major problem in many areas of the province, thus bringing the costs for a fully rehabilitated and gravelled 5.5m wide road to about R230 000 in some instances. Aside from depleting an increasingly...

  16. Liquefied Natural Gas as an alternative fuel: a regional-level social cost-benefit appraisal

    OpenAIRE

    Moreira, Paulo Pires; Caetano, Fernando J. P.

    2017-01-01

    The impact from traditional marine fuels has the potential of causing health and non-health damages and contributes to climate change. Here, the introduction of Liquefied Natural Gas (LNG) as an energy end-use fuel for marine purposes is analysed. The aim of this study is to verify LNG’s policy implementation feasibility as a step-change for a low carbon perspective for shipping by means of developing a social cost-benefit analysis on a regional basis. Emissions from the Portuguese merchant f...

  17. Comparative risk-benefit-cost effectiveness in nuclear and alternate power sources: methodology, perspective, limitations

    International Nuclear Information System (INIS)

    Vinck, W.; Van Reijen, G.; Maurer, H.; Volta, G.

    1980-01-01

    A critical survey is given of the use of quantitative risk assessment in defining acceptable limits of safety and of its use together with cost-benefit analyses for decision making. The paper indicates uncertainties and even unknowns in risk assessment in particular if the whole fuel cycle for energy production is considered. It is made clear that for decisions on acceptance of risk also the risk perception factor must be considered. A difficult issue here is the potential for low-probability/large consequence accidents. Examples are given, suggestions for improvement are made and perspectives are outlined

  18. Influencers of generic drug utilization: A systematic review.

    Science.gov (United States)

    Howard, Jennifer N; Harris, Ilene; Frank, Gavriella; Kiptanui, Zippora; Qian, Jingjing; Hansen, Richard

    2017-08-04

    With an increase in prescription drug spending and rising drug costs there is a need to encourage the use of generic prescription drugs. However, maximizing generic drug use is not possible without the public's positive perception and meeting their informational needs about generic drugs. Thus, improving the public's confidence in, and knowledge of generic drugs on the market is critical. The objective of this systematic review is to examine and evaluate the studies focusing on the nature and extent of key factors influencing generic drug use in the United States in order to help guide policy, education and practice interventions. Using multiple search engines and key word screening criteria, empirical studies published in English between January 1, 2005 and December 31, 2015 were identified. A qualitative synthesis of the evidence identified domains of key factors that influenced generic drug use across studies. Over 3000 citations met the key word screening criteria; 67 of these met inclusion criteria for the systematic review. Seven domains of factors that influence generic drug utilization were identified: 1) patient-related factors, 2) formulary management or cost containment, 3) healthcare policies, 4) promotional activities, 5) educational initiatives, 6) technology, and 7) physician-related factors. Patients, physicians, pharmacists, formulary managers, and policymakers play an important role in generic drug use. Understanding the factors influencing generic drug use can help guide future policy, education, and practice interventions to increase generic drug use. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Windpower project ownership and financing: The cost impacts of alternative development structures

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, R.H. [Lawrence Berkeley National Lab., CA (United States)

    1997-12-31

    This paper uses traditional financial cash-flow techniques to examine the impact of different ownership and financing structures on the cost of wind energy. While most large-scale wind projects are constructed, operated, and financed by non-utility generators (NUGs) via project financing, investor- and publicly-owned utilities have expressed interest in owning and financing their own facilities rather than purchasing wind energy from independent generators. A primary justification for utility ownership is that, because of financing and tax benefits, windpower may be cheaper when developed in this fashion. The results presented in this paper support that justification, though some of the estimated cost savings associated with utility ownership are found to be a result of shortcomings in utility analysis procedures and implicit risk shifting. This paper also discusses the comparative value of the federal production tax credit and renewable energy production incentive; estimates the financing premium paid by NUG wind owners compared to traditional gas-fired generation facilities; and explores the impact of electricity restructuring on financing.

  20. The Bottom supported fast breeder reactor vessel - an alternative approach to seismic accommodation and reduced cost

    International Nuclear Information System (INIS)

    Nakagawa, H.; Golan, S.; Petrozelli, J.; Kumaoka, Y.; Kawamura, Y.

    1988-01-01

    Most FBR vessels are supported by hanging from their top portions. A disadvantage of such a top supported reactor vessel (TSRV) structural configuration is that it may generate high reactor core accelerations. This is due to the long path the seismic vibrations must travel from the basemat up through the building and then down through the RV block to the core. To compensate for this disadvantage, TSRV blocks are often strengthened beyond what is required for other considerations, such as pressure, to satisfy seismic response criteria, thus increasing weights and costs. In addition to long load paths, TSRVs also have common load paths. For example, in a TSRV (with the core supported from the bottom of the RV) the sodium and core loads both travel along the RV pressure boundary. Therefore, one of these loads will likely control the RV thickness leaving excess margin for the other loads. It is the premise of this paper that the revision of a large pool FBR from a TSRV configuration to a specific bottom supported reactor vessel (BSRV) configuration can resolve the above TSRV disadvantages related to load path length and diversity, thereby improving seismic performance and simultaneously reducing RV block costs by reducing weights. This paper demonstrates this premise by comparing a reference TSRV block with a specific BSRV block design

  1. Scripting XML with Generic Haskell

    NARCIS (Netherlands)

    Atanassow, F.; Clarke, D.; Jeuring, J.T.

    2003-01-01

    A generic program is written once and works on values of many data types. Generic Haskell is a recent extension of the functional programming language Haskell that supports generic programming. This paper discusses how Generic Haskell can be used to implement XML tools whose behaviour depends on

  2. Scripting XML with Generic Haskell

    NARCIS (Netherlands)

    Atanassow, F.; Clarke, D.; Jeuring, J.T.

    2007-01-01

    A generic program is written once and works on values of many data types. Generic Haskell is a recent extension of the functional programming language Haskell that supports generic programming. This paper discusses how Generic Haskell can be used to implement XML tools whose behaviour depends on

  3. An audit of generic prescribing in a general surgical department.

    LENUS (Irish Health Repository)

    Gleeson, M

    2013-01-17

    BACKGROUND: The Health Service Executive introduced a generic prescription policy to reduce costs. Despite this, generic prescription rates remain low. AIM: To audit in-patient prescription practice in a single surgical department and identify potential savings which could be realised by adherence to the generic prescribing policy. METHODS: Surgical in-patient charts were obtained at the point of discharge and their drug prescription information was recorded. RESULTS: 51 % of prescriptions involved a trade-name prescription where an appropriate generic equivalent existed. The cost implications for hospital and community patients were found to be greatly affected by substitution policies that exist at hospital pharmacy level. CONCLUSION: There is a need to promote greater adherence to generic prescribing amongst hospital doctors in line with international best practice. It can have a positive impact in terms of safe prescribing and can have cost implications at both hospital and community level.

  4. Brand and generic medications: Are they interchangeable

    International Nuclear Information System (INIS)

    Al-Jazairi, Abdulrazak S.; Blhareth, S.; Eqtefan, Iyad S.; Al-Suwayeh, Saleh A.

    2008-01-01

    Generic substitution has become a common practice since the late 1970s in the United States. At that time, many of these generics caused bioavailability problems, which fueled suspicions about their efficacy and safety and the Food and Drug Administration (FDA) standards for bioequivalence. In Saudi Arabia, the increasing number of local products raised several concerns with regard to switching from brands to generics. Our objective was to review and examine the basis of the controversy surrounding brand and generic interchangeability and to explore a practical approach in pursuing a switch. Articles indexed initially under terms such as generic medications, generic substitution, bioequivalence and bioinequivalence were identified. These terms were used to search the indexing service, MEDLINE (1966-2006). References from the extracted articles and additional data sources, including the Code of Federal Regulations and Regulatory Guidelines from the FDA Center for Drug Evaluation and research were also reviewed. Foe most drugs, bioequivalence testing generally should enable clinicians to routinely substitute generic for innovator products. However, for narrow therapeutic, critical dose drugs, or for highly variable drugs, safe switching between products can not be assured. These drugs need special precautions and blood level monitoring upon switching. FDA firmly believes that approved generic and brand drugs can be dispensed with the full expectation that the consumer will receive the same clinical benefit. Performing the switch process is an advisable practice to reduce health care costs in countries with strong post-marketing surveillance program, but caution is to be exercised when narrow therapeutic index drugs or highly variable drugs are prescribed. (author)

  5. Cost-benefit analysis of retrofit of high-intensity discharge factory lighting with energy-saving alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Preston, D.J. [Alabama Industrial Assessment Center, The University of Alabama, 1530 W. Tremont St, Allentown, PA 18102 (United States); Woodbury, K.A. [Alabama Industrial Assessment Center, The University of Alabama, 290 Hardaway Hall, Box 870276, Tuscaloosa, AL 35487-0276 (United States)

    2013-05-15

    Due to increased concern about overall energy costs and the appearance of efficient and inexpensive lighting system alternatives, factories and plants with high-intensity discharge (HID) lighting are forced to consider retrofit with more modern, energy-efficient lighting. The decision is complicated from an economic perspective, and there is a lack of information readily available on the topic. This study provides an analysis of the replacement by retrofit of common probe-start metal halide and high-pressure sodium industrial lighting systems. Retrofit options considered include the more recent pulse-start metal halide lamps and a range of T5 high output and T8 fluorescent lamp configurations. Recent data on lighting system pricing, labor and energy costs, and time required for tasks are reported. The results generated include savings, payback period, and net present value for many retrofit options, as well as the change in energy consumption, carbon footprint, and lumen output for each retrofit. Effects of varying rate of return and daily duration of operation are considered. Based on change in lumen output, payback period, net present value, and comparison of lighting quality, one or two options are recommended from the overall retrofit options considered. A fluorescent retrofit is recommended for each of the HID initial scenarios considered. The payback period is no more than 3 years in any recommended case. The focus of this study is on the potential energy and cost savings, and some proposed solutions may, or may not, be acceptable due to lack of illuminance uniformity.

  6. Evaluation of generic and branded herbicides : technical report.

    Science.gov (United States)

    2015-03-01

    As with other generic brand products in the marketplace, generic herbicides often have a lower initial product cost than : their brand-name counterparts. While the purchase price of herbicides is important to TxDOT, it is essential to look at : more ...

  7. The performance of low-cost commercial cloud computing as an alternative in computational chemistry.

    Science.gov (United States)

    Thackston, Russell; Fortenberry, Ryan C

    2015-05-05

    The growth of commercial cloud computing (CCC) as a viable means of computational infrastructure is largely unexplored for the purposes of quantum chemistry. In this work, the PSI4 suite of computational chemistry programs is installed on five different types of Amazon World Services CCC platforms. The performance for a set of electronically excited state single-point energies is compared between these CCC platforms and typical, "in-house" physical machines. Further considerations are made for the number of cores or virtual CPUs (vCPUs, for the CCC platforms), but no considerations are made for full parallelization of the program (even though parallelization of the BLAS library is implemented), complete high-performance computing cluster utilization, or steal time. Even with this most pessimistic view of the computations, CCC resources are shown to be more cost effective for significant numbers of typical quantum chemistry computations. Large numbers of large computations are still best utilized by more traditional means, but smaller-scale research may be more effectively undertaken through CCC services. © 2015 Wiley Periodicals, Inc.

  8. The use of multicriteria decision making methods to find the environmental costs of hydropower development alternatives

    International Nuclear Information System (INIS)

    Carlsen, A.J.; Wenstoep, F.

    1994-01-01

    The conference paper deals with a decision support system (DSS) developed to find the costs of environmental goods. The system is based on multicriteria decision making and uses pairwise comparisons of two and two criteria. The criteria weights are calculated with linear regression. When one criterion is monetary, all criteria weights can be expressed in monetary units when the weights are known. The DSS has been tested on a hydropower project in the area of Sauda in Norway. To represent the decision makers, three panels each consisting of three persons were formed. The persons were selected from governmental agencies, the developers, the local environmental administration and a local politician. The DSS worked well with the panels. One problem was that impacts of hydropower projects are very site specific and also hard to quantify. Therefore, a considerable amount of time was used in creating a cognitive understanding of the issues involved and how they were represented by quantitative criteria. Some had also difficulties in accepting the principle of expressing environmental goods in monetary units. The results so far are preliminary. This research work is part of the Norwegian research programme Energy, Environment and Development. 3 refs., 4 figs., 2 tabs

  9. High SO{sub 2} removal duct injection: A low-cost FGD alternative

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, S.G. [Sorbent Technologies Corp., Twinsburg, OH (United States)

    1995-12-01

    Sorbent Technologies Corporation, of the United States, is currently developing and demonstrating a new waste free, retrofitable, high-SO{sub 2} removal duct-injection process. Up to 85 percent SO{sub 2} removal is achieved by simply injecting a new dry lime-based sorbent into the flue-gas duct, collecting the sorbent downstream in a particulate collector, and then recycling the sorbent. By avoiding large, expensive components, the process can have low capital costs, making it especially appropriate for smaller, older, less-utilized plants. The key to the new technology is the use of sorbent supports. Supported sorbents are produced by coating hydrated lime onto inexpensive mineral supports, such as exfoliated vermiculite or perlite. Consequently, there are no liquid, sludge, or solid wastes with the new technology. Once saturated with SO{sub 2}, the spent sorbent can be easily pelletized into a valuable soil-conditioning agricultural by-product, for the sustainable development that the future requires. This paper describes Sorbent Technologies` pilot demonstration of supported sorbent injection at the Ohio Edison Company`s R.E. Burger station. The Burger effort is also the first demonstration of the Electric Power Research Institute`s new {open_quotes}COHPAC{close_quotes} baghouse technology in a sorbent-injection desulfurization application.

  10. Management strategies to curb rhino poaching: Alternative options using a cost benefit approach

    Directory of Open Access Journals (Sweden)

    Sam M. Ferreira

    2014-05-01

    Full Text Available The combination of increasing demand and high black market prices for rhino horn in Asian markets has fueled an escalation in rhino poaching since 2007, particularly in South Africa. This situation has in turn resulted in greatly increased rhino protection costs, loss in confidence by the private sector in rhinos, loss of revenue to conservation authorities and reduced rhino population growth rates. Within current CITES processes, management responses to threats posed by poaching to rhino persistence fall within a mixture of reactive responses of increased protection and law enforcement and some pro-active responses such as demand reduction tactics, along with a parallel call for opening a legal trade in horn. These rhino management strategies carry different risks and benefits in meeting several conservation objectives. An expert-based risk-benefit analysis of five different rhino management strategies was undertaken to assess their potential for delivering upon agreed rhino conservation objectives. The outcomes indicated that benefits may exceed risks for those strategies that in some or other format legally provided horn for meeting demand. Expert risk-benefit approaches are suggested to offer a rational, inclusive and consensus generating means of addressing complex issues such as rhino poaching and augmenting the information used within the CITES decision-making processes.

  11. Generic phytosanitary irradiation treatments

    International Nuclear Information System (INIS)

    Hallman, Guy J.

    2012-01-01

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies. - Highlights: ► The history of phytosanitary irradiation (PI) treatments is given. ► Generic PI treatments in use today are discussed. ► Suggestions for future research are presented. ► A dose of 250 Gy for most insects may suffice.

  12. A Tutorial for Analysing the Cost-effectiveness of Alternative Methods for Assessing Chemical Toxicology: The Case of Acute Oral Toxicity Prediction

    NARCIS (Netherlands)

    Norlen, H.; Worth, A.P.; Gabbert, S.G.M.

    2014-01-01

    Compared with traditional animal methods for toxicity testing, in vitro and in silico methods are widely considered to permit a more cost-effective assessment of chemicals. However, how to assess the cost-effectiveness of alternative methods has remained unclear. This paper offers a user-oriented

  13. Impacts on irrigated agriculture of changes in electricity costs resulting from Western Area Power Administration's power marketing alternatives

    International Nuclear Information System (INIS)

    Edwards, B.K.; Flaim, S.J.; Howitt, R.E.; Palmer, S.C.

    1995-03-01

    Irrigation is a major factor in the growth of US agricultural productivity, especially in western states, which account for more than 85% of the nation's irrigated acreage. In some of these states, almost all cropland is irrigated, and nearly 50% of the irrigation is done with electrically powered pumps. Therefore, even small increases in the cost of electricity could have a disproportionate impact on irrigated agriculture. This technical memorandum examines the impacts that could result from proposed changes in the power marketing programs of the Western Area Power Administration's Salt Lake City Area Office. The changes could increase the cost of power to all Western customers, including rural municipalities and irrigation districts that rely on inexpensive federal power to pump water. The impacts are assessed by translating changes in Western's wholesale power rate into changes in the cost of pumping water as an input for agricultural production. Farmers can adapt to higher electricity prices in many ways, such as (1) using different pumping fuels, (2) adding workers and increasing management to irrigate more efficiently, and (3) growing more drought-tolerant crops. This study projects several responses, including using less groundwater and planting fewer waterintensive crops. The study finds that when dependence on Western's power is high, the cost of power can have a major effect on energy use, agricultural practices, and the distribution of planted acreage. The biggest percentage changes in farm income would occur (1) in Nevada and Utah (however, all projected changes are less than 2% of the baseline) and (2) under the marketing alternatives that represent the lowest capacity and energy offer considered in Western's Electric Power Marketing Environmental Impact Statement. The aggregate impact on farm incomes and the value of total farm production would be much smaller than that suggested by the changes in water use and planted acreage

  14. Generic robot architecture

    Science.gov (United States)

    Bruemmer, David J [Idaho Falls, ID; Few, Douglas A [Idaho Falls, ID

    2010-09-21

    The present invention provides methods, computer readable media, and apparatuses for a generic robot architecture providing a framework that is easily portable to a variety of robot platforms and is configured to provide hardware abstractions, abstractions for generic robot attributes, environment abstractions, and robot behaviors. The generic robot architecture includes a hardware abstraction level and a robot abstraction level. The hardware abstraction level is configured for developing hardware abstractions that define, monitor, and control hardware modules available on a robot platform. The robot abstraction level is configured for defining robot attributes and provides a software framework for building robot behaviors from the robot attributes. Each of the robot attributes includes hardware information from at least one hardware abstraction. In addition, each robot attribute is configured to substantially isolate the robot behaviors from the at least one hardware abstraction.

  15. Cost effectiveness of long-acting risperidone injection versus alternative antipsychotic agents in patients with schizophrenia in the USA.

    Science.gov (United States)

    Edwards, Natalie C; Locklear, Julie C; Rupnow, Marcia F T; Diamond, Ronald J

    2005-01-01

    The availability of long-acting risperidone injection may increase adherence and lead to improved clinical and economic outcomes for individuals with schizophrenia. The objective of this study was to assess the cost effectiveness of long-acting risperidone, oral risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, and haloperidol depot in patients with schizophrenia over 1 year from a healthcare system perspective. Published medical literature, unpublished data from clinical trials and a consumer health database, and a clinical expert panel were utilized to populate a decision analytical model comparing the seven treatment alternatives. The model captured rates of patient compliance, the rates, frequency and duration of relapse, incidence of adverse events, and healthcare resource utilization and associated costs. Primary outcomes were expressed in terms of percentage of patients relapsing per year, number of relapse days per year (number and duration of relapses per patient per year), and total direct 2003 medical cost per patient per year. On the basis of model projections, the proportions of patients experiencing a relapse requiring hospitalization in 1 year were 66% for haloperidol depot, 41% for oral risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole, and 26% for long-acting risperidone, whereas the proportions of patients with an exacerbation not requiring hospitalization were 60% for haloperidol depot, 37% for oral risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole, and 24% for long-acting risperidone. The mean number of days of relapse requiring hospitalization per patient per year were 28 for haloperidol depot, 18 for oral risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole, and 11 for long-acting risperidone, whereas the mean number of days of exacerbation not requiring hospitalization were eight for haloperidol depot, five for oral risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole

  16. Chemical gel barriers as low-cost alternative to containment and in situ cleanup of hazardous wastes to protect groundwater

    International Nuclear Information System (INIS)

    1997-01-01

    Chemical gel barriers are being considered as a low-cost alternative for containment and in situ cleanup of hazardous wastes to protect groundwater. Most of the available gels in petroleum application are non-reactive and relative impermeable, providing a physical barriers for all fluids and contaminants. However, other potential systems can be envisioned. These systems could include gels that are chemically reactive and impermeable such that most phase are captured by the barriers but the contaminants could diffuse through the barriers. Another system that is chemically reactive and permeable could have potential applications in selectivity capturing contaminants while allowing water to pass through the barriers. This study focused on chemically reactive and permeable gel barriers. The gels used in experiment are DuPont LUDOX SM colloidal silica gel and Pfizer FLOPAAM 1330S hydrolyzed polyacrylamide (HPAM) gel

  17. Transportation Energy Futures Series: Alternative Fuel Infrastructure Expansion: Costs, Resources, Production Capacity, and Retail Availability for Low-Carbon Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Melaina, W. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heath, Garvin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sandor, Debra [National Renewable Energy Lab. (NREL), Golden, CO (United States); Steward, Darlene [National Renewable Energy Lab. (NREL), Golden, CO (United States); Vimmerstedt, Laura [National Renewable Energy Lab. (NREL), Golden, CO (United States); Warner, Ethan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Webster, Karen W. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-04-01

    The petroleum-based transportation fuel system is complex and highly developed, in contrast to the nascent low-petroleum, low-carbon alternative fuel system. This report examines how expansion of the low-carbon transportation fuel infrastructure could contribute to deep reductions in petroleum use and greenhouse gas (GHG) emissions across the U.S. transportation sector. Three low-carbon scenarios, each using a different combination of low-carbon fuels, were developed to explore infrastructure expansion trends consistent with a study goal of reducing transportation sector GHG emissions to 80% less than 2005 levels by 2050.These scenarios were compared to a business-as-usual (BAU) scenario and were evaluated with respect to four criteria: fuel cost estimates, resource availability, fuel production capacity expansion, and retail infrastructure expansion.

  18. Integration of generic issues

    International Nuclear Information System (INIS)

    Thatcher, D.

    1989-01-01

    The NRC has recognized the need to integrate generic issues (GIs). The GI process includes a number of phases, all of which should recognize the potential for overlap and conflict among related issues. In addition to the issues themselves, other related NRC and industry programs and activities need to be factored into the GI process. Integration has taken place, or is taking place, for a number of GIs. Each case of integration involves a specific set of circumstances and, as a result, the way in which integration proceeds can vary. This paper discusses the integration of issues in the generic issue process and provides a number of examples

  19. Generic tacrolimus in solid organ transplantation

    DEFF Research Database (Denmark)

    Taube, D; Jones, G; O'Beirne, J

    2014-01-01

    The availability of a wide range of immunosuppressive therapies has revolutionized the management of patients who have undergone solid organ transplantation (SOT). However, the cost of immunosuppressive drugs remains high. This situation has led to the development of generic equivalents, which...... innovator tacrolimus drug (Prograf) in both healthy volunteers and kidney transplant patients. Clinical experience with this generic tacrolimus formulation has also been established in both de novo and conversion patients who have undergone kidney and liver transplantation, as well as in conversion of other...

  20. Modelling the Costs of Preserving Digital Assets

    DEFF Research Database (Denmark)

    Kejser, Ulla Bøgvad; Nielsen, Anders Bo; Thirifays, Alex

    2012-01-01

    Information is increasingly being produced in digital form, and some of it must be preserved for the longterm. Digital preservation includes a series of actively managed activities that require on-going funding. To obtain sufficient resources, there is a need for assessing the costs...... and the benefits accrued by preserving the assets. Cost data is also needed for optimizing activities and comparing the costs of different preservation alternatives. The purpose of this study is to analyse generic requirements for modelling the cost of preserving digital assets. The analysis was based...

  1. Developing a sustainable bioprocessing strategy based on a generic feedstock.

    Science.gov (United States)

    Webb, C; Koutinas, Wang R; Wang, R

    2004-01-01

    Based on current average yields of wheat per hectare and the saccharide content of wheat grain, it is feasible to produce wheat-based alternatives to many petrochemicals. However, the requirements in terms of wheat utilization would be equivalent to 82% of current production if intermediates and primary building blocks such as ethylene, propylene, and butadiene were to be produced in addition to conventional bioproducts. If only intermediates and bioproducts were produced this requirement would fall to just 11%, while bioproducts alone would require only 7%. These requirements would be easily met if the global wheat yield per hectare of cultivated land was increased from the current average of 2.7 to 5.5 tonnes ha(-1) (well below the current maximum). Preliminary economic evaluation taking into account only raw material costs demonstrated that the use of wheat as a generic feedstock could be advantageous in the case of bioproducts and specific intermediate petrochemicals. Gluten plays a significant role considering the revenue occurring when it is sold as a by-product. A process leading to the production of a generic fermentation feedstock from wheat has been devised and evaluated in terms of efficiency and economics. This feedstock aims at providing a replacement for conventional fermentation media and petrochemical feedstocks. The process can be divided into four major stages--wheat milling; fermentation of whole wheat flour by A. awamori leading to the production of enzymes and fungal cells; glucose enhancement via enzymatic hydrolysis of flour suspensions; and nitrogen/micronutrient enhancement via fungal cell autolysis. Preliminary costings show that the operating cost of the process depends on plant capacity, cereal market price, presence and market value of added-value by-products, labour costs, and mode of processing (batch or continuous).

  2. Generic waste management concepts for six LWR fuel cycles

    International Nuclear Information System (INIS)

    DePue, J.D.

    1979-04-01

    This report supplements the treatment of waste management issues provided in the Generic Environmental Statement on the use of recycle plutonium in mixed oxide fuel in light water cooled reactors (GESMO, NUREG-0002). Three recycle and three no-recycle options are described in this document. Management of the radioactive wastes that would result from implementation of either type of fuel cycle alternative is discussed. For five of the six options, wastes would be placed in deep geologic salt repositories for which thermal criteria are considered. Radiation doses to the workers at the repositories and to the general population are discussed. The report also covers the waste management schedule, the land and salt commitments, and the economic costs for the management of wastes generated

  3. Generic clearance values

    International Nuclear Information System (INIS)

    Bossio, M.C.; Muniz, C.C.

    2009-01-01

    This paper analyzes the Generic Clearance Values established for natural and artificial radionuclides with the objective of evaluating their degree of conservatism in views of adopting them into the regulatory body. Generic clearance values for natural radionuclides have been chosen by experts judgments as the optimum boundary between, on one hand, the ubiquitous unmodified soil concentrations and, on the other hand, activity concentrations in ores, mineral sands, industrial residues and wastes. For artificial radionuclides the clearance levels have been derived from the scenarios postulated in the document 'Safety Reports Series Nr 44' of the IAEA considering quantitative exemption criteria. A set of 8 scenarios were postulated covering external, ingestion and inhalation exposure pathways. For each radionuclide, the generic clearance level was derived as the more restrictive value obtained from the scenarios, that is the lowest ratio between the applicable individual dose and the dose per unit activity concentration (Bq/g). The individual dose was calculated by a formula depending on each scenario and pathway, with different parameters, such as exposure time, dosimetric factors, dilution factor, density of the material, geometric factors, etc. It was concluded that the basis and parameters used for the derivation of the generic clearance levels are quite conservative and therefore its the adoption in Argentina has been recommended. It is expected that their implementation will contribute to optimize the regulatory management system. (author)

  4. Generic Clearance Values

    International Nuclear Information System (INIS)

    Bossio, M.C.; Muniz, C.C.

    2010-01-01

    This paper analyzes the Generic Clearance Values established for natural and artificial radionuclides with the objective of evaluating their degree of conservatism in views of adopting them into the regulatory body. Generic clearance values for natural radionuclides have been chosen by experts judgments as the optimum boundary between, on the one hand, the ubiquitous unmodified soil concentrations and, on the other hand, activity concentrations in ores, mineral sands, industrial residues and wastes. For artificial radionuclides the clearance levels have been derived from the scenarios postulated in the document Safety Reports Series 44 of the IAEA considering quantitative exemption criteria. A set of 8 scenarios were postulated covering external, ingestion and inhalation exposure pathways. For each radionuclide, the generic clearance level was derived as the more restrictive value obtained from the scenarios, that is the lowest ratio between the applicable individual dose and the dose per unit activity concentration (Bq/g). The individual dose was calculated by a formula depending on each scenario and pathway, with different parameters, such as exposure time, dosimetric factors, dilution factor, density of the material, geometric factors, etc. It was concluded that the basis and parameters used for the derivation of the generic clearance levels are quite conservative and therefore its the adoption in Argentina has been recommended. It is expected that their implementation will contribute to optimize the regulatory management system. (authors) [es

  5. Generic phytosanitary irradiation treatments

    Science.gov (United States)

    Hallman, Guy J.

    2012-07-01

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies.

  6. Generic phytosanitary irradiation treatments

    Energy Technology Data Exchange (ETDEWEB)

    Hallman, Guy J [United States Department of Agriculture, Agricultural Research Service, Weslaco, TX (United States)

    2013-01-15

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies. (author)

  7. The generic strategy trap.

    Science.gov (United States)

    Miller, D

    1992-01-01

    Management experts claim that for a company to thrive, it must concentrate on a single generic strategy--on one thing it does better than its rivals. But specialization also has its disadvantages. The author suggests that a broader, mixed approach may be preferable.

  8. Sharing, samples, and generics: an antitrust framework.

    Science.gov (United States)

    Carrier, Michael A

    Rising drug prices are in the news. By increasing price, drug companies have placed vital, even life-saving, medicines out of the reach of consumers. In a recent development, brand firms have prevented generics even from entering the market. The ruse for this strategy involves risk-management programs known as Risk Evaluation and Mitigation Strategies ("REMS"). Pursuant to legislation enacted in 2007, the FDA requires REMS when a drug's risks (such as death or injury) outweigh its rewards. Brands have used this regime, intended to bring drugs to the market, to block generic competition. Regulations such as the federal Hatch-Waxman Act and state substitution laws foster widespread generic competition. But these regimes can only be effectuated through generic entry. And that entry can take place only if a generic can use a brand's sample to show that its product is equivalent. More than 100 generic firms have complained that they have not been able to access needed samples. One study of 40 drugs subject to restricted access programs found that generics' inability to enter cost more than $5 billion a year. Brand firms have contended that antitrust law does not compel them to deal with their competitors and have highlighted concerns related to safety and product liability in justifying their refusals. This Article rebuts these claims. It highlights the importance of samples in the regulatory regime and the FDA's inability to address the issue. It shows how a sharing requirement in this setting is consistent with Supreme Court caselaw. And it demonstrates that the brands' behavior fails the defendant-friendly "no economic sense" test because the conduct literally makes no sense other than by harming generics. Brands' denial of samples offers a textbook case of monopolization. In the universe of pharmaceutical antitrust behavior, other conduct--such as "pay for delay" settlements between brands and generics and "product hopping" from one drug to a slightly modified

  9. Generic Drugs: The Same Medicine for Less Money

    Science.gov (United States)

    ... about brand-name drugs. Resources Consumer Reports Best Buy Drugs can help you find lower-cost generic drugs. ... produced by Consumers Union and Consumer Reports Best Buy Drugs , a public information project supported by grants from ...

  10. Assessment of nuclear energy cost competitiveness against alternative energy sources in Romania envisaging the long-term national energy sustainability

    International Nuclear Information System (INIS)

    Margeanu, C. A.

    2016-01-01

    The paper includes some of the results obtained by RATEN ICN Pitesti experts in the IAEA.s Collaborative Project INPRO-SYNERGIES. The case study proposed to evaluate and analyze the nuclear capacity development and increasing of its share in the national energy sector, envisaging the long term national and regional energy sustainability by keeping collaboration options open for the future while bringing solutions to short/medium-term challenges. The following technologies, considered as future competing technologies for electric energy generation in Romania, were selected: nuclear technology (represented by PHWR CANDU Units 3 and 4 - CANDU new, advanced HWR - Adv. HWR, and advanced PWR - Adv. PWR) and, as alternative energy sources, classical technology (represented by Coal-fired power plant using lignite fossil fuel, with carbon capture - Coal_new, and Gas-fired power plant operating on combined cycle, with carbon capture - Gas_new). The study included assessment of specific economic indicators, sensitivity analyses being performed on Levelised Unit Energy Cost (LUEC) variation due to different perturbations (e.g. discount rate, overnight costs, etc). Robustness indices (RI) of LUEC were also calculated by considering simultaneous variation of input parameters for the considered power plants. The economic analyses have been performed by using the IAEA.s NEST program. The study results confirmed that in Romania, under the national specific conditions defined, electricity produced by nuclear power plants is cost competitive against coal and gas fired power plants electricity. The highest impact of considered perturbations on LUEC has been observed for capital intensive technologies (nuclear technologies) comparatively with the classic power plants, especially for discount rate changes. (authors)

  11. Cost-benefit analysis of using sewage sludge as alternative fuel in a cement plant: a case study.

    Science.gov (United States)

    Nadal, Martí; Schuhmacher, Marta; Domingo, José L

    2009-05-01

    To enforce the implementation of the Kyoto Protocol targets, a number of governmental/international institutions have launched emission trade schemes as an approach to specify CO(2) caps and to regulate the emission trade in recent years. These schemes have been basically applied for large industrial sectors, including energy producers and energy-intensive users. Among them, cement plants are included among the big greenhouse gas (GHG) emitters. The use of waste as secondary fuel in clinker kilns is currently an intensive practice worldwide. However, people living in the vicinity of cement plants, where alternative fuels are being used, are frequently concerned about the potential increase in health risks. In the present study, a cost-benefit analysis was applied after substituting classical fuel for sewage sludge as an alternative fuel in a clinker kiln in Catalonia, Spain. The economical benefits resulting in the reduction of CO(2) emissions were compared with the changes in human health risks due to exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and carcinogenic metals (As, Cd, Co, and Cr) before and after using sewage sludge to generate 20% of the thermal energy needed for pyro-processing. The exposure to PCDD/Fs and metals through air inhalation, soil ingestion and dermal absorption was calculated according to the environmental levels in soil. The carcinogenic risks were assessed, and the associated cost for the population was estimated by considering the DG Environment's recommended value for preventing a statistical fatality (VPF). In turn, the amount of CO(2) emitted was calculated, and the economical saving, according to the market prices, was evaluated. The use of sewage sludge as a substitute of conventional energy meant a probability cancer decrease of 4.60 for metals and a cancer risk increase of 0.04 for PCDD/Fs. Overall, a net reduction of 4.56 cancers for one million people can be estimated. The associated economical

  12. Prioritization of generic safety issues

    International Nuclear Information System (INIS)

    Emrit, R.; Minners, W.; VanderMolen, H.

    1983-12-01

    This report presents the priority rankings for generic safety issues related to nuclear power plants. The purpose of these rankings is to assist in the timely and efficient allocation of NRC resources for the resolution of those safety issues that have a significant potential for reducing risk. The report focuses on the prioritization of generic safety issues. Issues primarily concerned with the licensing process or environmental protection and not directly related to safety have been excluded from prioritization. The prioritized issues include: TMI Action Plan items under development; previously proposed issues covered by Task Action Plans, except issues designated at Unresolved Safety Issues (USIs) which had already been assigned high priority; and newly-proposed issues. Future supplements to this report will include the prioritization of additional issues. The safety priority rankings are HIGH, MEDIUM, LOW, and DROP and have been assigned on the basis of risk significance estimates, the ratio of risk to costs and other impacts estimated to result if resolutions of the safety issues were implemented, and the consideration of uncertainties and other quantitative or qualitative factors. To the extent practical, estimates are quantitative

  13. The cost-effectiveness of alternative vaccination strategies for polyvalent meningococcal vaccines in Burkina Faso: A transmission dynamic modeling study.

    Science.gov (United States)

    Yaesoubi, Reza; Trotter, Caroline; Colijn, Caroline; Yaesoubi, Maziar; Colombini, Anaïs; Resch, Stephen; Kristiansen, Paul A; LaForce, F Marc; Cohen, Ted

    2018-01-01

    The introduction of a conjugate vaccine for serogroup A Neisseria meningitidis has dramatically reduced disease in the African meningitis belt. In this context, important questions remain about the performance of different vaccine policies that target remaining serogroups. Here, we estimate the health impact and cost associated with several alternative vaccination policies in Burkina Faso. We developed and calibrated a mathematical model of meningococcal transmission to project the disability-adjusted life years (DALYs) averted and costs associated with the current Base policy (serogroup A conjugate vaccination at 9 months, as part of the Expanded Program on Immunization [EPI], plus district-specific reactive vaccination campaigns using polyvalent meningococcal polysaccharide [PMP] vaccine in response to outbreaks) and three alternative policies: (1) Base Prime: novel polyvalent meningococcal conjugate (PMC) vaccine replaces the serogroup A conjugate in EPI and is also used in reactive campaigns; (2) Prevention 1: PMC used in EPI and in a nationwide catch-up campaign for 1-18-year-olds; and (3) Prevention 2: Prevention 1, except the nationwide campaign includes individuals up to 29 years old. Over a 30-year simulation period, Prevention 2 would avert 78% of the meningococcal cases (95% prediction interval: 63%-90%) expected under the Base policy if serogroup A is not replaced by remaining serogroups after elimination, and would avert 87% (77%-93%) of meningococcal cases if complete strain replacement occurs. Compared to the Base policy and at the PMC vaccine price of US$4 per dose, strategies that use PMC vaccine (i.e., Base Prime and Preventions 1 and 2) are expected to be cost saving if strain replacement occurs, and would cost US$51 (-US$236, US$490), US$188 (-US$97, US$626), and US$246 (-US$53, US$703) per DALY averted, respectively, if strain replacement does not occur. An important potential limitation of our study is the simplifying assumption that all

  14. COMPLEAT (Community-Oriented Model for Planning Least-Cost Energy Alternatives and Technologies): A planning tool for publicly owned electric utilities. [Community-Oriented Model for Planning Least-Cost Energy Alternatives and Technologies (Compleat)

    Energy Technology Data Exchange (ETDEWEB)

    1990-09-01

    COMPLEAT takes its name, as an acronym, from Community-Oriented Model for Planning Least-Cost Energy Alternatives and Technologies. It is an electric utility planning model designed for use principally by publicly owned electric utilities and agencies serving such utilities. As a model, COMPLEAT is significantly more full-featured and complex than called out in APPA's original plan and proposal to DOE. The additional complexity grew out of a series of discussions early in the development schedule, in which it became clear to APPA staff and advisors that the simplicity characterizing the original plan, while highly desirable in terms of utility applications, was not achievable if practical utility problems were to be addressed. The project teams settled on Energy 20/20, an existing model developed by Dr. George Backus of Policy Assessment Associates, as the best candidate for the kinds of modifications and extensions that would be required. The remainder of the project effort was devoted to designing specific input data files, output files, and user screens and to writing and testing the compute programs that would properly implement the desired features around Energy 20/20 as a core program. This report presents in outline form, the features and user interface of COMPLEAT.

  15. Generic and biosimilar medicines: quid?

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2012-12-01

    Full Text Available Once intellectual property protection, data and marketing exclusivity of reference medicines have expired, generic medicines and biosimilar medicines can enter the off-patent market. This market entry is conditional on the approval of marketing authorization, pricing and reimbursement. Given that there tends to be confusion surrounding generic and biosimilar medicines, this Editorial introduces basic concepts related to generic and biosimilar medicines and presents the different studies and articles included in this supplement dedicated to generic and biosimilar medicines.

  16. The Square Curve Paradigm for Research in Alternative, Complementary, and Holistic Medicine: A Cost-Effective, Easy, and Scientifically Valid Design for Evidence-Based Medicine and Quality Improvement

    Directory of Open Access Journals (Sweden)

    Soren Ventegodt

    2003-01-01

    Full Text Available In this paper we present a new research paradigm for alternative, complementary, and holistic medicine — a low-cost, effective, and scientifically valid design for evidence-based medicine. Our aim is to find the simplest, cheapest, and most practical way to collect data of sufficient quality and validity to determine: (1 which kinds of treatment give a clinically relevant improvement to quality of life, health, and/or functionality; (2 which groups of patients can be aided by alternative, complementary, or holistic medicine; and (3 which therapists have the competence to achieve the clinically relevant improvements. Our solution to the problem is that a positive change in quality of life must be immediate to be taken as caused by an intervention. We define “immediate” as within 1 month of the intervention. If we can demonstrate a positive result with a group of chronic patients (20 or more patients who have had their disease or state of suffering for 1 year or more, who can be significantly helped within 1 month, and the situation is still improved 1 year after, we find it scientifically evidenced that this cure or intervention has helped the patients. We call this characteristic curve a “square curve”. If a global, generic, quality-of-life questionnaire like QOL5 or, even better, a QOL-Health-Ability questionnaire (a quality-of-life questionnaire combined with a self-evaluated health and ability to function questionnaire is administered to the patients before and after the intervention, it is possible to document the effect of an intervention to a cost of only a few thousand Euros/USD. A general acceptance of this new research design will solve the problem that there is not enough money in alternative, complementary, and holistic medicine to pay the normal cost of a biomedical Cochrane study. As financial problems must not hinder the vital research in nonbiomedical medicine, we ask the scientific community to accept this new research

  17. Generics Pricing: The Greek Paradox.

    Science.gov (United States)

    Karafyllis, Ioannis; Variti, Lamprini

    2017-01-01

    This paper explains and develops a methodological framework to help evaluate the performance of generic pharmaceutical policies and the correct evaluation of generics sales. Until today erroneous recording of generics does not help proper pricing and their penetration in the Greek market. This classifies Greece on the outliners in every study or comparison that is referred on papers or studies.

  18. Encouraging the use of generic medicines: implications for transition economies.

    Science.gov (United States)

    King, Derek R; Kanavos, Panos

    2002-08-01

    Generic drugs have a key role to play in the efficient allocation of financial resources for pharmaceutical medicines. Policies implemented in the countries with a high rate of generic drug use, such as Canada, Denmark, Germany, the Netherlands, the United Kingdom, and the United States, are reviewed, with consideration of the market structures that facilitate strong competition. Savings in these countries are realized through increases in the volume of generic drugs used and the frequently significant differences in the price between generic medicines and branded originator medicines. Their policy tools include the mix of supply-side measures and demand-side measures that are relevant for generic promotion and higher generic use. On the supply-side, key policy measures include generic drug marketing regulation that facilitates market entry soon after patent expiration, reference pricing, the pricing of branded originator products, and the degree of price competition in pharmaceutical markets. On the demand-side, measures typically encompass influencing prescribing and dispensing patterns as well as introducing a co-payment structure for consumers/patients that takes into consideration the difference in cost between branded and generic medicines. Quality of generic medicines is a pre-condition for all other measures discussed to take effect. The paper concludes by offering a list of policy options for decision-makers in Central and Eastern European economies in transition.

  19. Edible Cricothyrotomy Model: A Low-Cost Alternative to Pig Tracheas and Plastic Models for Teaching Cricothyrotomy

    Directory of Open Access Journals (Sweden)

    Robert J Bryant

    2017-01-01

    , Interquartile Range [IQR] 24-41 sec and PM (median 33 sec, IQR 28-39 sec than on the EC (44 sec, IQR 35-63. There was a statistically significant divergence in preference (p=0.0001 with participants rating the PT first (median rank 1, IQR 1-1, the EC second (median rank 2, IQR 2-2, and the PM third (median rank 3, IQR 2.5-3. Cost of the models at the time of analysis (October, 2104 was $2.77 for EC and $7.64 for PT. The plastic model was built from materials obtained in the emergency department (ventilator tubing, 4-inch white foam tape, ½ inch white tape, and Coban. These materials were not purchased, so cost per plastic model was not calculated. Conclusion: A novel, edible cricothyrotomy training model is a suitable and cost effective alternative to a pig trachea and has a role for learners seeking multiple attempts at the procedure for skills maintenance and retention.

  20. Generic Reed Solomon Encorder

    Directory of Open Access Journals (Sweden)

    Petrus Mursanto

    2006-11-01

    Full Text Available Reed Solomon (RS codes is a mechanism to detect and correct burst of errors in data transmission and storage systems. It provides a solid introduction to foundation mathematical concept of Galois Field algebra and its application. With the development of digital hardware technology, the RS concepts were brought into reality, i.e. the implementation of RS codec chips. This paper presents the development steps of a generic RS encoder using VHDL. The encoder is able to handle generic width of data, variable length of information, number of error as well as variable form of primitive polynomial and generator polynomial used in the system. The design has been implemented for FPGA chip Xilinx XC3S200-5FT256 and has a better performance than commercially available equivalent encoder.

  1. Uranium milling, project M-25. Volume I. summary and text. Final generic environmental impact statement

    International Nuclear Information System (INIS)

    1980-09-01

    The Final Generic Environmental Impact Statement (GEIS) on Uranium Milling focuses primarily upon the matter of mill tailings disposal. It evaluates both the costs and benefits of alternative tailings disposal modes and draws conclusions about criteria which should be incorporated into regulations. Both institutional and technical controls are evaluated. Health impacts considered were both short and long term. Restatement and resolution of all public comments received on the draft (GEIS) are presented. There are three volumes: Volume I is the main text and Volumes II and III are supporting appendices

  2. Comparison of generic-to-brand switchback patterns for generic and authorized generic drugs

    Science.gov (United States)

    Hansen, Richard A.; Qian, Jingjing; Berg, Richard; Linneman, James; Seoane-Vazquez, Enrique; Dutcher, Sarah K.; Raofi, Saeid; Page, C. David; Peissig, Peggy

    2018-01-01

    Background While generic drugs are therapeutically equivalent to brand drugs, some patients and healthcare providers remain uncertain about whether they produce identical outcomes. Authorized generics, which are identical in formulation to corresponding brand drugs but marketed as a generic, provide a unique post-marketing opportunity to study whether utilization patterns are influenced by perceptions of generic drugs. Objectives To compare generic-to-brand switchback rates between generics and authorized generics. Methods A retrospective cohort study was conducted using claims and electronic health records data from a regional U.S. healthcare system. Ten drugs with authorized generics and generics marketed between 1999 and 2014 were evaluated. Eligible adult patients received a brand drug during the 6 months preceding generic entry, and then switched to a generic or authorized generic. Patients in this cohort were followed for up to 30 months from the index switch date to evaluate occurrence of generic-to-brand switchbacks. Switchback rates were compared between patients on authorized generics versus generics using Kaplan-Meier curves and Cox proportional hazards models, controlling for individual drug effects, age, sex, Charlson comorbidity score, pre-index drug use characteristics, and pre-index healthcare utilization. Results Among 5,542 unique patients that switched from brand-to-generic or brand-to-authorized generic, 264 (4.8%) switched back to the brand drug. Overall switchback rates were similar for authorized generics compared with generics (HR=0.86; 95% CI 0.65-1.15). The likelihood of switchback was higher for alendronate (HR=1.64; 95% CI 1.20-2.23) and simvastatin (HR=1.81; 95% CI 1.30-2.54) and lower for amlodipine (HR=0.27; 95% CI 0.17-0.42) compared with other drugs in the cohort. Conclusions Overall switchback rates were similar between authorized generic and generic drug users, indirectly supporting similar efficacy and tolerability profiles for

  3. Satisfying the Energy Demand of a Rural Area by Considering the Investment on Renewable Energy Alternatives and Depreciation Costs

    Directory of Open Access Journals (Sweden)

    Masoud Rabbani

    2014-01-01

    Full Text Available In this paper, a fuzzy multiobjective model which chooses the best mix of renewable energy options and determines the optimal amount of energy to be transferred from each resource to each end use is proposed. The depreciation of equipment along with time value of money has been taken into account in the first objective function while the second and the third objective functions minimize the greenhouse gas emissions and water consumption, respectively. Also, this study is one of the pioneer works that has considered demand-side management (DSM as a competitive option against supply-side alternatives for making apt energy planning decisions. Moreover, the intrinsic uncertainty of demand parameter is considered and modeled by fuzzy numbers. To convert the proposed fuzzy multiobjective formulation to a crisp single-objective formulation the well-known fuzzy goal programming approach together with Jimenez defuzzifying technique is employed. The model is validated through setting up a diversity of datasets whose data were mostly derived from the literature. The obtained results show that DSM programs have greatly contributed to cost reductions in the network. Also, it is concluded that the model is capable of solving even large-scaled instances of problems in negligible central processing unit (CPU times using Lingo 8.0 software.

  4. 41 CFR 301-70.505 - May any travel costs be reimbursed if the employee travels to an alternate location for medical...

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May any travel costs be reimbursed if the employee travels to an alternate location for medical treatment? 301-70.505 Section 301-70.505 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES...

  5. Low-Budget Computer Programming in Your School (An Alternative to the Cost of Large Computers). Illinois Series on Educational Applications of Computers. No. 14.

    Science.gov (United States)

    Dennis, J. Richard; Thomson, David

    This paper is concerned with a low cost alternative for providing computer experience to secondary school students. The brief discussion covers the programmable calculator and its relevance for teaching the concepts and the rudiments of computer programming and for computer problem solving. A list of twenty-five programming activities related to…

  6. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: Results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    M.F. Hitzert (Marit); M.A.A. Hermus (Marieke A.A.); Boesveld, I.I.C. (Inge I.C.); A. Franx (Arie); K.M. van der Pal-De Bruin (Karin); E.A.P. Steegers (Eric); Van Den Akker-Van Marle, E.M.E. (Eiske M.E.)

    2017-01-01

    textabstractObjectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design

  7. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    Hitzert, M.; Hermus, M.M.; Boesveld, I.I.; Franx, A.; Pal-de Bruin, K.K. van der; Steegers, E.E.; Akker-van Marle, E.M. van den

    2017-01-01

    Objectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design Economic evaluation

  8. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth : Results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    Hitzert, Marit F.; Hermus, Marieke A. A.; Boesveld, Inge I.C.; Franx, Arie; van der Pal-de Bruin, Karin M.; Steegers, Eric A. P.; Van Den Akker-Van Marle, Eiske M.E.

    2017-01-01

    Objectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design Economic evaluation

  9. Generic patch inference

    DEFF Research Database (Denmark)

    Andersen, Jesper; Lawall, Julia

    2010-01-01

    A key issue in maintaining Linux device drivers is the need to keep them up to date with respect to evolutions in Linux internal libraries. Currently, there is little tool support for performing and documenting such changes. In this paper we present a tool, spdiff, that identifies common changes...... developers can use it to extract an abstract representation of the set of changes that others have made. Our experiments on recent changes in Linux show that the inferred generic patches are more concise than the corresponding patches found in commits to the Linux source tree while being safe with respect...

  10. Benefits of Digital Equipment Generic Qualification Activities

    International Nuclear Information System (INIS)

    Thomas, James E.; Steiman, Samuel C.

    2002-01-01

    As a result of nuclear power plant instrumentation and control obsolescence issues, there have been numerous activities during recent years relating to the qualification of digital equipment. Some of these activities have been 'generic' in nature in that the qualification was not limited to plant specific applications, but was intended to cover a broad base of potential applications of the digital equipment. These generic qualifications have been funded by equipment manufacturers and by utility groups and organizations. The generic activities sponsored by the Electric Power Research Institute (EPRI) have been pilot projects for an overall generic qualification approach. The primary benefit resulting from the generic qualification work to date is that a number of digital platforms and digital devices are now available for use in various nuclear safety-related applications. Many of the tests and evaluations necessary to support plant specific applications have been completed. The amount of data and documentation that each utility must develop on a case by case basis has been significantly reduced. There are also a number of additional benefits resulting from these industry efforts. The challenges and difficulties in qualifying digital equipment for safety-related applications are now more clearly understood. EPRI has published a lessons learned document (EPRI Report 1001452, Generic Qualification of Commercial Grade Digital Devices: Lessons Learned from Initial Pilots, which covers several different qualification areas, including device selection, project planning, vendor surveys and design reviews, and electromagnetic compatibility (EMC) qualification. Application of the experience and lessons learned from the EPRI pilot activities should help reduce the effort and cost required for future qualification work. Most generic qualification activities for commercial equipment have been conducted using the approach of EPRI TR-106439, Guideline on Evaluation and Acceptance

  11. Use and costs of prescription medications and alternative treatments in patients with osteoarthritis and chronic low back pain in community-based settings.

    Science.gov (United States)

    Gore, Mugdha; Tai, Kei-Sing; Sadosky, Alesia; Leslie, Douglas; Stacey, Brett R

    2012-09-01

    To evaluate the use and direct medical costs of pharmacologic and alternative treatments for patients with osteoarthritis (OA) and chronic low back pain (CLBP). The LifeLink™ Health Plan Claims Database was used to identify patients ≥18 years old, diagnosed with OA (N = 112,951) or CLBP (N = 101,294). Of these patients, 64,085 with OA and 47,386 with CLBP received pain-related treatments during CY2008 and were selected for inclusion. For patients in both cohorts, pharmacologic and alternative treatments, and direct medical costs were examined during CY2008. Opioids were the most frequently prescribed medication (>70%) in both groups, followed by nonselective nonsteroidal anti-inflammatory drugs (>50%). Over 30% received antidepressants, >20% received benzodiazepines, and 15% in each group received sedative hypnotics. Use of alternative treatments was as follows: chiropractor, OA 11%, CLBP 34%; physical therapy, 20% in both groups; transcutaneous electrical nerve stimulations (TENS), OA 14%, CLBP 22%; acupuncture, hydrotherapy, massage therapy, and biofeedback, patients were, OA: $15,638 ($22,595); CLBP: $11,829 ($20,035). Pharmacologic therapies accounted for approximately 20% of these costs, whereas alternative treatments accounted for only 3% to 4% of the total costs. Patients with OA and CLBP used a variety of pain-related and adjunctive medications. Although, alternative treatments are widely recommended, we found limited use of several of these in clinical practice, potentially due to the source of our data (commercial claims). Further research is needed to ascertain the extent to which such therapies contribute to the total costs of OA and CLBP management. © 2012 The Authors. Pain Practice © 2012 World Institute of Pain.

  12. Generic maintenance immunosuppression in solid organ transplant recipients.

    Science.gov (United States)

    Ensor, Christopher R; Trofe-Clark, Jennifer; Gabardi, Steven; McDevitt-Potter, Lisa M; Shullo, Michael A

    2011-11-01

    Survival after solid organ transplantation has increased in the era of tacrolimus and mycophenolate. This increased survival could be due in part to the broad clinical use of these potent and specific agents for maintenance immunosuppression. These drugs have enhanced specificity and potency for T and B lymphocytes compared with their predecessors, cyclosporine and azathioprine. Between 2008 and 2010, the United States Food and Drug Administration approved several generic formulations of both tacrolimus and mycophenolate mofetil. Deciding whether generic products can be safely substituted for the innovator product is a clinical dilemma similar to that which occurred when generic formulations of cyclosporine became available. We describe the concerns regarding generic immunosuppression use, summarize expert opinion and consensus statements in transplantation, analyze the potential impact of generic substitution, and provide estimates of populations affected based on generic drug market penetration. Formulary considerations such as cost, availability, and potential drug ordering and drug selection errors are described, and transplant coordinator and patient perspectives are reviewed. Finally, general recommendations about the use of generic maintenance immunosuppression in solid organ transplant recipients are provided. Although more research is needed to confirm clinical and therapeutic equivalence and pharmacoeconomic benefit, generic immunosuppressants can be safely substituted for innovator products as long as patients consistently receive the same product, patients and clinicians are aware of when substitutions occur, and enhanced therapeutic drug monitoring is provided during the transition.

  13. Generic medicines: Perceptions of Physicians in Basrah, Iraq

    Directory of Open Access Journals (Sweden)

    Adheed Khalid Sharrad

    2009-08-01

    Full Text Available BackgroundThe use of cheaper generic medicines is a strategy promotedin many countries to reduce rising health care costs. The aimof this study was to explore factors affecting generic medicineprescribing by physicians in Basrah, Iraq.MethodologyA purposive sample of ten physicians practicing in Basrahwas interviewed using a semi-structured interview guide.ResultsAnalysis of the interviews identified seven major themes:medicine prescribing practice, knowledge of therapeuticequivalency of generic medicine, patients’ acceptance ofgeneric medicine, counterfeit medicine, drug informationsource and effect of drug advertising on medicines choice,brand substitution practice by community pharmacists, and,finally strategies to improve generic medicine usefulness.Participants identified helpful strategies to increase genericprescribing including; physician and patient education ongeneric medicine; persuading physicians about the safety andefficacy of generic medicines; and finally educating seniormedical students on generic prescribing.ConclusionThe data suggest that participants were enthusiasticabout prescribing generic medicines. However physiciansinsist that pharmacists should not be allowed tosubstitute generic drugs without prior approval ofdoctors.

  14. Generic drug policy in Australia: a community pharmacy perspective

    Science.gov (United States)

    Beecroft, Grahame

    2007-01-01

    This article provides a commentary, from a community pharmacy perspective, on the policy environment for the pharmacy sector in Australia, with a particular focus on present challenges arising from proposals to achieve substantial PBS cost savings from an anticipated surge of new generic drugs. Some $2 billion of medicines currently on the PBS will come off patent in the next 4 years. This growth comes from a low base where generics currently account for only 15% of the total PBS budget. Remuneration for PBS dispensing is fixed through five year agreements with the government, so trading terms on generics are important for the cross-subsidy of other dispensing activities and professional services. These trading terms (discounts provided by generics suppliers) have become part of the overall cost and revenue structure of pharmacies. Despite these arrangements, generic substitution rates in Australia are lower than in most comparable countries, which the government views as an opportunity to promote generic use. The future of generic drug supply via the PBS is important to allow consumers access to medications at the lowest possible price and to provide space for PBS listing of new and expensive drugs. But considerations of PBS reform need to take account of the role and viability of community pharmacy sector as provider of pharmaceuticals in a timely and efficient manner to Australian residents. PMID:17543112

  15. Development of the generic drug industry in the US after the Hatch-Waxman Act of 1984

    Directory of Open Access Journals (Sweden)

    Garth Boehm

    2013-09-01

    Full Text Available The key events in the development of the US generic drug industry after the Hatch-Waxman Act of 1984 are systematically reviewed, including the process of approval for generic drugs, bioequivalence issues including “switchability”, bioequivalence for complicated dosage forms, patent extension, generic drug safety, generic substitution and low-cost generics. The backlog in generic review, generic drug user fees, and “quality by design” for generic drugs is also discussed. The evolution of the US generic drug industry after the Hatch-Waxman Act in 1984 has afforded several lessons of great benefit to other countries wishing to establish or re-establish a domestic generic drug industry.

  16. Technology, safety, and costs of decommissioning a reference pressurized water reactor power station. Appendices

    International Nuclear Information System (INIS)

    Smith, R.I.; Konzek, G.J.; Kennedy, W.E. Jr.

    1978-05-01

    Detailed appendices are presented under the following headings: reference PWR facility description, reference PWR site description, estimates of residual radioactivity, alternative methods for financing decommissioning, radiation dose methodology, generic decommissioning activities, intermediate dismantlement activities, safe storage and deferred dismantlement activities, compilation of unit cost factors, and safety assessment details

  17. An Analysis of the Cost Effectiveness of Various Electronic Alternatives for Delivering Distance Education Compared to the Travel Costs for Live Instruction.

    Science.gov (United States)

    Caffarella, Edward; And Others

    The feasibility and relative costs of four telecommunication systems for delivering university courses to distant locations in Colorado were compared. The four systems were compressed video, vertical blanking interval video, satellite video, and audiographic systems. Actual costs to install and operate each for a 5-year period were determined,…

  18. Advertising and generic market entry.

    Science.gov (United States)

    Königbauer, Ingrid

    2007-03-01

    The effect of purely persuasive advertising on generic market entry and social welfare is analysed. An incumbent has the possibility to invest in advertising which affects the prescribing physician's perceived relative qualities of the brand-name and the generic version of the drug. Advertising creates product differentiation and can induce generic market entry which is deterred without differentiation due to strong Bertrand competition. However, over-investment in advertising can deter generic market entry under certain conditions and reduces welfare as compared to accommodated market entry.

  19. Do higher-priced generic medicines enjoy a competitive advantage under reference pricing?

    Science.gov (United States)

    Puig-Junoy, Jaume

    2012-11-01

    In many countries with generic reference pricing, generic producers and distributors compete by means of undisclosed discounts offered to pharmacies in order to reduce acquisition costs and to induce them to dispense their generic to patients in preference over others. The objective of this article is to test the hypothesis that under prevailing reference pricing systems for generic medicines, those medicines sold at a higher consumer price may enjoy a competitive advantage. Real transaction prices for 179 generic medicines acquired by pharmacies in Spain have been used to calculate the discount rate on acquisition versus reimbursed costs to pharmacies. Two empirical hypotheses are tested: the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical presentations for which there are more generic competitors; and, the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical forms for which the consumer price has declined less in relation to the consumer price of the brand drug before generic entry (higher-priced generic medicines). An average discount rate of 39.3% on acquisition versus reimbursed costs to pharmacies has been observed. The magnitude of the discount positively depends on the number of competitors in the market. The higher the ratio of the consumer price of the generic to that of the brand drug prior to generic entry (i.e. the smaller the price reduction of the generic in relation to the brand drug), the larger the discount rate. Under reference pricing there is intense price competition among generic firms in the form of unusually high discounts to pharmacies on official ex-factory prices reimbursed to pharmacies. However, this effect is highly distorting because it favours those medicines with a higher relative price in relation to the brand price before generic entry.

  20. Comparison of Generic-to-Brand Switchback Rates Between Generic and Authorized Generic Drugs.

    Science.gov (United States)

    Hansen, Richard A; Qian, Jingjing; Berg, Richard; Linneman, James; Seoane-Vazquez, Enrique; Dutcher, Sarah K; Raofi, Saeid; Page, C David; Peissig, Peggy

    2017-04-01

    Generic drugs contain identical active ingredients as their corresponding brand drugs and are pharmaceutically equivalent and bioequivalent, whereas authorized generic drugs (AGs) contain both identical active and inactive ingredients as their corresponding brand drugs but are marketed as generics. This study compares generic-to-brand switchback rates between generic and AGs. Retrospective cohort study. Claims and electronic health record data from a regional U.S. health care system. The full cohort consisted of 5542 unique patients who received select branded drugs during the 6 months prior to their generic drug market availability (between 1999 and 2014) and then were switched to an AG or generic drug within 30 months of generic drug entry. For these patients, 5929 unique patient-drug combinations (867 with AGs and 5062 with generic drugs) were evaluated. Ten drugs with AGs and generics marketed between 1999 and 2014 were evaluated. The date of the first generic prescription was considered the index date for each drug, and it marked the beginning of follow-up to evaluate the occurrence of generic-to-brand switchback patterns over the subsequent 30 months. Switchback rates were compared between patients receiving AGs versus those receiving generics using multivariable Cox proportional hazards models, controlling for individual drug effects, age, sex, Charlson Comorbidity Score, pre-index drug use characteristics, and pre-index health care utilization. Among the 5542 unique patients who switched from brand to generic or brand to AG, 264 (4.8%) switched back to the brand drug. Overall switchback rates were similar for AGs compared with generics (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.65-1.15). The likelihood of switchback was higher for alendronate (HR 1.64, 95% CI 1.20-2.23) and simvastatin (HR 1.81, 95% CI 1.30-2.54) and lower for amlodipine (HR 0.27, 95% CI 0.17-0.42) compared with the other drugs evaluated. Overall switchback rates were similar

  1. Cost analysis and economic comparison for alternative fuel cycles in the heavy water cooled canadian reactor (CANDU)

    International Nuclear Information System (INIS)

    Yilmaz, S.

    2000-01-01

    Three main options in a CANDU fuel cycle involve use of: (1) natural uranium (0.711 weight percent U-235) fuel, (2) slightly enriched uranium (1.2 weight percent U-235) fuel, and (3) recovered uranium (0.83 weight percent U-235) fuel from light water reactor spent fuel. ORIGEN-2 computer code was used to identify composition of the spent fuel for each option, including the standard LWR fuel (3.3 weight percent U-235). Uranium and plutonium credit calculations were performed using ORIGEN-2 output. WIMSD-5 computer code was used to determine maximum discharge burnup values for each case. For the 3 cycles selected (natural uranium, slightly enriched uranium, recovered uranium), levelized fuel cycle cost calculations are performed over the reactor lifetime of 40 years, using unit process costs obtained from literature. Components of the fuel cycle costs are U purchase, conversion, enrichment, fabrication, SF storage, SF disposal, and reprocessing where applicable. Cost parameters whose effects on the fuel cycle cost are to be investigated are escalation ratio, discount rate and SF storage time. Cost estimations were carried out using specially developed computer programs. Share of each cost component on the total cost was determined and sensitivity analysis was performed in order to show how a change in a main cost component affects the fuel cycle cost. The main objective of this study has been to find out the most economical option for CANDU fuel cycle by changing unit prices and cost parameters

  2. InP-based generic foundry platform for photonic integrated circuits

    NARCIS (Netherlands)

    Augustin, L.M.; Lemos Alvares Dos Santos, R.M.; den Haan, E.; Kleijn, S.E.F.; Thijs, P.J.A.; Latkowski, S.; Zhao, D.; Yao, W.; Bolk, J.; Ambrosius, H.P.M.M.; Mingaleev, S.; Richter, A.; Bakker, A.; Korthorst, T.

    2017-01-01

    The standardization of photonic integration processes for InP has led to versatile and easily accessible generic integration platforms. The generic integration platforms enable the realization of a broad range of applications and lead to a dramatic cost reduction in the development costs of photonic

  3. Costs and outcomes associated with alternative discharge strategies following joint replacement surgery: analysis of an observational study using a propensity score.

    Science.gov (United States)

    Coyte, P C; Young, W; Croxford, R

    2000-11-01

    We estimated the impact of alternative discharge strategies, following joint replacement (JR) surgery, on acute care readmission rates and the total cost of a continuum of care. Following surgery, patients were discharged to one of four destinations. Propensity scores were used to adjust costs and outcomes for potential bias in the assignment of discharge destinations. We demonstrated that the use of rehabilitation hospitals may lower readmission rates, but at a prohibitive incremental cost of each saved readmission, that patients discharged with home care had longer acute care stays than other patients, that the provision of home care services increased health system costs, and that acute care readmission rates were greatest among patients discharged with home care. Our study should be seen as one important stepping stone towards a full economic evaluation of the continuum of care for patients.

  4. LISSAT Analysis of a Generic Centrifuge Enrichment Plant

    International Nuclear Information System (INIS)

    Lambert, H; Elayat, H A; O'Connell, W J; Szytel, L; Dreicer, M

    2007-01-01

    The U.S. Department of Energy (DOE) is interested in developing tools and methods for use in designing and evaluating safeguards systems for current and future plants in the nuclear power fuel cycle. The DOE is engaging several DOE National Laboratories in efforts applied to safeguards for chemical conversion plants and gaseous centrifuge enrichment plants. As part of the development, Lawrence Livermore National Laboratory has developed an integrated safeguards system analysis tool (LISSAT). This tool provides modeling and analysis of facility and safeguards operations, generation of diversion paths, and evaluation of safeguards system effectiveness. The constituent elements of diversion scenarios, including material extraction and concealment measures, are structured using directed graphs (digraphs) and fault trees. Statistical analysis evaluates the effectiveness of measurement verification plans and randomly timed inspections. Time domain simulations analyze significant scenarios, especially those involving alternate time ordering of events or issues of timeliness. Such simulations can provide additional information to the fault tree analysis and can help identify the range of normal operations and, by extension, identify additional plant operational signatures of diversions. LISSAT analyses can be used to compare the diversion-detection probabilities for individual safeguards technologies and to inform overall strategy implementations for present and future plants. Additionally, LISSAT can be the basis for a rigorous cost-effectiveness analysis of safeguards and design options. This paper will describe the results of a LISSAT analysis of a generic centrifuge enrichment plant. The paper will describe the diversion scenarios analyzed and the effectiveness of various safeguards systems alternatives

  5. Consumer choice between common generic and brand medicines in a country with a small generic market.

    Science.gov (United States)

    Fraeyman, Jessica; Peeters, Lies; Van Hal, Guido; Beutels, Philippe; De Meyer, Guido R Y; De Loof, Hans

    2015-04-01

    Generic medicines offer an opportunity for governments to contain pharmaceutical expenditures, since generics are generally 10%-80% lower in price than brand medicines. Belgium has a small generic market that takes up 15% of the total pharmaceutical market in packages sold. To determine the knowledge of consumers about the different available packages of a common over-the-counter medicine (acetaminophen) with regard to price advantage, quality, and effectiveness in a country with a small generic market. We conducted an online survey in the general Flemish population using a questionnaire with 25 statements. The questionnaire also contained 2 informative interventions. First, we showed the price per package and per tablet that the patient would pay in the pharmacy. Second, we provided the respondent with general information about generic medication (equivalence, effectiveness, price, and recognition). Before and after the interventions, we probed for preferences and knowledge about the different packages. Multivariate logistic models were used to examine the independent effects of consumer characteristics on responses to the survey statements. We obtained a sample of 1,636 respondents. The general attitude towards generic medication was positive-only 5% would rather not use a generic. Nevertheless, only 17% of the respondents were able to recognize a generic medicine. Older consumers (aged 60 years and above) were more often confused about the different packages (OR = 2.59, 95% CI = 1.76-3.80, P ≤ 0.001). Consumers without a higher education degree tended to be more doubtful about the difference in effectiveness and quality between the different brands (OR = 0.59, 95% CI = 0.44-0.79, P ≤ 0.001). Consumer recognition of the name of the active substance of acetaminophen was poor. When different brands were displayed, possible price advantage seemed to be an important motive to switch to a cheaper brand. Consumers generally found medicines

  6. Joint U.S./Russian Study on the Development of a Preliminary Cost Estimate of the SAFSTOR Decommissioning Alternative for the Leningrad Nuclear Power Plant Unit #1

    Energy Technology Data Exchange (ETDEWEB)

    SM Garrett

    1998-09-28

    The objectives of the two joint Russian/U.S. Leningrad Nuclear Power Plant (NPP) Unit #1 studies were the development of a safe, technically feasible, economically acceptable decom missioning strategy, and the preliminary cost evaluation of the developed strategy. The first study, resulting in the decommissioning strategy, was performed in 1996 and 1997. The preliminary cost estimation study, described in this report, was performed in 1997 and 1998. The decommissioning strategy study included the analyses of three basic RBM.K decommission- ing alternatives, refined for the Leningrad NPP Unit #1. The analyses included analysis of the requirements for the planning and preparation as well as the decommissioning phases.

  7. Article choice in plural generics

    NARCIS (Netherlands)

    Farkas, D.F.; Swart, Henriëtte de

    2007-01-01

    We discuss two groups of languages where article use contrasts in generic plural sentences but is otherwise essentially similar. The languages in the first group (English and Dutch) use bare plurals in the expression of kind reference (‘Dinosaurs are extinct’) and in generic

  8. Measuring population health: costs of alternative survey approaches in the Nouna Health and Demographic Surveillance System in rural Burkina Faso

    Directory of Open Access Journals (Sweden)

    Henrike Lietz

    2015-08-01

    Full Text Available Background: There are more than 40 Health and Demographic Surveillance System (HDSS sites in 19 different countries. The running costs of HDSS sites are high. The financing of HDSS activities is of major importance, and adding external health surveys to the HDSS is challenging. To investigate the ways of improving data quality and collection efficiency in the Nouna HDSS in Burkina Faso, the stand-alone data collection activities of the HDSS and the Household Morbidity Survey (HMS were integrated, and the paper-based questionnaires were consolidated into a single tablet-based questionnaire, the Comprehensive Disease Assessment (CDA. Objective: The aims of this study are to estimate and compare the implementation costs of the two different survey approaches for measuring population health. Design: All financial costs of stand-alone (HDSS and HMS and integrated (CDA surveys were estimated from the perspective of the implementing agency. Fixed and variable costs of survey implementation and key cost drivers were identified. The costs per household visit were calculated for both survey approaches. Results: While fixed costs of survey implementation were similar for the two survey approaches, there were considerable variations in variable costs, resulting in an estimated annual cost saving of about US$45,000 under the integrated survey approach. This was primarily because the costs of data management for the tablet-based CDA survey were considerably lower than for the paper-based stand-alone surveys. The cost per household visit from the integrated survey approach was US$21 compared with US$25 from the stand-alone surveys for collecting the same amount of information from 10,000 HDSS households. Conclusions: The CDA tablet-based survey method appears to be feasible and efficient for collecting health and demographic data in the Nouna HDSS in rural Burkina Faso. The possibility of using the tablet-based data collection platform to improve the quality

  9. Cost benefit indicators associated with the integration of alternative energy sources: A systems approach for Carinthia, Austria

    DEFF Research Database (Denmark)

    Wohlgemuth, N.

    1999-01-01

    Studies on how to promote the use of alternative energy sources (AES) typically focus on the relative efficiency and effectiveness of alternative subsidising mechanisms. Positive externalities of an increased AES utilisation are in general not explicitly taken into account. This paper analyses...... of AES use. Analysis of two strategies, "Subsidy" and "High Tax", shows that none of these strategies is dominant with respect to all indicators, i.e., there are conflicting objectives. (C) 1998 Elsevier Science Ltd. All rights reserved....

  10. Costs of slurry separation technologies and alternative use of the solid fraction for biogas production or burning

    DEFF Research Database (Denmark)

    Jacobsen, Brian H.

    2011-01-01

    separation, in order to establish the overall costs. Key parameters are livestock density, transport distance, price of additional land and cost of separation. The conclusion is that unless land prices or prices on slurry agreements are very high, traditional handling of animal manure has the lowest costs......The purpose of this paper is to analyse different separation concepts in order to evaluate the overall costs based on a systems approach from stable to field. When livestock are produced in livestock intensive areas the distribution of manure without creating a surplus of nutrients is often....... Decanter separation can be the cheapest if area is limited and cooperation with neighbours is possible as large volumes reduce separation costs per tonne. Flocculation is the best if much P has to be removed from the farm in the solid fraction. Separation will in the future in many cases be combined...

  11. Marginal CO2 reduction cost in ENERGY 2000 development. A socio-economic evaluation of the marginal cost for the alternative reduction methods

    International Nuclear Information System (INIS)

    Maeng, H.

    1995-01-01

    The official Danish environmental plan involves a reduction of CO 2 within the next 30-50 years. This report describes the analysis of socio-economic cost/consequences of marginal CO 2 reduction by means of various technical solution models. Calculations by means of the special program subroutine SAMFOKO are based on energy balance in annual, monthly, daily and hourly scale. Heat and power savings as well as the development of decentralized power plants are considered in the supply model. Socio-economic consequences in form of charges and cost are discussed. (EG)

  12. Accounting for costs, QALYs, and capacity constraints: using discrete-event simulation to evaluate alternative service delivery and organizational scenarios for hospital-based glaucoma services.

    Science.gov (United States)

    Crane, Glenis J; Kymes, Steven M; Hiller, Janet E; Casson, Robert; Martin, Adam; Karnon, Jonathan D

    2013-11-01

    Decision-analytic models are routinely used as a framework for cost-effectiveness analyses of health care services and technologies; however, these models mostly ignore resource constraints. In this study, we use a discrete-event simulation model to inform a cost-effectiveness analysis of alternative options for the organization and delivery of clinical services in the ophthalmology department of a public hospital. The model is novel, given that it represents both disease outcomes and resource constraints in a routine clinical setting. A 5-year discrete-event simulation model representing glaucoma patient services at the Royal Adelaide Hospital (RAH) was implemented and calibrated to patient-level data. The data were sourced from routinely collected waiting and appointment lists, patient record data, and the published literature. Patient-level costs and quality-adjusted life years were estimated for a range of alternative scenarios, including combinations of alternate follow-up times, booking cycles, and treatment pathways. The model shows that a) extending booking cycle length from 4 to 6 months, b) extending follow-up visit times by 2 to 3 months, and c) using laser in preference to medication are more cost-effective than current practice at the RAH eye clinic. The current simulation model provides a useful tool for informing improvements in the organization and delivery of glaucoma services at a local level (e.g., within a hospital), on the basis of expected effects on costs and health outcomes while accounting for current capacity constraints. Our model may be adapted to represent glaucoma services at other hospitals, whereas the general modeling approach could be applied to many other clinical service areas.

  13. Depleted uranium management alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Hertzler, T.J.; Nishimoto, D.D.

    1994-08-01

    This report evaluates two management alternatives for Department of Energy depleted uranium: continued storage as uranium hexafluoride, and conversion to uranium metal and fabrication to shielding for spent nuclear fuel containers. The results will be used to compare the costs with other alternatives, such as disposal. Cost estimates for the continued storage alternative are based on a life-cycle of 27 years through the year 2020. Cost estimates for the recycle alternative are based on existing conversion process costs and Capital costs for fabricating the containers. Additionally, the recycle alternative accounts for costs associated with intermediate product resale and secondary waste disposal for materials generated during the conversion process.

  14. Depleted uranium management alternatives

    International Nuclear Information System (INIS)

    Hertzler, T.J.; Nishimoto, D.D.

    1994-08-01

    This report evaluates two management alternatives for Department of Energy depleted uranium: continued storage as uranium hexafluoride, and conversion to uranium metal and fabrication to shielding for spent nuclear fuel containers. The results will be used to compare the costs with other alternatives, such as disposal. Cost estimates for the continued storage alternative are based on a life-cycle of 27 years through the year 2020. Cost estimates for the recycle alternative are based on existing conversion process costs and Capital costs for fabricating the containers. Additionally, the recycle alternative accounts for costs associated with intermediate product resale and secondary waste disposal for materials generated during the conversion process

  15. Generic drugs: Review and experiences from South India

    Directory of Open Access Journals (Sweden)

    Philip Mathew

    2015-01-01

    Full Text Available The cost of pharmaceuticals, as a percentage of total healthcare spending, has been rising worldwide. This has resulted in strained national budgets and a high proportion of people without access to essential medications. Though India has become a global hub of generic drug manufacturing, the expected benefits of cheaper drugs are not translating into savings for ordinary people. This is in part due to the rise of branded generics, which are marketed at a price point close to the innovator brands. Unbranded generic medicines are not finding their way into prescriptions due to issues of confidence and perception, though they are proven to be much cheaper and comparable in efficacy to branded medicines. The drug inventory of unbranded generic manufacturers fares reasonably when reviewed using the World Health Organization-Health Action International (WHO-HAI tool for analysing drug availability. Also, unbranded generic medicines are much cheaper when compared to the most selling brands and they can bring down the treatment costs in primary care and family practice. We share our experience in running a community pharmacy for an urban health center in the Pathanamthitta district of Kerala State, which is run solely on generic medicines. The drug availability at the community pharmacy was 73.3% when analyzed using WHO-HAI tool and the savings for the final consumers were up to 93.1%, when compared with most-selling brand of the same formulation.

  16. Pharmacokinetics and 48-week safety and efficacy of generic lopinavir/ritonavir in Thai HIV-infected patients

    NARCIS (Netherlands)

    Ramautarsing, Reshmie A.; van der Lugt, Jasper; Gorowara, Meena; Sophonphan, Jiratchaya; Ananworanich, Jintanat; Lange, Joep M. A.; Burger, David M.; Phanuphak, Praphan; Ruxthungtham, Kiat; Avihingsanon, Anchalee

    2013-01-01

    Background: Generic products reduce the costs of HIV treatment. Few generic second-line antiretroviral products are available. We assessed pharmacokinetics, safety and efficacy of generic lopinavir/ritonavir (LPV/r) produced by the Government Pharmaceutical Organization (GPO) of Thailand in Thai

  17. Cost-effectiveness analysis of paclitaxel + carboplatin vs. alternative combinations in the treatment of non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Mario Eandi

    2006-06-01

    Full Text Available Non-small cell lung cancer (NSCLC is the most common type of lung cancer and its medical and economical burden represents a serious matter in Europe and Usa, due to its high mortality rates and drug costs. Lung cancer is responsible for about 30% of cancer death in men and women; in Europe only about 8 per cent of people with lung cancer survive for 5 years. At present combination chemotherapy based on cisplatin or carboplatin associated with paclitaxel, vinorelbine or gemcitabine is the state of the art for the treatment in patients with stage IIIb or IV NSCLC. Aim of this study was to compare the cost-effectiveness of paclitaxel/carboplatin (PCb, gemcitabine/cisplatin (GC and vinorelbine/cisplatin (VC in the perspective of the Italian National Health Service. Therefore we perfomed a semi-Markov decision model mainly based on clinical results from the Italian Lung Cancer Project. The model included differential direct medical costs registered for two years from starting chemotherapy, using tariffs valid for 2005. Benefits was measured by years of life saved (YOLs. The model also allowed to estimate only costs accrued over the period of time, performing a cost-minimisation analysis. According to cost-effectiveness analysis, VC is dominated because it’s more costly and less effective than GC. On the contrary, combination chemotherapy with GC is more inexpensive but less effective than paclitaxel/carboplatin (PCb: in this case we compared the incremental cost-effectiveness ratio (ICER with a maximum acceptable willingness-to-pay (WTP value. In the base scenario the ICER of PCb over GC treatment is 52,326 euro/ YOLs, which is definitely lower than the maximum acceptable WTP value. Sensitivity analyses confirmed the robustness of the results from cost-effectiveness analysis in the base scenario.

  18. Generic immunosuppression in transplantation: current evidence and controversial issues.

    Science.gov (United States)

    El Hajj, Sandra; Kim, Miae; Phillips, Karen; Gabardi, Steven

    2015-05-01

    The overall success of organ transplantation in the 21st century has been predicated, in part, on the use of newer, more potent, and selective immunosuppressive agents. However, the high cost of lifelong immunosuppression represents a financial burden for many patients. In the past 15 years, regulatory agencies in Europe and America have approved several generic immunosuppressants. One concern is whether the conversion between innovator and generic immunosuppressants will prove to be problematic. This manuscript aims to compare and contrast the bioequivalence requirements among regulatory authorities in the USA, Europe, and Canada, evaluate published studies of generic immunosuppressants in transplant recipients, summarize consensus statements made by transplant organizations and discuss how to engage patients in discussion regarding the choice between innovator and generic immunosuppressants.

  19. Quality of generic medicines in South Africa

    DEFF Research Database (Denmark)

    Patel, Aarti; Gauld, Robin; Norris, Pauline

    2012-01-01

    Generic Medicines are an important policy option allowing for access to affordable, essential medicines. Quality of generic medicines must be guaranteed through the activities of national medicines regulatory authorities. Existing negative perceptions surrounding the quality of generic medicines ...

  20. Technology, safety and costs of decommissioning a reference boiling water reactor power station. Appendices. Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Oak, H.D.; Holter, G.M.; Kennedy, W.E. Jr.; Konzek, G.J.

    1980-06-01

    Appendices are presented concerning the evaluations of decommissioning financing alternatives; reference site description; reference BWR facility description; radiation dose rate and concrete surface contamination data; radionuclide inventories; public radiation dose models and calculated maximum annual doses; decommissioning methods; generic decommissioning information; immediate dismantlement details; passive safe storage, continuing care, and deferred dismantlement details; entombment details; demolition and site restoration details; cost estimating bases; public radiological safety assessment details; and details of alternate study bases.

  1. Costs and effects of paliperidone extended release compared with alternative oral antipsychotic agents in patients with schizophrenia in Greece: a cost effectiveness study.

    Science.gov (United States)

    Geitona, Maria; Kousoulakou, Hara; Ollandezos, Markos; Athanasakis, Kostas; Papanicolaou, Sotiria; Kyriopoulos, Ioannis

    2008-08-28

    To compare the costs and effects of paliperidone extended release (ER), a new pharmaceutical treatment for the management of schizophrenia, with the most frequently prescribed oral treatments in Greece (namely risperidone, olanzapine, quetiapine, aripiprazole and ziprasidone) over a 1-year time period. A decision tree was developed and tailored to the specific circumstances of the Greek healthcare system. Therapeutic effectiveness was defined as the annual number of stable days and the clinical data was collected from international clinical trials and published sources. The study population was patients who suffer from schizophrenia with acute exacerbation. During a consensus panel of 10 psychiatrists and 6 health economists, data were collected on the clinical practice and medical resource utilisation. Unit costs were derived from public sources and official reimbursement tariffs. For the comparators official retail prices were used. Since a price had not yet been granted for paliperidone ER at the time of the study, the conservative assumption of including the average of the highest targeted European prices was used, overestimating the price of paliperidone ER in Greece. The study was conducted from the perspective of the National Healthcare System. The data indicate that paliperidone ER might offer an increased number of stable days (272.5 compared to 272.2 for olanzapine, 265.5 f risperidone, 260.7 for quetiapine, 260.5 for ziprasidone and 258.6 for aripiprazole) with a lower cost compared to the other therapies examined (euro 7,030 compared to euro 7,034 for olanzapine, euro 7,082 for risperidone, euro 8,321 for quetiapine, euro 7,713 for ziprasidone and euro 7,807 for aripiprazole). During the sensitivity analysis, a +/- 10% change in the duration and frequency of relapses and the economic parameters did not lead to significant changes in the results. Treatment with paliperidone ER can lead to lower total cost and higher number of stable days in most of the

  2. A nested case-control study of influenza vaccination was a cost-effective alternative to a full cohort analysis

    NARCIS (Netherlands)

    Hak, E; Wei, F; Grobbee, D E; Nichol, K L

    OBJECTIVE: In the absence of trial results that are applicable to the target population, nested case-control studies might be an alternative to full-cohort analysis. We compared relative and absolute estimates of associations in an influenza vaccine study using both designs. STUDY DESIGN AND

  3. Deriving GENERIC from a Generalized Fluctuation Symmetry

    Science.gov (United States)

    Kraaij, Richard; Lazarescu, Alexandre; Maes, Christian; Peletier, Mark

    2018-02-01

    Much of the structure of macroscopic evolution equations for relaxation to equilibrium can be derived from symmetries in the dynamical fluctuations around the most typical trajectory. For example, detailed balance as expressed in terms of the Lagrangian for the path-space action leads to gradient zero-cost flow. We expose a new such fluctuation symmetry that implies GENERIC, an extension of gradient flow where a Hamiltonian part is added to the dissipative term in such a way as to retain the free energy as Lyapunov function.

  4. U.S. NRC's generic issues program

    International Nuclear Information System (INIS)

    Kauffman, J.V.; Foster, J.W.

    2008-01-01

    The United States Nuclear Regulatory Commission (NRC) has a Generic Issues Program (GIP) to address Generic Issues (GI). A GI is defined as 'a regulatory matter involving the design, construction, operation, or decommissioning of several, or a class of, NRC licensees or certificate holders that is not sufficiently addressed by existing rules, guidance, or programs'. This rather legalistic definition has several practical corollaries: First, a GI must involve safety. Second, the issue must involve at least two plants, or it would be a plant-specific issue rather than a GI. Third, the potential safety question must not be covered by existing regulations and guidance (compliance). Thus, the effect of a GI is to potentially change the body of regulations and associated guidance (e.g., regulatory guides). The GIP was started in 1976, thus it is a relatively mature program. Approximately 850 issues have been processed by the program to date. More importantly, even after 30 years, new GIs continue to be proposed. The entire set of Generic Issues (GIs) is updated annually in NUREG-0933, 'A Prioritization of Generic Safety Issues'. GIs normally involve complex questions of safety and regulation. Efficient and effective means of addressing these issues are very important for regulatory effectiveness. If an issue proves to pose a genuine, significant safety question, then swift, effective, enforceable, and cost-effective action needs to be taken. Conversely, if an issue is of little safety significance, the issue should be dismissed in an expeditious manner, avoiding unnecessary expenditure of resources and regulatory burden or uncertainty. This paper provides a summary of the 5-stage program, from identification through the regulatory assessment stage. The paper also includes a discussion of the program's seven criteria, sources of proposed GIs, recent improvements, publicly available information, historical performance, and status of current GIs. (authors)

  5. Cost-effectiveness of alternate strategies for childhood immunization against meningococcal disease with monovalent and quadrivalent conjugate vaccines in Canada.

    Directory of Open Access Journals (Sweden)

    Thomas E Delea

    Full Text Available Public health programs to prevent invasive meningococcal disease (IMD with monovalent serogroup C meningococcal conjugate vaccine (MCV-C and quadrivalent meningococcal conjugate vaccines (MCV-4 in infancy and adolescence vary across Canadian provinces. This study evaluated the cost-effectiveness of various vaccination strategies against IMD using current and anticipated future pricing and recent epidemiology.A cohort model was developed to estimate the clinical burden and costs (CAN$2014 of IMD in the Canadian population over a 100-year time horizon for three strategies: (1 MCV-C in infants and adolescents (MCV-C/C; (2 MCV-C in infants and MCV-4 in adolescents (MCV-C/4; and (3 MCV-4 in infants (2 doses and adolescents (MCV-4/4. The source for IMD incidence was Canadian surveillance data. The effectiveness of MCV-C was based on published literature. The effectiveness of MCV-4 against all vaccination regimens was assumed to be the same as for MCV-C regimens against serogroup C. Herd effects were estimated by calibration to estimates reported in prior analyses. Costs were from published sources. Vaccines prices were projected to decline over time reflecting historical procurement trends.Over the modeling horizon there are a projected 11,438 IMD cases and 1,195 IMD deaths with MCV-C/C; expected total costs are $597.5 million. MCV-C/4 is projected to reduce cases of IMD by 1,826 (16% and IMD deaths by 161 (13%. Vaccination costs are increased by $32 million but direct and indirect IMD costs are projected to be reduced by $46 million. MCV-C/4 is therefore dominant vs. MCV-C/C in the base case. Cost-effectiveness of MCV-4/4 was $111,286 per QALY gained versus MCV-C/4 (2575/206 IMD cases/deaths prevented; incremental costs $68 million.If historical trends in Canadian vaccines prices continue, use of MCV-4 instead of MCV-C in adolescents may be cost-effective. From an economic perspective, switching to MCV-4 as the adolescent booster should be considered.

  6. Cost-effectiveness of alternate strategies for childhood immunization against meningococcal disease with monovalent and quadrivalent conjugate vaccines in Canada.

    Science.gov (United States)

    Delea, Thomas E; Weycker, Derek; Atwood, Mark; Neame, Dion; Alvarez, Fabián P; Forget, Evelyn; Langley, Joanne M; Chit, Ayman

    2017-01-01

    Public health programs to prevent invasive meningococcal disease (IMD) with monovalent serogroup C meningococcal conjugate vaccine (MCV-C) and quadrivalent meningococcal conjugate vaccines (MCV-4) in infancy and adolescence vary across Canadian provinces. This study evaluated the cost-effectiveness of various vaccination strategies against IMD using current and anticipated future pricing and recent epidemiology. A cohort model was developed to estimate the clinical burden and costs (CAN$2014) of IMD in the Canadian population over a 100-year time horizon for three strategies: (1) MCV-C in infants and adolescents (MCV-C/C); (2) MCV-C in infants and MCV-4 in adolescents (MCV-C/4); and (3) MCV-4 in infants (2 doses) and adolescents (MCV-4/4). The source for IMD incidence was Canadian surveillance data. The effectiveness of MCV-C was based on published literature. The effectiveness of MCV-4 against all vaccination regimens was assumed to be the same as for MCV-C regimens against serogroup C. Herd effects were estimated by calibration to estimates reported in prior analyses. Costs were from published sources. Vaccines prices were projected to decline over time reflecting historical procurement trends. Over the modeling horizon there are a projected 11,438 IMD cases and 1,195 IMD deaths with MCV-C/C; expected total costs are $597.5 million. MCV-C/4 is projected to reduce cases of IMD by 1,826 (16%) and IMD deaths by 161 (13%). Vaccination costs are increased by $32 million but direct and indirect IMD costs are projected to be reduced by $46 million. MCV-C/4 is therefore dominant vs. MCV-C/C in the base case. Cost-effectiveness of MCV-4/4 was $111,286 per QALY gained versus MCV-C/4 (2575/206 IMD cases/deaths prevented; incremental costs $68 million). If historical trends in Canadian vaccines prices continue, use of MCV-4 instead of MCV-C in adolescents may be cost-effective. From an economic perspective, switching to MCV-4 as the adolescent booster should be considered.

  7. [Thin layer agar represents a cost-effective alternative for the rapid diagnosis of multi-drug resistant tuberculosis].

    Science.gov (United States)

    Hernández-Sarmiento, José M; Martínez-Negrete, Milton A; Castrillón-Velilla, Diana M; Mejía-Espinosa, Sergio A; Mejía-Mesa, Gloria I; Zapata-Fernández, Elsa M; Rojas-Jiménez, Sara; Marín-Castro, Andrés E; Robledo-Restrepo, Jaime A

    2014-01-01

    Using cost-benefit analysis for comparing the thin-layer agar culture method to the standard multiple proportion method used in diagnosing multidrug-resistant tuberculosis (MDR TB). A cost-benefit evaluation of two diagnostic tests was made at the Corporación para Investigaciones Biológicas (CIB) in Medellín, Colombia. 100 patients were evaluated; 10.8% rifampicin resistance and 14.3% isoniazid resistance were found. A computer-based decision tree model was used for cost-effectiveness analysis (Treeage Pro); the thin-layer agar culture method was most cost-effective, having 100% sensitivity, specificity and predictive values for detecting rifampicin and isoniazid resistance. The multiple proportion method value was calculated as being US$ 71 having an average 49 day report time compared to US$ 18 and 14 days for the thin-layer agar culture method. New technologies have been developed for diagnosing tuberculosis which are apparently faster and more effective; their operating characteristics must be evaluated as must their effectiveness in terms of cost-benefit. The present study established that using thin-layer agar culture was cheaper, equally effective and could provide results more quickly than the traditional method. This implies that a patient could receive MDR TB treatment more quickly.

  8. Generic Drugs: Questions and Answers

    Science.gov (United States)

    ... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Drugs Home Drugs Resources for You Information for Consumers (Drugs) Questions & Answers Generic Drugs: Questions & Answers Share Tweet Linkedin Pin it More ...

  9. Renewable energy finance and project ownership. The impact of alternative development structures on the cost of wind power

    International Nuclear Information System (INIS)

    Wiser, R.H.

    1997-01-01

    This paper uses traditional financial cash flow techniques to examine the impact of different ownership and financing structures on the cost of renewable energy, specifically wind power. Most large, non-hydroelectric, renewable energy projects are developed, owned and financed by private non-utility generators. Recently, however, US utilities have begun to consider owning and financing their own wind power facilities rather than purchasing power from independent renewable energy suppliers. Utilities in other countries have also expressed interest in direct renewable energy investments. A primary justification for utility ownership of wind turbine power plants is that utility self-financing and ownership is cheaper than purchasing wind energy from non-utility renewable energy suppliers. The results presented in this paper support that justification, although some of the estimated cost savings associated with utility ownership are a result of suboptimal utility analysis procedures and implicit risk shifting. Financing terms and variables are shown to significantly impact wind power costs. (author)

  10. Costs and effects of paliperidone extended release compared with alternative oral antipsychotic agents in patients with schizophrenia in Greece: A cost effectiveness study

    Directory of Open Access Journals (Sweden)

    Papanicolaou Sotiria

    2008-08-01

    Full Text Available Abstract Background To compare the costs and effects of paliperidone extended release (ER, a new pharmaceutical treatment for the management of schizophrenia, with the most frequently prescribed oral treatments in Greece (namely risperidone, olanzapine, quetiapine, aripiprazole and ziprasidone over a 1-year time period. Methods A decision tree was developed and tailored to the specific circumstances of the Greek healthcare system. Therapeutic effectiveness was defined as the annual number of stable days and the clinical data was collected from international clinical trials and published sources. The study population was patients who suffer from schizophrenia with acute exacerbation. During a consensus panel of 10 psychiatrists and 6 health economists, data were collected on the clinical practice and medical resource utilisation. Unit costs were derived from public sources and official reimbursement tariffs. For the comparators official retail prices were used. Since a price had not yet been granted for paliperidone ER at the time of the study, the conservative assumption of including the average of the highest targeted European prices was used, overestimating the price of paliperidone ER in Greece. The study was conducted from the perspective of the National Healthcare System. Results The data indicate that paliperidone ER might offer an increased number of stable days (272.5 compared to 272.2 for olanzapine, 265.5 f risperidone, 260.7 for quetiapine, 260.5 for ziprasidone and 258.6 for aripiprazole with a lower cost compared to the other therapies examined (€7,030 compared to €7,034 for olanzapine, €7,082 for risperidone, €8,321 for quetiapine, €7,713 for ziprasidone and €7,807 for aripiprazole. During the sensitivity analysis, a ± 10% change in the duration and frequency of relapses and the economic parameters did not lead to significant changes in the results. Conclusion Treatment with paliperidone ER can lead to lower total cost

  11. Hanford Generic Interim Safety Basis

    Energy Technology Data Exchange (ETDEWEB)

    Lavender, J.C.

    1994-09-09

    The purpose of this document is to identify WHC programs and requirements that are an integral part of the authorization basis for nuclear facilities that are generic to all WHC-managed facilities. The purpose of these programs is to implement the DOE Orders, as WHC becomes contractually obligated to implement them. The Hanford Generic ISB focuses on the institutional controls and safety requirements identified in DOE Order 5480.23, Nuclear Safety Analysis Reports.

  12. Hanford Generic Interim Safety Basis

    International Nuclear Information System (INIS)

    Lavender, J.C.

    1994-01-01

    The purpose of this document is to identify WHC programs and requirements that are an integral part of the authorization basis for nuclear facilities that are generic to all WHC-managed facilities. The purpose of these programs is to implement the DOE Orders, as WHC becomes contractually obligated to implement them. The Hanford Generic ISB focuses on the institutional controls and safety requirements identified in DOE Order 5480.23, Nuclear Safety Analysis Reports

  13. Acceptability and confidence in antiretroviral generics of physicians and HIV-infected patients in France.

    Science.gov (United States)

    Allavena, Clotilde; Jacomet, Christine; Pereira, Bruno; Morand-Joubert, Laurence; Bagheri, Haleh; Cotte, Laurent; Garaffo, Rodolphe; Gerbaud, Laurent; Dellamonica, Pierre

    2014-01-01

    Switching brand name medications to generics is recommended in France in the interest of cost effectiveness but patients and physicians are sometimes not convinced that switching is appropriate. Some antiretroviral (ARV) generics (ZDV, 3TC, NVP) have been marketed in France since 2013. A multicentric cross-sectional survey was performed in September 2013 to evaluate the perception of generics overall and ARV generics in physicians and HIV-infected patients and factors associated to their acceptability. Adult HIV outpatients were asked to complete a self-questionnaire on their perception of generics. Physicians completed a questionnaire on the acceptability of generics and ARV generics. Socio-demographic data, medical history and HIV history were collected. 116 physicians in 33 clinics (68% in University Hospital) included 556 patients (France-native 77%, active employment 59%, covered by social Insurance 100%, homosexual/bisexual contamination 47%, median HIV duration 13 years, hepatitis coinfection 16%, on ARV therapy 95%). Overall, patients accepted and had confidence in generics in 76% and 55% of the cases, respectively. Switching ARVs for generics was accepted by 44% of the patients but only by 17% if the pill burden was going to increase. 75% of the physicians would prescribe generics, but this decreased to only 26% if the combo had to be broken. The main reasons for non-prescription of generics were previous brand name ARV-induced side effects (35%), refusal of generics overall (37%), lack of understanding of generics (26%), risk of non-observance of treatment (44%), anxiety (47%) and depressive symptoms (25%). In multivariate analysis, factors associated with the acceptability of ARV generics in patients were the use of generics overall (p<0.001) and in physicians, the absence of concern regarding the drug efficacy (p<0.001) and being aware that the patient would accept generics overall (p=0.03) and ARV generics (p=0.04). No factors related to

  14. Factors affecting the opinions of family physicians regarding generic drugs – a questionnaire based study

    Directory of Open Access Journals (Sweden)

    Pawel Lewek

    2014-12-01

    Full Text Available A range of factors are believed to exert a negative influence on opinions of physicians about generic drugs.The aim of this study was to survey the opinions of primary care doctors on generics, and determine the factors which may affect them. A questionnaire comprising thirty eight questions was distributed among primary care doctors working in seventy out-patient clinics of the Lodzkie province, Poland, during the period of January 1, 2010 – December 31, 2010. A total of170 of 183 participants completed the survey (average age 48.5; 70.0% women: a 92.9%response rate. While 38.8% of physicians claimed that generics were worse than brand name drugs, 54.1% considered them to be better. However, 36.5% of the doctors did not choose generics for their own use. Two key opinions were identified among the responses concerning the effectiveness of generic drugs: use of generic drugs by the physician (p<0.001, and their opinion that pharmacists do inform patients about generic drugs (p<0.05. Although existing evidence confirms that generic and brand name drugs are equally effective, many physicians doubt this, which prevents them from being used as cost effective drug therapy. In order to increase healthcare savings through the use of generics, these factors should be addressed: for example, convincing a physician to adopt generics for personal use may be an efficient way to support more cost effective treatment of his patients.

  15. Cost-benefit analysis of unfired PuO2 pellets as an alternative plutonium shipping form

    International Nuclear Information System (INIS)

    Mishima, J.; Brackenbush, L.W.; Libby, R.A.; Soldat, K.L.; White, G.D.

    1983-10-01

    A limited cost-benefit evaluation was performed concerning use of unfired plutonium dioxide pellets as a shipping form. Two specific processing operations are required for this use, one to form the pellet (pelletizing) and a second to reconstitute an acceptable powder upon receipt (reconstitution). The direct costs for the pelletizing operation are approximately $208,000 for equipment and its installation and $122 per kg of plutonium processed (based upon a 20-kg plutonium/day facility). The direct costs for reconstitution are approximately $90,000 for equipment and its installation and $81 per kg of plutonium processed. The indirect cost considered was personnel exposure from these operations. Whole body exposures ranged from 0.04 man-rem per 100 kg of low-exposure plutonium reconstituted to 0.9 man-rem per 100 kg of average-exposure plutonium pelletized. Hand exposures were much higher - 17 man-rem power 100 kg of low-exposure plutonium reconstituted to 67 man-rem per 100 kg of average plutonium pelletized. The principal benefit is a potential twentyfold reduction of airborne release in the event of an accident. An experimental plan is outlined to fill the data gaps uncovered during this study in the areas of pelletizing and reconstitution process parameters and pellet response behavior to accident-generated stresses. A study to enhance the containment potential of the inner packaging used during shipment is also outlined

  16. Emulation-Based Virtual Laboratories: A Low-Cost Alternative to Physical Experiments in Control Engineering Education

    Science.gov (United States)

    Goodwin, G. C.; Medioli, A. M.; Sher, W.; Vlacic, L. B.; Welsh, J. S.

    2011-01-01

    This paper argues the case for emulation-based virtual laboratories in control engineering education. It demonstrates that such emulation experiments can give students an industrially relevant educational experience at relatively low cost. The paper also describes a particular emulation-based system that has been developed with the aim of giving…

  17. Alternative additives; Alternative additiver

    Energy Technology Data Exchange (ETDEWEB)

    2007-08-15

    In this project a number of industrial and agricultural waste products have been characterised and evaluated in terms of alkali-getter performance. The intended use is for biomass-fired power stations aiming at reducing corrosion or slagging related problems. The following products have been obtained, characterised and evaluated: 1) Brewery draff 2) Danish de-gassed manure 3) Paper sludge 4) Moulding sand 5) Spent bleaching earth 6) Anorthosite 7) Sand 8) Clay-sludge. Most of the above alternative additive candidates are deemed unsuitable due to insufficient chemical effect and/or expensive requirements for pre-treatment (such as drying and transportation). 3 products were selected for full-scale testing: de-gassed manure, spent bleaching earth and clay slugde. The full scale tests were undertaken at the biomass-fired power stations in Koege, Slagelse and Ensted. Spent bleaching earth (SBE) and clay sludge were the only tested additive candidates that had a proven ability to react with KCl, to thereby reduce Cl-concentrations in deposits, and reduce the deposit flux to superheater tubes. Their performance was shown to nearly as good as commercial additives. De-gassed manure, however, did not evaluate positively due to inhibiting effects of Ca in the manure. Furthermore, de-gassed manure has a high concentration of heavy metals, which imposes a financial burden with regard to proper disposal of the ash by-products. Clay-sludge is a wet clay slurring, and drying and transportation of this product entails substantial costs. Spent bleaching does not require much pre-treatment and is therefore the most promising alternative additive. On the other hand, bleaching earth contains residual plant oil which means that a range of legislation relating to waste combustion comes into play. Not least a waste combustion fee of 330 DKK/tonne. For all alternative (and commercial) additives disposal costs of the increase ash by-products represents a significant cost. This is

  18. Alternative Bio-Based Solvents for Extraction of Fat and Oils: Solubility Prediction, Global Yield, Extraction Kinetics, Chemical Composition and Cost of Manufacturing

    Directory of Open Access Journals (Sweden)

    Anne-Gaëlle Sicaire

    2015-04-01

    Full Text Available The present study was designed to evaluate the performance of alternative bio-based solvents, more especially 2-methyltetrahydrofuran, obtained from crop’s byproducts for the substitution of petroleum solvents such as hexane in the extraction of fat and oils for food (edible oil and non-food (bio fuel applications. First a solvent selection as well as an evaluation of the performance was made with Hansen Solubility Parameters and the COnductor-like Screening MOdel for Realistic Solvation (COSMO-RS simulations. Experiments were performed on rapeseed oil extraction at laboratory and pilot plant scale for the determination of lipid yields, extraction kinetics, diffusion modeling, and complete lipid composition in term of fatty acids and micronutrients (sterols, tocopherols and tocotrienols. Finally, economic and energetic evaluations of the process were conducted to estimate the cost of manufacturing using 2-methyltetrahydrofuran (MeTHF as alternative solvent compared to hexane as petroleum solvent.

  19. Measuring the distribution of equity in terms of energy, environmental, and economic costs in the fuel cycles of alternative fuel vehicles with hydrogen pathway scenarios

    Science.gov (United States)

    Meyer, Patrick E.

    Numerous analyses exist which examine the energy, environmental, and economic tradeoffs between conventional gasoline vehicles and hydrogen fuel cell vehicles powered by hydrogen produced from a variety of sources. These analyses are commonly referred to as "E3" analyses because of their inclusion of Energy, Environmental, and Economic indicators. Recent research as sought a means to incorporate social Equity into E3 analyses, thus producing an "E4" analysis. However, E4 analyses in the realm of energy policy are uncommon, and in the realm of alternative transportation fuels, E4 analyses are extremely rare. This dissertation discusses the creation of a novel E4 simulation tool usable to weigh energy, environmental, economic, and equity trade-offs between conventional gasoline vehicles and alternative fuel vehicles, with specific application to hydrogen fuel cell vehicles. The model, dubbed the F uel Life-cycle Analysis of Solar Hydrogen -- Energy, Environment, Economic & Equity model, or FLASH-E4, is a total fuel-cycle model that combines energy, environmental, and economic analysis methodologies with the addition of an equity analysis component. The model is capable of providing results regarding total fuel-cycle energy consumption, emissions production, energy and environmental cost, and level of social equity within a population in which low-income drivers use CGV technology and high-income drivers use a number of advanced hydrogen FCV technologies. Using theories of equity and social indicators conceptually embodied in the Lorenz Curve and Gini Index, the equity of the distribution of societal energy and environmental costs are measured for a population in which some drivers use CGVs and other drivers use FCVs. It is found, based on baseline input data representative of the United States (US), that the distribution of energy and environmental costs in a population in which some drivers use CGVs and other drivers use natural gas-based hydrogen FCVs can be

  20. Cost-effectiveness of cell salvage and alternative methods of minimising perioperative allogeneic blood transfusion: a systematic review and economic model.

    Science.gov (United States)

    Davies, L; Brown, T J; Haynes, S; Payne, K; Elliott, R A; McCollum, C

    2006-11-01

    To compare patient outcomes, resource use and costs to the NHS and NHS Blood Transfusion Authority (BTA) associated with cell salvage and alternative methods of minimising perioperative allogeneic blood transfusion. Electronic databases covering the period 1996-2004 for systematic reviews and 1994-2004 for economic evidence. Existing systematic reviews were updated with data from selected randomised controlled trials (RCTs) that involved adults scheduled for elective non-urgent surgery. Any resource use or cost data were extracted for potential use in populating an economic model. Relative risks or weighted mean difference of each outcome for each intervention were assessed, taking into account the number of RCTs included in each outcome and intervention and the presence of any heterogeneity. This allowed indirect comparison of the relative effectiveness of each intervention when the intervention is compared with allogeneic blood transfusion. A decision analytic model synthesised clinical and economic data from several sources, to estimate the relative cost-effectiveness of cell salvage for people undergoing elective surgery with moderate to major expected blood loss. The perspective of the NHS and patients and a time horizon of 1 month were used. The economic model was developed from reviews of effectiveness and cost-effectiveness and clinical experts. Secondary analysis explored the robustness of the results to changes in the timing and costs of cell salvage equipment, surgical procedure, use of transfusion protocols and time horizon of analysis. Overall, 668 studies were identified electronically for the update of the two systematic reviews. This included five RCTs, of which two were cell salvage and three preoperative autologous donation (PAD). Five published systematic reviews were identified for antifibrinolytics, fibrin sealants and restrictive transfusion triggers, PAD plus erythropoietin, erythropoietin alone and acute normovolaemic haemodilution (ANH

  1. Generic Example Proving Criteria for All

    Science.gov (United States)

    Yopp, David; Ely, Rob; Johnson­-Leung, Jennifer

    2015-01-01

    We review literature that discusses generic example proving and highlight ambiguities that pervade our research community's discourse about generic example arguments. We distinguish between pedagogical advice for choosing good examples that can serve as generic examples when teaching and advice for developing generic example arguments. We provide…

  2. Generic penetration in the retail antidepressant market.

    Science.gov (United States)

    Ventimiglia, Jeffrey; Kalali, Amir H

    2010-06-01

    In this article, we explore the accelerated penetration of generic antidepressants in the United States market following the availability of generic citalopram and sertraline. Analysis suggests that overall, generic penetration into the antidepressant market has grown from approximately 41 percent in January 2004 to over 73 percent in January 2010. Similar trends are uncovered when branded and generic prescriptions are analyzed by specialty.

  3. Considerations of health benefit-cost analysis for activities involving ionizing radiation exposure and alternatives. Technical report

    International Nuclear Information System (INIS)

    1977-01-01

    The report deals with development of methodology for the health benefit-cost analysis of activities that result in radiation exposure to humans. It attempts to frame the problems and to communicate the necessary elements of the complex technical process required for this method of analysis. The main thrust of the report is to develop a methodology for analyzing the benefits and costs of these activities. Application of the methodology is demonstrated for nuclear power production and medical uses of radiation, but no definitive analysis is attempted. The report concludes that benefit-cost analysis can be effectively applied to these applications and that it provides a basis for more informed governmental decision-making and for public participation in evaluating the issues of radiation exposure. It notes, however, that for cases where national policy is involved, decisions must inevitably be made on the basis of value judgements to which such analyses can make only limited contributions. An important conclusion is that a significant reduction in radiation exposure to the population is apparently achievable by development of methods for eliminating unproductive medical X-ray exposure

  4. Cost-effectiveness and public health impact of alternative influenza vaccination strategies in high-risk adults.

    Science.gov (United States)

    Raviotta, Jonathan M; Smith, Kenneth J; DePasse, Jay; Brown, Shawn T; Shim, Eunha; Nowalk, Mary Patricia; Wateska, Angela; France, Glenson S; Zimmerman, Richard K

    2017-10-09

    High-dose trivalent inactivated influenza vaccine (HD-IIV3) or recombinant trivalent influenza vaccine (RIV) may increase influenza vaccine effectiveness (VE) in adults with conditions that place them at high risk for influenza complications. This analysis models the public health impact and cost-effectiveness (CE) of these vaccines for 50-64year-olds. Markov model CE analysis compared 5 strategies in 50-64year-olds: no vaccination; only standard-dose IIV3 offered (SD-IIV3 only), only quadrivalent influenza vaccine offered (SD-IIV4 only); high-risk patients receiving HD-IIV3, others receiving SD-IIV3 (HD-IIV3 & SD-IIV3); and high-risk patients receiving HD-IIV3, others receiving SD-IIV4 (HD-IIV3 & SD-IIV4). In a secondary analysis, RIV replaced HD-IIV3. Parameters were obtained from U.S. databases, the medical literature and extrapolations from VE estimates. Effectiveness was measured as 3%/year discounted quality adjusted life year (QALY) losses avoided. The least expensive strategy was SD-IIV3 only, with total costs of $99.84/person. The SD-IIV4 only strategy cost an additional $0.91/person, or $37,700/QALY gained. The HD-IIV3 & SD-IIV4 strategy cost $1.06 more than SD-IIV4 only, or $71,500/QALY gained. No vaccination and HD-IIV3 & SD-IIV3 strategies were dominated. Results were sensitive to influenza incidence, vaccine cost, standard-dose VE in the entire population and high-dose VE in high-risk patients. The CE of RIV for high-risk patients was dependent on as yet unknown parameter values. Based on available data, using high-dose influenza vaccine or RIV in middle-aged, high-risk patients may be an economically favorable vaccination strategy with public health benefits. Clinical trials of these vaccines in this population may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending.

    Science.gov (United States)

    Wouters, Olivier J; Kanavos, Panos G; McKEE, Martin

    2017-09-01

    Policy Points: Our study indicates that there are opportunities for cost savings in generic drug markets in Europe and the United States. Regulators should make it easier for generic drugs to reach the market. Regulators and payers should apply measures to stimulate price competition among generic drugmakers and to increase generic drug use. To meaningfully evaluate policy options, it is important to analyze historical context and understand why similar initiatives failed previously. Rising drug prices are putting pressure on health care budgets. Policymakers are assessing how they can save money through generic drugs. We compared generic drug prices and market shares in 13 European countries, using data from 2013, to assess the amount of variation that exists between countries. To place these results in context, we reviewed evidence from recent studies on the prices and use of generics in Europe and the United States. We also surveyed peer-reviewed studies, gray literature, and books published since 2000 to (1) outline existing generic drug policies in European countries and the United States; (2) identify ways to increase generic drug use and to promote price competition among generic drug companies; and (3) explore barriers to implementing reform of generic drug policies, using a historical example from the United States as a case study. The prices and market shares of generics vary widely across Europe. For example, prices charged by manufacturers in Switzerland are, on average, more than 2.5 times those in Germany and more than 6 times those in the United Kingdom, based on the results of a commonly used price index. The proportion of prescriptions filled with generics ranges from 17% in Switzerland to 83% in the United Kingdom. By comparison, the United States has historically had low generic drug prices and high rates of generic drug use (84% in 2013), but has in recent years experienced sharp price increases for some off-patent products. There are policy

  6. Towards emotion modeling based on gaze dynamics in generic interfaces

    DEFF Research Database (Denmark)

    Vester-Christensen, Martin; Leimberg, Denis; Ersbøll, Bjarne Kjær

    2005-01-01

    Gaze detection can be a useful ingredient in generic human computer interfaces if current technical barriers are overcome. We discuss the feasibility of concurrent posture and eye-tracking in the context of single (low cost) camera imagery. The ingredients in the approach are posture and eye region...

  7. How Abbott’s Fenofibrate Franchise Avoided Generic Competition

    Science.gov (United States)

    Downing, Nicholas S.; Ross, Joseph S.; Jackevicius, Cynthia A.; Krumholz, Harlan M.

    2013-01-01

    The ongoing debate concerning the efficacy of fenofibrate has overshadowed an important aspect of the drug’s history: Abbott, the maker of branded fenofibrate, has produced several bioequivalent reformulations, which dominate the market even though generic fenofibrate has been available for almost a decade. This continued use of branded formulations, which cost twice as much as generic versions of fenofibrate, imposes an annual cost of approximately $700 million on our healthcare system. Abbott maintained its dominance of the fenofibrate market, in part, through a complex switching strategy involving the sequential launch of branded reformulations that had not been shown to be superior to the first generation product and patent litigation that delayed the approval of generic formulations. The small differences in dose of the newer branded formulations prevented substitution with generics of older generation products. As soon as direct generic competition seemed likely at the new dose level where substitution would be allowed, Abbott would launch another reformulation and the cycle would repeat. Our objective, using the fenofibrate example, is to describe how current policy can allow pharmaceutical companies to maintain market share using reformulations of branded medications without demonstrating the superiority of next generation products. PMID:22493409

  8. Avoidance of generic competition by Abbott Laboratories' fenofibrate franchise.

    Science.gov (United States)

    Downing, Nicholas S; Ross, Joseph S; Jackevicius, Cynthia A; Krumholz, Harlan M

    2012-05-14

    The ongoing debate concerning the efficacy of fenofibrate has overshadowed an important aspect of the drug's history: Abbott Laboratories, the maker of branded fenofibrate, has produced several bioequivalent reformulations that dominate the market, although generic fenofibrate has been available for almost a decade. This continued use of branded formulations, which cost twice as much as generic versions of fenofibrate, imposes an annual cost of approximately $700 million on the US health care system. Abbott Laboratories maintained its dominance of the fenofibrate market in part through a complex switching strategy involving the sequential launch of branded reformulations that had not been shown to be superior to the first-generation product and patent litigation that delayed the approval of generic formulations. The small differences in dose of the newer branded formulations prevented their substitution with generics of older-generation products. As soon as direct generic competition seemed likely at the new dose level, where substitution would be allowed, Abbott would launch another reformulation, and the cycle would repeat. Based on the fenofibrate example, our objective is to describe how current policy can allow pharmaceutical companies to maintain market share using reformulations of branded medications, without demonstrating the superiority of next-generation products.

  9. Theoretical analysis of the cumulative costs of different diesel bus alternatives for a public transport in the city of Belgrade

    Directory of Open Access Journals (Sweden)

    Jovanović Stevan S.

    2017-01-01

    Full Text Available This paper includes comparative analysis of the environmental, energetic, and financial costs of different bus propulsion, possibly applied on the public transport in the city of Belgrade. It considers the modern diesel bus, the trolleybus, the natural gas bus with the spark ignition engine, the electric bus using LiFePO4 battery, and the electric bus with ultra-capacitor. The results are presented according to the real data and the real electro-energetic situation in Serbia, with the dominantly used lignite coal as primary fuel. This model gives the exact exhaust emission of electric vehicles at the thermal power plant, enables its comparison to the internal combustion engine vehicles. The result in analysis shows that the natural gas bus is the most cost efficient in economical way with overall exploitation price of $87 per 100 km. The trolleybus is more economical then the natural gas powered bus only at high departures rate, higher than 230 per workday.

  10. Retailing policies for generic medicines.

    Science.gov (United States)

    Narciso, Susana

    2005-06-01

    As there is general disagreement about the way generic medicines should be commercialized, two retailing policies are analyzed, taking into account their effects on the welfare of patients, government, pharmacies and physicians. In the first policy scenario, pharmacies are allowed to substitute generic medicines for branded ones, while in the second, substitution is forbidden. In both cases a pharmacies association is allowed to have a share in the production of generic medicines. The model predicts that under some conditions patients may prefer substitution by pharmacies but when doctors' decisions are binding, they are never "excessively bad". However, the policy choice belongs to the government, which prefers to allow for substitution more often than patients would like.

  11. Pure versus hybrid: performance implications of Porter's generic strategies.

    Science.gov (United States)

    Kumar, K; Subramanian, R; Yauger, C

    1997-01-01

    This article identifies the strategic types in the hospital industry based on the hospital's use of Porter's generic strategies in their pure and hybrid forms. The article also examines differences in performance of hospitals across strategic types. Results indicate that hospitals that follow a focussed cost leadership strategy, in general, have superior performance on a variety of performance measures, while hospitals that use a combination of cost leadership and differentiation perform the poorest. Implications of findings for hospital administrators are also discussed.

  12. Generic Graph Grammar: A Simple Grammar for Generic Procedural Modelling

    DEFF Research Database (Denmark)

    Christiansen, Asger Nyman; Bærentzen, Jakob Andreas

    2012-01-01

    in a directed cyclic graph. Furthermore, the basic productions are chosen such that Generic Graph Grammar seamlessly combines the capabilities of L-systems to imitate biological growth (to model trees, animals, etc.) and those of split grammars to design structured objects (chairs, houses, etc.). This results...

  13. Cost-effective alternative to nano-encapsulation: Amorphous curcumin-chitosan nanoparticle complex exhibiting high payload and supersaturation generation.

    Science.gov (United States)

    Nguyen, Minh Hiep; Yu, Hong; Kiew, Tie Yi; Hadinoto, Kunn

    2015-10-01

    While the wide-ranging therapeutic activities of curcumin have been well established, its successful delivery to realize its true therapeutic potentials faces a major challenge due to its low oral bioavailability. Even though nano-encapsulation has been widely demonstrated to be effective in enhancing the bioavailability of curcumin, it is not without drawbacks (i.e. low payload and costly preparation). Herein we present a cost-effective bioavailability enhancement strategy of curcumin in the form of amorphous curcumin-chitosan nanoparticle complex (or curcumin nanoplex in short) exhibiting a high payload (>80%). The curcumin nanoplex was prepared by a simple yet highly efficient drug-polysaccharide complexation method that required only mixing of the curcumin and chitosan solutions under ambient condition. The effects of (1) pH and (2) charge ratio of chitosan to curcumin on the (i) physical characteristics of the nanoplex (i.e. size, colloidal stability and payload), (ii) complexation efficiency, and (iii) production yield were investigated from which the optimal preparation condition was determined. The nanoplex formation was found to favor low acidic pH and charge ratio below unity. At the optimal condition (i.e. pH 4.4. and charge ratio=0.8), stable curcumin nanoplex (≈260nm) was prepared at >90% complexation efficiency and ≈50% production yield. The amorphous state stability, colloidal stability, and in vitro non-cytotoxicity of the nanoplex were successfully established. The curcumin nanoplex produced prolonged supersaturation (3h) in the presence of hydroxypropyl methylcellulose (HPMC) at five times of the saturation solubility of curcumin. In addition, curcumin released from the nanoplex exhibited improved chemical stability owed to the presence of chitosan. Both results (i.e. high supersaturation and improved chemical stability) bode well for the ability of the curcumin nanoplex to enhance the bioavailability of curcumin clinically. Copyright © 2015

  14. An evaluation of consumers' knowledge, perceptions and attitudes regarding generic medicines in Auckland.

    Science.gov (United States)

    Babar, Zaheer-Ud-Din; Stewart, Joanna; Reddy, Shiwangni; Alzaher, Woroud; Vareed, Prateeka; Yacoub, Nineweh; Dhroptee, Bandhana; Rew, Anne

    2010-08-01

    The aim of this project was to evaluate the perceptions, knowledge and attitudes regarding generic medicines. A cross-sectional study, with self administered questionnaires, was conducted to survey consumers visiting pharmacies in four regions of Auckland (North Shore, Waitakere, Central Auckland and South Auckland). Through stratified random sampling, approximately 10% of pharmacies from each region were selected, which turn out to be 30 pharmacies. Every alternate customer coming to the pharmacy, who was eligible to participate in the study, was asked by the researchers to complete the questionnaire. A total of 441 questionnaires were included in the analysis. Different response rates were obtained in different regions of Auckland. Of all respondents, 51.6% had previous knowledge of generic medicines. Pharmacists were the main source of information regarding generic medicines followed by doctors and media. A higher level of education had a direct relationship with having correct knowledge of generics (P = .002). Attitude of participants toward the use of generic medicines was determined by their knowledge of generics, whether it was recommended by a pharmacist and their type of illness. Participants were more prepared to change to a generic for a minor illness (79%) than for a major illness (58.7%). Those who had better knowledge were more likely than those with poor knowledge to say they would to use a generic in major illness (P = .001) as well as minor illness (P < .0001). Previous positive experiences with generics also determined consumers' willingness to use generics. Many consumers have misconceptions regarding generic medicines. Having knowledge about generics and the advice by doctors and pharmacists are key indicators to improve the quality use of generic medicines.

  15. Life-Cycle Cost and Risk Analysis of Alternative Configurations for Shipping Low-Level Radioactive Waste to the Nevada Test Site

    International Nuclear Information System (INIS)

    PM Daling; SB Ross; BM Biwer

    1999-01-01

    The Nevada Test Site (NTS) is a major receiver of low-level radioactive waste (LLW) for disposal. Currently, all LLW received at NTS is shipped by truck. The trucks use highway routes to NTS that pass through the Las Vegas Valley and over Hoover Dam, which is a concern of local stakeholder groups in the State of Nevada. Rail service offers the opportunity to reduce transportation risks and costs, according to the Waste Management Programmatic Environmental Impact Statement (WM-PEIS). However, NTS and some DOE LLW generator sites are not served with direct rail service so intermodal transport is under consideration. Intermodal transport involves transport via two modes, in this case truck and rail, from the generator sites to NTS. LLW shipping containers would be transferred between trucks and railcars at intermodal transfer points near the LLW generator sites, NTS, or both. An Environmental Assessment (EA)for Intermodal Transportation of Low-Level Radioactive Waste to the Nevada Test Site (referred to as the NTSIntermodal -M) has been prepared to determine whether there are environmental impacts to alterations to the current truck routing or use of intermodal facilities within the State of Nevada. However, an analysis of the potential impacts outside the State of Nevada are not addressed in the NTS Intermodal EA. This study examines the rest of the transportation network between LLW generator sites and the NTS and evaluates the costs, risks, and feasibility of integrating intermodal shipments into the LLW transportation system. This study evaluates alternative transportation system configurations for NTS approved and potential generators based on complex-wide LLW load information. Technical judgments relative to the availability of DOE LLW generators to ship from their sites by rail were developed. Public and worker risk and life-cycle cost components are quantified. The study identifies and evaluates alternative scenarios that increase the use of rail (intermodal

  16. Life-Cycle Cost and Risk Analysis of Alternative Configurations for Shipping Low-Level Radioactive Waste to the Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    PM Daling; SB Ross; BM Biwer

    1999-12-17

    The Nevada Test Site (NTS) is a major receiver of low-level radioactive waste (LLW) for disposal. Currently, all LLW received at NTS is shipped by truck. The trucks use highway routes to NTS that pass through the Las Vegas Valley and over Hoover Dam, which is a concern of local stakeholder groups in the State of Nevada. Rail service offers the opportunity to reduce transportation risks and costs, according to the Waste Management Programmatic Environmental Impact Statement (WM-PEIS). However, NTS and some DOE LLW generator sites are not served with direct rail service so intermodal transport is under consideration. Intermodal transport involves transport via two modes, in this case truck and rail, from the generator sites to NTS. LLW shipping containers would be transferred between trucks and railcars at intermodal transfer points near the LLW generator sites, NTS, or both. An Environmental Assessment (EA)for Intermodal Transportation of Low-Level Radioactive Waste to the Nevada Test Site (referred to as the NTSIntermodal -M) has been prepared to determine whether there are environmental impacts to alterations to the current truck routing or use of intermodal facilities within the State of Nevada. However, an analysis of the potential impacts outside the State of Nevada are not addressed in the NTS Intermodal EA. This study examines the rest of the transportation network between LLW generator sites and the NTS and evaluates the costs, risks, and feasibility of integrating intermodal shipments into the LLW transportation system. This study evaluates alternative transportation system configurations for NTS approved and potential generators based on complex-wide LLW load information. Technical judgments relative to the availability of DOE LLW generators to ship from their sites by rail were developed. Public and worker risk and life-cycle cost components are quantified. The study identifies and evaluates alternative scenarios that increase the use of rail (intermodal

  17. Clinical effectiveness and cost-effectiveness of second- and third-generation left ventricular assist devices as either bridge to transplant or alternative to transplant for adults eligible for heart transplantation: systematic review and cost-effectiveness model.

    Science.gov (United States)

    Sutcliffe, P; Connock, M; Pulikottil-Jacob, R; Kandala, N-B; Suri, G; Gurung, T; Grove, A; Shyangdan, D; Briscoe, S; Maheswaran, H; Clarke, A

    2013-11-01

    Advanced heart failure (HF) is a debilitating condition for which heart transplant (HT) offers the best treatment option. However, the supply of donor hearts is diminishing and demand greatly exceeds supply. Ventricular assist devices (VADs) are surgically implanted pumps used as an alternative to transplant (ATT) or as a bridge to transplant (BTT) while a patient awaits a donor heart. Surgery and VADs are costly. For the NHS to allocate and deliver such services in a cost-effective way the relative costs and benefits of these alternative treatments need to be estimated. To investigate for patients aged ≥ 16 years with advanced HF eligible for HT: (1) the clinical effectiveness and cost-effectiveness of second- and third-generation VADs used as BTT compared with medical management (MM); and (2) the clinical effectiveness and cost-effectiveness of second- and third-generation VADs used as an ATT in comparison with their use as BTT therapy. Searches for clinical effectiveness studies covered years from 2003 to March 2012 and included the following data bases: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), HTA databases [NHS Centre for Reviews and Dissemination (CRD)], Science Citation Index and Conference Proceedings (Web of Science), UK Clinical Research Network (UKCRN) Portfolio Database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and National Library of Medicine (NLM) Gateway, Cochrane Central Register of Controlled Trials (CENTRAL), Current Controlled Trials and ClinicalTrials.gov. Reference lists of relevant articles were checked, and VAD manufacturers' websites interrogated. For economic analyses we made use of individual patient data (IPD) held in the UK Blood and Transplant Database (BTDB). Systematic reviews of evidence on clinical effectiveness and cost

  18. A simple and cost-effective method, as an appropriate alternative for visible spectrophotometry: development of a dopamine biosensor.

    Science.gov (United States)

    Abbaspour, Abdolkarim; Khajehzadeh, Abdolreza; Ghaffarinejad, Ali

    2009-08-01

    In this study, a new, simple, fast and inexpensive method as an alternative to visible spectrophotometry is developed. In this method the cells containing the sample solution were scanned with a scanner, then the color of each cell was analyzed with software written in visual basic (VB 6) media to red, green and blue values. The cells were built by creating holes in the Plexiglas sheet. The dimensions of identical cells were examined by Cr (III) solution with known concentrations. The validity of this new method was studied by determination of dopamine (DA) without using any other reagent. The parameters which affect the system were optimized. The comparison between the current and traditional UV-Vis spectrophotometry methods was studied and the results revealed similar trends in both methods. The developed method was successfully applied to the determination of dopamine in serum and urine without using any pretreatment. Finally comparing the results obtained in the developed method showed that microwave irradiation of the solution can decrease the experimental time, increase sensitivity and improve the limit of detection.

  19. Satellite-aided survey sampling and implementation in low- and middle-income contexts: a low-cost/low-tech alternative.

    Science.gov (United States)

    Haenssgen, Marco J

    2015-01-01

    The increasing availability of online maps, satellite imagery, and digital technology can ease common constraints of survey sampling in low- and middle-income countries. However, existing approaches require specialised software and user skills, professional GPS equipment, and/or commercial data sources; they tend to neglect spatial sampling considerations when using satellite maps; and they continue to face implementation challenges analogous to conventional survey implementation methods. This paper presents an alternative way of utilising satellite maps and digital aides that aims to address these challenges. The case studies of two rural household surveys in Rajasthan (India) and Gansu (China) compare conventional survey sampling and implementation techniques with the use of online map services such as Google, Bing, and HERE maps. Modern yet basic digital technology can be integrated into the processes of preparing, implementing, and monitoring a rural household survey. Satellite-aided systematic random sampling enhanced the spatial representativeness of the village samples and entailed savings of approximately £4000 compared to conventional household listing, while reducing the duration of the main survey by at least 25 %. This low-cost/low-tech satellite-aided survey sampling approach can be useful for student researchers and resource-constrained research projects operating in low- and middle-income contexts with high survey implementation costs. While achieving transparent and efficient survey implementation at low costs, researchers aiming to adopt a similar process should be aware of the locational, technical, and logistical requirements as well as the methodological challenges of this strategy.

  20. Cost Evaluation of Commonly Prescribed Antihypertensive Drugs ...

    African Journals Online (AJOL)

    It was also concluded that generic prescription should be encouraged among prescribers to lessen the financial burden of patients because drugs marketed under generic names are usually cheaper than those with brand names. Key words: Brand, Generic,Prescription, Antihypertensives,Cost. [Nig. Jnl Health & Biomedical ...

  1. Predictors of generic substitution: The role of psychological, sociodemographic, and contextual factors.

    Science.gov (United States)

    Drozdowska, Aleksandra; Hermanowski, Tomasz

    2016-01-01

    Escalating pharmaceutical costs have become a global challenge for both governments and patients. Generic substitution is one way of decreasing these costs. The aim of this study was to investigate factors associated with patients' choice between generic drugs and innovator drugs. The survey was conducted in June 2013, 1000 people from across Poland were chosen as a representative population sample. The outcome (a preference for generics/a preference for innovator pharmaceuticals/no preference) was modeled by multinomial logistic regression, adjusted for several variables describing patients' sensitivity to selected generic features (price, brand, and country of origin), to third-party opinions about generics (information on generics in the mass media, opinions of health professionals (i.e. physicians, pharmacists), relatives/friends), as well as patients' personal experiences and income per household. The results supported the predictive capacity of most independent variables (except for patient sensitivity to the country of origin and to the information on generics in the mass media), denoting patients' preferences toward generic substitution. Patient sensitivity to recommendations by physicians, generic brand, and household income were the strongest predictors of the choice between generic and innovator pharmaceuticals (P brand or their physician's opinion, as well as in respondents who were sensitive to recommendations by pharmacists or attached a greater value to a past experience with generics (their own experience or that of relatives/friends). In consideration of the foregoing, awareness-raising campaigns may be recommended, supported by a variety of systemic solutions and tools to encourage generic substitution. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. low-Cost, High-Performance Alternatives for Target Temperature Monitoring Using the Near-Infrared Spectrum

    Energy Technology Data Exchange (ETDEWEB)

    Virgo, Mathew [Argonne National Lab. (ANL), Argonne, IL (United States); Quigley, Kevin J. [Argonne National Lab. (ANL), Argonne, IL (United States); Chemerisov, Sergey [Argonne National Lab. (ANL), Argonne, IL (United States); Vandegrift, George F. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2017-02-01

    A process is being developed for commercial production of the medical isotope Mo-99 through a photo-nuclear reaction on a Mo-100 target using a highpower electron accelerator. This process requires temperature monitoring of the window through which a high-current electron beam is transmitted to the target. For this purpose, we evaluated two near infrared technologies: the OMEGA Engineering iR2 pyrometer and the Ocean Optics Maya2000 spectrometer with infrared-enhanced charge-coupled device (CCD) sensor. Measuring in the near infrared spectrum, in contrast to the long-wavelength infrared spectrum, offers a few immediate advantages: (1) ordinary glass or quartz optical elements can be used; (2) alignment can be performed without heating the target; and (3) emissivity corrections to temperature are typically less than 10%. If spatial resolution is not required, the infrared pyrometer is attractive because of its accuracy, low cost, and simplicity. If spatial resolution is required, we make recommendations for near-infrared imaging based on our data augmented by calculations

  3. A Critical Comparison of Alternative Distribution Configurations in Omni-Channel Retailing in Terms of Cost and Greenhouse Gas Emissions

    Directory of Open Access Journals (Sweden)

    Marco Melacini

    2018-01-01

    Full Text Available New opportunities and challenges forced by the ever-increasing importance of the online channel have arisen for retailers. The retailing industry is moving to a new phase, in which the distinctions between traditional and online channels disappear, namely omni-channel (OC retailing. At the same time, the awareness of environmentally sustainable processes has been enhanced around the world and the environmental impact that results from the online order fulfilment process is becoming a key issue for logistics managers. The new challenge is to understand how multiple channels can be synergistically managed to provide a seamless customer experience, taking an economic and environmental perspective simultaneously. Retailers need to define the distribution configuration for serving the online demand, making decisions on the integration level between online and traditional channels. In this paper, we developed an assessment model of the operational costs and greenhouse gas emissions for three distribution configurations in OC retailing. The model was also applied to a real case operating in the consumer electronics industry. Results highlighted that the search for synergies between online and traditional flows in both warehouse and transport activities is a key factor for the economic and environmental sustainability of OC systems.

  4. Transportation Energy Futures Series: Alternative Fuel Infrastructure Expansion: Costs, Resources, Production Capacity, and Retail Availability for Low-Carbon Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Melaina, M. W.; Heath, G.; Sandor, D.; Steward, D.; Vimmerstedt, L.; Warner, E.; Webster, K. W.

    2013-04-01

    Achieving the Department of Energy target of an 80% reduction in greenhouse gas emissions by 2050 depends on transportation-related strategies combining technology innovation, market adoption, and changes in consumer behavior. This study examines expanding low-carbon transportation fuel infrastructure to achieve deep GHG emissions reductions, with an emphasis on fuel production facilities and retail components serving light-duty vehicles. Three distinct low-carbon fuel supply scenarios are examined: Portfolio: Successful deployment of a range of advanced vehicle and fuel technologies; Combustion: Market dominance by hybridized internal combustion engine vehicles fueled by advanced biofuels and natural gas; Electrification: Market dominance by electric drive vehicles in the LDV sector, including battery electric, plug-in hybrid, and fuel cell vehicles, that are fueled by low-carbon electricity and hydrogen. A range of possible low-carbon fuel demand outcomes are explored in terms of the scale and scope of infrastructure expansion requirements and evaluated based on fuel costs, energy resource utilization, fuel production infrastructure expansion, and retail infrastructure expansion for LDVs. This is one of a series of reports produced as a result of the Transportation Energy Futures (TEF) project, a Department of Energy-sponsored multi-agency project initiated to pinpoint underexplored transportation-related strategies for abating GHGs and reducing petroleum dependence.

  5. Generic Software Architecture for Launchers

    Science.gov (United States)

    Carre, Emilien; Gast, Philippe; Hiron, Emmanuel; Leblanc, Alain; Lesens, David; Mescam, Emmanuelle; Moro, Pierre

    2015-09-01

    The definition and reuse of generic software architecture for launchers is not so usual for several reasons: the number of European launcher families is very small (Ariane 5 and Vega for these last decades); the real time constraints (reactivity and determinism needs) are very hard; low levels of versatility are required (implying often an ad hoc development of the launcher mission). In comparison, satellites are often built on a generic platform made up of reusable hardware building blocks (processors, star-trackers, gyroscopes, etc.) and reusable software building blocks (middleware, TM/TC, On Board Control Procedure, etc.). If some of these reasons are still valid (e.g. the limited number of development), the increase of the available CPU power makes today an approach based on a generic time triggered middleware (ensuring the full determinism of the system) and a centralised mission and vehicle management (offering more flexibility in the design and facilitating the long term maintenance) achievable. This paper presents an example of generic software architecture which could be envisaged for future launchers, based on the previously described principles and supported by model driven engineering and automatic code generation.

  6. Testing properties of generic functions

    NARCIS (Netherlands)

    Jansson, P.; Jeuring, J.T.; Cabenda, L.; Engels, G.; Kleerekoper, J.; Mak, S.; Overeem, M.; Visser, Kees

    2007-01-01

    A datatype-generic function is a family of functions indexed by (the structure of) a type. Examples include equality tests, maps and pretty printers. Property based testing tools like QuickCheck and Gast support the de¯nition of properties and test-data generators, and they check if a

  7. Generic component failure data base

    International Nuclear Information System (INIS)

    Eide, S.A.; Calley, M.B.

    1992-01-01

    This report discusses comprehensive component generic failure data base which has been developed for light water reactor probabilistic risk assessments. The Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR) was used to generate component failure rates. Using this approach, most of the failure rates are based on actual plant data rather then existing estimates

  8. 'Genericism' in Danish welfare professions

    DEFF Research Database (Denmark)

    Larsen, Verner

    and skills in the basic disciplines of the professions also termed as disciplinary and procedural knowledge '. Thus the main research question for this paper is: What consequences do recent reform actions in Danish welfare education concerning generic competence have on developing professional knowledge...

  9. Computer simulation of energy use, greenhouse gas emissions, and costs for alternative methods of processing fluid milk.

    Science.gov (United States)

    Tomasula, P M; Datta, N; Yee, W C F; McAloon, A J; Nutter, D W; Sampedro, F; Bonnaillie, L M

    2014-07-01

    Computer simulation is a useful tool for benchmarking electrical and fuel energy consumption and water use in a fluid milk plant. In this study, a computer simulation model of the fluid milk process based on high temperature, short time (HTST) pasteurization was extended to include models for processes for shelf-stable milk and extended shelf-life milk that may help prevent the loss or waste of milk that leads to increases in the greenhouse gas (GHG) emissions for fluid milk. The models were for UHT processing, crossflow microfiltration (MF) without HTST pasteurization, crossflow MF followed by HTST pasteurization (MF/HTST), crossflow MF/HTST with partial homogenization, and pulsed electric field (PEF) processing, and were incorporated into the existing model for the fluid milk process. Simulation trials were conducted assuming a production rate for the plants of 113.6 million liters of milk per year to produce only whole milk (3.25%) and 40% cream. Results showed that GHG emissions in the form of process-related CO₂ emissions, defined as CO₂ equivalents (e)/kg of raw milk processed (RMP), and specific energy consumptions (SEC) for electricity and natural gas use for the HTST process alone were 37.6g of CO₂e/kg of RMP, 0.14 MJ/kg of RMP, and 0.13 MJ/kg of RMP, respectively. Emissions of CO2 and SEC for electricity and natural gas use were highest for the PEF process, with values of 99.1g of CO₂e/kg of RMP, 0.44 MJ/kg of RMP, and 0.10 MJ/kg of RMP, respectively, and lowest for the UHT process at 31.4 g of CO₂e/kg of RMP, 0.10 MJ/kg of RMP, and 0.17 MJ/kg of RMP. Estimated unit production costs associated with the various processes were lowest for the HTST process and MF/HTST with partial homogenization at $0.507/L and highest for the UHT process at $0.60/L. The increase in shelf life associated with the UHT and MF processes may eliminate some of the supply chain product and consumer losses and waste of milk and compensate for the small increases in GHG

  10. A prioritization of generic safety issues

    International Nuclear Information System (INIS)

    Emrit, R.; Riggs, R.; Milstead, W.; Pittman, J.

    1991-07-01

    This report presents the priority rankings for generic safety issues and related to nuclear power plants. The purpose of these rankings is to assist in the timely and efficient allocation of NRC resources for the resolution of those safety issues that have a significant potential for reducing risk. The report focuses on the prioritization of generic safety issues. Issues primarily concerned with the licensing process or environmental protection and not directly related to safety have been excluded from prioritization. The prioritized issues include: TMI Action Plan items under development; previously proposed issues covered by Task Action Plans, except issues designated as Un-resolved Safety Issues (USIs) which had already been assigned high priority; and newly-proposed issues. Future supplements to this report will include the prioritization of additional issues. The safety priority rankings are High, Medium, Low, and Drop and have been assigned on the basis of risk significance estimates, the ratio of risk to costs and other impacts estimated to result if resolutions of the safety issues were implemented, and the consideration of uncertainties and other quantitative or qualitative factors. To the extent practical, estimates are quantitative. 1310 refs

  11. Might generic OCs create contraceptive price war?

    Science.gov (United States)

    1987-02-01

    Genora 1/35 and 1/50, the 1st generic oral contraceptives (OCs) in the world, are now being marketed in the US. Clinicians interviewed by "Contraceptive Technology Update" (CTU) offer differing opinions as to what this new OC may mean in the marketplace. Products of Rugby Laboratories, the pills are copy products of Ortho Pharmaceutical's ON 1/35 and ON 1/50 formulations. Most clinicians believe that Genora's success or failure in the OC market depends on its eventual retail price. The price difference of $3-$4 may be sufficiently substantial for retailers to charge less for the generic OCs. If that is the case, many doctors may prescribe a pill which will save their patients $4/month. Dr. Mildred Hanson, a Minneapolis gynecologist/obstetrician, feels any cost savings from Genora will have a significant impact on the OC market. She suggests that the less expensive OCs will catch the attention of health maintenance organizations (HMOs) and the business of women who participate in such health plans. Yet James Burns, director of family planning services for the Hartford City Health Department, thinks that even a full-scale retail price war won't have much effect from a clinic standpoint. He reports that clinics are able to obtain contraceptive supplies rather inexpensively through the contracting system. Hanson also expressed doubt over the potential popularity of Genora 1/50 as clinical concerns about the effects of combined OCs on serum lipid levels and carbohydrate metabolism have resulted in a nationwide push toward OCs containing less than 50 micrograms of estrogen. He indicated concern that declines in pharmaceutical house products from pricing competition with generic pills might have a negative impact on contraceptive research and development. Dick Haskitt, director of business planning for Syntex Laboratories, Inc., who will produce the OCs for Rugby, reports that their market research shows that people are very interested in having a generic OC available

  12. Value-impact analysis of regulatory options for resolution of Generic Issue C-8: MSIV [Main Steam Isolation Valve] leakage and LCS [Leakage Control System] failure

    International Nuclear Information System (INIS)

    Jamison, J.D.; Vo, T.V.; Tabatabai, A.S.

    1990-05-01

    This report describes the analysis conducted to establish the basis for answering two remaining regulatory questions facing the NRC staff regarding the resolution of Generic Issue C-8, specifically:(1) What action should the NRC take concerning plants that currently have a leakage control system (LCS)? and, (2) What action should the NRC take concerning plants that do not have an LCS? Using individual MSIV leak test data, the performance of a system of eight such valves in a standard BWR con-figuration was modeled. The performance model was used along with estimates of core damage accident frequency and calculated dose consequences to determine the public risk associated with each of the alternatives. The occupational exposure implications of each alternative were calculated using estimates of labor hours in radiation zones that would be incurred or avoided. The costs to industry of implementing each alternative were estimated using standard cost formulae and NRC staff estimates. The cost to the NRC were estimated based on the effort incurred or avoided for reviews or other staff actions engendered by the selection of or avoided for reviews or other staff actions engendered by the selection of a particular alternative. The cost and risks thus calculated suggest that no regulatory action can be justified on the basis of risk reduction or cost savings. 12 refs., 1 tab

  13. Viewpoint: "underutilisation of novel antiplatelet agents--myths, generics, and economics".

    Science.gov (United States)

    Serebruany, V L; Fortmann, S D

    2014-07-03

    Two oral antiplatelet agents have been recently introduced for acute coronary syndromes indication providing alternatives for dual therapy with aspirin and clopidogrel. In fact, worldwide prasugrel has been on the market for four years, and ticagrelor for over two years. Despite declared benefits over clopidogrel, including hypothetical cost saving advantages, in real life, the clinical utilisation of both agents is small. Generic clopidogrel, and price differences are claimed as major obstacles to prevent broader prasugrel and ticagrelor use. However, these economic difficulties are barely supported by available evidence, and served mostly to protect questionable management spending, as an exuse to explain why in reality cardiologists are so sceptical about both novel agents, and to convince the sharehoders that their money is not wasted, misleading the owners with regard to future success. Importantly, brand Plavix® is used worldwide 5-10 times more often than new agents, despite heavy generic competition. The future of prasugrel outside Japan, where much lower reasonable dose will be used is not impressive due to lack of further outcome studies, negative results of the latest trials, and less than four years left before patent expiration. The fate of ticagrelor will depend on verification of deaths numbers in the ongoing United States Department of Justice PLATO investigation, and confirmation of the mortality benefit in the PEGASUS TIMI-54 trial.

  14. Perception of antiretroviral generic medicines: one-day survey of HIV-infected patients and their physicians in France.

    Directory of Open Access Journals (Sweden)

    Christine Jacomet

    Full Text Available In the interest of cost effectiveness, switching antiretroviral brand name medications to generics is recommended in France since 2013. The study objective was to evaluate the perception of generics per se and antiretroviral generics in HIV-infected patients and their hospital physicians.556 out of 703 (79% adult HIV+ outpatients and 116 physicians in 33 clinics were included in a multicentric cross-sectional survey performed in September 2013. Patients completed a self-questionnaire on their perception and acceptability of generics. Physicians completed a questionnaire on their acceptability of switching antiretroviral to generic. Socio-demographic data, medical history and HIV history were collected. Among the 556 patients with a median HIV duration of 13 years, 77% were France native, 59% in active employment, 100% covered by social insurance, 95% on antiretroviral therapy. Seventy-six percent of the patients accepted generics and 55% trusted them overall. Antiretroviral generics were accepted by 44% of them but only by 17% if the pill burden was going to increase. The factor significantly associated with acceptability of antiretroviral generics was acceptance of generics per se (p<0.001. Among the 116 physicians following a median of 100 HIV-patients/year, 75% would prescribe generics, dropping to 26% if the combo had to be broken. Factors significantly associated with willingness to prescribe antiretroviral generics were the absence of concern regarding the chemical entity (OR = 0.33, being aware that the patient would accept generics for other pathologies (OR = 2.04 and would accept antiretroviral generics (OR = 1.94. No factor related to sociodemographic conditions, HIV status or comorbidities was associated with the acceptability of antiretroviral generics.Acceptability of antiretroviral generics in this French population was mostly dictated by the patient's and physician's knowledge and use of generics overall. It should be improved

  15. GENERIC Integrators: Structure Preserving Time Integration for Thermodynamic Systems

    Science.gov (United States)

    Öttinger, Hans Christian

    2018-04-01

    Thermodynamically admissible evolution equations for non-equilibrium systems are known to possess a distinct mathematical structure. Within the GENERIC (general equation for the non-equilibrium reversible-irreversible coupling) framework of non-equilibrium thermodynamics, which is based on continuous time evolution, we investigate the possibility of preserving all the structural elements in time-discretized equations. Our approach, which follows Moser's [1] construction of symplectic integrators for Hamiltonian systems, is illustrated for the damped harmonic oscillator. Alternative approaches are sketched.

  16. Exploring knowledge, perceptions and attitudes about generic ...

    African Journals Online (AJOL)

    Exploring knowledge, perceptions and attitudes about generic medicines among final-year health science students. ... had knowledge deficits about the safety, quality and efficacy of generic medicines. The dissemination of information about generic medicines may strengthen future knowledge, attitudes and perceptions.

  17. Comparing approaches to generic programming in Haskell

    NARCIS (Netherlands)

    Hinze, R.; Jeuring, J.T.; Löh, A.

    2006-01-01

    The last decade has seen a number of approaches to generic programming: PolyP, Functorial ML, `Scrap Your Boilerplate', Generic Haskell, `Generics for the Masses', etc. The approaches vary in sophistication and target audience: some propose full-blown pro- gramming languages, some suggest

  18. Comparing approaches to generic programming in Haskell

    NARCIS (Netherlands)

    Hinze, R.; Jeuring, J.T.; Löh, A.

    2006-01-01

    The last decade has seen a number of approaches to data- type-generic programming: PolyP, Functorial ML, `Scrap Your Boiler- plate', Generic Haskell, `Generics for the Masses', etc. The approaches vary in sophistication and target audience: some propose full-blown pro- gramming languages, some

  19. Proceedings Workshop on Generic Programming (WGP2000)

    NARCIS (Netherlands)

    Jeuring, J.T.

    2000-01-01

    This report contains the papers selected for presentation at the 2nd Workshop on Generic Programming (WGP2000), which was held on July 6, 2000 in Ponte de Lima, Portugal. Generic programming is about making programs more adaptable by making them more general. Generic programs often embody

  20. Restructuring upstream bioprocessing: technological and economical aspects for production of a generic microbial feedstock from wheat.

    Science.gov (United States)

    Koutinas, A A; Wang, R; Webb, C

    2004-03-05

    Restructuring and optimization of the conventional fermentation industry for fuel and chemical production is necessary to replace petrochemical production routes. Guided by this concept, a novel biorefinery process has been developed as an alternative to conventional upstream processing routes, leading to the production of a generic fermentation feedstock from wheat. The robustness of Aspergillus awamori as enzyme producer is exploited in a continuous fungal fermentation on whole wheat flour. Vital gluten is extracted as an added-value byproduct by the conventional Martin process from a fraction of the overall wheat used. Enzymatic hydrolysis of gluten-free flour by the enzyme complex produced by A. awamori during fermentation produces a liquid stream rich in glucose (320 g/L). Autolysis of fungal cells produces a micronutrient-rich solution similar to yeast extract (1.6 g/L nitrogen, 0.5 g/L phosphorus). The case-specific combination of these two liquid streams can provide a nutrient-complete fermentation medium for a spectrum of microbial bioconversions for the production of such chemicals as organic acids, amino acids, bioethanol, glycerol, solvents, and microbial biodegradable plastics. Preliminary economic analysis has shown that the operating cost required to produce the feedstock is dependent on the plant capacity, cereal market price, presence and market value of added-value byproducts, labor costs, and mode of processing (batch or continuous). Integration of this process in an existing fermentation plant could lead to the production of a generic feedstock at an operating cost lower than the market price of glucose syrup (90% to 99% glucose) in the EU, provided that the plant capacity exceeds 410 m(3)/day. Further process improvements are also suggested. Copyright 2004 Wiley Periodicals, Inc.

  1. Enhancing Safety through Generic Competencies

    Directory of Open Access Journals (Sweden)

    S. Mockel

    2014-03-01

    Full Text Available This article provides insights into proactive safety management and mitigation. An analysis of accident reports reveals categories of supervening causes of accidents which can be directly linked to the concept of generic competencies (information management, communication and coordination, problem solving, and effect control. These findings strongly suggest adding the human element as another safety-constituting pillar to the concept of ship safety next to technology and regulation. We argue that the human element has unique abilities in dealing with critical and highly dynamic situations which can contribute to the system's recovery from non-routine or critical situations. By educating seafarers in generic competencies we claim to enable the people onboard to successfully deal with critical situations.

  2. Generic medications for you, but brand-name medications for me.

    Science.gov (United States)

    Keenum, Amy J; Devoe, Jennifer E; Chisolm, Deena J; Wallace, Lorraine S

    2012-01-01

    Because generic medications are less expensive than brand-name medications, government and private insurers have encouraged and/or mandated the use of generics. This study aimed at evaluating perceptions about generic medications among English-speaking women of childbearing age currently enrolled in U.S. TennCare (Medicaid). We recruited a convenience sample of patients from the waiting room of a primary care/gynecology health clinic, with 80% recruitment rate among those approached. We orally administered a 25-item questionnaire to gather sociodemographic information and to assess beliefs regarding the efficacy, safety, cost, and preferences for personal use of generic medications. The average age of the women (n=172) was 28.8 ± 6.4 years, and most were white (82.0%) and currently married (58.1%). Nearly one-fifth (19.2%) had not completed high school. Most women believed that generic medications were less expensive (97.6%) and better value (60.5%) than brand-name medications, but only 45.3% preferred to take generics themselves. About a quarter (23.3%) believed that brand-name medications were more effective than generics, whereas 13.4% believed that generics caused more side effects. Few women reported that their doctor (29.7%) and/or pharmacist (35.5%) had ever talked to them about taking generics. Awareness of the benefits of generics did not equal preferences for personal use of generics among this sample of women enrolled in U.S. TennCare. Furthermore, women reported that providers-both physicians and pharmacists-infrequently discussed generic substitution with them. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Automated analysis in generic groups

    Science.gov (United States)

    Fagerholm, Edvard

    This thesis studies automated methods for analyzing hardness assumptions in generic group models, following ideas of symbolic cryptography. We define a broad class of generic and symbolic group models for different settings---symmetric or asymmetric (leveled) k-linear groups --- and prove ''computational soundness'' theorems for the symbolic models. Based on this result, we formulate a master theorem that relates the hardness of an assumption to solving problems in polynomial algebra. We systematically analyze these problems identifying different classes of assumptions and obtain decidability and undecidability results. Then, we develop automated procedures for verifying the conditions of our master theorems, and thus the validity of hardness assumptions in generic group models. The concrete outcome is an automated tool, the Generic Group Analyzer, which takes as input the statement of an assumption, and outputs either a proof of its generic hardness or shows an algebraic attack against the assumption. Structure-preserving signatures are signature schemes defined over bilinear groups in which messages, public keys and signatures are group elements, and the verification algorithm consists of evaluating ''pairing-product equations''. Recent work on structure-preserving signatures studies optimality of these schemes in terms of the number of group elements needed in the verification key and the signature, and the number of pairing-product equations in the verification algorithm. While the size of keys and signatures is crucial for many applications, another aspect of performance is the time it takes to verify a signature. The most expensive operation during verification is the computation of pairings. However, the concrete number of pairings is not captured by the number of pairing-product equations considered in earlier work. We consider the question of what is the minimal number of pairing computations needed to verify structure-preserving signatures. We build an

  4. Is There Evidence to Support Brand to Generic Interchange of the Mycophenolic Acid Products?

    Science.gov (United States)

    Phillips, Karen; Reddy, Prabashni; Gabardi, Steven

    2017-02-01

    The uptake of generic immunosuppressants lags comparatively to other drug classes, despite that the Food and Drug Administration (FDA) uses identical bioequivalence standards for all drugs. Transplant societies acknowledge the cost savings associated with generic immunosuppressants and support their use following heart, lung, kidney, or bone marrow transplantation. Seven studies of the pharmacokinetics or clinical efficacy of generic mycophenolate mofetil compared to the innovator product are published; all studies and products were ex-United States. Three studies did not demonstrate any pharmacokinetic differences between generic and innovator products in healthy subjects, achieving FDA bioequivalence requirements. Two studies in renal allograft recipients demonstrated no difference in area under the curves between generic and innovator products, and in one, the maximum concentration (Cmax) fell outside the FDA regulatory range. Two studies revealed no difference in acute organ rejection or graft function in renal allograft recipients. Patient surveys indicate that cost is a barrier to immunosuppressant adherence. Generics present a viable method to reduce costs to payers, patients, and health care systems. Adherence to immunosuppressants is crucial to prevent graft failure. An affordable regimen potentially confers greater adherence. Concerns regarding the presumed inferiority of generic immunosuppressants should be assuaged by regulatory requirements for bioequivalency testing, transplant society position statements, and pharmacokinetic and clinical studies.

  5. Brand Medications and Medicare Part D: How Eye Care Providers' Prescribing Patterns Influence Costs.

    Science.gov (United States)

    Newman-Casey, Paula Anne; Woodward, Maria A; Niziol, Leslie M; Lee, Paul P; De Lott, Lindsey B

    2018-03-01

    To quantify costs of eye care providers' Medicare Part D prescribing patterns for ophthalmic medications and to estimate the potential savings of generic or therapeutic drug substitutions and price negotiation. Retrospective cross-sectional study. Eye care providers prescribing medications through Medicare Part D in 2013. Medicare Part D 2013 prescriber public use file and summary file were used to calculate medication costs by physician specialty and drug. Savings from generic or therapeutic drug substitutions were estimated for brand drugs. The potential savings from price negotiation was estimated using drug prices negotiated by the United States Veterans Administration (USVA). Total cost of brand and generic medications prescribed by eye care providers. Eye care providers accounted for $2.4 billion in total Medicare part D prescription drug costs and generated the highest percentage of brand name medication claims compared with all other providers. Brand medications accounted for a significantly higher proportion of monthly supplies by volume, and therefore, also by total cost for eye care providers compared with all other providers (38% vs. 23% by volume, P total cost, P total cost attributable to eye care providers is driven by glaucoma medications, accounting for $1.2 billion (54% of total cost; 72% of total volume). The second costliest category, dry eye medications, was attributable mostly to a single medication, cyclosporine ophthalmic emulsion (Restasis, Allergan, Irvine, CA), which has no generic alternative, accounting for $371 million (17% of total cost; 4% of total volume). If generic medications were substituted for brand medications when available, $148 million would be saved (7% savings); if generic and therapeutic substitutions were made, $882 million would be saved (42% savings). If Medicare negotiated the prices for ophthalmic medications at USVA rates, $1.09 billion would be saved (53% savings). Eye care providers prescribe more brand

  6. Perceived and actual cost of healthier foods versus their less healthy alternatives: a case study in a predominantly black urban township in South Africa.

    Science.gov (United States)

    Muzigaba, M; Puoane, T

    2011-12-01

    There is an increasing awareness of the role played by the food retail characteristics in determining individuals' healthy food purchasing and consumption behaviors. The perceived costs of healthier food alternatives have been shown to contribute negatively to individual's food choices in developed societies. However, there is still a dearth of knowledge regarding this phenomenon in low to middle income countries particularly in Africa. This study explored health club member's experiences in buying healthier food options and compared their perceived cost of selected healthier and less healthy foods with actual market costs in a South African township. A cross-sectional study design using quantitative and qualitative research methods. The study was conducted in Khayelitsha, a township in the Western Cape Province in South Africa. Participants were 50 members of a health club, mostly female and above 50 years of age. The study was conducted in three phases. The first phase involved interviews with all 50 health club members. During the second phase ten purposively selected members participated in in-depth interviews based on their unhealthy food-purchasing and consumption patterns identified in the first phase. The third phase involved food price audits from supermarkets as well as convenient stores located in the study setting. Quantitative data were subjected to descriptive statistical analysis, while content analysis was used to analyze qualitative data. Most of the members were illiterate and unemployed, largely dependent on government grants. Qualitative findings showed that low household incomes, their inability to read and interpret nutritional information and personal food preferences contributed to Health club members' unhealthy food-purchasing behaviour. When objectively measured in local stores, the healthier food options proved to be more expensive than their less healthy equivalents. This was consistent with subjects' perceptions about the relative cost

  7. Perception of antiretroviral generic medicines: one-day survey of HIV-infected patients and their physicians in France.

    Science.gov (United States)

    Jacomet, Christine; Allavena, Clotilde; Peyrol, Fleur; Pereira, Bruno; Joubert, Laurence Morand; Bagheri, Haleh; Cotte, Laurent; Garaffo, Rodolphe; Gerbaud, Laurent; Dellamonica, Pierre

    2015-01-01

    In the interest of cost effectiveness, switching antiretroviral brand name medications to generics is recommended in France since 2013. The study objective was to evaluate the perception of generics per se and antiretroviral generics in HIV-infected patients and their hospital physicians. 556 out of 703 (79%) adult HIV+ outpatients and 116 physicians in 33 clinics were included in a multicentric cross-sectional survey performed in September 2013. Patients completed a self-questionnaire on their perception and acceptability of generics. Physicians completed a questionnaire on their acceptability of switching antiretroviral to generic. Socio-demographic data, medical history and HIV history were collected. Among the 556 patients with a median HIV duration of 13 years, 77% were France native, 59% in active employment, 100% covered by social insurance, 95% on antiretroviral therapy. Seventy-six percent of the patients accepted generics and 55% trusted them overall. Antiretroviral generics were accepted by 44% of them but only by 17% if the pill burden was going to increase. The factor significantly associated with acceptability of antiretroviral generics was acceptance of generics per se (pantiretroviral generics were the absence of concern regarding the chemical entity (OR = 0.33), being aware that the patient would accept generics for other pathologies (OR = 2.04) and would accept antiretroviral generics (OR = 1.94). No factor related to sociodemographic conditions, HIV status or comorbidities was associated with the acceptability of antiretroviral generics. Acceptability of antiretroviral generics in this French population was mostly dictated by the patient's and physician's knowledge and use of generics overall. It should be improved with an efficient information of both patients and physicians.

  8. Perception of Antiretroviral Generic Medicines: One-Day Survey of HIV-Infected Patients and Their Physicians in France

    Science.gov (United States)

    Jacomet, Christine; Allavena, Clotilde; Peyrol, Fleur; Pereira, Bruno; Joubert, Laurence Morand; Bagheri, Haleh; Cotte, Laurent; Garaffo, Rodolphe; Gerbaud, Laurent; Dellamonica, Pierre

    2015-01-01

    Background In the interest of cost effectiveness, switching antiretroviral brand name medications to generics is recommended in France since 2013. The study objective was to evaluate the perception of generics per se and antiretroviral generics in HIV-infected patients and their hospital physicians Methods and Findings 556 out of 703 (79%) adult HIV+ outpatients and 116 physicians in 33 clinics were included in a multicentric cross-sectional survey performed in September 2013. Patients completed a self-questionnaire on their perception and acceptability of generics. Physicians completed a questionnaire on their acceptability of switching antiretroviral to generic. Socio-demographic data, medical history and HIV history were collected. Among the 556 patients with a median HIV duration of 13 years, 77% were France native, 59% in active employment, 100% covered by social insurance, 95% on antiretroviral therapy. Seventy-six percent of the patients accepted generics and 55% trusted them overall. Antiretroviral generics were accepted by 44% of them but only by 17% if the pill burden was going to increase. The factor significantly associated with acceptability of antiretroviral generics was acceptance of generics per se (pantiretroviral generics were the absence of concern regarding the chemical entity (OR = 0.33), being aware that the patient would accept generics for other pathologies (OR = 2.04) and would accept antiretroviral generics (OR = 1.94). No factor related to sociodemographic conditions, HIV status or comorbidities was associated with the acceptability of antiretroviral generics. Conclusions Acceptability of antiretroviral generics in this French population was mostly dictated by the patient’s and physician’s knowledge and use of generics overall. It should be improved with an efficient information of both patients and physicians. PMID:25658627

  9. Evaluation of alternative methods for the disposal of low-level radioactive wastes

    International Nuclear Information System (INIS)

    Macbeth, P.; Wehmann, G.; Thamer, B.J.; Card, D.H.

    1979-07-01

    A comparative analysis of the most viable alternatives for disposal of solid low-level radioactive wastes is presented to aid in evaluating national waste management options. Four basic alternative methods are analyzed and compared to the present practice of shallow land burial. These include deeper burial, disposal in mined cavities, disposal in engineered structures, and disposal in the oceans. Some variations in the basic methods are also presented. Technical, socio-political, and economic factors are assigened relative importances (weights) and evaluated for the various alternatives. Based on disposal of a constant volume of waste with given nuclear characteristics, the most desirable alternatives to shallow land burial in descending order of desirability appear to be: improving present practices, deeper burial, use of acceptable abandoned mines, new mines, ocean dumping, and structural disposal concepts. It must be emphasized that the evaluations reported here are generic, and use of other weights or different values for specific sites could change the conclusions and ordering of alternatives determined in this study. Impacts and costs associated with transportation over long distances predominate over differences among alternatives, indicating the desireability of establishing regional waste disposal locations. The impacts presented are for generic comparisons among alternatives, and are not intended to be predictive of the performance of any actual waste disposal facility

  10. Perception of Antiretroviral Generic Medicines: One-Day Survey of HIV-Infected Patients and Their Physicians in France

    OpenAIRE

    Jacomet, Christine; Allavena, Clotilde; Peyrol, Fleur; Pereira, Bruno; Joubert, Laurence Morand; Bagheri, Haleh; Cotte, Laurent; Garaffo, Rodolphe; Gerbaud, Laurent; Dellamonica, Pierre

    2015-01-01

    Background In the interest of cost effectiveness, switching antiretroviral brand name medications to generics is recommended in France since 2013. The study objective was to evaluate the perception of generics per se and antiretroviral generics in HIV-infected patients and their hospital physicians Methods and Findings 556 out of 703 (79%) adult HIV+ outpatients and 116 physicians in 33 clinics were included in a multicentric cross-sectional survey performed in September 2013. Patients comple...

  11. Water Use in Enhanced Geothermal Systems (EGS): Geology of U.S. Stimulation Projects, Water Costs, and Alternative Water Source Policies

    Energy Technology Data Exchange (ETDEWEB)

    Harto, C. B. [Argonne National Lab. (ANL), Argonne, IL (United States); Schroeder, J. N. [Argonne National Lab. (ANL), Argonne, IL (United States); Horner, R. M. [Argonne National Lab. (ANL), Argonne, IL (United States); Patton, T. L. [Argonne National Lab. (ANL), Argonne, IL (United States); Durham, L. A. [Argonne National Lab. (ANL), Argonne, IL (United States); Murphy, D. J. [Argonne National Lab. (ANL), Argonne, IL (United States); Clark, C. E. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2014-10-01

    According to the Energy Information Administration (EIA) of the U.S. Department of Energy (DOE), geothermal energy generation in the United States is projected to more than triple by 2040 (EIA 2013). This addition, which translates to more than 5 GW of generation capacity, is anticipated because of technological advances and an increase in available sources through the continued development of enhanced geothermal systems (EGSs) and low-temperature resources (EIA 2013). Studies have shown that air emissions, water consumption, and land use for geothermal electricity generation have less of an impact than traditional fossil fuel–based electricity generation; however, the long-term sustainability of geothermal power plants can be affected by insufficient replacement of aboveground or belowground operational fluid losses resulting from normal operations (Schroeder et al. 2014). Thus, access to water is therefore critical for increased deployment of EGS technologies and, therefore, growth of the geothermal sector. This paper examines water issues relating to EGS development from a variety of perspectives. It starts by exploring the relationship between EGS site geology, stimulation protocols, and below ground water loss, which is one of the largest drivers of water consumption for EGS projects. It then examines the relative costs of different potential traditional and alternative water sources for EGS. Finally it summarizes specific state policies relevant to the use of alternative water sources for EGS, and finally explores the relationship between EGS site geology, stimulation protocols, and below ground water loss, which is one of the largest drivers of water consumption for EGS projects.

  12. Generic environmental impact statement in support of rulemaking on radiological criteria for license termination of NRC-licensed nuclear facilities. Final report, appendices A and B

    International Nuclear Information System (INIS)

    1997-07-01

    The action being considered in this Final Generic Environmental Impact Statement (GEIS) is an amendment to the Nuclear Regulatory Commission''s (NRC) regulations in 10 CFR Part 20 to include radiological criteria for decommissioning of lands and structures at nuclear facilities. Under the National Environmental Policy Act (NEPA), all Federal agencies must consider the effect of their actions on the environment. To fulfill NRC''s responsibilities under NEPA, the Commission is preparing this GEIS which analyzes alternative courses of action and the costs and impacts associated with those alternatives. In preparing the final GEIS, the following approach was taken: (1) a listing was developed of regulatory alternatives for establishing radiological criteria for decommissioning; (2) for each alternative, a detailed analysis and comparison of incremental impacts, both radiological and nonradiological, to workers, members of the public, and the environment, and costs were performed; and (3) based on the analysis of impacts and costs, conclusions on radiological criteria for decommissioning were provided. Contained in the GEIS are results and conclusions related to achieving, as an objective of decommissioning ALARA, reduction to preexisting background, the radiological criterion for unrestricted use, decommissioning ALARA analysis for soils and structures containing contamination, restricted use and alternative analysis for special site-specific situations and groundwater cleanup. In its analyses, the final GEIS includes consideration of comments made on the draft GEIS during the public comment period

  13. Generic environmental impact statement in support of rulemaking on radiological criteria for license termination of NRC-licensed nuclear facilities. Final report, main report

    International Nuclear Information System (INIS)

    1997-07-01

    The action being considered in this Final Generic Environmental Impact Statement (GEIS) is an amendment to the Nuclear Regulatory Commission's (NRC) regulations in 10 CFR Part 20 to include radiological criteria for decommissioning of lands and structures at nuclear facilities. Under the National Environmental Policy Act (NEPA), all Federal agencies must consider the effect of their actions on the environment. To fulfill NRC's responsibilities under NEPA, the Commission is preparing this GEIS which analyzes alternative courses of action and the costs and impacts associated with those alternatives. In preparing the final GEIS, the following approach was taken: (1) a listing was developed of regulatory alternatives for establishing radiological criteria for decommissioning; (2) for each alternative, a detailed analysis and comparison of incremental impacts, both radiological and nonradiological, to workers, members of the public, and the environment, and costs, were performed; and (3) based on the analysis of impacts and costs, conclusions on radiological criteria for decommissioning were provided. Contained in the GEIS are results and conclusions related to achieving, as an objective of decommissioning ALARA, reduction to preexisting background, the radiological criterion for unrestricted use, decommissioning ALARA analysis for soils and structures containing contamination, restricted use and alternative analysis for special site specific situations, and groundwater cleanup. In its analyses, the final GEIS includes consideration of comments made on the draft GEIS during the public comment period

  14. Identifying the spatial and temporal variability of economic opportunity costs to promote the adoption of alternative land uses in grain growing agricultural areas: an Australian example.

    Science.gov (United States)

    Lyle, G; Bryan, B A; Ostendorf, B

    2015-05-15

    Grain growers face many future challenges requiring them to adapt their land uses to changing economic, social and environmental conditions. To understand where to make on ground changes without significant negative financial repercussions, high resolution information on income generation over time is required. We propose a methodology which utilises high resolution yield data collected with precision agriculture (PA) technology, gross margin financial analysis and a temporal standardisation technique to highlight the spatial and temporal consistency of farm income. On three neighbouring farms in Western Australia, we found non-linear relationships between income and area. Spatio-temporal analysis on one farm over varying seasons found that between 37 and 49% (1082-1433ha) of cropping area consistently produced above the selected income thresholds and 43-32% (936-1257ha) regularly produced below selected thresholds. Around 20% of area showed inconsistent temporal variation in income generation. Income estimated from these areas represents the income forgone if a land use change is undertaken (the economic opportunity cost) and the average costs varied spatially from $190±114/ha to $560±108/ha depending on what scenario was chosen. The interaction over space and time showed the clustering of areas with similar values at a resolution where growers make input decisions. This new evidence suggests that farm area could be managed with two strategies: (a) one that maximises grain output using PA management in temporally stable areas which generate moderate to high income returns and (b) one that proposes land use change in low and inconsistent income returning areas where the financial returns from an alternative land use may be comparable. The adoption of these strategies can help growers meet the demand for agricultural output and offer income diversity and adaptive capacity to deal with the future challenges to agricultural production. Copyright © 2015 Elsevier Ltd

  15. Cassava flour slurry as a low-cost alternative to commercially available gel for obstetrical ultrasound: a blinded non-inferiority trial comparison of image quality.

    Science.gov (United States)

    Aziz, A; Dar, P; Hughes, F; Solorzano, C; Muller, M M; Salmon, C; Salmon, M; Benfield, N

    2018-01-12

    To evaluate the quality of ultrasound images obtained with cassava flour slurry (CFS) compared with conventional gel in order to determine objectively whether CFS could be a true low-cost alternative. Blinded non-inferiority trial. Obstetrical ultrasound unit in an academic medical centre. Women with a singleton pregnancy, undergoing anatomy ultrasounds. Thirty pregnant women had standard biometry measures obtained with CFS and conventional gel. Images were compared side-by-side in random order by two blinded sonologists and rated for image resolution, detail and total image quality using a 10-cm visual analogue scale. Ratings were compared using paired t-tests. Participant and sonographer experience was measured using five-point Likert scales. Image resolution, detail, and total image quality. Participant experience of gel regarding irritation, messiness, and ease of removal. We found no significant difference between perceived image quality obtained with CFS (mean = 6.2, SD = 1.2) and commercial gel (mean = 6.4, SD = 1.2) [t (28) = -1.1; P = 0.3]. Images were not rated significantly differently for either reviewer in any measure, any standardized image or any view of a specific anatomic structure. All five sonographers rated CFS as easy to obtain clear images and easy for patient and machine cleanup. Only one participant reported itching with CFS. CFS produces comparable image quality to commercial ultrasound gel. The dissemination of these results and the simple CFS recipe could significantly increase access to ultrasound for screening, monitoring and diagnostic purposes in resource-limited settings. This study was internally funded by our department. Low-cost homemade cassava flour slurry creates images equal to commercial ultrasound gel, improving access. © 2018 Royal College of Obstetricians and Gynaecologists.

  16. Generic Crystalline Disposal Reference Case

    Energy Technology Data Exchange (ETDEWEB)

    Painter, Scott Leroy [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Chu, Shaoping [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Harp, Dylan Robert [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Perry, Frank Vinton [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wang, Yifeng [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-02-20

    A generic reference case for disposal of spent nuclear fuel and high-level radioactive waste in crystalline rock is outlined. The generic cases are intended to support development of disposal system modeling capability by establishing relevant baseline conditions and parameters. Establishment of a generic reference case requires that the emplacement concept, waste inventory, waste form, waste package, backfill/buffer properties, EBS failure scenarios, host rock properties, and biosphere be specified. The focus in this report is on those elements that are unique to crystalline disposal, especially the geosphere representation. Three emplacement concepts are suggested for further analyses: a waste packages containing 4 PWR assemblies emplaced in boreholes in the floors of tunnels (KBS-3 concept), a 12-assembly waste package emplaced in tunnels, and a 32-assembly dual purpose canister emplaced in tunnels. In addition, three failure scenarios were suggested for future use: a nominal scenario involving corrosion of the waste package in the tunnel emplacement concepts, a manufacturing defect scenario applicable to the KBS-3 concept, and a disruptive glaciation scenario applicable to both emplacement concepts. The computational approaches required to analyze EBS failure and transport processes in a crystalline rock repository are similar to those of argillite/shale, with the most significant difference being that the EBS in a crystalline rock repository will likely experience highly heterogeneous flow rates, which should be represented in the model. The computational approaches required to analyze radionuclide transport in the natural system are very different because of the highly channelized nature of fracture flow. Computational workflows tailored to crystalline rock based on discrete transport pathways extracted from discrete fracture network models are recommended.

  17. GLAD: a generic lattice debugger

    International Nuclear Information System (INIS)

    Lee, M.J.

    1992-01-01

    Today, numerous simulation and analysis codes exist for the design, commission, and operation of accelerator beam lines. There is a need to develop a common user interface and database link to run these codes interactively. This paper will describe a proposed system, GLAD (Generic LAttice Debugger), to fulfill this need. Specifically, GLAD can be used to find errors in beam lines during commissioning, control beam parameters during operation, and design beam line optics and error correction systems for the next generation of linear accelerators and storage rings. (author)

  18. Generic maximum likely scale selection

    DEFF Research Database (Denmark)

    Pedersen, Kim Steenstrup; Loog, Marco; Markussen, Bo

    2007-01-01

    in this work is on applying this selection principle under a Brownian image model. This image model provides a simple scale invariant prior for natural images and we provide illustrative examples of the behavior of our scale estimation on such images. In these illustrative examples, estimation is based......The fundamental problem of local scale selection is addressed by means of a novel principle, which is based on maximum likelihood estimation. The principle is generally applicable to a broad variety of image models and descriptors, and provides a generic scale estimation methodology. The focus...

  19. Medication persistence and the use of generic and brand-name blood pressure-lowering agents.

    Science.gov (United States)

    Corrao, Giovanni; Soranna, Davide; La Vecchia, Carlo; Catapano, Alberico; Agabiti-Rosei, Enrico; Gensini, Gianfranco; Merlino, Luca; Mancia, Giuseppe

    2014-05-01

    Because of their lower cost, healthcare systems recommend physicians to prefer generic products, rather than brand-name medicaments. There is then considerable interest and debate concerning safety and effectiveness of generic products. Few studies have compared patients treated with brand-name and generic drugs for adherence to treatment, with somewhat inconsistent results. The primary objective of this study was to compare the risk of discontinuing antihypertensive drug therapy in patients treated with generic or brand-name agents. The 101,618 beneficiaries of the Healthcare system of Lombardy, Italy, aged 18 years or older who were newly treated on monotherapy with antihypertensive generic or brand-name drugs during 2008, were followed until the earliest date among those of the occurrence of treatment discontinuation to whatever antihypertensive drug therapy (outcome), or censoring (death, emigration, 12 months after treatment initiation). Hazard ratios of discontinuation associated with starting on generic or brand-name products (intention-to-treat analysis), and incidence rate ratio of discontinuation during periods on generic and brand-name products (as-treated analysis) were respectively estimated from a cohort and self-controlled case series analyses. Patients who started on generics did not experience a different risk of discontinuation compared with those starting on brand-name agents (hazard ratio: 1.00; 95% confidence interval 0.98-1.02). Discontinuation did not occur with different rates during periods covered by generics or brand-name agents (incidence rate ratio: 1.01; 95% confidence interval 0.96-1.11) within the same individuals. A number of sensitivity and subgroup analyses confirmed the robustness of these findings. Generic products are not responsible for the high rate of discontinuation from antihypertensive drug therapy. Assuming therapeutic equivalence, clinical implication is of prescribing generic drug therapies.

  20. An alternative non-vacuum and low cost ESAVD method for the deposition of Cu(In,Ga)Se{sub 2} absorber layers

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Mingqing; Liu, Junpeng; Choy, KwangLeong [UCL Centre for Materials Discovery, University College London (United Kingdom); Hou, Xianghui [Faculty of Engineering, University of Nottingham (United Kingdom); Gibson, Paul [IMPT Ltd, Nottingham (United Kingdom); Salem, Elhamali; Koutsogeorgis, Demosthenes; Cranton, Wayne [School of Science and Technology, Nottingham Trent University (United Kingdom)

    2015-01-01

    In this article, an environmentally friendly and non-vacuum electrostatic spray assisted vapor deposition (ESAVD) process has been developed as an alternative and low cost method to deposit CIGS absorber layers. ESAVD is a non-vacuum chemical vapor deposition based process whereby a mixture of chemical precursors is atomized to form aerosol. The aerosol is charged and directed towards a heated substrate where it would undergo decomposition and chemical reaction to deposit a stable solid film onto the substrate. A sol containing copper, indium, and gallium salts, as well as thiourea was formulated into a homogeneous chemical precursor mixture for the deposition of CIGS films. After selenization, both XRD and Raman results show the presence of the characteristic peaks of CIGSSe in the fabricated thin films. From SEM images and XRF results, it can be seen that the deposited absorbers are promising for good performance solar cells. The fabricated solar cell with a typical structure of glass/Mo/CIGSSe/CdS/i-ZnO/ITO shows efficiency of 2.82% under 100 mW cm{sup -2} AM1.5 illumination. (copyright 2015 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  1. Comparison of Generic Drug Reviews for Marketing Authorization between Japan and Canada.

    Science.gov (United States)

    Kuribayashi, Ryosuke; Appleton, Scott

    2017-09-01

    Generic drugs are assuming an increasingly important role in sustaining modern healthcare systems, as the cost of healthcare, including drug usage, is gradually expanding around the world. To date, published articles comparing generic drug reviews between different countries are scarce. The objective of this study was to examine generic drug reviews in Japan and Canada. We surveyed generic drug reviews from Japan and Canada and compared the following points: general matter (application types, type of partial change or Supplement to an Abbreviated New Drug Submission, application and approval numbers, review period, application format, review report, responsibility for review), bioequivalence studies for solid oral dosage forms, and bioequivalence guidelines, guidance, or basic principles regarding various dosage forms. This survey described the many similarities and differences in generic drug reviews between the two countries and points that should be improved to promote better generic drug reviews. In particular, regulations for the definition of the same or different active pharmaceutical ingredients (APIs) are similar for both authorities. The results clarified the future challenges of generic drug reviews, and the differences highlighted by this survey will be important considerations for the future. This is the first article to present and discuss the details of generic drug reviews between Japan and Canada.

  2. Generic Performance Measures. Chapter 8

    Energy Technology Data Exchange (ETDEWEB)

    Daube-Witherspoon, M. E. [Department of Radiology, University of Pennsylvania, Philadelphia, PA (United States)

    2014-12-15

    The generic nuclear medicine imager, whether a gamma camera, single photon emission computed tomography (SPECT) system or positron emission tomography (PET) scanner, comprises several main components: a detection system, a form of collimation to select γ rays at specific angles, electronics and a computing system to create the map of the radiotracer distribution. This section discusses these components in more detail. The first stage of a generic nuclear medicine imager is the detection of the γ rays emitted by the radionuclide. In the case of PET, the radiation of interest are the 511 keV annihilation photons that result from the interaction of the positron emitted by the radionuclide with an electron in the tissue. For general nuclear medicine and SPECT, there is one or sometimes more than one γ ray of interest, with energies in the range of <100 to >400 keV. The γ rays are detected when they interact and deposit energy in the crystal(s) of the imaging system. There are two main types of detector: crystals that give off light that can be converted to an electrical signal when the γ ray interacts (‘scintillators’) and semiconductors, crystals that generate an electrical signal directly when the γ ray deposits energy in the crystal. Scintillation detectors include NaI(Tl), bismuth germanate (BGO) and lutetium oxyorthosilicate (LSO); semiconductor detectors used in nuclear medicine imagers include cadmium zinc telluride (CZT). Radiation detectors are described in more detail in Chapter 6.

  3. Generic communications index: User's manual

    International Nuclear Information System (INIS)

    Dean, R.S.; Steinbrecher, D.H.; Hennick, A.

    1987-12-01

    This report is a manual for providing information required to use a special computer program developed by the NRC for indexing generic communications. The program is written in a user-friendly menu driven form using dBASE III programming language. It facilitates use of the required dBASE III search and sort capabilities to access records in a database called Generic Communications Index. This index is made up of one record each for all bulletins, circulars, and information notices, including revisions and supplements, from 1971, when such documentation started, through 1986 (or to the latest update). The program is designed for use by anyone modestly acquainted with the general use of IBM-compatible personal computers. The manual contains both a brief overview and a detailed description of the program, as well as detailed instructions for getting started using the program on a personal computer with either a two-floppy disk or a hard disk system. Included at the end are a brief description of how to handle problems which might occur, and notes on the makeup of the program and database files for help in adding records of communications for future years

  4. Exploring the opinions and experiences of patients with generic substitution: a representative study of Polish society.

    Science.gov (United States)

    Drozdowska, Aleksandra; Hermanowski, Tomasz

    2015-02-01

    Generics have the potential to contain drug therapy costs; successful implementation of generic substitution policy largely depends on consumers' willingness to choose generics. This study aims to analyse the opinions, experiences and preferences of Polish patients towards generic medicines. The study was performed in Poland. The survey was conducted in June 2013 by means of face-to-face interviews. Respondents were drawn from the general population according to a population structure. The study covered a representative sample of 1,000 Poles; the results can be generalized to apply to the Polish population at large. Fifty-two percent of respondents declared to be more often choosing generics, twenty-three percent did not have any specific preferences, and twenty-five percent were more willing to choose brand-name medicines. Past experience with cheaper generic medicines, secondary or lower education, low income and residence in specific regions of Poland were all significantly associated with an increased willingness to choose generics. Respondents' attitudes towards generics were mostly influenced by the opinions of doctors and pharmacists. According to respondents, attitudes towards generics among doctors, pharmacists, family and friends, and in the mass media were mostly positive. There was no relationship between the preference of respondents for generics and factors such as their age, life stage, gender, household size or urban/rural locality. As a result of substituting a brand-name drug with its generic equivalent, 72 % of respondents reported that they had not noticed any difference in drug effectiveness; 21 % had experienced a reduced effectiveness of treatment or increased side effects at least once; and 7 % claimed the generic worked better. The majority of respondents who used cheaper substitutes claimed that generics represented good or very good quality. The study demonstrates that, when choosing medicines, Poles rely mainly on the opinions of their

  5. Skin rash during treatment with generic itraconazole.

    Science.gov (United States)

    De Vuono, Antonio; Palleria, Caterina; Scicchitano, Francesca; Squillace, Aida; De Sarro, Giovambattista; Gallelli, Luca

    2014-04-01

    Generic drugs have the same active substance, the same pharmaceutical form, the same therapeutic indications and a similar bioequivalence with the reference medicinal product (branded). Although a similar efficacy is postulated, some cases of clinical inefficacy during treatment with generic formulations have been reported. In this case, we describe a woman with onychomycosis that developed a skin rash during treatment with a generic formulation of itraconazole. Drug administration and its re-challenge confirmed the association between itraconazole and skin rash. Both Naranjo probability scale and World Health Organization causality assessment scale documented a probable association between generic-itraconazole and skin rash. The switch from generic formulation to brand one induced an improvement of symptoms. Since we are unable to evaluate the role of each excipient in the development of skin rash, we cannot rule out their involvement. However, more data are necessary to better define the similarities or differences between branded and generic formulations.

  6. Competition in prescription drug markets: the roles of trademarks, advertising, and generic names.

    Science.gov (United States)

    Feldman, Roger; Lobo, Félix

    2013-08-01

    We take on two subjects of controversy among economists-advertising and trademarks-in the context of the market for generic drugs. We outline a model in which trademarks for drug names reduce search costs but increase product differentiation. In this particular framework, trademarks may not benefit consumers. In contrast, the generic names of drugs or "International Nonproprietary Names" (INN) have unquestionable benefits in both economic theory and empirical studies. We offer a second model where advertising of a brand-name drug creates recognition for the generic name. The monopoly patent-holder advertises less than in the absence of a competitive spillover.

  7. Generic medicines and generic substitution: contrasting perspectives of stakeholders in Ireland.

    Science.gov (United States)

    O'Leary, A; Usher, C; Lynch, M; Hall, M; Hemeryk, L; Spillane, S; Gallagher, P; Barry, M

    2015-12-15

    The Health (Pricing and Supply of Medical Goods) Act 2013 passed into law in July 2013 and legislated for generic substitution in Ireland. The aim of the study was to ascertain the knowledge and perceptions of stakeholders i.e. patients, pharmacists and prescribers, of generic medicines and to generic substitution with the passing of legislation. Three stakeholder specific questionnaires were developed to assess knowledge of and perceptions to generic medicines and generic substitution. Purposive samples of patients, prescribers and pharmacists were analysed. Descriptive quantitative and qualitative analyses were undertaken. A total of 762 healthcare professionals and 353 patients were recruited. The study highlighted that over 84% of patients were familiar with generic medicines and are supportive of the concept of generic substitution. Approximately 74% of prescribers and 84% of pharmacists were supportive of generic substitution in most cases. The main areas of concern highlighted by the healthcare professionals that might impact on the successful implementation of the policy, were the issue of bioequivalence with generic medicines, the computer software systems used at present in general practitioner (GP) surgeries and the availability of branded generics. The findings from this study identify a high baseline rate of acceptance to generic medicines and generic substitution among patients, prescribers and pharmacists in the Irish setting. The concerns of the main stakeholders provide a valuable insight into the potential difficulties that may arise in its implementation, and the need for on-going reassurance and proactive dissemination of the impact of the generic substitution policy. The existing positive attitude to generic medicines and generic substitution among key stakeholders in Ireland to generic substitution, combined with appropriate support and collaboration should result in the desired increase in rates of prescribing, dispensing and use of generic

  8. Generic domain models in software engineering

    Science.gov (United States)

    Maiden, Neil

    1992-01-01

    This paper outlines three research directions related to domain-specific software development: (1) reuse of generic models for domain-specific software development; (2) empirical evidence to determine these generic models, namely elicitation of mental knowledge schema possessed by expert software developers; and (3) exploitation of generic domain models to assist modelling of specific applications. It focuses on knowledge acquisition for domain-specific software development, with emphasis on tool support for the most important phases of software development.

  9. PROBLEM OF GENERIC REPLACEMENT: ADVANTAGES AND DISADVANTAGES

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2009-01-01

    Full Text Available The main differences between original and generic drugs as well as registration criteria for generics are described. Possible reasons of discrepancy in bioequivalence and therapeutic equivalence of original and generic drugs are reviewed. The examples of such a discrepancy as a result of comparative clinical trails (enalapril maleate are discussed. Approaches to planning of comparative trails on drug therapeutic equivalence are presented. 

  10. Skin rash during treatment with generic itraconazole

    OpenAIRE

    De Vuono, Antonio; Palleria, Caterina; Scicchitano, Francesca; Squillace, Aida; De Sarro, Giovambattista; Gallelli, Luca

    2014-01-01

    Generic drugs have the same active substance, the same pharmaceutical form, the same therapeutic indications and a similar bioequivalence with the reference medicinal product (branded). Although a similar efficacy is postulated, some cases of clinical inefficacy during treatment with generic formulations have been reported. In this case, we describe a woman with onychomycosis that developed a skin rash during treatment with a generic formulation of itraconazole. Drug administration and its re...

  11. Generic impact statement for commercial radioactive waste management

    International Nuclear Information System (INIS)

    Unruh, C.M.

    1976-01-01

    ERDA is preparing a generic environmental impact statement on the treatment and disposal of waste resulting from commercial reactors and post fission operations in the light water reactor (LWR) fuel cycle. Expert contributions will be provided by many of the ERDA national laboratories and contractors. The waste management aspects of the statement will be based on available technology as presented in the recently issued ''Alternatives for Managing Waste from Reactors and Post Fission Operations in the LWR Fuel Cycle,'' ERDA-76-43 Document. This 1500 page, five volume Technical Alternative Document (TAD) describes the status of technology (to September, 1975) for handling post fission radioactive waste generated by the production of electricity by nuclear power light water reactor-generator systems. The statement will be generic in nature discussing typical or hypothetical facilities in typical or hypothetical environments. It is not intended to replace environmental statements required in support of specific projects nor for Nuclear Regulatory Commission licensing procedures. A major purpose of the generic statement is to inform the public and to solicit comments on the ERDA program for: (1) the final disposition of commercial radioactive waste, (2) waste treatment, (3) waste interim storage, and (4) transportation of waste. The statement will discuss the ERDA contingency program to provide retrievable storage of such waste if they should be transferred to Federal custody prior to the availability of the geologic isolation facilities for terminal disposal. The generic statement will not address radioactive waste resulting from U.S. Defense Programs, the mining or milling of uranium, the management of waste from the breeder reactor program, waste from other nations, nor will it include an evaluation of the impact of waste resulting from power sources other than light water reactors

  12. Comparison of brand versus generic antiepileptic drug adverse event reporting rates in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS).

    Science.gov (United States)

    Rahman, Md Motiur; Alatawi, Yasser; Cheng, Ning; Qian, Jingjing; Plotkina, Annya V; Peissig, Peggy L; Berg, Richard L; Page, David; Hansen, Richard A

    2017-09-01

    Despite the cost saving role of generic anti-epileptic drugs (AEDs), debate exists as to whether generic substitution of branded AEDs may lead to therapeutic failure and increased toxicity. This study compared adverse event (AE) reporting rates for brand vs. authorized generic (AG) vs. generic AEDs. Since AGs are pharmaceutically identical to brand but perceived as generics, the generic vs. AG comparison minimized potential bias against generics. Events reported to the U.S. Food and Drug Administration Adverse Event Reporting System between January 2004 to March 2015 with lamotrigine, carbamazepine, and oxcarbazepine listed as primary or secondary suspect were classified as brand, generic, or AG based on the manufacturer. Disproportionality analyses using the reporting odds ratio (ROR) assessed the relative rate of reporting of labeled AEs compared to reporting these events with all other drugs. The Breslow-Day statistic compared RORs across brand, AG, and other generics using a Bonferroni-corrected Pbrand and generics for all three drugs of interest (Breslow-Day Pbrands and generics have similar reporting rates after accounting for generic perception biases. Disproportional suicide reporting was observed for generics compared with AGs and brand, although this finding needs further study. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Energy alternatives

    International Nuclear Information System (INIS)

    Sweet, C.

    1987-01-01

    The designated successor to fossil fuels is nuclear fission/fusion and that turns out to be problematic. Alternative Energy Systems have great potential but political forces seem to be hampering their development and introduction. The technologies are flexible in their use and scale of operation. The learning curve will not be short but neither will it be as long and as costly as nuclear power. It is time that this is recognised and some serious rethinking takes place in what presently passes for energy policies both in the industrialised countries and in the Third World. Alternative energy systems are defined and some of them which are relevant to the United Kingdom are discussed. (author)

  14. Cost-effectiveness of alternative strategies for the initial medical management of non-ST elevation acute coronary syndrome: systematic review and decision-analytical modelling.

    Science.gov (United States)

    Robinson, M; Palmer, S; Sculpher, M; Philips, Z; Ginnelly, L; Bowens, A; Golder, S; Alfakih, K; Bakhai, A; Packham, C; Cooper, N; Abrams, K; Eastwood, A; Pearman, A; Flather, M; Gray, D; Hall, A

    2005-07-01

    To identify and prioritise key areas of clinical uncertainty regarding the medical management of non-ST elevation acute coronary syndrome (ACS) in current UK practice. Electronic databases. Consultations with clinical advisors. Postal survey of cardiologists. Potential areas of important uncertainty were identified and 'decision problems' prioritised. A systematic literature review was carried out using standard methods. The constructed decision model consisted of a short-term phase that applied the results of the systematic review and a long-term phase that included relevant information from a UK observational study to extrapolate estimated costs and effects. Sensitivity analyses were undertaken to examine the dependence of the results on baseline parameters, using alternative data sources. Expected value of information analysis was undertaken to estimate the expected value of perfect information associated with the decision problem. This provided an upper bound on the monetary value associated with additional research in the area. Seven current areas of clinical uncertainty (decision problems) in the drug treatment of unstable angina patients were identified. The agents concerned were clopidogrel, low molecular weight heparin, hirudin and intravenous glycoprotein antagonists (GPAs). Twelve published clinical guidelines for unstable angina or non-ST elevation ACS were identified, but few contained recommendations about the specified decision problems. The postal survey of clinicians showed that the greatest disagreement existed for the use of small molecule GPAs, and the greatest uncertainty existed for decisions relating to the use of abciximab (a large molecule GPA). Overall, decision problems concerning the GPA class of drugs were considered to be the highest priority for further study. Selected papers describing the clinical efficacy of treatment were divided into three groups, each representing an alternative strategy. The strategy involving the use of GPAs

  15. Randomized, double blind comparison of brand and generic antibiotic suspensions: II. A study of taste and compliance in children.

    Science.gov (United States)

    El-Chaar, G M; Mardy, G; Wehlou, K; Rubin, L G

    1996-01-01

    The taste of oral liquid medications influences compliance in children. Generic preparations are prescribed to reduce cost and may taste worse than brand name products. This was a prospective, randomized, double blind, crossover trial of the differences in taste and compliance between brand and generic antibiotic suspensions in children 3 to 14 years of age. Verbal and visual assessment methods were used to assess taste, and compliance was measured by the amount of drug returned after use. Ten children in each of the cephalexin and erythromycin-sulfisoxazole groups did not report that the brand and generic formulations tasted differently. Fifteen children thought that brand trimethoprim-sulfamethoxazole tasted better than the generic preparation. Brand name oral liquid antibiotics do not necessarily taste better than their generic counterparts. Despite preference for the taste of brand trimethoprim-sulfamethoxazole, all of the children in this study were compliant with both brand and generic medications.

  16. Cost estimate guidelines for advanced nuclear power technologies

    International Nuclear Information System (INIS)

    Delene, J.G.; Hudson, C.R. II.

    1993-05-01

    Several advanced power plant concepts are currently under development. These include the Modular High Temperature Gas Cooled Reactors, the Advanced Liquid Metal Reactor and the Advanced Light Water Reactors. One measure of the attractiveness of a new concept is its cost. Invariably, the cost of a new type of power plant will be compared with other alternative forms of electrical generation. This report provides a common starting point, whereby the cost estimates for the various power plants to be considered are developed with common assumptions and ground rules. Comparisons can then be made on a consistent basis. This is the second update of these cost estimate guidelines. Changes have been made to make the guidelines more current (January 1, 1992) and in response to suggestions made as a result of the use of the previous report. The principal changes are that the reference site has been changed from a generic Northeast (Middletown) site to a more central site (EPRI's East/West Central site) and that reference bulk commodity prices and labor productivity rates have been added. This report is designed to provide a framework for the preparation and reporting of costs. The cost estimates will consist of the overnight construction cost, the total plant capital cost, the operation and maintenance costs, the fuel costs, decommissioning costs and the power production or busbar generation cost

  17. Generic Hurricane Extreme Seas State

    DEFF Research Database (Denmark)

    Wehmeyer, Christof; Skourup, Jesper; Frigaard, Peter

    2012-01-01

    Extreme sea states, which the IEC 61400-3 (2008) standard requires for the ultimate limit state (ULS) analysis of offshore wind turbines are derived to establish the design basis for the conceptual layout of deep water floating offshore wind turbine foundations in hurricane affected areas....... Especially in the initial phase of floating foundation concept development, site specific metocean data are usually not available. As the areas of interest are furthermore not covered by any design standard, in terms of design sea states, generic and in engineering terms applicable environmental background...... data is required for a type specific conceptual design. ULS conditions for different return periods are developed, which can subsequently be applied in siteindependent analysis and conceptual design. Recordings provided by National Oceanic and Atmospheric Administration (NOAA), of hurricanes along...

  18. Generic environmental impact statement in support of rulemaking on radiological criteria for decommissioning of NRC-licensed nuclear facilities. Appendices; Draft report for comment -- Volume 2

    International Nuclear Information System (INIS)

    1994-08-01

    The action being considered in this draft Generic Environmental Impact Statement (GEIS) is an amendment to the Nuclear Regulatory Commission's (NRC) regulations in 10 CFR Part 20 to include radiological criteria for decommissioning of lands and structures at nuclear facilities. Under the National Environmental Policy Act (NEPA), all Federal agencies must consider the effect of their actions on the environment. To fulfill NRC's responsibilities under NEPA, the Commission is preparing this GEIS which analyzes alternative courses of action and the costs and impacts associated with those alternatives. In preparing the GEIS, the following approach was taken: (1) a listing was developed of regulatory alternatives for establishing radiological criteria for decommissioning; (2) for each alternative, a detailed analysis and comparison of incremental impacts, both radiological and nonradiological, to workers, members of the public, and the environment, and costs, were performed; and (3) based on the analysis of impacts and costs, preliminary recommendations were provided. Contained in the GEIS are recommendations related to the definition of decommissioning, the scope of rulemaking, the radiological criteria, restrictions on use, citizen participation, use of the GEIS in site-specific cases, and minimization of contamination

  19. Generic environmental impact statement in support of rulemaking on radiological criteria for decommissioning of NRC-licensed nuclear facilities. Main report; Draft report for comment: Volume 1

    International Nuclear Information System (INIS)

    1994-08-01

    The action being considered in this draft Generic Environmental Impact Statement (GEIS) is an amendment to the Nuclear Regulatory Commission's (NRC) regulations in 10 CFR Part 20 to include radiological criteria for decommissioning of lands and structures at nuclear facilities. Under the National Environmental Policy Act (NEPA), all Federal agencies must consider the effect of their actions on the environment. To fulfill NRC's responsibilities under NEPA, the Commission is preparing this GEIS which analyzes alternative courses of action and the costs and impacts associated with those alternatives. In preparing the GEIS, the following approach was taken: (1) a listing was developed of regulatory alternatives for establishing radiological criteria for decommissioning; (2) for each alternative, a detailed analysis and comparison of incremental impacts, both radiological and nonradiological, to workers, members of the public, and the environment, and costs, were performed; and (3) based on the analysis of impacts and costs, preliminary recommendations were provided. Contained in the GEIS are recommendations related to the definition of decommissioning, the scope of rulemaking, the radiological criteria, restrictions on use, citizen participation, use of the GEIS in site-specific cases, and minimization of contamination

  20. How can pharmacist remuneration systems in Europe contribute to generic medicine dispensing?

    Directory of Open Access Journals (Sweden)

    Dylst P

    2012-03-01

    Full Text Available Generic medicines can generate larger savings to health care budgets when their use is supported by incentives on both the supply-side and the demand-side. Pharmacists’ remuneration is one factor influencing the dispensing of generic medicines.Objective: The aim of this article is to provide an overview of different pharmacist remuneration systems for generic medicines in Europe, with a view to exploring how pharmacist remuneration systems can contribute to generic medicine dispensing.Methods: Data were obtained from a literature review, a Master thesis in Pharmaceutical Care at the Catholic University of Leuven and a mailing sent to all members of the Pharmaceutical Group of the European Union with a request for information about the local remuneration systems of community pharmacists and the possible existence of reports on discounting practices.Results: Pharmacists remuneration in most European countries consists of the combination of a fixed fee per item and a certain percentage of the acquisition cost or the delivery price of the medicines. This percentage component can be fixed, regressive or capped for very high-cost medicines and acts as a disincentive for dispensing generic medicines. Discounting for generic medicines is common practice in several European countries but information on this practice tends to be confidential. Nevertheless, data for Belgium, France, the Netherlands and United Kingdom indicated that discounting percentages varied from 10% to 70% of the wholesale selling price.Conclusion: Pharmacists can play an important role in the development of a generic medicines market. Pharmacists should not be financially penalized for dispensing generic medicines. Therefore, their remuneration should move towards a fee-for-performance remuneration instead of a price-dependent reimbursement which is currently used in many European countries. Such a fee-for-performance remuneration system provides a stimulus for generic medicines

  1. 76 FR 57767 - Proposed Generic Communication; Draft NRC Generic Letter 2011-XX: Seismic Risk Evaluations for...

    Science.gov (United States)

    2011-09-16

    ... NUCLEAR REGULATORY COMMISSION [NRC-2011-0204] Proposed Generic Communication; Draft NRC Generic Letter 2011-XX: Seismic Risk Evaluations for Operating Reactors AGENCY: Nuclear Regulatory Commission... FR 54507), that requested public comment on Draft NRC Generic Letter 2011- XX: Seismic Risk...

  2. Regulatory analysis for the resolution of Generic Safety Issue 105: Interfacing system loss-of-coolant accident in light-water reactors

    International Nuclear Information System (INIS)

    1993-07-01

    An interfacing systems loss of coolant accident (ISLOCA) involves failure or improper operation of pressure isolation valves (PIVs) that compose the boundary between the reactor coolant system and low-pressure rated systems. Some ISLOCAs can bypass containment and result in direct release of fission products to the environment. A cost/benefit evaluation, using three PWR analyses, calculated the benefit of two potential modifications to the plants. Alternative 1 is improved plant operations to optimize the operator's performance and reduce human error probabilities. Alternative 2 adds pressure sensing devices, cabling, and instrumentation between two PIVs to provide operators with continuous monitoring of the first PIV. These two alternatives were evaluated for the base case plants (Case 1) and for each plant, assuming the plants had a particular auxiliary building design in which severe flooding would be a problem if an ISLOCA occurred. The auxiliary building design (Case 2) was selected from a survey that revealed a number of designs with features that provided less than optimal resistance to ECCS equipment loss caused by a ISLOCA-induced environment. The results were judged not to provide sufficient basis for generic requirements. It was concluded that the most viable course of action to resolve Generic Issue 105 is licensee participation in individual plant examinations (IPEs)

  3. Knowledge, attitudes and practices of community pharmacists on generic medicines in Palestine: a cross-sectional study.

    Science.gov (United States)

    Shraim, Naser Y; Al Taha, Tasneem A; Qawasmeh, Rawan F; Jarrar, Hiba N; Shtaya, Maram A N; Shayeb, Lama A; Sweileh, Waleed M

    2017-12-28

    Generic substitution in several countries has become a common practice. Besides, it is considered as a major cost minimizing strategy meant to contain pharmaceutical expenditure without compromising healthcare quality. However, the safety and quality issues of generic products are of top concerns of general practitioners and health work professionals. This study aimed to investigate community pharmacist's knowledge, attitudes and practices toward generic medicines in Palestine. This study was a cross-sectional observational study employing a self-administered questionnaire. The questionnaire was of four main sections: demographic and practice details of the participants, knowledge, attitudes and the influencing factors related to selection and dispensing of generic medicines. A convenience sampling technique was implemented in this study in which the data collection form was distributed in West Bank- Palestine among a set of practicing pharmacists. Mann-Whitney-U or Kruskal-Wallis tests were used to comparison of different issues as appropriate. P-values of marketing approval of generics, while 87.4% of participants agreed that they should be given the right to substitute generics and the majority (62.3%) support generic substitution for brand name drugs in all cases when a generic is available The main two factors affect pharmacists' selection and dispensing of generic medicines are personal faith in the product (86.1%) and cost effectiveness of generic medicines (84.1%). Generic medicines substitution among pharmacists is widespread and prevalent. Our data found that participant pharmacists in Palestine had basic knowledge with regards to generic medicine. However, their knowledge score pertaining the technical and regulatory aspects of bioequivalence and pharmacokinetic parameters in particular was insufficient.

  4. Generic Reliability-Based Inspection Planning for Fatigue Sensitive Details

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Straub, Daniel; Faber, Michael Havbro

    2005-01-01

    of fatigue sensitive details in fixed offshore steel jacket platforms and FPSO ship structures. Inspection and maintenance activities are planned such that code based requirements to the safety of personnel and environment for the considered structure are fulfilled and at the same time such that the overall......The generic approach for planning of in-service NDT inspections is extended to cover the case where the fatigue load is modified during the design lifetime of the structure. Generic reliability-based inspection planning has been developed as a practical approach to perform inspection planning...... expected costs for design, inspections, repairs and failures are minimized. The method is based on the assumption of “no-finds” of cracks during inspections. Each fatigue sensitive detail is categorized according to their type of details (SN curves), FDF values, RSR values, inspection, repair and failure...

  5. Hospitals plan to start their own generic drug company

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-01-01

    Full Text Available The New York Times reports that groups representing more than 450 hospitals plan to form their own generic drug company (1. Intermountain Healthcare is leading the collaboration with several other large hospital groups, Ascension, SSM Health and Trinity Health, in consultation with the U.S. Department of Veterans Affairs, to form a not-for-profit drug company. The new firm is looking to create generic versions of about 20 existing drugs that the group says cost too much now or are in short supply. The article did not name the drugs targeted but expects the first of its pharmaceutical products to become available in 2019. Members of the consortium will contribute funds to finance the new drug company.

  6. A Generic Approach to Parameter Control

    NARCIS (Netherlands)

    Karafotias, G.; Smit, S.K.; Eiben, A.E.

    2012-01-01

    On-line control of EA parameters is an approach to parameter setting that offers the advantage of values changing during the run. In this paper, we investigate parameter control from a generic and parameter-independent perspective. We propose a generic control mechanism that is targeted to

  7. Once more the generic name Passerina Vieillot

    NARCIS (Netherlands)

    Oort, van E.D.

    1910-01-01

    The note on the generic name of the Snow-bunting by Dr. E. Hartert in this part of our periodical gives me cause to revert to the subject of my note on the generic name Passerina Vieillot and to state here, that I stand to what I have said about the rejection of this name in Zoology (Notes Leyden

  8. HTGR generic technology program plan (FY 80)

    International Nuclear Information System (INIS)

    1980-01-01

    Purpose of the program is to develop base technology and to perform design and development common to the HTGR Steam Cycle, Gas Turbine, and Process Heat Plants. The generic technology program breaks into the base technology, generic component, pebble-bed study, technology transfer, and fresh fuel programs

  9. South African patient's acceptance of generic drugs

    African Journals Online (AJOL)

    mechanism in this regard for final consumers, insurance providers, and ... facilities are viewed as inferior, treated with sus- picion and ... to choose a generic drug if the decision was supported by their doctor ... The effect of brand to generic and ...

  10. Rough order of magnitude cost estimate for immobilization of 50MT of plutonium using new facilities at the Savannah River site: alternative 12A

    International Nuclear Information System (INIS)

    DiSabatino, A.

    1998-01-01

    The purpose of this Cost Estimate Report is to identify preliminary capital and operating costs for a facility to immobilize 50 metric tons of plutonium using ceramic in a new facility at Savannah River Site (SRS)

  11. Rough order of magnitude cost estimate for immobilization of 50 MT of plutonium using existing facilities at the Savannah River site: alternative 12B

    International Nuclear Information System (INIS)

    DiSabatino, A.

    1998-01-01

    The purpose of this Cost Estimate Report is to identify preliminary capital and operating costs for a facility to immobilize 50 metric tons of plutonium using ceramic in an existing facility (221-F) at an Savannah River Site (SRS)

  12. Brand vs generic adverse event reporting patterns: An authorized generic-controlled evaluation of cardiovascular medications.

    Science.gov (United States)

    Alatawi, Y; Rahman, Md M; Cheng, N; Qian, J; Peissig, P L; Berg, R L; Page, C D; Hansen, R A

    2018-06-01

    Some public scepticism exists about generics in terms of whether brand and generic drugs produce identical outcomes. This study explores whether adverse event (AE) reporting patterns are similar between brand and generic drugs, using authorized generics (AGs) as a control for possible generic drug perception biases. Events reported to the FDA Adverse Event Reporting System from the years 2004-2015 were analysed. Drugs were classified as brand, AG or generic based on drug and manufacturer names. Reports were included if amlodipine, losartan, metoprolol extended release (ER) or simvastatin were listed as primary or secondary suspect drugs. Disproportionality analyses using the reporting odds ratio (ROR) assessed the relative rate of reporting labelled AEs compared to reporting these AEs with all other drugs. The Breslow-Day test compared RORs across brand, AG and generic. Interrupted time series analysis evaluated the impact of generic entry on reporting trends. Generics accounted for significant percentages of total U.S. reports, but AGs accounted for smaller percentages of reports, including for amlodipine (14.26%), losartan (1.48%), metoprolol ER (0.35%) and simvastatin (0.70%). Whereas the RORs were significantly different for multiple brand vs generic comparisons, the AG vs generic comparisons yielded fewer statistically significant findings. Namely, only the ROR for AG differed from generic for amlodipine with peripheral oedema (P brand and generic compared with AG and generic. Use of AGs as a control for perception biases against generics is useful, but this approach can be limited by small AG report numbers. Requiring the manufacturer name to be printed on the prescription bottle or packaging could improve the accuracy of assignment for products being reported. © 2017 John Wiley & Sons Ltd.

  13. Patient knowledge, perceptions, and acceptance of generic medicines: a comprehensive review of the current literature

    Directory of Open Access Journals (Sweden)

    Alrasheedy AA

    2014-04-01

    Full Text Available Alian A Alrasheedy,1 Mohamed Azmi Hassali,1 Kay Stewart,2 David CM Kong,2 Hisham Aljadhey,3 Mohamed Izham Mohamed Ibrahim,4 Saleh Karamah Al-Tamimi1 1Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 2Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia; 3Medication Safety Research Chair, Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4College of Pharmacy, Qatar University, Doha, Qatar Background: Generic medicines have the same quality, safety, and efficacy as their counterpart original brand medicines. Generic medicines provide the same therapeutic outcomes but at a much cheaper cost, so are promoted in many countries to contain pharmaceutical expenditure and sustain the health care system. Thus, the perspective of patients and medicine consumers as end users of these medicines is an important factor to enhance the use and utilization of generic medicines. The objective of this paper is to review patients’ and consumers’ knowledge, perceptions, acceptance, and views of generic medicines in the current literature. Methods: An extensive literature search was performed in several databases, namely Scopus, PubMed, ISI Web of Knowledge, Proquest, and the Wiley online library, to identify relevant studies published in the English literature for the period 1990–2013. Results: A total of 53 studies were included in the review, comprising 24 studies from Europe, ten from North America, six from Asia, five from Australia and New Zealand, five from the Middle East, one from Africa, one from Latin America, and one from the Caribbean region. A large body of literature has reported misconceptions and negative perceptions about generic medicines on the part of patients and medicine consumers. Moreover, although it is reported in almost all countries, the percentage of consumers who had

  14. Incremental cost per quality-adjusted life year gained? The need for alternative methods to evaluate medical interventions for ultra-rare disorders

    NARCIS (Netherlands)

    Schlander, Michael; Garattini, Silvio; Holm, Søren; Kolominsky-Rabas, Peter; Nord, Erik; Persson, Ulf; Postma, Maarten; Richardson, Jeff; Simoens, Steven; De Solà Morales, Oriol; Tolley, Keith; Toumi, Mondher

    2014-01-01

    Drugs for ultra-rare disorders (URDs) rank prominently among the most expensive medicines on a cost-per-patient basis. Many of them do not meet conventional standards for cost-effectiveness. In light of the high fixed cost of R&D, this challenge is inversely related to the prevalence of URDs. The

  15. Bioequivalence and in vitro antimicrobial activity between generic and brand-name levofloxacin.

    Science.gov (United States)

    Sun, Hsin-Yun; Liao, Hsiao-Wei; Sheng, Meng-Huei; Tai, Hui-Min; Kuo, Ching-Hua; Sheng, Wang-Huei

    2016-07-01

    Generic agents play a crucial role in reducing the cost of medical care in many countries. However, the therapeutic equivalence remains a great concern. Our study aims to assess the in vitro antimicrobial activity and bioequivalence between generic and brand-name levofloxacin. Enantiomeric purity test, dissolution test, and in vitro antimicrobial susceptibility against seven clinically important pathogens by the agar dilution method were employed to assess the similarity between four generic products and brand-name levofloxacin (Daiichi Sankyo). All the generic and brand-name levofloxacin passed enantiomeric purity test. The results of dissolution tests were not similar among the generic products and the brand-name levofloxacin. Compared with the generic products, the brand-name levofloxacin had the smallest mean variations (-25% to 13%) with reference standard (United States Pharmacopeia levofloxacin Reference Standards). Variations were observed particularly in dissolution profiles and in vitro activity between generic products and brand-name levofloxacin. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Calculation of economic viability of alternative energy sources considering its environmental costs for small communities of Northeast Brazil; Calculo de viabilidade economica de fontes alternativas de energia considerando seus custos ambientais para pequenas comuidades da regiao nordeste brasileira

    Energy Technology Data Exchange (ETDEWEB)

    Stecher, Luiza Chourkalo

    2014-09-01

    There has been an increasing concern about current environmental issues caused by human activity, as the world searches for development. The production of electricity is an extremely relevant factor in this scenario since it is responsible for a large portion of the emissions that cause the greenhouse effect. Due to this fact, a sustainable development with alternative energy sources, which are attractive for such purpose, must be proposed, especially in places that are not supplied by the conventional electricity grid such as many communities in the Northeast Brazil. This work aims to calculate the environmental cost for the alternative sources of energy - solar, wind and biomass - during electricity generation, and to estimate the economic feasibility of those sources in small communities of Northeast Brazil, considering the avoided costs. The externalities must be properly identified and valued so the costs or benefits can be internalized and reflect accurately the economic feasibility or infeasibility of those sources. For this, the method of avoided costs was adopted for the calculation of externalities. This variable was included in the equation developed for all considered alternative energy sources. The calculations of economic feasibility were performed taking the new configurations in consideration, and the new equation was reprogrammed in the Programa de Calculo de Custos de Energias Alternativas, Solar, Eolica e Biomassa (PEASEB). The results demonstrated that the solar photovoltaic energy in isolated systems is the most feasible and broadly applicable source for small communities of Northeast Brazil. (author)

  17. Cost-effectiveness Analysis of Denosumab in the Prevention of Skeletal-related Events in Patients with Prostate Cancer in Kazakhstan

    Directory of Open Access Journals (Sweden)

    Carina Bektur

    2014-12-01

    .Conclusions.With the assumption that brand and generic ZAs are equally effective in the prevention of SREs in PC patients, denosumab seems to be a cost-effective alternative for brand ZA (insignificant difference in costs – less than 5% and a costly alternative for generic ZA from the perspective of MoH of Kazakhstan.

  18. Generic environmental assessment for implementing a radioactive waste classification system

    International Nuclear Information System (INIS)

    1977-09-01

    Potential impact on the environent, compliance with applicable water and air quality standards, cost-benefits due to the interface, unavoidable adverse effects, alternatives to the proposed action, and irreversible commitments of resources are discussed

  19. Utilization of complementary and alternative medicine (CAM) among children from a German birth cohort (GINIplus): patterns, costs, and trends of use.

    Science.gov (United States)

    Italia, Salvatore; Brand, Helmut; Heinrich, Joachim; Berdel, Dietrich; von Berg, Andrea; Wolfenstetter, Silke Britta

    2015-03-10

    The use of complementary and alternative medicine (CAM) is widespread among children in Germany and other European countries. Only a few studies are available on trends in pediatric CAM use over time. The study's objective was to present updated results for prevalence, predictors, and costs of CAM use among German children and a comparison with findings from a previous follow-up of the same birth cohort. Data were collected for 3013 children on their utilization of medicinal products (during the last 4 weeks) and consultation with CAM providers (in the preceding year) from a German birth cohort study (GINIplus, 15-year follow-up) using a self-administered questionnaire. The reported medicinal CAMs were classified into six categories (homeopathy, herbal drugs, nutritionals, minerals and trace elements, microorganisms, further CAM). Drug prices were traced using pharmaceutical identification numbers (PZNs), or otherwise conservatively estimated. Finally, the results were compared with data obtained from the 10-year follow-up of the same birth cohort study by adopting the identical methodology. In all, 26% of the reported 2489 drugs were medicinal CAM. The 4-week prevalence for homeopathy and herbal drug use was 7.5% and 5.6%, respectively. Some 13.9% of the children used at least one type of medicinal CAM in the preceding 4 weeks. The 1-year prevalence for consultation with CAM providers was 10.8%. From the drugs identified as CAM, 53.7% were homeopathic remedies, and 30.8% were herbal drugs. Factors associated with higher medicinal CAM use were female gender, residing in Munich, and higher maternal education. A homeopathy user utilized on average homeopathic remedies worth EUR 15.28. The corresponding figure for herbal drug users was EUR 16.02, and EUR 18.72 for overall medicinal CAM users. Compared with the 10-year follow-up, the prevalence of homeopathy use was more than halved (-52%) and dropped substantially for herbal drug use (-36%) and overall CAM use (-38

  20. Factors influencing consumer purchasing patterns of generic versus brand name over-the-counter drugs.

    Science.gov (United States)

    Kohli, Erol; Buller, Allison

    2013-02-01

    US consumers spend more than $20 billion/year on over-the-counter (OTC) drugs. Although generic and brand name OTC drugs share the same active ingredients and undergo the same rigorous Food and Drug Administration approval process, brand name formulations continue to lead the OTC drug market with a higher market share. There is a limited amount of publicly available information regarding consumer perceptions and awareness about generic and brand name OTC drugs. The main objective of this research was to understand what factors influence US consumers to purchase generic versus brand name OTC drugs. The researchers used a 20-question, self-administered, multiple-choice survey to collect data on the factors influencing consumers' preferences for generic versus brand name OTC drugs. Results revealed that the single most influential factor for participants when purchasing OTC drugs was lower cost. Although economic factors play an important role in influencing consumers to choose generic formulations, a variety of other factors including advertisements, duration of the OTC effectiveness, severity of sickness, preferable form of OTC medication, safety of the OTC, relief of multiple symptoms, and preferred company will persuade others to pay more for brand name drugs. Ultimately, increased awareness and use of generic OTC drugs may result in substantial cost savings for consumers.

  1. Regulatory analysis for the resolution of Generic Issue 99: Loss of RHR [residual heat removal] capability in PWRs

    International Nuclear Information System (INIS)

    Spano, A.H.

    1989-02-01

    Generic Issue 99 is concerned with the loss of residual heat removal (RHR) capability in pressurized water reactors during cold-plant outage operations. The issue focuses on two risk-significant common-cause failure modes of the RHR system: (1) air binding of the RHR pumps during reduced-inventory operations and (2) spurious closure of the RHR suction valves due to misapplication of the autoclosure interlocks. Resolution of this issue involves consideration of the adequacy of plant capabilities for (1) preventing losses of RHR, (2) responding promptly and effectively to such challenges in order to prevent core damage, and (3) ensuring timely containment protection against the release of radioactivity to the environment in the unlikely event of core damage due to loss of shutdown cooling. This entails examination of (1) relevant operational and accident response procedures, (2) the instrumentation available to the operator for accident diagnosis and mitigation, and (3) the administrative controls available for ensuring control room cognizance of ongoing maintenance activities that could potentially affect the stability of the reactor coolant system. This regulatory analysis provides quantitative assessments of the costs and benefits associated with several alternatives considered for the resolution of Generic Issue 99. 24 refs

  2. Generic Local Hamiltonians are Gapless

    Science.gov (United States)

    Movassagh, Ramis

    2017-12-01

    We prove that generic quantum local Hamiltonians are gapless. In fact, we prove that there is a continuous density of states above the ground state. The Hamiltonian can be on a lattice in any spatial dimension or on a graph with a bounded maximum vertex degree. The type of interactions allowed for include translational invariance in a disorder (i.e., probabilistic) sense with some assumptions on the local distributions. Examples include many-body localization and random spin models. We calculate the scaling of the gap with the system's size when the local terms are distributed according to a Gaussian β orthogonal random matrix ensemble. As a corollary, there exist finite size partitions with respect to which the ground state is arbitrarily close to a product state. When the local eigenvalue distribution is discrete, in addition to the lack of an energy gap in the limit, we prove that the ground state has finite size degeneracies. The proofs are simple and constructive. This work excludes the important class of truly translationally invariant Hamiltonians where the local terms are all equal.

  3. Generic physical protection logic trees

    International Nuclear Information System (INIS)

    Paulus, W.K.

    1981-10-01

    Generic physical protection logic trees, designed for application to nuclear facilities and materials, are presented together with a method of qualitative evaluation of the trees for design and analysis of physical protection systems. One or more defense zones are defined where adversaries interact with the physical protection system. Logic trees that are needed to describe the possible scenarios within a defense zone are selected. Elements of a postulated or existing physical protection system are tagged to the primary events of the logic tree. The likelihood of adversary success in overcoming these elements is evaluated on a binary, yes/no basis. The effect of these evaluations is propagated through the logic of each tree to determine whether the adversary is likely to accomplish the end event of the tree. The physical protection system must be highly likely to overcome the adversary before he accomplishes his objective. The evaluation must be conducted for all significant states of the site. Deficiencies uncovered become inputs to redesign and further analysis, closing the loop on the design/analysis cycle

  4. Generic physical protection logic trees

    Energy Technology Data Exchange (ETDEWEB)

    Paulus, W.K.

    1981-10-01

    Generic physical protection logic trees, designed for application to nuclear facilities and materials, are presented together with a method of qualitative evaluation of the trees for design and analysis of physical protection systems. One or more defense zones are defined where adversaries interact with the physical protection system. Logic trees that are needed to describe the possible scenarios within a defense zone are selected. Elements of a postulated or existing physical protection system are tagged to the primary events of the logic tree. The likelihood of adversary success in overcoming these elements is evaluated on a binary, yes/no basis. The effect of these evaluations is propagated through the logic of each tree to determine whether the adversary is likely to accomplish the end event of the tree. The physical protection system must be highly likely to overcome the adversary before he accomplishes his objective. The evaluation must be conducted for all significant states of the site. Deficiencies uncovered become inputs to redesign and further analysis, closing the loop on the design/analysis cycle.

  5. Generic theory for channel sinuosity.

    Science.gov (United States)

    Lazarus, Eli D; Constantine, José Antonio

    2013-05-21

    Sinuous patterns traced by fluid flows are a ubiquitous feature of physical landscapes on Earth, Mars, the volcanic floodplains of the Moon and Venus, and other planetary bodies. Typically discussed as a consequence of migration processes in meandering rivers, sinuosity is also expressed in channel types that show little or no indication of meandering. Sinuosity is sometimes described as "inherited" from a preexisting morphology, which still does not explain where the inherited sinuosity came from. For a phenomenon so universal as sinuosity, existing models of channelized flows do not explain the occurrence of sinuosity in the full variety of settings in which it manifests, or how sinuosity may originate. Here we present a generic theory for sinuous flow patterns in landscapes. Using observations from nature and a numerical model of flow routing, we propose that flow resistance (representing landscape roughness attributable to topography or vegetation density) relative to surface slope exerts a fundamental control on channel sinuosity that is effectively independent of internal flow dynamics. Resistance-dominated surfaces produce channels with higher sinuosity than those of slope-dominated surfaces because increased resistance impedes downslope flow. Not limited to rivers, the hypothesis we explore pertains to sinuosity as a geomorphic pattern. The explanation we propose is inclusive enough to account for a wide variety of sinuous channel types in nature, and can serve as an analytical tool for determining the sinuosity a landscape might support.

  6. Generic adversary characteristics: summary report

    International Nuclear Information System (INIS)

    Stewart, J.B. Jr.; Davidson, J.J.; Jones, H.B.; Fulwiler, C.H.; Mullen, S.A.

    1978-07-01

    The adversaries studied were found to be complex, often unpredictable, and dynamic. The adversary typically goes through a complex decision-making process between the time a potential target is identified and the moment the decision to act is made. This study analyzes the adversary characteristics, and the following conclusions are made: one of the least likely methods of attack is an overt armed assault. Terrorists and psychotics depend upon a high degree of personal dedication. No single generic adversary group or individual exhibits strength in every characteristic. Physical danger appears to have some deterrent effect on all adversaries except the psychotics. Organized and professional criminals often try to recruit insiders. Disoriented persons, white-collar criminals, and disgruntled employees tend to operate as insiders. Professional criminals, many terrorist groups, some extremist protest groups, and certain disoriented persons plan carefully before initiating a criminal mission. Organized crime and miscellaneous criminal adversaries rely on deception and ruse to bypass security. After the decision to commit a crime, the resources deployed by terrorists or organized criminals will be a function of their perception of the operational requirements of the crime. The nature of ''threat'' is dynamic; adversary behavior and capability appear to be related to prevailing political, economic, and social conditions

  7. International experiences of promoting generics use and its implications to China.

    Science.gov (United States)

    Sun, Jing

    2013-05-01

    To summarize international experiences in promoting use of generics and to extract essence for China's reference. This is a commentary of two systematic reviews about policies to promote use of generics and its implications to China. Price, reimbursement, and generic substitution policies in European countries, and approaches in low and middle income countries in promoting market competition, appropriate intellectual property right protection strategy, and necessary demand side incentives, are all meaningful for China to contain soaring pharmaceutical expenditures, and to maintain the achievements and outcomes of the national health system reform. Effective promotion of generics use must be practice based on the real situation. Tailor-made and comprehensive measures are needed to address both demand and supply sides barriers before achieving tangible cost containment effect without unexpected side effects. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  8. 78 FR 22553 - Generic Drug Facilities, Sites, and Organizations

    Science.gov (United States)

    2013-04-16

    ...] Generic Drug Facilities, Sites, and Organizations AGENCY: Food and Drug Administration, HHS. ACTION.... Generic drug facilities, certain sites, and organizations identified in a generic drug submission are... active pharmaceutical ingredients and certain other sites and organizations that support the manufacture...

  9. 78 FR 59911 - Generic Information Collection for Land Management Planning

    Science.gov (United States)

    2013-09-30

    ... DEPARTMENT OF AGRICULTURE Forest Service Generic Information Collection for Land Management... organizations on the proposed information collection, Generic Information Collection for Land Management... related to forest management. The intent of this generic information collection request (ICR) is to...

  10. Rough order of magnitude cost estimate for immobilization of 18.2 MT of plutonium sharing existing facilities at Hanford with MOX fuel fabrication facility: alternative 4B

    International Nuclear Information System (INIS)

    DiSabatino, A.

    1998-01-01

    The purpose of this Cost Estimate Report is to identify preliminary capital and operating costs for a facility to immobilize 18.2 metric tons (nominal) of plutonium as a ceramic in an existing facility at Hanford, the Fuels and Materials Examination Facility (FMEF). The MOX Fuel Fabrication Facility (MFFF), which is being costed in a separate report, will also be located in the FMEF in this co-location option

  11. Rough order of magnitude cost estimate for immobilization of 50 MT of plutonium sharing existing facilities at Hanford with pit disassembly and conversion facility: alternative 11

    International Nuclear Information System (INIS)

    DiSabatino, A.

    1998-01-01

    The purpose of this Cost Estimate Report is to identify preliminary capital and operating costs for a facility to immobilize 50 metric tons (nominal) of plutonium as a ceramic in an existing facility at Hanford, the Fuels and Materials Examination Facility (FMEF). The Pit Disassembly and Conversion Facility (PDCF), which is being costed in a separate report by LANL, will also be located in the FMEF in this co-location option

  12. Cisplatin-induced hyponatremia in malignancy: comparison between brand-name and generic formulation.

    Science.gov (United States)

    Ochi, Nobuaki; Yamane, Hiromichi; Hotta, Katsuyuki; Fujii, Hiromi; Isozaki, Hideko; Honda, Yoshihiro; Yamagishi, Tomoko; Kubo, Toshio; Tanimoto, Mitsune; Kiura, Katsuyuki; Takigawa, Nagio

    2014-01-01

    Widespread use of generic drugs is considered to be indispensable if reductions in total health care costs are to be achieved, but the market share of such drugs remains low. In general, generic drugs have the same active ingredients as brand-name drugs, but this is not always the case. Thus, toxicity profiles may vary when brand-name and generic drugs are compared. We retrospectively investigated the incidence of hyponatremia in patients receiving brand-name cisplatin (CDDP) and a generic counterpart thereof. We reviewed the medical records of patients treated with brand-name CDDP (n=53) and a generic formulation (n=26), and compared the incidences of hyponatremia and renal toxicity. Toxicities were graded using the Common Terminology Criteria for Adverse Events, version 4.0. Differences between groups were evaluated using the Student's t-test, and the odds ratio for hyponatremia was estimated via logistic regression analysis. Serum creatinine levels after chemotherapy increased significantly in both the brand-name and generic CDDP groups; no significant difference was evident between the two groups. Hyponatremia of grade 3 or above developed in 30.7% of the generic CDDP group compared to 15.1% of the brand-name CDDP group (P=0.011). Multivariate analysis showed that the use of generic CDDP increased the incidence of hyponatremia (odds ratio =5.661, 95% confidence interval =1.403-22.839; P=0.015). Oncologists should be aware that use of a generic CDDP might be associated with more hyponatremia than would use of brand-name CDDP.

  13. Exploring knowledge perceptions and attitudes about generic medicines among finalyear health science students

    Directory of Open Access Journals (Sweden)

    Varsha Bangalee

    2016-05-01

    Full Text Available Background. The use of generic medicines to reduce healthcare costs has become a mandated policy in South Africa. An increase in the use of generics can be achieved through improved knowledge, attitudes and perceptions of generic medicine among healthcare professionals. Objective. To explore knowledge, attitudes and perceptions among final-year health science students on generic medication. Methods. A cross-sectional survey was carried out among the final-year audiology, dental therapy, pharmacy, physiotherapy, occupational therapy, optometry, speech-language and sport science students enrolled at the University of KwaZulu-Natal. A questionnaire was used as the study tool, developed using information adapted from literature reviews. Data analysis was completed using Statistical Package for the Social Sciences (SPSS version 21, and computed using descriptive statistics. Results. Total number of participants was 211, as follows: audiology (n=14, dental therapy (n=15, pharmacy (n=81, physiotherapy (n=41, occupational therapy (n=6, optometry (n=25, speech-language (n=6 and sport science (n=23. A total of 90.0% of students had heard of generic medicines, with 20.9% of them agreeing that generic medicines are less effective than brand-name medicines. Concerning safety, 30.4% believed that brand-name medicines are required to meet higher safety standards than generic medicines. Regarding the need for information on issues pertaining to safety and efficacy of medicines, 53.3% of participants felt that this need was not being met. Conclusion. All groups had knowledge deficits about the safety, quality and efficacy of generic medicines. The dissemination of information about generic medicines may strengthen future knowledge, attitudes and perceptions.

  14. Factors influencing anti-asthmatic generic drug consumption in Morocco: 1999-2010.

    Science.gov (United States)

    Ghanname, Imane; Ahid, Samir; Berrada, Ghizlane; Belaiche, Abdelmjid; Hassar, Mohammed; Cherrah, Yahia

    2014-01-01

    The increasing availability of generic drugs (GD) resulted in a remarkable reduction in treatment costs that allowed a better access to health care.The aim of this study is to evaluate the share of anti-asthmatic generic drugs during the period 1999-2010 in Morocco and to look at the factors influencing generic development. In this study, we used Moroccan sales data from IMS Health (Intercontinental Marketing Services). The consumption of the drugs was expressed in DDD/1000 inhabitants/day according to the WHO ATC/DDD methodology. Between 1999 and 2010, anti-asthmatic consumption increased from 3.91 to 14.43 DDD/1000 inhabitants/day. The market of anti-asthmatic generic drugs progressed from 1.83 (47%) to 2.18 (23%) DDD/1000 inhabitants/day from 1999 to 2010. In 2010, inhaled glucocorticosteroids ranked first (0.83 DDD/1000 inhabitants/day), followed by inhaled short acting beta agonists (0.73 DDD/1000 inhabitants/day). The number of brands went from 27 in 1999 to 34 in 2010, with a generic share increasing from 55.55% to 70.59%. The number of anti-asthmatic pharmaceutical preparations increased from 57 to 64 during the same period, of which 31 and 42 were generic preparations. In 2010, the total cost of anti-asthmatic dugs was about 22 million euro, the generics representing 14 million euro. Despite the introduction of a compulsory insurance scheme called "AMO", that allows a refund for 69.5% of anti-asthmatic specialties marketed in Morocco, anti-asthmatic generic drug consumption remains limited. The Moroccan market is still largely dominated by the originator drugs with still valid patents.

  15. A Generic Modeling Process to Support Functional Fault Model Development

    Science.gov (United States)

    Maul, William A.; Hemminger, Joseph A.; Oostdyk, Rebecca; Bis, Rachael A.

    2016-01-01

    Functional fault models (FFMs) are qualitative representations of a system's failure space that are used to provide a diagnostic of the modeled system. An FFM simulates the failure effect propagation paths within a system between failure modes and observation points. These models contain a significant amount of information about the system including the design, operation and off nominal behavior. The development and verification of the models can be costly in both time and resources. In addition, models depicting similar components can be distinct, both in appearance and function, when created individually, because there are numerous ways of representing the failure space within each component. Generic application of FFMs has the advantages of software code reuse: reduction of time and resources in both development and verification, and a standard set of component models from which future system models can be generated with common appearance and diagnostic performance. This paper outlines the motivation to develop a generic modeling process for FFMs at the component level and the effort to implement that process through modeling conventions and a software tool. The implementation of this generic modeling process within a fault isolation demonstration for NASA's Advanced Ground System Maintenance (AGSM) Integrated Health Management (IHM) project is presented and the impact discussed.

  16. Deeply discounted medications: Implications of generic prescription drug wars.

    Science.gov (United States)

    Czechowski, Jessica L; Tjia, Jennifer; Triller, Darren M

    2010-01-01

    To describe the history of generic prescription pricing programs at major pharmacy chains and their potential implications on prescribing, quality of care, and patient safety. Publicly available generic prescription discount program drug lists as of May 1, 2009. Fierce competition among major pharmacy chains such as Walgreens, CVS, and Walmart has led to a generic prescription pricing war with unclear public health implications. Introduced in 2006, currently 7 of the 10 largest pharmacy chains advertise a version of a deeply discounted medication (DDM) program, accounting for more than 25,000 locations nationally. By early 2008, almost 70 million Americans had used these programs. Although DDM programs lower drug costs for many patients, DDM formularies include potentially ineffective or harmful medications, have the potential to influence physician prescribing behavior, and may impair pharmacists' ability to review complete drug-dispensing records. DDMs are widespread but have the potential for unintended consequences on patients, providers, and the health care system. A systematic review of DDMs needs to evaluate the clinical, economic, and system-level implications of such programs.

  17. Generic Penetration of the SSRI Market.

    Science.gov (United States)

    Cascade, Elisa F; Kalali, Amir H

    2008-04-01

    In this article, we investigate the penetration of generic selective serotonin reuptake inhibitors (SSRIs) in the US market and the implications for patient out-of-pocket expense. The data suggest that generic penetration into the SSRI market has grown from approximately nine percent in 2000, the year that the patent for Prozac((R)) expired, to 72 percent in 2007. For December, 2007, the difference in patient out-of-pocket expense for branded vs. generic agents was, on average, $55.42 for patients paying by cash (i.e., they had no prescription drug insurance) and $22.39 for patients with insurance coverage.

  18. Generic testability and test methods guidelines for ASIC devices

    International Nuclear Information System (INIS)

    Puri, K.; Takeda, H.

    1996-04-01

    Many industries are switching from analog equipment to digital equipment. This change has become desirable because digital devices have become cost-effective, easily available, highly reliable, easy to qualify and easy to test and replace when needed. The nuclear power industry is beginning to upgrade some of its instrumentation and control equipment from an analog design to digital design. A digital application specific integrated circuit (ASIC) device can be designed to perform the same functions as performed by analog modules. However, the ASIC must be designed for cost-effective testability and qualification. This report provides generic guidelines for designing cost-effective methods for testing and characterizing ASIC devices to accomplish qualification

  19. Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA: cost-effectiveness based on a 2-year randomized trial.

    Science.gov (United States)

    Sørensen, J; Primdahl, J; Horn, H C; Hørslev-Petersen, K

    2015-01-01

    To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient clinics and general practice, prescription and non-prescription medicine, dietary supplements, other health-care resources, and complementary and alternative care. Measures of effectiveness and costs were collected by self-reported questionnaires at inclusion and after 12 and 24 months. Incremental cost-effectiveness rates (ICERs) were estimated in comparison with rheumatologist consultations. Changes in disease activity, functional status, and health-related quality of life were not statistically significantly different for the three groups, although the mean scores were better for the shared care and nurse care groups compared with the rheumatologist group. Shared care and nurse care were non-significantly less costly than rheumatologist care. As both shared care and nurse care were associated with slightly better EQ-5D improvements and lower costs, they dominated rheumatologist care. At EUR 10,000 per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Shared care and nurse care seem to cost less but provide broadly similar health outcomes compared with rheumatologist outpatient care. However, it is still uncertain whether nurse care and shared care are cost-effective in comparison with rheumatologist outpatient care.

  20. Generic methods for design of small-bore pipe supports

    International Nuclear Information System (INIS)

    Clark, G.L.; LaSalle, F.R.

    1981-01-01

    Large numbers of supports for small-bore, low-temperature pipe are utilized in nuclear power plants. These supports often must meet ASME code and project seismic design requirements. Detailed analysis for each support is time consuming and costly. This paper describes some economical generic methods developed to design and qualify supports for two-inch and smaller pipe operating at temperatures less than 300 0 F (185 0 C), on the Fast Flux Test Facility. Use of standard designs, standard support spacing tables, anchor bolt and baseplate considerations, and field qualification methods are discussed

  1. Rough order of magnitude cost estimate for immobilization of 18.2 MT of plutonium using existing facilities at Hanford: alternatives 4A/8/10

    International Nuclear Information System (INIS)

    DiSabatino, A.

    1998-01-01

    The purpose of this Cost Estimate Report is to identify preliminary capital and operating costs for a facility to immobilize 18.2 metric tons (nominal) of plutonium as a ceramic in an existing facility, the Fuels and Materials Examination Facility (FMEF), at Hanford

  2. Rough order of magnitude cost estimate for immobilization of 50 MT of plutonium using existing facilities at Hanford: alternative 11B

    International Nuclear Information System (INIS)

    DiSabatino, A.

    1998-01-01

    The purpose of this Cost Estimate Report is to identify preliminary capital and operating costs for a facility to immobilize 50 metric tons (nominal) of plutonium as a ceramic in an existing facility at Hanford, the Fuels and Materials Examination Facility (FMEF)

  3. Potential impact of policy regulation and generic competition on sales of cholesterol lowering medication, antidepressants and acid blocking agents in Belgium.

    Science.gov (United States)

    Fraeyman, J; Van Hal, G; De Loof, H; Remmen, R; De Meyer, G R Y; Beutels, P

    2012-01-01

    Pharmaceutical expenditures are increasing as a proportion of health expenditures in most rich countries. Antidepressants, acid blocking agents and cholesterol lowering medication are major contributors to medicine sales around the globe. We aimed to document the possible impact of policy regulations and generic market penetration on the evolution of sales volume and average cost per unit (Defined Daily Doses and packages) of antidepressants, acid blocking agents and cholesterol lowering medication. We extracted data from the IMS health database regarding the public price and sales volume of the antidepressants (selective serotonin reuptake inhibitors (SSRI's), monoamine oxidase inhibitors (MAOl's) and tricyclic and remaining antidepressants (TCA's)), acid blocking agents (proton pump inhibitors (PPl's) and H2 receptor antagonists) and cholesterol lowering medication (statins and fibrates) in Belgium between 1995 and 2009. We describe these sales data in relation to various national policy measures which were systematically searched in official records. Our analysis suggests that particular policy regulations have had immediate impact on sales figures and expenditures on pharmaceuticals in Belgium: changes in reimbursement conditions, a public tender and entry of generic competitors in a reference pricing system. However, possible sustainable effects seem to be counteracted by other mechanisms such as marketing strategies, prescribing behaviour, brand loyalty and the entry of pseudogenerics. It is likely that demand-side measures have a more sustainable impact on expenditure. Compared with other European countries, generic penetration in Belgium remains low. Alternative policy regulations aimed at enlarging the generic market and influencing pharmaceutical expenditures deserve consideration. This should include policies aiming to influence physicians' prescribing and a shared responsibility of pharmacists, physicians and patients towards expenditures.

  4. Impacts of Generic Competition and Benefit Management...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Impacts of Generic Competition and Benefit Management Practices on Spending for Prescription Drugs - Evidence from Medicares Part D...

  5. Cost-effectiveness comparison between pituitary down-regulation with a gonadotropin-releasing hormone agonist short regimen on alternate days and an antagonist protocol for assisted fertilization treatments.

    Science.gov (United States)

    Maldonado, Luiz Guilherme Louzada; Franco, José Gonçalves; Setti, Amanda Souza; Iaconelli, Assumpto; Borges, Edson

    2013-05-01

    To compare cost-effectiveness between pituitary down-regulation with a GnRH agonist (GnRHa) short regimen on alternate days and GnRH antagonist (GnRHant) multidose protocol on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcome. Prospective, randomized. A private center. Patients were randomized into GnRHa (n = 48) and GnRHant (n = 48) groups. GnRHa stimulation protocol: administration of triptorelin on alternate days starting on the first day of the cycle, recombinant FSH (rFSH), and recombinant hCG (rhCG) microdose. GnRHant protocol: administration of a daily dose of rFSH, cetrorelix, and rhCG microdose. ICSI outcomes and treatment costs. A significantly lower number of patients underwent embryo transfer in the GnRHa group. Clinical pregnancy rate was significantly lower and miscarriage rate was significantly higher in the GnRHa group. It was observed a significant lower cost per cycle in the GnRHa group compared with the GnRHant group ($5,327.80 ± 387.30 vs. $5,900.40 ± 472.50). However, mean cost per pregnancy in the GnRHa was higher than in the GnRHant group ($19,671.80 ± 1,430.00 vs. $11,328.70 ± 907.20). Although the short controlled ovarian stimulation protocol with GnRHa on alternate days, rFSH, and rhCG microdose may lower the cost of an individual IVF cycle, it requires more cycles to achieve pregnancy. NCT01468441. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Patients' Preferences for Generic and Branded Over-the-Counter Medicines: An Adaptive Conjoint Analysis Approach.

    Science.gov (United States)

    Halme, Merja; Linden, Kari; Kääriä, Kimmo

    2009-12-01

    : Despite increased use of generic medicines, little is known about either the attitudes of patients towards them or the decision-making process surrounding them. Young adults use over-the-counter (OTC) analgesics relatively often. : To assess the preferences of patients for generic and branded OTC pain medicines, to identify clusters with different preference structures, and to estimate the price elasticity of a generic alternative among university students. : Finnish university students (n = 256; students in courses at the Helsinki School of Economics) responded to an adaptive conjoint analysis (ACA) questionnaire on the choice between branded and generic OTC ibuprofen products. Product attributes of price, brand, onset time of effect, place of purchase and source of information were included in the questionnaire on the basis of the literature, a focus group and a previous pilot study. Several socioeconomic and health behavior descriptors were employed. Individual-level utility functions were estimated, preference clusters were identified, and the price elasticity of the generic medicine was assessed. : Five clusters with characteristic individual-level preferences and price elasticity but few differences in socioeconomic background were detected. Approximately half of the respondents were strongly price sensitive while the others had other preferences such as brand or an opportunity to buy the medicine at a pharmacy or to have a physician or a pharmacist as an information source. : The study provided new information on the concomitant effects of brand, price and other essential product attributes on the choice by patients between branded and generic medicines.

  7. Low resolution scans can provide a sufficiently accurate, cost- and time-effective alternative to high resolution scans for 3D shape analyses

    Directory of Open Access Journals (Sweden)

    Ariel E. Marcy

    2018-06-01

    Full Text Available Background Advances in 3D shape capture technology have made powerful shape analyses, such as geometric morphometrics, more feasible. While the highly accurate micro-computed tomography (µCT scanners have been the “gold standard,” recent improvements in 3D surface scanners may make this technology a faster, portable, and cost-effective alternative. Several studies have already compared the two devices but all use relatively large specimens such as human crania. Here we perform shape analyses on Australia’s smallest rodent to test whether a 3D scanner produces similar results to a µCT scanner. Methods We captured 19 delicate mouse (Pseudomys delicatulus crania with a µCT scanner and a 3D scanner for geometric morphometrics. We ran multiple Procrustes ANOVAs to test how variation due to scan device compared to other sources such as biologically relevant variation and operator error. We quantified operator error as levels of variation and repeatability. Further, we tested if the two devices performed differently at classifying individuals based on sexual dimorphism. Finally, we inspected scatterplots of principal component analysis (PCA scores for non-random patterns. Results In all Procrustes ANOVAs, regardless of factors included, differences between individuals contributed the most to total variation. The PCA plots reflect this in how the individuals are dispersed. Including only the symmetric component of shape increased the biological signal relative to variation due to device and due to error. 3D scans showed a higher level of operator error as evidenced by a greater spread of their replicates on the PCA, a higher level of multivariate variation, and a lower repeatability score. However, the 3D scan and µCT scan datasets performed identically in classifying individuals based on intra-specific patterns of sexual dimorphism. Discussion Compared to µCT scans, we find that even low resolution 3D scans of very small specimens are

  8. Alternative security

    International Nuclear Information System (INIS)

    Weston, B.H.

    1990-01-01

    This book contains the following chapters: The Military and Alternative Security: New Missions for Stable Conventional Security; Technology and Alternative Security: A Cherished Myth Expires; Law and Alternative Security: Toward a Just World Peace; Politics and Alternative Security: Toward a More Democratic, Therefore More Peaceful, World; Economics and Alternative Security: Toward a Peacekeeping International Economy; Psychology and Alternative Security: Needs, Perceptions, and Misperceptions; Religion and Alternative Security: A Prophetic Vision; and Toward Post-Nuclear Global Security: An Overview

  9. Generic medicine and prescribing: A quick assessment

    Directory of Open Access Journals (Sweden)

    Mainul Haque

    2017-01-01

    Full Text Available Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. The Food and Drug Administration (FDA describes that generic drugs are essential possibilities that allow better access to healthcare for all Americans. They are replicas of brand-name drugs and are the identical as those of brand-name drugs in dosage form, safety, strength, route of administration, quality, performance features, and anticipated to use. Healthcare authorities and users can be guaranteed that FDA-approved generic drug products have met the same stiff principles as the innovator drug. The company that made Bayer aspirin fought in court enthusiastically to keep generic versions off the shelves, in the 1920s. The company lost in court, and consumers suddenly had an array of choices in generic aspirin. The Supreme Court of India uttering ‘the Supreme Court's ruling will prevent companies from further seeking unwarranted patents on HIV and other essential medicines.’ Generic medicine cannot be sold at a price higher than the branded medicine, so it is regularly a low-priced option. Thereafter, both the end user and the government who pay for part of the price of the medicine under the Pharmaceutical Benefits Scheme in Australia are benefitted. The treatment of diseases using essential drugs, prescribed by their generic names, has been emphasised by the WHO and many national health policies. Although there are some improvements in generic medicine prescribing, it has been advised by the WHO that ‘countries should intensify efforts to measure and regularly monitor medicine prices and availability, and adopt policy measures to address the issues identified.’

  10. The Cost-effectiveness of Welcome to Medicare Visual Acuity Screening and a Possible Alternative Welcome to Medicare Eye Evaluation Among Persons Without Diagnosed Diabetes Mellitus

    Science.gov (United States)

    Rein, David B.; Wittenborn, John S.; Zhang, Xinzhi; Hoerger, Thomas J.; Zhang, Ping; Klein, Barbara Eden Kobrin; Lee, Kris E.; Klein, Ronald; Saaddine, Jinan B.

    2013-01-01

    Objective To estimate the cost-effectiveness of visual acuity screening performed in primary care settings and of dilated eye evaluations performed by an eye care professional among new Medicare enrollees with no diagnosed eye disorders. Medicare currently reimburses visual acuity screening for new enrollees during their initial preventive primary care health check, but dilated eye evaluations may be a more cost-effective policy. Design Monte Carlo cost-effectiveness simulation model with a total of 50 000 simulated patients with demographic characteristics matched to persons 65 years of age in the US population. Results Compared with no screening policy, dilated eye evaluations increased quality-adjusted life-years (QALYs) by 0.008 (95% credible interval [CrI], 0.005–0.011) and increased costs by $94 (95% CrI, −$35 to $222). A visual acuity screening increased QALYs in less than 95% of the simulations (0.001 [95% CrI, −0.002 to 0.004) and increased total costs by $32 (95% CrI, −$97 to $159) per person. The incremental cost-effectiveness ratio of a visual acuity screening and an eye examination compared with no screening were $29 000 and $12 000 per QALY gained, respectively. At a willingness-to-pay value of $15 000 or more per QALY gained, a dilated eye evaluation was the policy option most likely to be cost-effective. Conclusions The currently recommended visual acuity screening showed limited efficacy and cost-effectiveness compared with no screening. In contrast, a new policy of reimbursement for Welcome to Medicare dilated eye evaluations was highly cost-effective. PMID:22232367

  11. Cost-benefit analysis for waste compaction alternatives at Lawrence Livermore National Laboratory: Addendum A to the Waste Minimization and Pollution Prevention Awareness Plan of May 31, 1991

    International Nuclear Information System (INIS)

    1992-01-01

    This report presents a cost-benefit analysis of the potential procurement and operation of various solid waste compactors or of the use of commercial compaction services, for compaction of solid transuranic (TRU), low-level radioactive, hazardous, and mixed wastes at Lawrence Livermore National Laboratory (LLNL) Hazardous Waste Management (HWM) facilities. The cost-benefit analysis was conducted to determine if increased compaction capacity at HWM might afford the potential for significant waste volume reduction and annual savings in material, shipping, labor, and disposal costs

  12. Industry requirements for introduction of alternative energies with emphasis on hydrogen fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Delabbio, F. [Rio Tinto, Canadian Exploration Ltd., Toronto, ON (Canada); Starbuck, D. [Newmont Mining Corp., Denver, CO (United States); Akerman, A. [CVRD-Inco, Toronto, ON (Canada); Betournay, M.C. [Natural Resources Canada, Ottawa, ON (Canada). CANMET Mining and Mineral Sciences Laboratories

    2007-07-01

    This paper discussed issues related to the use of alternate sources of energy in underground mining applications. Hydrogen power systems were examined in relation to operational drivers, available commercial supplies, site supplies, health and safety issues, capital and operating costs, mine production, and the role of government. Hydrogen power systems are being considered for mining applications in an effort to reduce greenhouse gas (GHG) emissions and reduce cooling and ventilation requirements. This article examined a range of issues that must be addressed before alternate energy systems such as hydrogen fuel cell technology can be used in larger-scale underground mining applications. The mining industry supports the development of new technologies. However, the introduction of alternate energy technologies must proceed in steps which include proof of concept testing, the development of generic infrastructure, power systems and regulations, and whole operating system studies. 13 refs., 1 fig.

  13. [General awareness and use of generic medication among citizens of Tubarão, state of Santa Catarina, Brazil].

    Science.gov (United States)

    Blatt, Carine Raquel; Trauthman, Silvana Cristina; Schmidt, Edegar Henrique; Marchesan, Samuel; da Silva, Luana May; Martins, João Luiz

    2012-01-01

    Although generic medication has been introduced in the country to offer an accessible alternative to brand-name medication, it represents only 14% of sales in number of units within the pharmaceutical market. The aim of this work was to research the level of awareness and the use of generic products among residents of the municipality of Tubarão, State of Santa Catarina, Brazil. A transversal study was carried out with a sample of 234 interviewees, distributed among municipal areas. With regard to use, the majority of those interviewed had used generic medication, and half of them had at least one such product in their home. To verify awareness of different types of medication, pictures with the generic, brand name and similar packaging for paracetamol and atenolol were shown and 91% were able to identify all products correctly. To be of higher economic standing, already having used generic products, believing that the generic medication has the same effect as the brand name medication, finding generic products in drugstores easily and being accustomed to buy generic products, were factors that were positively associated with the correct identification.

  14. Combining engineering and data-driven approaches: Development of a generic fire risk model facilitating calibration

    DEFF Research Database (Denmark)

    De Sanctis, G.; Fischer, K.; Kohler, J.

    2014-01-01

    Fire risk models support decision making for engineering problems under the consistent consideration of the associated uncertainties. Empirical approaches can be used for cost-benefit studies when enough data about the decision problem are available. But often the empirical approaches...... a generic risk model that is calibrated to observed fire loss data. Generic risk models assess the risk of buildings based on specific risk indicators and support risk assessment at a portfolio level. After an introduction to the principles of generic risk assessment, the focus of the present paper...... are not detailed enough. Engineering risk models, on the other hand, may be detailed but typically involve assumptions that may result in a biased risk assessment and make a cost-benefit study problematic. In two related papers it is shown how engineering and data-driven modeling can be combined by developing...

  15. TWTF design alternates

    International Nuclear Information System (INIS)

    Ayers, A.L. Sr.

    1982-03-01

    The Transuranic Waste Treatment Facility (TWTF) will process transuranic (TRU) waste in retrievable storage at the Idaho National Engineering Laboratory (INEL). The costs for a TWTF concept using a slagging pyrolysis incinerator were excessive. Alternate concepts using a slow speed shredder, a rotary kiln incinerator, and concrete immobilization should result in significant cost reductions. These will be included in future TWTF considerations

  16. It Is a Brave New World: Alternative Payment Models and Value Creation in Total Joint Arthroplasty: Creating Value for TJR, Quality and Cost-Effectiveness Programs.

    Science.gov (United States)

    Chen, Kevin K; Harty, Jonathan H; Bosco, Joseph A

    2017-06-01

    The increasing cost of our country's healthcare is not sustainable. To address this crisis, the federal government is transiting healthcare reimbursement from the traditional volume-based system to a value-based system. As such, increasing healthcare value has become an essential point of discussion for all healthcare stakeholders. The purpose of this study is to discuss the importance of healthcare value as a means to achieve this goal of value-based medicine and 3 methods to create value in total joint arthroplasty. These methods are to: (1) improve outcomes greater than the increased costs to achieve this improvement, (2) decrease costs without affecting outcomes, and (3) decrease costs while simultaneously improving outcomes. Following these guidelines will help practitioners thrive in a bundled care environment. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Alternative pricing methodologies

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    With the increased interest in competitive market forces and growing recognition of the deficiencies in current practices, FERC and others are exploring alternatives to embedded cost pricing. A number of these alternatives are discussed in this chapter. Marketplace pricing, discussed briefly here, is the subject of the next chapter. Obviously, the pricing formula may combine several of these methodologies. One utility of which the authors are aware is seeking a price equal to the sum of embedded costs, opportunity costs, line losses, value of service, FERC's percentage adder formula and a contract service charge

  18. 2015 Plan. Project 4: electric power supply, technologies, cost and availability. Sub-project alternative energy sources: solar, eolic, shale, ocean, hydrogen, organic wastes, peat and lignite

    International Nuclear Information System (INIS)

    1993-07-01

    Several aspects of solar, eolic and ocean energy and shale, peat lignite, hydrogen and organic waste in Brazil are described, including reserves, potential, technology economy and environment. Based in data and information presented in this report, the necessity of a more detailed survey with the potential of alternative energy sources in Brazil, emphasizing the more promiser regions is also mentioned. (C.G.C.)

  19. 42 CFR 447.506 - Authorized generic drugs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Authorized generic drugs. 447.506 Section 447.506... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment for Drugs § 447.506 Authorized generic drugs. (a) Authorized generic drug defined. For the purposes of this subpart, an authorized generic drug...

  20. [Performance of Slovak hospitals as related to Porter's generic strategies].

    Science.gov (United States)

    Hlavacka, S; Bacharova, L; Rusnakova, V; Wagner, R

    2001-01-01

    Porter's generic strategies characterize organizations in terms of their competitiveness, and are related to the performance of the organization. The aim of this study was to analyze the Porter's generic strategies and their effect on performance in the context of the Slovak hospital industry. Acute care hospitals with more than 30 beds were included into the study. National institutes providing specialized service were excluded from the study. Strategy and performance were evaluated on the basis of self-reported questionnaires, completed by chief administrators of hospitals (total 76 completed questionnaires were obtained, out of 81 distributed, i.e. 94% response rate). The cluster analysis was used for the identification of strategic orientation. Performance differences across strategic groups were tested using multivariate analysis of covariance (MANCOVA). The hierarchical cluster analysis uncovered a four-group taxonomy of hospitals: the group "Focused Cost Leadership" included 33% of hospitals, the group "Stuck-in-the middle" 49%, the group "Wait and See" 13% and the group "Cost leadership" 5%. Significant differences in performance were related to the Porter's pure, or hybrid strategies, respectively. In terms of industry evolution, the Slovak hospital industry could be characterized as fragmented, having a large number of small and medium size mainly state owned hospitals, with absence of market leaders, and with high exit barriers (mainly social and political) that hold back consolidation. (Tab. 1, Ref. 35.).