• Title/Summary/Keyword: Costs-effectiveness analysis

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Evaluation Standard of Cost-Effectiveness Analysis for Renew of Architectural Equipment in Public Building (공공건물 건축설비 갱신 계획시 비용-효율분석 평가기준에 관한 연구)

  • Jung, Soon-Sung
    • Journal of Power System Engineering
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    • v.17 no.4
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    • pp.131-138
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    • 2013
  • The purpose of this study is to suggest the evaluation standard of cost-effectiveness analysis for renew of architectural equipment in public building. Evaluation items of cost-effectiveness analysis for renew of architectural equipment in public building were used life cycle cost, energy consumption(ton of oil equivalent), green house gas emissions(ton of carbon dioxide) and maximum power demand. Life cycle cost is the process of making an economic assessment of an item, area, system, or facility by considering all significant costs of ownership over an economic life, expressed in terms of equivalent costs. The essence of life cycle costing is the analysis of equivalent costs of various alternative proposals. The social concern with green house gas and maximum power demand of architectural equipment field has been growing for the last several years.

Therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain: cost utility analysis based on a randomized controlled trial

  • Manchikanti, Laxmaiah;Pampati, Vidyasagar;Kaye, Alan D.;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.31 no.1
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    • pp.27-38
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    • 2018
  • Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

Reliability-based Life Cycle Cost Analysis for Optimal Seismic Upgrading of Bridges

  • Alfredo H-S. Ang;Cho, Hyo-Nam;Lim, Jong-Kwon;An, Joong-San
    • Computational Structural Engineering : An International Journal
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    • v.1 no.1
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    • pp.59-69
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    • 2001
  • This study is intended to propose a systematic approach for reliability-based assessment of life cycle cost (LCC) effectiveness and economic efficiency for cost-effective seismic upgrading of existing bridges. The LCC function is expressed as the sum of the upgrading cost and all the discounted life cycle damage costs, which is formulated as a function of the Park-Ang damage index and structural damage probability. The damage costs are expressed in terms of direct damage costs such as repair/replacement costs, human losses and property damage costs, and indirect damage costs such as road user costs and indirect regional economic losses. For dealing with a variety of uncertainties associated with earthquake loads and capacities, a simulation-based reliability approach is used. The SMART-DRAIN-2DX, which is a modified version of the well-known DRAIN-2DX, is extended by incor-porating LCC analysis based on the LCC function developed in the study. Economic efficiencies for optimal seismic upgradings of the continuous PC segmental bridges are assessed using the proposed LCC functions and benefit-cost ratio.

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Economic Evaluation of Rosuvastatin and Atorvastatin for the Treatment of Dyslipidemia from a Korean Health System Perspective (이상지질혈증 환자에게 사용되는 Rosuvastain과 Atorvastatin의 경제성 평가)

  • Suh, Sunghwan;Jung, Chang Hee;Hong, Soon-Jun;Kim, Jung-Sun;Song, Byung Ju;Sohn, Hyun Soon;Choi, Sung Hee
    • Journal of Lipid and Atherosclerosis
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    • v.5 no.1
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    • pp.61-77
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    • 2016
  • Objective: This study aims to analyze cost-effectiveness of two most-commonly used statins from the perspective of the Korean national health system. Methods: The scope of the analysis included rosuvastatin (5 mg, 10 mg, and 20 mg) and atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Effectiveness was defined as percentage (%) and absolute (mg/dL) reductions of low-density lipoprotein cholesterol (LDL-C) from the baseline. They were derived from published randomized controlled studies for rosuvastatin and atorvastatin. Effectiveness was defined as reductions in LDL-C levels per mg dose of the drugs. The annual direct medical costs including drug acquisition costs and monitoring costs over the one-year time horizon were calculated for each alternative. The average cost-effectiveness ratios (ACERs) and incremental cost-effectiveness ratios (ICERs) for each statin dose were calculated. Results: The ACERs for all doses of rosuvastatin (5 mg, 10 mg, and 20 mg) were lower than those for all doses of atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Rosuvastatin 10 mg was the most cost-effective statin for LDL-C reduction. In cost-effectiveness analyses for corresponding doses of rosuvastatin and atorvastatin, rosuvastatin was the superior strategy which suggests both higher effectiveness and lower costs than atorvastatin. However, we have to consider this analysis is highly influenced by current price of statins in each market. Conclusion: For reduction of LDL-C levels in Korean patients with dyslipidemia, rosuvastatin 10mg is the most cost-effective statin in the current Korean market.

Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot (당뇨병성 족부질환자에 대한 가정간호서비스의 비용-효과분석)

  • Song, Chong Rye;Kim, Yong Soon;Kim, Jin Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.19 no.4
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    • pp.437-448
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    • 2013
  • Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

The Correlations among the Categorized Quality Cost Factors on SMEs (Small & Medium-sized Enterprises) (중소 제조기업의 품질비용 행태에 관한 실증 연구)

  • Lee, Sang-Choon;Koo, Il-Seob
    • Proceedings of the Safety Management and Science Conference
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    • 2011.04a
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    • pp.731-746
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    • 2011
  • The successful and sustainable growth of SMEs depends on their ability of strengthen their competitiveness in quality and cost and service more than anything else as a fundamental of operation. Among these key competitive factors of SMEs, quality is the most critical factor in manufacturing business fields. Because quality strongly influence cost and service performance on this manufacturing business field. There are many different ways to improve the quality performance but it needs proper management decision to choose the best way what can maximize outputs with minimum inputs. And it needs effective measurement methods and some indicators to analysis the quality performance properly. The quality cost is one of the simplest key indicators to measure the quality performance and the effectiveness of quality related management decisions. The major purpose of this study is to diagnose the categorized current level of actual quality cost of local SMEs to maximize their quality management effectiveness through comparing their level with others what's expressed in early studies. In this study, through survey on local SMEs, we found that their average annual quality cost ratio versus turnover - Total amount of annual quality cost divided by annual turnover - is around 3.69% excluded some SME's performances what have different quality control measures with others. And we found some results what corresponded with the early studies on the correlations between those categorized quality costs factors and some discrepancies between some of the literature model and the early case study results as follows. There were negative correlations between the Prevention costs and the External failure costs, and the Appraisal costs and the External failure costs, and there was positive correlation between the Appraisal costs and Internal failure costs same as early studies. But, we couldn't found any strong negative correlations between the Cost of control - Preventive costs & Appraisal costs - and the Cost of Failure of control - Internal & External failure costs -. It reveals not only the lack of effectiveness on their preventive or appraisal activities but also it can reveal there were so many effective ways to prevent the failure costs properly such as some innovative investment on Factory automation includes Error Proofing and more preventive actions to improve the effectiveness of the typical management methods likes CE (Concurrent Engineering), APQP (Advanced Product Quality Planning), FMEA (Failure Mode & Effect Analysis) etc.

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Economic Evaluation of Gemcitabine-cisplatin Chemotherapy for Non Small-Cell Lung Cancer Patient in an Outpatient Setting (비용-효과 분석 기법을 이용한 Gemcitabine 외래 항암 치료의 경제성 평가)

  • Min, Su-Hyun;Ko, Su-Kyoung;Lim, Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.38 no.3
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    • pp.363-371
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    • 2008
  • Purpose: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. Methods: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. Results: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. Conclusion: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

DSM Cost-effectiveness Analysis System based on the Web (웹기반 수요관리 비용효과분석 시스템)

  • Park, Jong-Jin;Rhee, Chang-Ho
    • Proceedings of the KIEE Conference
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    • 2005.07a
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    • pp.757-759
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    • 2005
  • This rarer presents the cost- effectiveness analysis system of DSM programs on the web. The purpose of this paper is to analyze the energy consumption and peak reduction of DSM programs, evaluate the cost-effectiveness for DSM programs, and identify the benefits and the costs for each California Test. The proposed approach is applicable to DSM programs post-conducting in Korea.

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Cost Effectiveness Analysis of Different Management Strategies between Best Supportive Care and Second-line Chemotherapy for Platinum-resistant or Refractory Ovarian Cancer

  • Luealon, Phanida;Khempech, Nipon;Vasuratna, Apichai;Hanvoravongchai, Piya;Havanond, Piyalamporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.799-805
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    • 2016
  • Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

Cost-Effectiveness of Intensive Vs. Standard Follow-Up Models for Patients with Breast Cancer in Shiraz, Iran

  • Hatam, Nahid;Ahmadloo, Niloofar;Vazirzadeh, Mina;Jafari, Abdossaleh;Askarian, Mehrdad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5309-5314
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    • 2016
  • Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62 and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.