Acquisition Price Research Articles

Cost-Effectiveness of Juluca for Human Immunodeficiency Virus Infection Treatment in Virologically Suppressed Adults in Taiwan

ObjectivesAlthough the efficacy of traditional 3-drug regimens for the treatment of HIV is well established, tolerability and toxicity concerns remain. New 2-drug regimens such as Juluca (dolutegravir [DTG]/rilpivirine [RPV]) offer noninferior efficacy versus 3-drug regimens (SWORD-1 and SWORD-2 studies), while reducing cumulative drug exposure and potentially long-term toxicities and drug-drug interactions. Here, we assess the cost-effectiveness of DTG/RPV for the treatment of HIV-1 for virologically suppressed adults in Taiwan. MethodsA hybrid decision tree and Markov cohort state transition model was used to evaluate the expected economic costs and clinical outcomes associated with DTG/RPV and comparators. Model health states were defined by viral load and CD4 cell count. Efficacy and safety data were informed from SWORD-1 and SWORD-2 studies and the literature. The risk of long-term toxicities (cardiovascular disease, bone fractures, and chronic kidney disease) were included. Current branded drug acquisition prices were included, and healthcare costs informed by a bespoke costing study using National Health Insurance Research Database data. Incremental cost-effectiveness ratios were calculated and compared with a willingness-to-pay threshold of 2 times Taiwan’s gross domestic product (NT$1 550 000). ResultsDTG/RPV was found to be a cost-saving regimen compared to 3 comparators (rilpivirine [RPV]/emtricitabine [FTC]/tenofovir disoproxil fumarate [TDF], dolutegravir [DTG]/abacavir [ABC]/lamivudine [3TC], and elvitegravir [EVG]/cobicistat [c]/emtricitabine [FTC]/tenofovir alafenamide [TAF]) and fell in the southwest quadrant of the cost-effectiveness plane where it is generating significant savings with a small decrement in lifetime quality-adjusted life-years (–0.005). It was, however, more expensive than efavirenz [EFV]/emtricitabine [FTC]/ tenofovir disoproxil fumarate [TDF]. ConclusionsDTG/RPV is cost-saving compared to RPV/FTC/TDF, DTG/ABC/3TC, and EVG/c/FTC/TAF, and provides comparable efficacy with reduced cumulative drug exposure.

Pricing and coordination in a reverse supply chain with online and offline recycling channels: A power perspective

Faced with a large number and a wide variety of used products, it is of great significance to study how to design an effective reverse channel for recycling waste products, to obtain better economic and environmental benefits. In this paper, we explore how various channel power structures affect the pricing decisions and coordination in a reverse supply chain (RSC) with competitive online and offline recycling channels. One centralized and three decentralized RSC models are established under three power structures: remanufacturer-led, collector-led, and vertical Nash. Through equilibrium comparison, we find that either the remanufacturer or the collector has sufficient incentives to lead the RSC, however, the balanced power structure (Vertical Nash) is more favorable to the RSC system. In addition, we design a mechanism, which consists of an online acquisition price scheme and a two-part tariff contract, to coordinate dual-recycling channel RSCs under various power structures. Finally, we extend the model to asymmetric initial collection quantity and asymmetric recycling channel cost cases and verify the robustness of our basic propositions. Our analysis generates managerial insights into the relationship between the channel power structure and recycling channel competition and provides guidance for strategic decisions by remanufacturers and recyclers in dual-recycling channel RSC.

Platform or direct channel: government-subsidized recycling strategies for WEEE

We investigate how government subsidies affect pricing and service-quality strategies under different online-recycling channel structures. We consider two cases: the monopoly case, where the manufacturer recycles by itself, and the coopetition case, where a platform and the manufacturer compete for used products while the platform provides services to the manufacturer. We find the optimal price and service-quality strategies in these two cases with or without government subsidy. We also examine the recycling outcomes in terms of total recycling quantities and the parties’ profits. We find that with government subsidy, in the monopoly case, the manufacturer is motivated to increase both acquisition price and service quality and thus achieves higher recycling quantities and profit. In the case of coopetition, the manufacturer enjoys similar benefits from subsidy, but the platform suffers. The manufacturer gains competitive advantage from subsidy by offering a higher acquisition price, which forces the platform to increase acquisition price as well. To compensate for this increased cost, the platform must lower service quality, which leads to lower recycling quantities and profits. Only when the subsidy is high enough can the platform benefit. We also show that a subsidy can increase the total recycling quantity of the system only when consumers are fairly insensitive to service quality. Our study contributes to the understanding of how subsidy policy interacts with different online channel structures.

Goodwill Arising Out of Amalgamation – Depreciable ??

Strategic acquisition of a target by an acquirer by paying more than its book net worth is very common in mergers and acquisitions deals as the acquisition price is generally based on the fair market value of business. The excess price is generally paid on account of various factors such as brand, clientele, combined synergies etc., which may not be recorded in the books of accounts by the target and such excess price i.e. purchase price that exceeds the value of net assets, is recorded as goodwill in the books of accounts of the acquirer. Many issues are faced by the industry before taking the decision of mergers and acquisitions and one of the major issue that the industry faces today is whether goodwill arising out of amalgamation is eligible for depreciation under section 32 (1) (ii) of the Income Tax Act, 1961 (‘IT Act’) or not?

Economic viability of implementing an infrastructure for recycling bedding sand from a free-stall facility for dairy cows

This study proposes to examine the economic viability of implementing the necessary infrastructure for the recycling of bedding sand from a free-stall facility in a milk production system in southern Minas Gerais, Brazil. In specific terms, the total production cost (TC), total operating cost (TOC) and effective operating cost (EOC) of a cubic meter of recycled sand were estimated in order to estimate the total sand consumption for the free-stall system and per bed year-1 as well as the equilibrium point of the amount of recycled sand, in cubic meters. The experiment was carried out on a farm located in the south of Minas Gerais from January 2016 to December 2017. Three scenarios were analyzed by the tree-point estimation method (MOP - most likely, optimistic, and pessimistic). Utilization of 85%, 95% and 75% of the recycled sand was considered for scenarios 1, 2 and 3, respectively. In all of them, the value charged per cubic meter of sand by a supplier close to the farm was considered. Monte Carlo simulation was also carried out with hurdle rates (HR) of up to 90%. Under the studied conditions, sand recycling showed to be economically viable in all scenarios, with positive net present values (NPV), internal rates of return above the HR, simple and discounted payback below the 10-year horizon, and satisfactory cost benefit-1 ratios (greater than 1). The EOC of one cubic meter of recycled sand was estimated at R$5.04, R$4.51 and R$5.72 for scenarios 1, 2 and 3, respectively, whereas the average TC, considering all scenarios, was R$6.84 (+0.81), which is less than the acquisition price of R$28.57 at the sand extraction site. The TC was R$37,219.51 and R$34,637.74 for the scenarios with HR of 8.50 and 6.99%, respectively, whereas TOC was R$22,572.08 in all analyzed scenarios. The estimated total annual sand consumption by the free-stall system was 526.44 m³, with an estimated average of 1.23 m³ (+0.28) bed-1 year-1. All Monte Carlo simulation models showed positive NPV as well as HR of up to 90%, which reflect a high probability of positive NPV.

ANALISIS HUBUNGAN KESIAPAN BELAJAR SECARA DARING DI ERA PANDEMI COVID-19 TERHADAP HASIL BELAJAR STATISTIKA

This study was motivated by the transformation of the learning process from face-to-face to online learning due to the Covid-19 pandemic. This study aims to analyze students' online learning readiness in the Covid-19 pandemic era regarding statistics learning outcomes. This research is a quantitative descriptive study using a regression research design. Data collection was carried out by providing online learning readiness questionnaires and statistical material tests to students. Based on the results of data analysis, it was found that there was a relationship between online learning readiness and student learning outcomes statistics, with the acquisition price of Fcount = 4.195 and a significance value of 0.048 <0.05, and 46.1% of student statistics learning outcomes were influenced by learning readiness and the rest was influenced by external factors. student learning readiness. Based on these results, it is concluded that online learning readiness affects student learning outcomes statistics, where the large influence of learning readiness is 46.1%. Therefore, so that lecturers and students can maximize factors outside of learning readiness so that the achievements and objectives of the statistics course can be maximally achieved even though learning is carried out online.

Entrepreneurial exit by acquisition: the impact of heterogeneity in products and technology portfolio and marketing capabilities

PurposeThis paper aims to study the effect of two important marketing decisions on the extent of value capturing by the firm owners. First, it addresses the debate whether acquirers of young technology-based firms value targets that span multiple technology and market categories indicating multiples options for growth or prefer more narrowly defined targets with a clear product and market focus. Second, it investigates to what extent the use of alliances for marketing purposes contributes to value capturing and how they moderate the effect of diversification of technology and marketing.Design/methodology/approachTo estimate the acquisition price, a linear regression model is used, including a Heckman correction controlling for the likelihood of being acquired. The hypotheses are tested in a sample of British venture capital backed firms.FindingsFirms that convey focus in their marketing activities (either because they focus on a few market categories or because they rely on downstream alliance to market their inventions) receive higher valuations at acquisition than those that diversify. Further, also the size of the product portfolio is negatively correlated to the acquisition price. Finally, the results reveal that firms with a broad patent portfolio can reduce the negative effects on firm value by engaging in less downstream alliances.Originality/valueThis paper advances existing research on exit strategies for entrepreneurial firms by considering factors explaining acquisition prices, instead of acquisition probabilities. Further, it adds the categorization research by demonstrating how acquirers respond to complex combinations of technology and market categories.

Endogenous Third-Degree Price Discrimination in a Supply Chain with One Common Manufacturer and Duopoly Retailers

Assuming the two retailers decide whether to acquire information to segment consumers and price them differently, we investigate the problem of information acquisition and third-degree price discrimination in the supply chain composed of one common manufacturer and duopoly retailers. We explore how the supply chain members’ pricing decisions are affected by the fraction of high price-sensitivity consumers and the consumers’ difference in price sensitivity. Analytical results show that the manufacturer’s wholesale price increases with the fraction of high price-sensitivity consumers and decreases with the consumers’ difference in price sensitivity. Moreover, if a retailer chooses to acquire information and price discriminate, the retail prices for two types of consumers increase with the fraction of high price-sensitivity consumers. However, the retail price for consumers with high (low) price sensitivity decreases (increases) with the consumers’ difference in terms of price sensitivity. By comparing the results among different information acquisition and price discrimination decisions, we find that there exist two possible equilibrium decisions for both retailers: both retailers acquire information and price discriminate and no retailer acquires information and each charges a uniform price for all consumers. The strategy which dominates depends on the fraction of high price-sensitivity consumers and the consumers’ difference in price sensitivity. However, compared with no retailer acquiring information, the manufacturer is better off when two retailers acquire information. Consequently, the manufacturer designs a fixed fee contract to stimulate retailers to price discriminate and to achieve a win-win situation for them finally.

Robust Design of a Closed-Loop Supply Chain Considering Multiple Recovery Options and Carbon Policies Under Uncertainty

Increasing global warming, climate change and stringent governmental legislations are driving industry practitioners and decision makers to implement various strategies to reduce carbon emissions. One of the effective approaches to mitigate carbon emissions is the implementation of closed-loop supply chain (CLSC). The key motivation for considering multiple recovery options in the CLSC is to capture the remaining economic value and to reduce carbon emissions in the collection and recovery operations. Customer's willingness to return used product depends on the acquisition price and nearness to the collection center. This research proposes a deterministic mixed-integer linear programming (MILP) model for a multi-period and multi-product CLSC network under carbon pricing and carbon trading policies consideration. The model includes different acquisition price for returned products and multiple recovery options. Further, the study takes into consideration uncertainty in procurement cost, demand, and quantity of returned products. A robust optimization approach is adopted to address uncertainty in network parameters. Numerical results show that the proposed model captures trade-offs between total cost and carbon emission. Overall, the study reveals that the carbon trading policy incurs relatively lower total cost compared to the carbon pricing policy. Repair and recycling activities in the reverse supply chain contribute significantly to the total cost and carbon emission. This study provide evidence that it is possible to achieve an optimal CLSC network with reduced carbon emission at a moderate total supply chain cost. The proposed model could be used to guide firms to choose an appropriate budget of uncertainty toward achieving a robust supply chain network.

Cost-effectiveness of Maintenance Therapy Based on Molecular Classification Following Treatment of Primary Epithelial Ovarian Cancer in the United States

There are large randomized clinical trials-SOLO-1 (Olaparib Maintenance Monotherapy in Patients With BRCA Mutated Ovarian Cancer Following First Line Platinum Based Chemotherapy [December 2018]), PRIMA (A Study of Niraparib Maintenance Treatment in Patients With Advanced Ovarian Cancer Following Response on Front-Line Platinum-Based Chemotherapy [September 2019]), and PAOLA-1 (Platine, Avastin and Olaparib in 1st Line [December 2019])-reporting positive efficacy results for maintenance regimens for women with primary, advanced epithelial ovarian cancer. The findings resulted in approval by the US Food and Drug Administration of the treatments studied as of May 2020. However, there are pressing economic considerations given the many eligible patients and substantial associated costs. To evaluate the cost-effectiveness of maintenance strategies for patients with (1) a BRCA variant, (2) homologous recombination deficiency without a BRCA variant, or (3) homologous recombination proficiency. In this economic evaluation of the US health care sector using simulated patients with primary epithelial ovarian cancer, 3 decision trees were developed, one for each molecular signature. The maintenance strategies evaluated were olaparib (SOLO-1), olaparib-bevacizumab (PAOLA-1), bevacizumab (PAOLA-1), and niraparib (PRIMA). Base case 1 assessed olaparib, olaparib-bevacizumab, bevacizumab, and niraparib vs observation of a patient with a BRCA variant. Base case 2 assessed olaparib-bevacizumab, bevacizumab, and niraparib vs observation in a patient with homologous recombination deficiency without a BRCA variant. Base case 3 assessed olaparib-bevacizumab, bevacizumab, and niraparib vs observation in a patient with homologous recombination proficiency. The time horizon was 24 months. Costs were estimated from Medicare claims, wholesale acquisition prices, and published sources. Probabilistic sensitivity analyses with microsimulation were then conducted to account for uncertainty and assess model stability. One-way sensitivity analyses were also performed. The study was performed from January through June 2020. Incremental cost-effectiveness ratios (ICERs) in US dollars per progression-free life-year saved (PF-LYS). Assuming a willingness-to-pay threshold of $100 000/PF-LYS, none of the drugs could be considered cost-effective compared with observation. In the case of a patient with a BRCA variant, olaparib was the most cost-effective (ICER, $186 777/PF-LYS). The third-party payer price per month of olaparib would need to be reduced from approximately $17 000 to $9000 to be considered cost-effective. Olaparib-bevacizumab was the most cost-effective in the case of a patient with homologous recombination deficiency without a BRCA variant (ICER, $629 347/PF-LYS), and bevacizumab was the most cost-effective in the case of patient with homologous recombination proficiency (ICER, $557 865/PF-LYS). Even at a price of $0 per month, niraparib could not be considered cost-effective as a maintenance strategy for patients with homologous recombination proficiency. The findings of this study suggest that, at current costs, maintenance therapy for primary ovarian cancer is not cost-effective, regardless of molecular signature. For certain therapies, lowering the drug price alone may not make them cost-effective.

Design of Artificial Lighting in Broiler Housing

Abstract The work aim is to propose lighting system designs that would satisfy the broiler welfare in terms of intensity; wavelength; switching interval; and energy savings, and would help farmers to reduce the unit costs. BuildingDesign software with Wils 7.0.342 module was used to design suitable lighting, calculate and visualize it. By optimizing the required parameters and energy performance of system, four final designs were prepared with the appropriate evaluation with respect to the acquisition price and return on investment. The original lighting system included a combination of 68 pcs. of tungsten and fluorescent lamps with consumption of 2.17 kWh and a minimum illumination intensity of 7.02 lx. Measurements were conducted at 212 points of the control grid. Artificial lighting is the only light source in an environment of eco-friendly controlled farm. Based on the research analyses, there were proposed four lighting system alternatives with various light intensity; wavelength; switch-on interval; and energy savings. In terms of light intensity, all four designs meet the animal welfare requirements. The most advantageous alternative in the long term is design no. 4 with consumption of 0.734 kWh per one cycle (with energy savings of 66.17% in contrast to the original lighting), in which the intermittent switching mode showed a power savings of 56% and lighting intensity regulation of 40% while maintaining a minimum lighting intensity of 20 lx (total savings for switching and regulation reached up to 73.7%). By utilizing modern approaches, appropriate light colour and lighting quality suitable for broiler breeding were achieved.

Study of Low Dose Ibrutinib Use in a Community-Based Oncology Practice

Background: Ibrutinib, a small molecule inhibitor of Bruton's Tyrosine Kinase (BTK) is approved for use in a variety of lymphomas. Priced at $130,000/year, Ibrutinib imposes a significant financial burden on patients and society[1]. The study serving as the basis for the currently approved dose [2] demonstrated >95% BTK receptor occupancy at a dose of 2.5 mg/kg. Data suggests that lower doses of Ibrutinib are equally effective[3] and dose reductions[4, 5] do not compromise outcome. Objective: To evaluate patient outcomes and cost savings with clinically indicated low dose (LD) of Ibrutinib in a community practice in hematological malignancies. Method: All patients treated with standard and LD Ibrutinib between January 2014 and July 2020 were identified. Reason for dose modification and best responses were abstracted. Patients with inadequate follow up or less than a week of treatment were excluded from the analysis. Responses were defined based on the iwCLL response criteria for Chronic Lymphocytic Leukemia (CLL), Lugano criteria for Non-Hodgkin's Lymphoma and International Working Group on Waldenström's Macroglobulinemia (WM), as applicable. To calculate drug cost at lower doses of Ibrutinib, cumulative number of patient-months on different dose levels of ibrutinib was calculated by adding the number of months each patient had remained at the dose level at the time of data cut-off. Drug cost at LD was calculated by multiplying monthly wholesale acquisition price for different dose levels of ibrutinib by the cumulative number of patient-months at that dose level. Cost differential between actual drug cost and projected drug cost at full dose was calculated. Results: 98 patients were identified. 10 were excluded from the analysis based on drug not started (3), inadequate follow-up (3), other (4). Median length of follow up for all patients was 20 months (4-70 months) and on LD Ibrutinib 12.5 months (1-60 months). 10 and 12 patients received 140 mg and 280 mg of Ibrutinib respectively due to side effects. 61 patients had CLL, 9 WM, 15 mantle cell lymphoma (MCL), and 2 marginal zone lymphoma (MZL). Response rates were similar across diagnoses and dose levels (TABLE 1 and FIGURE 1). Progressive disease (PD) at low dose was seen in 2 CLL patients with complex cytogenetics, deletion 17p and extensive prior therapy. The one WM patient with PD had been extensively pretreated. Cumulative patient-months at the 140 mg and 280 mg dose levels of Ibrutinib was 177 and 123 months respectively. Drug cost for the 140 mg and 280 mg Ibrutinib cohorts were $712,276 and $989,943 respectively, for a total cost of $1,702,219. Potential drug cost for the 420 or 560 mg dose of Ibrutinib for the same duration of therapy was $3,621,828. Cumulative cost avoidance on LD Ibrutinib was $1,919, 608. Conclusions: Clinically indicated low dose Ibrutinib was equally effective and produced significant cost savings.

Cost Avoidance from Automated Dose Rounding of Biological and Cytotoxic Anticancer Drugs in an Integrated Delivery Network

Background: Projected costs of cancer care are expected to reach $172.8 billion dollars by 2020[1]. Cost of oncology drugs have outpaced other areas[2] with novel drugs priced at a median of $115,981/year between 2009 and 2013[3], making cost control an important priority. Rounding drug doses to the nearest vial size, as long as the difference is smaller than an accepted percentage, has been shown to reduce the cost of care[4]. This also allows workflow efficiency by simplifying compounding and decreasing waste documentation[5] and reduces the potential for medication errors[6]. Dose rounding has been recommended by the Hematology/Oncology Pharmacy Association (HOPA)[5] and the HOPA position paper was endorsed by NCCN[7]. Methods In accordance with HOPA position statement, an integrated community-based healthcare system comprised of 13 providers across 8 infusion centers implemented dose rounding to the nearest vial if within 10% based on actual calculated dose for biological and cytotoxic agents. Performed manually by oncology pharmacists at the time of initial introduction in January 2020, this was transitioned to automated dose rounding by the oncology chemotherapy software (Epic Beacon, Epic Systems, Verona, WI) in June 2020. To facilitate provider adoption and maximize cost-savings, we compiled a list of 31 biological and chemotherapy agents that provided the greatest therapeutic margin and potential for cost savings. Dose rounding parameters for each agent was developed to standardize and facilitate automated dose rounding. Lower and upper bounds were set so that the vial size was within 10% of the actual calculated dose (e.g. doses between 91 mg and 111 mg to a 100 mg vial, Table 1). Cost avoidance was calculated based on the acquisition price of the lowest vial size available and necessary to make the pre-rounded dose. Results Total cost avoidance between January 2020 and July 2020 by dose rounding 31 different chemotherapy and biological agents was $679,780.02. Automated dose rounding drugs introduced in June 2020 high value drugs resulted in cost savings of $ 112,994.12 over a seven week period. Dose rounding of biological drugs accounted for 89.4% of the total cost savings. Rounding of cytotoxic drugs resulted in a cost saving of $71,588.35. Trastuzumab dose rounding was associated with the greatest amount of cost avoidance of $147,194.44, accounting for 21.65% of total cost avoidance. Dose rounding up to the nearest vial ranged between 0.13%-9.75% (median 3.52%). Dose rounding down to the nearest vial ranged between -0.10% -9.93% (median -3.36%). Conclusions: We demonstrate feasibility of implementing an automated EHR based dose rounding protocol in an integrated delivery network, widespread adoption across multiple centers and significant cost avoidance accrued from the intervention. Similar dose rounding protocols should prioritize biologics agents due to their high utilization and costs.

Tri-party reverse supply chain coordination with competitive product acquisition process

A coordination model in a reverse supply chain (RSC) considering product acquisition management and competition of third-party collectors is developed. Motivated by a case study of plastic recycling, collectors not only compete on the return incentives paid to consumers but also control the quality level of returned products delivered to the remanufacturer. A tri-party two-part tariff mechanism is introduced to coordinate the links between competing collectors and the remanufacturer. We analyze the retail and acquisition prices, and the quality level decisions under decentralized, centralized, and coordination systems. The results demonstrate that the coordination model not only significantly enhances both the quantity and quality of items received by the remanufacturer but also provides a win-win-win situation for members.

Analisis Perlakuan Akuntansi Asset Biologis Berdasarkan PSAK 69 Pada Organisasi Simantri Kelompok Tani Ternak Sapi “Sato Amerta Utama”

Biological assets are assets in the form of animals or plants undergoing transformation, resulting in qualitative and quantitative changes. The application of biological assets to date has not been widely used by entities engaged in livestock entities, even though the PSAK 69 standard is active in Indonesia on January 1, 2018. This research was conducted to determine the accounting treatment of biological assets in the Simantri organization Sato Amerta Utama cattle group , Baluk Village based on PSAK 69. The purpose of this study was to determine the measurement, recognition and disclosure of biological assets in Simantri Sato Amerta. This research was conducted using qualitative methods. Data obtained from interviews, observations and documentation. Furthermore, the data from these results are analyzed by data reduction, data presentation and conclusion drawing.This research aims to understand the accounting treatment of biological assets based on PSAK 69 in the Simantri organization of the Sato Amerta Utama cattle group in Baluk Village based on PSAK 69. In this study, to get the data validity is done by triangulation. Achievements in this research show that related to the measurement, recognition and disclosure of biological assets in Simantri Sato Amerta Utama is not fully in accordance with applicable standards, namely PSAK 69. See from the measurement still uses historical costs as acquisition prices and recording is still simple.

Cost-Effectiveness of Evolocumab Therapy for Myocardial Infarction: The Chinese Healthcare Perspective.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are an indispensable lipid-lowering treatment option, but their cost-effectiveness has been questioned. This study aimed to perform a health economic evaluation of evolocumab versus placebo in patients with myocardial infarction (MI) in China. A Markov cohort state-transition model was developed in decision analysis software to estimate the incremental cost-effectiveness ratio (ICER), defined as cost per quality-adjusted life-year (QALY) saved. The simulation subjects could undergo non-fatal MI and/or stroke, or vascular or non-vascular death event. We integrated the Chinese population-specific demographics and event rates with the risk reduction of evolocumab based on the FOURIER trial and/or lowering of low-density lipoprotein cholesterol (LDL-C). Age-related change, event costs and utilities were included from published sources. At its current list price [33,748 Chinese yuan (CNY) annually per person], the ICER for evolocumab therapy was 927,713 CNY per QALY gained when integrating the FOURIER trial with absolute reduction of LDL-C. The probability of cost-effectiveness of evolocumab versus placebo was 1.96%, with a generally accepted threshold of 212,676 CNY per QALY gained. A reduction in acquisition price by approximately 70% (to less than 10,255 CNY annually) was needed to be cost-effective. Alternative scenario analyses of therapeutic benefit showed that the ICER for evolocumab in MI patients with uncontrolled familial hypercholesterolemia (FH) was 187,736 CNY per QALY gained. Evolocumab in patients with MI was not cost-effective based on the price in 2019 in China; however, treatment with evolocumab was more favorable in MI patients with FH.

Pertussis vaccination in pregnancy in Canada: a cost-utility analysis.

The Canadian National Advisory Committee on Immunization recommends universal vaccination against pertussis in pregnancy. We assessed the cost-effectiveness of vaccination with tetanus-diphtheria-acellular pertussis (Tdap) vaccine in pregnancy in Canada. We conducted a cost-utility analysis comparing a vaccination program to no program corresponding with the 2017 Canadian guideline for economic evaluation from the Canadian Agency for Drugs and Technologies in Health. We developed 2 models - part decision tree, part Markov model - to estimate the long-term cost and quality-adjusted life-years (QALYs) for pregnant women and their infants. We obtained epidemiologic data from 2006 to 2015, and derived costs and utility values from relevant sources. Results were reported in 2019 Canadian dollars. We obtained expected values through probabilistic analysis, with methodologic and structural uncertainty assessed through scenario analyses. The analysis adopted an acquisition price of Tdap vaccine of $12.50, with scenario analysis conducted to identify the threshold price for vaccination to be cost-effective. In the base-case scenario, for every 1000 pregnant women vaccinated, the program would lead to a gain of 0.3 QALYs, occurring solely in infants, at an increased total cost of $12 987, or $44 301 per QALY gained. Based on a threshold of $50 000 per QALY gained, vaccination would have been cost-effective in 6 of the 10 years included in the model (range of incremental costs $20 463-$100 348 per QALY gained). The threshold cost for Tdap vaccine to be cost-effective over the 10-year horizon was $14.03. Based on a threshold of $50 000 per QALY gained, vaccination against pertussis in pregnancy would be cost-effective if the acquisition cost per vaccine were $14.03 or less. Province- and territory-specific analyses should be done to inform local decision-making.

Dynamics of Physical Capital in Artisanal Fisheries and Policy Implications

The dynamics of physical capital stock and net investment in artisanal fisheries of Al-Seeb - a coastal fishing town of Muscat Governorate are examined covering the period 2004-2013 . Data were gathered from two sources namely the Ministry of Agriculture and Fisheries and field survey. A hedonic regression model is used to examine the influence of boat characteristics on the boat acquisition prices and then to derive the growth rate of physical capital stock. Boat characteristics comprising of ‘age’, ‘horsepower (hp)’ and ‘length (vl)’ are found to be statistically significant at the 5% level and carry sign consistent with the economic theory of depreciation and cost respectively. While inter-annual fluctuation of net investment is observed, a positive trend in cumulative investment with an average growth rate of 7.63% is experienced in the fishery during 2004-2013. A crude assessment of the operating costs and the gross revenue of surveyed boat-owners in 2015 showed that on average monthly economic profit of 570.97±169.36SD OMR was received by individual boat-owner which complements the positive trend in cumulative investment.These findings have important management and policy implications in relation to the effective management of harvesting capacity as well as attract investment in the fishery. Finally, some limitations of the study are discussed along with the indication of potential future research.

Bempedoic acid for high-risk patients with CVD as adjunct lipid-lowering therapy: A cost-effectiveness analysis

Bempedoic acid is a novel adenosine triphosphate citrate lyase inhibitor shown to reduce low density lipoprotein cholesterol when used as an adjunct lipid-lowering therapy in patients with high cardiovascular disease (CVD) risk. Our analysis aimed to determine the price at which bempedoic acid would be cost-effective from the Australian health care perspective. A Markov model was designed using data from the Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen (CLEAR) Harmony trial, to model the clinical outcomes and costs of 1000 patients treated with bempedoic acid over a lifetime horizon. Relevant health states were "Alive with CVD," "Alive with recurrent CVD," and "Dead." With annual cycles, patients were at risk of a nonfatal myocardial infarction, coronary revascularization, and death from CVD or non-CVD causes. Costs and utilities were obtained from published sources. Outcomes of interest were the incremental cost-effectiveness ratios in terms of cost per quality-adjusted life year (QALY) gained and cost per year of life saved. Outcomes were discounted at 5% per annum. Among 1000 individuals, bempedoic acid in addition to statin therapy was estimated to save 122 (discounted) years of life and 103 (discounted) QALYs compared with statin therapy alone. At an acquisition cost of AU$584.40 per year (USD$397.01), bempedoic acid would be considered cost-effective within the Australian setting, with an incremental cost-effectiveness ratio of AU$49,890 per QALY gained (USD$33,893) and AU$42,433 per year of life saved (USD$28,827). Bempedoic acid may be cost-effective within the Australian health care setting at an annual acquisition price less than $600.

ANALISIS IMPLEMENTASI PSAK 105 AKUNTANSI PEMBIAYAAN MUDHARABAH PADA BANK MUAMALAT CABANG BANDA ACEH

This study aims to find out how the mudharabah financing mechanism at Bank Muamalat Banda Aceh and whether the application of mudharabah accounting treatment at Bank Muamalat Banda Aceh is in accordance with PSAK 105. The research methodology used is a qualitative method using descriptive analysis techniques that provide an overview of the treatment mudharabah financing accounting at the Bank Muamalat Banda Aceh. The results of the analysis state that the accounting treatment of mudharabah financing at the Bank Muamalat Banda Aceh has been carried out well because the recording of transactions has been carried out in accordance with Financial Accounting Standards. However, at the beginning of the application of accounting, the recognition of the mudharabah contract was not regulated in PSAK 105. However, at that time the Bank Muamalat Banda Aceh recognized it first as an obligation because there had not yet been capital surrender to mudharib. In the application of accounting when recognition of purchases for acquisition prices is not regulated in PSAK 105. Bank Muamalat Banda Aceh recognizes it as an additional inventory. Mudharabah financing procedures at Bank Muamalat Banda Aceh are quite good and thorough so as to minimize the risk of financing. Starting from the request for financing, BI checking, decisions, realization, monitoring up to repayment to the bank as the owner of the funds