Average Cost Research Articles

ORGANIZATION OF DELIVERY OF THE COMPANY'S PRODUCTS BY OWN VEHICLES

Purpose. The purpose of the work is the formation and analysis of options for the organization of the delivery of the machine-building enterprise's products by its own vehicles. Methodology. The main stages of choosing a rational technology for the organization of product transportation by own transport based on the developed schedules have been formed. The research was performed on the basis of the analysis of graphs of the dependence of motor vehicle operation indicators on the technology of organizing the transportation of the company's products. Findings. The article develops and analyzes work schedules for the delivery of the company's products by tractor-trailer trucks with semi-trailers. According to the schedules, the duration of delivery of one product in a ready-to-install condition to the consignee, the maximum possible annual volumes of transportation, the maximum and actual average annual operating costs for the delivery of the company's products by its own vehicles are determined. Practical value. The results of the research can be used to make a decision on the expediency of refusing the services of logistics companies to organize the delivery of the company's products to customers.

Estimation of lifetime costs for patients receiving a transplant: the case of liver transplantation related to hepatitis B in Italy.

In Italy, post-liver transplant (LT) hepatitis B virus (HBV) reinfection prophylaxis is frequently based on a combined regimen of anti-HBV immunoglobulin (HBIG) and oral antivirals. However, little information is available at the national level on the cost of LT and the contribution of HBV prophylaxis. This study aimed to quantify the direct healthcare cost for adult patients undergoing LT for HBV-related disease over a lifetime horizon and from the perspective of a National Healthcare Service. A pharmaco-economic model was implemented with a 4-tiered approach consisting of 1) preliminary literature research to define the research question; 2) pragmatic literature review to retrieve existing information and inform the model; 3) micro-simulated patient cycles; and 4) validation from a panel of national experts. The average lifetime healthcare cost of LT for HBV-related disease was €395,986. The greatest cost drivers were post-transplant end-stage renal failure (31.9% of the total), immunosuppression (20.6%), and acute transplant phase (15.8%). HBV reinfection prophylaxis with HBIG and antivirals accounted for 12.4% and 6.4% of the total cost, respectively; however, lifetime HBIG prophylaxis was only associated with a 6.6% increase (~€422 k). Various sensitivity analyses have shown that discount rates have the greatest impact on total costs. This analysis showed that the burden of LT due to HBV is not only clinical but also economic.

Location Selection Methods for Urban Terminal Co-Distribution Centers with Air–Land Collaboration

Urban terminal logistics and distribution enterprises face the problems of duplicated network layouts, high costs, and inefficient urban environments. Recently, collaborative distribution using unmanned aerial vehicles (UAVs) and ground vehicles has been considered as a means of reducing costs and enhancing efficiency, thus overcoming the issues created by the high-density layout of enterprises’ relatively independent networks. This essentially involves constructing an air–ground collaborative common distribution network. To optimize the economic cost and distribution time of network operations, we established a site selection planning model for air–ground cooperative urban co-distribution centers and designed a solution method based on gray wolf optimization with K-means clustering. Taking the Wangsheren area of Jinan City, China, as an example, 15 UAV co-distribution centers and 13 vehicle co-distribution centers were identified. Although the average distribution cost of the network rose by 35–50% compared to traditional terminal distribution, the time saving was 80–85%, greatly improving the high-value-added service capacity. The end-distribution efficiency and customer satisfaction were also enhanced, which fully verifies the feasibility, validity, and applicability of the proposed model. Our approach can be applied to landing sites and the planning and optimization of large-scale commercial operations using logistics UAVs in urban areas.

A Nationwide Study on the Risks of Complications and Healthcare Costs of Snakebite Envenomation in Taiwan.

In Taiwan, six medically important venomous snakes, Trimeresurus stejnegeri stejnegeri, Protobothrops mucrosquamatus, Deinagkistrodon acutus, Daboia siamensis, Naja atra, and Bungarus multicinctus, are found. However, comprehensive research on the complications and associated healthcare costs of snakebite envenomation (SBE) is lacking. We retrospectively analyzed pertinent information from the Taiwan National Health Insurance Research Database dated January 2002 to December 2014. We investigated the risk factors for complications and their impact on healthcare costs. Among the 12,542 patients with SBE, those from N. atra or B. multicinctus were more likely to experience wound infections and neurological complications than were those from T. s. stejnegeri or P. mucrosquamatus. In addition, being female, being elderly, and having a Charlson Comorbidity Index equal to or greater than 3 points were associated with an increased likelihood of wound infections and psychological complications. The annual national economic burden averaged US$1,083,624, with an average healthcare cost of US$1,129 per SBE. Snakebite envenomations from N. atra or B. multicinctus, as well as various complications, resulted in significantly higher costs. It is crucial to comprehend the risk factors for complications and their role in increasing expenses to provide insight for tailored healthcare interventions, mitigate complications, and reduce the economic burdens associated with SBEs.

Efficacy, Safety, and Pharmacoeconomic Evaluation of Injectable Spearhead Pit Viper Hemagglutinin in Local Hemostatic Treatment of Non-Ruptured Upper Gastrointestinal Bleeding

Objective: To evaluate the efficacy, safety, and drug affordability of injectable spearhead pit viper hemagglutinin (TTP) in the local hemostatic treatment of non-ruptured upper gastrointestinal bleeding, and to provide an evidence-based reference for its rational clinical application. Methods: 80 cases of acute non-variceal upper gastrointestinal bleeding patients admitted to the hospital from October 2022 to April 2023 were screened as research subjects, and divided into a control group and a research group, both including 40 patients. The control group was selected to give hemostatic treatment for endoscopic bleeding foci according to the condition in endoscopic operation by clamping and coagulation, while the research group was selected to provide local hemostatic treatment for non-ruptured bleeding foci in endoscopic operation. The study group was given hemostatic treatment to endoscopic bleeding foci during endoscopic operation according to the condition (endoscopic spraying hemostasis or submucosal injection hemostasis). The study observed and analyzed the effectiveness, adverse reactions, as well as hospital stay, and cost of the patients in the two groups. Results: The total effective rate of hemostasis in the control group was 75.00%, and the total effective rate of hemostasis in the study group was 95.00%, which was significantly better than that in the control group (P < 0.05). The incidence rate of adverse events in patients in the experimental group was 5.00%, while that in the control group was 7.50%, and the difference between the two groups was not statistically significant (P > 0.05). The hospital stay in the patients in the study group was 3.02 ± 1.41 days, and the average hospitalization cost was 5274.89 ± 1691.21 yuan, both of which were significantly lower than 5.93 ± 1.43 days, and 11220.12 ± 3202.14 yuan in the control group, and the difference was statistically significant (P < 0.05). Conclusion: TTP, as a new type of hemostatic agent, can significantly improve the efficacy of upper gastrointestinal bleeding and has good affordability, so it can be considered for promotion and application in the clinic.

Cabozantinib use in second or subsequent line of treatment in renal cell carcinoma: an analysis of Italian administrative databases.

Cabozantinib use in everyday clinical practice for advanced or metastatic renal cell carcinoma (RCC) is relatively recent, and real-world data on treatment persistence, adherence and sequencing are still limited. We conducted an analysis based on an integrated administrative database, covering around 6.9 million health-assisted Italian individuals, to explore the use of cabozantinib for RCC. Patients with at least one prescription for cabozantinib during 2017-2020 were searched. These were characterized during all available period (i.e. from 2010 onwards) before the index date and were observed after inclusion. A total of 113 patients treated with cabozantinib in second or subsequent line were included, and their demographic, clinical and treatment characteristics were described. About half of these RCC patients were aged >65 years (47.8%). Sixty patients (53.1%) were highly adherent to cabozantinib therapy, and the median cabozantinib treatment duration of use was 8.7 months (95% confidence interval: 5.8-11.1). During the first year of follow-up, the average total cost per patient was €32,508. We described second or subsequent line cabozantinib treatment for RCC in a real-world setting and the economic burden of disease in Italy, taking advantage of large, integrated administrative databases.

Economic Evaluation of Using Ultracapacitors in Electric Vehicles

The main challenge of hybridizing ultracapacitors (UCs) with batteries in electric vehicles is their uncertain economic viability, besides their complexity and weight, which should be fully addressed. Therefore, this article determines the general condition for achieving a justified economic system, which is held when the average annual cost (AAC) of a battery‐UC system over a vehicle's useful life is lower than the annual cost of a sole‐battery for a specific system design, energy management strategy, vehicle type, and driving style. As such, the energy storage system is designed in a case study vehicle, and the optimal current distribution is found by dynamic programming (DP) under UDDS, HWFET, and US06 driving cycles. Then, by economic analysis, it is indicated that although adding an UC incurs additional costs, it saves the AAC by improving the battery health and prolonging its lifespan up to a maximum of 15‐year calendar life, which proves its economic justification. Investing in UCs is more economically viable for vehicles with severe driving cycles and high current stress. Finally, the DP optimal trajectory is implemented into an experimental setup under the US06 driving cycle to verify the evaluated strategy.

Sustainability of Production in Melon Growing Farms: The Case of Hatay Province

The aim of this study is to reveal the functioning and sustainability of melon producing farms in Hatay province. In the research, a face-to-face survey was conducted with 50 melon farmers in Hatay province. Additionally, the problems and disruptions encountered in melon production were identified in the study. Female labor is used extensively in melon production. In 2022, it was determined that women working in melon cultivation work for a daily wage of ₺150 (approximately $9). In 2021, 1 638 638 tons of melons were produced in an area of 668 753 ha in Türkiye. In Hatay, 32 537 tons of melons were produced from 13 230 decares of cultivation area. In addition, Kırıkhan melon received a geographical indication. Kırıkhan melon is a product that attracts attention in terms of taste and aroma. Melon prices follow a fluctuating trend during the production season. Input costs are also a serious problem in melon production. The average melon production cost was ₺10692 (approximately $590) for 1 decare. High costs threaten the sustainability of small family farms in production. As a result, farmers need to be supported and encouraged for production. Otherwise, melon production will be abandoned by small family farms. In this regard, it is important to increase training and publication activities.

A location-production-routing problem for distributed manufacturing platforms: A neural genetic algorithm solution methodology

Additive Manufacturing (AM) enhances the flexibility of manufacturing networks. In this paper, we present a Location-Production-Routing (LPR) problem designed for a distributed manufacturing platform, where the manufacturing facilities are distributed in different locations with the support of AM technologies. The proposed LPR problem encompasses three different types of decisions: location-allocation, production planning, and product delivery routing decisions. This is one of the first studies that analyzes integrated logistics and manufacturing optimization under distributed and resilient manufacturing platforms. To efficiently solve the complex problem, we design a novel solution method called the Neural Genetic Algorithm (NGA). The numerical experiments show that the proposed method can attain near-optimal solutions, achieving an average gap of 3% with a standard deviation of 1.4% and a 99% improvement in computational time compared to the CPLEX solver. The sensitivity analysis illustrates the high impact of the unit shortage cost on the customer service level and on the distribution of the AM facilities. Moreover, our results for a given instance show that through the periodic reconfiguration of AM supply chains using the proposed LPR model, we can achieve an average cost reduction of up to 25% in the supply network.

Implementation, intervention, and downstream costs for implementation of a multidisciplinary complex pain clinic in the Veterans Health Administration.

To determine the budget impact of implementing multidisciplinary complex pain clinics (MCPCs) for Veterans Health Administration (VA) patients living with complex chronic pain and substance use disorder comorbidities who are on risky opioid regimens. We measured implementation costs for three MCPCs over 2 years using micro-costing methods. Intervention and downstream costs were obtained from the VA Managerial Cost Accounting System from 2 years prior to 2 years after opening of MCPCs. Staff at the three VA sites implementing MCPCs were supported by Implementation Facilitation. The intervention cohort was patients at MCPC sites who received treatment based on their history of chronic pain and risky opioid use. Intervention costs and downstream costs were estimated with a quasi-experimental study design using a propensity score-weighted difference-in-difference approach. The healthcare utilization costs of treated patients were compared with a control group having clinically similar characteristics and undergoing the standard route of care at neighboring VA medical centers. Cancer and hospice patients were excluded. Activity-based costing data acquired from MCPC sites were used to estimate implementation costs. Intervention and downstream costs were extracted from VA administrative data. Average Implementation Facilitation costs ranged from $380 to $640 per month for each site. Upon opening of three MCPCs, average intervention costs per patient were significantly higher than the control group at two intervention sites. Downstream costs were significantly higher at only one of three intervention sites. Site-level differences were due to variation in inpatient costs, with some confounding likely due to the COVID-19 pandemic. This evidence suggests that necessary start-up investments are required to initiate MCPCs, with allocations of funds needed for implementation, intervention, and downstream costs. Incorporating implementation, intervention, and downstream costs in this evaluation provides a thorough budget impact analysis, which decision-makers may use when considering whether to expand effective programming.

Incidence of anastomotic leakage using powered circular staplers versus manual circular staplers for left colorectal anastomosis: a cost-effectiveness analysis

BackgroundColorectal anastomotic leakage causes severe consequences for patients and healthcare system as it will lead to increased consumption of hospital resources and costs. Technological improvements in anastomotic devices could reduce the incidence of leakage and its economic impact. The aim of the present study was to assess if the use of a new powered circular stapler is cost-effective.MethodThis observational study included patients undergoing left-sided circular stapled colorectal anastomosis between January 2018 and December 2021. Propensity score matching was carried out to create two comparable groups depending on whether the anastomosis was performed using a manual or powered circular device. The rate of anastomotic leakage, its severity, the consumption of hospital resources, and its cost were the main outcome measures. A cost-effectiveness analysis comparing the powered circular stapler versus manual circular staplers was performed.ResultsA total of 330 patients were included in the study, 165 in each group. Anastomotic leakage rates were significantly different (p = 0.012): 22 patients (13.3%) in the manual group versus 8 patients (4.8%) in the powered group. The effectiveness of the powered stapler and manual stapler was 98.27% and 93.69%, respectively. The average cost per patient in the powered group was €6238.38, compared with €9700.12 in the manual group. The incremental cost-effectiveness ratio was − €74,915.28 per patient without anastomotic complications.ConclusionThe incremental cost of powered circular stapler compared with manual devices was offset by the savings from lowered incidence and cost of management of anastomotic leaks.

Link-based full cost analysis of travel by automobile

This paper develops a link-based full cost model for auto travel, which identifies both internal and external costs of travel, and gives a link-based cost estimate for the Minneapolis – St. Paul (Twin Cities) metropolitan region. The key cost components are time, emissions, crashes, user monetary, and infrastructure. The estimates show that the average full cost of travel is a $0.694/veh-km traffic-weighted average over the study area, of which the time and user monetary costs account for approximately 70% of the total. Except for the infrastructure cost, highways are more cost-effective than other surface roadways considering all the other cost components, as well as the internal and full costs. Quantifying the full costs of auto travel is essential for making sustainable investments.

Ensuring energy security: situating the Bay of Bengal in cooperative architecture narrative

ABSTRACT In today’s world, the concept of security is incomplete without the concept of energy security. Unless a country has access to uninterrupted flow of energy resources, its massive stockpile of weapons and ammunition is unlikely to keep it safe. Therefore, contemporary security studies include concerns about energy security as one of the key components of non-traditional security issues. Ensuring free access to energy for all – is a top priority in the BIMSTEC region. Trans-border cooperation can help diversify energy sources, reduce average supply costs, and meet peak demands as the gap between supply and demand grows in BIMSTEC countries. The paper examines the current energy scenario in BIMSTEC, evaluates the scope of cross-border energy trade in the region. Energy security and maritime security are intertwined with each other in today’s world. The paper also addresses the broader geopolitical, geostrategic, and geoeconomic aspects of the Bay of Bengal, illustrating how maritime security is integral to ensuring energy security in the region.

Examining the Effect of 2023 Cash Crunch on the Poultry Egg Industry in Ogun State, Nigeria

Abstract This study examines the effects of the 2023 cash crunch on the poultry egg industry in Ogun State, Nigeria. Data from 64 poultry egg farmers were collected and analyzed via structured e-questionnaires. Results show 83% of respondents were small-medium scale farmers and 73% used commercial feeds. Total egg production before (12,210 crates) and during the cash crunch (12,391 crates) did not significantly differ. Average feed cost per bag was ₦7,097 before and ₦7,151 during the crunch. However, average sales of 2,213,867 crates before and 199,437 crates during the cash crunch differed. A 36% cumulative decrease in egg price from ₦2,472 (December 2022) to ₦1,587 (March 2023) led to an 83% drop in daily farm revenue. The price fall did not boost egg demand. Coping strategies included increased delivery to customers (18%), gifting eggs (56%), and selling poultry birds (25%). The study recommends government grants and review of loan tenure for farmers while encouraging collaborative egg processing efforts. Additionally, it underscores the need for animal science research to explore methods for temporarily halting egg laying during economic challenges.

Sales Revenues for New Therapeutic Agents Approved by the United States Food and Drug Administration From 1995 to 2014

ObjectivesThis study aimed to analyze worldwide sales of new therapeutic agents and to estimate the time it takes for product sales to exceed industry-wide average drug development costs. MethodsData obtained from company reports were analyzed to track worldwide sales of new medicines approved by the US Food and Drug Administration from 1995 to 2014. All sales figures were reported in 2019 US dollars. Kaplan-Meier curves were used to evaluate the time it took for discounted product sales to exceed the average costs associated with developing 1 new drug (accounting for the costs of failed trials), using published estimates of these costs. ResultsBased on data for 361 of 558 new therapeutic agents approved over the study period (median follow-up 13.2 years), mean sales revenue per product was $15.2 billion through the end of 2019; the median was $6.7 billion. These products jointly generated global sales of $5.5 trillion since approval. Revenues were highly skewed, with the 25 best selling products (7%, 25 of 361) accounting for 38% of this amount ($2.1 trillion of $5.5 trillion). Approximately 47% of products had discounted sales that exceeded the estimated industry-wide average costs of development within 5 years of approval, and 75% within 10 years. After attributing potential production, marketing, and other costs, these numbers dropped to 21% of products within 5 years of approval, and 46% within 10 years. ConclusionsSales of new medicines approved from 1995 to 2014 were highly skewed, but many products had net discounted sales that exceeded the industry-wide average costs of development within 10 years of approval. An understanding of how sales revenues accrue in the years after initial approval, alongside data on business costs, can inform discussions about how to incentivize private investment in innovation while ensuring affordable prices for patients and the healthcare system.

Cost-Outcome of Radiotherapy for Local Control and Overall Survival Benefits in Breast Cancer

PurposeRadiotherapy (RT) is an integral component in the treatment of breast cancer. The aims of this study were to estimate the cost per 5-year Local Control (LC) and Overall Survival (OS) benefits of the first course of RT, based on breast cancer stage, and the potential cost savings with adoption of the FAST-Forward protocol. Methods and MaterialsAll RT activities for breast cancer RT July 2017-June 2020 and their associated costs were consolidated together. The average cost of treatment course was calculated (average cost per fraction X average no. of fractions). Cost per outcome was estimated based on published gains in 5-year LC and OS with optimal use of radiotherapy. Results481 patients with breast cancer were analysed. The average cost per fraction was $285 AUD (£148 GBP) for all stages. The average costs for 5-year LC and OS gain were $31,483 AUD (£16 392 GBP) and $235,435 AUD (£122 566 GBP) respectively for all stages.The estimated costs for 5-year LC outcomes were $29,675 AUD (£15 450 GBP), $34,675 AUD (£18 053 GBP) and $32,478 AUD (£16 910 GBP) for Stage I-III respectively. The estimated costs for 5-year OS were $455,909 AUD (£237 378 GBP), $532,727 AUD (£ 277 375 GBP) and $60,717 AUD (£31 614 GBP) for Stage I-III respectively.266 patients had characteristics that made them eligible for the FAST-Forward protocol. A cost saving of $2592–3864 AUD (£1350–2012 GBP) per patient was estimated had these patients been treated with the protocol. ConclusionsThe cost of RT for LC outcome is similar across stages. The greatest value for OS outcome was seen in patients with Stage III breast cancer, due to the greater survival benefit with RT in these patients compared with Stage I-II breast cancer. Significant cost savings can be made by implementing the FAST-Forward protocol.

The cost-effectiveness of reusable flexible ureteroscopes: An institutional audit.

A flexible ureteroscope (FU) is an important tool in the urologist's armamentarium. This study aims to check the durability and cost-effectiveness of conventional FU. The institution registry of damaged FU over the last 7 years was reviewed. A total of 17 flexible scopes were used. The data of 13 scopes (11 Storz fiberoptic and 2 Seesheen digital) are included in this study. A total of 1905 cases were performed. The cost of scope, duration of use, number of cases done by each scope, and nature of damage were evaluated. We compared the cost-effectiveness of conventional scopes with published costs on disposable scopes. The mean number of cases done by fiberoptic scope was 159 (range 25-334). The total cases done by 2 digital scopes were 135 and 25. The mean life of fiberoptic and digital scopes was 17 (range 4-31) and 8 months, respectively. The mean cost of fiberoptic scope was Indian Rupee (INR) 338,951 ($4082.7221) and INR 525,000 ($6323.7138) for digital scope. The cost per case for reusable scope is calculated by dividing the mean cost of FU by the mean number of cases done. The reprocessing cost of INR 527 was then added. Thus, the average cost per procedure for fiberoptic and digital FU was INR 2658.76 and INR 7089.50, respectively. We compared this cost with a projected cost of disposable FUbased on today's market data, which ranged from INR 60,000 to 107,427. The reusable scopes are durable, cost-effective, and an excellent option for high case-load institutions.

An Economic Evaluation of Family-Based Versus Traditional Helicobacter pylori Screen-and-Treat Strategy: Based on Real-World Data and Microsimulation Model.

There is an economic evaluation on the family-based Helicobacter pylori screen-and-treat strategy (FBHS) in China. This study aimed to compare the cost-effectiveness of the FBHS with the traditional H. pylori screen-and-treat strategy (TBHS). A seven-state microsimulation model, including H. pylori infection and gastric cancer states, was constructed on the basis of the target family samples from 29 provinces in China. Taking a lifetime horizon from a healthcare system perspective, the long-term costs and health outcomes of the FBHS and TBHS screening strategies were simulated separately, and economic evaluations were performed. The model parameters were primarily derived from real-world data, published literature, and expert opinions. The primary outcome was the incremental cost-effectiveness ratio (ICER) expressed as cost/quality-adjusted life-year (QALY) gained. One-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis were performed to assess the uncertainty of the results. The base-case analysis revealed that the average costs for FBHS and TBHS were 563.67 CNY and 574.08 CNY, respectively, with corresponding average QALYs of 14.83 and 14.79. The ICER for the comparison between the two strategies was -214.07, indicating that FBHS was an absolutely dominant strategy with better cost-effectiveness. The results of both one-way sensitivity analysis and probabilistic sensitivity analysis were robust. When taking into account the added benefit of the higher H. pylori eradication rate in FBHS, the average costs were further reduced, and the average QALYs were increased, solidifying its position as an unequivocally dominant strategy. The FBHS is an absolutely dominant and cost-effective strategy that enables an optimized allocation of screening resources. Decision-makers should prioritize FBHS when developing H. pylori prevention and control strategies.

Assessment of Direct Medical Cost of Hospitalized COVID-19 Adult Patients in Kuwait During the First Wave of the Pandemic.

This study aims to estimate the direct medical cost of COVID-19 hospitalizations and to utilize prevalence estimates from Jaber Al-Ahmad Hospital to estimate the direct medical cost of all hospitalized adult patients in Kuwait using a decision tree analysis. A cost-of-illness model was developed. The Ministry of Health perspective was considered, direct medical costs were estimated from July 1st to September 30th, using a bottom-up approach. The mean cost per hospitalized patient was estimated using a decision analysis model. Prevalence estimates of ambulance use, use of ER, ICU admission, and mortality were considered in the current study. Patients aged 18 years and above with a confirmed diagnosis of COVID-19 were included. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were performed. Data for 2986 patients were analyzed. The mean age was 61 (SD= 11) years old. Most of the patients were Kuwaiti (2864, 95.91%), and more than half were females (1677, 56.16%). Of the total hospital admissions, 417 patients (14%) were admitted to the ICU. The average length of the hospital stay was 11 (SD= 9) days, and among all hospital admissions, 270 (9.04%) patients died. The total estimated direct medical cost of hospitalized patients at Jaber Al-Ahmad Hospital was $47,213,768 (14,283,203.6 KD). The average cost of hospital stay per patient was estimated at $15,498 (4,688.60 KD). The weighted average cost per hospitalized patient in Kuwait was estimated at $16,373 (4,953.08 KD). The total direct medical cost of hospitalized COVID-19 patients in Kuwait during the study period was estimated at $174,372,450 (52,751,502 KD). The COVID-19 pandemic constituted a significant burden on the Kuwaiti healthcare system. The findings of this study urge the need for preventive care strategies to reduce adverse health outcomes and the economic impact of the pandemic.

Pancreatic enzyme replacement therapy and resource utilization in patients with chronic pancreatitis in a US healthcare system: a retrospective study.

To assess the association between pancreatic enzyme replacement therapy (PERT) and resource utilization among patients with chronic pancreatitis (CP) in a large Midwestern US healthcare system. This retrospective cohort study used electronic medical record data. Eligible patients (N = 2445) were aged ≥18 years and diagnosed with non-cystic fibrosis CP between January 2005 and December 2018, with ≥6 months' follow-up; study initiation was first encounter with the healthcare system. Patients in the PERT group were prescribed PERT at ≥1 encounter; patients in the non-PERT group were not prescribed PERT at any encounter. In total, 62,899 encounters were reviewed (PERT, n = 22,935; non-PERT, n = 39,964). More patients in the PERT group were younger, male, White, married/partnered and with private insurance than those in the non-PERT group. They also received longer care and had more overall encounters, fewer outpatient and day surgery/24-hour observation encounters, and more inpatient encounters. Emergency room encounters were similar between groups. Average cost by encounter was similar between groups ($225 and $213, respectively). Despite similar average costs per encounter, the groups had very different encounter types. More inferential research on PERT use among patients with CP is needed, particularly regarding resource utilization and long-term outcomes.