Cost Comparison Research Articles

Economic evaluation of percutaneous cryoablation vs conventional surgery in extra-abdominal desmoid tumours in the Spanish healthcare system

BackgroundDesmoid tumours (DTs) or deep fibromatosis are benign soft-tissue tumours, sometimes locally aggressive, requiring intervention on some cases. Surgery has been the gold standard, but new less invasive techniques such as percutaneous cryoablation have proved their effectiveness, reducing health resources and complications. The study aimed to compare the total cost of percutaneous cryoablation and conventional surgery for patients with extra-abdominal and/or abdominal wall DTs, candidates for local ablative treatment in Spain.MethodsA cost-analysis model was developed. An expert panel provided data about resource consumption for the percutaneous cryoablation technique and validated the epidemiology used for target population estimation. Unitary resources cost (€ 2022) derived from local cost databases. A retrospective analysis of 54 surgical cases in 3 Spanish hospitals was performed to estimate the cost of conventional surgery based on the cost of the Diagnosis-Related group (DRG) codes identified on this patient sample, weighted by each DRG proportion. The total cost for each alternative included intervention cost and complications cost, considering debridement required in 4.5% of cases with percutaneous cryoablation and minor surgery for surgical site infection in 18.0% for conventional surgery.ResultsThe total cost for percutaneous cryoablation (€ 5774.78/patient-year) was lower than the total cost for conventional surgery (€ 6780.98/patient-year), yielding cost savings up to € 80,002 in 1 year for the entire cohort of 80 patients with DTs eligible for intervention estimated in Spain. One-way sensitivity analyses confirmed the results’ robustness.ConclusionPercutaneous cryoablation versus conventional surgery would yield cost savings for the management of DT patients in Spain.Critical relevance statementThis manuscript provides insight into the economic impact derived from the savings related to the use of percutaneous cryoablation for desmoid-type tumours from the perspective of the Spanish National Healthcare System, providing useful information for the health decision-making process.Key points• Desmoid tumours are locally aggressive and may require local therapy.• Percutaneous cryoablation procedure is less invasive than the conventional surgery.• Cost comparison shows savings associated to percutaneous cryoablation use.Graphical

Comparison of early postoperative outcomes for breast conservative surgery and modified radical mastectomy in breast cancer in a tertiary hospital: A prospective observational study

Breast cancer is the most common malignant tumour in women in the world, with an incidence of 13.5% in India. For patients diagnosed with breast cancer, surgical options include breast conserving therapy (BCT) or modified radical mastectomy (MRM). This study aims to compare early post-operative complications in carcinoma breast patients undergoing MRM vs BCS at a tertiary care center in India. Patients undergoing BCS and MRM for carcinoma breast were prospectively studied over an 18-month period and postoperatively followed up for 3 months. Incidence of early post-operative complications such as seroma, flap necrosis, wound dehiscence and quality of life (QOL) were compared between the two groups. 106 patients were included in this study, of which 75 underwent MRM and 31 underwent BCS. There was no significant difference noted between these two groups with respect to the following; seroma formation (16.1% BCS vs. 13.3% MRM; p value =0.710), flap necrosis (3.2% vs. 2.7%; p value =0.87), wound dehiscence (3.2% vs. 5.3%; p value =0.63), wound infection (6.5% vs. 5.3% p value =0.823), average number of days of lymphorrhoea (15 ±9.76 vs. 15.7 ±7.49) and QOL post-surgery. Comparison of cost (> Rs.50,000) showed that expense of surgical treatment was significantly higher in MRM (24.0%) compared to BCS (9.7%). Early postoperative complications seen in BCS and MRM are comparable, with the most common early complication being seroma and lymphorroea. Patients should be educated regarding breast conservative surgery, its comparable results with MRM and social and physical impact irrespective of age and menstrual status.

Strategies to reduce out-of-pocket medication costs for Canadians with peripheral arterial disease.

Given that peripheral arterial disease (PAD) disproportionately affects people of lower socioeconomic status, out-of-pocket expenses for preventive medications are a major barrier to their use. We carried out a cost comparison of drug therapies for PAD to identify prescribing strategies that minimize out-of-pocket expenses for these medications. Between March and June 2019, we contacted outpatient pharmacies in Hamilton, Ontario, Canada, to assess pricing of pharmacologic therapies at dosages included in the 2016 American College of Cardiology/American Heart Association guideline for management of lower extremity PAD. We also gathered pricing information for supplementary charges, including delivery, pill splitting and blister packaging. We calculated prescription prices with and without dispensing fees for 30-day brand-name and generic prescriptions, and 90-day generic prescriptions. Twenty-four pharmacies, including hospital-based, independent and chain, were included in our sample. In the most extreme scenario, total 90-day medication costs could differ by up to $1377.26. Costs were affected by choice of agent within a drug class, generic versus brand-name drug, quantity dispensed, dispensing fee and delivery cost, if any. By opting for prescriptions for 90 days or as long as possible, selecting the lowest-cost generic drugs available in each drug class, and identifying dispensing locations with lower fees, prescribers can minimize out-of-pocket patient medication expenses. This may help improve adherence to guideline-recommended therapies for the secondary prevention of vascular events in patients with PAD.

Comparison of Costs, Re-Intervention Rates, and Length of Hospital Stay for Three Uterus Sparing Interventions for Uterine Fibroids: A 2-Year Retrospective Claims Analysis.

To describe two-year post-operative outcomes, and healthcare utilization of three uterus-sparing interventions used to treat women with intramural and/or subserosal uterine fibroids. This was a post-market, randomized, prospective, multi-center, longitudinal, interventional, and comparative clinical study to evaluate the costs and health outcomes of LAP-RFA vs the standard uterine conserving technologies (myomectomy and UAE) for the treatment of symptomatic uterine fibroids in women who desire uterine conservation. For this RCT study, 54 subjects were randomized on a 1:1 ratio across the three procedures and followed out to two years. Their results were compared to retrospective US insurance claims from the IBM MarketScan® Commercial Database from 2017-2020 for 96,854 women who underwent a uterus-sparing procedure for fibroids. Mean ambulatory surgical center costs and the mean out-patient hospital costs were lowest for LAP-RFA ($13,134 and $14,428) and highest for UAE ($28,214 and $19,131). The total two-year re-intervention rate of any subsequent procedure (AM, LM, LAP-RFA, or UAE) was lowest in AM group (0%) followed by LM (4.2%), LAP-RFA (11%), and UAE (33%). Mean peri-operative reintervention costs and the mean reintervention total costs were $2429 and $5939 for LAP-RFA, $2122 and $8368 for LM, $4410 and $11,942 for AM, and $8113 and $46,692 for UAE subjects. In the RCT study, the average length of hospital stay was significantly less for the LAP-RFA group subjects (8.2 hours) in contrast to both the laparoscopic myomectomy group subjects (16.0 hours) and the abdominal myomectomy group subjects (33.6 hours). Despite the small numbers, two-year reintervention rates followed a similar pattern as the IBM MarketScan data. In comparing these three non-invasive approaches, LAP-RFA was associated with the lowest peri-operative cost, and UAE was associated with the highest peri-operative cost. Further studies are needed to assess the cost, effectiveness, and subject satisfaction with each procedure.

Sustainable Packaging Design using Life Cycle Thinking

This research examines environmental impact data, sustainable packaging qualities, consumer feedback surveys, and price comparisons to draw important findings. Research focuses on “Packaging Sustainability Revolution: Life Cycle Thinking Reveals Eco-Friendly Innovations.” This research examines sustainable packaging design evolution. Life cycle analysis (LCA) showed that packaging materials had an average carbon footprint of 120 grams of CO2 per unit and a 60% recycling rate. This shows the diverse environmental impacts of packing options. A study of sustainable package design shows that individuals have preferences. The favorability of biodegradable, recyclable, and minimalist packaging increased significantly. In subjective consumer feedback surveys, Packaging A and Packaging B scored 8.3 and 8.7 total satisfaction. In contrast, Packaging C and D do well. The cost increases among models in Cost comparisons expenditures show the economic effects of sustainable design. This emphasizes the tight balance between consumer satisfaction and sustainable practices' economic sustainability. The empirical findings improve scholarly discourse on life cycle thinking in Cost comparisons by revealing the sustainability variables driving the Packaging Sustainability Revolution.

УПРАВЛЕНИЕ ЭФФЕКТИВНОСТЬЮ ПРОЕКТНЫХ РЕШЕНИЙ С ПОМОЩЬЮ КОЭФФИЦИЕНТА КОММЕРЦИАЛИЗАЦИИ

The article evaluates the impact of technical and economic indicators of projected residential buildings on the unit costs per square meter of the sold area. The commercialization coefficient (hereinafter Cc) is one of the indicators characterizing the rationality of design decisions. Its purpose is to assess the effectiveness of design solutions in terms of commercial use of the area of a residential building. For this purpose, the Qc for a building as a whole is defined as the ratio of the area of all sold premises to the area of a residential building. Since pricing and cost comparisons in the real estate market are linked to the price of one square meter of the area of the premises being sold, then evaluating the effectiveness of design solutions requires appropriate cost estimates in relation to the unit area of the premises being sold. However, for the purposes of benchmarking construction projects, it is more appropriate to link the cost of erecting a building to a unit area of a residential building, which is the basis for determining the construction volume of a residential building.

Estimating minimum dietary diversity for children aged 6-23 months: a comparison of agreement and cost of two recall methods in Cambodia and Zambia.

To compare the agreement and cost of two recall methods for estimating children's minimum dietary diversity (MDD). We assessed child's dietary intake on two consecutive days: an observation on day one, followed by two recall methods (list-based recall and multiple-pass recall) administered in random order by different enumerators at two different times on day two. We compared the estimated MDD prevalence using survey-weighted linear probability models following a two one-sided test equivalence testing approach. We also estimated the cost-effectiveness of the two methods. Cambodia (Kampong Thom, Siem Reap, Battambang, and Pursat provinces) and Zambia (Chipata, Katete, Lundazi, Nyimba, and Petauke districts). Children aged 6-23 months: 636 in Cambodia and 608 in Zambia. MDD estimations from both recall methods were equivalent to the observation in Cambodia but not in Zambia. Both methods were equivalent to the observation in capturing most food groups. Both methods were highly sensitive although the multiple-pass method accurately classified a higher proportion of children meeting MDD than the list-based method in both countries. Both methods were highly specific in Cambodia but moderately so in Zambia. Cost-effectiveness was better for the list-based recall method in both countries. The two recall methods estimated MDD and most other infant and young child feeding indicators equivalently in Cambodia but not in Zambia, compared to the observation. The list-based method produced slightly more accurate estimates of MDD at the population level, took less time to administer and was less costly to implement.

The Financial Burden of Guideline-recommended Cancer Medications for Metastatic Urothelial Carcinoma

Bladder cancer is a significant global health concern owing to its prevalence, negative impact on quality of life, and high treatment costs. Treatment for metastatic urothelial carcinoma (mUC) traditionally relies on platinum-based chemotherapy regimens. However, clinical trial results have led to the approval of immune checkpoint inhibitors (ICIs) as viable treatment options. We assessed the escalating costs and economic viability of mUC treatment guidelines in Europe. We used a pragmatic approach that involved: (1) collection of the costs of the recommended medications in the five most populous European countries; (2) conversion of the costs into international dollars to account for differences in purchasing power parity among countries; (3) evaluation of the cost trends over time; and (4) comparison of the medication costs to World Health Organization thresholds. Introduction of ICIs in European guidelines substantially increased the cost of medications for mUC. Intriguingly, important differences across European countries emerged: the annual cost of medications was twofold higher in Italy than in France and the UK. Despite limitations, our study sheds light on the escalating costs and economic challenges of mUC treatment, and highlights the need for assessments of sustainable and cost-effective management approaches. Patient summaryWe looked at the costs of treatments for metastatic bladder cancer and found that costs have been rising over time, especially with the introduction of new immune therapies, with notable differences among European countries. While these new treatments improve patient outcomes, they also come with a high price tag, which could strain health care budgets. Our results suggest that cost-effectiveness studies will be essential in determining the best and most sustainable treatment strategies in the future.

Импортоемкость регионов российской экономики

In the pre-sanction period, foreign economic relations in Russia were growing in importance. While the country’s gross domestic product increased by 1.75 times in 2013 compared to 2000, imports increased by 5.7 times in comparable prices during this period. Despite actual and potential effects of comparative advantages, the growing dependence on foreign markets also had negative consequences. The study assesses the demand for imported goods, considering the existing interindustry relations in the Russian economy. The paper describes the first stage of comparison of direct and total costs for the Russian economy and presents mathematical tools used to calculate indicators of its import dependence. In the future, we are planning to extend this approach to examine the spatial economy of two macrozones, namely, the European and Asian parts of Russia. Statistics show that the direct import intensity of the Russian economy is approximately 6 %, which is less than the global average. The vertical specialisation index of about 11 % indicates a relatively low dependence of the export of domestic goods on imports. In 2014–2020, total import costs reduced the most in the pulp and paper industry (-5 %) and vehicle manufacturing industry (-3 %) mainly due to a decline in their import intensity. In general, the impact of forced import substitution turned out to be negative for most regions after 2013. The proposed methods can be used to forecast the trade balance and consequences of implementing various import substitution policies. Since that intermediate consumption flows are included in indirect and total costs, it is advisable to develop a methodology accounting for investment goods.

Numerical studies of floor heave control by the rock bolts reinforcement technology in retained gob-side gateroad

The effectiveness of modified rock bolts reinforcement technology for floor heave control in gob-side entry retaining was studied in this paper. A finite-element numerical simulation was used to analyse stress-strain state of surrounding rocks before and after immediate floor reinforcement with six floor support schemes. It was found that after immediate floor reinforcement with rock bolts with diameter 32 mm and 96 mm, floor heave in retained gob-side gateroad reduces by 2.94 – 3.6 times respectively. The modification of rock bolt reinforcement scheme by the additional installation of piles in the entry corners was proposed. Piles installation significantly reduces the zone of horizontal and vertical post-peak strains in the gateroad floor. The best variant among compared ones is a floor support scheme with two corner piles, 1 m and 2 m long. With this scheme, floor heave decreases by 3.05 times. The comparison of the materials costs of the floor support schemes were performed. As a result, the most effective floor support scheme was proposed and prospects for the further progress of floor reinforcing technologies were outlined.

Transformacija solventne potražnje i potrošnje hrane u Ukrajini u uvjetima rata

The article is devoted to the assessment of the state and peculiarities of the formation of the solvent demand for food products in Ukraine during the war and the determination of the optimal amount of wages to ensure the consumption of the main set of food products at the level of rational standards. A comprehensive analysis of structural changes in the solvent demand for food consumption in Ukraine in the war was carried out using the monographic method. Determination of actual and aggregate costs at the level of rational standards for food products was carried out using the calculation-constructive method. The comparison of actual and necessary costs at the level of rational norms for nutrition was carried out on the basis of collected statistical and calculated data by the method of comparative analysis. It is recognized that the war has negative consequences in the nutrition of Ukrainians. During the first year of the war, the price affordability of food products decreased by 26.6% on average. In 2010-2022, the share of population spending on food remains very significant (from 51.6% in 2010 to 57.8% in 2022). In 2023, this indicator is expected to grow to 58.5%. It has been proven that in order to consume basic food products in accordance with rational norms, the population of Ukraine had to spend 1.56 times more in 2021 than the actual expenses. To achieve the level of consumption in accordance with rational standards in 2022, an additional 23,478 UAH per year, or 1,957 UAH per month, is needed. The forecast for 2023 predicts a deterioration of the ratio of actual food costs to costs under rational standards to 1.68. It was determined that in 2021 the wage level should be at least UAH 33,944 (EUR 1,131) per person per month, which is 2.41 times higher than the actual wage level in the country. The war worsened this ratio to 2.6. It was established that in 2023, for food at the level of rational consumption standards, a Ukrainian should earn 38,564 UAH (964 EUR per month), which is 2.9 times higher than the actual wage level (13,423 UAH or 335 EUR). The novelty of the study consists in the development and practical testing of the methodology for determining the optimal wage of Ukrainians to ensure the consumption of the main set of food products at the level of rational standards.

Understanding the adjustment functions of solitude from a lifespan development perspective: A five-round comparison of benefits and costs

Understanding the adjustment functions of solitude from a lifespan development perspective: A five-round comparison of benefits and costs

DFIG-Based WECS With Partial-Scale Converter: Efficiency, Cost, and Volume Comparison of SiC-Based and IGBT-Based Converter Solution

DFIG-Based WECS With Partial-Scale Converter: Efficiency, Cost, and Volume Comparison of SiC-Based and IGBT-Based Converter Solution

Cost and Time Comparison between Corrugated Foam Mortar Technology and Girders (Study Case on Martadinata Pamulang Flyover Project)

A flyover builds to solve traffic problems in several areas. Girder often uses in flyover construction, but the use of Corrugated Foam Mortar Pusjatan is relatively new in Indonesia. This study aims to compare the cost and time of flyover construction using two different methods, Corrugated Foam Mortar and Girder. The comparison did for the same structural length of flyover 983.5 m. As a result, The Corrugated Foam Mortar method costs Rp. 46,463,841,131.40 and needs 201 days for completion, while the Girder costs Rp. 71,313,005,779.77 and needs 436 days. Based on the results, the Corrugated Foam Mortar method is 34% cheaper about Rp. 24,849,169,648.37 and 54% faster, with a time difference of 235 days faster than the girders. The cause of the biggest cost difference is material cost.

Comparison of costs of bevacizumab, ranibizumab, and aflibercept in loading dose administration for diabetic macular edema treatment: Observational cost analysis

Comparison of costs of bevacizumab, ranibizumab, and aflibercept in loading dose administration for diabetic macular edema treatment: Observational cost analysis

Performance and Cost Comparison of Drive Technologies for a Linear Electric Machine Gravity Energy Storage System

Performance and Cost Comparison of Drive Technologies for a Linear Electric Machine Gravity Energy Storage System

Cost comparison for metadata driven graphical user interface

Cost comparison for metadata driven graphical user interface

VIABILITY OF CARDBOARD SPLINTS IN THE EMERGENCY MANAGEMENT OF LOWER LIMB FRACTURES

At Mbarara Regional Referral Hospital Uganda, 60% of all admissions are due to severe trauma, 30-35% of which are from tibia/fibular fractures. Emergency splinting of these fractures can be lifesaving and ideally, Plaster of Paris (P.O.P) is the gold standard. Improvised cardboard splints have replaced P.O.P, since they were more readily available and thought to be less expensive to apply especially during the covid 19 pandemic supply chain crisis. While anecdotal evidence exists dating since the First World War, scarce published works exist in measuring the clinical effectiveness of cardboard splints in comparison to P.O.P. The aim of this study was to find out if cardboard can be an effective and cheaper emergency alternative splint to P.O.P especially during the supply chain crises frequent in low resource environments. A prospective, experimental, cadaveric study was done where 44 open tibia-fibular fractures were splinted with both cardboard and P.O.P. The clinical effectiveness of cardboard and P.O.P splints was found through the measurement of immobilization at a fracture site via the use of 5 angular and 9 linear measurements. Cost comparisons of the splint were also done. Cardboard proved to be the non-inferior splint in 9 of the 14 measures of effectiveness. In the other 4 measures, no statistically significant differences were seen, while P.O.P was superior in 1 measurement. Cardboard proved to be the least expensive splint. During extreme shortages, cardboard could be considered as an emergency material for adequate splinting of lower limb fractures.

Centralized and decentralized payments networks: a simple cost comparison

Centralized and decentralized payments networks: a simple cost comparison

Profit comparison analysis in production system simulation based on lean principles to achieve sustainable manufacturing

Companies can achieve effective and efficient process if they make continuous improvements to achieve sustainability. In general, companies are aware of waste in the production process, but do not carry out measurements and analyzes related to this waste, including unit cost and profit analysis. A production system is needed that is able to minimize the unit costs and maximize profits in the company, one of the concepts used is the lean concept. This study aims to analyze the cost unit and profit generated in production systems that apply lean principles. Production system simulation is carried out using the concepts of Heijunka, Jidouka, and Kanban System. These three concepts are applied to a production system simulation that uses miniature cars with unit cost and profit comparison outputs with traditional production systems, pull systems, heijunka, jidouka, and Kanban systems. The results show that the unit cost of simulations 1 to 6 is getting lower, while the profit is increasing. In simulations 1 and 2 no profit was obtained because of implementing the traditional system while in simulations 3 to 6 there was an increase in profit because they had applied lean principles to the production system. Simulations that have implemented the lean concept have low unit costs and increasing profits, but what distinguishes the work methods applied. Production systems that apply the lean concept can help a company achieve sustainability in the economic field.