Economic Cost-benefit Analysis Research Articles

Economic cost-benefit analysis of person-centred medicines reviews by general practice pharmacists.

Medicines reviews by general practice pharmacists improve patient outcomes, but little is known about the associated economic outcomes, particularly in patients at higher risk of medicines-related harm. To conduct an economic cost-benefit analysis of pharmacists providing person-centred medicines reviews to patients with hyperpolypharmacy (prescribed ≥ 10 regular medicines) and/or at high risk of medicines-related harm across multiple general practice settings. Service delivery costs were calculated based on the pharmacist's salary, recorded timings, and a general practitioner fee. Direct cost savings were calculated from the cost change of patients' medicines post review, projected over 1year. Indirect savings were calculated using two models, a population-based model for avoidance of hospital admissions due to adverse drug reactions and an intervention-based model applying a probability of adverse drug reaction avoidance. Sensitivity analyses were performed using varying workday scenarios. Based on 1471 patients (88.4% with hyperpolypharmacy), the cost of service delivery was €153 per review. Using the population-based model, net cost savings ranging from €198 to €288 per patient review and from €73,317 to €177,696 per annum per pharmacist were calculated. Using the intervention-based model, net cost savings of €651-€741 per review, with corresponding annual savings of €240,870-€457,197 per annum per pharmacist, were calculated. Savings ratios ranged from 181 to 584% across all models and inputs. Person-centred medicines reviews by general practice pharmacists for patients at high risk of medicines-related harm result in substantial cost savings. Wider investment in general practice pharmacists will be beneficial to minimise both patient harm and healthcare system expenditure.

Economic Cost-Benefit Analysis of Nerve Implanted into Muscle versus Targeted Muscle Reinnervation versus Regenerative Peripheral Nerve Interface, for Treatment of the Painful Neuroma.

This study investigated the relative cost utility of three techniques for the management of symptomatic neuromas after neuroma excision: (1) implantation of nerve into muscle, (2) targeted muscle reinnervation (TMR), and (3) regenerative peripheral nerve interface (RPNI). The costs associated with each procedure were determined using Common Procedural Terminology codes in combination with data from the Centers for Medicaid and Medicare Services Physician and Facility 2020 Fee Schedules. The relative utility of the three procedures investigated was determined using changes in Patient-Reported Outcomes Measurement Information System (PROMIS) and Numeric Rating Scale (NRS) pain scores as reported per procedure. The relative utility of each procedure was reported in terms of quality-adjusted life years (QALYs), as is standard in the literature. The least expensive option for the surgical treatment of painful neuromas was nerve implantation into an adjacent muscle. In contrast, for the treatment of four neuromas, as is common postamputation, TMR without a microscope was found to cost $50,061.55 per QALY gained, TMR with a microscope was found to cost $51,996.80 per QALY gained, and RPNI was found to cost $14,069.28 per QALY gained. While RPNI was more expensive than nerve implantation into muscle, it was still below the standard willingness-to-pay threshold of $50,000 per QALY, while TMR was not. Evaluation of costs and utilities associated with the various surgical options for the management of painful neuromas suggest that nerve implantation into muscle is the least expensive option with the best improvement in QALY, while demonstrating comparable outcomes to TMR and RPNI with regard to pain symptoms.

A Study of Efficiency and Economic Value of Grade Separated Construction Project: Case Study of Grade Separated Without Ramp across The Sri Ayutthaya Intersection Bangkok

This research was conducted to analyze the efficiency and economic value of grade separated construction projects in a large city due to heavy traffic volumes. This is consistent with the current situation where traffic volumes are continually increasing. In order to reduce fuel consumption, accidents and travel time. In this research, the efficiency and economic value of grade separated without ramp across Sri Ayutthaya intersection will be studied, Bangkok (Thailand), is considered in the form of an underpass through the intersection by using the VISSIM program to create and develop micro simulation traffic models. Then, the economic cost-benefit analysis of the project is evaluated by considering the economic worthiness of the project from a comparison between the case with the project and without the project. The economic worthiness of the project is analyzed by using Net Present Value (NPV), Benefit-Cost Ratio (B/C ratio) and Internal Rate of Return (IRR). From the results of this study, it was found that after developing the current area, which is a ground level intersection into an underpass. Traffic at intersections will be more efficient. And helps reduce traffic congestion at intersections. This is because the average delay of each type of vehicle decreased after the project. Performance measures at intersections can be summarized as the average vehicle delay in the project start year (2027) for motorcycles decreased from 364.48 seconds/vehicle to 85.93 seconds/vehicle, passenger cars decreased from 369.35 seconds/vehicle to 78.42 seconds/vehicle, trucks decreased from 282.19 seconds/vehicle to 78.96 seconds/vehicle, and buses decreased from 420.47 seconds/vehicle to 65.07 seconds/vehicle. And it can be concluded that the project of grade separated construction in the form of an underpass across Sri Ayutthaya Intersection. It is economically worthwhile and suitable for investment. Because the net present value (NPV) in the 15th year of the project (2041) is equal to 1,752.18 million baht, which is greater than 0, the benefits-costs ratio (B/C Ratio) in the 15th year of the project (2041) is equal to 3.61, which is greater than 1, and the internal rate of return (IRR) at the 15th year of the project (2041) is equal to 42%, which is greater than 12%.

A Comparative Benefit-cost Analysis for the Potential Waste Management Options for the Western Province, Sri Lanka

Sri Lanka generates 7,000 metric tons of solid waste per day while only 3,242 tons are being collected. Within the Western province 1783 metric tons are collected daily. Management of municipal solid waste is mainly a responsibility of local governmental entities. Only a few waste management options are often practiced while economic aspects of this problem are rarely taken into consideration. The present study was designed therefore with the objective of analysing current and potential waste management options for the western province and identifying the best option that maximises the net benefit to the country. Seven different options for municipal solid waste management were identified for the analysis (option 1–open dumping; 2-sanitary landfilling; 3- recycling paper, polythene, glass and other recyclable waste (15%) and open dumping the rest; 4- composting the biodegradable (62%) and open dumping the rest (38%); 5-composting the biodegradable (62%), recycling paper, polythene, glass and other recyclable waste (15%) and open dumping the remaining; 6–waste to energy handled by the government; 7–waste to energy collaborated with private organizations). Then costs and benefits, including environmental costs related to each option were identified and quantified using literature and information obtained from interviews held with coordinators of waste management projects under both government and private sectors. Economic cost-benefit analyses were conducted for the seven options for a period of 30 years assuming that a constant amount of municipal solid waste (100 MT) per day is treated by each method. All seven models were developed on the basis of current municipal solid waste composition. According to the net present value analysis, five options resulted in negative net present values, while options four and five showed positive net present values. In the next step, the value of compost was re-estimated considering the replacement benefit of imported nitrogen, phosphorus and potassium fertilizer which has yielded a much higher net present value than earlier. Furthermore, option five was identified as the economically most profitable option. The results of the study will provide guidance toward designing the most economically and environmentally viable waste management options for urban areas of Sri Lanka. 
 Keywords: Municipal solid waste, Composting, Recycling, Cost-benefit analysis

Environmental awareness and willingness to pay for biodiversity improvement in Puerto Rico

Biodiversity is vital for sustainable forest ecosystems. However, community values for forest biodiversity depend on environmental engagement, education, and awareness. The objectives of this study are to (1) assess households’ willingness to pay (WTP) for native plant and tree nursery in the Rio Hondo Community Forest (RHCF) of Puerto Rico, with the specific goal of supporting biodiversity and (2) examine the influence of environmental awareness on preferences for biodiversity improvement. Using a contingent valuation method, we find that households are willing to contribute $43/year to support biodiversity in the RHCF by planting native plants and trees, and that environmental awareness increases the support for biodiversity projects. The results suggest that outcomes of economic cost-benefit analyses can depend on environmental awareness. Hence, programs that support environmental awareness can improve economic efficiency of environmental protection projects.

Technical–Economic Evaluation of Water Reuse at the WWTP El Salitre (Bogotá, Colombia): Example of Circular Economy

Water resource management should be conducted from a multidisciplinary perspective. In this sense, the objective of this work is to analyze, from the perspective of the circular economy, the technical–economic feasibility of implementing different alternatives for the regeneration of wastewater for its subsequent reuse in industrial and sports companies located in Bogotá, Colombia. The development of the methodology is carried out through the method of economic cost–benefit analysis (ACB) and the technique of net present value (NPV). These methodologies facilitate decision making based on the economic feasibility of recovering the initial investment costs and the operating costs during the useful life of the WWTP. Establishing the cost and price of reclaimed water is essential to the efficient management of water resources; so far, the studies carried out only focus on the economic viability of the internal costs of the system, while the private impacts and the externalities are excluded and relegated to unsubstantiated statements about the advantages of water reuse. The economic feasibility incorporating the analysis of externalities presents a total profit that ranges between 6.52 EUR/m3 for the industrial sector and 2503 EUR/m3 for the irrigation of golf courses. This analysis demonstrates the technical and economic feasibility of carrying out a circular economy where the water already used returns as a new source of supply.

Who Wants to Leave? Global Survey Evidence on How Individual Emigration Aspirations Differ Between Peaceful and Conflict-Affected Contexts

Does conflict change who desires to emigrate? Surprisingly, we still lack globally comparable empirical evidence on whether the types of individuals who want to leave their country differ between peaceful and conflict-affected locations. In this paper, we address this gap. We analyze unique survey data with global coverage to assess whether individual-level determinants of international permanent emigration aspirations differ during intrastate armed conflict compared to peaceful times and regions. We argue that armed conflict acts as an equalizer that attenuates the effect which individual economic and demographic variables have on international permanent emigration aspirations in peaceful contexts. As a result, aspirations to relocate permanently to another country increase among those demographic groups which are less inclined to move in peaceful situations. Our results indicate that variables related to a longer-term economic cost-benefit analysis, such as income or age, significantly lose importance for international permanent emigration aspirations in conflict situations. This demographic-specific effect explains an overall increase in emigration aspirations during conflicts. On average, we find no evidence that conflict increases the aspirations of all respondents to permanently move to another country. In contrast to income and age, the effects of demographic variables such as gender, household composition, or marital status are not significantly different across contexts.

Does cost minimization of hypofractionated radiation therapy content all health stakeholders?

Does cost minimization of hypofractionated radiation therapy content all health stakeholders?

Economic case for sustainable peatland management: A case study in Kahayan-Sebangau Peat Hydrological Unit, Central Kalimantan, Indonesia

As Indonesia continues to promote peatland restoration to serve its climate target, current policies and economic practices on peatlands remain to be fully consolidated with conservation principles. Meanwhile, studies comparing costs and benefits of different peatland management models are limited. This study applies economic cost-benefit analysis on two peatland management scenarios, with a case study in Kahayan-Sebangau Peat Hydrological Unit (PHU), Central Kalimantan province. The first scenario consists of current peatland management and restoration practices, in line with existing policy target. Second scenario proposes implementation of strengthened peatland rewetting, paludiculture, and cessation of drainage-based operations, among others. Information on the costs and benefits was collected through a survey of 690 respondents, combined with literature review. Monte Carlo simulation technique is applied to account for parametric uncertainty within the cost-benefit analysis. The result shows that second scenario results in higher average Net Present Value in 50 years compared to the first scenario, with approximately 21% difference. This implies that peatlands may generate higher long-term societal welfare when conservation principles are fully endorsed, and the restoration ambition is enhanced. Also, improving the spatial alignment of Central Kalimantan land use plan (Rencana Tata Ruang Wilayah / RTRW) with the proposed land utilization model in second scenario may further prevent negative impact of emissions in the PHU, compared to the case where the existing RTRW is wholly implemented.

IPM Adoption and Impacts in the United States

Abstract Increased Integrated Pest Management (IPM) adoption hinges not only on the future of innovative research, but also on the willingness of growers to adopt new IPM technologies. Adoption and diffusion of innovations can encounter many different challenges. By better understanding the drivers of and barriers to IPM adoption, future research, extension, and education can better target behavior change. This study sought to better understand the IPM adoption drivers and barriers, along with the impacts of IPM, from the perspective of state IPM coordinators via an online Qualtrics survey. These professionals have a statewide perspective on IPM adoption. There were 37 completed surveys out of 56 email survey invitations, a 66% response rate. Overall, the participants ranked ‘high cost of practice’ as the most critical barrier to IPM adoption. ‘Difficulty of implementation’ and ‘lack of awareness’ were also highly ranked as critical barriers to adoption. When asked about ways to increase IPM adoption, participants ranked ‘improved cost-benefit analysis’ as the most critically important. Overall, these findings demonstrate the importance of providing improved IPM economic cost-benefit analyses to accompany the promotion of new and existing IPM innovations. Furthermore, even though the results of this study suggest that the impact of the Regional IPM Centers has been increasing regional IPM coordination, communication, collaboration, and cooperation. These findings also suggest a need for more comprehensive extension and education programs to specifically address the perceived ‘high cost of practice,’ ‘difficulty of implementation’, and ‘lack of awareness’ by communicating improved IPM cost-benefit analyses.

Life Cycle Assessment and Cost-Benefit Analysis of Technologies in Water Resource Recovery Facilities: The Case of Sludge Pyrolysis.

In Europe, sewage sludge is mostly used in agriculture (49%) or incinerated (25%). Technologies for sludge management that can support the transformation of wastewater treatment plants (WWTPs) to water resource recovery facilities (WRRFs) are emerging. Sludge pyrolysis is one of them. It can generate two main high-value co-products: heat and biochar. Moreover, biochar can be transformed into activated carbon. The economic and environmental impacts of sludge pyrolysis and its comparison to the direct application of sludge in agriculture and incineration are unknown. Therefore, we applied a life cycle assessment (LCA) and a cost-benefit analysis (CBA) of sludge pyrolysis. We quantified environmental externalities in an LCA and then applied the benefit transfer method to monetize these externalities, which were included in an economic CBA. Pyrolysis reduced impacts in five to nine LCA categories and had a positive economic net present value (NPV) compared to using sludge in agriculture. Pyrolysis with biochar production was not better than incineration, showing increased impacts in nine categories and negative NPVs (-19 to -22 €/t sludge). The factor driving differences between the alternatives was the assumed CO2 externality price (164 €/ton CO2-eq) and the removal rate of pharmaceutical micropollutants of the sludge-based activated carbon. High uncertainty in environmental prices is one of the limitations of our study.

Developing a conceptual model to quantify eco-compensation based on environmental and economic cost-benefit analysis for promoting the ecologically intensified agriculture

Eco-compensation is essential for promoting ecologically intensive agriculture to reduce the environmental impact of the agricultural sector. However, a comprehensive and performance-based tool to quantify eco-compensation is not yet available. Here, we present a comprehensive model of eco-compensation standards based on internal and external trade-offs (ESBIET) and their valuation methods based on farm-level cost-benefit analysis. We calculated the internal economic costs and benefits using conventional life cycle costing and profit analysis. The ecosystem service and disservice values were recorded as external benefits and costs, which were valued using the revealed preference approach and the Environmental Priorities Strategies model, respectively. We incorporated the Coase theorem and Pigou theory into this model to quantify government compensation, which complements market compensation. The ESBIET model was tested using a case study of greenhouse vegetable production in eight conventional (CON), eight organic (ORG), and seven community-supported agriculture (CSA) greenhouse vegetable production farms. This article also described the key features, potential users and future opportunities for improving our ESBITE model. At its core, the ESBIET model can be effectively used to design eco-compensation measures to promote ecologically intensified agriculture.

National offshore wind strategy for late-mover countries

This paper explores national strategies for emerging countries with ambitious policy targets for future offshore wind development. A scenario-based economic cost-benefit analysis of multiple approaches to the development of offshore wind projects is conducted based on (1) who takes the initiative on financing (public sector vs. private sector), (2) whether wind turbines are supplied locally or not, and (3) whether investment plans provide managerial flexibility to respond to changing circumstances or not (real options strategy vs. traditional investment decision-making). The analysis demonstrates that a real options strategy that allows flexibility regarding future uncertainties can significantly increase the economic value of a project regardless of the type of developer or dependence on foreign wind turbine technologies. The study concludes with a recommendation that late-mover countries focus on the combination of public-sector initiatives, a real options strategy, and the purchase of domestic turbines.

Economic and Production-Related Implications for Industrial Energy Efficiency: A Logistic Regression Analysis on Cross-Cutting Technologies

Increased industrial energy efficiency (EE) has become one of the main environmental actions to mitigate carbon dioxide (CO2) emissions, contributing also to industrial competitiveness, with several implications on the production system and cost management. Unfortunately, literature is currently lacking empirical evidence on the impact of energy efficiency solutions on production. Thus, this work primarily aims at investigating the economic and production-related influence on the reduction in industrial energy consumption, considering the cross-cutting technologies HVAC, motors, lighting systems and air compressor systems. The analysis is performed using data from previous studies that characterized the main EE measures for the cross-cutting technologies. Four logistic models were built to understand how costs and production influence energy efficiency across such cross-cutting technologies. In this way, motivating industries to implement measures to reduce electrical consumption, offering an economic cost–benefit analysis and optimizing industry processes so that the reduction in electricity consumption adds to industrial energy efficiency were the aims of this study. The results of this work show through the adjusted indicators that senior management is mainly responsible for energy savings. The operational measures of each piece of equipment can be oriented in the industry towards a specific maintenance process for each technology, becoming an active procedure in industrial productions to obtain EE. Additionally, maintenance planning and control is essential to the reliability of the reduced energy consumption of cross-cutting technologies. This article concludes with managerial implications and suggestions for future research in this field.

Nerve decompression in diabetics with chronic nerve compression: update 2022

The number of people with diabetes worldwide has reached epidemic proportions. Diabetics are well-known to have chronic nerve compressions, and the prevalence of compressions exceeds 50% in those with neuropathy. The loss of sensation in the feet of people with diabetic neuropathy is the primary cause of their ulceration and amputation, as well as pain. The aim of this article is to update the reader on the current status of lower extremity nerve decompression in patients with diabetic neuropathy. A review of the history and literature related to the current approach to the patient with chronic nerve compression plus diabetic neuropathy was undertaken. The current evidence is overwhelmingly clear, in diabetics with neuropathy and a positive Tinel sign over the tibial nerve at the tarsal tunnel, that decompression, by neurolysis of lower extremity nerves, can relieve pain, restore sensation, and prevent ulceration and amputation. Furthermore, economic cost-benefit analysis by the Markov technique demonstrates that lower extremity nerve compression is not only cost-effective compared to standard medical care, but also increases the quality of life and life expectancy. The remaining barriers to acceptance and implementation of this proven surgical approach must lie in the education of physicians in training and re-education of diabetes educators, primary care providers and endocrinologists.

Value‐based adoption of augmented reality: A study on the influence on online purchase intention in retail

AbstractThe increasing use of digital technology‐based retail services provides new opportunities for digital marketing. In this paper, we investigate how augmented reality (AR) technology can be leveraged as part of the firm's strategy. We explore the online purchase intention through AR smart glasses (ARSG), considering consumers' value assessment through a cost–benefit analysis and the influence of technical, experiential and social AR value drivers. We develop an augmented value‐based adoption model addressing four main objectives: (1) Evaluate the effect of the perceived value of ARSG, (2) Evaluate the effect of immersion (experiential dimension), (3) Evaluate the effect of AR devices and technical complexity (technical dimension) and (4) Evaluate the importance of subjective norms (social dimension) on the online purchase intention through AR technology. Based on an ESIC Tech Lab experiment with two types of ARSG from market leaders and AR retail apps, the study uses survey data from 253 participants. The results suggest that the technical dimension has an ambiguous effect, with tech‐complexity enhancing directly the perceived value of ARSG for online purchase while reducing the net value of consumers' economic cost–benefit analysis. We find strong evidence that the experiential and social AR dimensions (in the form of immersion and subjective norm) have a significant positive influence on consumers' purchase intention online, which are better predictors than the pure economic cost–benefit assessment (through usefulness and difficulty). Furthermore, the technical innovativeness of consumers is found to increase directly the online purchase intention through ARSG.

Evaluating adaptation options to sea level rise and benefits to agriculture: The Ebro Delta showcase

Sea level rise (SLR) is threatening low-lying coastal areas such as river deltas. The Ebro river Delta (Spain) is representative of coastal systems particularly vulnerable to SLR due to significant sediment retention behind upstream dams (up to 99%), thereby dramatically reducing the capacity for deltaic sediment accretion. Rice production is the main economic activity, covering 66% of the delta area, and is negatively affected by SLR because of flooding and soil salinization. Therefore, appropriate adaptation measures are needed to preserve rice production. We combined Geographic Information Systems and Generalized Linear Models to identify zones prone to flooding and increasing soil salinity, and to calculate the so-called sediment deficit, that is the amount of sediment needed to raise the land to compensate flooding and soil salinization. We modelled SLR scenarios predicted by the IPCC Fifth Assessment Report, and analysed the economic feasibility (not the technical feasibility) of reintroducing fluvial sediments retained in the upstream river dam reservoirs into the delta plain, which can contribute to maintaining land elevation and rice production with SLR. To do this, the costs of the sediment reintroduction measures and their benefits in terms of avoided loss of rice production income were evaluated with an approximate economic cost-benefit analysis. Results predicted that between 35 and 90% of the rice field area will be flooded in the best and worst SLR scenarios considered (SLR = 0.5 m and 1.8 m by 2100, respectively), with a sediment deficit of 130 and 442 million tonnes, with an associated cost of sediment reintroduction of 13 and 226 million €. The net benefit of rice production maintenance was 24.6 and 328 €/ha. The proposed adaptation measure has a positive effect on rice production and can be considered as an innovative management option for maintaining deltaic areas under SLR.

Rice straw-base power generation: a potential and economic cost–benefit analysis for a small power plant (10 MWe) in Vietnam

Rice straw-base power generation: a potential and economic cost–benefit analysis for a small power plant (10 MWe) in Vietnam

Risk-opportunity analysis for transformative policy design and appraisal

The climate crisis demands a strong response from policy-makers worldwide. The current global climate policy agenda requires technological change, innovation, labour markets and the financial system to be led towards an orderly and rapid low-carbon transition. Yet progress has been slow and incremental. Inadequacies of policy appraisal frameworks used worldwide may be significant contributors to the problem, as they frequently fail to adequately account for the dynamics of societal and technological change. Risks are underestimated, and the economic opportunities from innovation are generally not assessed in practice. Here, we identify root causes of those inadequacies and identify them to structural features of standard analysis frameworks. We use a review of theoretical principles of complexity science and the science of dynamical systems and formulate a generalisation of existing frameworks for policy analysis and the appraisal of outcomes of proposed policy strategies, to help better identify and frame situations of transformational change. We use the term “risk-opportunity analysis” to capture the generalised approach, in which conventional economic cost-benefit analysis is a special case. New guiding principles for policy-making during dynamic and transformational change are offered.

Differential privacy in health research: A scoping review.

Differential privacy is a relatively new method for data privacy that has seen growing use due its strong protections that rely on added noise. This study assesses the extent of its awareness, development, and usage in health research. A scoping review was conducted by searching for ["differential privacy" AND "health"] in major health science databases, with additional articles obtained via expert consultation. Relevant articles were classified according to subject area and focus. A total of 54 articles met the inclusion criteria. Nine articles provided descriptive overviews, 31 focused on algorithm development, 9 presented novel data sharing systems, and 8 discussed appraisals of the privacy-utility tradeoff. The most common areas of health research where differential privacy has been discussed are genomics, neuroimaging studies, and health surveillance with personal devices. Algorithms were most commonly developed for the purposes of data release and predictive modeling. Studies on privacy-utility appraisals have considered economic cost-benefit analysis, low-utility situations, personal attitudes toward sharing health data, and mathematical interpretations of privacy risk. Differential privacy remains at an early stage of development for applications in health research, and accounts of real-world implementations are scant. There are few algorithms for explanatory modeling and statistical inference, particularly with correlated data. Furthermore, diminished accuracy in small datasets is problematic. Some encouraging work has been done on decision making with regard to epsilon. The dissemination of future case studies can inform successful appraisals of privacy and utility. More development, case studies, and evaluations are needed before differential privacy can see widespread use in health research.