Economic Perspective Research Articles

Cost-effectiveness of multigene sequencing test and treatment for metastatic non-small cell lung cancer: A unique setting in the initial adoption phase in Japan allowing testing only after standard treatment

ObjectiveTo clarify the cost-effectiveness of comprehensive diagnosis and treatment of metastatic non-small cell lung cancer in Japan, from initial diagnosis to post-standard treatment, using three different strategies. MethodsA decision tree was created using three diagnostic and treatment strategies, assuming that Foundation One CDx (F1CDx), a comprehensive genome panel, was introduced in Japan in June 2019. This comprehensive decision tree includes Markov models, cost-effectiveness analyses (CEA), and cost-utility analyses (CUA) of the three strategies from the perspective of Japanese payers. Specifically, Strategy1 involves single-gene testing at the initial diagnosis and F1CDx after standard treatment; Strategy2 involves only single-gene testing at the initial diagnosis; Strategy3 involves F1CDx at the initial diagnosis. The incremental cost-effectiveness ratios (ICERs) of the three strategies are estimated. Sensitivity analyses were performed to assess the uncertainty of the parameter settings. ResultsStrategy3 was dominated for both CUA and CEA. The ICER/quality-adjusted life year (QALY) for Strategy2 versus Strategy1 was USD 13,734 (JPY 2,080,923, USD 1 = JPY 151.39 on April 1st, 2024), which is less than the willingness to pay of USD 45,900 (JPY 7,500,000), and Strategy2 was more cost-effective than Strategy1. F1CDx was not cost-effective compared to multiple simultaneous single tests at the initial diagnosis, either after standard treatment or at the initial diagnosis. Sensitivity analysis also showed that the most influential factor on the ICER for both CEA and CUA was treatment cost. ConclusionsFrom both patient benefit and health economic perspectives, introducing F1CDx after standard treatment in June 2019 was not as cost-effective as multiple simultaneous single tests at the initial diagnosis but was more realistic from a health economic perspective than introducing F1CDx at the time of initial diagnosis. Therefore, the policy at the time of F1CDx introduction in Japan was appropriate from a short-term health-economic perspective.

Evaluating video and hybrid group consultations in general practice: mixed-methods, participatory study protocol (TOGETHER 2).

General practice is facing an unprecedented challenge in managing the consequences of the pandemic. In the midst of a policy drive to balance remote and in-person service provision, substantial workload pressures remain, together with increasing prevalence of long-term conditions, and declining staff numbers and morale. To address these challenges, some practices in the UK have been delivering video and hybrid group consultations (VHGCs) providing clinical care to multiple patients at the same time. Despite positive initial findings and enthusiasm, there are still gaps in our understanding of the influence VHGCs have on patient experience, healthcare utilisation, quality, safety, equity and affordability. To generate an in-depth understanding of VHGCs for chronic conditions in general practice, surface assumptions and sociotechnical dynamics, inform practice and extend theorisation. Mixed-methods, multi-site research study using co-design and participatory methods, from qualitative, quantitative and cost-related perspectives. WP1 includes a national, cross-sectional survey on VHGC provision across the UK. In WP2 we will engage patients and general practice staff in co-design workshops to develop VHGC models with emphasis on digital inclusion and equity. In WP3 we will carry out a mixed-methods process evaluation in up to 10 GP practices across England (5 sites already running VHGCs and 5 comparison sites). Qualitative methods will include interviews, focus groups and ethnographic observation to examine the experiences of patients, carers, clinical and non-clinical NHS staff, commissioners and policy-makers. Quantitative methods will examine the impact of VHGCs on healthcare utilisation in primary and secondary care, patient satisfaction, engagement and activation. We will also assess value for money of group and individual care models from a health economics perspective. We aim to develop transferable learning on sociotechnical change in healthcare delivery, using VHGCs as an exemplar of technology-supported innovation. Findings will also inform the design of a future study.

Analisis Pengelolaan Badan Usaha Milik Desa (BUMDES) dalam Perspektif Ekonomi Islam

This researcher aims to explain the management of BUMDES in Rantau Badak Village, West Tanjung Jabung Regency and the management of BUMDES from an Islamic economic perspective. This researcher uses a qualitative method, data collection techniques are obtained from observation, interviews and documentation related to this research. In this study, the researcher conducted interviews with the village head, the head of BUMDES and one of the people in Rantau Badak Village. Based on the results of the research that has been conducted by the researcher, it can be concluded that the types of businesses studied are two types of businesses, namely drinking water depots and tent rentals. Both types of businesses are managed by BUMDES Rantau Badak Village. In the management of BUMDES, it has been able to improve the community's economy, for example by opening up employment opportunities, training community skills and expertise, but the error lies in the lack of public awareness because they do not utilize the facilities available at BUMDES. Then the management of BUMDES from an Islamic economic perspective in Rantau Badak Village has moved towards sharia, namely in the tent rental business and drinking water depot business because it is ta'awun which means helping each other and which is not sharia, namely in Brilink because it contains usury, and BUMDES has moved towards sharia

Dispossession after War: A Feminist Political Economy Perspective

“Post war” has been highlighted as an arena in which, under the banner of reconstruction, processes of accumulation by dispossession are often intensified. This conceptual article explores gaps in how “dispossession” is typically defined, to deepen understanding of the complex, gendered modalities that occur in post-war, when the population is already living in the wake of wartime land dispossession. Through an interdisciplinary feminist political economy and conflict studies lens, “dispossession” as a concept is interrogated beyond the original Marxist meaning of separation from the means of production via wholesale agrarian transition. The article argues that, in the long post-war “moment,” gendered dispossession might occur in three interrelated ways, all connected to wartime dispossession. The first is bodily dispossession which occurs through shifting forms of patriarchy. The second is dispossession manifesting within reconfigured social reproductive relations. The third is piecemeal dispossession, through the embedding of other capitalist relations, including lifetime debt. HIGHLIGHTS A feminist approach to dispossession reveals its less visible and its gendered dimensions. Conflict-related dispossession consists of more than mass land expulsion during war. In post-war, dispossession connects to both state and capitalist logics of accumulation. Dispossession can have different modes: it is an embodied process, occurs through social reproduction, and can happen covertly. A feminist re-conceptualization contributes to analyses of violence against women in war and post-war.

What causes polarized stagnation, corporate economy, or welfare state?: Insights from new development economics

AbstractThis study explores polarized economic stagnation from the perspective of a capitalist corporate economy. It introduces two institutional policy paradigms: economic differentiation (ED) and economic egalitarianism (EE). ED‐friendly “market democracy” promotes shared growth, whereas EE‐friendly “egalitarian democracy” leads to polarized stagnation. The corporate economy is portrayed as the epitome of the ED institution leading shared growth, whereas the redistributive welfare state based on EE institutions could bring polarized stagnation. Empirical analysis tests these hypotheses and discovers that the world's polarized stagnation may be linked to “welfare policy under egalitarian democracy” rather than “corporate growth under market democracy” as commonly thought.

Globalization In The 21st Century: Economic, Social, And Environmental Perspectives

Globalization In The 21st Century: Economic, Social, And Environmental Perspectives

Suggesting Priorities of Sustainable Development Goals Considering the Lingering Impacts of COVID-19

The Sustainable Development Goals (SDGs), aimed to be achieved by 2030, demand a more efficient approach for the remaining period due to the currently low achievement rate and the persisting impact of COVID-19. Consequently, this study analyzes United Nations statistics and previous studies to propose a global prioritization of SDGs. The arguments in each document were interpreted cross-sectionally with those of others. The analysis incorporates a simple system dynamics methodology and adds a national psychological and behavioral economic perspective. Among all SDGs, this study suggests that Goal 17 (Partnerships for the Goals) and ecosystem-related goals corresponding to Goals 13, 14, and 15 should be the foremost global priorities, given their capacity to establish the foundation for other goals. The general goals (Goals 1 to 9, 11, 12, and 16) and Goal 10 (Reduced Inequalities) follow as the subsequent priorities, fostering the most effective progression. The paper also suggests that among the targets of Goal 17, targets 17.2 (fully implement the commitment to Official Development Assistance), 17.18 (support available data to developing countries), and 17.11 (increase exports of developing countries) should be globally prioritized to focus on the economic recovery of developing countries in a short time. Furthermore, this study recommends that while each region maintains its local priorities, the international community should adhere to the global priorities presented. This alignment will lead to a worldwide virtuous circle—a structure where following each other's priorities helps resolve the next set of issues.

A REVIEW OF THE SUSTAINABILITY - CIRCULAR ECONOMY IN THE PHARMACEUTICAL INDUSTRY

Climate change, the number of the global population, and the diversity of activities with an impact on the planet have been on an upward slope, which requires taking preventive measures and changing from a social, economic, and environmental perspective, thus meaning that the adoption of a sustainable lifestyle is necessary. This study provides a review of the literature on the adoption of the circular economy and sustainability concepts in the pharmaceutical manufacturing sector. This study aims to qualitatively assess the need to implement sustainability in the pharmaceutical industry, given that the latter has a significant environmental impact on human existence. In this study, the “Web of Science," "Scopus,” databases, and “Springer Publishing” are used, from which works are extracted based on the keywords sustainability in the pharmaceutical industry and circular economy in the pharmaceutical industry, following the evolution of works written in the last ten years on this topic. The most relevant approaches of the authors to this topic are presented. It can be seen that this topic is one discussed by an important category of researchers, especially in countries where the need for medicines is greater due to the standard of living, such as those in Asia, for example. The research can also be extended to other databases using the same keywords or words related to sustainability or circular economy in the pharmaceutical industry.

Health economics perspectives of nursing services tariff setting in Islamic Republic of Iran

Health economics perspectives of nursing services tariff setting in Islamic Republic of Iran

Immigrants Through the Eyes of Citizens of Kazakhstan: The Attitude of the Host Society to the Immigrants’ Health

This article examines the attitudes of Kazakhstani citizens towards health problems among immigrants. Respondents (N=401) from different regions of Kazakhstan took part in the study in 2023. According to the results of the study, it was found that (1) male respondents demonstrated significantly higher engagement with news about migrants compared to females. (2) Age and level of education were not associated with news engagement. (3) The probability of emigration correlated negatively with age but positively with education level, and positively with frequency of following migration news. (4) Individuals with conservative ideological orientations and liberal economic perspectives were more likely to follow migration news. (5) Attitudes towards immigrant health varied, with the majority supporting continuous health monitoring but divided opinions on whether immigrants pose a danger to public health. (6) Socio-demographic factors such as language, gender, experience living abroad, and ideological orientation influenced attitudes toward immigrant health. Therefore, understanding the complex attitudes of citizens towards immigrant health issues is essential for developing targeted interventions and policies that promote integration and address the diverse needs of both immigrants and the host population in Kazakhstan.

Design and economic analysis of an innovative multi-generation system in different Countries with diverse economic contexts

This paper presents an innovative trigeneration system designed to maximize energy utilization by simultaneously producing power, cooling, and freshwater. The system integrates multiple energy sources, including biomass, natural gas, and geothermal energy, and comprises a modified gas turbine cycle, a geothermal power plant, a triple-effect absorption refrigeration cycle, and a multi-effect desalination unit. Performance metrics are evaluated from both thermodynamic and economic perspectives across four case studies: Australia, the USA, China, and Russia. The economic feasibility analysis utilizes real-state economic data, incorporating natural gas prices, electricity prices for households, interest rates, and inflation rates specific to each country. The system achieved impressive outputs, with net power, cooling, and freshwater production rates of 6299 kW, 140.1 kW, and 13.41 kg/s, respectively. Exergy analysis revealed that the combustion chamber, heat exchanger, and multi-effect desalination units exhibit the highest irreversibility, with exergy destruction rates of 2961 kW, 1125 kW, and 995.3 kW, respectively. The fixed capital investment cost is estimated at $13.5 million, resulting in a payback period of 6.75 years and a net present value of $7.287 million. In Australia, the system demonstrated a particularly favorable economic performance, with a payback period of 3.98 years and a net present value of $36.19 million. Conversely, in China, the payback period exceeds the system's expected lifetime, highlighting the economic challenges in certain environments. These results underscore the system's potential for profitability and sustainability, particularly in regions with favorable economic conditions.

Short-term optimal scheduling of wind-photovoltaic-hydropower-thermal-pumped hydro storage coupled system based on a novel multi-objective priority stratification method

In the new power system with high proportion of uncertain renewable energy sources (RES), there is a defect of RES consumption at the expense of other power sources' operational efficiency. This paper proposes a short-term optimal scheduling model of wind-photovoltaic-hydropower-thermal-pumped hydro storage (WPHTPHS) coupled system, which realizes the multiple optimization objectives involving minimizing operation cost of thermal power units, maximizing clean energy power generation, minimizing net load fluctuation and thermal power regulation. First, to overcome the dimension disaster problem in the solution space of high-dimensional random variables, a method for pre-solving integer state variables is proposed. Then, a novel multi-objective solution strategy of priority stratification-coupled feedback combined with improved plant growth simulation algorithm is designed. Finally, the effectiveness and superiority of the proposed model and solution method are demonstrated by case studies, and the numerical results show that the number of startups and shutdowns, standard deviation of output and operating cost of thermal power units are reduced by 90.9 %, 65.34 %, and 14.01 % respectively, compared with traditional wind-photovoltaic-thermal strategy. This study contributes to resolving the relationship between conflicting objectives and highlighting the potential advantages of WPHTPHS coupled system to maximize overall performance from economic and stability perspectives.

A Quantitative Assessment Approach to Implement Pneumatic Waste Collection System Using a New Expert Decision Matrix Related to UN SDGs

An innovative decision matrix has been developed to guide the selection and implementation of Pneumatic Urban Solid Waste Collection Systems (PUSWCS) in smart city projects. This study comprehensively collects and analyzes data on the advantages and disadvantages of pneumatic collection systems from technical, economic, and social perspectives. A decision-making tool was created to address the complexities of evaluating the desirability of incorporating PUSWCS in municipalities or specific areas, using a holistic approach. The tool assesses the technical, economic, and social feasibility of implementing PUSWCS, aligning it with the United Nations’ Sustainable Development Goals (SDGs). Specific variables are measured to assess compliance with the SDGs, distinguishing technical aspects from economic and social aspects. The methodology includes surveys of system users and technicians, expert assessments, and the development of a decision matrix that cross-references study variables and SDGs. The matrix assigns numerical values to the Magnitude (M) and Impact (I) of each variable, enabling quantitative interpretation. This holistic approach accommodates the complexities of waste management and diverse stakeholder perspectives. The results demonstrate the matrix’s effectiveness in accurately assessing the desirability of implementing PUSWCS. This confirms the matrix’s ability to optimally integrate with innovative smart city concepts and align with long-term sustainability goals. The study concludes that the design of the decision matrix allows the collection of information from experts, users, and stakeholders about economic, social, and environmental variables and relates them to the SDGs, to obtain a numerical result that allows to decide whether in a given urban environment it is advisable to implement a PUSWCS.

The conceptualisation of cardiometabolic disease policy model in the UK

BackgroundDecision models are increasingly used to inform policy-making processes, and there is a need to improve their credibility. The estimation of health and economic outcomes generated from decision models is influenced by the development process itself. This paper aims to present the conceptual model development process of cardiometabolic disease (CMD) policy models in the UK setting.MethodsThis conceptual model followed the International Society of Pharmacoeconomics and Outcomes Research-Society of Medical Decision Making (ISPOR-SMDM) Modelling Good Research Practices Task Force-2.ResultsFirst, for the conceptualisation of the problem, the CMD disease staging, progression and current clinical guidelines were summarised, followed by a systematic review of published policy models. We critically appraised policy models such as cardiovascular disease and type 2 diabetes. Key messages from the review emphasised the importance of understanding various determinants influencing model development, including risk factors, model structure, models’ parameters, data utilisation, economic perspective, equality/equity consideration, transparency and validation process. Second, as a sequential process, is model conceptualisation, to determine which modelling types and their attributes best represent the defined problem. Expert opinions, including a clinician and experienced modellers, provided input on the state transition model to ensure the structure is clinically relevant. From this stage, the consideration and agreement to establish a disease state in a state transition model was discussed.ConclusionThis conceptual model serves as a basis for representing the systematic process for structuring a CMD policy model to enhance its transparency and credibility.

Feasibility and structural prerequisites for conversion to outpatient treatment in proctology

Despite the introduction of the diagnosis-related groups (DRG) system, costs in the German healthcare system have risen continuously for years. In order to reduce costs the federal government is aiming to shift inpatient services to the outpatient sector. Outpatient services affect many areas of medicine, including proctological operations as these are common and can often be carried out on an outpatient basis. The aim of the present work is to discuss which areas of proctology are suitable for outpatient treatment and which structural requirements are necessary. The present article is intended to provide anarrative overview with reference to the literature on the topic of outpatient care in proctology. Aliterature search was carried out using the following keywords: outpatient care, selective sector-level remuneration, day care, proctological operations, AOP catalog and hybrid DRG. In proctology, outpatient surgical care is implementable in many cases; however, not every patient is suitable for this. In addition to previous illnesses, patient compliance and the possibility of postoperative care from relatives must also be taken into account. In addition, emergency treatment must be guaranteed. Contraindications include severe heart and circulatory diseases as well as severe coagulation or organ dysfunction. Extensive abscesses, complex fistulas or sphincter reconstructions should be surgically treated in an inpatient setting. The prerequisite for successful outpatient care is to make the sector boundaries between outpatient and inpatient patient care more permeable and to adequately remunerate the interventions. In addition to the surgical indications, the prerequisites for successful proctological operations are the correct assessment of the operational capability and compliance. From an organizational and economic perspective, better networking between outpatient and inpatient treatment and equal remuneration across the sector boundaries are crucial.

Optimal 4E design and innovative R-curve approach for a gas-solar- biological waste polygeneration system for power, freshwater, and methanol production

BackgroundCogeneration power plants traditionally rely on fossil fuels to produce stable power and heat. However, increasing energy demand and population growth have intensified the emission of biological pollutants due to fossil fuel use. The Global Alliance on Health and Pollution advocates for integrating renewable energy sources to mitigate these issues. ObjectivesThis study aims to evaluate the integration of a solar-biomass polygeneration system with a hybrid solar-waste-fossil fuel cogeneration system. The goal is to analyze the system from technical, economic, and environmental perspectives, focusing on optimizing energy demand and minimizing environmental impact. MethodsTo assess energy demand and supply, the R-curve methodology was applied to the hybrid cogeneration system, with a specific focus on solar and biomass renewable energies. Various scenarios were analyzed, including total annual costs, pollutant emissions, water footprint, and overall environmental impact based on life cycle assessment. The study examined and compared the performance of three types of biomass waste (Municipal solid waste, mixed paper waste, and date palm waste). Multi-objective optimization was performed using artificial intelligence and machine learning techniques, employing four meta-heuristic algorithms. The conditions generated by each algorithm were analyzed and compared. ResultsMunicipal solid waste, being the most readily available fuel, provided the most favorable economic conditions for the system. Environmentally, municipal solid waste ranked in the middle compared to other fuels. Among the optimization algorithms, the Salps swarm algorithm proved to be the most efficient in terms of calculation time and system efficiency improvements. The optimization improved net power generation by 5.25 %, overall energy efficiency by 16.27 %, total cost rate by 10.19 %, and total environmental impact rate by 14.02 %. ConclusionThe integrated system's performance was analyzed across different climatic change throughout the year. The multi-objective Salps swarm algorithm optimization demonstrated significant benefits in enhancing system efficiency and reducing costs and environmental impacts.

Engineering Escherichia coli for utilization of PET degraded ethylene glycol as sole feedstock

From both economic and environmental perspectives, ethylene glycol, the principal constituent in the degradation of PET, emerges as an optimal feedstock for microbial cell factories. Traditional methods for constructing Escherichia coli chassis cells capable of utilizing ethylene glycol as a non-sugar feedstock typically involve overexpressing the genes fucO and aldA. However, these approaches have not succeeded in enabling the exclusive use of ethylene glycol as the sole source of carbon and energy for growth. Through ultraviolet radiation-induced mutagenesis and subsequent laboratory adaptive evolution, an EG02 strain emerged from E. coli MG1655 capable of utilizing ethylene glycol as its sole carbon and energy source, demonstrating an uptake rate of 8.1 ± 1.3 mmol/gDW h. Comparative transcriptome analysis guided reverse metabolic engineering, successfully enabling four wild-type E. coli strains to metabolize ethylene glycol exclusively. This was achieved through overexpression of the gcl, hyi, glxR, and glxK genes. Notably, the engineered E. coli chassis cells efficiently metabolized the 87 mM ethylene glycol found in PET enzymatic degradation products following 72 h of fermentation. This work presents a practical solution for recycling ethylene glycol from PET waste degradation products, demonstrating that simply adding M9 salts can effectively convert them into viable raw materials for E. coli cell factories. Our findings also emphasize the significant roles of genes associated with the glycolate and glyoxylate degradation I pathway in the metabolic utilization of ethylene glycol, an aspect frequently overlooked in previous research.

The impact of digital finance on green economic development: A literature review

Green economic development has become an essential pathway to achieving high-quality economic growth, while digital finance represents a prominent trend in global financial advancement. The rapid expansion of digital finance in China has spurred extensive research in this domain. This study systematically combes the literature on digital finance and green economic development. Initially, it delineates the conceptual definition of digital finance, measurement indices and the conceptual definition of green economic development, identifies the key influencing factors. Subsequently, it synthesizes empirical findings on how digital finance influences the growth of green economy from economic, environmental, and energy perspectives. The economic perspective is divided into macroeconomic impacts, mechanisms of influence, and microeconomic aspects; the environmental perspective focuses on the pollution effects and carbon emission reduction attributable to digital finance, and the energy perspective reviews literature on improvements in energy efficiency and reductions in energy intensity driven by digital finance. Finally, the paper offers a comprehensive summary of current research trends and future directions in the field. It emphasizes the need for enhanced digital finance index systems, robust risk control and regulation, and a balanced approach to fostering a genuine green economy. Additionally, it highlights potential future research avenues, such as the effects of digital finance on government policies, foreign trade, environmental pollution, and energy utilization.

Sustainable practices for cotton production in Bangladesh: economic and environmental perspectives

Cotton is a major cash crop in the agriculture of Bangladesh, primarily fueling its substantial textile industry. Although local production is limited, cotton has the potential to bolster the country’s economic growth by supporting local economies and improving agricultural sustainability. An in-depth sustainability assessment of this integral crop is essential to ensure its long-term economic and environmental viability. This study aims to evaluate the sustainability of cotton production in Bangladesh and suggest strategic enhancements and policy measures to improve its environmental, economic, and social aspects. Data were collected from 60 farmers in two villages of Jashore district using a simple random sampling technique. A combination of descriptive, mathematical and statistical techniques was used to analyze the data. The findings highlighted a profitable benefit–cost ratio of 1.88 for cotton production. Positive impacts on cotton profitability were notably linked to the costs of labor, land preparation, and insecticides and pesticides. Despite this, 60% of farmers faced substantial challenges, including financial barriers, limited access to modern agricultural technologies, and a lack of training in sustainable practices. Economic constraints were a major barrier, although the environmental benefits of sustainable practices were widely acknowledged. To address these issues, the study recommends optimizing inputs like labor, land preparation, and pest management, and advocates for policy actions such as subsidies, tax incentives, and enhanced training programs to support the widespread adoption of sustainable practices across Bangladesh.

The United States veterinary workforce dilemma: are we asking the right questions?

This article explores the ongoing debate about whether there is a workforce shortage in veterinary medicine. Despite numerous discussions, no consensus has been reached on whether the demand for veterinarians and their teams exceeds supply. The authors argue that current public discussions fail to address the core issues. The article explores the workforce issue from an economic perspective and provides a perspective on the way forward. Key aspects covered include recognizing the distinction between needs and wants, collecting better data, employing rigorous empirical analysis, differentiating market failures from high prices, and fostering cooperation.