Cost Fee Research Articles

The Value of Patent and Trademark Pairs

The valuation of patents is assessed with respect to complemental IP strategies such as trademarks, design patents and utility models. I elaborate a novel method and database to gauge the combination of IP strategies regarding the same innovative project, when the patenter pairs the patenting strategy with other formal IP mechanisms. In particular I analyze jointly the content of legal documents using textual matching algorithms, and I link them with estimates on the market value of patents and historical renewal fee costs. I find ample evidences that patent and trademark pairs have a large impact both on the patent asset value and the premium value of the IP protection, and they are disproportionally associated with breakthrough inventions. One additional patent and trademark pair yields an increase of about PPP $ 80 million in the asset value, and it doubles the average premium value. These results hold after controlling for several patenter demographic characteristics and patent value indicators typica...

Cost-of-illness and disease burden of food-related pathogens in the Netherlands, 2011

To inform risk management decisions on control and prevention of food-related disease, both the disease burden expressed in Disability Adjusted Life Years (DALY) and the cost-of-illness of food-related pathogens are estimated and presented. Disease burden of fourteen pathogens that can be transmitted by food, the environment, animals and humans was previously estimated by Havelaar et al. (2012). In this paper we complement these by cost-of-illness estimates. Together, these present a complete picture of the societal burden of food-related diseases.Using incidence estimates for 2011, community-acquired non-consulting cases, patients consulting their general practitioner, hospitalized patients and the incidence of sequelae and fatal cases, estimates were obtained for DALYs, direct healthcare costs (e.g. costs for doctor's fees, hospitalizations and medicines), direct non-healthcare costs (e.g. travel costs to and from the doctor), indirect non-healthcare costs (e.g. productivity loss, special education) and total costs.The updated disease burden for 2011 was equal to 13,940DALY/year (undiscounted) or 12,650DALY/year (discounted at 1.5%), and was of the same magnitude as previous estimates. At the population-level thermophilic Campylobacter spp., Toxoplasma gondii and rotavirus were associated with the highest disease burden. Perinatal listeriosis infection was associated with the highest DALY per symptomatic case.The total cost-of-illness in 2011 of fourteen food-related pathogens and associated sequelae was estimated at € 468 million/year, if undiscounted, and at € 416 million/year if discounted by 4%. Direct healthcare costs accounted for 24% of total costs, direct non-healthcare costs for 2% and indirect non-healthcare costs for 74% of total costs. At the population-level, norovirus had the highest total cost-of-illness in 2011 with € 106 million/year, followed by thermophilic Campylobacter spp. (€ 76 million/year) and rotavirus (€ 73 million/year). Cost-of-illness per infected case varied from € 150 for Clostridium perfringens intoxications to € 275,000 for perinatal listeriosis.Both incident cases and fatal cases are more strongly correlated with COI/year than with DALY/year.More than 40% of all cost-of-illness and DALYs can be attributed to food, in total € 168 million/year and5,150 DALY/year for 2011. Beef, lamb, pork and poultry meat alone accounted for 39% of these costs. Products of animal origin accounted for € 86 million/year (or 51% of the costs attributed to food) and3,320 DALY/year (or 64% of the disease burden attributed to food). Among the pathogens studied Staphylococcus aureus intoxications accounted for the highest share of costs attributed to food (€ 47.1 million/year), followed by Campylobacter spp. (€ 32.0 million/year) and norovirus (€ 17.7 million/year).

Cost-Effectiveness Analysis of Latanoprost Compared with Dorzolamide/Timolol Fixed Combination for the Treatment of Open-Angle Glaucoma and Ocular Hypertension Patients in Korea.

Glaucoma is a major cause of visual impairment and a chronic disease requiring treatment for lifetime. Management of intraocular pressure (IOP) is the main focus of treatment, and many pharmacological treatment agents are recommended and available in Korea. This study was conducted to facilitate efficient allocation of limited resources amongst various pharmacological agents. The objective of this study was to evaluate costs and effectiveness of two most commonly used drugs in Korea which are latanoprost and dorzolamide/timolol fixed combination. A decision analytic model was developed from a payer perspective to evaluate clinical effectiveness, costs and utility values of latanoprost and dorzolamide/timolol fixed combination. The model was constructed based on a one-month cycle with a time horizon of one year. The treatment success to measure effectiveness was defined as achieving a ≥20% reduction IOP from baseline. Costs of medication, diagnostic fees, physician and pharmacy visitation fees, and surgery fees were included in the study. Utility values according to the severity of glaucoma were also incorporated in the model. Treatment success and failure rates as well as utility for each health state were obtained from previously published literature and local market analysis data. Cost information was obtained from Korea-specific data sources. The result of this study was expressed in an incremental cost-effectiveness ratio (ICER). One-way sensitivity analysis was conducted to evaluate different clinical parameters. The final effectiveness values for latanoprost and dorzolamide/timolol fixed combination were 0.9098 and 0.9089 in quality-adjusted life year (QALY), and the final costs were 550,737 KRW and 534,789 KRW respectively. Latanoprost displayed an ICER of 17,500,246 KRW/QALY compared to dorzolamide/timolol fixed combination. Under the currently implied ICER threshold in Korea, latanoprost can be interpreted as a cost-effective treatment option compared to dorzolamide/timolol fixed combination on the treatment of glaucoma.

From Doctor to Nurse Triage in the Danish Out-of-Hours Primary Care Service: Simulated Effects on Costs

Introduction. General practitioners (GP) answer calls to the Danish out-of-hours primary care service (OOH) in Denmark, and this is a subject of discussions about quality and cost-effectiveness. The aim of this study was to estimate changes in fee costs if nurses substituted the GPs. Methods. We applied experiences from The Netherlands on nurse performance in the OOH triage concerning the number of calls per hour. Using the 2011 number of calls in one region, we examined three hypothetical scenarios with nurse triage and calculated the differences in fee costs. Results. A new organisation with 97 employed nurses would be needed. Fewer telephone consultations may result in an increase of face-to-face contacts, resulting in an increase of 23.6% in costs fees. Under optimal circumstances (e.g., a lower demand for OOH services, a high telephone termination rate, and unchanged GP fees) the costs could be reduced by 26.2% though excluding administrative costs of a new organisation. Conclusion. Substituting GPs with nurses in OOH primary care may increase the cost in fees compared to a model with only GPs. Further research is needed involving more influencing factors, such as costs due to nurse training and running the organisation.

Attorney Advertising and the Contingency Fee Cost Paradox

It has long been taken as gospel that attorney advertising drives down the cost of legal services. The Supreme Court assumed it when first permitting attorney advertising in the landmark First Amendment case, Bates v. State Bar of Arizona. And, in the decades following Bates, courts, commentators, the ABA, and the FTC have followed suit, frequently touting advertising’s ability to cut consumer costs. The price effect of attorney advertising is thus both seemingly settled and also deeply embedded in its judicial justification.But there is a wrinkle. Though it appears advertising did drive down prices for routine legal services in the years immediately following Bates, in the intervening decades, there has been a decided, yet heretofore unexplored, shift. Contemporary attorney advertising is now mostly the province of the personal injury bar. Yet there is scant evidence that attorney advertising reduces the contingency fees personal injury lawyers charge. To the contrary, the best, most sophisticated, most comprehensive study of legal fees and attorney advertising ever conducted found that, unlike for most basic legal services (e.g., wills, personal bankruptcies, uncontested divorces), those who advertised personal injury legal services charged higher prices than their non-advertising counterparts. Other evidence likewise shows contingency fees have not dropped, even while personal injury lawyers’ ad expenditures have soared. This fact has been all but ignored, though it is of enormous consequence for both the legality of attorney advertising and the delivery of legal services more generally. This Article aims to reopen and reorient the “settled” attorney advertising debate, in light of the particularities of personal injury practice and the changing nature of the market for personal legal services in the United States.

Cost-effectiveness of regorafenib for pretreated metastatic colorectal cancer patients in the United States.

578 Background: There is an unmet need for treatments that provide a survival benefit for patients with heavily pretreated metastatic colorectal cancer (mCRC). In a randomized, double-blind, placebo-controlled trial, patients treated with regorafenib plus best supportive care (BSC) had significant improvement in overall survival (OS) versus patients in the placebo arm receiving BSC alone. The aim of this study was to estimate the cost-effectiveness of regorafenib for the treatment of patients with mCRC after failure or intolerance to irinotecan-, oxaliplatin-, and fluorouracil-based regimens, from the perspective of a U.S. health care payer. Methods: A cohort-partition model was developed to simulate treatment costs and survival for patients treated with regorafenib or BSC alone. Survival was projected by fitting Weibull distributions to trial data. Mean duration of treatment (3.0 months regorafenib, 2.1 months BSC), utilities (0.71 on treatment, 0.59 post-treatment) and serious adverse event rates were also based on trial data. Monthly drug monitoring and physician fee costs were based on Medicare fee schedules. Routine mCRC care and adverse event unit costs were obtained from an analysis of administrative claims in two large managed care databases. Costs were estimated in 2012 USD. Results: Patients treated with regorafenib had prolonged survival versus BSC alone (0.75 versus 0.60 years) and also had higher lifetime costs ($97,700 versus $59,494). The improvement in quality-adjusted life years (0.47 versus 0.37) was small due to the heavily pretreated nature of the patient population. The increase in costs was attributable to increases in costs for drug acquisition, adverse events , and routine care from increased survival. Conclusions: Regorafenib increases life expectancy for patients with pretreated metastatic colorectal cancer. The cost of this benefit could be considered high; however, it could be justifiable given high unmet need for these patients. The increase in cost is primarily due to drug acquisition costs, similar to other recent treatments for metastatic cancers.

In Reply

Conflict of interest statement Dr Wittmann has received consultancy fees from Bristol Myers Squibb and Servier. He has received honoraria for authorship in the context of a publication from Servier, which was relevant to the topic of the article. He has been reimbursed the costs for congress participation, travel, and accommodation, and fees for the preparation of scientific training courses from AstraZeneca, Servier, Wyeth, Lilly, Janssen-Cilag, GlaxoSmithKline, Pfizer, EISEI, and Lundbeck. He has accepted funds into a third-party account for performing commissioned clinical studies from Servier.

Could the polypill improve adherence? The patient perspective

Multiple medications are recommended for the management of ischaemic heart disease. Unfortunately, increasing the number of medicines reduces adherence to medicines therapy. The concept of a polypill with a fixed dose combination of the common cardiovascular medicines (aspirin, statin, two blood pressure-lowering medicines) has been promoted. Patient perceptions about this concept have not been explored. People taking at least three cardiovascular medicines were interviewed using a semi-structured interview about their views on a polypill that could reduce the number of tablets they would need to take. The participants considered that the polypill would be very convenient, especially when travelling and would reduce the pill burden. If the polypill was subsidised by the government, they would have reduced dispensing fee costs. There were concerns around the inflexibility of dosing of individual components of the polypill, and some concerns about safety and efficacy. Medical practitioners were identified as having an important role in influencing participants about the acceptability of the polypill. Generally the concept of the polypill was acceptable to participants, primarily because of the convenience and reduced number of tablets required daily. There were concerns about whether the polypill would be as effective and safe as the individual medicines.

Valuing Private Equity

We develop a dynamic valuation model of private equity (PE) investments by solving the portfolio-choice problem for a risk-averse investor (LP), who invests in a PE fund, managed by a general partner (GP). Key features are illiquidity, leverage, GP value-adding skills (alpha), and compensation, including management fees and carried interest. We find that the costs of management fees, carried interest, and illiquidity are high, and the GP needs to generate substantial value to cover these costs. Leverage substantially reduces these costs. Finally, we find that conventional interpretations of PE performance measures are optimistic. On average, LPs may just break even.

Health Care Costs of Peritoneal Dialysis Technique Failure and Dialysis Modality Switching

Although there is a strong economic rationale in favor of peritoneal dialysis (PD) over hemodialysis (HD), the potentially costly effect of PD technique failure is an important consideration in PD program promotion that is unknown. Incident dialysis patients were categorized by initial and subsequent modality changes during the first year of dialysis and tracked for inpatient and outpatient costs, physician claims, and medication costs for 3 years using merged administrative data sets. We determined unadjusted and adjusted total cumulative costs for each modality group using multivariable linear regression models. All incident dialysis patients from Alberta in 1999-2003. 3-year mean adjusted total cumulative costs. Mean direct health care costs by modality group determined using patient-level resource utilization data. 3-year adjusted total cumulative costs for patients in the PD-only and HD-to-PD groups were $58,724 (95% CI, $44,123-$73,325) and $114,503 (95% CI, $96,318-$132,688), respectively, compared with $175,996 (95% CI, $134,787-$217,205) for HD only. PD technique failure was associated with lower costs by $11,466 (95% CI, $248-$22,964) at 1 year compared with HD only; however, costs were similar at 3 years. Costs drivers in PD technique failure arose primarily from costs of dialysis provision, hospitalization, medications, and physician fees. This analysis is taken from the perspective of the health payer, and costs that are outside the health care system are not measured. Compared with patients who receive only HD, those who received PD only and those who transitioned from HD to PD therapy had significantly lower total health care costs at 1 and 3 years. Patients experiencing PD technique failure had costs similar and not in excess of HD-only patients at 3 years, further supporting the economic rationale for a PD-first policy in all eligible patients.

Sex Differences in Graduate School Choice for Black HBCU Bachelor’s Degree Recipients: A National Analysis

Data from the Baccalaureate and Beyond Longitudinal Study were analyzed to identify factors that historically Black colleges and universities graduates considered when choosing a graduate school; follow-up tests examined differences between Black men and women in the national sample. Interestingly, we found that Black men and women consider the same three factors most frequently when making graduate school decisions: reputation of school and faculty, proximity to home or work, and availability of an academic program. There were clear differences between men and women, however, in the extent to which they considered access to financial aid and costs of tuition and fees. Implications for theory, research, and practice are highlighted.

The Cost of ALS Care within the Veterans Health Administration (P03.172)

Objective: To determine the cost of Amyotrophic Lateral Sclerosis (ALS) care within the Veterans Health Administration (VHA). Background A 2006 report by the Institute of Medicine revealed that individuals that have served in the military have a 1.5 to 2 times increased risk of developing ALS. Based on this study, ALS became a compensable illness within the VHA in 2008. The cost of ALS care is considerable as patients require close monitoring of respiratory and nutritional needs as well as continued assessment of mobility and proper functional equipment. The VHA is a unique system in that patients receive all their care within a single payer system, which allows for reliable cost analysis. Design/Methods: Data was obtained retrospectively for fiscal years (FY) 2005-2010 from the Corporation Data Warehouse (CDW). Data merging and analysis were done through scrambled SSN; no patient identifiable information was used. ALS patients were identified by ICD-9 codes from the inpatient, outpatient and fee files. Results: There were 1522 patients with a diagnosis of ALS within the VHA in FY05 which increased to 2752 patients in FY10. The total cost of care increased from $35,890,466 to $114,288,333, respectively. The average total cost per patient in FY05 was $23,581 and $41,529 in FY10. The average inpatient, outpatient and fee basis costs per patient were $8,901, $11,566 and $3,115 in FY05, respectively. In FY10 these costs were $15,421, $19,272 and $6,836, respectively. Conclusions: The cost per patient and total cost of ALS care within the VHA has increased substantially from FY05 to FY10. The total cost dramatically increased in 2008 after ALS was declared a compensable illness. The cost per patient has also steadily increased, likely related to increased utilization of services within the VHA by veterans. The share of outpatient and inpatient costs in relation to overall total costs have remained stable. Disclosure: Dr. Khokhar has nothing to disclose. Dr. Patwa has nothing to disclose.

Arbitrage of Single Stocks Versus Futures in India

Whether for hedging, investing or trading purposes, securities regulators and stock exchanges along with domestic and foreign institutional investors all have a common interest in having fairly priced futures contracts. Achieving and sustaining fairly valued equity futures depends heavily on the existence of active arbitrage in which stocks and futures are paired off against one another by professional arbitrageurs seeking to exploit any mispricing. Current constraints on efficient arbitrage in India include the high costs of brokerage, government, exchange and regulatory fees, an underdeveloped securities lending business to support short selling and, to a lesser extent, an electronic stock execution platform in need of speedier execution. The result of these costs and constraints is that stock versus futures arbitrage in India is presently confined almost entirely to intraday transactions between selected single stocks and their stock futures contracts. Using recent single stock futures data this article explores specific arbitrage details of single stocks vs. their futures in the India market. The zero arbitrage band width for this type of arbitrage was found to be typically at least twice that occurring in mature global markets and in serious need of narrowing. If India regulators, exchanges and taxing authorities wish to encourage the growth of valuable arbitrage business, then steps will be needed to reduce the costs that widen this band. Knowledge of the requirements for successful arbitrage detailed in this paper can suggest to regulators and exchanges steps necessary for improving market liquidity and increasing participation in India's rapidly growing stock and futures markets.

Financial Planning for Retirement Village Living: A Qualitative Exploration

This Australian exploratory study investigates the financial considerations retirees experienced before moving into a retirement village. A qualitative content analysis was undertaken on the responses of 52 retirement village residents, who were part of a much larger study on retirees’ accommodation choices in 2007. The respondents were grouped according to income, and the results were compared across the following groups (self-funded retirees, part-pension retirees, and full-pension retirees). Differences between the groups extended beyond affordability. Both pension groups were more anxious about the increasing costs of maintenance fees than self-funded retirees, and the importance of pensions and superannuation was also discussed.

Who Gains and Who Loses from Credit Card Payments? Theory and Calibrations

Merchant fees and reward programs generate an implicit monetary transfer to credit card users from non-card (or “cash”) users because merchants generally do not set differential prices for card users to recoup the costs of fees and rewards. On average, each cash-using household pays $151 to card-using households and each card-using household receives $1,482 from cash users every year. Because credit card spending and rewards are positively correlated with household income, the payment instrument transfer also induces a regressive transfer from low-income to high-income households in general. On average, and after accounting for rewards paid to households by banks, the lowest-income household ($20,000 or less annually) pays $23 and the highest-income household ($150,000 or more annually) receives $756 every year. We build and calibrate a model of consumer payment choice to compute the effects of merchant fees and card rewards on consumer welfare. Reducing merchant fees and card rewards would likely increase consumer welfare.

Comparisons in Economic Returns between Double- and Triple Matings in Female Pigs in Commercial Herds

The present study compared economic returns between doubleand triple matings in first-serviced and reserviced female pigs. Our reproductive performance data included 102,553 service records in 117 commercial herds. The service included a singleor more mating events during estrus. The economic models for returns over mating costs per service were constructed by using the data on reproductive performance and economic assumptions. The value for a weaned pig was estimated by the market price per pig minus the costs for feed, vaccines, veterinary treatments, transportation, slaughter fees, labor and utility per pig. Sensitivity analysis was performed to determine a threshold point for the farrowing percentage in the double matings required to exceed the returns in the triple matings. In the first-service group, triple-mated gilts and sows had higher farrowing percentages and number of pigs born alive (PBA) than double-mated gilts and sows (P<0.05). In the reservice group, no differences in farrowing percentage and PBA were found between doubleand triple matings. The value per pig weaned was $101.1. For first-serviced gilts and sows, returns over mating costs for triple matings were higher than those for double matings. We recommend performing triple matings for females to be first-serviced, and double matings for females returning to estrus for maximizing profitability in Japan. Additionally, our sensitivity analysis indicates that the returns in double matings for sows would surpass those in triple matings when producers increase the farrowing percentage by 1.0%.

Decision analysis model for hepatitis B prophylaxis one year after liver transplantation

In patients receiving orthotopic liver transplantation, hepatitis B recurrence rates have decreased significantly with the use of various methods for prophylaxis. At present, a combination of hepatitis B immunoglobulin (HBIG) and lamivudine is the standard of care, resulting in recurrence rates of 0% to 11%. Recent data suggest that the addition of adefovir to lamivudine is successful in treating patients with recurrent hepatitis B infection. A Markov model was used to compare costs and outcomes of 2 strategies for hepatitis B prophylaxis 1 year after transplantation. The first consisted of prophylaxis with lamivudine and adefovir (strategy 1), whereas the second consisted of intramuscular HBIG and lamivudine (strategy 2) with the addition of adefovir in patients who subsequently developed hepatitis B recurrence. Patients who failed with adefovir and lamivudine were then treated with tenofovir and entecavir. 16.8% of liver transplant recipients had hepatitis B recurrence after 10 years of treatment with lamivudine and HBIG. The medical costs for strategy 1 and strategy 2 after 10 years of therapy were $151,819 and $166,246, respectively, and this resulted in cost savings of $14,427. The decision analysis model began 1 year after liver transplantation. A 1-way sensitivity analysis demonstrated that the model was most sensitive to cost changes of adefovir and HBIG injections as well as variations in the hepatitis B virus recurrence rate. The model was robust to costs of lamivudine, laboratory costs, administrative fees, and office visit fees. Our decision analysis model resulted in marked savings in costs with strategy 1 (lamivudine and adefovir), providing pharmacoeconomic support for the use of this strategy as first-line therapy in hepatitis B prophylaxis in liver transplant recipients 1 year after liver transplantation.

The Impact of Revenue‐Maximizing Priority Pricing on Customer Delay Costs

ABSTRACTSpeed is an increasingly important determinant of which suppliers will be given customers' business and is defined as the time between when an order is placed by the customer and when the product is delivered, or as the amount of time customers must wait before they receive their desired service. In either case, the speed a customer experiences can be enhanced by giving priority to that particular customer. Such a prioritization scheme will necessarily reduce the speed experienced by lower‐priority customers, but this can lead to a better outcome when different customers place different values on speed. We model a single resource (e.g., a manufacturer) that processes jobs from customers who have heterogeneous waiting costs. We analyze the price that maximizes priority revenue for the resource owner (i.e., supplier, manufacturer) under different assumptions regarding customer behavior. We discover that a revenue‐maximizing supplier facing self‐interested customers (i.e., those that independently minimize their own expected costs) charges a price that also minimizes the expected total delay costs across all customers and that this outcome does not result when customers coordinate to submit priority orders at a level that seeks to minimize their aggregate costs of priority fees and delays. Thus, the customers are better off collectively (as is the supplier) when the supplier and customers act independently in their own best interests. Finally, as the number of priority classes increases, both the priority revenues and the overall customer delay costs improve, but at a decreasing rate.

Is the cost of regulation spiralling out of control?

The cost of keeping your name on the Nursing and Midwifery Council (NMC) register is escalating every year, and it seems little is been done to explain or justify the costs. Recently, a colleague telephoned the NMC and asked for a breakdown of the expenditure so she could see where the money was being spent. Unfortunately, no satisfactory reply was offered (except some remarks about the spiralling costs of legal fees for professional misconduct cases).

The cost of education: saving for school and university fees

Having children can be an expensive business, not least when it comes to considering the costs of school and university fees. Most parents would agree that a good education is key to giving children the best start in life. This comes at a cost, however, especially for parents who choose to educate their children in private schools. As many young people continue their education into their early twenties, the financial cost to parents can continue for many years.