French Francs Research Articles

Incremental cost-effectiveness ratio of alteplase in patients with acute myocardial infarction in the French setting.

On the basis of data collected from general hospital centres in France on 704 patients initially presenting with acute myocardial infarction, the mean 1-year cost of treatment was calculated to be 52,160 French francs (F) per patient (1994 values). This was independent of whether the patient received thrombolysis, and included all costs associated with initial hospitalisation including a stay in intensive care, cardiology or medical units, as well as rehospitalisations, revascularisation procedures and any drugs prescribed. When only those patients who survived the initial hospitalisation were considered, the mean cost of treatment was F58,184 per patient. Among patients who received thrombolysis during their initial hospitalisation, the respective mean 1-year costs were F74,684 per patient for those treated with alteplase and F64,866 per patient for those treated with streptokinase (p = 0.09). This nonsignificant difference can be explained by the higher cost of alteplase relative to that of streptokinase, the lower mortality rate associated with alteplase during the initial hospitalisation period (9.2% versus 10.6%) and the difference in the percentage of additional revascularisations required in the 2 treatment groups (32.8% versus 42.3%). Combining the pharmacoeconomic data collected in the French general hospital setting with incremental patient survival data stemming from the Global Utilisation of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial showed that the incremental cost-effectiveness ratio of alteplase versus streptokinase amounted to F70128 per life-year saved for the total group, and F52035 per life-year saved for those patients who survived the initial period of hospitalisation.

Cost-effectiveness of screening blood donors for hepatitis C and non-A, non-B, non-C hepatitis. The EATHIS Eco Research Group. European Acute Transfusion Hepatitis Interferon Study.

The current approach to screening for hepatitis C and non-A, non-B, non-C hepatitis in French blood transfusion centers involves a combination of a transaminase assay and tests for antibodies to hepatitis B core antigen (anti-HBc) and antibodies to hepatitis C virus (anti-HCV). A decision-analysis model was used to assess the cost-effectiveness ratio of this approach compared to the former approach, which included only transaminase and anti-HBc screening. Cost data were collected by a questionnaire sent to 26 centers throughout France. The average costs of diagnostic kits, equipment, staff, and administration were calculated. Estimates of prevalence and sensitivity values came from the medical literature. The cost-effectiveness ratio was expressed in French francs per infected donor detected. A sensitivity analysis of the variables in the model was performed to estimate the validity of the cost-effectiveness ratio. For 100,000 donations the incremental cost of the current approach reached FrF 2,566,111 (about US $500,000), with a marginal effectiveness of 180 donations detected. The sensitivity analysis showed the effect of prevalence on the incremental cost-effectiveness ratio. Transfusion centers may change their screening approach in areas of high or low prevalence of hepatitis C in France.

A cost-utility analysis of second-line chemotherapy in metastatic breast cancer. Docetaxel versus paclitaxel versus vinorelbine.

The aim of this study was to determine the incremental effectiveness, the incremental health-related quality of life (differences in quality-adjusted progression-free survival between treatments), the incremental cost and the incremental cost-effectiveness and cost-utility ratios, for docetaxel, paclitaxel and vinorelbine, when these drugs were used as second-line treatment in patients with metastatic breast cancer. In the absence of comparative direct evidence of the relative efficacy of docetaxel, paclitaxel and vinorelbine in this setting, a model was designed to determine the effects of the 3 interventions on health outcome and cost. A Markov process model, based on 53 disease states, was thus constructed to evaluate the socioeconomics of the 3 treatment regimens. The model allows assessments from the start of second-line chemotherapy until death. Costs were evaluated from the combined view of the healthcare system and the patient. Direct nonmedical and indirect costs were excluded. Consumption per episode of care was estimated by retrospective analysis of 153 medical reports from 5 different hospitals. Hospital costs were allocated values from the national accounting costs by diagnosis-related group (DRG). The content of the health states was based on the multiattribute health states classification system (MASH). Preference values were assigned by application of a standard reference lottery using 20 oncological nurses as proxies for the patients. The health-related quality-of-life score was used as a quality adjustment weighting factor to calculate quality-adjusted progression-free survival associated with the 3 different regimens. Docetaxel reduces the time spent in progression, decreases the number of complications due to progressive disease and thereby provides better quality of life. It provides a benefit of 57 disease- and discomfort-free days compared with vinorelbine and 22 days compared with paclitaxel. Docetaxel may be thought of as self-financing as a result of savings in hospital admissions, providing net savings of 6800 French francs (FF; 1993 values) compared with expenditure associated with vinorelbine treatment and FF700 compared with the equivalent figures for paclitaxel.

Robust tests of forward exchange market efficiency with empirical evidence from the 1920s

SUMMARY This paper provides a robust statistical approach to testing the unbiasedness hypothesis in forward exchange market efficiency studies. The methods we use allow us to work explicitly with levels rather than differenced data. They are statistically robust to data distributions with heavy tails, and they can be applied to data sets where the frequency of observation and the futures maturity do not coincide. In addition, our methods allow for stochastic trend non-stationarity and general forms of serial dependence. The methods are applied to daily data of spot exchange rates and forward exchange rates during the 1920s, which marked the first episode of a broadly general floating exchange rate system. The tail behaviour of the data is analysed using an adaptive data-based method for estimating the tail slope of the density. The results confirm the need for the use of robust regression methods. We find cointegration between the forward rate and spot rate for the four currencies we consider (the Belgian and French francs, the Italian lira and the US dollar, all measured against the British pound), we find support for a stationary risk premium in the case of the Belgian franc, the Italian lira and the US dollar, and we find support for the simple market efficiency hypothesis (where the forward rate is an unbiased predictor of the future spot rate and there is a zero mean risk premium) in the case of the US dollar.

Estimation de la perte de revenus salariaux de la femme en présence d'enfants

Estimating the Loss in Earned Income for a Woman with Children by Christine Barnet-Verzat This paper sets out to make a contribution to the evaluation of the loss in earned income for women with children throughout working lives. Our method evaluates income curves from estimates of labour participation equations and wage equations survey data. The results show that the loss can be as high as one million French francs throughout the working life of a woman three children, that the timing of births has little effect on this, and that the sociocultural level is a determining factor. The of the cost of children taking the form of both a loss in income and a deterioration in human capital is largely confirmed.

Integrating information from global systems: Dealing with the “on‐ and off‐ramps”; of the information superhighway

The notion of an “information superhighway”; has attracted considerable attention. It offers the possibility to access information from around the world in support of many important applications in areas such as finance, manufacturing, and transportation (e.g., global risk management, integrated supply chain management, and global in‐transit visibility). Unfortunately, there are significant challenges to be overcome. One particular problem is context interchange which can be thought of as dealing with the “on‐ and off‐ramps”; of the information superhighway. Each source of information and potential receiver of that information may operate with a different context. A context is the collection of implicit assumptions about the context definition (i.e., meaning) and context characteristics (i.e., quality) of the information. When the information moves from one context to another, it may be misinterpreted (e.g., sender expressed the price in French francs; receiver assumed that it meant U.S. dollars). This ar...

Seroepidemiologic Screening of Echinococcus multilocularis Infection in a European Area Endemic for Alveolar Echinococcosis

In a serologic survey for Echinococcus multilocularis infection, we screened sera from 7,884 subjects from the Doubs Departement in France, an area endemic for alveolar echinococcosis (AE) of the liver. An enzyme-linked immunosorbent assay (ELISA) with a highly species-specific antigen (Em2) and an E. multilocularis crude antigen (Emc) was used for screening. An evaluation of the cost/benefit relationship of this screening, followed by therapeutic management of patients, was made and compared with the actual cost of the follow-up and treatment of the disease in symptomatic cases in this endemic area. Antibody reactions to Em2 and/or Emc made possible the detection of eight asymptomatic clinical cases (seroprevalence averaging 1/1,000), with typical lesions of active AE revealed by abdominal ultrasonography and computed tomography. All were seropositive using the Emc ELISA but two were seronegative using the Em2 ELISA. In five additional seropositive cases, the radiologic investigations revealed small calcified lesions similar to the lesions of abortive AE previously found in Alaska. The cost of this serologic screening program per screened subject and per diagnosed case averaged 50.00 French Francs (FF) (U.S. $8.60) and 60,000.00 FF (U.S. $10,909.00), respectively. The cost of diagnosis, follow-up and treatment of the patients was 5,086.00 FF (U.S. $929.00) per patient per month in the case of diseases diagnosed by the screening program and 7,086.00 FF (U.S. $1,288.00) per patient per month for patients with symptomatic AE. This survey indicates a high prevalence of AE in the target area; it confirms the long latency period of the larval growth in human AE and shows that abortive AE is present in Europe. The use of both the Emc and Em2 ELISAs seems to be better than using the Em2 ELISA alone. The cost of the hospitalization and treatment of the eight screened patients would appear to be relatively high. Even though two of them were asymptomatic, they had very severe forms of the disease. In fact, the total cost was much lower than the actual cost of the disease when diagnosed from clinical symptoms.

Forward exchange rates and expectations during the 1920s: A re-examination of the evidence

The Philips-Hansen fully modified Wald test is used to analyze whether or not the forward rate is an unbiased predictor of the future spot rate for the 1920s. Daily data for five exchange rates (German mark, Belgium franc, French franc, Italian lira and US dollar versus the British pound) are examined. The results suggest that the forward unbiasedness hypothesis can be rejected in three (Belgium franc, French Franc and German mark) out of the five currencies. This result may be due to the presence of a risk premium for the Belgian and French francs and to market failure in the case of the German mark, the forward and future spot exchange rates are cointegrated. (JEL F31).

The cost of treatment dropout in depression A cost-benefit analysis of fluoxetine vs. tricyclics

In this study, we tried to estimate the economic potential benefit of the use of fluoxetine (PROZAC R 20 mg, Lilly) versus tricyclic antidepressants (TCAs) in depression of mild to moderate intensity. Fluoxetine has demonstrated, in controlled studies, significantly lower rates of side-effects and treatment dropout than TCAs while showing similar efficacy. Treatment dropout, especially at an early stage of the therapy, can have profound consequences, including excessive lengthening of the depressive episode, symptomatic relapse, increase of repeated days out of work, even suicides or suicide attempts. We estimated the expected cost of treatment dropout using a Delphi expert panel. We then computed the economic benefit of fluoxetine by combining the dropout cost and the differential rate of total treatment dropout between fluoxetine and TCAs, as found in clinical trials. We thus showed that a 8 week fluoxetine could be beneficial to society provided society values a year of human life above a threshold varying from French Francs 23.800 to FF8.600 (respectively, about US$4500 and 1600) depending on the type of depression. As these values are extremely low compared to those found in the literature, we concluded that an apparently costly innovation such as fluoxetine may induce short-term financial savings for society.

The Bou Medfaa (Algeria) earthquake of 7 November 1959

The Bou Medfaa earthquake of 7 November 1959 occurred at 2 h 32 min 7 s (GMT); it is one of the most destructive seismic events that central Algeria experienced this century. The main shock, which lasted 8 s in Bou Medfaa, caused only two injuries but made at least 500 homeless; it destroyed or heavily damaged more than 80% of the houses, farms and public buildings in Bou Medfaa and its immediate surroundings. Poor-quality constructions were the main cause of the damage. The total cost of damage was estimated at 300 million French francs. The earthquake was preceded by two slight foreshocks and followed by a series of lower intensity aftershocks. It was associated with slight surface ground fissures in Bou Medfaa. Compilation and detailed study of the contemporary source documents relative to this earthquake have led to the reconstruction of its macroseismic field and thus to the re-assessment of the strength of the ground shaking. Intensities were re-evaluated anew in many sites. Maximum intensity has been re-estimated at I 0 = VIII (MSK), assigned to Bou Medfaa, Hammam Righa and their close vicinities, an area about 8 km radius. The shock was felt as far as Dellys 150 km away with intensity III (MSK). From the intensity data, the macroseismic epicentre was located slightly north of Bou Medfaa at 36·41°N, 2·48°E, and an isoseismal map of the main shock has been constructed. The surface-wave magnitude has been calculated, without station corrections, at 4·90 (±0·40). The instrumental epicentre has been relocated, using the present location procedure of the ISC, at 36·38°N, 2·55°E. The analysis of destructive earthquakes provides a fundamental means for the reduction of future seismic catastrophes by suggesting new ways of improving local construction procedures, building materials, strengthening and properly repairing existing structures and implantation of new urban and rural settlements.

Late referral to maintenance dialysis: detrimental consequences

Thirty per cent of patients who started maintenance haemodialysis at our institution between January 1989 and December 1991 had been referred at a very late stage of their renal disease. To assess the causes and consequences of such late referral we retrospectively compared clinical and laboratory features of 65 patients who had been referred less than 1 month prior to first dialysis (late referral, or LR group) and of 153 patients who had been previously followed-up by us for more than 6 months (early referral, or ER group). Age, sex ratio, and socioeconomic status were similar in the two groups. In the LR group, 38 patients had never been referred to a nephrology unit, whereas 27 had discontinued nephrological surveillance. Fluid overload, severe hypertension, and/or pulmonary oedema was present in 57% of LR versus 15% of ER patients (P < 0.001). Mean (+/- 1 SD) systolic and diastolic blood pressure was greater in the LR than the ER group (173 +/- 19/99 +/- 12 versus 147 +/- 15/84 +/- 8 mmHg, P < 0.001). Mean plasma concentration of creatinine, urea and phosphate was significantly greater, whereas bicarbonate, calcium, haematocrit and albumin were less in the LR than the ER group. Most (88%) LR patients started dialysis in emergency conditions through central vein catheterization. Total hospital stay lasted 34.5 +/- 16.3 days in LR versus 5.8 +/- 3.0 days in ER patients (P < 0.0001), resulting in an excess cost of 0.2 million French francs per LR patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Shifting Agriculture and Sustainable Development: An Interdisciplinary Study from North-eastern India, by P.S. Ramakrishnan. (Man and the Biosphere Series, Volume 10.) UNESCO, 7 Place de Fontenoy, 75700 Paris, France, and Parthenon, New Jersey, USA, and Carnforth, England, UK: xvii + 424 pp., illustr., tables, 24 × 16 × 3.5 cm, hardback, £48 or 480 French francs, 1992.

Shifting Agriculture and Sustainable Development: An Interdisciplinary Study from North-eastern India, by P.S. Ramakrishnan. (Man and the Biosphere Series, Volume 10.) UNESCO, 7 Place de Fontenoy, 75700 Paris, France, and Parthenon, New Jersey, USA, and Carnforth, England, UK: xvii + 424 pp., illustr., tables, 24 × 16 × 3.5 cm, hardback, £48 or 480 French francs, 1992. - Volume 20 Issue 1

Foreign position in French francs: An econometric study with stock data over the EMS period

Modelling exchange rates is a difficult challenge. This paper assumes that a correct exchange rate model cannot depart from a portfolio balance approach and from a full description of supply and demand in the foreign exchange market. Therefore this work analyses the foreign position in French francs by using net claims (pictured as stock data and not as flow data) and the cointegration technique. The first part summarizes some experiments in macroeconomic modelling of exchange rates and especially underlines the differences between reduced and structural forms. The second part points out the microeconomic foundations of the portfolio balance models of exchange rates. The third part presents an econometric study of the foreign position in French francs derived from a structural model and based on net claim data. The main result is that speculative behaviour only exists in the short run and that hedge behaviour appears in the long run as well as in the short run. This is relevant with regard to the exchange controls existing for the greater part of the period under review (1979–1989).

The Socio‐economic Cost of Diabetic Complications in France

The costs to the community of diabetes and diabetic complications are large and the allocation of resources to prevention, diagnosis, and health care is controversial. The direct economic costs of diabetes are for the most part medical charges, whereas the indirect costs encompass loss of working days and a range of effects on the patient's quality of life. In the present study the monetary cost is estimated for a sample of 109 patients. Data on current state of health, socio-economic characteristics and aspects of social and professional life were measured and expressed as the average medical annual cost of a patient in 1984. Medical expenditure categories included hospitalization, home visits, laboratory tests, pharmaceutical expenditure, and other medical and paramedical services. The average medical cost in 1984 was 12 178 French francs (FFr) for Type 1 diabetic patients and FFr 6908 for Type 2 diabetic patients. Omitting sick-leave expense, the average cost of diabetic patients was close to the French national average of medical costs (or consumption) (FFr 7711 (Type 1), FFr 5892 (Type 2) vs FFr 6462 (national average]. Hospitalization constituted 33.9% (Type 1) and 40.1% (Type 2) of costs in France. Hospitalization for diabetic complications was not evaluated in this study and is poorly documented in France.

Prolog III

Prolog III is available from PrologIA Luminy, Case 919 13288, Marseille Cedex 09, France. Tel: +33 91 26 86 36. Prices (French francs): Sun 3, 70 000; Sparc 100 000; Mac Plus/SE 30 000; Mac SE 30/II38 000; IBM PC 386 38 000. Prices exclude VAT. Universities are entitled to a 60% discount and research centres to 30%. Systems are also available for HP9000 (series 300 and series 800), VAX and DECstation.

La zone franc est-elle le bouc-émissaire de l'échec du développement ?

C. Freud — The Franc Zone, a Scapegoat for Development Failures. World Bank experts blame the failure of structural adjustment policies in countries belonging to the West African Franc Zone on the overvaluation of the CFA franc. They advocate, therefore, breaking up this monetary bloc. It is proven that the exchange rate between the CFA and French francs has barely changed over the past 30 years, and that overvaluation does little to account for failed adjustment policies. Examples from countries outside this zone show that devaluation does not inevitably stimulate economie growth. Abolishing the franc zone would probably cause more problems than it would solve. Thanks to this zone, the shocks of economie recession that would have hurt the most underprivileged have been absorbed.

Berthelemy, J. C, and C. Morrison. Agricultural Development in Africa and the Supply of Manufactured Goods. Paris: Development Centre of the Organization for Economic Co‐operation and Development, 1989, 129 pp., 110 French francs

American Journal of Agricultural EconomicsVolume 72, Issue 4 p. 1094-1094 Books Reviewed Berthelemy, J. C, and C. Morrison. Agricultural Development in Africa and the Supply of Manufactured Goods. Paris: Development Centre of the Organization for Economic Co-operation and Development, 1989, 129 pp., 110 French francs Arthur Domike, Arthur Domike DSL Capital Corporation, Washington DCSearch for more papers by this author Arthur Domike, Arthur Domike DSL Capital Corporation, Washington DCSearch for more papers by this author First published: 01 November 1990 https://doi.org/10.2307/1242645AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume72, Issue4November 1990Pages 1094-1094 RelatedInformation

Packaging production and consumption in the world and in some industrialized countries

AbstractThis paper reports on statistics concerning production and consumption of packaging (as a whole or per capita) in Europe, in the USA, in Japan and in the world. Data have been provided by National Trade Associations and by consultants specialized in packaging and in economics. It is estimated that in 1986 the global consumption of packaging reached 150 millions of tonnes valued at 1200 billions of French francs. Consumption could reach 247 million tonnes by the year 2000. Paper and board have the highest consumption rate, but plastics have the highest rate of growth. Nevertheless, consumption per capita in the industrialized countries will be more than 10 times the consumption in underdeveloped countries. The packaging industries take fourth place in the USA, sixth in Western Germany and twelfth in France.In Europe, as in the world, paper and board is the material most used (40%), with glass (a high density material) taking second place and plastics third, i.e. if we consider the quantity of materials and not their value. Some differences appear between the various countries, but the figures for USA and Japan lead to similar conclusions.The survey shows clearly that the USA as compared with Europe has twice the consumption of packaging materials per capita and this difference is even greater compared with the rest of the world.

Reporting book prices

American research libraries are again entering a period of collection retrenchment. This retrenchment, similar to the one that occurred in the late '70s and early '80s, is caused principally by the radical losses in the dollar's value over the past two and a half years. The dollar today b u y s rough ly 56.6% fewer D u t c h guilders, 13.7% fewer British pounds, 56.8% fewer German marks, and 44.5% fewer French francs than it did in July 1984. For libraries that purchase 40-60% of their materials overseas, this change has been catastrophic. Reports of collection budget shortfalls in fiscal year 1986/87 are already beginning to be heard. Some range from $100,000 to $500,000. Particularly affected have been the serial budgets where the combination of expensive scientific serials and the dollar's downturn has been devastating. Describing problems caused by the dollar's weakness the University of California at San Diego Newsletter of March 1987 reports:

Money versus pain: experimental study of a conflict in humans.

Ten healthy human males volunteered to be subjects in an experiment in which they were to be paid to endure a painful sensation. This sensation was produced by isometric muscular contraction in the thighs. For each of six sessions the subjects received either a payment that was changed for each session (0.2, 0.5, 1.25, 3.125, 7.8125 French francs per 20 s) or a lump sum. At the beginning of a session, the subjects assumed a seated position against a wall, but without a seat, and the duration for which they could hold this position was the chief variable measured. Heart rate, blood pressure, and magnitude estimation of pain were also recorded periodically throughout each session. Pain was reported after a mean delay of 15 +/- 7 s (SE), and the magnitude estimates then increased linearly with time. The duration of maintaining the painful position increased linearly in relation to the logarithm of the increase in the amount of payment. Thus, utility of money decreased when pitted against pain.