Low Unit Cost Research Articles

Route planning evaluation of a prototype optimised infield route planner for neutral material flow agricultural operations

The need to decrease unit production costs has led agricultural industries to develop larger and consequently heavier machinery. While this has increased the productivity of single machines, it has also caused significant soil compaction, which may cause reduced crop yield and crop quality. Therefore, mechanisation solutions that have both lower unit costs and reduce the risk of soil compaction are needed. Optimising infield routes will reduce labour costs, fuel consumption and field trafficking intensity, providing important benefits for infield operations. In this paper, a prototype of an optimised infield route planning tool for neutral material flow operations is evaluated. The evaluation parameters focused on distance and traffic intensity reductions, comparing the routes proposed by the tool prototype and the routes followed by a professional operator during mowing operations. The tool requires some minimum inputs: field boundaries, field gates, working width and minimum turning radius, in order to provide an optimised route. Twelve fields were recorded by a Global Positioning System (GPS) during mowing operations and later compared with the routes proposed by the tool. In all fields, the operator's normal route was longer in distance than the route proposed by the tool, being up to 18.4% longer. In total, 9.2 km of infield distance was saved, i.e. 7.5%. The traffic intensity was reduced in all fields, except for two of the smallest fields, where it equalled that of the normal route. Specifically, the traffic intensity was reduced in the working areas, as the tool confined all non-working distance to the headlands.

Economic performance of cable supported bridges

A new cable-supported bridge model consisting of suspension parts, self-anchored cable-stayed parts and earth-anchored cable-stayed parts is presented. The new bridge model can be used for suspension bridges, cable-stayed bridges, cable-stayed suspension bridges, and partially earth-anchored cable-stayed bridges by varying parameters. Based on the assumption that each structural member is in either an axial compressive or tensile state, and the stress in each member is equal to the allowable stress of the material, the material quantity for each component is calculated. By introducing the unit cost of each type of material, the estimation formula for the cost of the new bridge model is developed. Numerical examples show that the results from the estimation formula agree well with that from the real projects. The span limit of cable supported bridge depends on the span-to-height ratio and the density-to-strength ratio of cables. Finally, a parametric study is illustrated aiming at the relations between three key geometrical parameters and the cost of the bridge model. The optimization of the new bridge model indicates that the self-anchored cable-stayed part is always the dominant part with the consideration of either the lowest total cost or the lowest unit cost. It is advisable to combine all three mentioned structural parts in super long span cable supported bridges to achieve the most excellent economic performance.

Pay the farmer, or buy the land?—Cost-effectiveness of payments for ecosystem services versus land purchases or easements in Central Kenya

Payments for Ecosystem Services (PES) have emerged as a popular conservation tool, yet evaluation alongside other direct conservation strategies remains piecemeal. We prospectively compared cost-effectiveness of PES to Land Purchases or Easements (LPE) in Central Kenya. We spatially predicted opportunity costs and land prices using household survey and literature data, and sampled conservation management costs from four regional conservation organizations. We simulated a fixed-budget, spatial ecological–economic site selection process for conservation intervention (PES or LPE) over 30years. We included effects of land markets, property value fluctuations, rising agricultural productivity and climate change. Depending on the scenario, the LPE strategy led to larger reserves (by 26%–610%), better representation of mammal species' ranges (by 47%–112%) and lower unit costs (by 26%–48%). Adding a yearly egalitarian social development payment to the LPE strategy did not increase costs beyond the basic PES model. Our findings were robust to discount rate choice, but cost savings of LPE only materialized after about a decade. Furthermore, Kenyan law restricts foreign land ownership and the use of land easements, thus simpler institutional requirements make PES a more immediate, if less effective, property-based tool.

Production systems and supplier selection: a multi-phase process model

Purpose: This paper presents a combined multi-phase supplier selection model. The process repeatedly revisits the criteria and sourcing decision as the development process continues. This enables a structured adoption of product and production system innovation from strategic suppliers, where previously the literature purely focuses on product innovation or cost reduction. Design/methodology/approach: The authors adopted an embedded researcher style, inductive, qualitative case study of an industrial supply cluster comprising a focal automotive company and its interaction with three different strategic stamping suppliers. Findings: Our contribution is the multi-phased production and product innovation process. This is an advance from traditional supplier selection and also an extension of ideas of supplier-located product development as it includes production system development, and complements the literature on working with strategic suppliers. Specifically, we explicitly articulate the previously unreported issue of whether a supplier chosen for its innovation capabilities at the start of the new product development process will also be the most appropriate supplier during the production system development phase, when an ability to work collaboratively may be the most important attribute, or in the large-scale production phase when an ability to manufacture at low unit cost may be most important. Originality/value: The paper identifies a multi-phase approach to tendering within a fixed body of strategic suppliers which seeks to identify the optimum technological and process decisions as well as the traditional supplier sourcing choice. These areas have not been combined before and generate a valuable approach for firms to adopt as well as for researchers to extend our understanding of a highly complex process.

Optimum injection dose rate of hydrogen sulfide scavenger for treatment of petroleum crude oil

Hydrogen sulfide H2S scavengers are chemicals that favorably react with hydrogen sulfide gas to eliminate it and produce environmental friendly products. These products depend on the type and composition of the scavenger and the conditions at which the reaction takes place. The scavenger should be widely available and economical for industry acceptance by having a low unit cost. The optimum values of H2S scavenger injection dose rate of scavenging hydrogen sulfide from the multiphase fluid produced at different wells conditions in one of the Petroleum Companies in Egypt were studied. The optimum values of H2S scavenger injection dose rate depend on pipe diameter, pipe length, gas molar mass velocity, inlet H2S concentration and pressure. The optimization results are obtained for different values of these parameters using the software program Lingo. In general, the optimum values of H2S scavenger injection dose rate of the scavenging of hydrogen sulfide are increased by increasing of the pipe diameter and increasing the inlet H2S concentration, and decreased by increasing the pipe length, gas molar mass velocity and pressure.

Key elements of a low voltage, ultracompact plasma spectrometer

AbstractTaking advantage of technological developments in wafer‐scale processing over the past two decades, such as deep etching, 3‐D chip stacking, and double‐sided lithography, we have designed and fabricated the key elements of an ultracompact (1.5 cm)3 plasma spectrometer that requires only low‐voltage power supplies, has no microchannel plates, and has a high aperture area to instrument volume ratio. The initial design of the instrument targets the measurement of charged particles in the 3–20 keV range with a highly directional field of view and a 100% duty cycle; i.e., the entire energy range is continuously measured. In addition to reducing mass, size, and voltage requirements, the new design will affect the manufacturing process of plasma spectrometers, enabling large quantities of identical instruments to be manufactured at low individual unit cost. Such a plasma spectrometer is ideal for heliophysics plasma investigations, particularly for small satellite and multispacecraft missions. Two key elements of the instrument have been fabricated: the collimator and the energy analyzer. An initial collimator transparency of 20% with 3° × 3° angular resolution was achieved. The targeted 40% collimator transparency appears readily achievable. The targeted energy analyzer scaling factor of 1875 was achieved; i.e., 20 keV electrons were selected for only a 10.7 V bias voltage in the energy analyzer.

An Integrated Circuit for Chip-Based Analysis of Enzyme Kinetics and Metabolite Quantification.

We have created a novel chip-based diagnostic tools based upon quantification of metabolites using enzymes specific for their chemical conversion. Using this device we show for the first time that a solid-state circuit can be used to measure enzyme kinetics and calculate the Michaelis-Menten constant. Substrate concentration dependency of enzyme reaction rates is central to this aim. Ion-sensitive field effect transistors (ISFET) are excellent transducers for biosensing applications that are reliant upon enzyme assays, especially since they can be fabricated using mainstream microelectronics technology to ensure low unit cost, mass-manufacture, scaling to make many sensors and straightforward miniaturisation for use in point-of-care devices. Here, we describe an integrated ISFET array comprising 2(16) sensors. The device was fabricated with a complementary metal oxide semiconductor (CMOS) process. Unlike traditional CMOS ISFET sensors that use the Si3N4 passivation of the foundry for ion detection, the device reported here was processed with a layer of Ta2O5 that increased the detection sensitivity to 45 mV/pH unit at the sensor readout. The drift was reduced to 0.8 mV/hour with a linear pH response between pH 2-12. A high-speed instrumentation system capable of acquiring nearly 500 fps was developed to stream out the data. The device was then used to measure glucose concentration through the activity of hexokinase in the range of 0.05 mM-231 mM, encompassing glucose's physiological range in blood. Localised and temporal enzyme kinetics of hexokinase was studied in detail. These results present a roadmap towards a viable personal metabolome machine.

Innovated Process Integration for Panel Size Glass Substrate Manufacturing for SiP Application

Although Silicon interposer has good performance, however high cost is still the major issue and limits its high volume adoption. Therefore to decrease the assembly cost or develop low cost, high density interconnect interposer technology is the keys to enable 2.5D SiP integration. One possibility is to develop low cost interposer by adopting the alternative materials instead of Silicon. The glass, low CTE polymer material, ceramic, etc. may be included. Glass represents an attractive choice with potential of tailorable properties dependent on specific glass composition. By targeting the coefficient of thermal expansion (CTE), the CTE of glass can be made to match perfectly with silicon dies and for reliable package. In addition, the advantages of using glass for interposer derive from process flexibility for size and thickness since the glass fusion process provides sheets with dimensions of more than three meters. It is straight forward to provide glass substrate of almost any size needed. Large glass panels are ideally suited for fabrication of interposer where the panel process is expected to provide large number of interposers in each run compared with wafer processing. Additionally, the two sided processing of the panel, the avoidance of Si wafer CMP processes further enable lower unit cost for the interposer Consequently, glass is an ideal interposer material due to its insulating property, large panel size availability, high modulus and ability to tailor CTE. In this paper, we successfully demonstrate manufacturing feasibility of glass substrate with 4 build-up layers starting with a thin glass panel in 508mm×508mm panel size format and under the IC substrate manufacturing environment. Glass thickness of 100~300um could be processed through the IC substrate HVM line. The laser via in via or direct metallization technology could be selected for double side electrical connection. The copper line width/space of 8/8um was demonstrated by current substrate HVM line. By adopting advanced lithography process and material, line width/space less than 2/2um was achievable. TCT Reliability test without glass crack results will also be discussed.

Estimation and Ranking of the Photovoltaic Energy Potential for Local Government Areas in Akwa Ibom State, Nigeria

In this paper, a comparative assessment and ranking of the solar photovoltaic (PV) generation potential and unit cost of energy in ten Local Government Areas (LGAs) in Akwa Ibom State (AKS), Nigeria is presented. The meteorological data used in this study was obtained from the National Aeronautics and Space Administration Surface meteorology and Solar Energy (NASA SSE) website. Photovoltaic System (PVSyst.) simulation software, (Version 5.06) was used for the simulation and determination of the PV energy generation potential and unit cost of energy in each of the LGAs considered. The unit cost of energy in Naira/kWh and available energy per year (in kWh) are the two major parameters used to rank the LGAs from the top to bottom. A mathematical model relating the unit cost of energy and available energy in AKS is also developed. From the simulation results, Uyo LGA had the highest yearly energy output of 12422 kWh and lowest unit cost of energy of 104 Naira/kWh, while Uruan LGA had the lowest yearly energy output of 10591 kWh and highest unit cost of energy of 114 Naira/kWh. The results from this research are relevant for facilitating investment and adoption of photovoltaic power systems in AKS and to make realistic economic projections.

The optimal control of ozone production process

The cost optimisation and control strategy of ozone production process and the experimental results are described in this paper. The model of ozone production process taking the lowest unit cost of ozone production as optimisation target is established and the relationship between ozone concentrations and the ozone production costs is ascertained. The experimental results prove that the fluctuation of ozone concentrations was less than 3% when the optimal control was implemented in the ozone production process, and the fluctuation of the controlled variables was less than 5% after the system was stable. The implementation of the optimal control can largely reduce the operating costs of ozone production.

Design and prototyping of a FRCC modular and climate responsive affordable housing system for underserved people in the pacific island nations

This paper outlines the process of design and prototyping of a modular housing system aimed at serving the needs of people in the Pacific island nations. Many people in these islands are economically challenged and live in sub-standard housing at low elevations, making them vulnerable to increased tropical storms brought about by climate change.A collaborative team comprised of architecture and engineering faculty and students is currently developing a system to address the need for improved housing in the Pacific islands based on the criteria of affordability, customizable design, thermal comfort, durability, sustainability, and local reproducibility.To best address the design criteria, the team reviewed indigenous building and tropical architecture literature, studied climactic factors, formed alternative design strategies, and selected the most promising for further development. A method of using precast fiber-reinforced cementitious composite (FRCC) modular components was chosen, with a limited number of parts to lower unit cost. The assembly was designed to allow homeowners to participate in the construction process, and the house is adaptable by adding or reconfiguring modules. To provide thermal comfort, the design evolved to include shading overhangs, a narrow floor plate, porous walls, and a ridge vent for stack ventilation. Durability is addressed through structural design and material selection. The structure is designed to withstand anticipated hurricane and storm surge events. Local reproducibility is sought by using materials and methods of construction possible with moderate workforce training and minimal capitalization costs.A successful housing system for the Pacific Islands must address cultural, environmental, constructional, and structural factors, and therefore benefits from a collaborative design approach involving both architects and engineers. The proposed system as developed to date appears to be a promising solution to provide affordable, sustainable, and resilient housing for underserved people in the Pacific islands. Pending availability of funding, a first prototype house is slated for construction on a Pacific island site and evaluated for cost, thermal comfort, climate effect resistance, and occupant satisfaction.

Cost-Effectiveness of Introducing the SILCS Diaphragm in South Africa.

BackgroundThough South Africa has high contraceptive use, unintended pregnancies are still widespread. The SILCS diaphragm could reduce the number of women with unmet need by introducing a discreet, woman-initiated, non-hormonal barrier method to the contraceptive method mix.MethodsA decision model was built to estimate the impact and cost-effectiveness of the introduction of the SILCS diaphragm in Gauteng among women with unmet need for contraception in terms of unintended and mistimed pregnancies averted, assuming that the available contraceptives on the market were not a satisfying option for those women. Full costs were estimated both from a provider’s and user’s perspective, which also accounts for women’s travel and opportunity cost of time, assuming a 5% uptake among women with unmet contraceptive need. The incremental cost-effectiveness ratio is computed at five and 10 years after introduction to allow for a distribution of fixed costs over time. A probabilistic sensitivity analysis was conducted to incorporate decision uncertainty.ResultsThe introduction of the SILCS diaphragm in Gauteng could prevent an estimated 8,365 unintended pregnancies and 2,117 abortions over five years, at an annual estimated cost of US$55 per woman. This comes to a cost per pregnancy averted of US$153 and US$171 from a user’s and provider’s perspectives, respectively, with slightly lower unit costs at 10 years. Major cost drivers will be the price of the SILCS diaphragm and the contraceptive gel, given their large contribution to total costs (around 60%).ConclusionsThe introduction of the SILCS diaphragm in the public sector is likely to provide protection for some women for whom current contraceptive technologies are not an option. However to realize its potential, targeting will be needed to reach women with unmet need and those with likely high adherence. Further analyses are needed among potential users to optimize the introduction strategy.

Duplex and ferritic stainless steel sheet linings versus weld overlay and other metallic corrosion-resistant barriers

Sheet linings made from stainless steel can protect carbon steel substrates at lower initial direct cost for installation and subsequent direct inspection than weld overlay and thermal sprayed coating. Closely matched thermal expansion coefficients of ferritic and duplex stainless steel grades with carbon steel allow large “tile pieces” in reliable, leak-proof linings compared to linings from austenitic grades, simplifying and speeding installation. Sheet linings with ferritic and duplex grades typically have lower unit costs than weld overlay and thermal sprayed coatings. Ferritic and lean duplex grades resist corrosion and stress corrosion cracking in most alkaline pulping and liquor recovery environments. Super-duplex grades can replace acid-resistant brick linings in D-stage bleaching equipment, including pre-retention tubes and towers. Carefully specified sheet linings of ferritic and duplex stainless steels, professionally installed in accordance with longstanding industry standards, are reliable and economical protective barriers, especially compared with weld overlay, in many applications in modern pulp

An Online Documentary Film to Motivate Quit Attempts Among Smokers in the General Population (4Weeks2Freedom): A Randomized Controlled Trial.

Introduction:Online motivational films to promote quit attempts could encourage large numbers of smokers to stop at low unit cost. We evaluated an online film documenting the experiences of smokers who recorded the first month of their successful attempts to quit (4Weeks2Freedom). The film was designed to boost motivation and self-efficacy and provide role-models to promote ex-smoker identities.Methods:This was a randomized trial with individual assignment to a no-intervention control (n = 1016), an informational film (n = 1004), or 4Weeks2Freedom (n = 999). The development of 4Weeks2Freedom was informed by PRIME theory and focus-group testing with smokers. The 90-minute film was available online to view in one sitting or as chapters over 4 weeks to coincide with the progress of an attempt. The primary outcome was a quit attempt in the 4 weeks between assignment and study endpoint by intent-to-treat.Results:Participants smoked a mean of 13 cigarettes per day and 31% reported not wanting to stop. At follow-up, 55% reported viewing the informational control film and 56% viewing 4Weeks2Freedom. There was no detectable effect compared with the no-intervention control (OR = 0.99, 95% CI = 0.81 to 1.21, 24.3% vs. 24.5%) or informational control film (OR = 0.99, 95% CI = 0.80 to 1.21, 24.3% vs. 24.6%). Calculation of Bayes factors ruled out insensitive data and indicated the intervention was no more effective than either the no-intervention control (Bayes factor = 0.20) or informational control film (Bayes factor = 0.27). The pattern of results was unchanged in sensitivity analyses that examined the effect among only those who viewed the films.Conclusion:The online documentary film (4Weeks2Freedom) designed to boost motivation and self-efficacy and to promote ex-smoker identity does not appear to prompt quit attempts among smokers.Implications:This trial found that an online documentary film (4Weeks2Freedom) designed to boost motivation and self-efficacy and to promote ex-smoker identity was ineffective in prompting quit attempts among an unselected panel of smokers from the UK. This approach appears unpromising as a means of raising the rate at which smokers attempt to quit and is a low priority for future research.

Estimating the Cost of Early Infant Male Circumcision in Zimbabwe: Results From a Randomized Noninferiority Trial of AccuCirc Device Versus Mogen Clamp.

Background:Safe and cost-effective programs for implementing early infant male circumcision (EIMC) in Africa need to be piloted. We present results on a relative cost analysis within a randomized noninferiority trial of EIMC comparing the AccuCirc device with Mogen clamp in Zimbabwe.Methods:Between January and June 2013, male infants who met inclusion criteria were randomized to EIMC through either AccuCirc or Mogen clamp conducted by a doctor, using a 2:1 allocation ratio. We evaluated the overall unit cost plus the key cost drivers of EIMC using both AccuCirc and Mogen clamp. Direct costs included consumable and nonconsumable supplies, device, personnel, associated staff training, and environmental costs. Indirect costs comprised capital and support personnel costs. In 1-way sensitivity analyses, we assessed potential changes in unit costs due to variations in main parameters, one at a time, holding all other values constant.Results:The unit costs of EIMC using AccuCirc and Mogen clamp were $49.53 and $55.93, respectively. Key cost drivers were consumable supplies, capacity utilization, personnel costs, and device price. Unit prices are likely to be lowest at full capacity utilization and increase as capacity utilization decreases. Unit prices also fall with lower personnel salaries and increase with higher device prices.Conclusions:EIMC has a lower unit cost when using AccuCirc compared with Mogen clamp. To minimize unit costs, countries planning to scale-up EIMC using AccuCirc need to control costs of consumables and personnel. There is also need to negotiate a reasonable device price and maximize capacity utilization.

Analysis of Tailored Base-Surge Policies in Dual Sourcing Inventory Systems

We study a model of a firm managing its inventory of a single product by sourcing supplies from two supply sources, a regular supplier who offers a lower unit cost and a longer lead time than a second, emergency, supplier. A practically implementable policy for such a firm is a tailored base-surge (TBS) policy [Allon G, Van Mieghem JA (2010) Global dual sourcing: Tailored base-surge allocation to near- and offshore production. Management Sci. 56(1):110–124] to manage its inventory. Under this policy, the firm procures a constant quantity from the regular supplier in every period and dynamically makes procurement decisions for the emergency supplier. Allon and Van Mieghem describe this practice as using the regular supplier to meet a base level of demand and the emergency supplier to manage demand surges, and they conjecture that this practice is most effective when the lead time difference between the two suppliers is large. We confirm these statements in two ways. First, we show the following analytical result: when demand is composed of a base demand random component plus a surge demand random component, which occurs with a certain small probability, the best TBS policy is close to optimal (over all policies) in a well-defined sense. Second, we also numerically investigate the cost effectiveness of the best TBS policy on a test bed of problem instances. The emphasis of this investigation is the study of the effect of the lead time difference between the two suppliers. Our study reveals that the cost difference between the best TBS policy and the optimal policy decreases dramatically as the lead time of the regular supplier increases. On our test bed, this cost difference decreases from an average (over the test bed) of 21% when the lead time from the regular supplier is two periods (the emergency supplier offers instant delivery) to 3.5% when that lead time is seven periods.This paper was accepted by Martin Lariviere, operations management.

Syringe-push membrane absorption as a simple rapid method of urine preparation for clinical proteomics.

BackgroundThe analysis of urinary proteome might reveal biomarkers of clinical value. However, current methods of urine preparation for down-stream proteomic analysis are complicated, time-consuming, and/or expensive. This study aims to develop a robust, simple, inexpensive and readily accessible urine preparation method to facilitate clinical proteomic workflow.ResultSyringe-push membrane absorption (SPMA) was successfully developed by a combination of 5-ml medical syringe and protein-absorbable membrane. Comparing three membranes i.e., nitrocellulose, polyvinylidene difluoride (PVDF) and Whatman no.1, nitrocellulose combined with SPMA (nitrocellulose-SPMA) provided the greatest quality of proteome profile as demonstrated by 2-DE. The quality of the proteome profile and the performance of nitrocellulose-SPMA were systematically compared with three current methods of urine preparation (i.e., ultrafiltration, dialysis/lyophilization and precipitation). While different methods of urine preparation provided comparable proteome quality, nitrocellulose-SPMA had better working performance due to acceptable recovery yield, less workload, short working time, high accessibility and low unit cost. In addition, protein absorbed on nitrocellulose harvested from the SPMA procedure could be stored as a dried membrane at room temperature for at least 1-month without protein degradation or modification.ConclusionsSPMA is a simple rapid method of preparing urine for downstream proteomic analysis. Because of it is highly accessible and has long storage duration, this technique holds potential benefit for large-scale multi-center research and future development of clinical investigation based upon urinary proteomic analysis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12014-015-9087-4) contains supplementary material, which is available to authorized users.

Increasing Accuracy: A New Design and Algorithm for Automatically Measuring Weights, Travel Direction and Radio Frequency Identification (RFID) of Penguins.

A fully automated weighbridge using a new algorithm and mechanics integrated with a Radio Frequency Identification System is described. It is currently in use collecting data on Macaroni penguins (Eudyptes chrysolophus) at Bird Island, South Georgia. The technology allows researchers to collect very large, highly accurate datasets of both penguin weight and direction of their travel into or out of a breeding colony, providing important contributory information to help understand penguin breeding success, reproductive output and availability of prey. Reliable discrimination between single and multiple penguin crossings is demonstrated. Passive radio frequency tags implanted into penguins allow researchers to match weight and trip direction to individual birds. Low unit and operation costs, low maintenance needs, simple operator requirements and accurate time stamping of every record are all important features of this type of weighbridge, as is its proven ability to operate 24 hours a day throughout a breeding season, regardless of temperature or weather conditions. Users are able to define required levels of accuracy by adjusting filters and raw data are automatically recorded and stored allowing for a range of processing options. This paper presents the underlying principles, design specification and system description, provides evidence of the weighbridge’s accurate performance and demonstrates how its design is a significant improvement on existing systems.

Knaves, knights or networks: which assumption of lecturer and manager motivation should underlie further education policy?

Julian Le Grand, a well-known economist, identifies two types of public sector employee: knights (with altruistic motives) and knaves (with self-interested motives). He argues that the quasi-market, predicated on the assumption of knavish behaviour (or agent self-interest), is the most effective way of directing school managers and teachers towards improving education outputs at lower unit cost. In this article, a review of the literature on the English post-incorporation further education quasi-market is undertaken (under the Conservative government [1993–1997], New Labour [1997–2010] and the Coalition government [2010–2014]) to assess if such a premise is correct. The conclusion from the review is that an over-focus on policy, premised on agent self-interest, effects limited improvements in the quality of education outputs and needs-based equity for disadvantaged students because such policy marginalises other motivational inputs, such as intrinsic motivation, professional values and tacit knowledge from the production process. The solution, much of the FE literature suggests, is the replacement of top-down policy with democratic local governance and participative leadership as a means of encouraging intrinsically motivated tutors and managers (or knights) to meet economic and social goals through the productive potential of learning cultures (or networks).

Budgetary impact of adding ziv-aflibercept to a United States health plan formulary as a post-oxaliplatin biologic option for patients with metastatic colorectal cancer (mCRC).

765 Background: To assess the economic impact of the availability of ziv-aflibercept for patients with mCRC following disease progression after oxaliplatin, a user-adaptable budget impact model was developed for payers, based on use of 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) chemotherapy alone or combined with a biologic agent, including ziv-aflibercept. Methods: A Markov-like model simulated transition from progression-free survival (PFS) to progressive disease (PD) and death. Over the model time frame of 1 year, each 90-day cycle adjusted for the probability of patients experiencing PFS, PD or death. Treatment options were FOLFIRI alone or combined with a biologic agent, ziv-aflibercept, bevacizumab, cetuximab or panitumumab. April 2013 United States utilization rates were used as baseline, with biologic agent drug costs as per July 2014 Medicare Part B Drug Average Sales Price. PFS and overall survival were calculated from clinical trial data of biologic agents combined with chemotherapy. Adverse event cost calculations used documented incidence rates and published cost sources. Other costs were for biomarker testing, drug administration/monitoring and death/terminal care. Results: The estimated number of patients receiving FOLFIRI alone or with a biologic agent for mCRC was 57 per million-member health plan. Using April 2013 utilization rates (including ziv-aflibercept at 3.4%), estimated treatment costs were $5.259M, a per-member-per-month (PMPM) cost of $0.0438. Changes in utilization rates of biologic agents, including, for example, ziv-aflibercept at 20.1%, would decrease costs by 2.1% ($108,176) to $5.151M annually, a PMPM decrease of $0.009. The model suggests cost savings primarily due to lower unit costs for ziv-aflibercept and lower death-related costs, rather than decreased adverse event management. Conclusions: The model estimates a PMPM cost saving with increased utilization of biologics, including ziv-aflibercept. Sensitivity analysis of utilization rate changes supports these findings. Including further user-defined scenarios allows plan-specific modeling of budgetary impact.