Percent Of Cost Research Articles

Impact of pharmaceutical price controls on the cost of cardiovascular drugs: does essentiality matter?

ABSTRACT Background With the goal of improving the affordability of medicines, governments across the globe have instituted various forms of price controls. Since 2013, India has been regulating the prices of drugs included in its national list of essential medicines (NLEM). Here we evaluate the cost variations among available cardiovascular drugs and perform cost-analysis comparing essential and non-essential drugs. Methods Data on listed prices of selected cardiovascular drugs – essential (NLEM) and non-essential (NNLEM) – were sourced from multiple drug information compendia. Price of medications was calculated in cost-per-defined-daily-dose (DDD)-units and NLEM vs. NNLEM drugs were compared. Regression analysis was used to explore the determinants of percentage cost variation (PCV) of drugs. Results The median-cost/DDD of essential medicines was lower as compared to non-essential ones for all therapeutic drug classes, with greatest difference observed for antianginals and least for heart failure medicines. There were substantial cost variations with values in excess of 1000% for six medicines, all being essential. The regression analysis failed to demonstrate a significant effect of essentiality on PCV (β = 0.19, P = 0.314). Conclusions Our analyses demonstrate considerable cost variations for some essential cardiovascular medicines. Given the need for prolonged and often, lifelong-treatment, there is significant potential for cost savings based on chosen brand, highlighting the need for patient as well as prescriber education.

Osmo-predried fluted pumpkin (Telfairia occidentalis) leaf and its nutri-economic evaluation

Purpose Leafy vegetables are known to be highly perishable because of high moisture content, which had resulted in applications of different preservative methods. However, these methods were not without certain limitations during storage. Osmotic pre-dehydration had been proved to be a better alternative because of high retention and improvement in nutritional qualities and stability during storage. This study aims to investigate the osmotic pre-dehydration of fluted pumpkin (Telfairia occidentalis) leaves. Design/methodology/approach Fluted pumpkin (T. occidentalis) leaves were pre-dried using sucrose, corn syrup and sodium chloride solutions as osmotic agents, while unosmo-predried leaves were used as the control. Both osmo-predehydrated and unosmo-predried leaves were dried in a hot air oven, whereas the effect of the osmotic agents on the nutritional qualities was investigated using standard protocols. Findings There were significant differences (p-values ranged from 0.001 to 0.030) in the proximate compositions of samples. Osmo-predried leaves recorded higher mineral contents in Ca, Cu, Fe, K, Mg, Mn and Na. Osmotic pre-dehydration by NaCl had a significant effect (p = 0.02) on ascorbic acid. The amino acid profile of the oven-dried leaves (unosmo-predried) showed that histidine and cysteine recorded high amino acid scores of 120.42% and 135%, respectively. Threonine (43.73%) recorded the highest essential amino acid score (without histidine). The economic evaluation indicated the percentage cost index difference of leaves treated with NaCl as 2.08%, sucrose (11.19%) and corn syrup (16.43%). Originality/value The high proportion of beneficial elements such as calcium, magnesium, phosphorus, potassium and appreciable chemical compositions of the osmo-predried leaves compared to unpre-dried leaves proved osmotic pre-dehydration as a value-added technique for preservation of leafy vegetables. The best osmotic agent was sodium chloride. This process could be applied on a small scale for the development of self-entrepreneurs and home-scale industries.

Performance and cost-benefit analysis of Isa Brown layers on different management systems

BackgroundFew literatures exist on the performance and cost implication of birds reared on different management system. The cost benefit analysis of rearing Isa Brown layers on three different management systems was evaluated in a 9 (9)-week feeding trial. One hundred and forty-four (144) points of lay (19 weeks old) Isa-Brown chickens were procured from a reputable farm in Osun state. The birds were placed on three (3) treatments (battery cage, deep litter, and free range) of three (3) replicates and sixteen (16) birds per replicate in a completely randomized design. Birds reared on conventional cages were arranged into three birds per cage unit. Birds on deep litter were kept on wood shavings, in which perches, laying nests, feeders, and drinkers were provided. Hens on free range management system were kept in a large area of land camped using planks and hexagonal wire mesh which was partitioned into various replicates. Sheds were provided for the birds to protect them from harsh weather conditions, and perches, laying nests, feeders, and drinkers were also provided. The birds on all the treatments (battery cage, deep litter and free range) were given the same diet, and the study period lasted for sixty-five days. The weight gain per bird, percentage weight gain, hen day production (HDP), egg mass index, and feed conversion ratio were determined. At the end of the experiment, these records were used to evaluate economic indices.ResultsThe result showed that only the feed intake and total feed intake were significantly (p < 0.05) influenced by management systems in all the parameters measured for performance. The daily feed intake, total feed intake total cost of feed consumed, quantity of egg produced per bird, revenue generated from eggs, production cost, net benefit, cost-benefit ratio, and percentage cost of production were significantly (p < 0.05) influenced by management systems. Birds kept on deep litter system recorded the highest (48.87) number of eggs produced. The cost of construction was recorded to be highest in battery cage system while construction of free range facilities was at the minimum. Revenue generated from egg sold was highest (₦1384.56) in deep litter system while free range recorded the least significant (p < 0.05) (₦1301.44) value. Total cost of producing table eggs was significantly (p < 0.05) highest (₦2251.54) in battery cage, while free range had the least (₦2074.88) cost of production. Free range birds recorded the highest (₦326.56) net benefit, while the least (₦195.24) net benefit was obtained in battery cage.ConclusionIt was therefore concluded that free range management system resulted into better profit margin and could however be adopted by small scale farmers in rural areas willing to practice backyard poultry farming.

Multi-Objective optimisation of a micro-grid hybrid power system for household application

This research study aimed to design and optimise hybrid renewable energy systems at two optimisation objectives. The economic and environmental optimisation objectives of four hybrid power system scenarios were tested based on a non-dominated sorting genetic algorithm. The selected optimisation objectives were used simultaneously and parallel to sensitivity analysis in order to determine optimum system configuration under specific criteria. The environmental objective targeted the reduction of CO2 emissions, which resulted in a system with high renewable energy fractions. The economic objective targeted the reduction of system cost (net percentage cost), which resulted in a system size that could meet desired electrical loads. The novelty of this work lay in determining the relationship between two different optimisation objectives i.e., environmental and economic. Result showed that the optimisation process under the economic objective recorded the lowest energy cost for all scenarios with and without storage units. By contrast, the optimisation process under the environmental objective demonstrated a higher system cost value compared with that in the case of the economic optimisation objective for all scenarios. The analysis also shows the CO2 emission with and without considering systems components manufacturing primary emissions.

Cost variation analysis of oral anti-dyslipidaemic drugs available in Indian pharmaceutical market

Background: Dyslipidaemia is one of major risk factor contributing to cardiovascular disease, which further causes mortality and morbidity, so requires a long course of treatment. Physicians should be aware of the cost of drugs.Methods: Cost of the oral anti-dyslipidaemic drug, either as single drug or in combination manufactured by different pharmaceutical companies in the same strength and dosage form was obtained from current index of medical specialities (CIMS) April-July 2019. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage cost variation per 10 tablets was calculated.Results: In this study, existing findings showed a wide cost variation among different brands of the same oral anti-dyslipidaemic drug. Percentage cost variation for individual oral anti-dyslipidaemic drug was found to be highest with atorvastatin (80 mg film coated (FC) tablet): 358.84% followed by atorvastatin (5 mg FC tablet): 247%, fenofibrate (200 mg FC tablet): 134.22%, lovastatin (10 mg FC tablet): 108.56%, rosuvastatin (10 mg FC tablet): 78.60%, while lowest cost variation is seen with rosuvastatin 40 mg FC Tb: 1.598%. Among fixed dose combination therapy percentage cost variation was found to be highest with atorvastatin and fenofibrate (10 mg and 160 mg, FC tablet): 256%, followed by atorvastatin and ezetimibe (10 mg and 10 mg, tablet): 132.39%, while minimum cost variation was for rosuvastatin and fenofibrate (10 mg and 67 mg, tablet): 22.6%.Conclusions: These study findings showed that there is a wide variation in the cost of the same oral anti-dyslipidaemic drug. So, it is very necessary for regulatory authorities to regulate the wide variation in the cost, as well as physicians, should be sensitized to be aware of their cost variations to reduce the economic burden of drug-therapy to the patients.

A novel decomposition-based method for solving general-product structure assemble-to-order systems

Assemble-to-order (ATO) strategies are common to many industries. Despite their popularity, ATO systems remain challenging to analyze. We consider a general-product structure ATO problem modeled as an infinite horizon Markov decision process. As the optimal policy of such a system is computationally intractable, we develop a heuristic policy that is based on a decomposition of the original system, into a series of two-component ATO subsystems. We show that our decomposition heuristic policy (DHP) possesses many properties similar to those encountered in special-product structure ATO systems. Extensive numerical experiments show that the DHP is very efficient. In particular, we show that the DHP requires less than 10−5 the time required to obtain the optimal policy, with an average percentage cost gap less than 4% for systems with up to 5 components and 6 products. We also show that the DHP outperforms the state aggregation heuristic of Nadar et al. (2018), in terms of cost and computational effort. We further develop an information relaxation-based lower bound on the performance of the optimal policy. We show that such a bound is very efficient with an average percentage gap not exceeding 0.5% for systems with up to 5 components and 6 products. Using this lower bound, we further show that the average suboptimality gap of the DHP is within 9% for two special-product structure ATO systems, with up to 9 components and 10 products. Using a sophisticated computing platform, we believe the DHP can handle systems with a large number of components and products.

Closing the loop in supply chains: Economic and environmental effects

Over the past years, companies started to close the loop in their supply chains to comply with the regulations and increase the sustainability of their systems. In this study, we focus on the economic and environmental effects of closing the loop in supply chains in terms of total supply chain cost and carbon emission. We consider demand, return rate and returned product quality uncertainties simultaneously and propose a set of two-stage stochastic programming models for both forward and closed-loop supply chains to compare the optimal supply chain costs, supply chain emissions and model decisions with each other. We make various sensitivity analyses to see the effects of parameters. We also study three well-known and widely-used emission policies; carbon cap, carbon cap-and-trade and carbon tax together with the case of no emission regulation and compare the forward and closed-loop supply chains under these policies. Computational results allow us to obtain important insights regarding the percentage cost difference and emission difference between forward and closed-loop supply chains in different problem settings.

A pharmacoeconomic study on cost variation of antiplatelet drugs available in Indian market

Background: Expenditure spent on pharmaceutical products accounts for a significant percent of the total health-care expenses of any country. Hence, there is a need to prioritize different and sometimes competing health-care interventions or possibly different brands of a particular medicine, especially in case of chronic illnesses for countries with fixed resources. Pharmacoeconomics helps us to make such decisions. Since antiplatelet drugs are prescribed on long-term basis, they were included in this study. Aim and Objective: The aim of this study was to analyze the cost variation of the antiplatelet drugs available in the market under various brand names manufactured by different pharmaceutical industries. Materials and Methods: A cross-sectional study was conducted to analyze the cost variation of different antiplatelet drugs available in Indian market. Cost of each drug with respect to dosage and formulation was obtained from the “current index of medical specialties” website for India. Cost ratio and percentage cost variation were then calculated. Results: Among the injectable and oral and drugs included in this study, the percentage cost variation was observed to be maximum with eptifibatide 75 mg vial, prasugrel 5 mg film-coated tablets, and aspirin-clopidogrel (75 + 75 mg) capsules. Conclusion: Even though the cost variation is found to be wide among the antiplatelet drugs available in Indian market, getting a cost-effective drug is not building castles in the air for the beneficiaries. This could be rendered possible with the help of policy-makers, pharmaceutical companies, physicians, and pharmacists when they join hands together.

A Scenario-Driven Assessment of the Economic Feasibility of Rainwater Harvesting Using Optimized Storage

Regional water scarcity has given rise to the search for sustainable means of water supply. Rainwater harvesting (RWH) has been receiving unprecedented attention as low-cost and eco-friendly option. Given the conflicting nature of research findings with respect to the feasibility of RWH and the belief that such results have sometimes been unreasonably generalized, this study was undertaken to ascertain the feasibility of RWH under very specific climatic and socio-economic conditions. This study investigated the economic feasibility of RWH in a sub-Saharan African city (Enugu, Nigeria), considering eight dwelling categories. Life cycle cost analysis was performed for RWH system in each of the categories for specified levels of water consumption namely: basic water need (50 litres per capita per day, lpcd), pour flush (75 lpcd) and full plumbing connection (150 lpcd) and for two energy options namely: fuel generator and the national power supply grid. Capital cost ranged from 47 to 95% of the net present value (NPV), maintenance cost ranged from 4 to 40% and running cost ranged from 1 to 27% of NPV. The percentage cost contribution of underground tank to NPV ranged from 60.4–82%, 66.9–86% and 77.3–89% for basic water need, pour flush and full plumbing connection options respectively, using the national electricity grid as source of power for pumping water to the overhead tank. The corresponding cost contributions for the use of petrol generator as source of power for pumping are 56.5–75.9%, 63–81% and 73.9–85%. The unit cost of water ranged from 0.07–0.25 N/litres, 0.09–0.34 N/litres and 0.22–0.54 N/litres for basic water need, pour flush and full plumbing connection, using the national grid for pumping water. The corresponding unit costs for generator are 0.09–0.3 N/litres, 0.11–0.4 N/litres and 0.28–0.64 N/litres. Comparison of these costs with the costs of other sources of water supply shows that RWH is a cheaper source of water. 1$ = N360.

Antimicrobial utilization in University of Benin Health Care Centre, Benin City, Edo State, Nigeria

Purpose: The study evaluated the antimicrobial utilizations pattern in the University of Benin Health Centre, with a view to appraising the level of compliance of the Centre to WHO guidelines for rational use of antimicrobial agents. Methods: This was a descriptive cross-sectional prospective study of case files of 200 patients who attended the health centre from 30th May to June 29th 2017. A data collection form was used to collect the following information; name of antibiotics prescribed, indication for use, pattern of combination therapy, justification for antibiotic prescription (laboratory investigation), cost of antibiotic utilization as well as the age and gender of patients. All the case files of patients who were prescribed antibiotics during the study period were screened. Results: A total of 200 prescription encounters were evaluated. Children aged 0-9 years and young adults (20-39 years) were the highest recipients of antibiotics while patients aged 60 years and above received the least number of antibiotics. Malaria fever (31.8%) and respiratory tract infections (28.0%) accounted for the indications that received the highest number of antibiotic prescriptions among the 10 indications for antibiotic utilization. Beta-lactam antibiotics were the most prescribed class of antibiotics both in combination and as a single therapy. The average number of medicines per prescription was 3.71 and percentage of antibiotic prescriptions was 34.2%. Generic prescribing was at 38.0%, while laboratory investigations was 8.5%. However, the percentage cost of encounter was 30.6%. Conclusions: The low rate of percentage cost of antibiotics was rational in comparison with WHO standard range. But the higher than recommended standard for indicators such as average number of medicines per encounter, percentage of antibiotics prescribed and low rate of laboratory investigations implies irrational prescribing. Brand name prescribing was also common and irrational. Thus, there is high rate of irrational prescribing of antibiotics in the study centre and this could further worsen the burden of microbial resistances to these antibiotics. Keywords: Antimicrobials, compliance, guidelines, utilization

North American cost analysis of brand name versus generic drugs for the treatment of glaucoma.

BackgroundAccording to the World Health Organization, glaucoma is a leading cause of irreversible blindness worldwide. By 2020, 80 million people will be affected by glaucoma in the world, which represents a significant financial burden to society. Glaucoma medications alone make up 38–52% of the total direct cost. The purpose of this research is to conduct a cost-minimization analysis to evaluate brand-name medications versus generic medications for treating glaucoma patients.MethodsThe per-bottle cost (in Canadian dollars) of brand-name drugs for glaucoma was obtained from the wholesaler, McKesson Canada, and, for generic drugs, from the Ontario Drug Benefit (ODB) Formulary. Further, a wastage adjustment fee, a pharmacy mark-up, and an ODB dispensing fee ($CAD) was added to the cost of both brand and generic. Previously published frequencies of medication prescription were utilized to calculate the average annual cost for each class of brand and generic. For each medication class and for mono-, bi-, and tri-drug therapy, the cost differential between brands and generics over a six-year period was computed and analyzed from third-party payer perspective.ResultsIn descending order, the average annual government-funded health care system costs were: combination drugs such as Cosopt® ($748.23) were the most expensive, followed by prostaglandin analogs ($246.36), carbonic anhydrase inhibitors (CAIs) ($45.04), α-agonist ($30.34), β-blockers ($29.29), and cholinergic agonists ($16.51). Brand-name mono-drugs are 34% more expensive compared to generics. Brand-generic percentage cost differential for various medication classes over a six-year period was the highest for prostaglandin analogous (44%), followed by β-blockers (35%), α-agonist (31%), cholinergic agonists (22%), combination drugs (10%), and CAIs (1%).ConclusionBrand-name drugs are relatively more expensive than their generic counterparts, with variable cost differentials depending on drug class.

PDB38 COST OF ANTI-DIABETIC MEDICATIONS AMONG TYPE II DIABETES MELLITUS PATIENTS: A CROSS-SECTIONAL STUDY IN SOUTH INDIA

The study aimed to analyse the cost of anti-diabetic medications and its economic implications on patients with type II diabetes mellitus. A prospective, cross-sectional study was conducted in patients above 20 years of age and diagnosed with type II diabetes mellitus who attended the inpatient department of Endocrinology from October 2018 - April 2019. Patients were followed from the day of admission till their discharge. Relevant details were collected from medication charts, pharmacy bills and patient interviews and were recorded in a suitably designed data collection form. Microsoft Excel was used to describe data statistically. A total of 252 patients, who fulfilled criteria were recruited. Male predominance was found (61.9 %). The mean age of the patients was found to be 58.76±12.5. Cost of oral hypoglycemic agents were found to be INR 7.289±12.27 per day. Glimepiride showed highest percentage of cost variation with 493.33%. Diabetes imposes a large economic burden on individuals with diabetes and their families and to health systems and national economies through medication costs. Health care providers play a pivotal role in the betterment of patients’ health and lifelong management of the disease. Clinical pharmacist’s assistance can contribute to providing diabetes related services that focus on managing medications to positively impact health outcomes, reduce overall healthcare system costs, and empower patients and consumers to actively manage their health. Keywords: Type II diabetes mellitus, anti-diabetic medications, cost, percentage cost variation.

Variation of cost among anti-malarial drugs available in Indian market

Background: There are numerous brands of antimalarial existent in the market. Expensive drugs could result in financial drain that causes reduced compliance or even non-compliance. Non-adherence to therapy could consequently cause partial treatment that leads to higher morbidity and in certain cases mortality too. Thus this evaluation was conducted to measure the cost disparity of malaria therapy.Methods: The maximum and minimum price of each brand of the drug in Indian rupee rate was noted by using the latest edition of current index of medical specialities. The cost ratio and the percentage cost variation for individual drug brands were calculated.Results: The analysis of data reflected a considerable cost variation among antimalarial drugs. Chloroquine DS 500 mg showed the highest cost ratio and cost variation (cost ratio=15.3 and % cost variation=1434). Overall injectable antimalarials showed considerable cost variation as compared to oral antimalarial agents.Conclusions: The maximum variation shown by oral antimalarial was found to be for chloroquine DS 500 tablet. But there was significant price variation among injectable antimalarial. Injectable antimalarials are often the choice of drug when dealing with critically ill malaria patients specially when suffering from complicated malaria. So, such significant price variation creates burden on poor patients economically which leads to non-compliance and hence increased morbidity and mortality due to incomplete treatment.

A study of the cost analysis of various oral antihypertensive drugs available in Indian market

Background: Hypertension is a serious global public health problem. It accounts for 10% of all deaths in India and is the leading non-communicable disease. Recent studies have shown that the prevalence of hypertension is 25% in urban and 10% in rural people in India. It exerts a substantial public health burden on cardiovascular health status and health care systems in India. Antihypertensive treatment effectively reduces hypertension related morbidity and mortality. The cost of medications has always been a barrier to effective treatment. The increasing prevalence of hypertension requires use of cost effective treatment for the effective management of the disease.Methods: Cost of a particular drug (cost per 10 tablets) in the same strength and dosage forms being manufactured by different companies was obtained from Current Index of Medical Specialties, Jan‑April 2019 and “Indian Drug Review” (IDR) September 2018. Difference between the maximum and minimum cost of the same drug manufactured by different pharmaceutical companies was calculated and percentage cost variation was calculated.Results: The prices of a total of 24 drugs (15 single and 9 combination preparations), available in 59 different formulations were analysed. These 62 formulations are manufactured by different pharmaceutical companies.Conclusions: The average percentage price variation of different brands of the same oral antihypertensive drug manufactured in India is very wide. The appraisal and management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative personal and economic consequences.

Cost analysis of various topical eye preparations currently available in Indian market

Background: topical eye preparations are very commonly used in India for different eye diseases hence their prices should not be much different in Indian pharmaceutical industry. The common man therefore has to shell out more money with medicine prices spinning out of his reach. Aim of this study was to compare the cost of drugs of the different brand of topical ophthalmic drugs.Methods: cost of various topical eye preparations was compared using “Current Index of Medical Specialties” (CIMS) January-April 2019 and cost variation was recorded. Drugs were categorized into anti-infective and antiseptics, topical corticosteroids, mydriatics, anti-glaucoma drugs, anti-inflammatory and lubricants.Results: That of the 26 drug formulations studied, the percentage cost variation of 10 drug formulations was more than 100%, out of which one formulation of moxifloxacin had more than 1000% variation. Cost ratio of 10 drug formulations were more than two. Moxifloxacin 0.5% eye drops had maximum percentage cost variation of 5610.66% and cost ratio of 57.11, followed by ofloxacin 0.30% eye drops (310.92%, 4.11), timolol 0.50% eye drops (263.64%, 3.64), ciprofloxacin 0.30% eye drops (142.42%, 2.42), tobramycin 0.30% eye drops (120.14%, 2.20).Conclusions: There is a significant variation in the price of various topical eye preparations. As most of the preparations being prescribed on an out-patient basis, which was not covered under most of the insurance program. Out of pocket expenditure adversely affects the drug compliance in the long run. There should be a comprehensive action from policymakers, regulatory authorities, government agencies, doctors, pharmacists, and the general public to solve this issue of cost variation of drugs.

Cost analysis of various branded versus generic chemotherapeutic agents used for the treatment of early breast cancer- a deep insight from India

ABSTRACT Background Breast cancer (BC) stands first with high incidence and mortality in India. Most of the oncologists are unaware of cost savings by utilising generic drugs. Aim To perform a cost minimization analysis of generic versus branded chemotherapeutic regimen for treatment of BC. Methodology CIMS (current index of medical stores) was referred for the cost of branded drugs and the generic cost was taken from Jan Aushadhi scheme. The percentage cost variation and potential cost-saving particular to BC regimens on substituting available generic drug was calculated using standard formula and costs were presented in Indian Rupees and US Dollars (as of 2019). Results Among the branded agents considered, a range of 25% to 606.11% cost variation was observed with cyclophosphamide and 5-Fluorouracil respectively. Gemcitabine proposed the highest cost variation (373.68%-990.78%) and cyclophosphamide (71.42%-114.28%) with the lowest variation when compared to generic drugs. The highest level of cost-saving (₹60,807.3 to ₹1,31,864.1) with TAC regimen and the lowest range (₹12,15.84 to ₹15,667.2) with AC regimen was observed among adjuvant therapy regimens. Conclusion Our evaluation inferred that substituting generic chemotherapeutic drugs can bring potential cost savings. Healthcare professionals and patients should aware and opt generic drugs to achieve goals of BC therapy.

Experimental investigation of using nano-PCM/nanofluid on a photovoltaic thermal system (PVT): Technical and economic study

This paper shows a technoeconomic evaluation of a PVT system. The PV cooling system consists of a tank attached to the panel back side filled with PCM (paraffin wax) mixed with nano-SiC to increase its thermal conductivity and the reservoir is cooled by recycling nanofluid (water + nano-SiC). The MATLAB program was used for economic evaluation. The experimental work was also carried out and the data obtained were used for evaluation. To improve heat transfer more, nanofluid was used with nano-PCMs in the studied PVT compound. The nanomaterial used in the current study was silicon carbide (SiC) and the PCM selected was paraffin wax.The economic evaluation aspect provided that the cost of the life cycle, the cost per item, and the percentage cost of the system. The technical side introduced the efficiency of the inverter, the specific yield, and the capacity factor which were 97.3%, 190.4 kWh/kWp, and 25.9%, respectively. The output power of this system, electrical and thermal efficiencies were found to be 12.7 W, 13.7% and 72.0%, respectively. The cost of electricity and payback periods were 0.125 $/kWh and 5–6 years, respectively. The results indicated that the studied system is economically feasible and shows great promise.

Normative Listing and Description of Mutual Fund Transparent and Opaque Fees and Expenses

This study provides mutual fund shareholders with a normative listing of transparent and traditionally opaque fees and expenses designed for most all funds. The most likely next step, if any, would be for a few “stewardship funds” to adopt the normative listing of transparent and traditionally opaque fees and expenses and attach to each its percentage cost to total net assets, if any. This analysis is needed, for one reason, because a large percentage of individual investors, especially those with low financial literacy, are unaware of the existence of traditionally opaque fund fees and expenses, no less their percentage costs.

Spatial planning and optimisation for virtual distribution of BioCNG derived from palm oil mill effluent to meet industrial energy demand

Rise in energy prices and energy security concerns have become more crucial for the industrial sector to opt for an alternative fuel. Biogas could be used as fuel for electricity generation, boilers or upgraded and compressed as bio compressed natural gas (BioCNG) that can be utilised in various applications, such as transportation, fuel for industry and injected into a gas grid (as biomethane). Biogas, produced by anaerobic digestion (AD) of palm oil mill effluent (POME) can be used as a fuel substitute for natural gas in industry while reducing CO2 emission. Virtual distribution of BioCNG, which is from remotely located natural gas pipeline, has become economically attractive to the industry. However, this concept poses some issues concerning logistic due to the scattered spatial distribution of palm oil mills which discharge large quantities of POME for biogas recovery. Addressing these aspect require an integrated spatial planning and optimisation to synthesise location and allocation network of BioCNG virtual transportation to the respective industry. This paper presents the development of integrated spatial planning and optimisation of BioCNG supply and distribution network through virtual pipelines to meet the on-site energy demand of specific industry, while minimising the total operational cost. The data from network analysis of ArcGIS will be coded into the Generalised Algebraic Modelling System (GAMS) model to generate a supply cost curve for multiple sources of energy carrier, i.e., LNG, NG through pipeline network, BioCNG through virtual pipelines with and without upgrading. Two case studies were evaluated to determine the optimal energy supply allocation for demand location. This model is beneficial for BioCNG network management while reducing carbon emissions. Results showed the optimised combination of energy supply to meet energy demand of selected industries, which was 198.9 MW of BioCNG production and 401.1 MW of LNG import. The percentage cost reduction of the optimised energy supply is 36.3%.

Price variation in different brands of anticancer drugs available in Indian pharmaceutical market: a cost analysis study

Background: Cancer is one of the most expensive and lethal noncommunicable diseases globally. Availability and affordability of anticancer drugs are the most important factors on which management of cancer depends. The objective of the study was to evaluate the variation of cost among different brands of anti-cancer drugs available in the Indian market.Methods: “Current Index of Medical Specialties” July-October 2018 and “Drug Update” Sept - 2018 were used to obtain cost in INR* (Indian National Rupees) of anticancer drugs manufactured by different pharmaceutical companies in India, in the same strength and dosage form. Percentage cost variations were calculated by minimum and maximum costs of anticancer drug of different brands.Results: Percentage variation in cost was analyzed for 41 different formulations of 27 anticancer drugs. Highest cost variability seen with Alkylating agent Carboplatin 150 mg injection (1100%) and lowest with Antimetabolite anticancer agent Cytarabine 500 mg injection (6.56%). Three formulations showed more than 500% cost variation, largest with Carboplatin 150 mg injection (1100%) followed by Anastrozole 1 mg tablet (870%) and Letrozole 1 mg tablet (508.42%).Conclusions: Present study finding showed significant cost variation in different brand of many anticancer drugs in India. These results indicated that greater price transparencies required. This price variation issue requires a much more in-depth analysis of the health care system.