Price Reduction Research Articles

Dynamic regime differences in the market behavior of primary natural resources in response to geopolitical risk and economic policy uncertainty

The study explores the dynamic effects of geopolitical risks and economic policy uncertainties on oil and natural gas prices in the US market's less volatile and highly volatile regimes, employing Markov regime-switching dynamic regression models (MS-DR) with monthly data from January 2000 to November 2022. Our empirical results demonstrate that a positive shock in the geopolitical risk of the USA (GPR_US) causes an increase in the growth rate of the prices of WTI at the high volatile periods (regime 1), and its one-period lagged effects are negative at time t in the less volatile periods (regime 0), and it cumulatively causes an increase in WTI price. GPR_US and one lagged effect negatively and positively natural gas prices (NGAS) at both regimes. respectively, where the dynamic cumulative impact of GPR_US causes NGAS to increase. World geopolitical risks (GPR) lead to an increase in WTI and natural gas prices. Furthermore, US economic policy exerts a reduction in WTI price at both less and highly volatile regimes, and its lag influences are positive at both regimes, where it cumulatively causes a decrease in WTI price. In a similar manner, global economic policy uncertainty also reduces WTI. US economic policy and its lag effects exhibit an increase and decrease in NGAS prices in the high volatile regime but exhibited a cumulatively positive response to shock in economic policy uncertainty. Global economic policy uncertainty causes nature gas prices to go up. Hence, geopolitical risks and economic policy uncertainty might have a complex impact on the prices of natural resources. It depends on the specific circumstances and the supply-demand dynamics in the market. Our findings offer insightful implications for economic agents.

An assessment of the Iberian Exception to control electricity prices

The Iberian Exception, the mechanism designed by the Spanish and Portuguese governments to address high electricity prices resulting from the gas price crisis in 2021 and 2022, has been met with controversy, both regarding its real impact on electricity prices and also its unin- tended consequences, such as increased (and subsidized) exports to France. In this paper we review the evidence on these impacts from different studies, concluding that the mechanism may have produced, depending on the assumptions, some reductions in electricity prices for Iberian consumers or none at all, but always at the expense of subsidies to French consumers and also increased rents for gas combined cycles, higher gas consumption, and larger CO2 emissions. Alternative mechanisms, such as a temporary single-buyer scheme, might have produced similar benefits without the downsides of the Exception.

Pembrolizumab vs chemotherapy in the first-line setting of PD-L1≥50% metastatic non-small cell lung cancer: A real-world cost-effectiveness analysis.

21 Background: Despite the voiced concerns around the initial economic decision models for first-line pembrolizumab in PD-L1≥50% metastatic non-small cell lung cancer (mNSCLC), there has been a paucity of evidence on the anticipated cost-effectiveness of pembrolizumab in the real world. To resolve the uncertainties associated with the initial assessment, we evaluated the real-world cost-effectiveness of first line pembrolizumab versus platinum-based chemotherapy for mNSCLC patients with PD-L1≥50%. Methods: We retrospectively identified a population-based cohort of mNSCLC patients who received first-line pembrolizumab or platinum-based chemotherapy between April 1, 2013, and March 31, 2021, in Ontario, Canada. Employing a public payer’s perspective, all costs (in Canadian dollars) and effects were estimated over a 4-year horizon, adjusted for censoring and discounted at 1.5% yearly. The primary outcomes were incremental cost-effectiveness ratios (ICERs) for life-years gained (LYG) and quality-adjusted life year (QALY). To examine the sensitivity of the ICER to drug acquisition costs and discounting, we conducted a price reduction analysis and a scenario analysis of different discount rates. Results: Propensity-score matching resulted in a total of 1,142 pairs of matched mNSCLC patients. Pembrolizumab extended survival with an incremental effect of 0.37 LYG and 0.35 QALY, but at an incremental cost of $56,681; the resulting ICERs were $154,941/LYG and $163,039/QALY. Though the ICERs were not sensitive to discounting rate, 31% and 55% reductions to the price of pembrolizumab brought the ICER below $100,000/QALY and $50,000/QALY, respectively. Conclusions: In the real world, first-line pembrolizumab is not considered to be cost-effective for mNSCLC patients with PD-L1≥50%. Improvements in cost-effectiveness, however, may be achievable through price renegotiations for pembrolizumab.

Market reactions to drugs price reduction during COVID-19 distress in an emerging economy: value creation through CSR

PurposeThe coronavirus (COVID-19) is the worst pandemic in recent memory in terms of its economic and social impacts. Deadly second wave of COVID-19 in India shook the country and reshaped the ways organizations functions and societies behave. Medical infrastructure was unaffordable and unsupportive which created high distress in the Indian society, especially for poor. At this juncture, some pharmaceutical firms made a unique social investment when they reduced price of drugs used to treat COVID-19 patients. This study aims to examine how the market and the society respond to the price reduction announcement during the psychological distress of COVID-19.Design/methodology/approachMarket reactions have been analyzed by conducting an event study on stock market data and visual analytics-based sentiment analysis on Twitter data.FindingsOverall, this study finds positive abnormal returns on the day and around the day of event. Interestingly, this study finds that returns during the time of high distress are significantly higher. Sentiment analysis conveys that net sentiment is favorable to the pharmaceutical firms around the day of event and it sustains more during the time of high distress.Originality/valueThis study is unique in contributing to the business and industrial management literature by highlighting market reactions to social responsibility of business during the time of psychological distress in emerging economies.

О разработке нечеткой модели оценки лояльности потребителей для организаций электроэнергетики

The article emphasizes the relevance of improving the efficiency of the electric power industry organizations. It is revealed that the transition to market relations and the existing sectoral mechanisms for improving competi-tiveness do not contribute to the reduction of electricity prices, the steady growth of which is observed during the reform and post-reform periods. Attention is focused on the need to stimulate consumer loyalty as one of the effective mechanisms for increasing competitiveness in the electric power industry. The types of consumer loyalty, the main approaches to its assessment and management, and the features of consumer loyalty of elec-tric power organizations, determined by their functioning, are characterized. Significant factors influencing the loyalty of electricity consumers have been identified and, on their basis, a model of consumer loyalty of con-sumers in the commercial sector has been developed. The most appropriate soft modeling approach and im-plementation method for the developed model were selected. The possibility of using the developed fuzzy model for assessing consumer loyalty for energy sales and power grid organizations is shown.

Implementation of innovative technologies in Kazakhstan: A case of the energy sector

The implementation of innovative renewable energy projects is designed to meet the growing electricity demand and reduce carbon dioxide emissions into the atmosphere. In order to avoid resource dependence of the economy and meet the demand for electricity in remote areas of Kazakhstan, the development of renewable energy sources is urgent. The purpose of this study is to analyze the effectiveness of the implementation of existing mechanisms for the implementation of innovative renewable energy projects through auctions. Moreover, it identifies their shortcomings and offers proposals for improvement. The analysis uses data from the Kazakhstan Bureau of National Statistics on renewable energy sources, namely alternative energy sources such as solar and wind power plants, excluding biogas. The methodology provides for the assessment of projects implemented through auctions for 2018–2021, taking into account such indicators as the dynamics of the number of wind and solar energy projects, their capacity, the percentage of auction price reduction for a specific year. The paper discusses the mechanism for conducting auctions of solar and wind electricity, which, through the auction organizer, connects authorized bodies and investors. The main indicators of auctions for individual years are noted, and the main shortcomings of this mechanism are identified. The analysis of barriers to innovative renewable energy project implementation revealed the presence of contradictions in the price regulation of renewable electricity, the lack of market pricing mechanisms, and the unpreparedness of the energy infrastructure for integration with renewable sources. AcknowledgmentThis research is funded by the Science Committee of the Ministry of Education and Science of the Republic of Kazakhstan (Grant No. AP13268750).

Benefits of sphingosine-1-phosphate receptor modulators in relapsing MS estimated with a treatment sequence model

BackgroundThree sphingosine-1-phosphate receptor (S1PR) modulators are currently available as disease-modifying therapies (DMTs) for relapsing MS in the Netherlands (i.e. fingolimod, ozanimod and ponesimod). We aimed to identify which S1PR modulator yields the highest benefit from a health-economic and societal perspective during a patient's lifespan. MethodsIncorporating Dutch DMT list prices, we used the ErasmusMC/iMTA MS model to compare DMT sequences, including S1PR modulators and eight other DMT classes, for treatment-naïve patients with relapsing MS in terms of health outcomes (number of lifetime relapses, time to Expanded Disability Status Scale (EDSS) 6, lifetime quality-adjusted life years (QALYs)) and cost-effectiveness (net health benefit (NHB)). We estimated the influence of list price and EDSS progression on cost-effectiveness outcomes. ResultsIn deterministic and probabilistic analysis, DMT sequences with ponesimod have lower lifetime costs and higher QALYs resulting in a higher average NHB compared to sequences with other S1PR modulators. Ponesimod remains the most cost-effective S1PR modulator when EDSS progression is class-averaged. Given the variable effects on disability progression, list price reductions could make fingolimod but not ozanimod more cost-effective than ponesimod. ConclusionOur model favours ponesimod among the S1PR modulators for the treatment of relapsing MS. This implies that prioritizing ponesimod over other S1PR modulators translates into a more efficacious spending of national healthcare budget without reducing benefit for people with MS. Prioritizing cost-effective choices when counselling patients contributes to affordable and accessible MS care.

Determination of Production and Marketing Behaviors of Producers Selling Products to the Turkish Grain Board, (Kırşehir Province Mucur District Micro Field Study)

The aim of this study is to examine the socio-economic characteristics of producers who sell wheat to the Turkish Grain Board (TGB), which is an interventionist organization in the purchase and sale of grain in Türkiye, as well as some of their behaviors regarding production, marketing preferences, and their relations with TGB. The sample of the study consisted of 100 wheat producers in the Mucur district of Kırşehir province. The obtained data were interpreted by converting them into tables, cross-tabulations, and graphs. The data in the cross tables were statistically interpreted using Chi-square analysis. It can be said that producers are not satisfied with TGBs’ purchasing practices for some reasons. The most important reason for this is that quality-based purchasing practices have an extremely negative impact on prices. It was determined that they were not satisfied, and this resulted in high price reductions in quality-based purchasing, and as a result, there was distrust in analysis practices. Quality-based purchasing policy is a method that allows wheat quality characteristics to be determined with various devices in a short time. This method, which is decisive in quality classification and product pricing scale, must be explained correctly to producers. Otherwise, the producer ’s trust in the TGB may gradually decrease. This can be achieved through initiatives taken by the institution or through various publications and training activities. One of the most important results of this study is that TGBs and decision-makers are more sensitive to local producers. For decision-makers to maintain their influence on the producer, they must carefully examine the details of the processes with an inductive approach, starting from the bottom up. This situation is considered critical in terms of food security.

Strategi Pengembangan Usaha Mikro Kecil Menengah (UMKM) Kerupuk Sagu Di Desa Pulau Banjar Kari,Kecamatan Kuantan Tengah, Kabupaten Kuantan Singingi

Sago cracker MSMEs still produce sago to the extent of the household industry, simple processing technology and lack of promotion of sago crackers. The research objective was to analyze the internal and external environment of sago cracker MSMEs, formulate and determine technical strategies and policies for the development of sugo cracker MSMEs in Kuanta Singingi Regency. This research was conducted by survey with quantitative and qualitative descriptive analysis. Qualitative descriptive using IFE and EFE matrix while qualitative descriptive wing SWOT method. The total internal factor evaluation (IFE) score was 2.6694 and the total external factor evaluation (EFE) score was 2.9857. The GE matrix results in sago cracker MSMEs located in quadrant (hold and maintain), namely market and product development. The resulting strategies for the development of sago cracker MSMEs are a MSMEs have a long-term development strategy by The experience of MSM owners has been on busmess for a long time, c) Policy and political support for the development of MSMEX d) MSMEs get guidance from the government, dy Participate in exhibitions and expus organized by the government both inside and outside the area. e) Product diversification and innovation by utilizing trend models in the community Marketing strategies to communities, inibes religions and other segments of society. ) Carrying out product mapping so that the product innovations produced cannot be imitated, h) Product penetration marketing strategies through discounts and price reductions, i) Digitalization strategy for marketing MSME products to reach a wider market. Develop partnerships between business actors in product and market development andk) Establishing partnerships with raw material suppliers

Launch and Post-Launch Prices of Injectable Cancer Drugs in the US: Clinical Benefit, Innovation, Epidemiology, and Competition.

Rising cancer drug prices adversely affect patients' adherence and survival. We aimed to identify and quantify factors associated with launch prices and post-launch price changes of injectable cancer drugs in the US from 2005 to 2023. All anticancer drugs with US FDA approval between 2000 and 2022 were identified in the Drugs@FDA database. The sample was then restricted to cancer drugs covered under Medicare Part B (injectable drugs). Data characterizing each drug's clinical benefits, disease epidemiology, approved indications, competition, and price were obtained from FDA labels, the Global Burden of Disease study, and the Centers for Medicare and Medicaid Services. The association between launch/post-launch prices and collected variables was assessed in random-effects regressions. Of 170 cancer drugs with FDA approval between 2000 and 2022, we identified 66 (39%) injectable cancer drugs with quarterly price data from 2005 to 2023. In 2023, mean prices amounted to $27,688 per month, with an average price increase of 94% from 2005 to 2023. Launch and post-launch price changes were significantly associated with the treated disease epidemiology. A 1% decline in disease incidence was associated with a 0.2511% (p=0.008) increase in launch prices and a 0.0086% (p=0.032) annual increase in post-launch prices. Accordingly, launch prices were 120% (p=0.051) higher for orphan than non-orphan drugs, with 3% (p=0.008) greater annual post-launch price increases. Post-launch prices declined by up to -2% annually as new supplemental indications were approved for the same drug. We found no consistent association between launch/post-launch prices and the drugs' clinical benefit in terms of overall survival, progression-free survival, and tumor response. The market entry of new competitors was not associated with price reductions. 28 of 33 drug pairs within the same class had positive correlation coefficients. Pearson correlation coefficients were high (>0.80) for PD-1/PD-L1 inhibitors, CD38 antibodies, CD20 antibodies, HER2 antibodies, and mTOR inhibitors. Cancer drug prices regularly increase faster than inflation; however, there is no evidence that launch prices and post-launch price changes are aligned with the clinical benefit a drug offers to patients. In particular, patients with rare diseases experience greater price increases for their orphan drugs. There is no evidence that brand-brand competition results in drug price reductions.

The effect of agricultural trade openness on fruit prices in Korea

This study investigates the effect of agricultural trade openness on fruit prices in South Korea considering the quality improvement originating from agricultural trade policies by examining the U‐shaped relationship between agricultural openness and fruit prices. Utilising the autoregressive distributed lag (ARDL) model and annual data from the period 1988–2019, we find that while an increase of agricultural openness leads to a reduction in fruit prices, an increase of square of agricultural openness leads to a rise of fruit prices in the long‐run. In other words, our hypothesis of a U‐shaped relationship between agricultural openness and fruit prices is satisfied. This finding implies that determining the optimal amount of high‐quality fruit is important for fruit farmers' income. Additionally, Korea should divide the fruit consumer price index (CPI) into high‐quality and traditional fruit to solve the problem of an increase in fruit CPI without an actual increase in the price of traditional fruit.

Cost-effectiveness analysis of biologics for the treatment of chronic rhinosinusitis with nasal polyps in Canada

BackgroundDupilumab, omalizumab, and mepolizumab are the three biologics currently approved for use in CRSwNP in Canada. Despite evidence of efficacy, their cost-effectiveness, which is a key factor influencing prescribing patterns, has not yet been compared to each other.MethodsA cost-effectiveness model using quality-adjusted life years (QALYs) was constructed using a Decision Tree Markov analysis. A third-party healthcare payer perspective and a 10-year time horizon was used. A willingness-to-pay (WTP) threshold of 50,000 Canadian dollars (CAD) per QALY was used to determine cost-effectiveness. Dupilumab, omalizumab, and mepolizumab were each compared to each other.ResultsOmalizumab was the most cost-effective biologic using current estimates of cost and efficacy in CRSwNP. Using omalizumab as a baseline, dupilumab had an ICER of $235,305/QALY. Mepolizumab was dominated by omalizumab and dupilumab at the current drug prices and estimates of efficacy. Sensitivity analyses determined that when increasing the WTP threshold to $150,000/QALY, dupilumab became cost-effective compared to omalizumab in 22.5% of simulation scenarios. Additionally, altering dosing frequency had a significant effect on cost-effectiveness.ConclusionWhen comparing the relative cost-effectiveness of biologics in recalcitrant CRSwNP, omalizumab currently appears to be the most cost-effective option. Future reductions in drug prices, adjustments to currently approved dosing regimens, better patient selection, and improvements in sinus surgery outcomes will challenge the current cost-effectiveness models and necessitate reassessment as treatments for CRSwNP continue to evolve.

Effects of dual-credit policy and subsidy cancellation on decisions in an automotive supply chain

The green development of China's automotive supply chain is driven by policies. This study uses game theory to explore the pricing and emission reduction strategies of the automotive supply chain under dual-credit policy and subsidy policy (scenario DS), as well as dual-credit policy and subsidy cancellation (scenario DC). This study discusses the effects of dual-credit policy and subsidy cancellation on optimal decisions. The results show that increasing the intensity of dual-credit policy hinders the production and emission reduction of H-type fuel vehicles (FVs). Tougher corporate average fuel consumption (CAFC) standards do not affect L-type FVs; however, they can increase the production and emission reduction of E-type FVs. The more stringent production proportion target of new energy vehicles (NEVs) will limit the production of all types of FVs. Subsidy cancellation reduces the wholesale price of NEVs; however, its effects on the selling price and market size of NEVs are uncertain and depend on their respective thresholds. The government should formulate differentiated dual-credit policies based on different types of fuel consumption. This will ensure that FV manufacturers with different types of fuel consumption can reduce their emissions or increase the production of NEVs. Additionally, the government should ensure a smooth transition before subsidy cancellation to prevent negative effects on the NEV market.

Analysis of Printing Parameters for Sheet Metal Bending with FDM Printed Tools

The objective of this work is to use PLA plastic matrices printed using the FDM additive manufacturing technique as an alternative to conventional sheet metal bending. In this way, the demand of the industry to obtain highly customized short series bent parts at a reduced price is covered. To demonstrate this hypothesis, first, the maximum compressive strength of FDM printed specimens with different manufacturing parameters was characterized by performing a parametric analysis using a factorial design of experiments (DOE) model and based on the ISO 604 standard. Once the results were analysed, an articulated bending tool was designed and printed with the best configuration obtained previously. Then, 50 S280GD galvanized steel sheets of 1 mm thickness were bent. Finally, the bending angles of the sheets were examined, checking that the bending was performed correctly, obtaining the desired shape in the sheet. As for the analysis of the economic impact, a 97.75% reduction in the manufacturing price of the tooling with respect to conventional tooling was observed, demonstrating the viability of these dies in an industrial environment.

Thermo-economic and environmental analysis of a CO2 residential air conditioning system in comparison to HFC-410A and HFC-32 in temperate and subtropical climates

Energy conversion in accordance with environmental protection is becoming one of the dominant factors for the sustainable development of modern society. Most of the present air-conditioning (AC) systems use hydrofluorocarbons (HFCs), which contribute to global warming, as the working fluid. In contrast, natural refrigerants, such as CO2 (carbon dioxide), NH3 (ammonia), R290 (propane) and hydrocarbons (HCs) have a significantly lower climate relevance. Furthermore, R744 (carbon dioxide) is favorable, from the perspective of safety, compared to R290 and R717 (ammonia). In this study, an energetic, environmental, and economic analysis is conducted to evaluate the performance of a residential air-conditioning system using CO2, R410A, and R32 as the working fluids. An assessment is carried out by analyzing the AC systems in temperate and subtropical regions in Europe, in particular Munich, Florence, and Malaga. The load demand of a multi-family house is estimated by the Hourly Analysis Program (HAP). The AC systems and their energy consumption is simulated by Aspen Plus and validated by experimental data. The life cycle assessment is performed using SimaPro software and, additionally, an economic analysis is conducted. The results show that the annual emitted CO2-equivalents of the CO2 air-conditioning system are up to 75.1% lower than those of R410A and R32. However, in case of CO2 as the working fluid, the annual energy efficiency ratio is reduced by between 23.3% and 31.4%, while the life cycle cost increases by up to 55.4% compared to the studied HFC air-conditioning systems. In general, it was concluded that, for countries in the temperate zone, it is a promising way to adopt a CO2 air-conditioning system for space cooling in the near future with the assistance of an electricity price subsidy and CO2 compressor price reduction, while it is not suitable for countries in the subtropical zone, such as Malaga.

An analysis of the implementation of a hybrid renewable-energy system in a building by considering the reduction in electricity price subsidies and the reliability of the grid

Abstract This article discusses the implementation of a hybrid renewable-energy system to satisfy the electricity requirements of a building. The analysis is based on optimization calculations performed using HOMER software. The components of the simulated hybrid renewable-energy system include photovoltaics, generators powered by biogas, converters and a grid. The input data utilized by the HOMER software are derived from measurements and surveys. The electric load curve is obtained through measurements at the location of the case study. Through surveys, parameters pertaining to the components of the hybrid renewable-energy system were gathered. The analysis was carried out using two sensitivity variables, namely electricity price and grid reliability. On the basis of these two sensitivity variables, optimal system configuration, net present cost, energy cost, return on investment, internal rate of return and payback period were analysed. The results of the analysis indicated that reducing subsidies, which results in higher electricity prices, provided opportunities for economically competitive hybrid renewable-energy systems. With electricity prices of US$0.094/kWh, the return of investment and the internal rate of return increased to 15% and 19%, respectively, and the payback period decreased to 5.3 years. When a hybrid renewable-energy system is implemented in regions with low grid reliability, the same phenomenon occurs.

Association Between Prescription Drug Discount Cards and Out-of-Pocket Costs for HFrEF Regimens.

The burden from medication costs for treating heart failure can be financially toxic for uninsured/underinsured patients and their families. Prescription discount cards, which offer cash price reductions, may decrease out-of-pocket costs for patients without prescription benefits, but the degree to which they offer financial relief remains unclear. Our objective was to assess the financial burden for uninsured/underinsured patients prescribed a drug from each of the 4 standard classes of medications for heart failure with reduced ejection fraction. A second objective assessed whether discounts varied across economically and geographically diverse regions in Tennessee. This was a cross-sectional pricing analysis of guideline-directed medical therapy heart failure with reduced ejection fraction regimens utilizing prescription discount cards. Between February 9 and March 31, 2022, we conducted searches on 3 discount card websites (GoodRx, NeedyMeds, and Blink Health) for the prices of 30- and 90-day supplies of select guideline-directed medical therapy heart failure regimens for 6 Tennessee ZIP codes. Prices were compared with Amazon and Redbook prices. Monthly costs among discount card services varied from $10.58 to $30.86 for a generic 3-drug regimen consisting of beta blockers, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, and mineralocorticoid receptor antagonists. With the addition of a sodium-glucose cotransporter-2 inhibitor, prices increased to $540.32 to $593.74. The ideal 4-drug regimen (beta blocker, angiotensin receptor neprilysin inhibitor, mineralocorticoid receptor antagonist, and sodium-glucose cotransporter-2 inhibitor) ranged from $1188.31 to $1464.54. When compared with Amazon cash prices, the cards offered an average discount of 65% on a generic 3-drug regimen; when brand-name medications were added, discounts were modest (<12%). There were no significant variations in pricing based on ZIP codes in differing economic and geographic regions. Although prescription discount cards offered significant savings on generic medications, brand-name drug discounts were small and overall costs remained high. These findings highlight the potential for unequal access to life-saving therapies for heart failure with reduced ejection fraction.

진흥과 규제 사이

The South Korean government has actively pursued the development of the ICT industry, especially focusing on the 5th-Generation (5G) mobile communication technology as an engine of the nation’s future economic development. However, in 2023, the Korean government failed to build 5G infrastructure, particularly 5G base-stations using 28㎓ frequency band, which is a rare case in the history of Korea’s ICT industrial policies. This article argues that the technocracies, who gave in to the politicians’ policy preference for regulation, were caught between the incompatible policy goals of investment expansion and price reduction. The consequence was the weakening of the state-business coalition that used to support Korea’s successful ICT industrialization. This paper suggests that Korea’s industrial development model began to deviate from its path dependency.

Analysis of Financial Feasibility and Business Economics Manalagi Mango Cultivation

The assessment of the feasibility of Manalagi Mango cultivation in Mertani Village, Karanggeneng District, Lamongan Regency, and the analysis of the sensitivity of this cultivation to increased production costs, decreased production, and reduced output prices are the main objectives of this study. The study was conducted in Mertani Village, Karanggeneng District, Lamongan Regency, using a census approach encompassing all populations as respondents. Both primary and secondary data were employed, with data analysis involving quantitative metrics and sensitivity rate analysis using a 15% discount factor. Qualitative descriptive analysis was utilized to evaluate technical cultivation aspects and market factors. Data collection occurred in March 2021. The findings revealed that intensive Manalagi Mango cultivation in the area was financially feasible, with a Gross Benefit Cost Ratio of 4.7, Net Benefit Cost Ratio of 9.94, NPV of IDR 278,880,609, and an IRR of 35%. Additionally, the study demonstrated the resilience of mango cultivation to potential challenges, including a 10% increase in production costs, a 25% decrease in production, or a 10% reduction in output prices, highlighting its feasibility and profitability. The study also noted the favorable climate and rainfall conditions for Manalagi mangoes, though technological adoption among farmers remained limited. Despite variances in sales compared to other crops, the mango cultivation business in Mertani Village remains promising.

Cost-effectiveness analysis of atezolizumab in patients with non-small-cell lung cancer ineligible for treatment with a platinum-containing regimen: a United Kingdom health care perspective.

Cost-effectiveness of atezolizumab, as a treatment for advanced non-small-cell lung cancer (NSCLC) patients who cannot receive a platinum-containing regimen,was still unknown. Our objective was to evaluate the cost-effectiveness of atezolizumab vs. chemotherapy in this indication from the perspective of UK healthcare system. From the global, randomised, open-label, phase III IPSOS trial, clinical inputs and patient characteristics were obtained. A partitioned survival model with three health states was built: Progression-free survival, progressed disease and death. A lifetime time horizon was applied, with an annual discount rate of 3.5%. Additionally, the willingness-to-pay threshold of £50,000/QALY was utilized. Primary outcomes were quality-adjusted life-year (QALY), costs, and incremental cost-effectiveness ratio (ICER). Sensitivity, scenario, and subgroup analyses were used to assess the reliability of base-case results. Price simulations were carried out in order to provide information for the pricing strategy at specific willingness-to-pay threshold. In the base-case analysis, atezolizumab resulted in a gain of 0.28 QALYs and an ICER of £94,873/QALY compared to chemotherapy, demonstrating no cost-effectiveness. Price simulation results revealed that atezolizumab would be preferred at a price lower than £2,215 (a reduction of 41.8%) at the willingness-to-pay threshold of £50,000. Sensitivity, scenario and subgroup analyses revealed these conclusions were generally robust, the model was most sensitive to the price of atezolizumab and subsequent medication. Furthermore, atezolizumab was found to be more cost-effective for patients displaying a positive PD-L1 expression, with an ICER of £72,098/QALY as compared to chemotherapy. Atezolizumab is not cost-effective for patients with advanced NSCLC ineligible for platinum-containing regimen, potential price reduction is necessary.