Relevant Costs Research Articles

Assessing the economics of biologic and small molecule therapies for the treatment of moderate to severe ulcerative colitis in Japan: a cost per responder analysis of upadacitinib

Aim Patients with moderately to severely active ulcerative colitis have an increasing number of advanced therapy options including several biologics and Janus kinase inhibitors. Though data on efficacy and safety of these advanced therapies are available, less is known about the potential economic implications of their utilization in Japan. We evaluated the relative value of these advanced therapies in Japan using a locally developed cost per responder model. Methods A model was developed using relevant clinical endpoints and treatment costs to calculate cost per responder of all advanced therapies used for moderately to severely active ulcerative colitis treatment in Japan. Cost per responder was assessed in biologic-naïve and biologic-exposed populations, respectively. The model incorporated induction and maintenance therapy pathways as patients progressed through based on efficacy rates (clinical response, clinical remission and endoscopic improvement). Total costs for induction and maintenance included: drug acquisition, drug administration and serious adverse event management (as necessary) for responders, with additional rescue treatment cost only for non-responders. Results Upadacitinib showed lower cost per clinical response and cost per clinical remission across both biologic-naïve and biologic-exposed populations with only one exemption in cost per clinical remission in biologic-naïve population. In addition, upadacitinib demonstrated lower cost per endoscopic improvement in both populations. Janus kinase inhibitors outperformed with lower cost per responder than other mediations across all outcomes and patient populations with the exception of tofacitinib for clinical remission in biologic-exposed UC population. Limitations Comparative data used in this analysis have been derived from network meta-analysis, not from direct comparison. Conclusions The results of this cost per responder analysis suggest upadacitinib is a cost-effective option for the first- and second-line treatment of moderately to severely active ulcerative colitis in Japan.

Cost-utility analysis of atezolizumab combined with bevacizumab for unresectable hepatocellular carcinoma in Thailand.

Clinical trials have proven the efficacy and safety of atezolizumab combined with bevacizumab (A+B) in treating unresectable hepatocellular carcinoma (uHCC). This study aimed to assess the cost-utility of A+B compared to best supportive care (BSC) among uHCC patients in Thailand. We conducted a cost-utility analysis from a societal perspective. We used a three-state Markov model to estimate relevant costs and health outcomes over the lifetime horizon. Local cost and utility data from Thai patients were applied. All costs were adjusted to 2023 values using the consumer price index. We reported results as incremental cost-effectiveness ratios (ICERs) in United States dollars ($) per quality-adjusted life year (QALY) gained. We discounted future costs and outcomes at 3% per annum. We then performed one-way sensitivity analysis and probabilistic sensitivity analysis to assess parameter uncertainty. The budget impact was conducted to estimate the financial burden from the governmental perspective over a five-year period. Compared to BSC, A+B provided a better health benefit with 0.8309 QALY gained at an incremental lifetime cost of $45,357. The ICER was $54,589 per QALY gained. The result was sensitive to the hazard ratios for the overall survival and progression-free survival of A+B. At the current Thai willingness-to-pay (WTP) threshold of $4,678 per QALY gained, the ICER of A+B remained above the threshold. The projected budgetary requirements for implementing A+B in the respective first and fifth years would range from 8.2 to 27.9 million USD. Although A+B yielded the highest clinical benefit compared with BSC for the treatment of uHCC patients, A+B is not cost-effective in Thailand at the current price and poses budgetary challenges.

MiPhDUO: microwave imaging via physics-informed deep unrolled optimization

Microwave imaging (MWI) is a non-invasive technique that can identify unknown scatterer objects’ features while offering advantages such as low cost and portable devices with respect to other imaging methods. However, MWI faces challenges in solving the underlying inverse scattering problem, which involves recovering target properties from its scattered fields. Existing methods include linearized and non-linear optimization approaches, but they have limitations respectively in terms of range of validity and computational complexity (in view of the possible occurrence of ‘false solutions’). In recent years, learning-based approaches have emerged as they can allow real-time imaging but usually lack generalizability and a direct connection to the underlying physics. This paper proposes a physics-informed approach that combines convolutional neural networks with physics-based calculations. It is based on a few cascaded operations, making use of the gradient of the relevant cost function, and successively improving the estimation of the unknown target. The proposed approach is assessed using simulated as well as experimental Fresnel data. The results show that the integration of physics with deep learning can contribute to improve reconstruction accuracy, generalizability, and computational efficiency in MWI.

Probabilistic assessment of silane impregnation and electrochemical chloride removal treatment on protection effect against steel corrosion in marine concrete structures

This paper concerns the protective performance of maintenance strategies, i.e. silane impregnation (SI) and electrochemical chloride extraction (ECE), against chloride-induced corrosion for concrete elements in marine environment. The effectiveness of SI treatment is researched through long-term exposure tests, and the efficiency of ECE treatment is considered using a quantitative expression. The failure probability evolution is calculated through reliability theory and Monte-Carlo simulations. The maintenance planning is established, and relevant maintenance costs are determined. The obtained results show that (1) the effective protection life of initially applied silane is longer than 12 years, but the protective performance of reapplied silane is not as pronounced as the silane initially applied; (2) the chloride ions at steel surface are efficiently removed after ECE which is more conducive to sustain the steel rebars free from corrosion; (3) ECE treatment attains the optimal cost and is recommended for long life-span concrete elements in marine environment.

The Great Accounting Escape: A Teaching Tool for Relevant Costing and Short-Term Decisions

ABSTRACT This teaching case creates an Escape Room experience for managerial accounting students to reinforce relevant costing and short-term decision concepts. Within the Escape Room, students analyze five short-term decisions within 50 minutes to “escape” for the weekend. Specifically, students identify relevant information, perform the necessary calculations, and evaluate their results to make a recommendation on how to improve firm profitability. The Escape Room seeks to build a greater understanding of relevant costing by creating a narrative, linking the five short-term decisions, and formatting every decision using an input-process-output (IPO) framework. The Escape Room also uses gamification elements to promote engagement and interest in learning these concepts. Students agree that the Escape Room increases engagement and fosters an understanding of relevant costing and short-term decision concepts. We see one of the strongest benefits of the Escape Room is its ability to scale across class formats and provide automatic feedback to students. Data Availability: Data are available upon request.

Reduce the delivery time and relevant costs in a chaotic requests system via lean-Heijunka model to enhance the logistic Hamiltonian route

Online supply chain management (OSCM) is the smart way to deal with the vast amounts of data that come in from customers in a disorganized system to meet the quantities, volumes, and types of customer packages during both delivery and pick-up phases using a new design of vehicle boxes managed by IoT and to track their requests based on scheduling requests and sorting them to make a Hamiltonian route that guarantees the shortest travel distance. The OSCM framework consists of two sequential phases. 1st phase has four recruitment stages. The 1st stage discusses exploration resources (the relationship between the client and the vehicle) using IoT to receive customers' requests (Heijunka growth radius), then moves to exploration maturity to build a one-way Hamiltonian growth route direction. The 1st stage is based on tackling a Heijunka matrix fed through deep learning to classify the matrix into many conditional clusters according to customers' request forecasting and make the prediction value, which is the stop condition of cluster radius through next three stages. This study finds that XGboost outperforms Ada-boost by 14.352 % in the prediction stage. A heuristic rule based on NWBS enhances the FP-Growth algorithm over ECLAT by 7.648 % in the classification stage. Phase II is interested in reducing load and unloading activity time. This problem describes needing more than a different service at the same point (i.e., chaotic and unstable interaction leads to unstable delivery). Therefore, the online scheduling and tracking of the logistic routing using the IoT that Smart Lean Heijunka supports will enhance the SCM, increasing the visited points by 31.2 % and improving the profit by 41 %.

Ефективність та особливості управління маркетинговою діяльністю на підприємствах в умовах воєнного стану

The aim of the article is to study the efficiency and features of management of marketing activities in enterprises. Analyzing the latest research and publications of scholars, the general theoretical foundations of the features of management of marketing activities at enterprises are considered. The article highlights and theoretically substantiates the efficiency and features of management of marketing activities of enterprise, taking into account the conditions of martial law. In the context of the introduction of market relations in Ukraine, there is a need for a new business culture, one of the carriers of which is marketing. Due to the fact that competition in the market is increasing, entrepreneurs must organize economic activities in such a way that the highest results are achieved, and the relevant costs are the lowest possible. Business conditions have become much tougher, commercial activity is significantly reduced, and consumer interest in shopping is significantly reduced. Because of this, it is necessary to adapt in time and deal with the challenges that entrepreneurs face every day. That is why adaptation on the basis of marketing is one of the most important ways to continue your own business. In this regard, a modern enterprise should primarily focus on economic effectiveness. This can be achieved only by prioritizing the interests of the consumer. However, it should be remembered that only copying the experience of marketing activities of Western countries cannot bring the expected results within the framework of domestic realities. In addition, we should not forget that there is a war going on in the country, and all this has a significant impact on marketing activities. Undoubtedly, people are trying to save more and analyze their purchases more carefully, dividing them into what you can and cannot do without. That is why it is worth offering only high-quality products that are currently popular. It should be noted that in the conditions of crisis, only those enterprises that act actively and apply a set of measures to manage the enterprise on the basis of marketing, using marketing tools, survive and function.

Estimating the Costs of Product Development Projects Based on External Data: The New Product Development Cost Benchmarking Method

Activities for the development of new products are essential for most companies, and the investments for such activities can be substantial. Estimating the costs for new product development (NPD) projects is a challenging process as uncertainty is usually high and comparable data is scarce. While manifold work is available about general cost estimation methods, the estimation of NPD is still underrepresented in the literature. Except the few existing approaches, mostly build exclusively on internal data from within the company. In this article, we contribute to this gap by introducing an NPD cost benchmarking method. This approach faces the data availability problem by incorporating publicly available data of competitors into a regression model to estimate the average NPD costs of particular products. It is shown how specific adjustments to the data used for the model are necessary. The adjustments of input data account for macroeconomic circumstances and intercompany differences in accounting standards and development processes. Other adjustments (through a parametric model that builds on the regression results) account for company- and product-specific cost requirements. Using the method, relevant NPD cost estimations can be made for early-phase product management. The main output of this article is the introduction of the NPD cost benchmarking method as a novel solution to the challenging process of NPD cost management.

The illness trap: The impact of disability benefits on willingness to receive HCV treatment

Health care is assumed to be a primary good, implying that patients should always demand or accept treatments that may enhance their life expectancy and quality of life, especially if the risks associated with the treatment are low. We argue that, especially in countries with a well-developed welfare state, treating an invalidating condition may lead to opportunity costs in terms of reduced disability allowances that may represent a barrier to treatment for low-income individuals. We test this hypothesis by applying a recursive bivariate probit approach to population data from an ad hoc administrative database for Liguria (an Italian administrative region). The dataset includes data for more than 8 thousand people affected by hepatitis C Virus (HCV) infection between 2013 and 2020. After the discovery of new direct-acting antivirals (DAAs) in 2014, HCV eradication may now be possible. However, despite the national and international efforts, several patients diagnosed with HCV choose not to undergo drug therapy despite the adverse consequences for their personal health and relevant costs to the national health system. We show that five years after the implementation of the new drugs, approximately 41 % of the diagnosed population in Liguria remains untreated. This percentage increases to 64 % within the subgroup entitled to disability benefits and characterized by lower income levels. The “illness trap” effect is more substantial for older people but also low-income patients. Moreover, we find that this effect is higher in patients with an intermediate range of comorbidities; indeed, these patients are at a higher risk of losing economic benefits if they recover from HCV. These results suggest the need for healthcare policies addressing this distorting effect when designing benefit programs and granting financial benefits to patients.

УПРАВЛІННЯ ТОВАРНИМИ ЗАПАСАМИ ТОРГІВЕЛЬНИХ ПІДПРИЄМСТВ В СУЧАСНИХ УМОВАХ

The article is devoted to peculiarities of trade enterprises’ inventory management, which allows a modern company to maintain a balance between demand satisfaction and inventory storage costs. Stocks perform three functions: accumulation; protection against price changes and inflation; cost management. When determining the optimal balance between costs associated with keeping inventories one should determine that the sum of all relevant costs must be minimal. The main indicators that allow to determine efficiency of inventory management are considered. The ratio between the dynamics of stocks and the volume of sold products was analyzed on the example of wholesale trade enterprises (period 2013-2022). The main ways of more efficient use of stocks are proposed. Necessity of developing the enterprise’s product policy has been proven and its main stages have been determined. Peculiarities of the model of economically justified order size, which are used to optimize the size of production stocks and stocks of finished products are considered. Models of inventory management with a fixed period and a fixed volume are considered, the choice between them depends on a number of factors, including quantity of stocks, their price and importance as well as volume of the order. During the formation of the inventory management model, it is necessary to take into account specifics of business, limitations of the external environment, and the subjectivity of management decision-making. The main problem that arises when solving the task of stock management is the development of an effective and reliable system of their management, which should provide smooth production process, its realization maintaining the optimal stocks volume and minimizing expenses. In general, effective inventory management makes possible to reduce the duration of the production cycle and decrease current costs for their storage; to release financial funds from the current turnover in order to reinvest in other assets; to reduce production losses as a result of eliminating the shortage of production stocks; to accelerate the turnover of stocks, reduce the risk of their loss and reduce the costs of their storage. Managing inventory levels is essential in order to establish and support a company's long-term competitive advantage.

Ecological approaches to the formation of sustainable rural development

The article deals with the features of the functioning and development of rural areas as the basis for the formation of social infrastructure in the educational field. The author studies basic problems and the state of the program for the development of rural areas, analyzes indicators of socio-economic development, creates a program of social infrastructure in the framework of the development of the national project “Education”, applies the method of forecasting key indicators. Moreover, the author studies the features of developing rural areas analyzing key cost parameters; develops approaches to predicting changes in key cost indicators for the maintenance of preschool and educational institutions; considers the relationship of the most significant factors of their functioning. Due to a quantitative assessment of structural changes, the forecast values of costs for future periods have been revealed. It has been established that the resulting method can optimally organize the development process of an organization, thanks to a well-thought-out algorithm for calculating predicted values, and can be used for any organization in the social and cultural sphere. The author makes conclusions about prospects for developing rural areas in the context of the development program. The proposed action plan for managing costs in terms of maintaining social infrastructure facilities contributes to optimizing the process of making managerial decisions, takes into account relevant costs, simplifies the choice of the preferred option for solving the problem.

On indicative societal cost-benefit analysis in health care and social welfare: first experiences. A personalised integrated care approach

Introduction: The implementation of many programs that focus on an integrated approach of health and social issues, proves to be difficult. Among many obstacles, more than once the financing of the program is a stumbling block. The hesitation to invest is prompted by the uncertainties of the benefits these programs aim at. The intended results are not always easy to monetize. Moreover, the benefits may distribute among other stakeholders than those who bore the costs of the program, the so-called ‘wrong pocket problem’. To overcome the hesitation to invest, a social cost-benefit analysis (SCBA) offers a remedy.
 Indicative Societal Cost-Benefit Analysis (iSCBA): A SCBA is based on a broad concept of prosperity. In this concept, ‘soft’ values such as health and culture are also included as beneficial contributions to the well-being of both individuals and society. This type of analysis assesses the impact of an investment on society by estimating all relevant costs and revenues, both financial and non-financial, and their (re)distributions amongst stakeholders. Public research agencies in the Netherlands underline the contribution of SCBA’s to policymaking in the field of public health and social welfare. So far, many SCBA’s on health and social welfare issues are drafted from a macro perspective with barely any focus on the individual civilian and corresponding context. To overcome this objection, this research advocates an indicative SCBA (iSCBA), i.e., a SCBA through a context-sensitive lens of a local health care and welfare organization or network. In this approach, the consecutive research steps are explored in a bottom-up direction, starting with an innovation in a local organization and network and subsequently investigating all possible social cost-benefit effects, including spill-over effects outside the organization. 
 Approach: In terms of research design, a series of case studies were conducted with the cooperation of alumni of the Master Integrated Care Design of the University of Applied Sciences Utrecht. At the time these alumni were interviewed, they were involved in implementing a health care or welfare innovation. For the purpose of this innovation, these alumni had prepared an iSCBA. During the interviews, alumni were asked how their iSCBA were assessed by decision-making colleagues and whether the assumptions, as substantiated in their iSCBA, materialized. 
 Results: The case studies affirm that complementing the innovation proposal with an iSCBA was a convincing step in the assessments by decision makers. Moreover, several cases show how an iSCBA offered welcome arguments in the deliberations with both internal stakeholders such as board of directors, as well as external stakeholders such as health insurance companies. Several cases report that the presumed cause-effect relations and working mechanisms in the iSCBA were recognized as plausible and feasible by the stakeholders involved. Whether the presumptions practically materialized was difficult to verify. Although interviewees in all case studies were able to identify and demonstrate beneficial effects thanks to the innovation, it proved to be difficult to statistically estimate the impact of these effects due to the interfering effects of parallel developments, both inside and outside the organization and network. 

Multi-objective parameter optimization for stacking and sintering of screen-printed magnetic sheets

Screen printing enables the production of very thin magnetic sheet laminations in near net shape geometry. This minimizes material waste in production and simultaneously reduces losses during machine operation and in-creases geometric design freedom. The subsequent sintering process step is particularly relevant, since the geometrical and magnetic properties are defined, and relevant process costs are caused by the heat treatment. This paper presents the requirements of the debinding and sintering process for magnetic sheets and identifies relevant influencing factors to achieve defined product specifications in multiple iterations, using design of experiments. It focuses on the influencing factors furnace atmosphere, sintering temperature, holding time and stacking height and their impact on the magnetic and geometric properties of sintered magnetic sheets.

The assessment and communication of the benefits of competition interventions by the Competition and Markets Authority

The Competition and Markets Authority has a target of delivering, through its activities, direct financial benefits to consumers of at least ten times its relevant costs, measured over a rolling three-year period. This article assesses how these benefits are evaluated and communicated.

A cost-utility analysis of BRCA1 and BRCA2 testing in high-risk breast cancer patients and family members in Thailand: a cost-effective policy in resource-limited settings.

Screening for germline pathogenic BRCA1 or BRCA2 variants (gBRCA) in high-risk breast cancer patients is known to be cost-effective in high-income countries. Nationwide adoption of genetics testing in high-risk breast cancer population remains poor. Our study aimed to assess gBRCA health economics data in the middle-income country setting of Thailand. Decision tree and Markov model were utilized to assess cost-utility between the testing vs. no-testing groups from a societal and lifetime perspective and lifetime. We interviewed 264 patients with breast/ovarian cancer and their family members to assess relevant costs and quality of life using EQ-5D-5L. One-way sensitivity, probabilistic sensitivity (Monte Carlo simulation), and budget impact analyses were done to estimate the outcome under Thailand's Universal Health Coverage scheme. The predicted lifetime cost and Quality-adjusted Life Years (QALY) for those with breast cancer were $13,788 and 10.22 in the testing group and $13,702 and 10.07 in the no-testing group. The incremental cost-effectiveness ratio for gBRCA testing in high-risk breast cancer patients was $573/QALY. The lifetime cost for the family members of those with gBRCA was $14,035 (QALY 9.99), while the no-testing family members group was $14,077 (QALY 9.98). Performing gBRCA testing in family members was cost-saving. Cost-utility analysis demonstrated a cost-effective result of gBRCA testing in high-risk breast cancer patients and cost-saving in familial cascade testing. The result was endorsed in the national health benefits package in 2022. Other middle-income countries may observe the cost-effective/cost-saving aspects in common genetic diseases under their national health schemes.

Probabilistic approach to the sustainability assessment of reinforced concrete structures in conditions of climate change

The paper presents a probabilistic method based on two methodologies – Life Cycle Cost Analysis (LCCA) and Life Cycle Assessment (LCA), for evaluating the sustainability of reinforced concrete (RC) structures in terms of their costs and CO2 emissions. The method considers the whole life of a RC structure by taking into account CO2 initially embodied in its construction materials, the absorption of CO2 by concrete due to carbonation during the service life of the structure, potential damage to the structure due to carbonation-induced corrosion of reinforcing steel that may require repairs, and relevant costs. Since there are numerous uncertainties associated with the calculation of CO2 emissions and costs, a probabilistic approach is beneficial. The emphasis is made on RC structures made of the so-called “green concretes”, in which Portland cement is partially replaced with supplementary cementitious materials such as fly ash and ground granulated blast-furnace slag. The issue of a changing climate is also addressed. The method is illustrated by assessing the sustainability of a multi-story RC carpark made of different concrete types at three different locations (London, Paris and Marseille) for present and future climate conditions. This assessment's results show that using green concretes leads to a major reduction in CO2 emissions and a small decrease in the life-cycle cost of the carpark RC elements. The relative sustainability performance of green concretes slightly improves compared to Portland cement concrete for future climate conditions.

Why are joint arthroplasty registers needed? Part 1. (on the example of registers of knee arthroplasty)

This article examines the creation, assignment and management of knee arthroplasty registries. Methods of collecting relevant data, cost and ways of using thinformation are considered. Registries should strive to collect and analyze data of interest to both researchers and administrators. It is important to realize that without adequate research there will be no basis for real quality improvement. Registries have now become important tools in evidence-based practice. New implants and techniques are constantly being introduced, some of which do not work as expected. Registries will continue to be important tools for identifying problems and minimizing losses for years to come. They are important to the specialty as a whole because a well-documented profession is better equipped to compete for strained medical resources. Healthcare providers are more likely to provide funding when they can show past funding results, document treatment outcomes, and predict future trends.

Analisis Efisiensi Biaya Pembelian Impor Elevator Melalui Jasa Customs Clearence Atau Swakelola Pada PT Marico Gria Jakarta

The research was conducted at PT Marico Gria, a company in Jakarta that sells elevators. This research aims to determine the cost efficiency of import purchases through customs clearance and self-management services. Data was collected through interviews, documentation, and literature studies to then be analyzed using a qualitative descriptive method by calculating the amount of relevant costs that have occurred or will come. Efficiency is calculated based on assumptions seen from the company's purchasing potential. The results showed that the calculation of the cost of purchasing imports in one purchase through customs clearance services was greater, namely, IDR 8,550,000, while self-management was IDR 5,000,000. So the company's import purchases in 10 times the purchase per year In the next 5 years the company gets an efficiency of IDR 147,500,000, - if the company carries out customs clearance with self-management.
 
 Keyword: Cost efficiency, Import Purchases, Customs Clearance, Self-Management

Towards sustainable UAV operations: Balancing economic optimization with environmental and social considerations in path planning

Unmanned Aerial Vehicles (UAVs), i.e., drones, are expected to be widely used in various applications, such as parcel delivery and passenger transport, with the benefits of mitigating traffic congestion and reducing carbon emissions. In this paper, we study a UAV path planning problem under uncertain weather conditions, and design a data-driven dynamic decision support system for multiple types of UAVs. To this end, we categorize all relevant costs into three types, namely, economic, environmental, and social costs, and formulate a nonlinear two-stage stochastic programming model to establish optimal paths for UAV missions under weather uncertainty. We then discretize the nonlinear model and propose a tight linear approximation for the discretized problem to allow for a near real-time implementation. To quantify weather uncertainty, we propose a weather scenario generation algorithm to map ensemble-based weather forecast information to airspace blockage maps. With comprehensive computational studies through simulations, we show that our proposed stochastic approach can lower operating costs by an average of around 6%, where the savings increase as weather conditions become more severe and complex. We also find that, for missions operated by small UAVs, it is not sufficient to determine a path solely based on economic cost minimization, but it should rather be through total cost minimization, which involves environmental and social costs. Considering only the economic cost in the optimization may lead to much higher non-economic costs. However, for missions operated by large UAVs, it is sufficient to determine paths through economic cost optimization, as including environmental and social costs in the optimization process does not result in solutions that are much different from those obtained by considering only the economic costs. For both small and large UAVs, a path established solely through environmental or social cost minimization may not be economically sustainable, as doing so would imply very high economic costs.

Risk and reward of fractionally leveraged ETFs in a stock/bond portfolio

This article investigates using 1.25X leveraged stock and bond exchange-traded funds (ETFs) as an asset allocation strategy. Performance is analyzed by replicating funds from 1989 to 2017, including all relevant costs. Conditions for excess returns are derived analytically and confirmed empirically. Simulations are conducted to assess performance under a variety of market condi- tions, and demonstrate opportunities for excess returns over unlevered funds in a 60/40 stock/ bond allocation. These results are accomplished with a small reduction in the Sharpe ratio and no need to access margin. We conclude that this asset allocation strategy could be well suited for investors more interested in total returns during upward trending markets.