• Title/Summary/Keyword: Cost-efficacy

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Cost-Effectiveness Analysis of HPV Vaccination: Comparing the General Population with Socially Vulnerable Individuals

  • Han, Kyu-Tae;Kim, Sun Jung;Lee, Seo Yoon;Park, Eun-Cheol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8503-8508
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    • 2014
  • Background: After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Materials and Methods: Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. Results: In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. Conclusions: The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

The Determinants of User Resistance to Adopting e-Books : Based on Innovation Characteristics and User Attitude (전자책 수용에 대한 사용자 저항 결정요인 : 혁신특성과 사용자태도를 중심으로)

  • Lee, Aeri;Choi, Jaewon;Kim, Kyung Kyu
    • The Journal of Society for e-Business Studies
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    • v.17 no.4
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    • pp.95-115
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    • 2012
  • The e-Book market has rapidly grown as an innovative product which is mixed its traditional and technological characteristics. However, decreasing user resistance to the e-Book is very important to continually keeping up its market growth. Previous studies for user resistance have been studied as a negative barrier for various innovative products with importance of user resistance. Nevertheless, the factors for user' resistance to the e-Book field have not been found out considering both perceived value and switching cost. Especially, both innovative technology and user specifics should be considered when explaining user resistance to adopting e-Books. Thus, the purpose of this study is to understand the process for user resistance to the e-book and find out its antecedents with perceived value and switching cost at the same time. As a result, it appeared that triability, uncertainty and complexity affected perceived value and switching cost. The user-based antecedents like social norm and perceived value increased the effect of self-efficacy. Also, self-efficacy and perceived value decreased user resistance whereas switching cost increase user resistance to the e-Book perspective.

Diagnostic Efficacy of PET in Soft Tissue Tumors: Comparative Study with Conventional Methods (연부 조직 종양에서 PET의 유용성: 기존의 진단법과의 비교 연구)

  • Seo, Sung-Wook;Park, Sang-Min;Cho, Hwan-Seong
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.32-39
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    • 2005
  • Introduction: Currently, F-18 fluorodeoxyglucose positron emission tomography scans (FDG-PET) has been investigated in soft tissue tumor especially for tumor detection and noninvasive grading. However, the validity and the efficacy of FDG-PET are still unclear in clinical evaluation. The purpose of this study is to determine the efficacy of FDG-PET in compared to conventional diagnostic imaging studies currently used in the soft tissue tumor. Methods: Between March 2001 and March 2002, 29 patients (sixteen males, thirteen females, mean age, 47 years; a range from 4 to 73) diagnosed with soft tissue tumor were evaluated by both conventional diagnostic imaging and FDG-PET. Valid reference test of the local lesion was the histopathologic diagnosis, which was measured in all patients. The suspecting metastasis in the imaging studies was validated by pathology or follow up imaging for at least 6 months. Each imaging diagnosis was made independently. The accuracy of each diagnostic method was evaluated. The incremental cost accuracy ratio was determined in each diagnostic method. Results: For detection of local lesion, sensitivity, specificity, and accuracy for MRI and FDGPET scans were 91%, 57%, 83% and 95%, 43%, 83% respectively. For detection of distant lesion, sensitivity, specificity, accuracy for conventional diagnostic methods and FDG-PET scans were 77%, 89%, 87% and 92%, 94%, 93% respectively. The incremental cost accuracy ratio (ICAR) of FDG-PET for detection of distant lesion was 145,000won/%. According to ICAR for each tumor grade, PET strategy is most cost-effective at high grade tumors. Conclusions: For detection of local lesion such as recurrence or remnant tumor, FDG-PET scan was not more accurate than MRI. However, It was more accurate for detection of metastatic lesion than conventional methods. For detection of high grade tumor, PET was most costeffective than for detection of lower grade tumor.

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In Search of a Performing Seal: Rethinking the Design of Tight-Fitting Respiratory Protective Equipment Facepieces for Users With Facial Hair

  • Meadwell, James;Paxman-Clarke, Lee;Terris, David;Ford, Peter
    • Safety and Health at Work
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    • v.10 no.3
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    • pp.275-304
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    • 2019
  • Background: Air-purifying, tight-fitting facepieces are examples of respiratory protective equipment and are worn to protect workers from potentially harmful particulate and vapors. Research shows that the presence of facial hair on users' face significantly reduces the efficacy of these devices. This article sets out to establish if an acceptable seal could be achieved between facial hair and the facepiece. The team also created and investigated a low-cost "pressure testing" method for assessing the efficacy of a seal to be used during the early design process for a facepiece designed to overcome the facial hair issue. Methods: Nine new designs for face mask seals were prototyped as flat samples. A researcher developed a test rig, and a test protocol was used to evaluate the efficacy of the new seal designs against facial hair. Six of the seal designs were also tested using a version of the conventional fit test. The results were compared with those of the researcher-developed test to look for a correlation between the two test methods. Results: None of the seals performed any better against facial hair than a typical, commercially available facepiece. The pressure testing method devised by the researchers performed well but was not as robust as the fit factor testing. Conclusion: The results show that sealing against facial hair is extremely problematic unless an excessive force is applied to the facepiece's seal area pushing it against the face. The means of pressure testing devised by the researchers could be seen as a low-cost technique to be used at the early stages of a the design process, before fit testing is viable.

Simultaneous Inference in Steady-State Simulation (안정상태 시뮬레이션의 다수측도 동시추정)

  • 방준식
    • Journal of the Korea Society for Simulation
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    • v.3 no.2
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    • pp.27-36
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    • 1994
  • In many real-world simulation studies the several measures of performance are of interest simultaneously. There exist very limited number of studies that explain and suggest the methods or procedures of inferencing the system performances at the same time. This study presents a procedure for determining the number of simulation observations required to achieve the prespecified confidence level for several measures of system performance. Mean values are selected as the measures, for instance, expected ordering cost, expected holding cost, and expected shortage cost for a given period of time in the study of inventory problems. Basically, the batch means approach is applied and extended to develop an algorithm to carry out the procedure handling more than single parameter. The efficacy of the presented method is assessed through the experiments. The empirical results based on some stochastic systems such as queues and inventory problems show that the suggested method produces as excellent result in terms of the precision of estimated means and the number of observations required.

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Molecular Targeting Agents in Cancer Therapy: Science and Society

  • Shaikh, Asim Jamal
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1705-1708
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    • 2012
  • The inception of targeted agents has revolutionized the cancer therapy paradigm, both for physicians and patients. A large number of molecular targeted agents for cancer therapy are currently available for clinical use today. Many more are in making, but there are issues that remain to be resolved for the scientific as well as social community before the recommendation of their widespread use in may clinical scenarios can be done, one such issue being cost and cost effectiveness, others being resistance and lack of sustained efficacy. With the current knowledge about available targeted agents, the growing knowledge of intricate molecular pathways and unfolding of wider spectrum of molecular targets that can really matter in the disease control, calls for only the just use of the agents available now, drug companies need to make a serious attempt to reduce the cost of the agents. Research should focus on agents that show sustained responses in preclinical data. More needs to be done in laboratories and by the pharmaceutical industries, before we can truly claim to have entered a new era of targeted therapy in cancer care.

Digital Breast Tomosynthesis in Addition to Conventional 2D-Mammography Reduces Recall Rates and is Cost-Effective

  • Agostino, Pozzi;Angelo, Della Corte;el Lakis, Mustapha A;Heon-Jae, Jeong
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3521-3526
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    • 2016
  • Digital breast tomosynthesis (DBT) as a breast cancer screening modality, through generation of three-dimensional images during standard mammographic compression, can reduce interference from breast tissue overlap, increasing conspicuity of invasive cancers while concomitantly reducing false-positive results. We here conducted a systematic review on previous studies to synthesize the evidence of DBT efficacy, eventually 18 articles being included in the analysis. The most commonly emerging topics were advantages of DBT screening tool in terms of recall rates, cancer detection rates and cost-effectiveness, preventing unnecessary burdens on women and the healthcare system. Further research is needed to evaluate the potential impact of DBT on longer-term outcomes, such as interval cancer rates and mortality, to better understand the broader clinical and economic implications of its adoption.

Development of a Low-cost Lighting System for Line-acan Camera (라인 스캔 카메라를 위한 저가형 시 균일 조명장치 구현)

  • Kim, Hong-Gap;Kim, Hyeong-Seok
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.49 no.5
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    • pp.235-240
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    • 2000
  • A low cost lighting system for line-scan cameras has been developed with 3-phase power. When exposure time of line-scan camera is shorter than fluctuation period of illumination, the average gray value of each acquired 1-D image varies. Detecting defects on the objects's surface under such illuminating environment is very difficult. The proposed lighting system is composed of low-cost fluorescent lights based on 3-phase power. The specially designed lighting pack and the properly selected lighting position enable to get the rippleless lighting. The principle of the proposed lighting system has been explained analytically. The lighting system has been tested for fabric inspection with line-scan camera and it's efficacy has been proved.

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Utility Analysis for Pegfilgrastim in DLBCL Patients on R-CHOP Regimen (항암치료를 받는 미만성거대비세포 림프종 환자에서 페그필그라스팀에 대한 효용성 평가)

  • Jung, Hee Won;Kim, Jeong Mee;Min, Myung Sook;Lee, Young Mee;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.151-158
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    • 2015
  • Objective: This study was designed to compare pegfilgrastim and filgrastim in diffuse large B-cell lymphoma (DLBCL) patients treated with a rituximab with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen in terms of clinical efficacy and cost-effectiveness. Method: Clinical efficacy was measured by trough level of absolute neutrophil count (ANC), days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, duration of ANC recovery to baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP regimen. To evaluate cost-effectiveness, total prices of used filgrastim and pegfilgrastim within 1 cycle of R-CHOP were analyzed. Results: In terms of clinical efficacy, trough level of ANC and days to ANC recovery showed statistical significance. The median trough levels of ANC with administration of filgrastim and pegfilgrastim were 0.18 and 1.94 (p = 0.021), respectively, and the median durations of ANC recovery to baseline value were 5.5 days and 2 days (p = 0.023), respectively. For the median days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP, the pegfilgrastim group performed better than the filgrastim group. However the difference was not statistically significant. In terms of overall expense during 1 cycle of R-CHOP, pegfilgrastim is about 3.43 times more expensive than filgrastim. Conclusion: Pegfilgrastim is more efficient than filgrastim in terms of clinical efficacy. In terms of prices, pegfilgrastim is more expensive than filgrastim for patients, but it is more convenient in clinical use. Therefore, pegfilgrastim should be the preferred choice of G-CSF for neutropenic patients. Further comparative study of pegfilgrastim and filgrastim is needed.

Repeat Colonoscopy Every 10 Years or Single Colonoscopy for Colorectal Neoplasm Screening in Average-risk Chinese: A Cost-effectiveness Analysis

  • Wang, Zhen-Hua;Gao, Qin-Yan;Fang, Jing-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1761-1766
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    • 2012
  • Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.