• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Journal of Navigation and Port Research
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• v.45 no.3
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• pp.130-137
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• 2021

The main purpose of this study is to provide an objective evaluation standard for the assessment of marine spatial characteristics via Ulsan floating offshore wind power project using HEA.. Various levels of damage occur in the waters (5,017.6) near the floating offshore wind power terminals in Ulsan, including commercial damage, ecological destruction and reduction in quality of life due to seascape damage. Alternative restoration projects for calculating the economic value of damage were selected including artificial reef projects and estimates based on HEA. For basic households with a 4.5% social discount rate and a 100% maturity index over four years, the damage was approximately 457 hundred million won. The HEA in this study resolves the possible irrationality in the evaluation of marine spatial characteristics, since the value is calculated based on objective and clear DATA. Therefore, the study results are intended to facilitate conflict resolution between stakeholders in the future during the implementation of the marine spatial plan.

• Journal of Korea Port Economic Association
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• v.37 no.1
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• pp.1-18
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• 2021

A coastal marine ranching project in Uleungdo had been conducted for 5 years from 2013 to 2017 with investment costs of 5 billion won, for the special purpose of the deployment of artificial reefs, the release of young fishes. The paper focuses on an ex-post analysis of the economic feasibility for the project after completing the project, which is apart from a preliminary viability. For economic analysis, the economic benefits are derived from direct benefits including increasing effects of fisheries income and saving effects of harvesting costs, and indirect benefits including increasing effects of recreational fishing and preservation effects of coastal marine ecosystems while economic costs include releasing and purchasing costs of artificial reef and juvenile fish, R&D costs, maintenance costs and harvesting costs. The result shows that the project should not be accepted according to NPV=-0.125 billion won, IRR=4.5% and B/C ratio=0.98 under Scenario 1 which considers direct benefits and indirect benefits excluding the preservation values, while the project should be accepted under Scenario 2 indicating NPV=30.9 billion won, IRR=11.3% and B/C ratio=1.49 which considers the direct benefits as well as the indirect ones including the preservation values, based on 4.5% of the social rate of discount.

• Journal of Distribution Research
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• v.17 no.5
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• pp.39-57
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• 2012

The unabated influx of micro businesses has turned the Korean retailing market to a rat race, which causes severe financial distress for micro business owners due to heavy competition. The woes of these micro business owner's are exacerbated by the presence of large scale distributors such as Super Supermarket(SSM) and large discount stores. In summary, the Korean retail market is overburdened an uneconomically viable. Retailing has low barriers to entry which attracts unskilled labor or those with little capital. These start-ups have low opportunity costs since they would make low wages elsewhere in the economy. Thus, these owners are content with relatively low returns on their investment. These 'subsistence ventures' are maintained for economical viability rather than economic growth. These 'subsistence ventures' intensifies competition among small-scale businesses. The presence of large retail corporations also aggravates the situation. The recent stagnation of the economy has worsened the retail market in Korea. The overwhelming competition solidifies the coarse structural system and the prolonged economic sluggishness has increased the risk of insolvency for micro business owners. As the economy continues to stagnate, the imminent risk in retailing market will rise up to surface threatening economic stability. More systematic inflows and outflows of retailers are required in order to redress this structural problem. It has been empirically shown that the self-employment rate is high in Korea compared to other OECD countries. To draw the comparison of self-employment rate by industry, Korea shows high rates among transportation, whole sale, retail, education, lodging, and restaurants. In the case of the transportation and education service sectors, this high rate can be explained by the idiosyncratic nature of Korean culture. In the transportation sector, political policies favor private cap service and private freight carriers. In the education service sector, Koreans put particular emphasis on education that leads to many private institutions that outnumber other OECD countries. For these singular reasons, Korea maintains high micro business, self-employed rates particularly in retailing. A comparable nation is Japan, with its similar social, economic, cultural environment among OECD countries. Unlike Korea, Japan has much lower rates of micro business which continues to decrease. Also Korean retailers are much more destitute than Japanese. The fundamental problem of Korean retailing is the involuntary exit of these 'subsistence ventures,' micro businesses with low margins, in which a small drop in demand can lead to financial difficulties for the owner. This problem will be exacerbated when Korean babyboomers retire and join the micro business ventures. The first priority in order to cope with the severity of oversupply in retailing is to provide better opportunities for the potential self-employers. There should be viable alternatives to subsistent ventures. Strengthening the retirement program, scrutiny of exit process, reconfiguration of policy funds are the recommendations.