• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6177-6180
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• 2014

Background: Our study objectives were to evaluate the medical economics of cervical cancer prevention and thereby contribute to cancer care policy decisions in Japan. Methods: Model creation: we created presence-absence models for prevention by designating human papillomavirus (HPV) vaccination for primary prevention of cervical cancer. Cost classification and cost estimates: we divided the costs of cancer care into seven categories (prevention, mass-screening, curative treatment, palliative care, indirect, non-medical, and psychosocial cost) and estimated costs for each model. Cost-benefit analyses: we performed cost-benefit analyses for Japan as a whole. Results: HPV vaccination was estimated to cost $291.5 million, cervical cancer screening $76.0 million and curative treatment $12.0 million. The loss due to death was $251.0 million and the net benefit was -$128.5 million (negative). Conclusion: Cervical cancer prevention was not found to be cost-effective in Japan. While few cost-benefit analyses have been reported in the field of cancer care, these would be essential for Japanese policy determination.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.589-596
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• 2013

Background The treatment of pressure ulcers is complicated, given the various wound dressing products available. The cost of different treatments varies and the cost-effectiveness of each product has not been thoroughly evaluated. We compare two wound dressing protocols-alginate silver dressing (AlSD) and silver zinc sulfadiazine cream (AgZnSD) with regard to wound healing and cost-effectiveness Methods Patients with grade III or IV sacral or trochanteric pressure ulcers were eligible for this prospective, randomized controlled trial. The patients were randomized to receive one of the two dressings for an eight-week period. The criteria of efficacy were based on the Pressure Ulcer Scale for Healing (PUSH) scoring tool. The cost of treatment was also assessed. Results Twenty patients (12 women and 8 men) were randomly assigned to receive either AlSD (n=10) or AgZnSD cream (n=10). The demographic data and wound characteristics were comparable in the two groups. The two groups showed no significant difference in the reduction of PUSH score, wound size, or volume of exudate. The tissue type score was significantly lower in the AlSD group ($3.15{\pm}0.68-1.85{\pm}0.68$ vs. $2.73{\pm}0.79-2.2{\pm}0.41$; P=0.015). The cost of treatment was significantly lower in the AlSD group (377.17 vs. 467.74 USD, respectively; P<0.0001). Conclusions Alginate silver dressing could be effectively used in the treatment of grade III and IV pressure ulcers. It can improve wound tissue characteristics and is cost-effective.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5049-5054
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• 2013

Background: To assess the treatment pattern and expenditure incurred by cancer patients undergoing treatment at government tertiary hospitals in India. Materials and Methods: A cross-sectional study of 508 cancer patients randomly selected from tertiary cancer hospitals funded by central/state governments located in major cities of five states in India, namely Kerala, Maharashtra, Rajasthan, West Bengal and Mizoram, during March - May 2011 was conducted. Information related to direct costs, indirect costs and opportunity costs incurred on investigations and treatment, major source of payment and difficulties faced by patients during the course of treatment was collected. Results: About 45% of the patients used private health facilities as the first point of contact for cancer related diseases as against 32% in public hospitals. About 47% sought private health facilities for cancer investigations, 21% at district/sub-district hospitals, and about 4% contacted primary health care facilities. A majority of the patients (76%) faced financial problems while undergoing treatment. Conclusions: The results highlight the importance of involving the primary health care system in the cancer prevention activities.

• Korean Journal of Biological Psychiatry
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• 제7권2호
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• pp.198-205
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• 2000

Objectives : Risperidone and clozapine belong to a new generation of antipsychotics that are reportedly more effective and better tolerated than conventional neuroleptics. However, each of these agents costs far more per unit than conventional neuroleptics. The purpose of our retrospective study was to ascertain the total cost and effectiveness of treatment before and after administration of risperidone and clozapine in "revolving door" schizophrenia patients. Method : Data collected on revolving door schizophrenics for 2 years before clozapine and risperidone treatment and for at least 2 years after clozapine and risperidone treatment. Direct cost of inpatient and outpatient treatment was measured. Effectiveness was scaled as "years of mild disability gained". Result : Both risperidone and cloazpine result in higher costs and additional benefits to patients, for example, increased mild disability, reduced number of relapse, and reduced hospital length-of-stay. An ICER of risperidone was less than Rc and ICER of clozapine was greater than Rc. According to decision-analytic this model, risperidone had favorable cost-effectiveness ratios relative to clozapine. Conclusion : We have assumed that risperidone is more cost-effective than clozapine.

• Health Policy and Management
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• 제18권1호
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• pp.21-42
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• 2008

This study investigates economies of scale, cost complementarity and economies of scope for healthcare organizations using econometric approaches. The economies of scale appear to exist in each service provided by a hospital such as inpatient treatment services, outpatient treatment services, and other patient treatment services, respectively. When we test all services in aggregate level, it also indicates that the healthcare industry on average exhibits the economies of scale of 6 percent, which implies that scaling up hospital sizes will bring substantial cost savings to them Evidence shows that cost complementarity exists between outpatient services and other services for patients and, i.e., these other services for patients experience the reduction in marginal costs as the outputs of the outpatient services increase. For the economies of scope, they are present in most service areas; aggregate level services, outpatient services, and other services for patients, respectively. Inpatient treatment services, however, do not show any evidence of the economies of scope. Results show that the economies of scope are achieved by the general hospital type that provides all service areas such as inpatient treatments, outpatient treatments, and other services for patients. The existence of the economies of scope provides the rationale for extending the existing line of business in a hospital into more diverse areas of services where its benefit comes in the form of cost savings. In sum, it overall provides evidence that the M&As in this industry are encouraged to achieve cost reductions from the economies of scale and scope by changing the size and the output mix.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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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 Korean Society of Water and Wastewater
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• 제10권2호
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• pp.80-87
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• 1996

Treatment efficiencies of water quality parameters such as $KMnO_4$ Demand, $UV_{254}$, Turbidity, and LAS(Linear Alkyl Sulfonate) were compared between DAF(Dissolved Air Flotation) and CGS(Conventional Gravitational Sedimentation). The experimental results showed that DAF is much more efficient in treatment of water quality parameters than CGS. The optimum pH was about 7, and optimum alum($Al_2(SO_4)_3$) dose was about 30 ppm for DAF treatment. Economic aspects were also analyzed for bath systems. Even though production cost per ton of drinking water is slightly higher in DAF than in CGS, it turned out that construction cost and land value of CGS far surpass the production cost. DAF system is superior in removal efficiency of impurities and in production cost as a whole to CGS system.

• Journal of Environmental Science International
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• 제14권7호
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• pp.683-689
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• 2005

The consecutive combination process of a biological process as the pre-treatment and a chemical process as the post-treatment is applied for the dyeing wastewater. The poor efficiency of biological treatment using pure oxygen makes the chemical treatment cost high. It is necessary to improve the efficiency of biological treatment in order to reduce the cost of chemical treatment. The purpose of this paper is to find the minimum dose of chemical reagent to fit the Discharged Water Quality Standards for the different biological treatment effluents. Results revealed that the minimum dosage of Fenton's reagent lead to save the cost of chemical treatment based on the guideline dose in the treatment plant. The possible maximum saving reagents was up to $70\%$ for the effluent of the pilot plant packed with the carrier imbedded microorganisms which were selected from the present treatment plant.

• The Journal of the Korea Contents Association
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• 제22권2호
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• pp.782-793
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• 2022

The rise in chronic disease not only has a negative effect on people's lives, but it also increases the cost of medical care owing to the increased usage of medical care as health and medical technology improves, life expectancy rises, and rapid population ageing. In such context, this study examined the difference in the disease cost of hypertension according to demographic information and the effect of the initial diagnosis age and treatment period on the cost. This study used the Korean Health Panel Survey from 2010 to 2017, and selected subjects based on health insurance beneficiaries between the ages of 30 and under 80. With the selected data, the direct and indirect costs of disease loss were calculated according to the cost of illness approach, and we constructed a disease-loss ratio cohort considering the age of diagnosis and time of treatment for hypertension. From the results of the study, the annual cost of disease loss for hypertensive patients differed by gender by 110,107 won, and it was found that the cost increased by 1.8 times as the treatment time increased. In addition, when comparing disease loss ratios between the same age groups, it was found that the disease loss ratios between those in their 60s and 70s were affected by treatment time. This study confirmed that hypertension significantly affects the cost of the disease, and not only requires early diagnosis and management, but also preventive efforts to lower the incidence of hypertensive disease must be strengthened.

• Fisheries and Aquatic Sciences
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• 제1권2호
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• pp.255-259
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• 1998

This study was designed to evaluate the economic analysis of channel catfish production in 1998 based on fish value and total feed cost. Catfish received higher protein feeds with lesser amount based on the dietary protein levels, but received the constant total protein input for all treatments. Weight gain per pond for treatment 1 $(28\%\;protein,\;100\%\;of\;satiation)$ was higher (P<0.10) than for treatment 3 $(36\%\;protein,\;77.8\%\;of\;satiation)$, but not significantly higher than for treatment 2 $(32\%\;protein,\;87.5\%\;of\;satiation)$ at constant DE. At constant DE/P (treatments 4, 2 and 5), weight gain per pond for treatment 5 $(36\%\;protein,\;77.8\%\;of\;satiation)$ was lower (P<0.10) than for treatment 2, but not significantly lower than for treatment 4 $(28\%\;protein,\;100\%\;of\;satiation)$. At constant DE, feed conversion slightly improved as dietary protein level increased from $28\%\;to\;32\%$ and feed allowance decreased by $12.5\%$, but did not improve further as dietary protein level increased from $28\%\;to\;36\%$ and feed allowance decreased by $22.2\%$. At constant DE/P, feed conversion improved as dietary protein level increased from $28\%\;to\;32\%$ increased and feed allowance decreased by $12.5\%$, but did not improve as dietary protein level increased from $28\%\;to\;36\%$ and feed allowance decreased by $22.2\%$ Total feed cost for treatment 1 was slightly, but not significantly higher than for treatments 2 and 3 at constant DE. At constant DE/P, total feed cost for treatment 5 was higher (P<0.05) than for treatment 2, but not significantly higher than for treatment 4. Total value of fish ($ /ha) produced for treatment 1 was highest and lowest was for treatment 5. Return above feed cost was highest for treatment 1 and nearly the same as treatment 2. Return over feed cost for treatments 3 and 4 were slightly lower than for treatments 1 and 2. Economic analysis showed that feeding fish the diet containing $28\%$ protein and 3.08 kcal/g DE to satiation and the diet containing $32\%$ protein and 3.08 kcal/g DE to $87.5\%$ of satiation produced the highest profit to farmer.