The new nordic diet – consumer expenditures and economic incentives estimated from a controlled intervention

PubMed Central

2013-01-01

Background Several studies suggest that a healthy diet with high emphasis on nutritious, low-energy components such as fruits, vegetables, and seafood tends to be more costly for consumers. Derived from the ideas from the New Nordic Cuisine – and inspired by the Mediterranean diet, the New Nordic Diet (NND) has been developed as a palatable, healthy and sustainable diet based on products from the Nordic region. The objective of the study is to investigate economic consequences for the consumers of the NND, compared with an Average Danish Diet (ADD). Methods Combine quantity data from a randomized controlled ad libitum dietary 6 month intervention for central obese adults (18–65 years) and market retail price data of the products consumed in the intervention. Adjust consumed quantities to market price incentives using econometrically estimated price elasticities. Results Average daily food expenditure of the ADD as represented in the unadjusted intervention (ADD-i) amounted to 36.02 DKK for the participants. The daily food expenditure in the unadjusted New Nordic Diet (NND-i) costs 44.80 DKK per day per head, and is hence about 25% more expensive than the Average Danish Diet (or about 17% when adjusting for energy content of the diet). Adjusting for price incentives in a real market setting, the estimated cost of the Average Danish Diet is reduced by 2.50 DKK (ADD-m), compared to the unadjusted ADD-i diet, whereas the adjusted cost of the New Nordic Diet (NND-m) is reduced by about 3.50 DKK, compared to the unadjusted NND-i. The distribution of food cost is however much more heterogeneous among consumers within the NND than within the ADD. Conclusion On average, the New Nordic Diet is 24–25 per cent more expensive than an Average Danish Diet at the current market prices in Denmark (and 16–17 per cent, when adjusting for energy content). The relatively large heterogeneity in food costs in the NND suggests that it is possible to compose an NND where the cost exceeds that of ADD by less than the 24–25 per cent. PMID:24294977

Pulpwood Prices for the Midsouth, 1982

Treesearch

James F. Rosson

1984-01-01

Average prices for roundwood, chipped residues, and saw-dust rose 4 percent from 1981 to 1982. Pulpwood price increases are due to inflation as real costs have remained stable. The price for softwood roundwood is $52.89 per cord; hardwood roundwood is $39.79 per cord.

The upward spiral of drug costs: a time series analysis of drugs used in the treatment of hemophilia.

PubMed

Rogoff, Edward G; Guirguis, Hany S; Lipton, Richard A; Seremetis, Stephanie V; DiMichele, Donna M; Agnew, George M; Karpatkin, Margaret; Barish, Robert J; Jones, Robert L; Bianco, Celso; Knothe, Barbara D; Lee, Myung-Soo

2002-10-01

Hemophilia is an expensive disease because its treatment is heavily dependent on costly clotting factor drugs. Over the last nine years,a consortium of three Comprehensive Hemophilia Treatment Centers and other hospitals, which purchased clotting factors for their patients, has seen treatment costs escalate on average 17% annually. Currently, new, even more expensive drugs are entering the market. This study analyzes 3,244 purchases that were made over a nine-year period totaling nearly 500 million units of clotting factor, representing every product on the market. Purchases were made both apart from and under the Federal Public Health Service (PHS)discount pricing rules. The main cause of the increases was the move to newer, more expensive products. The average price of existing products increased less than 2%per year, but new products were priced, on average, 47% higher than existing products. Overall consumption increased by an average of 5% per year, likely reflecting prophylactic treatment modalities that require greater amounts of clotting factor. Government pricing programs, such as the PHS program, were ineffective or counterproductive at reducing costs. There is a notable absence of competition in this market, with a few dominant companies having a functional monopoly in the largest segments of the market. Prices of older products are not lowered, even when new products are brought to market. A few products that serve small patient groups have had their prices increased substantially. This escalation is likely to continue as new, more expensive clotting factor drugs are developed. Since these new products are not proven to be any safer or more effective than the current products, this situation creates a risk of intervention by government and insurers to address both treatment costs and exhaustion of patients' insurance caps. Drug companies are not serving the patients by pricing new, but often very similar, products so aggressively. The trends seen in this patient group will likely be seen in other patient groups in the future. Ultimately, doctors and patients will lose treatment options and health care availability unless collaborative strategies are developed to reduce costs.

Consumers Buy Lower-Cost Plans On Covered California, Suggesting Exposure To Premium Increases Is Less Than Commonly Reported.

PubMed

Gabel, Jon R; Arnold, Daniel R; Fulton, Brent D; Stromberg, Sam T; Green, Matthew; Whitmore, Heidi; Scheffler, Richard M

2017-01-01

With the notable exception of California, states have not made enrollment data for their Affordable Care Act (ACA) Marketplace plans publicly available. Researchers thus have tracked premium trends by calculating changes in the average price for plans offered (a straight average across plans) rather than for plans purchased (a weighted average). Using publicly available enrollment data for Covered California, we found that the average purchased price for all plans was 11.6 percent less than the average offered price in 2014, 13.2 percent less in 2015, and 15.2 percent less in 2016. Premium growth measured by plans purchased was roughly 2 percentage points less than when measured by plans offered in 2014-15 and 2015-16. We observed shifts in consumer choices toward less costly plans, both between and within tiers, and we estimate that a $100 increase in a plan's net annual premium reduces its probability of selection. These findings suggest that the Marketplaces are helping consumers moderate premium cost growth. Project HOPE—The People-to-People Health Foundation, Inc.

Accounting-Induced Distortion in Public Enterprise Pricing

NASA Astrophysics Data System (ADS)

Moncur, James E. T.; Pollock, Richard L.

1996-11-01

Municipal water utilities commonly aim to set prices at average cost. Because of various omissions and owing to inflation, unadjusted accounting data understate the economic costs of fixed assets and thus generate inefficiently low prices and high consumption rates for the output of these enterprises. We investigate the nature and extent of undercosting and underpricing for a group of large urban water utilities in the United States. Economic costs appear to be significantly greater than the corresponding accounting measures for the cases studied.

EVALUATION OF THE KNOWLEDGE ON COST OF ORTHOPEDIC IMPLANTS AMONG ORTHOPEDIC SURGEONS

PubMed Central

Arliani, Gustavo Gonçalves; Sabongi, Rodrigo Guerra; Batista, Alysson Ferreira; Astur, Diego Costa; Falotico, Guilherme Guadagnini; Cohen, Moises

2016-01-01

ABSTRACT Objective: To determine the knowledge of Brazilian Orthopedic Surgeons on the costs of orthopedic surgical devices used in surgical implants. Methods: A questionnaire was applied to Brazilian Orthopedic Surgeons during the 46th Brazilian Congress on Orthopedics and Traumatology. Results: Two hundred and one Orthopedic Surgeons completely filled out the questionnaire. The difference between the average prices estimated by the surgeons and the average prices provided by the supplier companies was 47.1%. No differences were found between the orthopedic specialists and other subspecialties on the prices indicated for specific orthopedic implants. However, differences were found among orthopedic surgeons who received visits from representatives of implant companies and those who did not receive those visits on prices indicated for shaver and radiofrequency device. Correlation was found between length of orthopedic experience and prices indicated for shaver and interference screw, and higher the experience time the lower the price indicated by Surgeons for these materials. Conclusion: The knowledge of Brazilian Orthopedic Surgeons on the costs of orthopedic implants is precarious. Reduction of cost of orthopedics materials depends on a more effective communication and interaction between doctors, hospitals and supplier companies with solid orientation programs and awareness for physicians about their importance in this scenario.Level of Evidence III, Cross-Sectional Study. PMID:28243178

Assessing potential prescription reimbursement changes: estimated acquisition costs in Wisconsin.

PubMed

Kreling, D H

1989-01-01

Potential impacts from two methods of changing prescription drug ingredient reimbursement in the Wisconsin Medicaid program were estimated. Current reimbursement amounts were compared with those resulting from either direct prices for eight manufacturers' products and average wholesale price less 10.5 percent for other products or wholesaler cost plus 5.01 percent for all products. The resulting overall average ingredient cost reimbursement reductions were 6.64 percent ($0.56 per prescription) and 6.94 percent ($0.59 per prescription) for the two methods, respectively. The results should be viewed from the perspective of both program savings and reduced pharmacists' revenues.

The price of innovation: new estimates of drug development costs.

PubMed

DiMasi, Joseph A; Hansen, Ronald W; Grabowski, Henry G

2003-03-01

The research and development costs of 68 randomly selected new drugs were obtained from a survey of 10 pharmaceutical firms. These data were used to estimate the average pre-tax cost of new drug development. The costs of compounds abandoned during testing were linked to the costs of compounds that obtained marketing approval. The estimated average out-of-pocket cost per new drug is 403 million US dollars (2000 dollars). Capitalizing out-of-pocket costs to the point of marketing approval at a real discount rate of 11% yields a total pre-approval cost estimate of 802 million US dollars (2000 dollars). When compared to the results of an earlier study with a similar methodology, total capitalized costs were shown to have increased at an annual rate of 7.4% above general price inflation. Copyright 2003 Elsevier Science B.V.

HMO market penetration and hospital cost inflation in California.

PubMed

Robinson, J C

1991-11-20

OBJECTIVE--Health maintenance organizations (HMOs) have stimulated price competition in California hospital markets since 1983, when the state legislature eliminated barriers to selective contracting by conventional health insurance plans. This study measures the impact of HMO-induced price competition on the rate of inflation in average cost per admission for 298 private, non-HMO hospitals between 1982 and 1988. DATA--HMO market penetration was calculated using discharge abstract data on insurance coverage, ZIP code of residence, and hospital of choice for 3.35 million patients in 1983 and 3.41 million patients in 1988. Data on hospital characteristics were obtained from the American Hospital Association and other sources. -HMO coverage grew from an average of 8.3% of all admissions in local hospital markets in 1983 to 17.0% of all admissions in 1988. The average rate of growth in costs per admission between 1982 and 1988 was 9.4% lower in markets with relatively high HMO penetration compared with markets with relatively low HMO penetration (95% confidence interval, 5.2 to 13.8). Cost savings for these 298 hospitals are estimated at $1.04 billion for 1988. CONCLUSION--Price competition between HMOs and conventional health insurers can significantly reduce hospital cost inflation if legislative barriers to selective contracting are removed. The impact of competition in California was modest, however, when evaluated in terms of the 74.5% average rate of California hospital cost inflation during these years.

Trends in Harvest Cost in New Hampshire: 1964 to 1983

Treesearch

Donald F. Dennis; Susan B. Remington; Susan B. Remington

1987-01-01

Timber harvesting costs for New Hampshire from 1964 to 1983 were examined. During this period, real harvesting costs for sawtimber decreased at an average annual rate of 1.2 percent, while stumpage prices increased. Real harvesting costs for pulpwood declined at a 0.8 percent average annual rate. Harvest cost data for fuelwood were available only for 1973 to 1983....

Administration costs of intravenous biologic drugs for rheumatoid arthritis.

PubMed

Soini, Erkki J; Leussu, Miina; Hallinen, Taru

2013-01-01

Cost-effectiveness studies explicitly reporting infusion times, drug-specific administration costs for infusions or real-payer intravenous drug cost are few in number. Yet, administration costs for infusions are needed in the health economic evaluations assessing intravenously-administered drugs. To estimate the drug-specific administration and total cost of biologic intravenous rheumatoid arthritis (RA) drugs in the adult population and to compare the obtained costs with published cost estimates. Cost price data for the infusions and drugs were systematically collected from the 2011 Finnish price lists. All Finnish hospitals with available price lists were included. Drug administration and total costs (administration cost + drug price) per infusion were analysed separately from the public health care payer's perspective. Further adjustments for drug brand, dose, and hospital type were done using regression methods in order to improve the comparability between drugs. Annual expected drug administration and total costs were estimated. A literature search not limited to RA was performed to obtain the per infusion administration cost estimates used in publications. The published costs were converted to Finnish values using base-year purchasing power parities and indexing to the year 2011. Information from 19 (95%) health districts was obtained (107 analysable prices out of 176 observations). The average drug administration cost for infliximab, rituximab, abatacept, and tocilizumab infusion in RA were €355.91; €561.21; €334.00; and €293.96, respectively. The regression-adjusted (dose, hospital type; using semi-log ordinary least squares) mean administration costs for infliximab and rituximab infusions in RA were €289.12 (95% CI €222.61-375.48) and €542.28 (95% CI €307.23-957.09). The respective expected annual drug administration costs were €2312.96 for infliximab during the first year, €1879.28 for infliximab during the forthcoming years, and €1843.75 for rituximab. The obtained average administration costs per infusion were higher (1.8-3.3 times depending on the drug) than the previously published purchasing power adjusted and indexed average administration costs for infusions in RA. The administration costs of RA infusions vary between drugs, and more effort should be made to find realistic drug-specific estimates for cost-effectiveness evaluations. The frequent assumption of intravenous drug administration costs equalling outpatient visit cost can underestimate the costs.

Trends in southern forest harvesting equipment and logging costs

Treesearch

Frederick W. Cubbage; Bryce J. Stokes; James E. Granskog

1988-01-01

Southern timber harvesting equipment and on-road vehicle costs were obtained for the years from 1967 to 1984. Average cost trends for equipment and vehicles were determined for the period. Average logging contract rates and price trends were also estimated. Comparisons indicated that equipment costs increased more than the general inflation rate and less than the...

The Effects of Market Concentration on Residential Solar PV Prices: Competition, Installer Scale, and Soft Costs

DOE Office of Scientific and Technical Information (OSTI.GOV)

OShaughnessy, Eric J

Competition among residential solar photovoltaic (PV) installers may reduce PV price markups and yield lower prices. At the same time, competition may reduce installer experience and opportunities for cost reductions through learning-by-doing and economies of scale. These dynamics suggest that PV non-hardware or 'soft' costs and installed prices depend on the distribution of market shares among installers, also known as market concentration. This study leverages a rich data set of 226,769 residential PV systems to examine the relationship between market concentration, soft costs, and PV prices. The results show that PV prices are lower, on average, in more concentrated markets,more » i.e., markets with fewer installers or where few installers hold high market share. The study provides evidence that this relationship is non-linear, such that prices are minimized in markets with an optimal balance of the benefits of market concentration and the benefits of competition.« less

Cutting costs: the impact of price lists on the cost development at the emergency department.

PubMed

Schilling, Ulf Martin

2010-12-01

It was shown that physicians working at the Swedish emergency department (ED) are unaware of the costs for investigations performed. This study evaluated the possible impact of price lists on the overall laboratory and radiology costs at the ED of a Swedish university hospital. Price lists including the most common laboratory analyses and radiological investigations at the ED were created. The lists were distributed to all internal medicine physicians by e-mail and exposed above their working stations continually. No lists were provided for the orthopaedic control group. The average costs for laboratory and radiological investigations during the months of June and July 2007 and 2008 were calculated. Neither clinical nor admission procedures were changed. The physicians were blinded towards the study. Statistical analysis was performed using the Student's t-test. A total of 1442 orthopaedic and 1585 medical patients were attended to in 2007. In 2008, 1467 orthopaedic and 1637 medical patients required emergency service. The average costs per patient were 980.27 SKR (98€)/999.41 SKR (100€, +1.95%) for orthopaedic and 1081.36 SKR (108€)/877.3 SKR (88€, -18.8%) for medical patients. Laboratory costs decreased by 9% in orthopaedic and 21.4% in medical patients. Radiology costs changed +5.4% in orthopaedic and -20.59% in medical patients. The distribution and promotion of price lists as a tool at the ED to heighten cost awareness resulted in a major decrease in the investigation costs. A significant decrease in radiological costs could be observed. It can be concluded that price lists are an effective tool to cut costs in public healthcare.

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis.

PubMed

Iyengar, Swathi; Tay-Teo, Kiu; Vogler, Sabine; Beyer, Peter; Wiktor, Stefan; de Joncheere, Kees; Hill, Suzanne

2016-05-01

New hepatitis C virus (HCV) medicines have markedly improved treatment efficacy and regimen tolerability. However, their high prices have limited access, prompting wide debate about fair and affordable prices. This study systematically compared the price and affordability of sofosbuvir and ledipasvir/sofosbuvir across 30 countries to assess affordability to health systems and patients. Published 2015 ex-factory prices for a 12-wk course of treatment were provided by the Pharma Price Information (PPI) service of the Austrian public health institute Gesundheit Österreich GmbH or were obtained from national government or drug reimbursement authorities and recent press releases, where necessary. Prices in Organisation for Economic Co-operation and Development (OECD) member countries and select low- and middle-income countries were converted to US dollars using period average exchange rates and were adjusted for purchasing power parity (PPP). We analysed prices compared to national economic performance and estimated market size and the cost of these drugs in terms of countries' annual total pharmaceutical expenditure (TPE) and in terms of the duration of time an individual would need to work to pay for treatment out of pocket. Patient affordability was calculated using 2014 OECD average annual wages, supplemented with International Labour Organization median wage data where necessary. All data were compiled between 17 July 2015 and 25 January 2016. For the base case analysis, we assumed a 23% rebate/discount on the published price in all countries, except for countries with special pricing arrangements or generic licensing agreements. The median nominal ex-factory price of a 12-wk course of sofosbuvir across 26 OECD countries was US$42,017, ranging from US$37,729 in Japan to US$64,680 in the US. Central and Eastern European countries had higher PPP-adjusted prices than other countries: prices of sofosbuvir in Poland and Turkey (PPP$101,063 and PPP$70,331) and of ledipasvir/sofosbuvir in Poland (PPP$118,754) were at least 1.09 and 1.63 times higher, respectively than in the US (PPP$64,680 and PPP$72,765). Based on PPP-adjusted TPE and without the cost of ribavirin and other treatment costs, treating the entire HCV viraemic population with these regimens at the PPP-adjusted prices with a 23% price reduction would amount to at least one-tenth of current TPE across the countries included in this study, ranging from 10.5% of TPE in the Netherlands to 190.5% of TPE in Poland. In 12 countries, the price of a course of sofosbuvir without other costs was equivalent to 1 y or more of the average annual wage of individuals, ranging from 0.21 y in Egypt to 5.28 y in Turkey. This analysis relies on the accuracy of price information and infection prevalence estimates. It does not include the costs of diagnostic testing, supplementary treatments, treatment for patients with reinfection or cirrhosis, or associated health service costs. Current prices of these medicines are variable and unaffordable globally. These prices threaten the sustainability of health systems in many countries and prevent large-scale provision of treatment. Stakeholders should implement a fairer pricing framework to deliver lower prices that take account of affordability. Without lower prices, countries are unlikely to be able to increase investment to minimise the burden of hepatitis C.

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis

PubMed Central

Tay-Teo, Kiu; Vogler, Sabine; Beyer, Peter; Wiktor, Stefan; de Joncheere, Kees; Hill, Suzanne

2016-01-01

Introduction New hepatitis C virus (HCV) medicines have markedly improved treatment efficacy and regimen tolerability. However, their high prices have limited access, prompting wide debate about fair and affordable prices. This study systematically compared the price and affordability of sofosbuvir and ledipasvir/sofosbuvir across 30 countries to assess affordability to health systems and patients. Methods and Findings Published 2015 ex-factory prices for a 12-wk course of treatment were provided by the Pharma Price Information (PPI) service of the Austrian public health institute Gesundheit Österreich GmbH or were obtained from national government or drug reimbursement authorities and recent press releases, where necessary. Prices in Organisation for Economic Co-operation and Development (OECD) member countries and select low- and middle-income countries were converted to US dollars using period average exchange rates and were adjusted for purchasing power parity (PPP). We analysed prices compared to national economic performance and estimated market size and the cost of these drugs in terms of countries’ annual total pharmaceutical expenditure (TPE) and in terms of the duration of time an individual would need to work to pay for treatment out of pocket. Patient affordability was calculated using 2014 OECD average annual wages, supplemented with International Labour Organization median wage data where necessary. All data were compiled between 17 July 2015 and 25 January 2016. For the base case analysis, we assumed a 23% rebate/discount on the published price in all countries, except for countries with special pricing arrangements or generic licensing agreements. The median nominal ex-factory price of a 12-wk course of sofosbuvir across 26 OECD countries was US$42,017, ranging from US$37,729 in Japan to US$64,680 in the US. Central and Eastern European countries had higher PPP-adjusted prices than other countries: prices of sofosbuvir in Poland and Turkey (PPP$101,063 and PPP$70,331) and of ledipasvir/sofosbuvir in Poland (PPP$118,754) were at least 1.09 and 1.63 times higher, respectively than in the US (PPP$64,680 and PPP$72,765). Based on PPP-adjusted TPE and without the cost of ribavirin and other treatment costs, treating the entire HCV viraemic population with these regimens at the PPP-adjusted prices with a 23% price reduction would amount to at least one-tenth of current TPE across the countries included in this study, ranging from 10.5% of TPE in the Netherlands to 190.5% of TPE in Poland. In 12 countries, the price of a course of sofosbuvir without other costs was equivalent to 1 y or more of the average annual wage of individuals, ranging from 0.21 y in Egypt to 5.28 y in Turkey. This analysis relies on the accuracy of price information and infection prevalence estimates. It does not include the costs of diagnostic testing, supplementary treatments, treatment for patients with reinfection or cirrhosis, or associated health service costs. Conclusions Current prices of these medicines are variable and unaffordable globally. These prices threaten the sustainability of health systems in many countries and prevent large-scale provision of treatment. Stakeholders should implement a fairer pricing framework to deliver lower prices that take account of affordability. Without lower prices, countries are unlikely to be able to increase investment to minimise the burden of hepatitis C. PMID:27243629

Multi-indication and Combination Pricing and Reimbursement of Pharmaceuticals: Opportunities for Improved Health Care through Faster Uptake of New Innovations.

PubMed

Persson, Ulf; Norlin, J M

2018-04-01

Many pharmaceuticals are effective in multiple indications and the degree of effectiveness may differ. A product-based pricing and reimbursement system with a single price per product is insufficient to reflect the variable values between different indications. The objective of this article is to present examples of actual pricing and reimbursement decisions using current value-based pricing in Sweden and to discuss their implications and possible solutions. The value of several cancer drugs was estimated for various indications based on a willingness-to-pay threshold of 1 million SEK (EUR 104,000) per QALY gained. For some drugs, the estimated value was higher than the drug acquisition cost in several indications, whilst in others, the estimated value was lower than the drug acquisition cost. Drugs used in combination present a special case. If a drug prolongs survival and consequently also a continued use of the anchor drug, the combination use may not be cost effective even at a zero price. In a product-based pricing and reimbursement system, patients may not get access to drugs or access may be delayed and manufacturers may be discouraged to invest in future indications. To overcome these issues, there are several approaches to link price and value. One approach is a "weighted-average" price based on an average of the value across all indications. Another is "multi-indication pricing," which enables price differentiation between indications. However, there are several barriers for applying multi-indication pricing and reimbursement schemes. One barrier is the lack of existing administrative infrastructure to track patients' indications.

The Impact of City-level Permitting Processes on Residential Photovoltaic Installation Prices and Development Times: An Empirical Analysis of Solar Systems in California Cities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiser, Ryan; Dong, Changgui

Business process or “soft” costs account for well over 50% of the installed price of residential photovoltaic (PV) systems in the United States, so understanding these costs is crucial for identifying PV cost-reduction opportunities. Among these costs are those imposed by city-level permitting processes, which may add both expense and time to the PV development process. Building on previous research, this study evaluates the effect of city-level permitting processes on the installed price of residential PV systems and on the time required to develop and install those systems. The study uses a unique dataset from the U.S. Department of Energy’smore » Rooftop Solar Challenge Program, which includes city-level permitting process “scores,” plus data from the California Solar Initiative and the U.S. Census. Econometric methods are used to quantify the price and development-time effects of city-level permitting processes on more than 3,000 PV installations across 44 California cities in 2011. Results indicate that city-level permitting processes have a substantial and statistically significant effect on average installation prices and project development times. The results suggest that cities with the most favorable (i.e., highest-scoring) permitting practices can reduce average residential PV prices by $0.27–$0.77/W (4%–12% of median PV prices in California) compared with cities with the most onerous (i.e., lowest-scoring) permitting practices, depending on the regression model used. Though the empirical models for development times are less robust, results suggest that the most streamlined permitting practices may shorten development times by around 24 days on average (25% of the median development time). These findings illustrate the potential price and development-time benefits of streamlining local permitting procedures for PV systems.« less

Assessing potential prescription reimbursement changes: Estimated acquisition costs in Wisconsin

PubMed Central

Kreling, David H.

1989-01-01

Potential impacts from two methods of changing prescription drug ingredient reimbursement in the Wisconsin Medicaid program were estimated. Current reimbursement amounts were compared with those resulting from either direct prices for eight manufacturers' products and average wholesale price less 10.5 percent for other products or wholesaler cost plus 5.01 percent for all products. The resulting overall average ingredient cost reimbursement reductions were 6.64 percent ($0.56 per prescription) and 6.94 percent ($0.59 per prescription) for the two methods, respectively. The results should be viewed from the perspective of both program savings and reduced pharmacists' revenues. PMID:10313098

The costs of introducing a malaria vaccine through the expanded program on immunization in Tanzania.

PubMed

Hutton, Guy; Tediosi, Fabrizio

2006-08-01

This report presents an approach to costing the delivery of a malaria vaccine through the expanded program on immunization (EPI), and presents the predicted cost per dose delivered and cost per fully immunized child (FIC) in Tanzania, which are key inputs to the cost-effectiveness analysis. The costs included in the analysis are those related to the purchase of the vaccine taking into account the wastage rate; the costs of distributing and storing the vaccine at central, zonal, district, and facility level; those of managing the vaccination program; the costs of delivery at facility level (including personnel, syringes, safety boxes, and waste management); and those of additional training of EPI personnel and of social mobilization activities. The average cost per FIC increases almost linearly from US 4.2 dollars per FIC at a vaccine price of US 1 dollars per dose to US 31.2 dollars at vaccine price of US 10 dollars per dose. The marginal cost is approximately 5% less than the average cost. Although the vaccine price still determines most of the total delivery costs, the analysis shows that other costs are relevant and should be taken into account before marketing the vaccine and planning its inclusion into the EPI.

Price Discrimination, Economies of Scale, and Profits.

ERIC Educational Resources Information Center

Park, Donghyun

2000-01-01

Demonstrates that it is possible for economies of scale to induce a price-discriminating monopolist to sell in an unprofitable market where the average cost always exceeds the price. States that higher profits in the profitable market caused by economies of scale may exceed losses incurred in the unprofitable market. (CMK)

Evidence on the cost of breast cancer drugs is required for rational decision making.

PubMed

Berghuis, Anne Margreet Sofie; Koffijberg, Hendrik; Terstappen, Leonardus Wendelinus Mathias Marie; Sleijfer, Stefan; IJzerman, Maarten Joost

2018-01-01

For rational decision making, assessing the cost-effectiveness and budget impact of new drugs and comparing the costs of drugs already on the market is required. In addition to value frameworks, such as the American Society of Clinical Oncology Value Framework and the European Society of Medical Oncology-Magnitude of Clinical benefit Scale, this also requires a transparent overview of actual drug prices. While list prices are available, evidence on treatment cost is not. This paper aims to synthesise evidence on the reimbursement and costs of high-cost breast cancer drugs in The Netherlands (NL). A literature review was performed to identify currently reimbursed breast cancer drugs in the NL. Treatment costs were determined by multiplying list prices with the average length of treatment and dosing schedule. Comparing list prices to the estimated treatment cost resulted in substantial differences in the ranking of costliness of the drugs. The average mean treatment length was unknown for 11/31 breast cancer drugs (26.2%). The differences in the 15 highest-cost drugs were largest for Bevacizumab, Lapatinib and everolimus, with list prices of €541, €158, €1,168 and estimated treatment cost of €174,400, €18,682 and €31,207, respectively. The lowest-cost (patented) targeted drug is €1,818 more expensive than the highest-cost (off-patent) generic drug according to the estimated drug treatment cost. A lack of evidence on the reimbursement and cost of high-cost breast cancer drugs complicates rapid and transparent evidence synthesis, necessary to focus strategies aiming to limit the increasing healthcare costs. Interestingly, the findings show that off-patent generics (such as paclitaxel or doxorubicin), although substantially cheaper than patented drugs, are still relatively costly. Extending standardisation and increasing European and national regulations on presenting information on costs per cancer drug is highly recommended.

Do healthier foods cost more in Saudi Arabia than less healthier options?

PubMed Central

Gosadi, Ibrahim M.; Alshehri, Muner A.; Alawad, Saud H.

2016-01-01

Objectives: To investigate whether healthy foods in Saudi Arabia cost more compared with less healthy options. Method: This is a cross-sectional study conducted in Riyadh, Saudi Arabia during June and July 2015. The study targeted well-known market chains in the city of Riyadh. The selection of food items was purposive to include healthy and less healthy food items in each category. Price, caloric value, salt, fat, sugar, and fiber contents for each food item were collected. To test for the correlation between nutritional contents and average price, Spearman’s correlation coefficients were calculated. The Mann-Whitney U test was used to test for the presence of average price difference between healthy and less healthy food items. Results: A total of 162 food items were collected. Sixty-six food items were classified as healthy compared with 96 less healthier options. The calculated correlation coefficients indicate an association between increased cost of food with increased caloric values (0.649 p=0.0000001), increased fat content (0.610 p=0.0000003), and increased salt contents (0.273 p=0.001). Prices of food items with higher fiber contents showed a weaker association (0.191 p=0.015). The overall average cost of healthy food was approximately 10 Saudi riyals cheaper than less healthy food (p=0.000001). Conclusion: The findings of the study suggest that the cost of healthy food is lower than that of less healthy items in the Saudi market. PMID:27570859

The role of capital costs in decarbonizing the electricity sector

NASA Astrophysics Data System (ADS)

Hirth, Lion; Steckel, Jan Christoph

2016-11-01

Low-carbon electricity generation, i.e. renewable energy, nuclear power and carbon capture and storage, is more capital intensive than electricity generation through carbon emitting fossil fuel power stations. High capital costs, expressed as high weighted average cost of capital (WACC), thus tend to encourage the use of fossil fuels. To achieve the same degree of decarbonization, countries with high capital costs therefore need to impose a higher price on carbon emissions than countries with low capital costs. This is particularly relevant for developing and emerging economies, where capital costs tend to be higher than in rich countries. In this paper we quantitatively evaluate how high capital costs impact the transformation of the energy system under climate policy, applying a numerical techno-economic model of the power system. We find that high capital costs can significantly reduce the effectiveness of carbon prices: if carbon emissions are priced at USD 50 per ton and the WACC is 3%, the cost-optimal electricity mix comprises 40% renewable energy. At the same carbon price and a WACC of 15%, the cost-optimal mix comprises almost no renewable energy. At 15% WACC, there is no significant emission mitigation with carbon pricing up to USD 50 per ton, but at 3% WACC and the same carbon price, emissions are reduced by almost half. These results have implications for climate policy; carbon pricing might need to be combined with policies to reduce capital costs of low-carbon options in order to decarbonize power systems.

Higher Prices, Fewer Choices: Shopping for Food in Rural America.

ERIC Educational Resources Information Center

Morris, Patricia McGrath

The Food Stamp Program is the U.S. government's primary program to prevent the rural poor from going hungry. Food stamp allotments are set each year based on the cost of the "Thrifty Food Plan" (TFP), a minimally adequate diet defined by the U.S. Department of Agriculture (USDA), which sets costs by examining average food prices in urban…

The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis.

PubMed

Malinowski, Krzysztof Piotr; Kawalec, Paweł

2015-04-01

The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions.

The farm cost of decreasing antimicrobial use in dairy production

PubMed Central

Tauer, Loren William; Gröhn, Yrjo Tapio

2018-01-01

Antimicrobials are used in animal agriculture to cure bacterial infectious diseases. However, antimicrobial use (AMU) inevitably leads to the selection of resistant bacteria, potentially infecting humans. As a global public threat, antimicrobial resistance has led policy makers to implement regulations supervising AMU. The objective of our research was to investigate the farm impact of several potential policies aimed at decreasing AMU. We modeled a dairy herd of 1000 cows with an average level of disease prevalence for the nine most frequent bacterial dairy diseases found in western countries. We calculated the farm net costs of AMU prohibition, as well as cost increases in antimicrobial treatments prices, and an increase in the milk withdrawal period after AMU. Sensitivity analyses were conducted to assess the impact of output and input prices, and disease prevalence. At a mean disease prevalence, the average net costs of not using antimicrobials were $61 per cow per year greater compared to a scenario modeling current farm AMU. The model predicted that the minimum and maximum increased costs associated with AMU prohibition were $46 and $73 per cow per year compared to current AMU. In each scenario, the cost difference increased with disease prevalence. Sensitivity analysis showed that the three stochastic variables which most significantly influenced the cost difference were respectively, cow replacement prices, cow slaughter price, and the milk price. Antimicrobial price increases of a factor of five, or extending the milk withdrawal period by 15 days, resulted in increasing the costs of diseases to a level where the farmer was better off not using antimicrobials. Our results suggest that the farm level costs of AMU prohibition in many cases might be minor, although the consequences of any policy instrument should be carefully evaluated to reach the ultimate goal of decreasing AMU without threatening the sustainability of milk production. PMID:29566103

Fuel prices, emission standards, and generation costs for coal vs natural gas power plants.

PubMed

Pratson, Lincoln F; Haerer, Drew; Patiño-Echeverri, Dalia

2013-05-07

Low natural gas prices and stricter, federal emission regulations are promoting a shift away from coal power plants and toward natural gas plants as the lowest-cost means of generating electricity in the United States. By estimating the cost of electricity generation (COE) for 304 coal and 358 natural gas plants, we show that the economic viability of 9% of current coal capacity is challenged by low natural gas prices, while another 56% would be challenged by the stricter emission regulations. Under the current regulations, coal plants would again become the dominant least-cost generation option should the ratio of average natural gas to coal prices (NG2CP) rise to 1.8 (it was 1.42 in February 2012). If the more stringent emission standards are enforced, however, natural gas plants would remain cost competitive with a majority of coal plants for NG2CPs up to 4.3.

Five-year examination of utilization and drug cost outcomes associated with benefit design changes including reference pricing for proton pump inhibitors in a state employee health plan.

PubMed

Johnson, Jill T; Neill, Kathryn K; Davis, Dwight A

2011-04-01

The Arkansas State Employee Benefits Division (EBD) is a self-insured program comprising public school and other state employees, their spouses, and dependents. Previous research published in JMCP (2006) showed drug cost savings of $2.20 per member per month (PMPM; 37.6%) or annualized savings of $3.4 million associated with a benefit design change and coverage of the proton pump inhibitor (PPI) omeprazole over-the-counter (OTC) beginning in March 2004. On May 1, 2005, brand esomeprazole was excluded from coverage, with current users grandfathered for 4 months until September 2005. Reference pricing for PPIs, including esomeprazole but excluding generic omeprazole, was implemented on September 1, 2005, and the beneficiary cost share for all PPIs except generic omeprazole was determined from comparison of the PPI actual price to the $0.90 omeprazole OTC reference price per unit. To examine PPI utilization and drug costs before and after (a) excluding esomeprazole from coverage (with grandfathering current users) and (b) implementing a therapeutic maximum allowable cost (TMAC), or reference-pricing benefit design, for the PPI class in a large state employee health plan with fairly stable enrollment of approximately 127,500 members in 2005 through 2008 and approximately 128,000 members in 2009 Q1. The pharmacy claims database for the EBD was used to examine utilization and cost data for PPIs in a longitudinal analysis for the 61-month period from March 1, 2004, through March 31, 2009. Pharmacy claims data were compared for the period 14 months prior to esomeprazole exclusion (preperiod), 4 months during the esomeprazole exclusion (postperiod 1), and the ensuing 43 months of PPI reference pricing (postperiod 2). PPI cost and utilization data for the intervention group of approximately 127,500 beneficiaries were compared with a group of 122 self-insured employers with a total of nearly 1 million beneficiaries whose pharmacy benefits did not include reference pricing for PPIs. Despite 79% of existing esomeprazole users being grandfathered during the 4-month esomeprazole-exclusion period (postperiod 1), the share of omeprazole OTC claims increased from 35.2% to 42.5% (+ 7.3 percentage points) of all PPI claims, and esomeprazole claims decreased from 16.7% to 12.0% (-4.7 percentage points), with little change in the use of other PPIs. The average allowed charge (price) per day of PPI drug therapy decreased in postperiod 1 by 8.9% from $2.81 to $2.56, while utilization increased by 2.2% from 1.83 days PMPM to 1.87 days PMPM; the net plan cost PMPM decreased by $0.40 PMPM from $3.78 to $3.38 (-10.6%), representing a reduction in spending of $35,664 per month while the average member copayment per claim was essentially unchanged. In the 43 months of reference pricing in postperiod 2, PPI utilization was essentially unchanged at 1.82 days PMPM compared with the preperiod (1.83 days PMPM) and 2.7% lower than the esomeprazole-exclusion period (1.87 days PMPM); however, price (charge per day) decreased by 38.4% during refer- RESEARCH ence pricing to $1.73 from $2.81 in the preperiod and by 32.4% compared with $2.56 in the esomeprazole-exclusion period, despite an increase in the average pharmacy dispensing fee to $5.21 per PPI claim. Net plan cost decreased by $1.87 PMPM (49.5%) to $1.91 PMPM during reference pricing compared with the preperiod ($3.78 PMPM) and by $1.47 PMPM (43.5%) compared with the esomeprazole-exclusion period 1 ($3.38 PMPM). Beneficiary costs (copayment per claim) for PPIs decreased to $1.24 PMPM ($23.27 per claim) compared with the preperiod ($1.37 PMPM, $24.95 per claim) and compared with the esomeprazole-exclusion period ($1.40 PMPM, $25.06 per claim). The reductions in net plan costs represented lower plan spending for the 43 months of reference pricing (postperiod 2) of approximately $9.4 million or an average of approximately $219,500 per month compared with the preperiod or $7.9 million (approximately $183,900 per month) compared with the esomeprazole-exclusion period. Compared with a group of self-insured health plans without pharmacy benefit reference pricing of PPIs, the cost savings over the 43-month period from September 1, 2005, through March 31, 2009, were approximately $7.2 million or $1.31 PMPM. For this state employee health plan, the policy change that excluded esomeprazole from coverage but grandfathered current users was associated with a relatively small reduction in PMPM spending on PPIs compared with the subsequent policy change that applied reference pricing to the PPI class based on the price (drug cost plus dispensing fee) for omeprazole OTC. Over 43 months of reference pricing, net plan costs fell dramatically by 49.5% PMPM compared with the preperiod or decreased by 43.5% compared with the esomeprazole-exclusion period. While utilization was essentially unchanged compared with the 18 months before reference pricing, the average pharmacy dispensing fee per PPI claim increased, and beneficiary costs PMPM decreased.

The comparative cost of food and beverages at remote Indigenous communities, Northern Territory, Australia.

PubMed

Ferguson, Megan; O'Dea, Kerin; Chatfield, Mark; Moodie, Marjory; Altman, Jon; Brimblecombe, Julie

2016-04-01

To determine the average price difference between foods and beverages in remote Indigenous community stores and capital city supermarkets and explore differences across products. A cross-sectional survey compared prices derived from point-of-sale data in 20 remote Northern Territory stores with supermarkets in capital cities of the Northern Territory and South Australia for groceries commonly purchased in remote stores. Average price differences for products, supply categories and food groups were examined. The 443 products examined represented 63% of food and beverage expenditure in remote stores. Remote products were, on average, 60% and 68% more expensive than advertised prices for Darwin and Adelaide supermarkets, respectively. The average price difference for fresh products was half that of packaged groceries for Darwin supermarkets and more than 50% for food groups that contributed most to purchasing. Strategies employed by manufacturers and supermarkets, such as promotional pricing, and supermarkets' generic products lead to lower prices. These opportunities are not equally available to remote customers and are a major driver of price disparity. Food affordability for already disadvantaged residents of remote communities could be improved by policies targeted at manufacturers, wholesalers and/or major supermarket chains. © 2015 The Authors.

Cost viability of 3D printed house in UK

NASA Astrophysics Data System (ADS)

Tobi, A. L. Mohd; Omar, S. A.; Yehia, Z.; Al-Ojaili, S.; Hashim, A.; Orhan, O.

2018-03-01

UK has been facing housing crisis due to the rising price of the property on sale. This paper will look into the viability of 3D printing technology as an alternative way for house construction on UK. The analysis will be carried out based on the data until the year of 2014 due to limited resources availability. Details cost breakdown on average size house construction cost in UK were analysed and relate to the cost viability of 3D printing technology in reducing the house price in UK. It is found that the 3D printing generates saving of up to around 35% out of total house price in UK. This cost saving comes from the 3D printed construction of walls and foundations for material and labour cost.

Evolutionary Dynamics of Biological Auctions

PubMed Central

Chatterjee, Krishnendu; Reiter, Johannes G.; Nowak, Martin A.

2011-01-01

Many scenarios in the living world, where individual organisms compete for winning positions (or resources), have properties of auctions. Here we study the evolution of bids in biological auctions. For each auction n individuals are drawn at random from a population of size N. Each individual makes a bid which entails a cost. The winner obtains a benefit of a certain value. Costs and benefits are translated into reproductive success (fitness). Therefore, successful bidding strategies spread in the population. We compare two types of auctions. In “biological all-pay auctions” the costs are the bid for every participating individual. In “biological second price all-pay auctions” the cost for everyone other than the winner is the bid, but the cost for the winner is the second highest bid. Second price all-pay auctions are generalizations of the “war of attrition” introduced by Maynard Smith. We study evolutionary dynamics in both types of auctions. We calculate pairwise invasion plots and evolutionarily stable distributions over the continuous strategy space. We find that the average bid in second price all-pay auctions is higher than in all-pay auctions, but the average cost for the winner is similar in both auctions. In both cases the average bid is a declining function of the number of participants, n. The more individuals participate in an auction the smaller is the chance of winning, and thus expensive bids must be avoided. PMID:22120126

A comparison of the fat composition and prices of margarines between 2002 and 2006, when new Canadian labelling regulations came into effect.

PubMed

Ricciuto, Laurie; Lin, Kevin; Tarasuk, Valerie

2009-08-01

To examine the effect of the new Canadian labelling regulations on the fat composition and prices of margarines. A survey of all margarines sold in major supermarkets in the Greater Toronto area was conducted in 2006, and results were compared with those of a similar survey conducted in 2002. Average fat composition, proportion of 'trans fat-free' margarines and average prices of margarines were compared. A general linear model procedure was used to compare the relationship between price and fat composition in 2002 and 2006. Average amounts of trans fatty acids (TFA) and MUFA decreased, while average amounts of PUFA increased significantly from 2002 to 2006. The proportion of margarines with less than 0.2 g TFA/10 g serving rose significantly from 31 % in 2002 to 69 % in 2006. Margarines lower in TFA on average cost significantly more than margarines with greater amounts of these fats, and this relationship appeared stronger in 2006 relative to 2002. There is evidence of reductions in TFA in margarines since new labelling regulations came into effect in Canada; however, TFA reductions appeared to be restricted to higher-priced margarines. Results suggest that voluntary approaches (i.e. manufacturer incentives via labelling) to reduce population intakes of TFA will yield little changes in TFA content of low-cost products and thus may have limited benefit for lower-income groups, who are at higher risk of heart disease.

The impact of patient assistance programs and the 340B Drug Pricing Program on medication cost.

PubMed

Castellon, Yelba M; Bazargan-Hejazi, Shahrzad; Masatsugu, Miles; Contreras, Roberto

2014-02-01

Patient assistance programs and the 340B Drug Pricing Program promise to improve the financial stability, better serve vulnerable patients, and decrease the burden of cost for uninsured patients. Our objective is to examine the financial impact that PAPs and the 340B Program have on improving medication cost. Retrospective analysis of medication dispensary data. Dispensary data for uninsured patients obtaining medications at 2 community health centers were collected from February 1 to February 29, 2012. Uninsured patients were divided into 2 samples: (1) patients receiving PAP medications and (2) patients receiving 340B medications. The main outcome measured was the patient's cost savings. Cost savings were calculated based on the amount a medication would have cost had it been purchased by patients at prices found on Epocrates software (drugstore.com). A paired sample t test model using continuous variables was utilized to calculate confidence intervals. A total of 1420 PAP and 2772 340B individual medications were dispensed to uninsured patients in February 2012. For patients receiving PAP medications the mean ± standard deviation (SD) for age = 52 ± 10. Average cost was $0.11 (95% CI, $0.04-$0.17) and average savings was $617.36 (95% Cl, $581.32-$653.40). For patients receiving 340B medications the mean ±SD for age = 50 ± 14. Average cost was $11.50 (95% CI, $10.55-$12.45). Average saving was $62.31 (95% CI, $57.99-$66.63). PAPs and 340B provide significant medication savings for uninsured patient. More research is needed to establish "best practices" for the successful integration of PAPs.

Controlling the Cost of Drugs: the Canadian Experience

PubMed Central

Fulda, Thomas K.; Dickens, Paul F.

1979-01-01

In 1969 Canada began programs at both the national and provincial levels to lower prescription drug prices. These programs may have contributed to a significant decline between 1970 and 1974 of 39 percent in the average price of 16 drugs selected for study. During this time, the average price for the same drugs in the United States declined only 1.4 percent. One major program, a change in the compulsory patent licensing, is described and analyzed. Other Canadian programs, designed to promote competition in the drug industry, and their effects are discussed. PMID:10309114

Long-term Medicaid excess payments from alleged price manipulation of generic lorazepam.

PubMed

Bian, Boyang; Gorevski, Elizabeth; Kelton, Christina M L; Guo, Jeff J; Martin Boone, Jill E

2012-09-01

Cost savings from the use of generic drugs versus brand-name drugs are well known. Both private and public prescription drug plans encourage the use of generic drugs through a variety of mechanisms. The magnitude of cost savings for a given generic drug is dependent on the degree to which the generic market is competitive. Should the competitive structure become compromised, higher prices and reduced cost savings may result. An alleged conspiracy between Mylan Laboratories and its active-ingredient suppliers in 1997 was associated with an increase in seller concentration in the generic lorazepam market. The Federal Trade Commission (FTC) alleged that Mylan raised costs to consumers by $120 million because of price increases for generic lorazepam from March through December 1998 and for generic clorazepate from January through December 1998. In November 2002, a settlement with Mylan was approved by the FTC, and a federal district court required Mylan to pay $147 million, including $28.2 million to state agencies including Medicaid. To (a) describe the seller concentration in the national Medicaid generic lorazepam market over a 19-year period from January 1991 through December 2009, (b) estimate the excess payments for generic lorazepam by Medicaid between 1998 and 2009, and (c) investigate potentially increased utilization and prices of 2 substitute pharmaceuticals: branded lorazepam (Ativan) and generic alprazolam (another widely used intermediate-acting benzodiazepine). Using Medicaid State Drug Utilization Data from the Centers for Medicare Medicaid Services, we calculated the 4-firm concentration ratio (CR₄) and the Herfindahl-Hirschman Index (HHI) for the Medicaid generic lorazepam market, along with pre-rebate reimbursement for pharmacy claims, number of claims (utilization), and average pre-rebate reimbursement per claim (average "price") for generic lorazepam, from 1991 through 2009. Medicaid's excess payments were estimated under 2 different assumptions regarding what the average generic lorazepam price would have been in the absence of the alleged conspiracy. To find counterfactual prices, the average per-claim reimbursement for lorazepam for the 4 quarters prior to the alleged conspiracy, $6.80, was inflated using (a) the quarterly change in the average per-claim reimbursement for generic alprazolam and (b) the Consumer Price Index (CPI) for all urban consumers, all goods. Potential impact of the alleged conspiracy on the branded lorazepam and generic alprazolam markets was investigated. The average pre-rebate reimbursements per claim for generic lorazepam were $10.25, $23.12, and $8.48 in 1991, 1998, and 2009, respectively. For the same 3 years, CR₄ = 52.80, 76.02, and 86.74, while HHI = 905.71, 2,166.25, and 2,233.36. Medicaid's excess payments from 1998-2009 were estimated at approximately $625-$657 million. The data also suggest the possibility of small impacts on the utilization of branded lorazepam and the price of generic alprazolam. Prior to the alleged conspiracy in 1997, average pre-rebate reimbursement per claim for generic lorazepam was declining, while seller concentration was rising. After a jump in average payment per claim in the years immediately following the alleged conspiracy, prices have gradually returned to their pre-1998 levels. However, the generic lorazepam market was more concentrated in 2009 than prior to the alleged conspiracy. Copyright © 2012, Academy of Managed Care Pharmacy. All rights reserved.

The economic cost of fuel price subsidies in Ghana

NASA Astrophysics Data System (ADS)

Ofori, Roland Oduro

I adapt the Harberger formula for deadweight loss to develop approximations for the deadweight loss created by multiple fuel price subsidies. I also estimate the own-price, cross-price, and income elasticities of demand for gasoline and diesel in Africa. I use data on fuel prices and sales in combination with my formulas and elasticity estimates to calculate the deadweight loss of fuel price subsidies in Ghana from 2009 to 2014. I show that the average efficiency cost of the gasoline and diesel price subsidies in Ghana is 0.8% of fuel price subsidy transfers. This result stresses the futility of basing subsidy reforms on economic efficiency losses, which are relatively small due to very inelastic energy demand, and the need for such reforms to be motivated by the poor-targeting of subsidies to low-income households and the impact of subsidies on government debt-financing.

Time Series Analysis on the Impact of Generic Substitution and Reference Pricing on Antipsychotic Costs in Finland.

PubMed

Koskinen, Hanna; Mikkola, Hennamari; Saastamoinen, Leena K; Ahola, Elina; Martikainen, Jaana E

2015-12-01

To analyze the medium- to long-term impact of generic substitution and the reference price system on the daily cost of antipsychotics in Finland. The additional impact of reference pricing over and above previously implemented generic substitution was also assessed. An interrupted time series design with a control group and segmented regression analysis was used to estimate the effect of the implementation of generic substitution and the reference price system on the daily cost of antipsychotics. The data have 69 monthly values of the average daily cost for each of the studied antipsychotics: 39 months before and 30 months after the introduction of reference pricing. For one of the studied antipsychotic, the time before the introduction of reference pricing could be further divided into time before and after the introduction of generic substitution. According to the model, 2.5 years after the implementation of reference pricing, the daily cost of the studied antipsychotics was 24.6% to 50.6% lower than it would have been if reference pricing had not been implemented. Two and a half years after the implementation of the reference price system, however, the additional impact of reference pricing over and above previously implemented generic substitution was modest, less than 1 percentage point. Although the price competition induced by reference pricing decreased the prices of antipsychotics in Finland in the short-term, the prices had a tendency to stagnate or even to turn in an upward direction in the medium- to long-term. Furthermore, the additional impact of reference pricing over and above previously implemented generic substitution remained quite modest. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The economic benefits of disease triggered early harvest: A case study of pancreas disease in farmed Atlantic salmon from Norway.

PubMed

Pettersen, J M; Rich, K M; Jensen, B Bang; Aunsmo, A

2015-10-01

Pancreas disease (PD) is an important viral disease in Norwegian, Scottish and Irish aquaculture causing biological losses in terms of reduced growth, mortality, increased feed conversion ratio, and carcass downgrading. We developed a bio-economic model to investigate the economic benefits of a disease triggered early harvesting strategy to control PD losses. In this strategy, the salmon farm adopts a PCR (Polymerase Chain Reaction) diagnostic screening program to monitor the virus levels in stocks. Virus levels are used to forecast a clinical outbreak of pancreas disease, which then initiates a prescheduled harvest of the stock to avoid disease losses. The model is based on data inputs from national statistics, literature, company data, and an expert panel, and use stochastic simulations to account for the variation and/or uncertainty associated with disease effects and selected production expenditures. With the model, we compared the impacts of a salmon farm undergoing prescheduled harvest versus the salmon farm going through a PD outbreak. We also estimated the direct costs of a PD outbreak as the sum of biological losses, treatment costs, prevention costs, and other additional costs, less the costs of insurance pay-outs. Simulation results suggests that the economic benefit from a prescheduled harvest is positive once the average salmon weight at the farm has reached 3.2kg or more for an average Norwegian salmon farm stocked with 1,000,000smolts and using average salmon sales prices for 2013. The direct costs from a PD outbreak occurring nine months (average salmon weight 1.91kg) after sea transfer and using 2013 sales prices was on average estimated at NOK 55.4 million (5%, 50% and 90% percentile: 38.0, 55.8 and 72.4) (NOK=€0.128 in 2013). Sensitivity analyses revealed that the losses from a PD outbreak are sensitive to feed- and salmon sales prices, and that high 2013 sales prices contributed to substantial losses associated with a PD outbreak. Copyright © 2015 Elsevier B.V. All rights reserved.

Managing prescription drug costs: a case study.

PubMed

DuBois, R W; Feinberg, P E

1994-06-01

Pharmacy costs in most private insurance companies and public concerns have risen over the past several years. To address the problem of increased expenditures in its government employee pharmacy program, the State of New York sought bids from outside vendors to help it control pharmaceutical costs. The following is a case study of the tools the state employed in that effort. Over time, both prescription drug coverage and mental health and substance abuse benefits were carved out of the medical plan and are now provided under free-standing programs. In order to participate, an independent pharmacy must accept a discount of 10% off the average wholesale price of brand name drugs and 25% off the average generic price of generic drugs.

The impact of alternative pricing methods for drugs in California Workers’ Compensation System: Fee-schedule pricing

PubMed Central

Wilson, Leslie; Turkistani, Fatema A.; Huang, Wei; Tran, Dang M.; Lin, Tracy Kuo

2018-01-01

Introduction California’s Workers’ Compensation System (CAWCS) Department of Industrial Relations questioned the adequacy of the current Medi-Cal fee-schedule pricing and requested analysis of alternatives that maximize price availability and maintain budget neutrality. Objectives To compare CAWCS pharmacy-dispensed (PD) drug prices under alternative fee schedules, and identify combinations of alternative benchmarks that have prices available for the largest percentage of PD drugs and that best reach budget neutrality. Methods Claims transaction-level data (2011–2013) from CAWCS were used to estimate total annual PD pharmaceutical payments. Medi-Cal pricing data was from the Workman’s Compensation Insurance System (WCIS). Average Wholesale Prices (AWP), Wholesale Acquisition Costs (WAC), Direct Prices (DP), Federal Upper Limit (FUL) prices, and National Average Drug Acquisition Costs (NADAC) were from Medi-Span. We matched National Drug Codes (NDCs), pricing dates, and drug quantity for comparisons. We report pharmacy-dispensed (PD) claims frequency, reimbursement matching rate, and paid costs by CAWCS as the reference price against all alternative price benchmarks. Results Of 12,529,977 CAWCS claims for pharmaceutical products 11.6% (1,462,814) were for PD drugs. Prescription drug cost for CAWCS was over $152M; $63.9M, $47.9M, and $40.6M in 2011–2013. Ninety seven percent of these CAWCS PD claims had a Medi-Cal price. Alternative mechanisms provided a price for fewer claims; NADAC 94.23%, AWP 90.94%, FUL 73.11%, WAC 66.98%, and DP 14.33%. Among CAWCS drugs with no Medi-Cal price in PD claims, AWP, WAC, NADAC, DP, and FUL provided prices for 96.7%, 63.14%, 24.82%, 20.83%, and 15.08% of claims. Overall CAWCS paid 100.52% of Medi-Cal, 60% of AWP, 97% of WAC, 309.53% of FUL, 103.83% of DP, and 136.27% of NADAC. Conclusions CAWCS current Medi-Cal fee-schedule price list for PD drugs is more complete than all alternative fee-schedules. However, all reimbursement approaches would require combinations of pricing benchmarks. We suggest keeping primary reimbursement at 100% of Medi-Cal and for drugs without a primary Medi-Cal price calculating the maximum fee as 60% of AWP and then 97% of WAC. Alternatively, we suggest using NADAC as a primary fee-schedule followed by either 60% AWP and 97% WAC or AWP-40% for drugs with no NADAC price. Fee-schedules may not offer the best price and a formulary approach may provide more flexibility. PMID:29799850

The impact of alternative pricing methods for drugs in California Workers' Compensation System: Fee-schedule pricing.

PubMed

Wilson, Leslie; Turkistani, Fatema A; Huang, Wei; Tran, Dang M; Lin, Tracy Kuo

2018-01-01

California's Workers' Compensation System (CAWCS) Department of Industrial Relations questioned the adequacy of the current Medi-Cal fee-schedule pricing and requested analysis of alternatives that maximize price availability and maintain budget neutrality. To compare CAWCS pharmacy-dispensed (PD) drug prices under alternative fee schedules, and identify combinations of alternative benchmarks that have prices available for the largest percentage of PD drugs and that best reach budget neutrality. Claims transaction-level data (2011-2013) from CAWCS were used to estimate total annual PD pharmaceutical payments. Medi-Cal pricing data was from the Workman's Compensation Insurance System (WCIS). Average Wholesale Prices (AWP), Wholesale Acquisition Costs (WAC), Direct Prices (DP), Federal Upper Limit (FUL) prices, and National Average Drug Acquisition Costs (NADAC) were from Medi-Span. We matched National Drug Codes (NDCs), pricing dates, and drug quantity for comparisons. We report pharmacy-dispensed (PD) claims frequency, reimbursement matching rate, and paid costs by CAWCS as the reference price against all alternative price benchmarks. Of 12,529,977 CAWCS claims for pharmaceutical products 11.6% (1,462,814) were for PD drugs. Prescription drug cost for CAWCS was over $152M; $63.9M, $47.9M, and $40.6M in 2011-2013. Ninety seven percent of these CAWCS PD claims had a Medi-Cal price. Alternative mechanisms provided a price for fewer claims; NADAC 94.23%, AWP 90.94%, FUL 73.11%, WAC 66.98%, and DP 14.33%. Among CAWCS drugs with no Medi-Cal price in PD claims, AWP, WAC, NADAC, DP, and FUL provided prices for 96.7%, 63.14%, 24.82%, 20.83%, and 15.08% of claims. Overall CAWCS paid 100.52% of Medi-Cal, 60% of AWP, 97% of WAC, 309.53% of FUL, 103.83% of DP, and 136.27% of NADAC. CAWCS current Medi-Cal fee-schedule price list for PD drugs is more complete than all alternative fee-schedules. However, all reimbursement approaches would require combinations of pricing benchmarks. We suggest keeping primary reimbursement at 100% of Medi-Cal and for drugs without a primary Medi-Cal price calculating the maximum fee as 60% of AWP and then 97% of WAC. Alternatively, we suggest using NADAC as a primary fee-schedule followed by either 60% AWP and 97% WAC or AWP-40% for drugs with no NADAC price. Fee-schedules may not offer the best price and a formulary approach may provide more flexibility.

Revisiting Parabolic Trough Concentrators for Industrial Process Heat in the United States

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turchi, Craig S.; Kurup, Parthiv; Zhu, Guangdong

After significant interest in the 1970s, but relatively few deployments, the use of concentrating solar collectors for thermal applications, including enhanced oil recovery, desalination, and industrial process heat (IPH), is again increasing in global interest. In particular, recent advances in collector design and manufacturing have led to reduced cost per square meter of aperture area. In this study, analysis of a modern parabolic trough that is suited for use in small solar IPH (SIPH) applications predicts that the installed solar field cost can be as low as $170/m2. A slightly higher cost of $200/m2 is estimated for facilities typical ofmore » a SIPH plant size. Full project costs will include additional costs for contingency, piping and heat exchanger interface, and project indirect costs. The cost for solar-generated heat by SIPH is quantified by defining the levelized cost of heat (LCOH). California offers a favorable environment for SIPH given its good insolation, gas prices typically higher than the national average, and policies promoting solar-thermal deployment. Given historically low gas prices, competing with natural gas remains the primary challenge to deployment. However, this study finds that the solar LCOH for many regions in California is lower than the LCOH from natural gas, using a representative installed solar hardware price and the average price for industrial natural gas in California. Lastly, modification are in progress to the parabolic trough model within NREL's System Advisor Model (SAM) to allow users to more easily predict performance for these steam-generation applications.« less

Information system technologies' role in augmenting dermatologists' knowledge of prescription medication costs.

PubMed

DeMarco, Sebastian S; Paul, Ravi; Kilpatrick, Russell J

2015-12-01

Despite the recent rising costs of once affordable dermatologic prescription medications, a survey measuring dermatologists' attitudes, beliefs, and knowledge of the cost of drugs they commonly prescribe has not been conducted. Awareness of drug costs is hindered by a lack of access to data about the prices of medicines. No surveys of physicians have addressed this issue by proposing new information system technologies that augment prescription medication price transparency and measuring how receptive physicians are to using these novel solutions in their daily clinical practice. Our research aims to investigate these topics with a survey of physicians in dermatology. Members of the North Carolina Dermatology Association were contacted through their electronic mailing list and asked to take an online survey. The survey asked several questions about dermatologists' attitudes and beliefs about drug costs. To measure their knowledge of prescription medications, the National Average Drug Acquisition Cost was used as an authoritative price that was compared to the survey takers' price estimates of drugs commonly used in dermatology. Physicians' willingness to use four distinct information system technologies that increase drug price transparency was also assessed. Dermatologists believe drug costs are an important factor in patient care and believe access to price information would allow them to provide a higher quality of care. Dermatologists' knowledge of the costs of medicines they commonly prescribe is poor, but they want to utilize information system technologies that increase access to drug pricing information. There is an unmet demand for information system technologies which increase price transparency of medications in dermatology. Physicians and IT professionals have the opportunity to create novel information systems that can be utilized to help guide cost conscious clinical decision making. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Less Physician Practice Competition Is Associated With Higher Prices Paid For Common Procedures.

PubMed

Austin, Daniel R; Baker, Laurence C

2015-10-01

Concentration among physician groups has been steadily increasing, which may affect prices for physician services. We assessed the relationship in 2010 between physician competition and prices paid by private preferred provider organizations for fifteen common, high-cost procedures to understand whether higher concentration of physician practices and accompanying increased market power were associated with higher prices for services. Using county-level measures of the concentration of physician practices and county average prices, and statistically controlling for a range of other regional characteristics, we found that physician practice concentration and prices were significantly associated for twelve of the fifteen procedures we studied. For these procedures, counties with the highest average physician concentrations had prices 8-26 percent higher than prices in the lowest counties. We concluded that physician competition is frequently associated with prices. Policies that would influence physician practice organization should take this into consideration. Project HOPE—The People-to-People Health Foundation, Inc.

Switching insurer in the Irish voluntary health insurance market: determinants, incentives, and risk equalization.

PubMed

Keegan, Conor; Teljeur, Conor; Turner, Brian; Thomas, Steve

2016-09-01

The determinants of consumer mobility in voluntary health insurance markets providing duplicate cover are not well understood. Consumer mobility can have important implications for competition. Consumers should be price-responsive and be willing to switch insurer in search of the best-value products. Moreover, although theory suggests low-risk consumers are more likely to switch insurer, this process should not be driven by insurers looking to attract low risks. This study utilizes data on 320,830 VHI healthcare policies due for renewal between August 2013 and June 2014. At the time of renewal, policyholders were categorized as either 'switchers' or 'stayers', and policy information was collected for the prior 12 months. Differences between these groups were assessed by means of logistic regression. The ability of Ireland's risk equalization scheme to account for the relative attractiveness of switchers was also examined. Policyholders were price sensitive (OR 1.052, p < 0.01), however, price-sensitivity declined with age. Age (OR 0.971; p < 0.01) and hospital utilization (OR 0.977; p < 0.01) were both negatively associated with switching. In line with these findings, switchers were less costly than stayers for the 12 months prior to the switch/renew decision for single person (difference in average cost = €540.64) and multiple-person policies (difference in average cost = €450.74). Some cost differences remain for single-person policies following risk equalization (difference in average cost = €88.12). Consumers appear price-responsive, which is important for competition provided it is based on correct incentives. Risk equalization payments largely eliminated the profitable status of switchers, although further refinements may be required.

Cost of glaucoma treatment in a developing country over a 5-year period

PubMed Central

Lazcano-Gomez, Gabriel; Ramos-Cadena, María de los Angeles; Torres-Tamayo, Margarita; Hernandez de Oteyza, Alejandra; Turati-Acosta, Mauricio; Jimenez-Román, Jesús

2016-01-01

Abstract The aim of the study was to disclose a realistic estimate of primary open-angle glaucoma treatment, follow-up costs, and patients’ monthly glaucoma-economic burden in an ophthalmology hospital in Mexico City. Prospective survey of 462 primary open-angle glaucoma patients from 2007 to 2012 was carried out. Costs from visits, glaucoma follow-up studies, laser, and glaucoma surgical procedures were obtained from hospital pricings. Education, employment, and monthly income were interrogated. Total cost was divided into hypotensive treatment cost, nonpharmacologic treatment cost (laser and surgeries), and follow-up studies and consults. Average wholesale price for drugs analyzed was obtained from IMS Health data; monthly cost was calculated using: Monthly cost  = ([average wholesale price/number of drops per eye dropper] × number of daily applications) × 30 days. Patients were classified according to their glaucoma severity, and data were analyzed based on monthly income (average annual exchange rate: 12.85 Mexican pesos = 1 USD). The mean age was 70 ± 10 years, women = 81%, elementary school = 39%, and unemployed = 53%. Low-income group = 266 patients (57%), 146 with mild glaucoma; moderate-income group = 176 patients (38%), 81 with mild glaucoma; high-income group = 20 patients (4.3%), 10 with mild glaucoma. Patients’ monthly average economic burden in glaucoma treatment: low-income patients = 61.5%, moderate-income patients = 19.5%, and high-income patients = 7.9%. Glaucoma-economic burden is substantial not only for health systems, but for the family and the patient. Therefore, screening plans for earlier diagnosis, and health policies that lessen the cost of disease management and increase adherence to treatment, and reduce the prevalence of blindness attributed to glaucoma are essential. These would improve quality of life, reduce personal and national expenditure, and help increase national economy. PMID:27893669

Cost of glaucoma treatment in a developing country over a 5-year period.

PubMed

Lazcano-Gomez, Gabriel; Ramos-Cadena, María de Los Angeles; Torres-Tamayo, Margarita; Hernandez de Oteyza, Alejandra; Turati-Acosta, Mauricio; Jimenez-Román, Jesús

2016-11-01

The aim of the study was to disclose a realistic estimate of primary open-angle glaucoma treatment, follow-up costs, and patients' monthly glaucoma-economic burden in an ophthalmology hospital in Mexico City.Prospective survey of 462 primary open-angle glaucoma patients from 2007 to 2012 was carried out. Costs from visits, glaucoma follow-up studies, laser, and glaucoma surgical procedures were obtained from hospital pricings. Education, employment, and monthly income were interrogated. Total cost was divided into hypotensive treatment cost, nonpharmacologic treatment cost (laser and surgeries), and follow-up studies and consults. Average wholesale price for drugs analyzed was obtained from IMS Health data; monthly cost was calculated using: Monthly cost  = ([average wholesale price/number of drops per eye dropper] × number of daily applications) × 30 days.Patients were classified according to their glaucoma severity, and data were analyzed based on monthly income (average annual exchange rate: 12.85 Mexican pesos = 1 USD).The mean age was 70 ± 10 years, women = 81%, elementary school = 39%, and unemployed = 53%. Low-income group = 266 patients (57%), 146 with mild glaucoma; moderate-income group = 176 patients (38%), 81 with mild glaucoma; high-income group = 20 patients (4.3%), 10 with mild glaucoma. Patients' monthly average economic burden in glaucoma treatment: low-income patients = 61.5%, moderate-income patients = 19.5%, and high-income patients = 7.9%.Glaucoma-economic burden is substantial not only for health systems, but for the family and the patient. Therefore, screening plans for earlier diagnosis, and health policies that lessen the cost of disease management and increase adherence to treatment, and reduce the prevalence of blindness attributed to glaucoma are essential. These would improve quality of life, reduce personal and national expenditure, and help increase national economy.

Excerpta Medica abstracting journals: a case study of costs to medical school libraries.

PubMed Central

La Rocco, A; Feng, C

1977-01-01

A cost comparison study was made of Excerpta Medica's abstracting journals, based upon actual costs to a library. Unit costs were determined for six sections of EM as compared with six corresponding abstract journals. On average, EM sections were found to be 138% more costly than corresponding abstract journals. The effects of splitting of EM journal titles were also analyzed. This practice increases the price of a total subscription to EM and makes comprehensive information retrieval more difficult. A survey of medical school librarians as users of EM points to dissatisfaction with its increasing price, particularly when it results from title splitting. PMID:843653

Fixed-dose combination and single active ingredient drugs: a comparative cost analysis.

PubMed

Hao, Jing; Rodriguez-Monguio, Rosa; Seoane-Vazquez, Enrique

2016-01-01

Fixed-dose combination (FDC) drugs are formulations of two or more active ingredients. To assess the pricing structure and price difference of all US FDA-approved FDCs and single drugs included in the combination. Data were collected from the FDA Orange Book and Drugs@FDA. Average Wholesale Price (AWP) unit price data were derived from The Red Book. The FDA approved 117 FDC. The average AWP difference percentage between the FDC and the sum of the single drugs in the FDC is 84.9 ± 26.2%, and varied by therapeutic class (p < 0.001). The FDC AWP averaged 83.3 ± 23.4% of the single drug AWP sum when there are no generics, and 95.1 ± 42.3% (p < 0.01) when there are two generic single active ingredients in the FDC. The price difference between FDC and single active ingredients in the combination is correlated with the therapeutic class, the year of FDC approval, and the number of single ingredients in the combination that have generics.

Menthol cigarette pricing at military and community retail outlets in the United States.

PubMed

Poston, Walker S C; Jahnke, Sara A; Haddock, Christopher K; Hyder, Melissa L; Taylor, Jennifer E; Lando, Harry A; Kaipust, Christopher M

2012-09-01

Cigarette prices at military exchanges historically have been discounted. DoD Instruction 1330.9 has mandated that prices be within 5% of the price offered in the local community since 2001. Because minorities are highly represented in the military, we determined whether menthol cigarette prices, the leading choice of African Americans, were compliant with the instruction. We collected, via telephone, menthol cigarette price data from 48 randomly selected US military installation exchanges and matched local area Walmarts. We collected prices after taxes to determine the cost to consumer. Newport was selected as the index brand for menthol cigarettes because it is the leading and second leading brand smoked by African Americans and by Hispanics, respectively and has the second overall highest market share in the US. Smokers purchasing menthols at exchanges would realize average savings of 22.78%. There were no significant differences in savings based on military service (F = 1.850, p = 0.152) or US Census Division (F = 1.226, p = 0.311: data not shown). In addition, not a single exchange price was compliant with the DoD instruction. Newport menthol cigarettes at military exchanges cost substantially less than the nearest Walmart, with an average savings of 23%. Our findings demonstrate that menthol cigarettes are substantially discounted on military installations, in a manner similar to other cigarette prices, and that DoD Instruction 1330.09 is not enforced.

Menthol cigarette pricing at military and community retail outlets in the United States

PubMed Central

2012-01-01

Background Cigarette prices at military exchanges historically have been discounted. DoD Instruction 1330.9 has mandated that prices be within 5% of the price offered in the local community since 2001. Because minorities are highly represented in the military, we determined whether menthol cigarette prices, the leading choice of African Americans, were compliant with the instruction. Methods We collected, via telephone, menthol cigarette price data from 48 randomly selected US military installation exchanges and matched local area Walmarts. We collected prices after taxes to determine the cost to consumer. Newport was selected as the index brand for menthol cigarettes because it is the leading and second leading brand smoked by African Americans and by Hispanics, respectively and has the second overall highest market share in the US. Results Smokers purchasing menthols at exchanges would realize average savings of 22.78%. There were no significant differences in savings based on military service (F = 1.850, p = 0.152) or US Census Division (F = 1.226, p = 0.311: data not shown). In addition, not a single exchange price was compliant with the DoD instruction. Conclusions Newport menthol cigarettes at military exchanges cost substantially less than the nearest Walmart, with an average savings of 23%. Our findings demonstrate that menthol cigarettes are substantially discounted on military installations, in a manner similar to other cigarette prices, and that DoD Instruction 1330.09 is not enforced. PMID:22938755

Alternative strategies for Medicare payment of outpatient prescription drugs--Part B and beyond.

PubMed

Danzon, Patricia M; Wilensky, Gail R; Means, Kathleen E

2005-03-01

Reimbursement options for pharmaceuticals reimbursed under Medicare Part B (physician-dispensed drugs) are changing and the new comprehensive Part D Medicare outpatient drug benefit brings further changes. The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) replaces traditional policy, of reimbursing Part B drugs at 95% of average wholesale price (AWP, a list price), with a percentage markup over the manufacturer's average selling price; in 2005 an indirect competitive procurement option will be introduced. In our view, although AWP-based reimbursement has been fraught with problems in the past, these could be fixed by constraining growth in AWP and periodically adjusting the discount off AWP. With these revisions, an AWP-based rule would preserve incentives for competitive discounting and deliver savings to Medicare. By contrast, basing Medicare reimbursement on a manufacturer's average selling price undermines incentives for discounting and, like any cost-based reimbursement rule, may result in higher prices to both public and private purchasers. Indirect competitive procurement for drugs alone, using specialty pharmacies, pharmacy benefit managers, or prescription drug plans, is unlikely to constrain costs to acceptable levels unless contractors retain flexibility to use standard benefit management tools. Folding Part B and Part D into comprehensive contracting with health plans for full health services is likely to offer the most efficient approach to managing the drug benefit.

Implementation of fuzzy logic to determining selling price of products in a local corporate chain store

NASA Astrophysics Data System (ADS)

Kristiana, S. P. D.

2017-12-01

Corporate chain store is one type of retail industries companies that are developing growing rapidly in Indonesia. The competition between retail companies is very tight, so retailer companies should evaluate its performance continuously in order to survive. The selling price of products is one of the essential attributes and gets attention of many consumers where it’s used to evaluate the performance of the industry. This research aimed to determine optimal selling price of product with considering cost factors, namely purchase price of the product from supplier, holding costs, and transportation costs. Fuzzy logic approach is used in data processing with MATLAB software. Fuzzy logic is selected to solve the problem because this method can consider complexities factors. The result is a model of determination of the optimal selling price by considering three cost factors as inputs in the model. Calculating MAPE and model prediction ability for some products are used as validation and verification where the average value is 0.0525 for MAPE and 94.75% for prediction ability. The conclusion is this model can predict the selling price of up to 94.75%, so it can be used as tools for the corporate chain store in particular to determine the optimal selling price for its products.

How do Hospitals Respond to Price Changes? Evidence from Norway.

PubMed

Januleviciute, Jurgita; Askildsen, Jan Erik; Kaarboe, Oddvar; Siciliani, Luigi; Sutton, Matt

2016-05-01

Many publicly funded health systems use activity-based financing to increase hospital production and efficiency. The aim of this study is to investigate whether price changes for different treatments affect the number of patients treated and the mix of activity provided by hospitals. We exploit the variations in prices created by the changes in the national average treatment cost per diagnosis-related group (DRG) offered to Norwegian hospitals over a period of 5 years (2003-2007). We use the data from Norwegian Patient Register, containing individual-level information on age, gender, type of treatment, diagnosis, number of co-morbidities and the national average treatment costs per DRG. We employ fixed-effect models to examine the changes in the number of patients treated within the DRGs over time. The results suggest that a 10% increase in price leads to about 0.8-1.3% increase in the number of patients treated for DRGs, which are medical (for both emergency and elective patients). In contrast, we find no price effect for DRGs that are surgical (for both emergency and elective patients). Moreover, we find evidence of upcoding. A 10% increase in the ratio of prices between patients with and without complications increases the proportion of patients coded with complications by 0.3-0.4 percentage points. Copyright © 2015 John Wiley & Sons, Ltd.

Financing pharmaceuticals in transition economies.

PubMed

Kanavos, P

1999-06-01

This paper (a) provides a methodological taxonomy of pricing, financing, reimbursement, and cost containment methodologies for pharmaceuticals; (b) analyzes complex agency relationships and the health versus industrial policy tradeoff; (c) pinpoints financing measures to balance safety and effectiveness of medicines and their affordability by publicly funded systems in transition; and (d) highlights viable options for policy-makers for the financing of pharmaceuticals in transition. Three categories of measures and their implications for pharmaceutical policy cost containing are analyzed: supply-side measures, targeting manufacturers, proxy demand-side measures, targeting physicians and pharmacists, and demand-side measures, targeting patients. In pursuing supply side measures, we explore free pricing for pharmaceuticals, direct price controls, cost-plus and cost pricing, average pricing and international price comparisons, profit control, reference pricing, the introduction of a fourth hurdle, positive and negative lists, and other price control measures. The analysis of proxy-demand measures includes budgets for physicians, generic policies, practice guidelines, monitoring the authorizing behavior of physicians, and disease management schemes. Demand-side measures explore the effectiveness of patient co-payments, the impact of allowing products over-the-counter and health promotion programs. Global policies should operate simultaneously on the supply, the proxy demand, and the demand-side. Policy-making needs to have a continuous long-term planning. The importation of policies into transition economy may require extensive and expensive adaptation, and/or lead to sub-optimal policy outcomes.

Has it become increasingly expensive to follow a nutritious diet? Insights from a new price index for nutritious diets in Sweden 1980-2012.

PubMed

Håkansson, Andreas

2015-01-01

Health-related illnesses such as obesity and diabetes continue to increase, particularly in groups of low socioeconomic status. The increasing cost of nutritious food has been suggested as an explanation. To construct a price index describing the cost of a diet adhering to nutritional recommendations for a rational and knowledgeable consumer and, furthermore, to investigate which nutrients have become more expensive to obtain over time. Linear programming and goal programming were used to calculate two optimal and nutritious diets for each year in the interval under different assumptions. The first model describes the rational choice of a cost-minimizing consumer; the second, the choice of a consumer trying to deviate as little as possible from average consumption. Shadow price analysis was used to investigate how nutrients contribute to the diet cost. The cost of a diet adhering to nutritional recommendations has not increased more than general food prices in Sweden between 1980 and 2012. However, following nutrient recommendations increases the diet cost even for a rational consumer, particularly for vitamin D, iron, and selenium. The cost of adhering to the vitamin D recommendation has increased faster than the general food prices. Not adhering to recommendations (especially those for vitamin D) offers an opportunity for consumers to lower the diet cost. However, the cost of nutritious diets has not increased more than the cost of food in general between 1980 and 2012 in Sweden.

40 CFR 600.502 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... into Mexico. (b) Cost of production of a car line shall mean the aggregate of the products of: (1) The average U.S. dealer wholesale price for such car line as computed from each official dealer price list effective during the course of a model year, and (2) The number of automobiles within the car line produced...

40 CFR 600.502 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... into Mexico. (b) Cost of production of a car line shall mean the aggregate of the products of: (1) The average U.S. dealer wholesale price for such car line as computed from each official dealer price list effective during the course of a model year, and (2) The number of automobiles within the car line produced...

40 CFR 600.502 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... into Mexico. (b) Cost of production of a car line shall mean the aggregate of the products of: (1) The average U.S. dealer wholesale price for such car line as computed from each official dealer price list effective during the course of a model year, and (2) The number of automobiles within the car line produced...

40 CFR 600.502-81 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Cost of production of a car line shall mean the aggregate of the products of: (i) The average U.S. dealer wholesale price for such car line as computed from each official dealer price list effective during the course of a model year, and (ii) The number of automobiles within the car line produced during...

Understanding the milk-to-feed price ratio as a proxy for dairy farm profitability.

PubMed

Wolf, C A

2010-10-01

This research examines the definition, historical pattern, and utility of the milk-to-feed price ratio (MF) as a measure of dairy farm profitability. The MF was generally an acceptable proxy of profitability in an annual sense from 1985 to 2006. The MF was steady at an average of 2.8 from 1985 to 2006 even as average annual milk price in nominal terms increased from $12 to $14/hundredweight. An alternative proxy for profitability is income over feed costs, which is measured in dollars per hundredweight. Comparison with an actual profit measure, rate of return on assets, is used to examine the appropriateness of the proxies. The volatility from 2007 to 2009 resulted in MF being a poor measure of profitability over that period. The implication is that MF is not the preferred measure of profitability when a significant change in the pattern of one or both price series occurs. Income over feed cost is a better measure of profitability in periods of volatility. Copyright © 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Pharmaceutical companies' variation of drug prices within and among countries can improve long-term social well-being.

PubMed

Lichtenberg, Frank R

2011-08-01

Drug prices vary considerably across and within countries. On average, pharmaceutical companies charge lower prices in low-income countries than in industrialized nations. Manufacturers' ability to price products differently for different markets--a practice known as price discrimination--increases their profits overall. But it is also likely to result in greater investment in research and development, and therefore in more new drugs on the market. Although reducing price discrimination in order to cut costs might benefit consumers in the short run, it would harm them in the long run by reducing the number of new drugs developed.

Effects of drug price reduction and prescribing restrictions on expenditures and utilisation of antihypertensive drugs in Korea

PubMed Central

Yoo, Ki-Bong; Lee, Sang Gyu; Park, Sohee; Kim, Tae Hyun; Ahn, Jeonghoon; Cho, Mee-Hyun; Park, Eun-Cheol

2015-01-01

Objectives To evaluate the quantitative effects of the drug price reduction on pharmaceutical expenditures and the new guidelines to restrict prescribing on drug utilisation for antihypertensive drugs. Design We used an interrupted time series design with the National patient sample data of Health Insurance Review and Assessment Service in South Korea. Methods 54 295 participants who were with primary hypertension from the National patient sample data of Health Insurance Review and Assessment Service were included. The study period was from March 2011 to December 2013. The dependent variables were antihypertensive drug costs, antihypertensive drug cost per prescribing day, daily drug utilisation, average number of drugs per month, percentage of original drugs per prescription, drug overutilisation and prohibited combinations. Segmented regression analysis was used. Results The drug price reduction reduced expenditure (US$−1.51, −10.2%), and the new guidelines reduced expenditures even more (US$−2.13; −16.2%). These policies saved US$4.22 (28%) of antihypertensive drug costs per patient in December 2013 compared to March 2012. Drug price reduction policy was introduced in April 2012. We established the policy effect by comparing it before (March 2012) with after(21 months later-December 2012). The effects of the guidelines decreased expenditures, daily drug utilisation and the average number of drugs per month more than did the drug price reduction. Conclusions Both policies saved money. The guidelines were more effective over time and had fewer side effects such as increasing daily drug utilisation and number of drugs than the effects of drug price reduction. PMID:26179644

Reference Pricing, Consumer Cost-Sharing, and Insurer Spending for Advanced Imaging Tests.

PubMed

Robinson, James C; Whaley, Christopher; Brown, Timothy T

2016-12-01

Fees charged for similar imaging tests often vary dramatically within the same market, leading to wide variation in insurer spending and consumer cost-sharing. Reference pricing is an insurance design that offers good coverage to patients up to a defined contribution limit but requires the patients who select high-priced facilities to pay the remainder out of pocket. To measure the association between implementation of reference pricing and patient choice of facility, test prices, out-of-pocket spending, and insurer spending for advanced imaging (CT and MRI) procedures. Difference-in-differences multivariable analysis of insurance claims data. Study included 4751 employees of a national grocery chain (treatment group) and 23,428 enrollees in the nation's largest private insurance plan (comparison group) that used CT or MRI tests between 2010 and 2013. Patient choice of facility, price paid per test, patient out-of-pocket cost-sharing, and employer spending. Compared with trends in prices paid by insurance enrollees not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 12.5% (95% CI, -25.0%, 2.1%) reduction in average price paid per test by the end of the second full year of the program for CT scans and a 10.5% (95% CI, -16.9%, 3.6%) for MRIs. Out-of-pocket cost-sharing by patients declined by $71,508 (13.8%). The savings accruing to employees amounted to 45.5% of total savings from reference pricing, with the remainder accruing to the employer. Implementation of reference pricing led to reductions in payments by both employer and employees.

Stranded cost recovery presents stumbling block to open access

DOE Office of Scientific and Technical Information (OSTI.GOV)

Del Roccili, J.A.

Much of the impetus for the movement to competitive power markets is a result of the tremendous variance in energy prices across the country. Large commercial and industrial customers are becoming increasingly aware of these discrepancies and are marshaling the market and political forces required to guarantee the eventual development of a national open-access transmission policy. Such a policy will facilitate competition and equalize prices on a regional, and to some extent, national level. The stumbling block, however, is the recovery of stranded investment. Under traditional regulation, historical costs could be collected through approved rates for a bundled service. Withmore » the protection of a monopoly franchise, average electricity prices provide the possibility of cost recovery for assets that might not be recoverable in a competitive market.« less

Cost drivers in total hip arthroplasty: effects of procedure volume and implant selling price.

PubMed

Kelly, Michael P; Bozic, Kevin J

2009-01-01

Total hip arthroplasty (THA), though a highly effective procedure for patients with end-stage hip disease, has become increasingly costly, both because of increasing procedure volume and because of the introduction and widespread use of new technologies. Data regarding procedure volume and procedure costs for THA were obtained from the National Inpatient Sample and other published sources for the years 1995 through 2005. Procedure volume increased 61% over the period studied. When adjusted for inflation, using the medical consumer price index, the average selling price of THA implants increased 24%. The selling price of THA implants as a percentage of total procedure costs increased from 29% to 60% during the period under study. The increasing cost of THA in the United States is a result of both increased procedure volume and increased cost of THA implants. No long-term outcome studies related to use of new implant technologies are available, and short-term results have been similar to those obtained with previous generations of THA implants. This study reinforces the need for a US total joint arthroplasty registry and for careful clinical and economic analyses of new technologies in orthopedics.

Pitfalls associated with the therapeutic reference pricing practice of asthma medication

PubMed Central

2012-01-01

Background Therapeutic reference pricing (TRP) based on the WHO daily defined dose (DDD) is a method frequently employed for the cost-containment of pharmaceuticals. Our objective was to compare average drug use in the real world with DDD and to evaluate whether TRP based on DDD could result in cost savings on maintenance medication and the total direct health expenditures for asthma patients treated with Symbicort Turbuhaler (SYT) and Seretide Diskus (SED) in Hungary. Methods Real-world data were derived from the Hungarian National Health Insurance Fund database. Average doses and costs were compared between the high-dose and medium-dose SYT and SED groups. Multiple linear regressions were employed to adjust the data for differences in the gender and age distribution of patients. Results 27,779 patients with asthma were included in the analysis. Average drug use was lower than DDD in all groups, 1.38-1.95 inhalations in both SED groups, 1.28-1.97 and 1.74-2.49 inhalations in the medium and high-dose SYT groups, respectively. Although the cost of SED based on the DDD would be much lower than the cost of SYT in the medium-dose groups, no difference was found in the actual cost of the maintenance therapy. No significant differences were found between the groups in terms of total medical costs. Conclusions Cost-containment initiatives by payers may influence clinical decisions. TRP for inhalation asthma drugs raises special concern, because of differences in the therapeutic profile of pharmaceuticals and the lack of proven financial benefits after exclusion of the effect of generic price erosion. Our findings indicate that the presented TRP approach of asthma medications based on the daily therapeutic costs according to the WHO DDD does not result in reduced public healthcare spending in Hungary. Further analysis is required to show whether TRP generates additional expenditures by inducing switching costs and reducing patient compliance. Potential confounding factors may limit the generalisability of our conclusions. PMID:22818402

Pitfalls associated with the therapeutic reference pricing practice of asthma medication.

PubMed

Kalo, Zoltan; Abonyi-Toth, Zsolt; Bartfai, Zoltan; Voko, Zoltan

2012-07-20

Therapeutic reference pricing (TRP) based on the WHO daily defined dose (DDD) is a method frequently employed for the cost-containment of pharmaceuticals. Our objective was to compare average drug use in the real world with DDD and to evaluate whether TRP based on DDD could result in cost savings on maintenance medication and the total direct health expenditures for asthma patients treated with Symbicort Turbuhaler (SYT) and Seretide Diskus (SED) in Hungary. Real-world data were derived from the Hungarian National Health Insurance Fund database. Average doses and costs were compared between the high-dose and medium-dose SYT and SED groups. Multiple linear regressions were employed to adjust the data for differences in the gender and age distribution of patients. 27,779 patients with asthma were included in the analysis. Average drug use was lower than DDD in all groups, 1.38-1.95 inhalations in both SED groups, 1.28-1.97 and 1.74-2.49 inhalations in the medium and high-dose SYT groups, respectively. Although the cost of SED based on the DDD would be much lower than the cost of SYT in the medium-dose groups, no difference was found in the actual cost of the maintenance therapy. No significant differences were found between the groups in terms of total medical costs. Cost-containment initiatives by payers may influence clinical decisions. TRP for inhalation asthma drugs raises special concern, because of differences in the therapeutic profile of pharmaceuticals and the lack of proven financial benefits after exclusion of the effect of generic price erosion. Our findings indicate that the presented TRP approach of asthma medications based on the daily therapeutic costs according to the WHO DDD does not result in reduced public healthcare spending in Hungary. Further analysis is required to show whether TRP generates additional expenditures by inducing switching costs and reducing patient compliance. Potential confounding factors may limit the generalisability of our conclusions.

Stock price analysis of sustainable foreign investment companies in Indonesia

NASA Astrophysics Data System (ADS)

Fachrudin, Khaira Amalia

2018-03-01

The stock price is determined by demand and supply in the stock market. Stock price reacts to information. Sustainable investment is an investment that considers environmental sustainability and human rights. This study aims to predict the probability of above average stock price by including the sustainability index as one of its variables. The population is all foreign investment companies in Indonesia. The target population is companies that distribute dividends – also as a sample. The analysis tool is a logistic regression. At 5% alpha, it was found that sustainability index did not have the probability to increase stock price average. The significant effects are free cash flow and cost of debt. However, sustainability index can increase the Negelkarke R square. The implication is that the awareness of sustainability is still necesary to be improved because from the research result it can be seen that investors only consider the risk and return.

Auction-theoretic analyses of the first offshore wind energy auction in Germany

NASA Astrophysics Data System (ADS)

Kreiss, J.; Ehrhart, K.-M.; Hanke, A.-K.

2017-11-01

The first offshore wind energy auction in Germany led to a striking result. The average award price was 0.44 ct/kWh and even more interesting, 3 out of 4 awarded projects had a strike price of 0.0 ct/kWh. That implies that those projects will only receive the actual wholesale market price for electricity as revenue. Although there has been a strong decline in costs of offshore wind projects, such a result is still surprising. We analyzed this result auction-theoretically and showed how the auction design and the market environment can explain part of the outcome. However, another aspect of the explanation is the high risk that the awarded bidders take regarding the future development of both the project costs and the wholesale market price.

Estimating procedure for major highway construction bid item cost : final report.

DOT National Transportation Integrated Search

1978-06-01

The present procedure for estimating construction bid item cost makes use of the quarterly weighted average unit price report coupled with engineering judgement. The limitation to this method is that this report format provides only the lowest bid da...

MEDICAL DEVICE PRICES IN ECONOMIC EVALUATIONS.

PubMed

Akpinar, Ilke; Jacobs, Philip; Husereau, Don

2015-01-01

Economic evaluations, although not formally used in purchasing decisions for medical devices in Canada, are still being conducted and published. The aim of this study was to examine the way that prices have been included in Canadian economic evaluations of medical devices. We conducted a review of the economic concepts and implications of methods used for economic evaluations of the eleven most implanted medical devices from the Canadian perspective. We found Canadian economic studies for five of the eleven medical devices and identified nineteen Canadian studies. Overall, the device costs were important components of total procedure cost, with an average ratio of 44.1 %. Observational estimates of the device costs were obtained from buyers or sellers in 13 of the 19 studies. Although most of the devices last more than 1 year, standard costing methods for capital equipment was never used. In addition, only eight studies included a sensitivity analysis for the device cost. None of the sensitivity analyses were based on actual price distributions. Economic evaluations are potentially important for policy making, but although they are being conducted, there is no standardized approach for incorporating medical device prices in economic analyses. Our review provides suggestions for improvements in how the prices are incorporated for economic evaluations of medical devices.

Reduce Operating Costs with an EnergySmart School Project

ERIC Educational Resources Information Center

US Department of Energy, 2008

2008-01-01

Energy costs are a school district's second highest expenditure after personnel. Public schools currently spend more than $8 billion per year for energy. School energy expenditures rose, on average, 20 percent per year between 2000 and 2002--and the costs continue to rise. Natural gas prices alone increased 14 percent annually between 2003 and…

Estimating Travel Cost Model: Spatial Approach

Treesearch

S.G. Kim; J.M. Bowker; S.H. Cho; D.M. Lambert; D.B.K. English; C.M. Starbuck

2010-01-01

High gasoline prices made headlines in 2008 and 2009. The average gasoline price in the United States peaked at $4.05 per gallon in the second week of July, and it remained fairly high most of the third quarter of 2008, dropped significantly through September to December in 2008, and began to rise again in January 2009 (Energy Information Administration, 2009).

Colorectal cancer: complexities and challenges in managed care.

PubMed

Minkoff, Neil B

2007-08-01

Managed care weighs advances and associated costs to determine whether the combination of longer life at sometimes significantly increased cost represents value. The price of treatment is only 1 factor. To review treatment decision processes for oncologic agents in managed care environments. Price can be exceptionally high for individuals. But if the population size is low, the per-member-per-month (PMPM) impact can be almost negligible, unlike treatments that have moderate costs but are used ubiquitously. Cancer therapies have, for the most part, escaped managed care's notice. For 2007, the national Cancer Institute projects that antineoplastic agents will consume almost a quarter of the overall drug spend. The Medicare population is a unique concern with regard to cancer. Traditionally, Medicare reimbursement of chemotherapeutic agents was based on average wholesale price (AWP) discounting, not the oncologist's purchasing cost. This allowed oncologists to use reimbursement for infusions to support their medical practices. The proposed plan of the Center for Medicare & Medicaid Services (CMS) to use average sales price (ASP) plus 6% to reimburse for drugs used in the office setting leads to significant problems. Pharmacy and therapeutics committees will also face challenges: fewer data are available for some agents because they have become available through the U.S. Food and drug administration's Fast Track, Priority review, or accelerated approval processes. Oncology disease management programs must reach out to patients and not necessarily deal with oncology issues directly, but address tangential issues that impact care, especially depression and pain management.

Variations in the open market costs for prostate cancer surgery: a survey of US hospitals.

PubMed

Pate, Scott C; Uhlman, Matthew A; Rosenthal, Jaime A; Cram, Peter; Erickson, Bradley A

2014-03-01

To examine variation in the open market cost of a radical prostatectomy (RP) procedure in the US hospitals for an uninsured patient, as many proposals for health care reform highlight the importance of individuals actively participating in selecting care. However, reports suggest that obtaining procedure prices remains challenging and highly variable. We used 2011-2012 US News and World Report rankings to identify a cohort of 100 hospitals making an effort to include an equal distribution of both academic and private centers, city size, and geographic region. Each hospital was called and the essence of the script included a caller stating he was a healthy, uninsured 55-year-old man recently diagnosed with Gleason 3 + 4 prostatic adenocarcinoma with no metastases. Facility, surgeon, and anesthesia fees were solicited. Seventy hospitals provided facility prices. Facility estimates averaged $34,720 (±20,335; range, $10,100-$135,000), which was statistically higher at academics centers. No significant differences were seen by region, population, or hospital ranking. Surgeon and anesthesia fees were provided by 10%, averaging $8280 (±$4282; range, $4028-$18,720). Thirty-three hospitals provided discounted fees for prompt payment averaging 34% (±16%; range, 10%-80%). There is wide variation in pricing for RP, with higher rates found in academic centers. Wide variation in facility costs were observed, and nearly all were unable to provide surgeon and/or anesthesia fees. Currently, it appears to be unacceptably difficult for men with prostate cancer without insurance to obtain prices for an RP procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

"Red-Yellow-Green": Effect of an Initiative to Guide Surgeon Choice of Orthopaedic Implants.

PubMed

Okike, Kanu; Pollak, Rachael; O'Toole, Robert V; Pollak, Andrew N

2017-04-05

Orthopaedic procedures are expensive, and devices account for a large proportion of the overall costs. Hospitals have employed a variety of strategies to decrease implant costs, but many center on restricting surgeon choice. At our institution, we developed an implant selection tool that guides surgeons toward more cost-effective implants, while minimally restricting choice. The purpose of this study was to assess the effect of this tool on preferred implant usage rates, vendor attitudes toward pricing structure, and hospital implant expenditures. For 6 commonly used orthopaedic trauma devices, similar constructs were created for the 4 vendors used at our hospital, and the costs were determined. On the basis of these costs, the available options for each device type were categorized as "green" (preferred vendor), "yellow" (midrange), or "red" (used for patient-specific requirements). The "Red-Yellow-Green" chart was posted on the wall of each orthopaedic trauma operating room. To assess the effect of the tool, we compared implant usage patterns before and after implementation of the implant selection tool. We also assessed changes in vendor contract prices, as well as overall savings to our institution. Implant usage changed significantly from 30% "red," 56% "yellow," and 14% "green" prior to the intervention, to 9% "red," 21% "yellow," and 70% "green" after the intervention (p < 0.0001). As a result of price renegotiation with vendors following implementation, we observed average price decreases that ranged from 1.1% to 22.4%. Average expenditures on these 6 implants decreased 20% during the study period, which represented a savings of $216,495 per year. At our institution, we designed and implemented "Red-Yellow-Green," a simple tool that guides surgeons toward the selection of lower-cost implants without violating vendor confidentiality clauses, limiting the implants from which surgeons can choose, or requiring surgeons to discern the prices of complex constructs. Following implementation, hospital implant expenditures decreased as a result of a combination of increased preferred vendor usage by surgeons, as well as increased competition among vendors, which resulted in lower overall prices.

Funding issues for Victorian hospitals: the risk-adjusted vision beyond casemix funding.

PubMed

Antioch, K; Walsh, M

2000-01-01

This paper discusses casemix funding issues in Victoria impacting on teaching hospitals. For casemix payments to be acceptable, the average price and cost weights must be set at an appropriate standard. The average price is based on a normative, policy basis rather than benchmarking. The 'averaging principle' inherent in cost weights has resulted in some AN-DRG weights being too low for teaching hospitals that are key State-wide providers of high complexity services such as neurosurgery and trauma. Casemix data have been analysed using international risk adjustment methodologies to successfully negotiate with the Victorian State Government for specified grants for several high complexity AN-DRGs. A risk-adjusted capitation funding model has also been developed for cystic fibrosis patients treated by The Alfred, called an Australian Health Maintenance Organisation (AHMO). This will facilitate the development of similar models by both the Victorian and Federal governments.

Inflation Accounting Methods and their Effectiveness

DTIC Science & Technology

1992-06-01

security is measured by the standard deviation of its returns in the past periods and is reflected in the security’ s market price . The Capital Asset Pricing ...purchasing power should be limited to items which are used by an average consumer. Economists tend to perceive the general price level as the cost of living...accounting. Two common measures of business performance are income and rate of return on capital . Since depreciation charges for long-lived assets do

Controlling supply expenses through capitated supply contracting.

PubMed

Kowalski, J C

1997-07-01

Some providers dealing with the financial challenges of managed care are attempting to control supply expenses through capitated supply contracting and similar risk/reward sharing arrangements. Under such arrangements, a supplier sells products and services to a provider for a fixed, prospective price in exchange for the provider's exclusive business. If expenses exceed the prospectively established amount, the supplier and provider share the loss. Conversely, if expenses are less than the fixed amount, they share the savings. For a capitated supply arrangement to be successful, providers must be able to identify and track supply expense drivers, such as clinical pathways, technology utilization, and product selection and utilization. Sophisticated information systems are needed to capture data, such as total and per-transaction product usage/volume; unit price per item; average and cost per item; average and total cost per transaction; and total cost per outcome. Providers also will need to establish mutually cooperative relationships with the suppliers with whom they contract.

Do higher-priced generic medicines enjoy a competitive advantage under reference pricing?

PubMed

Puig-Junoy, Jaume

2012-11-01

In many countries with generic reference pricing, generic producers and distributors compete by means of undisclosed discounts offered to pharmacies in order to reduce acquisition costs and to induce them to dispense their generic to patients in preference over others. The objective of this article is to test the hypothesis that under prevailing reference pricing systems for generic medicines, those medicines sold at a higher consumer price may enjoy a competitive advantage. Real transaction prices for 179 generic medicines acquired by pharmacies in Spain have been used to calculate the discount rate on acquisition versus reimbursed costs to pharmacies. Two empirical hypotheses are tested: the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical presentations for which there are more generic competitors; and, the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical forms for which the consumer price has declined less in relation to the consumer price of the brand drug before generic entry (higher-priced generic medicines). An average discount rate of 39.3% on acquisition versus reimbursed costs to pharmacies has been observed. The magnitude of the discount positively depends on the number of competitors in the market. The higher the ratio of the consumer price of the generic to that of the brand drug prior to generic entry (i.e. the smaller the price reduction of the generic in relation to the brand drug), the larger the discount rate. Under reference pricing there is intense price competition among generic firms in the form of unusually high discounts to pharmacies on official ex-factory prices reimbursed to pharmacies. However, this effect is highly distorting because it favours those medicines with a higher relative price in relation to the brand price before generic entry.

Cost Conscious: Incentive and Discount Programs Help Students Meet the Rising Cost of a Community College Education

ERIC Educational Resources Information Center

Ullman, Ellen

2013-01-01

Aware that rising costs could force some community colleges to compromise their long-standing open-door policies, administrators have put in place programs and incentives to offset the higher price of the average community college education. This article features ideas and programs to help struggling community colleges cope with rising costs such…

How state and federal policies as well as advances in genome science contribute to the high cost of cancer drugs.

PubMed

Ramsey, Scott D

2015-04-01

During a time when cancer drug prices are increasing at an unprecedented rate, a debate has emerged as to whether these drugs continue to provide good value. In this article I argue that this debate is irrelevant because under today's highly distorted market, prices will not be set with value considerations in mind. As an alternative, I suggest considering the "value" of three policy changes—Medicare's "average sales price plus 6 percent" payment program, laws that require insurance coverage of all new cancer drugs, and the Affordable Care Act—that are fueling manufacturers' willingness to set higher prices. More important than these issues, however, is the revolution that is occurring in molecular biology and its impact on scientists' ability to detect changes in the cancer genome. The lowered cost of discovery is driving more competitors into the market, which under distorted pricing paradoxically encourages drug makers to charge ever higher prices for their products. Project HOPE—The People-to-People Health Foundation, Inc.

The Impact of Biomass Feedstock Supply Variability on the Delivered Price to a Biorefinery in the Peace River Region of Alberta, Canada

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stephen, Jamie; Sokhansanj, Shahabaddine; Bi, X.T.

2010-01-01

Agricultural residue feedstock availability in a given region can vary significantly over the 20 25 year lifetime of a biorefinery. Since delivered price of biomass feedstock to a biorefinery is related to the distance travelled and equipment optimization, and transportation distance increases as productivity decreases, productivity is a primary determinant of feedstock price. Using the Integrated Biomass Supply Analysis and Logistics (IBSAL) modeling environment and a standard round bale harvest and delivery scenario, harvest and delivery price were modelled for minimum, average, and maximum yields at four potential biorefinery sites in the Peace River region of Alberta, Canada. Biorefinery capacitiesmore » ranged from 50,000 to 500,000 tonnes per year. Delivery cost is a linear function of transportation distance and can be combined with a polynomial harvest function to create a generalized delivered cost function for agricultural residues. The range in delivered cost is substantial and is an important consideration for the operating costs of a biorefinery.« less

U.S. Solar Photovoltaic System Cost Benchmark: Q1 2017

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fu, Ran; Feldman, David; Margolis, Robert

This report benchmarks U.S. solar photovoltaic (PV) system installed costs as of the first quarter of 2017 (Q1 2017). We use a bottom-up methodology, accounting for all system and projectdevelopment costs incurred during the installation to model the costs for residential, commercial, and utility-scale systems. In general, we attempt to model the typical installation techniques and business operations from an installed-cost perspective. Costs are represented from the perspective of the developer/installer; thus, all hardware costs represent the price at which components are purchased by the developer/installer, not accounting for preexisting supply agreements or other contracts. Importantly, the benchmark also representsmore » the sales price paid to the installer; therefore, it includes profit in the cost of the hardware, 1 along with the profit the installer/developer receives, as a separate cost category. However, it does not include any additional net profit, such as a developer fee or price gross-up, which is common in the marketplace. We adopt this approach owing to the wide variation in developer profits in all three sectors, where project pricing is highly dependent on region and project specifics such as local retail electricity rate structures, local rebate and incentive structures, competitive environment, and overall project or deal structures. Finally, our benchmarks are national averages weighted by state installed capacities.« less

Which types of hospital mergers save consumers money?

PubMed

Connor, R A; Feldman, R D; Dowd, B E; Radcliff, T A

1997-01-01

This study analyzes the changes in costs and prices from 1986 to 1994 for more than 3,500 U.S. short-term general hospitals, including 122 horizontal mergers. These mergers were generally financially beneficial to consumers, providing average price reductions of approximately 7 percent. Merger-related price reductions were considerably less in market areas with higher market concentration levels. Merger-related price reductions in areas with higher penetration by health maintenance organizations (HMOs) were approximately twice those in areas with lower HMO penetration. Merger-related price reductions were greater for low-occupancy hospitals, nonteaching hospitals, nonsystem hospitals, similar-size hospitals, and hospitals with greater premerger service duplication.

77 FR 58991 - State-Level Guarantee Fee Pricing

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-25

.../relatedservicinginfo/pdf/foreclosuretimeframes.pdf and http://www.freddiemac.com/learn/pdfs/service/exhibit83.pdf . The... Relative to the National Average Estimated Cost per day Foreclosure average Total time to relative to Rank.../guides/ssg/relatedservicinginfo/pdf/foreclosuretimeframes.pdf and http://www.freddiemac.com/learn/pdfs...

Techniques for cash management in scheduling manufacturing operations

NASA Astrophysics Data System (ADS)

Morady Gohareh, Mehdy; Shams Gharneh, Naser; Ghasemy Yaghin, Reza

2017-06-01

The objective in traditional scheduling is usually time based. Minimizing the makespan, total flow times, total tardi costs, etc. are instances of these objectives. In manufacturing, processing each job entails a cost paying and price receiving. Thus, the objective should include some notion of managing the flow of cash. We have defined two new objectives: maximization of average and minimum available cash. For single machine scheduling, it is demonstrated that scheduling jobs in decreasing order of profit ratios maximizes the former and improves productivity. Moreover, scheduling jobs in increasing order of costs and breaking ties in decreasing order of prices maximizes the latter and creates protection against financial instability.

Prescription Drug Price Paradox: Cost Analysis of Canadian Online Pharmacies versus US Medicare Beneficiaries for the Top 100 Drugs.

PubMed

Kim, Sean Hyungwoo; Ryu, Young Joo; Cho, Na-Eun; Kim, Andy Eunwoo; Chang, Jongwha

2017-10-01

Despite the introduction of Medicare Part D (MPD) and 2012 Affordable Care Act (ACA), patients have a cost burden due to increases in drug prices. To overcome cost barriers, some patients purchase their medications from Canadian online pharmacies as Canadian prescription drug prices are believed to be lower than US prescription drug prices. The objective of this study was to determine which top 100 Medicare drugs can be imported to the USA legally, and to determine which type of prescription drug would be more beneficial to be purchased from Canadian online pharmacies. Moreover, we also deemed it important to compare MPD beneficiary annual expenses with expenses patients would have when obtaining their prescriptions from Canadian online pharmacies. We conducted a cost analysis from a patient perspective. A list of the top 100 Medicare drugs was compiled and information on drug prices was collected from three Canadian online pharmacies and four MPD plans in Virginia. The annual cost of each Medicare drug and percent change between Canadian online pharmacies and MPD were compared. A total of 78 drugs from the top 100 Medicare drugs were included in the final analysis. Seventy-six prescription drugs (97.4%) that could be purchased from Canadian online pharmacies showed a significantly lower average drug price percent change of -72.71% (P < 0.0001). The heart health/blood pressure subgroup had the highest number of drugs that could be purchased from Canadian online pharmacies. The majority of prescription drugs can be purchased at lower prices from Canadian online pharmacies when compared to Medicare beneficiaries' potential expenses. Purchasing medications from Canadian online pharmacies may be a viable option to address cost barriers.

Epidemiological, demographic, and economic analyses: measurement of the value of trichiasis surgery in The Gambia.

PubMed

Frick, K D; Keuffel, E L; Bowman, R J

2001-07-01

Untreated trichiasis can lead to corneal opacity. Surgery to prevent the eyelashes from rubbing against the cornea is available, but many individuals with trichiasis never undergo the operation. This study estimates the cost of illness of untreated trichiasis and the willingness to pay for surgery and compares them with the actual cost of providing surgery. The cost of illness estimate is based on trichiasis patient demographics. Data on the implicit price of obtaining surgery and surgical utilization in a matched pair randomized trial are used to infer individual willingness to pay for trichiasis surgery. Patients in the study paid nothing out-of-pocket for surgery; the price of obtaining surgery is the value of the individual's time needed for travel and surgery plus the price of public transportation. The cost of producing surgery was calculated from project records. All monetary figures are reported in 1998 US dollars. The average cost of untreated trichiasis, or the net present value of life-time lost economic productivity, was $89. Individuals facing a lower cost were more likely to undergo an operation; the inferred average willingness to pay was $1.43 (SD 0.244). Surgery cost $6.13 to provide, including $0.86 for transportation to the village. Whether the value of trichiasis surgery exceeds the cost in The Gambia depends on how the value is measured. Individuals are willing to use only limited resources to obtain surgery even though lifetime economic productivity may increase substantially. All three economic measures can be used to inform policy.

Lower Costs, Higher Returns: UNCF HBCUs in a High-Priced College Environment. Financing African American College Aspirations Series

ERIC Educational Resources Information Center

Richards, David A. R.

2014-01-01

While research consistently shows the earning power of college degrees, those returns are best weighed against the cost of attending post-secondary institutions, historically black colleges and universities (HBCUs) included. This study is an update of "Affordability of UNCF-Member Institutions" (2009), and compares the average costs at…

7 CFR 1726.251 - Prior approved contract modification related to price escalation on transmission equipment...

Code of Federal Regulations, 2014 CFR

2014-01-01

... shop labor costs and shall be adjusted based on changes in the Bureau of Labor Statistics, Average... are opened to the month in which the work is accomplished. The adjustment for shop labor costs shall... partial payment deemed to represent shop labor costs. A portion of __ percent [the borrower will enter the...

7 CFR 1726.251 - Prior approved contract modification related to price escalation on transmission equipment...

Code of Federal Regulations, 2012 CFR

2012-01-01

... shop labor costs and shall be adjusted based on changes in the Bureau of Labor Statistics, Average... are opened to the month in which the work is accomplished. The adjustment for shop labor costs shall... partial payment deemed to represent shop labor costs. A portion of __ percent [the borrower will enter the...

7 CFR 1726.251 - Prior approved contract modification related to price escalation on transmission equipment...

Code of Federal Regulations, 2011 CFR

2011-01-01

... shop labor costs and shall be adjusted based on changes in the Bureau of Labor Statistics, Average... are opened to the month in which the work is accomplished. The adjustment for shop labor costs shall... partial payment deemed to represent shop labor costs. A portion of __ percent [the borrower will enter the...

7 CFR 1726.251 - Prior approved contract modification related to price escalation on transmission equipment...

Code of Federal Regulations, 2013 CFR

2013-01-01

... shop labor costs and shall be adjusted based on changes in the Bureau of Labor Statistics, Average... are opened to the month in which the work is accomplished. The adjustment for shop labor costs shall... partial payment deemed to represent shop labor costs. A portion of __ percent [the borrower will enter the...

Pricing strategies for capitated delivery systems

PubMed Central

Gruenberg, Leonard; Wallack, Stanley S.; Tompkins, Christopher P.

1986-01-01

This article discusses alternative methods for establishing a fairer pricing mechanism for Medicare recipients who enroll in health maintenance organizations and other competitive medical plans. The current method, based upon the adjusted average per capita cost, is inadequate because it fails to adjust premium levels for differences in health status; it establishes undesirable incentives that may lead to underservice, and it is tied to costs in the fee-for-service system. Alternative methods would incorporate health status, have Medicare share the risk with HMO's, and base payment on HMO experience. PMID:10311925

Regional Hospital Input Price Indexes

PubMed Central

Freeland, Mark S.; Schendler, Carol Ellen; Anderson, Gerard

1981-01-01

This paper describes the development of regional hospital input price indexes that is consistent with the general methodology used for the National Hospital Input Price Index. The feasibility of developing regional indexes was investigated because individuals inquired whether different regions experienced different rates of increase in hospital input prices. The regional indexes incorporate variations in cost-share weights (the amount an expense category contributes to total spending) associated with hospital type and location, and variations in the rate of input price increases for various regions. We found that between 1972 and 1979 none of the regional price indexes increased at average annual rates significantly different from the national rate. For the more recent period 1977 through 1979, the increase in one Census Region was significantly below the national rate. Further analyses indicated that variations in cost-share weights for various types of hospitals produced no substantial variations in the regional price indexes relative to the national index. We consider these findings preliminary because of limitations in the availability of current, relevant, and reliable data, especially for local area wage rate increases. PMID:10309557

Electric urban delivery trucks: energy use, greenhouse gas emissions, and cost-effectiveness.

PubMed

Lee, Dong-Yeon; Thomas, Valerie M; Brown, Marilyn A

2013-07-16

We compare electric and diesel urban delivery trucks in terms of life-cycle energy consumption, greenhouse gas (GHG) emissions, and total cost of ownership (TCO). The relative benefits of electric trucks depend heavily on vehicle efficiency associated with drive cycle, diesel fuel price, travel demand, electric drive battery replacement and price, electricity generation and transmission efficiency, electric truck recharging infrastructure, and purchase price. For a drive cycle with frequent stops and low average speed such as the New York City Cycle (NYCC), electric trucks emit 42-61% less GHGs and consume 32-54% less energy than diesel trucks, depending upon vehicle efficiency cases. Over an array of possible conditions, the median TCO of electric trucks is 22% less than that of diesel trucks on the NYCC. For a drive cycle with less frequent stops and high average speed such as the City-Suburban Heavy Vehicle Cycle (CSHVC), electric trucks emit 19-43% less GHGs and consume 5-34% less energy, but cost 1% more than diesel counterparts. Considering current and projected U.S. regional electricity generation mixes, for the baseline case, the energy use and GHG emissions ratios of electric to diesel trucks range from 48 to 82% and 25 to 89%, respectively.

The indirect costs of psoriatic arthritis: systematic review and meta-analysis.

PubMed

Kawalec, Paweł; Malinowski, Krzysztof Piotr

2015-02-01

The aim of this systematic review is to collect all current data on the indirect costs (IC) related to psoriatic arthritis (PsA). The search was conducted using MEDLINE (via PubMed), Embase and Centre for Reviews and Dissemination databases. We considered original studies, systematic reviews, economic evaluations, conference abstracts and posters. All collected data were recalculated to average annual cost per patient, expressed using the consumer price index for 2013 and converted to US dollars using purchasing power parity. Eight of the identified publications presented IC of PsA. Average annual IC per patient calculated using the friction cost approach range from US$1693.83 to $12,318.45, while using the human capital approach they range from US$1750.68 to $50,270.52. Result of the meta-analysis was a basis for calculating cost of work disability equaled US$10,754.04 per patient per year in 2013 prices. This systematic review revealed a great economic burden of the disease to the society. A small number of studies on IC in PsA justify further investigations.

Costs of major intracranial, gastrointestinal and other bleeding events in patients with atrial fibrillation - a nationwide cohort study.

PubMed

Jakobsen, Marie; Kolodziejczyk, Christophe; Klausen Fredslund, Eskild; Poulsen, Peter Bo; Dybro, Lars; Paaske Johnsen, Søren

2017-06-12

Use of oral anticoagulation therapy in patients with atrial fibrillation (AF) involves a trade-off between a reduced risk of ischemic stroke and an increased risk of bleeding events. Different anticoagulation therapies have different safety profiles and data on the societal costs of both ischemic stroke and bleeding events are necessary for assessing the cost-effectiveness and budgetary impact of different treatment options. To our knowledge, no previous studies have estimated the societal costs of bleeding events in patients with AF. The objective of this study was to estimate the 3-years societal costs of first-incident intracranial, gastrointestinal and other major bleeding events in Danish patients with AF. The study was an incidence-based cost-of-illness study carried out from a societal perspective and based on data from national Danish registries covering the period 2002-2012. Costs were estimated using a propensity score matching and multivariable regression analysis (first difference OLS) in a cohort design. Average 3-years societal costs attributable to intracranial, gastrointestinal and other major bleeding events were 27,627, 17,868, and 12,384 EUR per patient, respectively (2015 prices). Existing evidence shows that the corresponding costs of ischemic stroke were 24,084 EUR per patient (2012 prices). The average costs of bleeding events did not differ between patients with AF who were on oral anticoagulation therapy prior to the event and patients who were not. The societal costs attributable to major bleeding events in patients with AF are significant. Intracranial haemorrhages are most costly to society with average costs of similar magnitude as the costs of ischemic stroke. The average costs of gastrointestinal and other major bleeding events are lower than the costs of intracranial haemorrhages, but still substantial. Knowledge about the relative size of the costs of bleeding events compared to ischemic stroke in patients with AF constitutes valuable evidence for decisions-makers in Denmark as well as in other countries.

Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

PubMed

Rosenberg, Christian; Kroos, Kristin; Rosenberg, Britta; Hosten, Norbert; Flessa, Steffen

2013-08-01

Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.

The impact of hospital market structure on patient volume, average length of stay, and the cost of care.

PubMed

Robinson, J C; Luft, H S

1985-12-01

A variety of recent proposals rely heavily on market forces as a means of controlling hospital cost inflation. Sceptics argue, however, that increased competition might lead to cost-increasing acquisitions of specialized clinical services and other forms of non-price competition as means of attracting physicians and patients. Using data from hospitals in 1972 we analyzed the impact of market structure on average hospital costs, measured in terms of both cost per patient and cost per patient day. Under the retrospective reimbursement system in place at the time, hospitals in more competitive environments exhibited significantly higher costs of production than did those in less competitive environments.

Extreme prices in electricity balancing markets from an approach of statistical physics

NASA Astrophysics Data System (ADS)

Mureddu, Mario; Meyer-Ortmanns, Hildegard

2018-01-01

An increase in energy production from renewable energy sources is viewed as a crucial achievement in most industrialized countries. The higher variability of power production via renewables leads to a rise in ancillary service costs over the power system, in particular costs within the electricity balancing markets, mainly due to an increased number of extreme price spikes. This study analyzes the impact of an increased share of renewable energy sources on the behavior of price and volumes of the Italian balancing market. Starting from configurations of load and power production, which guarantee a stable performance, we implement fluctuations in the load and in renewables; in particular we artificially increase the contribution of renewables as compared to conventional power sources to cover the total load. We then determine the amount of requested energy in the balancing market and its fluctuations, which are induced by production and consumption. Within an approach of agent-based modeling we estimate the resulting energy prices and costs. While their average values turn out to be only slightly affected by an increased contribution from renewables, the probability for extreme price events is shown to increase along with undesired peaks in the costs. Our methodology provides a tool for estimating outliers in prices obtained in the energy balancing market, once data of consumption, production and their typical fluctuations are provided.

Cost minimization analysis of a store-and-forward teledermatology consult system.

PubMed

Pak, Hon S; Datta, Santanu K; Triplett, Crystal A; Lindquist, Jennifer H; Grambow, Steven C; Whited, John D

2009-03-01

The aim of this study was to perform a cost minimization analysis of store-and-forward teledermatology compared to a conventional dermatology referral process (usual care). In a Department of Defense (DoD) setting, subjects were randomized to either a teledermatology consult or usual care. Accrued healthcare utilization recorded over a 4-month period included clinic visits, teledermatology visits, laboratories, preparations, procedures, radiological tests, and medications. Direct medical care costs were estimated by combining utilization data with Medicare reimbursement rates and wholesale drug prices. The indirect cost of productivity loss for seeking treatment was also included in the analysis using an average labor rate. Total and average costs were compared between groups. Teledermatology patients incurred $103,043 in total direct costs ($294 average), while usual-care patients incurred $98,365 ($283 average). However, teledermatology patients only incurred $16,359 ($47 average) in lost productivity cost while usual-care patients incurred $30,768 ($89 average). In total, teledermatology patients incurred $119,402 ($340 average) and usual-care patients incurred $129,133 ($372 average) in costs. From the economic perspective of the DoD, store-and-forward teledermatology was a cost-saving strategy for delivering dermatology care compared to conventional consultation methods when productivity loss cost is taken into consideration.

Health, Wealth and the Price of Oil

PubMed Central

Evans, Robert G.

2016-01-01

The correlation between health and wealth is arguably a very solidly established relationship. Yet that relationship may be reversing. Falling oil prices have raised (average) per capita incomes, worldwide. But from a long-run perspective they are a public health disaster. The latter is easy to see: low oil reduces the incentive to develop alternative energy sources and “bend the curve” of global warming. Their principal impact on incomes has been redistributional – Alberta and Russia lose, Ontario and Germany gain, etc. Zero net gain. But the price has fallen because technical progress in extracting American shale oil has forced the Saudis' hand. These efficiencies have real benefits for (average) incomes, but costs for long-run health. A compensating carbon tax is an obvious response. PMID:27232232

Estimating the environmental and resource costs of leakage in water distribution systems: A shadow price approach.

PubMed

Molinos-Senante, María; Mocholí-Arce, Manuel; Sala-Garrido, Ramon

2016-10-15

Water scarcity is one of the main problems faced by many regions in the XXIst century. In this context, the need to reduce leakages from water distribution systems has gained almost universal acceptance. The concept of sustainable economic level of leakage (SELL) has been proposed to internalize the environmental and resource costs within economic level of leakage calculations. However, because these costs are not set by the market, they have not often been calculated. In this paper, the directional-distance function was used to estimate the shadow price of leakages as a proxy of their environmental and resource costs. This is a pioneering approach to the economic valuation of leakage externalities. An empirical application was carried out for the main Chilean water companies. The estimated results indicated that for 2014, the average shadow price of leakages was approximately 32% of the price of the water delivered. Moreover, as a sensitivity analysis, the shadow prices of the leakages were calculated from the perspective of the water companies' managers and the regulator. The methodology and findings of this study are essential for supporting the decision process of reducing leakage, contributing to the improvement of economic, social and environmental efficiency and sustainability of urban water supplies. Copyright © 2016 Elsevier B.V. All rights reserved.

The High Cost of Prescription Drugs in the United States: Origins and Prospects for Reform.

PubMed

Kesselheim, Aaron S; Avorn, Jerry; Sarpatwari, Ameet

The increasing cost of prescription drugs in the United States has become a source of concern for patients, prescribers, payers, and policy makers. To review the origins and effects of high drug prices in the US market and to consider policy options that could contain the cost of prescription drugs. We reviewed the peer-reviewed medical and health policy literature from January 2005 to July 2016 for articles addressing the sources of drug prices in the United States, the justifications and consequences of high prices, and possible solutions. Per capita prescription drug spending in the United States exceeds that in all other countries, largely driven by brand-name drug prices that have been increasing in recent years at rates far beyond the consumer price index. In 2013, per capita spending on prescription drugs was $858 compared with an average of $400 for 19 other industrialized nations. In the United States, prescription medications now comprise an estimated 17% of overall personal health care services. The most important factor that allows manufacturers to set high drug prices is market exclusivity, protected by monopoly rights awarded upon Food and Drug Administration approval and by patents. The availability of generic drugs after this exclusivity period is the main means of reducing prices in the United States, but access to them may be delayed by numerous business and legal strategies. The primary counterweight against excessive pricing during market exclusivity is the negotiating power of the payer, which is currently constrained by several factors, including the requirement that most government drug payment plans cover nearly all products. Another key contributor to drug spending is physician prescribing choices when comparable alternatives are available at different costs. Although prices are often justified by the high cost of drug development, there is no evidence of an association between research and development costs and prices; rather, prescription drugs are priced in the United States primarily on the basis of what the market will bear. High drug prices are the result of the approach the United States has taken to granting government-protected monopolies to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits. The most realistic short-term strategies to address high prices include enforcing more stringent requirements for the award and extension of exclusivity rights; enhancing competition by ensuring timely generic drug availability; providing greater opportunities for meaningful price negotiation by governmental payers; generating more evidence about comparative cost-effectiveness of therapeutic alternatives; and more effectively educating patients, prescribers, payers, and policy makers about these choices.

Low-Cost Phase Change Material for Building Envelopes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abhari, Ramin

2015-08-06

A low-cost PCM process consisting of conversion of fats and oils to PCM-range paraffins, and subsequent “encapsulation” of the paraffin using conventional plastic compounding/pelletizing equipment was demonstrated. The PCM pellets produced were field-tested in a building envelope application. This involved combining the PCM pellets with cellulose insulation, whereby 33% reduction in peak heat flux and 12% reduction in heat gain was observed (average summertime performance). The selling price of the PCM pellets produced according to this low-cost process is expected to be in the $1.50-$3.00/lb range, compared to current encapsulated PCM price of about $7.00/lb. Whole-building simulations using corresponding PCMmore » thermal analysis data suggest a payback time of 8 to 16 years (at current energy prices) for an attic insulation retrofit project in the Phoenix climate area.« less

Quantifying opportunities for hospital cost control: medical device purchasing and patient discharge planning.

PubMed

Robinson, James C; Brown, Timothy T

2014-09-01

To quantify the potential reduction in hospital costs from adoption of best local practices in supply chain management and discharge planning. We performed multivariate statistical analyses of the association between total variable cost per procedure and medical device price and length of stay, controlling for patient and hospital characteristics. Ten hospitals in 1 major metropolitan area supplied patient-level administrative data on 9778 patients undergoing joint replacement, spine fusion, or cardiac rhythm management (CRM) procedures in 2008 and 2010. The impact on each hospital of matching lowest local market device prices and lowest patient length of stay (LOS) was calculated using multivariate regression analysis controlling for patient demographics, diagnoses, comorbidities, and implications. Average variable costs ranged from $11,315 for joint replacement to $16,087 for CRM and $18,413 for spine fusion. Implantable medical devices accounted for a large share of each procedure's variable costs: 44% for joint replacement, 39% for spine fusion, and 59% for CRM. Device prices and patient length-of-stay exhibited wide variation across hospitals. Total potential hospital cost savings from achieving best local practices in device prices and patient length of stay are 14.5% for joint replacement, 18.8% for spine fusion;,and 29.1% for CRM. Hospitals have opportunities for cost reduction from adoption of best local practices in supply chain management and discharge planning.

Prices for Tobacco and Nontobacco Products in Pharmacies Versus Other Stores: Results From Retail Marketing Surveillance in California and in the United States.

PubMed

Henriksen, Lisa; Schleicher, Nina C; Barker, Dianne C; Liu, Yawen; Chaloupka, Frank J

2016-10-01

To examine disparities in the price of tobacco and nontobacco products in pharmacies compared with other types of stores. We recorded the prices of Marlboro, Newport, the cheapest cigarettes, and bottled water in a random sample of licensed tobacco retailers (n = 579) in California in 2014. We collected comparable data from retailers (n = 2603) in school enrollment zones for representative samples of US 8th, 10th, and 12th graders in 2012. Ordinary least squares regressions modeled pretax prices as a function of store type and neighborhood demographics. In both studies, the cheapest cigarettes cost significantly less in pharmacies than other stores; the average estimated difference was $0.47 to $1.19 less in California. We observed similar patterns for premium-brand cigarettes. Conversely, bottled water cost significantly more in pharmacies than elsewhere. Newport cost less in areas with higher proportions of African Americans; other cigarette prices were related to neighborhood income and age. Neighborhood demographics were not related to water prices. Compared with other stores, pharmacies charged customers less for cigarettes and more for bottled water. State and local policies to promote tobacco-free pharmacies would eliminate an important source of discounted cigarettes.

Prices for Tobacco and Nontobacco Products in Pharmacies Versus Other Stores: Results From Retail Marketing Surveillance in California and in the United States

PubMed Central

Schleicher, Nina C.; Barker, Dianne C.; Liu, Yawen; Chaloupka, Frank J.

2016-01-01

Objectives. To examine disparities in the price of tobacco and nontobacco products in pharmacies compared with other types of stores. Methods. We recorded the prices of Marlboro, Newport, the cheapest cigarettes, and bottled water in a random sample of licensed tobacco retailers (n = 579) in California in 2014. We collected comparable data from retailers (n = 2603) in school enrollment zones for representative samples of US 8th, 10th, and 12th graders in 2012. Ordinary least squares regressions modeled pretax prices as a function of store type and neighborhood demographics. Results. In both studies, the cheapest cigarettes cost significantly less in pharmacies than other stores; the average estimated difference was $0.47 to $1.19 less in California. We observed similar patterns for premium-brand cigarettes. Conversely, bottled water cost significantly more in pharmacies than elsewhere. Newport cost less in areas with higher proportions of African Americans; other cigarette prices were related to neighborhood income and age. Neighborhood demographics were not related to water prices. Conclusions. Compared with other stores, pharmacies charged customers less for cigarettes and more for bottled water. State and local policies to promote tobacco-free pharmacies would eliminate an important source of discounted cigarettes. PMID:27552272

Estimated effect of alcohol pricing policies on health and health economic outcomes in England: an epidemiological model.

PubMed

Purshouse, Robin C; Meier, Petra S; Brennan, Alan; Taylor, Karl B; Rafia, Rachid

2010-04-17

Although pricing policies for alcohol are known to be effective, little is known about how specific interventions affect health-care costs and health-related quality-of-life outcomes for different types of drinkers. We assessed effects of alcohol pricing and promotion policy options in various population subgroups. We built an epidemiological mathematical model to appraise 18 pricing policies, with English data from the Expenditure and Food Survey and the General Household Survey for average and peak alcohol consumption. We used results from econometric analyses (256 own-price and cross-price elasticity estimates) to estimate effects of policies on alcohol consumption. We applied risk functions from systemic reviews and meta-analyses, or derived from attributable fractions, to model the effect of consumption changes on mortality and disease prevalence for 47 illnesses. General price increases were effective for reduction of consumption, health-care costs, and health-related quality of life losses in all population subgroups. Minimum pricing policies can maintain this level of effectiveness for harmful drinkers while reducing effects on consumer spending for moderate drinkers. Total bans of supermarket and off-license discounting are effective but banning only large discounts has little effect. Young adult drinkers aged 18-24 years are especially affected by policies that raise prices in pubs and bars. Minimum pricing policies and discounting restrictions might warrant further consideration because both strategies are estimated to reduce alcohol consumption, and related health harms and costs, with drinker spending increases targeting those who incur most harm. Policy Research Programme, UK Department of Health. Copyright 2010 Elsevier Ltd. All rights reserved.

Financial Burden of Cancer Drug Treatment in Lebanon.

PubMed

Elias, Fadia; Khuri, Fadlo R; Adib, Salim M; Karam, Rita; Harb, Hilda; Awar, May; Zalloua, Pierre; Ammar, Walid

2016-01-01

The Ministry of Public Health (MOPH) in Lebanon provides cancer drugs free of charge for uninsured patients who account for more than half the total caseload. Other categories of cancer care are subsidized under more stringent eligibility criteria. MOPH's large database offers an excellent opportunity to analyze the cost of cancer treatment in Lebanon. Using utilization and spending data accumulated at MOPH during 20082013, the cost to the public budget of cancer drugs was assessed per case and per drug type. The average annual cost of cancer drugs was 6,475$ per patient. Total cancer drug costs were highest for breast cancer, followed by chronic myeloid leukemia (CML), colorectal cancer, lung cancer, and NonHodgkin's lymphoma (NHL), which together represented 74% of total MOPH cancer drug expenditure. The annual average cancer drug cost per case was highest for CML ($31,037), followed by NHL ($11,566). Trastuzumab represented 26% and Imatinib 15% of total MOPH cancer drug expenditure over six years. Sustained increase in cancer drug cost threatens the sustainability of MOPH coverage, so crucial for socially vulnerable citizens. To enhance the bargaining position with pharmaceutical firms for drug cost containment in a small market like Lebanon, drug price comparisons with neighboring countries which have already obtained lower prices may succeed in lowering drug costs.

Enhancing the comparability of costing methods: cross-country variability in the prices of non-traded inputs to health programmes

PubMed Central

Johns, Benjamin; Adam, Taghreed; Evans, David B

2006-01-01

Background National and international policy makers have been increasing their focus on developing strategies to enable poor countries achieve the millennium development goals. This requires information on the costs of different types of health interventions and the resources needed to scale them up, either singly or in combinations. Cost data also guides decisions about the most appropriate mix of interventions in different settings, in view of the increasing, but still limited, resources available to improve health. Many cost and cost-effectiveness studies include only the costs incurred at the point of delivery to beneficiaries, omitting those incurred at other levels of the system such as administration, media, training and overall management. The few studies that have measured them directly suggest that they can sometimes account for a substantial proportion of total costs, so that their omission can result in biased estimates of the resources needed to run a programme or the relative cost-effectiveness of different choices. However, prices of different inputs used in the production of health interventions can vary substantially within a country. Basing cost estimates on a single price observation runs the risk that the results are based on an outlier observation rather than the typical costs of the input. Methods We first explore the determinants of the observed variation in the prices of selected "non-traded" intermediate inputs to health programmes – printed matter and media advertising, and water and electricity – accounting for variation within and across countries. We then use the estimated relationship to impute average prices for countries where limited data are available with uncertainty intervals. Results Prices vary across countries with GDP per capita and a number of determinants of supply and demand. Media and printing were inelastic with respect to GDP per capita, with a positive correlation, while the utilities had a surprisingly negative relationship. All equations had relatively good fits with the data. Conclusion While the preferred option is to derive costs from a random sample of prices in each setting, this option is often not available to analysts. In this case, we suggest that the approach described in this paper could represent a better option than basing policy recommendations on results that are built on the basis of a single, or a few, price observations. PMID:16630364

Enhancing the comparability of costing methods: cross-country variability in the prices of non-traded inputs to health programmes.

PubMed

Johns, Benjamin; Adam, Taghreed; Evans, David B

2006-04-24

National and international policy makers have been increasing their focus on developing strategies to enable poor countries achieve the millennium development goals. This requires information on the costs of different types of health interventions and the resources needed to scale them up, either singly or in combinations. Cost data also guides decisions about the most appropriate mix of interventions in different settings, in view of the increasing, but still limited, resources available to improve health. Many cost and cost-effectiveness studies include only the costs incurred at the point of delivery to beneficiaries, omitting those incurred at other levels of the system such as administration, media, training and overall management. The few studies that have measured them directly suggest that they can sometimes account for a substantial proportion of total costs, so that their omission can result in biased estimates of the resources needed to run a programme or the relative cost-effectiveness of different choices. However, prices of different inputs used in the production of health interventions can vary substantially within a country. Basing cost estimates on a single price observation runs the risk that the results are based on an outlier observation rather than the typical costs of the input. We first explore the determinants of the observed variation in the prices of selected "non-traded" intermediate inputs to health programmes--printed matter and media advertising, and water and electricity--accounting for variation within and across countries. We then use the estimated relationship to impute average prices for countries where limited data are available with uncertainty intervals. Prices vary across countries with GDP per capita and a number of determinants of supply and demand. Media and printing were inelastic with respect to GDP per capita, with a positive correlation, while the utilities had a surprisingly negative relationship. All equations had relatively good fits with the data. While the preferred option is to derive costs from a random sample of prices in each setting, this option is often not available to analysts. In this case, we suggest that the approach described in this paper could represent a better option than basing policy recommendations on results that are built on the basis of a single, or a few, price observations.

Design of a pulse oximeter for price sensitive emerging markets.

PubMed

Jones, Z; Woods, E; Nielson, D; Mahadevan, S V

2010-01-01

While the global market for medical devices is located primarily in developed countries, price sensitive emerging markets comprise an attractive, underserved segment in which products need a unique set of value propositions to be competitive. A pulse oximeter was designed expressly for emerging markets, and a novel feature set was implemented to reduce the cost of ownership and improve the usability of the device. Innovations included the ability of the device to generate its own electricity, a built in sensor which cuts down on operating costs, and a graphical, symbolic user interface. These features yield an average reduction of over 75% in the device cost of ownership versus comparable pulse oximeters already on the market.

Competition in the Dutch hospital sector: an analysis of health care volume and cost.

PubMed

Krabbe-Alkemade, Y J F M; Groot, T L C M; Lindeboom, M

2017-03-01

This paper evaluates the impact of market competition on health care volume and cost. At the start of 2005, the financing system of Dutch hospitals started to be gradually changed from a closed-end budgeting system to a non-regulated price competitive prospective reimbursement system. The gradual implementation of price competition is a 'natural experiment' that provides a unique opportunity to analyze the effects of market competition on hospital behavior. We have access to a unique database, which contains hospital discharge data of diagnosis treatment combinations (DBCs) of individual patients, including detailed care activities. Difference-in-difference estimates show that the implementation of market-based competition leads to relatively lower total costs, production volume and number of activities overall. Difference-in-difference estimates on treatment level show that the average costs for outpatient DBCs decreased due to a decrease in the number of activities per DBC. The introduction of market competition led to an increase of average costs of inpatient DBCs. Since both volume and number of activities have not changed significantly, we conclude that the cost increase is likely the result of more expensive activities. A possible explanation for our finding is that hospitals look for possible efficiency improvements in predominantly outpatient care products that are relatively straightforward, using easily analyzable technologies. The effects of competition on average cost and the relative shares of inpatient and outpatient treatments on specialty level are significant but contrary for cardiology and orthopedics, suggesting that specialties react differently to competitive incentives.

2016 Wind Technologies Market Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiser, Ryan H.; Bolinger, Mark

The U.S. Department of Energy (DOE)’s Wind Technologies Market Report provides an annual overview of trends in the U.S. wind power market. You can find the report, a presentation, and a data file on the Files tab, below. Additionally, several data visualizations are available in the Data Visualizations tab. Highlights of this year’s report include: -Wind power additions continued at a rapid clip in 2016: $13 billion was invested in new wind power plants in 2016. In 2016, wind energy contributed 5.6% of the nation’s electricity supply, more than 10% of total electricity generation in fourteen states, and 29% tomore » 37% in three of those states—Iowa, South Dakota, and Kansas. -Bigger turbines are enhancing wind project performance: Increased blade lengths, in particular, have dramatically increased wind project capacity factors, one measure of project performance. For example, the average 2016 capacity factor among projects built in 2014 and 2015 was 42.6%, compared to an average of 32.1% among projects built from 2004 to 2011 and 25.4% among projects built from 1998 to 2001. -Low wind turbine pricing continues to push down installed project costs: Wind turbine prices have fallen from their highs in 2008, to $800–$1,100/kW. Overall, the average installed cost of wind projects in 2016 was $1,590/kW, down $780/kW from the peak in 2009 and 2010. -Wind energy prices remain low: After topping out at nearly 7¢/kWh for power purchase agreements (PPAs) executed in 2009, the national average price of wind PPAs has dropped to around 2¢/kWh—though this nationwide average is dominated by projects that hail from the lowest-priced Interior region of the country (such as Texas, Iowa, Oklahoma). These prices, which are possible in part due to federal tax support, compare favorably to the projected future fuel costs of gas-fired generation. -The supply chain continued to adjust to swings in domestic demand for wind equipment: Wind sector employment reached a new high of more than 101,000 full-time workers at the end of 2016. For wind projects recently installed in the U.S., domestically manufactured content is highest for nacelle assembly (>90%), towers (65-80%), and blades and hubs (50-70%), but is much lower (<20%) for most components internal to the turbine. -Continued strong growth in wind capacity is anticipated in the near term: With federal tax incentives still available, though declining, various forecasts for the domestic market show expected wind power capacity additions averaging more than 9,000 MW/year from 2017 to 2020.« less

Toward a new spacecraft optimal design lifetime? Impact of marginal cost of durability and reduced launch price

NASA Astrophysics Data System (ADS)

Snelgrove, Kailah B.; Saleh, Joseph Homer

2016-10-01

The average design lifetime of satellites continues to increase, in part due to the expectation that the satellite cost per operational day decreases monotonically with increased design lifetime. In this work, we challenge this expectation by revisiting the durability choice problem for spacecraft in the face of reduced launch price and under various cost of durability models. We first provide a brief overview of the economic thought on durability and highlight its limitations as they pertain to our problem (e.g., the assumption of zero marginal cost of durability). We then investigate the merging influence of spacecraft cost of durability and launch price, and we identify conditions that give rise cost-optimal design lifetimes that are shorter than the longest lifetime technically achievable. For example, we find that high costs of durability favor short design lifetimes, and that under these conditions the optimal choice is relatively robust to reduction in launch prices. By contrast, lower costs of durability favor longer design lifetimes, and the optimal choice is highly sensitive to reduction in launch price. In both cases, reduction in launch prices translates into reduction of the optimal design lifetime. Our results identify a number of situations for which satellite operators would be better served by spacecraft with shorter design lifetimes. Beyond cost issues and repeat purchases, other implications of long design lifetime include the increased risk of technological slowdown given the lower frequency of purchases and technology refresh, and the increased risk for satellite operators that the spacecraft will be technologically obsolete before the end of its life (with the corollary of loss of value and competitive advantage). We conclude with the recommendation that, should pressure to extend spacecraft design lifetime continue, satellite manufacturers should explore opportunities to lease their spacecraft to operators, or to take a stake in the ownership of the asset on orbit.

The Economic Impact of the Introduction of Biosimilars in Inflammatory Bowel Disease.

PubMed

Severs, M; Oldenburg, B; van Bodegraven, A A; Siersema, P D; Mangen, M-J J

2017-03-01

Inflammatory bowel disease [IBD] entails a high economic burden to society. We aimed to estimate the current and future impact of the introduction of biosimilars for infliximab on IBD-related health care costs. We designed a stochastic economic model to simulate the introduction of biosimilars in IBD, using a 5-year time horizon, based on the Dutch situation. Prevalence data on ulcerative colitis [UC] and Crohn's disease [CD] and IBD-related health care costs data were used as input. Assumptions were made on price reductions of anti-tumour necrosis factor [TNF] therapy, increase of anti-TNF prescription rate, and development of hospitalization costs. The base case scenario included a gradual decrease in prices of biosimilars up to 60%, a gradual decrease in prices of original anti-TNF compounds up to 50%, and an annual increase of anti-TNF prescription rate of 1%, and this was compared with no introduction of biosimilars. Sensitivity analyses were performed. For the base case, cost savings over the total of 5 years were on average €9,850 per CD patient and €2,250 per UC patient, yielding in €493 million total cost savings [a reduction of 28%] for The Netherlands. Results were predominantly determined by price reduction of anti-TNF therapy, threshold price reduction at which physicians switch patients towards biosimilars and the extent to which switching will take place. The introduction of biosimilars for infliximab can be expected to have a major impact on the cost profile of IBD. The economic impact will depend on local pricing, procurement policies and the physician's willingness to switch patients to biosimilars. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

77 FR 12847 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

.... The NADAC is a new pricing benchmark that will be based on the national average costs that pharmacies... costs collected directly from pharmacies through a nationwide survey process. This survey will be... NADAC Survey Request for Information has been developed to send to random pharmacies for voluntary...

Modelled female sale options demonstrate improved profitability in northern beef herds.

PubMed

Niethe, G E; Holmes, W E

2008-12-01

To examine the impact of improving the average value of cows sold, the risk of decreasing the number weaned, and total sales on the profitability of northern Australian cattle breeding properties. Gather, model and interpret breeder herd performances and production parameters on properties from six beef-producing regions in northern Australia. Production parameters, prices, costs and herd structure were entered into a herd simulation model for six northern Australian breeding properties that spay females to enhance their marketing options. After the data were validated by management, alternative management strategies were modelled using current market prices and most likely herd outcomes. The model predicted a close relationship between the average sale value of cows, the total herd sales and the gross margin/adult equivalent. Keeping breeders out of the herd to fatten generally improves their sale value, and this can be cost-effective, despite the lower number of progeny produced and the subsequent reduction in total herd sales. Furthermore, if the price of culled cows exceeds the price of culled heifers, provided there are sufficient replacement pregnant heifers available to maintain the breeder herd nucleus, substantial gains in profitability can be obtained by decreasing the age at which cows are culled from the herd. Generalised recommendations on improving reproductive performance are not necessarily the most cost-effective strategy to improve breeder herd profitability. Judicious use of simulation models is essential to help develop the best turnoff strategies for females and to improve station profitability.

Markets to Facilitate Wind and Solar Energy Integration in the Bulk Power Supply: An IEA Task 25 Collaboration; Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Milligan, M.; Holttinen, H.; Soder, L.

2012-09-01

Wind and solar power will give rise to challenges in electricity markets regarding flexibility, capacity adequacy, and the participation of wind and solar generators to markets. Large amounts of wind power will have impacts on bulk power system markets and electricity prices. If the markets respond to increased wind power by increasing investments in low-capital, high-cost or marginal-cost power, the average price may remain in the same range. However, experiences so far from Denmark, Germany, Spain, and Ireland are such that the average market prices have decreased because of wind power. This reduction may result in additional revenue insufficiency, whichmore » may be corrected with a capacity market, yet capacity markets are difficult to design. However, the flexibility attributes of the capacity also need to be considered. Markets facilitating wind and solar integration will include possibilities for trading close to delivery (either by shorter gate closure times or intraday markets). Time steps chosen for markets can enable more flexibility to be assessed. Experience from 5- and 10-minute markets has been encouraging.« less

The shadow price of CO2 emissions in China's iron and steel industry.

PubMed

Wang, Ke; Che, Linan; Ma, Chunbo; Wei, Yi-Ming

2017-11-15

As China becomes the world's largest energy consumer and CO 2 emitter, there has been a rapidly emerging literature on estimating China's abatement cost for CO 2 using a distance function approach. However, the existing studies have mostly focused on the cost estimates at macro levels (provinces or industries) with few examining firm-level abatement costs. No work has attempted to estimate the abatement cost of CO 2 emissions in the iron and steel industry. Although some have argued that the directional distance function (DDF) is more appropriate in the presence of bad output under regulation, the choice of directions is largely arbitrary. This study provides the most up-to-date estimate of the shadow price of CO 2 using a unique dataset of China's major iron and steel enterprises in 2014. The paper uses output quadratic DDF and investigates the impact of using different directional vectors representing different carbon mitigation strategies. The results show that the mean CO 2 shadow price of China's iron and steel enterprises is very sensitive to the choice of direction vectors. The average shadow prices of CO 2 are 407, 1226 and 6058Yuan/tonne respectively for the three different direction vectors. We also find substantial heterogeneity in the shadow prices of CO 2 emissions among China's major iron and steel enterprises. Larger, listed enterprises are found to be associated lower CO 2 shadow prices than smaller, unlisted enterprises. Copyright © 2017 Elsevier B.V. All rights reserved.

Health, Wealth and the Price of Oil.

PubMed

Evans, Robert G

2016-05-01

The correlation between health and wealth is arguably a very solidly established relationship. Yet that relationship may be reversing. Falling oil prices have raised (average) per capita incomes, worldwide. But from a long-run perspective they are a public health disaster. The latter is easy to see: low oil reduces the incentive to develop alternative energy sources and "bend the curve" of global warming. Their principal impact on incomes has been redistributional - Alberta and Russia lose, Ontario and Germany gain, etc. Zero net gain. But the price has fallen because technical progress in extracting American shale oil has forced the Saudis' hand. These efficiencies have real benefits for (average) incomes, but costs for long-run health. A compensating carbon tax is an obvious response. Copyright © 2016 Longwoods Publishing.

Relation between diet cost and Healthy Eating Index 2010 scores among adults in the United States 2007-2010

PubMed Central

Rehm, Colin D.; Monsivais, Pablo; Drewnowski, Adam

2016-01-01

Background Food prices may be one reason for the growing socioeconomic disparities in diet quality. Objective To evaluate the association between diet costs and the Healthy Eating Index-2010 (HEI-2010). Methods Cross-sectional study based on 11,181 adults from the 2007-2010 National Health and Nutrition Examination Survey, analyzed in spring 2014. Diet cost was estimated by linking dietary data with a national food price database. The HEI-2010, a measure of adherence to the Dietary Guidelines, was the outcome. The population ratio method was used to estimate the average HEI-2010 scores by quintile of energy-adjusted diet cost. Additional analyses evaluated the association between cost and HEI-2010 components. Results There was a strong positive association between lower energy-adjusted diet costs and lower HEI-2010 scores. The association was stronger among women (p-interaction=0.003). Lower diet costs were associated with lower consumption of vegetables, fruit, whole grains, and seafood, and higher consumption of refined grains and solid fat, alcohol and added sugars. Conclusions Lower energy-adjusted diet costs were associated with lower-quality diets. Future efforts to improve the nutritional status of the US public should take food prices and diet costs into account. PMID:25625693

Relation between diet cost and Healthy Eating Index 2010 scores among adults in the United States 2007-2010.

PubMed

Rehm, Colin D; Monsivais, Pablo; Drewnowski, Adam

2015-04-01

Food prices may be one reason for the growing socioeconomic disparities in diet quality. To evaluate the association between diet costs and the Healthy Eating Index-2010 (HEI-2010). Cross-sectional study based on 11,181 adults from the 2007-2010 National Health and Nutrition Examination Survey, analyzed in spring 2014. Diet cost was estimated by linking dietary data with a national food price database. The HEI-2010, a measure of adherence to the dietary guidelines, was the outcome. The population ratio method was used to estimate the average HEI-2010 scores by quintile of energy-adjusted diet cost. Additional analyses evaluated the association between cost and HEI-2010 components. There was a strong positive association between lower energy-adjusted diet costs and lower HEI-2010 scores. The association was stronger among women (p-interaction=0.003). Lower diet costs were associated with lower consumption of vegetables, fruits, whole grains, and seafood, and higher consumption of refined grains and solid fat, alcohol and added sugars. Lower energy-adjusted diet costs were associated with lower-quality diets. Future efforts to improve the nutritional status of the US public should take food prices and diet costs into account. Copyright © 2015. Published by Elsevier Inc.

Costs of current antihypertensive therapy in Switzerland: an economic evaluation of 3,489 patients in primary care.

PubMed

Schäfer, Hans Hendrik; Scheunert, Uta

2013-10-25

Due to greater life expectancy, costs of medication have increased within the last decade. This investigation assesses health care expenditures needed to manage the current state of blood pressure (BP) control in Switzerland. a) average day therapy costs (DTC) of substances, b) actual DTC of currently prescribed antihypertensive therapy, c) monetary differences of treatment regimens within different BP-groups and different high risk patients, d) estimated compliance-related financial loss/annum and adjusted costs/annum. Single-pill-combinations appear to be useful to increase patient's compliance, to reduce side effects and to bring more patients to their blood pressure goal. Costs were identified based on data from the Swiss department of health. We calculated DTC for each patient using prices of the largest available tablet box. The average antihypertensive therapy in Switzerland currently costs CHF 1.198 ± 0.732 per day. On average beta blockers were the cheapest substances, followed by angiotensin converting enzyme inhibitors (ARBs), calcium channel blockers and diuretics. The widest price ranges were observed within the class of ARBs. Most expensive were patients with impaired renal function. Throughout all stages, single-pill-combinations appeared to be significantly cheaper than dual-free-combinations. Stage-II-hypertension yielded the highest costs for dual free combination drug use. The actual costs for all patients observed in this analysis added up to CHF 1,525,962. Based on a compliance model, only treatment amounting to CHF 921,353 is expected to be actually taken. A disproportionately high healthcare cost is expected due to compliance reasons. The prescription of mono-therapies appears to be a major cost factor, thus, the use of single-pill-combination therapy can be considered as a suitable approach to saving costs throughout all BP- stages.

Solid oxide fuel cell systems for residential micro-combined heat and power in the UK: Key economic drivers

NASA Astrophysics Data System (ADS)

Hawkes, Adam; Leach, Matthew

The ability of combined heat and power (CHP) to meet residential heat and power demands efficiently offers potentially significant financial and environmental advantages over centralised power generation and heat-provision through natural-gas fired boilers. A solid oxide fuel cell (SOFC) can operate at high overall efficiencies (heat and power) of 80-90%, offering an improvement over centralised generation, which is often unable to utilise waste heat. This paper applies an equivalent annual cost (EAC) minimisation model to a residential solid oxide fuel cell CHP system to determine what the driving factors are behind investment in this technology. We explore the performance of a hypothetical SOFC system—representing expectations of near to medium term technology development—under present UK market conditions. We find that households with small to average energy demands do not benefit from installation of a SOFC micro-CHP system, but larger energy demands do benefit under these conditions. However, this result is sensitive to a number of factors including stack capital cost, energy import and export prices, and plant lifetime. The results for small and average dwellings are shown to reverse under an observed change in energy import prices, an increase in electricity export price, a decrease in stack capital costs, or an improvement in stack lifetime.

Decomposing variation in dairy profitability: the impact of output, inputs, prices, labour and management.

PubMed

Wilson, P

2011-08-01

The UK dairy sector has undergone considerable structural change in recent years, with a decrease in the number of producers accompanied by an increased average herd size and increased concentrate use and milk yields. One of the key drivers to producers remaining in the industry is the profitability of their herds. The current paper adopts a holistic approach to decomposing the variation in dairy profitability through an analysis of net margin data explained by physical input-output measures, milk price variation, labour utilization and managerial behaviours and characteristics. Data are drawn from the Farm Business Survey (FBS) for England in 2007/08 for 228 dairy enterprises. Average yields are 7100 litres/cow/yr, from a herd size of 110 cows that use 0·56 forage ha/cow/yr and 43·2 labour h/cow/yr. An average milk price of 22·57 pence per litre (ppl) produced milk output of £1602/cow/yr, which after accounting for calf sales, herd replacements and quota leasing costs, gave an average dairy output of £1516/cow/yr. After total costs of £1464/cow/yr this left an economic return of £52/cow/yr (0·73 ppl) net margin profit. There is wide variation in performance, with the most profitable (as measured by net margin per cow) quartile of producers achieving 2000 litres/cow/yr more than the least profitable quartile, returning a net margin of £335/cow/yr compared to a loss of £361/cow/yr for the least profitable. The most profitable producers operate larger, higher yielding herds and achieve a greater milk price for their output. In addition, a significantly greater number of the most profitable producers undertake financial benchmarking within their businesses and operate specialist dairy farms. When examining the full data set, the most profitable enterprises included significantly greater numbers of organic producers. The most profitable tend to have a greater reliance on independent technical advice, but this finding is not statistically significant. Decomposing the variation in net margin performance between the most and least profitable groups, an approximate ratio of 65:23:12 is observed for higher yields: lower costs: higher milk price. This result indicates that yield differentials are the key performance driver in dairy profitability. Lower costs per cow are dominated by the significantly lower cost of farmer and spouse labour per cow of the most profitable group, flowing directly from the upper quartile expending 37·7 labour h/cow/yr in comparison with 58·8 h/cow/yr for the lower quartile. The upper quartile's greater milk price is argued to be achieved through contract negotiations and higher milk quality, and this accounts for 0·12 of the variation in net margin performance. The average economic return to the sample of dairy enterprises in this survey year was less than £6000/farm/yr. However, the most profitable quartile returned an average economic return of approximately £50 000 per farm/yr. Structural change in the UK dairy sector is likely to continue with the least profitable and typically smaller dairy enterprises being replaced by a smaller number of expanding dairy production units.

Decomposing variation in dairy profitability: the impact of output, inputs, prices, labour and management

PubMed Central

WILSON, P.

2011-01-01

SUMMARY The UK dairy sector has undergone considerable structural change in recent years, with a decrease in the number of producers accompanied by an increased average herd size and increased concentrate use and milk yields. One of the key drivers to producers remaining in the industry is the profitability of their herds. The current paper adopts a holistic approach to decomposing the variation in dairy profitability through an analysis of net margin data explained by physical input–output measures, milk price variation, labour utilization and managerial behaviours and characteristics. Data are drawn from the Farm Business Survey (FBS) for England in 2007/08 for 228 dairy enterprises. Average yields are 7100 litres/cow/yr, from a herd size of 110 cows that use 0·56 forage ha/cow/yr and 43·2 labour h/cow/yr. An average milk price of 22·57 pence per litre (ppl) produced milk output of £1602/cow/yr, which after accounting for calf sales, herd replacements and quota leasing costs, gave an average dairy output of £1516/cow/yr. After total costs of £1464/cow/yr this left an economic return of £52/cow/yr (0·73 ppl) net margin profit. There is wide variation in performance, with the most profitable (as measured by net margin per cow) quartile of producers achieving 2000 litres/cow/yr more than the least profitable quartile, returning a net margin of £335/cow/yr compared to a loss of £361/cow/yr for the least profitable. The most profitable producers operate larger, higher yielding herds and achieve a greater milk price for their output. In addition, a significantly greater number of the most profitable producers undertake financial benchmarking within their businesses and operate specialist dairy farms. When examining the full data set, the most profitable enterprises included significantly greater numbers of organic producers. The most profitable tend to have a greater reliance on independent technical advice, but this finding is not statistically significant. Decomposing the variation in net margin performance between the most and least profitable groups, an approximate ratio of 65:23:12 is observed for higher yields: lower costs: higher milk price. This result indicates that yield differentials are the key performance driver in dairy profitability. Lower costs per cow are dominated by the significantly lower cost of farmer and spouse labour per cow of the most profitable group, flowing directly from the upper quartile expending 37·7 labour h/cow/yr in comparison with 58·8 h/cow/yr for the lower quartile. The upper quartile's greater milk price is argued to be achieved through contract negotiations and higher milk quality, and this accounts for 0·12 of the variation in net margin performance. The average economic return to the sample of dairy enterprises in this survey year was less than £6000/farm/yr. However, the most profitable quartile returned an average economic return of approximately £50 000 per farm/yr. Structural change in the UK dairy sector is likely to continue with the least profitable and typically smaller dairy enterprises being replaced by a smaller number of expanding dairy production units. PMID:22505774

Three essays on pricing and risk management in electricity markets

NASA Astrophysics Data System (ADS)

Kotsan, Serhiy

2005-07-01

A set of three papers forms this dissertation. In the first paper I analyze an electricity market that does not clear. The system operator satisfies fixed demand at a fixed price, and attempts to minimize "cost" as indicated by independent generators' supply bids. No equilibrium exists in this situation, and the operator lacks information sufficient to minimize actual cost. As a remedy, we propose a simple efficient tax mechanism. With the tax, Nash equilibrium bids still diverge from marginal cost but nonetheless provide sufficient information to minimize actual cost, regardless of the tax rate or number of generators. The second paper examines a price mechanism with one price assigned for each level of bundled real and reactive power. Equilibrium allocation under this pricing approach raises system efficiency via better allocation of the reactive power reserves, neglected in the traditional pricing approach. Pricing reactive power should be considered in the bundle with real power since its cost is highly dependent on real power output. The efficiency of pricing approach is shown in the general case, and tested on the 30-bus IEEE network with piecewise linear cost functions of the generators. Finally the third paper addresses the problem of optimal investment in generation based on mean-variance portfolio analysis. It is assumed the investor can freely create a portfolio of shares in generation located on buses of the electrical network. Investors are risk averse, and seek to minimize the variance of the weighted average Locational Marginal Price (LMP) in their portfolio, and to maximize its expected value. I conduct simulations using a standard IEEE 68-bus network that resembles the New York - New England system and calculate LMPs in accordance with the PJM methodology for a fully optimal AC power flow solution. Results indicate that the network topology is a crucial determinant of the investment decision as line congestion makes it difficult to deliver power to certain nodes at system peak load. Determining those nodes is an important task for an investor in generation as well as the transmission system operator.

The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization.

PubMed

Romley, John A; Axeen, Sarah; Lakdawalla, Darius N; Chernew, Michael E; Bhattacharya, Jay; Goldman, Dana P

2015-06-01

To explore the relationship between commercial health care prices and Medicare spending/utilization across U.S. regions. Claims from large employers and Medicare Parts A/B/D over 2007-2009. We compared prices paid by commercial health plans to Medicare spending and utilization, adjusted for beneficiary health and the cost of care, across 301 hospital referral regions. A 10 percent lower commercial price (around the average level) is associated with 3.0 percent higher Medicare spending per member per year, and 4.3 percent more specialist visits (p < .01). Commercial health care prices are negatively associated with Medicare spending across regions. Providers may respond to low commercial prices by shifting service volume into Medicare. Further investigation is needed to establish causality. © Health Research and Educational Trust.

Estimating the cost of improving service quality in water supply: A shadow price approach for England and wales.

PubMed

Molinos-Senante, María; Maziotis, Alexandros; Sala-Garrido, Ramón

2016-01-01

Service quality to customers is an aspect that cannot be ignored in the performance assessment of water companies. Nowadays water regulators introduce awards or penalties to incentivize companies to improve service quality to customers when setting prices. In this study, the directional distance function is employed to estimate the shadow prices of variables indicating the lack of service quality to customers in the water industry i.e., written complaints, unplanned interruptions and properties below the reference level. To calculate the shadow price of each undesirable output for each water company, it is needed to ascribe a reference price for the desirable output which is the volume of water delivered. An empirical application is carried out for water companies in England and Wales. Hence, the shadow price of each undesirable output is expressed both as a percentage of the price of the desirable output and in pence per cubic meter of water delivered The estimated results indicate that on average, each additional written complaint that needs to be dealt with by the water company includes a service quality cost of 0.399p/m(3). As expected, when looking at the other service quality variables which involve network repair or replacement, these values are considerably higher. On average, the water company must spend an extra 0.622p/m(3) to prevent one unplanned interruption and 0.702p/m(3) to avoid one water pressure below the reference level. The findings of this study are of great importance for regulated companies and regulators as it has been illustrated that improvements in the service quality in terms of customer service could be challenging and therefore ongoing investments will be required to address these issues. Copyright © 2015 Elsevier B.V. All rights reserved.

Association of Reference Pricing for Diagnostic Laboratory Testing With Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests.

PubMed

Robinson, James C; Whaley, Christopher; Brown, Timothy T

2016-09-01

Prices for laboratory and other clinical services vary widely. Employers and insurers increasingly are adopting "reference pricing" policies to create incentives for patients to select lower-priced facilities. To measure the association between implementation of reference pricing and patient choice of laboratory, test prices, patient out-of-pocket spending, and insurer spending. We conducted an observational study of changes in laboratory pricing and selection by employees of a large national grocery firm (n = 30 415) before and after the firm implemented a reference pricing policy for laboratory services and compared the findings with changes over the same period for policy holders of a large national insurer that did not implement reference pricing (n = 181 831). The grocery firm established a maximum payment limit at the 60th percentile of the distribution of prices for each laboratory test in each region. Employees were provided with data on prices at all laboratories through a mobile digital platform. Patients selecting a laboratory that charged more than the payment limit were required to pay the full difference themselves. A total of 2.13 million claims were analyzed for 285 types of in vitro diagnostic tests between 2010 and 2013. Patient choice of laboratory, price paid per test, patient out-of-pocket costs, and employer spending. Compared with trends in prices paid by insurance policy holders not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 31.9% reduction (95% CI, 20.6%-41.6%) in average price paid per test by the third year of the program. In these 3 years, total spending on laboratory tests declined by $2.57 million (95% CI, $1.59-$3.35 million). Out-of-pocket costs by patients declined by $1.05 million (95% CI, $0.73-$1.37 million). Spending by the employer declined by $1.70 million (95% CI, $0.92-$2.48 million). When combined with access to price information, reference pricing was associated with patient choice of lower-cost laboratories and reductions in prices and payments by both employer and employees.

The price of alcohol: a consideration of contextual factors.

PubMed

Treno, Andrew J; Gruenewald, Paul J; Wood, Darryl S; Ponicki, William R

2006-10-01

The current study considers the determinants of prices charged for alcoholic beverages by on-premise and off-premise outlets in Alaska. Alcohol outlet densities, a surrogate measure for local retail competition, are expected to be negatively associated with prices while costs associated with distribution are expected to be positively related to prices. Community demographic and economic characteristics may affect observed local prices via the level of demand, retail costs borne by retailers, or the quality of brands offered for sale. The core data for these analyses came from a telephone survey of Alaskan retail establishments licensed to serve alcohol. This survey utilized computer-assisted telephone interviewing (CATI) techniques to collect alcohol-pricing information from on-premise (i.e., establishments where alcohol is consumed at the point of purchase such as bars and restaurants) and off-premise (i.e., establishments such as grocery stores and convenience markets where consumption occurs in other locations) alcohol retailers throughout the state of Alaska. Price estimates were developed for each beverage-type based on alcohol content. Separate regression analyses were used to model each of the 8 price indices (on-premise and off-premise measures for beer, spirits, wine, and the average price across beverage types). All regressions also controlled for a set of zip-code level indicators of community economic and demographic characteristics based on census data. Outlet density per roadway mile was unrelated to price for both on- and off-premise establishments, either across or between beverage types. In contrast, overall distribution costs did appear to be related to alcohol price. The demographic and economic variables, as a group, were significantly related to observed prices. More attention needs to be directed to the manner in which sellers and buyers behave relative to alcoholic beverages. Alcohol demand remains responsive to prices; yet, consumers have considerable latitude in determining the price that they pay for alcohol.

Who Pays for Blended Learning? A Cost-Benefit Analysis

ERIC Educational Resources Information Center

Taplin, Ross H.; Kerr, Rosemary; Brown, Alistair M.

2013-01-01

Using cost-benefit analysis, the purpose of this study is to analyse the monetary value students place on having access, via the internet, to recorded lectures in a blended learning context. The principal results are that the average price students are willing to pay to download iLectures is approximately $30 per equivalent full time student.…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Horowitz, Kelsey A. W.; Fu, Ran; Woodhouse, Michael

This article examines current cost drivers and potential avenues to reduced cost for monolithic, glass-glass Cu(In,Ga)(Se,S)2 (CIGS) modules by constructing a comprehensive bottom-up cost model. For a reference case where sputtering plus batch sulfurization after selenization (SAS) is employed, we compute a manufacturing cost of $69/m2 if the modules are made in the United States at a 1 GW/year production volume. At 14% module efficiency, this corresponds to a manufacturing cost of $0.49/WDC and a minimum sustainable price (MSP) of $0.67/WDC. We estimate that MSP could vary within +/-20% of this value given the range of quoted input prices, andmore » existing variations in module design, manufacturing processes, and manufacturing location. Potential for reduction in manufacturing costs to below $0.40/WDC may be possible if average production module efficiencies can be increased above 17% without increasing $/m2 costs; even lower costs could be achieved if $/m2 costs could be reduced, particularly via innovations in the CIGS deposition process or balance-of-module elements. We present the impact on cost of regional factors, CIGS deposition method, device design, and price fluctuations. One metric of competitiveness-levelized cost of energy (LCOE) -- is also assessed for several U.S. locations and compared to that of standard multi-crystalline silicon (m(c-Si)) and cadmium telluride (CdTe).« less

The Reviewers Reviewed.

ERIC Educational Resources Information Center

LaBorie, Tim; Halperin, Michael

1983-01-01

Reports results of comparison of seven journals which review popular music recordings, including number of reviews, length of reviews, favorable versus unfavorable reviews, reading score, journal subscription price and average review cost, and music styles covered. Ten references are cited. (EJS)

The costs and benefits of library site licenses to academic journals

PubMed Central

Bergstrom, Carl T.; Bergstrom, Theodore C.

2004-01-01

Scientific publishing is rapidly shifting from a paper-based system to one of predominantly electronic distribution, in which universities purchase site licenses for online access to journal contents. Will these changes necessarily benefit the scientific community? By using basic microeconomics and elementary statistical theory, we address this question and find a surprising answer. If a journal is priced to maximize the publisher's profits, scholars on average are likely to be worse off when universities purchase site licenses than they would be if access were by individual subscriptions only. However, site licenses are not always disadvantageous. Journals issued by professional societies and university presses are often priced so as to maximize subscriptions while recovering average costs. When such journals are sustained by institutional site licenses, the net benefits to the scientific community are larger than if these journals are sold only by individual subscriptions. PMID:14715902

The costs and benefits of library site licenses to academic journals.

PubMed

Bergstrom, Carl T; Bergstrom, Theodore C

2004-01-20

Scientific publishing is rapidly shifting from a paper-based system to one of predominantly electronic distribution, in which universities purchase site licenses for online access to journal contents. Will these changes necessarily benefit the scientific community? By using basic microeconomics and elementary statistical theory, we address this question and find a surprising answer. If a journal is priced to maximize the publisher's profits, scholars on average are likely to be worse off when universities purchase site licenses than they would be if access were by individual subscriptions only. However, site licenses are not always disadvantageous. Journals issued by professional societies and university presses are often priced so as to maximize subscriptions while recovering average costs. When such journals are sustained by institutional site licenses, the net benefits to the scientific community are larger than if these journals are sold only by individual subscriptions.

Insurers’ Negotiating Leverage and the External Effects of Medicare Part D*

PubMed Central

Lakdawalla, Darius; Yin, Wesley

2014-01-01

By influencing the size and bargaining power of private insurers, public subsidization of private health insurance may project effects beyond the subsidized population. We test for such spillovers by analyzing how increases in insurer size resulting from the implementation of Medicare Part D affected drug prices negotiated in the non-Medicare commercial market. On average, Part D lowered prices for commercial enrollees by 3.7%. The external commercial market savings amount to $1.5 billion per year, which, if passed to consumers, approximates the internal cost-savings of newly-insured subsidized beneficiaries. If retained by insurers, it corresponds to a 5% average increase in profitability. PMID:25937676

Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data.

PubMed

Chen, Guo-Feng; Wei, Lai; Chen, Jing; Duan, Zhong-Ping; Dou, Xiao-Guang; Xie, Qing; Zhang, Wen-Hong; Lu, Lun-Gen; Fan, Jian-Gao; Cheng, Jun; Wang, Gui-Qiang; Ren, Hong; Wang, Jiu-Ping; Yang, Xing-Xiang; Jia, Zhan-Sheng; Fu, Qing-Chun; Wang, Xiao-Jin; Shang, Jia; Zhang, Yue-Xin; Han, Ying; Du, Ning; Shao, Qing; Ji, Dong; Li, Fan; Li, Bing; Liu, Jia-Liang; Niu, Xiao-Xia; Wang, Cheng; Wu, Vanessa; Wong, April; Wang, Yu-Dong; Hou, Jin-Lin; Jia, Ji-Dong; Zhuang, Hui; Lau, George

2016-01-01

Little is known on the cost-effectiveness of novel regimens for hepatitis C virus (HCV) compared with standard-of-care with pegylated interferon (pegIFN) and ribavirin (RBV) therapy in developing countries. We evaluated cost-effectiveness of sofosbuvir/ledipasvir for 12 weeks compared with a 48-week pegIFN-RBV regimen in Chinese patients with genotype 1b HCV infection by economic regions. A decision analytic Markov model was developed to estimate quality-adjusted-life-years, lifetime cost of HCV infection and incremental cost-effectiveness ratios (ICERs). SVR rates and direct medical costs were obtained from real-world data. Parameter uncertainty was assessed by one-way and probabilistic sensitivity analyses. Threshold analysis was conducted to estimate the price which can make the regimen cost-effective and affordable. Sofosbuvir/ledipasvir was cost-effective in treatment-experienced patients with an ICER of US$21,612. It varied by economic regions. The probability of cost-effectiveness was 18% and 47% for treatment-naive and experienced patients, and it ranged from 15% in treatment-naïve patients in Central-China to 64% in treatment-experienced patients in Eastern-China. The price of 12-week sofosbuvir/ledipasvir treatment needs to be reduced by at least 81% to US$18,185 to make the regimen cost-effective in all patients at WTP of one time GDP per capita. The price has to be US$105 to make the regimen affordable in average patients in China. Sofosbuvir/ledipasvir regimen is not cost-effective in most Chinese patients with genotype 1b HCV infection. The results vary by economic regions. Drug price of sofosbuvir/ledipasvir needs to be substantially reduced when entering the market in China to ensure the widest accessibility.

The Impact of a City-Level Minimum-Wage Policy on Supermarket Food Prices in Seattle-King County.

PubMed

Otten, Jennifer J; Buszkiewicz, James; Tang, Wesley; Aggarwal, Anju; Long, Mark; Vigdor, Jacob; Drewnowski, Adam

2017-09-09

Background : Many states and localities throughout the U.S. have adopted higher minimum wages. Higher labor costs among low-wage food system workers could result in higher food prices. Methods : Using a market basket of 106 foods, food prices were collected at affected chain supermarket stores in Seattle and same-chain unaffected stores in King County (n = 12 total, six per location). Prices were collected at 1 month pre- (March 2015) and 1-month post-policy enactment (May 2015), then again 1-year post-policy enactment (May 2016). Unpaired t-tests were used to detect price differences by location at fixed time while paired t-tests were used to detect price difference across time with fixed store chain. A multi-level, linear differences-in-differences model, was used to detect the changes in the average market basket item food prices over time across regions, overall and by food group. Results : There were no significant differences in overall market basket or item-level costs at one-month (-$0.01, SE = 0.05, p = 0.884) or one-year post-policy enactment (-$0.02, SE = 0.08, p = 0.772). No significant increases were observed by food group. Conclusions : There is no evidence of change in supermarket food prices by market basket or increase in prices by food group in response to the implementation of Seattle's minimum wage ordinance.

HMG versus rFSH for ovulation induction in developing countries: a cost-effectiveness analysis based on the results of a recent meta-analysis.

PubMed

Al-Inany, Hesham G; Abou-Setta, Ahmed M; Aboulghar, Mohamed A; Mansour, Ragaa T; Serour, Gamal I

2006-02-01

Both cost and effectiveness should be considered conjointly to aid judgments about drug choice. Therefore, based on the results of a recent published meta-analysis, a Markov model was developed to conduct a cost-effectiveness analysis for estimation of the cost of an ongoing pregnancy in IVF/intracytoplasmic sperm injection (ICSI) cycles. In addition, Monte Carlo micro-simulation was used to examine the potential impact of assumptions and other uncertainties represented in the model. The results of the study reveal that the estimated average cost of an ongoing pregnancy is 13,946 Egyptian pounds (EGP), and 18,721 EGP for a human menopausal gonadotrophin (HMG) and rFSH cycle respectively. On performing a sensitivity analysis on cycle costs, it was demonstrated that the rFSH price should be 0.61 EGP/IU to be as cost-effective as HMG at the price of 0.64 EGP/IU (i.e. around 60% reduction in its current price). The difference in cost between HMG and rFSH in over 100,000 cycles would result in an additional 4565 ongoing pregnancies if HMG was used. Therefore, HMG was clearly more cost-effective than rFSH. The decision to adopt a more expensive, cost-ineffective treatment could result in a lower number of cycles of IVF/ICSI treatment undertaken, especially in the case of most developing countries.

Cost structure and profitability of Assaf dairy sheep farms in Spain.

PubMed

Milán, M J; Frendi, F; González-González, R; Caja, G

2014-01-01

Twenty dairy sheep farms of Assaf breed, located in the Spanish autonomous community of Castilla y León and included in a group receiving technical support, were used to study their production cost structure and to assess their economic profitability during 2009. On average, farms had 89.2±38.0 ha (own, 38%), 592±63 ewes, yielded 185.9±21.1×10(3) L/yr (i.e., 316±15 L/ewe), and were attended by 2.3±0.2 annual working units (family, 72%). Total annual income was €194.4±23.0×10(3)/yr (€1.0=$1.3) from milk (78.6%), lamb (13.2%), culled ewes (0.5%), and other sales (0.8%, wool and manure), and completed with the European Union sheep subsidy (6.9%). Total costs were €185.9±19.0×10(3)/yr to attend to feeding (61.6%), labor (18.2%), equipment maintenance and depreciation (7.6%), finances (3.0%), animal health (2.5%), energy, water and milking supplies (2.2%), milk recording (0.5%), and other costs (4.4%; assurances, shearing, association fees, and so on). Mean dairy sheep farm profit was €8.5±5.8×10(3)/yr (€7.4±8.3/ewe) on average, and varied between -€40.6 and €81.1/ewe among farms. Only 60% of farms were able to pay all costs, the rest had negative balances. Nevertheless, net margin was €31.0±6.5×10(3)/yr on average, varying between €0.6 and €108.4×10(3)/yr among farms. In this case, without including the opportunity costs, all farms had positive balances. Total annual cost (TAC; €/ewe) and total annual income (TAI; €/ewe) depended on milk yield (MY; L/ewe) and were TAC=161.6 + 0.502 MY (R(2)=0.50), and TAI=78.13 + 0.790 MY (R(2)=0.88), respectively, with the break-even point being 291 L/ewe. Conversely, farm TAC (€/yr) and farm TAI (€/yr) were also predicted as a function of the number of ewes (NOE) per flock, as TAC=18,401 + 282.8 NOE (R(2)=0.89) and TAI=330.9 NOE (R(2)=0.98), with the break-even point being 383 ewes/flock. Finally, according to the increasing trend expected for agricultural commodity prices, it was calculated that a 10% increase of concentrate price will require 5.2% milk price increase for constant profit. Similarly, a 10% increase of forage price will require 2.0% milk price increase to maintain profitability. Under these scenarios of increasing the commodity prices of key feedstuffs, a change of flock feeding should be expected to compensate the losses in farm profitability. Most Assaf dairy sheep farms studied were economically profitable, with flock size, milk yield, and feeding costs key for their profitability. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Social Security cost-of-living adjustments and the Consumer Price Index.

PubMed

Burdick, Clark; Fisher, Lynn

2007-01-01

OASDI benefits are indexed for inflation to protect beneficiaries from the loss of purchasing power implied by inflation. In the absence of such indexing, the purchasing power of Social Security benefits would be eroded as rising prices raise the cost of living. By statute, cost-of-living adjustments (COLAs) for Social Security benefits are calculated using the Bureau of Labor Statistics (BLS) Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). Some argue that this index does not accurately reflect the inflation experienced by the elderly population and should be changed to an elderly-specific price index such as the Experimental Consumer Price Index for Americans 62 Years of Age and Older, often referred to as the Consumer Price Index for the Elderly (CPI-E). Others argue that the measure of inflation underlying the COLA is technically biased, causing it to overestimate changes in the cost of living. This argument implies that current COLAs tend to increase, rather than merely maintain, the purchasing power of benefits over time. Potential bias in the CPI as a cost-of-living index arises from a number of sources, including incomplete accounting for the ability of consumers to substitute goods or change purchasing outlets in response to relative price changes. The BLS has constructed a new index called the Chained Consumer Price Index for All Urban Consumers (C-CPI-U) that better accounts for those consumer adjustments. Price indexes are not true cost-of-living indexes, but approximations of cost-of-living indexes (COLI). The Bureau of Labor Statistics (2006a) explains the difference between the two: As it pertains to the CPI, the COLI for the current month is based on the answer to the following question: "What is the cost, at this month ' market prices, of achieving the standard of living actually attained in the base period?" This cost is a hypothetical expenditure-the lowest expenditure level necessary at this month's prices to achieve the base-period's living standard.... Unfortunately, because the cost of achieving a living standard cannot be observed directly, in operational terms, a COLI can only be approximated. Although the CPI cannot be said to equal a cost-of-living index, the concept of the COLI provides the CPI's measurement objective and the standard by which we define any bias in the CPI. While all versions of the CPI only approximate the actual changes in the cost of living, the CPI-E has several additional technical limitations. First, the CPI-E may better account for the goods and services typically purchased by the elderly, but the expenditure weights for the elderly are the only difference between the CPI-E and CPI-W. These weights are based on a much smaller sample than the other two indices, making it less precise. Second, the CPI-E does not account for differences in retail outlets frequented by the aged population or the prices they pay. Finally, the purchasing population measured in the CPI-E is not necessarily identical to the Social Security beneficiary population, where more than one-fifth of OASDI beneficiaries are under age 62. Likewise, over one-fifth of persons aged 62 or older are not beneficiaries, but they are included in the CPI-E population. Finally, changes in the index used to calculate COLAs directly affect the amount of benefits paid, and as a result, projected solvency of the Social Security program. A switch to the CPI-E for the December 2006 COLA (received in January 2007) would have resulted in an average monthly benefit $0.90 higher than that received. If the December 2006 COLA had been adjusted by the Chained CPI-U instead, the average monthly benefit would have been $4.70 less than with current indexing. Any changes to the COLA that would cause faster growth in individual benefits would make the projected date of insolvency sooner, while slower growth would delay insolvency. Hobijn and Lagakos (2003) estimated that switching to the CPI-E for COLAs would move projected insolvency sooner by 3-5 years. A projection by SSA's Office of the Chief Actuary estimated that annual COLAs based on the Chained C-CPI-U beginning in 2006 would delay the date of OASDI insolvency by 4 years.

The relationship between alcohol price and brand choice among underage drinkers: are the most popular alcoholic brands consumed by youth the cheapest?

PubMed

Albers, Alison B; DeJong, William; Naimi, Timothy S; Siegel, Michael; Jernigan, David H

2014-11-01

We examined the influence of price on alcohol brand choice among underage youth. Using a national sample of 1,032 youth, ages 13-20, recruited from a national Internet panel in 2011-2012, we compared differences in mean prices between popular and unpopular brands, examined the association of price and brand popularity using logistic regression, and rank ordered the average price of top brands. Lower brand-specific prices were significantly associated with higher levels of past 30-day consumption prevalence. However, youth did not preferentially consume the cheapest brands. These findings indicate that youth have preferences for certain brands, even if those brands cost more than competing brands. Our study highlights the need for research on the impact of brand-specific alcohol marketing on underage drinking.

Reduction potential, shadow prices, and pollution costs of agricultural pollutants in China.

PubMed

Tang, Kai; Gong, Chengzhu; Wang, Dong

2016-01-15

This paper analyses the reduction potential, shadow prices, and pollution costs of agricultural pollutants in China based on provincial panel data for 2001-2010. Using a parameterized quadratic form for the directional output distance function, we find that if agricultural sectors in all provinces were to produce on the production frontier, China could potentially reduce agricultural emissions of chemical oxygen demand (COD), total nitrogen (TN), and total phosphorus (TP) by 16.0%, 16.2%, and 20.4%, respectively. Additionally, our results show that the shadow price of TN increased rapidly and continuously, while that of COD and TP fluctuated for the whole period. For the whole country, the average shadow price of COD, TN, and TP are 8266 Yuan/tonne, 25,560 Yuan/tonne, and 10,160 Yuan/tonne, respectively. The regional shadow prices of agricultural pollutants are unbalanced. Furthermore, we show that the pollution costs from emissions of COD, TN, and TP are 6.09% of the annual gross output value of the agricultural sector and are highest in the Western and lowest in the Eastern provinces. Our estimates suggest that there is scope for further pollution abatement and simultaneous output expansion for China's agriculture if farmers promote greater efficiency in their production process. Policymakers are required to dynamically adjust the pollution tax rates and ascertain the initial permit price in an emission trading system. Policymakers should also consider the different pollution costs for each province when making the reduction allocations within the agricultural sector. Copyright © 2015 Elsevier B.V. All rights reserved.

U.S. Photovoltaic Prices and Cost Breakdowns. Q1 2015 Benchmarks for Residential, Commercial, and Utility-Scale Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, Donald; Davidson, Carolyn; Fu, Ran

The price of photovoltaic (PV) systems in the United States (i.e., the cost to the system owner) has continued to decline across all major market sectors. This report provides a Q1 2015 update regarding the prices of residential, commercial, and utility scale PV systems, based on an objective methodology that closely approximates the book value of a PV system. Several cases are benchmarked to represent common variations in business models, labor rates, and system architecture choice. We estimate a weighted-average cash purchase price of $3.09/W for residential scale rooftop systems, $2.15/W for commercial scale rooftop systems, $1.77/W for utility scalemore » systems with fixed mounting structures, and $1.91/W for utility scale systems using single-axis trackers. All systems are modeled assuming standard-efficiency, polycrystalline-silicon PV modules, and further assume installation within the United States.« less

Rising cost of antidotes in the U.S.: cost comparison from 2010 to 2015.

PubMed

Heindel, Gregory A; Trella, Jeanette D; Osterhoudt, Kevin C

2017-06-01

Our poison control center observed a large increase in the cost of many antidotes over the past several years. The high cost of antidotes has previously been cited as a factor leading to inadequate antidote supply at some hospitals. Continued increases in the cost of antidotes may lead to further reductions in antidote supply and represent serious concerns. This research aims to quantify recent trends in the costs of antidotes in the U.S. Antidotes and minimum stocking recommendations were retrieved from published guidelines. RED BOOK Online ® was used to identify the U.S. average wholesale price (AWP) of each antidote in 2010 and 2015. The AWP in 2010 was adjusted using the U.S. Consumer Price Index to adjust for inflation. The cost of minimum stocking levels for each antidote was calculated and compared between the year 2010 and 2015. The cost of stocking many antidotes demonstrated a large increase in AWP from 2010 to 2015. Of the antidotes evaluated, 15 out of 33 had greater than 50% increase in AWP and 8 out of 33 had greater than $1000 increase in AWP. Only four antidotes demonstrated decreases in AWP greater than 10% and only one antidote had its cost of stocking decrease in AWP by more than $1000. The price increase over the last 5 years may further hinder the willingness of hospitals to stock recommended antidotes at adequate quantities. This may impede timely treatment of patients, and negatively impact poisoning outcomes. The price of many antidotes substantially increased in the United States from 2010 to 2015. Strategies should be investigated to help decrease the cost associated with stocking and use of antidotes, including dose rounding, consignment, and regional sharing.

Correlated continuous time random walk and option pricing

NASA Astrophysics Data System (ADS)

Lv, Longjin; Xiao, Jianbin; Fan, Liangzhong; Ren, Fuyao

2016-04-01

In this paper, we study a correlated continuous time random walk (CCTRW) with averaged waiting time, whose probability density function (PDF) is proved to follow stretched Gaussian distribution. Then, we apply this process into option pricing problem. Supposing the price of the underlying is driven by this CCTRW, we find this model captures the subdiffusive characteristic of financial markets. By using the mean self-financing hedging strategy, we obtain the closed-form pricing formulas for a European option with and without transaction costs, respectively. At last, comparing the obtained model with the classical Black-Scholes model, we find the price obtained in this paper is higher than that obtained from the Black-Scholes model. A empirical analysis is also introduced to confirm the obtained results can fit the real data well.

The difference between energy consumption and energy cost: Modelling energy tariff structures for water resource recovery facilities.

PubMed

Aymerich, I; Rieger, L; Sobhani, R; Rosso, D; Corominas, Ll

2015-09-15

The objective of this paper is to demonstrate the importance of incorporating more realistic energy cost models (based on current energy tariff structures) into existing water resource recovery facilities (WRRFs) process models when evaluating technologies and cost-saving control strategies. In this paper, we first introduce a systematic framework to model energy usage at WRRFs and a generalized structure to describe energy tariffs including the most common billing terms. Secondly, this paper introduces a detailed energy cost model based on a Spanish energy tariff structure coupled with a WRRF process model to evaluate several control strategies and provide insights into the selection of the contracted power structure. The results for a 1-year evaluation on a 115,000 population-equivalent WRRF showed monthly cost differences ranging from 7 to 30% when comparing the detailed energy cost model to an average energy price. The evaluation of different aeration control strategies also showed that using average energy prices and neglecting energy tariff structures may lead to biased conclusions when selecting operating strategies or comparing technologies or equipment. The proposed framework demonstrated that for cost minimization, control strategies should be paired with a specific optimal contracted power. Hence, the design of operational and control strategies must take into account the local energy tariff. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cost comparisons for three harvesting systems operating in northern hardwood stands

Treesearch

Chris B. LeDoux; Neil K. Huyler

2000-01-01

Production rates, break-even piece (tree) sizes/costs (BEP), and operating costs were compared for a Koller K-300 cable yarder, a cut-to-length (CTL) harvester, and an A60F Holder tractor operating at three machine utilization rates (MUR) in northern hardwood stands. At an average product price of $0.40/ft3, the BEP size at an MUR of 90 was 7.64 ft3 for the Koller...

A real-time web-based optimal Biomass Site Assessment Tool (BioSAT): Module 1. An economic assessment of mill residues for the southern U.S.

Treesearch

Timothy M. Young; James H. Perdue; Andy Hartsell; Robert C. Abt; Donald Hodges; Timothy G. Rials

2009-01-01

Optimal locations for biomass facilities that use mill residues are identified for 13 southern U.S. states. The Biomass Site Assessment Tool (BioSAT) model is used to identify the top 20 locations for 13 southern U.S. states. The trucking cost model of BioSAT is used with Timber Mart South 2009 price data to estimate the total cost, average cost, and marginal costs for...

Nonlinear Pricing in Energy and Environmental Markets

NASA Astrophysics Data System (ADS)

Ito, Koichiro

This dissertation consists of three empirical studies on nonlinear pricing in energy and environmental markets. The first investigates how consumers respond to multi-tier nonlinear price schedules for residential electricity. Chapter 2 asks a similar research question for residential water pricing. Finally, I examine the effect of nonlinear financial rewards for energy conservation by applying a regression discontinuity design to a large-scale electricity rebate program that was implemented in California. Economic theory generally assumes that consumers respond to marginal prices when making economic decisions, but this assumption may not hold for complex price schedules. The chapter "Do Consumers Respond to Marginal or Average Price? Evidence from Nonlinear Electricity Pricing" provides empirical evidence that consumers respond to average price rather than marginal price when faced with nonlinear electricity price schedules. Nonlinear price schedules, such as progressive income tax rates and multi-tier electricity prices, complicate economic decisions by creating multiple marginal prices for the same good. Evidence from laboratory experiments suggests that consumers facing such price schedules may respond to average price as a heuristic. I empirically test this prediction using field data by exploiting price variation across a spatial discontinuity in electric utility service areas. The territory border of two electric utilities lies within several city boundaries in southern California. As a result, nearly identical households experience substantially different nonlinear electricity price schedules. Using monthly household-level panel data from 1999 to 2008, I find strong evidence that consumers respond to average price rather than marginal or expected marginal price. I show that even though this sub-optimizing behavior has a minimal impact on individual welfare, it can critically alter the policy implications of nonlinear pricing. The second chapter " How Do Consumers Respond to Nonlinear Pricing? Evidence from Household Water Demand" provides similar empirical evidence in residential water markets. In this paper, I exploit variation in residential water pricing in Southern California to examine how consumers respond to nonlinear pricing. Contrary to the standard predictions for nonlinear budget sets, I find no bunching of consumers around the kink points of their nonlinear price schedule. I then explore whether consumers respond to marginal price, expected marginal price, or average price when faced with nonlinear water price schedules. The price schedule of one service area was changed from a linear price schedule to a nonlinear price schedule. This policy change lead to an increase in marginal price and expected marginal price but a decrease in average price for many consumers. Using household-level panel data, I find strong evidence that consumers respond to average price rather than marginal or expected marginal price. Estimates of the short-run price elasticity for the summer and winter months are -.127 and -.097, and estimates of the long-run price elasticity for the summer and winter months are -.203 and -.154. I conclude with "The Effect of Cash Rewards on Energy Conservation: Evidence from a Regression Discontinuity Design" to examine the effect of an alternative form of nonlinear pricing that was developed to provide an explicit financial incentive for conservation. In the summer of 2005, California residents received a 20% discount on their summer electricity bills if they could reduce their electricity consumption by 20% relative to 2004. Nearly all households automatically participated in the program, but the eligibility rule required households to have started their electricity service by a certain cutoff date in 2004. This rule generated an essentially random assignment of the program among households that started their service right before and after the cutoff date. Using household-level monthly billing records from the three largest California electric utilities, I find evidence that the rebate incentive reduced consumption by 5% to 10% in the areas where summer temperature is persistently high and income-level is relatively low, but the estimated treatment effects are nearly zero in other areas. To save 1 kWh of electricity, the program cost 2 cents in inland areas, 91 cents in coastal areas, and 14.8 cents for all service areas.

Economic activities results and problems of the farm engaged in production of stick tomatoes in Erdemli (Mersin) Province

NASA Astrophysics Data System (ADS)

Direk, M.; Topkara, S.

2018-03-01

This study was carried out to investigate the socio-economic status of the stick-grown tomatoes located in Erdemli district of Mersin province and to examine the annual activity results and to reveal the problems. The data used in the research were obtained from questionnaires conducted with 44 selected farms by stratified random sampling method. The data obtained is for the 2016 production period. In the farmer surveyed, the operating area per farm was 7.01 da. In the enterprises, the average active capital per farm (69,916 ), 89.62% of the land capital and 2,40% of the operating capital. The ratio of own capital in the passive capital is 85.22%. In the examined farm, the average net yield was 3,150 , the agricultural income was 5,483 , the financial profitability was 4.29% and the economic profitability was 4.39%. As a result of the pie tomato cost analysis, the cost of tomato was determined to be below the tomato sales price. In the study, the cost of 1 kg product was calculated as 0,23 . The surplus supply in the time of the intensive production of tomatoes in the region of the study causes the prices to decrease. For this reason, it is necessary to try to ensure price stability by ensuring balanced distribution of the accrual during the season.

Good research practices for measuring drug costs in cost effectiveness analyses: issues and recommendations: the ISPOR Drug Cost Task Force report--Part I.

PubMed

Hay, Joel W; Smeeding, Jim; Carroll, Norman V; Drummond, Michael; Garrison, Louis P; Mansley, Edward C; Mullins, C Daniel; Mycka, Jack M; Seal, Brian; Shi, Lizheng

2010-01-01

The assignment of prices or costs to pharmaceuticals can be crucial to results and conclusions that are derived from pharmacoeconomic cost effectiveness analyses (CEAs). Although numerous pharmacoeconomic practice guidelines are available in the literature and have been promulgated in many countries, these guidelines are either vague or silent about how drug costs should be established or measured. This is particularly problematic in pharmacoeconomic studies performed from the "societal" perspective, because typically the measured cost of a brand name pharmaceutical is not a true economic cost but also includes transfer payments from some members of society (patients and third party payers) to other members of society (pharmaceutical manufacturer stockholders) in large part as a reward for biomedical innovation. Moreover, there are numerous and complex institutional factors that influence how drug costs should be measured from other CEA perspectives, both internationally and within the domestic US context. The objective of this report is to provide guidance and recommendations on how drug costs should be measured for CEAs performed from a number of key analytic perspectives. ISPOR Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis (Drug Cost Task Force [DCTF]) was appointed with the advice and consent of the ISPOR Board of Directors. Members were experienced developers or users of CEA models, worked in academia, industry, and as advisors to governments, and came from several countries. Because how drug costs should be measured for CEAs depend on the perspectives, five Task Force subgroups were created to develop drug cost standards from the societal, managed care, US government, industry, and international perspective. The ISPOR Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis (DCTF) subgroups met to develop core assumptions and an outline before preparing six draft reports. They solicited comments on the outline and drafts from a core group of 174 external reviewers and more broadly from the membership of ISPOR at two ISPOR meetings and via the ISPOR web site. Drug cost measurements should be fully transparent and reflect the net payment most relevant to the user's perspective. The Task Force recommends that for CEAs of brand name drugs performed from a societal perspective, either 1) CEA analysts use a cost that more accurately reflects true societal drug costs (e.g., 20-60% of average sales price), or when that is too unrealistic to be meaningful for decision-makers, 2) refer to their analyses as from a "limited societal perspective." CEAs performed from a payer perspective should use drug prices actually paid by the relevant payer net of all rebates, copays, or other adjustments. When such price adjustments are confidential, the analyst should apply a typical or average discount that preserves this confidentiality. Drug transaction prices not only ration current use of medication but also ration future biomedical research and development. CEA researchers should tailor the appropriate measure of drug costs to the analytic perspective, maintain clarity and transparency on drug cost measurement, and report the sensitivity of CEA results to reasonable drug cost measurement alternatives.

Weighted south-wide average pulpwood prices

Treesearch

James E. Granskog; Kevin D. Growther

1991-01-01

Weighted average prices provide a more accurate representation of regional pulpwood price trends when production volumes valy widely by state. Unweighted South-wide average delivered prices for pulpwood, as reported by Timber Mart-South, were compared to average annual prices weighted by each state's pulpwood production from 1977 to 1986. Weighted average prices...

The price may not be right: the value of comparison shopping for prescription drugs.

PubMed

Arora, Sanjay; Sood, Neeraj; Terp, Sophie; Joyce, Geoffrey

2017-07-01

To measure variations in drug prices across and within zip codes that may reveal simple strategies to improve patients' access to prescribed medications. We compared drug prices at different types of pharmacies across and within local markets. In-store prices were compared with a Web-based service providing discount coupons for prescription medications. Prices were collected for 2 generic antibiotics because most patients have limited experience with them and are less likely to know the price ranges for them. Drug prices were obtained via telephone from 528 pharmacies in Los Angeles (LA) County, California, from July to August 2014. Online prices were collected from GoodRx, a popular Web-based service that aggregates available discounts and directly negotiates with retail outlets. Drug prices found at independent pharmacies and by using discount coupons available online were lower on average than at grocery, big-box, or chain drug stores for 2 widely prescribed antibiotics. The lowest-price prescription was offered at a grocery, big-box, or chain drug store in 6% of zip codes within the LA County area. Drug prices varied dramatically within a zip code, however, and were less expensive in lower-income areas. The average price difference within a zip code was $52 for levofloxacin and $17 for azithromycin. Price shopping for medications within a small geographic area can yield considerable cost savings for the uninsured and consumers in high-deductible health plans with high negotiated prices. Clinicians and patient advocates have an incentive to convey this information to patients to improve adherence to prescribed medicines and lower the financial burden of purchasing prescription drugs.

A novel method of estimating cost of therapy by using patient population characteristics: analysis of fluoroquinolones in various populations with different distributions of renal function.

PubMed

Enzweiler, Kevin A; Bosso, John A; White, Roger L

2003-07-01

Formulary decisions regarding a given drug class are often made in the absence of patient outcome and/or sophisticated pharmacoeconomic data. Analyses that consider factors beyond simple acquisition costs may be useful in such situations. For example, the cost implications of using manufacturers' recommendations for dosing in patients with renal dysfunction may be important, depending on the distribution of various levels of renal function within a patient population. Using four 1000-patient populations representing different renal function distributions and a fifth population of our medical center's distribution, we determined the costs of therapy for intravenous and oral levofloxacin, gatifloxacin, and moxifloxacin for a 10-day course of therapy for community-acquired pneumonia. Costs considered were average wholesale prices (AWPs), 50% of AWP, or same daily price, plus intravenous dose preparation and administration costs when applicable. Costs for each renal function distribution were examined for significant differences with an analysis-of-variance test. Also, costs of failing to adjust dosing regimens for decreased renal function were determined. Differences in fluoroquinolone costs (AWP, 50% AWP, or when matched as the same daily price) among the populations were found. When considering same daily prices, differences among populations ranged from about 35,000 dollars with intravenous gatifloxacin to more than 51,000 dollars for intravenous levofloxacin (all fluoroquinolones, p>0.05). Within a population, differences in costs among the intravenous fluoroquinolones ranged from 47,000-99,000 dollars. Rank orders of the drugs and population costs of therapy were affected by the pricing structure used and varied by the specific population and drug. Differences among the fluoroquinolones or populations were much smaller (<2100 dollars) when considering oral regimens. Costs potentially incurred by failing to adjust dosing for renal function were substantial. Formulary decisions can be facilitated by considering factors such as patient characteristics and related dosing in addition to simple acquisition costs. In our example, consideration of the distribution of renal function within a given patient population and related dosing for these fluoroquinolones revealed potentially important differences within the class.

Manufacture of ammonium sulfate fertilizer from gypsum-rich byproduct of flue gas desulfurization - A prefeasibility cost estimate

USGS Publications Warehouse

Chou, I.-Ming; Rostam-Abadi, M.; Lytle, J.M.; Achorn, F.P.

1996-01-01

Costs for constructing and operating a conceptual plant based on a proposed process that converts flue gas desulfurization (FGD)-gypsum to ammonium sulfate fertilizer has been calculated and used to estimate a market price for the product. The average market price of granular ammonium sulfate ($138/ton) exceeds the rough estimated cost of ammonium sulfate from the proposed process ($111/ ton), by 25 percent, if granular size ammonium sulfate crystals of 1.2 to 3.3 millimeters in diameters can be produced by the proposed process. However, there was at least ??30% margin in the cost estimate calculations. The additional costs for compaction, if needed to create granules of the required size, would make the process uneconomical unless considerable efficiency gains are achieved to balance the additional costs. This study suggests the need both to refine the crystallization process and to find potential markets for the calcium carbonate produced by the process.

The Impact of a City-Level Minimum-Wage Policy on Supermarket Food Prices in Seattle-King County

PubMed Central

Tang, Wesley; Aggarwal, Anju; Vigdor, Jacob; Drewnowski, Adam

2017-01-01

Background: Many states and localities throughout the U.S. have adopted higher minimum wages. Higher labor costs among low-wage food system workers could result in higher food prices. Methods: Using a market basket of 106 foods, food prices were collected at affected chain supermarket stores in Seattle and same-chain unaffected stores in King County (n = 12 total, six per location). Prices were collected at 1 month pre- (March 2015) and 1-month post-policy enactment (May 2015), then again 1-year post-policy enactment (May 2016). Unpaired t-tests were used to detect price differences by location at fixed time while paired t-tests were used to detect price difference across time with fixed store chain. A multi-level, linear differences-in-differences model, was used to detect the changes in the average market basket item food prices over time across regions, overall and by food group. Results: There were no significant differences in overall market basket or item-level costs at one-month (−$0.01, SE = 0.05, p = 0.884) or one-year post-policy enactment (−$0.02, SE = 0.08, p = 0.772). No significant increases were observed by food group. Conclusions: There is no evidence of change in supermarket food prices by market basket or increase in prices by food group in response to the implementation of Seattle’s minimum wage ordinance. PMID:28891937

48 CFR 215.403-5 - Instructions for submission of cost or pricing data or information other than cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... submission of cost or pricing data or information other than cost or pricing data. 215.403-5 Section 215.403... DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403-5 Instructions for submission of cost or pricing data or information other than cost or pricing data. When the...

Comparing Utilization and Costs of Care in Freestanding Emergency Departments, Hospital Emergency Departments, and Urgent Care Centers.

PubMed

Ho, Vivian; Metcalfe, Leanne; Dark, Cedric; Vu, Lan; Weber, Ellerie; Shelton, George; Underwood, Howard R

2017-12-01

We compare utilization, price per visit, and the types of care delivered across freestanding emergency departments (EDs), hospital-based EDs, and urgent care centers in Texas. We analyzed insurance claims processed by Blue Cross Blue Shield of Texas from 2012 to 2015 for patient visits to freestanding EDs, hospital-based EDs, or urgent care centers in 16 Texas metropolitan statistical areas containing 84.1% of the state's population. We calculated the aggregate number of visits, average price per visit, proportion of price attributable to facility and physician services, and proportion of price billed to Blue Cross Blue Shield of Texas versus out of pocket, by facility type. Prices for the top 20 diagnoses and procedures by facility type are compared. Texans use hospital-based EDs and urgent care centers much more than freestanding EDs, but freestanding ED utilization increased 236% between 2012 and 2015. The average price per visit was lower for freestanding EDs versus hospital-based EDs in 2012 ($1,431 versus $1,842), but prices in 2015 were comparable ($2,199 versus $2,259). Prices for urgent care centers were only $164 and $168 in 2012 and 2015. Out-of-pocket liability for consumers for all these facilities increased slightly from 2012 to 2015. There was 75% overlap in the 20 most common diagnoses at freestanding EDs versus urgent care centers and 60% overlap for hospital-based EDs and urgent care centers. However, prices for patients with the same diagnosis were on average almost 10 times higher at freestanding and hospital-based EDs relative to urgent care centers. Utilization of freestanding EDs is rapidly expanding in Texas. Higher prices at freestanding and hospital-based EDs relative to urgent care centers, despite substantial overlap in services delivered, imply potential inefficient use of emergency facilities. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

78 FR 19029 - Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... POSTAL REGULATORY COMMISSION [Docket No. CP2013-6; Order No. 1680] Negotiated Service Agreement... applicable,'' and that the Amendment ``will not materially affect the cost coverage'' of the agreement. Id... of the agreement on the average increase in prices of general applicability for ``Priority Mail...

The price of surgery: markup of operative procedures in the United States.

PubMed

Gani, Faiz; Makary, Martin A; Pawlik, Timothy M

2017-02-01

Despite cost containment efforts, the price for surgery is not subject to any regulations. We sought to characterize and compare variability in pricing for commonly performed major surgical procedures across the United States. Medicare claims corresponding to eight major surgical procedures (aortic aneurysm repair, aortic valvuloplasty, carotid endartectomy, coronary artery bypass grafting, esophagectomy, pancreatectomy, liver resection, and colectomy) were identified using the Medicare Provider Utilization and Payment Data Physician and Other Supplier Public Use File for 2013. For each procedure, total charges, Medicare-allowable costs, and total payments were recorded. A procedure-specific markup ratio (MR; ratio of total charges to Medicare-allowable costs) was calculated and compared between procedures and across states. Variation in MR was compared using a coefficient of variation (CoV). Among all providers, the median MR was 3.5 (interquartile range: 3.1-4.0). MR was noted to vary by procedure; ranging from 3.0 following colectomy to 6.0 following carotid endartectomy (P < 0.001). MR also varied for the same procedure; varying the least after liver resection (CoV = 0.24), while coronary artery bypass grafting pricing demonstrated the greatest variation in MR (CoV = 0.53). Compared with the national average, MR varied by 36% between states ranging from 1.8 to 13.0. Variation in MR was also noted within the same state varying by 15% within the state of Arkansas (CoV = 0.15) compared with 51% within the state of Wisconsin (CoV = 0.51). Significant variation was noted for the price of surgery by procedure as well as between and within different geographical regions. Greater scrutiny and transparency in the price of surgery is required to promote cost containment. Copyright © 2016 Elsevier Inc. All rights reserved.

Linear triangular optimization technique and pricing scheme in residential energy management systems

NASA Astrophysics Data System (ADS)

Anees, Amir; Hussain, Iqtadar; AlKhaldi, Ali Hussain; Aslam, Muhammad

2018-06-01

This paper presents a new linear optimization algorithm for power scheduling of electric appliances. The proposed system is applied in a smart home community, in which community controller acts as a virtual distribution company for the end consumers. We also present a pricing scheme between community controller and its residential users based on real-time pricing and likely block rates. The results of the proposed optimization algorithm demonstrate that by applying the anticipated technique, not only end users can minimise the consumption cost, but it can also reduce the power peak to an average ratio which will be beneficial for the utilities as well.

Sales Trends in Price-Discounted Cigarettes, Large Cigars, Little Cigars, and Cigarillos-United States, 2011-2016.

PubMed

Wang, Teresa W; Falvey, Kyle; Gammon, Doris G; Loomis, Brett R; Kuiper, Nicole M; Rogers, Todd; King, Brian A

2017-12-15

Tobacco manufacturers continue to implement a range of pricing strategies to increase the affordability and consumption of tobacco products. To demonstrate the extent of retail- and brand-level price discounts at the point of sale, this study assessed national sales trends in price-discounted cigarettes, large cigars, little cigars, and cigarillos. Retail scanner data for tobacco product sales were obtained for convenience stores (C-store) and all-other-outlets-combined (AOC) from September 25, 2011, to January 9, 2016. The proportion of price-discounted sales, average nondiscounted unit price, and average discounted unit price were examined by product category and brand. JoinPoint regression was used to assess average monthly percentage change. Overall, price-discounted sales accounted for 11.3% of cigarette, 3.4% of large cigar, 4.1% of little cigar, and 3.9% of cigarillo sales. The average difference between nondiscounted and discounted prices was 25.5% (C-store) and 36.7% (AOC) for cigarettes; 11.0% (C-store) and 11.2% (AOC) for large cigars; 19.2% (C-store) and 9.6% (AOC) for little cigars; and 5.3% (C-store) and 14.7% (AOC) for cigarillos. Furthermore, price-discounted sales of top-selling tobacco brands comprised up to 36% of cigarette, 7.4% of large cigar, 7.7% of little cigar, and 4.2% of cigarillo unit sales. These findings highlight the use of price discounts by tobacco manufacturers to reduce the cost of cigarettes, large cigars, little cigars, and cigarillos to consumers. These sales patterns underscore the importance of sustained efforts to implement evidence-based strategies to increase prices and reduce availability and consumption of combustible tobacco in the United States. This study highlights the prevalence and provides a baseline of price-discounted cigarettes, large cigars, little cigars, and cigarillos. Surveillance of tobacco sales data, including state-level trends and additional product types, is critical for informing approaches to reduce tobacco consumption. These approaches include countering tobacco product price-discounting practices and raising and maintaining a high sales price for all tobacco products. The implementation of evidence-based population-level interventions, together with local, state, and federal regulation of tobacco products, could prevent tobacco initiation, increase tobacco cessation, and reduce overall tobacco use among US youth and adults. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Pricing and competition in the private dental market in Finland.

PubMed

Widström, E; Väisänen, A; Mikkola, H

2011-06-01

To investigate how the prices were set in private dental care, which factors determined prices and whether the recent National Dental Care Reform had increased competition in the dental care market in Finland. A questionnaire to all full time private dentists (n = 1,121) in the ten largest cities. Characteristics of the practice, prices charged, price setting, perceived competition and expectations for the practices were requested. The response rate was 59.6%. Correlation analysis (Pearson's) was used to study relationships between the prices of different treatment items. Linear regression analysis was used to study determinants of the price of a one surface filling. Most dentists' fee schedules were based on the price of a one surface filling and updated annually. Changes in practice costs calculated by the dentists' professional association and information on average prices charged on dental treatments in the country influenced pricing. High price levels were associated with specialisation, working in a group practice, working close to many other practices or in a town with a dental school. Less than half of the respondents had faced competition in dental services and price competition was insignificant. Price setting followed traditional patterns and private markets in dental services were not found to be very competitive.

The determinants of cost-effectiveness potential: an historical perspective on lipid-lowering therapies.

PubMed

Refoios Camejo, Rodrigo; McGrath, Clare; Miraldo, Marisa; Rutten, Frans

2013-05-01

The concept of cost effectiveness emerged in an attempt to link the prices of new healthcare technologies to the immediate value they provide, with payers defining the acceptable cost per unit of incremental effect over the alternatives available. It has been suggested that such measures allow developers to assess potential market profitability in an early stage of development, but may result in discouraging investment in efficient research if not used appropriately. The objective of this study is to identify the pattern of the factors determining cost effectiveness and assess the evolution of cost-effectiveness potential for drugs in development using lipid-lowering therapy as a case study. The study is based on observational clinical and market data covering a 20-year period (from 1990 to 2010) in the UK. Real-life clinical data including total cholesterol laboratory test results were extracted from the Clinical Practice Research Datalink (CPRD) and are used to illustrate how the clinical effectiveness of existing standard care changed over time in patients managed in clinical practice. Prescription Cost Analysis (PCA) data were extracted and the average price of the drug mix used was computed throughout the study period. Using this information, the maximum clinical benefit and cost savings to be had were estimated for each year of the analysis using a cost-effectiveness model. Subsequently, the highest price a new technology providing the maximum clinical effectiveness possible (i.e. eliminating cardiovascular risk from high cholesterol levels) could achieve under current cost-effectiveness rules was calculated and used as a measure of the potential cost effectiveness of drugs in development. The results in this study show that the total cholesterol values of patients managed in clinical practice moved steadily towards recommended clinical targets. Overall, the absolute potential for incremental health-related quality of life decreased by approximately 78 %, contracting from 0.36 QALYs to 0.08 QALYs, which resulted in a saving of approximately 15 % of the costs related to cardiovascular events. The price of the drug mix used in the management of high blood cholesterol varied considerably across the years: the weighted average monthly price (in year 2007 values) started at approximately £14, peaked around £26 and progressively decreased to its minimum at £6.85 in 2010. As a consequence, the maximum price allowed by current cost-effectiveness rules for a new technology achieving the clinical target was found to decrease by a minimum of 80 % between 1990 and 2010. The analysis supports the hypothesis that the potential for cost effectiveness of new therapies is dependent on factors specific to each disease area and furthermore to sub-populations within disease areas. Despite a clinical need still existing, the results suggest that no more technologies are likely to be developed in certain disease areas based on their low perceived cost-effectiveness potential. This occurs without considering the immediate and future value of the effectiveness lost, which may depend on the technical difficulty of materializing future advancements, and ignores the permanent character of such a decision. The analysis suggests that a single, static and arbitrary cost-effectiveness threshold may not be sufficient to capture the drug-development dynamics occurring at the disease level and successfully direct research to the disease areas that are most valued by society.

Meta-analysis of alcohol price and income elasticities – with corrections for publication bias

PubMed Central

2013-01-01

Background This paper contributes to the evidence-base on prices and alcohol use by presenting meta-analytic summaries of price and income elasticities for alcohol beverages. The analysis improves on previous meta-analyses by correcting for outliers and publication bias. Methods Adjusting for outliers is important to avoid assigning too much weight to studies with very small standard errors or large effect sizes. Trimmed samples are used for this purpose. Correcting for publication bias is important to avoid giving too much weight to studies that reflect selection by investigators or others involved with publication processes. Cumulative meta-analysis is proposed as a method to avoid or reduce publication bias, resulting in more robust estimates. The literature search obtained 182 primary studies for aggregate alcohol consumption, which exceeds the database used in previous reviews and meta-analyses. Results For individual beverages, corrected price elasticities are smaller (less elastic) by 28-29 percent compared with consensus averages frequently used for alcohol beverages. The average price and income elasticities are: beer, -0.30 and 0.50; wine, -0.45 and 1.00; and spirits, -0.55 and 1.00. For total alcohol, the price elasticity is -0.50 and the income elasticity is 0.60. Conclusions These new results imply that attempts to reduce alcohol consumption through price or tax increases will be less effective or more costly than previously claimed. PMID:23883547

Costs along the service cascades for HIV testing and counselling and prevention of mother-to-child transmission

PubMed Central

Bautista-Arredondo, Sergio; Sosa-Rubí, Sandra G.; Opuni, Marjorie; Contreras-Loya, David; Kwan, Ada; Chaumont, Claire; Chompolola, Abson; Condo, Jeanine; Galárraga, Omar; Martinson, Neil; Masiye, Felix; Nsanzimana, Sabin; Ochoa-Moreno, Ivan; Wamai, Richard; Wang’ombe, Joseph

2016-01-01

Objective: We estimate facility-level average annual costs per client along the HIV testing and counselling (HTC) and prevention of mother-to-child transmission (PMTCT) service cascades. Design: Data collected covered the period 2011–2012 in 230 HTC and 212 PMTCT facilities in Kenya, Rwanda, South Africa, and Zambia. Methods: Input quantities and unit prices were collected, as were output data. Annual economic costs were estimated from the service providers’ perspective using micro-costing. Average annual costs per client in 2013 United States dollars (US$) were estimated along the service cascades. Results: For HTC, average cost per client tested ranged from US$5 (SD US$7) in Rwanda to US$31 (SD US$24) in South Africa, whereas average cost per client diagnosed as HIV-positive ranged from US$122 (SD US$119) in Zambia to US$1367 (SD US$2093) in Rwanda. For PMTCT, average cost per client tested ranged from US$18 (SD US$20) in Rwanda to US$89 (SD US$56) in South Africa; average cost per client diagnosed as HIV-positive ranged from US$567 (SD US$417) in Zambia to US$2021 (SD US$3210) in Rwanda; average cost per client on antiretroviral prophylaxis ranged from US$704 (SD US$610) in South Africa to US$2314 (SD US$3204) in Rwanda; and average cost per infant on nevirapine ranged from US$888 (SD US$884) in South Africa to US$2359 (SD US$3257) in Rwanda. Conclusion: We found important differences in unit costs along the HTC and PMTCT service cascades within and between countries suggesting that more efficient delivery of these services is possible. PMID:27753679

Economic Evaluation of Lipid-Lowering Therapy in the Secondary Prevention Setting in the Philippines.

PubMed

Tumanan-Mendoza, Bernadette A; Mendoza, Victor L

2013-05-01

To determine the cost-effectiveness of lipid-lowering therapy in the secondary prevention of cardiovascular events in the Philippines. A cost-utility analysis was performed by using Markov modeling in the secondary prevention setting. The models incorporated efficacy of lipid-lowering therapy demonstrated in randomized controlled trials and mortality rates obtained from local life tables. Average and incremental cost-effectiveness ratios were obtained for simvastatin, atorvastatin, pravastatin, and gemfibrozil. The costs of the following were included: medications, laboratory examinations, consultation and related expenses, and production losses. The costs were expressed in current or nominal prices as of the first quarter of 2010 (Philippine peso). Utility was expressed in quality-adjusted life-years gained. Sensitivity analyses were performed by using variations in the cost centers, discount rates, starting age, and differences in utility weights for stroke. In the analysis using the lower-priced generic counterparts, therapy using 40 mg simvastatin daily was the most cost-effective option compared with the other therapies, while pravastatin 40 mg daily was the most cost-effective alternative if the higher-priced innovator drugs were used. In all sensitivity analyses, gemfibrozil was strongly dominated by the statins. In secondary prevention, simvastatin or pravastatin were the most cost-effective options compared with atorvastatin and gemfibrozil in the Philippines. Gemfibrozil was strongly dominated by the statins. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

48 CFR 2152.244-70 - Subcontracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost or pricing data and Certificate of Current Cost or Pricing Data, if required by other contract... consideration controlling establishment of initial or revised prices; (iii) The reason cost or pricing data were... subcontractor's cost or pricing data in determining the price objective and in negotiating the final price; (v...

48 CFR 15.403-5 - Instructions for submission of certified cost or pricing data and data other than certified cost...

Code of Federal Regulations, 2010 CFR

2010-10-01

... submission of certified cost or pricing data and data other than certified cost or pricing data. 15.403-5... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-5 Instructions for submission of certified cost or pricing data and data other than certified cost or pricing data. (a) Taking into...

48 CFR 15.403-5 - Instructions for submission of certified cost or pricing data and data other than certified cost...

Code of Federal Regulations, 2012 CFR

2012-10-01

... submission of certified cost or pricing data and data other than certified cost or pricing data. 15.403-5... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-5 Instructions for submission of certified cost or pricing data and data other than certified cost or pricing data. (a) Taking into...

48 CFR 15.403-5 - Instructions for submission of certified cost or pricing data and data other than certified cost...

Code of Federal Regulations, 2013 CFR

2013-10-01

... submission of certified cost or pricing data and data other than certified cost or pricing data. 15.403-5... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-5 Instructions for submission of certified cost or pricing data and data other than certified cost or pricing data. (a) Taking into...

48 CFR 15.403-5 - Instructions for submission of certified cost or pricing data and data other than certified cost...

Code of Federal Regulations, 2011 CFR

2011-10-01

... submission of certified cost or pricing data and data other than certified cost or pricing data. 15.403-5... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-5 Instructions for submission of certified cost or pricing data and data other than certified cost or pricing data. (a) Taking into...

48 CFR 15.403-5 - Instructions for submission of certified cost or pricing data and data other than certified cost...

Code of Federal Regulations, 2014 CFR

2014-10-01

... submission of certified cost or pricing data and data other than certified cost or pricing data. 15.403-5... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-5 Instructions for submission of certified cost or pricing data and data other than certified cost or pricing data. (a) Taking into...

48 CFR 570.110 - Cost or pricing data and information other than cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Cost or pricing data and information other than cost or pricing data. 570.110 Section 570.110 Federal Acquisition Regulations System... PROPERTY General 570.110 Cost or pricing data and information other than cost or pricing data. (a) The...

Price Transparency in the Online Age.

PubMed

Kaplan, Jonathan L; Mills, Parker H

2016-05-01

Plastic surgeons are sometimes hesitant to provide their pricing information online, due to several concerns. However, if implemented right, price transparency can be used as a lead generation tool that provides consumers with the pricing information they want and gives the physician the consumer's contact information for follow-up. This study took place during the author's first year in private practice in a new city. An interactive price transparency platform (ie, cost estimator) was integrated into his website, allowing consumers to submit a "wishlist" of procedures to check pricing on these procedures of interest. However, the consumer must submit their contact information to receive the desired breakdown of costs that are tailored based on the author's medical fees. During that first year, without any advertising expenditure, the author's website received 412 wishlists from 208 unique consumers. Consumers (17.8%) that submitted a wishlist came in for a consultation and 62% of those booked a procedure. The average value of a booked procedure was over US $4000 and cumulatively, all of the leads from this one lead source in that first year generated over US $92,000 in revenue. When compared with non-price-aware patients, price-aware patients were 41% more likely to book a procedure. Price transparency led to greater efficiency and reduced consultations that ended in "sticker shock." When prudently integrated into a medical practice, price transparency can be a great lead generation source for patients that are (1) paying out of pocket for medically necessary services due to a high-deductible health plan or (2) paying for services not typically covered by insurance, such as cosmetic services.

Offering A Price Transparency Tool Did Not Reduce Overall Spending Among California Public Employees And Retirees.

PubMed

Desai, Sunita; Hatfield, Laura A; Hicks, Andrew L; Sinaiko, Anna D; Chernew, Michael E; Cowling, David; Gautam, Santosh; Wu, Sze-Jung; Mehrotra, Ateev

2017-08-01

Insurers, employers, and states increasingly encourage price transparency so that patients can compare health care prices across providers. However, the evidence on whether price transparency tools encourage patients to receive lower-cost care and reduce overall spending remains limited and mixed. We examined the experience of a large insured population that was offered a price transparency tool, focusing on a set of "shoppable" services (lab tests, office visits, and advanced imaging services). Overall, offering the tool was not associated with lower shoppable services spending. Only 12 percent of employees who were offered the tool used it in the first fifteen months after it was introduced, and use of the tool was not associated with lower prices for lab tests or office visits. The average price paid for imaging services preceded by a price search was 14 percent lower than that paid for imaging services not preceded by a price search. However, only 1 percent of those who received advanced imaging conducted a price search. Simply offering a price transparency tool is not sufficient to meaningfully decrease health care prices or spending. Project HOPE—The People-to-People Health Foundation, Inc.

U.S. Residential Photovoltaic (PV) System Prices, Q4 2013 Benchmarks: Cash Purchase, Fair Market Value, and Prepaid Lease Transaction Prices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davidson, C.; James, T. L.; Margolis, R.

The price of photovoltaic (PV) systems in the United States (i.e., the cost to the system owner) has dropped precipitously in recent years, led by substantial reductions in global PV module prices. This report provides a Q4 2013 update for residential PV systems, based on an objective methodology that closely approximates the book value of a PV system. Several cases are benchmarked to represent common variation in business models, labor rates, and module choice. We estimate a weighted-average cash purchase price of $3.29/W for modeled standard-efficiency, polycrystalline-silicon residential PV systems installed in the United States. This is a 46% declinemore » from the 2013-dollar-adjusted price reported in the Q4 2010 benchmark report. In addition, this report frames the cash purchase price in the context of key price metrics relevant to the continually evolving landscape of third-party-owned PV systems by benchmarking the minimum sustainable lease price and the fair market value of residential PV systems.« less

Household demand for water in Sweden with implications of a potential tax on water use

NASA Astrophysics Data System (ADS)

HöGlund, Lena

1999-12-01

The purpose of this paper is to estimate empirically the effects of a water tax on water use and on the size and stability of the tax revenues. A tax exceeding value-added tax can be motivated on efficiency grounds when there are environmental external costs of water use and when water is a scarce resource. A household demand function for water is estimated using community level data for 282 (out of 286) Swedish communities studied annually over the period 1980-1992. Static and dynamic demand functions are estimated using panel data methods. The results show a long-run price elasticity of -0.10 in marginal price models and -0.20 in average price models. The findings imply that a tax of 1 Swedish Kronor (SEK) m-3 of water used (corresponding to a 5% increase in the mean average price) would generate ˜600 million SEK in tax revenues per year when levied on all households in Sweden. The water consumption would, however, only be reduced by ˜1%.

Optimizing and Diversifying Electric Vehicle Driving Range for U.S. Drivers

DOE PAGES

Lin, Zhenhong

2014-08-11

Properly determining the driving range is critical for accurately predicting the sales and social benefits of battery electric vehicles (BEVs). This study proposes a framework for optimizing the driving range by minimizing the sum of battery price, electricity cost, and range limitation cost referred to as the "range-related cost" as a measurement of range anxiety. The objective function is linked to policy-relevant parameters, including battery cost and price markup, battery utilization, charging infrastructure availability, vehicle efficiency, electricity and gasoline prices, household vehicle ownership, daily driving patterns, discount rate, and perceived vehicle lifetime. Qualitative discussion of the framework and its empiricalmore » application to a sample (N=36664) representing new car drivers in the United States is included. The quantitative results strongly suggest that ranges of less than 100 miles are likely to be more popular in the BEV market for a long period of time. The average optimal range among U.S. drivers is found to be largely inelastic. Still, battery cost reduction significantly drives BEV demand toward longer ranges, whereas improvement in the charging infrastructure is found to significantly drive BEV demand toward shorter ranges. In conclusion, the bias of a single-range assumption and the effects of range optimization and diversification in reducing such biases are both found to be significant.« less

The effect of CO2 regulations on the cost of corn ethanol production

NASA Astrophysics Data System (ADS)

Plevin, R. J.; Mueller, S.

2008-04-01

To explore the effect of CO2 price on the effective cost of ethanol production we have developed a model that integrates financial and emissions accounting for dry-mill corn ethanol plants. Three policy options are modeled: (1) a charge per unit of life cycle CO2 emissions, (2) a charge per unit of direct biorefinery emissions only, and (3) a low carbon fuel standard (LCFS). A CO2 charge on life cycle emissions increases production costs by between 0.005 and 0.008 l-1 per 10 Mg-1 CO2 price increment, across all modeled plant energy systems, with increases under direct emissions somewhat lower in all cases. In contrast, a LCFS increases the cost of production for selected plant energy systems only: a LCFS requiring reductions in average fuel global warming intensity (GWI) with a target of 10% below the 2005 baseline increases the production costs for coal-fired plants only. For all other plant types, the LCFS operates as a subsidy. The findings depend strongly on the magnitude of a land use change adder. Some land use change adders currently discussed in the literature will push the GWI of all modeled production systems above the LCFS target, flipping the CO2 price from a subsidy to a tax.

Optimizing and Diversifying Electric Vehicle Driving Range for U.S. Drivers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, Zhenhong

Properly determining the driving range is critical for accurately predicting the sales and social benefits of battery electric vehicles (BEVs). This study proposes a framework for optimizing the driving range by minimizing the sum of battery price, electricity cost, and range limitation cost referred to as the "range-related cost" as a measurement of range anxiety. The objective function is linked to policy-relevant parameters, including battery cost and price markup, battery utilization, charging infrastructure availability, vehicle efficiency, electricity and gasoline prices, household vehicle ownership, daily driving patterns, discount rate, and perceived vehicle lifetime. Qualitative discussion of the framework and its empiricalmore » application to a sample (N=36664) representing new car drivers in the United States is included. The quantitative results strongly suggest that ranges of less than 100 miles are likely to be more popular in the BEV market for a long period of time. The average optimal range among U.S. drivers is found to be largely inelastic. Still, battery cost reduction significantly drives BEV demand toward longer ranges, whereas improvement in the charging infrastructure is found to significantly drive BEV demand toward shorter ranges. In conclusion, the bias of a single-range assumption and the effects of range optimization and diversification in reducing such biases are both found to be significant.« less

Innovation in the pharmaceutical industry: New estimates of R&D costs.

PubMed

DiMasi, Joseph A; Grabowski, Henry G; Hansen, Ronald W

2016-05-01

The research and development costs of 106 randomly selected new drugs were obtained from a survey of 10 pharmaceutical firms. These data were used to estimate the average pre-tax cost of new drug and biologics development. The costs of compounds abandoned during testing were linked to the costs of compounds that obtained marketing approval. The estimated average out-of-pocket cost per approved new compound is $1395 million (2013 dollars). Capitalizing out-of-pocket costs to the point of marketing approval at a real discount rate of 10.5% yields a total pre-approval cost estimate of $2558 million (2013 dollars). When compared to the results of the previous study in this series, total capitalized costs were shown to have increased at an annual rate of 8.5% above general price inflation. Adding an estimate of post-approval R&D costs increases the cost estimate to $2870 million (2013 dollars). Copyright © 2016 Elsevier B.V. All rights reserved.

The Likely Effects of Price Increases on Commissary Patronage: A Review of the Literature

DTIC Science & Technology

2015-01-01

uniformed services and to eligible members of their families at cost plus a 5-percent surcharge, saving customers an average of more than 30 percent when...47 ix Summary The Defense Commissary Agency (DeCA) operates 245 commissaries worldwide, sell- ing groceries at cost plus a fixed...supermarkets by selling them at cost from the supplier plus a 5-percent surcharge. In FY 2013, DeCA sales were approximately $5.9 billion, with total

Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data

PubMed Central

Duan, Zhong-Ping; Dou, Xiao-Guang; Xie, Qing; Zhang, Wen-Hong; Lu, Lun-Gen; Fan, Jian-Gao; Cheng, Jun; Wang, Gui-Qiang; Ren, Hong; Wang, Jiu-Ping; Yang, Xing-Xiang; Jia, Zhan-Sheng; Fu, Qing-Chun; Wang, Xiao-Jin; Shang, Jia; Zhang, Yue-Xin; Han, Ying; Du, Ning; Shao, Qing; Ji, Dong; Li, Fan; Li, Bing; Liu, Jia-Liang; Niu, Xiao-Xia; Wang, Cheng; Wu, Vanessa; Wong, April; Wang, Yu-Dong; Hou, Jin-Lin; Jia, Ji-Dong; Zhuang, Hui; Lau, George

2016-01-01

Background Little is known on the cost-effectiveness of novel regimens for hepatitis C virus (HCV) compared with standard-of-care with pegylated interferon (pegIFN) and ribavirin (RBV) therapy in developing countries. We evaluated cost-effectiveness of sofosbuvir/ledipasvir for 12 weeks compared with a 48-week pegIFN-RBV regimen in Chinese patients with genotype 1b HCV infection by economic regions. Methods A decision analytic Markov model was developed to estimate quality-adjusted-life-years, lifetime cost of HCV infection and incremental cost-effectiveness ratios (ICERs). SVR rates and direct medical costs were obtained from real-world data. Parameter uncertainty was assessed by one-way and probabilistic sensitivity analyses. Threshold analysis was conducted to estimate the price which can make the regimen cost-effective and affordable. Results Sofosbuvir/ledipasvir was cost-effective in treatment-experienced patients with an ICER of US$21,612. It varied by economic regions. The probability of cost-effectiveness was 18% and 47% for treatment-naive and experienced patients, and it ranged from 15% in treatment-naïve patients in Central-China to 64% in treatment-experienced patients in Eastern-China. The price of 12-week sofosbuvir/ledipasvir treatment needs to be reduced by at least 81% to US$18,185 to make the regimen cost-effective in all patients at WTP of one time GDP per capita. The price has to be US$105 to make the regimen affordable in average patients in China. Conclusion Sofosbuvir/ledipasvir regimen is not cost-effective in most Chinese patients with genotype 1b HCV infection. The results vary by economic regions. Drug price of sofosbuvir/ledipasvir needs to be substantially reduced when entering the market in China to ensure the widest accessibility. PMID:27276081

Incentives and technologies for improving irrigation water use efficiency

NASA Astrophysics Data System (ADS)

Bruggeman, Adriana; Djuma, Hakan; Giannakis, Elias; Eliades, Marinos

2014-05-01

The European Water Framework Directive requires Member States to set water prices that provide adequate incentives for users to use water resources efficiently. These new water pricing policies need to consider cost recovery of water services, including financial, environmental and resource cost. Prices were supposed to have been set by 2010. So far the record has been mixed. The European Commission has sent reasoned opinions to a number of countries (Austria, Belgium, Denmark, Estonia, Finland, Germany, Hungary, Netherlands, Sweden) requesting them to adjust their national legislation to include all water services. Unbalanced water pricing may negatively affect the agricultural sector, especially in the southern EU countries, which are more dependent on irrigation water for production. The European Commission is funding several projects that aim to reduce the burden of increasing water prices on farmers by developing innovative technologies and decision support systems that will save water and increase productivity. The FP7 ENORASIS project (grant 282949) has developed a new integrated irrigation management decision support platform, which include high-resolution, ensemble weather forecasting, a GIS widget for the location of fields and sensors and a comprehensive decision support and database management software package to optimize irrigation water management. The field component includes wireless, solar-powered soil moisture sensors, small weather stations, and remotely controlled irrigation valves. A mobile App and a web-package are providing user-friendly interfaces for farmers, water companies and environmental consultants. In Cyprus, agricultural water prices have been set to achieve a cost recovery rate of 54% (2010). The pricing policy takes in consideration the social importance and financial viability of the agricultural sector, an important flexibility provided by the Water Framework Directive. The new price was set at 0.24 euro per m3 for water supply from the government irrigation network, with an additional fixed fee of 66.10 euro per ha per season. This is a substantial increase from the 0.17 euro per3 and 17.10 euro per ha fixed fee. The price for individual abstractions has been set at 0.11 euro per m^3. However, these new prices have not yet been approved by the Parliament. Agriculture in Cyprus is highly fragmented. The average farm size is 3.5 ha, while each farm holds on average 5 parcels (agricultural census of 2003). Stakeholder interviews indicated that, in general, small farmers in Cyprus have not considered investments in advanced irrigation scheduling technologies to counter balance the loom of higher water prices. However, the picture is different for large producers. A large citrus producer was interested in testing the ENORASIS technology. The first season of measurements indicated that water can be used more efficiently and that the ENORASIS system provides an important tool for reducing on-farm irrigation water use.

Projected savings through public health voluntary licences of HIV drugs negotiated by the Medicines Patent Pool (MPP).

PubMed

Juneja, Sandeep; Gupta, Aastha; Moon, Suerie; Resch, Stephen

2017-01-01

The Medicines Patent Pool (MPP) was established in 2010 to ensure timely access to low-cost generic versions of patented antiretroviral (ARV) medicines in low- and middle-income countries (LMICs) through the negotiation of voluntary licences with patent holders. While robust data on the savings generated by MPP and other major global public health initiatives is important, it is also difficult to quantify. In this study, we estimate the savings generated by licences negotiated by the MPP for ARV medicines to treat HIV/AIDS in LMICs for the period 2010-2028 and generate a cost-benefit ratio-based on people living with HIV (PLHIVs) in any new countries which gain access to an ARV due to MPP licences and the price differential between originator's tiered price and generics price, within the period where that ARV is patented. We found that the direct savings generated by the MPP are estimated to be USD 2.3 billion (net present value) by 2028, representing an estimated cost-benefit ratio of 1:43, which means for every USD 1 spent on MPP, the global public health community saves USD 43. The saving of USD 2.3 billion is equivalent to more than 24 million PLHIV receiving first-line ART in LMICs for 1 year at average prices today.

Hysteroscopic polypectomy prior to infertility treatment: A cost analysis and systematic review.

PubMed

Mouhayar, Youssef; Yin, Ophelia; Mumford, Sunni L; Segars, James H

2017-06-01

The cost of fertility treatment is expensive and interventions that reduce cost can lead to greater efficiency and fewer embryos transferred. Endometrial polyps contribute to infertility and are frequently removed prior to infertility treatment. It is unclear whether polypectomy reduces fertility treatment cost and if so, the magnitude of cost reduction afforded by the procedure. The aim of this study was to determine whether performing office or operative hysteroscopic polypectomy prior to infertility treatment would be cost-effective. PubMed, Embase, and Cochrane libraries were used to identify publications reporting pregnancy rates after hysteroscopic polypectomy. Studies were required to have a polypectomy treatment group and control group of patients with polyps that were not resected. The charges of infertility treatments and polypectomy were obtained through infertility organizations and a private healthcare cost reporting website. These charges were applied to a decision tree model over the range of pregnancy rates observed in the representative studies to calculate an average cost per clinical or ongoing pregnancy. A sensitivity analysis was conducted to assess cost savings of polypectomy over a range of pregnancy rates and polypectomy costs. Pre-treatment office or operative hysteroscopic polypectomy ultimately saved €6658 ($7480) and €728 ($818), respectively, of the average cost per clinical pregnancy in women treated with four cycles of intrauterine insemination. Polypectomy prior to intrauterine insemination was cost-effective for clinical pregnancy rates greater than 30.2% for office polypectomy and 52.6% for operative polypectomy and for polypectomy price <€4414 ($4959). Office polypectomy or operative polypectomy saved €15,854 ($17,813) and €6644 ($7465), respectively, from the average cost per ongoing pregnancy for in vitro fertilization/intracytoplasmic sperm injection treated women and was cost-effective for ongoing pregnancy rates greater than 26.4% (office polypectomy) and 31.7% (operative polypectomy) and polypectomy price <€6376 ($7164). These findings suggested that office or operative hysteroscopic polypectomy was cost-effective when performed prior to both intrauterine insemination and in vitro fertilization over a range of plausible pregnancy rates and procedural costs. Copyright © 2017 Elsevier B.V. All rights reserved.

Electricity Prices in a Competitive Environment: Marginal Cost Pricing

EIA Publications

1997-01-01

Presents the results of an analysis that focuses on two questions: (1) How are prices for competitive generation services likely to differ from regulated prices if competitive prices are based on marginal costs rather than regulated cost-of-service pricing? (2) What impacts will the competitive pricing of generation services (based on marginal costs) have on electricity consumption patterns, production costs, and the financial integrity of electricity suppliers?

Reforming antiretroviral price negotiations and public procurement: the Mexican experience.

PubMed

Adesina, Adebiyi; Wirtz, Veronika J; Dratler, Sandra

2013-01-01

Since antiretroviral (ARV) medicines represent one of the most costly components of therapy for HIV in middle-income countries, ensuring their efficient procurement is highly relevant. In 2008, Mexico created a national commission for the negotiation of ARV prices to achieve price reductions for their public HIV treatment programmes. The objective of this study is to assess the immediate impact of the creation of the Mexican Commission for Price Negotiation on ARV prices and expenditures. A longitudinal retrospective analysis of procurement prices, volumes and type of the most commonly prescribed ARVs procured by the two largest providers of HIV/AIDS care in Mexico between 2004 and 2009 was carried out. These analyses were combined with 26 semi-structured key informant interviews to identify changes in the procurement process. Prices for ARVs dropped by an average of 38% after the first round of negotiations, indicating that the Commission was successful in price negotiations. However, when compared with other upper-middle-income countries, Mexico continues to pay an average of six times more for ARVs. The Commission's negotiations were successful in achieving lower ARV prices. However, price reduction in upper-middle-income countries suggests that the price decrease in Mexico cannot be entirely attributed to the Commission's first round of negotiations. In addition, key informants identified inefficiencies in the forecasting and procurement processes possibly affecting the efficiency of the negotiation process. A comprehensive approach to improving efficiency in the purchasing and delivery of ARVs is necessary, including a better clarification in the roles and responsibilities of the Commission, improving supply data collection and integration in forecasting and procurement, and the creation of a support system to monitor and provide feedback on patient ARV use.

Cigarette Price-Minimization Strategies by U.S. Smokers

PubMed Central

Xu, Xin; Pesko, Michael F.; Tynan, Michael A.; Gerzoff, Robert B.; Malarcher, Ann M.; Pechacek, Terry F.

2015-01-01

Background Smokers may react to cigarette excise tax increases by engaging in price-minimization strategies (i.e., finding ways to reduce the cost of cigarette smoking) rather than by quitting or reducing their cigarette use, thereby reducing the public health benefits of such tax increases. Purpose To evaluate the state and national prevalence of five common cigarette price-minimization strategies and the size of price reductions obtained from these strategies. Methods Using data from the 2009–2010 National Adult Tobacco Survey, the prevalence of five common price-minimization strategies by type of strategy and by smoker’s cigarette consumption level were estimated. The price reductions associated with these price-minimization strategies also were evaluated. Analyses took place in November 2012. Results Approximately 55.4% of U.S. adult smokers used at least one of five price-minimization strategies in the previous year, with an average reduction of $1.27 per pack (22.0%). Results varied widely by state. Conclusions Cigarette price-minimization strategies are practiced widely among current smokers, and resulting price reductions are relatively large. Policies that decrease opportunities to effectively apply cigarette price-minimization strategies would increase the public health gains of cigarette excise tax increases. PMID:23597810

Cost awareness decreases total percutaneous coronary intervention procedural cost: The SHOPPING (Show How Options in Price for Procedures Can Be Influenced Greatly) trial.

PubMed

Asher, Elad; Mansour, John; Wheeler, Adam; Kendrick, Daniel; Cunningham, Michael; Parikh, Sahil; Zidar, David; Harford, Todd; Simon, Daniel I; Kashyap, Vikram S

2017-06-01

We initiated the SHOPPING Trial (Show How Options in Price for Procedures can be InflueNced Greatly) to see if percutaneous coronary intervention (PCI) procedures can be performed at a lower cost in a single institution. Procedural practice variability is associated with inefficiency and increased cost. We hypothesized that announcing costs for all supplies during a catheterization procedure and reporting individual operator cost relative to peers would spur cost reduction without affecting clinical outcomes. Baseline costs of 10 consecutive PCI procedures performed by 9 interventional cardiologists were documented during a 90-day interval. Costs were reassessed after instituting cost announcing and peer reporting the next quarter. The intervention involved labeling of all endovascular supplies, equipment, devices, and disposables in the catheterization laboratory and announcement of the unit price for each piece when requested. For each interventionalist, procedure time and costs were measured and analyzed prior to and after the intervention. We found that total PCI procedural cost was significantly reduced by an average of $234.77 (P = 0.01), equating to a total savings of $21,129.30 over the course of 90 PCI procedures. Major Adverse Cardiac and Cerebrovascular Event (MACCE) rates were similar during both periods (2.3% vs. 3.5%, P = NS). Announcing costs in the catheterization laboratory during single vessel PCI and peer reporting leads to cost reduction without affecting clinical outcomes. This intervention may have a role in more complex coronary and peripheral interventional procedures, and in other procedural areas where multiple equipment and device alternatives with variable costs are available. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Is $50/MWh solar for real? Falling project prices and rising capacity factors drive utility-scale PV toward economic competitiveness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bolinger, Mark; Weaver, Samantha; Zuboy, Jarett

Recently announced low-priced power purchase agreements (PPAs) for US utility-scale photovoltaic (PV) projects suggest $50/MWh solar might be viable under certain conditions. To explore this possibility, this paper draws on an increasing wealth of empirical data to analyze trends in three of the most important PPA price drivers: upfront installed project prices, operations, and maintenance (O&M) costs, and capacity factors. Average installed prices among a sample of utility-scale PV projects declined by more than one third (from 5.8/W AC to 3.7/WAC) from the 2007–2009 period through 2013, even as costlier systems with crystalline-silicon modules, sun tracking, and higher inverter loadingmore » ratios (ILRs) have constituted an increasing proportion of total utility-scale PV capacity (all values shown here are in 2013 dollars). Actual and projected O&M costs from a very small sample of projects appear to range from $20–$40/kW AC-year. Furthermore, the average net capacity factor is 30% for projects installed in 2012, up from 24% for projects installed in 2010, owing to better solar resources, higher ILRs, and greater use of tracking among the more recent projects. Based on these trends, a pro-forma financial model suggests that $50/MWh utility-scale PV is achievable using a combination of aggressive-but-achievable technical and financial input parameters (including receipt of the 30% federal investment tax credit). Although the US utility-scale PV market is still young, the rapid progress in the key metrics documented in this paper has made PV a viable competitor against other utility-scale renewable generators, and even conventional peaking generators, in certain regions of the country.« less

Is $50/MWh solar for real? Falling project prices and rising capacity factors drive utility-scale PV toward economic competitiveness

DOE PAGES

Bolinger, Mark; Weaver, Samantha; Zuboy, Jarett

2015-05-22

Recently announced low-priced power purchase agreements (PPAs) for US utility-scale photovoltaic (PV) projects suggest $50/MWh solar might be viable under certain conditions. To explore this possibility, this paper draws on an increasing wealth of empirical data to analyze trends in three of the most important PPA price drivers: upfront installed project prices, operations, and maintenance (O&M) costs, and capacity factors. Average installed prices among a sample of utility-scale PV projects declined by more than one third (from 5.8/W AC to 3.7/WAC) from the 2007–2009 period through 2013, even as costlier systems with crystalline-silicon modules, sun tracking, and higher inverter loadingmore » ratios (ILRs) have constituted an increasing proportion of total utility-scale PV capacity (all values shown here are in 2013 dollars). Actual and projected O&M costs from a very small sample of projects appear to range from $20–$40/kW AC-year. Furthermore, the average net capacity factor is 30% for projects installed in 2012, up from 24% for projects installed in 2010, owing to better solar resources, higher ILRs, and greater use of tracking among the more recent projects. Based on these trends, a pro-forma financial model suggests that $50/MWh utility-scale PV is achievable using a combination of aggressive-but-achievable technical and financial input parameters (including receipt of the 30% federal investment tax credit). Although the US utility-scale PV market is still young, the rapid progress in the key metrics documented in this paper has made PV a viable competitor against other utility-scale renewable generators, and even conventional peaking generators, in certain regions of the country.« less

Estimating the long-term costs of ischemic and hemorrhagic stroke for Australia: new evidence derived from the North East Melbourne Stroke Incidence Study (NEMESIS).

PubMed

Cadilhac, Dominique A; Carter, Rob; Thrift, Amanda G; Dewey, Helen M

2009-03-01

Stroke is associated with considerable societal costs. Cost-of-illness studies have been undertaken to estimate lifetime costs; most incorporating data up to 12 months after stroke. Costs of stroke, incorporating data collected up to 12 months, have previously been reported from the North East Melbourne Stroke Incidence Study (NEMESIS). NEMESIS now has patient-level resource use data for 5 years. We aimed to recalculate the long-term resource utilization of first-ever stroke patients and compare these to previous estimates obtained using data collected to 12 months. Population structure, life expectancy, and unit prices within the original cost-of-illness models were updated from 1997 to 2004. New Australian stroke survival and recurrence data up to 10 years were incorporated, as well as cross-sectional resource utilization data at 3, 4, and 5 years from NEMESIS. To enable comparisons, 1997 costs were inflated to 2004 prices and discounting was standardized. In 2004, 27 291 ischemic stroke (IS) and 4291 intracerebral hemorrhagic stroke (ICH) first-ever events were estimated. Average annual resource use after 12 months was AU$6022 for IS and AU$3977 for ICH. This is greater than the 1997 estimates for IS (AU$4848) and less than those for ICH (previously AU$10 692). The recalculated average lifetime costs per first-ever case differed for IS (AU$57 106 versus AU$52 855 [1997]), but differed more for ICH (AU$49 995 versus AU$92 308 [1997]). Basing lifetime cost estimates on short-term data overestimated the costs for ICH and underestimated those for IS. Patterns of resource use varied by stroke subtype and, overall, the societal cost impact was large.

Comprehensive assessment of the effective scope of modernization of thermal power plants to substantiate the rational structure of the generating capacities for the future until 2035

NASA Astrophysics Data System (ADS)

Veselov, F. V.; Erokhina, I. V.; Makarova, A. S.; Khorshev, A. A.

2017-03-01

The article deals with issues of technical and economic substantiation of priorities and scopes of modernizing the existing thermal power plants (TPPs) in Russia to work out long-term forecasts of the development of the industry. The current situation in the TPP modernization trends is analyzed. The updated initial figures of the capital and operation costs are presented and the obtained estimates of the comparative efficiency of various investment decisions on modernization and equipment replacement at gas-and-oil-burning and coal-fired TPPs with regard to the main zones of the national Unified Power System (UPS) of Russia are cited. The results of optimization of the generating capacity structure underlie a study of alternative TPP modernization strategies that differ in the scope of switching to new technologies, capital intensity, and energy efficiency (decrease in the average heat rate). To provide an integral economic assessment of the above strategies, the authors modified the traditional approach based on determination of the overall discounted costs of power supply (least-cost planning) supplemented with a comparison by the weighted average wholesale price of the electricity. A method for prediction of the wholesale price is proposed reasoning from the direct and dual solutions of the optimization problem. The method can be adapted to various combinations of the mechanisms of payment for the electricity and the capacity on the basis of marginal and average costs. Energy and economic analysis showed that the opposite effects of reduction in the capital investment and fuel saving change in a nonlinear way as the scope of the switch to more advanced power generation technologies at the TPPs increases. As a consequence, a strategy for modernization of the existing power plants rational with respect to total costs of the power supply and wholesale electricity prices has been formulated. The strategy combines decisions on upgrade and replacement of the equipment at the existing power plants of various types. The basic parameters of the strategy for the future until 2035 are provided.

48 CFR 15.402 - Pricing policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... certified cost or pricing data when required by 15.403-4, along with data other than certified cost or pricing data as necessary to establish a fair and reasonable price; or (2) When certified cost or pricing data are not required by 15.403-4, obtain data other than certified cost or pricing data as necessary...

48 CFR 15.402 - Pricing policy.

Code of Federal Regulations, 2011 CFR

2011-10-01

... certified cost or pricing data when required by 15.403-4, along with data other than certified cost or pricing data as necessary to establish a fair and reasonable price; or (2) When certified cost or pricing data are not required by 15.403-4, obtain data other than certified cost or pricing data as necessary...

A Cross-Sectional Survey of Interventional Radiologists and Vascular Surgeons Regarding the Cost and Reimbursement of Common Devices and Procedures

PubMed Central

Wang, Angela; Dybul, Stephanie L.; Patel, Parag J.; Tutton, Sean M.; Lee, Cheong J.; White, Sarah B.

2016-01-01

Purpose To evaluate knowledge of interventional radiologists (IRs) and vascular surgeons (VSs) on the cost of common devices and procedures and to determine factors associated with differences in understanding. Materials and Methods An online survey was administered to US faculty IRs and VSs. Demographic information and physicians’ opinions on hospital costs were elicited. Respondents were asked to estimate the average price of 15 commonly used devices and to estimate the work relative value units (wRVUs) and average Medicare reimbursements for 10 procedures. Answer estimates were deemed correct if values were ± 25% of the actual costs. Multivariate logistical regression was used to calculate odds ratios and 95% confidence intervals. Results Of the 4,926 participants contacted, 1,090 (22.1%) completed the questionnaire. Overall, 19.8%, 22.8%, and 31.9% were accurate in price estimations of devices, Medicare reimbursement, and wRVUs for procedures. Physicians who thought themselves adequately educated about wRVUs were more accurate in predicting procedural costs in wRVUs than physicians who responded otherwise (odds ratio = 1.40, 95% confidence interval, 1.29–1.52; P < .0001). Estimation accuracies for procedures showed a positive trend in more experienced physicians (≥ 16 y), private practice physicians, and physicians who practice in rural areas. Conclusions This study suggests that IRs and VSs have limited knowledge regarding device costs. Given the current health care environment, more attention should be placed on cost education and awareness so that physicians can provide the most cost-effective care. PMID:26706189

Maize flour fortification in Africa: markets, feasibility, coverage, and costs.

PubMed

Fiedler, John L; Afidra, Ronald; Mugambi, Gladys; Tehinse, John; Kabaghe, Gladys; Zulu, Rodah; Lividini, Keith; Smitz, Marc-Francois; Jallier, Vincent; Guyondet, Christophe; Bermudez, Odilia

2014-04-01

The economic feasibility of maize flour and maize meal fortification in Kenya, Uganda, and Zambia is assessed using information about the maize milling industry, households' purchases and consumption levels of maize flour, and the incremental cost and estimated price impacts of fortification. Premix costs comprise the overwhelming share of incremental fortification costs and vary by 50% in Kenya and by more than 100% across the three countries. The estimated incremental cost of maize flour fortification per metric ton varies from $3.19 in Zambia to $4.41 in Uganda. Assuming all incremental costs are passed onto the consumer, fortification in Zambia would result in at most a 0.9% increase in the price of maize flour, and would increase annual outlays of the average maize flour-consuming household by 0.2%. The increases for Kenyans and Ugandans would be even less. Although the coverage of maize flour fortification is not likely to be as high as some advocates have predicted, fortification is economically feasible, and would reduce deficiencies of multiple micronutrients, which are significant public health problems in each of these countries. © 2013 New York Academy of Sciences.

48 CFR 239.7406 - Cost or pricing data and information other than cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost or pricing data and information other than cost or pricing data. 239.7406 Section 239.7406 Federal Acquisition Regulations System... ACQUISITION OF INFORMATION TECHNOLOGY Telecommunications Services 239.7406 Cost or pricing data and...

77 FR 76939 - Defense Federal Acquisition Regulation Supplement: Definition of Cost or Pricing Data (DFARS Case...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... Cost or Pricing Data (DFARS Case 2011-D040) AGENCY: Defense Acquisition Regulations System, Department... ``certified cost or pricing data'' and ``data other than certified cost or pricing data.'' The DFARS changes... cost or pricing data. DATES: December 31, 2012. FOR FURTHER INFORMATION CONTACT: Mr. Mark Gomersall...

76 FR 67152 - Federal Acquisition Regulation; Submission for OMB Review; Cost or Pricing Data Requirements and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

...; Submission for OMB Review; Cost or Pricing Data Requirements and Information Other Than Cost or Pricing Data... extension of a previously approved information collection requirement concerning cost or pricing data requirements and information other than cost or pricing data. A noticed was published in the Federal Register...

Regional price differences and food consumption frequency among elementary school children.

PubMed

Sturm, R; Datar, A

2011-03-01

Food prices may affect diet and weight gain among youth and lead to geographic disparities in obesity. This paper examines the association between regional prices and consumption frequency of fruit/vegetables and snack items among elementary school children in the USA. Observational study using individual-level survey data of fifth-grade children (average age 11 years) and regional food prices based on store visits in 2004. Dependent variables are self-reported consumption frequency in fifth grade; primary explanatory variables are metropolitan area food prices relative to cost of living. Multivariate regression analysis. Price variation across metropolitan areas exists, and lower real prices for vegetables and fruits predict significantly higher intake frequency. Higher dairy prices predict lower frequency of milk consumption, while higher meat prices predict increased milk consumption. Similar price effects were not found for fast food or soft drink consumption. The geographic variation in food prices across the USA is sufficiently large to affect dietary patterns among youth for fruit, vegetables and milk. The price variation is either too small to affect children's consumption frequency of fast food or soft drinks, or the consumption of these foods is less price sensitive. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Regional price differences and food consumption frequency among elementary school children

PubMed Central

Sturm, R.; Datar, A.

2010-01-01

SUMMARY Objective Food prices may affect diet and weight gain among youth and lead to geographic disparities in obesity. This paper examines the association between regional prices and consumption frequency of fruit/vegetables and snack items among elementary school children in the USA. Study design Observational study using individual-level survey data of fifth-grade children (average age 11 years) and regional food prices based on store visits in 2004. Methods Dependent variables are self-reported consumption frequency in fifth grade; primary explanatory variables are metropolitan area food prices relative to cost of living. Multivariate regression analysis. Results Price variation across metropolitan areas exists, and lower real prices for vegetables and fruits predict significantly higher intake frequency. Higher dairy prices predict lower frequency of milk consumption, while higher meat prices predict increased milk consumption. Similar price effects were not found for fast food or soft drink consumption. Discussion The geographic variation in food prices across the USA is sufficiently large to affect dietary patterns among youth for fruit, vegetables and milk. This suggests that either the price variation is too small to affect children’s consumption frequency of fast food or soft drinks, or that the consumption of these foods is less price sensitive. PMID:21315395

Incentive pricing and cost recovery at the basin scale.

PubMed

Ward, Frank A; Pulido-Velazquez, Manuel

2009-01-01

Incentive pricing programs have potential to promote economically efficient water use patterns and provide a revenue source to compensate for environmental damages. However, incentive pricing may impose disproportionate costs and aggravate poverty where high prices are levied for basic human needs. This paper presents an analysis of a two-tiered water pricing system that sets a low price for subsistence needs, while charging a price equal to marginal cost, including environmental cost, for discretionary uses. This pricing arrangement can promote efficient and sustainable water use patterns, goals set by the European Water Framework Directive, while meeting subsistence needs of poor households. Using data from the Rio Grande Basin of North America, a dynamic nonlinear program, maximizes the basin's total net economic and environmental benefits subject to several hydrological and institutional constraints. Supply costs, environmental costs, and resource costs are integrated in a model of a river basin's hydrology, economics, and institutions. Three programs are compared: (1) Law of the River, in which water allocations and prices are determined by rules governing water transfers; (2) marginal cost pricing, in which households pay the full marginal cost of supplying treated water; (3) two-tiered pricing, in which households' subsistence water needs are priced cheaply, while discretionary uses are priced at efficient levels. Compared to the Law of the River and marginal cost pricing, two-tiered pricing performs well for efficiency and adequately for sustainability and equity. Findings provide a general framework for formulating water pricing programs that promote economically and environmentally efficient water use programs while also addressing other policy goals.

7 CFR 1437.11 - Average market price and payment factors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Average market price and payment factors. 1437.11... ASSISTANCE PROGRAM General Provisions § 1437.11 Average market price and payment factors. (a) An average... average market price by the applicable payment factor (i.e., harvested, unharvested, or prevented planting...

Necitumumab in Metastatic Squamous Cell Lung Cancer: Establishing a Value-Based Cost.

PubMed

Goldstein, Daniel A; Chen, Qiushi; Ayer, Turgay; Howard, David H; Lipscomb, Joseph; Ramalingam, Suresh S; Khuri, Fadlo R; Flowers, Christopher R

2015-12-01

The SQUIRE trial demonstrated that adding necitumumab to chemotherapy for patients with metastatic squamous cell lung cancer (mSqCLC) increased median overall survival by 1.6 months (hazard ratio, 0.84). However, the costs and value associated with this intervention remains unclear. Value-based pricing links the price of a drug to the benefit that it provides and is a novel method to establish prices for new treatments. To evaluate the range of drug costs for which adding necitumumab to chemotherapy could be considered cost-effective. We developed a Markov model using data from multiple sources, including the SQUIRE trial, which compared standard chemotherapy with and without necitumumab as first-line treatment of mSqCLC, to evaluate the costs and patient life expectancies associated with each regimen. In the analysis, patients were modeled to receive gemcitabine and cisplatin for 6 cycles or gemcitabine, cisplatin, and necitumumab for 6 cycles followed by maintenance necitumumab. Our model's clinical inputs were the survival estimates and frequency of adverse events (AEs) described in the SQUIRE trial. Log-logistic models were fitted to the survival distributions in the SQUIRE trial. The cost inputs included drug costs, based on the Medicare average sale prices, and costs for drug administration and management of AEs, based on Medicare reimbursement rates (all in 2014 US dollars). We evaluated incremental cost-effectiveness ratios (ICERs) for the use of necitumumab across a range of values for its cost. Model robustness was assessed by probabilistic sensitivity analyses, based on 10 000 Monte Carlo simulations, sampling values from the distributions of all model parameters. In the base case analysis, the addition of necitumumab to the treatment regimen produced an incremental survival benefit of 0.15 life-years and 0.11 quality-adjusted life-years (QALYs). The probabilistic sensitivity analyses established that when necitumumab cost less than $563 and less than $1309 per cycle, there was 90% confidence that the ICER for adding necitumumab would be less than $100 000 per QALY and less than $200 000 per QALY, respectively. These findings provide a value-based range for the cost of necitumumab from $563 to $1309 per cycle. This study provides a framework for establishing value-based pricing for new oncology drugs entering the US marketplace.

Access to diagnostic tests and essential medicines for cardiovascular diseases and diabetes care: cost, availability and affordability in the West Region of Cameroon.

PubMed

Jingi, Ahmadou M; Noubiap, Jean Jacques N; Ewane Onana, Arnold; Nansseu, Jobert Richie N; Wang, Binhuan; Kingue, Samuel; Kengne, André Pascal

2014-01-01

To assess the availability and affordability of medicines and routine tests for cardiovascular disease (CVD) and diabetes in the West region of Cameroon, a low-income setting. A survey was conducted on the availability and cost of twelve routine tests and twenty medicines for CVD and diabetes in eight health districts (four urban and four rural) covering over 60% of the population of the region (1.8 million). We analyzed the percentage of tests and medicines available, the median price against the international reference price (median price ratio) for the medicines, and affordability in terms of the number of days' wages it would cost the lowest-paid unskilled government worker for initial investigation tests and procurement for one month of treatment. The availability of tests varied between 10% for the ECG to 100% for the fasting blood sugar. The average cost for the initial investigation using the minimum tests cost 29.76 days' wages. The availability of medicines varied from 36.4% to 59.1% in urban and from 9.1% to 50% in rural settings. Only metformin and benzathine-benzylpenicilline had a median price ratio of ≤ 1.5, with statins being largely unaffordable (at least 30.51 days' wages). One month of combination treatment for coronary heart disease costs at least 40.87 days' wages. The investigation and management of patients with medium-to-high cardiovascular risk remains largely unavailable and unaffordable in this setting. An effective non-communicable disease program should lay emphasis on primary prevention, and improve affordable access to essential medicines in public outlets.

Monetary Shocks in Models with Inattentive Producers.

PubMed

Alvarez, Fernando E; Lippi, Francesco; Paciello, Luigi

2016-04-01

We study models where prices respond slowly to shocks because firms are rationally inattentive. Producers must pay a cost to observe the determinants of the current profit maximizing price, and hence observe them infrequently. To generate large real effects of monetary shocks in such a model the time between observations must be long and/or highly volatile. Previous work on rational inattentiveness has allowed for observation intervals that are either constant-but-long ( e.g . Caballero, 1989 or Reis, 2006) or volatile-but-short ( e.g . Reis's, 2006 example where observation costs are negligible), but not both. In these models, the real effects of monetary policy are small for realistic values of the duration between observations. We show that non-negligible observation costs produce both of these effects: intervals between observations are infrequent and volatile. This generates large real effects of monetary policy for realistic values of the average time between observations.

Monetary Shocks in Models with Inattentive Producers

PubMed Central

Alvarez, Fernando E.; Lippi, Francesco; Paciello, Luigi

2016-01-01

We study models where prices respond slowly to shocks because firms are rationally inattentive. Producers must pay a cost to observe the determinants of the current profit maximizing price, and hence observe them infrequently. To generate large real effects of monetary shocks in such a model the time between observations must be long and/or highly volatile. Previous work on rational inattentiveness has allowed for observation intervals that are either constant-but-long (e.g. Caballero, 1989 or Reis, 2006) or volatile-but-short (e.g. Reis's, 2006 example where observation costs are negligible), but not both. In these models, the real effects of monetary policy are small for realistic values of the duration between observations. We show that non-negligible observation costs produce both of these effects: intervals between observations are infrequent and volatile. This generates large real effects of monetary policy for realistic values of the average time between observations. PMID:27516627

Retail price and point of sale display of tobacco in the UK: a descriptive study of small retailers.

PubMed

Spanopoulos, Dionysis; Ratschen, Elena; McNeill, Ann; Britton, John

2012-01-01

Since the implementation of the 2002 Tobacco Advertising and Promotion Act, point-of-sale (PoS) tobacco displays are one of few remaining means of communication between the tobacco industry and customers in the UK. This study aimed to explore the characteristics of tobacco displays in a UK city, and particularly to assess the tobacco prices and promotional offers, types and pack sizes on display. Digital pictures of PoS displays were taken in 117 small retail shops in Nottingham in mid 2010. Data were analysed using Windows Photo Gallery software and SPSS version 16. Just over half (52%) of cigarette packs on display were packs of 20, and 43% packs of 10. Cigarette prices differed substantially between brands, ranging from £4.19 to £6.85 for 20-packs, and from £2.12 to £3.59 for 10-packs. Forty four percent of cigarette packs and 40% of RYO (Roll-Your-Own) tobacco pouches, almost exclusively lower priced brands, were displayed with a pricemark, implying a promotional price offer. Eighty percent of 20-pack cigarette brand or brand variants on sale were priced below the EU-defined Most Popular Price Category (MPPC) for the UK in 2010; 45% were priced below the Weighted Average Price (WAP), which replaced the MPPC in 2011. PoS displays communicate value by displaying a high proportion of lower cost brands, and smaller and hence lower-cost packs, and by displaying price discounts on packs. The MPPC substantially overestimated the prices at which most 20-cigarette packs were available. Removal of PoS displays will prevent this means of price marketing but our study also suggests that minimum pricing of 20-pack cigarettes, prohibition of sale of cigarettes in packs less than 20, and plain packaging to prevent pricemarking are necessary if price is to be used effectively as a tobacco control measure.

Retail Price and Point of Sale Display of Tobacco in the UK: A Descriptive Study of Small Retailers

PubMed Central

Spanopoulos, Dionysis; Ratschen, Elena; McNeill, Ann; Britton, John

2012-01-01

Background Since the implementation of the 2002 Tobacco Advertising and Promotion Act, point-of-sale (PoS) tobacco displays are one of few remaining means of communication between the tobacco industry and customers in the UK. This study aimed to explore the characteristics of tobacco displays in a UK city, and particularly to assess the tobacco prices and promotional offers, types and pack sizes on display. Methods Digital pictures of PoS displays were taken in 117 small retail shops in Nottingham in mid 2010. Data were analysed using Windows Photo Gallery software and SPSS version 16. Results Just over half (52%) of cigarette packs on display were packs of 20, and 43% packs of 10. Cigarette prices differed substantially between brands, ranging from £4.19 to £6.85 for 20-packs, and from £2.12 to £3.59 for 10-packs. Forty four percent of cigarette packs and 40% of RYO (Roll-Your-Own) tobacco pouches, almost exclusively lower priced brands, were displayed with a pricemark, implying a promotional price offer. Eighty percent of 20-pack cigarette brand or brand variants on sale were priced below the EU-defined Most Popular Price Category (MPPC) for the UK in 2010; 45% were priced below the Weighted Average Price (WAP), which replaced the MPPC in 2011. Conclusion PoS displays communicate value by displaying a high proportion of lower cost brands, and smaller and hence lower-cost packs, and by displaying price discounts on packs. The MPPC substantially overestimated the prices at which most 20-cigarette packs were available. Removal of PoS displays will prevent this means of price marketing but our study also suggests that minimum pricing of 20-pack cigarettes, prohibition of sale of cigarettes in packs less than 20, and plain packaging to prevent pricemarking are necessary if price is to be used effectively as a tobacco control measure. PMID:22242183

High-resolution Behavioral Economic Analysis of Cigarette Demand to Inform Tax Policy

PubMed Central

MacKillop, James; Few, Lauren R.; Murphy, James G.; Wier, Lauren M.; Acker, John; Murphy, Cara; Stojek, Monika; Carrigan, Maureen; Chaloupka, Frank

2012-01-01

Aims Novel methods in behavioral economics permit the systematic assessment of the relationship between cigarette consumption and price. Toward informing tax policy, the goals of this study were to conduct a high-resolution analysis of cigarette demand in a large sample of adult smokers and to use the data to estimate the effects of tax increases in ten U.S. States. Design In-person descriptive survey assessment. Setting Academic departments at three universities. Participants Adult daily smokers (i.e., 5+ cigarettes/day; 18+ years old; ≥8th grade education); N = 1056. Measurements Estimated cigarette demand, demographics, expired carbon monoxide. Findings The cigarette demand curve exhibited highly variable levels of price sensitivity, especially in the form of ‘left-digit effects’ (i.e., very high price sensitivity as pack prices transitioned from one whole number to the next; e.g., $5.80-$6/pack). A $1 tax increase in the ten states was projected to reduce the economic burden of smoking by an average of $531M (range: $93.6M-$976.5M) and increase gross tax revenue by an average of 162% (range: 114%- 247%). Conclusions Tobacco price sensitivity is nonlinear across the demand curve and in particular for pack-level left-digit price transitions. Tax increases in U.S. states with similar price and tax rates to the sample are projected to result in substantial decreases in smoking-related costs and substantial increases in tax revenues. PMID:22845784

High-resolution behavioral economic analysis of cigarette demand to inform tax policy.

PubMed

MacKillop, James; Few, Lauren R; Murphy, James G; Wier, Lauren M; Acker, John; Murphy, Cara; Stojek, Monika; Carrigan, Maureen; Chaloupka, Frank

2012-12-01

Novel methods in behavioral economics permit the systematic assessment of the relationship between cigarette consumption and price. Towards informing tax policy, the goals of this study were to conduct a high-resolution analysis of cigarette demand in a large sample of adult smokers and to use the data to estimate the effects of tax increases in 10 US States. In-person descriptive survey assessment. Academic departments at three universities. Adult daily smokers (i.e. more than five cigarettes/day; 18+ years old; ≥8th grade education); n = 1056. Estimated cigarette demand, demographics, expired carbon monoxide. The cigarette demand curve exhibited highly variable levels of price sensitivity, especially in the form of 'left-digit effects' (i.e. very high price sensitivity as pack prices transitioned from one whole number to the next; e.g. $5.80-6/pack). A $1 tax increase in the 10 states was projected to reduce the economic burden of smoking by an average of $530.6 million (range: $93.6-976.5 million) and increase gross tax revenue by an average of 162% (range: 114-247%). Tobacco price sensitivity is non-linear across the demand curve and in particular for pack-level left-digit price transitions. Tax increases in US states with similar price and tax rates to the sample are projected to result in substantial decreases in smoking-related costs and substantial increases in tax revenues. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Cost Validation Using PRICE H

NASA Technical Reports Server (NTRS)

Jack, John; Kwan, Eric; Wood, Milana

2011-01-01

PRICE H was introduced into the JPL cost estimation tool set circa 2003. It became more available at JPL when IPAO funded the NASA-wide site license for all NASA centers. PRICE H was mainly used as one of the cost tools to validate proposal grassroots cost estimates. Program offices at JPL view PRICE H as an additional crosscheck to Team X (JPL Concurrent Engineering Design Center) estimates. PRICE H became widely accepted ca, 2007 at JPL when the program offices moved away from grassroots cost estimation for Step 1 proposals. PRICE H is now one of the key cost tools used for cost validation, cost trades, and independent cost estimates.

Quit for My Finances | Smokefree 60+

Cancer.gov

You can save money by quitting smoking. Why should you quit now? The cost of smoking adds up quickly. If you smoke a pack a day, you're spending at least $43 per week. Use the calculator to find out how much you could save if you quit today. These amounts are based on a 2015 national average price of about $6.25 per pack. Depending on where you live, the cost of cigarettes could be more.

Quit for My Finances | Smokefree 60+

Cancer.gov

You can save money by quitting smoking. Why should you quit now? The cost of smoking adds up quickly. If you smoke a pack a day, you're spending at least $45 per week. Use the calculator to find out how much you could save if you quit today. These amounts are based on a 2018 national average price of about $6.35 per pack. Depending on where you live, the cost of cigarettes could be more.

Thresholds for decision-making: informing the cost-effectiveness and affordability of rotavirus vaccines in Malaysia.

PubMed

Loganathan, Tharani; Ng, Chiu-Wan; Lee, Way-Seah; Hutubessy, Raymond C W; Verguet, Stéphane; Jit, Mark

2018-03-01

Cost-effectiveness thresholds (CETs) based on the Commission on Macroeconomics and Health (CMH) are extensively used in low- and middle-income countries (LMICs) lacking locally defined CETs. These thresholds were originally intended for global and regional prioritization, and do not reflect local context or affordability at the national level, so their value for informing resource allocation decisions has been questioned. Using these thresholds, rotavirus vaccines are widely regarded as cost-effective interventions in LMICs. However, high vaccine prices remain a barrier towards vaccine introduction. This study aims to evaluate the cost-effectiveness, affordability and threshold price of universal rotavirus vaccination at various CETs in Malaysia. Cost-effectiveness of Rotarix and RotaTeq were evaluated using a multi-cohort model. Pan American Health Organization Revolving Fund's vaccine prices were used as tender price, while the recommended retail price for Malaysia was used as market price. We estimate threshold prices defined as prices at which vaccination becomes cost-effective, at various CETs reflecting economic theories of human capital, societal willingness-to-pay and marginal productivity. A budget impact analysis compared programmatic costs with the healthcare budget. At tender prices, both vaccines were cost-saving. At market prices, cost-effectiveness differed with thresholds used. At market price, using 'CMH thresholds', Rotarix programmes were cost-effective and RotaTeq were not cost-effective from the healthcare provider's perspective, while both vaccines were cost-effective from the societal perspective. Using other CETs, both vaccines were not cost-effective at market price, from the healthcare provider's and societal perspectives. At tender and cost-effective prices, rotavirus vaccination cost ∼1 and 3% of the public health budget, respectively. Using locally defined thresholds, rotavirus vaccination is cost-effective at vaccine prices in line with international tenders, but not at market prices. Thresholds representing marginal productivity are likely to be lower than those reflecting human capital and individual preference measures, and may be useful in determining affordable vaccine prices. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Proposal for a novel methodology to screen and score cost versus survival for anticancer drugs in metastatic disease: could cost weigh in evaluation?

PubMed

Guirgis, Helmy M

2012-07-01

Rising costs of anticancer drugs prompt concerns about their approval, use, and affordability. A methodology was developed to evaluate cost versus survival for anticancer drugs in metastatic breast cancer and non-small-cell lung cancer (NSCLC). Costs of evaluated drugs were calculated by using average wholesale prices in US dollars. Ratios of cost to day of survival (cost/survival/d) were obtained by dividing costs of the entire treatment by reported median survival gain in days. A crude score of 100% was assigned to a cost/survival/d of less than $25, and 0% to a cost/survival/d of more than $750. A strategy was designed to correct for overall survival (OS) versus progression-free survival (PFS), adverse effects, and quality of life. In breast cancer, PFS scores of bevacizumab varied between 0% and 60%. In NSCLC, OS scores of bevacizumab improved from 0% to 50%, as a result of histology, lower prices, and extended therapy. Gefitinib and erlotinib PFS scores were 80% and 70%, respectively. Correction for longer survival with erlotinib resulted in similar scores. In maintenance therapy, the OS score for pemetrexed was 70% as compared with 25% for erlotinib. Generic drugs scored 70% to 90%. Cost/survival varied with the number of cycles. In breast cancer, bevacizumab scores failed to justify its use. In NSCLC, 10 cycles of bevacizumab scored 0%. Scores improved with extended treatment and lower prices. Scores for gefitinib and erlotinib would support their approval. Erlotinib was preferred because of longer PFS. Results tended to endorse maintenance pemetrexed but not erlotinib. Generic drugs demonstrated high scores. Cost/survival could weigh in drug evaluation.

Technoeconomic analysis of wheat straw densification in the Canadian Prairie Province of Manitoba.

PubMed

Mupondwa, Edmund; Li, Xue; Tabil, Lope; Phani, Adapa; Sokhansanj, Shahab; Stumborg, Mark; Gruber, Margie; Laberge, Serge

2012-04-01

This study presents a technoeconomic analysis of wheat straw densification in Canada's prairie province of Manitoba as an integral part of biomass-to-cellulosic-ethanol infrastructure. Costs of wheat straw bale and pellet transportation and densification are analysed, including densification plant profitability. Wheat straw collection radius increases nonlinearly with pellet plant capacity, from 9.2 to 37km for a 2-35tonnesh(-1) plant. Bales are cheaper under 250km, beyond which the cheapest feedstocks are pellets from the largest pellet plant that can be built to exploit economies of scale. Feedstocks account for the largest percentage of variable costs. Marginal and average cost curves suggest Manitoba could support a pellet plant up to 35tonnesh(-1). Operating below capacity (75-50%) significantly erodes a plant's net present value (NPV). Smaller plants require higher NPV break-even prices. Very large plants have considerable risk under low pellet prices and increased processing costs. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Health care demand elasticities by type of service.

PubMed

Ellis, Randall P; Martins, Bruno; Zhu, Wenjia

2017-09-01

We estimate within-year price elasticities of demand for detailed health care services using an instrumental variable strategy, in which individual monthly cost shares are instrumented by employer-year-plan-month average cost shares. A specification using backward myopic prices gives more plausible and stable results than using forward myopic prices. Using 171 million person-months spanning 73 employers from 2008 to 2014, we estimate that the overall demand elasticity by backward myopic consumers is -0.44, with higher elasticities of demand for pharmaceuticals (-0.44), specialists visits (-0.32), MRIs (-0.29) and mental health/substance abuse (-0.26), and lower elasticities for prevention visits (-0.02) and emergency rooms (-0.04). Demand response is lower for children, in larger firms, among hourly waged employees, and for sicker people. Overall the method appears promising for estimating elasticities for highly disaggregated services although the approach does not work well on services that are very expensive or persistent. Copyright © 2017 Elsevier B.V. All rights reserved.

The effect of the water tariff structures on the water consumption in Mallorcan hotels

NASA Astrophysics Data System (ADS)

Deyà-Tortella, Bartolomé; Garcia, Celso; Nilsson, William; Tirado, Dolores

2016-08-01

Tourism increases water demand, especially in coastal areas and on islands, and can also cause water shortages during the dry season and the degradation of the water supply. The aim of this study is to evaluate the impact of water price structures on hotel water consumption on the island of Mallorca (Spain). All tourist municipalities on the island use different pricing structures, such as flat or block rates, and different tariffs. This exogenous variation is used to evaluate the effect of prices on water consumption for a sample of 134 hotels. The discontinuity of the water tariff structure and the fixed rate, which depends on the number of hotel beds, generate endogeneity problems. We propose an econometric model, an instrumental variable quantile regression for within artificial blocks transformed data, to solve both problems. The coefficients corresponding to the price variables are not found to be significantly different from zero. The sign of the effect is negative, but the magnitude is negligible: a 1% increase in all prices would reduce consumption by an average of only 0.024%. This result is probably due to the small share of water costs with respect to the total hotel operational costs (around 4%). Our regression model concludes that the introduction of water-saving initiatives constitutes an effective way to reduce consumption.

Applying Activity Based Costing (ABC) Method to Calculate Cost Price in Hospital and Remedy Services

PubMed Central

Rajabi, A; Dabiri, A

2012-01-01

Background Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990’s. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. Methods: To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. Results: The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Conclusion: Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services. PMID:23113171

48 CFR 15.406-2 - Certificate of current cost or pricing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... cost or pricing data. 15.406-2 Section 15.406-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.406-2 Certificate of current cost or pricing data. (a) When certified cost or pricing data are...

48 CFR 15.406-2 - Certificate of current cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost or pricing data. 15.406-2 Section 15.406-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.406-2 Certificate of current cost or pricing data. (a) When certified cost or pricing data are...

48 CFR 15.406-2 - Certificate of current cost or pricing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... cost or pricing data. 15.406-2 Section 15.406-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.406-2 Certificate of current cost or pricing data. (a) When certified cost or pricing data are...

48 CFR 22.101-2 - Contract pricing and administration.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-reimbursement contracts or for recognition of costs in pricing fixed-price contracts if they result in... organizations to settle disputes. (c) Strikes normally result in changing patterns of cost incurrence and... recognition of costs in pricing fixed-price contracts. Certain costs may increase because of strikes; e.g...

48 CFR 22.101-2 - Contract pricing and administration.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-reimbursement contracts or for recognition of costs in pricing fixed-price contracts if they result in... organizations to settle disputes. (c) Strikes normally result in changing patterns of cost incurrence and... recognition of costs in pricing fixed-price contracts. Certain costs may increase because of strikes; e.g...

48 CFR 52.244-2 - Subcontracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... certified cost or pricing data and Certificate of Current Cost or Pricing Data, if required by other... cost or pricing data were or were not required; (D) The extent, if any, to which the Contractor did not rely on the subcontractor's certified cost or pricing data in determining the price objective and in...

Competition in decentralized electricity markets: Three papers on electricity auctions

NASA Astrophysics Data System (ADS)

Harbord, David William Cameron

This thesis consists of three self-contained papers on the analysis of electricity auctions written over a period of twelve years. The first paper models price competition in a decentralized wholesale market for electricity as a first-price, sealed-bid, multi-unit auction. In both the pure and mixed-strategy equilibria of the model, above marginal cost pricing and inefficient despatch of generating units occur. An alternative regulatory pricing rule is considered and it is shown that offering to supply at marginal cost can be induced as a dominant strategy for all firms. The second paper analyses strategic interaction between long-term contracts and price competition in the British electricity wholesale market, and confirms that forward contracts will tend to put downward pressure on spot market prices. A 'strategic commitment' motive for selling forward contracts is also identified: a generator may commit itself to bidding lower prices into the spot market in order to ensure that it will be despatched with its full capacity. The third paper characterizes bidding behavior and market outcomes in uniform and discriminatory electricity auctions. Uniform auctions result in higher average prices than discriminatory auctions, but the ranking in terms of productive efficiency is ambiguous. The comparative effects of other market design features, such as the number of steps in suppliers' bid functions, the duration of bids and the elasticity of demand are analyzed. The paper also clarifies some methodological issues in the analysis of electricity auctions. In particular we show that analogies with continuous share auctions are misplaced so long as firms are restricted to a finite number of bids.

Midsouth Pulpwood Prices, 1986

Treesearch

Dennis M. May

1988-01-01

In 1986, the average price for a cord of Midsouth roundwood was $47.20, a decrease of 6 percent from the 1985 price. The average price for a green ton of chipped residues also decreased, down 1 percent to $21.77. The average price for a green ton of sawdust fell to $10.25, 3 percent below the 1985 price. Between 1977 and 1986, real prices for roundwood fell, but real...

Electricity prices in a competitive environment: Marginal cost pricing of generation services and financial status of electric utilities. A preliminary analysis through 2015

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-08-01

The emergence of competitive markets for electricity generation services is changing the way that electricity is and will be priced in the United States. This report presents the results of an analysis that focuses on two questions: (1) How are prices for competitive generation services likely to differ from regulated prices if competitive prices are based on marginal costs rather than regulated {open_quotes}cost-of-service{close_quotes} pricing? (2) What impacts will the competitive pricing of generation services (based on marginal costs) have on electricity consumption patterns, production costs, and the financial integrity patterns, production costs, and the financial integrity of electricity suppliers? Thismore » study is not intended to be a cost-benefit analysis of wholesale or retail competition, nor does this report include an analysis of the macroeconomic impacts of competitive electricity prices.« less

Cost associated with stroke: outpatient rehabilitative services and medication.

PubMed

Godwin, Kyler M; Wasserman, Joan; Ostwald, Sharon K

2011-10-01

This study aimed to capture direct costs of outpatient rehabilitative stroke care and medications for a 1-year period after discharge from inpatient rehabilitation. Outpatient rehabilitative services and medication costs for 1 year, during the time period of 2001 to 2005, were calculated for 54 first-time stroke survivors. Costs for services were based on Medicare reimbursement rates. Medicaid reimbursement rates and average wholesale price were used to estimate medication costs. Of the 54 stroke survivors, 40 (74.1%) were categorized as independent, 12 (22.2%) had modified dependence, and 2 (3.7%) were dependent at the time of discharge from inpatient rehabilitation. Average cost for outpatient stroke rehabilitation services and medications the first year post inpatient rehabilitation discharge was $17,081. The corresponding average yearly cost of medication was $5,392, while the average cost of yearly rehabilitation service utilization was $11,689. Cost attributed to medication remained relatively constant throughout the groups. Outpatient rehabilitation service utilization constituted a large portion of cost within each group: 69.7% (dependent), 72.5% (modified dependence), and 66.7% (independent). Stroke survivors continue to incur significant costs associated with their stroke for the first 12 months following discharge from an inpatient rehabilitation setting. Changing public policies affect the cost and availability of care. This study provides a snapshot of outpatient medication and therapy costs prior to the enactment of major changes in federal legislation and serves as a baseline for future studies.

Price and healthfulness of snacks in 32 YMCA after-school programs in 4 US metropolitan areas, 2006-2008.

PubMed

Mozaffarian, Rebecca S; Andry, Analisa; Lee, Rebekka M; Wiecha, Jean L; Gortmaker, Steven L

2012-01-01

A common perception is that healthful foods are more expensive than less healthful foods. We assessed the cost of beverages and foods served at YMCA after-school programs, determined whether healthful snacks were more expensive, and identified inexpensive, healthful options. We collected daily snack menus from 32 YMCAs nationwide from 2006 to 2008 and derived prices of beverages and foods from the US Department of Agriculture price database. Multiple linear regression was used to assess associations of healthful snacks and of beverage and food groups with price (n = 1,294 snack-days). We identified repeatedly served healthful snacks consistent with Child and Adult Care Food Program guidelines and reimbursement rate ($0.74/snack). On average, healthful snacks were approximately 50% more expensive than less healthful snacks ($0.26/snack; SE, 0.08; P = .003). Compared to water, 100% juice significantly increased average snack price, after controlling for other variables in the model. Similarly, compared to refined grains with trans fats, refined grains without trans fat significantly increased snack price, as did fruit and canned or frozen vegetables. Fresh vegetables (mostly carrots or celery) or whole grains did not alter price. Twenty-two repeatedly served snacks met nutrition guidelines and the reimbursement rate. In this sample of after-school programs, healthful snacks were typically more expensive than less healthful options; however, we identified many healthful snacks served at or below the price of less healthful options. Substituting tap water for 100% juice yielded price savings that could be used toward purchasing more healthful foods (eg, an apple). Our findings have practical implications for selecting snacks that meet health and reimbursement guidelines.

A decision-making tool to determine economic feasibility and break-even prices for artisan cheese operations.

PubMed

Durham, Catherine A; Bouma, Andrea; Meunier-Goddik, Lisbeth

2015-12-01

Artisan cheese makers lack access to valid economic data to help them evaluate business opportunities and make important business decisions such as determining cheese pricing structure. The objective of this study was to utilize an economic model to evaluate the net present value (NPV), internal rate of return, and payback period for artisan cheese production at different annual production volumes. The model was also used to determine the minimum retail price necessary to ensure positive NPV for 5 different cheese types produced at 4 different production volumes. Milk type, cheese yield, and aging time all affected variable costs. However, aged cheeses required additional investment for aging space (which needs to be larger for longer aging times), as did lower yield cheeses (by requiring larger-volume equipment for pasteurization and milk handling). As the volume of milk required increased, switching from vat pasteurization to high-temperature, short-time pasteurization was necessary for low-yield cheeses before being required for high-yield cheeses, which causes an additional increase in investment costs. Because of these differences, high-moisture, fresh cow milk cheeses can be sold for about half the price of hard, aged goat milk cheeses at the largest production volume or for about two-thirds the price at the lowest production volume examined. For example, for the given model assumptions, at an annual production of 13,608kg of cheese (30,000 lb), a fresh cow milk mozzarella should be sold at a minimum retail price of $27.29/kg ($12.38/lb), whereas a goat milk Gouda needs a minimum retail price of $49.54/kg ($22.47/lb). Artisan cheese makers should carefully evaluate annual production volumes. Although larger production volumes decrease average fixed cost and improve production efficiency, production can reach volumes where it becomes necessary to sell through distributors. Because distributors might pay as little as 35% of retail price, the retail price needs to be higher to compensate. An artisan cheese company that has not achieved the recognition needed to achieve a premium price may not find distribution through distributors profitable. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

24 CFR 84.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Cost and price analysis. 84.45....45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various...

41 CFR 105-72.505 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Cost and price analysis... § 105-72.505 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be...

49 CFR 19.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Cost and price analysis. 19.45 Section 19.45... Requirements Procurement Standards § 19.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price...

43 CFR 12.945 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Cost and price analysis. 12.945 Section 12... Requirements § 12.945 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be...

48 CFR 1615.407-1 - Rate reduction for defective pricing or defective cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... defective pricing or defective cost or pricing data. 1615.407-1 Section 1615.407-1 Federal Acquisition... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1615.407-1 Rate reduction for defective pricing or defective cost or pricing data. The clause set forth in section 1652.215-70...

48 CFR 1615.407-1 - Rate reduction for defective pricing or defective cost or pricing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... defective pricing or defective cost or pricing data. 1615.407-1 Section 1615.407-1 Federal Acquisition... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1615.407-1 Rate reduction for defective pricing or defective cost or pricing data. The clause set forth in section 1652.215-70...

48 CFR 1615.407-1 - Rate reduction for defective pricing or defective cost or pricing data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... defective pricing or defective cost or pricing data. 1615.407-1 Section 1615.407-1 Federal Acquisition... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1615.407-1 Rate reduction for defective pricing or defective cost or pricing data. The clause set forth in section 1652.215-70...

48 CFR 1615.407-1 - Rate reduction for defective pricing or defective cost or pricing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... defective pricing or defective cost or pricing data. 1615.407-1 Section 1615.407-1 Federal Acquisition... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1615.407-1 Rate reduction for defective pricing or defective cost or pricing data. The clause set forth in section 1652.215-70...

48 CFR 52.215-10 - Price Reduction for Defective Certified Cost or Pricing Data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Defective Certified Cost or Pricing Data. 52.215-10 Section 52.215-10 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.215-10 Price Reduction for Defective Certified Cost or Pricing Data... or Pricing Data (OCT 2010) (a) If any price, including profit or fee, negotiated in connection with...

Projected savings through public health voluntary licences of HIV drugs negotiated by the Medicines Patent Pool (MPP)

PubMed Central

Juneja, Sandeep; Gupta, Aastha; Moon, Suerie; Resch, Stephen

2017-01-01

The Medicines Patent Pool (MPP) was established in 2010 to ensure timely access to low-cost generic versions of patented antiretroviral (ARV) medicines in low- and middle-income countries (LMICs) through the negotiation of voluntary licences with patent holders. While robust data on the savings generated by MPP and other major global public health initiatives is important, it is also difficult to quantify. In this study, we estimate the savings generated by licences negotiated by the MPP for ARV medicines to treat HIV/AIDS in LMICs for the period 2010–2028 and generate a cost-benefit ratio–based on people living with HIV (PLHIVs) in any new countries which gain access to an ARV due to MPP licences and the price differential between originator’s tiered price and generics price, within the period where that ARV is patented. We found that the direct savings generated by the MPP are estimated to be USD 2.3 billion (net present value) by 2028, representing an estimated cost-benefit ratio of 1:43, which means for every USD 1 spent on MPP, the global public health community saves USD 43. The saving of USD 2.3 billion is equivalent to more than 24 million PLHIV receiving first-line ART in LMICs for 1 year at average prices today. PMID:28542239

Trends in Pulpwood Prices in the Southeast, 1962-1969

Treesearch

Cecil C. Hutchins

1970-01-01

Average prices paid for pulpwood bolts in the Southeast increased 5 percent in 1969 over the preceding year. Prices paid for roundwood averaged $20.90 per cord for pine and $16.35 for hardwood. Prices paid for chips averaged $8.45 per ton for pine and $6.75 for hardwood. Since 1962, average prices paid for pulpwood have increased by over 25 percent. Pulpmills...

7 CFR 760.640 - National average market price.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false National average market price. 760.640 Section 760.640....640 National average market price. (a) The Deputy Administrator will establish the National Average Market Price (NAMP) using the best sources available, as determined by the Deputy Administrator, which...

[Economic evaluation of a manual-based, multimodal cognitive behavioural therapy for school avoiding children with psychiatric disorder].

PubMed

Weschenfelder, Ann-Kathrin; Reissner, Volker; Knollmann, Martin; Hebebrand, Johannes; Wasem, Jürgen; Neumann, Anja

2018-01-01

Untreated school refusal increases the risk of a premature discontinuation of the educational career. The aim of this study is the economic evaluation of a manual-based treatment for school refusal in comparison to the standard treatment. Within the cost-minimisation analysis, resource use is measured retrospectively for six months using the CSSRI questionnaire. Unit costs for most health care services are derived from published standard prices. Costs are calculated from the societal perspective based on prices compiled in 2011. The cost comparison during the one-year intervention period applies a difference in differences Approach. The most common diagnoses among the 112 participants are phobic and emotional disorders. The average cost per patient during the intervention period amounts to 7197 € (95 %-CI: 4746 € – 10 079 €) for the manual group and 9294 € (95 %-CI: 6313 € – 12 878 €) for the control group. The difference in adjusted costs of 1453 € in favour of the manual group is not statistically relevant. The manual-based treatment is equivalent if not slightly advantageous compared to the standard treatment considering the clinical outcomes and cost of illness.

Midsouth Pulpwood Prices, 1983

Treesearch

Dennis M. May

1985-01-01

The average price per cord for Midsouth roundwood pulpwood increased less than 1 percent to $48.38 in 1983. The average price for a green ton of chipped mill residues fell 9.3 percent to $23.34. Sawdust prices averaged $13.04 per green ton, a 42.2 percent increase over 1982 prices. Prices for rail delivery of wood fiber continue to be slightly lower than truck...

U.S. Coast Guard Cutter Procurement Lessons Impacts on the Offshore Patrol Cutter Program Affordability

DTIC Science & Technology

2015-12-01

Budget Control Act BLS Bureau of Labor and Statistics C4ISR Command, Control, Communications, Computers, Intelligence, Surveillance, and...made prior to full-rate production. If the program is delinquent in the testing of all of the functionality and the ability to meet stated KPPs, the...estimated the price per pound of the ship by incorporating the Bureau of Labor Statistics calculations on shipbuilding labor costs, average material cost

Scientific Inquiry into Home Electronic Technology Usage

ERIC Educational Resources Information Center

Lazaros, Edward J.; Spotts, Thomas H.; Verdon, Jessica E.

2010-01-01

This activity promotes ways to save electricity in the home. Students identify electronic devices in the home and examine wattage, hours of use per month, estimated wattage per month, kilowatt hours per month, average retail price per kilowatt hour in each state, and the estimated cost per month. Students gain an appreciation for how saving power…

Optimal Government Subsidies to Universities in the Face of Tuition and Enrollment Constraints

ERIC Educational Resources Information Center

Easton, Stephen T.; Rockerbie, Duane W.

2008-01-01

This paper develops a simple static model of an imperfectly competitive university operating under government-imposed constraints on the ability to raise tuition fees and increase enrollments. The model has particular applicability to Canadian universities. Assuming an average cost pricing rule, rules for adequate government subsidies (operating…

7 CFR 210.16 - Food service management companies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... general nature of its food service, and the prices to be charged the children for meals; (5) Retain... preparing or serving meals at a school food authority facility; (8) Establish an advisory board composed of... standard for the purpose of basing bids or estimating average cost per meal. A school food authority with...

29 CFR 95.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Cost and price analysis. 95.45 Section 95.45 Labor Office of... Procurement Standards § 95.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be...

The Value of Renewable Energy as a Hedge Against Fuel Price Risk: Analytic Contributions from Economic and Finance Theory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bolinger, Mark A; Wiser, Ryan

2008-09-15

For better or worse, natural gas has become the fuel of choice for new power plants being built across the United States. According to the Energy Information Administration (EIA), natural gas-fired units account for nearly 90% of the total generating capacity added in the U.S. between 1999 and 2005 (EIA 2006b), bringing the nationwide market share of gas-fired generation to 19%. Looking ahead over the next decade, the EIA expects this trend to continue, increasing the market share of gas-fired generation to 22% by 2015 (EIA 2007a). Though these numbers are specific to the US, natural gas-fired generation is makingmore » similar advances in many other countries as well. A large percentage of the total cost of gas-fired generation is attributable to fuel costs--i.e., natural gas prices. For example, at current spot prices of around $7/MMBtu, fuel costs account for more than 75% of the levelized cost of energy from a new combined cycle gas turbine, and more than 90% of its operating costs (EIA 2007a). Furthermore, given that gas-fired plants are often the marginal supply units that set the market-clearing price for all generators in a competitive wholesale market, there is a direct link between natural gas prices and wholesale electricity prices. In this light, the dramatic increase in natural gas prices since the 1990s should be a cause for ratepayer concern. Figure 1 shows the daily price history of the 'first-nearby' (i.e., closest to expiration) NYMEX natural gas futures contract (black line) at Henry Hub, along with the futures strip (i.e., the full series of futures contracts) from August 22, 2007 (red line). First, nearby prices, which closely track spot prices, have recently been trading within a $7-9/MMBtu range in the United States and, as shown by the futures strip, are expected to remain there through 2012. These price levels are $6/MMBtu higher than the $1-3/MMBtu range seen throughout most of the 1990s, demonstrating significant price escalation for natural gas in the United States over a relatively brief period. Perhaps of most concern is that this dramatic price increase was largely unforeseen. Figure 2 compares the EIA's natural gas wellhead price forecast from each year's Annual Energy Outlook (AEO) going back to 1985 against the average US wellhead price that actually transpired. As shown, our forecasting abilities have proven rather dismal over time, as over-forecasts made in the late 1980's eventually yielded to under-forecasts that have persisted to this day. This historical experience demonstrates that little weight should be placed on any one forecast of future natural gas prices, and that a broad range of future price conditions ought to be considered in planning and investment decisions. Against this backdrop of high, volatile, and unpredictable natural gas prices, increasing the market penetration of renewable generation such as wind, solar, and geothermal power may provide economic benefits to ratepayers by displacing gas-fired generation. These benefits may manifest themselves in several ways. First, the displacement of natural gas-fired generation by increased renewable generation reduces ratepayer exposure to natural gas price risk--i.e., the risk that future gas prices (and by extension future electricity prices) may end up markedly different than expected. Second, this displacement reduces demand for natural gas among gas-fired generators, which, all else equal, will put downward pressure on natural gas prices. Lower natural gas prices in turn benefit both electric ratepayers and other end-users of natural gas. Using analytic approaches that build upon, yet differ from, the past work of others, including Awerbuch (1993, 1994, 2003), Kahn and Stoft (1993), and Humphreys and McClain (1998), this chapter explores each of these two potential 'hedging' benefits of renewable electricity. Though we do not seek to judge whether these two specific benefits outweigh any incremental cost of renewable energy (relative to conventional fuels), we do seek to quantify the magnitude of these two individual benefits. We also note that these benefits are not unique to renewable electricity: other generation (or demand-side) resources whose costs are not tied to natural gas would provide similar benefits.« less

48 CFR 52.215-10 - Price Reduction for Defective Certified Cost or Pricing Data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Price Reduction for... Text of Provisions and Clauses 52.215-10 Price Reduction for Defective Certified Cost or Pricing Data. As prescribed in 15.408(b), insert the following clause: Price Reduction for Defective Certified Cost...

Optimal Operation of Variable Speed Pumping System in China's Eastern Route Project of S-to-N Water Diversion Project

NASA Astrophysics Data System (ADS)

Cheng, Jilin; Zhang, Lihua; Zhang, Rentian; Gong, Yi; Zhu, Honggeng; Deng, Dongsheng; Feng, Xuesong; Qiu, Jinxian

2010-06-01

A dynamic planning model for optimizing operation of variable speed pumping system, aiming at minimum power consumption, was proposed to achieve economic operation. The No. 4 Jiangdu Pumping Station, a source pumping station in China's Eastern Route of South-to-North Water Diversion Project, is taken as a study case. Since the sump water level of Jiangdu Pumping Station is affected by the tide of Yangtze River, the daily-average heads of the pumping system varies yearly from 3.8m to 7.8m and the tide level difference in one day up to 1.2m. Comparisons of operation electricity cost between optimized variable speed and fixed speed operations of pumping system were made. When the full load operation mode is adopted, whether or not electricity prices in peak-valley periods are considered, the benefits of variable speed operation cannot compensate the energy consumption of the VFD. And when the pumping system operates in part load and the peak-valley electricity prices are considered, the pumping system should cease operation or lower its rotational speed in peak load hours since the electricity price are much higher, and to the contrary the pumping system should raise its rotational speed in valley load hours to pump more water. The computed results show that if the pumping system operates in 80% or 60% loads, the energy consumption cost of specified volume of water will save 14.01% and 26.69% averagely by means of optimal variable speed operation, and the investment on VFD will be paid back in 2 or 3 years. However, if the pumping system operates in 80% or 60% loads and the energy cost is calculated in non peak-valley electricity price, the repayment will be lengthened up to 18 years. In China's S-to-N Water Diversion Project, when the market operation and peak-valley electricity prices are taken into effect to supply water and regulate water levels in regulation reservoirs as Hongzehu Lake, Luomahu Lake, etc. the economic operation of water-diversion pumping stations will be vital, and the adoption of VFDs to achieve optimal operation may be a good choice.

Are cost differences between specialist and general hospitals compensated by the prospective payment system?

PubMed

Longo, Francesco; Siciliani, Luigi; Street, Andrew

2017-10-23

Prospective payment systems fund hospitals based on a fixed-price regime that does not directly distinguish between specialist and general hospitals. We investigate whether current prospective payments in England compensate for differences in costs between specialist orthopaedic hospitals and trauma and orthopaedics departments in general hospitals. We employ reference cost data for a sample of hospitals providing services in the trauma and orthopaedics specialty. Our regression results suggest that specialist orthopaedic hospitals have on average 13% lower profit margins. Under the assumption of break-even for the average trauma and orthopaedics department, two of the three specialist orthopaedic hospitals appear to make a loss on their activity. The same holds true for 33% of departments in our sample. Patient age and severity are the main drivers of such differences.

75 FR 53135 - Federal Acquisition Regulation; Definition of Cost or Pricing Data

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

... submit more data than what is needed can ``lead to increased proposal preparation costs, generally extend...; Definition of Cost or Pricing Data AGENCIES: Department of Defense (DoD), General Services Administration... ``certified cost or pricing data'' and ``data other than certified cost or pricing data'', and to clarify...

7 CFR 5.2 - Marketing season average price data.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 1 2012-01-01 2012-01-01 false Marketing season average price data. 5.2 Section 5.2 Agriculture Office of the Secretary of Agriculture DETERMINATION OF PARITY PRICES § 5.2 Marketing season... adjusted base prices and, therefore, marketing season average prices will be used. An allowance for any...

Midsouth Pulpwood Prices, 1985

Treesearch

Dennis M. May

1987-01-01

In 1985, the average price for a cord of Midsouth roundwood was $50.12, a decrease of less than 1 percent from the 1984 price. In contrast, the average price for a green ton of chipped residues decreased to $21.97, 14 percent below the price paid in 1984. The average price for a green ton of sawdust also fell in 1985, dropping 2 percent to $10.60. The 1985 expenditure...

Competition among hospitals for HMO business: effect of price and nonprice attributes.

PubMed

Young, Gary J; Burgess, James E; Valley, Danielle

2002-10-01

To investigate patterns of competition among hospitals for the business of health maintenance organizations (HMOs). The study focused on the relative importance of hospital price and nonprice attributes in the competition for HMO business. The study capitalized on hospital cost reports from Florida that are unique in their inclusion of financial data regarding HMO business activity. The time frame was 1992 to 1997. The study was designed as an observational investigation of acute care hospitals. Results indicated that a hospital's share of HMO business was related to both its price and nonprice attributes. However, the importance of both price and nonprice attributes diminished as the number of HMOs in a market increased. Hospitals that were market share leaders in terms of HMO business (i.e., 30 percent or more market share) were superior, on average, to their competitors on both price and nonprice attributes. Study results indicate that competition among hospitals for HMO business involves a complex set of price and nonprice attributes. The HMOs do not appear to focus on price alone. Hospitals likely to be the most attractive to HMOs are those that can differentiate themselves on the basis of nonprice attributes while being competitive on price as well.

Higher cigarette prices influence cigarette purchase patterns.

PubMed

Hyland, A; Bauer, J E; Li, Q; Abrams, S M; Higbee, C; Peppone, L; Cummings, K M

2005-04-01

To examine cigarette purchasing patterns of current smokers and to determine the effects of cigarette price on use of cheaper sources, discount/generic cigarettes, and coupons. Higher cigarette prices result in decreased cigarette consumption, but price sensitive smokers may seek lower priced or tax-free cigarette sources, especially if they are readily available. This price avoidance behaviour costs states excise tax money and dampens the health impact of higher cigarette prices. Telephone survey data from 3602 US smokers who were originally in the COMMIT (community intervention trial for smoking cessation) study were analysed to assess cigarette purchase patterns, use of discount/generic cigarettes, and use of coupons. 59% reported engaging in a high price avoidance strategy, including 34% who regularly purchase from a low or untaxed venue, 28% who smoke a discount/generic cigarette brand, and 18% who report using cigarette coupons more frequently that they did five years ago. The report of engaging in a price avoidance strategy was associated with living within 40 miles of a state or Indian reservation with lower cigarette excise taxes, higher average cigarette consumption, white, non-Hispanic race/ethnicity, and female sex. Data from this study indicate that most smokers are price sensitive and seek out measures to purchase less expensive cigarettes, which may decrease future cessation efforts.

48 CFR 1852.216-83 - Fixed price incentive.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Price Incentive (OCT 1996) The target cost of this contract is $___. The Target profit of this contract is $___. The target price (target cost plus target profit) of this contract is $___. [The ceiling price is $___.] The cost sharing for target cost underruns is: Government ___percent; Contractor...

48 CFR 1852.216-83 - Fixed price incentive.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Price Incentive (OCT 1996) The target cost of this contract is $___. The Target profit of this contract is $___. The target price (target cost plus target profit) of this contract is $___. [The ceiling price is $___.] The cost sharing for target cost underruns is: Government ___percent; Contractor...

Cost-effectiveness of vaccination against herpes zoster in adults aged over 60 years in Belgium.

PubMed

Bilcke, Joke; Marais, Christiaan; Ogunjimi, Benson; Willem, Lander; Hens, Niel; Beutels, Philippe

2012-01-11

To assess the cost-effectiveness of vaccinating all or subgroups of adults aged 60 to 85 years against herpes zoster. A deterministic compartmental static model was developed (in freeware R), in which cohorts can acquire herpes zoster according to their age in years. Surveys and database analyses were conducted to obtain as much as possible Belgian age-specific estimates for input parameters. Direct costs and Quality-Adjusted Life-Year (QALY) losses were estimated as a function of standardised Severity Of Illness (SOI) scores (i.e. as a function of the duration and severity of herpes zoster disease). Uncertainty about the average SOI score for a person with herpes zoster, the duration of protection from the vaccine, and the population that can benefit from the vaccine, exerts a major impact on the results: under assumptions least in favour of vaccination, vaccination is not cost-effective (i.e. incremental cost per QALY gained >€48,000 for all ages considered) at the expected vaccine price of €90 per dose. At the same price, but under assumptions most in favour of vaccination, vaccination is found to be cost-effective (i.e. incremental cost per QALY gained <€5500 for all ages considered). Vaccination of age cohort 60 seems more cost-effective than vaccination of any older age cohort in Belgium. If the vaccine price per dose drops to €45, HZ vaccination of adults aged 60-64 years is likely to be cost-effective in Belgium, even under assumptions least in favour of vaccination. Unlike previous studies, our analysis acknowledged major methodological and model uncertainties simultaneously and presented outcomes for 26 different target ages at which vaccination can be considered (ages 60-85). Copyright © 2011 Elsevier Ltd. All rights reserved.

Effect of corn stover compositional variability on minimum ethanol selling price (MESP).

PubMed

Tao, Ling; Templeton, David W; Humbird, David; Aden, Andy

2013-07-01

A techno-economic sensitivity analysis was performed using a National Renewable Energy Laboratory (NREL) 2011 biochemical conversion design model varying feedstock compositions. A total of 496 feedstock near infrared (NIR) compositions from 47 locations in eight US Corn Belt states were used as the inputs to calculate minimum ethanol selling price (MESP), ethanol yield (gallons per dry ton biomass feedstock), ethanol annual production, as well as total installed project cost for each composition. From this study, the calculated MESP is $2.20 ± 0.21 (average ± 3 SD) per gallon ethanol. Copyright © 2013. Published by Elsevier Ltd.

Effects of the Fuel Price Increase on the Operating Cost of Freight Transport Vehicles

NASA Astrophysics Data System (ADS)

Gohari, Adel; Matori, Nasir; Yusof, Khamaruzaman Wan; Toloue, Iraj; Myint, Kin Cho

2018-03-01

One of the most important criteria in freight modal choices is the transport operating cost in which fuel price changes has a significant effect on it. This paper presents the impact of fuel price increases on the operating cost of the different transport modes for the containerized freight transportation. In this study, an operating cost equation was applied to compare the operating cost of different freight transport vehicles as well as evaluation of the operating cost changes across a range of fuel prices between the current price and one-hundred percent increase. The equation consists of influential parameters such as fuel cost, driver wage and maintenance cost of a vehicle. It has been concluded that the effect of the fuel price increase on the operating cost of different freight transportation modes is not in the same rate. According to equation and effective parameters considered, comparing the results showed that truck has the highest cost, train has the largest increase in price. Finally, the ship is the most influenced vehicle in terms of operating cost percentage increase when the rate of fuel price increase, followed by train and truck.

48 CFR 1652.244-70 - Subcontracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... price analysis; (5) The subcontractor's current, complete, and accurate cost or pricing data and a Certificate of Current Cost or Pricing Data must be submitted to the Contracting officer if required by law... controlling establishment of initial or revised prices; (iii) An explanation of the reason cost or pricing...

7 CFR 5.5 - Publication of season average, calendar year, and parity price data.

Code of Federal Regulations, 2010 CFR

2010-01-01

... cases where preliminary marketing season average price data are used in estimating the adjusted base... parity price data. 5.5 Section 5.5 Agriculture Office of the Secretary of Agriculture DETERMINATION OF PARITY PRICES § 5.5 Publication of season average, calendar year, and parity price data. (a) New adjusted...

Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002.

PubMed

Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas

2010-12-01

The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.

Neighborhood Prices of Healthier and Unhealthier Foods and Associations with Diet Quality: Evidence from the Multi-Ethnic Study of Atherosclerosis.

PubMed

Kern, David M; Auchincloss, Amy H; Stehr, Mark F; Roux, Ana V Diez; Moore, Latetia V; Kanter, Genevieve P; Robinson, Lucy F

2017-11-16

It is known that the price of food influences the purchasing and consumption decisions of individuals; however, little work has examined if the price of healthier food relative to unhealthier food in an individual's neighborhood is associated with overall dietary quality while using data from multiple regions in the United States. Cross-sectional person-level data came from The Multi-Ethnic Study of Atherosclerosis (exam 5, 2010-2012 n = 2765); a food frequency questionnaire assessed diet. Supermarket food/beverage prices came from Information Resources Inc. (n = 794 supermarkets). For each individual, the average price of select indicators of healthier foods (vegetables, fruits, dairy) and unhealthier foods (soda, sweets, salty snacks), as well as their ratio, was computed for supermarkets within three miles of the person's residential address. Logistic regression estimated odds ratios of a high-quality diet (top quintile of Healthy Eating Index 2010) associated with healthy-to-unhealthy price ratio, adjusted for individual and neighborhood characteristics. Sensitivity analyses used an instrumental variable (IV) approach. Healthier foods cost nearly twice as much as unhealthier foods per serving on average (mean healthy-to-unhealthy ratio = 1.97 [SD 0.14]). A larger healthy-to-unhealthy price ratio was associated with lower odds of a high-quality diet (OR = 0.76 per SD increase in the ratio, 95% CI = [0.64-0.9]). IV analyses largely confirmed these findings although-as expected with IV adjustment-confidence intervals were wide (OR = 0.82 [0.57-1.19]). Policies to address the large price differences between healthier and unhealthy foods may help improve diet quality in the United States.

Neighborhood Prices of Healthier and Unhealthier Foods and Associations with Diet Quality: Evidence from the Multi-Ethnic Study of Atherosclerosis

PubMed Central

Kern, David M.; Stehr, Mark F.; Diez Roux, Ana V.; Moore, Latetia V.; Kanter, Genevieve P.; Robinson, Lucy F.

2017-01-01

It is known that the price of food influences the purchasing and consumption decisions of individuals; however, little work has examined if the price of healthier food relative to unhealthier food in an individual’s neighborhood is associated with overall dietary quality while using data from multiple regions in the United States. Cross-sectional person-level data came from The Multi-Ethnic Study of Atherosclerosis (exam 5, 2010–2012, n = 2765); a food frequency questionnaire assessed diet. Supermarket food/beverage prices came from Information Resources Inc. (n = 794 supermarkets). For each individual, the average price of select indicators of healthier foods (vegetables, fruits, dairy) and unhealthier foods (soda, sweets, salty snacks), as well as their ratio, was computed for supermarkets within three miles of the person’s residential address. Logistic regression estimated odds ratios of a high-quality diet (top quintile of Healthy Eating Index 2010) associated with healthy-to-unhealthy price ratio, adjusted for individual and neighborhood characteristics. Sensitivity analyses used an instrumental variable (IV) approach. Healthier foods cost nearly twice as much as unhealthier foods per serving on average (mean healthy-to-unhealthy ratio = 1.97 [SD 0.14]). A larger healthy-to-unhealthy price ratio was associated with lower odds of a high-quality diet (OR = 0.76 per SD increase in the ratio, 95% CI = [0.64–0.9]). IV analyses largely confirmed these findings although—as expected with IV adjustment—confidence intervals were wide (OR = 0.82 [0.57–1.19]). Policies to address the large price differences between healthier and unhealthy foods may help improve diet quality in the United States. PMID:29144387

Changes in animal performance and profitability of Holstein dairy operations after introduction of crossbreeding with Montbéliarde, Normande, and Scandinavian Red.

PubMed

Dezetter, C; Bareille, N; Billon, D; Côrtes, C; Lechartier, C; Seegers, H

2017-10-01

An individual-based mechanistic, stochastic, and dynamic simulation model was developed to assess economic effects resulting from changes in performance for milk yield and solid contents, reproduction, health, and replacement, induced by the introduction of crossbreeding in Holstein dairy operations. Three crossbreeding schemes, Holstein × Montbéliarde, Holstein × Montbéliarde × Normande, and Holstein × Montbéliarde × Scandinavian Red, were implemented in Holstein dairy operations and compared with Holstein pure breeding. Sires were selected based on their estimated breeding value for milk. Two initial operations were simulated according to the prevalence (average or high) of reproductive and health disorders in the lactating herd. Evolution of operations was simulated during 15 yr under 2 alternative managerial goals (constant number of cows or constant volume of milk sold). After 15 yr, breed percentages reached equilibrium for the 2-breed but not for the 3-breed schemes. After 5 yr of simulation, all 3 crossbreeding schemes reduced average milk yield per cow-year compared with the pure Holstein scheme. Changes in other animal performance (milk solid contents, reproduction, udder health, and longevity) were always in favor of crossbreeding schemes. Under an objective of constant number of cows, margin over variable costs in average discounted value over the 15 yr of simulation was slightly increased by crossbreeding schemes, with an average prevalence of disorders up to €32/cow-year. In operations with a high prevalence of disorders, crossbreeding schemes increased the margin over variable costs up to €91/cow-year. Under an objective of constant volume of milk sold, crossbreeding schemes improved margin over variable costs up to €10/1,000L (corresponding to around €96/cow-year) for average prevalence of disorders, and up to €13/1,000L (corresponding to around €117/cow-year) for high prevalence of disorders. Under an objective of constant number of cows, an unfavorable pricing context (milk price vs. concentrates price) increased slightly crossbreeding positive effects on margin over variable costs. Under an objective of constant volume of milk, only very limited changes in differences of margins were found between the breeding schemes. Our results, obtained conditionally to the parameterization values used here, suggest that dairy crossbreeding should be considered as a relevant option for Holstein dairy operations with a production level until 9,000 kg/cow-year in France, and possibly in other countries. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Examining the production costs of antiretroviral drugs.

PubMed

Pinheiro, Eloan; Vasan, Ashwin; Kim, Jim Yong; Lee, Evan; Guimier, Jean Marc; Perriens, Joseph

2006-08-22

To present direct manufacturing costs and price calculations of individual antiretroviral drugs, enabling those responsible for their procurement to have a better understanding of the cost structure of their production, and to indicate the prices at which these antiretroviral drugs could be offered in developing country markets. Direct manufacturing costs and factory prices for selected first and second-line antiretroviral drugs were calculated based on cost structure data from a state-owned company in Brazil. Prices for the active pharmaceutical ingredients (API) were taken from a recent survey by the World Health Organization (WHO). The calculated prices for antiretroviral drugs are compared with quoted prices offered by privately-owned, for-profit manufacturers. The API represents the largest component of direct manufacturing costs (55-99%), while other inputs, such as salaries, equipment costs, and scale of production, have a minimal impact. The calculated prices for most of the antiretroviral drugs studied fall within the lower quartile of the range of quoted prices in developing country markets. The exceptions are those drugs, primarily for second-line therapy, for which the API is either under patent, in short supply, or in limited use in developing countries (e.g. abacavir, lopinavir/ritonavir, nelfinavir, saquinavir). The availability of data on the cost of antiretroviral drug production and calculation of factory prices under a sustainable business model provide benchmarks that bulk purchasers of antiretroviral drugs could use to negotiate lower prices. While truly significant price decreases for antiretroviral drugs will depend largely on the future evolution of API prices, the present study demonstrates that for several antiretroviral drugs price reduction is currently possible. Whether or not these reductions materialize will depend on the magnitude of indirect cost and profit added by each supplier over the direct production costs. The ability to achieve price reductions in line with production costs will have critical implications for sustainable treatment for HIV/AIDS in the developing world.

The Affordable Care Act versus Medicare for All.

PubMed

Seidman, Laurence

2015-08-01

Many problems facing the Affordable Care Act would disappear if the nation were instead implementing Medicare for All - the extension of Medicare to every age group. Every American would be automatically covered for life. Premiums would be replaced with a set of Medicare taxes. There would be no patient cost sharing. Individuals would have free choice of doctors. Medicare's single-payer bargaining power would slow price increases and reduce medical cost as a percentage of gross domestic product (GDP). Taxes as a percentage of GDP would rise from below average to average for economically advanced nations. Medicare for All would be phased in by age. Copyright © 2015 by Duke University Press.

Extreme Markup: The Fifty US Hospitals With The Highest Charge-To-Cost Ratios.

PubMed

Bai, Ge; Anderson, Gerard F

2015-06-01

Using Medicare cost reports, we examined the fifty US hospitals with the highest charge-to-cost ratios in 2012. These hospitals have markups (ratios of charges over Medicare-allowable costs) approximately ten times their Medicare-allowable costs compared to a national average of 3.4 and a mode of 2.4. Analysis of the fifty hospitals showed that forty-nine are for profit (98 percent), forty-six are owned by for-profit hospital systems (92 percent), and twenty (40 percent) operate in Florida. One for-profit hospital system owns half of these fifty hospitals. While most public and private health insurers do not use hospital charges to set their payment rates, uninsured patients are commonly asked to pay the full charges, and out-of-network patients and casualty and workers' compensation insurers are often expected to pay a large portion of the full charges. Because it is difficult for patients to compare prices, market forces fail to constrain hospital charges. Federal and state governments may want to consider limitations on the charge-to-cost ratio, some form of all-payer rate setting, or mandated price disclosure to regulate hospital markups. Project HOPE—The People-to-People Health Foundation, Inc.

48 CFR 1315.407 - Special cost or pricing areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Special cost or pricing... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1315.407 Special cost or pricing areas. ...

48 CFR 15.407 - Special cost or pricing areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Special cost or pricing... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.407 Special cost or pricing areas. ...

14 CFR 1260.145 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Cost and price analysis. 1260.145 Section... price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various ways...

38 CFR 49.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Cost and price analysis... price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various ways...

40 CFR 30.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Cost and price analysis. 30.45 Section... price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various ways...

14 CFR 1274.506 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Cost and price analysis. 1274.506 Section... WITH COMMERCIAL FIRMS Procurement Standards § 1274.506 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every...

77 FR 2680 - Defense Federal Acquisition Regulation Supplement; Definition of Cost or Pricing Data

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-19

... Regulation Supplement; Definition of Cost or Pricing Data AGENCY: Defense Acquisition Regulations System... Acquisition Regulation Supplement (DFARS) to update text addressing the definition of cost or pricing data... update the DFARS for consistency with FAR changes addressing the definition of cost or pricing data...

48 CFR 52.215-13 - Subcontractor Certified Cost or Pricing Data-Modifications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Cost or Pricing Data-Modifications. 52.215-13 Section 52.215-13 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.215-13 Subcontractor Certified Cost or Pricing Data—Modifications. As prescribed in 15.408(e), insert the following clause: Subcontractor Certified Cost or Pricing Data...

48 CFR 5215.402 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... pricing in the Navy is through the use of competition, without the need for cost or pricing data and cost... procurement leadtime as a result of minimizing the requirement for cost or pricing data and associated audit reports. As competition is increasingly relied upon and the need for cost or pricing data is reduced...

7 CFR 550.47 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Cost and price analysis. 550.47 Section 550.47... OF AGRICULTURE GENERAL ADMINISTRATIVE POLICY FOR NON-ASSISTANCE COOPERATIVE AGREEMENTS Management of Agreements Procurement Standards § 550.47 Cost and price analysis. Some form of cost or price analysis shall...

5 CFR 591.209 - What is a price index?

Code of Federal Regulations, 2013 CFR

2013-01-01

... Allowances § 591.209 What is a price index? (a) The price index is the COLA area price divided by the DC area price and multiplied by 100. (b) Example: COLA Area Average Price for Item A = $1.233 DC Area Average...

5 CFR 591.209 - What is a price index?

Code of Federal Regulations, 2012 CFR

2012-01-01

... Allowances § 591.209 What is a price index? (a) The price index is the COLA area price divided by the DC area price and multiplied by 100. (b) Example: COLA Area Average Price for Item A = $1.233 DC Area Average...

5 CFR 591.209 - What is a price index?

Code of Federal Regulations, 2014 CFR

2014-01-01

... Allowances § 591.209 What is a price index? (a) The price index is the COLA area price divided by the DC area price and multiplied by 100. (b) Example: COLA Area Average Price for Item A = $1.233 DC Area Average...

5 CFR 591.209 - What is a price index?

Code of Federal Regulations, 2011 CFR

2011-01-01

... Allowances § 591.209 What is a price index? (a) The price index is the COLA area price divided by the DC area price and multiplied by 100. (b) Example: COLA Area Average Price for Item A = $1.233 DC Area Average...

Costing of Paediatric Treatment alongside Clinical Trials under Low Resource Constraint Environments: Cotrimoxazole and Antiretroviral Medications in Children Living with HIV/AIDS

PubMed Central

2016-01-01

Introduction. Costing evidence is essential for policy makers for priority setting and resource allocation. It is in this context that the clinical trials of ARVs and cotrimoxazole provided a costing component to provide evidence for budgeting and resource needs alongside the clinical efficacy studies. Methods. A micro based costing approach was adopted, using case record forms for maintaining patient records. Costs for fixed assets were allocated based on the paediatric space. Medication and other resource costs were costed using the WHO/MSH Drug Price Indicators as well as procurement data where these were available. Results. The costs for cotrimoxazole and ARVs are significantly different. The average costs for human resources were US$22 and US$71 for physician costs and $1.3 and $16 for nursing costs while in-patient costs were $257 and $15 for the cotrimoxazole and ARV cohorts, respectively. Mean or average costs were $870 for the cotrimoxazole cohort and $218 for the ARV. The causal factors for the significant cost differences are attributable to the higher human resource time, higher infections of opportunistic conditions, and longer and higher frequency of hospitalisations, among others. PMID:28042479

Impact of price and thickness on consumer selection of ribeye, sirloin, and top loin steaks.

PubMed

Leick, C M; Behrends, J M; Schmidt, T B; Schilling, M W

2012-05-01

Consumers (n=316) were recruited from college football picnickers to select ribeye, sirloin, and top loin steaks from 3 price groups based on thickness (n=10 steaks per price/type combination). Constant weight steaks were assigned to these groups: P1, thinnest, $19.80/kg ribeye and top loin, $10.99/kg sirloin; P2, average thickness, $22.00/kg ribeye and top loin, $13.19/kg sirloin; P3, thickest, $24.21/kg ribeye and top loin, $15.40/kg sirloin. Consumers selected 3 steaks per type and ranked selection criteria (price, color, marbling, thickness, texture). Percentage of steaks chosen from each price group did not differ (P>0.05), but consumers tended to select thinner ribeye steaks (P1 and P2) and thicker sirloin steaks (P2 and P3). Across all steak types, a greater number of consumers reported that marbling, color, and thickness were more important than price and visual texture. Data indicate that consumers may select steaks that display their preferred attributes, even if the steaks cost more. Copyright © 2011 Elsevier Ltd. All rights reserved.

Costs of breast cancer care in Mexico: analysis of two insurance coverage scenarios

PubMed Central

González-Robledo, María Cecilia; Wong, Rebeca; Ornelas, Héctor Arreola; Knaul, Felicia Marie

2015-01-01

Background Breast cancer (BC) is a major cause of disease and death worldwide. In addition to its contribution to mortality and disability, it is a major economic burden both public and private. Objective To estimate the average direct medical cost/year of care for the diagnosis and treatment of BC in two coverage scenarios in Mexico: What is ‘ideal’ based on service usage patterns according to international guidelines and what is ‘current’ using the service usage patterns of suppliers in Mexico. Material and Methods The pattern and intensity of use of procedures for the care of BC in the Mexican Social Security Institute (IMSS) for 2009 were identified and prices were associated using the guidelines from the System of Social Protection in Health (SPSS) and the IMSS for the current scenario and the ideal scenario, international patterns (Breast Health Global Initiative BHGI after its acronym in English) were used and prices were associated from the SPSS guidelines. Results The annual average direct medical cost per patient in the ‘current’ scenario was 8557 US$, while the cost in the ‘ideal’ scenario was 4554 US$. There are differences in costs between ‘what we do’ and ‘what should be done’, due to differences in the implementation of the interventions for the treatment of the different stages of the disease. A proportional increase in the average cost was also identified as the diagnosis stage advanced (from I to III). Conclusions Given that in Mexico there is universal insurance coverage for the treatment of BC, it is necessary to use economic resources more efficiently. It is necessary to continue to examine this topic in more depth and the next step will be to assess the effectiveness of both scenarios in order to provide enough evidence for the decision-making process. PMID:26557885

The availability and cost of healthier food alternatives.

PubMed

Jetter, Karen M; Cassady, Diana L

2006-01-01

Many people, especially low-income consumers, do not successfully follow dietary recommendations to eat more whole grains and less fat and added sugar. The food environment may have a significant impact on the choice by low-income consumers to eat healthier foods, as both the availability and price of healthier food items may limit their ability to eat a healthier diet. We investigated the cost and availability of a standard market basket of foods, and a healthier basket that included low-fat meat and dairy and whole grain products. Market-basket surveys were conducted in 25 stores in Los Angeles and Sacramento. Stores were selected from neighborhoods that were varied by income and surveyed three times from September 2003 to June 2004. The average cost of a standard market basket (based on the U.S. Department of Agriculture's Thrifty Food Plan [TFP]) and a healthier market basket was calculated from these prices and compared using a standard t-test to determine if they were significantly different from each other. The analysis was conducted in 2005. In neighborhoods served by smaller grocery stores, access to whole-grain products, low-fat cheeses, and ground meat with <10% fat is limited. Among all items that were unavailable, 64% were in small grocery stores. For the 2-week shopping list, the average TFP market-basket cost was $194, and the healthier market-basket cost was $230. The average cost of the healthier market basket was more expensive by $36 due to higher costs of whole grains, lean ground beef, and skinless poultry. The higher cost of the healthier basket is equal to about 35% to 40% of low-income consumers' food budgets of $2410 a year. The lack of availability in small grocery stores located in low-income neighborhoods, and the higher cost of the healthier market basket may be a deterrent to eating healthier among very low-income consumers. Public policies should take the food environment into account in order to develop successful strategies to encourage the consumption of healthier foods.

Complexity study on the Cournot-Bertrand mixed duopoly game model with market share preference

NASA Astrophysics Data System (ADS)

Ma, Junhai; Sun, Lijian; Hou, Shunqi; Zhan, Xueli

2018-02-01

In this paper, a Cournot-Bertrand duopoly model with market share preference is established. Assume that there is a degree of product difference between the two firms, where one firm takes the price as a decision variable and the other takes the quantity. Both firms are bounded rational, with linear cost functions and demand functions. The stability of the equilibrium points is analyzed, and the effects of some parameters (α, β, d and v1) on the model stability are studied. Basins of attraction are investigated and the evolution process is shown with the increase in the output adjustment speed. The simulation results show that instability will lead to the increase in the average utility of the firm that determines the quantity and reduce the average utility of the firm that determines price.

Is Europe still heading to a common price level for on-patent medicines? An exploratory study among 15 Western European countries.

PubMed

Leopold, Christine; Mantel-Teeuwisse, Aukje Katja; Vogler, Sabine; de Joncheere, Kees; Laing, Richard Ogilvie; Leufkens, Hubert G M

2013-10-01

Previous studies have suggested that medicines prices in Europe converge over time as a result of policy measures such as external price referencing. To explore whether ex-factory prices of on-patented medicines in Western European countries have converged over a recent period of time. Prices of ten on-patent medicines in five years (2007, 2008, 2010, 2011, 2012) of 15 European countries were analyzed. The unit of analysis was the ex-factory price in Euro per defined daily dose (exchange rate indexed to 2007). A score (deviation from the average price) per country as well as the ranges were calculated for all medicines. The prices between countries and selected products varied to a great extent from as low as an average price of € 1.3/DDD for sitagliptin in 2010-2012 to an average of € 221.5/DDD for alemtuzumab in 2011. Between 2008 and 2012, a price divergence was seen which was fully driven by two countries, Germany (up to 27% more expensive than the average) and Greece (up to 32% cheaper than the average). All other countries had stable prices and centered around the country average. Prices of less expensive as well as expensive medicines remained relatively stable or decreased over time, while only the price of sirolimus relatively increased. Our study period included the time of the recession and several pricing policy measures may have affected the prices of medicines. Instead of the expected price convergence we observed a price divergence driven by price changes in only two of the 15 countries. All other European countries remained stable around the country average. Further research is needed to expand the study to a bigger sample size, and include prescribing data and Eastern European countries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

48 CFR 1815.407 - Special cost or pricing areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Special cost or pricing... ADMINISTRATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1815.407 Special cost or pricing areas. ...

An international survey of the health economics of IVF and ICSI.

PubMed

Collins, JohnA

2002-01-01

The health economics of IVF and ICSI involve assessments of utilization, cost, cost-effectiveness and ability to pay. In 48 countries, utilization averaged 289 IVF/ICSI cycles per million of population per annum, ranging from two in Kazachstan, to 1657 in Israel. Higher national utilization of IVF/ICSI was associated with higher quality of health services, as indicated by lower infant mortality rates. IVF and ICSI are scientifically demanding and personnel-intensive, and are therefore expensive procedures. The average cost per IVF/ICSI cycle in 2002 would be US$9547 in the USA, and US$3518 in 25 other countries. Price elasticity estimates suggest that a 10% decrease in IVF/ICSI cost would generate a 30% increase in utilization. The average cost-effectiveness ratios in 2002 would be US$58,394 per live birth in the USA, and US$22,048 in other countries. In three randomized controlled trials, incremental costs per additional live birth with IVF compared with conventional therapy were US$ -26,586, $79,472 and $47,749. The national costs of IVF/ICSI treatment would be US$1.00 per capita in one current model, but the costs to individual couples range from 10% of annual household expenditures in European countries to 25% in Canada and the USA.

Midsouth Pulpwood Prices, 1987

Treesearch

John S. Vissage

1990-01-01

In 1987, the average price per cord of Midsouth pulpwood was $47.47, an increase of less than 1 percent from the 1988 price. The average price per green ton of chipped residues decreased less than 1 percent to $2164. The average price of other residues remained at $10.25 per green ton. The total expenditure for pulpwood in the Midsouth increased approximately 1...

A cost-effectiveness analysis to illustrate the impact of cost definitions on results, interpretations and comparability of pharmacoeconomic studies in the US.

PubMed

Tunis, Sandra L

2009-01-01

There is a lack of a uniform proxy for defining direct medical costs in the US. This potentially important source of variation in modelling and other types of economic studies is often overlooked. The extent to which increased expenditures for an intervention can be offset by reductions in subsequent service costs can be directly related to the choice of cost definitions. To demonstrate how different cost definitions for direct medical costs can impact results and interpretations of a cost-effectiveness analysis. The IMS-CORE Diabetes Model was used to project the lifetime (35-year) cost effectiveness in the US of one pharmacological intervention 'medication A' compared with a second 'medication B' (both unspecified) for type 2 diabetes mellitus. The complications modelled included cardiovascular disease, renal disease, eye disease and neuropathy. The model had a Markov structure with Monte Carlo simulations. Utility values were derived from the published literature. Complication costs were obtained from a retrospective database study that extracted anonymous patient-level data from (primarily private payer) adjudicated medical and pharmaceutical claims. Costs for pharmacy services, outpatient services and inpatient hospitalizations were included. Cost definitions for complications included charged, allowed and paid amounts, and for medications included both wholesale acquisition cost (WAC) and average wholesale price (AWP). Costs were reported in year 2007 values. The cost-effectiveness results differed according to the particular combination of cost definitions employed. The use of charges greatly increased costs for complications. When the analysis incorporated WAC medication prices with charged amounts for complication costs, the incremental cost-effectiveness ratio (ICER) for medication A versus medication B was $US6337 per QALY. When AWP prices were used with charged amounts, medication A became a dominant treatment strategy, i.e. lower costs with greater effectiveness than medication B. For both allowed and paid scenarios, there was a difference in the ICER of over $US10,300 per QALY when medication prices were defined by WAC versus AWP. Ratios of medication costs to cardiovascular complication costs ranged from under 0.45 to over 1.7, depending upon the combination of costing definitions. Explicitly addressing the cost-definition issue can help provide meaningful cost-effectiveness data to payers for policy development and management of healthcare expenditures. It can also help move the pharmacoeconomics and outcomes research fields forward in terms of both methodology and practical application.

The State of the Economy: Resources and Costs for Educational Services.

ERIC Educational Resources Information Center

Burkhead, Jesse

It is most difficult to believe that the American economy can soon return to the stable growth rates that were enjoyed from 1958 to 1973. Factors that contribute to a slow-growth economy include changes in the age of the average citizen, pressures for larger expenditures for armaments, pricefixing by oligopolies, rising raw materials prices,…

Job Schedules That Work for Students

ERIC Educational Resources Information Center

Ben-Ishai, Liz

2014-01-01

The price tag on a college education is higher than ever--but not having a degree is even more costly, according to recent studies. However, for lower-income students, getting to a college degree isn't so simple. Student financial need after grant aid (commonly referred to as "unmet need") averages $6,000 for students, even at…

40 CFR 600.502-81 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... imports into the United States at the date of entry into Mexico. (2) Cost of production of a car line shall mean the aggregate of the products of: (i) The average U.S. dealer wholesale price for such car... (ii) The number of automobiles within the car line produced during the part of the model year that the...

Can Payers Use Prices to Improve Quality? Evidence from English Hospitals.

PubMed

Allen, Thomas; Fichera, Eleonora; Sutton, Matt

2016-01-01

In most activity-based financing systems, payers set prices reactively based on historical averages of hospital reported costs. If hospitals respond to prices, payers might set prices proactively to affect the volume of particular treatments or clinical practice. We evaluate the effects of a unique initiative in England in which the price offered to hospitals for discharging patients on the same day as a particular procedure was increased by 24%, while the price for inpatient treatment remained unchanged. Using national hospital records for 205,784 patients admitted for the incentivised procedure and 838,369 patients admitted for a range of non-incentivised procedures between 1 December 2007 and 31 March 2011, we consider whether this price change had the intended effect and/or produced unintended effects. We find that the price change led to an almost six percentage point increase in the daycase rate and an 11 percentage point increase in the planned daycase rate. Patients benefited from a lower proportion of procedures reverted to open surgery during a planned laparoscopic procedure and from a reduction in long stays. There was no evidence that readmission and death rates were affected. The results suggest that payers can set prices proactively to incentivise hospitals to improve quality. Copyright © 2014 John Wiley & Sons, Ltd.

Economic Analysis of the Return-on-Investment of a Worksite Wellness Program for a Large Multistate Retail Grocery Organization.

PubMed

Light, Emily M W; Kline, Allison S; Drosky, Megan A; Chapman, Larry S

2015-08-01

The objective of this study is to measure the return on investment (ROI) of the Price Chopper/Golub Corporation employee population who participate in wellness programs available to them. Medical claims data, risk level, and presence of comorbidities such as diabetes and heart disease were compared in a matched retrospective cohort of participants and nonparticipants, with 2008, 2009, and 2010 serving as measurement years. Program costs and estimated savings were used to calculate an ROI of $4.33 for every dollar invested in wellness programs. Reductions in medical costs were observed at several risk and participation levels, with an average savings of $133 per participant and a 3-year savings estimate of $285,706. The positive ROI and savings estimate indicate that wellness interventions added economic value to Price Chopper/Golub Corporation.

Cost Analysis of an Office-based Surgical Suite

PubMed Central

LaBove, Gabrielle

2016-01-01

Introduction: Operating costs are a significant part of delivering surgical care. Having a system to analyze these costs is imperative for decision making and efficiency. We present an analysis of surgical supply, labor and administrative costs, and remuneration of procedures as a means for a practice to analyze their cost effectiveness; this affects the quality of care based on the ability to provide services. The costs of surgical care cannot be estimated blindly as reconstructive and cosmetic procedures have different percentages of overhead. Methods: A detailed financial analysis of office-based surgical suite costs for surgical procedures was determined based on company contract prices and average use of supplies. The average time spent on scheduling, prepping, and doing the surgery was factored using employee rates. Results: The most expensive, minor procedure supplies are suture needles. The 4 most common procedures from the most expensive to the least are abdominoplasty, breast augmentation, facelift, and lipectomy. Conclusions: Reconstructive procedures require a greater portion of collection to cover costs. Without the adjustment of both patient and insurance remuneration in the practice, the ability to provide quality care will be increasingly difficult. PMID:27536482

32 CFR 32.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Cost and price analysis. 32.45 Section 32.45... price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various ways...

Measuring Access to Medicines: A Survey of Prices, Availability and Affordability in Shaanxi Province of China

PubMed Central

Jiang, Minghuan; Yang, Shimin; Yan, Kangkang; Liu, Jun; Zhao, Jun; Fang, Yu

2013-01-01

Objective To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009. Methods Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. Findings The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day’s wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days’ wages for losartan. For originator brands, the costs rise to 1.2 days’ wages for salbutamol inhaler and 15.6 days’ wages for omeprazole. Conclusions The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for the poor. This requires multi-faceted interventions, as well as the review and refocusing of policies, regulations and educational interventions. PMID:23936471

Measuring access to medicines: a survey of prices, availability and affordability in Shaanxi province of China.

PubMed

Jiang, Minghuan; Yang, Shimin; Yan, Kangkang; Liu, Jun; Zhao, Jun; Fang, Yu

2013-01-01

To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009. Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days' wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day's wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days' wages for losartan. For originator brands, the costs rise to 1.2 days' wages for salbutamol inhaler and 15.6 days' wages for omeprazole. The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for the poor. This requires multi-faceted interventions, as well as the review and refocusing of policies, regulations and educational interventions.

A cost comparison of more and less nutritious food choices in US supermarkets.

PubMed

Katz, David L; Doughty, Kim; Njike, Valentine; Treu, Judith A; Reynolds, Jesse; Walker, Jennifer; Smith, Erica; Katz, Catherine

2011-09-01

The present study directly compared prices of more and less nutritious foods within given categories in US supermarkets. Foods selected from six supermarkets in Jackson County were categorized using the five criteria of the Nutrition Detectives™ (ND) programme and an item-to-item cost comparison was made using posted prices. The nutritional quality of foods was distinguished using the clues of the ND nutrition education programme for elementary-school children and validated using the Overall Nutritional Quality Index. Supermarkets in Jackson County, MO, USA. Not applicable. The average price of the item for more nutritious foods did not differ significantly from that of less nutritious foods overall ($US 2·89 (sd $US 0·74) v. $US 2·85 (sd $0·68), P = 0·76). More nutritious breads cost more than less nutritious breads ($US 3·36 (sd $ US 0·28) v. $US 2·56 (sd $US 0·80, P = 0·03), whereas more nutritious cereals ($US 2·46 (sd $US 0·69) v. $US 3·50 (sd $US 0·30), P < 0·01) and cookies ($US 2·76 (sd $US 0·50) v. $US 3·40 (sd $US0·28), P < 0·01) cost less. Our findings indicate that it is possible to choose more nutritious foods within many common categories without spending more money and suggest that making small improvements in dietary choices does not invariably cost more.

Green auctions and reduction of information rents in payments for environmental services: an experimental investigation in Sunan County, northwestern China.

PubMed

Deng, Xiaohong; Xu, Zhongmin

2015-01-01

Reducing information rents is an important task for government agencies wishing to purchase maximal environmental services with limited budgets. This paper reports on several green auction options for reducing information rents and improving the performance of the "Grain for Green" Payments for environmental services (PES) program implemented in northwestern China. In r experimental auctions and investigations, door-to-door interviews were conducted and bidding envelopes and survey questionnaires were used to determine the offers and the foregone profits of the participants. Three scenarios are analyzed in this paper: a uniform price auction, a discriminatory price auction, and an opportunity-cost system. The results show that compared to the uniform price auction system, the other auction systems can increase the cost-effectiveness of conservation contracting. Competitive bidding can reveal true opportunity costs and can reduce information rents extracted from the government by farmers using private information. The demographics and average bids of these auction types were also analyzed. "Perfect information" in the opportunity-cost offer system has the best performance but is very hard to implement in reality. The results of this research show that the auction is a valuable tool for purchasing conservation contracts in northwestern China, but that in the future, the performance of these auctions should be studied with relaxed model assumptions.

Green Auctions and Reduction of Information Rents in Payments for Environmental Services: An Experimental Investigation in Sunan County, Northwestern China

PubMed Central

Deng, Xiaohong; Xu, Zhongmin

2015-01-01

Reducing information rents is an important task for government agencies wishing to purchase maximal environmental services with limited budgets. This paper reports on several green auction options for reducing information rents and improving the performance of the “Grain for Green” Payments for environmental services (PES) program implemented in northwestern China. In r experimental auctions and investigations, door-to-door interviews were conducted and bidding envelopes and survey questionnaires were used to determine the offers and the foregone profits of the participants. Three scenarios are analyzed in this paper: a uniform price auction, a discriminatory price auction, and an opportunity-cost system. The results show that compared to the uniform price auction system, the other auction systems can increase the cost-effectiveness of conservation contracting. Competitive bidding can reveal true opportunity costs and can reduce information rents extracted from the government by farmers using private information. The demographics and average bids of these auction types were also analyzed. “Perfect information” in the opportunity-cost offer system has the best performance but is very hard to implement in reality. The results of this research show that the auction is a valuable tool for purchasing conservation contracts in northwestern China, but that in the future, the performance of these auctions should be studied with relaxed model assumptions. PMID:25793263

48 CFR 1602.170-5 - Cost or pricing data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Cost or pricing data. 1602... Terms 1602.170-5 Cost or pricing data. (a) Experience-rated carriers. Cost or pricing data for... payments made to providers of medical services for the provision of healthcare, such as capitation not...

48 CFR 1602.170-5 - Cost or pricing data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Cost or pricing data. 1602... Terms 1602.170-5 Cost or pricing data. (a) Experience-rated carriers. Cost or pricing data for... payments made to providers of medical services for the provision of healthcare, such as capitation not...

48 CFR 1602.170-5 - Cost or pricing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Cost or pricing data. 1602... Terms 1602.170-5 Cost or pricing data. (a) Experience-rated carriers. Cost or pricing data for... payments made to providers of medical services for the provision of healthcare, such as capitation not...

48 CFR 1602.170-5 - Cost or pricing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Cost or pricing data. 1602... Terms 1602.170-5 Cost or pricing data. (a) Experience-rated carriers. Cost or pricing data for... payments made to providers of medical services for the provision of healthcare, such as capitation not...

45 CFR 2543.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Cost and price analysis. 2543.45 Section 2543.45... ORGANIZATIONS Post-Award Requirements Property Standards § 2543.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every...

28 CFR 70.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Cost and price analysis. 70.45 Section 70... NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 70.45 Cost and price analysis. Some form of cost or price analysis must be made and documented in the procurement files in connection...

15 CFR 14.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Cost and price analysis. 14.45 Section... COMMERCIAL ORGANIZATIONS Post-Award Requirements Procurement Standards § 14.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with...

22 CFR 226.45 - Cost and price analysis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Cost and price analysis. 226.45 Section 226.45...-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with...

22 CFR 145.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Cost and price analysis. 145.45 Section 145.45 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER....45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the...

48 CFR 52.214-28 - Subcontractor Certified Cost or Pricing Data-Modifications-Sealed Bidding.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Cost or Pricing Data-Modifications-Sealed Bidding. 52.214-28 Section 52.214-28 Federal Acquisition... CONTRACT CLAUSES Text of Provisions and Clauses 52.214-28 Subcontractor Certified Cost or Pricing Data... Cost or Pricing Data—Modifications—Sealed Bidding (OCT 2010) (a) The requirements of paragraphs (b) and...

48 CFR 52.215-12 - Subcontractor Certified Cost or Pricing Data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Cost or Pricing Data. 52.215-12 Section 52.215-12 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-12 Subcontractor Certified Cost or Pricing Data. As prescribed in 15.408(d), insert the following clause: Subcontractor Certified Cost or Pricing Data (OCT 2010) (a) Before awarding...

48 CFR 970.1504-3-1 - Cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost or pricing data. 970... pricing data. (a) The certification requirements of 48 CFR 15.406-2 are not applied to DOE cost... operating contractors and their subcontractors obtain cost or pricing data prior to the award of a...

7 CFR 3019.45 - Cost and price analysis.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Cost and price analysis. 3019.45 Section 3019.45 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER... Standards § 3019.45 Cost and price analysis. Some form of cost or price analysis shall be made and...

A Case Study of Pharmaceutical Pricing in China: Setting the Price for Off-Patent Originators.

PubMed

Hu, Shanlian; Zhang, Yabing; He, Jiangjiang; Du, Lixia; Xu, Mingfei; Xie, Chunyan; Peng, Ying; Wang, Linan

2015-08-01

This article aims to define a value-based approach to pricing and reimbursement for off-patent originators using a multiple criteria decision analysis (MCDA) approach centered on a systematic analysis of current pricing and reimbursement policies in China. A drug price policy review was combined with a quantitative analysis of China's drug purchasing database. Policy preferences were identified through a MCDA performed by interviewing well-known academic experts and industry stakeholders. The study findings indicate that the current Chinese price policy includes cost-based pricing and the establishment of maximum retail prices and premiums for off-patent originators, whereas reference pricing may be adopted in the future. The literature review revealed significant differences in the dissolution profiles between originators and generics; therefore, dissolution profiles need to be improved. Market data analysis showed that the overall price ratio of generics and off-patent originators was around 0.54-0.59 in 2002-2011, with a 40% price difference, on average. Ten differentiating value attributes were identified and MCDA was applied to test the impact of three pricing policy scenarios. With the condition of implementing quality consistency regulations and controls, a reduction in the price gap between high-quality off-patent products (including originator and generics) seemed to be the preferred policy. Patents of many drugs will expire within the next 10 years; thus, pricing will be an issue of importance for off-patent originators and generic alternatives.

Economic impact of switching from an open to a closed enteral nutrition feeding system in an acute care setting.

PubMed

Phillips, Wendy; Roman, Brandis; Glassman, Kendra

2013-08-01

This study compared an open-system (OS) enteral nutrition (EN) delivery system with a closed system (CS). Factors evaluated included nursing time for administration, patient safety factors, and cost of formula and supplies. This study analyzed the cost of formula and supplies in 1 major academic medical center. Data were collected on patients requiring EN in acute care settings. Information collected included formula type and amount of formula ordered and delivered. The average daily cost to feed each adult patient using delivered volume with the OS was $3.84 compared with $4.31 if the patient had been receiving EN from a CS. Considering waste costs, the average cost to feed increased to $4.21 compared with $4.80, respectively. After factoring in increased nursing time with the OS, the cost increased to $9.83. For pediatric patients, formula delivery reached 1 L in only 2% of patient days. The average cost to feed each patient each day using actual delivered volume was $1.89 in the OS and $1.94 in the CS. When factoring in the cost of waste, those costs increased to $2.12 and $3.30, respectively. After factoring in increased nursing time with the OS, the cost increased to $8.92. Due to the higher contract price and increased waste of the CS formulas compared with the OS formulas, a higher daily average cost for formula delivered may be incurred by switching to a CS. However, the CS is more cost-effective when factoring in nursing time.

Higher prices in Jamaica.

PubMed

1982-03-01

Price increases in the Jamaica CSM program went into effect on August 31, 1981. The program began in 1975. While the need for higher prices has been under discussion for the past 3 years, this is the 1st time the requisite approval from the Jamaica Price Commission has been obtained. The Jamaica National Family Planning Board (JNFPB) reports that the Panther 3-pack (condom) is up US$0.15 to US$0.30. Each Perle package (oral contraceptive) was increased by US$0.20. Single cycle Perle now sells for US$0.50, and 3-pack Perle sells for US$1.10. The 6-year price stagnation experienced by the CSM program resulted in a decreasing operational budget as program costs continued to rise. Marketing costs alone during this period escalated by 100-300%. For example, Panther pop-up display cartons cost the project US 16U each in 1975. By 1979 the same product cost US 49U. Newspaper advertisements have increased from the 1975 cost of US$68.00 to nearly $200.00 per placement. The overall inflation rate in Jamaica during the last 5 years has averaged more than 20% annually. In the face of these rising costs, outlet expansion for Perle has been prevented, wholesaler margins have been unavailable, and new retailer training has been discontinued. It is projected that the new prices will result in an annual increased revenues of US$80,000 which will be used to reinstate these essential marketing activities. The JNFPB is also planning to introduce a Panther 12-pack and Panther strips to the CSM product line. According to Marketing Manager Aston Evans, "We believe the public is now ready for this type of packaging" which is scheduled to be available soon. Panther is presently only available in a 3-pack, but annual sales have been steady. The new 12-pack will be stocked on supermarket shelves to provide higher product visibility and wider distribution. The selling price has been set as US$1.20 and is expected to yield a 25% increase in sales during the 1st year. A complete sales promotion and advertising campaign will accompany the 12-pack introduction. The marketing plan for Panther strips emphasizes placement in government and private sector offices and factories throughout the country. In the deep rural areas the strips will be available for sale in shops, bars, nightclubs, and other distribution points. full text

Output and inflation components of medical care and other spending changes

PubMed Central

Peden, Edgar A.; Lee, Mei Lin

1991-01-01

From 1965 to 1990, spending on medical care rose from 5.9 to 12.2 percent of gross national product. This rise was the consequence of greatly expanded government and government subsidized private insurance coverage operating in an environment where payments for insured care by and large covered whatever costs were incurred. As a result, the personal consumption of medical care experienced both output and price average growth rates strikingly above economywide norms. Indeed, the output growth rate in this sector rivaled growth in several goods sectors with greatly expanded supplies. However, whereas goods in the latter sectors have become more accessible through lower relative prices, consumers with insufficient insurance coverage are being crowded out of the market for medical care by higher relative prices. PMID:10122363

The shadow price of substitutable sulfur in the US electric power plant: a distance function approach.

PubMed

Lee, Myunghun

2005-10-01

Given restrictions on sulfur dioxide emissions, a feasible long-run response could involve either an investment in improving boiler fuel-efficiency or a shift to a production process that is effective in removing sulfur dioxide. To allow for the possibility of substitution between sulfur and productive capital, we measure the shadow price of sulfur dioxide as the opportunity cost of lowering sulfur emissions in terms of forgone capital. The input distance function is estimated with data from 51 coal-fired US power units operating between 1977 and 1986. The indirect Morishima elasticities of substitution indicate that the substitutability of capital for sulfur is relatively high. The overall weighted average estimate of the shadow price of sulfur is -0.076 dollars per pound in constant 1976 dollars.

A process concept for the production of benzene-ethylene-SNG from coal using flash hydropyrolysis technology

NASA Astrophysics Data System (ADS)

Greene, M. I.; Ladelfa, C. J.; Bivacca, S. J.

1980-05-01

Flash hydropyrolysis (FHP) of coal is an emerging technology for the direct production of methane, ethane and BTX in a single-stage, high throughput reactor. The FHP technique involves the short residence time (1-2 seconds), rapid heatup of coal in a dilute-phase, transport reactor. When integrated into an overall, grass-roots conversion complex, the FHP technique can be utilized to generate a product consisting of SNG, ethylene/propylene, benzene and Fischer-Tropsch-based alcohols. This paper summarizes the process engineering and economics of conceptualized facility based on an FHP reactor operation with a lignitic coal. The plant is hypothetically sited near the extensive lignite fields located in the Texas region of the United States. Utilizing utility-financing methods for the costing of SNG, and selling the chemicals cogenerated at petrochemical market prices, the 20-year average SNG cost has been computed to vary between $3-4/MM Btu, depending upon the coal costs, interest rates, debt/equity ratio, coproduct chemicals prices, etc.

The effect of provider control of Blue Shield plans on health care markets.

PubMed

Arnould, R J; DeBrock, L M

1985-07-01

Blue Shield plans often are granted regulatory advantages by the states in which they operate. Run efficiently, such not-for-profit firms should use these lower costs to eliminate their less advantaged rivals, the commercial insurers. However, these higher-cost commercial providers have been able to offer insurance coverage at prices competitive with the Blues, as evidenced by the fact that Blue plans have, on average, less than 50 percent market share. Similar prices with lower overall costs implies that economic rents are being earned, rents which a not-for-profit firm cannot distribute to owners. In this paper we argue that when there are competing goals among the groups controlling the Blue Shield plans, the different possible "uses" of the regulatory advantage become endogenously determined, necessitating the use of simultaneous equation estimation. Testing this model we find the major effect of doctor-control of Blue Shield plans is to raise doctors' fees while lowering the amount of rents captured by both consumers and administrators.

Silicon wafer-based tandem cells: The ultimate photovoltaic solution?

NASA Astrophysics Data System (ADS)

Green, Martin A.

2014-03-01

Recent large price reductions with wafer-based cells have increased the difficulty of dislodging silicon solar cell technology from its dominant market position. With market leaders expected to be manufacturing modules above 16% efficiency at 0.36/Watt by 2017, even the cost per unit area (60-70/m2) will be difficult for any thin-film photovoltaic technology to significantly undercut. This may make dislodgement likely only by appreciably higher energy conversion efficiency approaches. A silicon wafer-based cell able to capitalize on on-going cost reductions within the mainstream industry, but with an appreciably higher than present efficiency, might therefore provide the ultimate PV solution. With average selling prices of 156 mm quasi-square monocrystalline Si photovoltaic wafers recently approaching 1 (per wafer), wafers now provide clean, low cost templates for overgrowth of thin, wider bandgap high performance cells, nearly doubling silicon's ultimate efficiency potential. The range of possible Si-based tandem approaches is reviewed together with recent results and ultimate prospects.

Purchasing factor concentrates in the 21st century through competitive tendering.

PubMed

Hay, C R M

2013-09-01

The increasing intensity of treatment, the widespread adoption of factor VIII and IX prophylaxis and increasing usage over the past decade have led to haemophilia becoming an almost uniquely expensive condition to treat. The average adult with severe haemophilia A in the UK used 250,000 IU of factor VIII in 2011/2012, at a cost in excess of £ 100,000 p.a. The cost to the end-user may be considerably higher than this for some US patients supplied by home care companies with high on-costs. This has led to a high level of administrative scrutiny of treatment and an imperative to procure clotting factor concentrates more efficiently and collectively. National procurement schemes have run successfully in various countries and will become commoner. The UK system of procurement is described. This system, following EU procurement rules, evaluated products technically and by price. The price of bioequivalent products was determined by reverse e-auction. Considerable cost reductions were achieved whilst retaining all suppliers and maintaining a degree of prescribing freedom. Elements of this system could be more widely applied. © 2013 John Wiley & Sons Ltd.

Mammography screening: how important is cost as a barrier to use?

PubMed Central

Urban, N; Anderson, G L; Peacock, S

1994-01-01

OBJECTIVES. Recent legislation will improve insurance coverage for screening mammography and effectively lower its cost to many women. Although cost has been cited as a barrier to use, evidence of the magnitude of its effect on use is limited. METHODS. Mammography use in the past 2 years among women aged 50 to 75 residing in four suburban or rural counties in Washington State was estimated from 1989 survey data. Logistic regression analysis was used to estimate the odds ratio of mammography use as a function of economic and other variables. Within a residential area, averages were used to measure the market price of mammography and the time cost to obtain a mammogram. RESULTS. Use was lower among women who faced a higher net price or who preferred to obtain a mammogram during weekend or evening hours and higher among women with higher incomes. Visiting no doctor regularly and smoking were predictors of failure to use mammography. CONCLUSION. The effects of economic variables on mammography use are important and stable across subsets of the population, but they are modest in size. PMID:8279611

Mammography screening: how important is cost as a barrier to use?

PubMed

Urban, N; Anderson, G L; Peacock, S

1994-01-01

Recent legislation will improve insurance coverage for screening mammography and effectively lower its cost to many women. Although cost has been cited as a barrier to use, evidence of the magnitude of its effect on use is limited. Mammography use in the past 2 years among women aged 50 to 75 residing in four suburban or rural counties in Washington State was estimated from 1989 survey data. Logistic regression analysis was used to estimate the odds ratio of mammography use as a function of economic and other variables. Within a residential area, averages were used to measure the market price of mammography and the time cost to obtain a mammogram. Use was lower among women who faced a higher net price or who preferred to obtain a mammogram during weekend or evening hours and higher among women with higher incomes. Visiting no doctor regularly and smoking were predictors of failure to use mammography. The effects of economic variables on mammography use are important and stable across subsets of the population, but they are modest in size.

Evaluation of the cost-effectiveness of evolocumab in the FOURIER study: a Canadian analysis.

PubMed

Lee, Todd C; Kaouache, Mohammed; Grover, Steven A

2018-04-03

Evolocumab, a proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor, has been shown to reduce low-density lipoprotein levels by up to 60%. Despite the absence of a reduction in overall or cardiovascular mortality in the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) trial, some believe that, with longer treatment, such a benefit might eventually be realized. Our aim was to estimate the potential mortality benefit over a patient's lifetime and the cost per year of life saved (YOLS) for an average Canadian with established coronary artery disease. We also sought to estimate the price threshold at which evolocumab might be considered cost-effective for secondary prevention in Canada. We calibrated the Cardio-metabolic Model, a well-validated tool for predicting cardiovascular events and life expectancy, to the reduction in nonfatal events seen in the FOURIER trial. Assuming that long-term treatment will eventually result in mortality benefits, we estimated YOLSs and cost per YOLS with evolocumab treatment plus a statin compared to a statin alone. We then estimated the annual drug costs that would provide a 50% chance of being cost-effective at willingness-to-pay values of $50 000 and $100 000. In secondary prevention in patients similar to those in the FOURIER study, evolocumab treatment would save an average of 0.34 (95% confidence interval [CI] 0.27-0.41) life-years at a cost of $101 899 (95% CI $97 325-$106 473), yielding a cost per YOLS of $299 482. We estimate that to have a 50% probability of achieving a cost per YOLS below $50 000 and $100 000 would require annual drug costs below $1200 and $2300, respectively. At current pricing, the use of evolocumab for secondary prevention is unlikely to be cost-effective in Canada. Copyright 2018, Joule Inc. or its licensors.

48 CFR 570.110 - Cost or pricing data and information other than cost or pricing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... competition. For price analysis of offered rental rates, the contracting officer may use a market survey, an... comparison, or other relevant market research data. For price analysis of offered tenant improvement costs...

48 CFR 570.110 - Cost or pricing data and information other than cost or pricing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... competition. For price analysis of offered rental rates, the contracting officer may use a market survey, an... comparison, or other relevant market research data. For price analysis of offered tenant improvement costs...

48 CFR 570.110 - Cost or pricing data and information other than cost or pricing data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... competition. For price analysis of offered rental rates, the contracting officer may use a market survey, an... comparison, or other relevant market research data. For price analysis of offered tenant improvement costs...

Midsouth Pulpwood Prices, 1984

Treesearch

Dennis M. May

1986-01-01

In 1984, the average price for a cord of Midsouth roundwood was $50.55, an increase of 4.5 percent from 1983. The average price for a green ton of chipped residues also increased, up 9.0 percent to $25.44. However, the average price for a green ton of sawdust fell 17.3 percent to $10.79. Rail delivery prices for wood fiber continue to be lower than truck delivery...

A global comparison of the cost of patented cancer drugs in relation to global differences in wealth.

PubMed

Goldstein, Daniel A; Clark, Jonathon; Tu, Yifan; Zhang, Jie; Fang, Fenqi; Goldstein, Robert; Stemmer, Salomon M; Rosenbaum, Eli

2017-09-22

There are major differences in cancer drug prices around the world. However, the patterns of affordability of these drugs are poorly understood. The objective of this study was to compare patterns of affordability of cancer drugs in Australia, China, India, Israel, South Africa, the United Kingdom, and the United States. Cancer drug prices are highest in the United States. Cancer drugs are the least affordable in India by a large margin. Despite lower prices than in the USA, cancer drugs are less affordable in middle-income countries than in high-income countries. We obtained the prices of a basket of cancer drugs in all 7 countries, and converted the prices to US$ using both foreign exchange rates and purchasing power parity. We assessed international differences in wealth by collecting values for gross domestic product (GDP) per capita in addition to average salaries. We compared patterns of affordability of cancer drugs by dividing the drug prices by the markers of wealth. Cancer drugs are less affordable in middle-income countries than in high-income countries. Differential pricing may be an acceptable policy to ensure global affordability and access to highly active anti-cancer therapies.

Higher nutritional quality at no additional cost among low-income households: insights from food purchases of "positive deviants".

PubMed

Marty, Lucile; Dubois, Christophe; Gaubard, Malu S; Maidon, Audrey; Lesturgeon, Audrey; Gaigi, Hind; Darmon, Nicole

2015-07-01

It is unknown whether diet quality is correlated with actual food expenditure. According to the positive deviance theory, the study of actual food expenditure by people with limited economic resources could help identify beneficial food-purchasing behavior. The aims were to investigate the relation between actual expenditure on food and nutritional quality and to identify "positive deviants" among low-income households. Individuals in deprived social situations (n = 91) were recruited as part of the "Opticourses" nutrition intervention conducted in 2012-2014 in poor districts of Marseille, France. Opticourses participants collected food-purchase receipts for their household over a 1-mo period. "Actual diet costs" and "estimated diet costs" were calculated per 2000 kcal of food purchases by using actual expenditures and a standard food price database of food consumed by a representative sample of French adults, respectively. Mean adequacy ratio (MAR), mean excess ratio (MER), and energy density (ED) were used as nutritional quality indicators. "Positive deviants" were defined as having a higher MAR and a lower MER than the respective median values. Opticourses participants selected less-expensive food options than the average French population, both within a food group and for a given food item. Higher diet costs were associated with higher nutritional quality (higher MAR, lower ED), regardless of whether costs were calculated from actual expenditure or on the basis of standard food prices. Twenty-one positive deviants were identified. They made significantly healthier purchases than did other participants (MAR: +13%; MER: -90%. ED: -22%) at higher estimated diet costs. Yet, they did not spend more on food (having the same actual diet costs), which showed that they purchased food with a higher nutritional quality for their price. In this low-income population, actual diet cost was positively correlated with nutritional quality, yet the results showed that higher diet quality is not necessarily more costly when foods with higher nutritional quality for their price are selected. The Opticourses intervention was registered at clinicaltrials.gov as NCT02383875. © 2015 American Society for Nutrition.

A cost-effectiveness analysis of trametinib plus dabrafenib as first-line therapy for metastatic BRAF V600-mutated melanoma in the Swiss setting.

PubMed

Matter-Walstra, K; Braun, R; Kolb, C; Ademi, Z; Dummer, R; Pestalozzi, B C; Schwenkglenks, M

2015-12-01

The treatment of patients with metastatic melanomas that harbour BRAF V600E or V600K mutations with trametinib plus dabrafenib appears to be superior to treatment with vemurafenib alone. This treatment regimen is likely to become available in Switzerland in the near future. To determine the cost-effectiveness of trametinib plus dabrafenib. A Markov cohort simulation was conducted to model the clinical course of typical patients with metastatic melanoma. Information on response rates, clinical condition and follow-up treatments were derived and transition probabilities estimated based on the results of a clinical trial that compared treatment with trametinib plus dabrafenib vs. vemurafenib alone. Treatment with trametinib plus dabrafenib was estimated to cost an additional CHF199 647 (Swiss francs) on average and yield a gain of 0·52 quality-adjusted life years (QALYs), resulting in an incremental cost-effectiveness ratio of CHF385 603 per QALY. Probabilistic sensitivity analyses showed that a willingness-to-pay threshold of CHF100 000 per QALY would not be reached at the current US price of trametinib. The introduction of trametinib in Switzerland at US market prices for the treatment of metastatic BRAF V600-mutated melanoma with trametinib plus dabrafenib is unlikely to be cost-effective compared with vemurafenib monotherapy. A reduction in the total price of the combination therapy is required to achieve an acceptable cost-effectiveness ratio for this clinically promising treatment. © 2015 British Association of Dermatologists.

Commercial viability of hybrid vehicles : best household use and cross national considerations.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santini, D. J.; Vyas, A. D.

1999-07-16

Japanese automakers have introduced hybrid passenger cars in Japan and will soon do so in the US. In this paper, we report how we used early computer simulation model results to compare the commercial viability of a hypothetical near-term (next decade) hybrid mid-size passenger car configuration under varying fuel price and driving patterns. The fuel prices and driving patterns evaluated are designed to span likely values for major OECD nations. Two types of models are used. One allows the ''design'' of a hybrid to a specified set of performance requirements and the prediction of fuel economy under a number ofmore » possible driving patterns (called driving cycles). Another provides an estimate of the incremental cost of the hybrid in comparison to a comparably performing conventional vehicle. In this paper, the models are applied to predict the NPV cost of conventional gasoline-fueled vehicles vs. parallel hybrid vehicles. The parallel hybrids are assumed to (1) be produced at high volume, (2) use nickel metal hydride battery packs, and (3) have high-strength steel bodies. The conventional vehicle also is assumed to have a high-strength steel body. The simulated vehicles are held constant in many respects, including 0-60 time, engine type, aerodynamic drag coefficient, tire rolling resistance, and frontal area. The hybrids analyzed use the minimum size battery pack and motor to meet specified 0-60 times. A key characteristic affecting commercial viability is noted and quantified: that hybrids achieve the most pronounced fuel economy increase (best use) in slow, average-speed, stop-and-go driving, but when households consistently drive these vehicles under these conditions, they tend to travel fewer miles than average vehicles. We find that hours driven is a more valuable measure than miles. Estimates are developed concerning hours of use of household vehicles versus driving cycle, and the pattern of minimum NPV incremental cost (or benefit) of selecting the hybrid over the conventional vehicle at various fuel prices is illustrated. These results are based on data from various OECD motions on fuel price, annual miles of travel per vehicle, and driving cycles assumed to be applicable in those nations. Scatter in results plotted as a function of average speed, related to details of driving cycles and the vehicles selected for analysis, is discussed.« less

The impact of reference pricing of nonsteroidal anti-inflammatory agents on the use and costs of analgesic drugs.

PubMed

Grootendorst, Paul V; Marshall, John K; Holbrook, Anne M; Dolovich, Lisa R; O'Brien, Bernie J; Levy, Adrian R

2005-10-01

To estimate the effect of reference pricing (RP) of nonsteroidal anti-inflammatory drugs (NSAIDs) on drug subsidy program and beneficiary expenditures on analgesic drugs. Monthly claims data from Pharmacare, the public drug subsidy program for seniors in British Columbia, Canada, over the period of February 1993 to June 2001. RP limits drug plan reimbursement of interchangeable medicines to a reference price, which is typically equal to the price of the lowest cost interchangeable drug; any cost above that is borne by the patient. Pharmacare introduced two different forms of RP to the NSAIDs, Type 1 in April 1994 and Type 2 in November 1995. Under Type 1 RP, generic and brand versions of the same NSAID are considered interchangeable, whereas under Type 2 RP different NSAIDs are considered interchangeable. We extrapolated average reimbursement per day of NSAID therapy over the months before RP to estimate what expenditures would have been without the policies. These counterfactual predictions were compared with actual values to estimate the impact of the policies; the estimated impacts on reimbursement rates were multiplied by the postpolicy volume of NSAIDS dispensed, which appeared unaffected by the policies, to estimate expenditure changes. After Type 2 RP, program expenditures declined by $22.7 million (CAN), or $4 million (CAN), annually cutting expenditure by about half. Most savings accrued from the substitution of low-cost NSAIDs for more costly alternatives. About 20 percent of savings represented expenditures by seniors who elected to pay for partially reimbursed drugs. Type 1 RP produced one-quarter the savings of type 2 RP. Type 2 RP of NSAIDs achieved its goal of reducing drug expenditures and was more effective than Type 1 RP. The effects of RP on patient health and associated health care costs remain to be investigated.

Repeated regulatory failures: British electric utilities, 1919--1937

NASA Astrophysics Data System (ADS)

van der Werf, Ysbrand John

This dissertation uses previously unexamined firm-level data to look at British electric utilities during the 1919--1937 period. The persistent influence of the 1882 and 1888 Electric Lighting Acts had a significant role in perpetuating the inefficient market structure and high costs of the industry. First, I examine factors that influence costs in 1919 and compare the relative cost efficiency of municipally-owned and investor-owned utilities (munis and IOUs). Scale and load factor are found to be more important than ownership in influencing costs, although IOUs enjoy a scale advantage. Given costs, there is no difference in prices between IOUs and munis, and on average prices were 20 percent below monopoly prices. Looking at the 1919--1928 period and examining changes in the industry as measured by the firms' choices in frequency, current, and interconnections with other utilities shows evidence for a great deal of change, which occurred in statistically predictable ways. Utilities are standardizing the type of current produced, and the eventual localized standard frequencies were selected by 1907. There is little in the way of market rivalry between mum's and IOUs but large munis are less likely to build networks and sell in the wholesale market. Finally, I compare the changes that occurred during the 1919--1928 period, under the weak intervention of the Electricity Commissioners, with those of the 1928--1937 period, under the strong intervention of the Central Electricity Board. Without the CEB localized frequency standards would likely have remained in place. The CEB intervened directly in the wholesale market, but contrary to common perceptions, this strong intervention had relatively little impact on trends observed in the industry under the weak intervention of the 1919--1928 period: the CEB reduced prices and costs by no more than about 15 percent and was responsible for at most a quarter of their decline during the 1928--37 period.

Pricing of NASA Space Shuttle transportation system cargo

NASA Technical Reports Server (NTRS)

Hale, C. W.

1979-01-01

A two-part pricing policy is investigated as the most feasible method of pricing the transportation services to be provided by NASA's SSTS. Engineering cost estimates and a deterministic operating cost model generate a data base and develop a procedure for pricing the services of the SSTS. It is expected that the SSTS will have a monopoly on space material processing in areas of crystal growth, glass processing, metallurgical space applications, and biomedical processes using electrophoresis which will require efficient pricing. Pricing problems, the SSTS operating costs based on orbit elevation, number of launch sites, and number of flights, capital costs of the SSTS, research and development costs, allocation of joint transportation costs of the SSTS to a particular space processing activity, and rates for the SSTS are discussed. It is concluded that joint costs for commercial cargoes carried in the SSTS can be most usefully handled by making cost allocations based on proportionate capacity utilization.

Exploration of approaches to adjusting brand-name drug prices in Mainland of China: based on comparison and analysis of some brand-name drug prices of Mainland and Taiwan, China.

PubMed

Weng, Geng; Han, Sheng; Pu, Run; Pan, Wynn H T; Shi, Luwen

2014-01-01

Under the circumstance of the New Medical Reform in Mainland of China, lowering drug prices has become an approach to relieving increase of medical expenses, and lowering brand-name medication price is a key strategy. This study, by comparing and analyzing brand-name medication prices between Mainland of China and Taiwan, explores how to adjust brand-name medication prices in Mainland of China in the consideration of the drug administrative strategies in Taiwan. By selecting brand-name drug with generic name and dose types matched in Mainland and Taiwan, calculate the average unit price and standard deviation and test it with the paired t-test. In the mean time, drug administrative strategies between Mainland and Taiwan are also compared systematically. Among the 70 brand-name medications with generic names and matched dose types, 54 are at higher prices in Mainland of China than Taiwan, which is statistically significant in t-test. Also, among the 47 medications with all of matched generic names, dose types, and manufacturing enterprises, 38 are at higher prices in Mainland than Taiwan, and the gap is also statistically significant in t-test. In Mainland of China, brand-name medication took cost-plus pricing and price-based price adjustment, while in Taiwan, brand-name medication took internal and external reference pricing and market-based price adjustment. Brand-name drug prices were higher in Mainland of China than in Taiwan. The adjustment strategies of drug prices are scientific in Taiwan and are worth reference by Mainland of China.

Cigarette Prices and Community Price Comparisons in US Military Retail Stores

PubMed Central

Poston, Walker S.C.; Haddock, Christopher K.; Jahnke, Sara A.; Smith, Elizabeth; Malone, Ruth E.; Jitnarin, Nattinee

2016-01-01

BACKGROUND Tobacco pricing impacts use, yet military retailers sell discounted cigarettes. No systematic research has examined how military retail stores use internal community comparisons to set prices. We analyzed data obtained through a Freedom of Information Act request on community price comparisons used by military retail to set cigarette prices. METHODS Data on cigarette prices were obtained directly from military retailers (exchanges) from January 2013–March 2014. Complete pricing data was provided from exchanges on 114 military installations. RESULTS The average price for a pack of Marlboro cigarettes in military exchanges was $5.51, which was similar to the average lowest community price ($5.45; Mean Difference=−0.06; p=0.104) and almost a $1.00 lower than the average highest price ($6.44). Military retail prices were 2.1%, 6.2%, and 13.7% higher than the lowest, average, and highest community comparisons and 18.2% of exchange prices violated pricing instructions. There was a negative correlation (r = −.21, p = 0.02) between the number of community stores surveyed and exchange cigarette prices. CONCLUSIONS There was no significant difference between prices for cigarettes on military installations and the lowest average community comparison, and in some locations the prices violated DoD policy. US Marine Corps exchanges had the lowest prices, which is of concern given that the Marines also have the highest rates of tobacco use in the DoD. Given the relationship between tobacco product prices and demand, a common minimum (or floor) shelf price for tobacco products should be set for all exchanges and discount coupon redemptions should be prohibited. PMID:27553357

Estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada.

PubMed

Morgan, Steven G; Li, Winny; Yau, Brandon; Persaud, Nav

2017-02-27

Canada's universal health care system does not include universal coverage of prescription drugs. We sought to estimate the effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. We used administrative and market research data to estimate the 2015 shares of the volume and cost of prescriptions filled in the community setting that were for 117 drugs on a model list of essential medicines for Canada. We compared prices of these essential medicines in Canada with prices in the United States, Sweden and New Zealand. We estimated the cost of adding universal public drug coverage of these essential medicines based on anticipated effects on medication use and pricing. The 117 essential medicines on the model list accounted for 44% of all prescriptions and 30% of total prescription drug expenditures in 2015. Average prices of generic essential medicines were 47% lower in the US, 60% lower in Sweden and 84% lower in New Zealand; brand-name drugs were priced 43% lower in the US. Estimated savings from universal public coverage of these essential medicines was $4.27 billion per year (range $2.72 billion to $5.83 billion; 28% reduction) for patients and private drug plan sponsors, at an incremental government cost of $1.23 billion per year (range $373 million to $1.98 billion; 11% reduction). Our analysis showed that adding universal public coverage of essential medicines to the existing public drug plans in Canada could address most of Canadians' pharmaceutical needs and save billions of dollars annually. Doing so may be a pragmatic step forward while more comprehensive pharmacare reforms are planned. © 2017 Canadian Medical Association or its licensors.

Brands, costs and registration status of antimalarial drugs in the Kenyan retail sector

PubMed Central

Amin, Abdinasir A; Snow, Robert W

2005-01-01

Background Although an important source of treatment for fevers, little is known about the structure of the retail sector in Africa with regard to antimalarial drugs. This study aimed to assess the range, costs, sources and registration of antimalarial drugs in the Kenyan retail sector. Methods In 2002, antimalarial drug registration and trade prices were established by triangulating national registration lists, government gazettes and trade price indices. Data on registration status and trade prices were compared with similar data generated through a retail audit undertaken among 880 randomly sampled retailers in four districts of Kenya. Results Two hundred and eighteen antimalarial drugs were in circulation in Kenya in 2002. These included 65 "sulfur"-pyrimethamine (sulfadoxine-pyrimethamine and sulfalene-pyrimethamine (SP), the first-line recommended drug in 2002) and 33 amodiaquine (AQ, the second-line recommended drug) preparations. Only half of SP and AQ products were registered with the Pharmacy and Poisons Board. Of SP and AQ brands at district level, 40% and 44% were officially within legal registration requirements. 29% of retailers at district level stocked SP and 95% stocked AQ. The retail price of adult doses of SP and AQ were on average 0.38 and 0.76 US dollars, 100% and 347% higher than trade prices from manufacturers and importers. Artemether-lumefantrine, the newly announced first-line recommended antimalarial drug in 2004, was found in less than 1% of all retail outlets at a median cost of 7.6 US dollars. Conclusion There is a need to ensure that all antimalarial drugs are registered with the Pharmacy and Poisons Board to facilitate a more stringent post-marketing surveillance system to ensure drugs are safe and of good quality post-registration. PMID:16042815

48 CFR 15.408 - Solicitation provisions and contract clauses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.408... contemplated. (b) Price Reduction for Defective Certified Cost or Pricing Data. The contracting officer shall... Certified Cost or Pricing Data, in solicitations and contracts when it is contemplated that certified cost...

Are energy-dense foods really cheaper? Reexamining the relation between food price and energy density.

PubMed

Lipsky, Leah M

2009-11-01

The inverse relation between energy density (kcal/g) and energy cost (price/kcal) has been interpreted to suggest that produce (fruit, vegetables) is more expensive than snacks (cookies, chips). The objective of this study was to show the methodologic weakness of comparing energy density with energy cost. The relation between energy density and energy cost was replicated in a random-number data set. Additionally, observational data were collected for produce and snacks from an online supermarket. Variables included total energy (kcal), total weight (g), total number of servings, serving size (g/serving), and energy density (kcal/g). Price measures included energy cost ($/kcal), total price ($), unit price ($/g), and serving price ($/serving). Two-tailed t tests were used to compare price measures by food category. Relations between energy density and price measures within food categories were examined with the use of Spearman rank correlation analysis. The relation between energy density and energy cost was shown to be driven by the algebraic properties of these variables. Food category was strongly correlated with both energy density and food price measures. Energy cost was higher for produce than for snacks. However, total price and unit price were lower for produce. Serving price and serving size were greater for produce than for snacks. Within food categories, energy density was uncorrelated with most measures of food price, except for a weak positive correlation with serving price within the produce category. The findings suggest the relation between energy density and food price is confounded by food category and depends on which measure of price is used.

Optimizing Household Chlorination Marketing Strategies: A Randomized Controlled Trial on the Effect of Price and Promotion on Adoption in Haiti.

PubMed

Ritter, Michael; Camille, Eveline; Velcine, Christophe; Guillaume, Rose-Kerline; Lantagne, Daniele

2017-07-01

Household water treatment can reduce diarrheal morbidity and mortality in developing countries, but adoption remains low and supply is often unreliable. To test effects of marketing strategies on consumers and suppliers, we randomized 1,798 households in rural Haiti and collected data on purchases of a household chlorination product for 4 months. Households received randomly selected prices ($0.11-$0.56 per chlorine bottle), and half received monthly visits from sales agents. Each $0.22 drop in price increased purchases by 0.10 bottles per household per month ( P < 0.001). At the mean price, each 1% drop in price increased purchases by 0.45% (elasticity = 0.45). There is suggestive evidence that household visits by some sales agents increased purchases at mid-range prices; however, the additional revenue did not offset visit cost. Choosing the lowest price and conducting visits maximizes chlorine purchase, whereas slightly raising the retail price and not conducting visits maximizes cost recovery. For the equivalent cost, price discounts increase purchases 4.2 times as much as adding visits at the current retail price. In this context, price subsidies may be a more cost-effective use of resources than household visits, though all marketing strategies tested offer cost-effective ways to achieve incremental health impact. Decisions about pricing and promotion for health products in developing countries affect health impact, cost recovery, and cost-effectiveness, and tradeoffs between these goals should be made explicit in program design.

A comparison of alternative methods for measuring cigarette prices.

PubMed

Chaloupka, Frank J; Tauras, John A; Strasser, Julia H; Willis, Gordon; Gibson, James T; Hartman, Anne M

2015-05-01

Government agencies, public health organisations and tobacco control researchers rely on accurate estimates of cigarette prices for a variety of purposes. Since the 1950s, the Tax Burden on Tobacco (TBOT) has served as the most widely used source of this price data despite its limitations. This paper compares the prices and collection methods of the TBOT retail-based data and the 2003 and 2006/2007 waves of the population-based Tobacco Use Supplement to the Current Population Survey (TUS-CPS). From the TUS-CPS, we constructed multiple state-level measures of cigarette prices, including weighted average prices per pack (based on average prices for single-pack purchases and average prices for carton purchases) and compared these with the weighted average price data reported in the TBOT. We also constructed several measures of tax avoidance from the TUS-CPS self-reported data. For the 2003 wave, the average TUS-CPS price was 71 cents per pack less than the average TBOT price; for the 2006/2007 wave, the difference was 47 cents. TUS-CPS and TBOT prices were also significantly different at the state level. However, these differences varied widely by state due to tax avoidance opportunities, such as cross-border purchasing. The TUS-CPS can be used to construct valid measures of cigarette prices. Unlike the TBOT, the TUS-CPS captures the effect of price-reducing marketing strategies, as well as tax avoidance practices and non-traditional types of purchasing. Thus, self-reported data like TUS-CPS appear to have advantages over TBOT in estimating the 'real' price that smokers face. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

48 CFR 5215.804-3 - Exemptions from or waiver of submission of certified cost or pricing data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... of submission of certified cost or pricing data. 5215.804-3 Section 5215.804-3 Federal Acquisition... 5215.804-3 Exemptions from or waiver of submission of certified cost or pricing data. (a) General. As explained in 5215.402, cost or pricing data would not normally be obtained because the predominant portion...

48 CFR 5215.804-3 - Exemptions from or waiver of submission of certified cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of submission of certified cost or pricing data. 5215.804-3 Section 5215.804-3 Federal Acquisition... 5215.804-3 Exemptions from or waiver of submission of certified cost or pricing data. (a) General. As explained in 5215.402, cost or pricing data would not normally be obtained because the predominant portion...

The Six-Food Elimination Diet for Eosinophilic Esophagitis Increases Grocery Shopping Cost and Complexity.

PubMed

Asher Wolf, W; Huang, Kevin Z; Durban, Raquel; Iqbal, Zahra J; Robey, Benjamin S; Khalid, Farah J; Dellon, Evan S

2016-12-01

The six-food elimination diet (SFED), where dairy, wheat, eggs, soy, nuts, and seafood are avoided, is an effective treatment for eosinophilic esophagitis (EoE). Patient-related costs of this approach, however, are unknown. We aimed to assess the cost of and ease of shopping for an SFED compared to an unrestricted diet. A dietitian with expertise in EoE generated menus meeting dietary requirements for a week's worth of meals for the SFED and an unrestricted diet. We compared prices and the number of missing items for both diets at standard and specialty grocery stores. The average weekly price of the SFED at a standard supermarket was $92.54 compared to $79.84 for an unrestricted diet (p = 0.0001). A patient shopping at a standard grocery store needed a higher proportion of items from a second store compared to an unrestricted diet (32 vs. 3 %, p = 0.0001). The prices of the SFED and unrestricted diet using a specialty supermarket were comparable ($106.47 vs. $105.96, p = 0.81), as was the percentage of items requiring a trip to a second store (6 vs. 2 % items, p = 0.03). Shopping at a specialty grocery store increased weekly grocery costs by $13.93 (p = 0.04) for the SFED and $26.12 (p = 0.03) for the unrestricted diet. In conclusion, for patients shopping at standard grocery stores, the cost of an SFED is higher, and an SFED requires more items from a second store. These differences disappear at specialty grocery stores, but costs were significantly higher. This cost and logistical burden can inform patients when selecting dietary therapy.

Nonlinear Pricing in Drug Benefits and Medication Use: The Case of Statin Compliance in Medicare Part D

PubMed Central

Jung, Kyoungrae; Feldman, Roger; McBean, A Marshall

2014-01-01

Objective To examine how enrollees' statin compliance responds to expected prices in Medicare Part D, which features a nonlinear price schedule due to a coverage gap. Data Sources/Study Setting Prescription Drug Event data for a 5 percent random sample of Medicare Advantage Prescription Drug Plan enrollees in 2008 who did not receive a low-income subsidy. Study Design We analyze statin compliance prior to the coverage gap, where the “effective price” is higher than the actual copayment for drugs because consumers anticipate that more spending will make them more likely to reach the gap. We construct each enrollee's effective price as her expected price at the end of the year, which is the weighted average between pre-gap and in-gap copayments with the weight being the predicted probability of hitting the gap. Compliance is defined as at least 80 percent of days covered. Principal Findings Part D enrollees' pre-gap statin compliance decreases by 3.7–4.7 percentage points for a $10 increase in the effective price. Conclusion The presence of a coverage gap decreases statin compliance prior to the gap, suggesting that incorporating expected future prices is important to assess the full impact of cost sharing on drug compliance under nonlinear price schedules. PMID:24354765

Competition among Hospitals for HMO Business: Effect of Price and Nonprice Attributes

PubMed Central

Young, Gary J; Burgess, James F; Valley, Danielle

2002-01-01

Objective To investigate patterns of competition among hospitals for the business of health maintenance organizations (HMOs). The study focused on the relative importance of hospital price and nonprice attributes in the competition for HMO business. Data Sources/Study Setting The study capitalized on hospital cost reports from Florida that are unique in their inclusion of financial data regarding HMO business activity. The time frame was 1992 to 1997. Study Design The study was designed as an observational investigation of acute care hospitals. Principal Findings Results indicated that a hospital's share of HMO business was related to both its price and nonprice attributes. However, the importance of both price and nonprice attributes diminished as the number of HMOs in a market increased. Hospitals that were market share leaders in terms of HMO business (i.e., 30 percent or more market share) were superior, on average, to their competitors on both price and nonprice attributes. Conclusions Study results indicate that competition among hospitals for HMO business involves a complex set of price and nonprice attributes. The HMOs do not appear to focus on price alone. Hospitals likely to be the most attractive to HMOs are those that can differentiate themselves on the basis of nonprice attributes while being competitive on price as well. PMID:12479496

Robust Unit Commitment Considering Uncertain Demand Response

DOE PAGES

Liu, Guodong; Tomsovic, Kevin

2014-09-28

Although price responsive demand response has been widely accepted as playing an important role in the reliable and economic operation of power system, the real response from demand side can be highly uncertain due to limited understanding of consumers' response to pricing signals. To model the behavior of consumers, the price elasticity of demand has been explored and utilized in both research and real practice. However, the price elasticity of demand is not precisely known and may vary greatly with operating conditions and types of customers. To accommodate the uncertainty of demand response, alternative unit commitment methods robust to themore » uncertainty of the demand response require investigation. In this paper, a robust unit commitment model to minimize the generalized social cost is proposed for the optimal unit commitment decision taking into account uncertainty of the price elasticity of demand. By optimizing the worst case under proper robust level, the unit commitment solution of the proposed model is robust against all possible realizations of the modeled uncertain demand response. Numerical simulations on the IEEE Reliability Test System show the e ectiveness of the method. Finally, compared to unit commitment with deterministic price elasticity of demand, the proposed robust model can reduce the average Locational Marginal Prices (LMPs) as well as the price volatility.« less

The principles of quality-associated costing: derivation from clinical transfusion practice.

PubMed

Trenchard, P M; Dixon, R

1997-01-01

As clinical transfusion practice works towards achieving cost-effectiveness, prescribers of blood and its derivatives must be certain that the prices of such products are based on real manufacturing costs and not market forces. Using clinical cost-benefit analysis as the context for the costing and pricing of blood products, this article identifies the following two principles: (1) the product price must equal the product cost (the "price = cost" rule) and (2) the product cost must equal the real cost of product manufacture. In addition, the article describes a new method of blood product costing, quality-associated costing (QAC), that will enable valid cost-benefit analysis of blood products.

Healthcare utilization and cost of Stevens-Johnson syndrome and toxic epidermal necrolysis management in Thailand.

PubMed

Dilokthornsakul, P; Sawangjit, R; Inprasong, C; Chunhasewee, S; Rattanapan, P; Thoopputra, T; Chaiyakunapruk, N

2016-01-01

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening dermatologic conditions. Although, the incidence of SJS/TEN in Thailand is high, information on cost of care for SJS/TEN is limited. This study aims to estimate healthcare resource utilization and cost of SJS/TEN in Thailand, using hospital perspective. A retrospective study using an electronic health database from a university-affiliated hospital in Thailand was undertaken. Patients admitted with SJS/TEN from 2002 to 2007 were included. Direct medical cost was estimated by the cost-to-charge ratio. Cost was converted to 2013 value by consumer price index, and converted to $US using 31 Baht/ 1 $US. The healthcare resource utilization was also estimated. A total of 157 patients were included with average age of 45.3±23.0 years. About 146 patients (93.0%) were diagnosed as SJS and the remaining (7.0%) were diagnosed as TEN. Most of the patients (83.4%) were treated with systemic corticosteroids. Overall, mortality rate was 8.3%, while the average length of stay (LOS) was 10.1±13.2 days. The average cost of managing SJS/TEN for all patients was $1,064±$2,558. The average cost for SJS patients was $1,019±$2,601 while that for TEN patients was $1,660±$1,887. Healthcare resource utilization and cost of care for SJS/TEN in Thailand were tremendous. The findings are important for policy makers to allocate healthcare resources and develop strategies to prevent SJS/TEN which could decrease length of stay and cost of care.

Costs of paying higher prices for equivalent effects on the Pharmaceutical Benefits Scheme.

PubMed

Karnon, Jonathan; Edney, Laura; Sorich, Michael

2017-03-01

Objective The aims of the present study were to illustrate and discuss the effects of the non-maintenance of equivalent prices when the comparators of pharmaceuticals listed on the Pharmaceutical Benefits Schedule (PBS) on a cost-minimisation basis come off-patent and are subject to statutory price reductions, as well as further potential price reductions because of the effects of price disclosure. Methods Service use, benefits paid, and price data were analysed for a selected sample of pharmaceuticals recommended for listing on a cost-minimisation basis between 2008 and 2011, and their comparators, to estimate the cost savings to the PBS of maintaining equivalent prices. Results Potential cost savings for 12 pharmaceuticals, including alternative compounds and combination products across nine therapeutic groups, ranged from A$570000 to A$40million to April 2015. Potential savings increased significantly following recent amendments to the price disclosure process. Conclusions Potential savings from maintaining equivalent prices for all pharmaceuticals listed on the PBS on a cost-minimisation basis could be over A$500million per year. Actions to reduce these costs can be taken within existing policy frameworks, but legislative and political barriers may need to be addressed to minimise these costs, which are incurred by the taxpayer for no additional benefit. What is known about the topic? Pharmaceuticals listed on the PBS must provide value for money. Many pharmaceuticals achieve this by demonstrating equal effectiveness to an already listed pharmaceutical and requesting the same price as this comparator; that is, listing on a cost-minimisation basis. When the comparator moves off-patent, the price of the still-patented pharmaceutical is protected, whereas the off-patent drug is subject to price disclosure and often steep price reductions. What does this paper add? This paper adds to recent evidence on the costs to government of paying different prices for two or more pharmaceuticals that are equally effective. Between 2008 and 2011, the direct comparators for 68 pharmaceuticals listed on a cost-minimisation basis have moved onto the price disclosure list. Across 12 of these listings, the potential cost savings in the 10 months to April 2015 were A$73million. What are the implications for practitioners? The PBS costs the Australian government over A$9 billion per year. Annual savings over A$500million per year could be achieved by maintaining cost-minimisation across equally effective pharmaceuticals. This would improve the efficiency of the PBS at no risk to patients. Legislation is required to remove the existing F1 and F2 categorisation of listed pharmaceuticals, but the proposed changes would remove the need for therapeutic group premiums and simplify the pricing of PBS items.

Impact of socioeconomic adjustment on physicians' relative cost of care.

PubMed

Timbie, Justin W; Hussey, Peter S; Adams, John L; Ruder, Teague W; Mehrotra, Ateev

2013-05-01

Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES). The importance of SES adjustment has not been explored in cost-profiling applications that measure costs using an episode of care framework. We assessed the relationship between SES and episode costs and the impact of adjusting for SES on physicians' relative cost rankings. We analyzed claims submitted to 3 Massachusetts commercial health plans during calendar years 2004 and 2005. We grouped patients' care into episodes, attributed episodes to individual physicians, and standardized costs for price differences across plans. We accounted for differences in physicians' case mix using indicators for episode type and a patient's severity of illness. A patient's SES was measured using an index of 6 indicators based on the zip code in which the patient lived. We estimated each physician's case mix-adjusted average episode cost and percentile rankings with and without adjustment for SES. Patients in the lowest SES quintile had $80 higher unadjusted episode costs, on average, than patients in the highest quintile. Nearly 70% of the variation in a physician's average episode cost was explained by case mix of their patients, whereas the contribution of SES was negligible. After adjustment for SES, only 1.1% of physicians changed relative cost rankings >2 percentiles. Accounting for patients' SES has little impact on physicians' relative cost rankings within an episode cost framework.

Economic and clinical comparison of atypical depot antipsychotic drugs for treatment of chronic schizophrenia in the Czech Republic.

PubMed

Einarson, Thomas R; Zilbershtein, Roman; Skoupá, Jana; Veselá, Sárka; Garg, Madhur; Hemels, Michiel E H

2013-09-01

The Czech Republic is faced with making choices between pharmaceutical products, including depot injectable antipsychotics. A pharmacoeconomic analysis was conducted to determine the cost-effectiveness of atypical depots. An existing 1-year decision-analytic framework was adapted to model drug use in this healthcare system. The average direct costs to the General Insurance Company of the Czech Republic of using paliperidone palmitate (Xeplion®), risperidone (Risperdal Consta®), and olanzapine pamoate (Zypadhera®) were determined. Literature-derived clinical rates populated the model, with costs adjusted to 2012 Euros using the consumer price index. Outcomes included quality-adjusted life-years (QALYs), days in remission, and proportions hospitalized or visiting emergency rooms. One-way sensitivity analyses were calculated for all important inputs. A multivariate probability analysis was used to examine the stability of results using 10,000 iterations of simulated input over reasonable ranges of all included variables. Expected average costs/per patient treated were €5377 for PP-LAI, €6118 for RIS-LAI, and €6537 for OLZ-LAI. Respective QALYs were 0.817, 0.809, and 0.811; ER visits were 0.127, 0.134, and 0.141; hospitalizations were 0.252, 0.298, and 0.289. Results were generally robust in sensitivity analyses. PP-LAI dominated RIS-LAI and OLZ-LAI in 90.2% and 92.1% of simulations, respectively. Results were insensitive to drug prices but sensitive to adherence and hospitalization rates. PP-LAI dominated the other two drugs, as it had a lower overall cost and superior clinical outcomes, making it the preferred choice. Using PP-LAI in place of RIS-LAI for chronic relapsing schizophrenia would reduce the overall costs of care for the healthcare system.

48 CFR 215.403-1 - Prohibition on obtaining cost or pricing data (10 U.S.C. 2306a and 41 U.S.C. 254b).

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost or pricing data (10 U.S.C. 2306a and 41 U.S.C. 254b). 215.403-1 Section 215.403-1 Federal... METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403-1 Prohibition on obtaining cost or pricing data (10 U.S.C. 2306a and 41 U.S.C. 254b). (b) Exceptions to cost or pricing data...

The maximum potential market for dengue drugs V 1.0.

PubMed

Dow, Geoffrey; Mora, Eric

2012-11-01

Drugs offer a complementary approach to vaccines for preventing the progression of symptoms and onset of the severe manifestations of dengue. Despite the rapid maturation of the research and development infrastructure for dengue drugs and the increasing frequency of dengue inhibitors reported in the scientific literature, the potential size of the market for dengue drugs has not been articulated. In the present work, extrapolating from publicly available information, we explored the economic burden attributable to dengue, the impact of dengue vaccines on clinical case loads, a possible alternative to tiered pricing for products for neglected diseases, and defined the maximum potential market for a dengue drug. Our projections suggest that in 2006, the annual global burden of dengue was US $1.7billion. Our proposed alternative to existing tiered pricing structures is that during a temporary period of market exclusivity, individual countries would pay 50% of the per-case equivalent of economic costs saved through the use of a dengue drug. This would yield prices per case of US $13-$239 depending on drug effectiveness and cost of medical and indirect costs and lost productivity in different countries. Assuming that such a pricing scheme was embraced, the maximum potential market for a dengue drug or drugs that on average reduced 40% of economic costs might be as high as US $338million annually. Our simulations suggest that dengue vaccines will begin to reduce the clinical case load of dengue in 2022, but that the number of cases will not decrease below 2006 levels and the proportion vaccinated will remain well below that required for the onset of herd immunity during the period of market exclusivity after the licensure of the first wave of dengue drugs. Copyright © 2012 Elsevier B.V. All rights reserved.

77 FR 23282 - All Items Consumer Price Index for All Urban Consumers; United States City Average

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... DEPARTMENT OF LABOR Office of the Secretary All Items Consumer Price Index for All Urban Consumers... the United States City Average All Items Consumer Price Index for All Urban Consumers (1967 = 100... Price Index for All Urban Consumers thus increased 356.2 percent from its 1974 annual average of 100 to...

76 FR 31991 - All Items Consumer Price Index for All Urban Consumers; United States City Average

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

... DEPARTMENT OF LABOR Office of the Secretary All Items Consumer Price Index for All Urban Consumers... United States City Average All Items Consumer Price Index for All Urban Consumers (1967=100) increased... 1974 as a base (1974=100), I certify that the United States City Average All Items Consumer Price Index...

78 FR 35054 - All Items Consumer Price Index for All Urban Consumers United States City Average

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... DEPARTMENT OF LABOR Office of the Secretary All Items Consumer Price Index for All Urban Consumers... United States City Average All Items Consumer Price Index for All Urban Consumers (1967=100) increased... 1974 as a base (1974=100), I certify that the United States City Average All Items Consumer Price Index...

75 FR 22164 - All Items Consumer Price Index for All Urban Consumers United States City Average

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... DEPARTMENT OF LABOR Office of the Secretary All Items Consumer Price Index for All Urban Consumers... United States City Average All Items Consumer Price Index for All Urban Consumers (1967=100) increased... 1974 as a base (1974=100), I certify that the United States City Average All Items Consumer Price Index...

Estimated costs of production and potential prices for the WHO Essential Medicines List

PubMed Central

Hill, Andrew M; Barber, Melissa J

2018-01-01

Introduction There are persistent gaps in access to affordable medicines. The WHO Model List of Essential Medicines (EML) includes medicines considered necessary for functional health systems. Methods A generic price estimation formula was developed by reviewing published analyses of cost of production for medicines and assuming manufacture in India, which included costs of formulation, packaging, taxation and a 10% profit margin. Data on per-kilogram prices of active pharmaceutical ingredient exported from India were retrieved from an online database. Estimated prices were compared with the lowest globally available prices for HIV/AIDS, tuberculosis (TB) and malaria medicines, and current prices in the UK, South Africa and India. Results The estimation formula had good predictive accuracy for HIV/AIDS, TB and malaria medicines. Estimated generic prices ranged from US$0.01 to US$1.45 per unit, with most in the lower end of this range. Lowest available prices were greater than estimated generic prices for 214/277 (77%) comparable items in the UK, 142/212 (67%) in South Africa and 118/298 (40%) in India. Lowest available prices were more than three times above estimated generic price for 47% of cases compared in the UK and 22% in South Africa. Conclusion A wide range of medicines in the EML can be profitably manufactured at very low cost. Most EML medicines are sold in the UK and South Africa at prices significantly higher than those estimated from production costs. Generic price estimation and international price comparisons could empower government price negotiations and support cost-effectiveness calculations. PMID:29564159

Do generics offer significant savings to the UK National Health Service?

PubMed

Kanavos, Panos

2007-01-01

The UK has traditionally had strong proxy demand-side measures favouring generic drug use, including prescribing guidance, financial incentives and encouraging generic prescribing. At distribution level, pharmacies are paid a salary for their dispensing work, based on volume dispensed, and procure generic products on the basis of discounts given to them by manufacturers or wholesalers. The supply-side has been subject to price regulation, and the recent requirement for manufacturers/wholesalers to report prices net of discounts to the DoH, indicate that reimbursed prices for generics may be higher than commodity level. To investigate the level of discounts off the Drug Tariff Price made available to pharmacies and, determine whether the NHS could have a better deal than currently from generic drug purchasing. Data on net prices were acquired for different presentations of 12 generic molecules selected across different therapeutic categories and included in the 50 most selling generic prescription only products in the UK in the first quarter of 2005. For these products, 31 out of a possible 34 presentations (90%) were surveyed. The data sources were price lists of three leading full-line wholesalers (one national, two regional), out of a possible 11 full-line wholesalers (27.2%), and three leading generic drug manufacturers, out of a possible 15 manufacturers (20%). Generic prescribing in the selected molecules was 94.6%, above the national average of 80%, and the total net ingredient cost (NIC) was 675 million pounds, of which 607.5 million pounds (90%) was generic. In 20 of the product presentations reviewed (64.5%), maximum discounts exceeded 60%, whereas in seven (22.6%) maximum discounts ranged between 50 and 60% off the Drug Tariff Price. Reimbursed prices for leading generic molecules are significantly higher than their pharmacy acquisition cost. The NHS is reimbursing generics at too high prices and a significant proportion of the reimbursed price accrues to the distribution chain in a fashion that resembles an indirect subsidy. The NHS can improve efficiency as well as increase savings, by purchasing generics closer to their market price. This would require changes in the way pharmacies are reimbursed, for instance, by changing the way the clawback is calculated, or altogether abolishing discounts and introducing a fixed dispensing fee; it could also mean introducing transparency in the determination of Drug Tariff prices by the relevant stakeholders. As the cost per generic script is, in the majority of cases, below the dispensing fee, the current reimbursement system for generics results in a re-distribution from patients and the NHS to the retail distribution chain.

Measuring market performance in restructured electricity markets: An empirical analysis of the PJM energy market

NASA Astrophysics Data System (ADS)

Tucker, Russell Jay

2002-09-01

Today the electric industry in the U.S. is transitioning to competitive markets for wholesale electricity. Independent system operators (ISOs) now manage broad regional markets for electrical energy in several areas of the U.S. A recent rulemaking by the Federal Energy Regulatory Commission (FERC) encourages the development of regional transmission organizations (RTOs) and restructured competitive wholesale electricity markets nationwide. To date, the transition to competitive wholesale markets has not been easy. The increased reliance on market forces coupled with unusually high electricity demand for some periods have created conditions amenable to market power abuse in many regions throughout the U.S. In the summer of 1999, hot and humid summer conditions in Pennsylvania, New Jersey, Maryland, Delaware, and the District of Columbia pushed peak demand in the PJM Interconnection to record levels. These demand conditions coincided with the introduction of market-based pricing in the wholesale electricity market. Prices for electricity increased on average by 55 percent, and reached the $1,000/MWh range. This study examines the extent to which generator market power raised prices above competitive levels in the PJM Interconnection during the summer of 1999. It simulates hourly market-clearing prices assuming competitive market behavior and compares these prices with observed market prices in computing price markups over the April 1-August 31, 1999 period. The results of the simulation analysis are supported with an examination of actual generator bid data of incumbent generators. Price markups averaged 14.7 percent above expected marginal cost over the 5-month period for all non-transmission-constrained hours. The evidence presented suggests that the June and July monthly markups were strongly influenced by generator market power as price inelastic peak demand approached the electricity generation capacity constraint of the market. While this analysis of the performance of the PJM market finds evidence of market power, the measured markups are markedly less than estimates from prior analysis of the PJM market.

HIV prevention costs and their predictors: evidence from the ORPHEA Project in Kenya

PubMed Central

Galárraga, Omar; Wamai, Richard G; Sosa-Rubí, Sandra G; Mugo, Mercy G; Contreras-Loya, David; Bautista-Arredondo, Sergio; Nyakundi, Helen; Wang’ombe, Joseph K

2017-01-01

Abstract We estimate costs and their predictors for three HIV prevention interventions in Kenya: HIV testing and counselling (HTC), prevention of mother-to-child transmission (PMTCT) and voluntary medical male circumcision (VMMC). As part of the ‘Optimizing the Response of Prevention: HIV Efficiency in Africa’ (ORPHEA) project, we collected retrospective data from government and non-governmental health facilities for 2011–12. We used multi-stage sampling to determine a sample of health facilities by type, ownership, size and interventions offered totalling 144 sites in 78 health facilities in 33 districts across Kenya. Data sources included key informants, registers and time-motion observation methods. Total costs of production were computed using both quantity and unit price of each input. Average cost was estimated by dividing total cost per intervention by number of clients accessing the intervention. Multivariate regression methods were used to analyse predictors of log-transformed average costs. Average costs were $7 and $79 per HTC and PMTCT client tested, respectively; and $66 per VMMC procedure. Results show evidence of economies of scale for PMTCT and VMMC: increasing the number of clients per year by 100% was associated with cost reductions of 50% for PMTCT, and 45% for VMMC. Task shifting was associated with reduced costs for both PMTCT (59%) and VMMC (54%). Costs in hospitals were higher for PMTCT (56%) in comparison to non-hospitals. Facilities that performed testing based on risk factors as opposed to universal screening had higher HTC average costs (79%). Lower VMMC costs were associated with availability of male reproductive health services (59%) and presence of community advisory board (52%). Aside from increasing production scale, HIV prevention costs may be contained by using task shifting, non-hospital sites, service integration and community supervision. PMID:29029086

48 CFR 215.408 - Solicitation provisions and contract clauses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY....215-11, Price Reduction for Defective Cost or Pricing Data—Modifications; (ii) FAR 52.215-12, Subcontractor Cost or Pricing Data; or (iii) FAR 52.215-13, Subcontractor Cost or Pricing Data—Modifications. (2...

48 CFR 215.403-3 - Requiring information other than cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... other than cost or pricing data. 215.403-3 Section 215.403-3 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403-3 Requiring information other than cost or pricing data...

48 CFR 215.403-3 - Requiring information other than cost or pricing data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... other than cost or pricing data. 215.403-3 Section 215.403-3 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403-3 Requiring information other than cost or pricing data...

48 CFR 215.403-3 - Requiring information other than cost or pricing data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... other than cost or pricing data. 215.403-3 Section 215.403-3 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403-3 Requiring information other than cost or pricing data...

Pricing Medicare's diagnosis-related groups: Charges versus estimated costs

PubMed Central

Price, Kurt F.

1989-01-01

Hospital payments under Medicare's prospective payment system (PPS) are based on prices established for 474 diagnosis-related groups (DRG's). Previous analyses using 1981 data demonstrated that DRG prices based on charges alone were not that different from prices calculated from estimated costs. Data for 1986 were used in this study to show that the differences between the two sets of DRG prices are much larger than previously reported. If DRG prices were once again based on estimated costs instead of the current charge-based prices, payments would be significantly redistributed. PMID:10313356

Analyzing the prices of the most expensive sheet iron all over the world: Modeling, prediction and regime change

NASA Astrophysics Data System (ADS)

Song, Fu-Tie; Zhou, Wei-Xing

2010-09-01

The private car license plates issued in Shanghai are bestowed the title of “the most expensive sheet iron all over the world”, more expensive than gold. A citizen has to bid in a monthly auction to obtain a license plate for his new private car. We perform statistical analysis to investigate the influence of the minimal price Pmin of the bidding winners, the quota N of private car license plates, the number N of bidders, as well as two external shocks including the legality debate of the auction in 2004 and the auction regime reform in January 2008 on the average price P of all bidding winners. It is found that the legality debate of the auction had marginal transient impact on the average price in a short time period. In contrast, the change of the auction rules has significant permanent influence on the average price, which reduces the price by about 3020 yuan Renminbi. It means that the average price exhibits nonlinear behaviors with a regime change. The evolution of the average price is independent of the number N of bidders in both regimes. In the early regime before January 2008, the average price P was influenced only by the minimal price Pmin in the preceding month with a positive correlation. In the current regime since January 2008, the average price is positively correlated with the minimal price and the quota in the preceding month and negatively correlated with the quota in the same month. We test the predictive power of the two models using 2-year and 3-year moving windows and find that the latter outperforms the former. It seems that the auction market becomes more efficient after the auction reform since the prediction error increases.

Cost, Price and Public Policy: Peering into the Higher Education Black Box. New Agenda Series[TM], Volume 1, Number 3.

ERIC Educational Resources Information Center

Stringer, William L.; Cunningham, Alisa F.

This report contains a conceptual framework for analyzing costs and prices by evaluating the higher education production function and the determinants of both prices and costs. The framework can be used to strengthen understanding of costs and prices within individual institutions and to inform macro level investments at state and national levels.…

Short-Term Energy Outlook Supplement: Constraints in New England likely to affect regional energy prices this winter

EIA Publications

2013-01-01

Since November, New England has had the highest average spot natural gas prices in the nation. Average prices at the Algonquin Citygate trading point, a widely used index for New England natural gas buyers, have been $3 per million British thermal units (MMBtu) higher than natural gas prices at the Henry Hub, and more than $2 per MMBtu higher than average spot price at Transco Zone 6 NY, which serves New York City and has historically traded at prices similar to those in New England.

Airport and Airway Costs: Allocation and Recovery in the 1980’s.

DTIC Science & Technology

1987-02-01

1997 [8]. 3*X S.% Volume 4, FAA Cost Recovery Options [9). Volume 5, Econometric Cost Functions for FAA Cost Allocation Model [10]. Volume 6, Users...and relative price elasticities ( Ramsey pricing technique). User fees based on the Ramsey pricing tend to be less burdensome on users and minimize...full discussion of the Ramsey pricing techniques is provided in Allocation of Federal Airport and Airway Costs for FY 1985 [6]. -12- In step 5

Changes in Pricing Behavior during the 1980s: An Analysis of Selected Case Studies.

ERIC Educational Resources Information Center

St. John, Edward P.

1992-01-01

Reports on changes in pricing decisions at public and private colleges in a low-cost and a high-cost state in the 1980s. Five liberal arts colleges studied used several pricing strategies: "elite" pricing strategy; "prestige" pricing strategy; and price reduction strategy. Study found multiple causes for price increases, more sophisticated pricing…

The Desire to Acquire: Forecasting the Evolution of Household Energy Services

NASA Astrophysics Data System (ADS)

Groves, Steven

People are constantly inventing and adopting new energy-using devices to make their lives more comfortable, convenient, connected, and entertaining. This study aggregates 134 energy-using household devices, not including major appliances, into categories based on the energy service they provide. By 2006, there were 43 energy-using devices in the average U.S. household that used over 4,700 kWh of electricity, natural gas, and gasoline. A fixed effects panel model was used to examine the relationship of demand for energy-using devices to energy price, household income, and the cost of these devices. This analysis finds that the elasticity of demand for these devices with respect to energy price is -0.52 with a 90% confidence interval of -1.04 to -0.01. The elasticity of demand to income is 0.52 (a 90% confidence interval of [-0.42, 1.46]. The cost of these devices was also statistically significant.

Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore

PubMed Central

Carrasco, Luis R.; Lee, Linda K.; Lee, Vernon J.; Ooi, Eng Eong; Shepard, Donald S.; Thein, Tun L.; Gan, Victor; Cook, Alex R.; Lye, David; Ng, Lee Ching; Leo, Yee Sin

2011-01-01

Background Dengue illness causes 50–100 million infections worldwide and threatens 2.5 billion people in the tropical and subtropical regions. Little is known about the disease burden and economic impact of dengue in higher resourced countries or the cost-effectiveness of potential dengue vaccines in such settings. Methods and Findings We estimate the direct and indirect costs of dengue from hospitalized and ambulatory cases in Singapore. We consider inter alia the impacts of dengue on the economy using the human-capital and the friction cost methods. Disease burden was estimated using disability-adjusted life years (DALYs) and the cost-effectiveness of a potential vaccine program was evaluated. The average economic impact of dengue illness in Singapore from 2000 to 2009 in constant 2010 US$ ranged between $0.85 billion and $1.15 billion, of which control costs constitute 42%–59%. Using empirically derived disability weights, we estimated an annual average disease burden of 9–14 DALYs per 100 000 habitants, making it comparable to diseases such as hepatitis B or syphilis. The proportion of symptomatic dengue cases detected by the national surveillance system was estimated to be low, and to decrease with age. Under population projections by the United Nations, the price per dose threshold for which vaccines stop being more cost-effective than the current vector control program ranged from $50 for mass vaccination requiring 3 doses and only conferring 10 years of immunity to $300 for vaccination requiring 2 doses and conferring lifetime immunity. The thresholds for these vaccine programs to not be cost-effective for Singapore were $100 and $500 per dose respectively. Conclusions Dengue illness presents a serious economic and disease burden in Singapore. Dengue vaccines are expected to be cost-effective if reasonably low prices are adopted and will help to reduce the economic and disease burden of dengue in Singapore substantially. PMID:22206028

19 CFR 351.414 - Comparison of normal value with export price (constructed export price).

Code of Federal Regulations, 2010 CFR

2010-04-01

... export price). (a) Introduction. The Secretary normally will average prices used as the basis for normal... calculate weighted averages for such shorter period as the Secretary deems appropriate. (e) Application of...

The effects of price and perceived quality on the behavioural economics of alcohol, amphetamine, cannabis, cocaine, and ecstasy purchases.

PubMed

Goudie, Andrew J; Sumnall, Harry R; Field, Matt; Clayton, Hannah; Cole, Jon C

2007-07-10

Behavioural economic models of substance use describe the relationship between changes in unit price and consumption. However, these models rarely take account of the perceived quality (i.e. potency) of controlled drugs. Therefore we investigated the effects of both price and quality on the decision to purchase controlled drugs by polysubstance misusers. Forty current polysubstance misusers (29 males, 11 females; mean age 23.8) were recruited into the study. Participants were asked to hypothetically purchase drugs from a price list of alcohol, amphetamine, cannabis, cocaine and ecstasy at different levels of quality and price (i.e. better quality drugs cost more money). The disposable income available for those purchases was systematically varied in order to determine the impact of income on the decision to purchase drugs. Demand for both normal and strong alcohol was income inelastic. Demand for both poor and average quality cannabis and ecstasy was income inelastic, but demand for good quality cannabis and ecstasy was income elastic. The demand for poor quality cocaine was income inelastic, with the demand for both average and good quality cocaine being income elastic. Participants reported too few purchases of amphetamine, which precluded behavioural economic analysis. These results suggest that, like other goods, controlled drugs are purchased based upon the consumer's interpretations of their relative value. Therefore, it is probable that the purchase and subsequent use of controlled drugs by polysubstance misusers will be heavily influenced by the economic environment.

Are retail prices "just" when they do not include social costs?

PubMed

McMahon, T F

1999-01-01

The price is "right" when the buyer agrees to purchase goods or service. But is it "just"? That is, does the price include social costs such as pollution and discrimination? Cost shifting is the passing down of these costs from the seller to the buyer. The amount of cost shifting depends upon the inelasticity or elasticity of supply or demands, methods of assigning social costs, means used in promotion and the role of the market price. Wal-Mart and Body Shop International exemplify the problems of social costs. Recommendations for marketing managers concludes the article.

Willingness to pay and benefit-cost analysis of modern contraceptives in Nigeria.

PubMed

Onwujekwe, Obinna; Ogbonna, Chinwe; Ibe, Ogochukwu; Uzochukwu, Benjamin

2013-08-01

To determine the willingness to pay (WTP) and the benefit-cost of modern contraceptives delivered through the public sector in Nigeria. Data were collected from 4517 randomly selected households. The WTP for the 6 major contraceptive methods available in the public sector was elicited. Logistic regression was used to determine whether the decision to state a positive WTP amount was valid; Tobit regression was used to test the validity of the elicited WTP amounts. For each contraceptive, 3 BCR values were computed, based on the official unit price, the unit cost per couple-year of protection (CYP), and the average actual expenditure for contraceptives in the month preceding the interview. The mean WTP for the different contraceptives varied by socioeconomic status and geographic (urban versus rural) location (P<0.01). The BCR analysis showed that the benefits of providing contraceptives through the public sector far outweighed the costs, except for female condoms, where the CYP-based BCR was 0.9. The benefits of providing contraceptives outweigh the costs, making public sector investment worthwhile. The median WTP amounts, which reflect the ideal upper thresholds for pricing, indicate that cost recovery is feasible for all contraceptives. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Cost and financial sustainability of a household-based water treatment and storage intervention in Zambia.

PubMed

Banerjee, Anyana; McFarland, Deborah A; Singh, Ritu; Quick, Robert

2007-09-01

Providing safe water to >1 billion people in need is a major challenge. To address this need, the Safe Water System (SWS) - household water treatment with dilute bleach, safe water storage, and behavior change - has been implemented in >20 countries. To assess the potential sustainability of the SWS, we analyzed costs in Zambia of "Clorin" brand product sold in bottles sufficient for a month of water treatment at a price of $0.09. We analyzed production, marketing, distribution, and overhead costs of Clorin before and after sales reached nationwide scale, and analyzed Clorin sales revenue. The average cost per bottle of Clorin production, marketing and distribution at start-up in 1999 was $1.88 but decreased by 82% to $0.33 in 2003, when >1.7 million bottles were sold. The financial loss per bottle decreased from $1.72 in 1999 to $0.24 in 2003. Net program costs in 2003 were $428,984, or only $0.04 per person-month of protection. A sensitivity analysis showed that if the bottle price increased to $0.18, the project would be self-sustaining at maximum capacity. This analysis demonstrated that efficiencies in the SWS supply chain can be achieved through social marketing. Even with a subsidy, overall program costs per beneficiary are low.

A Cost Analysis of a Pancreatic Cancer Screening Protocol in High-Risk Populations

PubMed Central

Bruenderman, Elizabeth; Martin, Robert CG

2016-01-01

Background Pancreatic cancer is the 4th leading cause of cancer death in the U.S. A screening protocol is needed to catch early stage, resectable disease. This study suggests a protocol for high-risk individuals and assesses the cost in the context of the Affordable Care Act. Methods Medicare and national average pricing were used for cost analysis of a protocol using MRI/MRCP biannually in high-risk groups. Results: ‘ Costs per year of life added’ based on Medicare and national average costs, respectively, are: $638.62 and $2542.37 for Peutz-Jehgers Syndrome, $945.33 and $3763.44 for Hereditary Pancreatitis, $1141.77 and $4545.45 for Familial Pancreatic Cancer and p16-Leiden mutations, and $356.42 and $1418.92 for new-onset diabetes over age 50 with weight loss or smoking. Conclusion A screening program using MRI/MRCP is affordable in high-risk populations. The U.S. Preventive Services Task Force must reevaluate its pancreatic cancer screening guidelines to make screening more cost-effective for the individual. PMID:26003200

Equitable Prices of Single-Source Drugs in Thailand.

PubMed

Ngorsuraches, Surachat; Chaiyakan, Kanokkan

2015-08-01

In Thailand, total drug expenditure has grown rapidly. Recently, the Thai government has addressed the issue of drug pricing, but the prices of single-source drugs remain a major challenge. To examine equitable prices of single-source drugs in Thailand. A total of 98 single-source and high-expenditure drugs were examined. Unit prices from the Drug and Medical Supplies Information Center (DMSIC) and National Average Drug Acquisition Cost (NADAC) were used to represent drug prices at the provider level in Thailand and the U.S., respectively. Data for measuring drug affordability, e.g., dose and poverty line, were obtained from Micromedex online and the National Statistical Office (NSO). The U.S. drug prices were adjusted by the Human Development Index (HDI) to be equitable prices for Thailand. Purchasing Power Parity (PPP) was used to convert US currency into Thai baht. All prices in this study were based on the year 2012. Catastrophic, Impoverishment, and WHO/Health Action International (HAI) approaches were used to determine Thai citizens' ability to afford the study drugs. Finally, uncertainty analyses were conducted. From all study drugs, 55 single-source drugs were priced higher than their equitable prices, ranging from 0.38 to 422.36% higher. Among these, 28 items were antineoplastic drugs. The prices of drugs outside the National List of Essential Medicines (NLEM), as well as the country's newer drugs, tended to be higher than their calculated equitable prices. The majority of drugs in Thailand priced higher than equitable prices were unaffordable for most Thai citizens. The uncertainty analyses revealed that almost all results were relatively robust. Most single-source drug prices in Thailand were higher than their equitable prices, and were likely to be unaffordable to Thai citizens.

Does drug price-regulation affect healthcare expenditures?

PubMed

Ben-Aharon, Omer; Shavit, Oren; Magnezi, Racheli

2017-09-01

Increasing health costs in developed countries are a major concern for decision makers. A variety of cost containment tools are used to control this trend, including maximum price regulation and reimbursement methods for health technologies. Information regarding expenditure-related outcomes of these tools is not available. To evaluate the association between different cost-regulating mechanisms and national health expenditures in selected countries. Price-regulating and reimbursement mechanisms for prescription drugs among OECD countries were reviewed. National health expenditure indices for 2008-2012 were extracted from OECD statistical sources. Possible associations between characteristics of different systems for regulation of drug prices and reimbursement and health expenditures were examined. In most countries, reimbursement mechanisms are part of publicly financed plans. Maximum price regulation is composed of reference-pricing, either of the same drug in other countries, or of therapeutic alternatives within the country, as well as value-based pricing (VBP). No association was found between price regulation or reimbursement mechanisms and healthcare costs. However, VBP may present a more effective mechanism, leading to reduced costs in the long term. Maximum price and reimbursement mechanism regulations were not found to be associated with cost containment of national health expenditures. VBP may have the potential to do so over the long term.

Three essays on auction markets

NASA Astrophysics Data System (ADS)

Shunda, Nicholas James

This dissertation contains a series of theoretical investigations of auction markets. The essays it contains cover wholesale electricity markets, a popular selling mechanism on eBay, and supplier entry into multi-unit procurement auctions. The study in Chapter 1 compares the procurement cost-minimizing and productive efficiency performance of the auction mechanism used by independent system operators in wholesale electricity auction markets in the U.S. with that of a proposed alternative. The current practice allocates energy contracts as if the auction featured a discriminatory final payment method when, in fact, the markets are uniform price auctions. The proposed alternative explicitly accounts for the market-clearing price during the allocation phase. We find that the proposed alternative largely outperforms the current practice on the basis of procurement costs in the context of simple auction markets featuring both day-ahead and real-time auctions and that the procurement cost advantage of the alternative is complete when we simulate the effects of increased competition. We also find that a tradeoff between the objectives of procurement cost minimization and productive efficiency emerges in our simple auction markets and persists in the face of increased competition. The study in Chapter 2 considers a possible rationale for an auction with a buy price. In an auction with a buy price, the seller provides bidders with an option to end the auction early by accepting a transaction at a posted price. The "Buy-It-Now" option on eBay is a leading example of an auction with a buy price. The study develops a model of an auction with a buy price in which bidders use the auction's reserve price and buy price to formulate a reference price. The model both explains why a revenue-maximizing seller would want to augment her auction with a buy price and demonstrates that the seller sets a higher reserve price when she can affect the bidders' reference price through the auction's reserve price and buy price than when she can affect the bidders' reference price through the auction's reserve price only. Introducing a small reference-price effect can shrink the range of buy prices bidders are willing to exercise. The comparative statics properties of bidding behavior are in sharp contrast to equilibrium behavior in other models where the existence and size of the auction's buy price have no effect on bidding behavior. The study in Chapter 3 investigates endogenous entry in multi-unit auctions. We formulate and study models of multi-unit discriminatory and uniform price auctions and investigate the entry incentives and procurement costs they generate in equilibrium. We study two types of endogenous entry: in auctions with "interim entry costs," suppliers know their private cost information before deciding whether or not to undertake entry; in auctions with ex ante entry costs, suppliers do not know their private cost information before deciding whether or not to enter. The discriminatory and uniform price auctions are efficient and procurement cost equivalent in all the environments we study. With interim entry costs, the two auctions provide identical entry incentives. In contrast, with ex ante entry costs, suppliers enter the discriminatory auction at a higher rate than they enter the uniform price auction.

48 CFR 15.403-2 - Other circumstances where certified cost or pricing data are not required.

Code of Federal Regulations, 2014 CFR

2014-10-01

... certified cost or pricing data are not required. 15.403-2 Section 15.403-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-2 Other circumstances where certified cost or pricing data are not required. (a...

48 CFR 15.403-2 - Other circumstances where certified cost or pricing data are not required.

Code of Federal Regulations, 2011 CFR

2011-10-01

... certified cost or pricing data are not required. 15.403-2 Section 15.403-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-2 Other circumstances where certified cost or pricing data are not required. (a...

48 CFR 15.403-2 - Other circumstances where certified cost or pricing data are not required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... certified cost or pricing data are not required. 15.403-2 Section 15.403-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-2 Other circumstances where certified cost or pricing data are not required. (a...

48 CFR 15.403-2 - Other circumstances where certified cost or pricing data are not required.

Code of Federal Regulations, 2013 CFR

2013-10-01

... certified cost or pricing data are not required. 15.403-2 Section 15.403-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-2 Other circumstances where certified cost or pricing data are not required. (a...

Price Estimation Guidelines

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.; Aster, R. W.; Firnett, P. J.; Miller, M. A.

1985-01-01

Improved Price Estimation Guidelines, IPEG4, program provides comparatively simple, yet relatively accurate estimate of price of manufactured product. IPEG4 processes user supplied input data to determine estimate of price per unit of production. Input data include equipment cost, space required, labor cost, materials and supplies cost, utility expenses, and production volume on industry wide or process wide basis.

48 CFR 5252.215-9000 - Submission of cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... pricing data. 5252.215-9000 Section 5252.215-9000 Federal Acquisition Regulations System DEPARTMENT OF THE... Clauses 5252.215-9000 Submission of cost or pricing data. As prescribed at 5215.407, insert the following provision: Submission of Cost or Pricing Data (NOV 1987) (a) It is expected that this contract will be...

Differential pricing of drugs: a role for cost-effectiveness analysis?

PubMed

Lopert, Ruth; Lang, Danielle L; Hill, Suzanne R; Henry, David A

2002-06-15

Internationally, the high costs of pharmaceutical products limit access to treatment. The principle of differential pricing is that drug prices should vary according to some measure of affordability. How differential prices should be determined is, however, unclear. Here we describe a method whereby differential prices for essential drugs could be derived in countries of variable national wealth, and, using angiotensin-converting enzyme inhibitors provide an example of how the process might work. Indicative prices for drugs can be derived by cost-effectiveness analysis that incorporates a measure of national wealth. Such prices could be used internationally as a basis of differential price negotiations.

Design the price signal mechanism of suppliers' cost in the commercial procurement process

NASA Astrophysics Data System (ADS)

Jinming, Huang; Wenjing, Li; Huazhen, Zhu

2016-06-01

In the process of commercial procurement, there exists information asymmetry between purchasers and suppliers in terms of commodity cost. The strike price is what purchasers care about, while the focus of suppliers is only the sales revenue. In order to achieve the relatively lower strike price, purchasers need to design a price signal mechanism, explicating the commodity cost of suppliers. In this article, we have designed a mechanism that purchasers can explicit the commodity cost price based on suppliers' choices by providing a variety of purchase contracts to suppliers.

48 CFR 52.214-27 - Price Reduction for Defective Certified Cost or Pricing Data-Modifications-Sealed Bidding.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Price Reduction for... PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.214-27 Price Reduction for Defective... following clause: Price Reduction for Defective Certified Cost or Pricing Data—Modifications—Sealed Bidding...

Activity-Based Costing in the After Press Services Industry

NASA Astrophysics Data System (ADS)

Shevasuthisilp, Suntichai; Punsathitwong, Kosum

2009-10-01

This research was conducted to apply activity-based costing (ABC) in an after press service company in Chiang Mai province, Thailand. The company produces all of its products by one-stop service (such as coating, stitching, binding, die cutting, and gluing). All products are made to order, and have different sizes and patterns. A strategy of low price is used to compete in the marketplace. After cost analysis, the study found that the company has high overhead (36.5% of total cost). The company's problem is its use of traditional cost accounting, which has low accuracy in assigning overhead costs. If management uses this information when pricing customer orders, losses may occur because real production costs may be higher than the selling price. Therefore, the application of ABC in cost analysis can help executives receive accurate cost information; establish a sound pricing strategy; and improve the manufacturing process by determining work activities which have excessively high production costs. According to this research, 6 out of 56 items had a production cost higher than the selling price, leading to losses of 123,923 baht per year. Methods used to solve this problem were: reducing production costs; establishing suitable prices; and creating a sales promotion with lower prices for customers whose orders include processes involving unused capacity. These actions will increase overall sales of the company, and allow more efficient use of its machinery.

Reactive Power Pricing Model Considering the Randomness of Wind Power Output

NASA Astrophysics Data System (ADS)

Dai, Zhong; Wu, Zhou

2018-01-01

With the increase of wind power capacity integrated into grid, the influence of the randomness of wind power output on the reactive power distribution of grid is gradually highlighted. Meanwhile, the power market reform puts forward higher requirements for reasonable pricing of reactive power service. Based on it, the article combined the optimal power flow model considering wind power randomness with integrated cost allocation method to price reactive power. Meanwhile, considering the advantages and disadvantages of the present cost allocation method and marginal cost pricing, an integrated cost allocation method based on optimal power flow tracing is proposed. The model realized the optimal power flow distribution of reactive power with the minimal integrated cost and wind power integration, under the premise of guaranteeing the balance of reactive power pricing. Finally, through the analysis of multi-scenario calculation examples and the stochastic simulation of wind power outputs, the article compared the results of the model pricing and the marginal cost pricing, which proved that the model is accurate and effective.

Confronting Cost and Pricing Issues in Distance Education.

ERIC Educational Resources Information Center

Taylor, Thomas H.; Parker, G. D., III; Tebeaux, Elizabeth

2001-01-01

Asserts that "the devil is in the details" when determining costs and prices for distance delivery of courses, and describes Texas A&M University's process of determining cost and price for distance education courses. (EV)

48 CFR 252.215-7000 - Pricing adjustments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... clauses entitled “Price Reduction for Defective Cost or Pricing Data—Modifications,” “Subcontractor Cost... increases and/or decreases in cost plus applicable profits. (End of clause) [56 FR 36479, July 31, 1991, as...

Costs of necrotizing enterocolitis and cost-effectiveness of exclusively human milk-based products in feeding extremely premature infants.

PubMed

Ganapathy, Vaidyanathan; Hay, Joel W; Kim, Jae H

2012-02-01

This study evaluated the cost-effectiveness of a 100% human milk-based diet composed of mother's milk fortified with a donor human milk-based human milk fortifier (HMF) versus mother's milk fortified with bovine milk-based HMF to initiate enteral nutrition among extremely premature infants in the neonatal intensive care unit (NICU). A net expected costs calculator was developed to compare the total NICU costs among extremely premature infants who were fed either a bovine milk-based HMF-fortified diet or a 100% human milk-based diet, based on the previously observed risks of overall necrotizing enterocolitis (NEC) and surgical NEC in a randomized controlled study that compared outcomes of these two feeding strategies among 207 very low birth weight infants. The average NICU costs for an extremely premature infant without NEC and the incremental costs due to medical and surgical NEC were derived from a separate analysis of hospital discharges in the state of California in 2007. The sensitivity of cost-effectiveness results to the risks and costs of NEC and to prices of milk supplements was studied. The adjusted incremental costs of medical NEC and surgical NEC over and above the average costs incurred for extremely premature infants without NEC, in 2011 US$, were $74,004 (95% confidence interval, $47,051-$100,957) and $198,040 (95% confidence interval, $159,261-$236,819) per infant, respectively. Extremely premature infants fed with 100% human-milk based products had lower expected NICU length of stay and total expected costs of hospitalization, resulting in net direct savings of 3.9 NICU days and $8,167.17 (95% confidence interval, $4,405-$11,930) per extremely premature infant (p < 0.0001). Costs savings from the donor HMF strategy were sensitive to price and quantity of donor HMF, percentage reduction in risk of overall NEC and surgical NEC achieved, and incremental costs of surgical NEC. Compared with feeding extremely premature infants with mother's milk fortified with bovine milk-based supplements, a 100% human milk-based diet that includes mother's milk fortified with donor human milk-based HMF may result in potential net savings on medical care resources by preventing NEC.

Constant Price of Anarchy in Network Creation Games via Public Service Advertising

NASA Astrophysics Data System (ADS)

Demaine, Erik D.; Zadimoghaddam, Morteza

Network creation games have been studied in many different settings recently. These games are motivated by social networks in which selfish agents want to construct a connection graph among themselves. Each node wants to minimize its average or maximum distance to the others, without paying much to construct the network. Many generalizations have been considered, including non-uniform interests between nodes, general graphs of allowable edges, bounded budget agents, etc. In all of these settings, there is no known constant bound on the price of anarchy. In fact, in many cases, the price of anarchy can be very large, namely, a constant power of the number of agents. This means that we have no control on the behavior of network when agents act selfishly. On the other hand, the price of stability in all these models is constant, which means that there is chance that agents act selfishly and we end up with a reasonable social cost.

Quality and efficiency of statin prescribing across countries with a special focus on South Africa: findings and future implications.

PubMed

Godman, Brian; Bishop, Iain; Campbell, Stephen M; Malmström, Rickard E; Truter, Ilse

2015-04-01

Statins are recommended first-line treatment for hyperlipidemia, with published studies suggesting limited differences between them. However, there are reports of under-dosing. South Africa has introduced measures to enhance generic utilization. Part one documents prescribed doses of statins in 2011. Part two determines the extent of generics versus originator and single-sourced statins in 2011 and their costs. Underdosing of simvastatin in 2011 with average prescribed dose of 23.7 mg; however, not for atorvastatin (20.91 mg) or rosuvastatin (15.02 mg). High utilization of generics versus originators at 93-99% for atorvastatin and simvastatin, with limited utilization of single-sourced statins (22% of total statins - defined daily dose basis), mirroring Netherlands, Sweden and UK. Generics priced 33-51% below originator prices. Opportunity to increase simvastatin dosing through education, prescribing targets and incentives. Opportunity to lower generic prices with generic simvastatin 96-98% below single-sourced prices in some European countries.

Hipoglicemiantes Orais Para Diabetes Mellitus Tipo 2: Comparação de Preços no Brasil e em Outros Sistemas Universais de Saúde.

PubMed

de Oliveira, Gustavo L A; Izidoro, Jans B; Ferré, Felipe; E Sousa, Samuel R A; Acurcio, Francisco A

2018-06-20

To estimate the average price of oral hypoglycemic agents provided by the Brazilian health system (SUS) and to compare them to other public health systems. Cross-sectional study about drug prices purchased by Belo Horizonte (municipal level), Minas Gerais (state level) and federal institutions in January and February of 2014. Average prices were calculated by defined daily dosage (DDD) and were compared to the management levels and the program "Aqui Tem Farmácia Popular" (ATFP). For international comparison, reimbursement values from Spain, Portugal, the United Kingdom and Canada (Province of Quebec) were used. Belo Horizonte had higher average prices than Minas Gerais. In general, essential oral hypoglycemic agents purchased by the SUS had lower prices than ATFP. For example, glibenclamide 5 mg was 1.023% more expensive. Metformin purchased by ATFP was more expensive than by SUS. Eight drugs purchased by SUS had average values above the respective Brazilian price ceiling. As an international comparison, SUS had lower average prices for glibenclamide and metformin. In ATFP, metformin was more expensive than in other countries, while glibenclamide was cheaper than Portugal only. The municipal management level had higher average prices than state level. Oral hypoglycemic agents purchased by SUS are predominantly cheaper than ATFP. Average prices paid by SUS are lower, while the prices paid by ATFP are higher than the reimbursed amounts from other countries. Copyright © 2018. Published by Elsevier Inc.

Changes in cigarette prices, affordability, and brand-tier consumption after a tobacco tax increase in Thailand: Evidence from the Global Adult Tobacco Surveys, 2009 and 2011

PubMed Central

Husain, Muhammad Jami; Kostova, Deliana; Mbulo, Lazarous; Benjakul, Sarunya; Kengganpanich, Mondha; Andes, Linda

2017-01-01

Despite the 2009 implementation of a tobacco tax increase in Thailand, smoking rates remained unchanged between 2009 and 2011. Prior evidence has linked cigarette tax increases to compensatory behaviours aimed at lowering the cost of smoking, such as switching to lower-priced cigarette brands. Using data from 2009 and 2011 Global Adult Tobacco Surveys in Thailand, we estimated unadjusted changes in cigarette prices paid, cigarette affordability, and consumption of cigarettes in three price categories classified as upper-, middle-, and lower-priced brand tiers (or price tertiles). We used ordered logit regression to analyse the correlates of price-tier choice and to estimate the change in price-tier consumption adjusted for demographic and region characteristics. Between 2009 and 2011, real cigarette prices increased, but the affordability of cigarettes remained unchanged overall. There was a significant reduction in the consumption of cigarette brands in the top price-tier overall, accompanied by increases in the consumption of brands in the bottom and middle price-tiers, depending on the region. Adjusted estimates from the logit models indicate that, on average, the proportion of smokers selecting brands from upper- and middle price-tiers decreased while consumption of lower price-tier brands increased during the study period. The estimated shifts in consumption from more expensive to less expensive cigarette brands and the overall lack of change in cigarette affordability in Thailand between 2009 and 2011 are both factors that may have contributed to the observed lack of change in smoking rates after the 2009 tax increase. PMID:28579499

Cigarette prices and community price comparisons in US military retail stores.

PubMed

Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara A; Smith, Elizabeth; Malone, Ruth E; Jitnarin, Nattinee

2016-09-01

Tobacco pricing impacts use, yet military retailers sell discounted cigarettes. No systematic research has examined how military retail stores use internal community comparisons to set prices. We analysed data obtained through a Freedom of Information Act request on community price comparisons used by military retail to set cigarette prices. Data on cigarette prices were obtained directly from military retailers (exchanges) from January 2013 to March 2014. Complete pricing data were obtained from exchanges on 114 military installations. The average price for a pack of Marlboro cigarettes in military exchanges was US$5.51, which was similar to the average lowest community price (US$5.45; mean difference=-0.06; p=0.104) and almost a US$1.00 lower than the average highest price (US$6.44). Military retail prices were 2.1%, 6.2% and 13.7% higher than the lowest, average and highest community comparisons, respectively, and 18.2% of exchange prices violated pricing instructions. There was a negative correlation (r=-0.21, p=0.02) between the number of community stores surveyed and exchange cigarette prices. There was no significant difference between prices for cigarettes on military installations and the lowest average community comparison, and in some locations, the prices violated Department of Defense (DoD) policy. US Marine Corps exchanges had the lowest prices, which is of concern given that the Marines also have the highest rates of tobacco use in the DoD. Given the relationship between tobacco product prices and demand, a common minimum (or floor) shelf price for tobacco products should be set for all exchanges and discount coupon redemptions should be prohibited. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

National Hospital Input Price Index

PubMed Central

Freeland, Mark S.; Anderson, Gerard; Schendler, Carol Ellen

1979-01-01

The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 percent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies. PMID:10309052

National hospital input price index.

PubMed

Freeland, M S; Anderson, G; Schendler, C E

1979-01-01

The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 per cent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies.

Studies on price indexes and innovation

NASA Astrophysics Data System (ADS)

Carreon-Rodriguez, Victor G.

This thesis develops two studies on price indexes and innovation. The first one analyzes the problems on the computation of price indexes when there are improvements in the goods' quality. These problems arise because we use price indexes that measure the prices of the goods that consumers buy rather than the prices of the services that consumers enjoy. In order to see this, I compute a true price for gasoline that is based on the services that it provides. We ask for the cost of moving one ton at a speed of 40 mph for a distance of 100 miles. This true price is compared with the official price for gasoline. The average annual bias (the rise in the official price relative to the true price) is 3.2% per year. We also compute the hours of work required to cover that cost. We find that in 1925 there were needed almost 1.5 hours of work, while by 1992 there were just needed about 8 minutes to move one ton as specified above. The second one develops a model of Cournot competition in innovation. This model introduces two new features. First, firm's investment in research and development is divided into two pieces, expenditures in human capital and expenditures in all other inputs (called R&D for simplicity). Second, the government also allocates resources to research and development, which affect the stock of knowledge available to the firms. Some interesting results arise from this model. First, investments in human capital and in R&D are increasing in the past government's investment. Second, investments per firm are decreasing in the number of firms in the industry, but the totals are larger if some conditions on the elasticities are satisfied. Third, the welfare analysis tells us that if there are entry barriers, each firm is overinvesting in both inputs. On the other hand, if there is free entry, there are too many firms engaged in the innovative race. Finally, we perform an empirical analysis and we find that there are lagged effects of the government's investment on the pharmaceutical industry's investments.

Cost-price: a useful way to evaluate timber growing alternatives.

Treesearch

Allen L. Lundgren

1973-01-01

This paper explains how to calculate and use cost-price as an investment criterion for timber and other forest products. Cost-price is the cost (including a return on invested capital) of producing a unit of output, usually expressed as dollars per cubic foot or other unit of output.

48 CFR 652.216-71 - Price Adjustment.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) The contract price may be increased or decreased in actual costs of direct service labor which result...] Government. Direct service labor costs include only the costs of wages and direct benefits (such as social... number] of this contract. Price adjustments will include only changes in direct service labor costs...

14 CFR 1214.202 - Reimbursement policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... according to the reimbursement schedule plus short term call-up additional costs. The additional costs will... services. (2) The price will be based on estimated costs. (3) The price will be held constant for flights...) Subsequent to the first three years, the price will be adjusted annually to insure that total operating costs...

10 CFR 600.145 - Cost and price analysis.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Cost and price analysis. 600.145 Section 600.145 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Uniform Administrative... Nonprofit Organizations Post-Award Requirements § 600.145 Cost and price analysis. Some form of cost or...

48 CFR 2152.216-70 - Fixed price with limited cost redetermination-risk charge.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost redetermination-risk charge. 2152.216-70 Section 2152.216-70 Federal Acquisition Regulations....216-70 Fixed price with limited cost redetermination—risk charge. As prescribed in 2116.270-1(a), insert the following clause when a risk charge is negotiated: Fixed Price With Limited Cost...

48 CFR 1615.406-2 - Certificate of accurate cost or pricing data for community-rated carriers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost or pricing data for community-rated carriers. 1615.406-2 Section 1615.406-2 Federal Acquisition... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1615.406-2 Certificate of accurate cost or pricing data for community-rated carriers. The contracting officer will require a carrier...

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Can price or cost be an issue in discussions? 636.508 Section 636.508 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND... Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 23 Highways 1 2012-04-01 2012-04-01 false Can price or cost be an issue in discussions? 636.508 Section 636.508 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND... Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Can price or cost be an issue in discussions? 636.508 Section 636.508 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND... Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Can price or cost be an issue in discussions? 636.508 Section 636.508 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND... Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Can price or cost be an issue in discussions? 636.508... TRAFFIC OPERATIONS DESIGN-BUILD CONTRACTING Discussions, Proposal Revisions and Source Selection § 636.508 Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

Essays in the California electricity reserves markets

NASA Astrophysics Data System (ADS)

Metaxoglou, Konstantinos

This dissertation examines inefficiencies in the California electricity reserves markets. In Chapter 1, I use the information released during the investigation of the state's electricity crisis of 2000 and 2001 by the Federal Energy Regulatory Commission to diagnose allocative inefficiencies. Building upon the work of Wolak (2000), I calculate a lower bound for the sellers' price-cost margins using the inverse elasticities of their residual demand curves. The downward bias in my estimates stems from the fact that I don't account for the hierarchical substitutability of the reserve types. The margins averaged at least 20 percent for the two highest quality types of reserves, regulation and spinning, generating millions of dollars in transfers to a handful of sellers. I provide evidence that the deviations from marginal cost pricing were due to the markets' high concentration and a principal-agent relationship that emerged from their design. In Chapter 2, I document systematic differences between the markets' day- and hour-ahead prices. I use a high-dimensional vector moving average model to estimate the premia and conduct correct inferences. To obtain exact maximum likelihood estimates of the model, I employ the EM algorithm that I develop in Chapter 3. I uncover significant day-ahead premia, which I attribute to market design characteristics too. On the demand side, the market design established a principal-agent relationship between the markets' buyers (principal) and their supervisory authority (agent). The agent had very limited incentives to shift reserve purchases to the lower priced hour-ahead markets. On the supply side, the market design raised substantial entry barriers by precluding purely speculative trading and by introducing a complicated code of conduct that induced uncertainty about which actions were subject to regulatory scrutiny. In Chapter 3, I introduce a state-space representation for vector autoregressive moving average models that enables exact maximum likelihood estimation using the EM algorithm. Moreover, my algorithm uses only analytical expressions; it requires the Kalman filter and a fixed-interval smoother in the E step and least squares-type regression in the M step. In contrast, existing maximum likelihood estimation methods require numerical differentiation, both for univariate and multivariate models.

48 CFR 15.403 - Obtaining certified cost or pricing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... or pricing data. 15.403 Section 15.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403 Obtaining certified cost or pricing data. ...

48 CFR 15.403 - Obtaining certified cost or pricing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... or pricing data. 15.403 Section 15.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403 Obtaining certified cost or pricing data. ...

48 CFR 15.403 - Obtaining certified cost or pricing data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... or pricing data. 15.403 Section 15.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403 Obtaining certified cost or pricing data. ...

48 CFR 15.403 - Obtaining certified cost or pricing data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... or pricing data. 15.403 Section 15.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403 Obtaining certified cost or pricing data. ...

48 CFR 15.403 - Obtaining certified cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... or pricing data. 15.403 Section 15.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403 Obtaining certified cost or pricing data. ...

A global comparison of the cost of patented cancer drugs in relation to global differences in wealth

PubMed Central

Goldstein, Daniel A.; Clark, Jonathon; Tu, Yifan; Zhang, Jie; Fang, Fenqi; Goldstein, Robert

2017-01-01

Introduction There are major differences in cancer drug prices around the world. However, the patterns of affordability of these drugs are poorly understood. The objective of this study was to compare patterns of affordability of cancer drugs in Australia, China, India, Israel, South Africa, the United Kingdom, and the United States. Results Cancer drug prices are highest in the United States. Cancer drugs are the least affordable in India by a large margin. Despite lower prices than in the USA, cancer drugs are less affordable in middle-income countries than in high-income countries. Materials and Methods We obtained the prices of a basket of cancer drugs in all 7 countries, and converted the prices to US$ using both foreign exchange rates and purchasing power parity. We assessed international differences in wealth by collecting values for gross domestic product (GDP) per capita in addition to average salaries. We compared patterns of affordability of cancer drugs by dividing the drug prices by the markers of wealth. Conclusions Cancer drugs are less affordable in middle-income countries than in high-income countries. Differential pricing may be an acceptable policy to ensure global affordability and access to highly active anti-cancer therapies. PMID:29069727

Cost-effectiveness analysis of atypical long-acting antipsychotics for treating chronic schizophrenia in Finland.

PubMed

Einarson, Thomas R; Pudas, Hanna; Zilbershtein, Roman; Jensen, Rasmus; Vicente, Colin; Piwko, Charles; Hemels, Michiel E H

2013-09-01

In Finland, regional rates of schizophrenia exceed those in most countries, impacting the healthcare burden. This study determined the cost-effectiveness of long-acting antipsychotic (LAI) drugs paliperidone palmitate (PP-LAI), olanzapine pamoate (OLZ-LAI), and risperidone (RIS-LAI) for chronic schizophrenia. This study adapted a decision tree analysis from Norway for the Finnish National Health Service. Country-specific data were sought from the literature and public documents, guided by clinical experts. Costs of health services and products were retrieved from literature sources and current price lists. This simulation study estimated average 1-year costs for treating patients with each LAI, average remission days, rates of hospitalization and emergency room visits and quality-adjusted life-years (QALY). PP-LAI was dominant. Its estimated annual average cost was €10,380/patient and was associated with 0.817 QALY; OLZ-LAI cost €12,145 with 0.810 QALY; RIS-LAI cost €12,074 with 0.809 QALY. PP-LAI had the lowest rates of hospitalization, emergency room visits, and relapse days. This analysis was robust against most variations in input values except adherence rates. PP-LAI was dominant over OLZ-LAI and RIS-LAI in 77.8% and 85.9% of simulations, respectively. Limitations include the 1-year time horizon (as opposed to lifetime costs), omission of the costs of adverse events, and the assumption of universal accessibility. In Finland, PP-LAI dominated the other LAIs as it was associated with a lower cost and better clinical outcomes.

48 CFR 52.215-11 - Price Reduction for Defective Certified Cost or Pricing Data-Modifications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Price Reduction for... CONTRACT CLAUSES Text of Provisions and Clauses 52.215-11 Price Reduction for Defective Certified Cost or Pricing Data—Modifications. As prescribed in 15.408(c), insert the following clause: Price Reduction for...

Mind the Gap: Why Closing the Doughnut Hole Is Insufficient for Increasing Medicare Beneficiary Access to Oral Chemotherapy.

PubMed

Dusetzina, Stacie B; Keating, Nancy L

2016-02-01

Orally administered anticancer medications are among the fastest growing components of cancer care. These medications are expensive, and cost-sharing requirements for patients can be a barrier to their use. For Medicare beneficiaries, the Affordable Care Act will close the Part D coverage gap (doughnut hole), which will reduce cost sharing from 100% in 2010 to 25% in 2020 for drug spending above $2,960 until the beneficiary reaches $4,700 in out-of-pocket spending. How much these changes will reduce out-of-pocket costs is unclear. We used the Medicare July 2014 Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files from the Centers for Medicare & Medicaid Services for 1,114 stand-alone and 2,230 Medicare Advantage prescription drug formularies, which represent all formularies in 2014. We identified orally administered anticancer medications and summarized drug costs, cost-sharing designs used by available plans, and the estimated out-of-pocket costs for beneficiaries without low-income subsidies who take a single drug before and after the doughnut hole closes. Little variation existed in formulary design across plans and products. The average price per month for included products was $10,060 (range, $5,123 to $16,093). In 2010, median beneficiary annual out-of-pocket costs for a typical treatment duration ranged from $6,456 (interquartile range, $6,433 to $6,482) for dabrafenib to $12,160 (interquartile range, $12,102 to $12,262) for sunitinib. With the assumption that prices remain stable, after the doughnut hole closes, beneficiaries will spend approximately $2,550 less. Out-of-pocket costs for Medicare beneficiaries taking orally administered anticancer medications are high and will remain so after the doughnut hole closes. Efforts are needed to improve affordability of high-cost cancer drugs for beneficiaries who need them. © 2015 by American Society of Clinical Oncology.

Cleaning to favor western white pine - its effects upon composition, growth, and potential values

Treesearch

Raymond J. Boyd

1959-01-01

The management of western white pine (Pinus monticola) requires the production of a high proportion of valuable white pine crop trees in order to defray the costs of protection from blister rust. Current average selling prices of lumber give white pine about $50 per m.b.f. advantage over western larch (Larix occidentalis) and Douglas-fir (Pseudotsuga menziesii), the...

48 CFR 970.1504-4 - Special cost or pricing areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Special cost or pricing areas. 970.1504-4 Section 970.1504-4 Federal Acquisition Regulations System DEPARTMENT OF ENERGY AGENCY... cost or pricing areas. ...

What difference a decade? The costs of psychosis in Australia in 2000 and 2010: comparative results from the first and second Australian national surveys of psychosis.

PubMed

Neil, Amanda L; Carr, Vaughan J; Mihalopoulos, Cathrine; Mackinnon, Andrew; Lewin, Terry J; Morgan, Vera A

2014-03-01

To assess differences in costs of psychosis between the first and second Australian national surveys of psychosis and examine them in light of policy developments. Cost differences due to changes in resource use and/or real price rises were assessed by minimizing differences in recruitment and costing methodologies between the two surveys. For each survey, average annual societal costs of persons recruited through public specialized mental health services in the census month were assessed through prevalence-based, bottom-up cost-of-illness analyses. The first survey costing methodology was employed as the reference approach. Unit costs were specific to each time period (2000, 2010) and expressed in 2010 Australian dollars. There was minimal change in the average annual costs of psychosis between the surveys, although newly included resources in the second survey's analysis cost AUD$3183 per person. Among resources common to each analysis were significant increases in the average annual cost per person for ambulatory care of AUD$7380, non-government services AUD$2488 and pharmaceuticals AUD$1892, and an upward trend in supported accommodation costs. These increases were offset by over a halving of mental health inpatient costs of AUD$11,790 per person and a 84.6% (AUD$604) decrease in crisis accommodation costs. Productivity losses, the greatest component cost, changed minimally, reflecting the magnitude and constancy of reduced employment levels of individuals with psychosis across the surveys. Between 2000 and 2010 there was little change in total average annual costs of psychosis for individuals receiving treatment at public specialized mental health services. However, there was a significant redistribution of costs within and away from the health sector in line with government initiatives arising from the Second and Third National Mental Health Plans. Non-health sector costs are now a critical component of cost-of-illness analyses of mental illnesses reflecting, at least in part, a whole-of-government approach to care.

48 CFR 31.204 - Application of principles and procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-price subcontract with economic price adjustment provisions. (c) Costs incurred as payments under firm-fixed-price subcontracts or fixed-price subcontracts with economic price adjustment provisions or... captures the essential nature of, the cost at issue. [48 FR 42301, Sept. 19, 1983, as amended at 53 FR...

48 CFR 15.407-3 - Forward pricing rate agreements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.407-3 Forward pricing rate agreements. (a) When certified cost or pricing data are required, offerors are required to... apply and to identify the latest cost or pricing data already submitted in accordance with the FPRA. All...

48 CFR 15.407-3 - Forward pricing rate agreements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.407-3 Forward pricing rate agreements. (a) When certified cost or pricing data are required, offerors are required to... apply and to identify the latest cost or pricing data already submitted in accordance with the FPRA. All...

48 CFR 15.407-1 - Defective certified cost or pricing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... or pricing data. 15.407-1 Section 15.407-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.407-1 Defective certified cost or pricing data. (a) If, before agreement on price, the contracting officer learns...

Concept of Price in a Library Context.

ERIC Educational Resources Information Center

Talaga, James A.

1991-01-01

Discusses pricing problems of public library service. The meaning of price in a library context is examined, including amount charged and patron's cost; components of price setting are described, including the impact of demand, cost, and competition; and library pricing strategies are suggested that should help achieve the library's goals. (13…

Healthcare utilization and cost of Stevens-Johnson syndrome and toxic epidermal necrolysis management in Thailand

PubMed Central

Dilokthornsakul, P; Sawangjit, R; Inprasong, C; Chunhasewee, S; Rattanapan, P; Thoopputra, T; Chaiyakunapruk, N

2016-01-01

Background: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening dermatologic conditions. Although, the incidence of SJS/TEN in Thailand is high, information on cost of care for SJS/TEN is limited. This study aims to estimate healthcare resource utilization and cost of SJS/TEN in Thailand, using hospital perspective. Methods: A retrospective study using an electronic health database from a university-affiliated hospital in Thailand was undertaken. Patients admitted with SJS/TEN from 2002 to 2007 were included. Direct medical cost was estimated by the cost-to-charge ratio. Cost was converted to 2013 value by consumer price index, and converted to $US using 31 Baht/1 $US. The healthcare resource utilization was also estimated. Results: A total of 157 patients were included with average age of 45.3±23.0 years. About 146 patients (93.0%) were diagnosed as SJS and the remaining (7.0%) were diagnosed as TEN. Most of the patients (83.4%) were treated with systemic corticosteroids. Overall, mortality rate was 8.3%, while the average length of stay (LOS) was 10.1±13.2 days. The average cost of managing SJS/TEN for all patients was $1,064±$2,558. The average cost for SJS patients was $1,019±$2,601 while that for TEN patients was $1,660±$1,887. Conclusions: Healthcare resource utilization and cost of care for SJS/TEN in Thailand were tremendous. The findings are important for policy makers to allocate healthcare resources and develop strategies to prevent SJS/TEN which could decrease length of stay and cost of care. PMID:27089110

The Shuttle Cost and Price model

NASA Technical Reports Server (NTRS)

Leary, Katherine; Stone, Barbara

1983-01-01

The Shuttle Cost and Price (SCP) model was developed as a tool to assist in evaluating major aspects of Shuttle operations that have direct and indirect economic consequences. It incorporates the major aspects of NASA Pricing Policy and corresponds to the NASA definition of STS operating costs. An overview of the SCP model is presented and the cost model portion of SCP is described in detail. Selected recent applications of the SCP model to NASA Pricing Policy issues are presented.

Cost and Price Increases in Higher Education: Evidence of a Cost Disease on Higher Education Costs and Tuition Prices and the Implications for Higher Education Policy

ERIC Educational Resources Information Center

Trombella, Jerry

2011-01-01

As concern over rapidly rising college costs and tuition sticker prices have increased, a variety of research has been conducted to determine potential causes. Most of this research has focused on factors unique to higher education. In contrast, cost disease theory attempts to create a comparative context to explain cost increases in higher…

Comparing the Cost of Treatment with Octreotide Long-Acting Release versus Lanreotide in Patients with Metastatic Gastrointestinal Neuroendocrine Tumors.

PubMed

Ayyagari, Rajeev; Neary, Maureen; Li, Shang; Rokito, Ariel; Yang, Hongbo; Xie, Jipan; Benson, Al B

2017-11-01

The 2 somatostatin analogs currently recommended by the National Comprehensive Cancer Network for the treatment of gastrointestinal (GI) neuroendocrine tumors (NETs) include octreotide long-acting release (Sandostatin LAR) for injectable suspension and lanreotide (Somatuline Depot) injection for subcutaneous use. To estimate the costs to payers associated with 30-mg octreotide LAR and 120-mg lanreotide treatment among patients with metastatic GI-NETs. The costs to payers associated with the 2 drugs were estimated by including the costs of each drug, drug administration, and adverse events. The unit drug costs for octreotide LAR and for lanreotide were obtained from ReadyPrice Wholesale Acquisition Cost; the doses were obtained from published studies. The adverse event rates were obtained from 2 phase 3 clinical trials, PROMID and CLARINET. Deterministic one-way sensitivity analyses were used to assess the impact of modifying assumptions and inputs on the results, including the 2017 Average Sales Price (ASP). All costs were estimated in 2016 US dollars, with a constant discount of 3%. The costs to payers associated with the treatment of GI-NETs during 1-, 3-, and 5-year horizons were $74,566, $180,082, and $262,344, respectively, for octreotide LAR and $84,856, $205,562, and $299,667, respectively, for lanreotide. Thus, octreotide LAR was associated with lower costs by $10,290 (1 year), $25,480 (3 years), and $37,323 (5 years) compared with lanreotide. Over a 5-year horizon, the costs of adverse events and administration accounted for 0.72% of the total cost for octreotide LAR and 0.51% of the total cost for lanreotide. Sensitivity analyses confirmed that the main factor affecting the cost difference was the price of the drugs; analyses using the ASP yielded similar results. For the management of metastatic GI-NETs, the cost to payers of treatment with 30-mg octreotide LAR is considerably lower than with 120-mg lanreotide over 1-, 3-, and 5-year horizons. In the presence of healthcare resource constraints, these findings may support decision-making when considering the care of patients with metastatic GI-NETs.

Reducing the energy penalty costs of postcombustion CCS systems with amine-storage.

PubMed

Patiño-Echeverri, Dalia; Hoppock, David C

2012-01-17

Carbon capture and storage (CCS) can significantly reduce the amount of CO(2) emitted from coal-fired power plants but its operation significantly reduces the plant's net electrical output and decreases profits, especially during times of high electricity prices. An amine-based CCS system can be modified adding amine-storage to allow postponing 92% of all its energy consumption to times of lower electricity prices, and in this way has the potential to effectively reduce the cost of CO(2) capture by reducing the costs of the forgone electricity sales. However adding amine-storage to a CCS system implies a significant capital cost that will be outweighed by the price-arbitrage revenue only if the difference between low and high electricity prices is substantial. In this paper we find a threshold for the variability in electricity prices that make the benefits from electricity price arbitrage outweigh the capital costs of amine-storage. We then look at wholesale electricity markets in the Eastern Interconnect of the United States to determine profitability of amine-storage systems in this region. Using hourly electricity price data from years 2007 and 2008 we find that amine storage may be cost-effective in areas with high price variability.

48 CFR 15.407-1 - Defective certified cost or pricing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Defective certified cost or pricing data. (a) If, before agreement on price, the contracting officer learns... based on an agreement about the total cost of the contract and there was no agreement about the cost of..., based on prime contract progress billings or deliveries, which included payments for a completed and...

The Cost and Price Dilemma of Scholarly Journals.

ERIC Educational Resources Information Center

King, Donald W.; Tenopir, Carol

2000-01-01

Examines overall costs of the scientific scholarly journal system and finds that relative system costs have not increased since the late 1970s. Describes scholarly publishing costs; factors that have contributed to spiraling price increases and changes in journal subscription demand; and alternative pricing policies that might help in the future.…

43 CFR 2547.3 - Price of land; payment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... fair market value at the time of appraisal. However, in determination of the price payable by the... administrative costs, including: (1) The cost of making the survey, (2) The cost of appraisal, and (3) The cost of making the conveyance. (c) The applicant shall be required to make payment of the sale price and...

43 CFR 2547.3 - Price of land; payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... fair market value at the time of appraisal. However, in determination of the price payable by the... administrative costs, including: (1) The cost of making the survey, (2) The cost of appraisal, and (3) The cost of making the conveyance. (c) The applicant shall be required to make payment of the sale price and...

43 CFR 2547.3 - Price of land; payment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... fair market value at the time of appraisal. However, in determination of the price payable by the... administrative costs, including: (1) The cost of making the survey, (2) The cost of appraisal, and (3) The cost of making the conveyance. (c) The applicant shall be required to make payment of the sale price and...

43 CFR 2547.3 - Price of land; payment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... fair market value at the time of appraisal. However, in determination of the price payable by the... administrative costs, including: (1) The cost of making the survey, (2) The cost of appraisal, and (3) The cost of making the conveyance. (c) The applicant shall be required to make payment of the sale price and...

Pricing strategies for combination pediatric vaccines based on the lowest overall cost formulary.

PubMed

Behzad, Banafsheh; Jacobson, Sheldon H; Sewell, Edward C

2012-10-01

This paper analyzes pricing strategies for US pediatric combination vaccines by comparing the lowest overall cost formularies (i.e., formularies that have the lowest overall cost). Three pharmaceutical companies compete pairwise over the sale of monovalent and combination vaccines. Particular emphasis is placed on examining the price of Sanofi Pasteur's DTaP-IPV/HIb under different conditions. The main contribution of the paper is to provide the lowest overall cost formularies for different prices of DTaP-IPV/HIb and other Sanofi Pasteur vaccines. The resulting analysis shows that DTaP-IPV/HIb could have been more competitively priced compared with the combination vaccine DTaP-HepB-IPV, for federal contract prices in 2009, 2010 and 2011. This study also proposes the lowest overall cost formularies when shortages of monovalent vaccines occur.

Viability of Carbon Capture and Sequestration Retrofits for Existing Coal-Fired Power Plants under an Emission Trading Scheme.

PubMed

Talati, Shuchi; Zhai, Haibo; Morgan, M Granger

2016-12-06

Using data on the coal-fired electric generating units (EGUs) in Texas we assess the economic feasibility of retrofitting existing units with carbon capture and sequestration (CCS) in order to comply with the Clean Power Plan's rate-based emission standards under an emission trading scheme. CCS with 90% capture is shown to be more economically attractive for a range of existing units than purchasing emission rate credits (ERCs) from a trading market at an average credit price above $28 per MWh under the final state standard and $35 per MWh under the final national standard. The breakeven ERC trading prices would decrease significantly if the captured CO 2 were sold for use in enhanced oil recovery, making CCS retrofits viable at lower trading prices. The combination of ERC trading and CO 2 use can greatly reinforce economic incentives and market demands for CCS and hence accelerate large-scale deployment, even under scenarios with high retrofit costs. Comparing the levelized costs of electricity generation between CCS retrofits and new renewable plants under the ERC trading scheme, retrofitting coal-fired EGUs with CCS may be significantly cheaper than new solar plants under some market conditions.

A validated methodology for determination of laboratory instrument computer interface efficacy

NASA Astrophysics Data System (ADS)

1984-12-01

This report is intended to provide a methodology for determining when, and for which instruments, direct interfacing of laboratory instrument and laboratory computers is beneficial. This methodology has been developed to assist the Tri-Service Medical Information Systems Program Office in making future decisions regarding laboratory instrument interfaces. We have calculated the time savings required to reach a break-even point for a range of instrument interface prices and corresponding average annual costs. The break-even analyses used empirical data to estimate the number of data points run per day that are required to meet the break-even point. The results indicate, for example, that at a purchase price of $3,000, an instrument interface will be cost-effective if the instrument is utilized for at least 154 data points per day if operated in the continuous mode, or 216 points per day if operated in the discrete mode. Although this model can help to ensure that instrument interfaces are cost effective, additional information should be considered in making the interface decisions. A reduction in results transcription errors may be a major benefit of instrument interfacing.

48 CFR 215.403 - Obtaining certified cost or pricing data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... or pricing data. 215.403 Section 215.403 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403 Obtaining certified cost or pricing data. ...

48 CFR 215.403 - Obtaining certified cost or pricing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... or pricing data. 215.403 Section 215.403 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403 Obtaining certified cost or pricing data. ...

48 CFR 215.403 - Obtaining certified cost or pricing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... or pricing data. 215.403 Section 215.403 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403 Obtaining certified cost or pricing data. ...

Prospective-pricing strategies for hospital and departmental effectiveness: the physician's response.

PubMed

Shapleigh, C

1985-10-01

Physician-practice patterns are discussed, and programs of decentralization designed to reduce ancillary use are described. The New England Medical Center (NEMC) conducted a study with two other major hospitals in Boston comparing physician-practice patterns for patients who had had carotid endarterectomies. The indications for surgery for these patients did not appear to be different among the hospitals; however, average charges and length of stay varied considerably. Operating-room time and postoperative management also varied substantially. Strategies to change physician-practice patterns must address the issues of incentives to physicians and hospitals. At NEMC, a program of decentralization is being implemented that involves physician participation in budgeting hospital resources. A program of product pricing has been developed, whereby the NEMC offers an HMO a fixed price for certain kinds of cases upon admission. A daily use report was started to report resource use for specific cases compared with annual medians for that type of case. Case types from many different surgical specialties are involved. The reports show physicians the difference between the actual and expected costs in terms of variances. The NEMC has reoriented its budgeting process to include clinical divisions. Clinical services are planning to budget the use of intermediate products across different cost centers. The clinical budgeting program makes the planning process more objective, lowers the use of ancillary services, and reduces costs.

What could family income be if health insurance were more affordable?

PubMed

Young, Richard A; Devoe, Jennifer E

2012-10-01

Adjusted for inflation, household income has been relatively flat since the mid-1990s, but the inflation rate of employer-sponsored health insurance has been greater than both household income growth and general inflation for 50 years. We estimated the effect on average family income if health insurance inflation matched the general inflation rate since 1996, and those savings were given to employees as income. We used data from the Medical Expenditure Panel Survey, the Milliman Medical Index, and other federal sources to model the relationship between private health insurance costs and household income over the last 15 years. If the cost of family health care costs had kept pace with the Consumer Price Index (CPI) rate since 1996, the average family income could have been $8,410 higher in 2010 ($68,805 versus $60,395), 13.9% more than actual earnings. If health care costs had not exceeded the CPI rate since 1996 and if all the excess costs were converted into employee wages, median family income could be substantially higher today.

Economic impact of thermostable vaccines.

PubMed

Lee, Bruce Y; Wedlock, Patrick T; Haidari, Leila A; Elder, Kate; Potet, Julien; Manring, Rachel; Connor, Diana L; Spiker, Marie L; Bonner, Kimberly; Rangarajan, Arjun; Hunyh, Delphine; Brown, Shawn T

2017-05-25

While our previous work has shown that replacing existing vaccines with thermostable vaccines can relieve bottlenecks in vaccine supply chains and thus increase vaccine availability, the question remains whether this benefit would outweigh the additional cost of thermostable formulations. Using HERMES simulation models of the vaccine supply chains for the Republic of Benin, the state of Bihar (India), and Niger, we simulated replacing different existing vaccines with thermostable formulations and determined the resulting clinical and economic impact. Costs measured included the costs of vaccines, logistics, and disease outcomes averted. Replacing a particular vaccine with a thermostable version yielded cost savings in many cases even when charging a price premium (two or three times the current vaccine price). For example, replacing the current pentavalent vaccine with a thermostable version without increasing the vaccine price saved from $366 to $10,945 per 100 members of the vaccine's target population. Doubling the vaccine price still resulted in cost savings that ranged from $300 to $10,706, and tripling the vaccine price resulted in cost savings from $234 to $10,468. As another example, a thermostable rotavirus vaccine (RV) at its current (year) price saved between $131 and $1065. Doubling and tripling the thermostable rotavirus price resulted in cost savings ranging from $102 to $936 and $73 to $808, respectively. Switching to thermostable formulations was highly cost-effective or cost-effective in most scenarios explored. Medical cost and productivity savings could outweigh even significant price premiums charged for thermostable formulations of vaccines, providing support for their use. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Consumers devise drug cost-cutting measures: medical and legal issues to consider.

PubMed

Ganguli, Gouranga

2003-01-01

Health care costs in general, and prescription drug costs in particular, are rapidly rising. Between 1996 and 2007 the average annual per capita health care cost is projected to increase from dollar 3,781 to dollar 7,100. [AQ1] The single leading component of health care cost is the cost of prescription drugs (currently 10% of total health care spending, projected to become 18% in 2008). The average cost per drug increased 40% during the 1993-1998 period. Forty-one million Americans have no health insurance, and those who have, have inadequate prescription drug coverage. [AQ2] To cope with this situation, many consumers are trying to economize by doing without the prescriptions or the appropriate doses, buying generics or medicines from Canada or Mexico, or splitting pills of higher doses to take advantage of the pricing policy of drug manufacturers. Some of these approaches are medically and/or legally acceptable, while some are dubious. Most adversely affected are the seniors and poor; for certain groups of seniors prescription drugs account for 30% of their health care spending. The problem must receive prompt concerted attention from consumers, insurers, pharmaceutical companies, and lawmakers before it gets out of hand.

Alternative to the traditional discount method of wholesaler purchasing.

PubMed

Lee, G F; Bair, J N; Piz, J W

1982-07-01

A program of purchasing drugs from wholesalers at the wholesaler's exact invoice cost plus a percentage is described and compared with the traditional method of average wholesale price (AWP) less a discount. The comparison was conducted by the pharmacy department of a 310-bed, teaching hospital that awarded a one-year contract to a wholesaler offering its items at the exact cost plus a pre-established percentage. Data collected from monthly wholesaler computer printouts gave the following information on each product: (1) list price per item, (2) actual cost to pharmacy per item, (3) percentage discount from AWP, and (4) quantity ordered. The net percentage discount from AWP for 12 months was calculated and compared to the former (traditional) discount rate. The net discount from AWP was 15.6% for purchases made by the hospital during the first 12 months of the program. When compared with the smaller discount the hospital traditionally received, the new program saved the hospital $5758 on annual purchases of $136,419. The actual dollar savings to an institution that changes from a traditional discount program to a cost-plus-percentage program depends on: (1) the negotiated percentage added to wholesaler cost, (2) the discount from AWP that the institution was previously receiving, and (3) the volume of wholesale purchases.