Cost analysis of plasma-derived factor VIII/von Willebrand factor versus recombinant factor VIII for treatment of previously untreated patients with severe hemophilia A in the United States

Background: Inhibitor development to factor VIII (FVIII) hemophilia therapy results in increased complications and substantial economic costs. The SIPPET study, the first randomized controlled trial to compare the immunogenicity of plasma-derived FVIII (pdFVIII)/von Willebrand factor (VWF) and recombinant-DNA-derived FVIII (rFVIII), demonstrated higher inhibitor rates in previously untreated patients (PUPs) treated with rFVIII than in PUPs treated with pdFVIII/VWF.

Objective: To quantify the economic impact of treating PUPs with pdFVIII/VWF vs rFVIII.

Methods: An Excel-based clinical and economic model was developed from a US healthcare payer perspective and run over a 5-year period. The analysis utilized a cohort approach to model patient treatment and outcomes over a monthly cycle to quantify differences in costs of FVIII, bypassing agents, and hospitalizations for serious bleeds. Rates of high-titer inhibitor development were obtained from the SIPPET study. Patients developing high-titer inhibitors were treated with immune tolerance induction (ITI). Patients who developed low-titer inhibitors and those who did not develop inhibitors continued their usual FVIII treatment. Patients who were successfully treated with ITI returned to FVIII treatment, while unsuccessfully treated patients received bypassing agents. Total costs per treated patient were estimated and a one-way sensitivity analysis was conducted to quantify the impact of parameter uncertainty on the model outcomes.

Results: Total cumulative costs per patient over 5 years were $834,621 for pdFVIII/VWF patients and $1,237,163 for rFVIII patients, representing a total saving of $402,542 per patient over the 5-year period, for an average annual saving of $80,508 per patient.

Conclusions: Based on data from the SIPPET study, this analysis found that initiating FVIII treatment in severe hemophilia A PUPs with pdFVIII/VWF has the potential to offer substantial cost savings to healthcare payers, amounting to a one-third reduction in costs.     

How shark conservation in the Maldives affects demand for dive tourism

Shark-diving tourism provides important economic benefits to the Maldives. We examine the link between shark conservation actions and economic returns from diving tourism. A combined travel cost and contingent behaviour approach is used to estimate the dive trip demand under different management scenarios. Our results show that increasing shark populations could increase dive-trip demand by 15%, raising dive tourists’ welfare by US$58 million annually. This could result in annual economic benefits for the dive-tourism industry of >US$6 million. Conversely, in scenarios where shark populations decline, where dive tourists observe illegal fishing, or if dive operators lack engagement in shark conservation, dive trip demand could decrease by up to 56%. This decline causes economic losses of more than US$24 million annually to the dive tourism industry. These results highlight the dependence of the shark-diving industry on the creation and enforcement of appropriate management regimes for shark conservation.     

在热电联产企业中精益成本管理的评价指标及应用对策

论文从热电联产企业的特征入手,通过对精益成本管理理论的研究,总结出热电联产企业精益成本管理的评价指标,并通过对指标的分析总结出精益成本管理在热电联产企业实际应用中的管理对策。     

集成管理理论在建设项目全过程造价咨询业务中的应用研究

建筑企业为了进一步扩大盈利空间,在项目运行期间于造价管理工作中引入集成管理理论,采用全过程造价咨询管控方式,提升项目成本管控能力。论文考虑到造价管理对建筑企业的重要性,着重介绍集成管理理论在全过程造价咨询领域的应用方式。     

基于BIM技术的工程造价精细化管理研究

为实现工程造价精细化管理目标,需要各个环节的相互配合来达到资源优化配置。BIM技术依托虚拟建模技术,实现了对工程项目的数字化建造管理。实践证明,将BIM技术融入项目工程造价管理体系中,有助于提升工程造价管理的整体质量。论文立足工程造价精细化管理的内涵,剖析了BIM技术在工程造价精细化管理中的应用价值,并提出了BIM技术在工程造价精细化管理中的具体应用策略。     

造价咨询企业全过程造价管理咨询服务分析

随着当前社会的不断发展,各行业都在有所改变,造价咨询企业也有着很大的进步。随着投资主体越来越丰富,那么全过程造价管理咨询已经逐渐地成为造价咨询行业的重要服务内容。论文先了解全过程造价咨询内容,再说明造价咨询企业全过程造价管理咨询服务的具体实施策略,为相关研究人员提供参考。     

Shipping cost and development of the landlocked developing countries: Panel evidence from the common correlated effects approach

We estimate the impact of shipping cost on development for landlocked developing countries (LLDCs). Since container trade is important to them, we construct a country-specific measure of shipping cost, called HarpexCost, which combines the global cost of container shipping with information on how exposed to container shipping each LLDC is. We employ the common correlated effects (CCE) estimator of Pesaran (Econometrica, 2006; 55: 967) to first estimate the impact of HarpexCost on the LLDCs’ development, and then recover the actual impact of shipping cost from these estimates. Overall, we observe that shipping cost has large negative effects on the LLDCs. Building upon these results, we provide new estimates on the cost of landlockedness and how trade benefits their development.