The paper examines the use of stated choice experiments (SC) to assess the economic value of alternative rail noise reduction
interventions on the Brennero railway in Italy. The paper formally tests the econometric robustness of the SC estimates under
three payment regimes: (a) a regional tax, where consumers must trade off welfare gains due to noise reduction for part of
their income; (b) a transport tax reallocation scheme, where consumers must trade off a part of the tax payments that are
currently spent on the public transport sector; and (c) an administration tax reallocation scheme, where consumers must trade
off a part of the tax payments that are currently spent on the administration sector. The test results are varied. On the
one hand, the SC estimates are found to be statistically different for the tax reallocation and the tax introduction regimes.
This confirms previous valuation research results, and thus reiterates the hypothesis that states the inequality between marginal
values of private income and public money. On the other hand, the SC estimates are not found to be statistically different
for the two proposed tax reallocation regimes, suggesting that, in the case study investigated here, the marginal value of
public money does not depend upon the budget source. 相似文献
Background: In 2011 the first payment-by-results (PbR) scheme in Catalonia was signed between the Catalan Institute of Oncology (ICO), the Catalan Health Service, and AstraZeneca (AZ) for the introduction of gefitinib in the treatment of advanced EGFR-mutation positive non-small-cell lung cancer. The PbR scheme includes two evaluation points: at week 8, responses, stabilization and progression were evaluated, and at week 16 stabilization was confirmed. AZ was to reimburse the total treatment cost of patients that failed treatment, defined as progression at weeks 8 or 16.
Objective: To estimate the financial consequences of this PbR reimbursement model and determine the perception of the stakeholders involved in the agreement.
Methods: Differential drug costs between two scenarios, with and without the PbR, were calculated. A qualitative investigation of the organizational elements was performed by interviewing the parties involved in the agreement.
Results: Forty-one patients were included from June 2011 to October 2013 and assessed at two evaluation points. Clinical results were comparable to those observed in the pivotal studies of gefitinib. The difference in the cost of gefitinib using the PbR compared to the traditional purchasing scenario was 6.17% less at 8 weeks, 11.18% at 16 weeks and 4.15% less for the overall treatment. The PbR resulted in total savings of around €36,000 (€880 per patient). From an operational and organizational perspective, the availability of adequate data systems to measure outcomes and monitor accountability and the involvement of healthcare professionals were acknowledged as crucial.
Conclusions: Tangible and intangible benefits were identified with respect to the interests of the parties involved. This has led to the incorporation of innovation for patients under acceptable conditions. 相似文献
This study examines the recent UK regulatory decision to ban the joint provision of consumer lending and payment protection or credit insurance (hereafter PPI). This case has wide regulatory implications following concerns that the sale of PPI has been detrimental to customers due to overpriced PPI and a cross-subsidy flowing from PPI to unsecured lending. The study examines whether interest rate setting of unsecured lending is influenced by banks issuing PPI or otherwise to help establish whether such cross-subsidies have been made. This assessment is undertaken over time for a diverse and comprehensive selection of banks offering unsecured lending with and without PPI between 1998 and 2011 for three levels of borrowing. It is reported that offering PPI is a significant explanatory variable of unsecured lending interest rate levels. When unsecured lending is offered with PPI, interest rates are lower, a finding consistent with a cross-subsidy flowing from PPI remiums to unsecured lending.相似文献
The effectiveness of agri-environment schemes (AES) in enhancing biodiversity on farmland and creating a long-lasting change in farmers’ motivation towards a more environmental-friendly practice is still strongly debated. Applying a regional approach has been advocated widely to make AES more ecologically and socially sustainable. In the Netherlands, some AES are performed collectively by large regional groups of farmers called Environmental Cooperatives (EC). We hypothesise that these cooperatives enhance farmers’ intention to participate by facilitating the application of AES, but also by generating group pressure. In the study at hand, we used an extended version of the Theory of Planned Behaviour (TPB) to investigate which factors are associated with farmers’ intention to participate in two kinds of collective AES (ditch bank management and the protection of meadow birds). Our results demonstrate that attitude and perceived personal ability to participate in these AES are associated with the intention of farmers to participate in ditch bank management. However, for the protection of meadow birds, social pressure, self-identity and facilitation by the EC also relate to the intention of farmers. We conclude that the facilitation undertaken by ECs positively relates to farmers’ intention to participate in collective AES. 相似文献