Reverse Auction: A Potential Strategy for Reduction of Pharmacological Therapy Cost

Background:Polypharmacy is a significant economic burden.Objective:We tested whether using reverse auction (RA) as compared with commercial pharmacy (CP) to purchase medicine results in lower pharmaceutical costs for heart failure (HF) and heart transplantation (HT) outpatients.Methods:We compared the costs via RA versus CP in 808 HF and 147 HT patients followed from 2009 through 2011, and evaluated the influence of clinical and demographic variables on cost.Results:The monthly cost per patient for HF drugs acquired via RA was $10.15 (IQ 3.51-40.22) versus $161.76 (IQ 86.05‑340.15) via CP; for HT, those costs were $393.08 (IQ 124.74-774.76) and $1,207.70 (IQ 604.48-2,499.97), respectively.Conclusion:RA may reduce the cost of prescription drugs for HF and HT, potentially making HF treatment more accessible. Clinical characteristics can influence the cost and benefits of RA. RA may be a new health policy strategy to reduce costs of prescribed medications for HF and HT patients, reducing the economic burden of treatment.

Encyclopédie d'histoire naturelle; ou, traité complet de cette science d'après les travaux des naturalistes les plus éminents de tous les pays et de toutes les époques: Buffon, Daubenton, Lacépède, G. Cuvier, F. Cuvier, Geoffroy Saint-Hilaire, Latreille, De Jussieu, Brongniart, etc.

Coléoptères No.1

O problema técnico-econômico da adubação

The authors discuss from the economic point of view the use of a few functions intended to represent the yield y corresponding to a level xof the nutrient. They point out that under conditions of scarce capital what is actually most important is not to obtain the highest profit per hectare but the highest return per cruzeiro spent, so that we should maximize the function z = _R - C_ = _R_ - 1 , C C where R is the gross income and C the cost of production (fixed plus variable, both per hectare). Being C = M + rx, with r the unit price of the nutrient and Af the fixed cost of the crop, wo are led to the equation (M + rx)R' - rR = 0. With R = k + sx + tx², this gives a solution Xo = - Mt - √ M²t² - r t(Ms - Kr)- _____________________ rt on the other hand, with R = PyA [1 - 10-c(x + b)], x0 will be the root of equation (M + rx)cL 10 + r 10c(x + b) = 0 (12). Another solution, pointed out by PESEK and HEADY, is to maximize the function z = sx + tx² _________ m + rx where the numerator is the additional income due to the nutrient, and m is the fixed cost of fertilization. This leads to a solution x+ = - mt - √m²t² - mrst (13) _________________ rt However, we must have x+< _r_-_s_ I if we want to satisfy t _dy_ > r. dx This condition is satisfied only if we have m < _(s__-__r)² (14), - 4 t a restriction apparently not perceived by PESEK and HEADY. A similar reasoning using Mitscherlich's law leads to equation (mcL 10 + r) + cr(L 10)x - r 10cx = 0 (15), with a similar restriction. As an example, data of VIEGAS referring to fertilization of corn (maize) gave the equation y - 1534 + 22.99 x - 0. 1069 x², with x in kg/ha of the cereal. With the prices of Cr$ 5.00 per kilo of maize, Cr$ 26.00 per kilo of P2O3,. and M = Cr$ 5,000.00, we obtain x0 = 61 kg/ha of P(2)0(5). A similar reasoning using Mitscherlich's law leads to x0 = 53 kg/ha. Now, if we take in account only the fixed cost of fertilization m = Cr$ 600.00 per hectare, we obtain from (13) x+ = 51 kg/ha of P2O5, while (14) gives x+ - 41 kg/ha. Note that if m = Cr$ 5,000.00, we obtain by formula (13) x+ = 88 kg/ha of P2O5, a solution which is not valid, since condition (14) is not satisfied.

Bulletin Zoologique : Contenant l'Analyse Raisonnee des Ouvrages les plus Remarquables.

1835

Die Rezeption von Kundenzeitschriften gesetzlicher Krankenkassen : Eine qualitative Untersuchung am Beispiel des „Gesundheitstelegramms“ der IKK gesund plus

Kundenmagazine sind ein wichtiges Instrument des Marketing und der Öffentlichkeitsarbeit. Dies haben auch die gesetzlichen Krankenkassen erkannt. Im Rahmen des Wettbewerbs nutzen sie ihre Kundenzeitschriften zur Mitgliedererhaltung. Wie aber werden diese Zeitschriften von ihrer Leserschaft rezipiert und welche Handlungsmotive liegen dem zugrunde? Im Rahmen einer qualitativen Untersuchung wurde dies anhand von Befragungen der Rezipienten des "Gesundheitstelegramms" der IKK gesund plus analysiert.

Encyclopédie d'histoire naturelle; ou, traité complet de cette science d'après les travaux des naturalistes les plus éminents de tous les pays et de toutes les époques: Buffon, Daubenton, Lacépède, G. Cuvier, F. Cuvier, Geoffroy Saint-Hilaire, Latreille, De Jussieu, Brongniart, etc.

Coléoptères No.2

Flore des serres et des jardins de l'Europe :ou descriptions et figures des plantes les plus rares et les plus méritantes, nouvellement introduites sur le continent ou en Angleterre ...

v.14 (1859-1861)

Annales d'horticulture et de botanique, ou Flore des jardins du royaume des Pays-Bas, et histoire des plantes cultivées les plus intéressantes des possessions néerlandaises aux Indes orientales, en Amérique et du Japon.

4

The Cost of ownership in the governance of interfirm collaborations

This paper investigates the selection of governance forms in interfirm collaborations taking into account the predictions from transaction costs and property rights theories. Transaction costs arguments are often used to justify the introduction of hierarchical controls in collaborations, but the ownership dimension of going from “contracts” to “hierarchies” has been ignored in the past and with it the so called “costs of ownership”. The theoretical results, tested with a sample of collaborations in which participate Spanish firms, indicate that the cost of ownership may offset the benefits of hierarchical controls and therefore limit their diffusion. Evidence is also reported of possible complementarities between reputation effects and forms of ownership that go together with hierarchical controls (i.e. joint ventures), in contrast with the generally assumed substitutability between the two.

Price competition under cost uncertainty: A laboratory analysis

We study the relation between the number of firms and price-cost margins under price competition with uncertainty about competitors' costs. We present results of an experiment in which two, three and four identical firms repeatedly interact in this environment. In line with the theoretical prediction, market prices decrease with the number of firms, but on average stay above marginal costs. Pricing is less aggressive in duopolies than in triopolies and tetrapolies. However, independently from the number of firms, pricing is more aggressive than in the theoretical equilibrium. Both the absolute and the relative surpluses increase with the number of firms. Total surplus is close to the equilibrium level, since enhanced consumer surplus through lower prices is counteracted by occasional displacements of the most efficient firm in production.

Cost Factors in Digital Projects: A Model Useful in Other Applications

Description of a costing model developed by digital production librarian to determine the cost to put an item into the Claremont Colleges Digital Library at the Claremont University Consortium. This case study includes variables such as material types and funding sources, data collection methods, and formulas and calculations for analysis. This model is useful for grant applications, cost allocations, and budgeting for digital project coordinators and digital library projects.

Quantitative method of viral pollution determination for large volume of water using ferric hydroxide gel impregnated on the surface of glassfibre cartridge

Quantitative method of viral pollution determination for large volume of water using ferric hydroxide gel impregnated on the surface of glassfibre cartridge filter. The use of ferric hydroxide gel, impregnated on the surface of glassfibre cartridge filter enable us to recover 62.5% of virus (Poliomylitis type I, Lsc strain) exsogeneously added to 400 liters of tap-water. The virus concentrator system consists of four cartridge filters, in which the three first one are clarifiers, where the contaminants are removed physically, without significant virus loss at this stage. The last cartridge filter is impregnated with ferric hydroxide gel, where the virus is adsorbed. After the required volume of water has been processed, the last filter is removed from the system and the viruses are recovered from the gel, using 1 liter of glycine/NaOH buffer, at pH 11. Immediately the eluate is clarified through series of cellulose acetate membranes mounted in a 142mm Millipore filter. For the second step of virus concentration, HC1 1N is added slowly to the eluate to achieve pH 3.5-4. MgC1, is added to give a final concentration of 0.05M and the viruses are readsorbed on a 0.45 , porosity (HA) cellulose acetate membrane, mounted in a 90 mm Millipore filter. The viruses are recovered using the same eluent plus 10% of fetal calf serum, to a final volume of 3 ml. In this way, it was possible to concentrate virus from 400 liters of tap-water, into 1 liter in the first stage of virus concentration and just to 3 ml of final volume in a second step. The efficiency, simplicity and low operational cost, provded by the method, make it feasible to study viral pollution of recreational and tap-water sources.

The Total fiscal cost of indirect taxation: an approximation using Catalonia's recent input-output table

In this note we quantify to what extent indirect taxation influences and distorts prices. To do so we use the networked accounting structure of the most recent input-output table of Catalonia, an autonomous region of Spain, to model price formation. The role of indirect taxation is considered both from a classical value perspective and a more neoclassical flavoured one. We show that they would yield equivalent results under some basic premises. The neoclassical perspective, however, offers a bit more flexibility to distinguish among different tax figures and hence provide a clearer disaggregate picture of how an indirect tax ends up affecting, and by how much, the cost structure.