Economic evaluation of four treatment strategies for postmenopausal patients with osteoporosis and a recent fracture in mainland China: a cost-effectiveness analysis.

Postmenopausal patients with osteoporosis who have a recent fracture are at very high risk of fracture, and this study finds that stratified treatment based on fracture risk would be a cost-effective treatment option for this population. PURPOSE: To evaluate the cost-effectiveness of four anti-osteoporosis medications (denosumab, zoledronate, teriparatide, and alendronate) for postmenopausal osteoporotic women in mainland China, using a stratified treatment strategy recommended by the American Association of Clinical Endocrinologists and the American College of Endocrinology (AACE/ACE). METHODS: A microsimulation Markov model was used to compare the cost-effectiveness of the four treatments in postmenopausal osteoporotic patients of different ages (65, 70, 75, and 80 years), with a recent fracture from the Chinese healthcare perspective. The primary outcome was the incremental cost-effectiveness ratio (ICER), which represent the incremental cost per quality-adjusted life-year (QALY) obtained. One-way deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were performed to assess the robustness of model findings. RESULTS: Alendronate was dominated by denosumab-to-alendronate and zoledronate at all ages examined, indicating that the costs of the two drugs were lower, but QALYs was greater. However, teriparatide-to-alendronate yielded an ICER of $76,432.07/ QALY, compared with alendronate at age 65, which exceeded the pre-determined willingness-to-pay threshold of $37,653/ QALY. The results were similar at other ages. The DSA showed that the most sensitive parameters were drug efficacy for vertebral and wrist fractures, the relative risk of vertebral fractures, and the persistence of the drugs. The PSA showed that zoledronate had a 100% probability of being the most cost-effective treatment, with a willingness-to-pay threshold of $37,653/ QALY. CONCLUSION: Stratified treatment based on very high fracture risk is more cost-effective than conventional pills in mainland China. Among the stratified treatments, zoledronate is the optimal option.

Outcomes and cost-effectiveness comparisons of progestin-primed ovarian stimulation, GnRH antagonist protocol, and luteal phase stimulation for fertility preservation.

OBJECTIVE: To compare the clinical outcomes and cost-effectiveness of progestin-primed ovarian stimulation (PPOS) and the gonadotropin-releasing hormone-antagonist (GnRH-A) protocol in fertility preservation (FP) in cancer patients. The stimulation option when patients were in the luteal phase was also explored. METHODS: This retrospective study analyzed clinical data from 163 patients who underwent FP. The number of retrieved oocytes and vitrified oocytes/embryos, total dose of gonadotropin, duration of stimulation, number of injections, and cost were compared among the PPOS, GnRH-A, and luteal phase stimulation (LPS) groups. RESULTS: No significant differences were noted in the numbers of retrieved oocytes and vitrified oocytes/embryos among the three groups. In the multiple regression model, age (P = 0.02) and antral follicle count (AFC) (P < 0.001), but not the controlled ovarian stimulation (COS) protocols (P = 0.586), were associated with the number of retrieved oocytes. The number of injections and the cost were all significantly lower in the PPOS and LPS groups than in the GnRH-A group(P < 0.001). CONCLUSION: PPOS had similar clinical results but was superior medically and economically to GnRH-A. For patients in the luteal phase, LPS was an optional protocol with similar outcomes and costs to PPOS.

Low-cost synthesis of small molecule acceptors makes polymer solar cells commercially viable.

The acceptor-donor-acceptor (A-D-A) or A-DA'D-A structured small molecule acceptors (SMAs) have triggered substantial progress for polymer solar cells (PSCs). However, the high-cost of the SMAs impedes the commercial viability of such renewable energy, as their synthesis via the classical pyridine-catalyzed Knoevenagel condensation usually suffers from low reaction efficiency and tedious purifying work-up. Herein, we developed a simple and cheap boron trifluoride etherate-catalyzed Knoevenagel condensation for addressing this challenge, and found that the coupling of the aldehyde-terminated D unit and the A-end groups could be quantitatively finished in the presence of acetic anhydride within 15 minutes at room temperature. Compared with the conventional method, the high reaction efficiency of our method is related to the germinal diacetate pathway that is thermodynamically favorable to give the final products. For those high performing SMAs (such as ITIC-4F and Y6), the cost could be reduced by 50% compared with conventional preparation. In addition to the application in PSCs, our synthetic approach provides a facile and low-cost access to a wide range of D-A organic semiconductors for emerging technologies.

A Cost-Effective Alpha-Fluorinated Bithienyl Benzodithiophene Unit for High-Performance Polymer Donor Material.

To reduce synthetic cost of the classic fluorinated bithienyl benzodithiophene (BDTT-F) unit, here, an alpha-fluorinated bithienyl benzodithiophene unit, namely, α-BDTT-F (F atom in the α position of the lateral thiophene unit), is developed by the isomerization strategy of exchanging the positions of the F atom and flexible alkyl chain on the lateral thiophene unit of the BDTT-F unit. The α-BDTT-F unit was synthesized with less synthetic steps, higher synthetic yield, and less purification times from the same raw materials as those of the BDTT-F unit, thus with low synthetic cost. Theoretical calculation indicates that the α-BDTT-F unit possesses a similar twisted conformation and electronic structures as those of the BDTT-F unit. The α-BDTT-F-based polymer α-PBQ10 exhibits similar light absorption and energy levels as those of the corresponding BDTT-F-based polymer PBQ10 but marginally increased molecular aggregation and stronger hole transport than PBQ10. In consequence, the α-PBQ10:Y6-based polymer solar cell demonstrates a slightly enhanced power conversion efficiency (PCE) of 16.26% compared with that of the PBQ10:Y6-based device (PCE = 16.23%). Also, the PCE is further improved to 16.77% through subtle microscopic morphology regulation of the photoactive layer with the fullerene derivative indene-C60 bisadduct as the third component. This work provides new ideas for the design of low-cost and high-efficiency photovoltaic molecules.

Understanding the Morphology of High-Performance Solar Cells Based on a Low-Cost Polymer Donor.

A low-cost and high-performance bulk heterojunction (BHJ) solar cell comprising an emerging polymer donor, poly[(thiophene)-alt-(6,7-difluoro-2-(2-hexyldecyloxy)quinoxaline)] (PTQ10), shows an efficiency of 12.7%. To improve the performance of the solar cells, a better understanding of the structure-property relationships of the PTQ10-based devices is crucial. Here, we fabricate PTQ10/nonfullerene and fullerene BHJ devices, including PTQ10/IDIC, PTQ10/ITIC, and PTQ10/PC71BM, processed with or without thermal annealing and additive and provide detailed descriptions of the relationships between the morphology and performance. PTQ10 is found to be highly miscible with nonfullerene IDIC and ITIC acceptors and poorly miscible with fullerene PC71BM acceptors. Thermal annealing promotes the crystallization of PTQ10 and phase separation of all PTQ10/IDIC, PTQ10/ITIC, and PTQ10/PC71BM devices, leading to an increased power conversion efficiencies (PCEs) of the PTQ10/IDIC and PTQ10/ITIC devices but a decreased PCE of PTQ10/PC71BM devices with 1,8-di-iodooctane (DIO) additive. Without thermal annealing, DIO greatly improves the morphology of PTQ10/PC71BM, leading to a higher PCE. The results show that the degree of phase separation and ordering in the PTQ10-based devices significantly influences device performance. The morphology-property correlations demonstrated will assist in the rational design of these low-cost polymer donor-based solar cells to achieve even higher performance.

Simplified synthetic routes for low cost and high photovoltaic performance n-type organic semiconductor acceptors.

The application of polymer solar cells (PSCs) with n-type organic semiconductor as acceptor requires further improving powder conversion efficiency, increasing stability and decreasing cost of the related materials and devices. Here we report a simplified synthetic route for 4,4,9,9-tetrahexyl-4,9-dihydro-s-indaceno [1,2-b:5,6-b'] dithiophene by using the catalyst of amberlyst15. Based on this synthetic route and methoxy substitution, two low cost acceptors with less synthetic steps, simple post-treatment and high yield were synthesized. In addition, the methoxy substitution improves both yield and efficiency. The high efficiency of 13.46% was obtained for the devices with MO-IDIC-2F (3,9-bis(2-methylene-5 or 6-fluoro-(3-(1,1-dicyanomethylene)-indanone)-4,4,9,9-tetrahexyl-5,10-dimethoxyl-4,9-dihydro-s-indaceno[1,2-b:5,6-b'] dithiophene) as acceptor. Based on the cost analysis, the PSCs based on MO-IDIC-2F possess the great advantages of low cost and high photovoltaic performance in comparison with those PSCs reported in literatures. Therefore, MO-IDIC-2F will be a promising low cost acceptor for commercial application of PSCs.

A low cost and high performance polymer donor material for polymer solar cells.

The application of polymer solar cells requires the realization of high efficiency, high stability, and low cost devices. Here we demonstrate a low-cost polymer donor poly[(thiophene)-alt-(6,7-difluoro-2-(2-hexyldecyloxy)quinoxaline)] (PTQ10), which is synthesized with high overall yield of 87.4% via only two-step reactions from cheap raw materials. More importantly, an impressive efficiency of 12.70% is obtained for the devices with PTQ10 as donor, and the efficiency of the inverted structured PTQ10-based device also reaches 12.13% (certificated to be 12.0%). Furthermore, the as-cast devices also demonstrate a high efficiency of 10.41% and the devices exhibit insensitivity of active layer thickness from 100 nm to 300 nm, which is conductive to the large area fabrication of the devices. In considering the advantages of low cost and high efficiency with thickness insensitivity, we believe that PTQ10 will be a promising polymer donor for commercial application of polymer solar cells.

Dynamic Monte Carlo simulation for highly efficient polymer blend photovoltaics.

We developed a model system for blend polymers with electron-donating and -accepting compounds. It is found that the optimal energy conversion efficiency can be achieved when the feature size is around 10 nm. The first reaction method is used to describe the key processes (e.g., the generation, the diffusion, the dissociation at the interface for the excitons, the drift, the injection from the electrodes, and the collection by the electrodes for the charge carries) in the organic solar cell by the dynamic Monte Carlo simulation. Our simulations indicate that a 5% power conversion efficiency (PCE) is reachable with an optimum combination of charge mobility and morphology. The parameters used in this model study correspond to a blend of novel polymers (bis(thienylenevinylene)-substituted polythiophene and poly(perylene diimide-alt-dithienothiophene)), which features a broad absorption and a high mobility. The I-V curves are well-reproduced by our simulations, and the PCE for the polymer blend can reach up to 2.2%, which is higher than the experimental value (>1%), one of the best available experimental results up to now for the all-polymer solar cells. In addition, the dependency of PCE on the charge mobility and the material structure are also investigated.