Estimating the Allocation of the Economic Value Generated by Utilization of All-Oral Direct-Acting Antivirals for Hepatitis C in the United States, 2015 to 2019.

OBJECTIVES: Between 2013 to 2019, several all-oral direct-acting antivirals (DAAs) were launched with the potential to cure patients with hepatitis C virus (HCV). They generated economic value in terms of the health gains for patients and cost-savings for the US healthcare system. We estimated the share of this value allocated to 4 manufacturers vs society. METHODS: For 2015 to 2019, we estimated the incremental impact of DAAs on HCV health outcomes and costs. We used the Center for Disease Analysis Foundation Polaris Observatory database to estimate utilization. Per-patient projections of lifetime quality-adjusted life-years (QALYs) gained and medical costs avoided were based on a standard 9-state HCV disease-progression model for DAA treatment vs alternatives. Annual QALY gains were valued at $114 000 per QALY. Outcomes and costs were discounted at 3%. Estimated revenues were based on reported sales. RESULTS: An estimated 1 080 000 patients received DAAs: 81.5% would not have received the pre-DAA standard of care. On average, these patients were projected to gain 4.4 QALYs and save $104 400 in lifetime healthcare costs, generating $531.8 billion in value. Those who would have received treatment gained 1.7 QALYs and saved $41 500 in lifetime costs, generating $47.4 billion in economic value. As treatment costs fell nearly 75%, the 4 manufacturers reported $37.4 billion from DAA sales-an allocation of 6.5% of the total value. CONCLUSIONS: The significant majority (∼90%) of the economic value of curing HCV with DAAs were health benefits to patients and net cost-savings to society. DAA manufacturers received a minority share (6.5%) of the aggregate economic value generated.

Cost-effectiveness of mepolizumab for severe eosinophilic asthma in China.

OBJECTIVE: To evaluate the economic value of mepolizumab as an add-on therapy to the standard of care (SoC) for patients with severe eosinophilic asthma in China. METHODS: A Markov model with three health conditions was constructed to calculate the incremental cost per quality-adjusted life year (QALY) in mepolizumab with SoC and SoC only groups from the perspective of the Chinese healthcare system throughout an entire lifespan. The model was populated with local costs, while efficacy parameters were obtained from the global Phase III MENSA trial and mortality was derived from two surveys. One-way and probabilistic sensitivity analyses were conducted. Additional scenario analysis was used to estimate the cost-effectiveness impact of changes in the price of mepolizumab. RESULTS: Over the lifetime treatment horizon, the incremental cost-effectiveness ratio (ICER) of mepolizumab plus SoC compared to SoC alone was $170 648.73 per QALY. Sensitivity analyses focused on these results. Scenario analysis showed that mepolizumab would require a price reduction of at least 82% to reach the current willingness-to-pay (WTP=$38 223.34/QALY) threshold. CONCLUSION: Mepolizumab is not a cost-effective healthcare resource in China at its current pricing.

Cashing in: cost-benefit analysis framework for digital hospitals.

BACKGROUND: For many countries, especially those outside the USA without incentive payments, implementing and maintaining electronic medical records (EMR) is expensive and can be controversial given the large amounts of investment. Evaluating the value of EMR implementation is necessary to understand whether or not, such investment, especially when it comes from the public source, is an efficient allocation of healthcare resources. Nonetheless, most countries have struggled to measure the return on EMR investment due to the lack of appropriate evaluation frameworks. METHODS: This paper outlines the development of an evidence-based digital health cost-benefit analysis (eHealth-CBA) framework to calculate the total economic value of the EMR implementation over time. A net positive benefit indicates such investment represents improved efficiency, and a net negative is considered a wasteful use of public resources. RESULTS: We developed a three-stage process that takes into account the complexity of the healthcare system and its stakeholders, the investment appraisal and evaluation practice, and the existing knowledge of EMR implementation. The three stages include (1) literature review, (2) stakeholder consultation, and (3) CBA framework development. The framework maps the impacts of the EMR to the quadruple aim of healthcare and clearly creates a method for value assessment. CONCLUSIONS: The proposed framework is the first step toward developing a comprehensive evaluation framework for EMRs to inform health decision-makers about the economic value of digital investments rather than just the financial value.

Methods and data needs to estimate the economic market value of livestock at different spatial scales.

Assessing the economic value of livestock such as cattle, goats, sheep, pigs, chickens and fish can offer information about their financial performance and economic importance at farm, national and global scale. Such information is needed for decision-making surrounding livestock finance, investment and strategic development. The aim of this study was to provide an overview of the key livestock valuation methods and associated data requirements. The study was conducted using a literature review. Five key livestock valuation methods were identified and described: historical costs, net current market value, replacement costs, net present value and cost of production. The findings of this study may be of interest to livestock scientists, veterinarians, policy-makers and other stakeholders who aim to assess the economic value of livestock herds. The Global Burden of Animal Diseases programme relied on the outcomes of this study to identify methods for the estimation of the economic value of livestock at the global scale and for its Ethiopia and Indonesia case studies.

L'estimation de la valeur économique des animaux d'élevage (bovins, caprins, ovins, porcins, poulets et poissons d'élevage) peut apporter un éclairage sur leurs performances financières et leur intérêt économique à l'échelle d'une exploitation, d'un pays ou du monde. Ces informations sont indispensables pour étayer les décisions de financement, d'investissement et de développement stratégique des élevages. L'étude présentée par l'autrice vise à donner une vue d'ensemble des principales méthodes d'estimation de la valeur des animaux d'élevage et des exigences qui leur sont associées en termes de données. L'étude repose sur un examen de la littérature sur le sujet. Cinq méthodes principales d'estimation de la valeur des animaux d'élevage y sont répertoriées et décrites : coûts historiques, valeur marchande courante nette, coûts de remplacement, valeur actuelle nette et coûts de production. Les résultats de cette étude pourraient intéresser les spécialistes de l'élevage, les vétérinaires, les décideurs politiques et d'autres parties prenantes qui cherchent à évaluer la valeur économique des cheptels. Le programme " Impact mondial des maladies animales " s'est appuyé sur les résultats de cette étude pour retenir les méthodes d'estimation de la valeur économique des animaux d'élevage appliquées à l'échelle mondiale ainsi que dans les études de cas conduites en Ethiopie et en Indonésie.

Evaluar el valor económico del ganado, como vacas, cabras, ovejas, cerdos, pollos y peces, puede ofrecer información sobre su desempeño financiero y su importancia económica tanto a nivel de la explotación como a escala nacional y mundial. Esta información es necesaria para la toma de decisiones en materia de financiación, inversión y desarrollo estratégico de la ganadería. El objetivo de este estudio era ofrecer una visión general de los principales métodos de valoración del ganado y de las necesidades de datos conexas. Para ello, se llevó a cabo una revisión bibliográfica y se distinguieron y describieron cinco métodos fundamentales de valoración de la ganadería: costes históricos, valor actual de mercado neto, costes de reposición, valor actual neto y costes de producción. Las conclusiones de este estudio pueden ser de interés para científicos que trabajan en el ámbito de la ganadería, veterinarios, responsables de la toma de decisiones y otras partes interesadas en la evaluación del valor económico del ganado. El programa sobre el Impacto Global de las Enfermedades Animales se basó en los resultados de este estudio para definir métodos de estimación del valor económico del ganado a escala mundial y para sus estudios de caso de Etiopía e Indonesia.

Quantifying intangible values of wetlands as instrument for conservation in the Po delta park (Italy).

Wetlands possess intangible values that are usually overlooked in decision-making processes. Based on questionnaire surveys, this work aims to quantify both the non-use and cultural values provided by the different wetlands of the Po Delta Park (Northern Italy), selected as ideal case study, using willingness to pay (WTP) for wetland conservation and travel cost methods, respectively. Their relationships with socio-economic variables and respondents' preferences for current and future use were also analysed. The 61.39% of participants were willing to pay a mean amount of 95.8 € (±40). The average travel cost was 38.68 € (±6.24), with higher values observed for environmental experts than for other citizens. Wetlands differ significantly in travel costs, current and future use, but not in WTP. Poisson regressions showed that non-use and cultural values were significantly dependent on personal information, preference variables and travel distance. Intangible dimensions, such as bequest and existence values, showed higher valuations/rates than option and direct use values. The results highlight that perceptions of the intrinsic value of nature are influenced by demographic characteristics, distance from the area and desired future uses. Non-use values seem abstract and generalised to the whole area, regardless of the ecological characteristics of the wetland, even though a significant relation to wetland uses was observed. In contrast, cultural values are tied to specific wetlands, as indication of the importance of historical relationships between people and nature. Such findings underline that the different dimensions of intrinsic value of nature may act at different scales and help decision-makers to incorporate such values into environmental accounting.

Recycling potential of cobalt metal from end-of-life new energy passenger vehicles in China.

The growing demand for new energy vehicles (NEVs) has resulted in a corresponding increase in demand for cobalt as a critical material. It is crucial to estimate the cobalt resource recycling potential of China's NEV industry to ensure a balance between the supply and demand for cobalt metal minerals. This article is based on using the historical data of the new energy passenger vehicle (NEPV) sales volume from 2013 to 2022 to estimate the NEPV sales volume from 2023 to 2035. On this basis, the Weibull distribution was used to analyse the different sales scenarios (low sales and high sales) of NEPVs in China, and the recycling potential of cobalt metal in NEPVs was evaluated under three battery life scenarios (8, 10 and 12 years) from 2023 to 2035. Based on the above scenarios, in 2035, the greatest recycling potential of cobalt is predicted to be 166.9 kilotonnes, with economic values of CNY 49.01-94.60 billion. Moreover, the extent to which the recycling potential of cobalt can cover the market demand for NEPVs was analysed. Our analysis concluded that recycling cobalt as a secondary supply has emerged as a necessary solution to supplement the primary supply, which can make a significant contribution to alleviating the pressure of the supply and demand.

Sustainable multi-trait selection index based on production, reproduction, and health traits for genetic improvement of Murrah buffaloes.

Selection of Murrah buffaloes based on production, reproduction, and health traits play an important role in sustainable genetic improvement. With the aim to construct an index comprising of production, reproduction and health traits of Murrah buffaloes, the production and reproduction data during a 50-year span (1971-2020) and for health traits data of 27 years (1994-2020) were analyzed. Various three, four, five, and six trait combinations of production, reproduction, and health traits were explored for construction of performance indices. The income and expenditure method was used to calculate relative economic values (REV) for traits under consideration. A total of 37 performance indices were constructed using a multi-trait combination of production, reproduction, and health traits. Out of 37 indices, the (ADMY-PY-DO-AFC-FF) based index was identified as the best, with 78%, 2%, and 20% weightage given to production, reproduction, and female fertility, respectively. Furthermore, when REVs of traits were increased by 25% and 50%, there was no change observed in the relative importance of traits in the best index, indicating that the index was robust to substantial increases in economic values. Therefore, it is recommended that the above constructed composite selection index can be employed in selection of female buffaloes to achieve sustainable genetic gain.

Where to measure water quality ? Application to nitrogen pollution in a catchment in France.

Information on the water quality of rivers can be used to judge the effectiveness of past policies or to guide future environmental policies. Consequently, the location of water quality monitoring stations (WQMSs) plays an important role in river pollution control. In the 2000s, a literature developed on the optimization of WQMS location to identify pollution hot spots, average quality, or to minimize the detection time of a potential source of accidental pollution. This article is part of a new literature aimed at locating WQMSs in order to optimize the economic value of information (EVOI) generated by water quality monitoring networks (WQMNs). The field of study is a catchment in northeastern France where the purpose of quality measurement is to define a policy of reduction of agricultural nitrogen fertilizers in order to reach the standard of 50 mg/l of nitrate at the WQMS. Agro-hydrological and economic models estimate the net benefit of input reduction depending on the location of the WQMS on the basis of different assumptions concerning the ecological damage generated by nitrate. We show that the magnitude of the ecological damage and, consequently, the perception of the contamination generated by nitrate in water, play a decisive role on the optimal location of the WQMS, as well as on the benefit of the economic optimization of locations, compared to traditional optimization. Locating WQMSs in a way that maximizes EVOI will be more attractive for very high or very low levels of damage. However, in this context, linking damage to nitrate concentration or to concentration coupled with riparian population density alone will have little impact.

Economic values of reproductive and growth traits in Chinese Yiling sheep.

This study aimed to calculate the economic value (EV) of reproductive and growth traits for Yiling sheep. A bio-economic model was developed to assess the economic value of litter size (LS), litter size at weaning (LSW), age at first lambing (AFL), lambing interval (LI), birth weight (BW), weaning weight (WW), and 6-month body weight (6MW). The sensitivity of the economic value of traits to changes in market prices was also analyzed. In this study, the trait with the highest EV was LSW (427.97 ¥), followed by LS (419.96 ¥), BW (52.13 ¥), 6MW (14.46 ¥), WW (11.03 ¥), AFL (-0.51 ¥), and LI (-9.09 ¥). LS was the most important trait in the production system with a relative economic weight of 22.81%, followed by 6MW and LSW with relative economic weights of 18.98% and 19.01%, respectively. All traits assessed, except AFL and LI, had positive economic values, indicating that genetic improvement of these traits would have a positive impact on profitability. The results of the sensitivity analysis showed that the economic value of AFL was not sensitive to price changes. All growth traits were unaffected by price changes in labor and medical costs. In addition, the LS, LSW, LI, WW, and 6MW were sensitive to changes in liveweight and feed prices. Generally, as feed prices increased, the economic value of all traits except LI and BW decreased. Except for LI and BW, the economic value of all traits increased due to the rise in liveweight prices. This suggested that liveweight and feed prices significantly affect the profitability of the production system.

Ecosystem health, ecosystem services, and the well-being of humans and the rest of nature.

An ecosystem is healthy if it is active, maintains its organization and autonomy over time, and is resilient to stress. Healthy ecosystems provide human well-being via ecosystem services, which are produced in interaction with human, social, and built capital. These services are affected by different ecosystem stewardship schemes. Therefore, society should be aiming for ecosystem health stewardship at all levels to maintain and improve ecosystem services. We review the relationship between ecosystem health and ecosystem services, based on a logic chain framework starting with (1) a development or conservation policy, (2) a management decision or origin of the driver of change, (3) the driver of change itself, (4) the change in ecosystem health, (5) the change in the provision of ecosystem services, and (6) the change in their value to humans. We review two case studies to demonstrate the application of this framework. We analyzed 6,131 records from the Ecosystem Services Valuation Database (ESVD) and found that in approximately 58% of the records data on ecosystem health were lacking. Finally, we describe how the United Nations' System of Environmental-Economic Accounting (SEEA) incorporates ecosystem health as part of efforts to account for natural capital appreciation or depreciation at the national level. We also provide recommendations for improving this system.

Does Every Minute Really Count? Road Time as an Indicator for the Economic Value of Emergency Medical Services.

OBJECTIVES: This article builds on the literature regarding the association between emergency medical service (EMS) response times and patient outcomes (death and severe injury). Three issues are addressed in this article with respect to the empirical estimation of this relationship: the endogeneity of response time (systematically quicker response for higher degrees of urgency), the nonlinearity of this relationship, and the variation between such estimations for different patient outcomes. METHODS: Binomial and multinomial logistic regression models are used to estimate the impact of response time on the probabilities of death and severe injury using data from French Fire and Rescue Services. These models are developed with response time as an explanatory variable and then with road time (dispatch to arrival) hypothesized as representing the exogenous variation within response time. Both models are also applied to data subsets based on response time intervals. RESULTS: The results show that road time yields a higher estimate for the impact of response time on patient outcomes than (total) response time. The impact of road time on patient outcomes is also shown to be nonlinear. These results are of both statistical significance (model coefficients are significant at the 95% confidence level) and economical significance (when taking into account the number of annual interventions performed). CONCLUSIONS: When using heterogeneous data on EMS interventions where endogeneity is a clear issue, road time is a more reliable indicator to estimate the impact of EMS response time on patient outcomes than (total) response time.

Diagnostic and economic value of biomarker testing for targetable mutations in non-small-cell lung cancer: a literature review.

We aimed to assess the diagnostic and economic value of next-generation sequencing (NGS) versus single-gene testing, and of liquid biopsy (LBx) versus tissue biopsy (TBx) in non-small-cell lung cancer biomarker testing through literature review. Embase and MEDLINE were searched to identify relevant studies (n = 43) from 2015 to 2020 in adults with advanced non-small-cell lung cancer. For NGS versus single-gene testing, concordance was 70-99% and sensitivity was 86-100%. For LBx versus TBx, specificity was 43-100% and sensitivity was ≥60%. Turnaround times were longer for NGS versus single-gene testing (but not vs sequential testing) and faster for LBx versus TBx. NGS was cost-effective, and LBx reduced US per-patient costs. NGS versus single-gene testing and LBx versus TBx were concordant. NGS and LBx may be cost-effective for initial screening.

Plain language summary Patients with lung cancer with specific genetic mutations can benefit from medications that are specific to those mutations, known as targetable mutations. There are many methods to test for specific genetic mutations in patients with lung cancer. To detect genetic mutations, doctors can test the blood or urine, or they can test biopsy tissue; a small piece of the tumor removed from the lung. These tests can either look for mutations in one specific gene at a time, or they can use technology that reads the entire DNA sequence to observe multiple genes at once. In this review, we examined scientific reports to answer important questions about using genetic testing to find targetable mutations in patients with lung cancer. How accurate are different genetic tests? How fast can doctors get results from different genetic tests? How much do different genetic tests cost? We found that reading the entire DNA sequence was as accurate as testing one specific gene. Reading the entire DNA sequence takes more time than testing one specific gene, but it might reduce overall costs. Testing blood or urine was not as accurate as testing tissue, but it took less time for doctors to receive genetic test results and reduced costs.

Short-term impact of PM2.5 on contemporaneous asthma medication use: Behavior and the value of pollution reductions.

Asthma ranks among the most costly of chronic diseases, accounting for over $50 billion annually in direct medical expenditures in the United States. At the same time, evidence has accumulated that fine particulate matter pollution can exacerbate asthma symptoms and generate substantial economic costs. To measure these costs, we use a unique nationwide panel dataset tracking asthmatic individuals' use of rescue medication and their exposure to PM2.5 (particulate matter with an aerodynamic diameter of <2.5 µm) concentration between 2012 and 2017, to estimate the causal relationship between pollution and inhaler use. Our sample consists of individuals using an asthma digital health platform, which relies on a wireless sensor to track the place and time of inhaler use events, as well as regular nonevent location and time indicators. These data provide an accurate measurement of inhaler use and allow spatially and temporally resolute assignment of pollution exposure. Using a high-frequency research design and individual fixed effects, we find that a 1 µg/m3 (12%) increase in weekly exposure to PM2.5 increases weekly inhaler use by 0.82%. We also show that there is seasonal, regional, and income-based heterogeneity in this response. Using our response prediction, and an estimate from the literature on the willingness to pay to avoid asthma symptoms, we show that a nationwide 1 µg/m3 reduction in particulate matter concentration would generate nearly $350 million annually in economic benefits.

A sustainable and economic strategy to reduce risk antibiotic resistance genes during poultry manure bioconversion by black soldier fly Hermetia illucens larvae: Larval density adjustment.

Black soldier fly (Hermetia illucens) larvae (BSFL) are common insects that are known for bioconversion of organic waste into a sustainable utilization resource. However, a strategy to increase antibiotic resistance gene (ARG) elimination in sustainable and economic ways through BSFL is lacking. In the present study, different larval densities were employed to assess the mcr-1 and tetX elimination abilities, and potential mechanisms were investigated. The application and economic value of each larval density were also analyzed. The results showed that the 100 larvae cultured in 100 g of manure group had the best density because the comprehensive disadvantage evaluation ratio was the lowest (14.97%, good bioconversion manure quality, low ARG deposition risk and reasonable larvae input cost). Further investigation showed that mcr-1 could be significantly decreased by BSFL bioconversion (4.42 ×107 copies/g reduced to 4.79 ×106-2.14 ×105 copies/g)(P＜0.05); however, mcr-1 was increasingly deposited in the larval gut with increasing larval density. The tetX abundance was stabilized by BSFL bioconversion, except that the abundance at the lowest larval density increased (1.22 ×1010 copies/g increase, 34-fold). Escherichia was the host of mcr-1 and tetX in all samples, especially in fresh manure; Alcaligenes was the host of tetX in bioconversion manure; and the abundance of Alcaligenes was highly correlated with the pH of bioconversion manure. The pH of bioconversion manure was extremely correlated with the density of larvae. Klebsiella and Providencia were both hosts of tetX in the BSF larval gut, and Providencia was also the host of mcr-1 in the BSF larval gut. The density of larvae influenced the bioconversion manure quality and caused the ARG host abundance to change to control the abundance of ARGs, suggesting that larval density adjustment was a useful strategy to manage the ARG risk during BSFL manure bioconversion.

Economic values for production, fertility and mastitis traits for temperate dairy cattle breeds in tropical Sri Lanka.

Economic values for annual milk yield (MY, kg), annual fat yield (FY, kg), annual protein yield (PY, kg), age at first calving (AFC, days), number of services per conception (NSC), calving interval (CI, days) and mastitis episodes (MS) were derived for temperate dairy cattle breeds in tropical Sri Lanka using a bio-economic model. Economic values were calculated on a per cow per year basis. Derived economic values in rupees (LKR) for MY, FY and PY were 107, -162 and -15, while for AFC, NSC, CI and MS, economic values were -59, -270, -84 and -8,303. Economic values for FY and PY further decreased with higher feed prices, and a less negative economic value for FY was obtained with increased price for fat. Negative economic values for FY and PY show that genetic improvement for these traits is not economical due to the high feed costs and/or the insufficient payment for fat and protein. Therefore, revision of milk fat and protein payments is recommended. Furthermore, the breeding objective developed in this study was dominated by milk production and fertility traits. Adaptability and functional traits that are important in a temperate dairy cattle breeding programme in tropical Sri Lanka, such as longevity, feed efficiency, disease resistance and heat tolerance should be recorded to incorporate them in the breeding objective. Continued trait recording of all traits is recommended to ensure dairy cows can be selected more effectively in a tropical environment based on a breeding objective that also includes adaptability and functional traits.

Economic values of reproductive, growth, feed efficiency and carcass traits in Nellore cattle.

A bioeconomic model was developed to calculate the economic value (ev) of reproductive and growth performance, feed efficiency and carcass traits of a seedstock Nellore herd. Data from a full-cycle cattle operation (1,436 dams) located in the Brazilian Cerrado were assessed. The ev was calculated by the difference in profit before and after one-unit improvement in the trait, with others remaining unchanged. The ev was standardized by the phenotypic standard deviation of each trait. Preweaning average daily gain (ADG) was the most economically important trait evaluated (R$ 58.04/animal/year), followed by age at first calving (R$ 44.35), postweaning ADG (R$ 31.43), weight at 450 days (R$ 25.36), accumulated productivity (R$ 21.43), ribeye area (R$ 21.35), calving interval (R$ 19.97), feed efficiency (R$ 15.24), carcass dressing per cent (R$ 8.27), weight at 120 days (R$ 6.22), weight at 365 days (R$ 6.06), weight at weaning (210 days, R$ 5.82), stayability (R$ 5.70) and the probability of early calving (R$ 0.32). The effects of all traits on profits are evidence that their selection may result in the economic and genetic progress of the herd if there is genetic variability.

An Application of a LPWAN for Upgrading Proximal Soil Sensing Systems.

In recent years, the Internet of Things (IoT), based on low-power wide-area network (LPWAN) wireless communication technology, has developed rapidly. On the one hand, the IoT makes it possible to conduct low-cost, low-power, wide-coverage, and real-time soil monitoring in fields. On the other hand, many proximal soil sensor devices designed based on conventional communication methods that are stored in an inventory face elimination. Considering the idea of saving resources and costs, this paper applied LPWAN technology to an inventoried proximal soil sensor device, by designing an attachment hardware system (AHS) and realizing technical upgrades. The results of the experimental tests proved that the sensor device, after upgrading, could work for several years with only a battery power supply, and the effective wireless communication coverage was nearly 1 km in a typical suburban farming environment. Therefore, the new device not only retained the original mature sensing technology of the sensor device, but also exhibited ultralow power consumption and long-distance transmission, which are advantages of the LPWAN; gave full play to the application value and economic value of the devices stored in inventory; and saved resources and costs. The proposed approach also provides a reference for applying LPWAN technology to a wider range of inventoried sensor devices for technical upgrading.

Future assessment of the impact of the COVID-19 pandemic on the electricity market based on a stochastic socioeconomic model.

This paper proposes a time-series stochastic socioeconomic model for analyzing the impact of the pandemic on the regulated distribution electricity market. The proposed methodology combines the optimized tariff model (socioeconomic market model) and the random walk concept (risk assessment technique) to ensure robustness/accuracy. The model enables both a past and future analysis of the impact of the pandemic, which is essential to prepare regulatory agencies beforehand and allow enough time for the development of efficient public policies. By applying it to six Brazilian concession areas, results demonstrate that consumers have been/will be heavily affected in general, mainly due to the high electricity tariffs that took place with the pandemic, overcoming the natural trend of the market. In contrast, the model demonstrates that the pandemic did not/will not significantly harm power distribution companies in general, mainly due to the loan granted by the regulator agency, named COVID-account. Socioeconomic welfare losses averaging 500 (MR$/month) are estimated for the equivalent concession area, i.e., the sum of the six analyzed concession areas. Furthermore, this paper proposes a stochastic optimization problem to mitigate the impact of the pandemic on the electricity market over time, considering the interests of consumers, power distribution companies, and the government. Results demonstrate that it is successful as the tariffs provided by the algorithm compensate for the reduction in demand while increasing the socioeconomic welfare of the market.

The clinical and economic value of a successful shutdown during the SARS-CoV-2 pandemic in Germany.

Background and aim: A shutdown of businesses enacted during the SARS-CoV-2 pandemic can serve different goals, e.g., preventing the intensive care unit (ICU) capacity from being overwhelmed ('flattening the curve') or keeping the reproduction number substantially below one ('squashing the curve'). The aim of this study was to determine the clinical and economic value of a shutdown that is successful in 'flattening' or 'squashing the curve' in Germany. Methods: In the base case, the study compared a successful shutdown to a worst-case scenario with no ICU capacity left to treat COVID-19 patients. To this end, a decision model was developed using, e.g., information on age-specific fatality rates, ICU outcomes, and the herd protection threshold. The value of an additional life year was borrowed from new, innovative oncological drugs, as cancer reflects a condition with a similar morbidity and mortality burden in the general population in the short term as COVID-19. Results: A shutdown that is successful in 'flattening the curve' is projected to yield an average health gain between 0.01 and 0.05 life years (0.1 to 0.6 months) per capita in the German population. The corresponding economic value ranges between €616 and €4797 per capita or, extrapolated to the total population, 1%-12% of the gross domestic product (GDP) in 2019. A shutdown that is successful in 'squashing the curve' is expected to yield a minimum health gain of 0.08 life years (1 month) per capita, corresponding to 19 % of the GDP in 2019. Results are particularly sensitive to mortality data and the prevalence of undetected cases. Conclusion: A successful shutdown is forecasted to yield a considerable gain in life years in the German population. Nevertheless, questions around the affordability and underfunding of other parts of the healthcare system emerge.

Leveraging the Contribution of Volunteers: The Critical Role and Economic Value of Volunteers in Older Americans Act Programs.

The United States is facing a surge in the aging population, which will increase the demand for services and supports that allow older adults to age independently. This study assessed the size and value of the volunteer labor force in two home- and community-based programs funded under the Older Americans Act (OAA). Using publicly available program data for fiscal years 2015-2019, we calculated the annual contribution of volunteers, based on the total number of volunteer hours and share of labor effort, and estimated the economic value of volunteers in these OAA programs. In fiscal year 2019, volunteers contributed a total value of $1.7 billion in the OAA Title III program and $14.0 million in the Title VII long-term care ombudsman program. These results highlight the value of volunteers in OAA programs and the need for policies to support volunteers in the aging services network.