Price, quality, and market dynamics of malaria rapid diagnostic tests: analysis of Global Fund 2009-2018 data.

BACKGROUND: Rapid diagnostic tests (RDTs) for malaria are a vital part of global malaria control. Over the past decade, RDT prices have declined, and quality has improved. However, the relationship between price and product quality and their larger implications on the market have yet to be characterized. This analysis used purchase data from the Global Fund together with product quality data from the World Health Organization (WHO) and Foundation for Innovative New Diagnostics (FIND) Malaria RDT Product Testing Programme to understand three unanswered questions: (1) Has the market share by quality of RDTs in the Global Fund's procurement orders changed over time? (2) What is the relationship between unit price and RDT quality? (3) Has the market for RDTs financed by the Global Fund become more concentrated over time? METHODS: Data from 10,075 procurement transactions in the Global Fund's database, which includes year, product, volume, and price, was merged with product quality data from all eight rounds of the WHO-FIND programme, which evaluated 227 unique RDT products. To describe trends in market share by quality level of RDT, descriptive statistics were used to analyse trends in market share from 2009 to 2018. A generalized linear regression model was then applied to characterize the relationship between price and panel detection score (PDS), adjusting for order volume, year purchased, product type, and manufacturer. Third, a Herfindahl-Hirschman Index (HHI) score was calculated to characterize the degree of market concentration. RESULTS: Lower-quality RDTs have lost market share between 2009 and 2018, as have the highest-quality RDTs. No statistically significant relationship between price per test and PDS was found when adjusting for order volume, product type, and year of purchase. The HHI was 3,570, indicating a highly concentrated market. CONCLUSIONS: Advancements in RDT affordability, quality, and access over the past decade risk stagnation if health of the RDT market as a whole is neglected. These results suggest that from 2009 to 2018, this market was highly concentrated and that quality was not a distinguishing feature between RDTs. This information adds to previous reports noting concerns about the long-term sustainability of this market. Further research is needed to understand the causes and implications of these trends.

Examining effects of unit price on preference for reduced nicotine content cigarettes and smoking rate.

Cigarette preference increases as a function of greater nicotine content, but manipulating cost can shift preference. The aims of the present study are to model whether (1) the behavioral-economic metric unit price (cost/reinforcer magnitude) accounts for preference shifts and (2) whether preference shifts toward reduced nicotine content are associated with smoking reductions. In a multisite study between 2015 and 2016, 169 daily smokers from vulnerable populations completed two concurrent-choice conditions examining preference for smoking normal (15.8 mg/g) and reduced (0.4 mg/g) nicotine content cigarettes. In Condition 1, both products were available at 10 responses/choice. In Condition 2, availability of the 0.4 mg/g dose remained at 10 responses/choice while the 15.8 mg/g dose was available on a progressive-ratio (PR) schedule wherein response cost increased following each choice. Unit prices were calculated by dividing dose by response requirement. Results were analyzed using ANOVA and binomial tests (p < .05). Participants preferred the 15.8 over 0.4 mg/g dose in Condition 1, but shifted preference to the 0.4 mg/g dose in Condition 2 (p < .001) immediately before the point in the PR progression where unit price for 15.8 dose exceeded unit price for the 0.4 dose (p < .001). This shift was associated with a reduction in smoking (p < .001). The unit price of nicotine appears to underpin cigarette product preference and may provide a metric for predicting preference and potentially impacting it through tobacco regulations. These results also demonstrate that reduced compared to normal nicotine content cigarettes sustain lower smoking rates discernible even under acute laboratory conditions and in vulnerable populations.

[Analysis of characteristics and problems of international trade of wolfberry in China].

Wolfberry has important unique medical values as well as edible and commerce values. In this paper,we analyze the characteristics and problems of international trade of wolfberry based on the customs data between 2008 and 2017. During periods of these ten years,the wolfberry was mainly exported with a small proportions of imports. The total export volume increased steadily,reached 82 182. 08 tons and 696. 622 million dollars respectively. Wolfberry came from 31 provinces/autonomous regions and exported to 105 countries and regions through 21 ports. Most of the total exports of wolfberry flew to markets of Asia and Europe,the Ningxia autonomous region was the major export province. Large amount of wolfberry exported through Tianjin port. Compared with the export volume,the import is almost negligible,mainly coming from North Korea,almost all through Changchun port,Jilin province to enter the domestic market. There is a situation of"import of domestic goods". To enhance the international competitiveness of wolf berry industry,we must rely on the fundamental research of wolfberry,speed up the standardization process,strengthen the scientific and technological innovation in wolfberry products,improve the added value and profit of wolfberry.

[Analysis of characteristics and problems of international trade of Poria cocos in China].

Poria cocos is one of medical materials frequently used in China and well marketed at home and abroad. Based on the analysis of exports and imports data of P. cocos, we found that large proportions of P. cocos were exported, while only a small proportions of those were imported in China between 2011 and 2016. During periods of these six years, the annual exporting trade of P. cocos in quantity significantly decreased, but that in dollars tend to increase slightly and the unit-prices of P. cocos significantly increased. Statistically, the average annual export trade of P. cocos from 2011 to 2016 in quantity and dollars were 9 279.73 tons and 35.454 million dollars, respectively. And the average annual export in unit-price was 4.14 dollars per kilogram. In total, P. cocos came from 29 provinces and exported to 44 countries through 21 ports. More than 98% of total exports of P. cocos were flew to the markets of countries in Asia, of which Hong Kong was the major partner in import trade of P. cocos. Large amount of P. cocos came from Guangdong province and exported mainly through Shenzhen port. Except the exports, China also imports P. cocos from other countries, among which Korea was the major country exports largest amount of P. cocos to China. And most of P. cocos were imported by Jilin province and mainly through Changchun port. To improve the export kinetic, quality and profits of P. cocos, and thus enhance the international competitiveness of the industry of P. cocos, Chinese governments should emphasize the researches on the products of P. cocos, broaden the demand space of the high-end customers, stimulate the high-end market grow in high speed and accelerate the process of standardization in future.

The Effect of Introducing a Minimum Price on the Distribution of Alcohol Purchase: A Counterfactual Analysis.

We use counterfactual analysis techniques to evaluate the impact of a $2 minimum unit price (MUP) on the distribution of Australian (Victorian) household off-trade alcohol purchases. Our estimates suggest that a $2 MUP significantly reduces the purchases of at-risk households by up to -0.92 [90% CI: -1.55, -0.28] standard drinks at the highest quantiles and has substantially less effect on households purchasing at light and moderate levels. A $2 MUP may reduce the proportions of male and female shoppers purchasing at the public health threshold of more than two standard drinks per household member per day by -3.03 [90% CI: -4.83, -1.22] percentage points (relative variation: -17%); and -1.85 [90% CI: -2.60, -1.10] percentage points (relative variation:-22%), respectively. Implementing an MUP on alcohol thus promises significant positive impacts on public health. Copyright © 2016 John Wiley & Sons, Ltd.

Restricted temporal access to food and anorexia in mice: Microstructure of eating within feeding opportunities.

Intake and body weight were recorded in a closed economy as male and female C57BL/6 mice progressed through either fixed interval (FI) or fixed unit price (FUP) schedules of cost for 20-mg food pellets. Access to food was constrained to four 40 min food opportunities (FOs) per day, spaced 4-h apart through the dark phase. Nose poke responses and pellet deliveries were collected at 10-s resolution to allow pellet-by-pellet analysis. In the FI protocol, mice maintained adequate food intake and body weight through the study, even though at the highest FI (50-s) they spent the entire 40-min FOs engaged in eating at or near the maximum rate allowed by the schedule. In the FUP protocol, mice greatly reduced their intake and lost weight at the highest FUP (50 responses/pellet). The analysis of response and pellet distributions showed these mice were not filling the FOs with responding and ate less at dusk (FO #1) and dawn (FO #4) than at FOs #2 and 3 in the middle of the night. The principal, and unexpected, sex difference was that females tended to eat more than males despite lower body weight, but behavioral changes as a function of feeding cost or schedule were qualitatively similar in both sexes. These results show that slow eating as imposed by an FI is not sufficient to produce hypophagia and, in the FUP protocol, hypophagia cannot be explained by slowed eating due to response requirements. We discuss the role of effort or time in FUP-induced anorexia, and suggest this murine model may emulate some aspects of human anorexia nervosa better than current activity-based protocols.

Alcoholic liver disease - the extent of the problem and what you can do about it.

It takes upwards of ten years for alcohol-related liver disease to progress from fatty liver through fibrosis to cirrhosis to acute on chronic liver failure. This process is silent and symptom free and can easily be missed in primary care, usually presenting with advanced cirrhosis. At this late stage, management consists of expert supportive care, with prompt identification and treatment of bleeding, sepsis and renal problems, as well as support to change behaviour and stop harmful alcohol consumption. There are opportunities to improve care by bringing liver care everywhere up to the standards of the best liver units, as detailed in the Lancet Commission report. We also need a fundamental rethink of the technologies and approaches used in primary care to detect and intervene in liver disease at a much earlier stage. However, the most effective and cost-effective measure would be a proper evidence-based alcohol strategy.

Impact of minimum price per unit of alcohol on patients with liver disease in the UK.

The slow epidemic of liver disease in the UK over the past 30 years is a result of increased consumption of strong cheap alcohol. When we examined alcohol consumption in 404 subjects with a range of liver disease, we confirmed that patients with alcohol-related cirrhosis drank huge amounts of cheap alcohol, with a mean weekly consumption of 146 units in men and 142 in women at a median price of 33p/unit compared with £1.10 for low-risk drinkers. For the patients in our study, the impact of a minimum unit price of 50p/unit on spending on alcohol would be 200 times higher for patients with liver disease who were drinking at harmful levels than for low-risk drinkers. As a health policy, a minimum unit price for alcohol is exquisitely targeted at the heaviest drinkers, for whom the impact of alcohol-related illness is most devastating.

Image analysis traits of multiple muscles and intermuscular/subcutaneous fat influence Japanese Black beef carcass price and genetic parameters.

OBJECTIVE: The purposes of this study were to investigate the relationship between carcass unit price per 1 kg (UP) and multiple muscles and intermuscular fat (IF)/subcutaneous fat of beef carcasses using image analysis of cross-section images for Wagyu beef cattle in Japan, and to estimate their genetic parameters. METHODS: The carcasses used in this study were 1,807 Japanese Black (Wagyu) cattle (1,216 steers and 591 heifers). An analysis of variance was conducted with UP as the dependent variable and market date, age in months, sex, and image analysis traits (IAT) as fixed effects, and standard partial regression coefficients were calculated for each IAT on UP. Also, the heritability of each IAT that affected UP and genetic correlation among IAT vs carcass grading traits were estimated. RESULTS: Not only IAT related to carcass grading traits, M. trapezius dorsi, M. latissimus dorsi, and IF traits were significant differences in UP (p<0.05). The heritability of IAT associated with UP was estimated at 0.38 to 0.85. The genetic correlations between the area and thickness of M. trapezius dorsi and M. latissimus dorsi vs rib eye area (REA) were estimated to be moderately positive (0.53 to 0.66), while the genetic correlations between the IF area percentage vs carcass weight, REA, and yield score were estimated to be negative (-0.40, -0.56, and -0.34). CONCLUSION: UP was influenced by various traits, including M. trapezius dorsi, M. latissimus dorsi, and IF traits, as well as image analysis associated with carcass grading traits. Since these IAT associated with UP had hereditary and desirable genetic correlations with carcass grading traits, these traits were also important for genetic improvement.

Modelling the impacts of volumetric and minimum unit pricing for alcohol on social harms in Australia.

AIMS: Alcohol pricing policies may reduce alcohol-related harms, yet little work has been done to model their effectiveness beyond health outcomes especially in Australia. We aim to estimate the impacts of four taxation and minimum unit pricing (MUP) interventions on selected social harms across sex and age subgroups in Australia. METHODS: We used econometrics and epidemiologic simulations using demand elasticity and risk measures. We modelled four policies including (A) uniform excise rates (UER) (based on alcohol units) (B) MUP $1.30 on all alcoholic beverages (C) UER + 10 % (D) MUP$ 1.50. People who consumed alcohol were classified as (a) moderate (≤ 14 Australian standard drinks (SDs) per week) (b) Hazardous (15-42 SDs per week for men and 14-35 ASDs for women) and (c) Harmful (> 42 SDs per week for men and > 35 ASDs for women). Outcomes were sickness absence, sickness presenteeism, unemployment, antisocial behaviours, and police-reported crimes. We used relative risk functions from meta-analysis, cohort study, cross-sectional survey, or attributable fractions from routine criminal records. We applied the potential impact fraction to estimate the reduction in social harms by age group and sex after implementation of pricing policies. RESULTS: All four modelled pricing policies resulted in a decrease in the overall mean baseline of current alcohol consumption, primarily due to fewer people drinking harmful amounts. These policies also reduced the total number of crimes and workplace harms compared to the current taxation system. These reductions were consistent across all age and sex subgroups. Specifically, sickness absence decreased by 0.2-0.4 %, alcohol-related sickness presenteeism by 7-9 %, unemployment by 0.5-0.7 %, alcohol-related antisocial behaviours by 7.3-11.1 %, and crimes by 4-6 %. Of all the policies, the implementation of a $1.50 MUP resulted in the largest reductions across most outcome measures. CONCLUSION: Our results highlight that alcohol pricing policies can address the burden of social harms in Australia. However, pricing policies should just form part of a comprehensive alcohol policy approach along with other proven policy measures such as bans on aggressive marketing of alcoholic products and enforcing the restrictions on the availability of alcohol through outlet density regulation or reduced hours of sale to have a more impact on social harms.

The effect of a minimum price per unit of alcohol in Scotland on alcohol-related ambulance call-outs: A controlled interrupted time-series analysis.

BACKGROUND AND AIMS: On 1 May 2018, Scotland introduced a minimum unit price (MUP) of £0.50 for alcohol, with one UK unit of alcohol being 10 ml of pure ethanol. This study measured the association between MUP and changes in the volume of alcohol-related ambulance call-outs in the overall population and in call-outs subsets (night-time call-outs and subpopulations with higher incidence of alcohol-related harm). DESIGN: An interrupted time-series (ITS) was used to measure variations in the daily volume of alcohol-related call-outs. We performed uncontrolled ITS on both the intervention and control group and a controlled ITS built on the difference between the two series. Data were from electronic patient clinical records from the Scottish Ambulance Service. SETTING AND CASES: Alcohol-related ambulance call-outs (intervention group) and total ambulance call-outs for people aged under 13 years (control group) in Scotland, from December 2017 to March 2020. MEASUREMENTS: Call-outs were deemed alcohol-related if ambulance clinicians indicated that alcohol was a 'contributing factor' in the call-out and/or a validated Scottish Ambulance Service algorithm determined that the call-out was alcohol-related. FINDINGS: No statistically significant association in the volume of call-outs was found in both the uncontrolled series [step change = 0.062, 95% confidence interval (CI) = -0.012, 0.0135 P = 0.091; slope change = -0.001, 95% CI = -0.001, 0.1 × 10-3 P = 0.139] and controlled series (step change = -0.01, 95% CI = -0.317, 0.298 P = 0.951; slope change = -0.003, 95% CI = -0.008, 0.002 P = 0.257). Similarly, no significant changes were found for the night-time series or for any population subgroups. CONCLUSIONS: There appears to be no statistically significant association between the introduction of minimum unit pricing for alcohol in Scotland and the volume of alcohol-related ambulance call-outs. This was observed overall, across subpopulations and at night-time.

Evaluating the impact of minimum unit pricing for alcohol on road traffic accidents in Scotland after 20 months: An interrupted time series study.

BACKGROUND AND AIMS: On 1 May 2018, Scotland implemented Minimum Unit Pricing (MUP) of £0.50 per unit of alcohol with the aim to lower alcohol consumption and related harms, and reduce health inequalities. We measured the impact of MUP on the most likely categories of road traffic accidents (RTAs) to be affected by drink-driving episodes (fatal and nighttime) up to 20 months after the policy implementation. Further, we checked whether any association varied by level of socio-economic deprivation. METHODS: An interrupted time series design was used to evaluate the impact of MUP on fatal and nighttime RTAs in Scotland and any effect modification across socio-economic deprivation groups. RTAs in England and Wales (E&W) were used as a comparator. Covariates representing severe weather events, bank holidays, seasonal and underlying trends were adjusted for. RESULTS: In Scotland, MUP implementation was associated with 40.5% (95% confidence interval: 15.5%, 65.4%) and 11.4% (-1.1%, 24.0%) increases in fatal and nighttime RTAs, respectively. There was no evidence of differential impacts of MUP by level of socio-economic deprivation. While we found a substantial increase in fatal RTAs associated with MUP, null effects observed in nighttime RTAs and high uncertainty in sensitivity analyses suggest caution be applied before attributing causation to this association. CONCLUSION: There is no evidence of an association between the introduction of minimum unit pricing for alcohol in Scotland and a reduction in fatal and nighttime road traffic accidents, these being outcome measure categories that are proxies of outcomes that directly relate alcohol consumption to road traffic accidents.

Effect of carcass traits on carcass prices of holstein steers in Korea.

The present study investigated the contribution of carcass traits on carcass prices of Holstein steers in Korea. Phenotypic data consisted of 76,814 slaughtered Holsteins (1 to 6 yrs) from all over Korea. The means for live body weight at slaughter (BWT), chilled carcass weight (CWT), dressing percentage (DP), quantity grade index (QGI), eye muscle area (EMA), backfat thickness (BF) and marbling score (MS), carcass unit price (CUP), and carcass sell prices (CSP) were 729.0 kg, 414.2 kg, 56.79%, 64.42, 75.26 cm(2), 5.77 mm, 1.98, 8,952.80 Korean won/kg and 3,722.80 Thousand Korean won/head. Least squares means were significantly different by various age groups, season of slaughter, marbling scores and yield grades. Pearson's correlation coefficients of CUP with carcass traits ranged from 0.12 to 0.62. Besides, the relationships of carcass traits with CSP were relatively stronger than those with CUP. The multiple regression models for CUP and CSP with carcass traits accounted 39 to 63% of the total variation, respectively. Marbling score had maximum economic effects (partial coefficients) on both prices. In addition, the highest standardized partial coefficients (relative economic weights) for CUP and CSP were calculated to be on MS and CWT by 0.608 and 0.520, respectively. Path analyses showed that MS (0.376) and CWT (0.336) had maximum total effects on CUP and CSP, respectively; whereas BF contributed negatively. Further sub-group (age and season of slaughter) analyses also confirmed the overall outcomes. However, the relative economic weights and total path contributions also varied among the animal sub-groups. This study suggested the significant influences of carcass traits on carcass prices; especially MS and CWT were found to govern the carcass prices of Holstein steers in Korea.

Which alcohol products might be affected by the introduction of a minimum unit price in Western Australia? Findings from a survey of alcohol retail prices.

INTRODUCTION: Minimum unit price (MUP) policies establish a retail floor price below which alcohol may not be sold, and have been shown to reduce harmful alcohol use. We aimed to collect retail price data to estimate the proportion of alcohol products that would potentially be impacted by a MUP policy in Western Australia. METHODS: We purposively sampled the four largest off-premises alcohol retail chains, a further random sample of other off-premise alcohol outlets (n = 16) and on-premise inner-city outlets (n = 11). Using website data from May to June 2021, we estimated the proportion of products across four beverage categories priced ≤A$1.30, ≤A$1.50 and ≤A$1.75 per standard drink (10 g alcohol). RESULTS: Of 27,797 off-premise products identified, 5.7% were available at ≤$1.30 per standard drink, 7.6% at ≤$1.50 and 10.4% at ≤$1.75. The proportion of products available at ≤$1.30 per standard drink varied by beverage category: 7.8% wine, 2.9% beer and cider, <0.1% spirits, 0.0% ready-to-drink spirits. Cask-packaged wines represented only 1.9% of off-premise wine products and 98.9% of this cask wine was priced ≤$1.30 per standard drink. No on-premise products were priced ≤$1.75 per standard drink. DISCUSSION AND CONCLUSIONS: A comprehensive survey of alcohol prices in Western Australia found only a small proportion of products would potentially be affected by a MUP of $1.30 to $1.75 per standard drink. A MUP policy has potential to target the small proportion of alcohol products available at very low prices (i.e., off-premise cask wine), with negligible impact on other off-premise beverage categories, and no impact on on-premises products.

Estimating the impact of the minimum alcohol price on consumers' alcohol expenditure in the Northern Territory, Australia.

OBJECTIVE: From October 2018, the Northern Territory (NT) government introduced a minimum unit price (MUP) for alcohol of $1.30 per standard drink. We assessed industry claims that the MUP penalised all drinkers by examining the alcohol expenditure of drinkers not targeted by the policy. METHODS: Participants recruited by a market research company using phone sampling (n=766, 15% consent fraction) completed a survey in 2019, post-MUP. Participants reported their drinking patterns and their preferred liquor brand. Estimated annual alcohol expenditure for each participant was calculated by collating the cheapest advertised price per standard drink of their preferred brand pre-and-post-MUP. Participants were grouped as consuming within the Australian drinking guidelines ("moderate") or over them ("heavy"). RESULTS: Based on post-MUP drinking patterns, moderate consumers had an average annual alcohol expenditure of AU$327.66 (CIs=325.61, 329.71) pre-MUP, which increased by AU$3.07 (0.94%) post-MUP. Heavy consumers had an estimated average annual alcohol expenditure of AU$2898.82 (CIs=2877.06, 2920.58) pre-MUP, which increased by AU$37.12 (1.28%). CONCLUSIONS: The MUP policy was associated with an increase of AU$3.07 in alcohol annual expenditure for moderate consumers. IMPLICATIONS FOR PUBLIC HEALTH: This article provides evidence that counters the alcohol industry's messaging, enabling an evidence-based discussion in an area dominated by vested interest.

The Blinded-Dose Purchase Task: assessing hypothetical demand based on cocaine, methamphetamine, and alcohol administration.

RATIONALE: Behavioral economic drug purchase tasks quantify the reinforcing value of a drug (i.e., demand). Although widely used to assess demand, drug expectancies are rarely accounted for and may introduce variability across participants given diverse drug experiences. OBJECTIVES: Three experiments validated and extended previous hypothetical purchase tasks by using blinded drug dose as a reinforcing stimulus, and determined hypothetical demand for experienced effects while controlling for drug expectancies. METHODS: Across three double-blind, placebo-controlled, within-subject experiments, cocaine (0, 125, 250 mg/70 kg; n=12), methamphetamine (0, 20, 40 mg; n=19), and alcohol (0, 1 g/kg alcohol; n=25) were administered and demand was assessed using the Blinded-Dose Purchase Task. Participants answered questions regarding simulated purchasing of the blinded drug dose across increasing prices. Demand metrics, subjective effects, and self-reported real-world monetary spending on drugs were evaluated. RESULTS: Data were well modeled by the demand curve function, with significantly higher intensity (purchasing at low prices) for active drug doses compared to placebo for all experiments. Unit-price analyses revealed more persistent consumption across prices (lower α) in the higher compared to lower active dose condition for methamphetamine (a similar non-significant finding emerged for cocaine). Significant associations between demand metrics, peak subjective effects, and real-world spending on drugs also emerged across all experiments. CONCLUSIONS: Orderly demand curve data revealed differences across drug and placebo conditions, and relations to real-world measures of drug spending, and subjective effects. Unit-price analyses enabled parsimonious comparisons across doses. Results lend credence to the validity of the Blinded-Dose Purchase Task, which allows for control of drug expectancies.

The Effect of Minimum Unit Pricing for Alcohol on Prescriptions for Treatment of Alcohol Dependence: A Controlled Interrupted Time Series Analysis.

In 2018, Scotland introduced a minimum unit price (MUP) for alcohol to reduce alcohol-related harms. We aimed to study the association between MUP introduction and the volume of prescriptions to treat alcohol dependence, and volume of new patients receiving such prescriptions. We also examined whether effects varied across different socio-economic groups. A controlled interrupted time series was used to examine variations of our two outcomes. The same prescriptions in England and prescriptions for methadone in Scotland were used as controls. There was no evidence of an association between MUP implementation and the volume of prescriptions for alcohol dependence (immediate change: 2.74%, 95% CI: -0.068 0.014; slope change: 0% 95%CI: -0.001 0.000). A small, significant increase in slope in number of new patients receiving prescriptions was observed (0.2% 95%CI: 0.001 0.003). However, no significant results were confirmed after robustness checks. We found also no variation across different socioeconomic groups. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-023-01070-6.

A wastewater-based assessment of the impact of a minimum unit price (MUP) on population alcohol consumption in the Northern Territory, Australia.

AIM: To test if there was a reduction in alcohol consumption in wastewater samples in the Northern Territory of Australia after the implementation of a minimum unit alcohol price policy (MUP) in October 2018. DESIGN, SETTING, CASES: Between August 2016 and February 2020, wastewater samples were collected across 66 sites in the Northern Territory and all other states and territories in Australia. Samples were collected every 2 months in capital cities and every 4 months in regional places during this period. Overall, 4917 samples were taken (2816 before MUP and 2101 after). MEASUREMENTS: The number of standard drinks per 1000 people per day in the respective catchment areas was estimated based on the concentration of an alcohol-specific metabolite, ethyl sulphate in the samples (using the excretion factor of ethyl sulphate, the flow of wastewater entering the wastewater treatment plants and the population of each wastewater catchment). FINDINGS: Results from a linear mixed model showed that there was a large drop in alcohol consumption immediately after the MUP in Northern Territory [estimated drop = 1231, 99% confidence interval (CI) = 830, 1633; 38.75%]. There was no significant drop in all other states/territories except for Queensland, which showed a significant but much smaller drop (estimated drop: 310; 99% CI = 114, 550). One year after the MUP, the drop narrowed to 520 (99% CI = 189, 851) and was no longer statistically significant in February 2020 (15 months after MUP; estimated drop = 283, 99% CI = -114, 681). CONCLUSIONS: Per-capita consumption of alcohol appears to have decreased substantially in the Northern Territory of Australia immediately after the implementation of a minimum unit price but consumption steadily recovered and almost returned to the pre-MUP consumption level after 15 months.

Impact of minimum unit pricing on shifting purchases from higher to lower strength beers in Scotland: Controlled interrupted time series analyses, 2015-2020.

INTRODUCTION: On 1 May 2018 Scotland introduced a minimum unit price (MUP) of GB50 pence per unit of alcohol (8 g) sold. We analysed household purchase data to assess the impact of MUP in shifting purchases from higher to lower strength beers. METHODS: Data from Kantar Worldpanel's household shopping panel, with 75 376 households and 4.76 million alcohol purchases, 2015-2020. We undertook interrupted time series analyses of the impact of introducing MUP in Scotland on changes in the proportion of the volume of purchased beer with an alcohol by volume (ABV) ≤3.5% using purchases in England as control. We analysed the moderating impact of the volume of purchased beer with an ABV ≤3.5% on the size of the associated impact of MUP in reducing purchases of grams of alcohol within beer. RESULTS: MUP was associated with a relative increase in the proportion of the volume of beer purchased with an ABV ≤3.5%, Scotland minus England, of 10.9% (95% CI 10.6-11.1), following a 43.6% (95% CI 40.1-47.1) increase in the volume of beer purchased with an ABV ≤3.5%, and a 9.6% (95% CI 9.4-9.8) decrease in the volume of beer purchased with an ABV >3.5%. MUP was associated with reduced purchases of grams of alcohol within beer by 8% (95% CI 7.8-8.3), increasing to 9.6% (95% CI 9.3-9.9), when accounting for the moderating impact of shifts to lower strength beer. DISCUSSION AND CONCLUSIONS: MUP seems an effective policy to reduce off-trade purchases of alcohol and encourage shifts to lower strength beers.

Within- and across-session increases in work requirement do not produce similar response output.

Demand curve fitting is a method of data analysis for interpreting reinforcer consumption. These methods were established and validated by examining increases in unit price (UP) across sessions. An alternative experimental preparation is the progressive-ratio (PR) schedule in which schedule requirements increase within a session. Although PR schedules provide an efficient alternative to traditional evaluations of UP, using demand curves to interpret data obtained via PR schedules has not been systematically evaluated in applied contexts. In this study, the experimenters compared demand curves constructed based on across- and within-session increases in UP and evaluated correspondence between the two methods. Results indicated poor correspondence between demand curves constructed with the two methods. Furthermore, within-session measures of responding suggest that higher rates of problem behavior and longer durations of postreinforcement pauses were more likely under PR schedules than fixed-ratio schedules. Results are discussed in terms of implications for clinical application.