Although infliximab (IFX) is effective for inducing and maintaining remission in patients with Crohn’s disease (CD), it is much more expensive than other treatments. The aim of this study is to evaluate the cost-effe...Although infliximab (IFX) is effective for inducing and maintaining remission in patients with Crohn’s disease (CD), it is much more expensive than other treatments. The aim of this study is to evaluate the cost-effectiveness of several therapies, including IFX, for moderately to severely active CD. A Markov cohort model was constructed to simulate treatment effectiveness and costs. Transition probabilities, utilities, direct medical costs, and productivity costs were estimated using the results of published research. The primary effectiveness measurement was quality-adjusted life years (QALYs), as estimated by the 15D instrument. Expected effectiveness and total costs were calculated for a 10-year period using a yearly discount rate of 3% for QALYs and costs. Multiple one-way sensitivity analyses were performed by varying parameters that were likely to change QALYs and costs. As compared with nonbiologic therapy, therapy with IFX alone resulted in more QALYs and lower costs for the 10-year period. Combination therapy with IFX and elemental diet yielded an additional 0.252 QALYs at an additional cost of $18,522 as compared with nonbiologic therapy over 10 years. The resulting incremental cost-effectiveness ratio (ICER) of combination therapy vs nonbiologic therapy was $73,500/QALY. Patient body weight was the most important factor for cost-effectiveness. In conclusion it was revealed that combination therapy with IFX plus elemental diet appears not to be a cost-effective treatment for moderately to severely active CD.展开更多
Traditional project effort estimation utilizes development models that span the entire project life cycle and thus culminates estimation errors. This exploratory research is the first attempt to break each project act...Traditional project effort estimation utilizes development models that span the entire project life cycle and thus culminates estimation errors. This exploratory research is the first attempt to break each project activity down to smaller work elements. There are eight work elements, each of which is being defined and symbolized with visually distinct shape. The purpose is to standardize the operations associated with the development process in the form of a visual symbolic flow map. Hence, developers can streamline their work systematically. Project effort estimation can be determined based on these standard work elements that not only help identify essential cost drivers for estimation, but also reduce latency cost to enhance estimation efficiency. Benefits of the proposed work element scheme are project visibility, better control for immediate pay-off and, in long term management, standardization for software process automation.展开更多
文摘Although infliximab (IFX) is effective for inducing and maintaining remission in patients with Crohn’s disease (CD), it is much more expensive than other treatments. The aim of this study is to evaluate the cost-effectiveness of several therapies, including IFX, for moderately to severely active CD. A Markov cohort model was constructed to simulate treatment effectiveness and costs. Transition probabilities, utilities, direct medical costs, and productivity costs were estimated using the results of published research. The primary effectiveness measurement was quality-adjusted life years (QALYs), as estimated by the 15D instrument. Expected effectiveness and total costs were calculated for a 10-year period using a yearly discount rate of 3% for QALYs and costs. Multiple one-way sensitivity analyses were performed by varying parameters that were likely to change QALYs and costs. As compared with nonbiologic therapy, therapy with IFX alone resulted in more QALYs and lower costs for the 10-year period. Combination therapy with IFX and elemental diet yielded an additional 0.252 QALYs at an additional cost of $18,522 as compared with nonbiologic therapy over 10 years. The resulting incremental cost-effectiveness ratio (ICER) of combination therapy vs nonbiologic therapy was $73,500/QALY. Patient body weight was the most important factor for cost-effectiveness. In conclusion it was revealed that combination therapy with IFX plus elemental diet appears not to be a cost-effective treatment for moderately to severely active CD.
文摘Traditional project effort estimation utilizes development models that span the entire project life cycle and thus culminates estimation errors. This exploratory research is the first attempt to break each project activity down to smaller work elements. There are eight work elements, each of which is being defined and symbolized with visually distinct shape. The purpose is to standardize the operations associated with the development process in the form of a visual symbolic flow map. Hence, developers can streamline their work systematically. Project effort estimation can be determined based on these standard work elements that not only help identify essential cost drivers for estimation, but also reduce latency cost to enhance estimation efficiency. Benefits of the proposed work element scheme are project visibility, better control for immediate pay-off and, in long term management, standardization for software process automation.
