A study on the quantity, type, economic value and reasons for pharmaceutical waste returned to pharmacies in Finland

INTRODUCTION

Some medicines purchased are not used, resulting in pharmaceutical waste. Finland, among many other countries, is seeking to reduce the amount of pharmaceutical waste, but little information on this is currently available. This study aimed to evaluate the quantity, type, economic value, and reasons for returning pharmaceutical waste from households to community pharmacies in Finland.

METHODS

Community pharmacies (n = 82) quantified and qualified the amount of pharmaceutical waste returned to them over three days in May 2022. The data was collected using an electronic form. The reasons for returning medicines were asked from customers who returned medicines using a paper questionnaire. The data was analyzed for frequencies and percentages. To estimate the economic value, we used the Finnish medicines prices at the end of June 2022. The annual economic value was calculated by means of a pharmacy size-weighted average. The confidence intervals were estimated using the non-parametric bootstrap method. Sensitivity analyses were conducted to examine the reliability of the results.

RESULTS

In total, 5173 medicines were returned to pharmacies, of which 66 % were prescription medicines. The most common medicines group returned were medicines for nervous system (18 %), respiratory system (16 %), and alimentary tract and metabolism (12 %). The estimated annual economic value of the medicines returned was 81 million euros (CI 95 % M€61-M€103), of which the cost to society was 43 million euros (CI 95 % M€30-M€60). 799 customers responded to the questionnaire (Response rate 81.9 %). The limited shelf life of the medicine after opening (36 %), improvement of the medical condition or symptom (25 %), and the unnecessarily large pack size (22 %) were common reasons for returning.

CONCLUSION

A considerable amount of pharmaceutical waste is returned to pharmacies, causing unnecessary costs to both individuals and society, indicating the need to reduce waste. The limited shelf life and large pack sizes of medicines account for a large proportion of causes for household pharmaceutical waste. Reducing pharmaceutical waste requires action from all actors in the pharmaceutical chain.

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.

Economic costs of the invasive Yellow-legged hornet on honey bees

Biological invasions have ecological impacts worldwide with potential massive economic costs. Among other ecosystem services such as nitrogen cycle, carbon sequestration and primary production, invasive alien species are particularly known to impact pollination. By predating honey bees (Apis mellifera), the invasive Yellow-legged hornet (Vespa velutina nigrithorax) increases the mortality risk of European bee colonies; however, little is known about its economic costs. We developed an analytic process combining large-scale field data, niche modelling techniques and agent-based models to spatially assess the ecological and economic impacts of the Yellow-legged hornet on honey bees and beekeeping in France. In particular, we estimated (i) the hornet-related risk of bee colony mortality, (ii) the economic cost of colony loss for beekeepers and (iii) the economic impact of livestock replacement compared to honey revenues at regional and national scales. We estimated an overall density of 1.08 hornet nest/km2 in France, based on the field record of 1260 nests over a searched area of 28,348 km2. However, this predator density was heterogeneously spread out across the country as well as the distribution of managed honey bee colonies. Overall, this hornet-related risk of bee colony mortality could reach up to 29.2 % of the beekeepers' livestock at national scale each year in high predation scenario. This national cost could reach as much as € 30.8 million per year due to colony loss, which represents for beekeepers an economic impact of livestock replacement of 26.6 % of honey revenues. Our results suggest non-negligible ecological and economic impacts of the invasive Yellow-legged hornet on honey bees and beekeeping activities. Moreover, this study meets the urgent need for more numerous and accurate economic estimations, necessary to calculate the impact of biological invasions on biodiversity and human goods, with a view to enhance policies of biodiversity conservation.

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.

Mining-induced changes in ecosystem services value and implications of their economic and relational cost in a mining landscape, Ghana

The surge in mining operations to meet the global demand for mineral resources adversely impacts ecosystem services and dependent households, but the issue barely attracts attention. This study evaluated the dynamics of mining-induced changes in the value of ecosystem services (ES) and the consequent economic and relational cost to rural households in the Ahafo region of Ghana. Face-to-face structured interviews with 200 householders were conducted in three mining communities. We determined relational values in the landscape through focus group discussion and the economic cost of the ecosystem services lost by applying replacement and contingency cost estimations. Old-growth forests, degraded forests, teak plantations, cultivated land, wetlands, and grassland were ecosystems identified in the mining landscape. The most valued ecosystem was old-growth forest, while the least was grassland. Provisioning service was the most valued ES, while supporting service was the least. Provisioning ES was rated the most impacted by the mine, whereas cultural services were the least affected. Mining activities caused a significant loss of 14 ecosystem services (including crops, livestock, capture fisheries, wild food, bush meat, biomass fuel, and freshwater) that were of priority to the communities. The affected households experienced relatively high monthly economic costs, approximating $300 per household, from the loss of priority ecosystem services. Canonical correspondence analysis revealed connections between ecosystem services valuation and the socio-demographic characteristics of the respondents. There was a perceived mine-adverse effect on the relational values of the people relating to cultural identity, sovereignty, symbolic value, security, subsistence and livelihood, sense of place, social cohesion, social memory, female emotional/mental health, and womanhood training opportunities. Actors in the mining industry should consider policies and management interventions that will limit ecosystem services loss, widely ascertain ecosystem benefits, and comprehensively mitigate the impact of their loss on households.

Prospects of recycling from end-of-life of Li-ion batteries on alleviating materials demand-supply gap in new electric vehicles in Asia

The acceptance of battery electric vehicles (BEVs) is continuously increasing to mitigate CO2 emissions, resulting in an increase in the future material demand for LIBs. Therefore, the proper handling of End-of-life (EOL) BEV batteries requires careful attention to mitigate the supply chain issues for future LIBs materials, especially in Asia. A system dynamics model assessment was performed to evaluate the EOL of LIBs by considering the dynamic lifespan, recovery rate, and economic value under three growth rate scenarios in Asia from 2022 to 2030, depending on the battery chemistry over time. We find that comparing three different scenarios to materials demand, the result showed that materials demand for LIBs is greater in higher scenarios as compared with lower and reference scenarios. Moreover, in the low scenario, the nickel demand and recovery from end-of-life LIBs BEVs will achieve 244.0 and 43.28 kt in 2030. Based on the dynamic economic evaluation, an overall, higher potential economic value of all materials would achieve around 1471 million USD in 2030 in the low scenario. This study manifested that recycling LIBs materials has enormous economic potential and would be a step towards economic sustainability, especially in Asia in the near future.

Quality evaluation and economic assessment of an improved mechanical recycling process for post-consumer flexible plastics

Packaging represents the largest fraction of plastic waste in Europe. Currently, mechanical recycling schemes are mainly focused on the recovery of rigid packaging (like bottles), while for flexible packaging, also called films, recycling rates remain very low. Existing mechanical recycling technologies for these films are quite basic, especially in the case of complicated post-consumer flexible plastics (PCFP) waste, leading to regranulate qualities that are often subpar for renewed use in demanding film applications. In this study, the technical and economic value of an improved mechanical recycling process (additional sorting, hot washing, and improved extrusion) of PCFPs is investigated. The quality of the four types of resulting regranulates is evaluated for film and injection molding applications. The obtained Polyethylene-rich regranulates in blown films offer more flexibility (45-60%), higher ductility (27-55%), and enhanced tensile strength (5-51%), compared to the conventional mechanical recycling process. Likewise, for injection molded samples, they exhibit more flexibility (19-49%), enhanced ductility (7 to 20 times), and higher impact strength (1.8 to 3.8 times). An economic assessment is made between the obtained increased market value and the capital investment required. It is shown that the economic value can be increased by 5-38% through this improved recycling process. Overall, the study shows that it is possible to increase the mechanical recycling quality of PCFP in an economically viable way, thus opening the way for new application routes and overall increased recycling rates.

Effects of Adding Different Levels of Hydroponic Barley Fodder on the Productive Performance and Economic Value of Broiler Chickens

The present study was conducted to disclose the impact of adding different levels of hydroponic barley fodder (HBF) on some productive features of the economic value of broilers chickens. One hundred forty-four one-day-old Ross 308 chicks were used in this study. Birds were randomly distributed into four treatments, with three replicates per each treatment (12 birds per replicate): The first treatment had no addition (T1:control). As for T2 and T3 treatments, 10% and 20% of HBF were added to the feed pellet. In T4, fresh HBF was chopped and fed as an additional free fodder. Results reflected an increase in the weekly live body weight (BW), body weight gain (BWG), feed intake (FI), and feed conversion ratio (FCR) of T2 birds; along with an improvement in the cumulative BWG, FI, and FCR of T2 and T4 during the 3rd to 5th weeks compared with the other treatments. Bacteriology and gut morphology demonstrated a decrease in total fungi, bacteria, and E. coli count with an increase in Lactobacillus count, in conjunction with an increase in the villus height and crypt depth of the jejunum of T2 birds. Economic value measures showed an increase in the production index and economic marker for broilers treated with T2 and T4. It can be concluded that there is an opportunity to include HBF by 10% or present it as freshly chopped HBF to ameliorate production performance, improve economic indicators and reduce broiler production costs by 9%.

Estimation and use of recreational fishing values in management decisions

In many countries, commercial and recreational fishing compete for access to marine resources. In some cases, recreational catch outweighs commercial harvest and may threaten species otherwise protected from commercial fishing. This has led to increasing calls for improved management of recreational fishing in the broader context of general fisheries management. As a result, fisheries managers face the challenge to decide how to allocate the available marine resources between competing uses. In this paper, we review and explain two common approaches that have been used to support recreational fishing allocation decisions. While economic activity analysis is an appropriate tool to assess how a change in resource allocation would affect regional economic activity (economic contributions and impacts), it is ill-suited to assess associated gains or losses in welfare of society as a whole (economic efficiency). Hence, economic activity analysis and social cost-benefit analysis complement each other, with each providing a different set of information answering a different set of questions. Unfortunately, both types of analysis use the term "economic value" suggesting that they are alternative approaches that provide the same information, whereas in fact they are not. If the objective of fishery managers is to ensure that society as a whole is made better off, the appropriate metric is economic value as defined by welfare economics. Under this definition, all goods and services provided by marine resources that are beneficial to humans have economic value. This includes non-use values such as the continued existence of an endangered marine species. The aim of this paper is to support managers and policymakers in allocating marine resources by reviewing relevant economic principles, concepts, and tools in the context of recreational fishing, including the use and challenges of estimating the non-market benefits generated by recreational fishing experiences.

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.

Cost-Effectiveness of Imipenem/Cilastatin/Relebactam Compared with Colistin in Treatment of Gram-Negative Infections Caused by Carbapenem-Non-Susceptible Organisms

INTRODUCTION

Imipenem/cilastatin/relebactam (IMI/REL), a combination β-lactam antibiotic (imipenem) with a novel β-lactamase inhibitor (relebactam), is an efficacious and well-tolerated option for the treatment of hospitalized patients with gram-negative (GN) bacterial infections caused by carbapenem-non-susceptible (CNS) pathogens. This study examines cost-effectiveness of IMI/REL vs. colistin plus imipenem (CMS + IMI) for the treatment of infection(s) caused by confirmed CNS pathogens.

METHODS

We developed an economic model comprised of a decision-tree depicting initial hospitalization, and a Markov model projecting long-term health and economic impacts following discharge. The decision tree, informed by clinical data from RESTORE-IMI 1 trial, modeled clinical outcomes (mortality, cure rate, and adverse events including nephrotoxicity) in the two comparison scenarios of IMI/REL versus CMS + IMI for patients with CNS GN infection. Subsequently, a Markov model translated these hospitalization stage outcomes (i.e., death or uncured infection) to long-term consequences such as quality-adjusted life years (QALYs). Sensitivity analyses were conducted to test the model robustness.

RESULTS

IMI/REL compared to CMS + IMI demonstrated a higher cure rate (79.0% vs. 52.0%), lower mortality (15.2% vs. 39.0%), and reduced nephrotoxicity (14.6% vs. 56.4%). On average a patient treated with IMI/REL vs. CMS + IMI gained additional 3.7 QALYs over a lifetime. Higher drug acquisition costs for IMI/REL were offset by shorter hospital length of stay and lower AE-related costs, which result in net savings of $11,015 per patient. Sensitivity analyses suggested that IMI/REL has a high likelihood (greater than 95%) of being cost-effective at a US willingness-to-pay threshold of $100,000-150,000 per QALY.

CONCLUSIONS

For patients with confirmed CNS GN infection, IMI/REL could yield favorable clinical outcomes and may be cost-saving-as the higher IMI/REL drug acquisition cost is offset by reduced nephrotoxicity-related cost-for the US payer compared to CMS + IMI.

Accessibility and Universal Design: Do They Provide Economic Benefits?

Certainly, the issue of accessibility has, in addition to a well-known social value, obvious economic repercussions. However, these are not easily measurable, as they can be investigated only on the basis of indicators that are mainly qualitative and indirect. That said, this paper will highlight some aspects that can be considered a first approach, identifying the variables and key players in the economic field. The approach, according to the principles of Universal Design, already identifies economic implications related to the design of spaces, objects, and services. The socio-economic relevance has also been underlined within Sen's economic theories based on the capability approach and is generally referable to the theme of corporate social responsibility. In recent years, all this has been finding a universalistic synthesis in the enunciation of the Sustainable Development Goals. The analysis is conducted according to an interdisciplinary qualitative approach from two main perspectives: the company and the public administration. The study highlights how accessibility-understood according to a broad meaning that considers material and immaterial factors-assumes significant economic value with different specificities, depending on the reference actor (company/public administration). In particular, it is evident that for the company, the issue of accessibility (both with regard to products and services and organizational profiles) is taking on an increasingly important dimension with reference to marketing and ratings. The present work defines with clear evidence the main areas in which the economic value of accessibility appears, although a more in-depth study is needed to define metrics useful for quantifying the phenomenon. The study can be useful in various public and private sectors that involve policy-makers, designers, managers, and companies that produce goods and services.

Quantifying the size of the informal care sector for Australian adults with mental illness: caring hours and replacement cost

PURPOSE

To quantify and value the total informal support provided by family and friends to Australian adults with mental illness in 2018.

METHODS

The number of mental health carers was drawn from the 2015 Survey of Disability, Ageing and Carers (SDAC), adjusted to the 2018 population. Annual caring hours by type of assistance were estimated using the SDAC, 2007 National Survey of Mental Health and Wellbeing and an online carer survey. Caring hours for each task were assigned an hourly replacement cost from the National Disability Insurance Scheme. Informal caring was valued as the sum of these costs minus expenditure on carer income support payments, estimating how much it would hypothetically cost governments to replace this care with formal support services.

RESULTS

An estimated 354,000 (95% uncertainty interval (UI): 327,000-383,000) Australian mental health carers provided 186 million (95% UI: 159-215) hours of support in 2018. The estimated replacement cost was AU$8.4 billion (95% UI: 7.0-10.0), excluding AU$1.3 billion in income support. Univariate sensitivity analyses demonstrated that results were robust to variation in model inputs, with total caring hours the most influential parameter. Using an alternative estimate of mean caring hours, the replacement cost could be as high as AU$13.2 billion (95% UI: 11.2-15.4).

CONCLUSION

Informal carers provide substantial support to people with mental illness, highlighting their important contribution to the mental health system and reinforcing the need for carer support services. Future valuation studies would benefit from refinement of available data collections, particularly on hours and types of care provided.

Economic Value of Life in Iran: The Human Capital Approach

Background:

The human life value is among the most important challenges of the health economic evaluation. This limitation has reduced the feasibility of applying the cost-benefit method in evaluations of health interventions and policies. Using the human capital approach and discounted value of future earnings, the present study calculated the human capital of different age groups.

Methods:

The required data were obtained using “income and expenditures of Iranian households” data in 2015 from the Statistical Center of Iran, which included the information on 19380 urban households.

Results:

According to the calculation of human capital, the maximum value of a statistical life year in the high-income group was related to the age group of 30–34 yr old (223,286 US$ equals to 9378 million Iranian Rials). The lowest value in all three groups of high, medium and low income is related to the age group of 85 and older. In addition, the economic value of statistical life year for men has been calculated as higher than that of women, however, in older age groups, the human capital of both genders have been converging.

Conclusion:

The economic value of life for young people aged between 20 to 30 yr was higher than other demographic groups. The findings of the research help to provide a more accurate base for the cost-benefit analysis of health and social policies. Considering the economic value of the statistical life for different age groups may change policy priorities in areas related to health and life of human beings.

Economic Valuation of Coccidioidomycosis (Valley Fever) Projections in the United States in Response to Climate Change

Coccidioidomycosis, or valley fever, is an infectious fungal disease currently endemic to the southwestern United States. Symptoms of valley fever range in severity from flu-like illness to severe morbidity and mortality. Warming temperatures and changes in precipitation patterns may cause the area of endemicity to expand northward throughout the western United States, putting more people at risk for contracting valley fever. This may increase the health and economic burdens from this disease. We developed an approach to describe the relationship between climate conditions and valley fever incidence using historical data and generated projections of future incidence in response to both climate change and population trends using the Climate Change Impacts and Risk Analysis (CIRA) framework developed by the U.S. Environmental Protection Agency. We also developed a method to estimate economic impacts of valley fever that is based on case counts. For our 2000-15 baseline time period, we estimated annual medical costs, lost income, and economic welfare losses for valley fever in the United States were $400,000 per case, and the annual average total cost was $3.9 billion per year. For a high greenhouse gas emission scenario and accounting for population growth, we found that total annual costs for valley fever may increase up to 164% by year 2050 and up to 380% by 2090. By the end of the twenty-first century, valley fever may cost $620,000 per case and the annual average total cost may reach $18.5 billion per year. This work contributes to the broader effort to monetize climate change-attributable damages in the United States.

Exploring the potential value of satellite remote sensing to monitor chlorophyll-a for US lakes and reservoirs

Assessment of chlorophyll-a, an algal pigment, typically measured by field and laboratory in situ analyses, is used to estimate algal abundance and trophic status in lakes and reservoirs. In situ-based monitoring programs can be expensive, may not be spatially, and temporally comprehensive and results may not be available in the timeframe needed to make some management decisions, but can be more accurate, precise, and specific than remotely sensed measures. Satellite remotely sensed chlorophyll-a offers the potential for more geographically and temporally dense data collection to support estimates when used to augment or substitute for in situ measures. In this study, we compare available chlorophyll-a data from in situ and satellite imagery measures at the national scale and perform a cost analysis of these different monitoring approaches. The annual potential avoided costs associated with increasing the availability of remotely sensed chlorophyll-a values were estimated to range between $5.7 and $316 million depending upon the satellite program used and the timeframe considered. We also compared sociodemographic characteristics of the regions (both public and private lands) covered by both remote sensing and in situ data to check for any systematic differences across areas that have monitoring data. This analysis underscores the importance of continued support for both field-based in situ monitoring and satellite sensor programs that provide complementary information to water quality managers, given increased challenges associated with eutrophication, nuisance, and harmful algal bloom events.

The Economic Value of Improved Productivity from Treatment of Chronic Hepatitis C Virus Infection: A Retrospective Analysis of Earnings, Work Loss, and Health Insurance Data

Introduction

Patients with chronic hepatitis C virus infection (HCV) may incur significant indirect costs due to health-related work loss. However, the impact of curative HCV therapy on work productivity is not well characterized. We estimated the economic value of improved productivity following HCV treatment.

Methods

Adults diagnosed with HCV infection (Optum Healthcare Solutions data; Q1 1999 to Q1 2017) were stratified into two cohorts: (1) treated cohort, patients who received HCV therapy and (2) untreated cohort, therapy-naïve patients. For the treated cohort, the index date was set at the end of the post-treatment monitoring period, assumed to be 6 months after the end of treatment for patients with cirrhosis or for those treated with interferon-based therapy, and 3 months after the end of treatment for patients without cirrhosis who received interferon-free therapy. For the untreated cohort, an index date was randomly selected post-HCV diagnosis. Time from the index date to the first work-loss event was assessed using time to event analyses. An economic modeling approach was used to monetize the improved productivity from reduced risk of work-loss event in the 4 years post-index.

Results

Patients in the treated cohort had a lower risk of experiencing a work-loss event compared to untreated patients [unadjusted and adjusted hazard ratios and 95% CI 0.72 (0.61–0.86), and 0.68 (0.55–0.85), respectively; p < 0.001 for both]. The mean cumulative added productivity value associated with HCV treatment was US$4511 (CI $2778–$6278) at 1 year post-index and $21,429 (CI $12,733–$30,199) at 4 years post-index.

Conclusion

HCV treatment reduces the risk of work loss resulting in productivity gains for employers and employees. The monetary value associated with these productivity gains is substantial, and, after about 4 years, it is comparable to the wholesale acquisition cost of some direct-acting antiviral regimens in the United States. Employers may derive economic benefits from adopting HCV elimination strategies.

Electronic supplementary material

The online version of this article (10.1007/s12325-020-01492-x) contains supplementary material, which is available to authorized users.

Economic evaluation of passive monitoring technology for seniors

Background

Advances such as passive monitoring technology (PMT), which provides holistic supervision of chronically ill and elderly patients, enable and support improved monitoring and observation, thus empowering the growing population of older adults to live more independently while lowering health care expenses.

Aims

This study develops a conceptual model to estimate the potential savings associated with PMT.

Methods

We first develop a conceptual model to identify the main cost variables associated with independent living, focusing on three pathways: (1) PMT, (2) independent living supported by the current standard of care, and (3) facility-based care. We examined the impact on three outcomes [i.e., health care costs, institutional costs, and health-related quality of life (HRQoL)] along each of the three care pathways (i.e., PMT, independent living supported by the standard of care, and facility-based care) and developed a cost-benefit model to calculate the net costs and benefits associated with each care pathway.

Results

The cost–benefit model showed savings between approximately $425 per-member per-month (PMPM) for those using PMT compared to those on the standard of care pathway. Sensitivity analysis demonstrated that a 5% increase in nursing home utilization generates cost savings of more than 30% PMPM.

Discussion

The total projected cost savings for individuals on the PMT arm are projected to be more than $425 PMPM, with annual savings of $5069 per-person per-year, and over $5.1 million for a target population of 1000 individuals.

Conclusions

The cost calculations in our cost–benefit simulation model clearly demonstrate the value of PMT and show the potential value to payers and integrated delivery systems in offering PMT to individuals who are likely to benefit the most from the services.

Electronic supplementary material

The online version of this article (10.1007/s40520-019-01323-2) contains supplementary material, which is available to authorized users.

Effect of dietary supplementation of alpha-galactosidase on the growth performance, ileal digestibility, intestinal morphology, and biochemical parameters in broiler chickens

BACKGROUND

This study was performed to investigate the effect of Alpha-galactosidase (AlphaGal) supplementation with two energy levels on the growth performance, amino acid ileal digestibility coefficient "AID%," economic value, intestinal histology, and blood biochemical parameters of broiler chickens. Two-hundred 3-day-old broiler chicks (average body weight 74.34 g ±0.52 Ross 308) were randomly assigned to a 2 × 2 factorial arrangement consisting of two energy diets groups: in the first group, the birds were fed on a recommended energy diet (RED) while the second group was reduced 120 kcal/kg diet as a low energy diet (LED) and two levels of AlphaGal (0 or 50 mg/kg diet) for RED and LED for the 35-day feeding period.

RESULTS

The interaction effects between the energy level and the AlphaGal supplementations resulted in significant decrease (P ≤ 0.05) in the body weight, body weight gain, and the relative growth rate. The feed conversion ratio was signficantly increased in LED without supplementation of AlphaGal group during the entire experimental period, this negative effect on the growth performance was corrected by AlphaGal supplementation. The AID% value was increased significantly by AlphaGal supplementation. Blood triglyceride concentrations were significantly decreased (P = 0.02) in the LED group with or without AlphaGal supplementation, while the level of high-density lipoprotein (HDL) was significantly decreased (P = 0.01) in the LED or RED groups supplemented with 50 mg RED AlphaGal. Histologically, the number of intestinal glands and goblet cells increased in both RED and LED groups supplemented with AlphaGal and their secretions were mainly neutral mucopolysaccharides and less acidic mucopolysaccharides.

CONCLUSION

AlphaGal supplementation improved the growth performance of broiler chickens fed LED and the growth performance is similar to those fed RED, thereby consequently improving the economic value of these diets. AlphaGal supplementation improves intestinal histology and morphology as well.

Shadow and extended shadow cost sharing associated to informal long-term care: the case of Spain

BACKGROUND

A large part of the long-term care is provided by non-professional caregivers, generally without any monetary payment but a value economic of time invested. The economic relevance of informal caregivers has been recognized in Spain; however, public provision may still be scarce. The objective of this paper is to estimate the economic burden associated with informal long-term care that should assume the families through a new concept of cost sharing that consider opportunity costs of time provided by informal caregivers.

METHODS

The study sample includes all dependent adults in Spain. Socioeconomic information and the number of hours of informal care was collected through the Spanish Disability and Dependency Survey. The terms of shadow and extended shadow cost sharing were defined as the difference between the maximum potential amount of money that families could receive for the provision of informal care and the amount that actually they received and the value of informal care time with respect to the amount received, respectively.

RESULTS

53.87% of dependent persons received an economic benefit associated to informal care. The average weekly hours of care were 71.59 (92.62 without time restrictions). Shadow cost sharing amounted to, on average, two thirds, whereas the State financed the remaining third. In terms of extended shadow cost sharing, the State financed between 3% and 10% of informal care provided by caregivers.

CONCLUSIONS

This study reveals the deficient support received for the provision of informal care in Spain. More than 90% of informal care time is not covered by the economic benefits that families receive from the State.

Predicting the effects of eutrophication mitigation on predatory fish biomass and the value of recreational fisheries

Improving water clarity is a core objective for eutrophication management in the Baltic Sea, but may influence fisheries via effects on fish habitat suitability. We apply an ensemble of species distribution models coupled with habitat productivity functions and willingness-to-pay estimates to assess these effects for two coastal predatory fish species, European perch (Perca fluviatilis) and pikeperch (Sander lucioperca). The models predicted a 37% increase in perch and 59% decrease in pikeperch biomass if reaching the reference level for water clarity in the Baltic Sea Action Plan. Reaching the target level was predicted to increase perch biomass by 13%. However, the associated economic gain for the recreational fisheries sector was countervailed by an 18% pikeperch reduction. Still, a net benefit was predicted since there are six times more fishing days for perch than pikeperch. We exemplify how ecological modelling can be combined with economic analyses to map and evaluate management alternatives.

Do Standards Matter? What is Their Value?

Standards allow us to manage expectations for a diverse range of goods and services across the globe. From coordinating international global telecommunications across 24 different time zones to ensuring access to safe drinking water, standards allow us to work, communicate, collaborate, and live with certain expectations about safety and efficacy. When standards are fit-for-purpose, they raise the quality of products and services without requiring us to think about how that quality is assured. The result is that the successful implementation of standards for certain products can counterintuitively make it easy to overlook their importance when creating policies and regulations for next-generation products, such as generic drugs vis-à-vis biosimilars. Here we review the value of public standards as applied to the pharmaceutical industry. Using case studies, we demonstrate how standards for complex products, such as biologics, can be created and managed to ensure their optimal value to society while minimizing the burden to the industry. We also discuss the sustainability of standard development and whether there is sufficient transparency to maintain their role in the public trust. Finally, we assess the ability of standards to promote access to reasonably priced and high-quality biosimilars while enabling efficient product development and review.

Rice bean: a lesser known pulse with well-recognized potential

Required genetic resources for the improvement of agronomic, nutritional and economic value of rice bean are available in the world collection. International cooperative effort is required to utilize and conserve them. Rice bean [Vigna umbellata (Thunb.) Ohwi and Ohashi], a lesser known pulse among the Asiatic Vigna, has long been considered as a food security crop of small and marginal farmers of Southeast Asia. Considered as a nutritionally rich food and fodder, it is also a source of genes for biotic and abiotic stress tolerance including drought, soil acidity and storage pest. Although it spread from its centre of domestication in the Indo-China region to other parts around the world, it never became an important crop anywhere probably because of agronomic disadvantages. Crop improvement for determinate nature, good yield, less variable seed colour, pleasant organoleptic properties and lower antinutrients is required. Scanning of scientific literature indicates that genetic resources with desirable agronomic and nutritional traits exist within the current collection but are spread across countries. Genomic studies in the species indicate that except for insect resistance and aluminium toxicity tolerance, not much attention has been paid to decipher and utilize other stress tolerance and nutritional quality traits. Collaborative efforts towards improving farming, food, trade value and off-farm conservation of rice bean would not only help marginal farmers but will also help to preserve the yet to be explored genomic resources available in this sturdy pulse.

Economic value of traffic noise reduction depending on residents' annoyance level

Noise is the most frequently encountered type of environmental pollution in everyday life and has a direct negative effect on humans. Individuals who are constantly exposed to noise tend to have a high incidence of cardiovascular disease and hypertension. Noise sources range from construction sites to political rallies and assemblies, but traffic is one of the most long-lasting and chronic sources of noise. Previously, researchers have conducted valuations of road traffic noise reduction, but they did not consider residents' annoyance levels in response to traffic noise. However, individuals' annoyance levels affect the economic value of noise reduction policies and thus must be considered to obtain an accurate estimate. Therefore, this study investigated residents' willingness to pay for traffic noise reduction depending on their annoyance level. We used the contingent valuation method and a survey to analyze how much 1022 respondents in Korea were willing to pay for noise reduction. We found that people who were annoyed and extremely annoyed by noise had a willingness to pay KRW 8422 (US $7.55) and KRW 9848 (US $8.83) annually per household, respectively, to reduce their annoyance level to zero. In addition, we determined the economic benefits of noise reduction policies using the respondents' willingness to pay to reduce noise by 1 dB(A), which totaled KRW 3.28 billion (US $2.91 million) per year. The results of this study provide estimates of the annual benefits of traffic noise reduction considering residents' annoyance level.

Catastrophic financial effect of replacing informal care with formal care: a study based on haematological neoplasms

Informal care is a substantial source of support for people with cancer. However, various studies have predicted its disappearance in the near future. The aim of this study is to analyse the catastrophic effect resulting from the substitution of informal care with formal care in patients with blood cancer throughout the different stages of treatment. A total of 139 haematological neoplasm patients who underwent stem cell transplantation in Spain, completed a longitudinal questionnaire according to the three phases of treatment between 2012 and 2013. The economic value of informal care was estimated using proxy good, opportunity cost, and contingent valuation methods. Catastrophic health expenditure measures with thresholds ranging from 5 to 100% were used to value the financial burden derived from substitution. A total of 88.5% of patients reported having received informal care. In 85.37%, 80.49%, and 33.33% of households, more than 40% of their monthly income would have to be devoted to the replacement with formal care, with monthly amounts of €2105.22, €1790.86, and €1221.94 added to the 40% in the short, medium, and long-term, respectively (proxy good method, value = 9 €/h). Informal caregivers are a structural support for patients with blood cancer, assuming significant care time and societal costs. The substitution of informal care with formal care would be financially unaffordable by the families of people with blood cancer.

Economic selection index in small rural dairy farms

This study aimed to calculate economic values (EVs) and economic selection indices for milk production systems in small rural properties. The traits 305-d milk yield in kg (MY), fat (FP) and protein (PP) percentage, daily fat (FY) and protein (PY) yield, cow live weight in kg (LW), calving interval (CI), and logarithm of daily somatic cell count (SCC) in milk were considered the goals and selection criteria. The production systems were identified from 29 commercial properties based on the inventory of revenues and costs and of zootechnical field data. Later, bioeconomic models were developed to calculate the productive performance, revenues, and costs concerning milk production to estimate EVs, which were calculated as the difference in annual profit with dairy production resulting from a change in one unit of the trait while keeping the others constant and dividing the value by the number of cows. After the EVs were known, ten economic selection indices were estimated for each system so they could be compared by modifying the selection criteria and calculating the relative importance of each selection criteria, the accuracy of the economic selection index, and response expected to the selection in USD, among other parameters. One of the systems detected was called less intensive (LS) and was characterized by having ten cows in lactation that produced 13·5 l/d and consumed 1·8 kg of concentrate/d. The second system detected was called more intensive (IS) and had 22 cows in lactation that produced 17·5 l/d and consumed 3·4 kg of concentrate/d. Monthly profits per cows in lactation of USD 2·60 and USD 68·77 were recorded for LS and IS, respectively. The EVs of the traits MY, FP, and PP were all positive, while for the other traits they were all negative in all situations. The best economic selection indices were those featuring selection criteria MY, LW, and CI, while the trait LW had the greatest importance in both systems. These results indicate that animal frame must be controlled in order to maximize the system's profit.

Valorization of date palm (Phoenix dactylifera L.) pruning biomass by co-composting with urban and agri-food sludge

In the Mediterranean countries, there is an increasing production of date palm wastes (Phoenix dactylifera L.), not only due to the raising production of date palm fruits, but also derived from the maintenance of urban and peri-urban green areas, especially in those affected by red palm weevil (Rhynchophorus ferrugineus). The management of this increasing volume of green wastes usually concludes with a controlled disposal that implies an important loss of resources, in terms of organic matter, nutrients and energy. In addition, the rise of wastewater generation and the incentive of the wastewater treatment processes have derived in an increase of the amount of the sludge produced, which makes difficult its management. This work studies the feasibility of co-composting palm wastes with sludge from the urban and agri-food sectors as alternative treatment to manage these organic waste streams and to obtain added-value compost. For this, four mixtures (P1, P2, P3 and P4) were prepared using as main component palm leave waste (PL) mixed with different types of sludge. In the piles P1, P2 and P3, sewage sludge (SS) was used as co-composting agent, while agri-food sludge (AS) was used in P4. Throughout composting, the thermal profile of the composting piles was assessed, as were physical, chemical, physico-chemical and maturity parameters. In addition, the changes in water-soluble organic matter were assessed using chemical analytical methods and the excitation-emission matrix (EEM) fluorescence spectroscopy. The results obtained showed the viability of the co-composting process to obtain end-products with adequate maturity degree and physical characteristics for their potential use as substrates, except for the salt contents that can limit their use in some agricultural sectors.

Economic value of trees in the estate of the Harewood House stately home in the United Kingdom

The estates of stately homes or manor houses are an untapped resource for assessing the ecosystem services provided by trees. Many of these estates have large collections of trees with clear value in terms of carbon storage, runoff prevention, and pollution removal along with additional benefits to biodiversity and human health. The estate of Harewood House in North Yorkshire represents an ideal example of such a stately home with a mixture of parkland and more formally planted gardens. The trees in each type of garden were analysed for height, diameter at breast height and light exposure. The data were then processed in iTrees software to generate economic benefits for each tree in both gardens. The analysis found that the larger North Front parkland garden had greater total benefits but the more densely planted formal West Garden had the greater per hectare value. In total, the trees on Harewood House estate are estimated to provide approximately £29 million in ecosystem service benefits. This study is the first to analyse the trees of stately homes for economic benefits and highlights that the trees are a valuable commodity for the estates. This should be considered in future planning and management of such estates.

Should biodiversity and nature have to earn their keep? What it really means to bring environmental goods into the marketplace

Pursuit of economic gain has sponsored much of our planet's despoliation. Yet conservation increasingly operates as an economic sector that markets biodiversity, ecosystems, and nature as natural capital, service provider, or option value. This essay first elucidates what basic moral theory says about the principle that the goodness of biodiversity and nature is largely economic. It explains why economic valuations may be morally unimportant, inapt for environmental goods, and subversive of more important ideals. It also shows why neither econometric notions of option value nor Daniel Faith's qualitative one credibly applies. The essay then turns to what an economic conception of goodness implies for conservation practice. It refers to two prominent conservation organizations, whose conservation principles match the market-based ones of the World Business Council on Sustainable Development's. The environmental record of the latter organization's practices according to these principles predicts what their adoption for conservation entails.

The value of self-medication: summary of existing evidence

AIM

The aim of this review was to identify the international evidence that is currently available on the economic value of self-care through responsible self-medication, in terms of the measures related to access to treatment, time, and productivity.

METHODS

A targeted literature search was conducted for 1990-2016, including data gathered from members of the World Self-Medication Industry and searches on PubMed, EBSCOHost, and Google Scholar. Specific searches of individual drug classes known to be switched to non-prescription status in this period were also conducted.

RESULTS

A total of 71 articles were identified, of which 17 (11 modeling studies, six retrospective analyses) were included in the review. Evidence from modeling studies and retrospective analyses of grouped data across a range of common conditions for which non-prescription medications are available in different countries/regions showed that the use of non-prescription products for the treatment of common conditions or for symptom management (e.g. allergies, chronic pain, migraine, vaginitis, gastrointestinal symptoms, or common cold symptoms) had considerable value to patients, payers, and employers alike in terms of cost savings and improved productivity. Potential benefits of self-medication were also identified in preventative healthcare strategies, such as those for cardiovascular health and osteoporosis.

LIMITATIONS

This review was limited by a targeted, but non-systematic approach to literature retrieval, as well as the inclusion of unpublished reports/white papers and patient self-reported data.

CONCLUSIONS

The evidence identified in this literature review shows that responsible, appropriate self-medication with non-prescription products can provide significant economic benefits for patients, employers, and healthcare systems worldwide.

The Economy of Shark Conservation in the Northeast Pacific: The Role of Ecotourism and Citizen Science

Historically sharks have been seen either as a source of income through harvesting, or as a nuisance and danger. The economic value of sharks has traditionally been measured as the total value of sharks caught for liver oil, fins, or meat for consumption. Sharks have also been killed to near extinction in cases where they were seen as a threat to fisheries on other species. This is illustrated by the mass extermination of Basking Sharks (Cetorhinus maximus) in British Columbia. They were seen as a nuisance to fishermen as they got entangled in gill nets during the salmon fishing season. However with the development of the SCUBA diving industry, and ecotourism in general, increased awareness of the role sharks play in marine ecosystems has resulted in changes in how they are perceived and utilized. Despite an ongoing harvest of sharks such as the North Pacific Spiny Dogfish (Squalus suckleyi), sharks now generate economic value through SCUBA diving enthusiasts who travel the globe to see, swim with, and photograph them. The use of digital cameras and other digital media has brought sharks into households around the world and increased awareness of the conservation issues facing many species. This renewed appreciation has led to a better understanding of sharks by the public, resulting in advocates calling for better protections and conservation. In particular, a growing part of the SCUBA diving community wants to contribute to conservation and research projects, which has led to participation in citizen science projects. These projects provide scientific data but also gain ground as ecotourism activities, thus adding to both economic value of tourism and conservation efforts.

Social and economic value of Portuguese community pharmacies in health care

Background

Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal.

Methods

The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: “with service” versus “without service”.

Results

It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption.

Conclusions

Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-017-2525-4) contains supplementary material, which is available to authorized users.

Environmental impacts and production performances of organic agriculture in China: A monetary valuation

Organic agriculture has developed rapidly in China since the 1990s, driven by the increasing domestic and international demand for organic products. Quantification of the environmental benefits and production performances of organic agriculture on a national scale helps to develop sustainable high yielding agricultural production systems with minimum impacts on the environment. Data of organic production for 2013 were obtained from a national survey organized by the Certification and Accreditation Administration of China. Farming performance and environmental impact indicators were screened and indicator values were defined based on an intensive literature review and were validated by national statistics. The economic (monetary) values of farming inputs, crop production and individual environmental benefits were then quantified and integrated to compare the overall performances of organic vs. conventional agriculture. In 2013, organically managed farmland accounted for approximately 0.97% of national arable land, covering 1.158 million ha. If organic crop yields were assumed to be 10%-15% lower than conventional yields, the environmental benefits of organic agriculture (i.e., a decrease in nitrate leaching, an increase in farmland biodiversity, an increase in carbon sequestration and a decrease in greenhouse gas emissions) were valued at 1921 million RMB (320.2 million USD), or 1659 RMB (276.5 USD) per ha. By reducing the farming inputs, the costs saved was 3110 million RMB (518.3 million USD), or 2686 RMB (447.7 USD) per ha. The economic loss associated with the decrease in crop yields from organic agriculture was valued at 6115 million RMB (1019.2 million USD), or 5280 RMB (880 USD) per ha. Although they were likely underestimated because of the complex relationships among farming operations, ecosystems and humans, the production costs saved and environmental benefits of organic agriculture that were quantified in our study compensated substantially for the economic losses associated with the decrease in crop production. This suggests that payment for the environmental benefits of organic agriculture should be incorporated into public policies. Most of the environmental impacts of organic farming were related to N fluxes within agroecosystems, which is a call for the better management of N fertilizer in regions or countries with low levels of N-use efficiency. Issues such as higher external inputs and lack of integration cropping with animal husbandry should be addressed during the quantification of change of conventional to organic agriculture, and the quantification of this change is challenging.

Valuing setting-based recreation for selected visitors to national forests in the southern United States

In this study we estimate selected visitors' demand and value for recreational trips to settings such as developed vs. undeveloped sites in U.S. national forests in the Southern United States using the travel cost method. The setting-based approach allows for valuation of multi-activity trips to particular settings. The results from an adjusted Poisson lognormal estimator corrected for truncation and endogenous stratification reveal that economic value per trip estimates are higher for wilderness compared to day-use developed settings, overnight-use developed settings, and general forest areas. Estimates of these economic values are important to resource managers because their management decisions and actions typically control recreational settings. For example, managers control developed campground capacity in a national forest, but typically not the number of campers below the capacity constraint and the number and types of activities visitors engage in during a multi-activity trip to a developed campground (within limits since some activities such as discharging a firearm are not permitted in a developed campground).

Scarcity of ecosystem services: an experimental manipulation of declining pollination rates and its economic consequences for agriculture

Ecosystem services (ES) such as pollination are vital for the continuous supply of food to a growing human population, but the decline in populations of insect pollinators worldwide poses a threat to food and nutritional security. Using a pollinator (honeybee) exclusion approach, we evaluated the impact of pollinator scarcity on production in four brassica fields, two producing hybrid seeds and two producing open-pollinated ones. There was a clear reduction in seed yield as pollination rates declined. Open-pollinated crops produced significantly higher yields than did the hybrid ones at all pollination rates. The hybrid crops required at least 0.50 of background pollination rates to achieve maximum yield, whereas in open-pollinated crops, 0.25 pollination rates were necessary for maximum yield. The total estimated economic value of pollination services provided by honeybees to the agricultural industry in New Zealand is NZD $1.96 billion annually. This study indicates that loss of pollination services can result in significant declines in production and have serious implications for the market economy in New Zealand. Depending on the extent of honeybee population decline, and assuming that results in declining pollination services, the estimated economic loss to New Zealand agriculture could be in the range of NZD $295-728 million annually.

Evaluating management tradeoffs between economic fiber production and other ecosystem services in a Chinese-fir dominated forest plantation in Fujian Province

Chinese fir (Cunninghamia lanceolata) is not only a valuable timber species, but also plays an important role in the provision of ecosystem services. Forest management decisions to increase the production of fiber for economic gain may have negative impacts on the long-term flow of ecosystem services from forest resources. Such tradeoffs should be taken into account to fulfill the requirements of sustainable forest management. Here we employed an established, ecosystem-based, stand-level model (FORECAST) in combination with a simplified harvest-scheduling model to evaluate the potential tradeoffs among indicators of provisional, regulating and supporting ecosystem services in a Chinese-fir-dominated landscape located in Fujian Province as a case study. Indicators included: merchantable volume harvested, biomass harvested, ecosystem carbon storage, CO2 fixation, O2 released, biomass nitrogen content, pollutant absorption, and soil fertility. A series of alternative management scenarios, representing different combinations of rotation length and harvest intensity, were simulated to facilitate the analysis. Results from the analysis were summarized in the form of a decision matrix designed to provide a method for forest managers to evaluate management alternatives and tradeoffs in the context of key indicators of ecosystem services. The scenario analysis suggests that there are considerable tradeoffs in terms of ecosystem services associated with stand and landscape-level management decisions. Longer rotations and increased retention tended to favor regulating and supporting services while the opposite was true for provisional services.

The impact of Septoria tritici Blotch disease on wheat: An EU perspective

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Zymospetoria tritici is a threat to wheat production in the EU Z.t.’s plastic genome increases the potential severity of this threat in the future.

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Climate change may also affect the risk from Z.t.

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We estimate the spore numbers produced by Z.t. during each infection cycle.

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We calculate 1) the economic value of wheat in the three main EU producers 2) the cost of and economic return for fungicide treatment of wheat vs Z.t.

Zymoseptoria tritici is the causal agent of one of the European Union’s most devastating foliar diseases of wheat: Septoria tritici Blotch (STB). It is also a notable pathogen of wheat grown in temperate climates throughout the world. In this commentary, we highlight the importance of STB on wheat in the EU. To better understand STB, it is necessary to consider the host crop, the fungal pathogen and their shared environment. Here, we consider the fungus per se and its interaction with its host and then focus on a more agricultural overview of the impact STB on wheat. We consider the climatic and weather factors which influence its spread and severity, allude to the agricultural practices which may mitigate or enhance its impact on crop yields, and evaluate the economic importance of wheat as a food and animal feed crop in the UK and EU. Finally, we estimate the cost of STB disease to EU agriculture.

The high cost of half-hearted breastfeeding promotion in Germany

The economic value of breastfeeding to the society at large is under researched and its importance as a preventive public health strategy is underestimated. What little research there is indicates that considerable savings would accrue from following the WHO/UNICEF advice to breastfeed exclusively for six months and continue breastfeeding along with complementary foods for two years or more. Despite relatively high breastfeeding initiation in Germany, neither exclusive breastfeeding nor breastfeeding duration come close to international recommendations. Breastfeeding is mostly regarded as a woman’s personal choice and the government has been slow to engage in breastfeeding promotion, support and research. Some structures in Germany do offer support for breastfeeding women – including the growing number of Baby Friendly Hospital Initiative (BFHI) certified hospitals and a comprehensive maternity leave policy. However, the costs of breastfeeding are mostly borne by the mothers and those for breastfeeding training mostly by the individual health care workers or hospital, while the health insurance companies and society-at-large are profiting from the financial savings from exclusive and long-term breastfeeding. Factors which might improve breastfeeding rates and duration in this country include broad expansion of and financial support for both BFHI hospitals as well as training for the health care personnel who support the mother-infant dyad during the breastfeeding period.

Significance and value of non-traded ecosystem services on farmland

Background. Ecosystem services (ES) generated within agricultural landscapes, including field boundaries, are vital for the sustainable supply of food and fibre. However, the value of ES in agriculture has not been quantified experimentally and then extrapolated globally. Methods. We quantified the economic value of two key but contrasting ES (biological control of pests and nitrogen mineralisation) provided by non-traded non-crop species in ten organic and ten conventional arable fields in New Zealand using field experiments. The arable crops grown, same for each organic and conventional pair, were peas (Pisum sativum), beans (Phaseolus vulgaris), barley (Hordeum vulgare), and wheat (Triticum aestivum). Organic systems were chosen as comparators not because they are the only forms of sustainable agriculture, but because they are subject to easily understood standards. Results. We found that organic farming systems depended on fewer external inputs and produced outputs of energy and crop dry matter generally less than but sometimes similar to those of their conventional counterparts. The economic values of the two selected ES were greater for the organic systems in all four crops, ranging from US$ 68-200 ha(-1) yr(-1) for biological control of pests and from US$ 110-425 ha(-1)yr(-1) for N mineralisation in the organic systems versus US$ 0 ha(-1)yr(-1) for biological control of pests and from US$ 60-244 ha(-1)yr(-1) for N mineralisation in the conventional systems. The total economic value (including market and non-market components) was significantly greater in organic systems, ranging from US$ 1750-4536 ha(-1)yr(-1), with US$ 1585-2560 ha(-1)yr(-1) in the conventional systems. The non-market component of the economic value in organic fields was also significantly higher than those in conventional fields. Discussion. To illustrate the potential magnitude of these two ES to temperate farming systems and agricultural landscapes elsewhere, we then extrapolate these experimentally derived figures to the global temperate cropping area of the same arable crops. We found that the extrapolated net value of the these two services provided by non-traded species could exceed the combined current global costs of pesticide and fertiliser inputs, even if utilised on only 10% of the global arable area. This approach strengthens the case for ES-rich agricultural systems, provided by non-traded species to global agriculture.