Currently used surgical methods were found to be cost saving over the lifetime of individuals treated in England.

Objective: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. Methods: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. Results: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. Conclusion: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis.

It was demonstrated that a current mix of bariatric surgery methods was cost-effective at 10 years post-surgery and cost-saving over the lifetime of the Belgian patient cohort considered in this analysis.

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Background and Objectives Ulcerative colitis is highly prevalent in Canada and cost-effective ulcerative colitis therapies are warranted. Vedolizumab subcutaneous (SC) formulation was recently approved for ulcerative colitis maintenance therapy. We assessed vedolizumab SC cost effectiveness vs conventional and advanced therapeutics in patients with moderately to severely active ulcerative colitis from a Canadian public healthcare payer perspective. Methods A hybrid decision tree/Markov model was developed to evaluate vedolizumab SC costs, quality-adjusted lifeyears, and cost effectiveness vs conventional therapy, adalimumab SC, infliximab intravenous, golimumab SC, tofacitinib, ustekinumab SC, and vedolizumab intravenous. This model predicts the number of patients achieving clinical response and remission after treatment induction, and sustained benefit during maintenance treatment. To account for statistical uncertainties, the base-case analysis was conducted in a probabilistic manner. Scenario analyses examined the impact of previous treatment with anti-tumor necrosis factor agents, dose escalation, loss of efficacy, and treatment adherence. Results In the base-case analysis, conventional therapy was the most cost-effective therapeutic option in the overall population. Vedolizumab SC was cost effective and dominant compared with other advanced therapies

The purpose of the study is to determine the optimal volume of fodder and grain-fodder crops of appropriate quality to meet the needs of the livestock industry using a systemic comparative economic approach. For the economic assessment of crops for fodder purposes, a systemic comparative economic approach to their production efficiency has been developed. Accounting was carried out according to the three most important indicators in fodder units: quantitative indicators—productivity per hectare of sowing, qualitative—the content of vegetable protein and cost—the production cost. Oats were taken as the primary culture. Their comparison made it possible to determine economically interrelated partial indices, which are reduced to the index of the systemic comparative economic approach, which contributes to optimizing the structure of the cultivated areas of these crops. This technique allows to determine each forage crop’s location in each farm or region’s conditions, analyzing the real situation and assessing the prospects for the development of production. The optimal structure of sown areas for grain-fodder and fodder crops, focused on the cultivation of high-protein crops, for the enterprises of the Northern forest-steppe zone of the Republic of Bashkortostan is proposed. Due to a change in sown areas’ structure, the gross harvest increases by 8%, digestible protein by 2%, and reduced production costs by 48%.

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