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Cancer Biomarkers are the key to unlocking the promise of precision oncology, selecting which patients will respond to a more personalised treatment while sparing non-responders the therapy-related toxicity. In this paper, we highlight the primacy of cancer biomarkers, but focus on their importance to patients and to health systems. We also highlight how cancer biomarkers represent value for money. We emphasise the need for cancer biomarkers infrastructure to be embedded into European health systems. We also highlight the need to deploy multiple biomarker testing to deliver the optimal benefit for patients and health systems and consider cancer biomarkers from the perspective of cost, value and regulation. Cancer biomarkers must also be situated in the context of the upcoming In Vitro Diagnostics Regulation, which may pose certain challenges (e.g. non-compliance of laboratory developed tests, leading to cancer biomarker shortages and increased costs) that need to be overcome. Cancer biomarkers must be embedded in the real world of oncology delivery and testing must be implemented across Europe, with the intended aim of narrowing, not widening the inequity gap for patients. Cancer patients must be placed firmly at the centre of a cancer biomarker informed precision oncology care agenda.

Post Tender Negotiation (PTN) procedure is part of the tendering process in procurement of goods and services. The procedure could be triggered if the initial tendering activity does not result in the selection of a supplier. This could be due to a lack of clear Value for Money (VfM) bidder. The PTN procedure is sparingly applied in the UK public sector procurement and the reasons adduced for this are based on ethical considerations. The UK Office of Government Procurement (OGP), formerly known as the Office for Government Commerce (OGC) and the European Union (EU) are the chief proponents of restricting the use of PTN to exceptional cases. The premise of their argument is that the buyer could unethically tilt her/his actions in the process of applying the PTN procedure to favor certain suppliers. It is the argument of this paper that buyers from the public sector in UK are being deprived of the procedure’s benefit and therefore, the restrictions should be relaxed. Evidence from this study suggests that the procedure could offer the opportunity for further clarifications of supplier’s bid. The study also identifies that, for PTN to be successful, factors ensuring success in negotiations including cooperation should be present.

Background: Parkinson’s disease (PD) is a complex and debilitating condition that requires care from a multispecialty team. The Integrated Parkinson Care Network (IPCN) is an innovative pragmatic care model that focuses on integrated care, self-management support and technology-enabled care. Objective: This study aims to estimate the costs of the IPCN and assess whether benefits gained from the intervention offset its costs based on a single center experience. Methods: We conducted a return on investment (ROI) analysis of the IPCN from a societal perspective. The ROI for the IPCN was estimated as a ratio of the net savings and the intervention cost. The intervention cost was calculated as a sum of set-up and implementation costs. Cost savings was measured as the absolute reduction in the societal costs realized by PD patients. A positive ROI indicated that savings generated from the intervention offset its cost. Results: The total cost of the IPCN for 100 PD patients was C$135,669, or C$226 per patient per month. IPCN was associated with the reduction in societal cost of C$915 per patient per month (95%CI: –2,782, 951). The ROI per PD patient per month for the IPCN was 3.08 (95%CI: –0.60, 22.93), suggesting that for every C$1 invested in the IPCN, C$4.08 is gained through reduction in societal costs. The returns were greater among advanced PD patients. Conclusion: The IPCN has the potential to offer a good return on investment for PD patients, and its value for money is higher among advanced PD patients.

This paper provides an assessment of how Maltese healthcare performance compares against that of other selected EU countries. The study analyses a chosen set of key performance indicators (KPIs) re...

This study aims to determine the financial governance model of the DPRD Secretariat of Pinrang Regency based on the perspective of good governance. It is hoped that the results of this study can be a source of reference for further researchers as well as information for the Secretariat of the DPRD of Pinrang Regency. Data collection techniques used are documentation, observation, and interviews with personal paper data sources and places. The analysis technique used is descriptive qualitative analysis. The results of the study indicate that financial governance at the DPRD Secretariat of Pinrang Regency has implemented the principles of good governance. Financial governance indicators used are community participation in regional financial management, transparency in regional financial management, accountability, and value for money.

The background of this research is the phenomenon of very good village fund management, so that it becomes very effective and efficient in its use, even though in very unsupportive conditions due to the covid-19 outbreak. The purpose of this study was to determine the performance of Subun Bestobe Village Financial Management using the value for money (VFM) method, namely with measurement indicators (economical, efficiency, and effectiveness). The results showed that the economic level for the last 5 years was in the >100% category, thus meeting the economic standard of value for money. The efficiency level for the last 5 years is at the standard >40%, the ratio is above 100% so that the efficiency ratio does not meet the efficient value for money standard. The effectiveness ratio for the last 5 years has met the standard so that it shows that the Subun Bestobe Village Government has been effective in managing village finances for the village community. This is because the effectiveness of financial management can increase if the village community is satisfied with the performance of good financial management, especially in village development. So that in the future the village can become a superior, independent and competitive village.

Background With 50% of Australians having chronic disease, health consumer views are an important barometer of the "health" of the healthcare system for system improvement and sustainability. Aims To describe the views of Australian health consumers with and without chronic conditions when accessing healthcare. Methods A survey of a representative sample of 1,024 Australians aged over 18 years, distributed electronically and incorporating standardised questions and questions co-designed with consumers. Results Respondents were aged 18-88 years (432 males, 592 females) representing all states and territories, and rural and urban locations. General practices (84.6%), pharmacies (62.1%) and public hospitals (32.9%) were the most frequently accessed services. Most care was received through face-to-face consultations; only 16.5% of respondents accessed care via telehealth. The 605 (59.0%) respondents with chronic conditions were less likely to have private health insurance (50.3% vs 57.9%), more likely to skip doses of prescribed medicines (53.6% vs 28.6%), and miss appointments with doctors (15.3% vs 10.1%) or dentists (52.8% vs 40.4%) because of cost. Among 480 respondents without private health insurance unaffordability (73.5%) or poor value for money (35.3%) were the most common reasons. Most respondents (87.7%) were confident that they would receive high-quality and safe care. However, only 57% of people with chronic conditions were confident that they could afford needed healthcare compared with 71.3% without. Conclusions Health consumers, especially those with chronic conditions, identified significant cost barriers to access of healthcare. Equitable access to healthcare must be at the centre of health reform. This article is protected by copyright. All rights reserved.

Water companies are regional monopolies in the UK, and subject to quinquennial price reviews to ensure customers receive value for money. This paper documents the application and evolution of state...

This study aimed to determine the measurement of performance in the Village Government of Jabal Nur, Kec. Kodeoha, North Kolaka Regency in 2015-2019 using the concept of Value For Money. Performance measurement is one of the factors for a private or public organization. Performance measurement is used as a control tool in an organization to evaluate the results of activity and determine the success of the management carried out by an organization. The application of the value for money concept is important for the government as a public service because the implementation of this concept will provide benefits for assessing: 1) the effectiveness of public services, 2) the quality of public services, 3) spending allocations that are more oriented to the public interest, and 4) increasing public cost awareness as the root of the implementation of public accountability. The results of this study indicate that the performance of the Jabal Nur village government has been said to be economical because the percentage ratio has never exceeded 100%; in terms of efficiency, government performance is efficient even though the first 3 years are in balanced efficiency, but in years 4 and 5 the level of efficiency has increased, and from in terms of the effectiveness of the performance of the village government of Jabal Nur has been effective even though in 2017 the level of effectiveness was according to. Still, the following year the level of effectiveness increased again.

Objective: The objective of this study is to review published cost-utility analyses of vaccination strategies in eight European countries and to assess whether there are differences in cost-effectiveness terms among countries and vaccinations. Methods: A systematic search of the literature was conducted using the National Health Service Economic Evaluation Database and the PubMed database. Cost-utility analyses of any type of vaccination that used quality-adjusted life years (QALYs) as measure of benefit and conducted in Belgium, France, Germany, Italy, Spain, Sweden, the Netherlands or the UK were included. Results: A total of 94 studies were identified. As a result of our search methodology, the vast majority of studies were conducted in the Netherlands or UK (33 and 30 studies, respectively). The most frequent vaccination types were against Human papillomavirus (HPV) with 23 studies, followed by vaccination against pneumococcal infections (19 studies). The analysed vaccinations were generally cost-effective but with high variability. Considering an incremental cost effectiveness ratio (ICER) of 40,000€/QALY, we noticed that the following vaccinations studies are below this threshold, i.e. all varicella and influenza (with one outlier) studies, 90% of the studies for HPV and 75% of the studies for pneumococcal vaccinations. Rotavirus vaccination was considered as not cost-effective, with only 30% of studies below the threshold of 40,000€/QALY. There was no clear trend for vaccinations being more cost-effective in some countries. Conclusions: The published literature has shown that vaccination strategies are generally cost-effective in European countries. High heterogeneity in the results among studies and countries was found.

PurposeOn the basis of the justice, attachment, social support, self-determination theories, this research paper examines the impact of the student–instructor relationship construct on the customer-centric measures of overall student satisfaction, and perceived value for money and their impact of the behavioral intentions as an endogenous construct. We considered universities as providers of complex services focusing on students' service quality and students as the customers of the higher education institutions.Design/methodology/approachA survey instrument was used to collect data among undergraduate and graduate business students in a medium-sized Canadian university (N = 178). Partial least squares structural equation modeling was used to analyze the strength, significance, and effect sizes of the relationships between the key constructs.FindingsThe results indicate that the student–instructor relationship is significantly related to student satisfaction and value for money perceptions. Also, the student satisfaction and behavioral intentions, value for money and student satisfaction, and value for money and behavioral intentions relationship were significant.Originality/valueThe perceived quality of student–instructor relationship and its relationship to customer-centric measures like satisfaction, value for money and behavioral intentions has received relatively little attention in previous research and was discovered to be an important contributor to the perceived student satisfaction and value for money. The importance of the student–instructor relationship is further emphasized indirectly via the perceived value for money construct to student satisfaction.

For the Government projects, Value for Money (VFM) is an important parameter based on which the projects are procured through Public-Private Partnership (PPP) by the public sector. The objective of this paper is to identify and evaluate perceptions of VFM factors affecting Indian road projects undertaken by PPP. Eighteen VFM factors were shortlisted through a literature survey and were validated with experienced professionals. A questionnaire survey was conducted to investigate the most important VFM factors and was grouped into three categories: financial implications, the expertise of the private sector, and contract efficiency using factor analysis. Important VFM factors were identified using the Importance Index Method. The perception was analyzed with various statistical tools. The findings from this study provide more information and understanding about VFM in an early stage, which will be helpful for decision making about PPP.

The online fashion market is the largest market segment in Ghana. This present study investigates what drives Ghanaian consumers to purchase fashion products online from perceived risk and perceived value for money perspectives. Moving away from the purely monetary perspective, this study operationalizes value for money to include ease of use (qualitative perspective). Findings from this study highlight the fact that the average Ghanaian e-buyer is more influenced to shop for fashion products online by their perceived value for money than by their perceived risk and this insight is relevant in boosting e-commerce transactions significantly in the economy.

Since the creation of the National Health Service in 1948, different groups of experts have competed to inform the development of British health policy. This article analyzes the long-term rise of one of these groups-management consultants. The scale and regularity of their engagement has increased considerably over time, strikingly in recent years, and the functions fulfilled by consultants have become ever more diverse. At important moments they were often seen by policymakers-particularly when there was understood to be a lack of internal expertise-as possessors and imparters of important knowledge. Firms and individuals worked consciously to integrate themselves into emerging health policy networks. But there has often been relatively little consideration of their real suitability for work in the health field. Many debates around the use of external consultants today-accountability, value for money, dependency-were foreshadowed during earlier periods, with implications for current policymakers.

Private Finance Initiative (PFI) was introduced in 2006 aimed at achieving value for money. Nevertheless, most of the PFI projects in Malaysia are currently facing difficulties in meeting the expectation. Therefore, a brainstorming workshop involving 69 PFI practitioners from diverse backgrounds was conducted to investigate the implementation issues at the operational level and strategies towards achieving the project goals. The results showed that skills and knowledge, procedures and implementation, challenges in project management, and conflict on documentation were among the issues debated among workshop participants. “Loopholes” were identified to facilitate the improvement of the PFI project implementation in Malaysia. Keywords: Operational Performance; Private Finance Initiative (PFI); Issues; Strategies. eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bsby e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5iSI3.2531

Background Despite the burden of varicella, there is no universal varicella vaccination (UVV) program in the United Kingdom (UK) due to concerns that it could increase herpes zoster (HZ) incidence. We assessed the cost-utility of a first-dose monovalent (varicella [V]) or quadrivalent (measles-mumps-rubella-varicella [MMRV]) followed by a second-dose MMRV UVV program. GSK and MSD varicella-containing vaccines (VCVs) were considered. Methods Dynamic transmission and cost-effectiveness models were adapted to the UK. Outcomes measured included varicella and HZ incidences and the incremental cost-utility ratio (ICURs) over a lifetime horizon. Payer and societal perspectives were evaluated. Results The impact of V-MMRV and MMRV-MMRV UVV programs on varicella incidence was comparable between both VCVs at equilibrium. HZ incidence increased by 1.6%–1.7% over 7 years after UVV start, regardless of the strategies, then decreased by >95% at equilibrium. ICURs ranged from £5665 (100 years) to £18 513 (20 years) per quality-adjusted life-year (QALY) gained with V-MMRV and from £9220 to £27 101 per QALY gained with MMRV-MMRV (payer perspective). MMRV-MMRV was cost-effective in the medium- and long-terms with GSK VCV and only cost-effective in the long term with MSD VCV at a £20 000 per QALY gained threshold. Without the exogenous boosting hypothesis, HZ incidence decreased through UVV implementation. ICURs were most sensitive to discount rates and MMRV price. Conclusions A 2-dose UVV was demonstrated to be a cost-effective alternative to no vaccination. With comparable effectiveness as MSD VCV at lower costs, GSK VCV may offer higher value for the money., A 2-dose universal varicella vaccination was demonstrated to be a cost-effective alternative to no vaccination. With comparable effectiveness as MSD varicella-containing vaccines (VCVs) at lower costs, GSK VCV may offer higher value for the money.

PurposeThe procurement strategy challenges that influence the development of sustainable smart housing require a holistic system approach that models the relationships between procurement strategies and sustainable smart housing development approach. This considers the use of technology partnering to ensure value for money. The purpose of the paper is to assess the mediation effect of the technology partnership on procurement strategy influencing sustainable smart housing development.Design/methodology/approachThis study used a quantitative approach and primary data were collected via a structured questionnaire. In total, 500 survey questionnaires were administered to project managers in the Nigerian construction industry and a stratified proportionate random sampling method was used for the selection of respondents.FindingsThe results indicated that the procurement strategy influenced sustainable smart housing development in Nigeria, and the technology partnership mediates the relationship between procurement strategy and sustainable smart housing development.Research limitations/implicationsThis quantitative study is based on the perception of construction project managers in Nigeria. The findings serve as an awareness of the government and other stakeholders in the construction industry on the development of sustainable smart housing in Nigeria.Practical implicationsThe study establishes that technology partnership mediates the relationship between procurement strategy factors and sustainable smart housing development through enhancement of smart housing development and serves as awareness to stakeholders on the factors influencing smart housing development in Nigeria.Social implicationsThe study suggests that technology partnership influences the effect of procurement strategy factors on sustainable smart housing and hence improves the development of smart housing in developing countries.Originality/valueMediation roles of technology partnership minimize procurement strategy challenges and enhance sustainable smart housing development.

The purpose of this research was to determine partially and simultaneously the influence of accountability, public participation and supervision of budget performance with the concept of value for money in the Bengkalis District Financial and Asset Management Agency. This research uses descriptive quantitative analysis method. The sampling technique uses boring sampling method. The data analysis technique used is multiple linear of regression. The results showed that partial accountability, participation and supervision had a positive and significant effect on budget performance with the concept of value for money in the Bengkalis District Financial and Asset Management Agency. While simultaneously accountability, participation and supervision have a positive and significant effect on budget performance with the concept of value for money in the Regional Financial and Asset Management Agency in Bengkalis Regency with a 93.5% influence.

The public has put increased pressure on organizations providing public services to demonstrate the most productive use of resources, with due regard for value received. Education is no exception. This study focus on the presentation and evaluation of public organizations (public grammar schools in our case) in education on the basis of their economy, efficiency and effectiveness as one of the indicators of performance assessment. The methodology of Value For Money presented in this study can provide useful information about the situation of education for public forces and for public grammar schools themselves. Also, this methodology may help to gain a deeper insight into strengths of individual schools, as well as in which they can improve. A limitation of the concept of VFM is that performance evaluation is possible only between homogeneous services. The originality and value of the study are reflected in its focus on such topics as monitoring and measuring of performance for public service organizations (i.e., education services). It also provides a tool for districts and individual schools to gain information using indicators employed here for identifying and solving the performance problems that occur in education system of Slovakia.

Online apparel industry is suffering from a major issue of return, with a high rate of return for apparels that are sold online it becomes necessary to investigate the probable reasons of return in online apparel industry. The objective of the study is to develop a multi-criterion approach for evaluation of various factors that are responsible for the return of apparels purchased online in context of India. A total of 34 factors were identified through literature review and discussion with experienced experts from the fashion domain. In this study, best–worst method has been employed to prioritize and rank the factors for online return more effectively. Sensitivity analysis has been carried out to check the robustness of the proposed model of the study. The findings of the study show that fit and size variation, defects, found a better product (wisdom of purchase), wrong product delivery, lenient return policy and value for money were identified as crucial factors for online apparel return. The present study provides valuable research implications which can be used for retail policy improvements and also to online selling strategy.

This study investigates the changing discourses of the value of degrees in prospectuses between 1976 and 2013, chosen due to the massification of higher education and use of the particular ...

This article seeks to develop our understanding of the agency of vulnerable groups who at first sight may not seem to have much agency in their lives. It explores the co-constructed nature of agency in three Danish homeless shelters. Unlike earlier interview-based studies, our research is based on naturalistic data drawn from 23 video-recorded placement meetings. Using concepts from Goffman, we examine how versions of the neediness and worthiness of homeless people are negotiated verbally and bodily between staff and clients. We find that homeless people have to juggle two partly contradictory roles when they are given or take the roles of either a (active) citizen or a (passive) client. Clientship is actively negotiated by both parties and demonstrates the agency of homeless people: they can collaborate with (as clients) or challenge (as citizens) the staff's attempts to formulate solutions to their troubles. We further examine how the professional ideology of client centredness affects the meeting between the two parties. However, we show that, like any discourse, client centredness has no intrinsic meaning and is played out by actors in very different ways. In work with the homeless, the discourse of client centredness is related to discourses of 'neediness', 'worthiness' and 'value for money' that define agency in different ways and make three different client positions available: the resolute client, the acquiescent client and the passive client.

Background The Grazax Asthma Prevention (GAP) trial has recently demonstrated significant reductions in the odds of asthma symptoms or medication use in patients treated with SQ® grass SLIT-tablet relative to placebo, both in combination with allergy and asthma pharmacotherapy. The objective of the present analysis was to evaluate the cost-effectiveness of SQ grass SLIT-tablet relative to placebo in children with AR from the perspective of a German healthcare payer. Methods A cost-utility model was developed in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) to evaluate the cost-utility of SQ grass SLIT-tablet in combination with pharmacotherapy versus pharmacotherapy alone in patients with AR. Transition probabilities were derived from the GAP trial, and costs were taken from a real-world insurance database analysis. Future costs and effects were discounted at 3% per annum, and extensive deterministic and probabilistic sensitivity analyses were performed. Results Over a 10-year time horizon, the base case analysis showed an increase in overall treatment costs of €897 per child being treated with SQ grass SLIT-tablet relative to pharmacotherapy alone. The increased treatment costs were accompanied by an improvement in patient quality of life of 0.10 quality-adjusted life years (QALYs) yielding an ICER of €8978 per QALY gained, falling well below a willingness-to-pay threshold of €17,800 per QALY gained. The base case results were insensitive to changes in all individual model parameters. Discussion Improvements in quality of life with the SQ grass SLIT-tablet would be accompanied by only a modest increase in costs over a 10-year time horizon, with the SQ grass SLIT-tablet therefore representing excellent value for money from the German healthcare payer perspective.

Purpose This paper aims to answer the following question: Is PPP a financially viable alternative for the management of regional airports in Brazil? Design/methodology/approach The methodology is based on the case study of the innovative model of Zona da Mata Regional Airport management. It was used Value for Money as a method to compare this case with the conventional airport management alternative. Findings It was observed that, when compared to the airport management alternative through contracting third parties, the public–private partnership (PPP) provided a reduction of almost 70% of public spending on the management of this infrastructure. Besides the financial advantage, other benefits of this PPP contract were also observed. Research limitations/implications The analyses carried out in this study are not exhaustive and can be improved and remade as the life cycle of the PPP contract studied is progressed. Practical implications It was concluded, from the results found, that PPP is an efficient alternative for the management of regional airports in Brazil, and the model can be replicated for similar airports. Originality/value When analyzing the results of this innovative project of managing a regional airport through a PPP, this work made it possible to measure the positive impacts of this alternative and demonstrate the potential of the PPP as an alternative for the management of other regional airports in Brazil.

This study analysed the behavioural differences between e- and m-bookers in online hotel booking. The theoretical relationships among functionality and usability, perceived value for money and time, and satisfaction and loyalty were analysed based on the quality–satisfaction–loyalty framework. Results from a sample of 431 and 401 e- and m-bookers, respectively, affirmed the similarities and differences between the two types of bookers. Results also showed that e- and m-bookers substantially differ in their perceptions on functionality and usability performance, perceived value for money and relative importance of functionality and usability in online hotel booking. Moreover, the findings revealed the moderating effects of perceived value for money and time on the satisfaction–loyalty link among m-bookers.

Johannes Pöhlmann,1 Roberta Montagnoli,2 Giusi Lastoria,3 Witesh Parekh,4 Marie Markert,5 Barnaby Hunt1 1Health Economics, Ossian Health Economics and Communications, Basel 4051, Switzerland; 2External Affairs-Region Europe, Novo Nordisk SpA, Rome IT00144, Italy; 3Medical Advice, Novo Nordisk SpA, Rome IT00144, Italy; 4European HEOR, Nova Nordisk Ltd, West Sussex RH6 0PA, UK; 5Global Market Access, Novo Nordisk A/S, Søborg DK-2860, DenmarkCorrespondence: Barnaby HuntHealth Economics, Ossian Health Economics and Communications GmbH, Bäumleingasse 20, Basel CH-4051, SwitzerlandTel +41 61 271 6214Email hunt@ossianconsulting.comObjective: Italian treatment guidelines for type 2 diabetes mellitus (T2DM) target good glycemic control but acknowledge the associated risk of hypoglycemia. Unlike traditional antidiabetic therapies, modern treatment options such as fixed-ratio combinations of basal insulin and glucagon-like peptide 1 receptor agonists are associated with improved glycemic control, reduced body weight and low risk of hypoglycemia. The cost-effectiveness of the fixed-ratio combinations of basal insulin and glucagon-like peptide 1 receptor agonists IDegLira and iGlarLixi was assessed for Italy in patients with T2DM uncontrolled on basal insulin, to evaluate how short-term clinical benefits translate into long-term health economic outcomes.Methods: The IQVIA CORE Diabetes Model was used to project clinical and economic outcomes over patient lifetimes. Treatment effects were sourced from an indirect treatment comparison. The analysis captured direct medical costs (expressed in 2017 Euros) from the perspective of the Italian National Health Service (NHS) and patient-related quality of life. Sensitivity analyses were performed.Results: IDegLira was associated with gains of 0.09 life years and 0.13 quality-adjusted life years (QALYs) relative to iGlarLixi, due to a lower cumulative incidence and delayed onset of diabetes-related complications. IDegLira was associated with an incremental cost of EUR 930 over patient lifetimes, leading to an incremental cost-effectiveness ratio of EUR 7,386 per QALY gained.Conclusion: Over the lifetime of patients with T2DM uncontrolled on basal insulin, IDegLira was associated with improved clinical outcomes at higher costs relative to iGlarLixi. At a willingness-to-pay threshold of EUR 30,000 per QALY gained, IDegLira was considered to be cost-effective versus iGlarLixi from the perspective of the Italian NHS.Keywords: cost-effectiveness, fixed-ratio combination, IDegLira, iGlarLixi, Italy, type 2 diabetes

Purpose: This paper analyses the impact that performance audit has on improving procurement activities which lead to enhanced value for money. Therefore, the goal was to establish whether or not procurement-focused performance audits generally had an impact on undertaking positive actions/changes within the audited institutions in Kosovo., Methodology: OLM model is used to test the hypothesis raised that what kind of impact did performance audits have on changes undertaken within the entity that would enhance the value for money in the procurement process. The data was obtained through a questionnaire administered with 86 officials within institutions which were subject to performance audits carried out by the KNAO., Findings: We have managed to illustrate which were the changes undertaken by the audited entities after the audit and also determine that auditees’ perceptions are generally positive concerning the role of the Kosovo National Audit Office (KNAO) as a factor in improving performance and undertaking changes within entities. As well, the model results shows a positive and significant relationship between performance audit and changes undertaken by auditee institutions, confirming once again the positive role of the Kosovo NAO., Originality/Value: The main contribution of our research is to draw attention to the impact of performance audit in countries with high levels of corruption and irregularities, such as Kosovo. In addition, this research reveals audit entities key persons’ perceptions, on the factors that influence the undertaking of changes that derive from performance audits., peer-reviewed

Public–private partnerships (PPPs) have been used worldwide in infrastructure services to achieve better value for money. However, PPPs in the water sector have witnessed many failures in b...

Value for money (VfM) assessments often lack effective automatic processes and reasoning support in public-private partnership (PPP) projects. To automate these assessments, this paper proposes a comprehensive approach that aligns with the goals of building information modeling (BIM) as the necessary information support and ontology for the knowledge process. The main contribution of this work is the retrieval of information from the BIM environment with the ontological knowledge base to enable more efficient and persuasive methods for project and finance management that facilitate decision-making rather than an experience-based approach. The constructed ontology can also be reused and further expanded to include project needs from end-user perspectives. This work is expected to further the research on expanding semantic BIM-based decision making in different infrastructure procurement projects.

Many governments have recognised the socio-economic importance of broadband. The market often provides a broadband connection but when this does not occur governments have stepped in. Throu...

Contains fulltext : 205487.pdf (Publisher’s version ) (Open Access) OBJECTIVES: To assess the cost-effectiveness of frequently used monitoring strategies for vestibular schwannoma (VS). DESIGN: A state transition model was developed to compare six monitoring strategies for patients with VS: lifelong annual monitoring; annual monitoring for the first 10 years after diagnosis; scanning at 1-5, 7, 9, 12, 15 years after diagnosis and subsequently every 5 years; a personalised monitoring strategy for small and large tumours; scanning at 1, 2 and 5 years after diagnosis and no monitoring. Input data were derived from literature and expert opinion. Quality-adjusted life years (QALYs) and healthcare costs of each strategy were modelled over lifetime. Net monetary benefits (NMBs) were calculated to determine which strategy provided most value for money. Sensitivity analyses were performed to address uncertainty. RESULTS: Omitting monitoring is least effective with 18.23 (95% CI 16.84-19.37) QALYs per patient, and lifelong annual monitoring is most effective with 18.66 (95% CI 17.42-19.65) QALYs. Corresponding costs were euro6526 (95% CI 5923-7058) and euro9429 (95% CI 9197-9643) per patient, respectively. Lifelong annual monitoring provided the best value with a NMB of euro363 765 (339 040-383 697), but the overall probability of being most cost-effective compared to the other strategies was still only 23%. Sensitivity analysis shows that there is large uncertainty in the effectiveness of all strategies, with largely overlapping 95% confidence intervals for all strategies. CONCLUSIONS: Due to the largely overlapping 95% confidence intervals of all monitoring strategies for VS, it is unclear which monitoring strategy provides most value for money at this moment.

The purpose of the research to test the effect of accountability, transparency, participation, and supervision on the performance of budget based on the value for money in OPD Sleman Regency. The research sample are 101 respondents. The result shows that accountability, transparency, and participation has a significant effect on the performance of budget based on the value for money while supervision has no significant impact on the performance of budget based on the value for money

Private finance initiative (PFI) is a way of creating "public–private partnerships" (PPPs) where private firms are contracted to complete and manage public projects. The purpose of this paper is to investigate how to achieve a desirable procurement contract in PFIs. In the first part, we develop an incomplete contracting model to analyze the effectiveness of PFIs. We show that an appropriate fixed compensation is important in disentangling adverse selection. In the second part, we test the validity of this theoretical implication by case study of “Thalasso Fukuoka” and by cross-sectional analysis on Japan’s PFIs. The case study indicates that adverse selection under overestimated value for money (VFM) was a major reason for why the project failed. The cross-sectional analysis also shows that when the local government had overestimated the initial VFM, adverse selection discouraged private companies with higher reservation profits to apply for the project. It suggests that the overestimated initial VFM could make the project less productive even if it did not lead the project to bankrupcy.

Two of the most fundamentalist concepts for reshaping the regional public finance are the transparency process and the public accountability through the public sector accounting. To support the realization of both of these ideas, there is a concept that has been discussed in the term of local public accounting system recently, which is called ‘Value for Money’. By using Content Analysis method, the aim of this study is to find out more about the issue problem and the use of ‘Value For Money’ to analyze the transparency and public accountability problem in Indonesia.

Cost-effectiveness analysis is increasingly relevant in humanitarian action. The cost of response has increased exponentially in the past decade, alongside concurrent donor budget restrictions. However, there remains limited comprehension and application of these methods in this field. This paper documents methods developed for use within Action Against Hunger, an international humanitarian organisation, in response to a lack of understanding of this topic within the humanitarian community and limited evidence of the cost-effectiveness of humanitarian action. These methods encompass costs to both implementing institutions and participating communities. Activity-based cost analyses are conducted to assess resources per programme activity. Cost-effectiveness is evaluated using successful programme outcomes, and uncertainty is appraised via sensitivity analysis. This paper aims to advance knowledge, stimulate discussion, and promote the adoption of cost-effectiveness methods for building the evidence base for humanitarian action, including consideration of community costs, to enable analytical outputs that are useful for managers and policymakers alike.

The Department of Agriculture Agricultural Training Institute is continually keeping up with the challenges on the implementation of its extension programs." This study elaborates on the effectiveness of the Learning Sites (LS) and School for Practical Agriculture (SPA) in delivering technologies to farmers. Mixed methods approach was used to generate qualitative and quantitative measures. These included the conduct of focus group discussion, survey, and field visits. There were 10 participants in the FGD and 154 respondents for the survey. Regression analysis was used to explain the determinants of the effectiveness of established program objectives. Return on investment and value for money estimates showed that farmers' income increased. Moreover, the sufficiency of inputs and conduciveness of the facilities were found to directly relate to program success. Consequently, the implementation of LS and SPA is deemed effective and sustainable.

Value for Money (VfM) is increasingly a funding requirement for UK aid. This article builds on research around different VfM approaches to highlight the challenges faced by the sector in ap...

The start of 2019 has seen universities in the United Kingdom come under increasing pressure to demonstrate that their courses offer value for money to the growing number of students who move throu...

Public‒private partnerships (PPPs) are often promoted as a means to lower the costs and increase the quality and value for money (VfM) of public construction and infrastructure projects. While the increasing capital stock of PPPs warrants evaluation of their performance there has until now been limited systematic assessment of PPP versus conventional public procurement. This article contributes to the literature by presenting the findings of a systematic review of empirical peer‐reviewed studies comparing the costs, quality, and/or VfM of infrastructure PPP projects with conventional public procurement. The international literature suggests that PPPs are on average more costly and provide approximately similar VfM as conventional procurement. The number of empirical evaluations is limited, however, and evidence on the quality of infrastructure facilities is particularly scarce. While infrastructure PPPs continue to proliferate, systematic assessment of their performance is warranted to assist policy‐makers in choosing the procurement method that offers best value for taxpayers, users and society.

Background In self-regulated procedural simulation, learners practise on many simulators (e.g. paracentesis), self-regulating their choice of simulators, time and goals. Current needs assessments cannot predict the number of simulators needed to plan cost-effective self-regulated simulation. Knowing the ratios of simulators and participants would allow for better-informed purchase decisions to be made. Methods We designed 90-minute sessions of self-regulated procedural simulation for internal medicine residents. In Phase 1, 51 participants (8.5 per group) could use 22 simulators (US$69 925): ultrasound-guided central (n = 6) and peripheral (n = 2) venous catheterisation; thoracocentesis (n = 2); paracentesis (n = 2); lumbar puncture (n = 6); and arthrocentesis (n = 4). We calculated minimal numbers of simulators based on the time that participants used each simulator in order to design a resource-effective Phase 2, with 24 participants (with 12 per group) using 14 simulators (US$48 720) to meet their needs. Results Calculated from time of use (83 minutes in total), the optimal ratios of simulators expressed for 10 participants were 9.2: 3.7 for jugular and subclavian venous catheterisation (33 minutes); 1.5 for thoracocentesis (13 minutes), 1.0 for femoral venous catheterisation (9 minutes), 1.0 for lumbar puncture (9 minutes), 0.8 for peripheral venous catheterisation (8 minutes), 0.7 for paracentesis (6 minutes) and 0.5 for arthrocentesis (5 minutes). In Phase 2, the usage rate of simulators increased from 35.5% to 76.6%, maintaining the total time of use at 80.4 minutes. Conclusions We present a replicable method for the cost-effective planning of self-regulated simulation by measuring the use of simulators. Expressed as ratios of simulators per participant, this information can support purchase decisions and be shared with similar programmes.

The research explored the approaches used by government agencies (as client organizations) to drive occupational health and safety (OHS) performance improvements in publicly funded infrastr...

Research location in South Sulawesi Province in 2013-2015. Measurement analysis uses Financial and Value For Money Aspects of efficiency and effectiveness. This study aims to analyze how: (1) the consistency between the Regional Expenditure Revenue Budget and the realization of the education sector development budget management of the South Sulawesi provincial government in terms of financial aspects, (2) the level of efficiency and effectiveness of the allocation of development budget management in the education sector from the Regional Expenditure Budget seen from the realization of the budget, expenditure plans and realization of the education sector expenditure in the South Sulawesi provincial government. The results of this study indicate that: (1) there is consistency between the regional expenditure budget and the realization of the development budget management in the education sector of the government of South Sulawesi Province in terms of financial aspects, (2) governance of the development budget in the education sector allocated from the expenditure budget In terms of budget realization, the expenditure plan and realization of the education sector expenditure in the provincial government of South Sulawesi are said to be efficient with a value of more than 90% and the level of effectiveness by paying attention to the outcome achieved.

Background Daylight photodynamic therapy (DL-PDT) with methyl-5-aminolaevulinate (MAL) is an effective treatment for mild and moderate actinic keratosis (AK). Objectives To assess the clinical efficacy, tolerability and cost-effectiveness of 5-aminolaevulinic acid nanoemulsion (BF-200 ALA) compared with MAL in DL-PDT for grade I-II AKs. Methods This nonsponsored, prospective randomized double-blind multicentre trial included 69 patients with 767 grade I-II AKs located symmetrically on the face or scalp. A single DL-PDT was given in a randomized split-face design. The primary outcome was clearance of the AKs at 12 months as assessed by a blinded observer. The secondary outcomes were pain, treatment reactions, cosmetic outcome and the cost-effectiveness of the therapy. Results In the per-patient (half-face) analysis, clearance was better for the BF-200 ALA sides than for those treated with MAL (P = 0·008). In total, BF-200 ALA cleared 299/375 AKs (79·7%) and MAL 288/392 (73·5%) (P = 0·041). The treatment was practically painless with both photosensitizers, the mean pain visual analogue scale being 1·51 for BF-200 ALA and 1·35 for MAL (P = 0·061). Twenty-six patients had a stronger skin reaction on the BF-200 ALA side, seven on the MAL side and 23 displayed no difference (P = 0·001). The cosmetic outcome was excellent or good in > 90% of cases with both photosensitizers (P = 1·000). The cost-effectiveness plane showed that the costs of DL-PDT were similar for both photosensitizers, but the effectiveness was slightly higher for BF-200 ALA. Conclusions Our results indicate that BF-200 ALA is more effective than MAL in DL-PDT for grade I-II AKs. BF-200 ALA provides slightly better value for money than MAL.

TCCs are seen to be a procurement model capable of achieving value for money through aligning the objectives of the parties to reduce costs. The use of Target Cost Contracts (TCCs) within the UK construction industry has increased dramatically over the past few years. TCCs have been employed successfully on recent large scale projects such as Heathrow Terminal 5, Crossrail Procurement Strategy and the 2012 Olympic Games and Paralympic Games Infrastructure. Due to the success of TCCs over recent years, many clients are now turning to them in a bid to obtain value for money. However, it seems that they do not always drive parties to minimise costs and provide value for money. This research paper investigates the extent to which TCCs promote collaborative behaviours and provide value for money within the UK construction industry. More particularly, the research explores the following: which projects TCCs should be used on and how the maturity of the design when agreeing the target cost can affect value for money; how setting both the target cost and the pain/gain mechanism can affect the incentivisation of the contractor to minimise costs; the extent to which TCCs promote collaboration between the contractor, client and supply chain; and what is required to manage a TCC post-contract to ensure that incentivisation is maintained. It has become apparent from the research that TCCs are complex procurement models which require extensive consideration and management to ensure parties are incentivised to minimise costs. The research reveals that although TCCs can promote collaborative behaviours and provide value for money, there is a prerequisite to doing so: developing and managing the TCC correctly to ensure that the objectives of the parties are aligned.

Building on widespread calls for policies and development strategies that align human and ecological goals, an increasing number of scholars and practitioners are turning to the concept of “sustainable diet” as a guiding principle to address the multidimensional implications of food production on society, the environment and the economy. After discussing the core principles of this concept and providing some examples of its practical application, this article explores the potential of food procurement in progressing sustainable diets in public canteens. A critical review of the literature shows that there are three main barriers that need to be overcome to embed the principles of “sustainable diet” in public contracts: the primacy of a rigid ‘value for money’ ethos, which reinforces a risk-averse culture around public food provision that inhibits individuals and organisations from driving change; the tendency by governments to promote ‘silo-ed’ approaches to change leadership on issues like public procurement, which inhibit the levels of knowledge-sharing and collective endeavor across departments that is required to underpin sustainable procurement reform; and a lack of technical knowledge related to sustainable procurement and sustainable food provision. Con base en llamamientos generalizados por políticas y estrategias de desarrollo que alinean objetivos humanos y ecológicos, un número creciente de estudiosos y profesionales está recurriendo al concepto de "dieta sustentable" como un principio orientador para abordar las implicaciones multidimensionales de la producción de alimentos en la sociedad, en el medio ambiente y en la economía. Después de discutir los principios fundamentales de este concepto y proporcionar algunos ejemplos de su aplicación práctica, este artículo explora el potencial de la compra de alimentos en el desarrollo de dietas sostenibles en compras públicas de alimentos. Una revisión crítica de la literatura muestra que hay tres barreras principales que deben ser superadas para incorporar los principios de la dieta sostenible en las compras públicas: la primacía de un ethos rígido, "value for money", que refuerza una cultura aversión al riesgo en torno de la provisión de alimentos públicos que inhibe a individuos y organizaciones de impulsar el cambio; la tendencia de los gobiernos de promover enfoques "silenciados" para cambiar el liderazgo en cuestiones como las compras públicas, que inhiben los niveles de intercambio de conocimiento y esfuerzo colectivo entre los departamentos necesarios para sostener la reforma sostenible de adquisiciones; y falta de conocimiento técnico Com base em apelos generalizados por políticas e estratégias de desenvolvimento que alinhem objetivos humanos e ecológicos, um número crescente de estudiosos e profissionais está recorrendo ao conceito de “dieta sustentável” como um princípio orientador para abordar as implicações multidimensionais da produção de alimentos na sociedade, no meio ambiente e na economia. Depois de discutir os princípios fundamentais deste conceito e fornecer alguns exemplos da sua aplicação prática, este artigo explora o potencial da aquisição de alimentos no desenvolvimento de dietas sustentáveis em compras públicas de alimentos. Uma revisão crítica da literatura mostra que há três barreiras principais que precisam ser superadas para incorporar os princípios da “dieta sustentável” nas compras públicas: a primazia de um ethos rígido, “value for money”, que reforça uma cultura avessa ao risco em torno da provisão de alimentos públicos que inibe indivíduos e organizações de impulsionar a mudança; a tendência dos governos de promover abordagens "silenciadas" para mudar a liderança em questões como as compras públicas, que inibem os níveis de compartilhamento de conhecimento e esforço coletivo entre os departamentos necessários para sustentar a reforma sustentável de aquisições; e falta de conhecimento técnico relacionado a compras sustentáveis e fornecimento sustentável de alimentos.