Costs avoidable

The developments in the treatment of RA are tempered by the lack of evidence describing the long-term safety and efficacy of the BRMs. In addition, the cost associated with the medications can be a deterrent to use. Long-term data are needed to determine if patients receiving BRM therapy early in the course of disease have reduced disease activity, reduced joint deformities and disability, improved quality of life, and continued function as productive members of society. Cost analyses of long-term data may indicate that the increased expenses associated with BRMs are offset by the costs avoided for the treatment of advanced RA. 

The usable cooling energy content of the cubic meter of ice is about 100 kWh. Therefore, the cost avoidance based on Canadian commercial electricity rates was about 5- 50 per cubic meter of ice. Farmers pay about 25 per cubic meter for delivered ice used in harvesting operations. Fishermen pay about 10 per cubic meter for ice made in large quantifies, and cube ice sold primarily in summer for chilling of drinks sells for an equivalent of about 200 per cubic meter. Cost considerations led to an initial cost goal of 120 (1979 ) per cubic meter of ice [11],... 

Mount the specimen on the holder, so that it is securely held without vibration or creep but is not strained by the mounting. This is achieved by fixing the specimen at one point only, using PVC adhesive tape (as supplied for ciystal growth laboratories). Kinematic location (resting under gravity with minimum constraints) may be used in some diffractometers. At all costs avoid over-constraint of the specimen. 

During the development of the proposal, the process owner should consider requesting subject matter experts to assist with the development of the problem statement, risk assessment, and cost avoidance or savings. Many times a process owner s core competencies align closely with the process but may lack business or project management skills. The process owner may need assistance to clearly articulate to the leadership what the benefits are to accept the proposed change versus the risks for not adopting the proposal. 

As part of the schedule, it should be considered that the majority of the development of computer systems fails due to poor gathering of requirements. This situation leads to negatively affect subsequent development activities and associated work products. An investment up front can yield notable savings (cost avoidance) later. 

Power plants to burn scrap tires involve large capital investments and annual operating expenses. However, plants located near large supplies of tires can be feasible. A key variable in determining economic feasibility for these plants is the buy-back rate granted by the utility. In areas of the country where the rate is high, such as California and the northeast, power plants are feasible. The buy-back rate is the rate the utilities pay for electricity generated from alternative fuel, and reflects the fuel and other costs avoided by the utility. 

Woods JE (1989) Cost avoidance and productivity in owning and operating buildings. Occupational Medicine 4(4) 753-770. 

A critical aspect of integrating sustainability into business is in the area of valuation. How do we know the financial impacts of our decisions How can performing more sustainability help to reduce costs, avoid future costs, increase the company s value proposition, support growth, and so on What are the links between intangibles related to social and environmental performance and a hrm s overall performance What contributes to value creation in the chemical industry How can we reconcile the fact that we may incur costs for performing more sustainably in the short term while the benefits may not be captured until the long term similarly, how do we justify costs associated with our business decisions when the benefits might accrue to others in the value chain We know the value of ecosystem services is both invaluable - that is, our life depends on them - and of no real market value how then should we value ecosystem services in order to protect them for our survival and that of our business institutions This section attempts to offer points of view on these topics. 

Outcomes, or consequences, of the services described were considered in all 104 papers. Nineteen (18%) of the papers were found to be full economic analyses because they considered two or more alternatives to care and measured both input costs and outcomes. The most common outcomes measured were drug costs avoided, length of hospital stay, use of nonpharmaceutical resources, rates of adverse drug reactions, frequency of pharmacist-driven therapeutic interventions, and qualitative changes in prescribing patterns. In 93 (89%) of the papers, beneficial financial impacts of clinical pharmacy services were described. 

Chuang, L.C. Sutton, J.D. Henderson, G.T. Impact of a clinical pharmacist on cost saving and cost avoidance in drug therapy in an intensive care unit. Ho.sp. Pharm. 1994, 29 (3), 215 218. 

Seventy-one studies (68%) did not evaluate the cost of providing the clinical service as part of the economic evaluation of that service. Most commonly, costs were considered as an outcome or consequence of the service (i.e., as in drug costs avoided) rather than as an input (i.e., as in the investment required to establish and maintain the program under study). Of the 33 (32%) studies that did consider some input costs, the most common cost assessed was personnel n = 25). In these cases, the costs of the program under study were quantified in terms of sa-... 

Outcome measurements should include more than just drug costs avoided. Nonfinancial outcomes... 

To assess the quality and cost avoidance of RPh interventions using physician assessors OD None None DCA, LOS Positive impact on patient care, estimated reduced LOS by 3.7 days Physician reviewers estimated reduction in LOS resulting from interventions... 

To cost justify clinical pharmacy service on general surgery team COD None Personnel costs DCA, type of intervention, clinical impact of intervention Positive impact on outcomes net cost avoidance of 441.46/patient Small sample... 

Decreased average total cost/admission by 1293 decreased average pharmacy cost/admission by 155 for decentralized Cost avoided of 3.47/prescription processed... 

ChW2] To determine impact of clinical interventions on cost and quality of patient care OD None None Number of inappropriate laboratory tests, DCA Annual dmg cost avoidance of 26,580 ... 

To evaluate impact of pediatric pharmacokinetic service using guidelines as basis for appropriate monitoring CA Control group None Costs avoided through decrease in inappropriate monitoring Annual cost avoidance 12,325 based on fewer inappropriate laboratory assays Input costs not considered... 

To evaluate effectiveness of serum digoxin concentration monitoring, and determine cost impact of service OD None None NOI, timing of digoxin serum concentrations, laboratory costs avoided Decreased number of digoxin serum drug concentrations ordered Input costs not considered... 

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