42 research outputs found
State-of-the-art of mini grids for rural electrification in West Africa
The current electrification status in West African countries presents rural electrification rates below 40%, national grid losses above 39% with frequent disruptions, and electricity prices averaging 0.66/kWh. With this, off-grid systems have gained great attention during the last decade as energy solutions; especially solar home systems (SHS) and mini grids. Nowadays, 385 mini grids with a power of near 30 MW are operating in West Africa, with 95% based on PV. Since 2019, result-based tenders with international aid funding—more effective than previous competitive tenders—seek to install at least 317 new mini grids in Togo, 250 in Nigeria, 100 in Burkina Faso, and two in Mali. Besides, the market for mini-grid energy access start-ups grew from 339 million in 2018. Despite this recent development in West Africa, research and data for mini grids in this region is scarce, and it is mostly approached from the technological side, with a striking lack of information regarding the social impact. This work tries to describe the present status of research and current operating installations, as well as the main challenges for future development of off grid mini grids in West Africa, which pose as the missing link between SHS and grid extension
Off-grid solar waste in sub-Saharan Africa: Market dynamics, barriers to sustainability, and circular economy solutions
Health-economic modelling of infectious disease diagnostics: current approaches and future opportunities
Objectives: Antimicrobial resistance (AMR) is a public health threat; infections with resistant organisms are estimated to cause over 650.000 infections and over 30.000 deaths in Europe. AMR is associated with antibiotic consumption: appropriate prescribing of antibiotics is key in combating AMR. To fight this threat, it has been suggested that point-of-care diagnostics to inform antibiotics prescribing are an important tool in reducing antibiotics prescriptions. With the objective of knowing the state of the art, we reviewed diagnostic cost-effectiveness analyses (CEAs) for infectious disease, focussing on model types, effects on prescriptions and AMR. Methods: We searched the literature comprehensively through the PUBMED, Web of Science and EMBASE databases, as well as grey literature for the period 2000-2018. We included economic evaluations for diagnostic strategies for infectious disease in all geographic areas. Data extraction was based on the Consolidated Health Economic Evaluation Reporting Standards statement, with an additional focus on the modelling type and inclusion of AMR.Results: In general, CEAs of diagnostics for infectious disease fall in two categories: trial-based cost-effectiveness, focusing on short-term outcomes, and long-term models, focusing on outcomes extrapolated beyond the trial. Outcomes measured are for example prescriptions saved or hospitalizations saved. Cost-utility analyses seem to be difficult, as QALY differences between various diagnostic strategies are minor. Antimicrobial resistance is considered indirectly: as an ICER with prescriptions saved as an outcome; by calculating the threshold cost of resistance that would change the conclusion of cost-effectiveness; or as a point estimate; often, it is not considered at all.Conclusions: CEAs of diagnostic strategies for infectious disease are relatively scarce and it can be challenging to prove the cost-effectiveness of diagnostic strategies, especially in the context of relatively inexpensive treatments, such as antibiotics. However, there is an important opportunity of including the societal costs of AMR in future CEAs.<br/
Health-economic modelling of infectious disease diagnostics: current approaches and future opportunities
REFLECTIONS AND PERSPECTIVES ON BIOSIMILARS IN BRAZIL
Objective: Biological agents are among the medicines with the highest revenue in the world market. Biosimilars are copies of biological products introduced into the market to offer clinical efficacy like the originator or reference product at lower prices. This study aimed to verify the characteristics and price differences between biological medicines registered and marketed in Brazil until the end of 2019.
Methods: All records were collected by November 2019 on the website of the National Health Surveillance Agency (Anvisa). The list of the Chamber of Regulation of the Medicines Market (CMED) consulted for the price analysis, has an economic classificatory criterion with eight ranges. Categorization, according to the date/period of authorization for marketing, was also made.
Results: At Anvisa site, there are 144 drugs present in 277 products distributed in three regulatory categories: new, biological, and similar. Approximately 73% of drugs have been approved in the past five years. Three classes represent 77.9% of all drugs-antineoplastics and immunomodulatory agents (38.6%), blood and blood organ forming (20.7%), and alimentary tract and metabolism (18.6%). Of the 178 products listed in the CMED, 26 (14.6%) have prices above 10,000 reais.
Conclusion: The prices of original products, for most of the inputs, are lower than those of biosimilars, reversing the international logic
Extensive validation of CM SAF surface radiation products over Europe
This work presents a validation of three satellite-based radiation products over an extensive network of 313 pyranometers across Europe, from 2005 to 2015. The products used have been developed by the Satellite Application Facility on Climate Monitoring (CM SAF) and are one geostationary climate dataset (SARAH-JRC), one polar-orbiting climate dataset (CLARA-A2) and one geostationary operational product. Further, the ERA-Interim reanalysis is also included in the comparison. The main objective is to determine the quality level of the daily means of CM SAF datasets, identifying their limitations, as well as analyzing the different factors that can interfere in the adequate validation of the products. The quality of the pyranometer was the most critical source of uncertainty identified. In this respect, the use of records from Second Class pyranometers and silicon-based photodiodes increased the absolute error and the bias, as well as the dispersion of both metrics, preventing an adequate validation of the daily means. The best spatial estimates for the three datasets were obtained in Central Europe with a Mean Absolute Deviation (MAD) within 8–13 W/m 2 , whereas the MAD always increased at high-latitudes, snow-covered surfaces, high mountain ranges and coastal areas. Overall, the SARAH-JRC's accuracy was demonstrated over a dense network of stations making it the most consistent dataset for climate monitoring applications. The operational dataset was comparable to SARAH-JRC in Central Europe, but lacked of the temporal stability of climate datasets, while CLARA-A2 did not achieve the same level of accuracy despite predictions obtained showed high uniformity with a small negative bias. The ERA-Interim reanalysis shows the by-far largest deviations from the surface reference measurements
Health economic evaluation of gene replacement therapies:Methodological issues and recommendations
Objective: To provide recommendations for addressing previously identified key challenges in health economic evaluations of Gene Replacement Therapies (GRTs), including: 1) the assessment of clinical effectiveness; 2) the valuation of health outcomes; 3) the time horizon and extrapolation of effects beyond trial duration; 4) the estimation of costs; 5) the selection of appropriate discount rates; 6) the incorporation of broader elements of value; and 7) affordability.
Methods: A literature review on economic evaluations of GRT was performed. Interviews were conducted with 8 European and US health economic experts with experience in evaluations of GRT. Targeted literature reviews were conducted to investigate further potential solutions to specific challenges.
Recommendations: Experts agreed on factors to be considered to ensure the acceptability of historical cohorts by HTA bodies. Existing prospective registries or, if not available, retrospective registries, may be used to analyse different disease trajectories and inform extrapolations. The importance of expert opinion due to limited data was acknowledged. Expert opinion should be obtained using structured elicitation techniques. Broader elements of value, beyond health gains directly related to treatment, can be considered through the application of a factor to inflate the quality-adjusted life years (QALYs) or a higher cost-effectiveness threshold. Additionally, the use of cost-benefit analysis and saved young life equivalents (SAVE) were proposed as alternatives to QALYs for the valuations of outcomes of GRT as they can incorporate broader elements of value and avoid problems of eliciting utilities for paediatric diseases.
Conclusions: While some of the limitations of economic evaluations of GRT are inherent to limited clinical data and lack of experience with these treatments, others may be addressed by methodological research to be conducted by health economists