Elements for European logistics policy - A discussion paper

Following a Finnish initiative the European Commission is preparing a communication on logistics in 2006. To support the preparations Finland arranged the so called EULOC-process in which logistics experts from different countries were invited to participate. First, an industry foresight of European logistics in 2015 was created. Next, the mission, vision and policy priorities of the European logistics policy were discussed. The mission for European logistics policy was created from the viewpoint of citizens, companies, states and Europe. Seven vision elements were created. The driving visions are “Seamless systems” and “Intelligent regulation”. The guiding and enabling visions are “Resources” and “Cost efficiency”. The outcome visions are “Europe’s competitiveness”, “Equal business opportunity” and “Sustainability”. According to the experts’ views the priority areas of European logistics policy are Infrastructure – Seamless systems require investments Research, development and training – Strengthen the competitiveness of the European Union Enterprises – The reinforcement of logistic industry Regulation – Innovative and intelligent Cost Efficiency – Effective logistics Sustainability – From environmental, social and economic viewpoint, a must in modern logistics Co-Operation – A strategic issue in network society Public-Private Partnership – Agile solutions for investments

Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)

Background Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II). Methods Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K. Results Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results. Interpretation Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This `win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure