11 research outputs found
Product quality or market regulation? Explaining the slow growth of Europe's wine cooperatives, 1880-1980
Wine cooperatives were relatively scarce in Europe before the Second World War, but by the 1980s accounted for more than half of all wines made in France, Italy, and Spain, the three major producer countries. Unlike Danish dairy cooperatives, whose success before the First World War was linked to their ability to improve product quality and compete in high-value niche markets, wine cooperatives are often associated with the production of large volumes of low-quality products. This article argues that the initial slow diffusion of wine cooperatives was caused by the difficulties of improving quality due to environmental conditions in European vineyards (terroir') and measurement problems, rather than institutional shortcomings. Cooperatives only became widespread when the state found them a useful instrument to regulate markets, especially after 1950. The problems associated with poor wine quality were never resolved, and cooperatives have become increasingly uncompetitive in the market place, especially following the major decline in per capita consumption and shift towards premium wines from the 1980s.Financial assistance was provided by the Spanish government (ECO2012-36213) and Fundación Ramón Areces (‘Desigualdad and Conflicto’ Project)
Disease burden and economic impact of diagnosed non-alcoholic steatohepatitis (nash) in five european countries in 2018: A cost-of-illness analysis.
BACKGROUND AND AIMS
Non-alcoholic steatohepatitis (NASH) is a chronic disease that can progress to end-stage liver disease (ESLD). A large proportion of early-stage NASH patients remain undiagnosed compared to those with advanced fibrosis, who are more likely to receive disease management interventions. This study estimated the disease burden and economic impact of diagnosed NASH in the adult population of France, Germany, Italy, Spain and the United Kingdom (UK) in 2018.
METHODS
The socioeconomic burden of diagnosed NASH was estimated using cost-of-illness methodology applying a prevalence approach to estimate the number of adults with NASH and the attributable economic and wellbeing costs. Given undiagnosed patients do not incur costs in the study, the probability of diagnosis is central to cost estimation. The analysis was based on literature review, databases and consultation with clinical experts, economists and patient groups.
RESULTS
The proportion of adult NASH patients with a diagnosis ranged from 11.9% to 12.7% across countries, which increased to 38.8% to 39.1% for advanced fibrosis (F3 to F4 compensated cirrhosis). Total economic costs were €8,548-19,546M. Of these, health system costs were €619-1,292M. Total wellbeing costs were €41,536-90,379M. The majority of the undiagnosed population (87.3% to 88.2% of total prevalence) was found to have early stage NASH which, left untreated, may progress to more resource consuming ESLD over time.
CONCLUSIONS
This study found the majority of economic and wellbeing costs of NASH are experienced in late disease stages. Earlier diagnosis and care of NASH patients could reduce future healthcare costs