Soybean dreg pre-digested by enzymes can effectively replace part of the fishmeal included in feed pellets for rearing gold-lined seabream

The present study aimed to formulate diets using soybean dreg to replace part of fish meal (30% and 60%) and to incorporate dietary supplement to the diets with papain to promote fish growth and decrease total cost of feed formulations for gold-lined seabream (Rhabdosargus sarba). In Experiment 1, papain was used to supplement feeds containing soybean dreg to replace part of the fish meal. In Experiment 2, bromelain and a microalgae supplement were used to supplement feeds containing soybean substitutes as a replacement of the fish meal. Results from Experiment 1 indicated that the growth performance of fish fed diets with up to 60% replacement of fishmeal with soybean residues predigested with papain were not significantly different (p > 0.05) from the control (a formula developed by Agriculture, Fisheries and Conservation Department (AFCD), which contained 49.4% fishmeal, 45.2% raw trashfish, 4.9% alpha starch and 0.5% vitamin premix). It indicated that plant protein predigested with a small amount of enzyme supplement (e.g. papain) can be used to replace fish meal in traditional fish diets, and the cost could subsequebtly be reduced. In Experiment 2, the diets containing bromelain, soybean dreg pre-digested with bromelain and supplemented with microalgae resulted in significantly better growth performance than other diet groups. Results from the present study suggested that predigesting soybean dreg with enzymes could replace up to 60% fishmeal in the moist pellets while achieving economic benefits.

Improving access to antiretrovirals in China: economic analyses of dolutegravir in HIV-1 patients

BACKGROUND

The World Health Organisation recommended dolutegravir (DTG)-based antiretroviral therapy (ART) regimens are available but not reimbursed through the public reimbursement system in China. The objective of this analysis was to evaluate the cost-effectiveness of DTG (DTG + TDF/3TC) compared to efavirenz (EFV + TDF/3TC) in treatment-naive and ritonavir-boosted lopinavir (LPV/r + TDF/3TC) in first-line ART failure HIV-1-infected patients in China.

METHODS

A dynamic Markov model comprising of 5 response states and 6 CD4+ count-based health states was used. Efficacy, estimated as probability of virologic suppression (HIV RNA < 50 copies/mL) at 48 weeks, was obtained from a published network meta-analysis for ART-naive patients and from the DAWNING study for patients failing first-line ART. Baseline cohort characteristics were informed using DTG phase 3 studies and the DAWNING study data, respectively. Health state utilities were derived from DTG phase 3 studies. A 5-year cost-effectiveness analyses was conducted using the societal perspective. Outcomes were quality-adjusted-life-years (QALYs), life-years (LYs), incremental cost per QALYs (ICER).

RESULTS

The viral suppression rates for DTG + TDF/3TC were higher than EFV + TDF/3TC (75.3% vs 64.0%) in treatment-naive and LPV/r + TDF/3TC (74.8% vs 58.4%) in first-line ART failure patients. This resulted in higher QALYs for DTG + TDF/3TC in treatment-naive (4.232 vs 4.227) and first-line failure settings (4.224 vs 4.221). Total discounted cost for DTG + TDF/3TC patients (RMB 219.259 in treatment-naive and RMB 238,746 in first-line failures) were lower than comparators (EFV + TDF/3TC:RMB 221,605; LPV/r + TDF/3TC:RMB 244,364), thereby DTG dominated in both settings. Probabilistic sensitivity analyses indicated the probability of DTG + TDF/3TC being cost effective was 98.2% in treatment-naive setting and 100% in first-line failure setting at a willingness to pay threshold of RMB 100,000/QALY.

CONCLUSIONS

With lower costs, higher response rates and higher QALYs, DTG + TDF/3TC can be considered as a cost-effective alternative for treatment naive and first-line failure patients in China.

Economic Analyses of Surgical Trips to the Developing World: Current Concepts and Future Strategies

The surgical burden of disease disproportionately affects individuals living in the developing world. In response, the surgical community has increased efforts to provide care to patients in these countries during short-term surgical trips. This article (1) summarizes the current concepts used in the economic evaluation of surgical outreach and (2) presents a conceptual model to describe the ideal approach to performing an economic analysis of surgical interventions in developing countries. This model may ensure that policymakers are provided with information to decrease cost and improve the access to specialty surgery in the developing world.

Using surveillance and economic data to make informed decisions about rotavirus vaccine introduction

While rotavirus vaccines are available, safe, and effective, many countries are not yet widely using these vaccines. Surveillance for rotavirus disease and potential vaccine adverse events is critical for country decision making about rotavirus vaccine. This special issue shares rotavirus and intussusception disease surveillance data and rotavirus vaccine cost-effectiveness analyses from countries that have yet to introduce rotavirus vaccines into their routine infant immunization programs. The studies highlight the substantial burden of rotavirus disease and the cost-effectiveness of rotavirus vaccine in a broad set of countries without rotavirus vaccine in their routine immunization programs.

Carbon farming economics: What have we learned?

This study reviewed 62 economic analyses published between 1995 and 2014 on the economic impacts of policies that incentivise agricultural greenhouse (GHG) mitigation. Typically, biophysical models are used to evaluate the changes in GHG mitigation that result from landholders changing their farm and land management practices. The estimated results of biophysical models are then integrated with economic models to simulate the costs of different policy scenarios to production systems. The cost estimates vary between $3 and $130/t CO2 equivalent in 2012 US dollars, depending on the mitigation strategies, spatial locations, and policy scenarios considered. Most studies assessed the consequences of a single, rather than multiple, mitigation strategies, and few considered the co-benefits of carbon farming. These omissions could challenge the reality and robustness of the studies' results. One of the biggest challenges facing agricultural economists is to assess the full extent of the trade-offs involved in carbon farming. We need to improve our biophysical knowledge about carbon farming co-benefits, predict the economic impacts of employing multiple strategies and policy incentives, and develop the associated integrated models, to estimate the full costs and benefits of agricultural GHG mitigation to farmers and the rest of society.

Improving the quality of abstract reporting for economic analyses in oncology

BACKGROUND

The increasing cost of cancer drugs underscores the importance of economic analyses. Although guidelines for abstract reporting of randomized controlled studies and phase i trials are available, similar recommendations for conference abstracts of economic analyses are lacking. Our objectives were to identify items considered to be essential in abstracts of economic analyses;to evaluate the quality of abstracts submitted to the American Society of Clinical Oncology (asco), the American Society of Hematology (ash), and the International Society for Pharmacoeconomics and Outcomes Research (ispor) meetings; andto propose guidelines for future abstract reporting at conferences.

METHODS

Health economic experts were surveyed and asked to rate each of 24 possible abstract elements on a 5-point Likert scale. A scoring system for abstract quality was devised based on elements with an average expert rating of 3.5 or greater. Abstracts for economic analyses from asco, ash, and ispor meetings were reviewed and assigned a quality score.

RESULTS

Of 99 experts, 50 (51%) responded to the survey (average age: 53 years; 78% men; 54% from the United States, 28% from Europe, 18% from Canada). In total, 216 abstracts were reviewed: asco, 53%; ash, 14%; and ispor, 33%. The median quality score was 75, but notable deficiencies were observed. Cost perspective was reported in only 61% of abstracts, and time horizon was described in only 47%. Abstracts from recent years demonstrated better quality scores. We also observed disparities in quality scores for various cancer sites (p = 0.005).

CONCLUSIONS

The quality of conference abstracts for economic analyses in oncology has room for improvement. Abstracts may be enhanced using the guidelines derived from our survey of experts.