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Demand for an Environmental Public Good in the Time of COVID-19: A Statewide Water Quality Referendum COVID-19时期对环境公共产品的需求:全州水质公投
IF 3.4 4区 经济学 Q2 ECONOMICS Pub Date : 2022-02-10 DOI: 10.1017/bca.2021.14
G. Parsons, L. Paul, K. Messer
Abstract Due to COVID-19, many households faced hardships in the spring of 2020 – unemployment, an uncertain economic future, forced separation, and more. At the same time, the number of people who participated in outdoor recreation in many areas increased, as it was one of the few activities still permitted. How these experiences affect the public’s willingness to pay (WTP) for environmental public goods is unknown. During the early months of the pandemic, we conducted a stated preference survey to value statewide water quality improvements in Delaware. While a majority of participants report experiencing hardship of some sort (economic, emotional, etc.), mean household WTP declined by only 7 % by May 2020.
由于新冠肺炎疫情,许多家庭在2020年春天面临着困难——失业、不确定的经济前景、被迫分离等等。与此同时,在许多地区,参加户外娱乐活动的人数增加了,因为这是少数仍被允许的活动之一。这些经验如何影响公众对环境公共产品的支付意愿(WTP)是未知的。在大流行的最初几个月,我们进行了一项明确的偏好调查,以评估特拉华州全州水质改善的价值。虽然大多数参与者表示经历了某种困难(经济、情感等),但到2020年5月,平均家庭WTP仅下降了7%。
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引用次数: 0
Benefit-Cost Ratios of Continuing Routine Immunization During the COVID-19 Pandemic in Africa 非洲COVID-19大流行期间持续常规免疫接种的效益-成本比
IF 3.4 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-18 DOI: 10.1017/bca.2021.13
E. Watts, J. Mak, B. Patenaude
Abstract Disruptions in routine immunization caused by COVID-19 put African countries with large vaccine-preventable disease burdens at high risk of outbreaks. Abbas et al. (2020) showed that mortality reduction from resuming immunization outweighs excess mortality from COVID-19 caused by exposure during immunization activities. We leverage these estimates to calculate benefit-cost ratios (BCRs) of disrupted immunization and apply cost of illness (COI) and value of statistical life-year (VSLY) approaches to estimate the cost of excess child deaths from eight vaccine-preventable diseases. BCRs were computed for each country, vaccine, and Expanded Program on Immunization visit. Secondary estimates that include the cost of providing immunization are presented in scenario analysis. Suspended immunization may cost $4949 million due to excess mortality using the COI approach, or $34,344 million using the VSLY approach. Likewise, excess COVID-19 deaths caused by exposure from immunization activities would cost $53 and $275 million using the COI and VSLY approaches, respectively. BCRs of continuing routine immunization are 94:1 using COI and 125:1 using VSLY, indicating that the economic costs of suspending immunization exceed that of COVID-19 deaths risked by routine immunization. When including the costs of providing routine immunization during the COVID-19 pandemic, the BCRs are 38:1 and 97:1 using the COI and VSLY approaches, respectively.
COVID-19造成的常规免疫中断使疫苗可预防疾病负担沉重的非洲国家面临疫情的高风险。Abbas等人(2020)表明,恢复免疫接种降低的死亡率超过了免疫活动期间暴露造成的COVID-19超额死亡率。我们利用这些估计来计算中断免疫接种的效益成本比(bcr),并应用疾病成本(COI)和统计生命年价值(VSLY)方法来估计八种疫苗可预防疾病造成的超额儿童死亡的成本。计算每个国家、疫苗和扩大免疫规划访问的bcr。情景分析中列出了包括提供免疫接种费用在内的二次估计。由于使用COI方法死亡率过高,暂停免疫可能花费4.949亿美元,或使用VSLY方法花费343.44亿美元。同样,使用COI和VSLY方法,免疫活动暴露造成的COVID-19额外死亡将分别造成5300万美元和2.75亿美元的损失。使用COI和VSLY继续常规免疫的bcr分别为94:1和125:1,表明暂停免疫的经济成本超过常规免疫带来的COVID-19死亡风险。在包括COVID-19大流行期间提供常规免疫的成本时,使用COI和VSLY方法的bcr分别为38:1和97:1。
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引用次数: 2
BCA volume 13 issue 3 Cover and Back matter BCA第13卷第3期封面和封底
IF 3.4 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-01 DOI: 10.1017/bca.2022.26
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引用次数: 0
Valuing COVID-19 Morbidity Risk Reductions. 评估 COVID-19 降低的发病风险。
IF 2 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-01 Epub Date: 2022-08-03 DOI: 10.1017/bca.2022.11
Lisa A Robinson, Michael R Eber, James K Hammitt

Many economic analyses, including those that address the COVID-19 pandemic, focus on the value of averting deaths and do not include the value of averting nonfatal illnesses. Yet incorporating the value of averting nonfatal cases may change conclusions about the desirability of the policy. While per case values may be small, the number of nonfatal cases is often large, far outstripping the number of fatal cases. The value of averting nonfatal cases is also increasingly important in evaluating COVID-19 policy options as vaccine- and infection-related immunity and treatments reduce the case-fatality rate. Unfortunately, little valuation research is available that explicitly addresses COVID-19 morbidity. We describe and implement an approach for approximating the value of averting nonfatal illnesses or injuries and apply it to COVID-19 in the United States. We estimate gains from averting COVID-19 morbidity of about 0.01 quality-adjusted life year (QALY) per mild case averted, 0.02 QALY per severe case, and 3.15 QALYs per critical case. These gains translate into monetary values of about $5,300 per mild case, $11,000 per severe case, and $1.8 million per critical case. While these estimates are imprecise, they suggest the magnitude of the effects.

许多经济分析,包括针对 COVID-19 大流行的分析,都只关注避免死亡的价值,而不包括避免非致命疾病的价值。然而,纳入避免非致命病例的价值可能会改变有关政策可取性的结论。虽然每个病例的价值可能很小,但非致命病例的数量往往很大,远远超过致命病例的数量。在评估 COVID-19 政策方案时,避免非致命病例的价值也越来越重要,因为疫苗和感染相关的免疫和治疗可降低病死率。遗憾的是,目前很少有明确针对 COVID-19 发病率的估值研究。我们描述并实施了一种近似估算避免非致命性疾病或伤害价值的方法,并将其应用于美国的 COVID-19。我们估计,从避免 COVID-19 发病率中获得的收益为:每避免一个轻症病例约 0.01 质量调整生命年 (QALY),每避免一个重症病例约 0.02 QALY,每避免一个危重病例约 3.15 QALY。这些收益的货币价值分别为:每个轻度病例约 5,300 美元,每个重度病例约 11,000 美元,每个危重病例约 180 万美元。虽然这些估算并不精确,但它们表明了效果的大小。
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引用次数: 0
BCA volume 13 issue 1 Cover and Front matter BCA第13卷第1期封面和封面问题
IF 3.4 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-01 DOI: 10.1017/bca.2022.7
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引用次数: 0
“We Test”: An Imagined Regulatory Future “我们测试”:想象中的监管未来
IF 3.4 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-01 DOI: 10.1017/bca.2022.23
C. Sunstein
Abstract There can be a serious tension between the commitment to cost-benefit analysis and a realistic appreciation of the limits of official knowledge. Without significant efforts to reduce those limits, that analysis might be inadequately informed. Whenever regulators face significant informational deficits, or what is sometimes called “the knowledge problem,” it is important to explore tools that take advantage of what the private sector knows; market-friendly tools, such as economic incentives, have important advantages on that count. An advanced regulatory system should also try to reduce the knowledge problem through three routes: (i) creative use of notice-and-comment rulemaking; (ii) retrospective analysis of regulations and their costs and benefits; and (iii) advance testing, as a way of informing ex ante analysis. For the future, the most promising approach is (iii).
在对成本效益分析的承诺和对官方知识局限性的现实认识之间可能存在严重的紧张关系。如果没有减少这些限制的重大努力,这种分析可能是不充分的。每当监管机构面临严重的信息赤字,或者有时被称为“知识问题”时,探索利用私营部门知识的工具就很重要;在这方面,经济激励等市场友好型工具具有重要优势。一个先进的监管体系也应该尝试通过三种途径来减少知识问题:(i)创造性地使用通知和评论规则制定;(ii)法规及其成本和效益的回顾性分析;(iii)提前测试,作为预先分析的一种方式。对于未来,最有希望的方法是(iii)。
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引用次数: 1
Costs and Benefits of Branded Drugs: Insights from Cost-Effectiveness Research 品牌药的成本和收益:来自成本效益研究的见解
IF 3.4 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-01 DOI: 10.1017/bca.2022.12
Iii H. E. Frech, M. Pauly, W. Comanor, Joseph R Martinez
The relationship between costs and health benefits of branded pharmaceuticals remains controversial. This paper examines the incremental costs incurred for incremental health benefits gained from the largest available sample of cost-effectiveness studies of branded drugs in the USA, the 1994–2015 Tufts Registry of Cost-Effectiveness Analyses. Earlier studies used small, specialized samples of drugs. We use linear regression analysis to estimate the association in those studies between additional quality-adjusted life years (QALYs) and incremental pharmaceutical costs. The preferred sample uses 476 studies involving branded pharmaceuticals with both higher costs and increased effectiveness compared to the previous standard of care. Regressions of costs on QALYs imply that an additional QALY is associated, on average, with a $28,561 increase in cost (95 % CI, $18,853–$38,270). This regression explains 20 % of the variation in sample costs. In this analytical sample, a share of the variation in the cost of pharmaceuticals is, therefore, not random but rather associated with variation in QALYs; prices are to some extent “value-based.” Our results are robust to varying sample inclusion criteria and to the funding source. In subgroup analyses, the highest cost per QALY was $44,367 (95 % CI, $35,373–$53,361). Costs of pharmaceuticals in this data set are, on average, lower than common estimates of the monetary value of a QALY to American consumers. As in other studies, we find that sellers of patent-protected beneficial new technology appear to capture only a fraction of the benefits provided.
品牌药品的成本与健康效益之间的关系仍然存在争议。本文从1994-2015年塔夫茨成本-效果分析注册库这一美国最大的品牌药成本-效果研究样本中,研究了为获得增量健康效益而产生的增量成本。早期的研究使用了小的、专门的药物样本。我们使用线性回归分析来估计这些研究中额外质量调整生命年(QALYs)与增加药物成本之间的关联。首选样本使用了476项研究,涉及与以前的护理标准相比成本更高且效果更好的品牌药物。QALY的成本回归表明,平均而言,额外的QALY与成本增加28,561美元相关(95% CI, 18,853 - 38,270美元)。这种回归解释了20%的样本成本变化。因此,在本分析样本中,药品成本变化的份额不是随机的,而是与质量aly的变化有关;价格在某种程度上是“基于价值的”。我们的结果对不同的样本纳入标准和资金来源都是稳健的。在亚组分析中,每个QALY的最高成本为44,367美元(95% CI, 35,373 - 53,361美元)。该数据集中的药品成本平均低于美国消费者对QALY货币价值的一般估计。与其他研究一样,我们发现,受专利保护的有益新技术的销售者似乎只获得了所提供利益的一小部分。
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引用次数: 3
Early Education and Adult Health: Age 37 Impacts and Economic Benefits of the Child-Parent Center Preschool Program. 早期教育与成人健康:37 岁儿童-家长中心学前计划的影响和经济效益。
IF 2 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-01 Epub Date: 2022-05-10 DOI: 10.1017/bca.2022.4
Nishank Varshney, Judy A Temple, Arthur J Reynolds

This paper evaluates the long-term impacts of the Chicago Child-Parent Center (CPC) program, a comprehensive early childhood program launched in the 1960s, on the physical and mental health outcomes. This study follows a cohort of 1539 participants born in 1979-1980 and surveyed most recently at age 35-37 by employing a matched study design created by including all students who were enrolled in kindergarten classrooms in CPC school sites as well as entire kindergarten classrooms in a matched set of similar high-poverty schools. Using propensity score weighting that addresses potential issues with differential attrition and nonrandom treatment assignment, results reveal that CPC preschool participation is associated with significantly lower rates of adverse health outcomes such as smoking and diabetes. Further, evaluating the economic impacts of the preschool component of the program, the study finds a benefit-cost ratio in the range of 1.35 to 3.66 (net benefit: $3,896) indicating that the health benefits of the program by themselves offset the costs of the program even without considering additional benefits arising from increased educational attainment and reduced involvement in crime reported in earlier cost-benefit analyses. The findings are robust to corrections for multiple hypothesis testing, sensitivity analysis using a range of discount rates, and Monte Carlo analysis to account for uncertainty in outcomes.

芝加哥儿童与家长中心(CPC)计划是 20 世纪 60 年代推出的一项综合性幼儿计划,本文评估了该计划对身心健康的长期影响。本研究对 1979-1980 年出生的 1539 名参与者进行了追踪调查,最近一次调查是在他们 35-37 岁时进行的。本研究采用了匹配研究设计,将所有在 CPC 学校所在地的幼儿园班级就读的学生以及与之匹配的类似高贫困率学校的整个幼儿园班级的学生都包括在内。利用倾向得分加权法解决了不同自然减员和非随机治疗分配的潜在问题,结果表明,CPC 学前教育的参与与吸烟和糖尿病等不良健康后果发生率的显著降低有关。此外,在评估该计划学前教育部分的经济影响时,研究发现效益成本比在 1.35 到 3.66 之间(净效益:3,896 美元),这表明即使不考虑早期成本效益分析中报告的教育程度提高和犯罪率降低所带来的额外效益,该计划的健康效益本身也能抵消该计划的成本。这些研究结果对多重假设检验、使用一系列贴现率进行的敏感性分析以及对结果的不确定性进行的蒙特卡罗分析进行了校正。
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引用次数: 0
BCA volume 13 issue 3 Cover and Front matter BCA第13卷第3期封面和封面问题
IF 3.4 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-01 DOI: 10.1017/bca.2022.25
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引用次数: 0
BCA volume 13 issue 1 Cover and Back matter BCA第13卷第1期封面和封底
IF 3.4 4区 经济学 Q2 ECONOMICS Pub Date : 2022-01-01 DOI: 10.1017/bca.2022.8
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引用次数: 0
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Journal of Benefit-Cost Analysis
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