Search Results (5)

Condensable particulate matter (CPM) is different from filterable particulate matter (FPM), which could escape from air pollution control devices (APCDs) and pose a great threat to the environment and human health. Thus, modeling and experimental studies were conducted on CPM particle behavior and removal, in a cold electrode electrostatic precipitator (CE−ESP) coupled with a electric field, temperature field and concentration field. A multi−field force coupling model was then established that was based on the mechanical behavior of particles inside the CE−ESP. The results showed that temperature field was beneficial to depositing small size particles and that, the greater the temperature gradient, the higher CPM’s removal efficiency. While the electric field tended to gather larger size particles, the greater the voltage provided, the higher the removal efficiency for CPM and FPM. In the multi−field, the augmented coagulation and the removal efficiencies of both CPM and FPM increased significantly, reaching 89% and 98%, respectively. Subsequently, experiments were conducted by a self−made CE−ESP device, which showed the removal efficiencies of CE−ESP of a CPM in a multi−field were 91% and 81% for a coal−fired power plant and a waste incineration plant, respectively. This research could make a great contribution to CPM condensation, aggregation and removal. Full article

This article provides evidence and a rationale based on adaptive governance studies for why creating meaningful youth engagement should be understood in terms of intergenerational dialogue, collaboration, learning, and substantive decision-making in global environmental governance. We have centered our discussion on the International Union for the Conservation of Nature (IUCN), as the largest global conservation organization. Through an organizational ethnography approach, we have demonstrated how generational concerns within the IUCN have been framed in terms of participation, and then present the IUCN Intergenerational Partnership for Sustainability (IPS) as a case study of a grassroots movement that is focused on transforming the IUCN towards being a fully intergenerational global governance system for nature conservation. We have described the development of intergenerational thinking and action within the IUCN, and discussed intergenerational governance as being essential for addressing nature conservation challenges faced by local communities in times of increasing global uncertainty. We conclude by providing recommendations for enhancing intergenerational dialogue and building intergenerational governance structures within global conservation organizations. Full article

Objective: To update the health economic evaluation of pirfenidone in the treatment of idiopathic pulmonary fibrosis (IPF) compared to all available alternatives strategies (Best supportive care—BSC and nintedanib), based on a cost-utility model previously validated by the CEESP’s (French Committee for Economic Evaluation) in 2014. Methods: A standard Markov cohort model, adapted to French methodology guidelines, was used to simulate the therapeutic management and the course of IPF patients (including potential adverse events) using the collective perspective. Cost-effectiveness was evaluated regarding life years (LY); quality-adjusted life-years (QALY); average cumulative costs; the incremental cost-effectiveness ratio (ICER) expressed in cost per QALY gained. Data were retrieved from trials, meta-analysis, literature, health insurance and hospitalisation databases, and national tariffs. Results: Over 15 years, total costs accumulated in the pirfenidone strategy were estimated at €99,477 per patient, €104,610 in nintedanib, and €14,177 in Best Supportive Care (BSC). The total number of QALYs accumulated equalled 5.20 (6.91 LYs), 4.52 (5.98 LYs), and 3.79 (4.98 LYs), respectively. Pirfenidone was estimated to be dominant over nintedanib with incremental costs of −€5,133 and 0.67 more QALYs accumulated. Incremental cost versus BSC was €85,300 and 1,404 QALY gained. The cost-effectiveness ratio was estimated at 60,738€/QALY when compared to BSC. Conclusion: Pirfenidone is likely to be a cost–effective strategy compared to BSC and seems more efficient and less costly compared to nintedanib for the treatment of patients with IPF in France. Full article

Background: Despite the guidelines for Economic and Public Health Assessment Committee (CEESP) submission having been available for nearly six years, the dossiers submitted continue to deviate from them, potentially impacting product prices. Objective: to review the reports published by CEESP, analyse deviations from the guidelines, and discuss their implications for the pricing and reimbursement process. Study design: CEESP reports published until January 2017 were reviewed, and deviations from the guidelines were extracted. The frequency of deviations was described by type of methodological concern (minor, important or major). Results: In 19 reports, we identified 243 methodological concerns, most often concerning modelling, measurement and valuation of health states and results presentation and sensitivity analyses; nearly 63% were minor, 33% were important and 4.5% were major. All reports included minor methodological concerns, and 17 (89%) included at least one important and/or major methodological concern. Global major methodological concerns completely invalidated the analysis in seven dossiers (37%). Conclusion: The CEESP submission dossiers fail to adhere to the guidelines, potentially invalidating the health economics analysis and resulting in pricing negotiations. As these negotiations tend to be unfavourable for the manufacturer, the industry should strive to improve the quality of the analyses submitted to CEESP. Full article

The Social Security Funding Law for 2012 introduced the Economic and Public Health Assessment Committee (Commission Evaluation Economique et de Santé Publique, or CEESP) in the Social Security Code as a specialised committee affiliated with the Haute Autorité de Santé in charge of providing recommendations and health economic opinions. This article provides an in-depth description of the CEESP's structure and working methods, and analyses the impact of health economic assessment on market access of drugs in France. It also points out the areas of uncertainty and the conflicting rules following the introduction of the health economic assessment in France. The authors also provide their personal opinion on the likely future of health economic assessment of drugs in France, including the possible merge of the CEESP and the Transparency Committee, the implementation of a French threshold, and the extension of health economic assessment to a larger number of products. Full article