Downstream costs were estimated by identifying services in administrative data, medical records, and patient surveys for 6 months.
Here, too, a modest amount of increased front-end spending often led to an order-of-magnitude reduction in downstream costs.
For business and the public, this translates to higher costs for transportation fuels and electricity derived from fossil fuels, with the downstream costs filtering to a wider segment of the province's economy than in Australia.
Advances in upstream processing (the bioreactor phase) have been successful in achieving high product titres, and downstream costs now typically dominate the overall manufacturing costs.
Cardiomyopathy patients were expected to gain substantially less benefit (20 QALYs per 10,000 patients tested; CR: 4.5−40) but also to be associated with lower downstream costs ($896,000, CR: $490,000 $1.9 million), for an ICER of $44,800 955% CR: $18,300 $217,800).
Mean 6-month downstream costs did not differ statistically between the control and WGS arms in either setting (cardiology: difference = −$1,560, 95% confidence interval −$7,558 to $3,866, p = 0.36; primary care: difference = $681 ,95% confidence interval −$884 to $2,171, p = 0.70).
More impressively, they have reduced the most expensive downstream costs (surgical, specialist and emergency visits) 40-80%.
We will assess outcomes and related downstream costs for patients who access physical therapy at the primary care level compared to those that receive usual care only.
"Primary care is the main entry point for individuals into an increasingly complex healthcare system, making it the ideal setting for providing patient education, encouraging preventive care and controlling downstream costs," said Natauri, in a statement.
