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At least 19 recordsLinked to original sources
PubMed1994

The impact of disposable equipment on room fee reimbursement for endoscopic retrograde cholangiopancreatography.

Disposable equipment is widely used in many gastroenterologic procedures. Such equipment decreases risks of cross contamination, is convenient, and decreases the processing, storage, and cost of reusable equipment. However, disposable equipment has a far-reaching environmental impact. Most disposable equipment must be handled as infectious waste. Moreover, cumulative costs associated with disposable equipment may be quite high. In this study, the authors attempted to delineate the percentage of room fee reimbursement spent on disposable equipment. The procedure selected for the study was Endoscopic Retrograde Cholangiopancreatography (ERCP). Two hundred forty-eight procedures were surveyed over a 6-month period between September 1992 and February 1993, and the total cost of each procedure was calculated. Reimbursement figures for diagnostic and therapeutic ERCPs were obtained for Medicare, contracted providers, and private payors. The percentage of room fee reimbursement monies used for disposable equipment for diagnostic ERCPs ranged from 5.8 to 12.8%. For disposable equipment in therapeutic ERCPs the percentage of room fee reimbursement monies ranged from 40.5 to 59.7%. Combining both diagnostic and therapeutic ERCPs, the percentage of room fee reimbursement to defray the cost of disposable equipment was 42.4%. Disposable equipment costs are a large portion of the room fee reimbursement. leaving potentially inadequate revenues for salaries, general upkeep of equipment, and capital to buy new or replace aging equipment.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMedDate not supplied

Decision-support tool for assessing biomanufacturing strategies under uncertainty: stainless steel versus disposable equipment for clinical trial material preparation.

This paper presents the application of a decision-support tool, SIMBIOPHARMA, for assessing different manufacturing strategies under uncertainty for the production of biopharmaceuticals. SIMBIOPHARMA captures both the technical and business aspects of biopharmaceutical manufacture within a single tool that permits manufacturing alternatives to be evaluated in terms of cost, time, yield, project throughput, resource utilization, and risk. Its use for risk analysis is demonstrated through a hypothetical case study that uses the Monte Carlo simulation technique to imitate the randomness inherent in manufacturing subject to technical and market uncertainties. The case study addresses whether start-up companies should invest in a stainless steel pilot plant or use disposable equipment for the production of early phase clinical trial material. The effects of fluctuating product demands and titers on the performance of a biopharmaceutical company manufacturing clinical trial material are analyzed. The analysis highlights the impact of different manufacturing options on the range in possible outcomes for the project throughput and cost of goods and the likelihood that these metrics exceed a critical threshold. The simulation studies highlight the benefits of incorporating uncertainties when evaluating manufacturing strategies. Methods of presenting and analyzing information generated by the simulations are suggested. These are used to help determine the ranking of alternatives under different scenarios. The example illustrates the benefits to companies of using such a tool to improve management of their R&D portfolios so as to control the cost of goods.

Clinical Trials as Topic↗