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DIFFICULT to judge whether obstinacy, optimism or mere force of habit was the prime motivation for the reintroduction in Parliament in late January of another PLR Bill— effected by prominent campaigner Lord (Ted) Willis.

This study proposes targeted modernization of the Department of Defense (DoD's) Joint Forces Ammunition Logistics information system by implementing the optimized innovative information technology open architecture design and integrating Radio Frequency Identification Device data technologies and real-time optimization and control mechanisms as the critical technology components of the solution. The innovative information technology, which pursues the focused logistics, will be deployed in 36 months at the estimated cost of $568 million in constant dollars. We estimate that the Systems, Applications, Products (SAP)-based enterprise integration solution that the Army currently pursues will cost another $1.5 billion through the year 2014; however, it is unlikely to deliver the intended technical capabilities.

The applicability and shortcomings of a well-defined cost-estimating process to forecasting resources required for developing and fielding innovative technologies are examined. Whereas the process itself provides a suitable approach for estimating the cost of any program, investment is required for collecting historical data on analogous programs to serve as the foundation for the estimating methodologies. Particular challenges in costing innovation are summarized. An appropriate form of the cost probability distribution for research programs is offered.

This study reviews and examines the role of low energy in the relationship of depression to decreased work productivity. Three-month findings are presented from a naturalistic clinical study of depression treatment in 573 primary care patients. Low energy was the most frequently reported symptom, was more predictive of poorer work and social functioning than other aspects of depressive symptomatology, and its improvement was more strongly related to improved work productivity than was a decrease in the number of depressive symptoms. Findings suggest that depression interventions to raise energy level may also be most suitable in speeding a return to work productivity.

This investigation focuses on patients hospitalized with congestive heart failure (CHF) to evaluate the effects of insurance status on resource utilization (costs and procedure intensity), and the process of inpatient care (length of stay). Data include hospital discharge claims from fourteen states across the U.S. for 88,000 primary and another 135,000 secondary CHF patients under age 65. Risk adjustment methods control for clinical, demographic, and risk selection factors in order to isolate the effects of insurance status on the variables of interest.Results indicate that insurance status significantly affects the type and intensity of care. Lengths of stay are shortest for privately managed patients and longest for patient in public programs. Nonetheless access to high intensity treatment procedures favors private payors, especially those covered by indemnity plans. Overall hospitalization and treatment costs are less sensitive to payor status than length of stay and appear to be driven by high intensity procedure utilization. The marginal effects of CHF are substantial, raising length of stay and treatment cost by up to 40% and reinforcing the insurance status effect on length of stay and utilization found in patients hospitalized with CHF as a primary diagnosis. Despite these process-of-care differences, no significant inpatient mortality/morbidity differences were ascertained in either the primary or secondary analyses.

Drugs in the same therapeutic class differ in their therapeutic profile, metabolism, adverse effects, dosing schedules, delivery systems, and other features. In addition, such agents can provide backup if the initial drug sometimes fails in the development stage or in the market. The availability of a broad range of medicines enables physicians to treat with precision the individual needs of diverse patients and provides options when the first agent used is either ineffective or not tolerated. Some incremental innovations have been associated with overall cost savings. Competition among drugs in a therapeutic class drives prices down. Policies that limit research on incremental innovations may deny access to important therapies, reduce competition, and erode incentives for research.

Suicide ranks among the most tragic events in human life. It is important to demonstrate that suicide is the cause of substantial economic losses in a societal perspective and to develop preventive measures with a high population impact.Would individuals who commit suicide have had the same life expectancy and productivity as others in the population? This assumption can be challenged on the basis of available evidence on the long-term course of depression.The main effects in suicide prevention on a population basis can be expected if resources are used to: increase public awareness of treatment options, decrease stigmatization, and increase knowledge about the diagnosis and treatment of depression within the health care system.

The purpose of this study was to assess the relationship between quality of life (QOL) and willingness to pay (WTP) for in vitro fertilization (IVF) in patients undergoing treatment for infertility. Adult women (N = 86) in treatment for infertility completed a self-administered mail survey. The Short-Form 36 was used to measure QOL and the contingent valuation method was used to measure WTP. Mean WTP for IVF was $10,277 (SD = $13,210, median $8,000) and mean total QOL was 574.6 (SD = 145.7). There was no significant difference in QOL (p = 0.70) or WTP (p = 0.20) among patients in Stages 1, 2, and 3 of infertility treatment. QOL and WTP were negatively (r = −0.05), but not significantly (p = 0.65) correlated.

Previous studies have indicated that individuals with depression have increased workplace absenteeism, leading to substantial costs to employers. However, depressed patients are also more likely to be cigarette smokers, and smoking is also associated with increased absenteeism. We evaluated the impact of depression and smoking status on workplace absenteeism in a study of airline reservation agents. Smoking was associated with absenteeism for all levels of depression, but depression increased absenteeism only among current smokers. These results suggest that part of the workplace burden associated with depression may be attributable to smoking.

The change from using clinical endpoints to surrogate marker endpoints in antiretroviral (ARV) trials for human immunodeficiency virus (HIV) disease, combined with the multiplicity of factors that may influence the effectiveness of ART in the community, requires the systematic integration of data through mathematical modeling in order for these data to be useful for most decision makers. Many issues must be considered in the construction of such models, but once constructed the models may be used to compare the expected value, epidemiological, and budget impacts of competing therapies and programs to help select the most cost effective approaches given local conditions.