Utilization reporting system facilitates physician practice analysis.

We are reporting the results of a small-scale batch extraction with and without in situ wet oxidation of soils polluted with polycyclic aromatic hydrocarbons (PAHs) using subcritical water (liquid water at high temperatures and pressures but below the critical point as the removal agent). Two types of soil; one spiked with four PAHs, and an aged sample were used. Experiments were carried out in a 300 ml volume reactor in the batch mode. In each experiment, the reactor was filled with 45-50 g of soil and 200-220 ml of double distilled water. For extraction without oxidation, the reactor was pressurized with nitrogen, while for those with the oxidation, an oxidizing agent (air, oxygen or hydrogen peroxide) was used. The extraction only experiments were carried out at 230, 250 and 270 degrees C for spiked soil samples, and at 250 degrees C for aged soil samples, while all of the combined extraction and oxidation experiments were carried out at 250 degrees C. Removal of PAHs from spiked soil in extraction-only experiments was from 79 to 99+% depending on the molecular weight of the PAH. This was in the range of 99.1% to excess of 99.99% for the combined extraction and oxidation. While 28-100% of extracted PAHs can be found in water phase in case of extraction alone, this reduces to a maximum of 10% if the extraction is combined with oxidation. With aged soil similar or comparable results were obtained. Based on these results, extraction with hot water, if combined with oxidation, would probably reduce the cost of post treatment for the water and can be used as a feasible alternative technique for remediation of contaminated soils and sediments.

Costs and Cost Analysis↗

PubMed2002

Reference drug pricing.

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Costs and Cost Analysis↗

PubMed2002

[Generic drugs in the medical-economic context of drug prescriptions].

REIMBURSABLE DRUGS: The reimbursement, or coverage of pharmaceutical costs by the sickness benefits is governed in the French system by two conditions: the drugs must have been prescribed, and must be listed in the reimbursable drug list. Inscription in the reimbursable drugs list requires approval by the transparency commission, sole commission capable of assessing the medical service rendered (MSR) by the drugs and to propose a reimbursement rate of 65 or 35%. Exceptional drugs and those prescribed in the context of long-term treatments have a specific reimbursement status. ESTABLISHING THE PRICE: The coverage of drugs by the health insurance does not permit free pricing. The costs of drugs are established by the economic committee of health products (Comité Economique des Produits de Santé--CEPS), following approval by the transparency commission, who assesses the improvement in medical services rendered (IMSR) by new products, compared with existing products. THE ECONOMIC ADVANTAGES OF GENERICS: Physicians must be as economical as possible in terms of quality, safety and efficacy of the care they provide. Moreover, to be reimbursed by the social services, a generic must provide improved medical services or lead to savings in the cost of treatment. In such conditions one can conceive that the price of a generic (which does not provide any improvement in medical services compared with the original drug) is legitimately cheaper than the original product, and source of economy for better allocation of available funds. TWO MOTIVATING MEASURES: However, the French generic market is one of the least developed among industrialized countries. Presently, the volume of generics only represents 5% of the French drug market. Its further development is foreseen within the framework of all the plans for medicalized control of health costs. Other than the classical motives that encourage prescription of generics, i.e., citizens' awareness, labelling and the control by the French medicines agency, new determinating measures in our right for health are: the pharmacists' right to substitute and the physicians' authorization and incitement then to prescribe a product under its international non-proprietary name.

Costs and Cost Analysis↗