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In 2010–2011, University of Colorado (CU) librarians implemented a multi-campus pilot study to measure the institutional value of library resources used by faculty in their research. The study incorporated quantitative methods including return on investment (ROI), cost benefit analysis (CBA), and citation analysis of journal articles published by faculty; and qualitative methodologies such as in-person interviews with faculty. The study resulted in a CU ROI model that can be used to measure faculty perceptions of value and the economic benefits of electronic journal collections for faculty research in terms of ROI. The CU ROI methodology provides outcomes beyond a single ROI number and led to unexpected benefits for informing collection development decisions and strategies. [Copyright &y& Elsevier]

State, public, academic, and special libraries are conducting and publishing the results of studies aimed at showing the value of their services and resources. Librarians must be prepared and proactive so when asked to justify budget allocations they have the tools to show their library's value and understand the importance of expressing value in terms familiar to the administrators. By identifying stakeholders and obtaining their buy in, librarians can turn data into evidence of the organization's return on investment (ROI) in the library. ROI is a powerful tool to use when establishing credibility, accountability, and evidence demonstrating the library's value. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To assess the cost‐effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS). Design: We used the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), a Markov‐based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self‐helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive telephone calls; nicotine replacement therapy (mono and combo) [prescription nicotine replacement therapy (Rx NRT)]; varenicline (standard duration); or bupropion. A rate of 3% was used to discount life‐time costs and benefits. Setting: Spain. Participants: Adult smoking population (16+ years). Measurements: Health‐care costs associated with treatment of smoking attributable diseases (lung cancer, coronary heart disease, chronic obstructive pulmonary infection and stroke); intervention costs; quality‐adjusted life years (QALYs). Costs and outcomes were summarized using various ROI estimates. Findings: The cost of implementing the current provision of smoking cessation services is approximately €61 million in the current year. This translates to 18 quitters per 1000 smokers and a life‐time benefit–cost ratio of 5, compared with no such provision. All alternative scenarios were dominant (cost‐saving: less expensive to run and generated more QALYs) from the life‐time perspective, compared with the current provision. The life‐time benefit–cost ratios were: 1.87 (proactive telephone calls); 1.17 (Rx NRT); 2.40 (varenicline‐standard duration); and bupropion (2.18). The results remained robust in the sensitivity analysis. Conclusions: According to the EQUIPTMOD modelling tool it would be cost‐effective for the Spanish authorities to expand the reach of existing GP brief interventions for smoking cessation, provide pro‐active telephone support, and reimburse smoking cessation medication to smokers trying to stop. Such policies would more than pay for themselves in the long run. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To evaluate potential health and economic returns from implementing smoking cessation interventions in Hungary. Methods: The EQUIPTMOD, a Markov‐based economic model, was used to assess the cost‐effectiveness of three implementation scenarios: (a) introducing a social marketing campaign; (b) doubling the reach of existing group‐based behavioural support therapies and proactive telephone support; and (c) a combination of the two scenarios. All three scenarios were compared with current practice. The scenarios were chosen as feasible options available for Hungary based on the outcome of interviews with local stakeholders. Life‐time costs and quality‐adjusted life years (QALYs) were calculated from a health‐care perspective. The analyses used various return on investment (ROI) estimates, including incremental cost‐effectiveness ratios (ICERs), to compare the scenarios. Probabilistic sensitivity analyses assessed the extent to which the estimated mean ICERs were sensitive to the model input values. Results: Introducing a social marketing campaign resulted in an increase of 0.3014 additional quitters per 1 000 smokers, translating to health‐care cost‐savings of €0.6495 per smoker compared with current practice. When the value of QALY gains was considered, cost‐savings increased to €14.1598 per smoker. Doubling the reach of existing group‐based behavioural support therapies and proactive telephone support resulted in health‐care savings of €0.2539 per smoker (€3.9620 with the value of QALY gains), compared with current practice. The respective figures for the combined scenario were €0.8960 and €18.0062. Results were sensitive to model input values. Conclusions: According to the EQUIPTMOD modelling tool, it would be cost‐effective for the Hungarian authorities introduce a social marketing campaign and double the reach of existing group‐based behavioural support therapies and proactive telephone support. Such policies would more than pay for themselves in the long term. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To evaluate costs, effects and cost‐effectiveness of increased reach of specific smoking cessation interventions in Germany. Design: A Markov‐based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health‐care perspective (extended to include out‐of‐pocket payments) with life‐time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates. Setting: Germany. Participants: Cohort of current smoking population (18+ years) in Germany. Interventions: Interventions included group‐based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group‐based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England. Measurements: EQUIPTMOD considered reach, intervention cost, number of quitters, quality‐of‐life years (QALYs) gained, cost‐effectiveness and return on investment. Findings: The highest returns through reduction in smoking‐related health‐care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group‐based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost‐savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return‐on‐investment estimates. At a hypothetical willingness‐to‐pay threshold of only €5000, the probability of being cost‐effective is approximately 75% for prospective scenario 1. Conclusions: Increasing the reach of group‐based behavioural support, financial incentives and varenicline for smoking cessation by just 1% of current annual quit attempts provides a strategy to German policymakers that improves the population's health outcomes and that may be considered cost‐effective. [ABSTRACT FROM AUTHOR]

Background: Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms.Methods: We conducted a cost-benefit analysis, measuring economic return on investment, of a task-shifted cognitive-behavioral therapy (CBT) intervention delivered by paraprofessionals to reduce alcohol use in a modeled cohort of 13,440 outpatients in Kenya. In our base-case, we estimated the costs and economic benefits from a societal perspective across a six-year time horizon, with a 3% annual discount rate. Costs included all costs associated with training and administering task-shifted CBT therapy. Benefits included the economic impact of lowered HIV incidence as well as the improvements in household and labor-force productivity. We conducted univariate and multivariate probabilistic sensitivity analyses to test the robustness of our results.Results: Under the base case, total costs for CBT rollout was $554,000, the value of benefits were $628,000, and the benefit-to-cost ratio was 1.13. Sensitivity analyses showed that under most assumptions, the benefit-to-cost ratio remained above unity indicating that the intervention was cost-saving (i.e., had positive return on investment). The duration of the treatment effect most effected the results in sensitivity analyses.Conclusions: CBT can be effectively and economically task-shifted to paraprofessionals in Kenya. The intervention can generate not only reductions in morbidity and mortality, but also economic savings for the health system in the medium and long term. The findings have implications for other countries with generalized HIV epidemics, high prevalence of alcohol consumption, and shortages of mental health professionals.Trial Registration: This paper uses data derived from "Cognitive Behavioral Treatment to Reduce Alcohol Use Among HIV-Infected Kenyans (KHBS)" with ClinicalTrials.gov registration NCT00792519 on 11/17/2008; and preliminary data from "A Stage 2 Cognitive-behavioral Trial: Reduce Alcohol First in Kenya Intervention" ( NCT01503255 , registered on 12/16/2011). [ABSTRACT FROM AUTHOR]

Background: Participation in daily physical activity and consuming a balanced diet high in fruits and vegetables and low in processed foods are behaviours associated with positive health outcomes during all stages of life. Previous literature suggests that the earlier these behaviours are established the greater the health benefits. As such, early learning settings have been shown to provide an effective avenue for exploring and influencing the physical activity and healthy eating behaviours of children before school entry. However, in addition to improving individual level health of children, such interventions may also result in a number of social benefits for the society. In fact, research among adult populations has shown that sufficient participation in physical activity can significantly lower hospital stays and physician visits, in turn leading to positive economic outcomes. To our knowledge there is very limited literature about economic evaluations of interventions implemented in early learning centers to increase physical activity and healthy eating behaviours among children. The primary purpose of this paper is to identify inputs and costs needed to implement a physical activity and healthy eating intervention (Healthy Start-Départ Santé (HS-DS)) in early learning centres throughout Saskatchewan and New Brunswick over the course of three years. In doing so, implementation cost is estimated to complete the first phase of a social return on investment analysis of this intervention.Methods: In order to carry out this evaluation the first step was to identify the inputs and costs needed to implement the intervention, along with the corresponding outputs. With stakeholder interviews and using existing database, we estimated the implementation cost by measuring, valuing and monetizing each individual input.Results: Our results show that the total annual cost of implementing HS-DS was $378,753 in the first year, this total cost decreased slightly in the second year ($356,861) and again in the third year ($312,179). On average, the total annual cost is about $350,000 which implies an annual cost of $285 per child. Among all inputs, time-cost accounted for the larger share of total resources need to implement the intervention. Overall, administration and support services accounted for the largest portion of the total implementation cost each year: 74% (year 1), 79% (year 2), and 75% (year 3).Conclusions: The results from this study shed lights for future implementation of similar interventions in this context. It also helps to assess the cost effectiveness of future interventions. [ABSTRACT FROM AUTHOR]

Background: The European-study on Quantifying Utility of Investment in Protection from Tobacco (EQUIPT) project aimed to study transferability of economic evidence by co-creating the Tobacco Return On Investment (ROI) tool, previously developed in the United Kingdom, for four sample countries (Germany, Hungary, Spain and the Netherlands). The EQUIPT tool provides policymakers and stakeholders with customized information about the economic and wider returns on the investment in evidence-based tobacco control, including smoking cessation interventions. A Stakeholder Interview Survey was developed to engage with the stakeholders in early phases of the development and country adaptation of the ROI tool. The survey assessed stakeholders' information needs, awareness about underlying principles used in economic analyses, opinion about the importance, effectiveness and cost-effectiveness of tobacco control interventions, and willingness to use a Health Technology Assessment (HTA) tool such as the ROI tool.Methods: A cross sectional study using a mixed method approach was conducted among participating stakeholders in the sample countries and the United Kingdom. The individual questionnaire contained open-ended questions as well as single choice and 7- or 3-point Likert-scale questions. The results corresponding to the priority and needs assessment and to the awareness of stakeholders about underlying principles used in economic analysis are analysed by country and stakeholder categories.Results: Stakeholders considered it important that the decisions on the investments in tobacco control interventions should be supported by scientific evidence, including prevalence of smoking, cost of smoking, quality of life, mortality due to smoking, and effectiveness, cost-effectiveness and budget impact of smoking cessation interventions. The proposed ROI tool was required to provide this granularity of information. The majority of the stakeholders were aware of the general principles of economic analyses used in decision making contexts but they did not appear to have in-depth knowledge about specific technical details. Generally, stakeholders' answers showed larger variability by country than by stakeholder category.Conclusions: Stakeholders across different European countries viewed the use of HTA evidence to be an important factor in their decision-making process. Further, they considered themselves to be capable of interpreting the results from a ROI tool and were highly motivated to use it. [ABSTRACT FROM AUTHOR]

Objective. To determine the relationship between return on investment (ROI) and quality of study methodology in workplace health promotion programs. Data Source. Data were obtained through a systematic literature search of National Health Service Economic Evaluation Database (NHS EED), Database o f Abstracts of Reviews of Effects (DARE), Health Technology Database (HTA), Cost Effectiveness Analysis (CEA) Registry, EconLit, PubMed, Embase, Wiley, and Scopus. Study Inclusion and Exclusion Criteria. Included were articles written in English or German reporting cost(s) and benefit(s) and single or multicomponent health promotion programs on working adults. Retum-to-work and workplace injury prevention studies were excluded. Data Extraction. Methodological quality was graded using British Medical Journal Economic Evaluation Working Party checklist. Economic outcomes were presented as ROI. Data Synthesis. ROI was calculated as ROI= (benefits - costs of program)/costs o f program. Results were weighted by study size and combined using meta-analysis techniques. Sensitivity analysis was performed using two additional methodological quality checklists. The influences o f quality score and important study characteristics on ROI were explored. Results. Fifty-one studies (61 intervention arms) published between, 1984 and 2012 included 261,901 participants and 122,242 controls from nine industry types across 12 countries. Methodological quality scores were highly correlated between checklists (r= .84-.93). Methodological quality improved over time. Overall weighted ROI [mean ± standard deviation (confidence interval)] was 1.38 ± 1.97 (1.38-1.39), which indicated a 138% return on investment. When accounting for methodological quality, an inverse relationship to ROI teas found. High-quality studies (n = 18) had a smaller mean ROI, 0.26 ± 1.74 (.2 3 -.3 0 ), compared to moderate (n = 16) 0.90 ± 1.25 (.90-.91) and low-quality (n = 27) 2.32 ± 2.14 (2.30-2.33) studies. Randomized control trials (RCTs) (n = 12) exhibited negative ROI, -0.22 ± 2.41(-.2 7 to -.16). Financial returns become increasingly positive across quasi-experimental, nonexperimental, and modeled studies: 1.12 ± 2.16 (1.11-1.14), 1.61 ± 0.91 (1.56-1.65), and 2.05 ± 0.88 (2.04-2.06), respectively. Conclusion. Overall, mean weighted ROI in workplace health promotion demonstrated a positive ROI. Higher methodological quality studies provided evidence of smaller financial returns. Methodological quality and study design are important determinants. [ABSTRACT FROM AUTHOR]

This study analyzes the costs incurred on an intensive silvopastoral system (ISS) based on Leucaena leucocephala on gravity fed irrigation soil, and the economic benefits that are generated in this type of systems, all this in order to evaluate the economic profitability of the investment and to make a comparison between the ISS and the conventional ones (40% grass monoculture Tanzania Panicum maximum, 30% of forage sorghum sorghum vulgar under a cutting system and 30% of rangeland with native grasses). The feed for dual-purpose Swiss cattle was complemented in the ISS with polished rice at the rate of 1.50 kg/ day per cow during milking, while the traditional system used 3.50 kg/day of commercial feed by milked cow. The results showed an Internal Rate of Return (IRR) for the ISS of 13.30% and a Net Present Value (NPV) of 10% with a positive balance of $2'202,170 (Mexican pesos) while the traditional system obtained an IRR of 0.7% and a NPV of 10% with a negative balance of -4'717,022 (Mexican pesos). When switching from the conventional system to the ISS the productivity and profitability of the ranch incremented and turned it into a lucrative business. [ABSTRACT FROM AUTHOR]

This paper estimates the effects of human capital skills largely created through education on life's chances over the life cycle. Qualifications as a measure of these skills affect earnings, and schooling affects private and social non-market benefits beyond earnings. Private non-market benefits include better own-health, child health, spousal health, infant mortality, longevity, fertility, household efficiency, asset management and happiness. Social benefits include increased democratisation, civil rights, political stability, reduced crime, lower prison, health and welfare costs, and new ideas. Individual benefits enhance community-wide development. New ‘narrow’ social rates of return using UK Labour Force earnings correct for institutional costs, longitudinal trends and ability. The paper's objective, however, is to estimate these earnings plus non-market outcomes comprehensively without overlaps and also relative to costs. Non-market outcomes are measured by averaging regression coefficients from published studies that meet scientific standards. New UK ‘narrow’ social rates of return average 12.1 per cent for short-cycle and 13.6 per cent for bachelor's programmes. Augmented with non-market effects on life chances, they are over twice that. Short degrees are found effective for regional development and have potential for developing countries. [ABSTRACT FROM PUBLISHER]

Abstract: Ecological and economic evaluation should be a key component of biodiversity conservation programmes since it underpins the efficient allocation of resources. However, most such programmes are not currently assessed in terms of the rate of return on investment that they provide. The UK Government launched the UK Biodiversity Action Plan in 1994. We collected data from those responsible for monitoring this programme, then used a form of cost-effectiveness analysis to evaluate its effectiveness and efficiency at meeting the targets of individual Species Action Plans. In this context, effectiveness refers to the goal of maximising total conservation gains, whereas efficiency refers to maximising conservation gain per unit cost. We define the latter as a basic economic objective for conservation resource allocation. We find that the distribution of spending across plans was highly biased towards vertebrates and there was no correlation between cost and effectiveness. Non-vertebrate plans tended to be more efficient than vertebrate plans. However, following a species utility-based weighting, this tendency was less pronounced and a significant positive correlation between cost and effectiveness emerged. Nevertheless, this evidence suggests that the efficiency of the UK Biodiversity Action Plan could be improved by correcting the imbalance in spending between vertebrate and non-vertebrate plans. This study highlights the importance of effective monitoring and reporting in determining the utility of biodiversity conservation programmes. It demonstrates how explicit cost-effectiveness analysis can be used to evaluate such programmes, and shows that it could also be adapted to accommodate other forms of ecological and social value. [Copyright &y& Elsevier]

Explores alternative approaches to an economic analysis of logistics investment opportunities. Definition of economic analysis; Time-value-of-money principle; Dimensions to an economic analysis using present value; Payback; Naive rate of return; Average return on investment; Internal rate of return; Net present value; Benefit and cost ratio.

Abstract: Background and Aims: Although clear benefits are associated with reducing smoking, there is increasing pressure on public health providers to justify investment in tobacco control measures. Decision‐makers need tools to assess the Return on Investment (ROI)/cost‐effectiveness of programmes. The EQUIPT project adapted an ROI tool for England to four European countries (Germany, the Netherlands, Spain and Hungary). EQUIPTMOD, the economic model at the core of the ROI tool, is designed to assess the efficiency of packages of smoking cessation interventions. The objective of this paper is to describe the methods for EQUIPTMOD and identify key outcomes associated with continued and cessation of smoking. Methods: EQUIPTMOD uses a Markov model to estimate life‐time costs, quality‐adjusted life years (QALYs) and life years associated with a current and former smoker. It uses population data on smoking prevalence, disease prevalence, mortality and the impact of smoking combined with associated costs and utility effects of disease. To illustrate the tool's potential, costs, QALYs and life expectancy were estimated for the average current smoker for five countries based on the assumptions that they continue and that they cease smoking over the next 12 months. Costs and effects were discounted at country‐specific rates. Results: For illustration, over a life‐time horizon, not quitting smoking within the next 12 months in England will reduce life expectancy by 0.66, reduce QALYs by 1.09 and result in £4961 higher disease‐related health care costs than if the smoker ceased smoking in the next 12 months. For all age–sex categories, costs were lower and QALYs higher for those who quit smoking in the 12 months than those who continued. Conclusions: EQUIPTMOD facilitates assessment of the cost effectiveness of smoking cessation strategies. The demonstrated results indicate large potential benefits from smoking cessation at both an individual and population level. [ABSTRACT FROM AUTHOR]

This paper reports on a study undertaken for the UK Joint Information Systems Committee (JISC), which explored the economic implications of alternative scholarly publishing models. Rather than simply summarising the study's findings, this paper focuses on the approach and presents a step-by-step account of the research process, highlighting the combination of process mapping, activity costing and macro modelling. Method. The analysis relies primarily on existing sources, collating activity cost information from the wide-ranging literature on scholarly communication. Where necessary, these sources were supplemented by targeted informal consultation with experts. Analysis. We examine the costs and potential benefits of the major alternative models for scholarly publishing, including subscription publishing, open access publishing and self-archiving. Adopting a formal approach to modelling the scholarly communication process and identifying activity costs, this paper presents activity and system-wide costs for each of the alternative publishing models. It then explores the potential impacts of enhanced access on returns to R&D. Results. We find that different scholarly publishing models could make a material difference to the costs faced by various parties and to the returns on investment in R&D that might be realised. Conclusion. It seems likely that more open access could have substantial benefits in the longer term. While the benefits may be lower during a transitional period they would be likely to be positive for both open access publishing and self-archiving alternatives. [ABSTRACT FROM AUTHOR]