Centers for Disease Control and Prevention as a Strategic Agent in the Pediatric Vaccine Market: An Analytical Approach

2020 ◽  
Author(s):  
Kayla Cummings ◽  
Banafsheh Behzad ◽  
Susan Martonosi
Keyword(s):  
Public Sector ◽  
Disease Control ◽  
Optimization Model ◽  
Analytical Approach ◽  
Cost Effective ◽  
The United States ◽  
Problem Definition ◽  
Game Theoretic ◽  
Pediatric Vaccines ◽  
Centers For Disease Control

Problem definition: Pediatric vaccine markets in the United States are vulnerable to the development of monopolies due to few manufacturers and high research and development costs. This work addresses how the government can ensure the cost-effective procurement of pediatric vaccines by all U.S. children from private manufacturers. The Centers for Disease Control and Prevention’s (CDC) significant patronage of pediatric vaccines affords them leverage in negotiating public-sector prices that prevent the formation of monopolies, but existing vaccine pricing literature excludes the CDC as a rational player. Academic/practical relevance: We combine optimization and game theoretic techniques to address cost-effective immunization of all U.S. children. Methodology: Our optimization model from the CDC’s perspective minimizes negotiated government costs while ensuring adequate national vaccination levels, linking dynamics in public and private sectors, and incorporating competitive manufacturer behavior. The optimization model embeds an extant game theoretic price model to capture competitive interactions among manufacturers in the private sector, where they compete independently of the CDC. The model is validated in an extended case study of the Infanrix–Daptacel vaccine duopoly. Results: The study indicates that dissimilar products advantageously segment markets with asymmetric manufacturers. Furthermore, markets are at lower risk when high-capacity manufacturers have moderate target profits, especially in cases of high demand and asymmetry. We demonstrate that our model can help restabilize a market that experiences a vaccine shortage and that the CDC might mitigate the same shortage using strategies that depend on which manufacturer is limited. We also underline scenarios in which the CDC may be able to prevent monopolies through financial incentives to manufacturers. The results support a paradigm shift from annual contracts to ongoing negotiations, which would enable the CDC to exercise control over high-risk markets. Managerial implications: Our study demonstrates an analytical approach for managerial government officials to influence pediatric vaccine prices via the procurement of public-sector goods.

Pension Enhancements and the Retention of Public Employees

ILR Review ◽  
2016 ◽  
Vol 70 (2) ◽  
pp. 519-551 ◽  
Author(s):  
Cory Koedel ◽  
P. Brett Xiang
Keyword(s):  
United States ◽  
Public Sector ◽  
Employee Retention ◽  
Cost Effective ◽  
The United States ◽  
Pension Plans ◽  
Public Employees ◽  
Public School Teachers ◽  
School Teachers ◽  
Public Pension Plans

The authors use data from workers in the largest public-sector occupation in the United States—teaching—to examine the effect of pension enhancements on employee retention. Specifically, they study a 1999 enhancement to the benefit formula for public school teachers in St. Louis, Missouri, that resulted in an immediate and dramatic increase in their incentives to remain in covered employment. To identify the effect of the enhancement on teacher retention, the analysis leverages the fact that the strength of the incentive increase varied across the workforce depending on how far teachers were from retirement eligibility when it was enacted. The results indicate that the St. Louis enhancement—which was structurally similar to enhancements that were enacted in other public pension plans across the United States in the late 1990s and early 2000s—was not a cost-effective way to increase employee retention.

scholarly journals A Review of the Centers for Disease Control and Prevention's Response to the HIV/AIDS Crisis Among Blacks in the United States, 1981–2009

2009 ◽  
Vol 99 (S2) ◽  
pp. S351-S359 ◽  
Author(s):  
Madeline Y. Sutton ◽  
Rhondette L. Jones ◽  
Richard J. Wolitski ◽  
Janet C. Cleveland ◽  
Hazel D. Dean ◽  
...  
Keyword(s):  
United States ◽  
Disease Control ◽  
The United States ◽  
Aids Crisis ◽  
Centers For Disease Control ◽  
Hiv Aids

Aligning Public Health Training and Practice in Evaluation: Implications and Recommendations for Educators

2021 ◽  
pp. 237337992110336
Author(s):  
Bree L. Hemingway ◽  
Sarah Douville ◽  
Leslie A. Fierro
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Online Survey ◽  
The United States ◽  
Evaluation Framework ◽  
Community Practice ◽  
Public Health Training ◽  
Health Practitioners ◽  
Centers For Disease Control ◽  
Public Health Practitioners

Objective. This study aimed to understand the extent to which master of public health (MPH) graduates engage in evaluation on the job, to learn how MPH graduates implement evaluation, and to hear from MPH graduates about how their academic training prepared them for the evaluation work they perform. Methods. Using the Centers for Disease Control and Prevention’s Evaluation Framework, this convergent mixed-methods study included an online survey with 89 public health practitioners and follow-up interviews with 17 survey respondents. The study was performed in the United States during summer 2020. Results. In addition to participating in evaluation activities related to all six Centers for Disease Control and Prevention framework steps, MPH graduates engage in evaluation capacity building, evaluating for health equity and social justice, and funding activities. Participants noted a disconnect between academic preparation and community practice, were least confident in focusing the evaluation design, and most often used surveys to collect data. Conclusions. Public health practitioners commonly engage in evaluation activities but do not feel fully prepared to do so given their MPH training. Many opportunities exist to enhance graduate/postgraduate training through connecting public health with the broader professional practice of evaluation.

Reactions of Pediatricians to a New Centers for Disease Control Recommendation for Universal Immunization of Infants With Hepatitis B Vaccine

PEDIATRICS ◽  
1993 ◽  
Vol 91 (4) ◽  
pp. 699-702
Author(s):  
Gary L. Freed ◽  
W. Clayton Bordley ◽  
Sarah J. Clark ◽  
Thomas R. Konrad
Keyword(s):  
Clinical Practice ◽  
Hepatitis B ◽  
Disease Control ◽  
Risk Groups ◽  
The United States ◽  
Effect Change ◽  
New Strategy ◽  
Single Well ◽  
Physician Awareness ◽  
Centers For Disease Control

Despite immunization programs targeting high-risk groups, the incidence of hepatitis B has risen 37% over the last decade with 300000 new infections and 5000 related deaths now occurring annually in the United States. As a new strategy to control the spread of hepatitis B, the Advisory Committee on Immunization Practices of the Centers for Disease Control (CDC) recommended in November 1991 universal hepatitis B immunization of infants. Details were published in an addendum to Morbidity and Mortality Weekly Report. There was no other federal effort to disseminate this recommendation. On February 14, 1992, the American Academy of Pediatrics (AAP) issued a similar recommendation. The time between the CDC and AAP recommendations presented the opportunity to determine the singular effect on clinical practice of the CDC's dissemination effort. The purpose of this study was to assess (1) the effectiveness of the CDC in disseminating a new immunization recommendation, (2) the effect of the new recommendation on clinical practice, and (3) the degree to which noneconomic barriers may affect adoption of universal hepatitis B immunization. All 778 pediatricians in North Carolina were surveyed by mail 2 to 3 months after publication of the new CDC recommendation. Descriptive statistics, χ2 analysis, and logistic regression were used to assess the relationship of variables hypothesized to predict physician awareness of and/or agreement with the new recommendation. The response rate was 78%. Although 82% of pediatricians who administer immunizations were aware of the new recommendation, only 32% believed it was warranted in their practices. Twenty-six percent of respondents expect more than half of parents to refuse three injections at a single well-child visit, a possible result of adding this vaccine to the primary immunization series. Additionally, 29% expect nurses to resist giving three injections at one visit. It is concluded that current CDC efforts are insufficient to effect change in clinical practice. Practical concerns of physicians and their patients regarding multiple injections and other issues must be considered when formulating new immunization recommendations if their implementation is to be successful.

Hitch a Sugar to a Protein

2019 ◽  
pp. 197-222
Author(s):  
Janet R. Gilsdorf
Keyword(s):  
United States ◽  
Bacterial Meningitis ◽  
American Indian ◽  
Disease Control ◽  
The United States ◽  
Indian Children ◽  
Control And Prevention ◽  
Centers For Disease Control ◽  
American Children ◽  
Native Alaskan

The success of the conjugate Hib vaccines has been spectacular. Prior to their introduction, an estimated 10,000 cases of Hib meningitis occurred annually in the United States, which was approximately 1 in 300 children. It was even higher among native Alaskan and American Indian children. Since the widespread use of the vaccine, the disease has nearly disappeared in the United States, with only 40 cases in children under age 5 years reported by the Centers for Disease Control and Prevention in 2014. Thus, bacterial meningitis, once a scourge that killed and damaged too many American children is, for the most part, now a bad memory.

Nurses’ Implementation of Guidelines for Ventilator-Associated Pneumonia From the Centers for Disease Control and Prevention

2007 ◽  
Vol 16 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Carolyn L. Cason ◽  
Tracy Tyner ◽  
Sue Saunders ◽  
Lisa Broome
Keyword(s):  
Intensive Care ◽  
Disease Control ◽  
Intensive Care Units ◽  
Oral Care ◽  
The United States ◽  
Hand Washing ◽  
Ventilator Associated Pneumonia ◽  
Care Protocol ◽  
Control And Prevention ◽  
Centers For Disease Control

• Background Ventilator-associated pneumonia accounts for 47% of infections in patients in intensive care units. Adherence to the best nursing practices recommended in the 2003 guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention should reduce the risk of ventilator-associated pneumonia. • Objective To evaluate the extent to which nurses working in intensive care units implement best practices when managing adult patients receiving mechanical ventilation. • Methods Nurses attending education seminars in the United States completed a 29-item questionnaire about the type and frequency of care provided. • Results Twelve hundred nurses completed the questionnaire. Most (82%) reported compliance with hand-washing guidelines, 75% reported wearing gloves, half reported elevating the head of the bed, a third reported performing subglottic suctioning, and half reported having an oral care protocol in their hospital. Nurses in hospitals with an oral care protocol reported better compliance with hand washing and maintaining head-of-bed elevation, were more likely to regularly provide oral care, and were more familiar with rates of ventilator-associated pneumonia and the organisms involved than were nurses working in hospitals without such protocols. • Conclusions The guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in rates of ventilator-associated pneumonia may be achieved by broader implementation of oral care protocols.

Evaluation of the 1990 Centers for Disease Control and Prevention Smoke-Free Policy

1995 ◽  
Vol 9 (6) ◽  
pp. 456-461 ◽  
Author(s):  
Seth L. Emont ◽  
S. Christine Zahniser ◽  
Stephen E. Marcus ◽  
Anne E. Trontell ◽  
Sherry Mills ◽  
...  
Keyword(s):  
Air Quality ◽  
Disease Control ◽  
Smoking Behavior ◽  
The United States ◽  
Smoking History ◽  
Smoking Ban ◽  
Chewing Tobacco ◽  
Smoke Free Policy ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose. To determine the prevalence of tobacco use among Centers for Disease Control and Prevention (CDC)/Agency for Toxic Substances and Disease Registry (ATSDR) employees and the effect of the smoke-free policy on smoking behavior and air quality at work. Design. A stratified telephone survey of 1181 CDC/ATSDR employees randomly selected from employee rosters. Setting. CDC/ATSDR work sites in Atlanta, Georgia, and other major CDC locations throughout the United States and Puerto Rico. Subjects. Randomly selected employees of CDC/ATSDR1, or about 22% of the total CDC/ATSDR population; 98% of eligible persons selected agreed to participate. Measures. Demographic and smoking history variables, attitudes toward and impact of the smoke-free policy on smoking behavior, and self-report changes in air quality were the measures used. Results. Overall cigarette smoking prevalence was only 11.1%. One percent reported using chewing tobacco, 1.1% reported smoking a pipe, and 1.4% reported smoking cigars. Average self-reported, daily cigarette comsumption significantly decreased after the smoking ban took effect. Overall, 90 % of the employees supported the smoke-free policy, and 80 % of the employees believed that smokers were complying with the smoke-free policy. Most employees believed that the air quality of work areas and nonwork areas (65% and 69%, respectively) had improved since the smoke-free policy was implemented. Conclusions. These findings are consistent with previous evaluations of smoke-free policies and suggest that most employees are generally supportive of workplace smoking restrictions. Such policies can also have a positive impact on smoking behavior and perceived air quality.

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