Charles River Associates

Energy storage provides firm peaking capacity and ancillary services to support the integration of variable renewable energy (VRE) sources, which form a critical part of the energy transition in most countries, including India. Several storage options are being pursued in India, including battery energy storage systems (BESS), pumped storage hydro plants (PSP), and conventional hydro (mostly run-of-river, ROR, with or without pondage). However, the financial viability of these options, including a market-price-based assessment, has not been explored to understand the relative merits of these competing options. This paper proposes an optimization model to undertake a market-based assessment of BESS, PSP, and ROR. The model assesses energy arbitrage opportunities, revenue from ancillary services, and risk hedging strategies, considering critical drivers such as price variability and hydrological risks. The analysis compares a notional 1 MW unit for each option using historical Indian Energy Exchange (IEX) spot prices and other publicly available data across all states in India that have potential for pumped storage and/or hydro options. The findings suggest that energy arbitrage in the incumbent IEX would have generally fallen short of a typical hurdle rate of return of 10% for all storage options in the majority of historical years. If the revenue from ancillary services is included and part of the output could be hedged through contracts, the business case improves, especially for BESS and PSP. The model provides a rigorous and transparent framework for policymakers to evaluate storage alternatives that support the energy transition.

Datopotamab deruxtecan (Dato-DXd) is an investigational antibody–drug conjugate that has shown promising results in phase III clinical trials of lung and breast cancers. Stomatitis is a common adverse event associated with Dato-DXd in these trials, and there are currently no formalized guidelines for its prevention and management. An expert consensus was needed to establish these guidelines. Fifteen experts participated in a modified three-round Delphi to achieve consensus on the prevention and management of Dato-DXd-related stomatitis in lung and breast cancer patients. Fourteen experts had managed Dato-DXd-induced stomatitis and served as investigators in the TROPION-Lung01, TROPION-Lung05, and TROPION-Breast01 phase III clinical trials. The first two rounds consisted of anonymized surveys with a mixture of open- and closed-ended questions, and the third round consisted of a consensus group meeting and 1:1 follow-up meetings. Experts recognized stomatitis as an important adverse event associated with several anticancer treatments and its impact on patients’ quality of life. Lung and breast cancer specialists noted similar manifestations of stomatitis with Dato-DXd, with breast cancer experts referencing similarities to everolimus-induced conditions and lung cancer experts reporting ulcerative lesions. There was consensus on the need for standardized guidelines to improve outcomes and reduce treatment disruptions. Agreed preventive measures emphasized patient education, oral hygiene, and prophylactic mouthwashes. Management strategies focused on patient-centered care, monitoring of symptoms, and timely interventions, such as the use of a steroid-containing mouthwash to maintain treatment schedules and quality of life. We used the expert consensus to provide guidelines for the prevention and management of stomatitis in patients treated with Dato-DXd. Dato-DXd has shown promising results in clinical trials for lung and breast cancers. However, many patients in these trials developed stomatitis, an adverse event that may impact quality of life and disrupt treatment regimens. The lack of standardized guidelines for dealing with stomatitis in this context necessitated the establishment of best practices via expert consensus. This study provides peer-reviewed guidance for the prevention and management of stomatitis secondary to Dato-DXd. Most experts selected for this study had experience using this therapy and preventing and managing stomatitis associated with Dato-DXd and other anticancer treatments. Thus, the study has collected the perspectives of well-placed, expert clinicians and derived best practices pending the completion of clinical trials. The development and implementation of this guidance and the education therein will lead to improved quality of life, greater treatment compliance, and better clinical outcomes.

We model a vertical merger of an upstream monopolist with one of two downstream producers engaged in Bertrand competition. The theoretical model suggests a statistic-the net downstream pricing pressure (NDPP)-that can serve as a screen for which vertical mergers are most likely to result in consumer harm. We simulate the effect of a vertical merger for four different functional forms of demand. In the simulations, relatively few vertical mergers lead to price increases that harm consumers. Of those that do, many would be unprofitable absent efficiencies, and many would be with the smaller of the two downstream firms. Moreover, predicted merger effects are not robust to the assumption about the functional form for demand. In contrast, the NDPP statistic is highly correlated with the change in real output for all functional forms.

This study presents a quantitative analysis of a randomized survey experiment with Italian high school students (N = 1,433). It aims to evaluate trust levels in various institutions-healthcare, education, politics, judiciary, and defense-and identify determinants influencing trust in the scientific field, particularly regarding health issues. Using experimental scenarios, potential causal relationships among factors influencing confidence and trust scores are explored. Three distinct experimental scenarios are included in the survey: the first examines the influence of various social media platforms, the second and the third evaluate the impact of doctors, parents, and friends on trust-building among young individuals. Our results indicate a high level of trust in science among adolescents and emphasize high confidence in scientific experts. The study provides policy insights aimed at fostering trust, including recommendations for investments in education, increased involvement of specialists in direct communication, and enhanced transparency measures to mitigate misinformation.

Economic research usually endows consumers with a strictly concave utility function. When choices are rationalizable, this assumption can be tested by the strong axiom of revealed preferences, SARP, as if they fail such a test, the convexity of the utility is not strict. We extend this test to non-rationalizable choices using partial efficiency, the most popular method to analyze such choices. Under partial efficiency, a strictly concave utility cannot be tested. Hence, the existence of a strictly concave utility is falsified if, and only if, choices are rationalizable but fail SARP, which we do not observe in laboratory data. From an empirical standpoint, our results suggest that assuming a strictly concave utility does not carry a cost.