Institute of Technology Assessment

SummaryThere is a high consensus that decarbonization of the mobility sector is possible by replacing internal combustion engine vehicles with battery electric vehicles. Among the lithium-ion batteries, the NMC 811 battery chemistry is commonly used in electric vehicles. This work evaluates the cradle-to-gate environmental impacts of industrial-scale NMC 811 battery production in the Visegrad countries—Czech Republic, Hungary, Poland, and Slovakia. Norway, with its low-carbon electricity mix, is included for comparison. This study showed how differences in electricity grid profiles influence the environmental impacts of lithium ion battery (LIB) production. The battery production in Poland has the highest global warming potential and Norway, due to its cleaner electricity grid, contributed the least for the same NMC 811 battery production. Hungary, Slovakia, and the Czech Republic reported lower GWP values. These variations highlight the critical importance of decarbonizing electricity grids to reduce emissions associated with LIB production.

Alectinib was approved by the US, Europe and China in 2024 as the first adjuvant targeted therapy for ALK+ NSCLC, lowering risk of disease recurrence or death by 76%. Alectinib addresses a critical gap in postoperative adjuvant therapy for ALK+ NSCLC. From Chinese healthcare-system perspective, this study evaluates the impact of introducing alectinib in adjuvant therapy for stage IB (tumor ≥ 4 cm) to IIIA (UICC/AJCC 7th edition) ALK+ NSCLC on prevention of recurrence and the associated direct medical costs, compared to platinum-based chemotherapy. A Markov model was developed to estimate the number of locoregional and metastatic recurrences over a 10-year period by defining four health states: disease-free survival, locoregional recurrence, metastatic recurrence, and death. In the control group, all patients received platinum-based chemotherapy, while in the intervention group, 75% received alectinib and 25% received platinum-based chemotherapy. Clinical data were collected from open-label, randomized phase 3 trials ALINA and ALEX. Cost parameters were derived from local charges, expert consultation, and published literature. Compared to control group, the intervention group would reduce recurrences by 11,300 cases over 10 years, including 3,684 locoregional and 7,616 metastatic cases. This corresponds to a 45.82% lower recurrence rate. Estimated recurrence-related cost savings amounted to 6.910 billion RMB, with 1.445 billion RMB saved from locoregional recurrences and 5.465 billion RMB from metastatic recurrences. This represents a 41.49% reduction in costs compared to control group. These findings were robust across various scenario analyses. Using alectinib in postoperative adjuvant therapy significantly reduces both the recurrence rate and recurrence-related treatment costs for stage IB (tumor ≥ 4 cm) to IIIA ALK+ NSCLC patients, compared to platinum-based chemotherapy. From perspective of Chinese healthcare system, this approach shows substantial potential for preventing recurrence and achieving cost savings.

Sodium-ion batteries (SIB) have recently emerged as an alternative to current lithium-ion batteries (LIB), using low-cost and abundant raw materials. However, previous assessments have come to controversial results regarding their economic competitiveness, and the potential impacts of SIB on the wider energy system are still unexplored. This study combines a bottom-up cost modelling including future performance developments on material level for SIB with a global energy system model to obtain a comprehensive assessment of the potential impact of SIB on the global energy-industry transition until 2050. The results show that with recent cost developments and learning curves, batteries are no longer a cost-critical component in the energy system with projected utility-scale battery system capex of 28.5–51.9 €/kWh cap by 2050. SIB potentially outperform LIB on the medium term and are less prone to price spikes and supply shortages. Being a so-called drop-in technology, they could be produced on existing LIB production lines with only minor modifications. Therefore, concerns about supply shortages or price increases can be seen as resolved, since any disturbance in LIB supply would simply trigger a shift to SIB. The overall energy system structure remains virtually unaffected, with similar solar photovoltaic shares, but a shift in power-to-X processes operation. In this sense, electrochemical energy storage is not found to be a limiting factor for the global energy transition. Correspondingly, this work projects the possibly highest stationary battery demand published with a range of 67.9–106.5 TWh cap by 2050, above those in existing cost-optimised energy-industry system analyses. • Sodium-ion and lithium-ion battery cell cost modelling with current material cost • Thorough learning rate investigation and application for future cost estimation • Sodium-ion battery cells close to cost parity today, higher prospects for reduction • Cheaper batteries do not trigger more solar PV but battery capacity. • More battery capacity is used to run Power-to-X in higher load.

BackgroundSocio-technical imaginaries, visions and utopias concerning energy and sustainability offer ideas about how the world should be. As such, they are normative endeavors that require a critical ethical assessment. However, normative assumptions about energy futures often remain implicit, thereby escaping critical scrutiny. This study combines science fiction and normative energy ethics to evaluate competing visions of renewable energy futures. We introduce a conceptual framework that distinguishes between the two main ways in which energy intersects with utopian futures: energy abundance and energy sufficiency. Next, we identify the ethical pros and cons of energy abundance and sufficiency as desirable future states, examining this through popular science fiction texts and normative energy ethics perspectives such as energy justice, virtue ethics, and critical theory of technology.ResultsThe vision of renewable energy abundance provides a very appealing prospect and can motivate different stakeholders to speed up the transition to a low-carbon energy system. However, striving towards such an energy utopia comes with several caveats. First, the idea of renewable energy abundance in the near future is dangerous because it is, so far, a technological illusion. Second, regional visions of energy abundance often neglect global and intergenerational energy justice considerations. Third, according to virtue ethics, pursuing energy abundance can be considered excessive, not virtuous and hence immoral. Fourth, energy abundance can lead to problematic forms of alienation and, therefore, dystopian versions of the good life. Utopias based on renewable energy and sufficiency aim to avoid these issues. Yet they face two additional problems that seem to hinder the adoption of energy sufficiency as the leading energy policy paradigm. First, there is a real danger that citizens would protest and slow down the energy transition if energy sufficiency were to be promoted by governments on a large scale. Second, in practice, the lines between energy sufficiency and abundance, and between energy needs and wants, remain unclear and highly contextual, leading to philosophical and practical problems.ConclusionsWe propose distinguishing between two questions that may require different answers: Firstly, what kind of energy future do we, as a society, want? And what energy future should we strive for in our energy policies? Taking critiques of the pursuit of renewable energy abundance seriously, we conclude that we should resist the tendency to unquestioningly incorporate utopian ideas of renewable energy abundance into energy policies and technologies, despite the strong rhetorical appeal of abundance. This implies that the second concern regarding energy sufficiency — namely, its ambiguity, context dependency, and challenging measurement issues — should be addressed directly instead of being avoided. Energy policies must engage more explicitly with the normative assumptions underlying desirable energy futures, particularly with regard to sufficiency versus abundance.

Background: Chronic kidney disease (CKD) is rapidly becoming more prevalent among younger populations, posing significant impacts on health and socio-economic development. Therefore, analyzing direct medical costs (DMCs) in CKD treatment is essential. Objective: To analyze DMCs in the treatment of CKD at Thong Nhat Dong Nai General Hospital in 2024. Subjects and Methods: A cross-sectional descriptive study was conducted using retrospective electronic billing data of all CKD patients who met the sampling criteria at Thong Nhat Dong Nai General Hospital from January to December 2024. Results: The study analyzed data from 7,634 patients, with a mean age of 63.41 ± 13.76 years. Among them, 24.18% were diagnosed with stage 1 CKD. The average annual DMC per patient, per inpatient episode, and per outpatient visit was 14.02 million VND (95% CI: 13.28-14.77 million VND), 10.81 million VND (95% CI: 9.76-11.85 million VND), and 3.45 million VND (95% CI: 3.38-3.53 million VND), respectively. The majority of the costs were reimbursed by health insurance (ranging from 89.30% to 93.06%). Factors associated with DMCs included gender, CKD stage, insurance reimbursement rate, type of insurance coverage, and the presence of vascular comorbidities. Conclusion: The annual DMCs for CKD treatment were estimated to account for approximately 12.3% of the national GDP per capita in 2024, with inpatient DMCs representing around 9.48% and outpatient DMCs accounting for approximately 3.03%.

Urban-rural fringe areas (URFAs) are transitional zones where rapid urban expansion intersects with rural landscapes, posing significant socio-environmental challenges. In China, this issue is particularly critical, with the urbanisation rate increasing from 17.9 % in 1978 to over 67 % in 2024, driving rapid land use transformation and reshaping the design and functionality of public spaces. Community parks (CPs) play a vital role in these areas in enhancing liveability and socio-ecological resilience. However, while policies increasingly emphasise the importance of green spaces, their quality and alignment with residents’ needs remain underexplored. This study examines the role of CPs in Wuhan’s URFAs by analysing park usage patterns, resident satisfaction, and functional design elements. Using structured questionnaire surveys (n = 452), the findings reveal that: (1) CPs within a 1,000-meter or 15-minute walking radius significantly enhance accessibility and utilisation; (2) resident satisfaction is influenced by infrastructure quality, particularly the availability of toilets, fitness equipment, and well-maintained facilities; and (3) CPs do not meet diverse community needs, highlighting a gap between quantity-based provision and quality-driven usability. This underscores the significance of prioritising functionality, inclusivity, and user-centred design. In response, this study advocates for a shift from a supply “quantity” driven approach towards a “quality” first planning approach, emphasising participatory design and people-centred approaches to optimise CP infrastructure. By providing empirical evidence, this research contributes to the discourse on urban liveability enhancement and offers insights for improving green space planning in rapidly urbanising regions. • Community parks in Urban-rural Fringe Areas support liveability and urban-rural resilience. • 1,000-meter/15-minute walking access increases community park use in Urban-rural Fringe Areas. • Resident satisfaction depends on infrastructure quality and maintenance. • Community parks often fail to meet diverse user requirements in fringe settings. • Study calls for a shift from quantity-based to quality-led park planning.

Health economic methods can support the development and evaluation of new healthcare interventions by generating data on the resources used and relating these to a defined benefit. However, the standard methodology of health economic evaluation that is usually used does not do justice to the high degree of complexity of interventions in healthcare. As a result, there is a lack of decision-relevant information, for example, on the preferences of the target group, on spillover effects on the part of carers, or on implementation costs and the role of different contexts in the implementation of interventions into routine care. The UK Medical Research Council's (MRC) standard-setting framework for complex interventions therefore emphasises the need to incorporate health economic aspects more strongly into all phases of the development and evaluation of complex interventions. To make this possible, the MRC's recommendations for expanding and adapting the standard methodology of health economic evaluation must be concretised and supplemented. Building on already established methodological procedures, recommendations should be developed and proposals for necessary further research formulated.

Sodium-ion batteries (SIBs) are considered the most promising candidate for electrochemical storage after lithium-ion batteries (LIBs) to meet the globally growing energy storage demand. Assessments to identify environmental hotspots and address them in further development at regular intervals are inevitable to ensure low environmental impact of SIBs in the future. However, the number of studies assessing the environmental impacts of SIBs is limited, and existing studies are mostly based on theoretical models and few limited sources. This study is one of the few to provide life cycle inventory data from actual production processes of SIBs, allowing for hotspot analysis of environmental impacts. A comparative life cycle assessment of two emerging SIB technologies is conducted based on primary laboratory data, focusing on the synthesis of the two cathode active materials (CAMs), sodium vanadium phosphate (NVP/C), and a Prussian white (PW). The results show that the impacts of NVP/C-based pouch cells are significantly higher than the PW-based cells in all impact categories due to lower gravimetric energy densities and higher CAM synthesis-related impacts. To ensure the correct order of magnitude a benchmark NMC-based LIB is assessed at the same laboratory, showing lower impacts than both SIBs, due to higher gravimetric energy densities.