7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
1/31
GAW[@-@D CGC@FGCJ K@ DWEr
I.J. ]ucz Mjokj
Easpctjo Pfcv`rsctjrca := k` Agtumr` (Ljkrck)
Pfckjk k` ]`prakuggcf Euljfj
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
2/31
Xur`zj yjgt cv ckjk`sp`gdcg j
:330
rDWE
W`bur ckjk
@dcgjgcj
Gafscst`fgcj
uDWE
:357
EcpdcscsDWE
:308
@GI
rOE
rEGB
=887:378s
S`buj
Jft cgu`rpas
G`rkaDWE
ueLB
]`jggcaf`s
oagjo`s
Gast`-@dcgc`fgcj k` oj DWEr
]`jggcaf`soagjo`s y`d`gtass`gufkjr cas
Gastam`f`d cg ca
Ecstar cj k` ojs Baf jkatrapcfjs
uDWE-EX
:328
(Mu`fj cfv`rscf fsjouk)
:337
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
3/31
WPMW[JFGCJ JG[CTJ
GAO@G[J P]CFJ]CJ
XP]CDCGJGCAF
GPO[CTA G@OPOJ]
[]JKCGCAFJO
MCA[@GFAOABCJ
X]AKPG[A D CFJO
BAFJKA[]AXCFJW
Gast`-@dcgc`fgcj k` oj DWEr
Jcs ojlc`fta b`f`squ` ga kc d cgjf oj DWE
Gou ojs eu`sp`k k` ljld`ra
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
4/31
Gast`-@dcgc`fgcj k` oj DWEr
BafjorDWE-
PC < 8,70
Xur`bfrDWE-PC < 8,7:
L`fapur
uELB-EXPC < 8,==
Dast cpuruDWE
PC < 8,:3
Xr`gca k` ojs Bafjka trap cfjs
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
5/31
Gast`-@dcgc`fgcj k` oj DWEr
Djrljga`gafalj
:. @s oj jpo cgjgcf k` oj vjoujgcf gaflcgj pjrj oju tc o czjgcf ls rjg cafjo k` oas drljgas y p ra g`k cl c`ftas .
=. Xrcar czj oj jscbfjgcf k` r`gursas .7. Cftrakug` atras gafg`ptas k` vjoujgcf jk`ls k` oas
k` @dcgjgcj y W`burck jk
Gaft`fg cf k` gast`s < @dcg c`fgcj gafl cgj
W` pu`k` y k`m` vjoujr gujoqu c`r k`gcscf qu`clpocq u` ufj o`gg cf ftr` kas a ls apg caf`s yqu` t`fbj ufj r`p`rguscf f oj sjouk y f oasr`gursas.
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
6/31
Gast`-@dcgc`fgcj k` oj DWEr
Oj vjoujgcf gaflcgj k` ojs []JGafg`pta s prgtcgas
@dcgjgcj9 `s `o m`f`dcgca utcockjk k` ufj t`gfaoabj al`kcgjl`fta `f pjgc`ft`s k` ufj k`t`rlcfjkj pamojgcf mjia
gafkcgcaf`s k` usa ck`jo`s. K` ljf`rj ck`jo, oj l`kckj k` oj
`dcgjgcj s` mjsj `f oas r`suotjkas k` `fsjyas gaftraojkas gaf
kcstrcmugcf jo`jtarcj (pr`buftj sc `o l`kcgjl`fta pu`k` dufgcafjr).
@d`gtcvckjk9 brjka `f `o qu` ufj k`t`rlcfjkj cft`rv`fgcf,prag`kclc`fta l`kcgjl`fta, pu`stas `f prgtcgj oabrjf oa qu` s`
pr`t`fk` gafs`bucr pjrj ufj pamojgcf k`t`rlcfjkj (r`suotjkas),
`f gcrgufstjfgcjs gofcgjs ejmctujo`s. ]`quc`r` t`f`r `vck`fgcjs,
lck` oj utcockjk. Oo`vj clpogctas oas gafg`ptas k` `dcgjgcj yjg`ptjgcf.
@dcgc`fgcj9 Oj `dcgc`fgcj pu`k` k`dcfcrs` `f trlcfas k`jogjfzjr `o lxcla m`f`dcgca `f sjouk, gaf ufj k`t`rlcfjkj
gjftckjk k` r`gursas, (lfclj gjftckjk k` r`gursas pjrj jogjfzjr
uf ami`tcva k`t`rlcfjka).
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
7/31
Gast`-@dcgc`fgcj k` oj DWEr
Oj vjoujgcf gafl cgj k` ojs []JGafg`ptas prgtcgas
@dcgjgj9 oa qu` kcg` oj t`arj
@dcgc`fgcj9 oa qu` quc`r` oj b`r`fgcj
@d`gtcvckjk9 oa qu` `s `f r`jockjk
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
8/31
Gast`-@dcgc`fgcj k` oj DWEr
Ltakas k` vjoujg cf gaflcgj
Jfocscs k` l cfcl czjgcf k ` ga st`s(K`lastrjr oj cbujokjk k` d`gtas samr` oj sjouk)
(Galpjrjr g as t`s y o`b cr o ls mjrjta)
Jfocs cs k` ga st`-`d`gtcv ckjk
Jfocs cs k` gas t`-m`f`dcg ca(Xramo`lj 9 vjoarjgcf laf`tjrcj k` `d`gtas cftjfbcmo`s)
Jfocs cs k` ga st`-ut c o ckjk
GAW[@W @D@G[AW f oj WJOPK
Cbujo`s
Pfckjk`s k`
@d`gtcvckjk (gofcgas)
@d`gtcvckjk (jas)garr`bckj par
gjockjk k` vckj
(JTJG / ZJOS)
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
9/31
Gast`-@dcgc`fgcj k` oj DWEr
:. ]`vcs caf`s scs t`ltcgjs=. L`tj-jfocscs7. ]`v cs caf`s ]`t rasp`g t cvjs;. Jfo cs cs prasp`gt cvas
0. Xjf`o k` xp`r tas4. Ck`ft cd cgjg cf k` oas gast`s
(kcr`gta s, cfkcr`gtas, cftjfbcmo`s)2. Gujftc d cgjgcf k` oas gas t`s
Kcs`a k` uf jfocs cs Gast`-@d`g t cv ckjk
Du`ft`s k` cfda rljgcf* @dcgjgcj* Gas t`s
E`rrjlc`ftjs
:. rmao k` k`g cs caf`s=. Lak`oa (Ljrnav )7. J ius t`s t`lpa rjo`s;. Jfocs cs cfgr`l`ftjo (p ojfa)0. Jfo cs cs k` s`fscm c o ckjk
(`vjoujgcf k` cfg`rt ckul mr`4. ]`suotjkas
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
10/31
Gast`-@dcgc`fgcj k` oj DWEr
WC[PJGCAF@W XAWCMO@W:) Zu` oj fu`vj t`rjpcj s`j ls d`gtcvj p`ra ls gas tas j. (F@)=) Zu` oj fu`vj t`rjpcj s`j ls d`gt cvj y l`fas gasta sj. (W@)7) Zu` oj fu`vj t`rjp cj s`j l`fas d`g t cvj p`ra l `fas gastasj . (WA)
;) Zu` oj fu`vj t`rjpcj s`j l`fas d`gt cvj y ls gasta sj. (FA)
Jfocs cs cfgr`l`ftjo (Xojfa k` gasta -`d`gtcv ckjk )
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
11/31
Gast`-@dcgc`fgcj k` oj DWEr
Jfocscs k` s`fscmcockjk
Jfocs cs k` s`fs cm co ck jk 9:. Ck`ftcdcgjr pjrl`tras gaf cfg`rtckulmr`
=. Ck`ftcdcgjr rjfba k` vjoar`s
7. Gjoguojr r`suotjkas gaf kcd`r`ft`s vjoar`s k`o pjrl`tra
Tjoar ul mrjo 9 @o fcv`o k` gastas y d`gtas qu` saf`stjmo`gckas gala jg`ptjmo`s
Tjoa r`s puftujo`s vs jfocs cs pramjm cos tcg a@stjmo`g`r k cd`r`ft`s sg`fjrcas (ls pramjmo`, p`ar y l`iar)
Ojs gafgou scaf`s s` gafs ck`rjrf ramus tjs s c ojslak cd cgjgcaf `s r`joczjkjs f ojs vjrcjmo`s lsclpa r tjft`s fa praku g`f gjlmcas f oas r`su o tjkas
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
12/31
Gast`-@dcgc`fgcj k` oj DWEr
Jfocs cs Gasta -`d`gtcv ckjk
(`dcgc`fgcj)Zu cf`s saf oas jg ta r`s1
:. Wcs t`ljs k` sjouk (d cfjfgcjkar, js`burjkar y pralata r)=. @lpr`sjs djrljgutcgjs (prav``kar y p ralata r)
7. Xrad`scafjo`s gofcgas (gafsuo tar`s, musgjf spafsa r);. @xp`rta s f Drljga-`gafalj (tgf cgas jfjotc gas)0. Xjtrag cfjkar`s ( @stjkas y @lpr`sjs djrljgutcgjs)
@o jfjocs tj (`xp`rta f drl jga-`gafalj), pu`k``stjr gafkcg cafjka par oas am i`t cvas k`o pjtragcfjkar
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
13/31
Gast`-@dcgc`fgcj k` oj DWEr
K`stcfjtjrcas k` oas jfocs cs gasta -`d`gtcv ckjk([aljka r`s k` k`gcscaf`s)
:. Arbjfcslas cfk cv ckuas (prad`s cafjo`s k` oj sjouk)qu` k`gck`f oj gam`rturj a r``lma osa k ` pr`stjgcaf`s`f oj sjfckjk pmocg j.
=. B`s ta r`s sjf ctjr cas7. Xaot cgas;. Lkcgas p r`sgr cp tar`s0. @sp`gcjo cstjs ok`r`s k` ap cfcf4. Gafsulckar`s (pjg c`f t`s )
Xascm o`s s`sba s / ljfcpuojgcaf`s9
j. W`o`gg cafjr apgcaf`s galpjrjt cvjs cf`d cgc`ft`sm. Fa gafsck`rjr takas oas ga stas r`o`vjft`sg. Cfd ojr oas ga sta s (qu` fa s` praku g`f f r`jo ckjk)k. Cfd ojr oj utc o czjgcf k` r`gu rsas .
`. Du`ft`s k` cfda rljgcf cfjk`gujkjs
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
14/31
Gast`-@dcgc`fgcj k` oj DWEr Lak`oa k` Ljrnav
@o la k`oa gafl cga k` Ljrnav, s oj r`pr`s`ftjgcf k ` oj r`jo ckjk gaf o qu`s` cft`ftj sclu ojr takjs ojs pascm c o ckjk`s qu` pu `k`f agu rr cr. W` trjtj k` uflak`oa p ram jmcostcg a, utc o czjfka oj cf g`rt ckulmr` gal a p jrt` k`o gogu oa.
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
15/31
rma o k` k`gcscaf`s
Gast`-@dcgc`fgcj k` oj DWEr
G d W
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
16/31
Gast`-@dcgc`fgcj k` oj DWEr Du`ft`s k` cfdarljgcf
JA JP[A]@W GALXJ]J[CTA @FKXACF[ DJTA]JMO@
:330 Kjyj uDWE vs ELB
@lmjrjza
gofcga / gcgoa uDWE (FA s.`)
=888 Jbrjwjo uDWE vs ELB
@lmjrjza
gofcga / gcgoa ELB (FA s.`)
=88=Kjyj y
Bulmy(:5) rDWE vs uDWE-EX@lmjrjza
gofcga / gcgoa rDWE (WC s.`.)
=887 Tjf R`oy (3) rDWE vs uELB
@lmjrjza
gofcga y ]F uELB (FA s.`)
=887 Jo-Cfjfy (=8) rDWE vs u[AKJW
@lmjrjza
gofcga / gcgoa rDWE (FA s.`)
=880 Jo-Cfjfy (5) rDWE vs uELB
@lmjrjza
gofcga y ]F uELB (FA s.`)
=880@stukcaL@]C[ rDWE vs ELB-EX
@lmjrjzagofcga y ]F uELB-EX(s.`.)
=8:= Tjf R`oy (;7) rDWE vs ELB-
EX,uDWE,uDWE-EX
@lmjrjza
gofcga y ]F
Fa kcd`r`fgcjs
G t @dc c c k o DWE
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
17/31
Gast`-@dcgc`fgcj k` oj DWEr
Galpjrjgcf9 rDWE vs uDWE f []J (k` oj l cslj lpr`sj d jrl jgut cgj) (=88:)Gala fk pacf t 9 `lmjrjzas gofcg as := s`ljfjs
Kjtas gof cgas9 L`tjjfocsc s k` Kjyj jfk Buf my (:333) y ]`bcst ra s DCTFJ[ (Drjfgcj)>ED@J (PN), WJ][ (PWJ) y apcf cf k` xp`rtas (rjfba s k` pramjmco ckjk)
@st cljgcf k` gas t`s9 Fjtcafjo E`jote W`rvc g` (PN) y gofcg js prc vjkjsLak`oa ljt`ltcg a9 Ljrnav , taka s oas jga ft`gcl c`ftas f 7 gcgoas k` DCT-CGWC (dr`sg as y
gaf b`ojkas )- @stjkas k` sjouk 4: (dr`sg a) y :7 (gafb`ojkas)Wcluojgcf9 0.888 scl uojgca f`s Laf t` Gjroa gaf u fj gaea rt` k` :88.888 pjgc`ft`s]`suo tjkas9 @lm jrjzas rDWE (;8.020)> uDWE (72.705). Gasta par lmjrjza rDWE (0.384 ) ,
uDWE (4.848 ) . Gast` cfgr`l`ftjo (;.:;5 ) pa r gjkj lmjrjza gofcg ajkcg cafjo gaf rDWE
Wpafsar 9 W`rafa cft`rfjtcafjoGafgouscaf`s9 rDWE s ls gas t`-`d`gtc vj y dcgc`f t` qu ` oj uDWE
Kjyj W, O`kb `r R, Ju rjy IX, Kuru B, Wcov`rm`rb N , Rcnojfk L, Ma uzjy`f ], Eawo`s G, M`r`sf cjn J.9 Gast-`dd`gt cv`f`ssla k`o o cfb ad r`galm cfjft- v`rsus urcfjry-DWE cf jsscs t`k r`prakugt caf t`gef cqu`s cf te` PN.Eul ]`prak =88:> :49 =047-=043.
G t @dc c c k o DWE
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
18/31
Gast`-@dcgc`fgcj k` oj DWEr
Jfocs cs k` ga st`-`d`gt cv ckjk
`f @spjj
Mjrrc XF, Mjojsge I, ]al`u J, ]ucz Mjok j IJ, Kjyj W, t jo. 9 Gast`-`d`gt cv ckjk k ` oj earla fj daoguoa -`st cluojf t`
r`gal mcf jft` y u rcfjrcj f ojs tgfcg js k` r `pra ku ggcf jscst ck j f o s`g tar s jfctjrca prcv jka spjao.]`v Cm`rajl D`rt c o =88=> :39 :30-=8=.
Galpjrjgcf9 rDWE v s uDWE f []J (k` oj l csl j lp r`sj d jrljgutcg j) (=88=)Gala fk pa cf t9 lmjrjza s g ofcg as := s `ljfjs
Kjta s gofc ga s9 K` oas l`tj-jfocscs rjfkal czjkas y vjo ckjgcf par xp`rta s k` ojs pra mjmc o ckjk`s y]`bc st ra Gjtjof DCTGJ[
@st cljgcf k` ga st`s9Kjtas pum o cgjkas y Gofcgjs prcv jkjsLak `oa ljt`ltcga9 Ljrnav , taka s oas jgaf t`gclc`ftas f 7 g cgoas k ` DCT-CGWC (d r`sgas y gafb `ojkas)[rjtjl c`f ta s tjkst cgj9 tak as o as stjkas k ` sjouk f 7 gcg oas k ` DCT-CGWC (7 dr`sgas + gaf b`ojka s)Wcluojgcf9 0.888 scl uojgcaf `s Laft` Gjroa gaf u fj gaea rt` k` :88.888 pjgc`ft`s]`suo tjkas9 @lmjrjza s rDWE (;=.5:: 7.=:5) vs uDWE (73.784 7.=0:)(p?8,888:).
Gasta pa r lmjrjza rDWE (:3.273 :.502) vs uDWE (=8.;42 =.827) (p ?8 ,888:)Gcgoas f `g`sjrcas p jrj amt`f`r uf l mjrjza9 rDWE (;,43) vs u DWE (0,=:)Wpafsar 9 W`r afa @spjjGafgouscaf`s9 ]`ojgcf ga st`-`d`gtcv ckjk k ` oj rDWE ls djv arjm o` qu` oj uDWE f o W@G[A] X]CTJKA@WXJAO
G t @dc c c k o DWE
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
19/31
Gast`-@dcgc`fgcj k` oj DWEr
@stuk cas k` gast`-`d`gt cv ckjk f @spjj
Jrtgu oa ga f l `taka oabj s cl cojrjo jft`rcarLak`oa k` Ljrnaw y scluojgcf`f p am ojgcf k` :88.888 pjgc`ft`sJfocs cs gas t`-`d`gtcv ckjk k` ojs[]J f o scst`lj pmocga k`
sjouk
Gast` par lmjrjza9rDWE9 :=.2=: :.=8= vs uDWE9 :7.882 :.7:3 (p ? 8.888:)
Gcgoas f `g`sjrcas p jrj am t`f`r uf lmjrjza9
rDWE9 ;,43 vs uDWE9 0,=:
]`ojgcf gas t` d`gtcv ckjk k ` oj rDWE ls djva rjm o` qu` oj k` oj uDWE f`o W@G[A] XPMOCGA @WXJAO
]al`u J , Mjojsge I, ]ucz Mjokj IJ, t jo . Gast-`dd`gt cv`f`ss ad r`galm cfjft v`rsus urcfjry dao o cg o`-
st cluojt cfb ea rla f` cf jsscs t`k r`prakugt caf t`gef cqu`s cf te` Wpjfcse pumo cg e`jo te gjr` syst`l.I Js scst ]`p rak B`f`t. =887>=8(5)9=3;788.
Gast` @dcgc`fgcj k ` oj DWEr
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
20/31
Gast`-@dcgc`fgcj k` oj DWEr
]ucz-Mjokj I J, Op`z IL, Xrc`ta O.9 @stu kca k` gas t`-`d`gt cv ckjk k ` ojs tgfcg js k ` r`p rak ugg cf jscs t ckj f @spjj.]`v @sp @g af Wjouk =880> ;9 34-:8=.
Galpjrjgcf9 rDWE vs uELB `f []J (=880)Gala fk pacft 9 fjg ckas vcvasKjta s gofc ga s9 =;.240 k`o r`bcs tra J o`ljf (Oukw cb-=.88;)@st cljgcf k` gast`s9 Kjtas st cl jkas j =880 k`o stu kca k` ]al `u pjrj g`ftra s pmocga s. Easp.:= k`
Agtumr` k` LjkrckLak`oa ljt`ltcga9 Ljrnav
Wadwjr`9 KJ[J []@@JB@ 7.0 pjrj o jfocscs k` o as kjta s.[rjtjl c`f ta s tjkst cgj9 Jfocsc s st jkstcg a k` o as kjta s g af WXWW v:: y Lcg ra sa dt @xg `o =887Wcluojgcf9 0.888 scl uojgcaf `s Laft` Gjroa ga f ufj gaea rt` k` :88.888 pjgc`ft`s]`suo tjkas9 [rjtjkjs gaf rDWE oab rjf ]F f 8,02 gcg oas l`fas qu ` ojs trjtjkjs g af uELB (?74 jas )
@f lui`r`s k` 6 k` 74 jas stj kc d`r`fg cj jul`f tj j 7,7: gcgoa s l js f t rjtjkjs g af uELBGafgouscaf`s9 Oj rDWE s u fj jot`rf jtcvj ls dcg c`ft` (gas t`-`d`gtcvj) qu` oj uELBWpafsar 9 Ojmarjtar ca W`rafa
@stukca s k` ga st`-`d`gt cv ckjk`f @spjj
Gast` @dcgc`fgcj k ` oj DWEr
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
21/31
Gast`-@dcgc`fgcj k` oj DWEr
@stuk cas k ` gast`-`d`gt cv ckjk`f PN
R`x-R`geawsn c I t jo . EX-EbLB v`rsus rDWE cf tr`jtl`fts gal mcfcfb dr`se jfk draz`f CTD
gyg o`s9 sugg`ss rjt`s jfk gafal cg vjoujt caf.]`prak ugtcv ` McaL`kcg cf` Afocf` (=8:8) =:, :44:25
Galpjrjgcf9 rDWE v s uELB-EX (=8:8)Gala fk pacf t 9 r`gc`f fjgcka vcvaKjtas gof cgas9 = @GJ L@]C[ (f
7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn
22/31
Gast`-@dcgc`fgcj k` oj DWEr
@stuk cas k` gast`-`d`gt cv ckjk f @spjjuELB-EX v s rDWE (=8:8)
Kjtas k `o L@]C[ y k`o @CWB fDCT/CGWC pjrj r`su otjka s fjbafcstj y k ` Mas ge =885 pjrjjftjbafcstjGast`s k` lu`str j r`pr`s`ftjt cvjk` gofc gjs pum ocg js (]al`u =887)jgtujo czjkaLak`oa k` gaea rt` scluojkj k`08.888 pjg c`ft`s
Jbafcs tjsGas t` l`kca par g cgoa DCT rDWE9 ;.;:2 vs uELB-EX9 ;.787 (p?8.88:)L`kcjfj k` gast` par ]F vcva DCT rDWE9 :4.8;2 vs uELB-EX9:=.5=8 (p?8.88:)
Wcl cojr t`fk`fgcj f CGWCJftjbafcs tjsL`kcj k` gas t`s par gcg oa k` trjtjlc`fta rDWE9 ;.333 vs uELB-EX9 ;.5;4 Wpafsa r D`rr cfb WJP
L`iar p`rd c o k` gas t`-`d`gt cvck jk pjrj uELB-EX f
g of cgjs Xm ocgjs k` @spjj
Gast` @dcgc`fgcj k ` oj DWEr
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Gast`-@dcgc`fgcj k` oj DWEr
@stuk ca k` gas t`-`d`gt cv ckjk
`f Wu`gcj
rDWE vs uELB-EX (=8:7) ]`vc scf k` @G y l `tjjfocs cs (=8:7)
Kjtas gof cg as9 =8:8 Ww`kcse CTD r`bcstry /Farw`bcjf gaeart stu ky Gastas= g`ftras pmocga s y = Xrcvjkas k` Wu`gcj Wcluojgcfk` 7 gcg oa s k ` trjtjl c`fta g aeart` k` :8.888 pjgc`ft`s Fa k cd`r`fgcjs ftr` jlm js rjljs f fjgcka s vcva s p`ra s uf ljyar
fl`ra k ` avag ctas gaf rDWE (:.34 CG 30%9 :.8=-=.38) y l jyarfl`ra k` gcg oas g af lm r caf`s gaf b`ojkas.
@o jearra k` ga st` pa r pjgc`ft` f oj rDWE du` k` 7:0 Ljyar d cg c`f gcj k` rDWE vs uELB -EXWpaf sars 9 D`rrcfb Xejrljg`ut cgjos, L`rgnW`rafa tg..
R`x-R`geawsn c I, Jmau-W`ttj JL,. @gafal cg vjoujt caf a d ecbe oy pur c d c`k euljf ljfapjusjobafjkatrap cf v`rsus r`galmcfjft euljf dao o cg o`-st cluojt cf earlaf ` cf dr`se jfk draz`f cf vc t ra
d`rt co czjt caf/ cft rjgytapojsljt cg sp`rl-cf i`gt caf g ygo`s cf Ww`k`fGo cf cga@gafal cgs jfk Autgal `s ]`s`jrge (=8:7)
Gast` @dcgc`fgcj k ` oj DWEr
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Gast`-@dcgc`fgcj k` oj DWEr
@stuk cas k` gast`-`d`gt cv ckjk f PN y Wu`gcj
(=8:8)J djva ruELB
(=8:7)J djva r rDWE
Gast`-@dcgc`fgcj k ` oj DWEr
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@stuk cas k` gas t`-`d`gt cv ckjk
`f Br`gcj
Gast`-@dcgc`fgcj k` oj DWEr
Galpjrjgcf9 rDWE vs uELB-EX f []J (=8:=)Gala fk pa cf t 9 @lmjrjzas y fjg ckas v cvasKjtas g of cg as9 =;.24; k`o r`bcs tra J o`ljf@st cljgcf k` gast`s9 Kjtas k` 7 gofcg js prcvjkjs y js`sa rjl c`fta k` xp`rta sLak`oa l jt`ltcg a9 Ljrnav pjrj 48.888 pjgc`f t`sWcluojgcf9 0.888 scl uojgca f`s Laf t` Gjroa `f gaeart ` k` :88.888 pjgc`f t`s]`suotjkas9 Xar gjkj :.888 pjgc`ft`s s` a mtc`f`f 0= fjg cka s ls g af rDWE
Gas t` pa r gcg oa9 rDWE (;.740 ) vs uELB-EX (7.5:0 )
Gas t` fjgck a vc va 9 rDWE (:4.384) vs uELB-EX (:2.=54
)Gast` cfgr`l`ftjo par f jgcka g af rDWE s` st cl f :;.0;8
Gafgous caf`s9 Oj rDWE s ufj jot`rfjtcv j ls dcg c`ft ` (ga st`-`d`gtc vj) qu` ojuELB-EX
Wpafsar 9 Ojmarjtar ca L`rgnW`rafa
Drjbauojncs T, t jo. @gaf al cg vjoujtcaf ad jot`rfjtcv` jsscs t`k r`praku gtca f t`gefcq u`s cfljfjb`l`ft ad cfd`rt c o c ty cf Br``g`. Go cf cga`gafal cgs jfk a utgal `s ]`s`jrge (=8:=)
Gast`-@dcgc`fgcj k ` oj DWEr
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Gast`-@dcgc`fgcj k` oj DWEr
Galpjrjgcf9 uELB vs rDWE f pjcs`s f vjs k` k`sjrra ooa (=884)Gala fk p a cf t 9 @lmjrjza g of cgaKjtas g of cgas 9 L`tj-jfocs cs (J o-Cfjf y =880)
@st cljgcf k` gas t`s9 Jg t cv ckjk prcv jkj f @bcpta.Xr`gca Bf9 (pr`g ca k` uELB 8,4; @BX /PC y k`orDWE (648% sup`rca r) y k`m`rj t`f`r uf pr`gcak` 8,4: @BX pjrj s`r ga st`-`d`gtcv j.
Lak`oa9 Ljrna v gaf scl uojgcf k` Laft` Gjroa f :88.888 gcgoa s[rjtjl c`f ta st jkstcg a9 Jfocs cs k` s`fs cm cock jk pra mjm cos tcg a]`suotjkas9 Gas t` pa r g cg oa :7.3;4 @BX(uELB) y :5,2=: (rDWE)
;.040 lmjrjzas ls gaf oj uELB / :88.888 gcg oas
Oj st clu ojg cf avrcgj gaf uELB s ls gast`-`d`gt cv j. ]`p`rgus cf k`o pr`gca k` ojs Bf (samr`
ta ka f pjs`s f vjs k` k`sjrra ooa ) f oas JG@.
ELB v`rsus rDWE dar avuojt caf cfku gt caf cf k`v`oapcfbgauftr c`s9 j gast-`d d`gt cv`f`ss jfjoyscs mjs`k af te` r`suo tsad j r`g`ft l`tj-jfjoys cs.J o-Cfjfy EB, t jo . ]`prak M cal`k Af ocf`. =884 D`m>:=(=)9:47-3.
Gast`-@dcgc`fgcj k ` oj DWEr
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Gast` @dcgc`fgcj k` oj DWEr
Galpjrjgcf9 Bru pa s k` kjk l jt`rfj (78-77> 7;-72> 75-;:> ;=-;0) y fl`ra k` cft`ft as (=8:8)Gala fk pa cf t 9 @lmjrjzas y Fjgckas vcv asKjta s gofc ga s9 Ju str jocjf jfk F`w Y`jojfk Js scs t`k ]`pra ku gtca f Kjtjmjs` ja =88=
@st cljgcf k` g ast`s9 Justr jo cjf Cfs t c tut` ad E`jote jfk R`odjr`.[rjtjl c`f ta s tjkst cgj9 Jfocsc s k` s`fscm co ckjk pram jmcostcg a]`suo tjkas9 @o gast` cfgr`l`ftjo par f jgcka vcva f lu i`r`s brup a k` kjk (78-77) f su p rcl`ra yt`rg `r gcg oa s JP$ =2.727 S JP$ 7:.354. @f l ui`r`s ga f kjk sup`rca r j ;= jas o ga st` cf gr `l`ftjopar fjgcka vcva s JP$ :78.30: y JP$ :52.0:0 f sus prcl `rj y s`buf kj t`ftjt cvj. Fa stf cf gou cka s oa sbjsta s k` oj EA fc ojs b`stjgca f`s lot cpo`s. Ljyar d`gta f oas g ast`s oj kjk qu ` f k` k` gcgoa s.
Brcd d c tes J, Ky`r WL, Oark WI, Xjrky G, Drjs`r CW, @gn`rl jff W. J gas t-`dd`gt cv`f`ss jfjoyscs a d cf-vctra d`rt c o czjt caf myljt`rfjo jb` jfk fulm`r a d t r`jtl`ft jt t`lp ts. Eul ]`prak. =8:8>=0(;)93=;37:.
@stuk cas k` gast`-`d`gt cv ckjk f Jus trjo cj
Gast`-@dcgc`fgcj k ` oj DWEr
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Gast` @dcgc`fgcj k` oj DWEr
Iae f Woad . Gal pjrjgcf k`o gast` k` oj st cl uojgcf avrcgj gaftr aojkj ga f rDWE-jodj y rDWE- m`tj f pr`s`ftjgca f`spjrj ju tacf y`gtar. ]`v Cm`r. D`rt9 Tao. =2- f 0 - W`ptc`lmr`-Agtu mr` =8:8
:. @s tuk ca k` gas t`s djrljga ob cgas fcgjl`ft` (juta cfy`g tar )
=. Xra taga oas ejm c tujo`s (2) k` s t clu ojg cf gaf Jbaf cs tjs yJf tjbafcs tjs, f fa rla ,jotj y mjij r`spu `stj, f lafat`rjpcj a pjutjgalmcfjkj.
7. Kjfka p ar vockj oj dcg c`fg cj k` ojs rDWE (k` ljf`rj b`f`rjo) f oasjfocs cs k ` gast`-`d`gtcv ckjk r`joczjka s e jstj oj d`gej, k`m`rj s`r ogas ta djrljgaobcga k` ojs ka s DWE r`galmcfjft`s, oa qu` cfgo cf js` oj
mjojf zj ejg cj oj ls gaflcg j.;. ]`su o tjkas 9 Oj k c d`r`fg cj k`o gas t` par g cg oa 9 `ftr ` ;7 y =3=
Jea rra f gas t` djrljga obcga f tr` o 4,5 y :2,0% s`bf pjutj k``stcluojgcf. Je arra djrljgaobcga pjrj oj rDWE-
0. Xjtra gcf jka r9 Wge`rcfb -Xoaube - Arbjfa f @spjaoj
Gast`-@dcgc`fgcj k ` oj DWEr
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Gast` @dcgc`fgcj k` oj DWEr
]`v`o o c J t jo. ]`gal mcfjft v`rs us ecb eoy-pu rc d c`k, urcf jry dao o cgo`-st clu ojt cfb earl af` (r-DWE vs.
EX-uDWE) cf av uojt caf cfkugt caf9 j pras p`gt cv`, rjfkal cz`k stuk y w c te gas t-lcfclczjtcaf jfjoyscs.]`prakugt cv` Mcaoab y jfk @fkagr cfa oaby =884, ;975
Galpjrjgcf9 rDWE vs uDWE-EX f cfkug gcf k` avuojgcf (=884)Gala fk pacf t 9 Fjgckas vcvasKjtas gof cgas 9 Oas k`o stukca pras p`gt cva y rjfkal czjka (Xjutj 20 uc pjrj gjkj mrjza)@st cljgcf k` gas t`s9 P.C. DWE r`qu`rckjs f oj st cl uojgcf. Xr`gca p ar vcjo k ` 20 P.C.
Jfocscs k` lcf clczjgcf k` gast`s (Gast` par fjg cka v cva f fl`ra k` vcjo`s)]`suo tjkas9 Tcjo`s k` uDWE 08% l`fa s k` pr `gca/ L`far ga fsula k` rDWE par g cg oaFl`ra k` fjgck as vcva sup`rcar f r DWE (78%). Gast` par f jgcka rDWE(-:8%)
Gafgouscaf`s9 Oj rDWE s ufj jot`rf jtcvj ls dcg c`ft` (ga st`-`d`gtcv j) qu` oj uDWE-EXWpafsar 9 Ojmarjtar ca W`rafa
@stukca k` l cfcl czjgcf k` ga st`s f Ctjo cj f CA
Gast`-@dcgc`fgcj k ` oj DWEr
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Gast` @dcgc`fgcj k` oj DWEr
Gafgouscaf`s
:. @f ojs galpjrjgcaf`s k` oj rDWE gaf ojs uDWE `f b`f`rjo,pr`kalcfjf oas l`tj-jfocscs gaf ljyar `dcgjgcj k` ojs
r`galmcfjft`s.
=. @f oj galpjrjgcf rDWE vs eLB-EX, `f oas brjfk`s
l`tjjfocscs (Tjf R`oy , Jo-Cfjfy) lu`strjf, `f trlcfas
k` `lmjrjzas gofcgas a tjsj k` fjgckas vcvas par lui`r,ufj t`fk`fgcj fa `stjkstcgjl`ft` scbfcdcgjtcvj djvarjmo` j
oj eLB-EX, par oa qu` fa s` pu`k` gafgoucr qu` s`j l`iar
qu` oj DWEr.
7. Wcf `lmjrba jo cfgoucr gcgoas k` gafb`ojkas `f oas jfocscsk` gast`-`d`gtcvckjk (Kjyj, Mjrrc, ]al`u, R`x), gaf
scluojgcaf`s k` uf brjf fl`ra k` gcgoas, oj rDWE `s ls
gast`-`d`gtcvj (ljyar fl`ra k` avagctas y `lmrcaf`s).
Gast`-@dcgc`fgcj k ` oj DWEr
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Gast` @dcgc`fgcj k` oj DWEr
Gafgouscaf`s b`f`rjo`s
:. Oas prad`scafjo`s f `o lal`fta jgtujo, `stjlas galpral`tckas gaf oj
lcfclczjgcf k` gastas.=. Oas JG@ saf k` brjf jyukj f oj talj k` k`gcscaf`s (fa uf sustctuta)
7. Ojs kcd`r`ft`s gafgouscaf`s k` oas JG@, k` ljf`rj b`f`rjo, k`p`fk`f
k` sus pralatar`s y ls sc j oj v`z saf prav``kar`s k`o prakugta j
galpjrjr.
;. Jufqu` oj r`p`rguscf k` oas l`kcgjl`ftas `f `o gast` tatjo k`o fjgckavcva `s clpartjft` (=8-=0%), `o jearra ljyar s` prakug` jo oclctjr
jobufjs cfkcgjgcaf`s (`kjk, fl`ra k` gcgoas pr`vcas `tg.)> k`gcscaf`s
qu` pu`k`f pojft`jr pramo`ljs tcgas.
0. Pf l`kcgjl`fta gasta-`d`gtcva pu`k` jyukjr `f9
j. Kcslcfugcf k`o gasta par gcgoa r`joczjkam. L`far fl`ra k` gcgoas pjrj gafs`bucr uf `lmjrjza
g. Dcfjfgcjr ls trjtjlc`ftas jkcgcafjo`s (lcslas r`gursas)
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