INTRODUÇÃO: Uma epidemia de coqueluche ocorreu no Brasil, de 2011 a 2014. Isto levou à introdução da vacina tríplice acelular de adultos (dTpa) no calendário público de vacinação da gestante. Existem outras estratégias de vacinação envolvendo a dTpa, que poderiam complementar o controle da doença. Os objetivos deste estudo são descrever a epidemiologia da doença e avaliar custo-efetividade da vacinação de adultos com dTpa. MÉTODOS: 1) Uma revisão de literatura foi realizada nas bases MEDLINE, Excerpta Medica, CRD e Lilacs a partir de 2000. 2) Foi desenvolvido estudo observacional incluindo dados de vacinação e os casos notificados para o sistema de vigilância no Estado de São Paulo (ESP), de 2001 a 2015. 3) Foi realizado estudo descritivo dos pacientes com idade de 20 a <40 anos atendidos em um hospital do ESP entre 2010 e 2014, destacando-se a utilização de serviços de saúde. 4) Foi desenvolvido modelo dinâmico, para comparar a estratégia de vacinação com dTpa aos 20 anos de idade com o programa atual (vacinação com dT). Dados epidemiológicos e de custos foram retirados de sistemas de informação de saúde e da literatura nacional e internacional. Foram considerados como desfecho número de casos e mortes por coqueluche e anos de vida ganho (AVG). Considerouse a perspectiva do sistema de saúde, horizonte temporal de vinte anos e custos em Reais (R$) de 2015. Os resultados foram sumarizados em razão de custo-efetividade incremental (RCEI). Análises de sensibilidade uni e multivariadas foram realizadas. RESULTADOS: 1) Foram revisadas 28 avaliações econômicas de estratégias com dTpa. A vacinação de adolescentes e de adultos foram as mais avaliadas. A correção da subnotificação, uso de modelos dinâmicos, proteção de rebanho e altas coberturas vacinas influenciaram para o bom desempenho das estratégias. 2) Houve aumento de incidência da coqueluche entre 2011 e 2014 e queda da mesma em 2015, em todas as faixas etárias no ESP. Os lactentes foram os principais acometidos, mas a proporção de casos nessa faixa etária apresentou tendência de queda ao longo dos anos. A proporção de casos com idade de 1 a < 4, 5 a = 20 anos aumentou significativamente. Houve queda não significativa na proporção dos casos com idade < 2 meses de idade. 3) Entre 36 casos estudados no hospital, 33,3% passou por consulta prévia, 25,3% por consulta de retorno e 8,33% foram hospitalizados. Hemograma e radiografia de tórax foram os exames mais realizados. Não houve complicações ou óbito. 4) A vacinação de adultos com dTpa, com cobertura vacinal de 40% e efetividade de 75%, incluindo proteção de rebanho para os menores de um ano, evitaria 19.300 casos sintomáticos e 221 óbitos em 10 anos. A RCEI seria R$28.054,38/AVG. Na análise de sensibilidade, os resultados foram mais sensíveis a variações da incidência e à retirada da proteção de rebanho. CONCLUSÃO: O comportamento cíclico da doença é a principal causa da epidemia de coqueluche entre 2011 e 2014 e queda da incidência em 2015. A vacinação de adultos com dTpa não se mostrou custo-efetiva na realidade brasileira de 2015 / INTRODUCTION: A pertussis outbreak occurred in Brazil from 2011 to 2014. This led to the introduction of the maternal vaccination with tetanus-diphtheria-acellular pertussis vaccine (Tdap) in the public immunization schedule. There are other vaccination strategies involving Tdap, which could complement the strategies of disease control. The objectives of this study are to describe the epidemiology of the disease and to evaluate cost-effectiveness of vaccination of adults with Tdap. METHODS: 1) A review was performed in the MEDLINE, Excerpta Medica, CRD and Lilacs databases from 2000. 2) Observational study was performed including vaccination data and the cases reported data from health surveillance datasets in the State of São Paulo from 2001 to 2015. 3) A descriptive study of patients aged 20 to < 40 years attended at a State of São Paulo hospital between 2010 and 2014 was performed, highlighting the use of health services.4) A dynamic model was developed to compare the vaccination strategy with Tdap at the age of 20 years with the current program (dT vaccination). Epidemiological and cost data were collected from health information systems and national and international studies. Number of cases and deaths by pertussis and life years saved (LYS) were considered as outcome. It was considered the health system perspective, a time horizon of 20 years and costs in 2015 Real (R$). The results were summarized by incremental costeffectiveness ration (ICER). Univariate and multivariate sensitivity analyzes were performed. RESULTS: 1) 28 economic evaluations of strategies with Tdap were reviewed. Vaccination of adolescents and adults were the most evaluated strategies. Underreporting correction, use of dynamic models, herd protection and high vaccination coverage influenced positively the performance of strategies. 2) The incidence of pertussis increased between 2011 and 2014, and its fall in 2015, among all age groups. Infants were the main affected, but the proportion of cases in this age group showed a downward trend over the years. The proportion of cases aged 1 to < 4, 5 to = 20 years increased significantly. There was a non-significant decrease in the proportion of cases aged < 2 months of age. 3) Among 36 cases studied in the hospital, 33.3% had a prior medical visit, 25.3% a return visit, and 8.33% were hospitalized. Blood count and chest X-ray were the most performed exams. There were no complications or death. 4) Vaccination of adults with Tdap, with 40% vaccine coverage and 75% effectiveness, including herd protection for children less than one year, would prevent 19,300 symptomatic cases and 221 deaths in 10 years. The ICER would be R$ 28,054.38/AVG. In the sensitivity analysis, the results were more sensitive to variations in incidence and withdrawal of herd protection. CONCLUSION: The cyclical pattern of the disease is the main cause of the pertussis epidemic between 2011 and 2014, and decreasing incidence in 2015. Adult vaccination with Tdap was not cost-effective in the 2015 Brazilian scenario

Esta tese representa o aprofundamento do estudo das estimativas de custos, componente integrante e determinante das avaliações econômicas, enquanto parte do projeto de pesquisa Estudos de custo-efetividade da incorporação de novas vacinas à rotina do Programa Nacional de Imunizações: Rotavírus, Varicela, Pneumocócica conjugada, Meningocócica C conjugada e Hepatite A desenvolvido por solicitação do Programa Nacional de Imunização/PNI da Secretaria de Vigilância em Saúde/SVS do Ministério da Saúde, a partir de 2005. A tese teve como objetivo analisar as condições de uso, dificuldades e repercussões de diferentes métodos de estimativas de custos em estudos de custo-efetividade de vacinas de duas tecnologias específicas, vacinas contra rotavírus e varicela, assim como a relação entre as estimativas de custos e os resultados. As estimativas de custos estão condicionadas pelas características gerais da doença sob análise (aguda no caso de rotavírus e com seqüela no caso de varicela), assim como por questões metodológicas gerais (escolha teórico-conceitual, métodos e fontes de dados) e especificidades do caso brasileiro. Para esta tese, houve maior detalhamento das estimativas de custos diretos no cuidado da doença, com a inclusão de custos específicos do sistema de saúde suplementar para as duas doenças, inclusão de participação pública na dispensação de medicamentos no caso de rotavírus e inclusão de custos de medicamentos do sistema público de saúde no caso de varicela. Como resultado, houve aumento do custo total da doença estimado de 16% para rotavírus e 11% para varicela, assim como aumento de economia (custo total da doença evitado) de 18% e 16%, respectivamente, com a introdução de cada vacina. Apesar do maior detalhamento das estimativas de custos ter reduzido a razão de custo-efetividade incremental em 20% para rotavírus e 4% para varicela, o nível de custo-efetividade dos dois programas de vacinação não foi alterado. Os resultados das avaliações econômicas de vacinação contra rotavírus e varicela mostraram-se mais sensíveis às estimativas de custos do programa de vacinação, em especial o preço da vacina, apontando a relevância do custo da tecnologia sob análise para incorporação em comparação aos demais custos / This thesis represents a deeper study of the cost estimates, an integrant and determinative component of economic evaluations, as part of the project Costeffectiveness studies of the incorporation of new vaccines into the routine of the National Immunisation Program: Rotavirus, Varicella, Pneumococcal conjugate, Meningococcal C conjugate and Hepatitis A. The project has been developed on the request of the National Immunisation Program/PNI of the Secretary of Sanitary Surveillance/SVS of the Ministry of Health since 2005. The objective of the thesis was to analyse the conditions of use, difficulties and repercussions of different cost estimates methods in the cost-effectiveness studies of two specific technologies, vaccines against rotavirus and varicella, as well as the relationship between the cost estimates and the results. The cost estimates are conditioned by general characteristics of the disease under analysis (acute in the case of rotavirus and with long-term disability in the case of varicella), general methodological issues (theoretical choice, methods and sources of data) and specificities to the Brazilian case. This thesis brings a more detailed estimation of direct medical costs, with the inclusion of specific costs of the private health care system for the two diseases, inclusion of public participation for dispensing drugs in the case of rotavirus and inclusion of drugs costs in the public health care system in the case of varicella. As a result, there was an estimated disease total cost increase of 16% for rotavirus and 11% for varicella, as well as increase of savings (disease total cost avoided) of 18% and 16%, respectively, with the introduction of each vaccine. Although the more detailed cost estimates have reduced the incremental cost-effectiveness ratio by 20% for rotavirus and 4% for varicella, the cost-effectiveness level of the two vaccination programs was not altered. The results of the economic evaluations of vaccination against rotavirus and varicella were more sensitive to the vaccination program cost estimates, especially the vaccine price, pointing out the relevance of the cost of the technology under analysis for incorporation comparatively to the other costs

Context: Exploratory Testing (ET) and Scripted Testing (ST) are two of the more commonly practiced manual testing approaches in industry. ST is a traditional testing approach in which testing is carried out by executing pre-designed test cases. While in ET, learning, test designing and test execution are carried out simultaneously. In many instances, ET and ST complement each other very well in projects; however, proponents of ET claim that ET is more cost-beneficial in comparison to ST. Moreover, a few studies have indicated that ET is more effective in defect detection. Nevertheless, to the best of our knowledge, no study has been conducted to compare the costs and benefits of these two approaches. Objectives: The aim of this study was to conduct a qualitative Cost-Benefit Analysis (CBA) of ET in comparison with ST. By comparing and analyzing these two testing approaches, this study attempts to aid in decision-making with respect to how resources should be allocated for ET and ST for certain projects. Methods: The factors of costs and benefits of ET and ST were identified by conducting six semi-structured interviews in industry. Based on the analysis of these factors, a CBA model is proposed. The academic and industrial evaluation of the proposed CBA model was performed by conducting five interviews with researchers and practitioners. In addition, a qualitative CBA of a process of ET, Session-Based Testing Management (SBTM), and a process of ST, Test-Case Based Testing (TCBT) is conducted by collecting data through questionnaires and interviews with industry practitioners. A total of 22 questionnaire responses and seven interviews were analyzed. Results: By analyzing the identified cost and benefit factors, a CBA model was developed based on the testing phases stated in the ISO/IEC 29119 standard. A qualitative CBA of the SBTM process in comparison with the TCBT process was conducted by applying the CBA model in a questionnaire. The following findings were gathered from the CBA: • The differences of the SBTM and TCBT processes are identified by an analysis of the activities performed in various organizations, which the respondents belonged to. • The results of the analysis and comparison, of the costs (in terms of effort) and benefits (quality of the testing activities) of these two testing processes, are presented with respect to each testing phase. • The factors that impact the costs and benefits of using SBTM and TCBT, are summarized and discussed in this report. • The scenarios, in which SBTM and TCBT can be more cost-beneficial, are identified based on practitioners’ opinions. Conclusions: According to the survey results, industry practitioners consider SBTM as more cost-beneficial in comparison with TCBT, particularly in the test design, implementation and test execution phases. However, industry practitioners also stressed that ET should not be considered as a replacement for ST. In some contexts, testing objectives are better achieved through a more scripted approach, while, in other contexts, testing objectives will benefit more from the ability to create and improve tests as they are being executed. Whether a testing approach is valuable or cost-beneficial also depends on the context of project and the required benefits.

Human induced climate change poses a series of ethical challenges to the current political economy, although it has often be regarded by economists as only an ethical issue for those concerned about future generations. The central debate in economics has then concerned the rate at which future costs and benefits should be discounted. Indeed the full range of ethical aspects of climate change are rarely even discussed. Despite recent high profile and lengthy academic papers on the topic the ethical remains at best superficial within climate change economics. Recognising the necessary role of ethical judgment poses a problem for economists who conduct exercises in cost-benefit analysis and deductive climate modelling under the presumption of an objectivity that excludes values. Priority is frequently given to orthodox economic methodology, but that this entails a consequentialist utilitarian philosophy is forgotten while the terms of the debate and understanding is simultaneously restricted. We set out to raise the relevance of a broader range of ethical issues including: intergenerational ethics as the basis for the discount rate, interregional distribution of harm, equity and justice issues concerning the allocation of carbon budgets, incommensurability in the context of compensation, and the relationship of climate ethics to economic growth. We argue that the pervasiveness of strong uncertainty in climate science, incommensurability of values and nonutilitarian ethics are inherent features of the climate policy debate. That mainstream economics is ill-equipped to address these issues relegates it to the category of misplaced concreteness and its policy prescriptions are then highly misleading misrepresentations of what constitutes ethical action. (authors' abstract) / Series: SRE - Discussion Papers

Objetivos. Determinar la relación costo-efectividad de la vacunación contra el (virus del papiloma humano) VPH y el tamiz de lesiones cervicales, frente a un programa de tamiz solo. Materiales y métodos. Se realizó una evaluación costo-efectividad y se empleó un modelo de Markov, con un horizonte temporal de 70 años y tres alternativas de prevención para el (cáncer del cuello uterino) CCU (tamiz solo, tamiz + vacuna bivalente, y tamiz + vacuna cuadrivalente), en una cohorte hipotética de niñas de diez años, desde la perspectiva del Ministerio de Salud. Resultados. La vacunación contra el VPH y tamiz es más costo-efectiva que el tamiz solo a partir de una voluntad de pago de S/ 2000 (USD 1 290,32). En el análisis determinístico, la vacuna bivalente es marginalmente más costo-efectiva que la vacuna cuadrivalente (S/ 48 [USD 30,97] frente a S/ 166 [USD 107,10] por AVAC, respectivamente). Sin embargo, en el análisis probabilístico ambas intervenciones generan nubes de puntos superpuestos, con una tendencia de la vacuna cuadrivalente a ser más costo-efectiva. Es decir, ambas son costo-efectivas y, por ende, intercambiables. El modelo fue especialmente sensible a variaciones de la cobertura y en la prevalencia de infección persistente por genotipos oncológicos no incluidos en la vacuna. Conclusiones. A partir de una disponibilidad de pago de S/ 2000 [USD 1 290,32] el tamiz y la vacunación son más costo-efectivos que el tamiz solo. La diferencia de costo-efectividad entre ambas vacunas carece de robustez probabilística y ambas vacunas pueden considerarse intercambiables desde la perspectiva costo-efectividad. / Objectives. To determine the cost-effectiveness of human papillomavirus (HPV) vaccination and cervical lesion screening versus screening alone for the prevention of uterine cervical cancer (UCC). Materials and methods. This cost-effectiveness evaluation from the perspective of the Ministry of Health employed a Markov model with a 70-year time horizon and three alternatives for UCC prevention (screening alone, screening + bivalent vaccine, and screening + quadrivalent vaccine) in a hypothetical cohort of 10-year-old girls. Results. Our model, which was particularly sensitive to variations in coverage and in the prevalence of persistent infection by oncologic genotypes not included in the vaccine, revealed that HPV vaccination and screening is more cost-effective than screening alone, assuming a payment availability from S/ 2 000 (US dollars (USD) 1 290.32) per subject. In the deterministic analysis, the bivalent vaccine was marginally more cost-effective than the quadrivalent vaccine (S/ 48 [USD 30.97] vs. S/ 166 [USD 107.10] per quality-adjusted life-year, respectively). However, in the probabilistic analysis, both interventions generated clouds of overlapping points and were thus cost-effective and interchangeable, although the quadrivalent vaccine tended to be more cost-effective. Conclusions. Assuming a payment availability from S/ 2000 [USD 1,290.32], screening and vaccination were more cost-effective than screening alone. The difference in cost-effectiveness between the two vaccines lacked probabilistic robustness, and therefore the vaccines can be considered interchangeable from a cost-effectiveness perspective.

Cette thèse aborde la question de la fiabilité du temps de transport. L’étude de la fiabilité du temps de transport trouve ses sources dans le fait que, dans biens des situations, le temps de transport n’est pas certain, mais aléatoire. De nombreux évènements peuvent en effet modifier le temps de transport prévu par les opérateurs ou espéré par les usagers. Par ailleurs, lors de l’évaluation socioéconomique de projets d’investissement en infrastructure de transport, il peut exister un arbitrage entre gain de temps et gain de fiabilité. Or, comme la fiabilité est encore à l’heure actuelle, difficilement intégrable dans ce type d’évaluation, ces projets d’investissement voient leur rentabilité collective sous-estimée conduisant à leurs reports. Il émerge ainsi trois problématiques majeures relatives à l’étude de la fiabilité du temps de transport : sa mesure, sa valorisation monétaire (i.e. la disposition à payer des individus pour améliorer la fiabilité du temps de transport) et enfin, sa prise en compte dans les analyses coûts-avantages. Un premier chapitre permet d’adapter les mesures usuelles de la fiabilité du temps de transport appliquées dans le cadre du transport routier, aux modes de transport collectif (fer et aérien plus particulièrement). Nous proposons également une nouvelle mesure de la fiabilité, le Delay-at-Risk (DaR) inspiré de la littérature financière. Le DaR est une transposition de la mesure de la Value-at-Risk (V aR) à l’économie des transports. Cette mesure est plus utile du point de vue des usagers pour la planification des trajets avec correspondance que les autres mesures. Le deuxième chapitre a pour principal objectif de déterminer la disposition à payer des individus pour améliorer la fiabilité du temps de transport. Nous proposons un cadre théorique inspiré de la théorie de la décision en univers risqué à partir duquel nous définissons la préférence des individus à l’égard de la fiabilité (i.e. reliabilityproneness) ainsi que la prudence. Nous développons des nouvelles mesures de la fiabilité du temps de transport, exprimées comme des primes de risque : la reliability-premium et la V OR. La reliability-premium détermine le temps de transport maximum supplémentaire qu’un individu est prêt à accepter pour supprimer l’intégralité du risque sur le temps de transport. La V OR, quant à elle, se définit comme la disposition maximale à payer d’un individu pour supprimer l’intégralité du risque sur le temps de transport. Par ailleurs, nous établissons également les conséquences sur la valeur du temps (V TTS) et de la fiabilité (V OR), de la prise en considération de l’attitude à l’égard du risque sur le temps de transport des usagers (aversion et prudence). Le dernier chapitre de cette thèse a pour objet d’intégrer la fiabilité dans les évaluations socioéconomiques de projet d’investissement et plus particulièrement dans la détermination du surplus des usagers. Nous mettons en exergue un effet de diffusion des gains de fiabilité par rapport aux gains de temps. Ainsi, nous proposons des recommandations quant à l’arbitrage entre les projets générateurs de gain de temps et de gain de fiabilité en fonction des valeurs monétaires du temps (V TTS) et de la fiabilité (V OR). / This thesis deals with the issue of travel time reliability. The study of travel time reliability emerges from the fact that in many situations, travel time is random. Many events can change the travel time forecasted by operators or expected by users. Moreover, a tradeoff may exist between time and reliability benefits when evaluating socio economic appraisal of transport infrastructure. However, since reliability is still difficult to integrate in this type of evaluation, investment projects’ collective profitability is underestimated and often postponed. Thus, three main issues of travel time reliability analysis emerge: measurement, monetary valuation and implication for cost benefit analysis. This thesis is organized in three chapters. The first chapter adapts the measure of travel time reliability typically used in the road transport context to the collective modes (rail and air, in particular). We also develop a new reliability measure: the Delay-at-Risk (DaR). DaR is an implementation of the Value-at-Risk (V aR) measure into the transport economic framework. The DaR seem to be relevant and understandable information for the users, especially to plan their travel and avoid missing their connections. The main objective of the second chapter is to define the users’ willingness to pay to improve travel time reliability. We present a theoretical framework based on decision theory under risk. We introduce the concept of reliability-proneness (i.e. travel time risk aversion) and prudence. We develop new measures of travel time reliability expressed as risk premium: the reliability-premium and V OR. The reliability-premium is the maximum amount of additional travel time that an individual is willing to accept to escape all the risk of travel time. The V OR is defined as the maximum monetary amount that an individual is willing to pay to escape all the risk of travel time. Furthermore, we also establish the link with attitudes towards risks of travel time (aversion and prudence) and the impact of the value of travel time (V TTS) and the value of reliability (V OR). The final chapter of this thesis integrates reliability in investments project’s socioeconomic appraisal. More particularly, it allows to determine users’ surplus valuation. We highlight a diffusion effect of reliability benefits with regard to travel time benefits. Thus, we propose recommendations regarding the tradeoff between projects that generate time benefits compared with reliability benefits, according to the monetary values of travel time (V TTS) and reliability (V OR).

Provoquées par des efflorescences saisonnières de macro-algues vertes de la famille des ulvacées, les marées vertes appartiennent à la classe plus large des blooms algaux nuisibles (HAB), en rapide développement dans le monde depuis trois décennies, sous l’effet notamment de l’eutrophisation des eaux côtières due aux activités humaines. L’accumulation massive des algues vertes sur les côtes produit une série de nuisances pour diverses activités marchandes et non marchandes, et peut être une source de danger pour la santé humaine. Dans le même temps, les algues vertes sont une ressource aux potentialités encore peu exploitées, et des programmes visant à valoriser industriellement les algues collectées lors des marées vertes ont vu le jour dans des pays impactés par ce phénomène, tels que la Chine et la France.Cette thèse traite de l’évaluation économique des marées vertes. Pour cela elle prend en compte, dans une optique coût-avantage, les coûts subis par les agents privés et les collectivités publiques, ainsi que les bénéfices issus de la valorisation des algues collectées lors de ces épisodes. La thèse repose sur deux cas d’étude, l’un en Chine (Mer Jaune) et l’autre en France (Bretagne). Les deux premiers chapitres sont consacrés aux marées vertes qui, depuis une dizaine d’années, se développent au printemps en Mer Jaune et viennent s’échouer sur les côtes du Shandong. Le premier chapitre étudie les mécanismes bioéconomiques à l’origine de ce phénomène, ses conséquences économiques, les politiques mises en œuvre pour y faire face, et les perceptions des acteurs et du public. Le deuxième chapitre cherche à évaluer le coût social des marées vertes, en le décomposant en coût de gestion d’une part (déduction faite de la valorisation d’une partie des algues récoltées) et en coût résiduel pour les activités marchandes et non marchandes d’autre part. Prenant la Bretagne comme cas d’étude, le troisième chapitre se focalise sur le thème de la valorisation des algues vertes. À l’aide d’un tableau entrées-sorties régionalisé, il évalue à différentes échelles spatiales les effets directs, indirects et induits d’un programme de valorisation industrielle des algues récoltées lors des marées vertes bretonnes. / Due to seasonal blooms of green macro-algae belonging to the ulvaceae family, green tides are part of the larger class of harmful algal blooms (HAB), which has developed worldwide at a high rate during the last three decades, favoured by the eutrophisation of coastal waters due to human activities. The massive accumulation of seaweeds on the shore resulting from green tides generates a variety of damages to market and non-market activities, and is a potential threat to human health. In the same time, green algae are a natural resource that may be turned into a variety of valuable products through industrial processing. R&D programs devoted to this subject have been launched in countries subject to green tides, such as China and France.The subject of this dissertation is the economic assessment of green tides, in a cost-benefit perspective. To this end, it studies the costs of green tides for private agents and public bodies, as well as the benefits due to the processing of algae.The dissertation relies on two case studies, one in China (Yellow Sea), and the other in France (Brittany). Chapter 1 and chapter 2 are dedicated to the case of the green tides that have developed each spring in the Yellow Sea and reached the southern shore of the Shandong province during the last decade. Chapter 1 investigates the bio-economic mechanisms of these episodes, their economic consequences, public management policies, and stakeholders’ perceptions. Chapter 2 tries to quantify the social cost of green tides, including management costs (minus benefits generated by green algae processing) and residual costs to market and non-market activities. Chapter 3 relies on the Brittany case, and focuses on the economic consequences of green algae industrial processing. Making use of a regionalized input-output table, it estimates, at various geographical scales, the economic impact of a program concerning the industrial processing of algae that are collected during the green tides on the Brittany shoreline.

Public expenditures are a very important part of public finance. These expenditures are one kind of state interventions. In long term we can observe an increasing trend of public expenditures. Very often, these expenditures are spended inefficiently and uneconomically. To be spend efficiently and economically, it should be obvious to evaluate their effectiveness. But the current situation of this problem in the Czech Republic is not ideal and usually effectiveness is not evaluated. Absence of this evaluation is a big problem of system of public finance. This thesis solves the problem of evaluating effectiveness of the public expenditure programs on the real program, called "Flood prevention". This program is implemented by the Ministry of Agriculture and itś main aim is to increase the protection against flood in the Czech Republic. The first phase of this program was realized in the years 2002-2007 (the second phase has been realized in the years 2007-2012). This thesis is devoted to the first phase and the main aim is to evaluate this program with an available method. One hypothesis was set: That the program "Flood prevention" was effective and all the targets were realized. In this work I tried to find, if this hypothesis is true or fals.

Public projects are still subject of heated discussions, especially with the respect to their efficiency that is usually not sufficient enough. In spite of existence of many ways how to increase their efficiency, it is readily possible to identify one fundamental criterion which is high-quality information for decision-making. It is important to deliver high-quality information to those who make decision in order to reduce wastage of the public funds on not efficient public projects. All substantial information about effects incurred by project's realization can be offered by the Cost-Benefit analysis. The Cost Benefit analysis should be prepared for each significant public project to prevent from realization of ineffective ones. It is essential to process each Cost-Benefit analysis in required qualitative level for making right decision. Purpose of this thesis is appraisal of usefulness of the Cost-Benefit analysis for specific purposes of the public sector and assessment of indexes used in the Analysis. In the thesis will be introduced public projects, related public sector and evaluation of public projects. Subsequently, the Cost-Benefit analysis itself will be presented as well as steps for processing high-quality Cost-Benefit analysis. The emphasis will be focused at discount rate and its determination, since I consider it as the critical issue of the Cost-Benefit analysis. A practical example of the Cost-Benefit analysis will be presented at the end of this thesis.

The aim of this thesis is the evaluation of the effectiveness of the investment project in the public sector. Evaluation is based on C&B analysis, which is primarily intended for evaluating investments and interventions in the public sphere. Its aim is to give all the financial impacts of the project, whether positive or negative in order to evaluate the benefits arising from the implementation in relation to financial investments made in the project. The criterion for the success of these projects is not profit, but social benefits arising from them. The higher these benefits are, the greater is the efficiency of investment. The thesis is divided into three parts (excluding introduction and conclusion). The first section explains the important concepts that readers bring to the evaluation of investment efficiency in the public sector. In the second part contains the theoretical basis from which comes out the practical part. In her is then applied method of CBA and determined the final results.