Cost-effectiveness of osimertinib in the UK for advanced EGFR-T790M non-small cell lung cancer

Aim: This study presents the cost-utility analysis that was developed to inform the NICE health technology assessment of osimertinib vs platinum-based doublet chemotherapy (PDC) in patients with EGFR-T790M mutation-positive non-small cell lung cancer (NSCLC) who have progressed on epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy.

Methods and materials: A partitioned survival model with three health states (progression-free, progressed disease, and death) from a UK payer perspective and over lifetime (15 years) was developed. Direct costs included disease management, treatment-related (acquisition, administration, monitoring, adverse events), and T790M testing costs. Efficacy and safety data were taken from clinical trials AURA extension and AURA2 for osimertinib and IMPRESS for PDC. An adjusted indirect treatment comparison was applied to reduce the potential bias in the non-randomized comparison. Parametric functions were utilized to extrapolate survival beyond the observed period. Health state utility values were calculated from EQ-5D data collected in the trials and valued using UK tariffs. Resource use and costs were based on published sources.

Results: Osimertinib was associated with a gain of 1.541 quality-adjusted life-years (QALYs) at an incremental cost of £64,283 vs PDC (incremental cost-effectiveness ratio [ICER]: £41,705/QALY gained). Scenario analyses showed that none of the plausible scenarios produced an ICER above £44,000 per QALY gained, and probabilistic sensitivity analyses demonstrated a 63.4% probability that osimertinib will be cost-effective at a willingness-to-pay threshold of £50,000.

Limitations: The analysis is subject to some level of uncertainty inherent to phase 2 single-arm data and the immaturity of the currently available survival data for osimertinib.

Conclusions: Osimertinib may be considered a cost-effective treatment option compared with PDC in the second-line setting in patients with EGFR-T790M mutation-positive NSCLC from a UK payer perspective. Further data from the ongoing AURA clinical trial program will reduce the inherent uncertainty in the analysis.     

Psychophysiological Responses to Background Brand Placements in Video Games

Researchers have typically employed cognitive and affective measures to study the effectiveness of brand placements in video games. A psychophysiological approach to measuring effectiveness has been sorely lacking and is necessary to help both academics and practitioners further their understanding of how brand placements work. The current study measures individuals’ orienting responses in terms of increased skin conductance and decreased heart rate upon exposure to brands in video games. Results indicate that game players register background advertisements subconsciously even though they may not be able to explicitly recall them later. There were no differences between gamers and nongamers in the recall and recognition of brands from the video game. Furthermore, brands with preexisting favorable attitudes automatically received further processing, suggesting orienting response is an indicator of initial perception rather than further elaboration.     

Advertising in China and Hong Kong

A study of a selection of major US corporations was undertaken to determine how advertising budgets are appropriated. The relationship between profit and sales and the size of the advertising budget was examined to see if advertising allocations are being increasingly arrived at using ‘modern’ techniques such as mathematical decision rules or whether simple rules of thumb are still predominant in practice. Budget allocations for 80 companies to six media and their relations to sales and profit were also evaluated. Advertising budgets were examined in three matched categories: for brand advertising, for corporate advertising and for mixed advertising.     

The impact of oil price changes on Spanish and euro area consumer price inflation

This paper assesses the impact of oil price changes on Spanish and euro area consumer price inflation. We find that the inflationary effect of oil price changes in both economies is limited, even though crude oil price fluctuations are a major driver of inflation variability. The impact on Spanish inflation is found to be somewhat higher than in the euro area. In both economies, direct effects have increased in the last decade, reflecting the higher expenditure share of households on refined oil products, whereas indirect and second-round effects seem to be losing importance.     

Shareholder Theory and Kant’s ‘Duty of Beneficence’

This article draws on the moral philosophy of Immanuel Kant to explore whether a corporate ‘duty of beneficence’ to non-shareholders is consistent with the orthodox ‘shareholder theory’ of the firm. It examines the ethical framework of Milton Friedman’s argument and asks whether it necessarily rules out the well-being of non-shareholders as a corporate objective. The article examines Kant’s distinction between ‘duties of right’ and ‘duties of virtue’ (the latter including the duty of beneficence) and investigates their consistency with the shareholder theory. The article concludes that it is possible within the ethical framework of shareholder theory for managers to pursue directly the happiness of non-shareholders. Furthermore, shareholders have a duty to hold management to account for the moral consequences of the firm’s activities on non-shareholding stakeholders.     

The Trading of Purchase Interest for Concept Believability

The increasing riskiness and cost associated with product development are major blocks to the successful marketing of new products. This study discusses the application of magnitude estimation scaling and benefit modelling to the measurement of consumer reactions for a wide array of systematically varied product concepts. The trade-off between different consumer reactions (e.g., purchase interest vs believability) is considered in the light of optimal combinations of benefits for directing concept and strategy development. Implications for product development and the identification of alternative advertising copies are additional benefits which emerge from the modelling process.     

Small & Medium Gold & Fashion Enterprises (SMEs) in Arezzo,Italy: Competitive Challenges and Strategic Implications

ABSTRACT

This paper provides some empirical evidence on organizational characteristics and strategies of firms in the Italian gold and fashion industries. The analysis is based on a data set of three SME clusters in Arezzo (a city and province in Tuscany, Italy, southeast of Florence) which led us to the identification of two main alternative strategies which can be implemented when facing the new global competition: a firm-centered brand strategy and an outsourcing strategy (a supply alliance with co-branding possibilities with one or more large Italian firms). We analyzed the resources and competencies of firms that adopted different export marketing strategies and further explored the relationship between strategic choices and performance of participating firms (measured in terms of growth, innovation, and export capabilities). The results show that the choice of a strategy is strongly influenced by the ability of SMEs to respond to changes in consumer behavior and competition, and that some variables significantly affect performance. Both strategies can be effective, and in some cases it is suggested to follow the middle of the road competitive approach: combining the two strategies, exporting own brand directly to the end markets and collaborating with a large firm in order to achieve a sustainable and significant competitive advantage.     

Economic Liberalization and Conditional Volatility of Exchange Rate in Sub‐Saharan Africa: Asymmetric GARCH Analysis

Abstract: For small open economies, an understanding of movements in the exchange rate is imperative in analyzing trade and capital flows. In addition, reliable forecasting of exchange rate volatility is important in risk‐taking assessment and investment decision‐making, both of which are critical to long‐term growth. Using an asymmetric GARCH‐type approach, this paper examines the implications of economic liberalization on the stochastic behavior of the exchange rate series in a sample of sub‐Sahara African (SSA) countries over the 1970–2004 period. The results indicate that exchange rate volatility is variable, and is less volatile under fixed exchange rate regime (pre‐economic liberalization) and higher under flexible regime (post‐economic liberalization), that is, it is asymmetric. For most of the countries, the EGARCH and TGARCH models are robust to parameter stability and gives better forecasting performance compared to the standard GARCH model.     

On the general equilibrium costs of perfectly anticipated inflation

In monetary models where M0 has no social costs and a positive demand for cash and deposits is taken as a primitive, we show that the compensating variation in endowment is the exact general equilibrium measure of welfare costs of perfectly anticipated inflation. As a consequence, we show that a good approximation to the welfare costs of inflation is given by the area under the compensated demand for M0, a result that brings us back to Bailey (J Polit Econ 64:93–110, 1956). The estimated welfare costs of inflation are bounded at less than a quarter of a percent of the GDP for the U.S. economy.