Budget impact analysis of secukinumab versus adalimumab in the treatment of ankylosing spondylitis

Background: Biologic treatments have enhanced the treatment outcomes of patients with active ankylosing spondylitis (AS). Until recently, TNF-alpha-inhibitors have been the only biologics approved for the treatment of active AS. The objective of this study was to assess the potential financial impact of the first non-TNF-alpha biologic secukinumab (fully human IL-17A-inhibitor) vs adalimumab (TNF-alpha-inhibitor) in the treatment of AS in Finland.

Materials and methods: In this model-based budget impact analysis, patients were treated either with secukinumab (150?mg) or adalimumab (40?mg). The number of patients and market share of different biologics were based on national reimbursement registry data. Adalimumab was the most commonly used biologic treatment for AS, and in the base case analysis all adalimumab patients are assumed to switch to secukinumab. Response rates were based on a matching-adjusted indirect comparison between secukinumab and adalimumab. Patients not achieving response were switched to another biologic treatment.

Results: Treating AS patients with secukinumab instead of adalimumab leads to potential savings of 18.2 million euros within a 5-year time period. The total costs within the follow-up time were 59.5 million euros and 77.7 million euros with and without secukinumab, respectively. According to sensitivity analyses, a higher adoption rate of secukinumab corresponds to higher potential savings.

Conclusions: Secukinumab is a cost-saving treatment option compared with adalimumab in the treatment of AS in Finland. More patients could be treated with a biologic by allocating resources more efficiently.     

Investigating stability and linearity of a German M1 money demand function

Starting from a linear error correction model (ECM) the stability and linearity of a German M1 money demand function are investigated, applying smooth transition regression techniques. Using seasonally unadjusted quarterly data from 1961(1) to 1990(2) it is found that the money demand equation considered is both linear and stable. After extending the sampling period until 1995(4) a clear structural instability due to the monetary unification on 1 July 1990 is found and subsequently modelled. A non-linear specification for the extended period is presented and discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

Exact decomposition of the Fisher ideal total factor productivity index

Decompositions of total factor productivity (TFP) shed light on the driving factors behind productivity change. We develop the first exact decomposition of the Fisher ideal TFP index which contains no debatable mixed-period components or residuals. We systematically isolate five effects of (1) technical change, (2) technical efficiency, (3) scale efficiency, (4) allocative efficiency, and (5) price effect. The three efficiency components (2–4) represent the efficiency of achieving a given target point. Components (1) and (5) capture the changes of the target point. While the technical change component is well-established, changes in the relative input–output prices can have real effects on the scale and scope of the target. Such changes are captured by the new price effect component (5). The new decomposition is compared with existing decompositions both in theory and by means of an empirical application to a panel data of 459 Finnish farms in years 1992–2000.

Joint estimation of technology choice and technical efficiency: an application to organic and conventional dairy farming

This paper proposes an econometric framework for joint estimation of technology and technology choice/adoption decision. The procedure takes into account the endogeneity of technology choice, which is likely to depend on inefficiency. Similarly, output from each technology depends on inefficiency. The effect of the dual role of inefficiency is estimated using a single-step maximum likelihood method. The proposed model is applied to a sample of conventional and organic dairy farms in Finland. The main findings are: the conventional technology is more productive, ceteris paribus; organic farms are, on average, less efficient technically than conventional farms; both efficiency and subsidy are found to be driving forces behind adoption of organic technology.     

Marketing sustainable tourism: the role of value orientation,well-being and credibility

Abstract

Marketing for sustainable tourism primarily attracts customers with a biospheric–altruistic value orientation. To reach a broader consumer group and also persuade people with a self-enhancement orientation to book sustainable hotels, the effectiveness of three different communication styles (emotionality levels, amount of sustainability information and inclusion of a label) is investigated, considering the consumer’s value orientation. An experiment with 337 participants was conducted to analyze the effects of communication on consumer perceptions of well-being and credibility. Multigroup structural equation modeling was used to compare the impacts of communication style on participant’s attitude toward booking a sustainable hotel, mediated by well-being and credibility. The results highlight significantly different communication effects among the two contrasting target groups. Consumers who are highly interested in sustainability (biospheric–altruistic value orientation) are persuaded by messages that include details about the hotel’s sustainability performance, in order to increase the social–environmental well-being, whereas for customers who are less interested in sustainability (self-enhancement value orientation), a self-referential emotionally communication is essential, as it increases the emotional well-being. Inconsistent findings regarding the role of communication in raising the perception of credibility were obtained.     

The warnings puzzle: an upstream explanation

Enforcement agencies issuing warnings are an empirical regularity in the enforcement of laws and regulations, but a challenge to the standard economic theory of public enforcement. A number of recent contributions explain the popularity of warnings as a response to information asymmetries between regulator and regulatee. We offer a distinct, but complementary explanation: Warnings can serve as a signaling device in the interaction between the enforcement agency and its budget-setting authority. By using costly warnings for minor offenses that would otherwise not be pursued, the agency can generate observable activity to escape budget cuts in subsequent periods. We show in a stylized model that warnings may indeed occur in an equilibrium of a game in which warnings are entirely unproductive in the agency-regulatee interaction, and thereby derive a testable hypothesis on regulatory agency behavior.     

The Intergenerational Transfer of Solar Radiation Management Capabilities and Atmospheric Carbon Stocks

Solar radiation management (SRM) technologies are considered one of the likeliest forms of geoengineering. If developed, a future generation could deploy them to limit the damages caused by the atmospheric carbon stock inherited from the current generation, despite their negative side effects. Should the current generation develop these geoengineering capabilities for a future generation? And how would a decision to develop SRM impact on the current generation’s abatement efforts? Natural scientists, ethicists, and other scholars argue that future generations could be more sanguine about the side effects of SRM deployment than the current generation. In this paper, we add economic rigor to this important debate on the intergenerational transfer of technological capabilities and pollution stocks. We identify three conjectures that constitute potentially rational courses of action for current society, including a ban on the development of SRM. However, the same premises that underpin these conjectures also allow for a novel possibility: If the development of SRM capabilities is sufficiently cheap, the current generation may for reasons of intergenerational strategy decide not just to develop SRM technologies, but also to abate more than in the absence of SRM.     

Techno-economic modeling of value network configurations for public wireless local area access

The growing amount of mobile data traffic increases the demand for local area network deployments, and therefore is likely to have an effect on the mobile communications ecosystem. Several alternative value network configurations exist giving new business opportunities to different actors, but the attractiveness and success of local area access provisioning remains uncertain. This article analyzes the business of public local area access from the point of view of two potential providers: service application providers, i.e. companies whose core business is to provide information and content services in the Internet, and mobile operators. A quantitative techno-economic model is constructed to quantify the costs and required revenues of operating viable public local area access networks. The results show that the revenue requirements vary between public venue types and value network configurations.