Economic modelling of costs associated with outcomes reported for type 2 diabetes mellitus (T2DM) patients in the CANVAS and EMPA-REG cardiovascular outcomes trials

Aims: To model direct medical costs associated with reductions in cardiovascular disease (CVD) events in T2DM patients reported in the CANVAS and EMPA-REG trials, which assessed the cardiovascular safety of canagliflozin and empagliflozin, respectively.

Materials and methods: Costs were modeled from a US managed care organization (MCO) perspective for the CVD outcomes included in both trials: three-point major adverse cardiovascular event (MACE) and its components (cardiovascular-related death, nonfatal myocardial infarction, nonfatal stroke), as well as heart failure requiring hospitalization. The rate of CVD events averted (difference between study drug and placebo) was projected to the portion of an MCO T2DM population matching the respective trial’s inclusion criteria. A targeted literature search for paid amounts directly associated with each CVD event provided the unit costs, which were applied to the projected number of events averted, to calculate costs avoided per member per year (PMPY). One-way sensitivity analyses were performed on events averted, unit costs, and percentages of trial-applicable patients.

Results: Based on three-point MACE events averted, costs avoided PMPY of $6.17 (range: $1.27–$10.94) for CANVAS and $2.75 ($0.19–$4.83) for EMPA-REG were estimated. Costs avoided for individual components of MACE ranged from $0.77 to $3.84 PMPY for CANVAS and from -$0.97 (additional costs) to $1.54 for EMPA-REG. PMPY costs avoided for heart failure were $2.72 for CANVAS and $1.32 for EMPA-REG.

Limitations and conclusions: Models assumed independent, non-recurrent outcomes and were restricted to medical costs directly associated with the trial-reported events. The reductions in CVD events in T2DM patients reported for both CANVAS and EMPA-REG project to a positive cost avoidance for these events in an MCO population. The analysis did not include an assessment of the impact on total cost, as the costs associated with adverse events, drug utilization or other clinical outcomes were not examined.     

What's on the Menu? Policies to Reduce Young People's Sugar Consumption

Young people in the UK consume far above the maximum recommended levels of added sugar. It is likely that neither they nor their parents fully take account of the future health, social and economic costs of this high sugar consumption. This provides a rationale for policy intervention. The majority of young people's added sugar consumption occurs in the home, where purchases are typically made by parents. This means that understanding the purchase decisions of adults is important for policy design, even if the policies aim to reduce the consumption of young people. We discuss the merits of popular policies, including taxes, advertising restrictions and restrictions on the availability of specific foods, and we identify promising avenues for future research.     

Attitudes about EU expansion and zero‐sum thinking

EU expansion can be seen as a positive‐sum process benefiting all countries by creating larger markets that stimulate more productive economies through increased specialization and economies of scale, implying that the general public in all countries should favour expansion. Contrarily, expansion can be perceived as zero‐sum. Capital and production relocate from higher to lower wage regions while labour does the opposite, possibly raising unemployment and reducing wages in the higher wage regions. The general public in these countries may come to oppose EU expansion attributing any deterioration in their work situation to the gains of new citizens of the European Union. Analysis of changes in Irish attitudes towards EU expansion in 2002, 2007 and 2009 finds no evidence of a link from lowered economic conditions to increased opposition to EU expansion. The only evidence for zero‐sum thinking is that diminished economic circumstances are associated with increased opposition to immigration, but this is not associated with increased opposition to further EU expansion.     

Mitigating information asymmetry through sustainability assurance: The role of accountants and levels of assurance

This paper aims to examine the usefulness of sustainability reporting in reducing information asymmetry as result of lower dispersion and higher accuracy in financial analysts’ earnings forecasts. The empirical results from an international sample of listed companies indicate that the disclosure of sustainability information alone is not sufficient in this regard as our findings indicate that information asymmetry is reduced to a greater when such information is assured, supporting the value relevance role of sustainability reporting and assurance. In addition, the empirical findings suggest differences in terms of assurance attributes (provider and level of engagement) and such differences are even more relevant when controlling the institutional context. Assurance is highly appreciated by investors in more stakeholder-oriented countries; however, in more shareholder-oriented environments, assurance affects information asymmetries only when it is provided by accounting professionals who also report a “reasonable” opinion.     

Knowledge Management in Supply Chains: The Role of Explicit and Tacit Knowledge

We theorize, building on the knowledge‐based view and the theoretical distinction between explicit and tacit knowledge, that knowledge management capability across the supply chain manifests itself in explicit and tacit knowledge, which in turn effectuates supply chain performance. The model is tested with survey data from 195 small‐ and medium‐sized enterprises reporting on their primary supply chain. The results indicate that the supply chain's knowledge management capability manifests itself in both explicit and tacit knowledge, with the latter being influenced more strongly. Moreover, it was found that while both explicit and tacit knowledge influence supply chain performance, the latter exerts a significantly greater impact than the former. Exploratory post hoc analyses add robustness to these findings and investigate mechanisms inherent to the transformation of tacit into explicit knowledge. Overall, this research contributes to academic theory development in logistics and supply chain management by the dichotomization of knowledge types and the demonstration of their differential magnitude of effects, and to managerial practice by providing important guidance for logistics managers structuring their knowledge management efforts across supply chains.     

Our Collaborative Future: Activities and Roles of Stakeholders in Sustainability‐Oriented Innovation

While stakeholders have long been at the forefront of sustainable development debates, the emphases have tended to be on different stakeholder pressures, or managing stakeholder expectations about controversial issues. In this paper we bring a fresh direction to these debates and ask in what ways different stakeholders can contribute to sustainable innovation in firms. Based on 80 semi‐structured interviews, we conduct a fine‐grained qualitative analysis of stakeholder activities in sustainability‐oriented innovation (SOI) processes in 13 different companies across Europe. Our analysis identifies eight roles that stakeholders play in SOI processes: stimulator, initiator, broker/mediator, concept refiner, legitimator, educator, context enabler and impact extender. More traditional roles such as legitimator and educator are less common in our cases. However, emerging roles such as stimulator, concept refiner, context enabler and impact extender are clearly identifiable and could be particularly valuable for SOI. We enhance a collaborative perspective of stakeholder theory, finding that stakeholders can play highly collaborative and proactive roles, and argue that secondary stakeholders may actually be more relevant for SOI than primary stakeholders. Copyright © 2017 John Wiley & Sons, Ltd and ERP Environment     

The uncertainty challenge of contingent collaboration

Contingent knowledge workers will play an increasingly important role in organisational success as workers transition in and out of project‐based innovation teams with more frequency. Our research finds that collaborators in the contingent, high‐skill workforce face uncertainty challenges to their work that are unique from the independent, contingent professionals more often studied. The article proposes a theoretical framework of uncertainty to guide us in understanding collaborative contingent knowledge workers’ work experience. Interviews with postdoctoral researchers reveal four findings about the influence of these highly uncertain work environments on collaborative contingent knowledge workers – collaboration isolation, frustrated independence, performance anxiety and internalised blame. Perhaps most concerning is that the workers internalise the negative impacts as personal failings instead of recognising them as consequences of a poorly designed work environment. This study argues for the need to manage and mitigate different sources of uncertainty to avoid creating an unnecessary burden on contingent knowledge workers, and to enable a sustainable, contingent knowledge workforce.     

Critical success factors for the sustainability of Kaizen event human resource outcomes: An empirical study

Kaizen events have been widely reported to produce positive change in business results and human resource outcomes. However, sustaining or improving upon the results of a Kaizen event over time can be difficult for many organizations and has received limited empirical research attention to date. This paper identifies the factors that most strongly influence the sustainability of work area employee attitudes and commitment to Kaizen events based on a field study of 65 events in eight manufacturing organizations. The findings also present guidelines for organizations and areas for future research.     

The effects of social TV on television advertising effectiveness

Social TV is the use of communication devices to connect with family and friends watching other TV screens. Plausible arguments suggest both positive and negative effects of social TV viewing on ad-effectiveness. This study contributes by providing evidence for the direction of social TV's effects. The results of a controlled laboratory experiment suggest that the benefits of social TV, principally its association with live TV and therefore less ad-avoidance, come at the cost of negative distraction effects. Like normal coviewing, social TV viewing distracts from ad-processing, reducing unaided recall and brand attitude favorability, compared to individual (solus) viewing. However, social TV messaging about ads improved brand attitude. Perceived creativity increased the likelihood of ad-related messaging. Social TV also has an additional source of distraction, multitasking, but in this study, multitasking did not further reduce ad-effectiveness compared to coviewing. The paper concludes with implications for advertisers and future research.