Diffusion of technical change in medicine— a case study of oncology in a traditional society

This article reviews a new program established to provide modern modes of oncologic therapy to Arab cancer patients in the West Bank. The population of this region is distinguished by its fatalistic and traditional attitudes, and communication via word of mouth is prevalent. Therefore, the social system can be considered as one of traditional norms discouraging the adoption of new ideas. Demonstration effects and face-to-face communication proved effective in bringing about social change in health patterns.     

EU/ACP Economic Partnership Agreements: Impact, Options and Prerequisites

The EU and the African, Caribbean and Pacific countries (ACP) are presently renegotiating their trade relations. Behind these negotiations are the fundamental conflict between the existing arrangement and multilateral trade rules, the frustration regarding poor ACP trade performance, the ineffectiveness of trade and trade-related ACP policies, and the inefficiency of corresponding EU assistance. This article highlights the fundamentals of the envisaged Economic Partnership Agreements (EPAs) between the EU and the ACP countries, sums up previous estimates of their probable economic impact, discusses policy options for ACP countries and sheds light on basic prerequisites, particularly on institutional conditions, that should be fulfilled to ensure the success of EPAs.     

Spieltheoretische Analyse von Konflikt und Kooperation

Mit dem diesj?hrigen Nobelpreis für Wirtschaftswissenschaften wurden die Forscher Robert Aumann und Thomas Schelling für ihre spieltheoretischen Beitr?ge zu Konflikt und Kooperation in (wiederholten) Spielen ausgezeichnet. Inwieweit haben die beiden Forscher die Spieltheorie weiterentwickelt? Auf welche zentralen sozialwissenschaftlichen Fragestellungen lassen sich ihre Erkenntnisse anwenden?     

Economic evaluation of BST-CarGel as an adjunct to microfracture vs microfracture alone in knee cartilage surgery

Objectives:

Knee cartilage damage is a common cause of referral for orthopedic surgery. Treatment aims to reduce pain and symptoms by repairing cartilage. Microfracture, the current standard of care, yields good short-term clinical outcomes; however, treatment might fail after 2–3 years. A Chitosan-Beta glycerolphosphate-based medical device (BST-CarGel) is used as an adjunct to microfracture and demonstrates improvements in quantity and quality of repaired tissue, potentially reducing the risk of treatment failure. This study aimed to establish the economic value of BST-CarGel vs microfracture alone in knee cartilage repair from the societal perspective, using Germany as the reference market.

Methods:

A decision tree with a 20-year time-horizon was constructed, in which undesirable clinical events were inferred following initial surgery. These events consisted of pain management, surgery, and total knee replacement. Clinical outcomes were taken from the pivotal clinical trial, supplemented by other literature. Data and assumptions were validated by a Delphi panel. All relevant resource use and costs for procedures and events were considered.

Results:

In a group of patients with all lesion sizes, the model inferred that BST-CarGel yields a positive return on investment at year 4 (with 20-year cumulative cost savings of €6448). Reducing the incremental risk of treatment failure gap between the device and microfracture by 25–50% does not alter this conclusion. Cost savings are greatest for patients with large lesions; results for patients with small lesions are more modest.

Limitations:

Clinical evidence for microfracture and other interventions varies in quality. Comparative long-term data are lacking. The comparison is limited to microfracture and looks only at costs without considering quality-of-life.

Conclusion:

BST-CarGel potentially represents a cost-saving alternative for patients with knee cartilage injury by reducing the risk of clinical events through regeneration of chondral tissue with hyaline characteristics. Since the burden of this condition is high, both to the patient and society, an effective and economically viable alternative is of importance.     

Agglomeration,tax competition,and fiscal equalization

This paper analyzes the impact of fiscal equalization on asymmetric tax competition when positive agglomeration externalities are present. It uses a model focusing on the strategic reason for capital taxes to demonstrate that per capita fiscal capacity equalization improves the spatial allocation of capital provided a sufficiently rich (marginally) larger region and sufficiently strong agglomeration externalities. If tax revenue is used to finance public goods, per capita fiscal capacity equalization generally cannot simultaneously eliminate public good inefficiency and spatial inefficiency. However, the achievement of full efficiency for ex ante identical regions requires excessive (full) equalization in the presence (absence) of agglomeration externalities.     

Performance of acquirers of divested assets: Evidence from the U.S. software industry

We provide a comparative analysis of acquirer returns in acquisitions of public firms, private firms, and divested assets. On the basis of a sample of 5,079 acquisitions by U.S. software industry companies during 1988–2008, we find that acquisitions of divested assets outperform acquisitions of privately held firms, which in turn outperform acquisitions of publicly held firms. While the higher returns for acquisitions of divested assets relative to stand‐alone acquisition targets can be explained by market efficiency arguments, seller distress and improved asset fit further enhance the positive returns of acquirers of divested assets consistent with the relative bargaining power explanation. Finally, we find that the effects of these buyer bargaining advantages are mutually strengthening and that they also hold for longer‐term acquirer performance Copyright © 2013 John Wiley & Sons, Ltd.