A cost–utility analysis of degarelix in the treatment of advanced hormone-dependent prostate cancer in the United Kingdom

Objective:

To determine the cost-effectiveness of the treatment of advanced hormone-dependent prostate cancer with degarelix compared to luteinizing hormone-releasing hormone (LHRH) agonists in the UK using the latest available evidence and the model submitted to AWMSG.

Methods:

A cost-effectiveness model was developed from the perspective of the UK National Health Service evaluating monthly injection of degarelix against 3-monthly leuprorelin therapy plus anti-androgen flare cover for the first-line treatment of patients with advanced (locally advanced or metastatic) hormone-dependent prostate cancer. A Markov process model was constructed using the patient population characteristics and efficacy information from the CS21 Phase III clinical trial and associated extension study (CS21A). The intention-to-treat (ITT) population and a high-risk sub-group with a PSA level >20?ng/mL were modeled.

Results:

In the base-case analysis using the patient access scheme (PAS) price, degarelix was dominant compared to leuprorelin with cost savings of £3633 in the ITT population and £4310 in the PSA?>?20?ng/mL sub-group. The chance of being cost-effective was 95% in the ITT population and 96% in the PSA?>?20?ng/mL sub-group at a threshold of £20,000 per quality-adjusted life-year (QALY). In addition, degarelix remained dominant when PSA progression was assumed equal and only the benefits of preventing testosterone flare were taken into account. Treatment with degarelix also remained dominant in both populations when the list price was used. The additional investment required to treat patients with degarelix could be offset in 19 months for the ITT population and 13 months for the PSA?>?20?ng/mL population. The model was most sensitive to the hazard ratio assumed for PSA progression between degarelix and leuprorelin and the quality-of-life (utility) of patients receiving palliative care.

Conclusion:

Degarelix is likely to be cost-effective compared to leuprorelin plus anti-androgen flare cover in the first-line treatment of advanced hormone-dependent prostate cancer.     

The human side of mechanism design: a tribute to Leo Hurwicz and Jean-Jacque Laffont

This paper considers the human side of mechanism design, the behavior of economic agents in gathering and processing information and responding to incentives. I first give an overview of the subject of mechanism design, and then examine a pervasive premise in this field that economic agents are rational in their information processing and decisions. Examples from applied mechanism design identify the roles of perceptions and inference in agent behavior, and the influence of systematic irrationalities and sociality on agent responses. These examples suggest that tolerance of behavioral faults be added to the criteria for good mechanism design. In principle-agent problems for example, designers should consider using experimental treatments in contracts, and statistical post-processing of agent responses, to identify and mitigate the effects of agent non-compliance with contract incentives.     

An exploratory study of the Internet as an industrial communication tool: Examining buyers' perceptions

A thorough understanding of the impact of the Internet on industrial purchase decisions is of critical importance for industrial marketers seeking to incorporate the Internet in their overall communication strategy. Accordingly, this study examines (1) the degree to which purchasing professionals perceive the Internet as useful, (2) how purchasing professionals are using the Internet for communication activities, (3) how the Internet compares to other promotional tools in influencing buyers' purchase decisions, and (4) whether differences among buyers can be identified relative to the perceived influence of suppliers' websites. The results provide some practical implications for industrial marketers regarding the use of the Internet relative to other promotional tools.     

Pareto optimality and competitive equilibrium in infinite horizon economies

The paper presents a general model of a decentralized economy evolving over an infinite time horizon. Alternative notions of price systems, competitive equilibria, efficiency and optimality are introduced. The main results characterize conditions under which the two fundamental theorems of welfare economics are valid in such a general framework.     

Extended Framework for Modeling Choice Behavior

We review the case against the standard model of rational behavior and discuss the consequences of various anomalies of preference elicitation. A general theoretical framework that attempts to disentangle the various psychological elements in the decision-making process is presented. We then present a rigorous and general methodology to model the theoretical framework, explicitly incorporating psychological factors and their influences on choices. This theme has long been deemed necessary by behavioral researchers, but is often ignored in demand models. The methodology requires the estimation of an integrated multi-equation model consisting of a discrete choice model and the latent variable model system. We conclude with a research agenda to bring the theoretical framework into fruition.     

Network analyses of brand switching behavior

Networks are extremely important in marketing because so much of marketing is relational, and network methods are important and appropriate tools for studying such structures of interconnections. In this paper, we model data that represent consumer brand switching in the French and British automobile marketplaces. We describe network methods that range from simple to sophisticated. We believe it is novel to consider brand switching patterns as networks, exploring results that arise from network methodologies and philosophies and examining what leverage network methods might have for understanding purchase transition behavior. Our methods include the modeling of multiple networks simultaneously to study such phenomena as dynamic markets and cross-cultural competitive market structure.     

Formal and Informal Corruption Environments and Multinational Enterprise Social Irresponsibility

Using an institutional theory framework we theorize, hypothesize, and empirically show that higher levels of formal and informal corruption environments found in a firm's operating portfolio are related to higher levels of corporate social irresponsibility (CSiR). Failing to consider corruption's informal dimension leads to potentially false perceptions about a multinational enterprise's (MNE) operating environment, particularly when the formal dimension is low but the informal corruption dimension is high, as is the case in about one third of our sample. Including the informal corruption environment component provides additional explanatory power over the formal corruption environment alone in predicting CSiR and yields a superior understanding of both the formal and informal dimensions of the corruption institutional environment's influence on corporate social irresponsibility levels of MNEs. Managerial implications and future research directions are discussed.     

JBBM at 21: Variety of Theories,Methods, and Countries While Giving Further Voice to Emerging Markets Within Africa

ABSTRACT

Purpose: The articles published in the Journal of Business-to-Business Marketing (JBBM) are reviewed for three themes: the varieties of theories used and tested, the methodologies of choice, and most pertinent to this article, the countries from which the data were obtained in the empirical studies.

Methodology/approach: Literature review of the JBBM issues, all inclusive.

Findings: The JBBM has had papers involving surveys 74%; case studies 11%; interviews 6%, experiments 4%, and networks 3%. There is a tremendous breadth of country representation, more than most other marketing journals.

Research implications: The authors encourage more frequent investigations into emerging markets, using African countries as exemplars.

Practical implications: To begin to understand marketing phenomena in the variety of African countries, the authors encourage researchers to establish partnerships, with African scholars and global multinationals whose marketing managers may have interest in understanding these markets and who may have data to share.

Contribution of the paper: Although a seemingly infinite number of marketing questions still exist even in well-developed markets, and scholars have begun to recognize opportunities in developing markets, future research will prove useful into emerging and nascent markets.