Cost comparison of continued anticoagulation with rivaroxaban versus placebo based on the 1-year EINSTEIN-Extension trial efficacy and safety results

Aims: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (vs placebo) after 6–12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo, based on the EINSTEIN-EXT event rates.

Methods: Total healthcare cost was calculated as the sum of treatment and clinical event costs from a US managed care perspective. Treatment duration and event rates were obtained from the EINSTEIN-EXT study. Adjustment on treatment duration was made by assuming a 10% non-adherence rate. Drug costs were based on wholesale acquisition costs. Cost estimates for clinical events (i.e. recurrent deep vein thrombosis [DVT], recurrent pulmonary embolism, major bleeding, clinically relevant non-major bleeding) were determined from the literature. Results were examined over a ±20% range of each cost component and over 95% confidence intervals (CIs) of event rate differences in deterministic (one-way) and probabilistic sensitivity analyses (PSA).

Results: Total healthcare cost was $1,454 lower for rivaroxaban-treated (vs placebo-treated) patients in the base-case, with a lower clinical event cost fully offsetting drug cost. The cost savings of recurrent DVT alone (–$3,102) was greater than drug cost ($2,723). Total healthcare cost remained lower for rivaroxaban in the majority (73%) of PSA (cost difference [95% CI]?=?–$1,454 [–$2,396, $1,231]).

Limitations: This study was conducted over the 1-year observation period of the EINSTEIN-EXT trial, which limited “real-world” applicability and examination of long-term economic impact. Assumptions on drug and clinical event costs were US-based and, thus, not applicable to other healthcare systems.

Conclusions: Total healthcare costs were estimated to be lower for patients continuing rivaroxaban therapy compared to those receiving placebo in VTE patients who had completed 6–12 months of VTE treatment.     

基于经济新常态的长春市水资源开发利用潜力评价

以长春市为研究对象,基于未来经济处于新常态的发展态势,构建包含水资源、社会、经济、生态环境4个子系统的评价指标体系,并确定各指标的评价等级标准;基于模糊数学理论以及层次分析法构建包括目标层、准则层、指标层的3层模糊综合评价模型,以2015年为现状水平年,应用模型对长春市水资源开发利用潜力进行综合评价。结果表明:长春市水资源开发利用程度处于中等偏上水平,各辖区水资源开发利用规模不平衡,可通过产业结构调整提高全市用水效率,为经济持续增长提供保障。     

Inflation,real economic growth and unemployment expectations: an empirical analysis based on the ECB survey of professional forecasters

Expectations are at the centre of modern macroeconomic theory and policymakers. In this article, we examine the predictive ability and the consistency properties of macroeconomic expectations using data of the European Central Bank (ECB) Survey of Professional Forecasters (SPF). In particular, we provide evidence on the properties of forecasts for three key macroeconomic variables: the inflation rate, the growth rate of real gross domestic product and the unemployment rate.     

Impact of state-dependent oil price on US stock returns using local projections

In this paper, we investigate the impact of oil prices on both aggregate and industry US real stock returns over the period 1973–2017. The empirical analysis contributes to the related literature introducing a state-dependent oil price (high and low) and the local projections approach. Our main finding is that, depending on the nature of the shock and industry, the negative effects of oil price shocks become exacerbated -and the positive effects get moderated- if oil prices are already high.     

A destination imagery processing model: Structural differences between dream and favourite destinations

The present paper aims at understanding how destination imagery is processed in tourists’ working memory. The research focuses on two highly desirable, but contrasting, destination brand categories: Favourite Destination, which involves retrospective memory of positive experiences in situ; and Dream Destination, based on tourists’ prospective memory. Through an online multilingual survey, 23,446 responses consisting of perceptions, evoked by way of free-recall, associated to Dream and Favourite Destinations, were collected. Findings point to clear structural differences between the imagery of Dream and Favourite Destinations. Additionally, a theoretical destination imagery model that offers a basis for future studies is proposed, and some managerial implications of significant relevance to destination marketing are discussed.     

Predicting the equity market with option-implied variables

We comprehensively analyze the predictive power of several option-implied variables for monthly S&P 500 excess returns and realized variance. The correlation risk premium (CRP) and the variance risk premium (VRP) emerge as strong predictors of both excess returns and realized variance. This is true both in- and out-of-sample. Our results also reveal that statistical evidence of predictability does not necessarily lead to economic gains. However, a timing strategy based on the CRP leads to utility gains of more than 5.03% per annum. Forecast combinations provide stable forecasts for both excess returns and realized variance, and add economic value.     

The Impact of Sustainability Aspects in the Meat Sector: A Cluster Analysis Based on Consumer Attitudes and Store Format Choice

Several consumer studies have shown considerable market potential for sustainable meat products, however, their markets shares are still marginal. In Germany, the sustainable aspects “organic,” “local origin,” and “animal welfare” are of special interest. To obtain a precise overview of potential target groups for these meat categories and their choice of store format, 620 German consumers were surveyed on their attitudes toward sustainable meat production and their shopping behavior. First, target groups based on consumers’ attitudes were identified by cluster analysis, taking into account possible overlaps. Consumers were also clustered by their store format choice and their preferred type of meat packaging. A cross tabulation of the results then provided insights into which store format and type of meat packaging is preferred by the target groups for sustainable meat products. Due to overlaps found in the target groups, the existence of important subgroups was shown. Amongst the target groups, only a slight preference for unpackaged meat products was found. Basically, the offer of sustainable meat products appears of interest for all store formats, with particular emphasis on supermarkets. The results of this study can support producers and retailers developing new and tailored marketing strategies for sustainable meat products.     

Financial development,economic growth and convergence clubs

To study the role of financial development in economic growth, we apply an array of convergence tests designed to capture nonlinear transitional dynamics to real outputs per capita. Strong evidence of multiple convergence clubs is observed, implying that the clubs are formed based on the initial level of real output per capita and average growth rate. Our empirical results show that the stage of economic growth of each country plays an important role for the composition of the convergence clubs. Furthermore, financial development emerges to be a significant determinant, albeit plays differently in the economic growth of each convergence club.     

Will China's WTO accession worsen farm household incomes?

Many fear China's accession to the World Trade Organization (WTO) will impoverish its farmers via greater import competition in its agricultural markets. We explore that possibility bearing in mind that, even if producer prices of some (land-intensive) farm products fall, prices of other (labor-intensive) farm and nonfarm products could rise. New estimates, from the global, economy-wide numerical simulation model known as Global Trade Analysis Project (GTAP), of the likely changes in agricultural and other product prices as a result of WTO accession, are drawn on to examine empirically the real income implications of China's WTO accession. The results suggest farm–nonfarm income inequality may well rise within China but rural–urban income inequality need not. The article concludes with some policy suggestions for alleviating any pockets of farm household poverty that may emerge as a result of WTO accession.     

Business groups,the financial market and modernization*

Business groups are an important aspect of the industrial organization of many developing countries. This paper develops a theory suggesting that they may be organizations that facilitate modernization in the presence of financial market constraints. An important function of the stockmarket is the diversification of risk that comes with specialized, productive technology. But in the face of serious information problems a well functioning stockmarket may fail to emerge, relegating the economy to a low productivity‐poverty trap. Bilateral links between a firm and a group of others may be a more cost effective way to achieve risk‐sharing. Such business groups may be feasible when a full‐fledged stockmarket is not. As modernization takes place, either because information problems become less severe or more firms enter the economy, business groups actually expand in size before being abruptly rendered obsolete by the stockmarket. This is consistent with empirical results from a number of emerging economies.