Cost-effectiveness of second-line atezolizumab in Canada for advanced non-small cell lung cancer (NSCLC)

Aim: To assess the cost-effectiveness in Canada of atezolizumab compared with docetaxel or nivolumab for the treatment of advanced NSCLC after first-line platinum-doublet chemotherapy.

Materials and methods: A three-state partitioned-survival model was developed. Clinical inputs were obtained from the phase III OAK trial comparing atezolizumab with docetaxel in patients with advanced NSCLC who progressed after first-line platinum-doublet chemotherapy. Overall survival (OS) and progression-free survival (PFS) were extrapolated beyond the trial period using parametric models. A cure model assuming a 1% cure fraction was fitted to the OS data for atezolizumab. Outcomes for nivolumab were informed by a network meta-analysis (NMA) vs atezolizumab. Resource use and costs were informed by clinical expert opinion and published Canadian sources. Utility values were obtained from the OAK trial. The perspective of the analysis was that of the Canadian publicly-funded healthcare system. The base case time horizon was 10?years, and the discount rate was 1.5% annually for both costs and effects. Scenario analyses were performed to test the robustness of the results and all analyses were performed probabilistically.

Results: Atezolizumab demonstrated a quality-adjusted life-year (QALY) gain of 0.60 compared with docetaxel at an incremental cost of $85,073, resulting in an incremental cost-effectiveness ratio (ICER) of $142,074/QALY. Atezolizumab dominated nivolumab (regardless of dosing regimen), based on modest differences in both QALYs and costs. Docetaxel was most likely to be cost effective at willingness-to-pay (WTP) thresholds below $125,000/QALY gained, while atezolizumab was most likely to be cost effective beyond this WTP threshold. In most scenario analyses, the results remained robust to changes in parameters. A reduced time horizon and alternative approaches to the NMA had the greatest impact on cost-effectiveness results.

Conclusion: Atezolizumab represents a cost-effective therapeutic option in Canada for the treatment of patients with advanced NSCLC who progress after first-line platinum doublet chemotherapy.     

The past,present, and future of brand research

Marketing Letters - This article discusses the past, present, and future of brand research. We begin by reviewing three historical eras of branding development in the past: the information,...     

Optimal investment and pricing in the presence of defaults

We consider the optimal investment problem with random endowment in the presence of defaults. For an investor with constant absolute risk aversion, we identify the certainty equivalent, and compute prices for defaultable bonds and dynamic protection against default. This latter price is interpreted as the premium for a contingent credit default swap, and connects our work with earlier articles, where the investor is protected upon default. We consider a multiple risky asset model with a single default time, at which point each of the assets may jump in price. Investment opportunities are driven by a diffusion X taking values in an arbitrary region . We allow for stochastic volatility, correlation, and recovery; unbounded random endowments; and postdefault trading. We identify the certainty equivalent with a semilinear parabolic partial differential equation with quadratic growth in both function and gradient. Under minimal integrability assumptions, we show that the certainty equivalent is a classical solution. Numerical examples highlight the relationship between the factor process, market dynamics, utility‐based prices, and default insurance premium. In particular, we show that the holder of a defaultable bond has a strong incentive to short the underlying stock, even for very low default intensities.     

Female franchisees; a lost opportunity for franchising sector growth?

Abstract

The purpose of this study is to investigate why female franchisees are under-represented in franchise ownership. A qualitative approach was adopted using a collective, instrumental case study of 30 female franchisees. A number of different types of influences were identified in the literature and then elucidated and assessed. It was found that push and pull factors, work–family life balance, franchising sector characteristics and external influences act as variable incentives and disincentives among female franchisees’ selection of the franchise business model with different levels of risk-taking propensity. The marketing efforts of franchises would be more effective if the way in which the identified influences that impinge on the selection of the franchise business model informed the prospecting of potential female franchisees. A further need is identified for franchises to adjust their recruitment programmes to reflect the variable effect of incentives and disincentives at different levels of capital investment. Limited research specifically examines the selection of the franchise business model by female franchisees with various levels of risk-taking propensity and identifies the nature of influences that act as incentives and/or disincentives on that selection decision.     

Using Experimental and Neurological Data to Gain a Deeper Understanding of Realization Utility Theory

Starting with the premise that realization utility theory helps explain trading behavior, this study combines a carefully crafted experimental design with functional magnetic resonance imaging technology to offer a more inclusive examination of factors that affect REIT trading behavior beyond whether a REIT is simply trading up or down. We add to the nascent field of neurological real estate by finding that local gains/loss domains are more relevant than are global gain/loss considerations, financial skewness is a significant determinant of trading behavior, and that performance inside the REIT market influences how hard subjects think when performing tasks outside the market.     

Has Dodd–Frank affected bank expenses?

Journal of Regulatory Economics - This paper examines the potential effects of the Dodd–Frank Act of 2010 on banks’ noninterest expenses. Using data on U.S. bank holding companies from...     

TAXATION IN MATCHING MARKETS

We analyze the effects of taxation in two-sided matching markets where agents have heterogeneous preferences over potential partners. Our model provides a continuous link between models of matching with and without transfers. Taxes generate inefficiency on the allocative margin, by changing who matches with whom. This allocative inefficiency can be nonmonotonic, but is weakly increasing in the tax rate under linear taxation if each worker has negative nonpecuniary utility of working. We adapt existing econometric methods for markets without taxes to our setting, and estimate preferences in the college-coach football market. We show through simulations that standard methods inaccurately measure deadweight loss.     

Hungarian Border Politics as an Anti-Politics of the European Union

ABSTRACT

This essay contextualises Hungarian antipolitics of Europe as an element of radical conservative nation-building and as a reflection of the strategic use of borders. Two concrete examples of border politics will be elaborated that document shifts from EU-conformity to EU-contestation and the increasing political significance of culturalist arguments. These cases, moreover, are exemplary of the dual nature of then nationalist-conservative agenda which involves: 1) the implementation of an ethnopolitical and thus extraterritorial, de-bordered notion of nation and 2) the unilateral securitisation of Hungary’s borders, for example with Serbia, in a self-proclaimed defence of European integrity. The research that informs this essay is based on a review of media sources, academic and policy-focused literature. The essay begins with a discussion of links between Hungarian euroscepticism and the radical conservative nation-building project and continues with an analysis of post-1989 border politics with regards to the areas mentioned above. Considerable attention will be devoted to the Hungarian government’s politics of borders and contestations of European Union within the context of the so-called refugee crisis and wider debates regarding immigration and asylum.