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.     

Pharmaceutical cost‐sharing systems and savings for healthcare systems from parallel trade

This paper studies the consequences of parallel trade in a two‐country model. It compares a coinsurance scheme (consumers pay a percentage of the drug price) and an indemnity insurance scheme (reimbursement is independent of the drug price) with respect to changes in copayments and public health expenditure. In the destination country, copayments for patients decrease to a larger extent under indemnity insurance, whereas reductions in public health expenditure occur only under coinsurance. In the source country, copayments increase less under coinsurance, whereas health expenditure is reduced more under indemnity insurance. In both countries, total expenditure under parallel trade is lower.     

Bank lending channel in a dual banking system: Why are Islamic banks so responsive?

We examine the interest rate sensitivity of both deposits and credits at Islamic and conventional banks in Turkey. We find that the bank lending channel is especially operative for Islamic banks. Impulse responses for conventional and Islamic banks reveal that Islamic bank depositors’ sensitivity to policy rate changes is substantially larger than that of conventional bank depositors. Next to heavily dependence on deposit funding, we consider that inertia in Islamic bank deposit rates impedes these banks to keep those depositors who consider the opportunity cost of monetary policy rates is unbearable. On the lending side, we obtain similar results, implying that tight monetary policy leads to a larger contraction in Islamic bank credits. This finding is a reflection of the favourable attitude of Islamic banks towards small and medium‐sized enterprise (SME) financing. When similar relationships are analysed for currency and inflation shocks, we again find larger responses for Islamic banks showing the cyclical nature of SME credits.     

MONETARY AND FISCAL POLICIES INTERACTION IN MONETARY UNIONS

In this paper, the literature on the interaction between monetary and fiscal policies in a monetary union is surveyed. By adopting the concept of symbiosis as a starting point, the paper highlights the importance of uncertainty, policy makers' preferences and targets. Then, the role of commitment to policy rules and coordination is addressed. The analysis also focuses on the importance of the data considered for the generation of the policy mix. As a final step, the paper discusses the main results in the literature on public debt management in a monetary union. All the reported theoretical results are then adopted to retrieve policy and institutional implications for the European Monetary Union.     

系统性金融风险的历史考察与防范对策

深入学习习近平在中国共产党第十九次全国代表大会上的报告，在考察20世纪以来的12次金融危机的基础上，对系统性金融风险发生的根源进行了研究，并结合我国当前系统性金融风险面临的形势，提出了防范系统性金融风险的对策建议。研究表明，将过去100多年引发金融危机的系统性金融风险的根源与我国当前的金融形势进行比较分析，可以发现我国面临的系统性金融风险形势十分严峻，必须在党的领导下，采取打击金融腐败、适当收紧货币政策、完善金融监管体系、维护币值稳定、加强金融科技监管等相关政策来防止系统金融风险的发生。     

重庆市农业科技创新资源配置效率及影响因素研究

[目的]通过分析重庆市农业科技资源配置效率及影响因素,以期对重庆市的农业科技资源的合理配置提出参考建议。[方法]构建评价指标体系,以农业科技创新资源配置环境、农业科技资源经费投入、农业科技人才储备和农业科技创新成果4个方面构成综合层,向下分16个具体指标,运用层次分析法和模糊评判综合评价重庆市农业科技资源配置效率及影响因素。[结果]重庆市农业科技创新资源的配置效率综合得分为81.08,为2级水平,其中农业科技人员流失比例较大,投入产出效率较低成为主要制约因素。[结论]重庆市农业科技创新资源的配置效率处于中等水平,合理配置农业科技人员和经费投入以及提高资源配置环境是提高重庆市农业科技协同创新资源的配置效率的关键;农业科技资金投入浪费严重和农业科技活动成果的转化率较低、农业科技人才结构和农业科技创新资源配置方式的不合理以及农业科技市场机制尚不完善是影响农业科技资源配置效率的主要因素。     

The Resource Curse Hypothesis: Dynamic Heterogeneous Approach

Natural resources influence economic performance through many different mechanisms, both beneficial and harmful. Some of these mechanisms tend to set in fast while others are rather slow. This suggests that pooling the long- and short-run effect as typical in the resource empirical literature may lead to incorrect inferences. This article provides an evaluation of the income contribution of natural resources using a panel cointegration approach that allows for short-run dynamic heterogeneity while imposing the restriction of long-run homogeneity. It finds, in a sample of developing countries over the period 1990–2012, that natural resources are a curse in the long run. The evidence is robust to alternative dynamic specifications, different measures and types of natural resource wealth, and controlling for regional effects.     

Twenty-Five Years after the Fall of the Berlin Wall: An Empirical Revisit of West German Consumers' Attitudes Toward Products and Brands from Former East Germany

More than 25 years after the German reunification, data show that products/brands from the eastern regions of Germany (“Neue Länder”) still do not have significant shares in the country's western part (“Alte Länder”). To analyze potential reasons for this phenomenon, our current study replicates a previous study that investigated selected attitudes of Alte Länder consumers toward products/brands from the Neue Länder. It is shown that factors such as consumer ethnocentrism, product judgment, willingness to buy, and economic animosity continue to influence consumer behavior and as such our study offers potential explanation for the failure of Neue Länder products/brands in the western regions of Germany.     

松嫩平原北部黑土区水土资源平衡效应研究

研究目的:分析松嫩平原北部黑土区在土地利用和农业气候资源变化条件下的水土资源平衡效应。研究方法:在傅抱璞假设理论的基础上,通过拟合参数ω回归方程求得实际蒸散量,以此来构建水分盈亏模型,分析水土资源平衡效应。研究结果:(1)1985—2015年,松嫩平原北部土地利用表现为湿地面积大幅度减少,水田和旱地面积不断增加;潜在蒸散量和气温具有较为明显的变化趋势,气温以0.27℃/10 a上升,潜在蒸散量以5.15 mm/a下降;(2)经过拟合参数ω方程求得实际蒸散量可以有效反映土地利用状况、地貌特征和土壤属性;(3)1985—2015年间总体的水分亏缺率均值是0.25、0.2、0.31和0.13,而土地利用的影响使严重缺水面积逐年增加,其增加量是总面积的1.59%,约是原有面积的2倍。研究结论:基于傅抱璞理论改进的参数ω能够提高地区实际蒸散量的估算精度,对区域水土平衡评价具有重要意义,为实现区域资源合理利用提供指导。     

Introduction to symposium: Smallholders in communist and postcommunist societies

The primary contributions of smallholders during the communist and early postcommunist periods have been food production and labour for large farms. Those conditions are changing, however, as modern farms require less labour and food supply may be imported. For most smallholders in Central and Eastern European and former Soviet Union countries, the postcommunist neoliberal environment has not brought significant improvement, and strong arguments can be made that land grabbing, social and economic exclusion, and rural poverty are worse than regime bias during the communist period. Cooperatives, which have empowered smallholders in other parts of the world, have not been as well developed in postcommunist nations.