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.     

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.     

Consequences of Customer Dissatisfaction in Upscale and Budget Hotels: Focusing on Dissatisfied Customers’ Attitude Toward a Hotel

It is important to understand customer dissatisfaction in order to maintain a sustainable business, given that the negative effects of customer dissatisfaction in service businesses may be even greater than the positive effects of satisfaction. This study investigates customer dissatisfaction and its consequences by focusing on the mediating role of attitude toward a hotel according to different hotel classes related to customer expectation level. The results show a mediating role for attitude in the relationship between customer dissatisfaction and specific negative behavioral intentions. This study broadens our knowledge of customer dissatisfaction and the role of attitude toward a hotel in the relevant literature. The empirical findings demonstrate that regardless of hotel type, customer dissatisfaction significantly affects their attitude and their consequent negative behavioral intention.     

城市化进程中的乡村衰落现象：成因及治理——“乡村振兴战略”实施视角的分析

党的十九大报告提出了“实施乡村振兴战略”。乡村振兴是“中国梦”不可或缺的组成部分，城市化进程中的乡村衰落现象不容忽视，乡村问题的解决关系到乡村振兴战略能否实现和现代乡村能否建成。为此，剖析了我国乡村衰落的成因，探索了乡村振兴战略落实的办法，提出了现代乡村建设的可能路径。     

基于水权交易和面源污染控制的农户灌溉施肥行为模型

将水权交易和面源污染控制有机结合,以种植面积、农业用水定额、污染物浓度为约束条件,运用边际分析方法建立农户灌溉施肥行为模型,分析水权交易和排污控制对农户行为的影响。结果表明:灌溉用水量与农作物价格成正相关,与交易水价和边际灌溉成本成负相关;一定范围内肥料施用量与农作物价格成正相关,与边际施肥成本或边际环境成本成负相关。模型证明,当农业用水定额内水权可交易时,水市场的存在和水价政策将激励农户减少灌水量,节约用水。     

Effects of pro-growth policies on employment: evidence of regional disparities

The main objective of our research is to study the direct impact of pro-growth economic policies on employment creation globally and regionally, as evidence has countered policy-makers’ expectation that output growth leads automatically to job creation. We innovate by using the ratio of employment to the population above 25 years as dependent variable instead of the customary employment elasticity. We apply generalized methods of moments’ econometrics on dynamic panel data models and find that growth stimulates employment creation on average across 76 countries. The policies promoting private sector credit, investments, openness, services, education spending, tertiary enrollment, and a fixed exchange rate are the ones that create employment. Larger government size undermines job creation, while policies promoting FDI and industrial development fail to stimulate employment. However, we establish that the effect of pro-growth policies on employment varies significantly across regions, with evidence of weaker links between economic policies and employment in Sub-Saharan Africa and the Middle East.     

Service innovation in the hotel industry: culture,behavior, performance

The aim of this study is to focus on the service innovation culture (SIC) in the formation of frontline employees’ (FLE) innovation performance based on two fit theories. More specifically, the research evaluates and examines the mediating role of challenge-oriented citizenship behavior (COCB) and charged behavior in the aforementioned relationship. To test the hypotheses, two-step structural equation modeling with bootstrapping estimation was conducted in AMOS, using data from 215 full-time frontline hotel employees over a one-month time period. This study establishes that the development of a SIC is positively related to the innovation performance of FLE. Likewise, the results indicate that there is a partially mediating role for the COCB and expanded charged behavior (encompassing vitality and creative self-efficacy) of FLE in the relationship between SIC and innovation performance. The findings of this study highlight the need for managers to incorporate a secure and trusting work environment so FLE will eagerly participate in the service innovation process by voicing their novel ideas. Managers can also consider the significance of the employee selection procedures and take advantage of employing university graduate for frontline service jobs.     

Unfolding Patterns of Unpaid Household Work in Latin America

Although Colombia, Mexico, Peru, and Uruguay show similar empirical patterns in terms of time women devote to unpaid work, they also present important variations in how unpaid work is distributed between men and women. Using time-use surveys for the 2007–10 period, this study finds a uniform pattern across the four countries regarding the main individual-level variables related to the allocation of unpaid work. When decomposing the gender gap in hours devoted to unpaid work, most of the difference cannot be attributed to variations in observable characteristics of men and women: the unexplained part of the gap is the dominant part. Results suggest that both the strength of traditional gender roles and existing welfare architecture are relevant factors in understanding variations in how unpaid work is distributed between men and women in these four countries. The results reaffirm that powerful interventions are needed to shift gender norms about unpaid work.     

The Urban–Rural Gap of Chinese Household Finance

Using data from a large household survey, we investigate the size of China’s urban–rural gap in ownership of bank deposits, risky financial assets, and credit cards. We further examine the factors underlying the gap using decomposition analysis. Compared to their urban counterparts, rural Chinese are much less likely to own a variety of financial products. Both demand-side barriers and supply-side barriers to financial inclusion exist in China. More, we use instrumental variable analysis to address the endogeneity of the local supply of financial service. Above all, our study indicates that a large financial services vacuum in rural areas needs to be filled.