Economic modeling for the US of the cost-efficiency and associated expanded treatment access of conversion to biosimilar pegfilgrastim-bmez from reference pegfilgrastim

Abstract

Aims: For this economic analysis, we aimed to model: (1) the cost-efficiency of prophylaxis with biosimilar pegfilgrastim-bmez for chemotherapy-induced (febrile) neutropenia (CIN/FN) compared to reference pegfilgrastim, and (2) the expanded access to CIN/FN prophylaxis and anti-neoplastic treatment that could be achieved with biosimilar cost-savings on a budget-neutral basis.

Methods: In a hypothetical panel of 20,000 cancer patients receiving CIN/FN prophylaxis and using the average sales price (ASP) for the second quarter of 2019 for reference pegfilgrastim, we: conducted an ex ante simulation from the payer perspective of the cost-savings of 10–100% conversion from reference to biosimilar pegfilgrastim-bmez using drug price discounting ranging from 10–35%; estimated the budget-neutral expanded access to biosimilar pegfilgrastim-bmez enabled by these cost-savings; and estimated the budget-neutral expanded access to anti-neoplastic treatment with pembrolizumab. The simulations were replicated using fourth quarter 2019 wholesale acquisition cost (WAC) for reference pegfilgrastim and biosimilar pegfilgrastim-bmez in a post facto analysis.

Results: In ASP simulations, cost-savings of using pegfilgrastim-bmez over reference pegfilgrastim in a 20,000 patient panel range from $1.3?M (at 15% price discount) to $3?M (35%) at 10% conversion rate and from $6.4?M to $14.9?M, respectively, at 50% conversion. These savings could provide prophylaxis with pegfilgrastim-bmez to an additional 352 (15% discount) to 1,076 patients (35%) at 10% conversion or 1,764–5,384, respectively, at 50% conversion. Alternatively, savings could be reallocated for anti-neoplastic treatment with pembrolizumab to 3 (15% discount) to 9 (35%) patients at 10% conversion or 19–45, respectively, at 50% conversion. When utilizing WAC, cost-savings range from $4.6?M (10% conversion) to $23.1?M (50%) which could provide pegfilgrastim-bmez to an additional 1,174 (10% conversion) to 5,873 patients (50%).

Conclusions: Prophylaxis with biosimilar pegfilgrastim-bmez increases the value of cancer care by generating significant cost-savings that could be reallocated to provide expanded access to CIN/FN prevention and anti-neoplastic therapy on a budget-neutral basis.     

Does local political support influence financial markets? A study on the impact of job approval ratings of political representatives on local stock returns

Using data on job approval ratings of governors, U.S. senators, and the president, we find that firms located in states with high approval ratings outperform firms located in states with low approval ratings by .64% per month. Furthermore, this relationship is stronger when investors are actively involved in politics, when local politicians are closer to the center of political power, for small firms that have a larger proportion of local investors, and for financially strong areas where investors are ready to execute investments in local stocks. Overall, our study shows that investors’ political sentiment is important in determining stock returns.     

Out-of-stock,sold out,or unavailable? Framing a product outage in online retailing

Terms, such as “out-of-stock,” “sold out,” and “unavailable” are commonly used by retailers to communicate a product or brand outage. Although these terms are technically equivalent, prior research on product outage and product scarcity suggest that they may be interpreted and processed differently by consumers. The present research investigated whether the manner in which a product outage was framed elicited different consumer behavioral intentions, attributions, and perceptions in the context of online retailing. Data were collected by means of an online experiment. The experiment incorporated a hypothetical scenario approach in which research participants were asked to react to a particular combination of treatment and blocking factors. Results demonstrated that ceteris paribus, framing a product or brand outage as “sold out” produces fewer negative product and website reactions than does framing it as “out-of-stock” or “unavailable.”     

Employee mobility,spin‐outs,and knowledge spill‐in: How incumbent firms can learn from new ventures

Research summary: We consider conditions in which incumbent firms are particularly poised to benefit from knowledge spilling in from new ventures that employ individuals previously employed by the focal incumbent firm. We distinguish between inventors who leave their incumbent employers to found spin‐outs and those who become non‐founding employees of existing new ventures. Using a sample of new ventures and incumbent firms in the U.S. information technology (IT) sector, we find that incumbents are more likely to benefit from patented knowledge that spills in from their spin‐outs than from new ventures that employ non‐founding inventors formerly employed by the respective incumbent. Any advantage that parent firms have in reaping such knowledge quickly dissipates, however, when these parents have a history of misappropriating the intellectual property of others. Managerial summary: It has long been acknowledged that new ventures can acquire valuable knowledge from their larger and more established counterparts by hiring away their talented employees. We consider the possibility of a reverse flow of knowledge where established firms learn from those new ventures that have poached employees from them. We find that established information technology (IT) firms are more likely to learn and build on the technology of their spin‐outs (i.e., new ventures founded by their former inventors) than from new ventures that simply employ non‐founding inventors formerly employed by the respective IT firm. Any advantage that these IT firms had in reaping technical know‐how from their spin‐outs quickly dissipated, however, when they had a history of misappropriating the intellectual property of others. Copyright © 2016 John Wiley & Sons, Ltd.     

PARTISAN ADVOCATES

This paper studies the problem of an uninformed decision maker who acquires expert advice prior to making a decision. I show that it is less costly to hire partisan agents than impartial agents, especially under advocacy, and that the decision maker prefers partisan advocacy to other forms of institutions. I also extend the literature, originating with Dewatripont and Tirole ( 1999 ), to a setting with contracts that condition on information provided and not just the decision made.     

How credible is the North Korean threat?

We perform event analysis on particular episodes of tension in the Korean peninsula between 2000 and 2008, and investigate the effect of the events on South Korean financial markets (stock markets, bond yield spreads and the exchange rate) given that South Korea would be the first affected by a military aggression from North Korea. Surprisingly, in nearly all cases, these events, which have often been dramatized in the world media, have no significant impact on either of these variables or only a very small one. We also find no significant impact of events on listed firms that would a priori be likely to suffer from increased tension between the two Koreas. Since financial markets often contain better predictions than expert opinions or surveys, these results strongly suggest that the North Korean threat is non‐credible.     

User-generated product reviews on the internet: the drivers and outcomes of the perceived usefulness of product reviews

This study examines how people cope with the user-generated product reviews (UGPRs) found on various websites where anonymous web users post and share their personal product usage experiences. Based on information processing model of communication, we postulate that there are source, message, media, and receiver factors to influence individuals' psychological processing of the UGPR messages, and its subsequent behavioral outcomes. A survey was administered by a professional market research firm to 262 randomly selected US residents from 18 to 55 years old. Consistent with the predictions, the results of the structural equation modeling analysis showed that the perceived source expertise, message objectivity, website credibility, and receiver–source similarity had positive and direct impacts on the perceptions of UGPR usefulness, which, in turn, positively influenced individuals' willingness to share product reviews with others. A series of causal model invariance tests also confirmed that the findings were statistically invariant across different subgroups divided by such factors as product categories, websites, subjective product class knowledge, past UGPR experience, and the susceptibility to informational influence.     

Premia for correlated default risk

Using data on corporate default experience in the U.S. and market rates of CDX index and tranche swaps of various maturities, we estimate reduced-form models of correlated default timing in the CDX High Yield and Investment Grade portfolios under actual and risk-neutral probabilities. The striking contrast between the estimated processes followed by the actual and risk-neutral arrival intensities of defaults, and between the parameters governing the actual and risk-neutral dynamics of the risk-neutral intensities, indicates the presence of substantial default risk premia in CDX swap market rates. The effects of risk premia on swap rates covary strongly across maturities, and depend on general stock market volatility and several measures of credit spreads. Large moves in the effects of these premia on swap rates have natural interpretations in terms of economic and financial market developments during the sample period, April 2004 to October 2007. Our results suggest that a large portion of the movements in CDX swap market rates observed during the sample period may be caused by changing attitudes toward correlated default risk rather than changes in the economic factors affecting the actual risk of clustered defaults, which ultimately governs swap payoffs.