Cost effectiveness of benralizumab for severe,uncontrolled oral corticosteroid–dependent asthma in Sweden

Abstract

Aim: We investigated cost effectiveness of benralizumab vs. standard of care (SOC) plus oral corticosteroids (OCS) for patients with severe, eosinophilic OCS-dependent asthma in Sweden.

Materials and methods: A three-state, cohort-based Markov model of data from three Phase III benralizumab clinical trials (ZONDA [NCT02075255], SIROCCO [NCT01928771], and CALIMA [NCT01914757]) was used to assess the incremental cost-effectiveness ratio of benralizumab vs. SOC plus OCS. Health outcomes were estimated in terms of quality-adjusted life-years (QALYs). The model included costs and disutilities associated with extrapolated OCS-related adverse events. Patients with severe asthma were defined as those receiving OCS ≥5?mg/day.

Results: Benralizumab demonstrated a cost-effectiveness ratio vs. SOC plus OCS of 2018 Swedish Kronor (SEK) 366,855 (€34,127) per QALY gained, based on increases of 1.33 QALYs and SEK 488,742 (€45,344) per patient. Benralizumab treatment costs contributed most to incremental costs. The probability of benralizumab’s being cost-effective with willingness-to-pay (WTP) thresholds between SEK 429,972 (€40,000) and SEK 752,452 (€70,000) ranged from 75% to 99%.

Limitations: Potential limitations of these analyses include the use of combined data from three different clinical trials, a one-way sensitivity analysis that did not include mortality and transition estimates, and Observational & Pragmatic Research Institute (OPRI) data from the UK as a proxy of the Swedish health care system.

Conclusions: The results of these analyses demonstrate that benralizumab has a high probability of being cost-effective compared with SOC plus OCS for a subgroup of patients with severe, eosinophilic asthma receiving regular OCS treatment and may support clinicians, payers and patients in making treatment decisions.     

An Analysis of Tax Incentives to Attract FDI in Bangladesh： An Empirical Study

The purpose of the study is to understand whether it is still viable to use tax incentives to attract foreign direct investment （FDI） considering their effectiveness and costs to the country, and if not, what should be the alternative, effective, and viable means of promoting the vital FDI inflow. The study investigated various incentives provided by BOI, and other relevant sources available as secondary sources. However, the multinational enterprises （MNEs） are not attracting for investment in Bangladesh always with tax incentives and there are alternative means of attracting FDI such as direct financial grants, subsidies loan guarantees, etc. This paper focuses on tax incentives and the debate against the effectiveness and efficiency in attracting FDI.     

Client Importance and Audit Quality at the Individual Audit Partner,Office, and Firm Levels

We investigate whether audit partner level data provides a more powerful measure than office or firm level measures of client importance. We find that the likelihood of issuing a going-concern opinion (any and first-time) increases, and the absolute value of discretionary accruals decreases, in relation to the proportion of audit fees to the total audit fees received by audit partners from all their clients. We also find that the likelihood of issuing a going-concern opinion (any and first-time) increases, and the absolute value of discretionary accruals decreases, in relation to the proportion of non-audit services fees from a client to total non-audit service fees, and the proportion of total audit and non-audit service fees from a client to total fees from all their clients at the office and firm levels. Our findings provide evidence to regulators, audit clients, and stakeholders that audit partners do not succumb to pressure from economically more important clients as audit quality has a positive association with client importance.     

A tale of two states: asymmetries in the UK small,value and momentum premiums

This article performs comparative analysis of the asymmetries in size, value and momentum premium and their macroeconomic determinants over the UK economic cycles, using Markov switching approach. We associate Markov switching regime 1 with economic upturn and regime 2 with economic downturn. We find clear evidence of cyclical variations in the three premiums, most notable being that in the size premium, which changes from positive in expansions to negative in recessions. Macroeconomic indicators prompting such cyclicality the most are variables that proxy credit market conditions, namely the interest rates, term structure and credit spread. Overall, macro factors tend to have more significant impact on the three premiums during economic downturns. The results are robust to the choice of information variable used in modelling transition probabilities of the two-stage Markov switching model. We show that exploiting cyclicality in premiums proves particularly profitable for portfolios featuring small cap stocks in recessions at a feasible level of transaction costs.     

Does CEO–Audit Committee/Board Interlocking Matter for Corporate Social Responsibility?

Journal of Business Ethics - This study examines the impact of the Chief Executive Officer (CEO)’s interlocking, created through serving on other companies’ audit committees and/or...     

The evolution of aquatic agricultural systems in Southwest Bangladesh in response to salinity and other drivers of change

Aquatic agricultural systems (AAS) in coastal Southwest Bangladesh have evolved in response to a number of stimuli and constraints including improving market access, technological change, and salinization. Farming systems in the region are highly dynamic, and are characterized by the integration of varying combinations of freshwater prawns, rice, fish, vegetables, and brackish water shrimp. This paper examines the developmental history, productivity, and profitability of three distinct AAS: a low-salinity freshwater prawn-dominated system; an intermediate-salinity-mixed prawn and shrimp system, and a high-salinity shrimp-dominated system. Productivity, cropping intensity, and profitability are found to be highest in the diversified low- and intermediate-salinity systems, and lower in the high-salinity system, where cultivation of rice and vegetables is no longer possible. The paper concludes that more diverse integrated systems reduce risk and vulnerability for farming households. Salinization is found to be a double-edged sword – proving a stimulus to diversification at low levels, but reducing agro-biodiversity at higher salt concentrations. While the adaptation strategies in all systems have been successful in maintaining or improving most, though not all, system functions due to high levels of social resilience, support for effective community-based adaptation strategies will enable continued transformation and adaptation to future drivers of change.     

Chief Financial Officers’ Short‐ and Long‐term Incentive‐based Compensation and Earnings Management

This study examines the association between chief financial officers’ (CFOs) short‐ and long‐term compensation and discretionary current and non‐current accruals. The CFO's cash bonus is used as a measure of short‐term incentives and shares plus options is used as a measure of long‐term incentives. The results show a significant and positive association between CFOs’ short‐term compensation and the absolute value of discretionary current accruals. The results also show a significant and positive association between CFOs’ long‐term compensation and the absolute value of discretionary non‐current accruals. STUDY provides evidence that the earnings management behaviour of CFOs is associated with type of CFO compensation.     

Investment banking in the gulf: A case study of investcorp in bahrain

Investcorp is a low-profile investment banking company that was originally founded on the tiny island of Bahrain in the Arabian Gulf. Although little known to the general public, the company is a major player in North American and European investment markets. This case study presents a profile of the company, its founder, Nemir Kirdar, and his three “founding friends.” It relates details of the company's successes and explores how these were achieved. As most of the original Management Committee members are preparing to retire, efforts are being made to ensure the continuing prosperity of the company. This requires the risky step of appointing an almost completely new management team. Readers are invited to reflect on the likely success of this strategy and whether Investcorp's focus on North America and Europe remains appropriate in a global marketplace.