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.     

Mapping themes in the study of new work practices

Both shaping and shaped by technological, economic and social facets, the world of work has witnessed a wide array of changes. This review article sets out to provide a synthesis of some of the main directions and insights of existing research connected to the new world of work. In particular, we approached the topic of new work practices through four key dimensions: (1) Conceptual and methodological dimensions in the study of new work practices; (2) Spatial and temporal manifestations of new work practices in the collaborative economy; (3) Individuals, organizations and new work configurations; (4) Power and control. The review article critically discusses the future of work and argues that the ‘new’ world of work simply repeats asymmetrical power relations and inequalities that characterise work activities, with the potential of exacerbating even further disparities, inequalities and precarity.     

Wage and competition channels of foreign direct investment and new firm entry

Using a rich data set of the Dutch manufacturing sector between 1995 and 2010, we investigate the effect of foreign direct investment (FDI) on domestic new firm entry. The emerging empirical literature has focused on the direct relationship between FDI and entry, but has not explored the mechanisms behind the observed effect. Drawing on a simultaneous equations model, our analysis features both the direct effect of FDI as well as indirect effects through two channels: industry competition and wages. We estimate the parameters through 3SLS and take into account the endogeneity of competition and wages with respect to entry. Our results show that there is a significant negative direct effect of FDI on entry. At the same time, FDI decreases competition and increases wage levels, which then impact entry positively and negatively, respectively. The total effect of FDI is negative, but small and virtually disappears after one year. Policy implications are discussed.

     

How resilient is La Réunion in terms of international tourism attractiveness: an assessment from unit root tests with structural breaks from 1981-2015

Even if local policymakers increasingly claim that tourism is one of the key factors of future economic development for the French small island La Réunion, international tourist arrivals are observed to be locked in a stagnation phase since the beginning of the 2000s. Starting from this stylized fact, this article aims to study if this phenomenon results from major external events hurting this economy regularly. Next, by using univariate unit root procedures with structural breaks, we test for evidence of permanent or transitory effects of external shocks on international tourist inflows (total, by source markets, and by category) over the period 1981–2015. Finally, the empirical analysis allows us to reject the null of a unit root. Then, stagnation of tourism arrivals to La Réunion is not due to exogenous shocks but probably results from endogenous impediments within the domestic tourism industry and unsuitable public policies.     

The risk-based approach under the new EU data protection regulation: a critical perspective

Abstract

The first broad reform of personal data protection legislation in the European Union entered into force in May 2018 (Regulation (EU) 2016/679, the General Data Protection Regulation). Remarkably, with this reform a risk-based approach has been introduced as the core data protection enforcement model, while data protection authorities see their regulatory role significantly weakened. The risk-based approach is to be implemented by the data controllers (i.e. the operators) via data protection impact assessments (evoking the established environmental impact assessment procedure) and notification of breaches, among other procedures. Hence the scope of both the concepts of risk and risk regulation spread beyond conventional domains, namely the environment, public health or safety, i.e. physical risks, to encompass risks to intangible values, i.e. individual rights and freedoms, presumably harder to assess and manage. Strikingly, the reform has been accompanied by a confident discourse by EU institutions, and their avowed belief in the reform’s ability to safeguard the fundamental right to data protection in the face of evolving data processing techniques, specifically, big data, the Internet of Things, and related algorithmic decision-making. However, one may wonder whether there isn’t cause for concern in view of the way the risk-based approach has been designed in the data protection legislation. In this article, the risk-based approach to data protection is analysed in the light of the reform’s underlying rationality. Comparison with the risk regulatory experience in environmental law, particularly the environmental impact assessment procedure, is drawn upon to assist us in pondering the shortcomings, as well as the opportunities of the novel risk-based approach.     

Participants' perceptions on the role of facilitators using Group Decision Support Systems

The impact of facilitation upon group meetings has been a topic of research and debate for over 40 years. However, with the emergence and increasing usage of Group Decision Support Systems (GDSS), the role of facilitators is once more being addressed. Facilitators aim to substantially increase the effectiveness of group working, making meetings more productive and efficient through the management of both content and process. However, while the benefit that facilitators can bring is acknowledged, developing the necessary skills and techniques is more problematic. There are few manuals for would-be faciliators to draw upon, and much of their ability is acquired through experience. This article therefore attempts to increase the knowledge available and to provide facilitators with some practical suggestions. The research focuses on a series of interviews with group members (participants) who had used a particular GDSS—Strategic Options Development and Analysis (SODA)—for organizational decision making. From the analysis of the interviews, a number of reoccurring issues were identified which are presented as a set of learning points. These cover not only the workshop/meeting itself, but also the pre-workshop and post-workshop stages. The article also reflects on the impact which these identified learning points have on design and future GDSS development.     

Volunteerism,compassion and religiosity as drivers of donations practices

• The topic of donations is one of high relevance and has been widely covered in contemporary marketing literature. It is a topic of interest to both theoreticians and practitioners alike, particularly due to its implicit links to fundraising activities and research. The reality of what makes an individual donor ultimately part with his money and give it away to a nonprofit organization is a hot contemporary topic. This study looks into the role of religiosity as a predictor of donations practices. Also volunteerism and compassion, two acts of pro‐social behaviour are analysed as predictors of donations practices. Using data collected from a survey of 612 charity donors in Portugal, the results show unequivocally that religiosity does influence donations practices, and so being a predictor of donations practices. Moreover, pro‐social behaviour is a predictor of donations practices when in the case of volunteerism, but not in the form of compassion.
• The findings are particularly useful for nonprofit organizations that want to attract and retain individual charitable donors and may also help to increase donation regularity, to obtain higher amounts, and donations both to religious and to secular organizations. Finally, it can be stated that the understanding of religiosity sheds light on knowledge about donations practices, and that this study also makes an important contribution to academia, as it is the first study conducted in Portugal that assesses the drivers of donations practices.

Copyright © 2015 John Wiley & Sons, Ltd.     

Central bank disclosure as a macroprudential tool for financial stability

The Basel Capital Accord (pillar 3) states that disclosure of information (transparency) is essential to financial stability. This study analyzes, through inflation reports, the disclosure of information from the Central Bank of Brazil concerning the credit market. We consider credit risk and capital buffers as measures of financial stability in this analysis. Furthermore, in order to measure the perception of the monetary authority on the credit market, we built two indices based on the central bank’s communication on credit development. We performed a panel data analysis based on a sample of 125 banks for the period from June 1999 to September 2014 (7000 observations). The findings suggest that central bank communication regarding expectations concerning the credit market contributes to financial stability. Therefore, this kind of communication of central banks (about credit development) may constitute an important macroprudential tool to improve financial stability.