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.     

The Effects of Alternative Methods of Crow Benefit Payment on Economic Rents of Farm Input Suppliers in Western Canada

This paper uses a multi-market partial equilibrium model to assess the impact of selected alternative methods of payment of the Crow Benefit on the economic welfare of farm input suppliers for the feed grain sector in western Canada. the model is calibrated using data representative of the period from 1986 to 1988. Inputs are grouped into categories of land, labor, machinery and buildings, and other purchased inputs. Impacts of alternative policy regimes are found to differ substantially by the characteristics of the particular policy proposal and also by the nature of the input in question. Input suppliers would be worse off under the method of payment embodied in the so-called Gilson, 50:50 and Agricultural Diversification Alliance proposals, but would be better off under the Grain Trasportation Refund plan. Adverse impacts on landowne welfare, measured as percentage change in economic rents received, would be larger than the effects on other input suppliers, in some cases exceeding 10% of the rents received under the status quo. L'étude utilise un modèle multi-marchéàéquilibre partiel pour évaluer les incidences de diverses méthodes de paiement du montant compensatoire du Nid-de-Corbeau sur la situation économique des agrofournisseurs du secteur des céréles de provendes dans l'ouest du Canads. Le modèle est étalonné au moyen de données représentatives d'une période allant de 1986 à 1988. Les intrants sont groupés en catégories: fonds de terre, main-d'oeuvre, machinerie et bâtiments et autres fournitures achetées. Les effets des divers régimes diffèrent sensiblement par les caractères du projet do politique et aussi par la nature des intrants en question. La situation des fournisseurs serait empirée si l'on emploie la méthode de paicment comprise dans les programmes Gilson, 50:50 et Agricultural Diversification Alliance, mais elle serait meilleure avec le plan de remboursement sur le transport du grain. Les effets négatifs sur la situation des propriétaires de terre, mesurés par le changement en pourcentage du loiyer économique reçu, étaient plus importants que les effets sur les autres catégories d'agrofournisseurs, dépassant parfois 10% du loye reçu dans le régime actuel.     

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.     

Empirical performance of alternative pricing models of currency options

This article examines the out‐of‐sample pricing performance and biases of the Heston’s stochastic volatility and modified Black‐Scholes option pricing models in valuing European currency call options written on British pound. The modified Black‐Scholes model with daily‐revised implied volatilities performs as well as the stochastic volatility model in the aggregate sample. Both models provide close and similar correspondence to actual prices for options trading near‐ or at‐the‐money. The prices generated from the stochastic volatility model are subject to fewer and weaker aggregate pricing biases than are the prices from the modified Black‐Scholes model. Thus, the stochastic volatility model may provide improved estimates of the measures of option price sensitivities to key option parameters that may lead to more effective hedging and speculative strategies using currency options. © 2000 John Wiley & Sons, Inc. Jrl Fut Mark 20:265–291, 2000     

“A healthy outside starts from the inside”: A matter of sustainable consumption behavior in Italy and Pakistan

The aim of this research is to determine people's motives when purchasing organic food and how these motives are moderated by price sensitivity and ethical concerns in a cross-cultural setting. A highly structured questionnaire was used to collect the data from 673 Italian and 594 Pakistani consumers, using the convenience sampling technique. Based on the etic research approach, the measurement invariance tests were performed, and data were analyzed using structural equation modeling. The results indicate that environmental concerns and health-consciousness are significant predictors of subjective norms and purchase attitudes among Italian consumers. Food safety concern proved the strongest predictor of purchase attitude and perceived behavioral control among Pakistani consumers. The results also confirm the moderating role of ethical concerns and price sensitivity in buying organic food in both cultures. In terms of originality, this study fills significant gaps in the literature, particularly regarding the roles of attitude, behavioral control, and subjective norms in consumer buying motives and purchasing intentions in cross-cultural studies but more importantly, the results validate that consumer concerns across the globe are related to the Sustainability Development Goals and the U.N. 2030 agenda, which aptly provides a blue print for the development and developmental goals and concerns across nations.     

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.     

Is Trade Liberalisation Pro-Poor in Pakistan? Evidence from Large-Scale Manufacturing

This article aims to analyse the impact of industry-level trade liberalisation (measured through industry-specific tariff rates) on poverty in Pakistan. Combining data for tariff rates with the Labour Force Survey of Pakistan, we use quantile regression analysis to estimate the impact of changes in tariff rates on workers’ wages (associated with the manufacturing sector of Pakistan) that are at different points of the income distribution. Our findings meaningfully signal that trade liberalisation helps to reduce poverty in the economy. Based on these results, this study provides policy recommendations to reap maximum benefits from trade liberalisation.     

Future of Ethically Effective Leadership

This research focuses on (a) introducing and exploring ethically effective leadership, (b) introducing and testing theory on triad of typical–maximal–ideal ethically effective leadership performances, (b) theorizing and empirically testing that each of typical–maximal–ideal ethically effective leadership performance is different from each others, in other words exploring mean differences between each pair of typical–maximal–ideal effective leadership performances, (c) introducing, theorizing, and testing mechanism to quantify respondents’ intrinsic desire and inherent potential to enhance their ethically effective leadership performances, (d) exploring precedents of each of typical–maximal–ideal ethically effective leadership performances, and finally (e) exploring bases and feasibility of virtual, robotic, and mixed reality ethically effective leadership that may or may not be same as conventional ethically effective leadership. This paper explores global leadership aspect of ethically effective leadership performance at three data collection levels (via typical, maximal, and ideal effective leadership performances) adding precision to assessment of ethically effective leadership and resolving an important challenge (precise assessment) to ethical leadership development. It explores respondents’ typical ethically effective leadership performance E_T, their maximal ethically effective leadership performance E_M, and their ideal ethically effective leadership performance E_I. It presents non-western perspectives on ethically effective leadership disregarding homogenization of leadership behavior. It advances our insight into ethical leadership development by empirically identifying presence, direction and magnitude of respondents’ (a) intrinsic desire and (b) existing intrinsic potential for alteration of their ethically effective leadership. Means of typical ethically effective leadership performance E_T, maximal ethically effective leadership performance E_M, and ideal ethically effective leadership performance E_I are distinct. Typical ethically effective leadership performance E_T is positively associated with maximal ethically effective leadership performance E_M and ideal ethically effective leadership performance E_I. This article concludes that the selected leaders report their ideal ethically effective leadership performance E_I to be higher than their typical ethically effective leadership performance E_T and maximal ethically effective leadership performance E_M depicting significant intrinsic desire for 14 % enhancing their ethically effective leadership performance. Respondents have significant existing intrinsic potential for 10 % enhancing their ethically effective leadership performance. Regression constants for regression models for typical ethically effective leadership performance E_T, maximal ethically effective leadership performance E_M and ideal ethically effective leadership performance E_I are significant depicting that the researchers have to look for other variables to fully explain variance in typical ethically effective leadership performance E_T, maximal ethically effective leadership performance E_M and ideal ethically effective leadership performance E_I. Regression coefficient of typical ethically effective leadership performance E_T is significant in model for ideal ethically effective leadership performance E_I as well as maximal ethically effective leadership performance E_M and vice versa. So, the paper suggests that training strategies may be feasible to alter typical ethically effective leadership performance E_T and maximal ethically effective leadership performance E_M in such a way as to bring it closer to ideal ethically effective leadership performance E_I but for this, researchers have to look for other variables too.     

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.