Real-life cost of vitamin K antagonist treatment in patients with non-valvular atrial fibrillation in France in 2013

Aims: Data highlighting the cost drivers for non-valvular atrial fibrillation (NVAF) patients in terms of vitamin K antagonist (VKA) treatment and monitoring are lacking in France. This study aimed to evaluate the real-life daily cost of VKA treatment in 2013, in French patients suffering from NVAF.

Methods: This longitudinal observational study was performed using the EGB (Echantillon Généraliste des Bénéficiaires) database, a random sample of the French national insurance (NHI) database, which covers 80% of the population. All adult patients whose first NVAF anticoagulant treatment in 2013 was a VKA were analyzed. Costs were calculated for the duration of follow-up and then divided by the number of days of therapy. The analysis was performed both from the French NHI perspective (amount reimbursed by the NHI) and from a collective perspective.

Results: In this study, 3,254 NVAF patients treated with VKA in 2013 were included, and this sample comprised 52.6% males. The mean daily cost of VKA treatment was €1.13 (±1.18) according to the collective perspective (89.4% of this cost was associated to INR measurement) and €1.05 (±1.16) according to the NHI perspective.

Limitations: As diagnoses associated with procedures are not available in the EGB database, proxies were used, and an algorithm was created to define the AF population.

Conclusions: This analysis is the first to consider an exhaustive spectrum of the costs of VKA treatment in France using EGB data. VKA medication requires exhaustive follow-up, and, thus, associated costs are important. The results of the present study confirmed this close follow-up for VKA patients, making the cost of treatment by VKA nearly 10-times more expensive than the cost of medication itself.     

Does transparency in central bank intervention policy bring noise to the FX market?: The case of the Bank of Japan

This paper empirically investigates the induced effect of a more and less transparent central bank intervention (CBI) policy on rumors that can emerge. Using the case of Japan, we estimate a dynamic-probit model that explains the main determinants of false reports (i.e. falsely reported interventions) and anticipative rumors (i.e. rumors about future interventions) with reference to the intervention strategy adopted by the central bank for actual and oral interventions, and the uncertainty climate of the market captured by two volatility measures. Our results suggest that the induced effect of a transparent CBI policy on market rumors critically depends on the type of speeches made by officials.     

Decomposing poverty changes into vertical and horizontal components

Variations in aggregate poverty indices can be due to differences in average poverty intensity, to changes in the welfare distances between those poor of initially unequal welfare status and/or to emerging disparities in welfare among those poor of initially similar welfare status. This note uses a general cost‐of‐inequality approach that decomposes the total change in poverty into a sum of indices of each of these three components. This decomposition can serve inter alia to integrate horizontal and vertical equity criteria in the poverty alleviation assessment of social and economic programmes. The use of these measures is briefly illustrated using Tunisian data.     

Absolute and Relative Deprivation and the Measurement of Poverty

This paper develops the link between poverty and inequality by focussing on a class of poverty indices (some of them well–known) which aggregate normative concerns for absolute and relative deprivation. The indices are distinguished by a parameter value that captures the ethical sensitivity of poverty measurement to "exclusion" or "relative–deprivation" aversion. The indices can be readily used to predict the impact of growth on poverty. An illustration using LIS data finds that the United States show more relative deprivation than Denmark and Belgium whatever the percentiles considered, but that overall deprivation comparisons of the four countries considered will generally depend on the intensity of the ethical concern for relative deprivation. The impact of growth on poverty also depends on the presence of and on the attention granted to concerns over relative deprivation.     

ASSESSING THE PERFORMANCE OF AN INCOME TAX

The paper proposes an indicator of the performance of a tax and benefit system in generating a high level of social welfare. Under standard assumptions on the form of the admissible social welfare functions, the indicator is shown to be increasing in the progressivity of the system. Using UK household data for 1985, the paper asks (i) What can the performance of a tax system with constant residual progression be? (ii) Relative to a proportional system, what is the performance of existing or proposed tax and benefit systems? (iii) How can we estimate the average residual progression of unevenly progressive tax and benefit systems?     

Pro-poor indirect tax reforms,with an application to Mexico

This paper proposes a methodology for testing for whether tax reforms are pro-poor. This is done by extending stochastic dominance techniques to identify tax reforms that will be deemed absolutely or relatively pro-poor by a wide spectrum of poverty analysts. The statistical properties of the various estimators are also derived in order to make the method implementable using survey data. The methodology is used to assess the pro-poorness of possible reforms to Mexico’s indirect tax system. This leads to the identification of several possible pro-poor tax reforms in that country. It also shows how the pro-poorness of a tax reform depends on one’s conception of poverty as well as on the revenue and efficiency impact of the reform.     

Gini Indices and the Redistribution of Income

Just as the Gini inequality index captures people's relative deprivation (Yitzhaki, 1979), so, we show in this paper, Gini-based progressivity and horizontal inequity indices capture individual perceptions of relative fiscal harshness and ill-fortune. In fact, we find that these links between individualistic perceptions and the measurement of the distribution and redistribution of income generalise to the family of indices based on the extended Ginis of Donaldson and Weymark (1980) and Yitzhaki (1983). Through 'leaky bucket' experiments, we also suggest how we can parameterise the inequality aversion present in these indices. Analysis of the Canadian gross and net income distributions (conducted using recently developed statistical inference procedures) shows the distribution and the aggregation of these individual indicators of relative deprivation, fiscal harshness and ill-fortune in 1981 and in 1990.     

TESTING FOR PRO-POORNESS OF GROWTH, WITH AN APPLICATION TO MEXICO

This paper proposes techniques to test for whether growth has been pro-poor. We first review different definitions of pro-poorness and argue for the use of methods that can generate results that are robust over classes of pro-poor measures and ranges of poverty lines. We then provide statistical procedures that rely on the use of sample data to infer whether growth has been pro-poor in a population. We apply these procedures to Mexican household surveys for 1992, 1998, and 2004. We find strong normative and statistical evidence that Mexican growth has been absolutely anti-poor between 1992 and 1998, absolutely pro-poor between 1998 and 2004 and between 1992 and 2004, and relatively pro-poor between 1992 and 2004 and between 1998 and 2004. The relative assessment of the period between 1992 and 1998 is statistically too weak to lead to a robust evaluation of that period.     

Testing for poverty dominance: an application to Canada

Abstract The paper proposes and applies statistical tests for poverty dominance that check for whether poverty comparisons can be made robustly over ranges of poverty lines and classes of poverty indices. This helps provide both normative and statistical confidence in establishing poverty rankings across distributions. The tests, which can take into account the complex sampling procedures that are typically used by statistical agencies to generate household‐level surveys, are implemented using the Canadian Survey of Labour and Income Dynamics (SLID) for 1996, 1999, and 2002. Although the yearly cumulative distribution functions cross at the lower tails of the distributions, the more recent years tend to dominate earlier years for a relatively wide range of poverty lines. Failing to take into account SLID’s sampling variability (as is sometimes done) can inflate significantly one’s confidence in ranking poverty. Taking into account SLID’s complex sampling design (as has not been done before) can also decrease substantially the range of poverty lines over which a poverty ranking can be inferred.     

SEQUENTIAL STOCHASTIC DOMINANCE AND THE ROBUSTNESS OF POVERTY ORDERINGS

When comparing poverty across distributions, an analyst must select a poverty line to identify the poor, an equivalence scale to compare individuals from households of different compositions and sizes, and a poverty index to aggregate individual deprivation into an index of total poverty. A different choice of poverty line, poverty index or equivalence scale can of course reverse an initial poverty ordering. This paper develops easily-checked sequential stochastic dominance conditions that throw light on the robustness of poverty comparisons to these important measurement issues. These general conditions extend well-known results to any order of dominance, to the choice of individual versus family based aggregation, and to the estimation of "critical sets" of measurement assumptions. Our theoretical results are briefly illustrated using data for four countries drawn from the Luxembourg Income Study databases.