Estimating healthcare resource use associated with the treatment of metastatic melanoma in eight countries

Objectives Studies reporting healthcare resourse use (HRU) for melanoma, one of the most costly cancers to treat, are limited. Using consistent, robust methodology, this study estimated HRU associated with the treatment of metastatic melanoma in eight countries.

Methods Using published literature and clinician input, treatment phases were identified: active systemic treatment (pre-progression); disease progression; best supportive care (BSC)/palliative care; and terminal care. HRU elements were identified for each phase and estimates of the magnitude and frequency of use in clinical practice were obtained through country-specific Delphi panels, comprising healthcare professionals with experience in oncology (n?=?8).

Results Medical oncologists are the key care providers for patients with metastatic melanoma, although in Germany dermato-oncologists also lead care. During the active systemic treatment phase, each patient was estimated to require 0.83–2 consultations with a medical oncologist/month across countries; the median number of such assessments in 3 months was highest in Canada (range?=?3.5–5) and lowest in France, the Netherlands and Spain (1). Resource use during the disease progression phase was intensive and similar across countries: all patients were estimated to consult with medical oncologists and 10–40% with a radiation oncologist; up to 40% were estimated to require a brain MRI scan. During the BSC/palliative care phase, all patients were estimated to consult with medical oncologists, and most to consult with a primary care physician (40–100%).

Limitations Panelists were from centers of excellence, thus results may not reflect care within smaller hospitals; data obtained from experts may be less variable than data from broader clinical practice. Treatments for metastatic melanoma are continually emerging, thus some elements of our work could be superseded.

Conclusions HRU estimates were substantial and varied across countries for some resources. These data could be used with country-specific costs to elucidate costs for the management of metastatic melanoma.     

A Multicultural Joint Venture Under the Post-Developmental State in Singapore

As a multi-cultural country with a British colonial past hosting many different ethnic groups including Westerners, Singapore juggles with the often conflicting forces of Westernization (holding the promise of economic prosperity) and Asianization (holding the promise of a distinct cultural identity). Although the endorsement of ‘Asian values’ by Singapore political leaders such as Lee Kuan Yew may be seen as a mere rhetoric device to either explain ethnic Chinese business success or the Asian crisis, the question needs to be raised as to the ways in which the Asian Values discourse affects both Western and Asian MNCs operating in Singapore. In order to address this question, this article investigates the participation of a European–Japanese joint venture in a large government-sponsored reclamation project in Singapore. It is a rather unique situation in which the state as paymaster has the upper hand over the partners. The investigation shows that reference to ‘Asian values’ is a significant boundary-marking strategy used by both the Singapore government and the joint venture partners to manipulate the power balances in this triangular relationship. The outcome is more often than not advantageous for the Singapore state.     

Measuring market power in the French Comte cheese market

A new empirical industrial organisation approach is used tomeasure seller market power in the French Comté cheesemarket, characterised by government-approved supply control.The estimation is performed on quarterly data at the wholesalestage over the period 1985–2005. Three different elasticityshifters are included in the demand specification, and the supplyequation accounts for the existence of the European dairy quotapolicy. The market power estimate is small and statisticallyinsignificant. Monopoly is clearly rejected. Results appearto be robust to the choice of functional form and suggest littleeffect of the supply control scheme on consumer prices.     

Does irritation induced by charitable direct mailings reduce donations?

Charities rely mainly on direct mailings to attract the attention of potential donors. Individuals may feel irritated by these mailings, in particular when they receive many mailings. This might harm the revenues charities receive from their mailing activities. Moreover, target selection by charities likely results in many mailings being sent to the best donors, and hence they might become most irritated. As such, irritation with direct mailings could well be endogenously determined. To ensure exogenous variation in irritation, we performed a unique controlled field experiment in cooperation with five of the largest charities in the Netherlands. Our analysis reveals that direct mailings do result in irritation, but surprisingly, this irritation affects neither stated nor actual donating behavior.     

Dynamic Effects of Sponsoring: How Sponsorship Awareness Develops Over Time

This study takes a longitudinal perspective to investigate sponsorship awareness in a multiple-year, international context pertaining to the Union of European Football Associations (UEFA) Champions League, a prestigious European soccer competition for club teams with worldwide exposure. A logit model aims to predict sponsorship awareness for one of the main sponsors of the league using data pertaining to more than 25,000 consumers from five countries, over the period 2005 to 2009. The findings provide an empirical argument for building long-term relationships. Sponsorship awareness levels increase over the measurement period, and the highest increase occurs in the second year of sponsorship.