Economic cost–benefit analysis of the addictive digital game industry

This study attempts to estimate the economic costs and benefits of the addictive digital game industry. Addiction to digital games induces economic costs such as increase in crime, facilities investments for curbing addiction, increase in counselling costs and other welfare losses. As a case study, we investigate the digital game industry in South Korea which is known to have one of the highest rates of game addiction. According to our calculations, the annual cost of game addiction is estimated to be approximately $3.5B while the annual benefit is approximately $24.3B ($3.7B for addicted user market). The proportion of the total costs to total benefits from the game industry is an alarming 14% (95% for addicted user market). We offer some policy recommendations.     

Do Financial and Institutional Variables Enhance the Impact of Remittances on Economic Growth in Latin America and the Caribbean? A Panel Cointegration Analysis

Using recently developed panel unit root and panel cointegration tests and the Fully-Modified OLS methodology (FMOLS), this paper estimates the impact of remittances on the economic growth of selected upper and lower income Latin American & Caribbean (LAC) countries over the 1990–2007 period. Despite the large flow of remittances to the region, there have been relatively few empirical studies assessing the impact of remittances on economic growth in LAC. Panel unit root tests suggest that several of the macro variables included in the model exhibit unit roots, yet, at the same time, Pedroni’s panel cointegration test determined that there is a cointegrating relationship among the variables in the estimated model. The FMOLS estimates suggest that remittances have a positive and significant effect on economic growth in both groups of countries. The estimates also indicate that both the degree of economic freedom and credit provided by the banking system have a positive and significant effect on economic growth in upper (middle) income LAC countries. The sign of the interaction term between remittances and the credit (and EFI) variables suggest that remittances act as substitutes for these variables. Finally, the effect of remittances on both sets of countries is stronger in the presence of a financial (credit) variable.     

Is Private Saving in Latin America and the Caribbean Different?

Private saving and economic growth are intimately linked, and low saving rates in Latin America and the Caribbean (LAC) have often been held responsible for disappointing growth in the region. Thus, identifying factors that spur saving is critical. This paper surveys previous empirical studies on LAC, highlighting contradictions, omissions and in some cases inconclusiveness of findings. Relying on a large dataset and a nested econometric framework, it analyzes private saving patterns and explores the role of its determinants in LAC, across LAC sub‐regions and compared with other regions. While the results highlight great heterogeneity in private saving rates within LAC and compared with the rest of the world, saving determinants are broadly the same notwithstanding some differences in sensitivity and contributions' sizes, and include its lag, income, demographics and public saving.     

Veblen’s Imperial Germany and the Industrialization of Latin America

Veblen’s Imperial Germany is a theory of development and industrialization, and the role the business enterprise played in these processes. Through a reassessment of Veblen’s Imperial Germany, this paper explores the main aspects that Veblen considered about the industrialization of England and Germany, deriving theoretical implications for the preconditions of a successful industrialization and development, based on an evolutionary Institutional perspective. Veblen’s analysis is then used to analyze the current state of the industrialization of Latin America, evaluating the last two decades since the 1990s, and comparing the orthodox approach, the neostructural view and the Veblenian perspective, arguing for the validity of a policy framework not reduced only to targeted protectionism but emphasizing the necessity of generating the institutional preconditions suggested by Veblen in his seminal work.     

Regional Integration and Intra-industry Trade in Latin America, 1980–90

The decade of the 1980s saw profound changes in the political economy of Latin America. The stabilisation and debt crises forced many countries in the region to re-examine their economic policies individually as well as collectively. The consequence was both a movement in the direction of neoliberal reform that included an emphasis on export promotion as well as a revival of interest in regional integration. The specific purpose of the present paper is to examine the consequences of these changes for the structure of intra-regional trade among and between Latin American countries. More specifically, we are interested in assessing the region's performance in terms of intra-regional, intra-industry trade over the period 1980–90.     

Civil Society and Investor–state Dispute Settlement: Assessing the Social Dimensions of Investment Disputes in Latin America

Investor–state dispute settlement (ISDS) has come to the forefront of debate over corporate rights in the contemporary era. While proponents laud ISDS as a neutral and efficient means of dispute resolution, critics claim that it shields transnational corporations from the oversight of national legal systems while enhancing their ability to interfere in host state policy matters. Moreover, because dispute settlement is carried out in international tribunals, ISDS is argued to disable citizen-driven politics. Governments have called on arbitration bodies to enhance the transparency of ISDS procedures and open spaces for civil society involvement. This reflects a desire to increase the legitimacy of ISDS in the face of mounting contestation. In this paper, I examine the multiple ways in which civil society actors intervene in investor–state arbitration inside and outside of formal channels. I focus specifically on two disputes involving foreign investors active in the water and hydrocarbons sectors of Argentina and Ecuador, respectively. I find that political pressure exerted by civil society actors influenced government decisions to break with investment rules and helped to shape government positioning within arbitral processes. Civil society actors must therefore be recognised as important participants in investor–state disputes.     

Economic burden of hypoglycemia: Utilization of emergency department and outpatient services in the United States (2005–2009)

Objective: To estimate the economic burden of hypoglycemia on the healthcare system at the national level in the US between the years of 2005–2009.

Methods: This study analyzed the National Hospital Ambulatory Medical Care Survey (NHAMCS), including emergency department (ED) and outpatient department (OPD) components, and the National Ambulatory Medical Care Survey (NAMCS). The annual rates of ED and OPD visits associated with hypoglycemia were reported. Subsequent medical services after disposition were studied. The unit cost of specific medical service was estimated from the Medical Expenditure Panel Survey (MEPS). All annualized costs were adjusted to US 2009 dollars. We also estimated the rates of injury and ambulance use incurring within a visit for hypoglycemia.

Results: The total direct medical cost of hypoglycemia was estimated as $3.49 billion in 2005 and decreased gradually to $1.84 billion in 2009. The declining trend was correlated with hospital admissions from ED, which decreased from 170 665 in 2005 to 71,751 in 2009. Consequently, the estimated annual expenditure of hospitalization for hypoglycemia from ED declined over time by more than half ($2.90 billion in 2005, $1.25 billion in 2009). Injury was reported among 9.5% of the ED visits for hypoglycemia. Ambulances were used among 58% of the ED visits for hypoglycemia.

Conclusion: Hypoglycemia poses a significant burden on the healthcare system; however, annual direct medical cost of severe hypoglycemia in the US decreased over the 5 years studied, which is attributable to tremendous decrease in need of hospitalization following an ED visit.     

Choice of angiotensin receptor blocker in moderate hypertension. A UK-based cost–benefit comparison of olmesartan- and candesartan-based regimens

Abstract

Introduction:

Selection of antihypertensive therapy hinges on an appropriate combination of efficacy, tolerability and compatibility with co-morbidities. Within a given class of antihypertensives, the choice of agent is often driven by cost, with the cheapest appropriate agent being chosen. Amongst the angiotensin receptor blockers (ARBs), this choice will often be losartan, as it is available in generic form. However, as the blood pressure lowering efficacy of losartan is modest, some patients will require an alternative ARB. In the UK this choice is often candesartan, although the agent with greatest BP lowering efficacy is olmesartan. The objective of this study was to use a cost-benefit model to compare the costs associated with target achievement using each of these two agents, in order to guide optimum use of prescribing budgets.

Method:

A probabilistic cost-benefit model was constructed for a cohort of patients with moderate hypertension, based on a standardised titration and maintenance algorithm using either olmesartan or candesartan, combined with thiazide and calcium channel blocker where required. Direct treatment costs were recorded, along with the proportion of patients achieving pre-defined treatment targets at each treatment level. Results were expressed as mean treatment cost per patient reaching target.

Results:

Based on the current QoF target of 150?mmHg systolic, 94.3% of patients on the olmesartan-based regimen reached target of 150?mmHg, compared with 89.0% of those on the candesartan-based regimen. 86% of olmesartan patients reached target on <3 drugs, compared with 74% of candesartan patients. The mean 12-month cost per patient reaching target was £171.36 for olmesartan versus £189.91 for candesartan. Ongoing annual maintenance costs for patients at target were £169.97 and £182.64, respectively. Similar results were obtained when considering alternative treatment targets

Limitations:

The study only compared two ARBs – candesartan and olmesartan and the results relate to prescribing costs only and do not include other healthcare costs. Additionally, the chosen outcome was blood pressure target achievement, rather than clinical endpoints. Given the stated objectives of the model, we do not believe these issues will have introduced bias in the direction of either comparator

Conclusion:

Although olmesartan has an apparently higher acquisition cost than candesartan, its superior BP lowering efficacy means that the overall cost per patient treated to target is actually lower. This result could have significant implications for making savings within primary care prescribing budgets in the UK.     

Empirical investigation of the agriculture–malnutrition nexus in Africa: Spatial clustering and spillover effects

Many studies have been conducted to examine the direct effect of agriculture on the prevalence of malnutrition; however, there is little solid evidence on spatial spillover effects and much less on the heterogeneous effects stemming from spatial differences in nutritional conditions. We make up this gap by using a dynamic spatial Durbin model to characterize the impact of agricultural productivity on malnutrition in Africa. Our results show that countries in Eastern Africa are more likely to suffer from severe malnutrition than other regions. We find evidence for convergence in agricultural productivity across countries with moderate and high prevalence of malnutrition as disparities in their agricultural productivity narrow down over the sample period. It appears that the negative effect of agriculture on malnutrition is more evident in countries where the prevalence of malnutrition is lower. This implies that agricultural development does not play a substantial role in reducing malnutrition in the worst affected areas. We also report that poor agricultural development can deteriorate the nutritional status among neighboring countries in the short term, consistent with the spatial-locking effect of agriculture.     

Economic burden of selected adverse events in patients aged ≥65 years with metastatic renal cell carcinoma

Abstract

Objective:

To estimate the costs of adverse events (AEs) in patients aged ≥65 years with metastatic renal cell carcinoma (mRCC).

Methods:

Retrospective study using the linked Surveillance, Epidemiology and End Results (SEER) Medicare database. Study subjects consisted of persons in SEER-Medicare, aged ≥65 years, with evidence of newly diagnosed mRCC between January 1, 2007 and December 31, 2007. Adverse events of interest consisted of Grade 3 or 4 toxicities that have been reported with frequency ≥5% in randomized controlled trials of sunitinib, sorafenib, bevacizumab, and pazopanib (i.e., targeted therapies for mRCC), and included abdominal pain, back pain, diarrhea, dyspnea, extremity pain, fatigue/asthenia, hand-foot syndrome, hypertension, lymphopenia, nausea/vomiting, neutropenia, proteinuria, and thrombocytopenia. Patients in SEER-Medicare with these events were identified based on ICD-9-CM diagnosis codes on Medicare claims. For each AE of interest, costs were tallied among evented patients over 30 days, beginning with the date of each patient’s first mention of the AE, and were compared with those of non-evented patients over a similar 30-day period beginning with an identical ‘shadow’ index date. Total costs were compared on an unadjusted basis and with adjustment for differences in baseline characteristics using a generalized linear model.

Results:

A total of 881 patients with mRCC met study entry criteria; 60% of these patients had Medicare claims with mention of one or more AEs of interest. Events occurring with frequency >20% included abdominal pain, dyspnea, and fatigue/asthenia; 10–20% of study subjects had encounters for back pain, extremity pain, and nausea/vomiting. Mean (standard deviation) total cost of care over 30 days was substantially higher among patients with AEs ($13,944 [$14,529]) compared with those without mention of these events ($1878 [$5264]). Adjusting for differences in baseline characteristics, the mean (95% confidence interval) difference in costs between evented and non-evented patients was $12,410 ($9217–$16,522). Study limitations include problems in event ascertainment due to inaccuracies in ICD-9-CM coding on Medicare claims data, and restriction of the study population to patients with metastatic involvement at initial diagnosis of RCC.

Conclusions:

Costs of care are substantially higher in patients aged ≥65 years with mRCC who experience AEs commonly associated with sunitinib, sorafenib, bevacizumab, and pazopanib. Efforts to prevent and/or better manage these events potentially can reduce healthcare costs.     

The role of permanent and transitory components in the fluctuations of Latin–American real exchange rates

Following the approach suggested by Engel and Kim (1999 Engel, C. 1999. Accounting for U.S. real exchange rates changes. Journal of Political Economy, 107: 507–38. [Crossref], [Web of Science ®] , [Google Scholar]), we estimate the permanent and transitory components of the real exchange rates in four Latin–American countries for the period 1957:01 to 2002:04. Results suggest that transitory component is the driving force of the real exchange rates in Argentina and Mexico. A principal role of the permanent component is observed in the real exchange rates of Brazil and Chile. Estimates probabilities of the high-variance regime allow to identify the principal events happened in these countries. This information is closely related to nominal shocks and therefore, it explains the significant role of this component in these countries.     

Post-capitalist Development in Latin America’s Left Turn: Beyond Peronism and the Magical State

The persistence of struggles by popular sectors in the context of the pink tide has generated ongoing debates about how to interpret the region’s left turn. For some, these movements are understood as forming part of a tense but ultimately productive relationship with left governments in the pursuit of post-neoliberal development. For others, it points to potentially irreconcilable political differences, and neoliberal continuities in pink tide governance. In this paper, I address these debates by presenting research on two social movements: Argentina’s recuperated enterprises and Venezuela’s popular economy. Using a Marxian-inspired, situated case study approach, I argue that these movements can be understood as ‘post-capitalist struggles’, that is, attempts to articulate new forms of democracy and cooperation that point beyond capitalism. As such, these movements push beyond the politics of Kirchnerismo and Chavismo that reproduce, albeit in new forms, the limitations to post-capitalist development associated with Peronism and the ‘magical state’. These movements therefore reveal both the region’s potential post-capitalist future, and the barriers that stand against it in the context of the region’s latest phase of development.     

Do changes in the rules of the game affect FDI flows in Latin America? A look at the macroeconomic,institutional and regional integration determinants of FDI

This paper aims to identify the main determinants of FDI in Latin America during the period 1990–2010. Evidence points to positive influences on FDI inflows of trade openness, maintaining low short-term debt levels and presenting a balance of payment deficit, government stability and low expropriation risk. Countries such as Argentina, Bolivia, Ecuador and Venezuela, in which the investment framework has become relatively less stable over the last decade, are finding it more difficult to attract foreign investors. From a risk-management perspective, both public solutions (such as sovereign guarantees) and private institutions have important roles to play in reducing the uncertainty involved in foreign investment decisions. Another result is that the DR CAFTA agreement does not seem to have played a significant role in the recent increase in investment directed towards Central America.     

Cyclical behavior of price–cost margins in the Turkish banking industry

Using a dynamic panel data framework, the cyclical behavior of the banks' price–cost margins in Turkey over the period 2002Q1–2008Q2 is analyzed. The findings provide evidence towards countercyclical behavior of the margins. This is important for the Turkish economy since the countercyclicality of banks' margins may deepen the contraction by constraining the credit opportunities over economic downturn periods. Furthermore, the control variables, monetary policy, market structure and financial deepening of the economy indicate significant effect on the price–cost margins of the banks. The findings also serve as evidence towards the “financial accelerator” mechanism in Turkish economy over the sample period.     

A cost–utility analysis of degarelix in the treatment of advanced hormone-dependent prostate cancer in the United Kingdom

Objective:

To determine the cost-effectiveness of the treatment of advanced hormone-dependent prostate cancer with degarelix compared to luteinizing hormone-releasing hormone (LHRH) agonists in the UK using the latest available evidence and the model submitted to AWMSG.

Methods:

A cost-effectiveness model was developed from the perspective of the UK National Health Service evaluating monthly injection of degarelix against 3-monthly leuprorelin therapy plus anti-androgen flare cover for the first-line treatment of patients with advanced (locally advanced or metastatic) hormone-dependent prostate cancer. A Markov process model was constructed using the patient population characteristics and efficacy information from the CS21 Phase III clinical trial and associated extension study (CS21A). The intention-to-treat (ITT) population and a high-risk sub-group with a PSA level >20?ng/mL were modeled.

Results:

In the base-case analysis using the patient access scheme (PAS) price, degarelix was dominant compared to leuprorelin with cost savings of £3633 in the ITT population and £4310 in the PSA?>?20?ng/mL sub-group. The chance of being cost-effective was 95% in the ITT population and 96% in the PSA?>?20?ng/mL sub-group at a threshold of £20,000 per quality-adjusted life-year (QALY). In addition, degarelix remained dominant when PSA progression was assumed equal and only the benefits of preventing testosterone flare were taken into account. Treatment with degarelix also remained dominant in both populations when the list price was used. The additional investment required to treat patients with degarelix could be offset in 19 months for the ITT population and 13 months for the PSA?>?20?ng/mL population. The model was most sensitive to the hazard ratio assumed for PSA progression between degarelix and leuprorelin and the quality-of-life (utility) of patients receiving palliative care.

Conclusion:

Degarelix is likely to be cost-effective compared to leuprorelin plus anti-androgen flare cover in the first-line treatment of advanced hormone-dependent prostate cancer.