Economic Valuation of Environmental Damages due to the Prestige Oil Spill in Spain

This paper presents a parametric and non-parametric analysis of data from a contingent valuation study (CVM) conducted to estimate environmental use and passive use losses due to the Prestige oil spill. This is the first CVM study conducted in Europe after a large oil spill. The CVM survey was implemented using in person interviews. Mean willingness to pay (WTP) values were computed with both, a parametric and non-parametric approach. Parametric WTP estimation indicates that respondents in the sample are willing to pay about 40.51 € per household to avoid a similar future oil spill in Spain. This implies that on average, the Spanish society places a value of the environmental losses caused by the Prestige oil spill around 574 € million. Non-parametric estimates are slightly higher at 58.08 € per household. WTP results are similar to those obtained in the Exxon Valdez study.     

Costs of managing severe hypoglycaemia in three European countries

Abstract

Objectives: To assess the costs of severe hypoglycaemic events (SHEs) in diabetes patients in Germany, Spain and the UK.

Methods: Healthcare resource use was measured by surveying 639 patients aged ≥16 years, receiving insulin for type 1 (n=319) or type 2 diabetes (n=320), who experienced ≥1 SHE in the preceding year. Patients were grouped by location of SHE treatment: group 1, community (family/domestic); group 2, community (healthcare professional); group 3, hospital. Costs were calculated from published unit costs applied to estimated resource use. Costs per SHE were derived from patient numbers per subgroup. Weighted average costs were derived using a prevalence database.

Results: Hospital treatment was a major cost in all countries. In Germany and Spain, costs per SHE for type 1 patients differed from those for type 2 patients in each group. Average SHE treatment costs were higher for patients with type 2 diabetes (Germany, €533; Spain, €691; UK, €537) than type 1 diabetes patients (€441, €577 and €236, respectively). Telephone calls, visits to doctors, blood glucose monitoring and patient education contributed substantially to costs for non-hospitalised patients.

Conclusions: Treatment of SHEs adds significantly to healthcare costs. Average costs were lower for type 1 than for insulin-treated type 2 diabetes, in all three countries.     

Economic impact of onabotulinumtoxinA for overactive bladder with urinary incontinence in Europe

Background: Overactive bladder (OAB) is a common condition that has a significant impact on patients’ health-related quality-of-life and is associated with a substantial economic burden to healthcare systems. OnabotulinumtoxinA has a well-established efficacy and safety profile as a treatment for OAB; however, the economic impact of using onabotulinumtoxinA has not been well described.

Methods: An economic model was developed to assess the budget impact associated with OAB treatment in France, Germany, Italy, Spain and the UK, using onabotulinumtoxinA alongside best supportive care (BSC)—comprising incontinence pads and/or anticholinergic use and/or clean intermittent catheterisation (CIC)—vs BSC alone. The model time horizon spanned 5 years, and included direct costs associated with treatment, BSC, and adverse events.

Results: Per 100,000 patients in each country, the use of onabotulinumtoxinA resulted in estimated cost savings of €97,200 (Italy), €71,580 (Spain), and €19,710 (UK), and cost increases of €23,840 in France and €284,760 in Germany, largely due to day-case and inpatient administration, respectively. Projecting these results to the population of individuals aged 18 years and above gave national budget saving estimates of €9,924,790, €27,458,290, and €48,270,760, for the UK, Spain, and Italy, respectively, compared to cost increases of €12,160,020 and €196,086,530 for France and Germany, respectively. Anticholinergic treatment and incontinence pads were the largest contributors to overall spending on OAB management when onabotulinumtoxinA use was not increased, and remained so in four of five scenarios where onabotulinumtoxinA use was increased. This decreased resource use was equivalent to cost offsets ranging from €106,110 to €176,600 per 100,000 population.

Conclusions: In three of five countries investigated, the use of onabotulinumtoxinA, in addition to BSC, was shown to result in healthcare budget cost savings over 5 years. Scenario analyses showed increased costs in Germany and France were largely attributable to the treatment setting rather than onabotulinumtoxinA acquisition costs.     

Eurowinners and Eurolosers: The distribution of seigniorage wealth in EMU

The European Monetary Union (EMU) will involve socialization of the existing seigniorage wealth of the national central banks. This socialization will create windfall gains for countries with relatively low monetary bases such as France and the UK and it will be disadvantageous for countries like Germany, Austria, Spain or the Netherlands which will suffer per capita wealth losses of between 406 and 182 ecus. The paper quantifies the gains and losses in seigniorage wealth under alternative membership and bank regulation scenarios.     

Regional and gender differentials in the persistence of unemployment in Europe

The persistence of unemployment increased during the recent great recession in many European countries, although with diversified impacts. We therefore analyse such impacts in four European countries – Italy, Spain, France and the UK – which represent different institutional frameworks and may reflect the so-called continental European and Anglo-Saxon frameworks. We analyse the determinants of unemployment persistence using individual-level data from the European Union Statistics on Income and Living Conditions (EU-SILC) panel for the period 2007–2013. These data enable us to take into account initial conditions and state dependence in addition to individual and household characteristics. We focus on gender and regional effects, which have a strong impact on the persistence in the state of unemployment. We find that gender gap is significant in Italy and the UK, implying that male workers show a higher probability of remaining unemployed. In Italy, such a pattern is due to the worsening of male workers’ conditions during the crisis, whereas in the UK, male workers show higher unemployment rates than women. Regional effects are significant in all countries analysed and underline a relevant structural factor that should be addressed on policy grounds in Europe. Such effects are greater in Spain and Italy.     

Cost-effectiveness of grass pollen subcutaneous immunotherapy (SCIT) compared to sublingual immunotherapy (SLIT) and symptomatic treatment in Austria,Spain, and Switzerland

Background: While specific immunotherapy (SIT) has been proven to be cost-effective for the treatment of allergic rhinitis compared to symptomatic treatment, there is a lack of European studies in which sublingual (SLIT) and subcutaneous (SCIT) immunotherapy were compared. The present analysis is focused on the cost-effectiveness of SCIT compared to SLIT and symptomatic treatment of grass pollen allergy in Austria, Spain, and Switzerland. It will address specific properties of the underlying healthcare systems.

Methods: The investigation is based on a previously published health economic model calculation. This was designed as a Markov model with pre-defined health stages and a duration of 9 years covering specific preparations for SCIT (Allergovit) and SLIT (Oralair). The effectiveness was assessed as symptom-score based quality-adjusted life years (QALYs). Additionally, total cost has been determined as well as the cost-effectiveness of SCIT. The robustness of model results was proved in further sensitivity analyses.

Results: With regard to the effectiveness of both SCIT and SLIT, preparations were dominant compared to pharmacological symptomatic therapy. Both strategies were associated with additional cost, but, combined with the results on effectiveness, both have to be regarded as cost-effective. A direct comparison of the SCIT (Allergovit) and SLIT (Oralair) showed lower total costs of SCIT vs SLIT for Austria, Spain, and Switzerland (€1,368 vs €2,012, €2,229 vs €2,547, and €1,901 vs €2,220) and superior effectiveness (SCIT =8.02 QALYs; SLIT =7.98 QALYs; and symptomatic therapy =7.90 QALYs).

Conclusion: In patients with allergic rhinitis, SIT offers cost-effective treatment options compared to symptomatic treatment. When comparing SCIT (Allergovit) and SLIT (Oralair), SCIT was dominant in terms of QALYs as well as costs, in particular due to a slightly higher patient compliance and lower drug costs.     

The Influence of Household Financial Debt on Monetary and Exchange Rate Policy: France and Britain compared

The structure of household financial debt may have a major effect on the ability of governments to use monetary policy as a means of influencing exchange rate values. This is illustrated by a discussion of the comparative situation of France and Britain during the 1992–93 ‘crisis’ in the European exchange rate mechanism. The large volume of floating rate household debt in the UK placed a significant limitation on the ability of the UK authorities to use monetary policy. By contrast, the lower volume of mainly fixed rate household debt in France enabled the French authorities to make full use of monetary policy as desired in the pursuit of exchange rate targets. As modern financial markets are highly volatile, governments should take policy measures to create more stable structures of household debt.     

Evaluating drug cost per responder and number needed to treat associated with lixisenatide on top of glargine when compared to rapid-acting insulin intensification regimens on top of glargine,in patients with type 2 diabetes in the UK,Italy, and Spain

Objectives: This study investigated the cost per responder and number needed to treat (NNT) in type 2 diabetes mellitus (T2DM) patients for lixisenatide compared to insulin intensification regimens using composite endpoints in the UK, Italy, and Spain.

Methods: Efficacy and safety outcomes were obtained from GetGoal Duo-2, a 26-week phase 3 trial comparing lixisenatide vs insulin glulisine (IG) once daily (QD) and three times daily (TID). Response at week 26 was extrapolated to 52 weeks, assuming a maintained treatment effect, based on long-term evidence in other T2DM populations. Responders were defined using composite end-points, based on an HbA1c threshold and/or no weight gain and/or no hypoglycemia. The HbA1c threshold was varied in sensitivity analyses. Annual treatment costs were estimated in euros (1 GBP?=?1.26 EUR), including drug acquisition and resource use costs. Cost per responder was computed by dividing annual treatment costs per patient by the proportion of responders.

Results: Lixisenatide was associated with the lowest cost per responder for all composite end-points that included a weight-related component. For the main composite end-point of HbA1c ≤7.5% AND no weight gain AND no symptomatic hypoglycemia, cost per responder results were: UK: 6,867€, 8,746€, and 12,410€; Italy: 7,057€, 9,160€, and 12,844€; Spain: 8,370€, 11,365€, and 17,038€, for lixisenatide, IG QD, and TID, respectively. The NNT analysis showed that, for every 6.85 and 5.86 patients treated with lixisenatide, there was approximately one additional responder compared to IG QD and TID, respectively.

Limitations: A limitation of the clinical inputs is the lack of 52-week trial data from GetGoal Duo-2, which led to the assumption of a maintained treatment effect from week 26 to 52.

Conclusions: This analysis suggests lixisenatide is an efficient economic resource allocation in the UK, Italy, and Spain.     

Innovation and Productivity in European Industries

The labour productivity impact of innovation is investigated in this paper combining neo-Schumpeterian insights on the variety of innovation with the importance of industrial structures and firm size; two models are proposed for explaining productivity and export success in European manufacturing industries and firm-size classes. The empirical estimates are based on data from the European innovation survey (CIS 2), covering Austria, France, Italy, the Netherlands, and the UK, broken down by 22 sectors and for large, medium, and small firms. The econometric results, obtained adopting cross-sectional estimation methodologies able to account for unobserved industrial characteristics, show that productivity in Europe relies on product and process innovation, with the support of the efficiency gains provided by grouped business structures. Conversely, in Italy the introduction of new machinery linked to innovation appears as the key mechanism supporting domestic productivity. When export success is considered, all countries have to rely on an innovation-based model of competitiveness.     

Policy uncertainty and international financial markets: the case of Brexit

ABSTRACT

This study assesses the impact of the Brexit probability on both the UK and on international financial markets, for the first and the second statistical moments. As financial markets are by nature highly interlinked, one might expect that the uncertainty engendered by Brexit also has an impact on financial markets in several other countries. We first estimate the time-varying interactions between UK policy uncertainty, which to a large extent is attributed to uncertainty about Brexit and UK financial market volatilities. Second, we use two other measures of the perceived probability of Brexit before the referendum, namely daily data released by Betfair and results of polls published by Bloomberg. Based on these data sets, and using both panel and single-country SUR estimation methods, we analyse the Brexit effect on levels of stock returns, sovereign CDS, 10-year interest rates in 19 predominantly European countries, and those of the British pound and the euro. We show that Brexit-induced policy uncertainty will continue to cause instability in key financial markets and has the potential to damage the real economy in both the UK and other European countries. The main losers outside the UK are the ‘GIIPS’ economies: Greece, Ireland, Italy, Portugal and Spain.     

Valuing Global Ecosystem Services: What Do European Experts Say? Applying the Delphi Method to Contingent Valuation of the Amazon Rainforest

Valuing global public goods like the Amazon rainforest by stated preference surveys of a representative sample of the global population would be very costly and time consuming. We explore the use of the Delphi Method in contingent valuation (CV) by asking a panel of 49 European environmental valuation experts in two rounds what they think would be the result if a European CV survey of Amazon Rainforest protection plans was conducted. The experts’ best guess for the mean willingness-to-pay (WTP) by European households for preserving the current Amazon Rainforest, and thus avoiding a predicted loss in forest area by 2050 from currently 85% to 60% of the original forest in the 1970s, was 28 € per household annually as an additional income tax. Aggregated over all European households this amounts to about 8.4 billion € annually. This preliminary estimate indicate that WTP of distant beneficiaries is substantial, and could justify preservation of global ecosystem services where aggregated benefits of the local population often do not exceed the opportunity costs of preservation in terms of lost income from commercial activities. The income elasticity of WTP with respect to per-capita income in the European countries is 0.5–0.6. Recognizing the limitations and assumptions of the Delphi CV method, it could still be a time saving and cost-effective benefit transfer tool for providing international donors with much needed order-of-magnitude estimates of the non-use value of ecosystem services of global significance.     

Wages and prices in Europe before and after the onset of the Monetary Union

This paper investigates possible structural changes induced by the Euro on the relations among wages, prices and unemployment for the five major European economies. The dynamic adjustment and the level relations are found to be different across subperiods as well as across countries. During the European Economic and Monetary Union (EMU) period, there is evidence of a conventionally-sloped Phillips Curve for the four economies within the EMU, with a higher degree of homogeneity with respect to the pre-EMU period; the UK presents instead a positively-sloped Phillips Curve in the EMU period. In this latter period, deviations from reference values are found to influence unemployment for all countries, including the UK. Only for Germany and Spain, instead, we find evidence that deviations from reference values influence inflation dynamics.     

How (not) to run auctions: The European 3G telecom auctions

There were enormous differences in the revenues from the European “third generation” (3G, or “UMTS”) mobile-phone license auctions, from 20 Euros per capita in Switzerland to 650 Euros per capita in the UK, though the values of the licenses sold were similar. Poor auction designs in some countries facilitated collusion between firms and failed to attract entrants. The sequencing of the auctions was also crucial. We discuss the auctions in the UK, Netherlands, Germany, Italy, Austria, Switzerland, Belgium, Greece and Denmark.     

Firm heterogeneity in productivity across Europe: evidence from multilevel models

This paper analyses the Total Factor Productivity (TFP) heterogeneity of a sample of manufacturing firms operating in seven EU countries (Austria, France, Germany, Hungary, Italy, Spain and the UK). TFP data refer to 2008. The empirical setting is based on the multilevel modeling which provides two main results. Firstly, we show that TFP heterogeneity is largely due to firm-specific features (85% of TFP variability in the empty model). Interestingly, we find that some key-drivers of firm performance (size, family management, group membership, innovations and human capital) are significantly related to TFP, but do not, on the whole, absorb much of firm TFP variance, implying that differences in productivity are due to notable yet unobservable firm characteristics. Secondly, as far the role of localization is concerned, we demonstrate that the country effect is more influential than region effect in explaining individual productivity. Net of the country effect, the localization in different European regions explains about 5% of TFP firm heterogeneity. When considering the case of three individual countries, France, Italy and Spain, location in different regions explains 5.3% of TFP heterogeneity in Italy, while this proportion is lower (3.6%) in France and higher (9.9%) in Spain.     

Impacts from restoration strategies: Assessment through valuation workshops

Recent decades have seen a wide range of pollutant spills affecting natural, industrial, urban and rural areas (Exxon Valdez, Amoco Cadiz, Erika, Prestige, the Chernobyl nuclear power plant, and the Aznalcóllar mines in Spain, to name a few). The extent of damage covers both time and space. Therefore, in order to mitigate the effects of pollution, it is necessary to adopt integrated management of both productive and natural areas. However, to be effective it is necessary to consider not only the health or biophysical effects of the countermeasures, but also the response of individuals to these changes. The purpose of this study is to assess the potential social and environmental impacts derived from the implementation of restoration strategies resulting from spills. Our approach is based on a choice experiment applied within the context of a citizens' valuation workshop or market stall in Cumbria (UK) and Zaragoza (Spain). The results highlight the advantages of this participatory technique versus traditional surveys.     

Does environmental quality influence health expenditures? Empirical evidence from a panel of selected OECD countries

In this paper we examine the role of environmental quality in determining per capita health expenditures. We take a panel cointegration approach in order to explore the possibility of estimating both short-run and long-run impacts of environmental quality. Our empirical analysis is based on eight OECD countries, namely Austria, Denmark, Iceland, Ireland, Norway, Spain, Switzerland, and the UK for the period 1980-1999. We find that per capita health expenditure, per capita income, carbon monoxide emissions, sulphur oxide emissions and nitrogen oxide emissions are panel cointegrated. While short-run elasticities reveal that income and carbon monoxide emissions exert a statistically significant positive effect on health expenditures, in the long-run in addition to income and carbon monoxide, we find that sulphur oxide emissions have a statistically significant positive impact on health expenditures.     

IS MARKET‐ORIENTED REFORM PRODUCING A ‘TWO‐TRACK’ EUROPE? EVIDENCE FROM ELECTRICITY AND TELECOMMUNICATIONS

ABSTRACT: The European Commission has formally recognized that adequate provision of basic household services, including energy, communications, water and transport, is key to ensuring equity, social cohesion and solidarity. Yet little research has been done on the impact of the reform of these services in this regard. This article offers an innovative way to explore such questions by analyzing and contrasting stated and revealed preferences on citizen satisfaction with and expenditure on two services, telecommunications and electricity, in two large countries, Spain and the UK. We find evidence that in telecommunications, but not in electricity, reform has led to a ‘two‐track’ Europe, where citizens who are elderly, not working or the less‐educated behave differently in the market, with the result that they are less satisfied with these services than their younger, working, better‐educated, counterparts.     

A cost-effectiveness modeling evaluation comparing a biosimilar follitropin alfa preparation with its reference product for live birth outcome in Germany,Italy and Spain

Abstract

Background/objective: Although biosimilar drugs may be cheaper to purchase than reference biological products, they may not be the most cost-effective treatment to achieve a desired outcome. The analysis reported here compared the overall costs to achieve live birth using the reference follitropin alfa (GONAL-f) or a biosimilar (Ovaleap) in Spain, Italy and Germany.

Methods: Patient and treatment data was obtained from published sources; assisted-reproductive technology, gonadotropin, follow-up and adverse-event-related costs were calculated from tariffs and reimbursement frameworks for each country. Incremental cost-effectiveness ratios (ICERs) were calculated from the difference in costs between reference and biosimilar in each country, divided by the difference in live-birth rates. Mean cost per live birth was calculated as total costs divided by the live-birth rate.

Results: The published live birth rates were 32.2% (reference) and 26.8% (biosimilar). Drug costs per patient were higher for the reference recombinant human follicle-stimulating hormone in all three countries, with larger cost differences in Germany (€157.38) and Italy (€141.50) than in Spain (€22.41). The ICER for the reference product compared with the biosimilar was €2917.47 in Germany, €415.43 in Spain and €2623.09 in Italy. However, the overall cost per live birth was higher for the biosimilar in all three countries (Germany €8135.04 vs. €9185.34; Italy €8545.22 vs. €9733.37; Spain €14,859.53 vs. €17,767.19). Uncertainty in efficacy, mean gonadotropin dose and costs did not have a strong effect on the ICERs.

Conclusions: When considering live birth outcomes, treatment with the reference follitropin alfa was more cost effective than treatment with the biosimilar follitropin alfa.     

Tracing distant environmental impacts of agricultural products from a consumer perspective

Globally, trade flows of agricultural products are increasing. While value is typically added along the whole production chain, certain environmental impacts, such as land and water use, biomass appropriation, and soil degradation, are intrinsically linked to where the primary products originate from. When taking a consumer oriented approach on environmental problems, bilateral trade statistics can help in providing a clearer picture about the location of impacts caused by consumption elsewhere. However, in today's increasingly globalized world, consumer goods are often imported from countries other than where the primary product originated from. For instance, soybeans are transported from Brazil to the Netherlands, where they are processed into soy oil, which is shipped to Austria, where it is consumed. Utilizing bilateral trade matrices and matrix algebra, we present a method that allows to clearly link consumption patterns to the origin of primary products. In this, the method can help to provide information about consumption related, distant environmental impacts. We employ the case of land and water use linked to Austria's soy product consumption to demonstrate the approach's relevance. Finally, we outline some possible applications of this method to show its potential in enhancing understanding for informed consumer based environmental decision making.