An advantage of the bargaining set over the core

An example of a market game is described for which the bargaining set seems to be intuitively more acceptable than the (nonempty) core. It also yields more insight into the nature of the competition that may exist among the traders.     

Cost-minimization analysis of sublingual immunotherapy versus subcutaneous immunotherapy for house dust mite respiratory allergic disease in Denmark

Objectives Currently, patients with persistent moderate-to-severe house dust mite (HDM) allergic rhinitis despite use of symptom-relieving medication can be offered subcutaneously administered allergy immunotherapy (SQ SCIT; Alutard SQ) as standard care of treatment in Denmark. Recently, a HDM sublingually administered allergy immunotherapy tablet (SQ SLIT-tablet; ACARIZAX) has been developed for at-home treatment. The purpose of this analysis is to compare the costs related to treatment and administration of SQ SLIT-tablet and SQ SCIT.

Methods Assuming equal efficacy between ther SQ SLIT-tablet and SQ SCIT, the cost-minimization analysis was the most appropriate for the comparison. According to guidelines and Summary of Product Characteristics, the treatment duration of SQ SLIT-tablet is 3 years and 3–5 years for SQ SCIT. The courses of treatment vary among patients and, therefore, the costs of treatment have been calculated for an average patient with HDM respiratory allergic disease (RAD) receiving either SQ SLIT-tablet or SQ SCIT. All costs associated with allergy immunotherapy were collected, i.e., cost of medication, administration and treatment setting, and discounted according to Danish guidelines. Comprehensive univariate sensitivity analyses were carried out.

Results The treatment costs for an average patient with HDM RAD are €3094 for SQ SLIT-tablet and €3799 for SQ SCIT; however, when adding indirect costs to the calculations the total costs of the treatments are €3697 and €6717 for SQ SLIT-tablet and SQ SCIT, respectively. Therefore, if 2500 patients with HDM RAD were treated with SQ SLIT-tablet instead of SQ SCIT, it would elicit a saving to the healthcare system of ～€1.8 million. The conclusion was robust to any changes in the sensitivity analysis.

Conclusion With regards to the cost of treating Danish patients with HDM RAD, it is clearly cost-saving to treat patients with SQ SLIT-tablet compared to SQ SCIT.     

用好八大资源 服务福建经济

在市场经济条件下政府的职责是去伪存真，将更多好的企业送到市场中去政府扶持企业发展其素质的过程就是调动社会硌种资源以助之的过程，这个道理如同种花，只有好的土壤，花才能茁壮成长，而政府能为企业提供土壤的各类资源，针对福建发展的现状，政府可以对下列八种资源进行深层次开发。     

The tax advantage of public firms over private firms in the German household solid waste disposal industry

We measure the tax advantage of public firms over private firms, which operate at municipality level in the German household solid waste disposal industry. Public firms with sovereign duties pay no taxes, but equivalent private firms have to. In a simple risk-free setting, we develop a measure of the percentage difference of the charges of both types of firms demanded under their respective tax treatments. We model a cost-covering public firm and a net present value maximizing private firm. For sensible model parameters from the German waste disposal industry the private firm has to demand an about 16% to 18% higher charge. The by far biggest impact on the measure has the value added tax, with revenues as a much larger tax base than profits. Tax savings, which directly affect pre-tax profits, only alleviate the disadvantage bit. There is some evidence that at least one type of private firms—that is, private law firms that are also majority privately owned, are productive enough to overcome the tax advantage of public firms and be able to charge a lower price than public firms.     

The competitive advantage of honesty

We study competitive markets where firms may lie to their workers to reduce costs. Consumers may benefit from firms’ dishonesty through lower market prices. Does firms’ (dis-)honesty affect consumers’ purchasing decisions? Our experiment shows that when honesty is fully transparent, it can provide a competitive advantage: Honest firms sell more and – despite higher costs – achieve higher profits. This finding is in line with our equilibrium predictions when allowing for dishonesty-averse consumers. By identifying circumstances in which consumers – although not the addressee of dishonesty – “punish” firms for their within-firm dishonesty, we contribute both to behavioral ethics and behavioral industrial organization.     

The economic advantages of response in the treatment of advanced breast cancer

Summary

The introduction of a new class of drugs, the taxoids, has dramatically improved the outlook for patients with advanced, metastatic breast cancer. Second-line monotherapy with the most effective taxoid, docetaxel, in patients with anthracycline-resistant metastatic breast cancer, shows an overall response rate up to 55% in this patient population. Increased response rate is associated with improved quality of life for these patients.

We carried out a cost analysis to determine the economic benefits of being in a response state compared with the other health states associated with advanced breast cancer: stable, progressive or terminal disease.

We found that the cost of care for responders is 40% of that for early progressive disease and just over a third of that for late progressive disease. The costs associated with stable disease are only a little less than those for progressive disease, and are more than double the costs for patients who have responded to chemotherapy. The costs during terminal disease are the highest, and are more than nine times those associated with caring for responders.

Our findings confirm other studies which demonstrate that the cost of chemotherapy can be offset against the reduction in costs incurred for patients who remain in healthier states for longer. The key parameter determining the economic efficiency of treatments for advanced breast cancer is response rate.     

Antiepileptic drug treatment patterns and economic burden of commercially-insured patients with refractory epilepsy with partial onset seizures in the United States

Abstract

Objective:

To assess the economic burden in direct healthcare utilization and costs for refractory epileptic patients with partial onset seizures (POS) and assess the antiepileptic drug (AED) treatment patterns among these patients.     

The economic value of reducing medication dosing frequency with drug delivery technologies: an evidence assessment

Objective: To critically evaluate published cost-effectiveness studies of novel drug products requiring less-frequent medication dosing compared to conventional formulations of the same drug substance.

Methods: A search was conducted in the Medline and Embase databases for cost-effectiveness studies published before May 2009 that compared two or more drug delivery technologies formulated with the same active drug substance. The Quality of Health Economic Studies (QHES) grading criteria for cost-effectiveness studies was applied to the selected publications.

Results: The literature search identified approximately 907 articles of which six cost-effectiveness studies met the inclusion criteria. The studies spanned four chronic conditions, were conducted from various international perspectives and used decision-analytic models to project economic outcomes. The base-case results of all six studies indicated that the drug product with sustained therapeutic efficacy was either more effective and less costly (‘dominant’) or more cost effective than the conventional formulation of the same drug substance. Quality scores ranging from 70 to 84 (scale 0 to 100) were assigned to the studies, with a mean of 78.

Limitations: This review likely did not capture all relevant drug delivery technologies and drug products. Only one reviewer critically evaluated the cost-effectiveness studies and independently assigned quality scores using the QHES grading criteria, which may be limited in its ability to identify poorly analyzed studies.

Conclusion: Evaluation of the published literature suggests that drug products with less-frequent medication dosing can be cost effective when compared to conventional formulations, but assessments are challenging because of complex relationships among therapeutic drug levels, dosing frequency, medication adherence, and health outcomes. Additional product-specific, comparative, pragmatic studies in this area are needed.     

The accidental agro-power: constructing comparative advantage in Brazil

Brazil has emerged as an agro-export powerhouse: from being a net-agricultural importer and food aid recipient as recently as the 1960s and 1970s, it has now become the world’s third largest agricultural exporter, after the US and EU. What is more, Brazil’s new role as a major agricultural trader has provided an important foundation for its enhanced status and influence in global economic governance, as an emerging power and one of the ‘BRICS’. This paper analyses how such a remarkable transformation was brought about. I argue that Brazil’s emergence as an agricultural powerhouse was the result not of its natural factor endowments, but extensive intervention on the part of the Brazilian state that had the effect of constructing a new comparative advantage. This transformation was propelled by state-driven innovation and related policies that opened up massive new areas of the country to agriculture, enabled it to shift to producing goods in direct competition with the world’s dominant agricultural exporters, and generated significant gains in productivity and competitiveness. The irony is that the intention of these policies, initiated in the 1970s, was to foster industrial development in Brazil as part of its import-substitution industrialisation programme, yet they wound up having precisely the opposite effect – transforming Brazil into one of the world’s dominant agricultural powers.     

Technological change and factor mix over the product cycle: A model of dynamic comparative advantage

This paper presents a simple dynamic model of how, for a given set of factor prices, the optimizing mix of factor inputs changes over a product cycle, and of how (as a result) comparative advantage in international trade shifts. The model is designed to be consistent with, and to explain, the following stylized facts. When a new technology comes into being, follow-on improvements of the original basic design tend to occur at a rapid rate. Opportunities for improvement and the nonroutinized nature of the production process put a premium on flexibility and insight. As the technology settles down, the premium placed on problem solving ability declines, obsolescence of equipment occurs less rapidly, and unskilled workers and machinery are substituted for skilled workers.     

The treatment of uncertainty in the application of rational expectations to the analysis of economic policy

This study uses a familiar set of variables to characterize the determinants of training (based around individual characteristics, qualifications, and workplace characteristics). However, it goes further by using data drawn from a recent quarter of the UK Labour Force Survey, and thus contains an up-to-date and extensive set of core variables. The dependent variable used covers three subgroups: those who have never been offered training by their current employer; those who have been offered but did not receive training in the last three months; and those workers who received training within the last three months. The hypothesis that large employers not only provide more work-related training, but that they are also more willing to train workers with characteristics that indicate a lower probability of obtaining a return on any investment outlay, is tested. This was confirmed (especially for male workers), along with a range of results that mostly accord with previous studies into the determinants of UK employer-based training.     

转轨经济中的掠夺之手

经济转轨中的政府可能成为掠夺之手。在我国由于长期存在的意识形态的惯性和强政府弱社会的格局以及税制改革造成了地方政府的掠夺行为。为此，如欲限制政府的掠夺行为，在长期必须以经济改革促宪政转轨，形成社会的“自生能力”；在短期必须改革税制，缩短行政代理链条。     

The signs of change in economic evolution

Neo-Schumpeterian evolutionary economics has, since the early works of Nelson and Winter, defined evolution as the change of the mean of a characteristic of a population. This paper trancends the previous paradigm and explores novel aspects of evolution in economics. Within the traditional paradigm change is provided by directional selection (and directional innovation). However, the full definition of evolutionary processes has to include two important types of selection that change the variance without necessarily changing the mean. Stabilizing selection removes any outlier and diversifying selection promotes the coexistence of behavioural variants. This paper emphasizes the need for an integrated analysis of all three types of selection. It also demonstrates that the evolutionary algebra provided by Price’s equation increases the intellectual coherence and power of thinking about selection and other aspects of evolutionary processes. Directional, stabilizing and diversifying selection are then related to fitness functions that can produce the different types of selection; and the functions are used for simple simulations of the change of the population distribution of a quantitative characteristic. Finally, the paper adds to evolutionary economics a novel way of using Price’s equation to decompose the statistics of the changes of the frequency distributions. The changes of mean, variance, skewness and kurtosis are all decomposed as the sum of a selection effect and an intra-member effect. It is especially the signs of these effects that serve to define and characterize the different types of selection. Both this result and the general analysis of the types of selection are of relevance for applied evolutionary economics.     

The choice of technology in economic development

The impact of capital accumulation on job creation is an important and interesting issue in economic development. This model provides a general-equilibrium framework for studying technology choice with unemployment in a developing economy based on micro-foundations. Unemployment in the urban sector results from the existence of efficiency wages. Manufacturing firms engage in oligopolistic competition and choose technologies to maximise profits. A more advanced technology uses more capital and less labour. In the steady state, an increase in the amount of capital induces firms to choose more advanced technologies and the wage rate increases. While a higher capital stock always induces firms to choose more advanced technologies, urban unemployment rate may decrease and agricultural sector employment may increase.     

The economic burden of common adverse events associated with metastatic colorectal cancer treatment in the United States

Aims: Adverse events (AEs) associated with treatments for metastatic colorectal cancer (mCRC) may compromise the course of treatment, impact quality-of-life, and increase healthcare resource utilization. This study assessed the direct healthcare costs of common AEs among mCRC patients in the US.

Methods: Adult mCRC patients treated with chemotherapy or targeted therapies were identified from administrative claims databases (2009–2014). Up to the first three mCRC treatment episodes per patient were considered and categorized as with or without the AE system/organ category during the episode. Total healthcare costs (2014 USD) were measured by treatment episode and reported on a monthly basis. Treatment episodes with the AE category were matched by treatment type and line of treatment to those without the AE category. Adjusted total cost differences were estimated by comparing costs during treatment episodes with vs without the AE category using multivariate regression models; p-values were estimated with bootstrap.

Results: A total of 4158 patients with ≥1 mCRC treatment episode were included (mean age?=?59 years; 58% male; 60% with liver and 14% with lung metastases; 2,261 [54%] with a second and 1,115 [27%] with a third episode). On average, two treatment episodes were observed per patient with an average length of 166 days per episode. Adjusted monthly total cost difference by AE category included hematologic ($1,480), respiratory ($1,253), endocrine/metabolic ($1,213), central nervous system (CNS; $1,136), and cardiovascular ($1,036; all p?Limitations: Claims do not include information on the cause of AEs, and potentially less severe AEs may not have been reported by the physician when billing the medical service. This study aimed to assess the association between costs and AEs and not the causation of AEs by treatment.

Conclusions: The most costly AEs among mCRC patients were hematologic, followed by respiratory, endocrine/metabolic, CNS, and cardiovascular.