A comparative review of the pharmacoeconomic guidelines in South Africa

Objective: To compare the pharmacoeconomic guidelines in South Africa (SA) with other middle- and high-income countries.

Methods: A comparative review of key features of the pharmacoeconomic guidelines in SA was undertaken using the Comparative Table of Pharmacoeconomic Guidelines developed by the International Society of Pharmacoeconomics and Outcomes Research, and published country-level pharmacoeconomics guidelines. A random sample of guidelines in high- and middle-income countries were analyzed if data on all key features were available. Key features of the pharmacoeconomic guidelines in SA were compared with those in other countries, and divergent features were identified and elaborated.

Results: Five upper middle-income countries (Brazil, Colombia, Cuba, Malaysia, and Mexico), one lower middle-income country (Egypt), and six high-income countries (Germany, Ireland, Norway, Portugal, Taiwan, and the Netherlands) were analyzed. The pharmacoeconomic guidelines in SA differ in important areas when compared with other countries. In SA, the study perspective and costs are limited to private health-insurance companies, complex modelling is discouraged and models require pre-approval, equity issues are not explicitly stated, a budget impact analysis is not required, and pharmacoeconomic submissions are voluntary.

Conclusions: Future updates to the pharmacoeconomic guidelines in SA may include a societal perspective with limitations, incentivize complex and transparent models, and integrate equity issues. The pharmacoeconomic guidelines could be improved by addressing conflicting objectives with policies on National Health Insurance, incentivize private health insurance companies to disclose reimbursement data, and require the inclusion of a budget impact analysis in all pharmacoeconomic submissions. Further research is also needed on the impact of mandatory pharmacoeconomic submissions in middle-income countries.     

The role of international reserves holding in buffering external shocks

An extended literature analyses the accumulation foreign exchange holding observed in many developing and emerging countries since the 2000s. Empirical studies on the self-insurance motive suggest that high-reserves economies are more resilient to financial crises and to international capital inflows volatility. They show also that pre-crisis foreign reserve accumulation explains post-crisis growth. However, some papers suggest that the relationship between international reserves holding and reduced vulnerability is nonlinear, meaning that reserve holding is subject to diminishing returns. This article devotes more attention to the potential nonlinear relationship between the foreign reserves holding and macroeconomic resilience to shocks. For a sample of nine emerging economies, we assess to what extent the accumulation of international reserves allows to mitigate negative impacts of external shocks on the output gap. While a major part of the literature focuses on the global financial crisis, we investigate this question by considering two sub-periods: 1995–2003 and 2004–2013. We implement threshold VAR model in which the structure is allow to change if the threshold variable crosses a certain estimated threshold. We find that the effectiveness of reserve holding to improve the resilience of domestic economies to shocks has increased over time. Hence, the diminishing returns of foreign reserve holding stressed in the previous literature must be qualified.     

Oil shocks and stock volatility: new evidence via a Bayesian,graph-based VAR approach

ABSTRACT

This article examines the temporal dependence between three oil shocks and realized volatility in the stock markets of G20 countries between 1994 and 2019. By applying a novel, graphical, Bayesian VAR (BGVAR) model, we calculate unidirectional linkages of oil and stock volatility with a full and segmented sample. The results suggest an overall causality from stock volatility to oil shocks. For certain short, specific periods, the causal direction reverses. Depending on the country and the source of an oil shock, the magnitude and type of the effect can vary considerably. Specific oil-market shocks occur most often in our full sample. In a time-varying structure, oil supply shocks’ impact on stock volatility is more prominent, and net oil-importing countries’ responses to these shocks are greater than for oil-exporting countries. In addition, we find that relationship dynamics can capture market information, such as global economic growth during the 2008–2009 financial crisis.     

The social cost of foreign exchange reserves

Abstract

There has been a very rapid rise since the early 1990s in foreign reserves held by developing countries. These reserves have climbed to almost 30% of developing countries' GDP and 8 months of imports. Assuming reasonable spreads between the yield on reserve assets and the cost of foreign borrowing, the income loss to these countries amounts to close to 1% of GDP. Conditional on existing levels of short-term foreign borrowing, this does not seem too steep a price as an insurance premium against financial crises. But why developing countries have not tried harder to reduce short-term foreign liabilities in order to achieve the same level of liquidity (thereby paying a smaller cost in terms of reserve accumulation) remains an important puzzle.     

Optimal versus adequate level of international reserves: evidence for Turkey

The determination of international reserve balance for emerging economies is part of the efforts to strengthen the immunity of these economies to crises. However, there is still evidence on crises even for the countries with large foreign reserves. It has usually been experienced that the countries with greatest need for reserves economize more than others on their holdings since they might underestimate the cost of crisis. In this study, the official international reserves of Turkey are tested against optimality and adequacy. During 1988–2002, the actual reserves fell short of both the optimal and the adequate levels. They are only optimal when the expected cumulative contraction is about 5.2% of real GDP under crisis. However, early evidence from emerging economies and Turkey show that crises hit more heavily. Hence, it is found that the current financial structure in Turkey such as the absence of capital controls and a highly dollarized banking system necessitates more foreign reserves for preventing any future economic and/or financial shocks.     

The fiscal implications of hurricane strikes in the Caribbean

This paper empirically traces the fiscal impacts of hurricane strikes. To this end, a hurricane damage index is derived from a physical wind field model for a panel of Caribbean countries over 36 years. Results, based on panel VAR and impulse response functions analysis, show that, overall, hurricane strikes exert a short-term impact. Indeed, the study finds that the response of government spending is positive and significant while public investment, debt and tax revenue do not appear to respond (significantly) to hurricane strikes. Moreover, the study finds that Governments respond to hurricane strikes by engaging in short term deficit financing.     

A (nearly) global look at the dynamics of youth smoking initiation and cessation: the role of cigarette prices

This study investigates the role of cigarette prices on smoking initiation and cessation among youth in a sample of eight primarily non-Western low, middle, and high income countries, with a particular focus on a subsample of 40 low- and middle-income countries (LMICs). Using split-population duration models on longitudinally-transformed individual data from the Global Youth Tobacco Survey (GYTS), the average impact of cigarette prices in the presence of unobserved country heterogeneity and shifting cultural norms within countries is identified by the variation of cigarette prices within countries over time. Price increases are found to effectively reduce initiation in early youth, and girls are considerably more responsive than boys. The price elasticity of initiation in LMICs is ?0.82 for the combined gender analysis, ?0.46 for boys only and ?1.5 for girls only. There is some indication that youths in developing countries may be slightly less responsive to price changes than in high-income countries. No evidence is found that cigarette prices increase quitting rates in youth, which may be due to the difficulty of defining true quitting among smokers in early life.     

Volatility transmission between stock and foreign exchange markets: a connectedness analysis

ABSTRACT

This paper empirically investigates volatility transmission among stock and foreign exchange markets in seven major world economies during the period July 1988 to May 2018. To this end, we first perform a static and dynamic analysis to measure the total volatility connectedness in the entire period (the system-wide approach). Second, we make use of a dynamic analysis to evaluate the net directional connectedness for each market. To gain further insights, we examine the time-varying behaviour of net pair-wise directional connectedness during the financial turmoil periods experienced in the sample period Our results suggest that slightly more than half of the total variance of the forecast errors is explained by shocks across markets rather than by idiosyncratic shocks. Furthermore, we find that volatility connectedness varies over time, with a surge during periods of increasing economic and financial instability.     

International Reserves and the Composition of Foreign Equity Investment

This paper studies the effect of central banks' international reserve hoardings on the composition of foreign equity investment. Specifically, it examines whether reserves affect the share of foreign portfolio equity investment (PEI) in total foreign equity investment, which includes both PEI and foreign direct investment (FDI). Foreign investors' decisions regarding the location and the type of equity capital investment might be influenced by a country's level of international reserves. In a simple theoretical model, it is shown that higher reserves, thanks to their ability to lower exchange rate risk, reduce the risk premium of PEI. Hence, higher reserves are expected to increase the inflow of PEI relative to FDI. This hypothesis is tested for a sample of 76 developing countries during the period 1980–2010 using different estimation methods, model specifications and data samples. The results suggest that higher levels of reserves are associated with a larger share of PEI relative to FDI. This result points to a collateral benefit of reserves that has been neglected so far. Reserves may contribute to develop domestic financial markets and facilitate domestic firms' access to foreign portfolio equity financing. In addition, this paper finds a strong negative effect of the global financial crisis beginning in 2008 on the share of PEI, which confirms the hypothesis that PEI is more crisis‐dependent than FDI.     

Trade liberalization,financial modernization and economic development: An empirical study of selected Asia–Pacific countries

This study investigates the relationship between trade liberalization, financial modernization and economic development for 14 countries in the Asia and Pacific region over the period spanning from 1961 to 2011. The study uses panel data as they have many advantages over cross-sectional or time series data. In addition to analyzing the full panel, we also divide the 14 countries under study into two sub-samples: high-income countries and middle-income countries, based on World Bank's income classification as of 1st July 2013. The panel cointegration tests show a long run relationship between the above variables. The study uses Feasible Generalized Least Squares (FGLS) method to estimate the models and then conducts Granger causality tests to identify patterns of causation among the variables of interest. In general, the results indicate unidirectional causality (1) from financial modernization to economic development for the entire panel and the panel of middle-income countries; (2) from trade liberalization to economic development for the whole panel as well as two subpanels of high-income and middle-income countries; and (3) from trade liberalization to financial modernization for the whole panel as well as two subpanels. The findings of this study support that the actual effect of financial depth on economic development (and vice versa) seems to depend on the level of financial development.     

The monetary autonomy of Finland: What can the time series analysis tell us?

The effectiveness of domestic monetary policy under fixed exchange rates is highly dependent on the response of the foreign exchange reserves to a monetary expansion or contraction. Domestic monetary conditions, in turn, can be expected to be subject to shocks emerging from changes in reserves. These shocks can badly harm stabilization objectives if they are not neutralized. This paper analyzes the monetary autonomy of the Finnish economy during the 1970's and early 1980's using a data-oriented approach suggested byGeweke. A purely empiristic interpretation of the results would indicate that the degree of monetary autonomy is high and increasing over time. However, incorporating theoretical considerations turns this conclusion upside down. The Finnish financial system has in all likelihood experienced structural changes that have reduced the potential for effective monetary policies. On the other hand, we do not find any evidence of strong effects of reserve shocks on the domestic money and credit markets, though the importance of such shocks may have increased slightly. Methodologically, the analysis highlights that economic theory is needed in organizing empirical observations even when the point of departure is data-oriented.     

The economic growth impact of natural disasters in developing countries: Evidence from hurricane strikes in the Central American and Caribbean regions

In this paper we investigate the macroeconomic impact of natural disasters in developing countries by examining hurricane strikes in the Central American and Caribbean regions. Our innovation in this regard is to employ a wind field model on hurricane track data to arrive at a more scientifically based index of potential local destruction. This index allows us to identify damages at a detailed geographical level, compare hurricanes' destructiveness, as well as identify the countries that are most affected, without having to rely on potentially questionable monetary loss estimates. Combining our destruction index with macroeconomic data we show that the average hurricane strike caused output to fall by at least 0.83 percentage points in the region, although this depends on controlling for local economic characteristics of the country affected and what time of the year the storm strikes.     

On the Causality between Trade Credits and Imports: Evidence and Possible Implication for Trade Penalties on Debt Defaults

Abstract

This study investigates the association between trade credits and imports of developing countries. Made available by its creditors, the main function of trade credits is to facilitate cross-border transactions of goods and services. This study finds that the reliance of imports on trade credits varies across regions and income: towards the end of the 1990s, the trade credits to imports ratio ranged from 0.20 for East Asia & the Pacific to 0.87 for Africa, and from 0.24 for high-income countries to 0.79 for low-income countries. Applying panel and cross-country estimation, we find that past trade credits help predict current imports, but past imports do not alter the future path of trade credits. Further, the positive association between trade credits and imports is larger for countries more dependent upon trade credits. The findings support the notion that countries make debt repayments to avoid any potential disruption on the line of trade credits. We also find that the trade credits penalty could materialize within less than two quarters.     

Risk sharing role of foreign aid in developing countries

The effects of foreign aid on economic growth have been extensively investigated over the past 40 years. However, even though foreign aid can be a significant source of insurance against domestic output shocks for developing countries, its risk-sharing role has not been well explored. Using a sample of 22 developing countries over the period 2003–2013, we estimate the degree of income smoothing generated by foreign aid serving as an effective channel of international income smoothing. In particular, for the period 2003–2008, we estimate that foreign aid offset about 4% of the domestic output shocks. Furthermore, we investigate the determinants of the extent of risk sharing via foreign aid, recognizing the diversification of the originating countries as a key factor. Surprisingly, humanitarian aid seems to have a negative effect, which might be explained by its predominant role in the short run.     

Global banking,global crises? The role of the bank balance-sheet channel for the transmission of financial crises

We examine whether shocks to leveraged creditors with cross border holdings have an incidence on debtor countries׳ risk of suffering financial turmoil. We construct a new proxy of shocks to international banks׳ balance-sheets using credit ratings and the structure of their international assets. This allows us investigating the effect of (foreign) bank balance-sheet shocks on domestic financial turmoil in a large sample of 146 developed and emerging economies from 1984 to 2011. Our proxies of shocks towards bank balance-sheets are strong predictors of systemic banking crises in their debtor countries. Confirming these results, bilateral bank flows significantly decrease when creditor banks׳ assets are hit by negative shocks, as measured by credit rating downgrades from third-party countries. Short-term liabilities towards global banks appear to increase roll-over and funding risks, thereby amplifying the impact of shocks to foreign lenders’ balance-sheets. Domestic banking sectors vulnerabilities, such as illiquid assets and a low deposit-asset ratio, are found to increase crisis contagion risk. In contrast, a high level of global liquidity attenuates the transmission of shocks to international banks׳ assets to debtor countries.     

Spillovers to low-income countries: importance of systemic emerging markets

This article documents the expanding economic linkages between low-income countries (LICs) and a narrow group of ‘Emerging Market (EM) leaders’ that have become major players in international trade and financial flows. VAR models show that these linkages have increased the share of growth volatility that can be attributed to foreign shocks in LICs. Dynamic panel models further analyse the impact of LIC trade orientation and production structure on the sensitivity to foreign shocks. The empirical results demonstrate that the elasticity of growth to trading partners’ growth is high for LICs in three out of the five regions: Asia, Latin America and the Caribbean, and Europe and Central Asia. However, for commodity-exporting LICs in Sub-Saharan Africa and the Middle East, terms of trade shocks and demand from the EM leaders are the main channels of transmission of foreign shocks     

Threshold effects in the patent-growth relationship: a PSTR approach for 60 developed and developing countries

ABSTRACT

This study analyzes whether there is a threshold effect in the innovation-growth relationship. Using data from the period 2008–2017, we perform an analysis using 60 countries in the whole sample and a split-sample analysis in which we separate developed countries (36) from developing countries (24). The results for the panel smooth transition regression (PSTR) model indicate that there is a threshold effect in the innovation-growth relationship. We find that below the threshold, the effect of innovation measured by the number of patents is not significant for developed and developing countries. However, surpassing the optimal threshold, the effect becomes positive only for the whole sample and developed countries. Furthermore, findings also indicate that research and development expenditure, domestic and foreign investments stimulate economic growth.     

PRICE DYNAMICS,FOREIGN EXCHANGE AND ANTICIPATED SHOCKS IN A TOURISM ECONOMY

Using a dynamic model of an open monetary economy, this paper examines the effects of tourism‐related anticipated shocks on goods prices and foreign exchange reserves. Foreign tourists consume mainly non‐traded goods in holiday destinations, converting them into exportable goods. This gives rise to a tourism terms‐of‐trade effect that affects the accumulation of foreign exchange. Announcements of anticipated events bring tourist visits forward, resulting in an initial under‐adjustment or an over‐adjustment in the prices of the non‐traded goods when the tourism terms‐of‐trade effect is positive or negative. This leads to an increase or a decrease in foreign reserves in the long run.     

Kalman filter approach to estimate the demand for international reserves

A few studies have provided empirical support for the fact that the demand for international reserves experienced structural instability in 1973 and 1979 due to a change in exchange rate system and oil price shocks. Thus, under the current managed float due to exchange rate and oil price fluctuations, coefficient estimates could be time dependent. After showing that indeed, estimated coefficients are time dependent, the Kalman filter estimation method is employed and the reserve demand function for 19 industrial countries estimated. The Kalman filter approach incorporates the time-varying properties of coefficients estimates.