STRATEGIC INVESTMENT DECISION-MAKING: COMPLEXITIES, POLITICS AND PROCESSES*

This article is a preliminary report on an investigation into the processes of investment decision-making. Three case studies from three firms are presented which show disparities in a number of aspects of process, for example, the length of time taken to arrive at a decision, the number and intensity of disagreements and uncertainties encountered. Data were collected for these cases through semi-structured interviewing from multiple informants in the three organizations, thereby permitting the use of analysis of variance techniques of the different perspectives given by informants. Perceptions of the effectiveness of the decisions were also gathered. One finding from the study is that the decisions with the lowest perceived effectiveness (in firm HE) also lost support from those involved in making the decision during the process, although the decision was eventually implemented. This decision also had the least agreement amongst informants as to the main sources of disagreements. Informants of all three decisions saw effect upon product quality and productivity, fit with business strategy and competitive position of the company as the most important factors to take into account in evaluating the decisions. In firm CG, however, there were disagreements as to how the investment should be evaluated. In the conclusions to the article a disucssion is given as to the nature of evaluation procedures in relation to the developing theory of information systems.     

Conceptualising the dynamics of employee information and consultation: evidence from the Republic of Ireland

The debate concerning the emerging regulatory environment for employee voice continues apace, in particular the requirements to inform and consult employees as a result of the European Employee Information and Consultation Directive. This article examines the processes used to inform and consult employees across 15 case studies in the Republic of Ireland. It evaluates different voice arrangements using a conceptual framework that seeks to capture the dynamics of different employee voice schemes across union and non‐union companies. The findings suggest that participation is more robust when the channels for information and consultation accommodate both conflictual and cooperative processes. It is shown that robust forms of participation are more likely through processes that facilitate independent representation. The evidence also shows that some employers may devise their own counterbalancing forms of (pseudo) consultation, in an attempt to minimise the impact of regulatory rights for employee voice.     

The association between the severity of chronic kidney disease and medical costs among patients with type 2 diabetes

Aims: Examine healthcare costs across chronic kidney disease (CKD) stages for US patients with type 2 diabetes (T2D).

Materials and methods: IQVIA Real World Data Adjudicated Claims linked electronic medical records and insurance claims from January 1, 2012 through March 31, 2017 were used for this retrospective study. Adults diagnosed with T2D and comorbid CKD were included. General linear models incorporating splines were constructed, and information from these regressions were used to inform the relationship between medical costs and CKD. Multivariable analyses controlled for patient characteristics, vital signs, general health, prior medication use, prior visit to specialists, index A1c, and year of index date.

Results: There were 6,645 individuals who met the study criteria. Results generally indicate sharp increases in annual total medical costs and non-drug medical costs in the 1?year post-period for patients with Stage 4 or 5 CKD (estimated glomerular filtration rate [eGFR]?≤?30?mL/min/1.73 m²) with each 1 point reduction in eGFR from 30 associated with an increase of $1,870 in all-cause total medical costs (p?<?0.0001) and $1,805 of all-cause non-drug medical costs (p?<?0.0001). Similarly, each point decline below 30?mL/min was associated annual cost increases of $1,701 for CKD-related total medical costs, $1,695 for CKD-related non-drug medical costs, $173 for diabetes-related medical costs, and $187 for diabetes-related non-drug medical costs (all p?<?0.0001).

Limitations: The investigation included only patients with medical insurance and laboratory test results, and results may not be generalizable to all T2D patients with CKD. The methodology allowed us to determine associations, not causation, and potential confounders, such as duration of diabetes, diet, exercise, or social support, could not be assessed.

Conclusions: Results indicate there are sharp and significant increases in medical costs among T2D patients with Stage 4 and 5 CKD compared to those with earlier stages of CKD.     

Unleashing the Power of Networks: Shareholder Activism,Sustainable Development and Corporate Environmental Policy

In recent years, a new trend has emerged in which shareholder activists have formed networks to empower shareholders and magnify shareholder voices. This study explores the structural patterns and effectiveness of shareholder activism networks and shows how those networks affect corporate sustainability policies. We draw upon stakeholder influence theory, stakeholder network management theory and recent studies on activism networks to examine a shareholder activism network formed around environmental issues. The study found that (1) the structure of shareholder activist networks is largely driven by organizational attributes such as organization type, organizations’ human resources, media visibility and history; and (2) activist organizations with high centralities and eigenvector centralities enjoy more efficient results. This study contributes to our understanding of the business responses to shareholder demands on improving environmental performance and paves the way for future research on sustainable development through partnerships with shareholder networks. Copyright © 2017 John Wiley & Sons, Ltd and ERP Environment     

A review of Personalist Economics

The recent focus on sustainability as guiding principle for economic activity has generated many (often conflicting) definitions of sustainable economic development. Yet while the terminology may be new, the discussion is not. It parallels the discussion about biases of economic valuation concepts that have led to the neglect of the domestic and subsistence contributions relegated to the "informal" or household sector. This paper argues that the narrow definition of economic theory, methodology, and valuation concepts has led to the detrimental neglect of sustaining functions without which economic activity is impaired. To move toward sustainability it is imperative to regain a broader understanding of economics. Three principles are identified as essential for this conceptual expansion of economics. They are: concreteness rather than abstraction, connectedness rather than isolation, and diversity rather than homogeneity. All three are informed by feminist theory. Thus it is argued that the voices of women who have gone largely unheard in economics are essential to reconceptualizing economics as sustainable.     

Annual patient and caregiver burden of oncology clinic visits for granulocyte-colony stimulating factor therapy in the US

Objective:

Prophylactic treatment with granulocyte-colony stimulating factors (G-CSFs) is indicated for chemotherapy patients with a significant risk of febrile neutropenia. This study estimates the annual economic burden on patients and caregivers of clinic visits for prophylactic G-CSF injections in the US.

Methods:

Annual clinic visits for prophylactic G-CSF injections (all cancers) were estimated from national cancer incidence, chemotherapy treatment and G-CSF utilization data, and G-CSF sales and pricing information. Patient travel times, plus time spent in the clinic, were estimated from patient survey responses collected during a large prospective cohort study (the Prospective Study of the Relationship between Chemotherapy Dose Intensity and Mortality in Early-Stage (I–III) Breast Cancer Patients). Economic models were created to estimate travel costs, patient co-pays and the economic value of time spent by patients and caregivers in G-CSF clinic visits.

Results:

Estimated total clinic visits for prophylactic G-CSF injections in the US were 1.713 million for 2015. Mean (SD) travel time per visit was 62 (50) min; mean (SD) time in the clinic was 41 (68) min. Total annual time for travel to and from the clinic, plus time at the clinic, is estimated at 4.9 million hours, with patient and caregiver time valued at $91.8 million ($228 per patient). The estimated cumulative annual travel distance for G-CSF visits is 60.2 million miles, with a total transportation cost of $28.9 million ($72 per patient). Estimated patient co-pays were $61.1 million, ～$36 per visit, $152 per patient. The total yearly economic impact on patients and caregivers is $182 million, ～$450 per patient.

Limitations:

Data to support model parameters were limited. Study estimates are sensitive to the assumptions used.

Conclusions:

The burden of clinic visits for G-CSF therapy is a significant addition to the total economic burden borne by cancer patients and their families.     

Firms navigating through innovation spaces: a conceptualization of how firms search and perceive technological,market and productive opportunities globally

The main contribution of this paper is a theory-based conceptual framework of innovation spaces, and how firms must navigate through them to innovate. The concept of innovation systems - at the regional, sectoral and national levels - have been highly influential. Previous literature developing the concept of innovation systems has stressed the importance of institutions, networks and knowledge bases at the regional, sectoral and national levels. This paper primarily draws upon an evolutionary and Schumpeterian economics perspective, in the following three senses. The conceptualization of 'innnovation spaces' focuses upon how and why firm search for innovations is influenced the opportunities within certain geographical contexts. This means that the firm create opportunities and can span different context, but they are influence by the context in term of the access, flow and co-evolution of ideas, resources, technology, people and knowledge, which help stimulate business innovation in terms of products, process and services. The paper concludes with an agenda for future research and especially the need to focus on globalization as a process of intensifying linkages across the globe.     

Relating business model innovations and innovation cascades: the case of biotechnology

This article conceptualizes innovation as a process, where the scientific and industrial application of technological knowledge nurtures new routines and institutions, in order to relate changing business model innovations to innovation cascades. Innovation in science-based, high-tech sectors is changing its tempo, from the evolutionary pace of incremental novelties punctuated by occasional radical novelties, to innovation cascades. These cascades involve a long series of interlinked radical innovations, which can be traced through various scientific and technological indicators like patents and publications. Innovation cascades are relevant to industry, because they make the future less predictable. They are particularly interesting because these changes also enable the testing an abundance of new business models. Innovation cascades have a major impact on the number and sustainability of business models and on strategy. Business model innovations are visible not only in the existing organizations that undergo change, but also new organizational models appear. The case of biotechnology after the 1980s is used to illustrate our conceptualization.     

Rational expectations for large CGE models: A practical algorithm and a policy application

We describe a simple iterative method for solving large dynamic CGE models under rational expectations. Details are given for Australia's MONASH model but the approach applies to a wide range of CGE models. The method is automated in the RunMONASH Windows software, putting CGE modelling under rational expectations within the reach of non-specialist modellers. We provide an illustrative application in which MONASH results under rational expectations are compared with results under static expectations. The application and supporting software can be downloaded. Results from the application are interpreted in terms of elementary economic mechanisms.