Cost-effectiveness analysis of secukinumab in ankylosing spondylitis from the Canadian perspective

Aim: To assess the cost-effectiveness of interleukin (IL)-17A inhibitor secukinumab vs the currently licensed biologic therapies in ankylosing spondylitis (AS) patients from a Canadian healthcare system perspective.

Methods: A decision analytic model (semi-Markov) evaluated the cost-effectiveness of secukinumab 150?mg compared to certolizumab pegol, adalimumab, golimumab, etanercept and etanercept biosimilar, and infliximab and infliximab biosimilar in a biologic-naïve population, over 60 years of time horizon (lifetime). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI 50) response rate was used to assess treatment response at week 12. Non-responders or patients discontinuing initial-line of biologic therapy were allowed to switch to subsequent-line biologics. Model input parameters (short-term and long-term changes in BASDAI and Bath Ankylosing Spondylitis Functional Index [BASFI], withdrawal rates, adverse events, costs, resource use, utilities, and disutilities) were obtained from clinical trials, published literature, and other Canadian sources. Benefits were expressed as quality-adjusted life years (QALYs). Cost and benefits were discounted with an annual discount rate of 1.5% for all treatments.

Results: In the biologic-naïve population, secukinumab 150?mg dominated all comparators, as patients treated with secukinumab 150?mg achieved the highest QALYs (16.46) at the lowest cost (CAD 533,010) over a lifetime horizon vs comparators. In the deterministic sensitivity analysis, results were most sensitive to changes in baseline BASFI non-responders, BASDAI 50 at 3 months and discount rates. Probabilistic sensitivity analysis showed that secukinumab 150?mg demonstrated higher probability of achieving maximum net monetary benefit vs all comparators at various cost thresholds.

Conclusions: This analysis demonstrates that secukinumab 150?mg is the most cost-effective treatment option for biologic-naïve AS patients compared to certolizumab pegol, adalimumab, golimumab, etanercept and etanercept biosimilar, and infliximab and infliximab biosimilar for a lifetime horizon in Canada. Treatment with secukinumab translates into substantial benefits for patients and the healthcare system.     

Investment decisions in the wireless industry applying real options

The wireless industry is one of the most capital intensive high-technology industries. This paper applies real options techniques to estimate investments under uncertainty in two new ventures: (a) deferral of the expansion from 2.5G to 3G networks; and (b) expansion of a 2.5G network using Wi-Fi as an alternative technology. The cases are examined and analyzed both qualitatively and quantitatively, using realistic assumptions and parameters. Investment cost, number of subscribers, pricing of services, and risk are at the core of investment decision processing. In both cases, sensitivity analysis of the value of the (real) option considering the above key parameters was conducted, to extrapolate useful findings that should be taken into consideration by the decision makers in wireless companies.     

Decision delegation: A conceptualization and empirical investigation

This paper examines a purchase context in which consumers, instead of deciding on their own, delegate either a part of or the entire purchase decision to a surrogate. A path model linking the antecedent variables and delegation is tested in the context of personal computer purchases. It was found that the factors that ensure decision quality emanating from the surrogate's expertise differentials, trustworthiness, accountability, and willingness to customize increase the likelihood of decision delegation. In addition to its direct positive effect on delegation, trustworthiness mediates the effect of expertise difference, surrogate accountability, and customization on delegation. Perceived loss of control inhibits delegation, but only at the stage when the final choice decision is made. Also, if a decision task is repeatable, the high return on effort has a negative effect on delegation, but only at attribute set and choice set delegations. Contributions of the study and directions for future research are discussed. © 2008 Wiley Periodicals, Inc.     

Asymmetric competition in retail store formats: Evaluating inter- and intra-format spatial effects

Our study aims to analyze the role of store format in retail competitive interactions, specifically, the relationship between growth, location strategy, and market response. To assess this relationship, we propose an extension of the classic models of spatial interaction, which incorporate the asymmetric competitive effects linked to the concept of store format. An empirical application allows us to confirm greater spatial rivalry within store formats (intra-format) than between store formats (inter-format). This implies a certain hierarchical organization when consumers select a retail store, first choosing the type of store at which they will shop and later a particular store within this format. The results are important for retailers who want to configure an optimal network of store locations as well as public administrators who must regulate commercial activity.     

The impact of collinearity on regression analysis: the asymmetric effect of negative and positive correlations

The purpose of this paper is to ascertain how collinearity in general, and the sign of correlations in specific, affect parameter inference, variable omission bias, and their diagnostic indices in regression. It is found that collinearity can reduce parameter variance estimates and that positive and negative correlation structures have an asymmetric effect on variable omission bias. It is also shown that the effects of collinearity are moderated by the relationship between the dependent variable and the regressors, a consideration not incorporated into most commonly used collinearity diagnostics. The formulae derived enable researchers to assess the sensitivity of regression results to the underlying correlation structure in the data.     

Mediating role of trust in the impact of perceived empathy and customer orientation on intention to continue relationship in Indian banks

Journal of Financial Services Marketing - Despite the relevance of empathy in banking services, very few studies in literature have investigated the multidimensional nature of both cognitive and...     

On the measurement of corporate diversification strategy: Evidence from large U.S. service firms

Actual, not potential, relatedness determines the results of diversification strategies. An external examination of a firm's businesses, products, markets and technologies permits an assessment of potential relatedness among its various businesses. Potential relatedness is, however, often not realized. Also, relatedness may be externally invisible. Hence, actual relatedness may diverge from externally measured potential relatedness. This paper provides evidence suggesting that measures of corporate diversification strategy based on internal data differ significantly from those based on externally available data.     

The future of technology and marketing: a multidisciplinary perspective

Journal of the Academy of Marketing Science -     

Quantity restrictions and endogenous quality choice

In a vertical product differentiation model under Cournot competition both foreign and domestic firms respond by lowering their investment in long-run quality for a quantity restriction at, and in the neighborhood of, the free trade import level. Average quality increases only when the low-quality foreign firm faces a substantially restrictive quota/voluntary export restraint. The change in quality depends on whether the foreign firm is of high or low quality and upon the restrictiveness of the quota. The imposition of quantity restrictions has important strategic effects on the long-run choice of quality.