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Richard F. Pollock Fabien Colaone Laura Guardiola Suki Shergill Victoria K. Brennan 《Journal of medical economics》2020,23(6):593-602
AbstractBackground and aims: A wide range of treatment options are available for hepatocellular carcinoma (HCC), including systemic treatment with tyrosine kinase inhibitors (TKIs) such as sorafenib and lenvatinib, immunotherapies, locoregional therapies such as selective internal radiation therapy (SIRT) and treatments with curative intent such as resection, radiofrequency ablation and liver transplantation. Given the substantial economic burden associated with HCC treatment, the aim of the present analysis was to establish the cost of using SIRT with SIR-Spheres yttrium-90 (Y-90) resin microspheres versus TKIs from healthcare payer perspectives in France, Italy, Spain and the United Kingdom (UK).Methods: A cost model was developed to capture the costs of initial systemic treatment with sorafenib (95%) or lenvatinib (5%) versus SIRT in patients with HCC in Barcelona Clinic Liver Cancer (BCLC) stages B and C. A nested Markov model was utilized to model transitions between progression-free survival (PFS), progression and death, in addition to transitions between subsequent treatment lines. Cost and resource use data were identified from published sources in each of the four countries.Results: Relative to TKIs, SIRT with SIR-Spheres Y-90 resin microspheres were found to be cost saving in all four country settings, with the additional costs of the microspheres and the SIRT procedure being more than offset by reductions in drug and drug administration costs, and treatment of adverse events. Across the four country settings, total cost savings with SIR-Spheres Y-90 resin microspheres fell within the range 5.4–24.9% and SIRT resulted in more patients ultimately receiving treatments with curative intent (4.6 vs. 1.4% of eligible patients).Conclusion: SIR-Spheres Y-90 resin microspheres resulted in cost savings relative to TKIs in the treatment of unresectable HCC in all four country settings, while increasing the proportion of patients who become eligible for treatments with curative intent. 相似文献
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Laura Levi 《Decisions in Economics and Finance》1995,18(1):33-45
In questa nota si estendono alcuni precedenti risultati dovuti a Beccacece-Castagnoli [1]–[2] e Levi [7], sulla dominanza temporale, stocastica e stocastico-temporale tra flussi finanziari, certi o aleatori, nel caso discreto e finito. Largo spazio viene anche dato ad esempi critici e controesempi.
Ricerca parzialmente finanziata dal M.U.R.S.T. e dall'Università Bocconi. 相似文献
Summary This paper extends previous results by Beccacece-Castagnoli [1]–[2] and Levi [7] on time dominance, stochastic dominance, time-stochastic dominance for discrete, finite, deterministic or stochastic, cashflows. Last sections are devoted to critical examples and counterexamples.
Ricerca parzialmente finanziata dal M.U.R.S.T. e dall'Università Bocconi. 相似文献
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Cognitive function is an important predictor of mortality in the elderly. Over the past few years, an increasing number of life insurance companies have incorporated screening for cognitive impairment into the underwriting process at older ages. Many different test instruments provide a measurement of cognitive function. Among these, the 10 word delayed word recall test (DWR) offers the best opportunity to study mortality directly, because of a long history of use in long-term care risk assessment. This article revises and extends a previous report published in the Journal in 2006 looking at the relationship between DWR score and mortality. 相似文献
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Patricia H. Werhane Laura P. Hartman Dennis Moberg Elaine Englehardt Michael Pritchard Bidhan Parmar 《Journal of Business Ethics》2011,100(1):103-118
There are important synergies for the next generation of ethical leaders based on the alignment of modified or adjusted mental models. This entails a synergistic application of moral imagination through collaborative input and critique, rather than “me too” obedience. In this article, we will analyze the Milgram results using frameworks relating to mental models (Werhane et al., Profitable partnerships for poverty alleviation, 2009), as well as work by Moberg on “ethics blind spots” (Organizational Studies 27(3):413–428, 2006), and by Bazerman and Chugh on “bounded awareness” (Harvard Business Review, 2006; Mind &; Society 6:1–18, 2007) Using these constructs to examine the Milgram experiment, we will argue that the ways in which the experiments are framed, the presence of an authority figure, the appeal to the authority of science, and the situation in which the naïve participant finds herself or himself, all create a bounded awareness, a narrow blind spot that encourages a climate for obedience, brackets out the opportunity to ask the moral question: “Am I hurting another fellow human being?” and may preclude the subject from utilizing moral imagination to opt out of the experiment. We will conclude that these forms of almost blind obedience to authority are correctable, but with difficulty. We will argue that linking the modification of mental models to an unbinding of awareness represents an important synergistic relationship and one that can build effectively on the lessons learned from our experience with moral imagination. 相似文献
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This article takes a fresh look at employee selection interviews as they are practiced in most organizations. Interviewers' selection decisions are demonstrated to be idiosyncratic and it is concluded that variation in interviewers' decision processes jeopardizes organizational effectiveness. Practical recommendations for improving employment interviews are offered. © 1996 by John Wiley & Sons, Inc. 相似文献
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Quality & Quantity - The purpose of the paper is the study of tourism competitiveness and its determinants for the almost 8000 Italian municipalities. The partial least squares method... 相似文献