Real-world healthcare resource utilization related to migraine treatment failure: a panel-based chart review in France,Germany, Italy,and Spain

Abstract

Aims: This retrospective chart review examined the six-month migraine-related healthcare resource use (HRU) among European patients who had ≥4 migraine days per month and previously failed at least two prophylactic migraine treatments.

Methods: Neurologists, headache specialists, and pain specialists in France, Germany, Italy, and Spain who treated ≥10 patients with migraine in 2017 were recruited (April–June 2018) to extract anonymized patient-level data. Eligible physicians randomly selected charts of up to five adult patients with clinically-confirmed migraine, ≥4 migraine days in the month prior to the index date, and had previously failed at least two prophylactic migraine treatments. Treatment failure was defined as discontinuation due to lack of efficacy and/or tolerability. Demographic and disease characteristics as of the index date, and migraine-related HRU incurred during the 6-month study period, were recorded.

Results: A total of 104 physicians contributed 168 charts for patients (63% female). On average, patients were 38?years old and failed 2.3 prophylactic treatments as of the index date. During the study period, 83% of patients had ≥1 outpatient visit for migraine in the physician’s office, and 27% went to the ER/A&E. Approximately 5% of patients were hospitalized for migraine, with an average of one hospitalization and an average length of stay of 3 days. Approximately 39% of patients had ≥1 blood test, 22% had ≥1 magnetic resonance imaging, 17% had ≥1 electroencephalogram, and 13% had ≥1 computerized tomography scan. Visits to other healthcare providers were common.

Limitations: This study is subject to the limitations of chart review studies, such as errors in data entry.

Conclusions: Across four European countries, the HRU burden of migraine among patients who previously failed at least two prophylactic treatments was high, indicating a need for more effective prophylactic treatments to appropriately manage migraine and reduce the HRU burden attributable to this common disorder.     

Regulating a Monopolist with Unknown Demand: Costly Public Funds and the Value of Private Information

In this paper, we analyze the optimal regulation policy when the regulated firm has better information concerning the market demand than the regulator. We show that introducing a cost on public funds into the Planner's objective function does not lead to qualitative results similar to those obtained by introducing distributional considerations. In particular we show that under constant marginal cost the full information policy is not implementable and that the optimal regulatory policy results in informational rents. The social value of private information and the firm's informational rents are both increasing functions of the cost of the public funds.     

Does Shareholder Composition Matter? Evidence from the Market Reaction to Corporate Earnings Announcements

We examine whether institutional ownership composition is related to parameters of the market reaction to negative earnings announcements. When firms report earnings below analysts' expectations, the stock price response is more negative for firms with higher levels of ownership by momentum or aggressive growth investors. There is no evidence, however, that these institutions cause an “overreaction” to earnings news. Ownership structure is also related to trading volume and to stock price volatility on days around earnings announcements. Our findings are consistent with the idea that the composition of institutional shareholders effects stock price behavior around the release of corporate information.     

Measuring and forecasting retail trade in real time using card transactional data

We build big data retail trade indicators for Spain using high-dimensional card transaction data from one of the country’s biggest banks. The resulting indicators replicate the dynamics of the Spanish retail trade indices (RTI), regional RTIs (Spain’s autonomous regions), and RTI by retailer type (distribution classes) released by the Spanish National Statistics Institute. The new indicators not only have a higher frequency (daily data) and higher geographical and sectorial breakdown but are also shown to improve nowcasting and forecasting power for the official RTI, making them key variables to monitor consumption.     

Tourism employment during economic transition

This study examines labor mobility into tourism employment during economic transition. Working from the proposition that the industry serves as a refuge, it discusses the inward mobility patterns from other economic sectors, assesses the impact of the change, and measures the motivations for taking up such occupations. The study found that workers came from an unusually wide range of industries, which supports the idea of upheaval in the labor market. While there is little indication it is causing widespread personal suffering, evidence for the “refuge” role of tourism was found. Employment in this industry emerges as being attractive and accessible for people with various stock of human capital.     

Insight into everyday media use with multiple screens

ABSTRACT

Multiscreening has been shown to affect consumers' brand attitudes and their memory of advertisements. However, little is known about the prevalence of using multiple screens simultaneously. The aim of this study is to provide insight into multiscreening by examining its prevalence, the composition of screens, and who is likely to multiscreen. A diary study with a representative sample of the Dutch population (n = 2,399) was conducted. First, the results showed that almost 60% of the participants multiscreened at least once. They multiscreened on average three days a week, mostly on Sundays, and on average more than 80 minutes per day. Second, the most prevalent screen combinations were TV-smartphone, TV-laptop, and TV-tablet. Third, multiscreeners were on average 41 years old, predominantly female, have a higher than average education, and own on average more than four screens. Finally, it was found that, in general, younger participants multiscreened longer than older participants.     

Freedom of choice between unitary and two-tier boards: An empirical analysis

We examine board structure in France, which since 1966 has allowed firms the freedom to choose between unitary and two-tier boards. We analyze how this choice relates to characteristics of the firm and its environment. Firms with severe asymmetric information tend to opt for unitary boards; firms with a potential for private benefits extraction tend to adopt two-tier boards. Chief executive officer turnover is more sensitive to performance at firms with two-tier boards, indicating greater monitoring. Our results are broadly consistent with the Adams and Ferreira (2007) model and suggest that gains result from allowing freedom of contract about board structure.