Cost-effectiveness of rivaroxaban versus warfarin for stroke prevention in non-valvular atrial fibrillation in the Japanese healthcare setting

Abstract

Aims: This article aimed to examine the cost-effectiveness of rivaroxaban in comparison to warfarin for stroke prevention in Japanese patients with non-valvular atrial fibrillation (NVAF), from a public healthcare payer’s perspective.

Materials and methods: Baseline event risks were obtained from the J-ROCKET AF trial and the treatment effect data were taken from a network meta-analysis. The other model inputs were extracted from the literature and official Japanese sources. The outcomes included the number of ischaemic strokes, myocardial infarctions, systemic embolisms and bleedings avoided, life-years, quality-adjusted life-years (QALYs), incremental costs and incremental cost-effectiveness ratio (ICER). The scenario analysis considered treatment effect data from the same network meta-analysis.

Results: In comparison with warfarin, rivaroxaban was estimated to avoid 0.284 ischaemic strokes per patient, to increase the number of QALYs by 0.535 per patient and to decrease the total costs by ¥118,892 (€1,011.11) per patient (1 JPY = 0.00850638 EUR; XE.com, 7 October 2019). Consequently, rivaroxaban treatment was found to be dominant compared to warfarin. In the scenario analysis, the ICER of rivaroxaban versus warfarin was ¥2,873,499 (€24,446.42) per QALY.

Limitations: The various sources of data used resulted in the heterogeneity of the cost-effectiveness analysis results. Although, rivaroxaban was cost-effective in the majority of cases.

Conclusion: Rivaroxaban is cost-effective against warfarin for stroke prevention in Japanese patients with NVAF, giving the payer WTP of 5,000,000 JPY.     

The endogeneity of the Optimum Currency Area criteria in East Asia

The Asian financial crisis in mid-1997 has increased interest in policies to achieve greater regional exchange rate stability in East Asia. It has renewed calls for greater monetary and exchange rate cooperation. A country's suitability to join a monetary union depends, inter alia, on the trade intensity and the business cycle synchronization with other potential members of the monetary union. However, these two Optimum Currency Area criteria are endogenous. Theoretically, the effect of increased trade integration (after the elimination of exchange fluctuations among the countries in the region) on the business cycle synchronization is ambiguous. Reduction in trade barriers can potentially increase industrial specialization by country and therefore resulting in more asymmetry business cycles from industry-specific shocks. On the other hand, increased trade integration may result in more highly correlated business cycles due to common demand shocks or intra-industry trade. If the second hypothesis is empirically verified, policy makers have little to worry about the region being unsynchronized in their business cycles as the business cycles will become more synchronized after the monetary union is formed. This paper assesses the dynamic relationships between trade, finance, specialization and business cycle synchronization for East Asian economies using a Generalized Method of Moments (GMM) approach. The dynamic panel approach improves on previous efforts to examine the business cycle correlations — trade link using panel procedures, which control for the potential endogeneity of all explanatory variables. Based on the findings on how trade, finance and sectoral specialization have effects on the size of common shocks among countries, potential policies that can help East Asian countries move closer toward a regional currency arrangement can be suggested. The empirical results of this study suggest that there exists scope for East Asia to form a monetary union.     

Corporate tax avoidance and cost of equity capital: international evidence

ABSTRACT

This study examines the association between firm’s tax avoidance activities and cost of equity capital across 17 countries. Consistent with the prior study based on the U.S. evidence, within strong investor protection countries, the extent of firm’s tax avoidance is negatively associated with its cost of equity capital. This result indicates that strong investor protection induces investors to perceive firm’s tax avoidance activities as the results of efficient tax planning to reduce tax liabilities. To the contrary, we find that the extent of firm’s tax avoidance is positively associated with its cost of equity capital within weak investor protection countries. This result suggests that investors impose equity risk premium on firm’s tax avoidance activities in weak investor protection countries, where agency conflicts prevail more on firm’s tax avoidance activities. As the first international study on the association between firm’s tax avoidance activities and its cost of equity capital, this study contributes to the literature by suggesting that such an association may vary across countries depending on the strength of investor protection within each country of domicile.     

Managements' views on share buy‐backs: an Australian survey

Share buy‐backs are a relatively new concept in the Australian business environment. This study surveys managements' motivations and various other aspects concerning share buy‐back activity. The results reveal that these motivations vary across the five different types of buy‐backs. For on‐market buy‐backs the most relevant motivations are to improve financial performance (i.e., earnings per share) and financial position (i.e., net asset backing per share) followed by signalling of future expectations or underpricing. Interestingly, managements' response regarding the relevant motivations is similar regardless of whether their companies had conducted a buy‐back or not. This provides evidence of widespread support for the relevant motivations. In addition, Australian managers believe that they are familiar with the potential benefits and legislative requirements of buy‐backs, but that their shareholders often do not understand or are not favourably disposed towards buy‐back events. Finally, two major explanations are identified for the initial conservatism towards buy‐backs. Those explanations are (i) legal complexity and cost and (ii) the perceived negative disposition of the sharemarket towards buy‐backs.     

Homeowners Insurance With Bundled Catastrophe Coverage

We estimate the demand for homeowners insurance in Florida and New York with indicated loss costs as our proxy for the quantity of real insurance services demanded. We decompose the demand into the demand for coverage of catastrophe perils and the demand for noncatastrophe coverage and estimate these demand functions separately. Our results are relatively consistent in New York and Florida, including evidence that catastrophe demand is more price elastic than noncatastrophe demand. We also find evidence that consumers value options that expand coverage, buy more insurance when it is subsidized through regulatory price constraints, and consider state guaranty fund provisions when purchasing insurance.     

Composing Urban Orders from Rubbish Electronics: Cityness and the Site Multiple

What do cities look like when rubbish electronics are the vehicle with which they are explored? This article is an experiment designed to offer a response to that question, and in doing so to productively intervene in the conversation about ‘cityness', ‘metrocentricity' and ‘subaltern urbanism'. We intervene by following flows of rubbish electronics and the action that enacts them as waste and value, drawing on fieldwork in Dhaka, Singapore, Accra and Canada's Greater Golden Horseshoe. Our intervention is an experiment in writing an urban geography of rubbish electronics as a site multiple. We show how following the circulation of rubbish electronics offers a manyfolded synopsis of cities: urban enclaves of high finance and the information economy are also industrial waste producers. Peri‐urban industrial zones are also managers of brands, legal liability and corporate public relations. Cities off the map are also urban innovation systems, while waste is rekindled as value and accumulated as poison. Thereby we suggest how a sensitivity to the site multiple may be a helpful way of grappling with shifting ontology and the performativity of our research practices in urban studies.     

Fama–French in China: Size and Value Factors in Chinese Stock Returns

We investigate the size and value factors in the cross‐section of returns for the Chinese stock market. We find a significant size effect but no robust value effect. A zero‐cost small‐minus‐big (SMB) portfolio earns an average premium of 0.61% per month, which is statistically significant with a t‐value of 2.89 and economically important. In contrast, neither the market portfolio nor the zero‐cost high‐minus‐low (HML) portfolio has average premiums that are statistically different from zero. In both time‐series regressions and Fama–MacBeth cross‐sectional tests, SMB represents the strongest factor in explaining the cross‐section of Chinese stock returns. Our results contradict several existing studies which document a value effect. We show that this difference comes from the extreme values in a few months in the early years of the market with a small number of stocks and high volatility. Their impact becomes insignificant with a longer sample and proper volatility adjustment.     

Chinese Students’ Perceptions of the Teaching in an Australian Accounting Programme – An Exploratory Study

ABSTRACT

This exploratory study is designed to elicit and understand the views of Mainland Chinese students concerning their learning experience in an Australian accounting education programme. The article contributes to the literature by investigating the issues and implications associated with international students’ perceptions of teaching, as little research has been undertaken in this context. Data were obtained from focus group interviews at two Australian universities, comprising students who had no prior experience of Western education. Based on an adaptation of Ramsden's 2003 model [Learning to teach in higher education (2nd ed.). London: Routledge], the data show that the students’ educational experience in China has a direct and negative influence on their perceptions of the teaching and learning experience in Australia. The negativity is particularly strong for entry-level students but dissipates to some extent with time. Issues concerning teachers’ enthusiasm, commitment, delivery skills and students’ expectations also emerged as important factors affecting student perceptions.