The cost-effectiveness of dulaglutide versus liraglutide for the treatment of type 2 diabetes mellitus in Spain in patients with BMI ≥30 kg/m2

Objective: Dulaglutide 1.5?mg once weekly is a novel glucagon-like peptide 1 (GLP-1) receptor agonist, for the treatment of type two diabetes mellitus (T2DM). The objective was to estimate the cost-effectiveness of dulaglutide once weekly vs liraglutide 1.8?mg once daily for the treatment of T2DM in Spain in patients with a BMI ≥30?kg/m².

Methods: The IMS CORE Diabetes Model (CDM) was used to estimate costs and outcomes from the perspective of Spanish National Health System, capturing relevant direct medical costs over a lifetime time horizon. Comparative safety and efficacy data were derived from direct comparison of dulaglutide 1.5?mg vs liraglutide 1.8?mg from the AWARD-6 trial in patients with a body mass index (BMI) ≥30?kg/m². All patients were assumed to remain on treatment for 2 years before switching treatment to basal insulin at a daily dose of 40?IU. One-way sensitivity analyses (OWSA) and probabilistic sensitivity analyses (PSA) were conducted to explore the sensitivity of the model to plausible variations in key parameters and uncertainty of model inputs.

Results: Under base case assumptions, dulaglutide 1.5?mg was less costly and more effective vs liraglutide 1.8?mg (total lifetime costs €108,489 vs €109,653; total QALYS 10.281 vs 10.259). OWSA demonstrated that dulaglutide 1.5?mg remained dominant given plausible variations in key input parameters. Results of the PSA were consistent with base case results.

Limitations: Primary limitations of the analysis are common to other cost-effectiveness analyses of chronic diseases like T2DM and include the extrapolation of short-term clinical data to the lifetime time horizon and uncertainty around optimum treatment durations.

Conclusion: The model found that dulaglutide 1.5?mg was more effective and less costly than liraglutide 1.8?mg for the treatment of T2DM in Spain. Findings were robust to plausible variations in inputs. Based on these results, dulaglutide may result in cost savings to the Spanish National Health System.     

The Impact of Exchange Rate Uncertainty on the Level of Investment

Conventional wisdom has it that increasing price or exchange rate uncertainty will depress investment. Using the Dixit–Pindyck model, we find that there are situations where this will happen; and situations where it does not. There are threshold effects which allows us to identify when rising volatility would increase or decrease investment; and also to identify which types of industries would gain, and which would suffer, from a move to fixed exchange rates. This is important for monetary union in Europe since it is likely that, even if trade is insensitive to exchange rate volatility, investment with its longer horizon will be affected.     

The Behaviour and Performance of Young Micro Firms: Evidence from Businesses in Scotland

This paper is an empirical study, making appeal to firsthand evidence gathered by face-to-face interviews with the owner-managers of 150 small firms in Scotland. It investigates the performance of the micro firm in the early years of its life cycle, by reference to four key behavioural characteristics: (i) strengths, weaknesses, opportunities and threats (SWOT) analysis; (ii) the gathering of trade intelligence on the firm's rivals; (iii) the use of information technology (IT) in the business; and (iv) financial form and the owner-manager's preferences as regards the form of their equity stake holding. Seven propositions, based on the evidence accumulated, are formulated, and tested. These are illustrated by boxplots and cross-tabulations, and supported with chi-square statistics for testing measures of association. Taken together, the data provide an illuminating picture of the strategic behaviour of the young micro firm, and the subsequent effect that actions can have on firm performance. In particular, it is found that the use of IT in clusters of devices has a highly significant positive association with performance.     

Looking For a Network Organization: The Case of GESTO

We present ten propositions to explore an ideal type of network organizations with emphasis on internal structure relating properties to organizational structure and processes. Network organizations are flat, flexible structures, with high reachability and high information access enabling learning. Based on an exploratory case study we use network analysis and find that this organization has the properties of a network organization. The employees participate in several networks, work is done in project groups that are initiated and organized by the employees. Oligarchy or hierarchy are not distinct features of the organization; the flexibility of the structures is demonstrated by showing that the members change network position in project networks over time. Tenure, the most important integrating mechanism, influences centrality measures, skill levels, and the ability to propose and organize projects.     

Understanding the contribution of curb appeal to retail real estate values

The concept of curb appeal and its impact on property values has been largely neglected in the real estate literature. In the context of retail real estate, curb appeal represents the general attractiveness of a store as viewed from the sidewalk or parking lot that is expected to affect consumer patronage decisions and consequently property values. We first develop a measurement instrument for curb appeal and assess its validity using exploratory and confirmatory factor analysis. Our results suggest that curb appeal is multidimensional and consists of an atmospheric, architectural and authenticity dimension. Then, we use survey responses, transaction data and spatial regression to quantify the impact of curb appeal on sales prices. We find that the atmospheric and architectural dimensions have a significantly positive impact on sales prices. We also show that curb appeal dimensions are highly correlated with observable building features traditionally included in hedonic pricing models.     

The family in the center of international assignments: a systematic review and future research agenda

Over the past 30 years, the number of studies investigating the family interface of international assignments has risen substantially. While alternative forms of international assignments have been gaining importance, this article focuses specifically on the family interface of traditional organization assigned expatriation as the most prominent and most researched form of global work. Thus far, research has investigated a broad array of topics ranging from the family’s willingness to relocate over family adjustment to work-family balance and utilized a large variety of theoretical foundations. Given this variety in the literature, the field is fragmented and lacks a consistent theoretical argumentation. As a first step to provide some organization, we synthesize the family expatriation literature by developing a comprehensive multi-level framework of the determinants and dimensions of family outcomes. To achieve this objective, we critically assess publications between 1985 and 2017 in peer-viewed international journals, examine theoretical foundations and review the extant literature based on our framework. With this we uncover similarities and inconsistencies in the field, which allows us to deduce an agenda for future research and offer recommendations for practice.     

Assessing Consumer and Producer Preferences for Animal Welfare Using a Common Elicitation Format

We assess pig farmers’ willingness‐to‐accept (WTA) higher farm animal welfare (FAW) standards and consumers’ willingness‐to‐pay (WTP) for thus enhanced standards. The analysis is based on discrete choice experiments with nearly identical choice sets for both farmers (N=140) and consumers (N=554). Based on preference estimates from a random parameter logit (RPL) model, supply and demand curves for high‐welfare pork in Germany are estimated and market equilibria are derived for alternative levels of FAW. We find that estimates of consumer WTP are significantly positive for all FAW attributes: consumers value more surface space per pig, more bedding and manipulable material, less surgical interventions and shorter transportation times. In contrast, our model revealed significant producer WTA estimates only for surface area per pig and the amount of bedding material on offer, but not for the other FAW attributes. Farmers who expect to continue farming and engage in direct marketing are more likely to adopt higher FAW standards. Male consumers and those who find price more important than brand, origin or taste are less likely to buy high‐welfare pork, as are consumers who never purchase organic meat products. Market simulations for high‐welfare pork indicate increasing divergence between demand and supply with rising FAW standards. We estimate a market share of 44.6% for pork produced in compliance with an entry‐level FAW programme with standards only slightly above the legal minimum. Programmes with more demanding standards are estimated to gain much smaller market shares.     

Estimating the Income Elasticity of Demand for Housing: A Comparison of Traditional and Lorenz-Concentration Curve Methodologies

This paper provides a comparative analysis of traditional and Lorenz concentration curve (LC) approaches to estimating the income elasticity of demand for housing. Using data from the 1989 American Housing Survey, we compare LC results with those obtained from a traditional model in which tenure choice and housing demand are jointly determined, and which includes non-income determinants of demand. The comparison is intended to provide researchers with information concerning specific differences in empirical results obtained using the two approaches.     

From Empowerment Dynamics to Team Adaptability: Exploring and Conceptualizing the Continuous Agile Team Innovation Process

To foster their innovation teams’ adaptability, organizations are increasingly relying on agile teams. While research on the adoption of agile methods and practices has grown tremendously in the past decade, little is currently known about the human side of agile teams and how it contributes toward the emergence of adaptability. While the Agile Manifesto states that individuals and interactions are more important for agile product development than tools and processes, research on how these interactions unfold is still in its infancy. To shed light on the human side of adaptability, 44 semi-structured, in-depth interviews were conducted with team members and leaders from various teams at three organizations (i.e., two German and one multinational European firm). The inductive analysis identified empowerment as a focal human factor for adaptability emergence. A model of the continuous agile team innovation process is developed and uncovers the importance of dynamic empowerment states and their temporary equilibria for team adaptability. The underlying findings demonstrate that empowerment is not a static state, but rather emerges through the interactions between various actors. Specifically, the team and its leader engage in both empowerment-enhancing and empowerment-reducing activities. These activities are further influenced by the agile team’s immediate context: Two-fold customer influences, that is, supporting and hindering empowerment interactions, and the organizational environment, that is, undergoing an agile transformation and supportive top management behaviors, play an important role in affecting the empowerment dynamics that result in team adaptability. As such, this study contributes to the innovation and management literatures by revealing the dynamic role of the empowerment and adaptability constructs for agile innovation processes and the importance of various actors and the organizational environment for fostering adaptability. Practical insights are offered to management, teams, and team members on how to create conditions for empowerment dynamics and consequently adaptability to unfold.