Cost-effectiveness of second-line atezolizumab in Canada for advanced non-small cell lung cancer (NSCLC)

Aim: To assess the cost-effectiveness in Canada of atezolizumab compared with docetaxel or nivolumab for the treatment of advanced NSCLC after first-line platinum-doublet chemotherapy.

Materials and methods: A three-state partitioned-survival model was developed. Clinical inputs were obtained from the phase III OAK trial comparing atezolizumab with docetaxel in patients with advanced NSCLC who progressed after first-line platinum-doublet chemotherapy. Overall survival (OS) and progression-free survival (PFS) were extrapolated beyond the trial period using parametric models. A cure model assuming a 1% cure fraction was fitted to the OS data for atezolizumab. Outcomes for nivolumab were informed by a network meta-analysis (NMA) vs atezolizumab. Resource use and costs were informed by clinical expert opinion and published Canadian sources. Utility values were obtained from the OAK trial. The perspective of the analysis was that of the Canadian publicly-funded healthcare system. The base case time horizon was 10?years, and the discount rate was 1.5% annually for both costs and effects. Scenario analyses were performed to test the robustness of the results and all analyses were performed probabilistically.

Results: Atezolizumab demonstrated a quality-adjusted life-year (QALY) gain of 0.60 compared with docetaxel at an incremental cost of $85,073, resulting in an incremental cost-effectiveness ratio (ICER) of $142,074/QALY. Atezolizumab dominated nivolumab (regardless of dosing regimen), based on modest differences in both QALYs and costs. Docetaxel was most likely to be cost effective at willingness-to-pay (WTP) thresholds below $125,000/QALY gained, while atezolizumab was most likely to be cost effective beyond this WTP threshold. In most scenario analyses, the results remained robust to changes in parameters. A reduced time horizon and alternative approaches to the NMA had the greatest impact on cost-effectiveness results.

Conclusion: Atezolizumab represents a cost-effective therapeutic option in Canada for the treatment of patients with advanced NSCLC who progress after first-line platinum doublet chemotherapy.     

Do capital flows drive credit growth and consumption in Central and Eastern Europe?

Domestic credit expansion in CEE economies, fuelled in part by foreign capital inflows, helped increase household welfare before the 2008 financial crisis caused a contraction across the region. How strong are the linkages between the current account, domestic credit and consumer spending? This study compiles a quarterly dataset of domestic credit as a share of GDP for 11 CEE European Union members and isolates structural breaks in the series’ growth rates that often align with the 2008 crisis. Vector autoregressive methods, particularly impulse response functions, show that increased current-account deficits lead to increased consumption in six of the 11 countries and increased credit growth in three, and that shocks to credit growth increase consumption in six countries. Capital inflows significantly increase consumption through domestic credit in Slovenia, while the Baltics show a large share of significant effects.     

The marketing of love: how attachment styles affect romantic consumption journeys

Journal of the Academy of Marketing Science - The experience of romantic love is closely interlocked with consumption journeys—yet how and why consumers engage in romantic consumption is not...     

Performance evaluation of National Football League teams

Most recent empirical analyses of production in the sports economic literature have focused on Major League Baseball. This paper extends that literature by analysing football production in the National Football League (NFL). Using the Poisson regression model, we measure the performance of NFL teams and head coaches. The measure is based on a production process where player skills are converted into games won. The evidence reveals that quality coaching is an important component in the production process. It appears that efficient coaching can account for an additional three to four victories in a given season. Copyright © 2000 John Wiley & Sons, Ltd.     

Progression,Stability, or Decline? Sociological Mechanisms Underlying Change in Specialization Among Birdwatchers

Using a panel of American birdwatchers collected in 1997 and 2002, we tested the extent to which birdwatchers progressed over a five-year period. The impact different career contingencies and life course events had on predicting change in birdwatchers' behavior, skill, and commitment was also examined. Findings indicated that although progression characterized some birdwatchers' participation, involvement by others was better characterized by stability or decline, which was true for each of the indicators used to measure specialization. Career contingencies and life course changes had only a moderate influence on predicting change in the specialization indicators over time. Support from family members and retirement were the best predictors of change in specialization.     

What Would Veblen Say?

It has been more than 100 years since Thorstein Veblen published The Theory of the Leisure Class (TLC). The book was a scathing attack on the greedy leisure class of his day and described how people used wealth to elevate their social position in society. Surprisingly, few researchers use this book to understand leisure in contemporary society. TLC remains as relevant today as it did when first published. In this essay I elucidate some of Veblen's ideas and show how they shed light on leisure spending, emulation among birdwatchers, our display of books, boundary maintenance and social distance, and environmental destruction.     

Network science: A Review Focused on Tourism

This paper presents a review of the methods of the science of networks with an application to the field of tourism studies. The basic definitions and computational techniques are described and a case study (Elba, Italy) used to illustrate the effect of network typology on information diffusion. A static structural characterization of the network formed by destination stakeholders is derived from stakeholder interviews and website link analysis. This is followed by a dynamic analysis of the information diffusion process within the case destination demonstrating that stakeholder cohesion and adaptive capacity have a positive effect on information diffusion. The outcomes and the implications of this analysis for improving destination management are discussed.     

Combining forecasts: An application to elections

We summarize the literature on the effectiveness of combining forecasts by assessing the conditions under which combining is most valuable. Using data on the six US presidential elections from 1992 to 2012, we report the reductions in error obtained by averaging forecasts within and across four election forecasting methods: poll projections, expert judgment, quantitative models, and the Iowa Electronic Markets. Across the six elections, the resulting combined forecasts were more accurate than any individual component method, on average. The gains in accuracy from combining increased with the numbers of forecasts used, especially when these forecasts were based on different methods and different data, and in situations involving high levels of uncertainty. Such combining yielded error reductions of between 16% and 59%, compared to the average errors of the individual forecasts. This improvement is substantially greater than the 12% reduction in error that had been reported previously for combining forecasts.     

The Influence of Gratitude on Franchisor‐Franchisee Relationships

Set within a franchising context that is an integral and significant component of the small business sector, this paper is the first attempt at modeling the sentiment of gratitude, a critical nascent relationship construct, as mediating the linkage between relational norms (as antecedents) and relationship quality constructs (as consequents). Data from a sample of 439 Australian franchisees are used to test the hypotheses. Relational norms were captured using the well‐accepted taxonomy of solidarity, flexibility, and mutuality, and relationship quality was conceptualized in terms of its constituent constructs of trust, commitment, and relationship satisfaction. Structural equation modeling was used to test the six hypothesized relationships. Results show that all six hypotheses are supported, that is, relational norms significantly and positively affect the emergence of gratitude, and in turn, gratitude significantly and positively influences the relationship quality constructs of trust, commitment, and relationship satisfaction. Managerial implications for the franchising industry in particular and small businesses in general are discussed.