Concentration in Indonesia Manufacturing, 1975–93

This paper analyses trends and levels of industrial concentration in 102 Indonesian industries between 1975 and 1993. There was a long-term decline in industrial concentration across the manufacturing sector over this period. The simple average four-firm concentration ratio declined from 64% in 1975 to 54% in 1993, while the percentage of industries classified as highly concentrated fell from 39% in 1975 to 28% in 1993. Allowing for foreign trade substantially reduces average concentration measures: in 1993 the average concentration of a sample of 67 industries was 53% without adjustment for foreign trade, but 41% if foreign trade was allowed for. Thus, competition is stronger in Indonesian markets than domestic concentration ratios would suggest.     

Comparison of costs and outcomes of dapagliflozin with other glucose-lowering therapy classes added to metformin using a short-term cost-effectiveness model in the US setting

Objective: To compare 1-year costs and benefits of dapagliflozin (DAPA), a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, with those of other treatments for type 2 diabetes (T2D), such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), sulfonylureas (SUs), thiazolidinediones (TZDs), and dipeptidyl peptidase-4 inhibitors (DPP-4i), all combined with metformin.

Methods: A short-term decision-analytic model with a 1-year time horizon was developed from a payer’s perspective in the United States setting. Costs and benefits associated with four clinical end-points (glycated hemoglobin [A1C], body weight, systolic blood pressure [SBP], and risk of hypoglycemia) were evaluated in the analysis. The impact of DAPA and other glucose-lowering therapy classes on these clinical end-points was estimated from a network meta-analysis (NMA). Data for costs and quality-adjusted life-years (QALYs) associated with a per-unit change in these clinical end-points were taken from published literature. Drug prices were taken from an annual wholesale price list. All costs were inflation-adjusted to December 2016 costs using the medical care component of the consumer price index. Total costs (both medical and drug costs), total QALYs, and incremental cost-effectiveness ratios (ICERs) were estimated. Sensitivity analyses (SA) were performed to explore uncertainty in the inputs. To assess face validity, results from the short-term model were compared with long-term models published for these drugs.

Results: The total annual medical cost for DAPA was less than that for GLP-1RA ($186 less), DPP-4i ($1,142 less), SU ($2,474 less), and TZD ($1,640 less). Treatment with DAPA resulted in an average QALY gain of 0.0107, 0.0587, 0.1137, and 0.0715 per treated patient when compared with GLP-1RA, DPP-4i, SU, and TZD, respectively. ICERs for DAPA vs SU and TZD were $19,005 and $25,835, respectively. DAPA was a cost-saving option when compared with GLP-1RAs and DPP-4is. Among all four clinical end-points, change in weight had the greatest impact on total annual costs and ICERS. Sensitivity analysis showed that results were robust, and results from the short-term model were found to be similar to those of published long-term models.

Conclusion: This analysis showed that DAPA was cost-saving compared with GLP-1RA and DPP-4i, and cost-effective compared with SU and TZD in the US setting over 1 year. Furthermore, the results suggest that, among the four composite clinical end-points, change in weight and SBP had an impact on cost-effectiveness results.     

Consumer spending self-control effectiveness and outcome elaboration prompts

Decision making related to finances is of significant importance. A major factor underlying financial decision making involves differences in consumers?? spending self-control (CSSC). We conceptualize CSSC as an individual difference, distinct from general self-control, develop a parsimonious measure to assess it, and demonstrate important related consequences and behaviors. Further, we examine how underlying differences in CSSC impact the effectiveness of a self-control strategy that has recently received attention in public policy legislation??enhancing consumers?? awareness of the future consequences of present behavior through the provision of outcome elaboration prompts. Results from our studies suggest that outcome elaboration prompts (that is, external stimuli used to encourage consumers to consider the future outcomes of their present decisions) differentially impact consumers?? self-control effectiveness depending on their inherent CSSC. Specifically, the presence of outcome elaboration prompts enhances self-control for low CSSC consumers, but does not affect the choices of high CSSC consumers. Furthermore, we provide direct evidence that it is a differential focus on future outcomes that drives the distinct responses of high- versus low-CSSC consumers to the provision of outcome elaboration prompts.