Cost-effectiveness analysis of secukinumab for the treatment of active psoriatic arthritis: a Canadian perspective

Objective: The study evaluates the cost-effectiveness of secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin (IL)-17A, vs currently licensed biologic treatments in patients with active psoriatic arthritis (PsA) from a Canadian healthcare system perspective.

Methods: A decision analytic semi-Markov model evaluated the cost-effectiveness of secukinumab 150?mg and 300?mg compared to subcutaneous biologics adalimumab, certolizumab pegol, etanercept, golimumab, and ustekinumab, and intravenous biologics infliximab and infliximab biosimilar in biologic-naive and biologic-experienced patients over a lifetime horizon. The response to treatments was evaluated after 12 weeks by PsA Response Criteria (PsARC) response rates. Non-responders or patients discontinuing initial-line of biologic treatment were allowed to switch to subsequent-line biologics. Model input parameters (Psoriasis Area Severity Index [PASI], Health Assessment Questionnaire [HAQ], withdrawal rates, costs, and resource use) were collected from clinical trials, published literature, and other Canadian sources. Benefits were expressed as quality-adjusted life years (QALYs). An annual discount rate of 5% was applied to costs and benefits. The robustness of the study findings were evaluated via sensitivity analyses.

Results: Biologic-naive patients treated with secukinumab achieved the highest number of QALYs (8.54) at the lowest cost (CAD 925,387) over a lifetime horizon vs all comparators. Secukinumab dominated all treatments, except for infliximab and its biosimilar, which achieved minimally more QALYs (8.58). However, infliximab and its biosimilar incurred more costs than secukinumab (infliximab: CAD 1,015,437; infliximab biosimilar: CAD 941,004), resulting in higher cost-effectiveness estimates relative to secukinumab. In the biologic-experienced population, secukinumab dominated all treatments as it generated more QALYs (8.89) at lower costs (CAD 954,692). Deterministic sensitivity analyses indicated the results were most sensitive to variation in PsARC response rates, change in HAQ, and utility values in both populations.

Conclusions: Secukinumab is either dominant or cost-effective vs all licensed biologics for the treatment of active PsA in biologic-naive and biologic-experienced populations in Canada.     

Time-variation in term premia: International survey-based evidence

Using a large, previously unexplored data set of survey-based interest rate forecasts that covers a broad range of countries, this paper re-examines the expectations hypothesis of the term structure of interest rates. We find that survey-based interest rate forecasts outperform not only a random walk forecast, but also outperform forecasts from forward rates. When using these superior survey-based forecasts in a modified expectations hypothesis test, the expectations hypothesis is rejected for fewer countries, at lower significance levels, and has greater explanatory power than when using a traditional forward rates-based test. We furthermore document strong time-variation in the term premia, which is an important reason why the traditional expectations hypothesis test is rejected so frequently. This time-variation seems to arise from the changing attitudes towards risk among market participants and as a compensation for the change in liquidity in the term structure. Finally, we find that generalizing findings from earlier U.S. studies to other countries may lead to bias in the true economic relationships in these countries.     

Sentiment and Financial Health Indicators for Value and Growth Stocks: The European Experience

In this study, we analyse the effect of macroeconomic surprises on inflation compensation data – the sum of inflation expectation, risk and liquidity premia – in the euro area. The empirical analysis is based on a daily data set, which covers a wide spectrum of maturities, stemming from inflation-indexed markets between 2 January 2004 and 31 December 2007. Our results suggest that when gauging short- and medium-term inflation compensations, market operators are sensitive to surprises related to real activity and prices. Notwithstanding, long-term inflation compensations remain generally unresponsive to macroeconomic surprises, attesting the European Central Bank's high credibility on the sample under consideration. The study also cross-checks the results from two different euro area inflation-indexed instruments (bonds and swaps) which differ slightly regarding medium-term horizon but give a similar picture regarding long-term horizons.     

Assessing the Assessments

They said of the July 1997 Asian regional financial crisis that ‘…it could never happen again’. They were right. There has not been another regional crisis—just an international one! This paper owes its origins to the Asian financial crisis. The crisis sparked the development of an assessment model for the evaluation of insolvency laws. The paper reviews the considerable developments in this area, commencing with the pioneering work of the Asian Development Bank in the aftermath of the Asian financial crisis in 1997 and culminating in the, now, quite established triennial practice of the European Bank for Reconstruction and Development (EBRD) in its assessment of the insolvency laws of its ‘countries of operation’. Along the way, mention is also made of the development and application of the World Bank ‘Principles’ and the United Nations Commission on International Trade Law Legislative Guide for Insolvency Law. All of these diagnostic tools have been variously employed in an endeavour to provide a fair and acceptable basis for evaluating an insolvency law. The paper draws comparisons from these tools and concludes that there is a considerable degree of correlation between them, such that approaches taken in 1998 have remained much the same to this time. The EBRD assessment programme is singled out for fuller analysis. It was developed with the benefit of the earlier assessment models and is consistently used as a means of tracking the development of insolvency laws. Accordingly, the paper presents the survey questionnaire on which the EBRD assessment is based, explains the methodology behind it and presents the results of the last of such assessments (2009). It invites an examination of the bases on which the EBRD assessments are undertaken and whether the approach is sufficiently broad, objective and fair and its use in possibly creating aspirations for reform. One purpose of the paper is to capture and record the historical origins and development of the assessment models before it all becomes lost in the passage of time. The paper also advances the use of the EBRD assessment model as a teaching tool in courses in comparative and international insolvency law. Copyright © 2014 INSOL International and John Wiley & Sons, Ltd     

Plural Cities and Ethnic Enclaves: Introducing a Measurement Procedure for Comparative Study

World cities attract two major streams of migrants – those who occupy the upper levels of their occupational hierarchies (the ‘globalized professionals’) on the one hand and marginalized, low–skill workers on the other. These two groups are often of different ethnic status, and it is argued that multicultural world cities are thus fractured in both their labour and housing markets along ethnic as well as economic lines. There has been little formal testing of these ideas, however. In this introductory article we introduce a method that can be used for comparative studies of residential fragmentation – an index of residential concentration – and apply it to three cities which have experienced rapid, multiethnic immigration in recent decades (New York, Sydney and Auckland). The patterns displayed indicate much greater fragmentation in New York than in the other two cities, suggesting that the ‘conventional wisdom’ regarding ethnic residential patterns may over–emphasize ‘American exceptionalism’. Les villes mondiales attirent deux grands flux de migrants: ceux qui occupent les niveaux supérieurs de leurs hiérarchies professionnelles (les ‘experts mondialisés’) d’une part, et les travailleurs peu qualifiés et marginalisés, de l’autre; ces deux groupes sont souvent de statut ethnique différent. De ce fait, ces grandes villes multiculturelles subissent, dit–on, une fracture de leurs marchés du travail et du logement selon des critères à la fois ethniques et économiques – affirmations qui ont rarement été mises à l’épreuve. Cet article introductif présente une méthode utilisable dans des études comparatives de fragmentation résidentielle – indice de concentration résidentielle – en l’appliquant à trois villes ayant connu une rapide immigration multiethnique au cours des dernières décennies (New York, Sydney et Auckland). Les modèles obtenus indiquent une fragmentation bien plus importante à New York que dans les deux autres villes, suggérant que la ‘croyance populaire’à l’égard des schémas résidentiels ethniques surestime peut–être ‘l’exception américaine’.     

An Evaluation of Import Tariffs in the Canada-U.S. Fresh Tomato Market

A quarterly econometric simulation model of the Canada-U.S. tomato market was constructed to evaluate the effects of tariff policies on producers, consumers, and international trade. The model consisted of seven behavioral equations and four identities. Mexican participation in the Canada-U.S. market is explicitly included through an equation defining the supply of Mexican tomatoes available for export. The model was used to compare simulated market outcomes over time with all variables held at actual levels to outcomes resulting from simulations where U.S. and Canadian tariffs were changed from their historical levels. The effect of the U.S. tariff on the U.S. winter market was examined by first doubling U. S. tariff values and then by eliminating U. S. tariffs. The effect on the Canadian summer market was tested by similar changes in the Canadian tariff. Results indicate that due to the ad valorem nature of the Canadian tariff structure, Canadian producers have received considerably more protection in recent years than have U.S. producers. The tariff mechanism does provide an effective means to administratively manipulate international competition in the North American fresh tomato market. On a bati un modéle simulé d'économetrie trimestrielle du marché de tomates canadien-américain pour évaluer les effels de la politique douaniére sur les producteurs, les consommateurs et le commerce international. Le modéle consistait en sept équations behavioristes et quatre identités. On a tenu compte explicitement de la participation du Mexique au sein du marché canadien-américain gráce á une équation qui déftnit l'offre en tomates mexicaines destinées á l'exportation. On a utilisé le modéle pour comparer d'une part les résultats á long terme des marchés simulés dont toutes les variables étaient fixées aux niveaux réels et d'autre part, les résultats provenant de simulations oú les tarifs douaniers americains et canadiens furent modifiés par rapport à leurs niveaux historiques. On a examiné l'effet du tarif douanier américain sur le marchè d'hiver américain, d'abord en doublant les valeurs des tarifs douaniers américains, ensuite en éliminant ces mémes tarifs. Gráce á des changements similaires portant sur les tarifs douaniers canadiens, on a testé l'effet sur le marché d'été canadien. Les résultants indiquent que, á cause de la nature proportionnelle de la structure des tarifs douaniers canadiens les producteurs canadiens ont reçu beaucoup plus de protection ces derníeres années que leurs homologues américains. Le mécanisme douanier fournit bien un moyen efficace de manipuler administrativement la concurrence internationale dans la marché américain de la tomate fraìche.     

Budgeting in Catholic Parishes: An Exploratory Study

In this paper an aspect of accounting, namely budgeting, has been studied in an organizational context. According to Booth (1993) churches represent 'extreme cases' in which to study the impact of accounting. Following on from Laughlin (1988) Booth considered the sacred and secular divide to be a significant element in the use of accounting by church organizations. The parishes of the Catholic Archdiocese of Melbourne form the context of this study in which evidence is sought for the sacred and secular divide by studying the role of budgeting in the parish. Questions were asked regarding participation in the budgetary process and the development and use of the budget. It was found that there was little consultation or participation in the budgetary process and that the use of the budget was restricted. These findings suggest that the sacred and secular divide operates at the parish level.     

Information technology investment and firm performance in US retail trade

We examine the relationship between investments in information technology (IT) and retail firm performance. We use untapped firm and establishment micro data from the Censuses of Retail Trade and the Assets and Expenditures Survey. We show that large firms account for most retail IT investment, employment, and establishment growth. We find evidence of a significant relationship between IT investment intensity and productivity growth.