A within-trial cost-effectiveness analysis of panitumumab compared with bevacizumab in the first-line treatment of patients with wild-type RAS metastatic colorectal cancer in the US

Abstract

Aims: This analysis investigated the cost-effectiveness of panitumumab plus mFOLFOX6 (oxaliplatin, 5-fluorouracil, and leucovorin) compared with bevacizumab plus mFOLFOX6 in the first-line treatment of patients with wild-type RAS metastatic colorectal cancer (mCRC).

Materials and methods: The cost-effectiveness analysis was developed from a third-party payer perspective in the US and was implemented using a partitioned survival model with health states for first-line treatment (progression-free), disease progression with and without subsequent active treatment, and death. Survival analyses of patients with wild-type RAS mCRC from the PEAK head-to-head clinical trial of panitumumab vs bevacizumab were performed to estimate time in the model health states. Additional data from PEAK informed the amount of each drug consumed, duration of therapy, subsequent therapy use, and toxicities related to mCRC treatment. Literature and US public data sources were used to estimate unit costs associated with treatment and duration of subsequent active therapies. Utility weights were calculated from patient-level data from panitumumab trials in the first-, second-, and third-line settings. A life-time perspective was taken with future costs and outcomes discounted at 3% per annum. Scenario, one-way, and probabilistic sensitivity analyses were performed.

Results: Compared with bevacizumab, the use of panitumumab resulted in an incremental cost of US $60,286, and an incremental quality-adjusted life-year (QALY) of 0.445, translating into a cost per QALY gained of US $135,391 in favor of panitumumab. Results were sensitive to wastage and dose rounding assumptions modeled.

Limitations: Progression-free and overall survival were extrapolated beyond the follow-up of the primary analysis using fitted parametric curves. Costs and quality of life were estimated from multiple and different data sources.

Conclusions: The efficacy of panitumumab in extending progression-free and overall survival and improving quality of life makes it a cost-effective option for first-line treatment of patients with wild-type RAS mCRC compared with bevacizumab.     

Too dynamic to fail: empirical support for an autocatalytic model of Minsky’s financial instability hypothesis

Solomon and Golo (Account Econ Law 3(3):167–260, 2013) have recently proposed an autocatalytic (self-reinforcing) feedback model which couples a macroscopic system parameter (the interest rate), a microscopic parameter that measures the distribution of the states of the individual agents (the number of firms in financial difficulty) and a peer-to-peer network effect (contagion across supply chain financing). In this model, each financial agent is characterized by its resilience to the interest rate. Above a certain rate the interest due on the firm’s financial costs exceeds its earnings and the firm becomes susceptible to failure (ponzi). For the interest rate levels under a certain threshold level, the firm loans are smaller then its earnings and the firm becomes ‘hedge.’ In this paper, we fit the historical data (2002–2009) on interest rate data into our model, in order to predict the number of the ponzi firms. We compare the prediction with the data taken from a large panel of Italian firms over a period of 9 years. We then use trade credit linkages to discuss the connection between the ponzi density and the network percolation. We find that the ‘top-down’–‘bottom-up’ positive feedback loop accounts for most of the Minsky crisis accelerator dynamics. The peer-to-peer ponzi companies contagion becomes significant only in the last stage of the crisis when the ponzi density is above a critical value. Moreover the ponzi contagion is limited only to the companies that were not dynamic enough to substitute their distressed clients with new ones. In this respect the data support a view in which the success of the economy depends on substituting the static ‘supply-network’ picture with an interacting dynamic agents one.     

Pay‐Level Satisfaction and Employee Outcomes: The Moderating Effect of Employee‐Involvement Climate

The present study examined employee‐involvement climate (i.e., information‐sharing and decision‐making climate) as a moderator of the relationship between pay‐level satisfaction and employee outcomes (i.e., job satisfaction, affective commitment, and turnover intention). Survey data were collected from 22,662 Belgian employees, representing 134 organizations. The hypotheses derived from distributive justice theory and from research on the meaning of pay received partial support. Multilevel analyses revealed that a decision‐making climate buffered the negative effects of low pay‐level satisfaction, and that an information‐sharing climate exacerbated the negative effects of low pay‐level satisfaction. Theoretical and practical implications of this differential moderating effect are discussed.     

The efficiencies of Chinese coal-fired power plants: a stochastic-frontier approach

We apply the stochastic frontier of translog production function to estimate the efficiencies of Chinese coal-fired power plants, using a survey sample of 300 power plants over 5 years from 2004 to 2008 for estimation. By taking into account, the ages of generators and a technological factor reflected by a dummy for supercritical generators, we identified the improvement of efficiencies in the Chinese power industry over the period, and the coal-fired power plants that still run inefficiently by approximate 9% on average when compared with the best practice of cost efficiency in the power industry.     

Prediction of Ideas Number During a Brainstorming Session

In this paper, we present an approach allowing the prediction of ideas number during a brainstorming session. This prediction is based on two dynamic models of brainstorming, the non-cognitive and the cognitive models proposed by Brown and Paulus (Small Group Res 27(1):91–114, 1996). These models describe for each participant, the evolution of ideas number over time, and are formalized by differential equations. Through solution functions of these models, we propose to calculate the number of ideas of each participant on any time intervals and thus in the future (called prediction). To be able to compute solution functions, it is necessary to determine the parameters of these models. In our approach, we use optimization model for model parameters calculation in which solution functions are approximated by numerical methods. We developed two generic optimization models, one based on Euler’s and the other on the fourth order Runge–Kutta’s numerical methods for the solving of differential equations, and we apply them to the non-cognitive and respectively to the cognitive models. Through some feasibility tests, we show the adequacy of the proposed approach to our prediction context.     

Real estate prices: An international study of seasonality's sentiment effect

The current study shows that real estate prices in several countries reveal a significant and persistent seasonality, where the highest rates of return are obtained in the spring and early summer, and the lowest rates of return are obtained in the fall. This seasonality is explained by a joint effect of the change in the number of daylight hours and the latitude of the area zone under consideration. Notably, latitude affects real estate prices above and beyond the effect of the change in the number of daylight hours, which by itself is a function of latitude. This joint effect is robust to the two explanations for seasonality given in the literature: the Matching Theory and the Bargaining Power Hypothesis, as well as to several macroeconomic variables. The effect also conforms to the well-known Seasonal Affective Disorder (SAD), which has been found in other studies to affect people's health, their risk attitude, and consequently their risk perception and investment decisions which, in turn, affect asset prices.     

Consumers’ willingness to pay for eco-friendly apples under different labels: Evidences from a lab experiment

An experiment was conducted in France to evaluate the impact of health and environmental information on consumers’ choices between conventional and organic apples. Results show that additional and precise messages about both pesticides use and pesticides residues significantly impact consumers’ choices between both products. The experiment also studied the effect of a new label signaling apples that only use few pesticides compared to conventional apples. With elicited willingness-to-pay, we show that the introduction of this new label increases the average participants’ surplus whatever the information context for participants, because of a higher quality compared to conventional apples and a lower price compared to organic products. In order to complement this label, a minimum-quality standard imposing the use of few pesticides is socially optimal when initial participants’ knowledge is limited.     

Economic and Cultural Implications of China's One Belt One Road Initiative for the Film Industry: Cultural Distance and Taste Preference

China's official One Belt One Road (OBOR) strategy has aroused considerable interest worldwide. This grand concept is potentially of great significance for China's film industry, among others, which has been included as an important part of the national drive to expand China's cultural influence overseas. OBOR represents a great opportunity for China's film industry to shift the emphasis of its market segmentation from reliance on Western influences to a more Eastern orientation. Its promise of closer economic and cultural ties brings great international marketing potential. China's film industry should embrace this significant opportunity by further addressing the cultural variables in its overseas distribution, creating detailed national taste profiles. The synergic development of the Asian film industries can unlock resources, technology and a very large market, presenting both opportunities and challenges. This study quantifies the cultural distances (CDs) and differences in genre preference between China and other countries involved in the OBOR initiative, based on 2016 box‐office data. The analysis reveals an absence of systematic and persistent correlation in CD and genre preference from country to country. In addition, the clustered distribution of genre preference within geographical boundaries makes cultural integration more directional.     

Heterogeneous treatment and self-selection in a wage subsidy experiment

The Self-Sufficiency Project (SSP) is a research and demonstration project that offered a generous time-limited income supplement to randomly selected welfare applicants under two conditions. The first, the eligibility condition, required that they remain on welfare for at least 12 months. The second, the qualification condition, required that they find a full-time job within 12 months after establishing eligibility. In this paper we focus on a neglected and important feature of the program, namely that the financial reward for becoming qualified is inversely related to the expected wage rate. Under very simple assumptions we show that those who have a low expected wage rate have a clear incentive to establish eligibility.Empirical non-parametric evidence strongly suggests that individuals self-select into eligibility. We jointly estimate a participation equation and a wage equation that are correlated through individual random effects. Our results show that the omission of self-selectivity into qualification translates into slightly underestimated treatment effects.