The economic burden of common adverse events associated with metastatic colorectal cancer treatment in the United States

Aims: Adverse events (AEs) associated with treatments for metastatic colorectal cancer (mCRC) may compromise the course of treatment, impact quality-of-life, and increase healthcare resource utilization. This study assessed the direct healthcare costs of common AEs among mCRC patients in the US.

Methods: Adult mCRC patients treated with chemotherapy or targeted therapies were identified from administrative claims databases (2009–2014). Up to the first three mCRC treatment episodes per patient were considered and categorized as with or without the AE system/organ category during the episode. Total healthcare costs (2014 USD) were measured by treatment episode and reported on a monthly basis. Treatment episodes with the AE category were matched by treatment type and line of treatment to those without the AE category. Adjusted total cost differences were estimated by comparing costs during treatment episodes with vs without the AE category using multivariate regression models; p-values were estimated with bootstrap.

Results: A total of 4158 patients with ≥1 mCRC treatment episode were included (mean age?=?59 years; 58% male; 60% with liver and 14% with lung metastases; 2,261 [54%] with a second and 1,115 [27%] with a third episode). On average, two treatment episodes were observed per patient with an average length of 166 days per episode. Adjusted monthly total cost difference by AE category included hematologic ($1,480), respiratory ($1,253), endocrine/metabolic ($1,213), central nervous system (CNS; $1,136), and cardiovascular ($1,036; all p?Limitations: Claims do not include information on the cause of AEs, and potentially less severe AEs may not have been reported by the physician when billing the medical service. This study aimed to assess the association between costs and AEs and not the causation of AEs by treatment.

Conclusions: The most costly AEs among mCRC patients were hematologic, followed by respiratory, endocrine/metabolic, CNS, and cardiovascular.     

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Early Experiences of the Enforcement of the Unfair Commercial Practices Directive in Scotland

This exploratory study examines the early impact of the Unfair Commercial Practices Directive 2005/29/EC on enforcers in Scotland within the context of current policy developments regarding the use of civil and criminal enforcement mechanisms within the UK. The Directive has been implemented in the UK by means of the Consumer Protection from Unfair Trading Regulations 2008 SI 1277 and the duty to enforce the Regulations falls primarily to local authority trading standards services. Twenty-one in-depth interviews were conducted with a range of officers employed within the trading standards service based in eight local authorities in Scotland on their perceptions of the new Regulations. The main findings were that officers’ views of the new Regulations and the civil and criminal enforcement routes available to them was affected by structural, operational, and cultural issues which varied from one authority to another. A number of officers were finding the Regulations a challenge to old ways and there was evidence that many felt unprepared for the Regulations. A number of positive views were expressed regarding the flexibility of the new Regulations and the advantages of the provisions relating to misleading omissions. Overall officers’ experiences of the Regulations were heavily influenced by the complaints received by their particular local authority service.     

Edith Penrose: A Feminist Economist?

We re-read a foundational work, The Theory of the Growth of the Firm by Edith Penrose, not to identify the androcentric bias but instead to recover a challenge to such bias. Our purpose is to show in Penrose an alternative view of human "nature" and revulsion from "Cartesian" dualisms. At the same time, Penrose had a deep interest in the real world and used metaphor and story alongside empirical observation in the pursuit of theoretical advance. The Theory of the Growth of the Firm provides an approach to industrial organization that is not only consistent with feminist economics but can be read as a methodological and expositional examplar.     

Compositional data analysis and zeros in micro data

The application of compositional data analysis methods in economics has some attraction. The methodology relies upon the use of 'log-ratios' in the statistical analysis. Such an approach is not possible when the data to be analysed include observations where the observed budget share is zero. We, therefore, consider and extend the methods of compositional data analysis in the situation where the data to be analysed include observations where the observed budget share is zero. The modified compositional data methods are discussed both in statistical terms and through potential economic interpretations of the method. Further, the modified methodology is applied to the 1988-89 Australian Household Expenditure Survey yielding estimates for a system of Engel curves.     

Structural reliability of conjoint measurement in health care: an empirical investigation

This paper is concerned with the structural reliability of conjoint measurement when applied in a health care setting. The clinical context was the diagnosis and treatment of knee injuries. A conjoint measurement study was conducted which used the pairwise choice approach to preference elicitation. Each choice included two scenarios: a conventional treatment approach to management (arthroscopy) and an approach using magnetic resonance imaging. In order to test for structural reliability two separate conjoint measurement exercises were conducted: exercise A where scenarios were defined in terms of three attributes and exercise B where scenarios included all four attributes. The assessment of structural reliability involved a comparison of two random effects probit models, for exercises A and B. Data were collected on a total of 176 students of sports science. The results strongly indicate that the models for the two exercises are different, although the instability is limited to the constant term and a single model attribute (i.e. the avoidance of surgery). The finding of instability in the constant coefficient raises important questions about the appropriateness of labelling scenarios in conjoint measurement exercises.     

2006 IIE-EED Business Meeting Minutes

The duration measure of weighted average life has been applied in the capital budgeting literature as a measure of project liquidity. Duration is superior to payback methods because it considers both the timing and present value of the entire cash flow stream. However, the literature is ambivalent on the choice of discount rate in calculating project duration. For duration to properly serve as a project liquidity measure, the internal rate of return should be used to discount future cash flows. Examples show that using the firm's cost of capital to calculate duration fails to measure the time to recover initial project outlays in present value dollars.     

Development and implementation of customer solutions: A study of process dynamics and market shaping

A broad, dynamic network perspective on solution processes remains scarce. This article presents the process of developing and implementing customer solutions and its effects on the wider business environment by investigating customers and suppliers in the global mining industry (Australia, Chile, and Sweden), analyzing the deployment of a new customer solution, and assessing the changes to the competitive environment and focal firms' relationships with other customers and suppliers. It shows that the forces that drive customer and supplier interests and motivation to co-develop customer solutions may change over time, thus redefining the aim and scope of solutions and creating failure risks. Customers present problems; suppliers respond, on the basis of not only the feasibility of the customer-specific solution but also of their evaluation of future solutions in a broader market; then suppliers aim to standardize successful solutions across markets. Customers want close supplier relationships and unique solutions but also like standardized and repeatable solutions, so they can share development costs with competitors and expose the supplier to competition to avoid lock-in effects. From a network perspective, a novel solution can have a market-shaping effect and evoke reactions from other actors who want to enhance their market position. However, these changes are not necessarily deliberate, and the dynamics that market introductions of solutions trigger may be difficult to predict.     

Women's Leisure as Political Practice: A Feminist Analysis of Orange Is the New Black

ABSTRACT

The purpose of this article is to examine representations of women's leisure portrayed on the popular Netflix television series Orange Is the New Black (OITNB). Using a feminist lens rooted in the notion of interconnectivity, we draw on four television tropes proposed by Pozner (2010 Pozner, J. L. (2010). Reality bites back: The troubling truth about guilty pleasure TV. Berkeley, CA: Seal Press. [Google Scholar]) that are commonly used to depict women characters on television to analyze representations of women's leisure in the first three seasons of OITNB. Our analysis reveals the complex and messy ways representations of women's leisure on OITNB can be used to discipline, reproduce, but also challenge power relations associated with common media tropes, acting as a form of political practice. We conclude by considering the implications of how these representations can influence the lives of women consuming this media content as part of their leisure.