Evaluation of medical costs associated with use of new oral anticoagulants compared with standard therapy among venous thromboembolism patients

Objective:

This study evaluated differences in medical costs associated with clinical end-points from randomized clinical trials that compared the new oral anticoagulants (NOACs), dabigatran, rivaroxaban, apixaban, and edoxaban, to standard therapy for treatment of patients with venous thromboembolism (VTE).

Research design and methods:

Event rates of efficacy and safety end-points from the clinical trials (RE-COVER, RE-COVER II, EINSTEIN-Pooled, AMPLIFY, Hokusai-VTE trial) were obtained from published literature. Incremental annual medical costs among patients with clinical events from a US payer perspective were obtained from the literature or healthcare claims databases and inflation adjusted to 2013 costs. Differences in total medical costs associated with clinical end-points for the NOACs vs standard therapy were then estimated. One-way and Monte Carlo sensitivity analyses were carried out.

Results:

A lower rate of major bleedings was associated with use of any of the NOACs vs standard therapy. Except for dabigatran, use of NOACs was also associated with a lower rate of recurrent VTE/death. As a result of the reduction in clinical event rates, the overall medical cost differences were ?$146, ?$482, ?$918, and ?$344 for VTE patients treated with dabigatran, rivaroxaban, apixaban, and edoxaban, respectively, vs patients treated with standard therapy.

Conclusions:

When any of the four NOACs are used instead of standard therapy for acute VTE, treatment medical costs are reduced. Apixaban is associated with the greatest reduction in medical costs, which is driven by medical cost reductions associated with both efficacy and safety end-points. Further evaluation may be needed to validate these results in the real-world setting.     

An Anatomy Of Racial and Ethnic Trends in Male Earnings in the U.S

Progress in narrowing black–white earnings differences has been far from continuous, with some of the apparent progress resulting from labor force withdrawal among lower‐skilled African Americans. This paper documents racial and ethnic differences in male earnings from 1950 through 2010 using data from the decennial census and American Community Surveys. Emphasis is given to annual rather than weekly or hourly earnings. We take a quantile approach, providing evidence on medians and other percentiles of the distribution. Treatment of imputed earnings greatly affects measured outcomes. Hispanic men have exhibited earnings growth similar to white men over several decades. Black men have been left behind economically due in large part to increased joblessness, a process exacerbated by weak labor market conditions. By 2010, joblessness had risen to over 40 percent and the median black–white earnings gap was the largest in at least 60 years.     

Collateral equilibrium,I: a basic framework

Much of the lending in modern economies is secured by some form of collateral: residential and commercial mortgages and corporate bonds are familiar examples. This paper builds an extension of general equilibrium theory that incorporates durable goods, collateralized securities, and the possibility of default to argue that the reliance on collateral to secure loans and the particular collateral requirements chosen by the social planner or by the market have a profound impact on prices, allocations, market structure, and the efficiency of market outcomes. These findings provide insights into housing and mortgage markets, including the subprime mortgage market.     

A nonparametric analysis of multi-product oligopolies

We develop revealed preference tests for models of multi-product oligopoly, building on the work in Carvajal et al. (Econometrica 81(6):2351–2379, 2013). We analyze a Cournot model with multiple goods and show that it has testable restrictions when at least one good is produced by two or more firms. We also develop a revealed preference test for Bertrand oligopoly in a setting where each firm produces a single differentiated good, and these goods are potentially substitutes for each other. Our tests require qualitative assumptions on the shape of the demand curves and (in the Bertrand case) their evolution across observations, but they do not rely on the estimation of market demand.     

Heterogeneous returns to personality: the role of occupational choice

We analyze the role of personality in occupational choice and wages using data from Germany for the years 1992 to 2009. Characterizing personality by use of seven complementary measures (Big Five personality traits, locus of control, and a measure of reciprocity), the empirical findings show that personal characteristics are important determinants of occupational choice. Associated with that, identical personality traits are differently rewarded across occupations. Hence, breaking down the analysis on the level of occupational groups provides more detailed results of returns to personality. By evaluating different personality profiles, we additionally estimate the influence of personality as a whole. The estimates establish occupation-specific patterns of significant returns to particular personality profiles. These findings underline the importance to consider the occupational distribution when analyzing returns to personality due to its heterogeneous valuation.     

Undergraduate Coursework in Economics: A Survey Perspective

Survey results from a large sample of economics departments describe offerings for principles courses, coursework requirements for economics majors, and program augmentations such as capstone courses, senior seminars, and honors programs. Findings are reported for all institutions, and institutions are subdivided into six different categories based on public or private control and the highest economics degree offered. The coursework required for the economics major typically consists of ten courses, five in a required core and five electives. The most conspicuous curriculum change over the past 30 years is the rise of econometrics as a required course, now mandatory at about half of major programs. The authors estimate that about 40 percent of students who matriculate as first-year undergraduates take at least one economics course before they leave.     

Repurchases of convertible preferred stock and shareholder wealth

In this paper we provide the first comprehensive examination of the stock price reaction to announcements of convertible preferred stock repurchases over the 1981 to 2005 period. We document a positive and significant average common stock abnormal return of 3.27% around announcements of these repurchases. We test signaling and free cash flow explanations for the observed wealth effects by studying abnormal returns and changes in operating performance around repurchase announcements. We find that abnormal returns are positively related to size of repurchases and managerial ownership. We find no evidence of higher stock price reactions for low-q and high free cash flow firms. In addition, we find significant improvements in accounting profitability subsequent to repurchases, but not for low-q firms. Collectively, our results are most consistent with the signaling hypothesis.     

Commentary on Schembri and Boyle (2013): From representation towards expression in videographic consumer research

In this commentary on Schembri and Boyle (2013) we offer an alternative perspective on the use of video in consumer research. The dominant modus operandi for visual research, as recently demonstrated by Schembri and Boyle in the pages of this journal, follows a paradigm typical of anthropological tradition. We propose an alternative approach: an expressive imperative in consumer videography emerging from theory on cinematography and experimental filmmaking, which emphasizes the evocative power of moving images.     

“You Can't Make a Good Wine without a Few Beers”: Gatekeepers and knowledge flow in industrial districts

Knowledge sharing sometimes plays a key role in the performance of clustered organizations, particularly small and medium-sized enterprises (SMEs), however, SMEs also face significant knowledge-related disadvantages due to their lack of absorptive capacity and functional expertise. This study investigates the influence of technical specialists on knowledge flow in a wine cluster in Australia. The main contribution of this paper is a finding that the technical specialist's gatekeeping role both links clustered SMEs to the global wine “systemworld” by transferring knowledge of technical developments and innovation, and simultaneously develops and refines regional winemaking styles by sharing locally specific, experientially derived knowledge. Technical specialists drew on bridging and bonding social capital to identify and retrieve specialist knowledge, and were capable of assimilating complex technical knowledge into the cluster. These findings are particularly significant because recipients were typically small and micro-firms, which are frequently located outside cluster knowledge-network.