Celecoxib for the treatment of pain resulting from osteoarthritis (OA) was reviewed by the Tandvårds- och läkemedelsförmånsverket–Dental and Pharmaceutical Benefits Board (TLV) in Sweden in late 2010. This study aimed to evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib plus a proton pump inhibitor (PPI) compared to diclofenac plus a PPI in a Swedish setting.
Methods:
The National Institute for Health and Care Excellence (NICE) in the UK developed a health economic model as part of their 2008 assessment of treatments for OA. In this analysis, the model was reconstructed and adapted to a Swedish perspective. Drug costs were updated using the TLV database. Adverse event costs were calculated using the regional price list of Southern Sweden and the standard treatment guidelines from the county council of Stockholm. Costs for treating cardiovascular (CV) events were taken from the Swedish DRG codes and the literature.
Results:
Over a patient’s lifetime treatment with celecoxib plus a PPI was associated with a quality-adjusted life year (QALY) gain of 0.006 per patient when compared to diclofenac plus a PPI. There was an increase in discounted costs of 529kr per patient, which resulted in an incremental cost-effectiveness ratio (ICER) of 82,313kr ($12,141). Sensitivity analysis showed that treatment was more cost effective in patients with an increased risk of bleeding or gastrointestinal (GI) complications.
Conclusions:
The results suggest that celecoxib plus a PPI is a cost effective treatment for OA when compared to diclofenac plus a PPI. Treatment is shown to be more cost effective in Sweden for patients with a high risk of bleeding or GI complications. It was in this population that the TLV gave a positive recommendation. There are known limitations on efficacy in the original NICE model. 相似文献
Russian organizations have undergone significant changes since the 1990s. A new generation of Russian managers has come to the fore in Russia, who are eager to learn and open to Western knowledge. In turn, Western multinationals have also learned the fundamentals of doing business in Russia. How these developments are reflected in today's operations of Western multinationals in Russia remains – albeit with a few exceptions – largely unexplored in the academic literature. To address this gap, this paper explores what are the organizational practices and how do Western multinationals utilize them when striving to succeed in today's Russia. Based on two explorative case studies and 64 personal interviews with top and line managers it identifies four organizational practices, such as management training, corporate culture management, intercultural and linguistic training, and HRM practices, and two internalization mechanisms, such as boundary spanning, and reliance on local competence. The analysis elucidates important changes that have occurred in Western-Russian business relations and underscores important practical implications. 相似文献
Boundary spanners play an important role in multinational corporations (MNC), yet it is unclear who these valuable individuals are and why certain individuals, and not others, perform this role. We advance a ‘recognition’ perspective based on whether and how relevant others on both sides on the boundary experience positive impact. A dynamic integrated mixed method analysis of 118 individuals involved in headquarters-subsidiary interactions in four MNCs, shows that only a minority are ‘recognized boundary spanners’, experienced by others to positively impact intergroup relations. We identify different categories and mechanisms of recognition, and make a methodological contribution by integrating qualitative and quantitative analysis. 相似文献
All European countries have some form of compulsory insurance against the loss of income due to temporary disability. The insurance schemes vary widely between countries both in terms of measurable entities (such as the compensation level) as well as in unmeasurable traits concerning the actual implementation of the programs. In this paper we use European Labour Force Survey data to study how the measurable differences in the programs is associated with differences in absence rates. We also summarize the theoretical literature on insurance principles in this field. Based on the empirical literature we then discuss how different forms of incentives may affect the work absence rate. 相似文献
This paper studies the effects of tax schedule changes on prices and tenure choice in the housing market. It is shown that, given the present asymmetric treatment of owner-occupants vs. renters, an increase in the degree of progressivity is likely to lead to an increasein the prices of both owner-occupied and rental housing. A numerical example indicates that the effects may be quite large. Equilibrium prices are calculated based on the actual Swedish income tax schedules for 1971 and 1979. According to these simulations the tax changes that took place between these years caused the price of owner-occupied houses to increase by around 30 percent, and the rent level to increase by 2 or 3 percent. 相似文献
ABSTRACTThe current study provides a social constructionist approach to crisis communication in the Chinese context. Crisis communication is viewed as a form of strategic communication, involving multiple stakeholders in situations that are dependent on context, space and time. This approach provides a much-needed path for investigating and understanding crisis communication practices in contemporary China. The distinct Chinese context for crisis communication, with both an authoritarian government structure and a digital transformation of society, challenges theories originally developed in the Western countries. To address this issue, this study proposes a three-theme analytical framework to examine crisis communication practices in the Chinese context: (1) an audience (or stakeholder) orientation—focusing sense-making, (2) a proactive and interactive approach—focusing communication, and (3) a community—focused approach—focusing a long-range precrisis perspective. 相似文献
The aim of this study is to describe and analyze a transboundary crisis, focusing on crisis communication from the perspective of an involved major corporation. More concretely, the intent is to increase understanding of how Findus Nordic in Sweden managed the crisis communication response and repair of its trust and corporate brand during and after the horsemeat scandal in 2013. The case study is based on a theoretical framework that consists of three theories or concepts: transboundary crisis, image repair strategy, and rhetorical arena. Findus Nordic followed its corporate values and applied a consistent image repair strategy: denial and blame shifting towards the supplier Comigel in an extremely multivocal arena. This strategy was supplemented with responsibility evasion. Towards the end of the public crisis, Findus Nordic used the crisis as an opportunity to recover their position and started a campaign that had a positive impact on trust and the corporate brand. The launch of the campaign was very fast and might have been dangerous. However, according to the analysis, the success of the campaign may be explained as a consequence of its sensemaking and auto-communicative approach. 相似文献
Should product architectures be considered inputs to – or outputs from – new product development (NPD)? Whereas the mirroring hypothesis suggests the former, NPD stage models suggests the latter. Elaborating on these conflicting propositions, this paper analyses the relationships between product architectures and development processes in NPD projects. The analysis demonstrates how project managers use product architectures to interpret their tasks and devise appropriate responses to perceived challenges. Thus, architectures provide useful linkages between knowledge development and organisational change in R&D organisations. 相似文献
Microeconomic data often have within‐cluster dependence, which affects standard error estimation and inference. When the number of clusters is small, asymptotic tests can be severely oversized. In the instrumental variables (IV) model, the potential presence of weak instruments further complicates hypothesis testing. We use wild bootstrap methods to improve inference in two empirical applications with these characteristics. Building from estimating equations and residual bootstraps, we identify variants robust to the presence of weak instruments and a small number of clusters. They reduce absolute size bias significantly and demonstrate that the wild bootstrap should join the standard toolkit in IV and cluster‐dependent models. 相似文献