Real-world healthcare resource utilization related to migraine treatment failure: a panel-based chart review in France,Germany, Italy,and Spain

Abstract

Aims: This retrospective chart review examined the six-month migraine-related healthcare resource use (HRU) among European patients who had ≥4 migraine days per month and previously failed at least two prophylactic migraine treatments.

Methods: Neurologists, headache specialists, and pain specialists in France, Germany, Italy, and Spain who treated ≥10 patients with migraine in 2017 were recruited (April–June 2018) to extract anonymized patient-level data. Eligible physicians randomly selected charts of up to five adult patients with clinically-confirmed migraine, ≥4 migraine days in the month prior to the index date, and had previously failed at least two prophylactic migraine treatments. Treatment failure was defined as discontinuation due to lack of efficacy and/or tolerability. Demographic and disease characteristics as of the index date, and migraine-related HRU incurred during the 6-month study period, were recorded.

Results: A total of 104 physicians contributed 168 charts for patients (63% female). On average, patients were 38?years old and failed 2.3 prophylactic treatments as of the index date. During the study period, 83% of patients had ≥1 outpatient visit for migraine in the physician’s office, and 27% went to the ER/A&E. Approximately 5% of patients were hospitalized for migraine, with an average of one hospitalization and an average length of stay of 3 days. Approximately 39% of patients had ≥1 blood test, 22% had ≥1 magnetic resonance imaging, 17% had ≥1 electroencephalogram, and 13% had ≥1 computerized tomography scan. Visits to other healthcare providers were common.

Limitations: This study is subject to the limitations of chart review studies, such as errors in data entry.

Conclusions: Across four European countries, the HRU burden of migraine among patients who previously failed at least two prophylactic treatments was high, indicating a need for more effective prophylactic treatments to appropriately manage migraine and reduce the HRU burden attributable to this common disorder.     

The perfect gift card: An exploration of teenagers' gift card associations

This study provides new insights into the meaning and value of gift cards in gift exchange among teenagers who gave and/or received gift cards during the Christmas/Hanukkah season. From their reflections of the reasons for giving gift cards and their feelings about receiving gift cards from others, the social roles played out in buying gift cards as a gift selection strategy are assessed and the values associated with gift cards explored. The results suggest that givers playing the roles of acknowledger and pleaser are heavy gift card givers when buying gifts for difficult recipients. Acknowledgers incorporate gift cards into existing strategies for gift selection (especially “settle,” “pawn off,” and “buy relationship affirming gifts”), but for pleasers, buying gift cards may be part of a new gift selection strategy—“play it safe.” Importantly, although gift cards can reflect economic, social, and functional value, the giving of gift cards seems to result in a new form of value for the recipients—the value of choice, which occurs when the control over gift selection is transferred from giver to receiver. © 2008 Wiley Periodicals, Inc.     

Does literacy and numeracy training for adults increase employment and employability? Evidence from the Skills for Life programme in England

The employment effects of participation in adult literacy and numeracy courses are assessed, one year after participation, using a matched comparison, longitudinal design, with difference‐in‐differences analysis. Employability improvements, but no employment effects, are found. Effects on employment may result in the longer term from an increased likelihood of subsequent training.     

Risk aversion in agricultural water management investments in Northern Ghana: experimental evidence

Sub‐Saharan Africa (SSA) is one of the regions in the world most affected by food price volatility and production variability. Poor small‐scale farmers in this region are particularly vulnerable to this variability. As a result, households may be reluctant to adopt new agricultural water management (AWM) technologies when they involve more risk than what they mitigate. Despite risk's role in AWM investments, there have been few attempts to estimate the magnitude and nature of risk aversion in relation to this type of farm decisions. To partially close this gap, this article uses an experimental approach applied to 137 households in Northern Ghana. We find that more than 70% of households are moderately or slightly risk averse. This contrasts with other studies in SSA, where most household decision‐makers exhibit severe to extreme risk aversion. We also find that households that stand to lose as well as gain something from participation in games are less risk averse than households playing gains‐only games. This result suggests that most farmers’ current wealth put them at risk of falling into a poverty trap. Thus, the losses from the riskiest investments on AWM technologies may fall more heavily on the poor, suggesting that additional efforts be given to the creation of viable insurance mechanisms.     

Understanding the changes in accounting thought

Financial accounting and reporting are in the midst of one of the most significant revolutionary changes in modern history. The purpose of this paper is to provide a framework that will contribute to the dialogue surrounding these developments. We use Kuhn’s [Kuhn, T. S. (1970). The structure of scientific revolutions. Chicago, IL: The University of Chicago Press] framework on the theory of scientific revolution to describe how changes in the need for information, coupled with the lack of relevant accounting information, led to reporting anomalies that have spurred a revolutionary shift in accounting paradigms. We are moving from an accounting paradigm that existed in the age of an industrial economy to an accounting paradigm that fits the economy in an information age. This redirection has resulted in the following: a change in the conceptualization and application of relevance and reliability, an increased use of fair value versus historical cost measurements, a renewed emphasis on principles versus rules, and an evaluation of the composition of the basic financial statements.     

Owners on both sides of the deal: mergers and acquisitions and overlapping institutional ownership

Using a corporate governance lens, this study considers owners with a stake in both the acquiring and the target firms in the context of mergers and acquisitions. A possible agency problem arises with regard to monitoring implications as managers may be able to take advantage of compromised monitoring because overlapping owners may focus on the aggregate value for both the acquiring and the target firms and nonoverlapping owners may be interested only in the acquirer's side of the deal. The results suggest that when more owners overlap in their ownership of both the acquiring and target firms, the acquiring firms are more likely to experience decreased shareholder value through merger and acquisition deals. This effect, however, can be constrained by stronger board control. Copyright © 2010 John Wiley & Sons, Ltd.     

Patent Rights and Trade: Analysis of Biological Products, Medicinals and Botanicals, and Pharmaceuticals

This article analyzes the effects of foreign patent rights on U.S. bilateral exports. The empirical analysis covers three highly disaggregated drug industries over three decades. We estimate bilateral trade equations for each industry using cross-country data on the strength of national patent rights. The findings show that strong foreign patent rights enhance the market power of U.S. drug exporters across countries with weak imitative abilities. Alternatively, strong foreign patent rights stimulate the market expansion of U.S. drug exports across countries with strong imitative abilities. These effects are larger in magnitude during the 1980–90s relative to the 1970s.     

Discussion of Who Is My Peer? A Valuation‐Based Approach to the Selection of Comparable Firms

Bhojraj and Lee present a new approach to deriving warranted valuation multiples and selecting comparable firms. Conference participants' comments centered on two key issues. First, participants questioned the motivation for deriving warranted valuation multiples and selecting comparable firms. Second, participants questioned the procedure through which valuation theory was incorporated in the valuation multiple forecasting process.