Singapore's Perspectives on the Proliferation of RTAs in East Asia and Beyond

Abstract

In this article the viewpoints and adopted strategies of Singapore in managing its trading relationship with other countries in the world is discussed. Trade being the lifeline and basis for its economic survival, Singapore has been very active in the negotiation and establishment of Free Trade Agreements (FTAs) with countries, practically in every continent. Singapore's activism in bilateral FTAs is a reinforcement of its development strategy of expanding and ensuring market access for local and foreign investors. This is also in alignment with Singapore's pro- business strategy philosophy and the objective of ensuring economic viability. Also Singapore's trade accords go beyond trade liberalization and include “behind the border” impediments to trade; this is reckoned to keep the momentum of trade talk going and to hasten the process of liberalization by inducing other countries to liberalize.     

Cost-effectiveness of sacubitril/valsartan versus enalapril in patients with heart failure and reduced ejection fraction

Background: Sacubitril/valsartan reduces cardiovascular death and hospitalizations for heart failure (HF). However, decision-makers need to determine whether its benefits are worth the additional costs, given the low-cost generic status of traditional standard of care.

Aims: To evaluate the cost-effectiveness of sacubitril/valsartan compared to enalapril in patients with HF and reduced ejection fraction, from the Singapore healthcare payer perspective.

Methods: A Markov model was developed to project clinical and economic outcomes of sacubitril/valsartan vs enalapril for 66-year-old patients with HF over 10 years. Key health states included New York Heart Association classes I–IV and deaths; patients in each state incurred a monthly risk of hospitalization for HF and cardiovascular death. Sacubitril/valsartan benefits were modeled by applying the hazard ratios (HRs) in PARADIGM-HF trial to baseline probabilities. Primary model outcomes were total and incremental costs and quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) for sacubitril/valsartan relative to enalapril

Results: Compared to enalapril, sacubitril/valsartan was associated with an ICER of SGD 74,592 (USD 55,198) per QALY gained. A major driver of cost-effectiveness was the cardiovascular mortality benefit of sacubitril/valsartan. The uncertainty of this treatment benefit in the Asian sub-group was tested in sensitivity analyses using a HR of 1 as an upper limit, where the ICERs ranged from SGD 41,019 (USD 30,354) to SGD 1,447,103 (USD 1,070,856) per QALY gained. Probabilistic sensitivity analyses showed the probability of sacubitril/valsartan being cost-effective was below 1%, 12%, and 71% at SGD 20,000, SGD 50,000, and SGD 100,000 per QALY gained, respectively.

Conclusions: At the current daily price sacubitril/valsartan may not represent good value for limited healthcare dollars compared to enalapril in reducing cardiovascular morbidity and mortality in HF in the Singapore healthcare setting. This study highlights the cost-benefit trade-off that healthcare professionals and patients face when considering therapy.     

Is the ASEAN Free Trade Area a Second Best Option?

This paper evaluates the ASEAN Free Trade Area (AFTA) which has been accepted as an ASEAN endeavour to be achieved by 2008 in the Singapore Summit in 1992. Noting the new circumstances and environment which have prompted a more proactive strategy of economic integration, the paper first surveys empirical studies on the economic impact of complete trade liberalisation. The consensus is that AFTA would not have a substantial impact in increasing intra-ASEAN trade. This suggests that AFTA, like previous ASEAN efforts at economic cooperation, seems more a political than economic effort. The inherent lack of complementarity in trade remains though the ASEAN countries' industrial structures have become more competitive and complementary. The paper however concludes that AFTA would still be useful as a demonstration of ASEAN solidarity and commitment especially if supplemented by other measures such as more deregulation and cross-country investment and other exchanges of factors like technology and human resource development.     

The intelligent city: singapore achieving the next lap

Singapare has become one of the Asian dragons, or newly industrializing economies (NIEs), and aspures tobecome a developed country over the next lap of 30-40 years. Its economic restruchuring to become an intelligent' city-state thrwing on manufacturing cum-services is spported by entigtened human resource development which has hanessed infosrmeation technology and telecommunications (IT&T). The success of Singapore as an intelligent city' is not only driven by companies but also bu clear-sighted govenmnent stratgies. In the next lap, IT&T is envisaged as upgrading the quality of life too.     

AN INPUT–OUTPUT STUDY OF THE SINGAPORE INFORMATION SECTOR

The development and use of information and communication technologies is one of the key drivers of the ‘knowledge economy.’ In this paper, we investigate the impact of information technology on the output growth of the Singapore economy using the input–output framework. The input–output framework allows us to understand the impact of information sector in an integrated framework in terms of its linkages to the manufacturing and service sectors. In particular, we adopt the input–output approach to shed light on both production and diffusion activities of the information sector on the Singapore economy. The results indicate that the ICT sector provided the key linkages for the expansion of high-value added manufacturing activities and electronics export for the Singapore economy.     

TRADE LIBERALIZATION,LABOR DEMAND SHIFTS AND EARNINGS INEQUALITY IN SINGAPORE

This article investigates the relative wage between skilled and low skilled labor in a small open economy with traditionally few labor market rigidities. It looks at the role of relative skills demand and supply in determining skills premium and explores the extent to which trade liberalization affects the skills wage gap. Indications are that greater openness is linked to higher labor demand elasticity and/or technological progress. The evidence also suggests that rapid acceleration in labor demand for skills and trade liberalization has widened the wage gap between skilled and low skilled labor. This result persists regardless of industry type.     

Bilateral ‘WTO‐Plus’ Free Trade Agreements: The WTO Trade Policy Review of Singapore 2004

The World Trade Organisation's 2004 Trade Policy Review of Singapore (WTO‐TPR Singapore 2004) depicts the small and outward‐oriented economy as one of the most open countries to international trade and investment. The review highlights the benefits of the outward‐oriented strategy that has enabled the Singapore economy to weather recent external shocks such as the Asian financial crisis to the SARS and to the recent unfavourable conditions in the Middle East. In particular, the report commended Singapore's efforts on its liberalisation of the services sector and its economic benefits to consumers and global trade. However, the WTO‐TPR Singapore 2004 highlights several key areas of concerns: (a) the commitment to multilateral agreements with the rising number of bilateral free trade agreements signed by Singapore and (b) the lack of growth of total factor productivity, a key indicator for long‐run efficiency of the economy. The paper addresses the above key concerns raised in the WTO's TPR of Singapore in terms of its commitment to global trade in terms of WTO‐plus bilateral FTAs, which intends to support a multilateral trading system, and its overall industrial strategies to raise its competitiveness.     

Chicken,or the egg,or both? The interrelationship between a firm's inventor specialization and scope of technologies

Firms with different scope of technologies experience different firm growth. Understanding such heterogeneity requires knowing not only what drives technologies' scope but also why these drivers remain different across firms. I propose inventor specialization as a driver of technologies' scope: firms with more specialized inventors create narrower scope technologies. I also propose that these narrower scope technologies themselves in turn induce these firms' inventors to remain more specialized. I empirically demonstrate this two‐way interrelationship in the U.S. communication equipment industry using policy shocks as natural experiments and a new measure of scope. This interrelationship has important implications for why resources and organization appear isomorphic within a firm but heterogeneous across firms. t © 2013 John Wiley & Sons, Ltd.