The cost-effectiveness of dulaglutide versus liraglutide for the treatment of type 2 diabetes mellitus in Spain in patients with BMI ≥30 kg/m2

Objective: Dulaglutide 1.5?mg once weekly is a novel glucagon-like peptide 1 (GLP-1) receptor agonist, for the treatment of type two diabetes mellitus (T2DM). The objective was to estimate the cost-effectiveness of dulaglutide once weekly vs liraglutide 1.8?mg once daily for the treatment of T2DM in Spain in patients with a BMI ≥30?kg/m².

Methods: The IMS CORE Diabetes Model (CDM) was used to estimate costs and outcomes from the perspective of Spanish National Health System, capturing relevant direct medical costs over a lifetime time horizon. Comparative safety and efficacy data were derived from direct comparison of dulaglutide 1.5?mg vs liraglutide 1.8?mg from the AWARD-6 trial in patients with a body mass index (BMI) ≥30?kg/m². All patients were assumed to remain on treatment for 2 years before switching treatment to basal insulin at a daily dose of 40?IU. One-way sensitivity analyses (OWSA) and probabilistic sensitivity analyses (PSA) were conducted to explore the sensitivity of the model to plausible variations in key parameters and uncertainty of model inputs.

Results: Under base case assumptions, dulaglutide 1.5?mg was less costly and more effective vs liraglutide 1.8?mg (total lifetime costs €108,489 vs €109,653; total QALYS 10.281 vs 10.259). OWSA demonstrated that dulaglutide 1.5?mg remained dominant given plausible variations in key input parameters. Results of the PSA were consistent with base case results.

Limitations: Primary limitations of the analysis are common to other cost-effectiveness analyses of chronic diseases like T2DM and include the extrapolation of short-term clinical data to the lifetime time horizon and uncertainty around optimum treatment durations.

Conclusion: The model found that dulaglutide 1.5?mg was more effective and less costly than liraglutide 1.8?mg for the treatment of T2DM in Spain. Findings were robust to plausible variations in inputs. Based on these results, dulaglutide may result in cost savings to the Spanish National Health System.     

Land Market Interactions between Heterogeneous Agents in a Heterogeneous Landscape—Tracing the Macro-Scale Effects of Individual Trade-Offs between Environmental Amenities and Disamenities

Heterogeneity in both the spatial environment and economic agents is a crucial driver of land market dynamics. We present an agent‐based land market model where land from agriculture use is transferred into urban. The model combines the microeconomic demand, supply, and bidding foundations of spatial economics models with the spatial heterogeneity of spatial econometric models in a single methodological platform. Heterogeneous agents exchange heterogeneous spatial goods via simulated bilateral market interactions. We model a coastal city where both coastal amenities and flooding or erosion disamenities drive land market outcomes, facilitating separate analysis of the effects of each driver on land rents and land development patterns. We also analyze the implications of homogeneous versus heterogeneous but unbiased flood risk perceptions. Since buyers with low risk perceptions drive market outcomes, spatial development under heterogeneous risk perceptions differs qualitatively, with more expansion into risky areas. Our results highlight the shortcomings of policy models based on representative agent assumptions and the importance of including agent‐level data in empirical modeling. L'hétérogénéité de l'environnement spatial et des agents économiques constitue un élément moteur crucial de la dynamique du marché foncier. Nous présentons un modèle multi‐agent du marché foncier dans lequel des terres agricoles ont été transférées pour des fins urbaines. Le modèle combine les fondements microéconomiques de la demande, de l'offre et des enchères de modèles de l'économie spatiale avec l'hétérogénéité spatiale des modèles de l'économétrie spatiale dans une plateforme méthodologique unique. Les agents hétérogènes échangent des biens hétérogènes par le biais du jeu des forces du marché bilatéral simulé. Nous avons modélisé une ville côtière où les agréments côtiers et les désagréments causés par les inondations ou l'érosion influent sur le marché foncier, facilitant l'analyse individuelle des effets de chaque élément moteur sur les loyers fonciers et les modèles d'aménagement de terrain. Nous avons également analysé les répercussions des perceptions homogènes et hétérogènes mais non biaisées à l'égard du risque d'inondation. Étant donné que les acquéreurs qui ont de faibles perceptions du risque motivent les effets du marché, le développement spatial selon des perceptions hétérogènes à l'égard du risque varie qualitativement, avec plus d'expansion dans les zones à risque. Nos résultats ont mis en lumière les lacunes des modèles de politiques fondés sur les hypothèses d'un agent représentatif et l'importance d'inclure des données sur l'hétérogénéité des agents dans la modélisation empirique.     

Perceived Differences: Chinese and Russian Farmers on Business,Law, Management,and Environment

The People's Republic of China has been following a strategy for several decades to encourage its enterprises to invest overseas. Since the liberalization of the Sino-Soviet border in the 1990s, Chinese farmers have been actively engaged in the economy of the Russian Far East (RFE). This article examines Chinese and Russian public relations messages broadcast by media about Chinese-Russian agricultural cooperation that use different arguments, methods of reasoning, and points of view. There is a clash of different national management methods. Legislation applying to Chinese working in Russia has been erratic and unstable, and that makes cooperation more challenging. The concepts of environmental protection and obedience to the law are understood differently by Russians and by Chinese. Cross-cultural management differences affect the way people on both sides interpret institutions, interactions, and the ability to trust third parties. There are different values and priorities expressed by Russians and by Chinese when it comes to development of rural areas in the RFE.     

Innovation by design: SPARK and the Overcoming of Stanford University's Translational “Valley of Death” in Bio-Medicine

Stanford University's world leadership as an entrepreneurial university induced a “paradox of success,” inhibiting further development of its organizational infrastructure for entrepreneurship support. Nevertheless, some prospective academic entrepreneurs realized that there were invisible persisting gaps in the university's innovation system. We discuss the role of the entrepreneurial university and provide a case study of SPARK, an organizational innovation, created to address Stanford's translational research gap, that was then spread to other universities. The creation of a support structure to encourage students and faculty to define entrepreneurial projects as part of their education and research revealed a novel organizational change dynamic.     

Chinese Migrant Farmers in the Russian Far East: Impact on Rural Labor Markets

The close proximity of China and Russia, the activities of Chinese farmers, and the reduction in Russian labor resources have created job opportunities for Chinese workers in the Russian Far East (RFE). Chinese workers fill a labor shortage in agriculture, but little research has been done on them. We developed an econometric model to test the effects of Chinese intermittent migration on labor markets in the RFE. We found the proximity of Chinese to Russian farms reduces wages for both Russian and Chinese workers and increases their part-time employment on Russian farms. The greater availability of Chinese workers in the region results in lower number of family members working on Russian farms. Thus, the influx of Chinese workers may contribute to demographic shifts in the Russian population.     

Business cycle stylized facts and inventory behaviour: New evidence for the Euro area

The purpose of this paper is for the first time to use Business Tendency Survey data, first, to identify new facts that are useful for the interpretation of the decline in the volatility of real activity in the Euro area, and, second, to test the inventory management hypothesis as an explanation for the Great Moderation in Europe. We present stylized facts from the Business Tendency data on series for inventories, current production, current orders, and expected production for the Euro area, emphasizing the decline in the volatility of the series. Further, we investigate whether the decline in inventory volatility can be attributed to an endogenous change in the persistence of shocks to the accumulation dynamics of inventories or to an exogenous change in the shocks hitting the inventory optimisation process. Our results at Euro level generally indicate that there is no evidence of a break in the inventory accumulation process. On the contrary, the impact of exogenous shocks on inventory volatility appears to be steadily declining over time, beginning from the mid-1980s.     

Trust during retail encounters: A touchy proposition

Adopting an interpersonal communication perspective, this study examines the propositions that a salesperson's touch increases trust, which increases product evaluations and purchase intention. These relationships are evaluated in a contact and non-contact culture, with need for touch (NFT) examined as an additional moderator. An exploratory series of in-depth interviews provides an initial understanding of these relationships, followed by a 2 (touch/no touch condition) × 2 (consumers in France/Germany) experiment with wine serving as the example category. The findings indicate that touch does not uniformly instill trust in customers. Instead a salesperson's touch relates to greater trust only when consumers have an inherent NFT or when they are from a culture where personal touching behavior is less prevalent. Trust, in turn, relates positively to evaluations of product attractiveness, quality, and to purchase intention.     

Strategy for Implementation of IFAC International Education Guideline No. 9: "Prequalification Education, Tests of Professional Competence and Practical Experience of Professional Accountants": A Task Force Report of the International Association for Accounting Education and Research (IAAER)

This paper provides strategies for implementing the recommendations of the International Education Guideline No. 9 (hereafter referred to as Guideline), issued by the International Federation of Accountants. The three principal implementation issues addressed in this paper are as follows. (1) How to instill the characteristics of lifelong learning in future professional accountants through accounting education. (2) How to design and implement a program of accounting education that achieves the objectives of the Guideline . (3) How to develop awareness and encourage adoption of the recommendations of the Guideline by communicating and disseminating information through a series of projects within IFAC's constraints and policies.     

The current account as a dynamic portfolio choice problem

The current account can be understood as the outcome of investment decisions made by domestic and foreign investors. These decisions can be decomposed into portfolio rebalancing and portfolio growth components, as highlighted by theoretical models. The empirical literature draws attention to the relative importance of portfolio rebalancing to explain fluctuations in capital flows, although they do not shed light on the mechanisms behind these rebalancing effects. In this paper, we provide empirical evidence of the importance of portfolio rebalancing driven by changes in investment opportunities for the dynamics of the current account. In particular, we evaluate the predictions of a partial-equilibrium model of the current account with dynamic portfolio choices, in which portfolio rebalancing is driven by changes in expected asset returns. Focusing on the dynamics of the current account between Japan and the US, we find evidence supporting innovations in investment opportunities as an important mechanism to explain international capital flows.     

Inheritance patterns in migration-prone communities of the Peruvian Highlands

On the basis of detailed information on inheritance practices collected in the course of an in-depth survey of three Andean communities of Peru, and unlike most empirical studies which rely on remittance functions, we have been able to estimate an inheritance function with a view to identifying the main factors associated with particular patterns of land bequests. A central result is that the positive relationship between caring and a favourable access to land bequest indeed exists, yet is only observed for migrant children (whether urban or rural, long-distance or short-distance migrants). Combined with other findings and observations, this result strengthens the case for an interpretation based on an active role of potential heirs in the determination of inheritance outcomes. It therefore calls into question the strategic bequest theory which presumes that parents are the ultimate decision-makers in this matter. In addition, our study shows that inheritance patterns are complex: besides migration and caring behavior, personal characteristics of potential heirs, such as gender, birth order, and family status (having children or not), do appear to influence division of parental land.