Cost-effectiveness of once-weekly semaglutide versus dulaglutide and lixisenatide in patients with type 2 diabetes with inadequate glycemic control in Sweden

Abstract

Aims: This analysis evaluated the cost-effectiveness of once-weekly semaglutide vs glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D) uncontrolled on metformin or basal insulin in Sweden.

Materials and methods: This cost-effectiveness analysis (CEA) was conducted using the Swedish Institute of Health Economics (IHE) Diabetes Cohort Model. Analyses were conducted from the Swedish societal perspective over a time horizon of 40?years. For patients uncontrolled on metformin, dulaglutide was the comparator, and data from the SUSTAIN 7 clinical trial was used. For patients uncontrolled on basal insulin, lixisenatide was chosen as the comparator and data was obtained from a network meta-analysis (NMA).

Results: The results show that, in patients with inadequate control on metformin, semaglutide 1.0?mg dominated (i.e. provided greater clinical benefit, and was less costly) dulaglutide 1.5?mg. In patients with inadequate control on basal insulin, semaglutide 1.0?mg dominated lixisenatide. The reduction in costs is largely driven by the reduction in complications seen with once-weekly semaglutide.

Limitations and conclusions: It is likely that this analysis is conservative in estimating the cardiovascular (CV) cost benefits associated with treatment with once-weekly semaglutide. In patients inadequately controlled on basal insulin, the analyses vs lixisenatide were based on results from an NMA, as no head-to-head clinical trial has been conducted for this comparison. These CEA results show that once-weekly semaglutide is a cost-effective GLP-1 RA therapy for the treatment of T2D in patients inadequately controlled on metformin or basal insulin, addressing many current clinician, patient, and payer unmet needs in Sweden.     

Relationship commitment and value creation in sponsorship relationships

Purpose: The sponsorship industry has evolved considerably in recent years due to the strategic business opportunities that it provides. Despite increased interest in sponsorship, analysis of the relationship between relationship commitment and value creation and of relationship commitment as comprising multiple types or components in the context of sponsorship relationships is lacking. To address these gaps, this paper analyzes relationship commitment (in terms of affective commitment and value-based commitment) as a significant mediating variable, and value creation in the context of sponsorship relationships.

Methodology/approach: A questionnaire was sent to Swedish Hockey League sponsors to collect data and to verify the study’s conceptual model and relationships. The response rate for the survey was 19.8%, that is, 122 completed questionnaires out of 616 sent. The respondents represented the most common industries in Sweden, but most of them belonged to the construction, repair, and electronics industries (18.0%), manufacturing and production industry (13.1%), and commerce industry (11.5%). Most sponsoring companies (30.3%) were categorized as medium-sized (50–249 employees). Most respondents (38.5%) had invested EUR 4300–15,000, whereas 11.5% had invested less than EUR 4300. Moreover, we found that most sponsors had been in their sponsorship relationships for more than 10 years (32.8%). Structural equation modeling (SEM) was used for the data analysis.

Findings: This study demonstrates that relationship commitment is an important driver of value creation in sponsorship relationships. Furthermore, the various forms of affective commitment and value-based commitment should not be considered merely components or forms but distinct types. Certainly, there is interaction between the two types, but sequentially in such a way that affective commitment is a prerequisite for value-based commitment. This means that a sponsor must have an emotional relationship with the sponsee in order to understand, perceive, and calculate the sponsorship relationship’s future business value in terms of profits and other benefits. This study also finds that value-based commitment is the most significant type of commitment in sponsorship relationships.

Research implications: The study demonstrates that shared values, trust, and affective commitment are fundamental conditions for value-based commitment. If the parties agree on how they should behave in the relationship, the rules and objectives that apply lead to the emergence of mutual trust, which in turn makes the parties want to continue the relationship for emotional reasons. But this is not enough for value creation; they must also see that there are future business benefits from the relationship. Therefore, the parties more or less explicitly make calculations. If the calculations indicate that the long-term benefits of the relationship outweigh the short-term sacrifices, they are prepared to invest in the relationship, and this may lead to value creation. In other words, there is both interplay and tension between shared values, trust, and affective commitment, on one hand, and value-based commitment, on the other. Another theoretical contribution is that previous research has considered the links between relationship commitment and value but has ignored the different types of commitment that play key roles in the value-creation process; this study has addressed that oversight. The study demonstrates that affective commitment and value-based commitment have different roles and meanings. Affective commitment indirectly affects value creation, while value-based commitment directly affects value creation. Affective commitment has the role of partial mediator, while value-based commitment has the role of full mediator. Furthermore, they differ in their basic characteristics: affective commitment is an emotional aspect, while value-based commitment is a calculative aspect.

Originality/value/contribution: Previous studies have not analyzed the relationship between relationship commitment and value creation. However, this study demonstrates that relationship commitment is an important driver of value creation in sponsorship relationships. Furthermore, most previous research argues that relationship commitment consists of various components or forms that interact in parallel with each other. However, this study demonstrates that the various forms of affective commitment and value-based commitment should not be considered merely components or forms but distinct types. Certainly, there is interaction between the two types, but sequentially in such a way that affective commitment is a prerequisite for value-based commitment. Furthermore, previous studies have consistently noted that affective commitment is the most important component, form, or type of relationship commitment. However, this study finds that value-based commitment is the most significant type of commitment in sponsorship relationships.     

Realization of Open Innovation: A Case Study in the Manufacturing Industry

Continuous innovation is regarded as an imperative for most companies. In this regard, open innovation suggests a successful approach to new product development, wherein the emphasis is on external collaboration. Previous research has provided examples from some industries, whereas mature and traditional companies such as manufacturing firms have gained limited interest. Thus, this paper seeks to answer two critical questions: why should manufacturing companies shift toward open innovation approaches and how can they adopt open innovation for product development. Based on case study in two companies, a list of opportunities, challenges, and efforts for organizational change toward open innovation are discussed.     

CO2-Stabilization May Be a 'No-Regrets' Policy

Restricting CO₂ emissions requires changing today's consumption pattern away from energy and emission intensive commodities towards cleaner goods. The cost of stabilizing CO₂ emissions at the 1990 level by the year 2000, say, as compared to a business-as-usual trend, is estimated by several researchers to be on the order of 1% of GNP. We will argue that the cost may be overestimated because of a too simple model describing the working of the economic system and the evaluation of welfare. We demonstrate that by expanding a model to include the actual tax system and negative externalities, the cost to present generations from restricting emissions by a CO₂ tax may be negative. That is, some reduction may actually correspond to a 'no-regrets' policy. The reasons are inefficiencies in today's tax system and non-optimal handling of negative externalities. Our analysis suggests that a CO₂ tax and reduced emissions will lessen such inefficiencies.     

The effects of input tariffs on productivity: panel data evidence for OECD countries

Based on a panel of 16 OECD countries and 10 manufacturing industries over 1996–2007, this paper investigates the impact of tariffs on foreign intermediate goods on productivity growth in downstream manufacturing industries. The results show that imposing tariffs on imported intermediate goods is particularly harmful for industries that operate close to the global technological frontier. We also consider the possibility that input-tariff liberalisation may have different effects depending on the technological content of imported intermediate goods. Our findings suggest that protecting imports of high-technological goods is more harmful for productivity improvements in industries that operate close to global best practice.     

Intellectual structure of management innovation: bibliometric analysis

Management Review Quarterly - Due to the growing field of management innovation, there is a need to synthesise and reflect on the existing literature, inventory the work done and identify new...     

Evaluation of a home injury prevention program in a WHO Safe Community

The objective of this study was to evaluate the effect of a community-based injury prevention program on home injuries. Unintentional injuries occurring in private homes and during leisure time account for 70-80% of injuries treated in public health care. A quasiexperimental design was used for the study, with cross-sectional preand post-implementation measurements in the program area and in a neighboring control community. Children and the elderly were two main target groups of the intervention program, which was based on a participative strategy for community involvement. The study was based on defined total populations. The total relative risk for home injury occurrence decreased in the study area, whereas it increased in the control area. Regarding age and gender, there was a decrease for females and males in the study area and a slight increase in the control area. For males, the youngest and oldest age groups showed no decrease, whereas females showed a decrease among the youngest and those aged 60-79. No decrease was observed in the control area. The study showed that the Safe Community approach had a general effect on the incidence of home injuries.