Cost-effectiveness of obinutuzumab plus bendamustine followed by obinutuzumab monotherapy for the treatment of follicular lymphoma patients who relapse after or are refractory to a rituximab-containing regimen in the US

Aims: Obinutuzumab (GA101, G) was approved in February 2016 by the US Food and Drug Administration to treat follicular lymphoma (FL) patients who relapsed after, or are refractory to (R/R), a rituximab-containing regimen (R/R-rituximab). In the GADOLIN trial, R/R-rituximab patients who received G plus bendamustine (B) followed by G-monotherapy (G?+?B) for up to 2 years had significantly improved progression-free survival and overall survival compared to patients receiving B-monotherapy. This study estimated the cost-effectiveness of G?+?B vs B-monotherapy for R/R-rituximab FL patients from a US payer perspective.

Materials and methods: Patient outcomes were simulated using a 3-state area under the curve model including progression-free survival, progressive disease, and death. This study used R/R-rituximab data from the National LymphoCare Study to extrapolate the GADOLIN trial’s refractory FL progression-free and overall survival data to a R/R-rituximab FL population. Drug utilization and adverse events were based on trial data, and costs were based on Medicare reimbursements and drug wholesale acquisition costs in 2016. Utility estimates were derived from published literature. Post-progression treatment costs were based on observed post-progression therapies in GADOLIN. Sensitivity analyses were conducted to assess model uncertainty.

Results: G?+?B resulted in an increase in quality-adjusted life years relative to B-monotherapy of 1.24 (95% CR?=?0.61–1.87); the incremental total cost was $58,100 (95% CR?=?$54,500–$61,500). The incremental cost-effectiveness ratio was $47,000 per QALY gained, and, based on probabilistic simulations, there was a 98% probability that G?+?B was cost-effective at the $100,000 per QALY threshold.

Limitations and conclusions: This US-based analysis suggests that treatment with G?+?B compared to B-monotherapy is likely cost-effective in R/R-rituximab FL patients. Modeling a R/R-rituximab population based on a synthesis of GADOLIN and the National LymphoCare Study data introduces uncertainty in the analysis. However, the findings were robust to sensitivity analyses.     

The patterns of output growth of firms and countries: Scale invariances and scale specificities

This work brings together two distinct pieces of evidence concerning, at the macro level, international distributions of incomes and their dynamics, and, at the micro level, the size distributions of firms and the properties of their growth rates. Our contribution to the literature is twofold. First, our empirical analysis provides a new look at the international distributions of incomes and growth rates by investigating more closely the relationship between the two entities and the statistical properties of the growth process. Second, we identify the statistical properties that are invariant with respect to the scale of observation (country or firm) as distinct from those that are scale specific. This exercise proposes a few major interpretative challenges regarding the correlating processes underlying the statistical evidence.     

Social Bond Development Through Continuous Indebtedness

The state of being indebted arises when someone borrows money and later on pays it back. Continuous indebtedness is when a person incurs several loans in a row, such as from banks, credit companies and relatives, without paying off the previous ones. The aim of this paper is to investigate how continuous indebtedness changes the structure of social relations. The Theory of the Gift provides a framework to analyse social bonds among people. A qualitative approach was used to conduct in-depth interviews with 19 indebted households. Findings point to four structures of social relationship trajectories that occur as a result of the continuous indebtedness process. These are Positive Gift Relationship, when the debt reinforces a social bond; Negative Gift Relationship, when a social bond is broken; Selfish Gift Relationship when a person wants to get out of a social bond and Vampire Gift Relationship, when the debt arises due to the debtor’s desire to attract people of a certain reference group. Understanding how the continuous indebtedness process changes social relationships might help in the development of an action plan to avoid extreme financial situations.     

Financial hedging with derivatives and its impact on the Colombian market value for listed companies

The financial theory (Modigliani & Miller, 1958) presents risk management as a matter without importance in companies, given that the shareholders themselves managed their hedges, diversifying their portfolios. However, subsequent studies dispute said premise and present evidence that business financial hedging improves performance and increases the value of the same (Ahmed, Azevedo, & Guney, 2014; Allayannis & Weston, 2001; Kapitsinas, 2008). The efficient market risk management is supported in the financial derivatives, and demands strategic and efficient administrators in hedges that add value, especially in the face of clashes and macroeconomic and financial imbalances. The empirical evidence analyzes the behavior of the Q-Tobin as an indicator of the effect of the hedge strategies for the exchange rate associated to the market value. The aim of this work is to find evidence in Colombia on the effect of the use of derivatives in the market value of the company. Its added value lies in the analysis that is done by economic sectors, identified by ISIC codes and grouped into five (5) macro sectors (Agriculture and livestock, Commercial, Industrial or Manufacture, Services, and Construction). The methodology used includes the estimation of several regression models in data panels, using a Pooled regression model with fixed and random effect estimators through the maximum likelihood estimator. In general, a statistical and financially significant premium for hedges was found for companies exposed to exchange rate risks that use derivatives of a 6.3% average on the market value. Additionally, mixed results were found in relation to the variables analyzed in the model.     

Learning from the Dark Web: leveraging conversational agents in the era of hyper-privacy to enhance marketing

Journal of the Academy of Marketing Science - The Web is a constantly evolving, complex system, with important implications for both marketers and consumers. In this paper, we contend that over the...     

Research Trends of Marketing: A Bibliometric Study 1990–2017

Abstract

Interest in the role of marketing has grown in recent decades due to its impact in brand value, value creation for customers, profitability of customer base, and organizational results. The paper shows an overall view on marketing research to explore the development of research trends, showing the high-frequency keywords at different time periods. Using bibliometric methods, the research analyzes publications between 1990 and 2017 found in the Web of Science and Scopus databases. The paper shows the evolution of keywords to reveal emerging topics as demonstrated in the connections network which includes “advertising,” “consumer behavior,” “trust,” “innovation,” and “customer satisfaction.”     

Mixed methods research in service-learning: an integrative systematic review

Quality & Quantity - In view of the challenges involved in designing a study of Mixed Methods (MM), as well as the problematics inherent in studying Service-Learning (S-L) from new research...     

Multicriteria framework for selecting a process modelling language

The choice of process modelling language can affect business process management (BPM) since each modelling language shows different features of a given process and may limit the ways in which a process can be described and analysed. However, choosing the appropriate modelling language for process modelling has become a difficult task because of the availability of a large number modelling languages and also due to the lack of guidelines on evaluating, and comparing languages so as to assist in selecting the most appropriate one. This paper proposes a framework for selecting a modelling language in accordance with the purposes of modelling. This framework is based on the semiotic quality framework (SEQUAL) for evaluating process modelling languages and a multicriteria decision aid (MCDA) approach in order to select the most appropriate language for BPM. This study does not attempt to set out new forms of assessment and evaluation criteria, but does attempt to demonstrate how two existing approaches can be combined so as to solve the problem of selection of modelling language. The framework is described in this paper and then demonstrated by means of an example. Finally, the advantages and disadvantages of using SEQUAL and MCDA in an integrated manner are discussed.     

Who skims the cream of the Italian graduate crop? Wage employment versus self-employment

This paper tests whether academic achievement is a significant determinant of employment status in the Italian labor market: are new entrepreneurs selected from the top or bottom end of the graduate ability distribution? Is the cream of the graduate crop pulled into self-employment by the higher expected earnings or are individuals with lower degree score pushed into entrepreneurship by poor alternatives? Our data show a strong negative relation between academic achievement and self-employment status, i.e., we find skimming of the best graduates into wage and salary work.