Healthcare resource utilization among patients with relapsed multiple myeloma in the UK,France, and Italy

Aims: To assess the real-world healthcare resource utilization (HRU) and costs associated with different treatment regimens used in the management of patients with relapsed multiple myeloma in the UK, France, and Italy.

Methods: Retrospective medical chart review of characteristics, time to progression, level of response, HRU during treatment, and adverse events (AEs). Data collection started on June 1, 2015 and was completed on July 15, 2015. In the 3 months before record abstraction, eligible patients had either disease progression after receiving one of their country’s most commonly prescribed regimens or had received the best supportive care and died. Costs were calculated based on HRU and country-specific diagnosis-related group and/or unit reference costs, amongst other standard resources.

Results: Physicians provided data for 1,282 patients (387 in the UK, 502 in France, 393 in Italy) who met the inclusion criteria. Mean [median] total healthcare costs associated with a single line of treatment were €51,717 [35,951] in the UK, €37,009 [32,538] for France, and €34,496 [42,342] for Italy, driven largely by anti-myeloma medications costs (contributing 95.0%, 90.0%, and 94.2% of total cost, respectively). During active treatment, the highest costs were associated with lenalidomide- and pomalidomide-based regimens. Mean cost per month was lowest for patients achieving a very good partial response or better. Unscheduled events (i.e. not considered part of routine management, whether or not related to multiple myeloma, such as unscheduled hospitalization, AEs, fractures) accounted for 1–9% of total costs and were highest for bendamustine.

Limitations: The use of retrospective data means that clinical practice (e.g. use of medical procedures, evaluation of treatment response) is not standardized across participating countries/centers, and some data (e.g. low-grade AEs) may be incomplete or differently adjudicated/reported. The centers involved may not be fully representative of national practice.

Conclusions: Drug costs are the main contributor to total HRU costs associated with multiple myeloma. The duration of active treatment may influence the average total costs, as well as response, associated with a single line of therapy. Improved treatment outcomes, and reductions in unscheduled events and concomitant medication use may, therefore, reduce the overall HRU and related costs of care in multiple myeloma.     

Investment and the rate of profit in a financial context: the French case

The growth regime prevailing in France since the middle of the 1980s allowed for a recovery of profitability, yet without durable resumption of growth or accumulation of fixed capital. The financialization of this growth regime shows on both the asset and liability sides of the balance sheets. Following a post‐Keynesian framework, we analyse and test the main determinants of real investment and financial capital accumulation for non‐financial companies in France, based on data from the flow‐of‐funds accounts. This analysis points to an arbitrage, prevailing between real and financial accumulation, as a key reason explaining the insufficient recovery of investment.     

Path analysis for mixed qualitative and quantitative variables

In this report path analysis models are considered for mixed qualitative/quantitative variables. Only endogenous variables that are dependent in all its relations are supposed to be quantitative, but this restriction can easily be dropped. Qualitative variables are handled using a dummy-variable for each category. Parameters are estimated by ordinary least squares. The method allows decomposition of total effects in direct and indirect effects, which makes interpretation easier.     

Management accounting in its social context: Rimailho revisited

The homogeneous sections method prescribed by the Plan comptable general (the French national accounting plan) since its origin is commonly attributed to the influence of the Rimailho Report (1928, in its final version). An in-depth analysis of the processes and management systems Rimailho set up, described in minute detail in his major works, has led to the belief that he was the pioneer of a certain type of the activity-based costing method. But other aspects of his work are far more interesting. With Rimailho, accountancy plays a role which is closely linked to his political and social convictions. Rimailho's management accounting appears as the strategic tool in a type of corporate regulation involving organizational slack, possible in a defender 's strategy deployed in a specific competitive and technological environment. Rimailho's organization does not fit into today's standard typologies (Anthony, Woodward, Ouchi, etc.). It is an appropriate challenge for researchers in accounting and management control.     

Verifying a demand system by simulation

An intriguingly small value of the asymptotic standard error of the estimate of the income flexibility inspired us to simulate the demand system. The procedure used should have more general applicability.     

The geographic distribution of world income, 1950–1990

Summary PPP-based data (PPP=purchasing power parity) for gross domestic products are used to assess the affluence of more than 100 non-Communist countries in 1950–1990. A seven-region classification, based on the distinction between temperate and tropical zones, is used to summarize the data on individual countries. The seven regions account for nearly 90 percent of the inequality among these countries in each year. Another classification, based on the position of countries with respect to the European Union, is applied to 18 countries in Western Europe. Five journeys around the world are described; the main result is that affluence tends to decline when the traveler moves from temperature zones (in either the Northern or the Southern Hemisphere) toward the Equator. Another topic considered is that of the G-7 countries, the populations of which are all concentrated in the temperate zones of the Northern Hemisphere. Also, attention is paid to Kuznet's hypothesis of divergenceconvergence in a cross-country context.Dedicated to the Memory of Jan TinbergenTheil is the McKethan-Matherly Eminent Scholar Emeritus and Courtesy Professor of Food and Resource Economics, while Seale is Associate Professor of Food and Resource Economics, both at the University of Florida (UF). This paper summarizes results of research conducted jointly with Sri Devi Deepak and Charles B. Moss of the UF Food and Resource Economics Department. Robert Summers of the University of Pennsylvania deserves our gratitude for making the data available to us. Florida Agricultural Experiment Station Journal Series No. N-00973.     

Recente ontwikkelingen in de micro-economie

Summary This article provides a nonmathematical survey of the system-wide approach to microeconomics. The allocation character of consumption theory is emphasized and is related to similar characteristics of other areas in the social sciences. The measurement of the change in the quality of consumption is discussed, and also the independence transformation which describes the consumer's preferences and the firm's technology in the simplest possible form. The system-wide approach is compared with conventional economy-wide macromodels.

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Hennipman-lezing gehouden op 17 maart 1979 aan de Universiteit van Amsterdam.     

Simulation evidence on the ridge and the shrinkage of the maximum entropy variance

Haque's and Meisner's (1980) analysis of the expectations of the ridge and shrinkage of the maximum entropy variance is extended to include their standard deviations and correlation coefficients.