Economic modelling of costs associated with outcomes reported for type 2 diabetes mellitus (T2DM) patients in the CANVAS and EMPA-REG cardiovascular outcomes trials

Aims: To model direct medical costs associated with reductions in cardiovascular disease (CVD) events in T2DM patients reported in the CANVAS and EMPA-REG trials, which assessed the cardiovascular safety of canagliflozin and empagliflozin, respectively.

Materials and methods: Costs were modeled from a US managed care organization (MCO) perspective for the CVD outcomes included in both trials: three-point major adverse cardiovascular event (MACE) and its components (cardiovascular-related death, nonfatal myocardial infarction, nonfatal stroke), as well as heart failure requiring hospitalization. The rate of CVD events averted (difference between study drug and placebo) was projected to the portion of an MCO T2DM population matching the respective trial’s inclusion criteria. A targeted literature search for paid amounts directly associated with each CVD event provided the unit costs, which were applied to the projected number of events averted, to calculate costs avoided per member per year (PMPY). One-way sensitivity analyses were performed on events averted, unit costs, and percentages of trial-applicable patients.

Results: Based on three-point MACE events averted, costs avoided PMPY of $6.17 (range: $1.27–$10.94) for CANVAS and $2.75 ($0.19–$4.83) for EMPA-REG were estimated. Costs avoided for individual components of MACE ranged from $0.77 to $3.84 PMPY for CANVAS and from -$0.97 (additional costs) to $1.54 for EMPA-REG. PMPY costs avoided for heart failure were $2.72 for CANVAS and $1.32 for EMPA-REG.

Limitations and conclusions: Models assumed independent, non-recurrent outcomes and were restricted to medical costs directly associated with the trial-reported events. The reductions in CVD events in T2DM patients reported for both CANVAS and EMPA-REG project to a positive cost avoidance for these events in an MCO population. The analysis did not include an assessment of the impact on total cost, as the costs associated with adverse events, drug utilization or other clinical outcomes were not examined.     

Researching taste: an interview of Antoine Hennion

ABSTRACT

Antoine Hennion is a Professor of Sociology at the Centre de Sociologie de l’Innovation (Mines-Paris Tech, PSL/CNRS). He has been researching taste and cultural practices through a pragmatic lens for three decades. He has developed an original and impactful theoretical framework bridging the Actor-Network Theory to Cultural Studies. More precisely, he reconceptualized the notions of mediation and attachment. Antoine Hennion has explored various empirical settings, including music, wine, and sports. More recently, he has contributed to a large research project on migration. His books and academic articles have had an impact on Sociology, and are getting greater attention in consumer research.     

The Euro — A Tale of 20 Years: What Are the Priorities Going Forward?

Intereconomics - First, we need to recall the initial objectives set for the euro and how these have changed over time, notably due to the weaknesses that came to the fore throughout the recent...     

THEORY AND EVIDENCE IN PSYCHOLOGY AND ECONOMICS ABOUT MOTIVATION CROWDING OUT: A POSSIBLE CONVERGENCE?

The empirical relevance of motivation crowding out is a controversial issue in economics and psychology. As already pointed out by Frey and Jegen ( 2001 ), this is partly due to the historical development of two distinct and parallel strands of literature that stem from different theoretical traditions, have radically different tenets and therefore, are difficult to reconcile. In this survey, we go back to the details of the debates that took place independently among psychologists and economists, and sketch an integrative interdisciplinary approach likely to favor a more fruitful collaboration between economics and psychology. From this perspective, experimental economics (both field and laboratory) is viewed as a major research field shedding new light on the conditions of relevance of motivation crowding out.     

The effect of entrepreneurship education in schools on entrepreneurial outcomes: a systematic review

Management Review Quarterly - This study systematically reviewed 21 quantitative and qualitative articles on the effect of entrepreneurship education in schools. We reviewed short-term effects,...     

Export survival and the dynamics of experience

This paper focuses on developing countries’ pioneer exports to the OECD and obtains several important results on export dynamics, linking export experience and export survival. Using product level data at the SITC 5-digit level for 114 developing countries over the 1962–2009 period, we show that prior export experience obtained in non-OECD markets significantly increases survival of pioneer exports toward the OECD. The experience does not need to last long, as gaining experience for more than two years does not confer any additional benefit. The effect of experience depreciates rapidly with time: a break in export experience prior to entering the OECD reduces the advantage on survival. Finally, the role of prior export experience is particularly relevant for survival in the first two years upon entry into the OECD. The geographic dynamic of export experience reveals that experience is acquired in neighboring, easy to access markets before reaching more distant, richer partners and ultimately serving the OECD with a higher probability of survival.     

In Search of the Transmission Mechanism of Fiscal Policy in the Euro Area

This paper applies the DSGE‐VAR methodology to assess the size of fiscal multipliers in the data and the relative contributions of two transmission mechanisms of government spending shocks, namely hand‐to‐mouth consumers and Edgeworth complementarity. Econometric experiments show that a DSGE model with Edgeworth complementarity is a better representation of the transmission mechanism of fiscal policy as it yields dynamic responses close to those obtained with the flexible DSGE‐VAR model (i.e. an impact output multiplier larger than one and a crowding‐in of private consumption). The estimated share of hand‐to‐mouth consumers is too small to replicate the positive response of private consumption. Copyright © 2016 John Wiley & Sons, Ltd.     

Working towards sincere encounters in volunteer tourism: an ethnographic examination of key management issues at a Nordic eco-village

This article explores host–guest dynamics at Sólheimar eco-village, Iceland to contribute to the conceptualization of transformative learning in volunteer tourism. At the eco-village, the host and volunteers come together to share similar goals and meaningful experiences. This interaction gets complicated, however: the eco-village exists within the global capitalist system and must operate using market norms. The idealist and educational expectations of the volunteers often clash with the practical short-term goals of the community: there are also cultural and experiential differences between the parties. This clash is used to discuss the importance of sincerity in volunteer tourism at the eco-village. Data were collected through fieldwork, primarily including participant observations and interviews, to help interpret the patterns of behaviors and perceptions of both parties in relation to the aim. Ultimately, the experience that binds host and guests cannot solely be about learning to do things alternatively and sustainably; it requires sincerity, using Taylor's 2001 sincerity concept, to tackle the difficulties in working alternatively and sustainably to attain this experience. It is argued that transformative learning during the volunteer experience in alternative spaces should be conceptualized to include the promotion of sincere encounters, and adjusted to concern both the host and its guests.