An efficiency measure satisfying the Dmitruk–Koshevoy criteria on DEA technologies

The purpose of this paper is to develop an efficiency measurement model by enhancing a CCR (Charnes?CCooper?CRhodes) model and then to prove that the enhanced model satisfies five desirable properties: indication, strict monotonicity, homogeneity, continuity and units unvariance. In order for our model to be empirically tractable, we also provide an algorithm aimed at estimating efficiency scores.     

A cost-effectiveness analysis of denosumab for the prevention of skeletal-related events in patients with multiple myeloma in the United States of America

Objective: A large, pivotal, phase 3 trial in patients with newly diagnosed multiple myeloma (MM) demonstrated that denosumab, compared with zoledronic acid, was non-inferior for the prevention of skeletal-related events (SREs), extended the observed median progression-free survival (PFS) by 10.7 months, and showed significantly less renal toxicity. The cost-effectiveness of denosumab vs zoledronic acid in MM in the US was assessed from societal and payer perspectives.

Methods: The XGEVA Global Economic Model was developed by integrating data from the phase 3 trial comparing the efficacy of denosumab with zoledronic acid for the prevention of SREs in MM. SRE rates were adjusted to reflect the real-world incidence. The model included utility decrements for SREs, administration, serious adverse events (SAEs), and disease progression. Drug, administration, SRE management, SAEs, and anti-MM treatment costs were based on data from published studies. For the societal perspective, the model additionally included SRE-related direct non-medical costs and indirect costs. The net monetary benefit (NMB) was calculated using a willingness-to-pay threshold of US$150,000. One-way deterministic and probabilistic sensitivity analyses were conducted.

Results: From a societal perspective, compared with zoledronic acid, the use of denosumab resulted in an incremental cost of US$26,329 and an incremental quality-adjusted life-year (QALY) of 0.2439, translating into a cost per QALY gained of US$107,939 and a NMB of US$10,259 in favor of denosumab. Results were sensitive to SRE rates and PFS parameters.

Limitations: Costs were estimated from multiple sources, which varied by tumor type, patient population, country, and other parameters. PFS and overall survival were extrapolated beyond the follow-up of the primary analysis using fitted parametric curves.

Conclusion: Denosumab’s efficacy in delaying or preventing SREs, potential to improve PFS, and lack of renal toxicity make it a cost-effective option for the prevention of SREs in MM compared with zoledronic acid.     

Population and Urbanization Trends in Post-war Japan

This paper analyses the population change and urbanization process in post-war Japan. We trace the process of population concentration into urban areas, in parallel with economic development after the war. The concentration of population into urban areas can be characterized by three major metropolitan regions: Tokyo, Keihanshin (Kyoto-Osaka-Kobe) and Nagoya. We also show that the urbanization process of Japan in the period from 1965 to 1985 can be characterized by two spatial phenomena; firstly, the suburbanization of the existing metropolitan areas and, secondly, the spatial dispersal of urbanized areas.     

The business cycle model with a unique stable limit cycle

This paper provides the mathematical foundation to the long-standing academic belief that Goodwin's 1951 nonlinear business cycle model has a unique stable limit cycle. In spite of the asymmetric nonlinearity of investment function, the model has certainly a unique stable limit cycle in an economically meaningful region. Once solution paths start from any initial point in the region, they all tend to the limit cycle without escaping from the region or hitting the ceiling or floor of investment during a transition period. The structural stability of the model prevents the limit cycle from vanishing in the face of small perturbations.