Rivaroxaban for non-valvular atrial fibrillation and venous thromboembolism in the Netherlands: a real-world data based cost-effectiveness analysis

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) have been included in international guidelines as important alternatives to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (NVAF). Meanwhile, in the Netherlands, NOACs are widely used next to VKAs. The objective of this study is to estimate the cost-effectiveness of treatment with rivaroxaban compared to VKAs in NVAF and VTE patients in the Netherlands, using data from international prospective observational phase IV studies.

Methods: Two models were developed to represent NVAF and VTE patients, populated with patients from the XANTUS (NCT01606995) and XALIA (NCT01619007) international prospective observational studies. The 1-year cost-effectiveness of rivaroxaban use, compared to VKAs, was explored in a population consisting of NVAF and VTE patients (base case) as well as for four scenarios with sub-populations: NVAF patients only, VTE patients only, NVAF patients with unstable international normalized ratio (INR), and NVAF patients using an INR self-measuring device.

Results: In the base case, rivaroxaban saved €72,350 and gained 21 quality-adjusted life-years (QALYs) in a simulation of 2,000 patients over the use of VKAs. Ergo, rivaroxaban was dominant over VKAs. The probabilistic sensitivity analysis showed a probability of 85% for rivaroxaban being dominant and 100% at a willingness-to-pay threshold of €20,000/QALY. Rivaroxaban appeared to be dominant in all scenarios as well, except for the NVAF-patients-only scenario where the incremental cost-effectiveness ratio (ICER) was €157/QALY.

Conclusions: In patients with NVAF or VTE, rivaroxaban treatment is likely to be cost-effective and a potentially cost-saving alternative to VKA in the Netherlands.     

寻求HR的职业发展阶梯

拓展你的职业生涯,从赢得上司的尊重开始。当人们试图使自己的事业发展更进一步时,许多人将注意力集中到寻找新的雇主、接受更高级的教育和通过专业协会增加自己的交际网络上来。但是,这些方法并不是提升职业生涯的最好方式。对于人力资源从业者,尤其是刚刚开始新的工作或者正处于基层职位的人来说,另一个有效的提升方式是在职发展计划。人力资源从业者可以在工作中磨练重要的技能,并从自己的经理或者主管那里获得职业发展的机会,这其实也是最好的方法之一。     

Getting consumers to eat more whole-grains: The role of policy, information, and food manufacturers

The 2005 Dietary Guidelines were unique because they offered quantitative recommendations for consumption of whole-grains. This case study examines the hypothesis that the changed recommendations were responsible for the recent increase in retail sales and consumption of whole-grain food products. We find that release of the Dietary Guidelines and related media attention did increase availability and sales of whole-grain foods. A large impact on consumption occurred through reformulation of existing products, induced by competition among food suppliers. This study reveals the key role product reformulation plays in inter-firm competition and in realization of dietary changes recommended by public policy.     

Innovation And Inter-Firm Co-Operation: The Case Of The West Midlands

Drawing upon the innovative milieux and industrial districts literature, the paper provides substantial empirical evidence that firms have a greater chance of being innovative if they co-operate with other firms over innovation, albeit undertaking no investment in RLD. This is an important result especially for small firms. In particular, the paper focuses on inter-firm cwperation along the supply chain, using a swey of firms in the West Midlands to investi-gate co-operation over innovation between suppliers and buyers. A probit model is used to test the link between innovation performance and four innovation inputs: R&D expenditure, R&D personnel, networking with suppliers and networking with client firms.     

The effect of commute time on racial earnings inequality: a case study of the Houston metropolitan statistical area

Data from the United States Census confirm a substantial increase in the racial earnings gap between 1980 and 1990. This paper examines data on whites and non-white wage and salary incomes in Houston TX for 1980 and 1990. Data on time travelled to work is used to simulate what would be the impact of shorter commute times on earnings inequality. The central finding is that a reduction in travel time from residence to work would cause a very small reduction in racial earnings and income inequality. This suggests that advances in urban transportation policy alone are not sufficient to solve the problem of racial earnings inequality.     

Too close for comfort? Distinguishing between team intimacy and team cohesion

The authors examine theory and research on team intimacy and team cohesion, and argue that the two have often been confused, merged, and used interchangeably in recent theoretical, empirical, and applied work on team effectiveness. The authors propose distinct definitions to clarify and distinguish between team intimacy and team cohesion, and suggest areas that will aid research and application. Their examination provides a framework for understanding the inconsistent findings in team effectiveness and team building research and thus helps to improve human resource management (HRM) interventions.     

The sociology of innovation and new biotechnologies

Understanding the social processes that support innovations in new biotechnologies presents an interesting challenge. Evidence from the Australian bioindustry reveals how the development and integration of new biotechnologies is a dynamic social process. Our findings highlight how new technology acceptance and integration rested on the micro‐politics of sense‐making and relational networking.     

The Role of Future‐Market Focus in the Early Stages of NPD across Varying Levels of Innovativeness

The concept of future‐market focus (FMF) arose out of the debate about firm size and incumbency in the face of radical or disruptive innovations, and has been demonstrated to have a positive correlation with radical innovation (RI) success. This study examines the relationship between FMF and the processes used in the early stages of NPD for four types of innovation projects: incremental innovations, technological breakthroughs, market breakthroughs, and radical innovations. We found that the future‐market focus of a project team can influence the early stage processes used in a new product innovation project, and does so differentially across levels of innovativeness. In particular, the concept generation process, understanding of market needs, and screening decision criteria are different for low‐ versus high‐FMF projects and there are differences based on the level of innovation. In addition, we found that radical innovation projects rated low in FMF are markedly different than the radical innovation projects described in prior studies.     

The heterogenous relationship of food stamp participation with body mass: Quantile regression model

This study explores the heterogenous relationship between Food Stamp Program (FSP) participation and body mass index (BMI) for low income individuals whose per capita family income falls in the bottom two quintiles. We estimate changes in the dispersion of the entire distribution of BMI following FSP participation using a quantile regression model in both cross-sectional and longitudinal analyses. For women, we find that the mean OLS estimate of FSP participation underestimates the extent of the positive association with BMI at the top quantiles in both cross-sectional and longitudinal individual fixed effects models. Controlling for individual fixed effects in the quantile regression model reduces the estimated magnitude of the association by a factor of three to four, although the estimates remain statistically significant for women. For men, a marginally statistically significant positive association of FSP participation with BMI is found at the top quantiles compared to no statistically significant mean estimate although the association is no longer statistically significant when time-constant individual heterogeneity is adjusted for in the individual fixed effect models.