Community advisory panels within the chemical industry: Antecedents and issues

Community Advisory Panels (CAPs) are currently being sponsored by the American chemical industry as a way to repair lost trust. Over 200 CAPs are currently in operation. Their goals, composition and impact vary. Like governmental advisory committees they run the risk of being vehicles of persuasion as opposed to bodies which bring about organisational or health and safety changes. This article reviews the evidence we have to date about CAP operations and sets an agenda for future research.     

A Political Economic Analysis of U.S. Rice Export Programs to Japan and South Korea: A Game-Theoretic Approach

The Uruguay Round Agreement on agriculture has contributed to the increase in U.S. and world rice trade since 1994. Despite this, the Japanese and Korean rice markets continue to be characterized by high levels of trade intervention. This article attempts to analyze both import markets incorporating econometric estimates and public choice theory in a game-theoretic framework. Various scenarios are analyzed. The results show that the overall Nash equilibrium occurs with a 4% tariff reduction for Japan and Korea under the U.S. Market Development Program, which includes the Market Access Program and Foreign Market Development Program.     

The Paradox of Diversity Initiatives: When Organizational Needs Differ from Employee Preferences

Women are underrepresented in the upper echelons of management in most countries. Despite the effectiveness of identity conscious initiatives for increasing the proportion of women, many organizations have been reluctant to implement such initiatives because potential employees may perceive them negatively. Given the increasing competition for labor, attracting talent is relevant for the long-term success of organizations. In this study, we used an experimental design (N = 693) to examine the effects of identity blind and identity conscious gender diversity initiatives on people’s pursuit intentions toward organizations using them. We used counterfactual thinking, derived from fairness theory, as a guiding framework for our hypothesis development and investigated the moderating influence of a forthcoming government-mandated gender quota as well as individual characteristics (e.g., gender). Participants reviewed statements regarding workplace diversity initiatives and rated either the initiatives’ effectiveness or indicated their intentions to pursue employment with organizations using them. Of those rating pursuit intentions, half were informed that the country in which they were conducting their job search was about to implement gender quotas. Results indicated a diversity management paradox such that initiatives perceived as more effective made organizations using them less attractive as employers. However, these negative perceptions were mitigated by a government-mandated quota, and also lower among women. Implications for the study and practice of diversity are discussed.     

To Help or Not to Help? The Good Samaritan Effect and the Love of Money on Helping Behavior

This research tests a model of employee helping behavior (a component of Organizational Citizenship Behavior, OCB) that involves a direct path (Intrinsic Motives → Helping Behavior, the Good Samaritan Effect) and an indirect path (the Love of Money → Extrinsic Motives → Helping Behavior). Results for the full sample supported the Good Samaritan Effect. Further, the love of money was positively related to extrinsic motives that were negatively related with helping behavior. We tested the model across four cultures (the USA., Taiwan, Poland, and Egypt). The Good Samaritan Effect was significant for all four countries. For the indirect path, the first part was significant for all countries, except Egypt, whereas the second part was significant for Poland only. For Poland, the indirect path was significant and positive. The love of money may cause one to help in one culture (Poland) but not to help in others. Results were discussed in the light of ethical decision making.

The Value of Equitable Redemption in Commercial Mortgage Contracting

Equitable redemption is a feature of all common law mortgages that allows a borrower a chance to “redeem” the real estate in the event of default. What is puzzling is that equitable redemption is universally enforced in all mortgages, including commercial mortgages. The purpose of this study is to understand if there might be conditions under which the universal enforcement of equitable redemption could be an efficient legal doctrine. We build a model of asymmetric information where the cash flows from the investment are known to the borrower but not to the lender. We show that there exists a separating equilibrium where high-risk borrowers choose to include equitable redemption (and pay a higher interest rate) while low-risk borrowers choose not to (and pay a lower interest rate). We then show that there exist conditions under which a universal enforcement of equitable redemption results in a higher total surplus than this separating equilibrium.

An innovative role for nurse practitioners in managing chronic disease

Under the current care delivery model, persons with chronic illnesses, such as diabetes, are not receiving all recommended interventions and failing to meet targeted outcomes. The Chronic Care Model provides a framework for new approaches and roles for many members of the multidisciplinary team. Using the Chronic Care Model as a guide, a group of hospital-based clinics in an academic system incorporated nurse practitioners into the care model for patients with diabetes. Through use of planned visits, a patient registry, drug intensification protocols, and collaboration with other members of the team, the pilot sample improved processes of care and clinical outcomes. Use of nurse practitioners in this model of care for chronically ill patient populations has economic implications, as the payers begin to pay for performance.     

The Informativeness of Relative Performance Information and Its Effect on Effort Allocation in a Multitask Environment

Prior research documents that providing relative performance information (RPI) motivates employees to increase effort; however, a potential downside of RPI is that it also motivates employees to distort their effort allocations between tasks such that it can be detrimental to overall firm performance. This study investigates via an experiment how the informativeness of RPI affects employees' effort allocations and performance in a multitask environment. We investigate the informativeness of two RPI design choices that are observed in practice: detail level and temporal aggregation. Regarding detail level, firms may provide each employee's performance ranking on tasks, which is less informative than providing the actual performance score of each employee. Regarding temporal aggregation, firms may provide RPI that is reset each period, which is less informative than RPI that is based on cumulative performance. We find RPI detail level and temporal aggregation interact to influence effort distortion. Specifically, we find that, compared to reset RPI, cumulative RPI leads to greater distortion of effort away from firm‐preferred allocations and that this effect is magnified when RPI provides actual performance scores rather than performance rankings. Finally, high levels of effort distortion hurt overall performance, thereby demonstrating the potentially detrimental effect of effort distortion on performance. Results of our study enhance our understanding of how firms can use their control over the design of RPI to enhance its usefulness in directing employees' effort in multitask environments by highlighting the role that informativeness of information can have on employee behavior.     

Cost-effectiveness of axicabtagene ciloleucel for adult patients with relapsed or refractory large B-cell lymphoma in the United States

Abstract

Purpose: Axicabtagene ciloleucel (axi-cel) was recently approved for treatment of relapsed or refractory (R/R) large B-cell lymphoma (LBCL) following two or more prior therapies. As the first CAR T-cell therapy available for adults in the US, there are important questions about clinical and economic value. The objective of this study was to assess the cost-effectiveness of axi-cel compared to salvage chemotherapy using a decision model and a US payer perspective.

Materials and methods: A decision model was developed to estimate life years (LYs), quality-adjusted life years (QALYs), and lifetime cost for adult patients with R/R LBCL treated with axi-cel vs salvage chemotherapy (R-DHAP). Patient-level analyses of the ZUMA-1 and SCHOLAR-1 studies were used to inform the model and to estimate the proportion achieving long-term survival. Drug and procedure costs were derived from US average sales prices and Medicare reimbursement schedules. Future healthcare costs in long-term remission was derived from per capita Medicare spending. Utility values were derived from patient-level data from ZUMA-1 and external literature. One-way and probabilistic sensitivity analyses evaluated uncertainty. Outcomes were calculated over a lifetime horizon and were discounted at 3% per year.

Results: In the base case, LYs, QALYs, and lifetime costs were 9.5, 7.7, and $552,921 for axi-cel vs 2.6, 1.1, and $172,737 for salvage chemotherapy, respectively. The axi-cel cost per QALY gained was $58,146. Cost-effectiveness was most sensitive to the fraction achieving long-term remission, discount rate, and axi-cel price. The likelihood that axi-cel is cost-effective was 95% at a willingness to pay of $100,000 per QALY.

Conclusion: Axi-cel is a potentially cost-effective alternative to salvage chemotherapy for adults with R/R LBCL. Long-term follow-up is necessary to reduce uncertainties about health outcomes.