Cost-effectiveness analysis of secukinumab in ankylosing spondylitis from the Canadian perspective

Aim: To assess the cost-effectiveness of interleukin (IL)-17A inhibitor secukinumab vs the currently licensed biologic therapies in ankylosing spondylitis (AS) patients from a Canadian healthcare system perspective.

Methods: A decision analytic model (semi-Markov) evaluated the cost-effectiveness of secukinumab 150?mg compared to certolizumab pegol, adalimumab, golimumab, etanercept and etanercept biosimilar, and infliximab and infliximab biosimilar in a biologic-naïve population, over 60 years of time horizon (lifetime). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI 50) response rate was used to assess treatment response at week 12. Non-responders or patients discontinuing initial-line of biologic therapy were allowed to switch to subsequent-line biologics. Model input parameters (short-term and long-term changes in BASDAI and Bath Ankylosing Spondylitis Functional Index [BASFI], withdrawal rates, adverse events, costs, resource use, utilities, and disutilities) were obtained from clinical trials, published literature, and other Canadian sources. Benefits were expressed as quality-adjusted life years (QALYs). Cost and benefits were discounted with an annual discount rate of 1.5% for all treatments.

Results: In the biologic-naïve population, secukinumab 150?mg dominated all comparators, as patients treated with secukinumab 150?mg achieved the highest QALYs (16.46) at the lowest cost (CAD 533,010) over a lifetime horizon vs comparators. In the deterministic sensitivity analysis, results were most sensitive to changes in baseline BASFI non-responders, BASDAI 50 at 3 months and discount rates. Probabilistic sensitivity analysis showed that secukinumab 150?mg demonstrated higher probability of achieving maximum net monetary benefit vs all comparators at various cost thresholds.

Conclusions: This analysis demonstrates that secukinumab 150?mg is the most cost-effective treatment option for biologic-naïve AS patients compared to certolizumab pegol, adalimumab, golimumab, etanercept and etanercept biosimilar, and infliximab and infliximab biosimilar for a lifetime horizon in Canada. Treatment with secukinumab translates into substantial benefits for patients and the healthcare system.     

The hydroelectricity consumption and economic growth in Asian countries - evidence using an asymmetric cointegration approach

ABSTRACT

This study examines the four commonly tested hypotheses in hydroelectricity consumption – economic growth literature for 12 Asian countries. Our results from a recently developed hidden cointegration technique uncover rich and significant relationships between negative and positive components of the variables under consideration. In particular, we find evidence to support the neutrality hypothesis in five countries (Bangladesh, Indonesia, Pakistan, Philippines, and Thailand), the growth hypothesis in four countries (India, Japan, South Korea and Taiwan), and both growth and conservation hypotheses in three countries (China, Malaysia, and New Zealand). These findings suggest that appropriate economic policies should be elaborated on the basis of the country’s specific hydroelectricity consumption–growth nexus. Finally, our new evidence suggests that the lack of stable relationship between hydroelectricity consumption and economic growth documented in previous studies for some of these countries could be due to the failure to properly account for the nonlinearity property in the data.     

Adoption of weather‐index insurance: learning from willingness to pay among a panel of households in rural Ethiopia

In this article we examine which farmers would be early entrants into weather‐index insurance markets in Ethiopia, were such markets to develop on a large scale. We do this by examining the determinants of willingness to pay for weather insurance among 1,400 Ethiopian households that have been tracked for 15 years as part of the Ethiopian Rural household Survey. This provides both historical and current information with which to assess the determinants of demand. We find that educated, wealthier individuals are more likely to purchase insurance. Risk aversion is associated with low insurance take‐up suggesting that models of technology adoption can inform the purchase and spread of weather index insurance. We also assess how willingness to pay varied as two key characteristics of the contract were varied and found that basis risk reduces demand for insurance particularly when the price of the contract is high, and that provision of insurance through groups is preferred by female headed households and individuals with lower levels of education.     

Wavelet Analysis of the Bombay Stock Exchange Index

The fluctuations in the rate of returns of the Bombay stock exchange are analyzed through wavelet transform. The fluctuations, in various time scales, naturally separated by the wavelets, are subjected to statistical analysis. The localization and multiresolution properties of the wavelets enable one to identify collective behaviour in the stock market and the extent of their influence at various time scales. The Gaussian nature of the rate of returns at certain scales and the periodic nature of the same, at other scales, are clearly brought out by this analysis. The utility of this approach for modeling purpose is also elucidated.

     

Operational excellence in a green supply chain for environmental management: A case study

Nowadays, organizations have started to become more conscious about the environment in their supply chain operations. The greening process has guided supply chain practices into new ways of thinking according to green standards. The assessment of the performance of green supply chain management (GSCM) requires a holistic view for the whole supply chain. In this context, given that becoming green in the operational side of activities is essential, the performance assessment of operational activities also requires a holistic view to be taken. In this paper, an attempt has been made to improve the performance of GSCM by examining and evaluating the green operational excellence of a hot dip galvanizing company. The framework includes several green operational excellence key criteria, namely, quality management, efficiency management, green production/manufacturing, eco‐packaging, and green design. First, the weights of the criteria and the respective measurements were found by fuzzy analytic network process. Then, the overall operational performance score was found by a weighted scoring method. Finally, both managerial and theoretical implications were suggested according to the outcomes and findings of the case study.     

Economic Properties of Statistical Indices: The Case of a Multidimensional Gini Index

This paper seeks to construct a Gini index of the distribution of standard of living. Since standard of living has various dimensions, we need a multidimensional Gini index (MGI). The literature on index numbers contains two distinct approaches: the statistical and the economic. In the context of MGIs the statistical approach (which obtains the indices from conditions based on statistical or data-related considerations) seems to be open to the criticism that it sometimes yields indices that violate economic norms. However, the economic approach (where the indices are derived from norms based on economic theory) also does not seem to have succeeded so far in obtaining an MGI satisfying the various normative requirements that have been proposed in the literature. This paper shows that it is possible to obtain an MGI from the statistical approach ensuring, at the same time, that the economic norms are satisfied. In this sense it is an attempt to bring the two disparate traditions in index construction referred to above closer to each other. The index that is developed here does not appear in the existing literature. Moreover, the literature does not seem to contain any other MGI satisfying all of the proposed economic norms.

     

On the size distortion of tests after an overidentifying restrictions pretest

In the linear instrumental variables model, we provide theoretical and Monte Carlo evidence for the size distortion of a two‐stage hypothesis test that uses a test of overidentifying restrictions (OR) in the first stage. We derive a lower bound for the asymptotic size of the two‐stage test. The lower bound is given by the asymptotic size of a test that rejects the null hypothesis when two conditions are met: the test of OR used in the first stage does not reject and the test in the second stage rejects. This lower bound can be as large as 1 ? ε_P, where ε_P is the pretest nominal size, for a parameter space that allows for local non‐exogeneity of the instruments but rules out weak instruments. Copyright © 2011 John Wiley & Sons, Ltd.     

A unified approach to bivariate discrete distributions

Here we introduce a bivariate generalized hypergeometric factorial moment distribution (BGHFMD) through its probability generating function (p.g.f.) whose marginal distributions are the generalized hypergeometric factorial moment distributions introduced by Kemp and Kemp (Bull Int Stat Inst 43:336–338,1969). Well-known bivariate versions of distributions such as binomial, negative binomial and Poisson are special cases of this distribution. A genesis of the distribution and explicit closed form expressions for the probability mass function of the BGHFMD, its factorial moments and the p.g.f.’s of its conditional distributions are derived here. Certain recurrence relations for probabilities, moments and factorial moments of the bivariate distribution are also established.     

Investigating business cycle asymmetry for the G7 countries: Evidence from over a century of data

In this paper we test for asymmetric behaviour of business cycles for the G7 countries, using the entropy-based test for asymmetry suggested by Racine and Maasoumi [Racine, J.S., & Maasoumi, E. (in press-a). A versatile and robust metric entropy test of time-reversibility, and other hypotheses, Journal of Econometrics; Racine, J.S., & Maasoumi, E. (in press-b). A robust entropy based test for asymmetry. Econometric Reviews.]. We find overwhelming evidence of symmetry. In only 14% of the cases, we find some evidence of asymmetric behaviour of GDP and per capita GDP. More importantly, the period marked by the flexible exchange rate regime, over which much of the empirical work for the G7 countries has been conducted, evidence suggests that the two GDP series are symmetric.