Cost-effectiveness of blinatumomab versus salvage chemotherapy in relapsed or refractory Philadelphia-chromosome-negative B-precursor acute lymphoblastic leukemia from a US payer perspective

Objective: To evaluate the cost-effectiveness of blinatumomab (Blincyto) vs standard of care (SOC) chemotherapy in adults with relapsed or refractory (R/R) Philadelphia-chromosome-negative (Ph?) B-precursor acute lymphoblastic leukemia (ALL) based on the results of the phase 3 TOWER study from a US healthcare payer perspective.

Methods: The Blincyto Global Economic Model (B-GEM), a partitioned survival model, was used to estimate the incremental cost-effectiveness ratio (ICER) of blinatumomab vs SOC. Response rates, event-free survival (EFS), overall survival (OS), numbers of cycles of blinatumomab and SOC, and transplant rates were estimated from TOWER. EFS and OS were estimated by fitting parametric survival distributions to failure-time data from TOWER. Utility values were based on EORTC-8D derived from EORTC QLQ-C30 assessments in TOWER. A 50-year lifetime horizon and US payer perspective were employed. Costs and outcomes were discounted at 3% per year.

Results: The B-GEM projected blinatumomab to yield 1.92 additional life years and 1.64 additional quality-adjusted life years (QALYs) compared with SOC at an incremental cost of $180,642. The ICER for blinatumomab vs SOC was estimated to be $110,108/QALY gained in the base case. Cost-effectiveness was sensitive to the number and cost of inpatient days for administration of blinatumomab and SOC, and was more favorable in the sub-group of patients who had received no prior salvage therapy. At an ICER threshold of $150,000/QALY gained, the probability that blinatumomab is cost-effective was estimated to be 74%.

Limitations: The study does not explicitly consider the impact of adverse events of the treatment; no adjustments for long-term transplant rates were made.

Conclusions: Compared with SOC, blinatumomab is a cost-effective treatment option for adults with R/R Ph???B-precursor ALL from the US healthcare perspective at an ICER threshold of $150,000 per QALY gained. The value of blinatumomab is derived from its incremental survival and health-related quality-of-life (HRQoL) benefit over SOC.     

The Determinants of Chinese Outward Foreign Direct Investment: A Closer Look

Over the last fifteen years, China rapidly expanded its outward foreign direct investment (OFDI) through remarkable economic growth and the “go global” policy. Chinese firms explored investment avenues especially in developing and emerging countries. As a result, China became the third largest contributor of OFDI. We examine the determinants of Chinese OFDI in 67 countries during the period lasting from 2006 to 2015 using the feasible generalized least square method. We find that the size of the economy, market opportunities, cost advantages due to low wage structure, ease of doing business, country risk, and geographical proximity are the prominent factors leading to changes in Chinese OFDI in developing and emerging economies. We find that China’s investments in different developing and emerging countries are driven by a different set of factors and the determinants of Chinese OFDI vary in low and high per capita income countries.     

How Does Financial Literacy Impact Attitude Toward Student Loan Providers?

ABSTRACT

We examined whether financial literacy changes college students' assessments of their student-loan providers. As predictors in our backward regression, we included (a) financial literacy, (b) perceived importance of loan, (c) satisfaction with college, (d) financial optimism, (e) experience using credit cards, and (f) perceived importance of decisions about credit cards. We also included two-way interactions between financial literacy and the other variables. Our regression explained about 24% of the variance in the dependent variable. Our results indicated that financial literacy was a significant predictor of attitude toward the student loan provider—but only in the interaction terms.     

Gijs Mom. The Electric Vehicle: Technology and Expectations in the Automobile Age. Baltimore: Johns Hopkins University Press, 2004. xiii + 423 pp. ISBN 0-8018-7138-7, $54.95.

Automotive historians have long dismissed the electric vehicle;who would want a car with limited speed that had to be rechargedevery hundred miles? But in 1905, Gijs Mom reminds us, "morethan half of all commercial vehicles in the United States wereelectric powered," and by 1940 tens of thousands of electriccars and trucks had been produced (pp. 206, 265). In the UnitedStates and Europe, electric vehicles appeared as taxicabs, deliveryvans, and even fire engines, as     

Remote data analysis,visualization and problem solving environment (PSE) based on wavelets in the geosciences

We discuss here the issues faced by earth scientists in analyzing and visualizing large datasets over a GRID-like setup from a client-server perspective. We approach this problem by using a remote, web-based visualization and data analysis framework, called WEB-IS, and by employing second-generation wavelets as a means for reducing the amount of data transferred and for extracting coherent features in complex geophysical flows and surface faulting patterns. As an example, we describe how onboard processors on satellites can function as a server for beaming down extracted information to the client computer on the ground, thus exemplifying WEB-IS as a viable middleware on a GRID network for geosciences.     

Dodging Adverse Selection: How Donor Type and Governance Condition Aid’s Effects on School Enrollment

We employ AidData to test the effects of primary-education aid on school enrollment. We argue that the problem of adverse selection complicates both the allocation and the effectiveness of aid. We hypothesize that bilateral donors ought to have greater freedom to condition aid on recipient governance quality than multilateral donors, which are often bound by institutional rules to provide aid more impartially. Compared to their multilateral counterparts, bilateral donors may have advantages in overcoming adverse selection, resulting in bilateral aid’s boosting enrollments to a greater degree. AidData’s extensive coverage of multilateral aid enables this analysis for up to 100 low- and low-middle-income countries from 1995 to 2008. Latent growth regression analysis suggests that, compared to multilateral donors, bilateral donors indeed condition their primary education aid on recipient control of corruption and that bilateral aid is significantly related to improved enrollments.     

Rationalizing forecast inefficiency

We show analysts’ own earnings forecasts predict error in their own forecasts of earnings at other horizons, which we argue provides a measure of the extent to which analysts inefficiently use information. We construct our measure by exploiting two sources of variation in analysts’ incentives: (i) more recent forecasts have greater salience at the time of the earnings release so accuracy incentives are higher (lower) at shorter (longer) forecast horizons and (ii) analysts have greater incentives for optimism (pessimism) at longer (shorter) horizons. Consistent with these incentives affecting the incorporation of information into forecasts, we document (i) current year forecasts underweight (overweight) information in shorter (longer) horizon forecasts and (ii) the mis-weighting is more pronounced when recent news is negative—when analysts have greater (weaker) incentives to incorporate the news into shorter (longer) horizon forecasts. Finally, returns tests suggest that forecasts adjusted for the inefficiency we document better represent market expectations of earnings.

     

The capitalization of metro rail access in urban housing markets

Increasing access to public transportation (including metro rail) can help alleviate traffic congestion and address climate and environmental priorities. Living close to a metro line may be especially important in terms of providing improved commuting options. However, proximity to metro lines can also be associated with negative externalities, such as noise and crime, that may make living near a station less desirable. One way to assess the net value that residents place on metro rail access is to examine how proximity to metro lines is capitalized into house prices. Using a hedonic spatial difference-in-differences model, we analyze the impact of proximity to the stations on the Gold and Expo Lines in Los Angeles, California, on nearby house prices. Our findings suggest that the capitalization effect is heterogeneous. Some residents value living near new metro stations, while others do not. Overall, our results provide evidence that the value residents place on metro rail access varies based on their income levels and other demographics.