Cost-effectiveness of once-weekly semaglutide versus dulaglutide and lixisenatide in patients with type 2 diabetes with inadequate glycemic control in Sweden

Abstract

Aims: This analysis evaluated the cost-effectiveness of once-weekly semaglutide vs glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D) uncontrolled on metformin or basal insulin in Sweden.

Materials and methods: This cost-effectiveness analysis (CEA) was conducted using the Swedish Institute of Health Economics (IHE) Diabetes Cohort Model. Analyses were conducted from the Swedish societal perspective over a time horizon of 40?years. For patients uncontrolled on metformin, dulaglutide was the comparator, and data from the SUSTAIN 7 clinical trial was used. For patients uncontrolled on basal insulin, lixisenatide was chosen as the comparator and data was obtained from a network meta-analysis (NMA).

Results: The results show that, in patients with inadequate control on metformin, semaglutide 1.0?mg dominated (i.e. provided greater clinical benefit, and was less costly) dulaglutide 1.5?mg. In patients with inadequate control on basal insulin, semaglutide 1.0?mg dominated lixisenatide. The reduction in costs is largely driven by the reduction in complications seen with once-weekly semaglutide.

Limitations and conclusions: It is likely that this analysis is conservative in estimating the cardiovascular (CV) cost benefits associated with treatment with once-weekly semaglutide. In patients inadequately controlled on basal insulin, the analyses vs lixisenatide were based on results from an NMA, as no head-to-head clinical trial has been conducted for this comparison. These CEA results show that once-weekly semaglutide is a cost-effective GLP-1 RA therapy for the treatment of T2D in patients inadequately controlled on metformin or basal insulin, addressing many current clinician, patient, and payer unmet needs in Sweden.     

Trade integration and the EU economic membership criteria

The purpose of this paper is to consider whether the European Union (EU)'s economic membership criteria for the Central and Eastern European countries (CEECs) and Cyprus (the Candidate Countries) are fulfilled. To this end, I examine the actual and potential levels of trade between the Candidate Countries and the EU countries using the gravity model. The results show a high degree of trade integration between all Candidate Countries and the EU, indicating that the Candidate Countries would not face any serious difficulties in coping with the competitive pressure and market forces within the Union in the medium term. The European Commission, however, suggested the contrary for some of the Candidate Countries in its opinions of 1997.     

Biotechnology Firms in Sweden

The purpose of this study is to create an understanding of the strategies that biotechnology firms in Sweden implement, how they manage to keep their competence ahead and how they finance their research. Their main factor of success is the ability to rapidly identify the latest research findings from academia and turn them into commerciable technology. The collaboration with academia is thus an important part of the networking strategy of the biotechnology firms in Sweden. Outsourcing parts of their activities keeps the firms flexible, which is necessary in this high risk business.Whether a firm chooses an intermediary or integrating position is not found to be correlated to age or size. It is instead heavily influenced by the strategies of large pharmaceutical companies, the nature of the firms' core technology, expectations of investors and the overall access of capital. The private capital market in Sweden has undergone a change during the last years. New marketplaces for young, innovative firms have been created in Sweden and their existence is most likely one reason for the increasing presence of venture capitalists in the country. That, in turn, increases the opportunities for new firms within biotechnology to develop in Sweden.     

Skateboarding beyond the limits of gender? Strategic interventions in Sweden

Sweden prides itself as a country where young women can enjoy gender equality. Yet many young women skateboarders still experience discomfort when skateboarding in public spaces. We argue that diverse strategies are required to intervene in the intransigent problem of gender inequality in the male-dominated sport of skateboarding. We discuss two intertwined strategies adopted in Swedish skateboarding contexts, strategic visibility and strategic entitlement. Strategic visibility is premised on making girls a special case, separated from the boys, and therefore highly visible. The other intervention goes beyond the limits of gender, aiming to achieve strategic entitlement, which takes-for-granted girls’ participation and competence. Drawing from ethnographic data, we explore the paradoxical spaces of these interventions, identifying the benefits and risks of each strategy. We conclude that both strategies are important, yet the latter breaks new ground. Strategic entitlement, which constructs skateboarding girls as ordinary and indistinguishable from boys, no longer constructs gender as a limiting factor. Interventions to promote gender equality should include strategies that seek to go beyond gender and strategies that acknowledge the significance of gender. We need to keep experimenting with and researching the unintended consequences of all strategies for challenging and changing male dominance in sport and leisure.     

Gender,Social Networks,and Entrepreneurial Outcomes in Tanzania

This article presents results of a study that investigates egocentric network differences between female and male entrepreneurs and their entrepreneurial outcomes in Tanzania. Based on a random sample of 272 micro-, small, and medium-size enterprises, the study reveals that female and male entrepreneurs have diverse networks. However, when compared to their male counterparts, female entrepreneurs' strong ties included more kin members. No significant gender difference in the composition of weaker ties was observed, suggesting gender differences in the choice of individuals with whom to have strong ties but not with whom to have weak ties. A significant gender difference in entrepreneurial outcomes at both start up and at the time of research was found, suggesting an antecedent networking behavior influence on performance.     

Retail Image as Seen through Consumers' Eyes: Studying International Retail Image through Consumer Photographs of Stores

Abstract

The aim of this article is to explore how retail store image is perceived by consumers from different cultural backgrounds and with different degrees of awareness and experience of the retailer. The subject is IKEA, a retailer recognized as having a global approach to the markets in which it operates, resulting in a highly standardized approach to store branding. However, rather than employing traditional methodologies to elicit consumer perceptions of store image, we attempt to capture consumer perceptions through interpretations of the visual images generated by the participants themselves. The photo-elicitation method employed captured the different interpretations and meanings attached to commonly identified elements of store image and reinforced the central role played by the store itself in retail image formation.     

Patterns of foreign direct investment in poor countries

This paper introduces endogenous adoption costs for productive assets in a Ramsey-type growth model with international capital flows. There are two classes of productive assets: owner-specific and location-specific. Adoption costs are an increasing function of the level of technology embodied in the investor's owner-specific assets and a declining function of the host country's location-specific assets. In this setting, the observed pattern of international capital flows is consistent with diminishing returns to capital. Further, our model predicts that the sectoral allocation of foreign direct investment is similar in rich and poor countries.     

Attitudes and Donation Behavior When Reading Positive and Negative Charity Appeals

This article tries to clarify whether negative charity appeals (i.e., advertisements emphasizing the bad consequences of not helping) or positive charity appeals (i.e., advertisements emphasizing the good consequences of helping) are more effective. Previous literature does not provide a single answer to this question and we suggest that one contributing reason for this is that different studies have operationalized appeal effectiveness in different ways (e.g., actual behavior, self-rated helping intentions, or expressed attitudes about the ad or the organization). Results from four separate studies suggest that positive appeals are more effective in inducing favorable attitudes toward the ad and toward the organization but that negative appeals are more effective (in studies 1A and 1B) or at least equally effective (in studies 1C and 1D) in eliciting actual donations. Also, although people’s attitude toward the appeal (i.e., liking) was a good predictor for the expected effectiveness in increasing donation behavior (in Study 2), it was a poor predictor of actual donation behavior in all four main studies. These results cast doubt on marketing theories suggesting that attitudes toward an advertisement and toward the brand always lead to higher purchase behavior.     

Relationship commitment and value creation in sponsorship relationships

Purpose: The sponsorship industry has evolved considerably in recent years due to the strategic business opportunities that it provides. Despite increased interest in sponsorship, analysis of the relationship between relationship commitment and value creation and of relationship commitment as comprising multiple types or components in the context of sponsorship relationships is lacking. To address these gaps, this paper analyzes relationship commitment (in terms of affective commitment and value-based commitment) as a significant mediating variable, and value creation in the context of sponsorship relationships.

Methodology/approach: A questionnaire was sent to Swedish Hockey League sponsors to collect data and to verify the study’s conceptual model and relationships. The response rate for the survey was 19.8%, that is, 122 completed questionnaires out of 616 sent. The respondents represented the most common industries in Sweden, but most of them belonged to the construction, repair, and electronics industries (18.0%), manufacturing and production industry (13.1%), and commerce industry (11.5%). Most sponsoring companies (30.3%) were categorized as medium-sized (50–249 employees). Most respondents (38.5%) had invested EUR 4300–15,000, whereas 11.5% had invested less than EUR 4300. Moreover, we found that most sponsors had been in their sponsorship relationships for more than 10 years (32.8%). Structural equation modeling (SEM) was used for the data analysis.

Findings: This study demonstrates that relationship commitment is an important driver of value creation in sponsorship relationships. Furthermore, the various forms of affective commitment and value-based commitment should not be considered merely components or forms but distinct types. Certainly, there is interaction between the two types, but sequentially in such a way that affective commitment is a prerequisite for value-based commitment. This means that a sponsor must have an emotional relationship with the sponsee in order to understand, perceive, and calculate the sponsorship relationship’s future business value in terms of profits and other benefits. This study also finds that value-based commitment is the most significant type of commitment in sponsorship relationships.

Research implications: The study demonstrates that shared values, trust, and affective commitment are fundamental conditions for value-based commitment. If the parties agree on how they should behave in the relationship, the rules and objectives that apply lead to the emergence of mutual trust, which in turn makes the parties want to continue the relationship for emotional reasons. But this is not enough for value creation; they must also see that there are future business benefits from the relationship. Therefore, the parties more or less explicitly make calculations. If the calculations indicate that the long-term benefits of the relationship outweigh the short-term sacrifices, they are prepared to invest in the relationship, and this may lead to value creation. In other words, there is both interplay and tension between shared values, trust, and affective commitment, on one hand, and value-based commitment, on the other. Another theoretical contribution is that previous research has considered the links between relationship commitment and value but has ignored the different types of commitment that play key roles in the value-creation process; this study has addressed that oversight. The study demonstrates that affective commitment and value-based commitment have different roles and meanings. Affective commitment indirectly affects value creation, while value-based commitment directly affects value creation. Affective commitment has the role of partial mediator, while value-based commitment has the role of full mediator. Furthermore, they differ in their basic characteristics: affective commitment is an emotional aspect, while value-based commitment is a calculative aspect.

Originality/value/contribution: Previous studies have not analyzed the relationship between relationship commitment and value creation. However, this study demonstrates that relationship commitment is an important driver of value creation in sponsorship relationships. Furthermore, most previous research argues that relationship commitment consists of various components or forms that interact in parallel with each other. However, this study demonstrates that the various forms of affective commitment and value-based commitment should not be considered merely components or forms but distinct types. Certainly, there is interaction between the two types, but sequentially in such a way that affective commitment is a prerequisite for value-based commitment. Furthermore, previous studies have consistently noted that affective commitment is the most important component, form, or type of relationship commitment. However, this study finds that value-based commitment is the most significant type of commitment in sponsorship relationships.