Medication adherence and persistence in the treatment of rheumatoid arthritis with adalimumab and etanercept. Six years of analysis

Objective:

The aim of this study was to evaluate medication adherence and persistence of patients treated with Etanercept and Adalimumab for Rheumatoid Arthritis, also giving economic evaluations on therapy costs for Received Daily Dose (RDD).

Materials and methods:

This retrospective study took into account 6 years from January 1, 2007 to December 31, 2012. Medication adherence was quantified utilizing the ratio between RDD and Prescribed Daily Dose (PDD). Persistence has been reckoned taking into account the actual days of therapy comparing posology with supplied dose. The persistence has been graphed according to Kaplan-Meier method. The cost per RDD was reckoned starting from the expense incurred by Pescara General Hospital.

Results:

Medication adherence gave results in values between 0.88–0.97 for Etanercept and 0.83–0.90 for Adalimumab. The value of persistence was 100% for Etanercept and 90% for Adalimumab for the first year, and 70% for Etanercept and 80% for Adalimumab for the second year. In the 3rd year the persistence for Etanercept was 50% while for Adalimumab it was 60%. In the fourth year the persistence for Etanercept was 21% while for Adalimumab it was 27%. The statistical analysis was conducted using the Log rank test. The average cost per RDD was €32.97 for Etanercept and for Adalimumab it was €32.00 as an average of 6 years.

Conclusion:

The medication adherence was good for both Etanercept and Adalimumab. The rate of persistence decreased strictly in the fourth year of treatment. This data suggests the need for continuous monitoring of patients in treatment with TNF blockers.     

‘Just one of us’: consumers playing oligopoly in mixed markets

Consumer cooperatives represent a highly successful example of democratic form of enterprises operating in developed countries. They are usually medium to large-scale companies competing with the profit-maximizing firms in the retail sector. This paper describes this situation as a mixed oligopoly in which consumer cooperatives maximize the utility of consumer-members and, in return, refund them with a share of the profits corresponding to the ratio of their individual spending to the cooperative’s total sales. We show that when consumers possess quasi-linear preferences over a bundle of symmetrically differentiated goods, and companies operate using a linear technology, the presence of consumer cooperatives positively affects total industry output, as well as welfare. The effect of cooperatives on welfare proves to be even more significant when goods are either complements or highly differentiated, and when competition is à la Cournot rather than à la Bertrand.     

A methodology of technological foresight: A proposal and field study

The study of one's own business future is a distinctive element of a business strategy. Innovative companies are aware of weak signals coming from the periphery and of trends in their industry, and they monitor the coherence between weak signals and trends (the external perspective) and strategic direction (the internal perspective).The literature today does not provide well-framed and complete methodologies for assessing the coherence among trends, vision and products. Therefore, the authors propose a methodology called “the methodology of future coverage”, which measures how much the strategy oriented to the future effectively covers trends and megatrends. In other words, it helps to check the contents and the coherence of the firm' vision and products and those of the trends that will have relevance for the future of the industry, and this process supplies firms with supplementary information on how to improve. The authors tested this methodology and exemplified its use via the Eurotech case study, employing longitudinal analysis.The methodology can be useful as a tool for diagnosing the coherence between trends and company strategy. Moreover, from a dynamic point of view, it can be used as a tool to check on the company's progress in following up on trends by adapting its strategy over time. Finally, the methodology can be also used as a tool for cross-comparison of the “level of future orientation” among companies in the same industry.     

Determinants of the Use of the Internet as a Tourist Information Source

The modelling of usage behaviour of New Information Technologies is of great utility to managers who need to evaluate the probability of success in the introduction of these technologies. The present study empirically contrasts the capacity of Davis's Technology Acceptance Model 1989 to help understand the determinants of the intention to use the Internet to search for holiday information. The findings show that the above theory does explain the intention to use the Internet on the part of the tourist, but it should be expanded to take account of the tourist's satisfaction with previous experiences of searching for holiday information.     

The rise of the machines: Capital imports and real manufacturing wages in 57 nations

Outward-oriented policy reform has attracted a large number of academics to the study of the trade-labour market nexus. One of these fields has focused on capital intensive (machinery) imports and its effect on manufacturing wages. The skill-enhancing-trade (SET) hypothesis was put forth to explain a potential relationship where an inflow of capital imports results in increased demand for skilled labour and decreased that of unskilled labour, and thus resulted in a rise in skilled wages and a decrease in their unskilled counterparts. This study revisits this hypothesis with a panel from the manufacturing sector of 57 nations. We improve upon previous studies in a number of ways. We add developed nations to the sample and examine capital imports from rich countries as well as the rest of the world. This takes into account the prominence of vertical production networks in international trade. We adhere closely to the neo-classical trade model and employ definitions of skilled and unskilled workers that capture the production process of particular items. Finally, we fit a robust dynamic panel data model that accounts for the endogeneity of the determinants of trade and wages. In this way we test whether the SET hypothesis is generally applicable as opposed to previous studies which use an ad hoc selection of countries and variables. We find that the SET hypothesis is not driving changes in manufacturing wages. Instead, worker productivity and GDP per capita explain these labour market outcomes.     

R&D, Imperfect Competition and Growth with Human Capital Accumulation

This paper studies the long‐run consequences of imperfect competition on growth and the sectoral distribution of skills within an R&D‐based growth model with human capital accumulation. We find that steady‐state growth is driven only by incentives to accumulate skills. In the model imperfect competition has a positive growth effect, while influencing the allocation of human capital to the different economic activities employing this factor input. Contrary to general wisdom, the share of resources invested in R&D turns out not to be monotonically increasing in the product market power and its correlation with the equilibrium output growth rate is not unambiguous.     

EVALUATING RATIONAL PARTISAN BUSINESS CYCLE THEORY: A RESPONSE*

In a recent article published in this journal Steven Sheffrin presented the results of two tests on the so called “Rational Partisan Theory”. Sheffrin concluded that the evidence provides “little support for a strict interpretation of the theory”. This note argues that, although interesting in itself, the tests performed by Sheffrin are not particularly informative about the empirical relevance of the Rational Partisan Theory. Also, this note reconciles Sheffrin's results on OECD economies with the literature, which, in general, has found rather supportive evidence for the Rational Partisan Theory.     

On the determinants of inequality in Bosnia and Herzegovina

We provide empirical evidence on the determinants of income inequality in Bosnia and Herzegovina after the civil war. To do this, we use a an ordered probit approach and take advantage of the first post‐war household survey for the country which sheds some light on the influence of regional differences as well as household characteristics on income quintile determination. With respect to the former, we find large income differences between the two entities in the country, the Federation and Republika Srpska. Such income differences are also noticeable inside entities. On the latter, there are some signs that education, experience, and employment, among others, may help reduce the probability of income decline. Our results are robust to changes of specification as shown by applying a formal sensitivity analysis. JEL classification: O15, O10, I30.     

Price behaviour in the Italian manufacturing industry

This paper sets out to test the hypothesis that the price-cost margins of Italian manufacturing industries are influenced by excess domestic demand and by international prices of manufactured products. Using annual data (1956–1982) a mark-up equation is estimated for each of the twelve industries in which the manufacturing sector has been disaggregated. The ratio of industry price to average total cost is functionally related to the ratio of international price to domestic cost and a measure of excess demand. On the basis of the estimates, which are obtained by Maximum Likelihood techniques, and some specification tests, it is concluded that both factors influence pricing behaviour although their effect is not uniformly significant in every sector.