Outcomes of tumor necrosis factor inhibitor cycling versus switching to a disease-modifying anti-rheumatic drug with a new mechanism of action among patients with rheumatoid arthritis

Objectives: To examine treatment patterns, treatment effectiveness, and treatment costs for 1 year after patients with rheumatoid arthritis switched from a tumor necrosis factor inhibitor (TNFi) (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab), either cycling to another TNFi (“TNFi cyclers”) or switching to a new mechanism of action (abatacept, tocilizumab, or tofacitinib) (“new MOA switchers”).

Methods: This retrospective cohort study used administrative claims data for a national insurer. Treatment persistence (without switching again, restarting, or discontinuing), treatment effectiveness (defined below), and costs were assessed for the 12-month post-switch period. Patients were “effectively treated” if they satisfied all six criteria for a treatment effectiveness algorithm (high adherence, no dose increase, no new conventional synthetic disease-modifying anti-rheumatic drug, no subsequent switch in therapy, no new/increased oral glucocorticoids, and <2 glucocorticoid injections). Multivariable logistic models were used to adjust for baseline factors.

Results: The database included 581 new MOA switchers and 935 TNFi cyclers. New MOA switchers were 39% more likely than TNFi cyclers to persist after the switch (odds ratio [OR]?=?1.39; 95% confidence interval [CI]?=?1.12–1.74; p?=?.003) and 36% less likely to switch therapy again (OR?=?0.64; 95% CI?=?0.51–0.81; p?p?=?.006). New MOA switchers had 16% lower drug costs than TNFi cyclers (cost ratio?=?0.84; 95% CI?=?0.79–0.88; p?p?Limitations: Claims payments may not reflect rebates or other cost offsets. Medical and pharmacy claims do not include clinical end-points or reasons that lead to new MOA switching vs TNFi cycling.

Conclusions: These results support switching to a new MOA after a patient fails treatment with a TNFi, which is consistent with recent guidelines for the pharmacologic management of established rheumatoid arthritis.     

“Fact or artifact? Empirical evidence on the robustness of compromise effects in binding and non-binding choice contexts”

In this article, the compromise effect (CE) is investigated according to which the choice share of a particular product is expected to increase when it is in an intermediate position in a subset of a product line. In a laboratory-based replication study, we tested CE both in hypothetical non-binding settings most commonly used in previous research on CE as well as in settings where experienced consumers make unforced and binding purchase decisions between real brands of two particular categories. While results prove robustness of the compromise effect even in the binding choice context, its magnitude is significantly reduced, hence indicating a hypothetical bias. Thus, since the CE is evidently less prevalent in the more realistic binding choice setting, compromise effects must be considered overrated to a certain degree in the previous studies on hypothetical decisions.     

Trade Policy and Productivity Growth in OECD Manufacturing *

Trade liberalization may promote economic growth in a number of ways, including by accelerating the rate of technological change. Firms that face more intense import competition may be spurred to greater rates of innovation; firms which export may absorb new technologies through their contact with international markets. This paper examines evidence on trade policy and productivity growth for a sample of thirteen OECD countries and including eighteen manufacturing sectors, using data primarily from the 1980s. Within individual sectors, there are strong productivity convergence effects within the OECD. After controlling for convergence, we find a positive association between high rates of productivity growth and low tariffs, and between high productivity growth and strong export performance. We found no particular association between high productivity growth and import penetration. The results are consistent with the possibility of positive linkages between trade liberalization and accelerated productivity growth. [F1, O4]     

Class Struggle or Embedded Markets? Marx,Polanyi and the Meanings and Possibilities of Social Transformation

Marx and Polanyi both held that socialism, in one form or another, was a preferable and possible alternative to capitalism. Their ideas are seen to offer theoretical tools to understand the tensions and contradictions of capitalism, and to inform ways to overcome them. This paper discusses Polanyi's work from a Marxist perspective in order to illuminate his strengths and weaknesses. Its main focus is to discuss Polanyi's juxtaposing of commodification against exploitation, in diagnosing the problems of capitalist expansion. We suggest that by juxtaposing these two moments, Polanyi not only misses out on a crucial arena of capitalist activity (exploitation), but also undermines his own explication of processes of commodification. This has deleterious consequences for his understanding of the prevalence of poverty under capitalism. It also means that his vision of social transformation and of socialism is profoundly different, and potentially antithetical, to that of Marx. We suggest that for Polanyi's conception of de-commodification to gain greater traction it needs to be combined with Marx's analysis of exploitation and class struggle.     

“I recycle,I turn out the lights”: understanding the everyday sustainability practices of backpackers

As holidays merge more intimately with the everyday lives of an increasing number of people, questions of sustainability in tourism contexts become ever more urgent. Using the concept of everyday practices, in which sustainability is thought to emerge in the routines of people going about their day-to-day lives, this mixed-method study aimed to understand how sustainability figures in the practices, of backpackers. Findings revealed sustainability to be of minimal concern to most backpackers who nevertheless performed a range of sustainable practices but unintentionally. Environmental sustainability was practised via reduced resource consumption and waste, economic sustainability by working and spending more money overall than other tourist types, and social sustainability through demonstrating cultural respect and community participation. The main factors encouraging sustainable practices amongst backpackers were their low-budget focus and their use as a labour source by industries that require temporary and flexible workers. When backpackers were employed, each facet of sustainability became mutually reinforcing. The results of this study are in contrast to usual perceptions of tourism as a time in which norms of sustainable behaviour are suspended, as backpacking was found to provide opportunities for the performance of more sustainable practices compared to home.     

The impact of job security on job satisfaction in economic contractions versus expansions

Job security, often measured using the perceived risk of job loss in the near future, is a significant determinant of job satisfaction. We posit that the impact job security has on job satisfaction is not only a function of how likely it is that a worker loses a job but also how likely it is that a worker could find another. The effect this has on worker job satisfaction then is different depending on whether perceived job loss occurs (or not) when job openings are scarce or when job openings are plentiful. We use difference-in-differences analysis of the 1997 and 2008 waves from the National Study of the Changing Workforce to show that three measures of job security increase private sector worker job satisfaction, and reduce worker incentives to quit, more when job openings are relatively scarce (during contractions) than when job openings are relatively plentiful (during expansions). We find that our results are strongest among less-educated workers.     

Why adopt social enterprise software? Impacts and benefits

This paper explores the performance impacts and benefits of the adoption of Social Enterprise Software (SES). SES forms a nested innovation, given that its adoption requires an already established infrastructure of Information and Communication Technology. To control for induced sample selection, we use a two-step estimation procedure. Based on German firm-level data our results confirm that firms which use business-to-business (B2B) e-commerce applications are more likely to adopt SES. The estimated correlations also provide weak evidence for complementarity between B2B e-commerce and SES. We show that two measures of firm performance, i.e. sales and labor productivity, are highest for firms using SES and B2B e-commerce applications in conjunction.     

Social franchising: A systematic review

Abstract

Social franchising is starting to garner more interest among researchers and practitioners as a replication approach used to help address a growing array of societal issues in both developed countries and emerging economies. While there has been a proliferation of experimentation with social franchising that is occurring on the global stage, the knowledge base remains fragmented. A comprehensive review of the empirical and practitioner literature has not been done. This article fills the void by reviewing the past decade of literature and will be of interest to governments, non-governmental organizations (NGOs), philanthropists, social impact investors, corporations devoted to social goals, and other key players who support the scaling up or replication of ventures that strive to address societal ills by creating pathways to health and prosperity.     

Morally Contentious Technology-Field Intersections: The Case of Biotechnology in the United States

Technologies can be not only contentious—overthrowing existing ways of doing things—but also morally contentious—forcing deep reflection on personal values and societal norms. This article investigates that what may impede the acceptance of a technology and/or the development of the field that supports or exploits it, the lines between which often become blurred in the face of morally contentious content. Using a unique dataset with historically important timing—the United States Biotechnology Study fielded just 9 months after the public announcement of the successful cloning of the first mammal (i.e., Dolly the sheep)—we find that microlevel factors (i.e., conservative Christianity) predict unfavorable judgments of the technology-field intersection while macrolevel representations [i.e., exposure to Science, Technology, Engineering, and Mathematics disciplines and media coverage] predict more favorable judgments.     

Globalization,technical change and the skill premium: magnification effects from human – capital investments

This paper shows that endogenous adjustments in the composition of labour supplies magnify the effects of changes in commodity prices on the measured skill premium under quite plausible conditions. These composition effects arise from decisions of individuals with heterogeneous inherent abilities about acquiring human capital. They reinforce the well-known Stolper?–?Samuelson effect on the measured skill premium in countries with a sufficiently high relative supply of skilled labour, but compensate them otherwise. As a result, the model can account for the observation of a worldwide increase in the skill premium during the last two decades.