Regulatory Barriers and Entry into a New Competitive Industry

We model the effects of license fees and bureaucratic delay on firm entry into a new competitive industry, whose profitability is initially unknown. A license fee alone reduces the number of first movers and the steady‐state number of firms. The combination of license fee and delay may cause some entrepreneurs to purchase licenses speculatively, only using them to enter production later if profitability is revealed to be sufficiently favourable. Alternatively, some entrepreneurs may wait, possibly buying a license only after profitability is revealed; but it is never found that some entrepreneurs adopt one of these strategies and some the other.     

Cost comparison of continued anticoagulation with rivaroxaban versus placebo based on the 1-year EINSTEIN-Extension trial efficacy and safety results

Aims: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (vs placebo) after 6–12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo, based on the EINSTEIN-EXT event rates.

Methods: Total healthcare cost was calculated as the sum of treatment and clinical event costs from a US managed care perspective. Treatment duration and event rates were obtained from the EINSTEIN-EXT study. Adjustment on treatment duration was made by assuming a 10% non-adherence rate. Drug costs were based on wholesale acquisition costs. Cost estimates for clinical events (i.e. recurrent deep vein thrombosis [DVT], recurrent pulmonary embolism, major bleeding, clinically relevant non-major bleeding) were determined from the literature. Results were examined over a ±20% range of each cost component and over 95% confidence intervals (CIs) of event rate differences in deterministic (one-way) and probabilistic sensitivity analyses (PSA).

Results: Total healthcare cost was $1,454 lower for rivaroxaban-treated (vs placebo-treated) patients in the base-case, with a lower clinical event cost fully offsetting drug cost. The cost savings of recurrent DVT alone (–$3,102) was greater than drug cost ($2,723). Total healthcare cost remained lower for rivaroxaban in the majority (73%) of PSA (cost difference [95% CI]?=?–$1,454 [–$2,396, $1,231]).

Limitations: This study was conducted over the 1-year observation period of the EINSTEIN-EXT trial, which limited “real-world” applicability and examination of long-term economic impact. Assumptions on drug and clinical event costs were US-based and, thus, not applicable to other healthcare systems.

Conclusions: Total healthcare costs were estimated to be lower for patients continuing rivaroxaban therapy compared to those receiving placebo in VTE patients who had completed 6–12 months of VTE treatment.     

To push performance,check the leader’s power motive

The power motive, defined as the desire to impact the behavior and emotions of another person, has long been controversial. On one side, the exercise of power has been put forth as a fundamental human need greater in strength than the need to survive. On the other, it has been vilified for its potentially devastating consequences. We argue the latter view is distorted, and, by relying too heavily on it, we have come to misunderstand the essential nature of power and its use by leaders charged with driving performance. It is not the power motive that leads to corruption and tyranny, but rather how the power motive is channeled into behavior by other personality factors. Consequently, those charged with leader selection should place greater emphasis on how individuals with strong power motives differ in how they channel power. Doing so will support the selection of executives best equipped to deliver organizational performance.