Estimated burden of cardiovascular disease and value-based price range for evolocumab in a high-risk,secondary-prevention population in the US payer context

Aim: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population.

Materials and methods: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into four cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (n?=?1448), acute coronary syndrome (ACS) (n?=?602), ischemic stroke (IS) (n?=?151), and heart failure (HF) (n?=?291) incident cohorts. The value-based price range for evolocumab was assessed using a previously published economic model. The model incorporated CPRD CV event rates and considered CV event reduction rate ratios per 1?mmol/L reduction in low-density lipoprotein-cholesterol (LDL-C) from a meta-analysis of statin trials by the Cholesterol Treatment Trialists Collaboration (CTTC), i.e. CTTC relationship.

Results: Multiple-event rates of composite CV events (ACS, IS, or coronary revascularization) per 100 patient-years were 12.3 for the high-risk prevalent ASCVD cohort, and 25.7, 13.3, and 23.3, respectively, for incident ACS, IS, and HF cohorts. Approximately one-half (42%) of the high-risk ASCVD patients with a new CV event during follow-up had a subsequent CV event. Combining these real-world event rates and the CTTC relationship in the economic model, the value-based price range (credible interval) under a willingness-to-pay threshold of $150,000/quality-adjusted life-year gained for evolocumab was $11,990 ($9,341–$14,833) to $16,856 ($12,903–$20,678) in ASCVD patients with baseline LDL-C levels ≥70?mg/dL and ≥100?mg/dL, respectively.

Conclusion: Real-world CVD burden is substantial. Using the observed CVD burden in CPRD and the CTTC relationship, the cost-effectiveness analysis showed that, accounting for uncertainties, the expected value-based price for evolocumab is higher than its current annual cost, as long as the payer discount off list price is greater than 20%.     

Boards and Sustainability: the Contingent Influence of Director Interlocks on Corporate Environmental Performance

This paper highlights the importance of a firm's board with respect to sustainability issues by analysing the relationship between director interlocks, i.e. directors who simultaneously belong to the boards of directors of several companies, and a firm's environmental performance. The previous literature has focused on the influence of firm‐level resources on corporate environmental performance. This study utilizes insights from a resource‐based view and research on social capital to demonstrate that the environmental performance of a firm is also influenced by the difficult‐to‐imitate capabilities that are embedded in the network relationships of its directors. Our results support a contingency perspective of the social capital theory that finds that director interlocks are positively connected with the environmental performance of a firm in two specific situations: (1) when the firm is linked to a larger parent company and (2) in cases of low and high levels of interlock diversity. Copyright © 2013 John Wiley & Sons, Ltd and ERP Environment.     

A Recursive Protocol for Negotiating Contracts Under Non-monotonic Preference Structures

Negotiating contracts with multiple interdependent issues may yield non-monotonic preference spaces for the participating agents. These negotiations are specially challenging because of the complexity and dimension of the search space. Automated negotiation mechanisms designed and proven useful for monotonic utility spaces may fail in these negotiation scenarios. This paper presents a novel solution to the problem of automated multi-issue negotiations in the context of complex utility spaces. We seek to address the challenge of intractably large contract spaces and utility functions with multiple local optima in automated negotiation scenarios. A protocol for automated bilateral multi-attribute negotiation processes is proposed, in which the individual agents??preferences can be non-monotonic and discontinuous. The protocol is based on a recursive non-mediated bargaining mechanism, which involves two agents who simultaneously exchange proposals defined as regions within the negotiation space. An agreement on a region implies a new bargaining which is restricted to that region. This recursive process is governed by a set of rules which modulate the joint exploration of the negotiation space until an agreement is found or a deadline expires. The protocol is experimentally evaluated under monotonic and non-monotonic preference scenarios, confirming that the protocol is able to produce outcomes close to the Pareto frontier in acceptable negotiation time, outperforming previous approaches.     

Incentives and disincentives for stakeholder involvement in participatory research (PR): lessons from potato-related PR from Bolivia,Ethiopia, Peru and Uganda

Participatory research (PR) has been presented as an alternative to develop sustainable agricultural technologies more responsive to farmer needs. However, the institutionalization of PR methods is influenced by stakeholders' perceptions about incentives and disincentives. The study was conducted by gathering and analysing information from farmers, facilitators and institutional representatives involved in conducting potato-related PR in Bolivia, Ethiopia, Peru and Uganda between 2005 and 2007. Results indicate that at the farmer level the most important incentives are related to the benefits they can acquire (improving human and social capital, which is essential for more sustainable results). At the facilitator level, operational and organizational factors represent incentives, for example, perception of additional benefits, existing capabilities and skills, and access to logistic support. Some factors also represent disincentives such response to different types of demands, and instability of jobs within institutions. At the organization level, both financial and operational factors represent incentives or disincentives, such as the cost of PR methods, availability of skillful human resources, quality of technologies generated and the sustainability of financial support. These factors at both individual and organizational level need to be taken into consideration by organizations aiming at scaling up and out-of-PR methods and derived technologies in a sustainable way.     

The ex-post behavior of firms offering optimal employment contracts

The influential papers of Azariadas (1975) and Baily (1974) have clearly demonstrated that with imperfect labor mobility expected profit maximizing firms will offer employment contracts that will not result in profit maximizing behavior once the ‘state of nature’ is disclosed. This Letter shows that such firms will behave as if their objective were to maximize the expected utility of each individual worker subject to a profit target. The rule that emerges when there is unemployment will be shown to be formally equivalent to Meade's Rule for optimal population [Meade (1955, ch. 6)].     

Staggered prices in a utility-maximizing framework

We develop a model of staggered prices along the lines of Phelps (1978) and Taylor (1979, 1980), but utilizing an analytically more tractable price-setting technology. ‘Demands’ are derived from utility maximization assuming Sidrauski-Brock infinitely-lived families. We show that the nature of the equilibrium path can be found out on the basis of essentially graphical techniques. Furthermore, we demonstrate the usefulness of the model by analyzing the welfare implications of monetary and fiscal policy, and by showing that despite the price level being a predetermined variable, a policy of pegging the nominal interest rate will lead to the existence of a continuum of equilibria.     

The missing links: cultural,software, task and personal influences on computer self-efficacy

Culture exerts a fundamental effect on employees and their use of technologies. We examine the influence of culture (and other factors) on computer self-efficacy (CSE). CSE, or employees' judgments about their capabilities to use a specific software system, is important given its relationship with work performance. By drawing a sample from two different countries, we show that culture affects CSE indirectly through employees' preferences for individualism and task interdependence. Furthermore, individualism, task interdependence and software personal innovativeness relate positively, whereas task ambiguity and software complexity associate negatively with CSE. Finally, we discuss several implications for human resource management.     

Adapting and testing the Fama and French model,with some variations of company characteristics

We examine whether the Fama and French (1992) (F&F) model can be adapted to become a more versatile and flexible tool, capable of incorporating variations of company characteristics in a more dynamic form. For this, the risk factors are reconstructed at the end of each reading of monthly data. We argue that, over time, the evaluation of a company may change as a result of variations in its market price, size or book price, and we are aware that the F&F model does not accurately reflect these dynamics. Our results show that the adapted model is able to capture the behaviour of a greater number of stocks than the original F&F model and risk factors are more significant when building them through our procedure. In addition, we carry out these adaptations during a period of instability in financial markets.     

Diversity in trade union membership: a typology based on the study of a Spanish trade union

While existing literature on the changing nature of trade union membership concentrates on unidimensional differences between members, this article proposes a multidimensional typology, which considers demographic characteristics as well as labour market position and length of union membership. Our results allow the identification of different member profiles; these are significantly associated to differences in employment conditions, work participation, job satisfaction and union activism. In the last section of the article, we discuss the practical implications that these different member profiles may have for union policy and organisation.