Do VCs use inside rounds to dilute founders? Some evidence from Silicon Valley

In the bank-borrower setting, a firm's existing lender may exploit its positional advantage to extract rents from the firm in subsequent financings. Analogously, a startup's existing venture capital investors (VCs) may dilute the founder through a follow-on financing from these same VCs (an “inside” round) at an artificially low valuation. Using a hand-collected dataset of Silicon Valley startup firms, we find little evidence that VCs use inside rounds to dilute founders. Instead, our findings suggest that inside rounds are generally used as “backstop financing” for startups that cannot attract new money, and these rounds are conducted at relatively high valuations (perhaps to reduce litigation risk).     

Real-world cost of treatment for multiple sclerosis patients initiating and receiving infused disease-modifying therapies per recommended label in the United States

Abstract

Aims: The study evaluated the real-world cost of treatment in multiple sclerosis (MS) patients initiating infused disease-modifying-therapies (DMT) in the United States.

Materials and Methods: This retrospective cohort study using administrative claims data included adult patients with MS initiating index infusion DMT (ocrelizumab (OCR), natalizumab (NTZ) or alemtuzumab (ATZ)) from April 2017–September 2018 with 6-months pre/12-months post-index continuous enrollment. The primary cohort included patients who had prescribed annual dosing visits indicated by the approved product label (PL): 3 OCR, 5 ATZ, and 12–13 NTZ infusion visits within the first year of initiation. Annual treatment cost was the sum of all costs on index DMT infusion visit dates. Costs were summarized for a primary and secondary cohort of patients receiving additional doses than prescribed in PL (>3 OCR, >5 ATZ, and >13 NTZ infusion visits); and an overall cohort of patients who met minimum required annual dose (≥3 OCR, ≥5 ATZ, and ≥12 NTZ), further stratified by insurance type.

Results: For patients in the primary cohort (123 OCR, 18 ATZ, and 48 NTZ), mean (standard-deviation) annual cost of treatment with OCR, ATZ, and NTZ cohorts was $72,066 ($34,480), $121,053 ($51,097) and $93,777 ($38,815), respectively. Among patients initiating OCR and NTZ, 15 and 6% respectively, had additional infusion visits leading to greater costs. Mean annual costs of index infusion DMT treatment in the overall cohort (162 patients treated with OCR, 18 with ATZ, 56 with NTZ) were $80,582, $121,053, and $93,807, respectively. The mean costs for commercial enrollees were higher than those for MAPD enrollees.

Limitations: Small sample size, limited population generalizability, and cost-reduction for ATZ beyond the second year need to be accounted for.

Conclusions: Real-world infusion DMT treatment costs for commercially insured patients were higher than perceived expenditures based on wholesale acquisition cost and administration costs via a physician-fee schedule. Consideration of real-world costs in cost-effectiveness and treatment/coverage decisions is needed.     

Sources of professional staff turnover in public accounting firms: Some further evidence

A recent article by Rhode et al. (1977) identified 39 variables associated with professional staff turnover in public accounting firms. The present study attempted to extend this prior work by examining the antecedents of the turnover act, namely those variables associated with the turnover decision. Using a valence-instrumentality-expectancy framework, measures of task outcome valence and instrumentality were evaluated with turnover expectations for a sample of 306 staff-level accountants. The findings indicated that the turnover decision was largely a function of negatively-valued task outcomes and the likelihood of obtaining these outcomes in one's current position, and the higher likelihood of obtaining certain positive outcomes in alternative positions.     

Implications of formal grammars for accounting policy development

The problems of accounting policy formulation are approached using the methods of formal language theory. The use of a formal grammar makes it possible to provide a clearer logical basis for the arguments for and against particular pronouncements of the FASB in three areas: possibility, consistency and resolution of accounting principles. Two examples are presented that suggest ways in which many different questions of accounting policy can be raised and answered. A linguistic framework for classifying accounting pronouncements is presented. Accounting as a formal language is evaluated together with speculation on the implications for accounting policy development.     

How Institutional Identity Shapes College Student Recruitment: The Relationship Between Religious Distinctiveness and Market Demand

Institutional diversity has long been recognized as a signature strength of the American system of higher education, yet the sector contributing most to this remarkable feature—small and midsized private colleges—currently finds itself under significant financial pressure as a result of recent social and economic disruptions. To overcome such challenges, campus leaders must understand the market positioning of the institutions they serve. This article investigates the relationship between market demand and organizational distinctiveness within one segment of the diverse private sector—religiously affiliated colleges. It draws upon longitudinal data from the membership of one national professional association, the Council for Christian Colleges & Universities, to develop an empirical typology of institutional religious distinctiveness and examine patterns of market demand over time. Results suggest that religious distinctiveness has a medium effect on student demand at both the application and matriculation phases of the admissions process. The article concludes by considering appropriate recruitment strategies for faith‐based colleges and universities depending on their degree of religious distinctiveness.