Peginterferon beta-1a versus other self-injectable disease-modifying therapies in the treatment of relapsing-remitting multiple sclerosis in Scotland: a cost-effectiveness analysis

Aims: Peginterferon beta-1a 125?mcg administered subcutaneously every 2 weeks, a new disease-modifying therapy (DMT) for relapsing-remitting multiple sclerosis (RRMS), was approved in January 2015 by the Scottish Medicines Consortium. This study assesses long-term clinical and economic outcomes of peginterferon beta-1a compared with other self-injectable DMTs (interferon beta-1a [22?mcg, 30?mcg, and 44?mcg], interferon beta-1b, and glatiramer acetate 20?mg) in the treatment of RRMS, from the National Health Service and Personal Social Services perspective in Scotland.

Methods: A previously published, validated Markov cohort model was adapted for this analysis. The model estimates changes in patient disability, occurrence of relapses, and other adverse events, and translates them into quality-adjusted life years and costs. Natural history data came from the ADVANCE trial of peginterferon beta-1a, the London Ontario (Canada) database, and a large population-based MS survey in the UK. The comparative efficacy of each DMT vs placebo was obtained from a network meta-analysis. Costs (2015 British Pounds) were obtained from public databases and literature. Clinical and economic outcomes were projected over 30 years and discounted at 3.5% per year.

Results: Over 30 years, peginterferon beta-1a was dominant compared with interferon beta-1a (22, 30, and 44?mcg), and interferon beta-1b, and cost-effective compared with glatiramer acetate 20?mg. Results were most sensitive to variations in each DMT’s efficacy and acquisition costs. Deterministic and probabilistic sensitivity analyses confirmed the robustness of the results.

Limitations: The impact of improved adherence with peginterferon beta-1a on clinical and economic outcomes and the impact of subsequent DMTs after treatment discontinuation were not considered. Oral and infused DMTs were not included as comparators.

Conclusion Long-term treatment with peginterferon beta-1a improves clinical outcomes, while its cost profile makes it either dominant or cost-effective compared with other self-injectable DMTs for the treatment of RRMS in Scotland.     

Using Parametric Bootstrap to Introduce and Manage Uncertainty: Replicated Loaded Insurance Life Tables

Insurance companies develop loaded life tables to protect themselves against deviations, for example, in the number of expected deaths or in the (residual) expectation of life of their insured. In doing so, however, the single random vector of experience crude death rates from which loaded tables are constructed is treated as deterministic or, at best, as a single realization of an underlying stochastic process, omitting the fact that it is estimated and subject to error and uncertainty. This can result in serious consequences for the insurer. To solve this problem, we follow the example of other researchers and propose a method to replicate loaded life tables using parametric bootstrap. We focus on estimating period-loaded life tables from company portfolios, where the sizes of the exposed-to-risk populations are significantly smaller than those of general populations. If we have a set of B loaded life tables, the average behavior and some extreme values can be computed and subsequently used in managing premiums or reserves. This article offers life insurers a simple way of incorporating the experience uncertainty in actuarial tasks (for example, in pricing) by comparing the limits of the confidence intervals obtained between parametric bootstrap and classical approaches (such as limit theorems).     

Market orientation for the hotel segment： The Portuguese case

In view of the importance of the hotel segment for the tourism and for the economy of countries such as Portugal, the objective of this study was to measure the level of orientation for the market of the largest hotel groups of Portugal. This investigation initially emphasized the importance of the marketing for the organizations, mainly the orientation for the market. After a brief explanation on the hotel segment in Portugal, an empirical study was presented, of quantitative, exploratory and traversal character, performed with the largest groups of 20 hotels of Portugal, using as an instrument of collection data, the traditional Markor scale （market orientation） adapted to the hotel sector. After analyzing the data, it was found in the investigated organizations that a good capacity to generate market information and response to the market, which formed two of the three constructs of Markor scale. However the results obtained with the construct of the dissemination of market information were below the expectations. It was possible to conclude that marketing professionals of the large hotel groups in Portugal are well oriented to the market, something not shared by other investigated departments of the hotels. So the current challenge for the main networks of hotels in Portugal is to improve the internal dissemination of information that marketing professionals gathered at the market.     

Portfolio selection in quantile decision models

Annals of Finance - This paper develops a model for optimal portfolio allocation for an investor with quantile preferences, i.e., who maximizes the $$tau $$ -quantile of the portfolio return, for...     

Spillover across Eurozone credit market sectors and determinants

We examine spillover and its determinants among Eurozone sector level credit markets using time and frequency domain spillover approaches. Based on network theory and connectedness analysis, we identify the sectors that are major transmitters and receivers of spillover during normal and crisis periods. The rolling window analysis shows that short-run spillover among credit market sectors intensifies during global and Eurozone crisis periods. Further, using Bayesian model averaging, we find that overall financial conditions and stock market volatility are the main drivers of total and sector-level spillover. Our findings have important implications for policymakers and investors interested in Euro-area credit risk at the sector level.     

Corporate governance and IPO underpricing in a cross‐national sample: A multilevel knowledge‐based view

Prior studies of IPO underpricing, mostly using agency theory and single‐country samples, have generally fallen short. In this study, we employ the knowledge‐based view (KBV) to explore underpricing across 17 countries. We find that agency indicators are insignificant predictors, board of director knowledge limits underpricing, and external knowledge both substitutes for and complements internal board knowledge. This third finding suggests that future KBV studies should consider how internal and external knowledge states interact with each other. Our study offers new insights into the antecedents of underpricing and extends our understanding of comparative governance and the KBV of the firm. Copyright © 2014 John Wiley & Sons, Ltd.     

The welfare cost of means‐testing: pensioner participation in income support

We estimate parametric and semi‐parametric binary choice models of benefit take‐up by British pensioners and use a revealed preference argument to infer the cash‐equivalent value of disutility arising from stigma or complexity of the claims process. These implicit costs turn out to be relatively small, averaging about £3–4 per week across Income Support recipients. Using the Foster–Greer–Thorbecke measure of poverty among pensioners, we find that allowing for implicit claim costs incurred by benefit recipients raises the measured degree of poverty by not more than 13%. Copyright © 2007 John Wiley & Sons, Ltd.     

Barriers to innovation and public policy in Catalonia

The present paper analyses the link between firms’ decisions to innovate and the barriers that prevent them from being innovative. The aim is twofold. First, it analyses three groups of barriers to innovation: the cost of innovation projects, lack of knowledge and market conditions. Second, it presents the main steps taken by Catalan Government to promote the creation of new firms and to reduce barriers to innovation. The data set used is based on the 2004 official innovation survey of Catalonia which was taken from the Spanish CIS4 sample. This sample includes individual information on 2,954 Catalan firms in manufacturing industries and knowledge-intensive services (KIS). The empirical analysis reveals pronounced differences regarding a firm’s propensity to innovate and its perception of barriers. Moreover, the results show that cost and knowledge barriers seem to be the most important and that there are substantial sectoral differences in the way that firms react to barriers. The results of this paper have important implications for the design of future public policy to promote entrepreneurship and innovation together.

How Should the Graduate Economics Core be Changed?

The authors present suggestions by graduate students from a range of economics departments for improving the first-year core sequence in economics. The students identified a number of elements that should be added to the core: more training in building microeconomic models, a discussion of the methodological foundations of model-building, more emphasis on institutions to motivate and contextualize macroeconomic models, and greater focus on econometric practice rather than theory. The authors hope that these suggestions will encourage departments to take a fresh look at the content of the first-year core.