Rivaroxaban for non-valvular atrial fibrillation and venous thromboembolism in the Netherlands: a real-world data based cost-effectiveness analysis

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) have been included in international guidelines as important alternatives to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (NVAF). Meanwhile, in the Netherlands, NOACs are widely used next to VKAs. The objective of this study is to estimate the cost-effectiveness of treatment with rivaroxaban compared to VKAs in NVAF and VTE patients in the Netherlands, using data from international prospective observational phase IV studies.

Methods: Two models were developed to represent NVAF and VTE patients, populated with patients from the XANTUS (NCT01606995) and XALIA (NCT01619007) international prospective observational studies. The 1-year cost-effectiveness of rivaroxaban use, compared to VKAs, was explored in a population consisting of NVAF and VTE patients (base case) as well as for four scenarios with sub-populations: NVAF patients only, VTE patients only, NVAF patients with unstable international normalized ratio (INR), and NVAF patients using an INR self-measuring device.

Results: In the base case, rivaroxaban saved €72,350 and gained 21 quality-adjusted life-years (QALYs) in a simulation of 2,000 patients over the use of VKAs. Ergo, rivaroxaban was dominant over VKAs. The probabilistic sensitivity analysis showed a probability of 85% for rivaroxaban being dominant and 100% at a willingness-to-pay threshold of €20,000/QALY. Rivaroxaban appeared to be dominant in all scenarios as well, except for the NVAF-patients-only scenario where the incremental cost-effectiveness ratio (ICER) was €157/QALY.

Conclusions: In patients with NVAF or VTE, rivaroxaban treatment is likely to be cost-effective and a potentially cost-saving alternative to VKA in the Netherlands.     

What can price volatility tell us about market efficiency? Conditional heteroscedasticity in historical commodity price series

The development in the working of markets has been an important topic in economic history for decades. The volatility of market prices is often used as an indicator of market efficiency in the broadest sense. Yet, the way in which volatility is estimated often makes it difficult to compare price volatility across regions or over time for two reasons. First, if prices are non-stationary, the variance is inflated. Second, the variance of commodity prices contains information on a number of region- and time-specific factors that are not related to market efficiency. Hence, the popular coefficient of variation and related indicators are not adequate measures of the efficiency of markets and are incomparable across regions. As a solution, we suggest using a conditional heteroscedasticity model to estimate the residual (conditional) variance of commodity prices. This measure reflects how markets react to unexpected events and can therefore be seen as a measure of market efficiency. Using this approach on grain prices from the Early Modern Pisa, Paris, Vienna, and Japan, we find that the residual price volatility had declined (and market efficiency increased) in the European markets in the late sixteenth century while it remained stable in Japan.     

Social Interaction Effects in Disability Pension Participation: Evidence from Plant Downsizing*

We estimate the magnitude of social interaction effects in disability pension participation among older workers in Norway. The problem of omitted variable bias is addressed using the exposure of an individual's neighbors to plant‐downsizing events as an instrument for the disability entry rate among the individual's previously employed neighbors. Our instrumental variable (IV) estimates suggest that an increase of one percentage point in the participation rate of previously employed neighbors increased the subsequent four‐year entry rate of older workers by about 0.4 percentage points. Numerous robustness and specification tests appear to support the validity of the identifying assumption in our IV strategy.     

Input versus output taxation in an experimental international economy

This paper presents the results of a policy oriented macroeconomic experiment involving an ‘international’ economy with a relatively small ‘home’ country and a large ‘foreign’ country. It compares the economic performance of two alternative tax systems: a wage tax system and a sales-tax-cum-labor-subsidy system. The two systems are applied to the small country, while the wage tax system always obtains in the large country. The main result is that the sales tax system outperforms the wage tax system, using standard economic indicators. Moreover, it turns out that under the sales tax system economic activities appear to be moving toward the ‘better’ of two theoretical equilibria. It is argued that producers’ reluctance to incur costs up-front while being uncertain about product prices can explain these results. Several pieces of evidence are provided to support this claim. The results strongly suggest that behavioral aspects should be taken into account also in applied macroeconomic models.     

THE ROLE OF PREFERENCE SHOCKS AND CAPITAL UTILIZATION IN THE GREAT DEPRESSION*

The article examines the proposition that preference shocks play a central role in our understanding of the Great Depression. I identify a series of unusually large negative shocks that destabilized the U.S. economy during the 1930s. When the artificial economy is paired with variable capital utilization and mildly increasing returns to scale in production, it is able to account for most of the decline in economic activity and it predicts a tepid recovery.     

风险管理，你犯错了吗？

我们无法预测“黑天鹅事件”的发生,与其一味幻想可以执掌未来,防堵风险,不如设法降低此类威胁带来的不良影响。     

Science-based entrepreneurship education as a means for university-industry technology transfer

This paper explores the potential of university-industry technology transfer through science-based entrepreneurship education (SBEE). The scientific literature focuses mostly on enabling university-industry technology transfer via university-industry collaboration in research, and not so much in (science) education. The paper identifies four strands of relevant literature for further theorizing SBEE principles to research its contribution to industry-technology transfer: 1. Embedding entrepreneurship education in universities; 2. Balancing theory and practice of entrepreneurship education; 3. Cultivating an entrepreneurial mindset through entrepreneurship education; and 4. Creating spin-offs through entrepreneurship education. One of the main theoretical contributions of this paper is, that SBEE is different from regular entrepreneurship education in its need for being firmly embedded in a science, technology and R&D environment, both within and outside the university. This is important in order to give SBEE students the opportunity to gain experience with handling the hurdles for successful university-industry technology transfer. The main empirical finding is that elements in the program, related to for example the balance between teaching entrepreneurship through theory and experiential learning, are not systematically covered. It means that fundamental questions such as: Can entrepreneurship be indeed taught? Which elements of entrepreneurship can be taught through theory, and which ones must be experienced in practice? are currently left unanswered. Systematic coverage of these questions enables a better exploitation of the possibilities that SBEE offers for university-industry technology transfer.

     

PROBLEMS IN THE COMPILATION OF INPUT-OUTPUT TABLES IN THE NETHERLANDS

This article deals with some aspects of the compilation of input-output tables (I.O. tables). A global view is given of the way in which I.O. tables are compiled in The Netherlands. It is indicated that in The Netherlands a number of developments are in progress that have led to an extension of the uses that are made of I.O. tables. The changing demands on I.O. tables that result from these developments can be met in future to an important degree. This has been made possible by extending and improving basic statistics and by increasing the uses made of automation facilities. Some problems remain, however, and one of these problems takes a central place in this article. This is the problem of accuracy and continuity: how can yearly I.O. tables be compiled that combine accuracy with consistency over time. Accuracy means here that the tables should be as complete as possible and in optimal accordance with all available information. Consistency over time means that estimates of details of I.O. tables compared with the same estimates for previous years reflect real economic developments. It is obvious that those two demands may conflict, particularly for years in which new information becomes available. It then must be decided whether accuracy or consistency in time deserves priority. What problems result from this decision and what are the consequences for the yearly I.O. tables? The problems arising from the conflicting demands of accuracy and continuity apply to the Netherlands in the last few years. This led to a revision of I.O. tables and national accounts for 1977. This revision resulted in an increase of estimated national income of more than 6 percent. For some components the adjustments have been much larger; this is particularly true for the services sector. More information on the 1977 revision is given in an annex.     

Trading-up on unmet expectations? Evaluating consumers’ expectations in online premium grocery shopping logistics

Geography and retail store locations are inherently bound together; this study links food retail changes to systemic logistics changes in an emerging market. The later include raising income and education, access to a wide range of technologies, traffic and transport difficulties, lagging retail provision, changing family structure and roles, as well as changing food culture and taste. The study incorporates demand for premium products defined by Kapferer and Bastien [2009b. The Luxury Strategy. London: Kogan Page] as comprising a broad variety of higher quality and unique or distinctive products and brands including in grocery organic ranges, healthy options, allergy free selections, and international and gourmet/specialty products through an online grocery model (n?=?356) that integrates a novel view of home delivery in Istanbul. More importantly from a logistic perspective our model incorporates any products from any online vendors broadening the range beyond listed items found in any traditional online supermarkets. Data collected via phone survey and analysed via structural equation modelling suggest that the offer of online premium products significantly affects consumers’ delivery logistics expectations. We discuss logistics operations and business management implications, identifying the emerging geography of logistic models which respond to consumers’ unmet expectations using multiple sourcing and consolidation points.