Evaluation of medical costs associated with use of new oral anticoagulants compared with standard therapy among venous thromboembolism patients

Objective:

This study evaluated differences in medical costs associated with clinical end-points from randomized clinical trials that compared the new oral anticoagulants (NOACs), dabigatran, rivaroxaban, apixaban, and edoxaban, to standard therapy for treatment of patients with venous thromboembolism (VTE).

Research design and methods:

Event rates of efficacy and safety end-points from the clinical trials (RE-COVER, RE-COVER II, EINSTEIN-Pooled, AMPLIFY, Hokusai-VTE trial) were obtained from published literature. Incremental annual medical costs among patients with clinical events from a US payer perspective were obtained from the literature or healthcare claims databases and inflation adjusted to 2013 costs. Differences in total medical costs associated with clinical end-points for the NOACs vs standard therapy were then estimated. One-way and Monte Carlo sensitivity analyses were carried out.

Results:

A lower rate of major bleedings was associated with use of any of the NOACs vs standard therapy. Except for dabigatran, use of NOACs was also associated with a lower rate of recurrent VTE/death. As a result of the reduction in clinical event rates, the overall medical cost differences were ?$146, ?$482, ?$918, and ?$344 for VTE patients treated with dabigatran, rivaroxaban, apixaban, and edoxaban, respectively, vs patients treated with standard therapy.

Conclusions:

When any of the four NOACs are used instead of standard therapy for acute VTE, treatment medical costs are reduced. Apixaban is associated with the greatest reduction in medical costs, which is driven by medical cost reductions associated with both efficacy and safety end-points. Further evaluation may be needed to validate these results in the real-world setting.     

Retaining volunteers for the cause: Hope and pride associated with cause-related charity events in cancer control

Special charity events are an important source of revenue for non-profit organisations in cancer control yet volunteering is declining and turnover is high. Experiences at cause-related events may influence retention, particularly emotions connected to the cause and ceremonies which honour cancer survivors and remember loved ones. We explore the degree to which emotions associated with cause-related volunteering and collective action in the literature are felt in response to Relay For Life and what emotions predict three indicators of retention: intention to return for future events, satisfaction with volunteering, and organisational commitment. Volunteers (n = 410) completed a cross-sectional survey at Relay For Life events in Queensland, Australia. Multiple regression analyses examined whether emotions associated with events predicted each indicator of retention, adjusting for number of years spent volunteering for events. Sixty-two percent reported an intention to return the following year. The most commonly reported event-related emotions were hope, pride, and empathy (62–69%). Intention to return, satisfaction, and commitment were each significantly predicted by hope and pride. The findings suggest special charity events in cancer control could retain volunteers by fostering pride and hope (e.g., for a cancer free future); however, future prospective research which examines the mechanisms of these relationships is warranted.     

When hubs forget,lie, and play favorites: Interpersonal network structure,information distortion,and organizational learning

The interpersonal network structure of an organization directly influences the diffusion and recombination of ideas and can thus facilitate or impede organizational learning. Most interpersonal networks have ‘hubs’—individuals who have significantly more connections than does the average member. This raises important questions about how hubs influence organizational learning outcomes. Does the presence of hubs improve or impair performance? What happens if hubs forget or misrepresent information that is transmitted through the network? Using simulation models, we find that moderately hubby networks outperform both very hubby and democratic networks. We also find that moderate amounts of information omission or misrepresentation can be surprisingly beneficial to performance, though the patterns of their effects are strikingly different. Copyright © 2013 John Wiley & Sons, Ltd.     

Archaeological sites,modern communities,and tourism

Archaeology is a major component of the tourism industry in both developed and developing countries, which has especially significant implications for indigenous people and other disenfranchised groups. Archaeological tourism celebrates the cultural richness of a region’s history and has the potential to bring local or descendant communities financial gain. But what is the role of the archaeologist in the sustainable and responsible development and maintenance of archaeological tourism? Drawing upon their own field research, the authors suggest that when tourism and archaeological sites meet, archaeologists avoid arguments about ownership and act as facilitators for frank conversations about the consequences of tourism development for all parties involved.     

An International Investigation of Problem‐Solving Performance in the Semiconductor Industry*

Using a unique survey of engineers in major semiconductor companies located in Japan, South Korea, and the United States, this article analyzes how a firm's human resource (HR) system (i.e., practices that structure work, develop skills, and reward performance) and knowledge system (i.e., information access, sharing and control) are related to the problem‐solving performance of engineers. Because of the short product market life cycles in the semiconductor industry, expeditious problem solving is an important performance goal. Therefore, this article examines the performance of engineers in terms of the time it takes them to solve problems in the context of their firms' HR and knowledge systems. It was anticipated during this study that externally oriented organizational systems, which support individual career performance and mobility (an externally oriented HR system) and the use of private knowledge sources (an externally oriented knowledge system), would be associated with superior performance in terms of problem‐solving speed. The findings support this hypothesis and demonstrate the importance of externally oriented HR systems and at the same time suggest the surprising insignificance of the orientation of the knowledge systems. These findings are applicable to engineers in the sample from the United States, whereas the findings for the Korean and Japanese engineers are inconclusive. International variation is found where the U.S. engineers work under the most externally oriented and the Japanese engineers under the least externally oriented systems, and the Korean engineers fall in between. The findings of this article suggest that when constructing a work environment for new product development, managers should take into account how the underlying components of their organizational systems contribute to an internal or external focus, and how this orientation may influence performance.     

Informed Trading around Merger Announcements: An Empirical Test Using Transaction Volume and Open Interest in Options Market

This paper provides empirical evidence on the level of trading activity in the stock options market prior to the announcement of a merger or an acquisition. Our analysis shows that there is a significant increase in the trading activity of call and put options for companies involved in a takeover prior to the rumor of an acquisition or merger. This result is robust to both the volume of option contracts traded and the open interest. The increased trading suggests that there is a significant level of informed trading in the options market prior to the announcement of a corporate event. In addition, abnormal trading activity in the options market appears to lead abnormal trading volume in the equity market. This finding supports the hypothesis that the options market plays an important role in price discovery.     

Contributing Factors to the Spread of Sexually Transmitted Diseases

A bstract .   Economists have long studied the determinants and effects of income transfers. This article examines an indirect effect of welfare payments on participating individuals: an increase in the incidence of sexually transmitted disease ( STD ) rates.
Several studies have found a significant and positive link between the size of welfare benefits and out-of-wedlock fertility rates. Higher welfare payments reduce the cost of bearing and raising a child, and thus reduce the full cost of engaging in unprotected sex. An unintended consequence of unprotected sex is exposure to contagious diseases. This implies that states with higher welfare payments per child will experience higher rates of STDs.
We test this hypothesis using statewide data on the incidence of three types of bacterial STDs, chlamydia, gonorrhea, and syphilis, for the years 1994 through 1998. The empirical specification is based on the standard microeconomic model of utility-maximizing behavior. The included explanatory variables are demographic proxies reflecting differences in state population characteristics. These characteristics capture unobservable or intrinsically unmeasureable differences in the perceived costs and benefits of engaging in unprotected sex.
The explanatory variable of primary interest is the size of the real welfare payment per recipient. Our empirical results indicate that states with higher real welfare payments are associated with greater rates of STDs.     

Financial Modernization in US Banking Markets: A Local or Global Event?

Abstract:   We test the hypothesis that the passage of the Financial Services Modernization Act (FSMA) of 1999 has spillover effects cross‐nationally, using a sample of US, non‐US transactional (Australian, Canadian, and UK), and relationship (German, Japanese, Dutch, and Swiss) banks. Our results suggest that financial modernization in the US has limited cross‐national effects. We find strong evidence that US banks were affected favorably. Although we detect some evidence of significant reactions by banks in certain countries, a closer examination reveals that the reaction is most likely attributable to events in the respective countries during the event period. We do find, however, that non‐US transactional banks have been more likely to elect financial holding company status compared to relationship banks, suggesting they are positioning themselves to exploit the expanded opportunity set created by the FSMA. Nonetheless, the majority of elections have been made by US banks. In general, the results suggest that the respective banking markets are efficient in filtering events that are largely country‐specific with only limited implications for other international banks.     

The softness of medical production and implications for specifying hospital outputs

This paper considers the implications of an inarticulate medical production function when specifying and interpreting estimated hospital production functions. Lack of scientific knowledge regarding the relationship between medical inputs and outputs results in variations in styles of care, and medical payment contains inefficient production incentives. These production distortions are implicit in reported hospital data. Empirical results of this study provide information regarding the extent and direction of bias resulting from estimating production functions using reported outputs under retrospective cost-reimbursement.     

Effects of an Employee Volunteering Program on the Work Force: The ABN-AMRO Case

One of the new ways used by companies to demonstrate their social responsibility is to encourage employee volunteering, whereby employees engage in socially beneficial activities on company time, while being paid by the company. The reasoning is that it is good for employee motivation (internal effects) and good for the company reputation (external effects). This article reports an empirical investigation of the internal effects of employee volunteering conducted amongst employees of the Dutch ABN-AMRO bank. The study showed that (a) socio-demographic characteristics from employee volunteers markedly differ from those of non-volunteers and community volunteers and (b) employee volunteering seems to have positive effects on attitudes and behavior towards the organization.