Real-world dosing and drug costs with everolimus or axitinib as second targeted therapies for advanced renal cell carcinoma: a retrospective chart review in the US

Objective:

To describe dosing patterns and to compare the drug costs per month spent in progression-free survival (PFS) among patients with advanced renal cell carcinoma (aRCC) treated with everolimus or axitinib following a first tyrosine kinase inhibitor (TKI).

Methods:

A medical record retrospective review was conducted among medical oncologists and hematologists/oncologists in the US. Patient eligibility criteria included: (1) age ≥18 years; (2) discontinuation of first TKI (sunitinib, sorafenib, or pazopanib) for medical reasons; (3) initiation of axitinib or everolimus as a second targeted therapy during February 2012–January 2013. Real-world dosing patterns were summarized. Dose-specific drug costs (as of October 2014) were based on wholesale acquisition costs from RED BOOK Online. PFS was compared between everolimus and axitinib using a multivariable Cox proportion hazards model. Everolimus and axitinib drug costs per month of PFS were compared using multivariable gamma regression models.

Results:

A total of 325 patients received everolimus and 127 patients received axitinib as second targeted therapy. Higher proportions of patients treated with axitinib vs everolimus started on a higher than label-recommended starting dose (14% vs 2%) or experienced dose escalation (11% vs 1%) on second targeted therapy. The PFS did not differ significantly between patients receiving everolimus or axitinib (adjusted hazard ratio (HR)?=?1.16; 95% confidence interval [CI]?=?0.73–1.82). After baseline characteristics adjustment, axitinib was associated with 17% ($1830) higher drug costs per month of PFS compared to everolimus ($12,467 vs $10,637; p?<?0.001).

Limitations:

Retrospective observational study design and only drug acquisition costs considered in drug costs estimates.

Conclusions:

Patients with aRCC receiving axitinib as second targeted therapy were more likely to initiate at a higher than label-recommended dose and were more likely to dose escalate than patients receiving everolimus. With similar observed durations of PFS, drug costs were significantly higher—by 17% per month of PFS—with axitinib than with everolimus.     

A limited-dependent analysis of the choice of regular labour contract in seasonal agriculture

The paper examines both theoretically and empirically the factors determining the demand for regular labour in seasonal agriculture. In an implicit contract framework it is argued that there are ‘hoarding costs’ of regular labour in the slack period when there is not much work to be done. Consequently, the number of regular labour employed is constrained by the hoarding cost where larger employment-intensive farms tend to hire more regular labour. Evidence from the ICRISAT villages in India, too, show that though the marginal costs of regular labour are zero, there are significant hoarding costs of regular labour among small farms so that larger farmers are the major demanders of regular labour. Estimates of the double-hurdle model jointly determining the probability of hiring regular labour and demand for regular labour-hours (if a regular labour is hired) are shown to be an improvement over univariate tobit estimates of the demand for regular labour-hours only.     

Union-oligopoly bargaining and entry deterrence: a reassessment of limit pricing

This paper introduces wage bargaining in the framework of Milgrom and Roberts (Econometrica 50(2):443–459, 1982) where the workers’ reservation wage is the private information parameter critical for entry. We show that entry threat significantly distorts the wage, which in some cases adversely affects the firm’s ability to signal through price. Consequently, the separating equilibrium (in price) does not always exist. If, however, wage agreements are made public, signalling occurs with or without distortions in wage depending on whether the union’s bargaining power is high or low. Pooling equilibrium also exists and it features similar distortions. We also examine which signal, wage or price, generates greater social welfare. We would like to thank two referees for their helpful comments and suggestions. This paper is partially based on a chapter of Pal’s PhD thesis done at Indira Gandhi Institute of Development Research (IGIDR), India. For remaining errors we are solely responsible.     

Determinants of occupational change and mobility in rural India

With a view to redress the dearth of economic analysis on occupational dynamics in rural household economies, this study examines the nature and characteristics of occupational change and mobility in rural India. Using the unique WIDER data-set from six villages in West Bengal, India the factors causing a change of primary occupation among those who tried to change occupation over a twelve-month recall period has been analysed. Bivariate probit estimates jointly determining the probability of trying to change occupation and having been successful suggest that success in changing occupation depends crucially on socially constructed ‘status’- being older, male, from larger farming families or having higher schooling experience. They also exemplify the effects of regional diversity, levels of prosperity and different patterns of employment between agricultural and non-agricultural activities.     

成功应用CRM的三大法宝

现实中，人们常常会因为对现有系统的不满而考虑采用一个CRM系统，但根据一份从2000年以来的客户调查结果显示，超过80%的CRM系统最初都没有经过周密的组织部署，只有少数行业如零售、医药和航空例外。许多公司由于缺乏资金、组织或兴趣，不得不采用渐进式地，自下而上的“游击式”CRM系统（gCRM）。在未来的三年内，成功的CRM战略将克服组织、渠道、价值、产品和技术的障碍，成为极具价值的客户管理系统。但是，这将依赖于IT经理是否对将要进行的CRM项目做战略计划。这里将介绍几种方法来推动CRM项目——虽然目前还没有完美的方…     

The impact of group incentives on performance of small firms: Hausman–Taylor estimates

This paper investigates the impact of group incentives on firms' performance. It shows that group incentive raises firms' performance. This result empirically validates the implication of the theoretical literature that performance‐related pay can potentially improve firms' performance, in the context of a developing country, and indicates the importance of group incentives in small firms. It also shows that partnership firms perform better than private limited companies and labour unions have a negative impact on firms' performance. It employs the Hausman–Taylor random effects estimator in order to isolate the effects of time‐invariant covariates and also to tackle potential endogeneity problem. Copyright © 2010 John Wiley & Sons, Ltd.     

Sabotaging cost containment

We show that sabotage may be particularly profitable for a vertically-integrated provider (VIP) when its downstream rival can devote effort to reducing its operating costs. Demand-reducing sabotage limits the return the rival anticipates from its cost management activities, and thereby inhibits those activities. The resulting higher costs for the rival increase the VIP’s profit in settings where sabotage would not be profitable if the rival could not manage its operating costs. To limit sabotage by the VIP, the rival may find it profitable to intentionally diminish its ability to reduce its production costs. The diminished ability can produce Pareto gains.     

COOPERATIVE MANAGERIAL DELEGATION,R&D AND COLLUSION

Existing literature on managerial delegation indicates that collusive outcomes can be obtained in an oligopoly game through cooperative managerial delegation. In contrast, this paper shows that, if managers are delegated to choose R&D, in addition to choosing production levels, full‐collusive outcomes cannot be achieved through cooperative delegation. Moreover, (i) under cooperative delegation, semi‐collusion always yields lower profit, higher R&D, higher price and lower social welfare than that in the case of competition and (ii) cooperative delegation leads to a higher profit lower R&D, higher price and lower social welfare than the no delegation case, irrespective of product market conduct.     

Time-frequency dynamics of return spillover from crude oil to agricultural commodities

ABSTRACT

We explore return spillover from crude oil to ethanol, corn, soybean and wheat on daily data during 17 May 2005–27 June 2018. This study is unique in capturing the time-frequency dynamics of return spillover. We use the frequency-dependent spillover measure that jointly captures information from time and frequency domain. We also identify two endogenous break dates that segregate the study period in three sub-periods. Our results indicate that return spillover from crude oil to ethanol, major feed stocks (i.e. corn and soybean) and food crop (i.e. wheat) is pronounced only in lower frequency band or long-term (more than 1 month). We find that return spillover is stronger only during 2005–2010, i.e. the period of energy and food crisis.