Healthcare utilization and costs among relapsed or refractory multiple myeloma patients on carfilzomib or pomalidomide as monotherapy or in combination with dexamethasone

Aim: To compare monthly healthcare resource utilization (HRU) and costs among adult patients with multiple myeloma (MM) receiving second or subsequent line of treatment (LOT) with carfilzomib or pomalidomide as monotherapy or in combination with dexamethasone.

Methods and materials: Adult MM patients who received carfilzomib or pomalidomide as second/subsequent LOT between 2006 and 2014 were selected from the MarketScan databases. LOT was determined using Medical/pharmacy claims using a published algorithm. For each patient, first LOT with carfilzomib or pomalidomide was defined as index LOT. Patients with first LOT as index LOT, who received other chemotherapy in combination with carfilzomib or pomalidomide, or who underwent stem cell transplant (STC) during index LOT were excluded. Monthly HRU and costs during index LOT were compared using inverse probability of treatment weights (IPTW) based on propensity scores for receipt of carfilzomib estimated by logistic regression with LOT, patient demographics, Charlson index, comorbidities, pre-index healthcare cost, and receipt of prior SCT as covariates.

Results: After weighting, baseline characteristics were well balanced among 114 carfilzomib and 144 pomalidomide patients. Mean (95% CI) numbers of outpatient visits per month were 7.1 (5.2–8.0) with carfilzomib and 4.7 (3.9–6.1) with pomalidomide (p?=?0.006). Otherwise, there were no statistically significant differences between the groups in mean monthly HRU and costs or median time to therapy discontinuation. Mean (95% CI) monthly total healthcare costs were $19,776 (15,322–27,748) with pomalidomide and $17,321 (12,412–21,874) with carfilzomib (p?=?0.522).

Limitations: Comparison of carfilzomib vs pomalidomide may be biased if there are unobserved factors not balanced by IPTW. The relatively small sample size limits the power of analyses to detect potential differences between treatment groups.

Conclusions: Monthly HRU and costs are similar among patients with relapse or refractory MM patients receiving carfilzomib or pomalidomide as monotherapy or in combination with dexamethasone.     

Inflation Linkages Within The Eurozone: Core vs. Periphery

We examine the process of inflation transmission among GIIPS countries (Greece, Ireland, Italy, Portugal and Spain) and Germany. Our findings suggest that inflation spillovers have increased since 2001. We also find that peripheral economies are (dis‐)inflation transmitters to the core. This finding is significant for policy formulation, given the very low inflation environment that currently exists in the Euro area and the macroeconomic implications that arise from this.     

FDI Location and the Relevance of Spatial Linkages: Evidence from Provincial and Industry FDI in China

In this study both aggregate and industry‐level foreign direct investment (FDI) data are employed to investigate the spatial dependence of FDI hosts. The analysis contributes to the existing literature by focusing on the heterogeneous spatial correlation of FDI in different industries. Using more comprehensive FDI data across multiple industries and multiple provinces in China from 1999 to 2007, the results show a significant spatial correlation among provinces. Aggregate FDI tends to be regional trade platform oriented indicating neighboring provinces become competitors for FDI. In contrast, results based on industry‐level provincial FDI show stronger support for vertical or complex vertical FDI.     

Universally optimal balanced changeover designs with first residuals

Considering the presence of first order residual effects of treatments, a family of variance balanced changeover designs has been presented and universal optimality of the designs is established. The designs use only v experimental units and (v ? 1)/2 periods for v = 4t + 3 prime or prime power number of treatments; t being a positive integer. A special feature of the proposed designs is that ‘in the order of presentation of treatments to experimental units over periods, each treatment is once immediately preceded by only half of the other treatments and is immediately followed once by the remaining half of the treatments’. This characteristic results in reducing the size of the variance balanced designs considerably.     

Evaluation of subsidiary marketing performance: combining process and outcome performance metrics

Issues in evaluating marketing performance and devising appropriate metrics for measurement have taken center stage in marketing thought and practice in recent years. We propose an empirical model that enables a multinational enterprise (MNE) to assess the marketing performance of its subsidiaries, taking into explicit consideration the fact that tactical actions by subsidiaries contribute to the creation of assets that can be harnessed for marketing outcomes. Thus, our model captures the asset creation abilities of marketing expenditures and also takes in to account the environmental differences of the context in which each MNE subsidiary operates. We evaluate comparative, overall, and process-level (creation of market assets and market yield) marketing performance in the context of multi-country operations. This simultaneous examination of marketing process and marketing outcome performance enables a global corporation to gain strategic, operational, and diagnostic insights into the performance of its subsidiaries. Our approach is empirically illustrated with an evaluation of the marketing performance of subsidiaries of a large global corporation.     

Bayesian model averaging and identification of structural breaks in time series

Bayesian Model Averaging (BMA) is used for testing for multiple break points in univariate series using conjugate normal-gamma priors. This approach can test for the number of structural breaks and produce posterior probabilities for a break at each point in time. Results are averaged over specifications including: stationary; stationary around trend and unit root models, each containing different types and number of breaks and different lag lengths. The procedures are used to test for structural breaks on 14 annual macroeconomic series and 11 natural resource price series. The results indicate that there are structural breaks in all of the natural resource series and most of the macroeconomic series. Many of the series had multiple breaks. Our findings regarding the existence of unit roots, having allowed for structural breaks in the data, are largely consistent with previous work.     

Estimating the impact of rural investments in Nepal

As a largely rural society, most people in Nepal still depend upon agriculture as their major livelihood strategy. Therefore, it is important to improve the allocation efficiency of limited public expenditures to promote agricultural growth and poverty reduction. However, evaluating the returns of public investment is limited by methodological challenges. We use hedonic and panel data methods to examine the returns to different types of rural public investments including roads, irrigation and extension advice. The use of diverse identification strategies reduces the risk of using a narrower set of results driven primarily by a particular methodology. We find that rural roads and irrigation are one of the most productive public expenditures according to the benefit-cost ratio calculations, though the magnitudes of these ratios depend on methodology.     

Productivity,Energy Intensity and Output: A Unit Level Analysis of the Indian Manufacturing Sector

Journal of Quantitative Economics - The objective of this study is to calculate total factor productivity and determine factors related to energy intensity for the pre-existing manufacturing plants...     

An investigation of the effects of exchange rate volatility on exports in East Asia

This study investigates the effects of the exchange rate volatility on the export flows of Indonesia, Malaysia, Republic of Korea, Singapore, Thailand, and the Philippines during 1974–2011. Towards this goal a trade weighted real effective (rather than the bilateral) exchange rate and three different measures of volatility, i.e. obtained from an ARCH model, a GARCH model and a moving-average standard deviation measure are used in this study. Specifically, the export flows between six Asian countries and the rest of the world are investigated rather than focusing on trade with only one country. Our findings reveal that the exchange rate volatility has a significant impact on export flows in the short run as well as in the long run for all the countries in the sample. The impact in the long run is predominantly negative with the exception of Singapore, but in the short run the impact varies across countries. Moreover, our results are robust to the alternative measures of volatility used and most of the findings in the long run and short run are also robust to the crisis period.