Economic evaluations in migraine: systematic literature review and a novel approach

Abstract

Background: For novel migraine therapies, economic evaluations will be required to understand the trade-offs between additional health benefit and additional cost. The purpose of this study was to conduct a systematic literature review (SLR) to identify previous economic evaluations in migraine from the United Kingdom or Irish perspective to critically appraise these evaluations and to propose, if necessary, a novel modelling approach that can be used for future economic evaluations of migraine therapies.

Methods: An SLR was conducted to identify previous economic evaluations of preventive migraine treatments. Key opinion leaders were consulted to determine the criteria for a robust migraine economic evaluation. Economic evaluations identified in the SLR were appraised against these criteria, and a novel cost-effectiveness model structure was then proposed.

Results: Eight records reporting on published economic evaluations were identified and critically appraised for general quality. Expert consultation provided 6 recommendations on the ideal model structure for migraine that is both clinically and economically meaningful. A decision-tree plus Markov structure was then developed as a cost-effectiveness model for migraine therapies where each health state is associated with a patient distribution across monthly migraine day (MMD) frequencies.

Conclusions: Future migraine economic evaluations should allow for assessments across the full spectrum of migraine, a response-based stopping rule, and the estimation of benefits and resource costs based on MMD frequency. The approach proposed in this paper captures all of the desired elements for an economic evaluation of migraine therapy and is suitable to assess new migraine therapies.     

Improving customer-focused marketing capabilities and firm financial performance via marketing exploration and exploitation

Evidence within the marketing literature has shown that marketing capabilities are important drivers of firm performance. However, very little is known about how firms improve their marketing capabilities via the embedding of new market knowledge. Organizational learning theory provides us with a theoretical lens through which we can examine how existing customer-focused marketing capabilities may be improved and new customer-focused marketing capabilities may be created via marketing exploitation and exploration capabilities. In addition, this study investigates whether ambidexterity in marketing exploration and exploitation exists and finds that firms cannot do both at high levels without risking a negative impact on customer-focused marketing capabilities. This study also presents findings demonstrating how improving the two customer-focused marketing capabilities in our study, brand management and customer relationship management, impacts objective financial performance.     

The relationship between HRM practices and service behaviour in South African service organizations

This paper reports on findings from research conducted in South African service organizations that frontline employees' perceptions of HRM practices have a direct influence on their service behaviour. Specific HRM practices have more impact than others and this was attributed to the influence of external factors such as the socio-political situation and national culture and to internal factors linked to the way managers implemented the HRM practices in the organization. Organizational commitment was found to play a mediating role in the relationship between frontline employees' perceptions of HRM and their service behaviour.     

Profiling the desirable psychological contract for different groups of employees: evidence from Greece

This study aimed to examine potential variations in employees' perceptions of the desirable psychological contract, based on gender, age, and educational level. A total of 1145 employees – 642 of whom were female – aged between 18 and 64, who had attended all educational levels, participated in the study. T-tests and analyses of variance suggest that there is no uniform view of the psychological contract content among different groups of employees. With the exception of involvement with decision-making affecting the organization, women tend to expect more from their employment relationship. As for age groups, the ‘new generation’ emphasizes balance in personal life, the ‘old generation’ is rather indifferent, while the ‘desert generation’ is the most demanding and attached to the ‘old psychological contract’. Finally, individuals with at least college education have relatively increased expectations, with the exception of co-worker support for personal problems and continuous training.     

Exploring the inclusion of beneficiary voices in international development fundraising campaign creation

Charitable fundraising appeals for international development created for potential donors in the Global North are often, if not always, designed without the inclusion of voices and insights from the intended beneficiaries in the Global South. The implications of these appeals, void of beneficiary input, may serve to proliferate poverty porn and racial stereotypes, promote paternalistic and colonial thinking, and strengthen white savior syndrome. This exploratory paper, through a set of interviews and a focus group with fundraising professionals at international development organizations, examines the need for a beneficiary-centered Code of Ethics. A framework, based on the four major findings, is proposed that begins with beneficiary input and considerations offer charities an inclusive method for the design of future fundraising appeals and a way to fulfill their responsibility in how the beneficiary is depicted and the societal understanding of their situation.     

Vertical Integration and Exclusive Behavior of Insurers and Hospitals

We examine vertical integration and exclusive behavior in health care markets in which insurers and hospitals bilaterally bargain over contracts. We employ a bargaining model of two hospitals and two health insurers competing on premiums. We show that asymmetric equilibria exist in which one insurer contracts one hospital whereas the other insurer contracts both hospitals, even if all players are equally efficient in their production. Asymmetric equilibria arise if hospitals are sufficiently differentiated. In these cases, total industry profits increase and consumer welfare decreases in comparison to the case in which both insurers have contracts with both hospitals. Vertical integration makes these equilibria possible for a wider range of parameters.     

Financial counterparts of saving and investment and inconsistency in some simple macro models

Zusammenfassung Die finanziellen Aspekte von Sparen und Investieren und die Inkonsistenz einiger einfacher Makro-Modelle. — Ein System, in dem die finanziellen Aspekte der effektiven Nachfrage explizit gemacht werden, wird entwickelt und als Grundlage für die Kritik einiger gebr?uchlicher statischer MakroModelle verwendet: des IS-LM-Modells, des Modells, das die permanente Einkommenshypothese benutzt, und eines Modells, das eine Ersparnis-Verm?gensrelation enth?lt. Diese kritische Würdigung zeigt, da\, wenn die Finanzen ausdrücklich in die Betrachtung einbezogen werden, die Modelle dynamisch sind und die ?Gleichgewichtsl?sung? nur für einen Zeitpunkt gilt. Au\erdem führen die Interdependenzen, die durch die Einbeziehung der finanziellen Aspekte geschaffen werden, zu unannehmbaren Nachfragefunktionen auf dem Markt, der unter Berufung auf das Walrassche Gesetz au\er Betracht blieb. Es wird gezeigt, da\ diese Probleme nicht bei solchen Modellen auftreten, die nur die Anteile der verschiedenen Formen der Verm?genshaltung am Gesamtverm?gen bestimmen wollen und nicht sein absolutes Niveau. Sie fehlen auch bei einem Modell, das auf dem Prinzip der Bestandsanpassung basiert, in dem also Stromgr?\en direkt auf Bestandsungleichgewichte zurückgeführt werden.

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Résumé Les contreparties financières de l’épargne et de l’investissement et l’incontinence dans quelques modèles macro-économiques. — Un système qui éclaircit bien l’aspect financier de la demande effective est développé et employé comme fondament de quelques modèles statiques et macro-économiques en usage commun: les modèles SI-LM et de revenu permanent et, en outre, un modèle qui incorpore la relation entre l’épargne et la fortune. L’appréciation critique montre que les modèles sont dynamiques et que la solution d’équilibre n’est valable que pour un moment si les finances sont considérées expressément. En outre, les interdépendances créées par l’inclusion des finances conduisent aux fonctions de la demande inacceptables sur le marché qui fut omi en se référant à la loi de Walras. Il est montré que ces problèmes n’apparaissent pas aux modèles qui déterminent seulement la relation entre les actifs différents et pas leurs niveaux absolus. Ils manquent aussi dans un modèle dérivé du principe d’ajustement des stocks, dans lequel les flux sont rapportés directement aux déséquilibres des stocks.

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Resumen La concordancia financiera del ahorro y la inversión y su divergencia en modelos macroeconómicos simples. — El autor elabora un sistema que incluye la parte financiera de la demanda efectiva y que se utiliza como base para algunos modelos macroeconómicos estáticos y comunes, como lo son por ejemplo los modelos IS-LM, los modelos del ingreso permanente y un modelo que incluye la relación entre ahorros y patrimonio. La evaluación crftica demuestra que los modelos son dinámicos y que la ?solución de equilibrio? sólo vale para un breve momento, si se tienen en cuenta explicitamente los aspectos financieros. Además, las interdependencias que resultan de la inclusión de las finanzas originan funciones de demanda inadmisibles en el mercado, del cual se hizo caso omiso invocando la ley walrasiana. El autor demuestra que estos problemas no surgen en modelos que únicamente determinan la relación entre las distintas formas en que se tiene el partimonio, y no sus valores absolutos. Tampoco surgen en un modelo que se deriva del ?stock adjustment principle? y en el que ingresos se aplican directamente a los desequilibrios de existencias.

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Riassunto Corrispondenze finanziarie di risparmio ed investimenti e la loro non concordanza in alcuni macro-modelli semplici. — Viene sviluppato un sistema che chiarisce in pieno l’aspetto fmanziario della domanda effettiva e viene impiegato come base per un macro-modello statico di uso generale, cioè per i modelli IS-LM, per permanenti modelli di reddito e per un modello che includa il rapporto risparmiopatrimonio. Questo apprezzamento critico mostra che i modelli sono dinamici e che la ?soluzione di equilibrio? è valida solo per un breve momento, se le finanze sono espressamente comprese nella considerazione. Inoltre le interdipendenze, che sono create mediante le inclusioni delle finanze, conducono, a causa dell’inosservanza della legge di Walras, ad inaccettabili funzioni di domanda sul mercato. Viene mostrato che questi problemi non compaiono in modelli che determinano soltanto il rapporto del patrimonio tenuto in diverse forme e non i suoi livelli assoluti. Essi mancano anche in un modello che è derivato dal principio di ?adattamento delle scorte? (?stock adjustment?-principle) in cui gli afflussi vengono riferiti direttamente agli squilibri di scorte.

     

Placing emergency department crowding on the decision agenda

The causes of emergency department crowding (EDC), and the outcomes and strategies for resolution are reviewed. This is a call to the nursing profession to elevate EDC on hospital, community, and national agendas to garner resources to restore timely emergency care.     

TV advertising of OTC medicines and its effects on child viewers

The influence of over-the-counter (OTC) medicine commercials on children's choices concerning use of OTC medicines was investigated in two experiments. In the first, 115 third and fourth graders were exposed to commercials for six different OTC medicines or commercials for other products. They were then asked to recommend either a medicine or nonmedicine remedy for a child and an adult with various illnesses and/or problems. The OTC medicine commercials appeared to influence children's recommendations only with respect to use of sleeping pills. In the second experiment 234 third and fourth graders were exposed to either fever and cold medicine commercials, all of which were directed toward the child viewer, or nondrug commercials. Only the fever medicine commercials appeared to influence the children. It was concluded that OTC medicine commercials do not, in general, influence children's choices concerning use of those medicines. Possible exceptions to this general case are noted.