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.     

Trading Partners and Trading Volumes: Implementing the Helpman–Melitz–Rubinstein Model Empirically

Helpman, Melitz and Rubinstein [Quarterly Journal of Economics (2008) Vol. 123, pp. 441–487] (HMR) present a rich theoretical model to study the determinants of bilateral trade flows across countries. The model is then empirically implemented through a two‐stage estimation procedure. We argue that this estimation procedure is only valid under the strong distributional assumptions maintained in the article. Statistical tests using the HMR sample, however, clearly reject such assumptions. Moreover, we perform numerical experiments which show that the HMR two‐stage estimator is very sensitive to departures from the assumption of homoskedasticity. These findings cast doubts on any inference drawn from the empirical implementation of the HMR model.     

Persistence,mean reversion and non-linearities in the US housing prices over 1830–2013

The objective of this study is to provide a direct estimate of the degree of persistence of measures of nominal and real house prices for the US economy, covering the longest possible annual sample of data, namely 1830–2013. The estimation of the degree of persistence accommodates for non-linear (deterministic) trends using Chebyshev polynomials in time. In general, the results show a high degree of persistence in the series along with a component of non-linear behaviour. In general, if we assume uncorrelated errors, non-linearities are observed in both nominal and real prices, but this hypothesis is rejected in favour of linear models for the log-transformation of the data. However, if autocorrelated errors are permitted, non-linearities are observed in all cases, and mean reversion is found in the case of logged prices, though given the wide confidence intervals, the unit root null hypothesis cannot be rejected in these cases.     

Well-being effects of self-employment: A spatial inquiry

Our paper presents an empirical analysis of entrepreneurial well-being using a large-scale longitudinal household survey from the UK that tracks almost 50,000 individuals across seven waves over the period 2009–2017, as well as a number of exploratory case studies. We contribute to the existing literature by investigating how entrepreneurial well-being varies across locations along the urban-rural continuum, and across wealthy-deprived neighbourhoods. We use a Coarsened Exact Matching (CEM) approach to compare the well-being outcomes of individuals who switch into self-employment from waged employment, and show that entrepreneurial well-being, in the form of job satisfaction, is significantly higher for those living in semi-urban locations, relative to those living in urban and rural locations. We argue that semi-urban locations provide an optimal combination of ease of doing business and quality of life. Our results also show that individuals in wealthy neighbourhoods who switch into self-employment experience higher job satisfaction than otherwise comparable individuals living in materially deprived neighbourhoods, although the latter experience greater levels of life satisfaction following the switch.     

World Human Development: 1870–2007

How has wellbeing evolved over time and across regions? How does the West compare to the Rest? What explains their differences? These questions are addressed using a historical index of human development. A sustained improvement in world wellbeing has taken place since 1870. The absolute gap between OECD and the Rest widened over time, but an incomplete catching up—largely explained by education—occurred between 1913 and 1970. As the health transition was achieved in the Rest, the contribution of life expectancy to human development improvement declined and the Rest fell behind in terms of longevity. Meanwhile, in the OECD, as longevity increased, healthy years expanded. A large variance in human development is noticeable in the Rest since 1970, with East Asia, Latin America, and North Africa catching up to the OECD, and Central and Eastern Europe and Sub‐Saharan Africa falling behind.     

Crowdsourcing and work: individual factors and circumstances influencing employability

The development of a fast and reliable Internet, new technologies online payment systems, and changes in work structure that enable and demand flexible working patterns have driven a move to a new form of Internet‐enabled labour exchange called crowdsourcing. Evidence from an in‐depth qualitative study is presented, focusing on selected users' interactions and experiences of working on two UK‐based crowdsourcing platforms. The paper shows that workers engaged in this form of labour exchange need to deploy existing employability skills and networks to effectively meet the challenges, and take advantage of the opportunities, that crowdsourcing presents. Individual factors and circumstances emerge as paramount for workers' continued engagement in this form of employment. Using selected components from an employability framework, the findings suggest that crowdsourcing can offer new pathways to practising skills and enhancing employability for some workers.     

Indigenous Peoples’ Health Care: New approaches to contracting and accountability at the public administration frontier

Abstract

This article analyses reforms to contracting and accountability for indigenous primary health care organizations in Canada, New Zealand, and Australia. The reforms are presented as comparative case studies, the common reform features identified and their implications analysed.

The reforms share important characteristics. Each proceeds from implicit recognition that indigenous organizations are ‘co-principals’ rather than simply agents in their relationship with government funders and regulators. There is a common tendency towards more relational forms of contracting; and tentative attempts to reconceptualize accountability. These ‘frontier’ cases have broad implications for social service contracting.     

Modelling innovation support systems for regional development – analysis of cluster structures in innovation in Portugal

The present article offers a concise theoretical conceptualization and operational analysis of the contribution of innovation to regional development. The latter concepts are closely related to geographical proximity, knowledge diffusion and filters and clustering. Institutional innovation profiles and regional patterns of innovation are two mutually linked, novel conceptual elements in this article. Next to a theoretical framing, the article employs the regional innovation systems concept as a vehicle to analyse institutional innovation profiles. Our case study addresses three Portuguese regions and their institutions, included in a web-based inventory of innovation agencies which offered the foundation for an extensive database. This data-set was analysed by means of a recently developed principal coordinates analysis followed by a Logistic Biplot approach (leading to a Voronoi mapping) to design a systemic typology of innovation structures where each institution is individually represented. There appears to be a significant difference in the regional innovation patterns resulting from the diverse institutional innovation profiles concerned. These profiles appear to be region specific. Our conclusion highlights the main advantages in the use of the method used for policy-makers and business companies.     

Behaviour‐Based and Outcome‐Based Control Systems: A Meta‐Analytic Study

Sales control systems are instruments used by firms to improve performance and other organizational outcomes. To understand their antecedents and consequences, this paper conducts a meta‐analysis based on 104 studies. The results showed significant relationships between behaviour‐ and outcome‐based control systems and the complexity of the products, bonuses, financial performance, sales innovation, organizational support and satisfaction with supervisors. The outcomes revealed that behaviour‐based control systems were the most effective mechanism in turbulent markets and for determining financial performance. However, outcome‐based control systems were the most efficient instrument for complex products.     

The ethos of business students

Business schools are the “nurseries” of the corporate world. This article offers an empirical analysis of the business student ethos on the basis of research conducted at three Dutch universities. A theoretical framework in the tradition of virtue ethics and dubbed “moral ethology” is used to identify the values business schools convey to their students. The central research question is: What types of ethos do Dutch business students have? Forty-three undergraduate students participated in Q-methodological research, a mixed qualitative–quantitative small-sample method. Five different types of ethos were generated: Do-Good Managers, Market Managers, Searching Managers, Balancing Managers, and Radical Market Managers. Some general characteristics that apply to all the types of ethos were identified, such as the search for efficiency. It is argued that business schools should pay much more attention to the values that are endorsed in both life and business and should help students to address situations in which values are neglected.