Cost of adverse events during treatment with everolimus plus exemestane or single-agent chemotherapy in patients with advanced breast cancer in Western Europe

Objective:

Treatment options for recurrent or progressive hormone receptor-positive (HR+) advanced breast cancer include chemotherapy and everolimus plus exemestane (EVE?+?EXE). This study estimates the costs of managing adverse events (AEs) during EVE?+?EXE therapy and single-agent chemotherapy in Western Europe.

Methods:

An economic model was developed to estimate the per patient cost of managing grade 3/4 AEs for patients who were treated with EVE?+?EXE or chemotherapies. AE rates for patients receiving EVE?+?EXE were collected from the phase III BOLERO-2 trial. AE rates for single-agent chemotherapy, capecitabine, docetaxel, or doxorubicin were collected from published clinical trial data. AEs with at least 2% prevalence for any of the treatments were included in the model. A literature search was conducted to obtain costs of managing each AE, which were then averaged across Western European countries (when available). Per patient costs for managing AEs among patients receiving different therapies were reported in 2012 euros (€).

Results:

The EVE?+?EXE combination had the lowest average per patient cost of managing AEs (€730) compared to all chemotherapies during the first year of treatment (doxorubicin: €1230; capecitabine: €1721; docetaxel: €2390). The most costly adverse event among all patients treated with EVE?+?EXE was anemia (on average €152 per patient). The most costly adverse event among all patients treated with capecitabine, docetaxel, or doxorubicin was lymphocytopenia (€861 per patient), neutropenia (€821 per patient), and leukopenia (€382 per patient), respectively.

Conclusions:

The current model estimates that AE management during the treatment of HR+ advanced breast cancer will cost one-half to one-third less for EVE?+?EXE patients than for chemotherapy patients. The consideration of AE costs could have important implications in the context of healthcare spending for advanced breast cancer treatment.     

The Effects of Earnings Guidance on Investors’ Perceptions of Firm Credibility in a Two-Firm Setting

This study investigates how a peer firm's earnings guidance affects investors' credibility assessments of a target firm. Results suggest that when both a target firm and a peer firm provide earnings guidance, contrast effects occur such that the more accurate the earnings guidance of the target firm relative to the peer, the greater are investors' credibility assessments for the target. However, such contrast effect diminishes as the target firm's earnings guidance becomes more accurate. On the contrary, when a peer provides earnings guidance but the target firm does not, assimilation effects as opposed to contrast effects dominate investors' credibility judgments.     

There is nothing permanent except change—analyzing individual price dynamics in “pay-what-you-want” situations

This study is examines the dynamics in prices paid in “pay-what-you-want” situations over multiple customer–seller transactions on an individual customer level. The analysis of potential dynamism in prices paid allows for an assessment of the profitability of pay-what-you-want pricing for sellers of frequently bought products and services. To empirically validate the framework, the authors conduct a field study that focuses on the aggregate and individual dynamics in prices paid over customers’ multiple purchases. Using latent growth modeling, the authors find significant but declining decreases in prices paid. Further, they identify stable individual and relational difference factors which predict steeper or more gradual declines in prices paid. Customers’ individual preferences for fairness and price consciousness as well as their overall satisfaction with the seller alleviate price declines. The authors discuss the practical and theoretical implications of these findings.     

Engines of growth. Innovation and productivity in industry groups

The diversity of technological activities that contribute to growth in labour productivity is examined in this article for manufacturing and services industries in eight major EU countries. We test the relevance of two “engines of growth”, i.e., the strategies of technological competitiveness (based on innovation in products and markets) and cost competitiveness (relying on innovation in processes and machinery) and their impact on economic performance. We propose models for the determinants of changes in labour productivity and we carry out empirical tests for both the whole economy and for the four Revised Pavitt classes that group manufacturing and services industries with distinct patterns of innovation. Tests are carried out by pooling industries, countries and three time periods, using innovation survey data from CIS 2, 3 and 4, linked to economic variables. The results confirm the specificity of the two “engines of growth”; economic performances in European industries appear as the result of different innovation models, with strong specificities of the four Revised Pavitt classes.     

An assessment of the Europe agreements’ effects on bilateral trade, GDP, and welfare

The so-called Europe Agreements had been enacted in the 1990s to initiate the integration of goods markets between the 15 EU incumbent economies as of 1995 and 10 potential entrants located in Central and Eastern Europe. This paper evaluates the trade, GDP, and welfare effects of these agreements by means of structural analysis of a bilateral trade flow model. The results support three conclusions. First, the agreements exerted significant positive effects on goods trade between the EU15 incumbents and the CEEC and, at the same time, they induced trade redirection from other countries. Second, EU15 GDP responded by an increase of much less than 1% while that in the 10 CEEC increased by several percent in response to the agreements. Third, the effects on welfare were moderate in the EU15 but amounted to more double-digit percentage changes in the involved CEEC.     

Networks and geography in the economics of knowledge flows

This paper reviews the literature dealing with the economic geography of knowledge flows by summarising the most relevant problems and open questions that, according to the authors’ view, have been dealt in the past and should be dealt in the future by network analysis in order to model, understand and measure the structure and dynamics of knowledge flows. The interaction between “networks” and “geography” elements within a theoretical, methodological and empirical perspective is discussed throughout the paper by making reference to previous works by the authors and to the established literature. Thus, these references, far from being complete and exhaustive, are instrumental to the achievement of the paper’s goal: to demonstrate that “networks” and “geography” are the necessary ingredients for every study of the innovative process at any level of analysis, from individual agent to institution/organization, from the regional to the national and international level.     

How do managerial successions shape corporate financial policies in family firms?

Despite recent evidence on the importance of chief executive officer (CEO) successions in family firms, we still know little about the differences in corporate strategies entailed by family and professional managers around transition. We investigate the consequences of managerial successions for the financial policies of Italian family firms. Our findings indicate that the appointment of non-family professional CEOs leads to a significant increase in the use of debt, primarily driven by short-term maturities. We document substantial heterogeneity in the impact of professional successions on debt financing: the increase in debt is particularly pronounced for young firms, firms with a high level of investment, and firms in which the controlling family maintains a dominant representation on the board of directors. Examining the importance of financial flexibility, we find that the increase in debt occurs primarily when firms are cash-poor, and when incoming CEOs can exploit spare borrowing capacity.     

Institutional environment for entrepreneurship in rapidly emerging major economies: the case of Brazil,China, India,and Korea

The country institutional profile (CIP) construct has become the most widely used conceptualization of institutional environment for entrepreneurship. This construct is frequently employed to study institutional forces influencing entrepreneurial activity at the national level. However, relatively little is known about the cross-national equivalence of the construct. Moreover, the institutional environment for entrepreneurship in emerging economies remains largely under-explored. To address these issues, in the current study, we used the most frequently utilized CIP scale to collect data from 809 young adults in four rapidly emerging countries: Brazil, China, India, and South Korea. We examined the invariance of the CIP construct and unraveled differences in perceived institutional profiles among these rapidly emerging economies. Results support the CIP construct as largely invariant in the four REME countries and revealed important differences in specific aspects of institutional environments in these countries. Implications for future research and practice are discussed.