Brentuximab vedotin in relapsed/refractory Hodgkin lymphoma post-autologous stem cell transplant: a cost-effectiveness analysis in Scotland

Objective: To evaluate cost-effectiveness of brentuximab vedotin in patients with relapsed/refractory Hodgkin lymphoma who have received autologous stem cell transplantation, from a Scottish healthcare payer perspective.

Methods: A Microsoft Excel-based partitioned survival model comprising three health states (progression-free survival [PFS], post-progression survival, and death) was developed. Relevant comparators were chemotherapy with or without radiotherapy (C/R) and C/R with intent to allogeneic hematopoietic stem cell transplantation (alloSCT). Data were obtained from the pivotal phase II single-arm trial in 102 patients (SG035-0003; NCT00848926), a systematic literature review and clinical expert opinions (where empirical evidence was unavailable). PFS and overall survival for brentuximab vedotin were estimated using 5-year follow-up data from SG035-0003, and extrapolated using event rates observed for comparator treatments from published survival data. Resource use included drug acquisition and administration; alloSCT; treatment of adverse events; and long-term follow-up. Deterministic and probabilistic sensitivity analyses were conducted to evaluate the impact of uncertainty.

Results: In the base case, the incremental cost-effectiveness ratio (ICER) for brentuximab vedotin was £38,769 per quality-adjusted life year (QALY) vs C/R, whereas C/R with intent to alloSCT was dominated by brentuximab vedotin. ICERs for brentuximab vedotin generated by the deterministic sensitivity analysis ranged between £32,000–£54,000 per QALY. Including productivity benefits reduced the ICER to £28,881 per QALY.

Limitations: Limitations include lack of comparative data from this single arm study and the heterogeneous population. Inconsistent baseline characteristic reporting across studies prevented complete assessment of heterogeneity and the extent of potential bias in clinical and cost-effectiveness estimates.

Conclusions: Although the base case ICER is above the threshold usually applied in Scotland, it is relatively low compared with other orphan drugs, and lower than the ICER generated using a previous data cut of SG035-0003 that informed a positive recommendation from the Scottish Medicines Consortium, under its decision-making framework for assessment of ultra-orphan medicines.     

The evolution of inflation expectations in Canada and the US

We model inflation forecasts as monotonically diverging from an estimated long‐run anchor point towards actual inflation as the forecast horizon shortens. Fitting the model with forecaster‐level data for Canada and the US, we identify three key differences between the two countries. First, the average estimated anchor of US inflation forecasts has tended to decline gradually over time in rolling samples, from 3.4% for 1989–1998 to 2.2% for 2004–2013. By contrast, it has remained close to 2% since the mid‐1990 for Canadian forecasts. Second, the variance of estimates of the long‐run anchor is considerably lower for the panel of Canadian forecasters than US ones following Canada's adoption of inflation targets. And third, forecasters in Canada look much more alike than those in the US in terms of the weight that they place on the anchor. One explanation for these results is that an explicit inflation‐targeting regime (Canada) provides for less uncertainty about future monetary policy actions than a monetary policy regime where there was no explicit numerical inflation target (the US before 2012) to anchor expectations.     

Pricing and Mispricing of Accounting Fundamentals in the Time‐Series and in the Cross Section

This study examines the extent to which parsimonious and general cross‐sectional valuation models, restricted to include only publicly available historical accounting information, explain share prices in the cross section, identify periods when market mispricing may be more pervasive, and also identify which shares within those cross sections are more likely to be mispriced. Our model simply includes historical book value, earnings, dividends, and growth, but it explains on average over 60 percent of the cross‐sectional variation in share prices in annual estimations across 1975–2011. We also examine the extent to which the residuals indicate mispricing. The quintile of stocks picked by our model as most likely underpriced outperform the quintile of stocks picked as most likely overpriced by an average of 9.9 percent over the following 12 months, after controlling for size. We also predict and find that value residuals are better predictors of future abnormal returns: (i) among firms that are not covered by analysts; (ii) among firms that face fewer accounting measurement challenges; and (iii) when we estimate value model parameters by industry/year. We also predict and find our approach works better in periods when the mapping of fundamentals into prices is weaker. This study contributes a novel and straightforward approach to map accounting fundamentals into share prices in order to identify mispricing in time‐series and in the cross section.     

Do former athletes make better managers? Evidence from a partially adaptive grouped-data regression model

The goal of this paper is to introduce a partially adaptive estimator for the grouped-data regression model based on an error structure described by a mixture of two normal distributions. The model we introduce is easily estimated by maximum likelihood using the EM algorithm adapted from the work of Bartolucci and Scaccia (Comput Stat Data Anal 48:821–834, 2005). The partially adaptive estimator is applied to data used by Long and Caudill (Rev Econ Stat 73:525–531, 1991) to examine the impact of intercollegiate athletics on income. We estimate a variation of the original regression model and find that there is a considerable financial advantage for those male athletes now working in business management. This finding is consistent with the idea that athletes acquire team-building and organizational skills that are helpful in business.     

Development through synergistic reforms

For many less developed countries production of high quality output is a precondition for firms to become exporters. Institutional deficiencies that raise costs of high quality production therefore limit the positive impact that trade facilitation can have on income. Consequently, institutional reforms that reduce costs of high quality production and trade reform have synergistic effects. In contrast, institutional reforms that reduce costs of low quality production (e.g., reforms that disproportionately benefit small businesses) interfere with the impact of trade reform. We obtain these results in a heterogeneous firm model that displays standard “industry rationalization” responses to reduced trade costs.     

Does Foreign Aid Promote Growth? Exploring the Role of Financial Liberalization

This paper examines the impact of foreign aid on the process of economic development in India by controlling for the degree of financial liberalization. A composite index is constructed using the method of principal component analysis to capture the joint influence of various financial sector policies. The results show that while foreign aid exerts a direct negative influence on output expansion, its indirect effect via financial liberalization is positive. Therefore, an important implication of the findings in this paper is that adequate liberalization in the financial system of the host country is a crucial requirement for effective foreign aid. Our results are robust to a number of control variables and estimation techniques.     

2004年加拿大预防血透病人医院血流感染的成本-效益分析

目的：血液透析相关的血流感染是一个严重的公共健康问题,因为加拿大的血液透析病人从1996年到2005翻了一番。本研究目的在于确定加拿大医院血流感染的成本,估算在综合性医院中建立感染控制项目的成本,并进行成本-效益分析。材料与方法：用加拿大医院感染监测项目的数据来估算医院血流感染的发生率。用加拿大健康信息所数据来估算2004年加拿大平均一次血流感染住院的额外成本。建立和维护一个感染控制项目的成本用美国疾病预防与控制中心1985年的成本换算为2004年的加拿大成本来估算。假设感染控制项目能降低医院血流感染病例的20％～30％。结果：2004年的加拿大15278名血液透析病人中估计共有2524人发生血流感染。全年用于治疗血流感染的成本估计为4901万加元。医院血流感染预防和人力资源的总投资成本为815万加元。建立医院感染控制项目后能带来1452万加元的医疗成本节约。效益成本比在1．0：1到1．8：1之间。结论：本研究提供的证据表明,如果医院感染控制项目能降低20％～30％的感染,该项目的经济效益将远超过增加的成本。医院感染控制项目将带来双重效益：节约货币成本的同时改善医疗质量。     

Research opportunities in supply chain management

Since its introduction as a concept in the 1980s, supply chain management (SCM) has undergone significant modification and expansion. A qualitative analysis of 166 unique definitions of SCM published in the literature identified three major themes associated with the supply chain and SCM: (1) activities; (2) benefits; and (3) constituents/components. Utilizing these themes, key research questions and issues within the supply chain and SCM are identified that could be examined by marketing scholars.     

Dysfunctional executive behavior: What can organizations do?

Much has been made of dysfunctional executive behavior in recent years. As such, the purpose of this article is to assist organizations in the design of executive work. To better construct a work environment that diminishes self-serving and unethical behavior, we propose that organizations structure an executive's work around three factors: the accountability environment, managerial discretion, and relationship composition. These factors are used to describe how organizations can better design executives’ work so as to promote more desirable executive behavior. We describe how these factors should be calibrated, as well as how they affect each other.