Cost-effectiveness of 3-month paliperidone therapy for chronic schizophrenia in the Netherlands

Background: A new depot formulation of paliperidone has been developed that provides effective treatment for schizophrenia for 3 months (PP3M). It has been tested in phase-3 trials, but no data on its cost-effectiveness have been published.

Purpose: To determine the cost-effectiveness of PP3M compared with once-monthly paliperidone (PP1M), haloperidol long-acting therapy (HAL-LAT), risperidone microspheres (RIS-LAT), and oral olanzapine (oral-OLZ) for treating chronic schizophrenia in The Netherlands.

Methods: A previous 1-year decision tree was adapted, based on local inputs supplemented with data from published literature. The primary analysis used DRG costs in 2016 euros from the insurer perspective, as derived from official lists. A micro-costing analysis was also conducted. For the costing scenario, official list prices were used. Clinical outcomes included relapses (treated as outpatients, requiring hospitalization, total), and quality-adjusted life-years (QALYs). Rates and utility scores were derived from the literature. Economic outcomes were the incremental cost/QALY-gained or relapse-avoided. Model robustness was examined in scenario, 1-way, and probability sensitivity analyses.

Results: The expected cost was lowest with PP3M (8,781€), followed by PP1M (10,325€), HAL-LAT (11,278€), RIS-LAT (11,307€), and oral-OLZ (13,556€). PP3M had the fewest total relapses/patient (0.36, 0.94, 1.39, 1.21, and 1.70, respectively), hospitalizations (0.11, 0.46, 0.40, 0.56, and 0.57, respectively), emergency room visits (0.25, 0.48. 0.99, 0.65, and 1.14, respectively) and the most QALYs (0.847, 0.735, 0.709, 0.719, and 0.656, respectively). In both cost-effectiveness and cost-utility analyses, PP3M dominated all other drugs. Sensitivity analyses confirmed base case findings. In the costing analysis, total costs were, on average, 31.9% higher than DRGs.

Conclusions: PP3M dominated all commonly used drugs. It is cost-effective for treating chronic schizophrenia in the Netherlands. Results were robust over a wide range of sensitivity analyses. For patients requiring a depot medication, such as those with adherence problems, PP3M appears to be a good alternative anti-psychotic treatment.     

Real exchange rate (RER) as a policy tool for industrial diversification and growth in Africa

Appropriate exchange rate (ER) policies in some Asian and Latin American countries have led to improvement in industrial diversification and growth. The growth ‘miracle’ of the Asian countries centres on the effective use of ER and trade policies, specifically the adoption of depreciation of real exchange rate (RER). However, the case of Africa is different, as the continent is yet to adopt an appropriate ER policy that enhances industrial diversification and growth. Examining the effectiveness of the RER as a policy tool for industrial diversification and growth in 36 African countries, this study applied a dynamic generalised method of moments (GMM) estimation technique to determine how changes in RER affects the growth composition of the three main productive sectors – primary, secondary, and tertiary and their response rates. Our findings suggest that the primary sector leads to appreciation of the RER, while the secondary and tertiary lead to depreciation of the RER. This result has serious policy implication for the Africa continent that has relied so much on the production of primary commodities. Rather than pursue the policy of ER depreciation which affects the primary and secondary sectors, policy shift in favour of the tertiary sector should be highly encouraged.     

Environmental disturbances,organizational transitions and transformations: A view from the dark side

Published over two decades ago, “Environmental Disturbances and Organizational Transitions and Transformations: Some Alternative Models” (Laughlin, 1991), presents a comprehensive view of what choices may be available to organizations in navigating the change process. Laughlin's discussion also provides some rationale for why organizations may pursue particular pathways in response to environmental disturbances. Responding to his call to future researchers, the current paper builds upon Laughlin's work by drawing on Social Network Theory (SNT) as offering an explanation about how the dynamic processes implicit in his framework may operate in effecting change within organizations and as a consequence, why particular pathways may be adopted. While Laughlin's initial premise and consequent contentions are grounded largely in critical theory, in augmenting his framework with insights derived from SNT, this paper contends that the dynamic processes invoked in response to environmental disturbances are capable of being operationalized, generalized and tested. Laughlin's framework therefore offers a foundation for a positivist frame of reference, pointing to the amenability of the framework to further investigation from researchers from a diverse range of research traditions.     

Determinants and value relevance of UK CEO pay slice

This paper studies the CEO pay slice (CPS) of UK listed firms during the period 2003 to 2009. We investigate the determinants of CPS. We study the links between CPS and measures of firm performance. We find that firms with higher levels of corporate governance ratings and those with more independent boards tend to have higher CPS. In addition, we find that CEOs are more likely to receive lower compensation when they chair the board and when they work in firms with large board size. We also find that higher CPS is positively associated with firm performance after controlling for the firm-specific characteristics and corporate governance variables. We get compatible results when we examine the association between equity-based CPS and firm performance. Our results remain robust to alternative accounting measures of firm performance. Our results suggest that high UK CPS levels do indeed reflect top managerial talent rather than managerial power.     

Company Support for Employee Volunteering: A National Survey of Companies in Canada

Company support for employee volunteerism (CSEV) benefits companies, employees, and society while helping companies meet the expectations of corporate social responsibility (CSR). A nationally representative telephone survey of 990 Canadian companies examined CSEV through the lens of Porter and Kramer’s (2006, ‘Strategy and society: the link between competitive advantage and corporate social responsibility’, Harvard Business Review, 78–92.) CSR model. The results demonstrated that Canadian companies passively support employee volunteerism in a variety of ways, such as allowing employees to take time off without pay (71%) or adjusting their work schedules (78%). These Responsive CSR efforts contribute to the company’s value chain by enhancing employee morale, a perceived CSEV benefit. More active forms of support requiring company time or money are less common; for example, 29% allow time off with pay. Companies perceive that support for employee volunteering enhances their public image, a Responsive CSR strategy when employed to ameliorate a damaged reputation or a Strategic CSR strategy when contributing to a competitive position. A minority perceive challenges like covering the workload. Many companies target and/or exclude particular causes and link CSEV efforts with other philanthropic donations, suggesting a Strategic CSR application of CSEV. Where programs exist, they frequently are neither tracked nor evaluated, suggesting that companies are not using these programs as strategically as they might.     

Nonpoint Source Pollution and Present Values: A Contingent Valuation Study of Lake Mendota

A split sample contingent valuation survey was conducted to estimate the aggregate willingness to pay of a group of Wisconsin residents for improving the water quality of a popular recreational lake. Extensive limnological research specific to the lake allowed for a thorough understanding of the relationship between pollutant loading and water quality response, thus making the lake an excellent candidate for a contingent valuation study. Results show that the water quality improvement will provide positive net benefits to the public and that payment time horizon has a significant effect on valuation statements.     

Optimal Sovereign Debt for an Overdebted Country

In this study, the role of debt maturity is analysed in a framework that blends a number of key macro‐economic factors with a process of estimating an optimal debt maturity maximising net present value. The purpose is to reduce the real value of government liabilities for a highly indebted country, as for example in the case of Greece, over a 35‐year period. The conclusion that emerges is that management of debt maturity is an essential component of the equilibrium policy and, as such, it can play an important role both in implementing tax smoothing programmes and in reducing costs associated with debt financing.     

Cause‐Related Marketing from the Nonprofit's Perspective: Classifying Goals and Experienced Outcomes

This research examines the cause‐related marketing (CRM) experience from a nonprofit (NPO) perspective, using qualitative and quantitative methods. U.S. NPO managers with direct CRM experience (n = 154) participated. Results demonstrate that NPOs have both first order (immediate financial support) and second order (less tangible, longer term) goals when undertaking CRM, and that they generally realize these outcomes, though not always. NPOs primarily seek event support, networking opportunities and public awareness, followed by funding opportunities, with less emphasis on gaining business expertise. This research extends the framework of Gourville and Rangan (2004 Gourville, J. T. and Rangan, V. K. 2004. Valuing the cause marketing relationship.. California Management Review, 47: 38–57. [Crossref], [Web of Science ®] , [Google Scholar]) by offering a more precise, differentiated model.