Cost-effectiveness of 3-month paliperidone treatment for chronic schizophrenia in Spain

Background: A 3-month long treatment of paliperidone palmitate (PP3M) has been introduced as an option for treating schizophrenia. Its cost-effectiveness in Spain has not been established.

Aims: To compare the costs and effects of PP3M compared with once-monthly paliperidone (PP1M) from the payer perspective in Spain.

Methods: This study used the recently published trial by Savitz et al. as a core model over 1 year. Additional data were derived from the literature. Costs in 2016 Euros were obtained from official lists and utilities from Osborne et al. The authors conducted both cost-utility and cost-effectiveness analyses. For the former, the incremental cost per quality-adjusted life-year (QALY) gained was calculated. For the latter, the outcomes were relapses and hospitalizations avoided. To assure the robustness of the analyses, a series of 1-way and probability sensitivity analyses were conducted.

Results: The expected cost was lower with PP3M (4,780€) compared with PP1M (5,244€). PP3M had the fewest relapses (0.080 vs 0.161), hospitalizations (0.034 v.s 0.065), and emergency room visits (0.045 v.s 0.096) and the most QALYs (0.677 v.s 0.625). In both cost-effectiveness and cost-utility analyses, PP3M dominated PP1M. Sensitivity analyses confirmed base case findings. For the primary analysis (cost-utility), PP3M dominated PP1M in 46.9% of 10,000 simulations and was cost-effective at a threshold of 30,000€/QALY gained.

Conclusions: PP3M dominated PP1M in all analyses and was, therefore, cost-effective for treating chronic relapsing schizophrenia in Spain. For patients who require long-acting therapy, 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.     

Guilt and giving: A process model of empathy and efficacy

This research develops a model of consumer response to charity appeals. Using the Extended Parallel Process Model from the fear appeal literature as a foundation, the current model proposes that empathy and self‐efficacy generate guilt and reduce maladaptive responses, which, in turn, shapes donation intention. The results demonstrate that the impact of empathy on charitable donation intention is fully mediated by guilt and maladaptive responses. The impact of self‐efficacy is partially mediated by guilt and maladaptive responses. Therefore, both empathy and self‐efficacy determine whether guilt or maladaptive responses result. This model clarifies the process through which guilt appeals operate, by identifying the roles of empathy and self‐efficacy. © 2008 Wiley Periodicals, Inc.     

Estimates of the cost of equity for public utilities, 1961–1976

Using a simple version of the dividend cash flow (DCF) model of stock valuation, the cost of equity for public utilities is often inferred to be equal to the sum of the dividend yield and the expected rate of growth in dividends. Witnesses who employ this approach generally extrapolate past growth patterns into the future and then assume that investors expect these trends to continue; no effort is made to actually assess the expectations of investors. This approach to estimating the cost of equity for public utilities is criticized for the failure to develop testable hypotheses as an inferential basis for testing the statistical reliability of estimates of the cost of equity. This article demonstrates an alternative to the traditional approach, based on the premise that reliable estimates of the cost of equity are derived only within a methodological framework that produces testable hypotheses. The Gordon model of share valuation is formulated in such a way as to show that there is a systematic and predictable relationship between the ratio of market price to book value of common stock and a firm's normal or expected return on equity. This relationship suggests an econometric model that not only tests the Gordon model of share valuation but produces at the same time, inferences concerning the cost of equity. Using this approach, year-end estimates of the cost of equity for electric utilities are determined for the 16-yr period from 1961 to 1976.     

The 'particular gain or loss upon each article we deal in': an aspect of mercantile accounting, 1300-1800

Merchandise accounts for each category of goods, voyage or venture are a prominent feature of many ledgers of the period 1300 to 1800. The characteristics of these accounts and the uses to which such accounts were put are considered.     

A reconsideration of the public sector's contribution to growth

A recent development in macroeconomic theory suggests that public investmentper se is relevant to economic growth, without regard to the means of financing government activity. This study undertakes an empirical investigation of this proposition, comparing two subperiods of the manufacturing sector's performance in Greece. Our test results support the conventional view that the size of public capital formation and the real intertemporal allocation of public sector may be important for determining manufacturing costs and profits but public deficits are likely to be of comparable or even dominating importance in determining manufacturing output. The emphasis on the financial as opposed to the real aspects of the government's decisions allows the establishment of a benchmark model as an appealing alternative to the newclassical analysis.     

The future as metaphor

One of the fascinating and frustrating facts of modern future watching is the almost shameless manner with which the concept of the future is used and abused. It is demonstrably an idea and a word that means quite different things according to a variety of factors. As the assumptions we make about what we call ‘the future’ can influence our choices, a clearer understanding of our inconsistent employment of the term is always in order. In this essay five prominent ways we can think about the future are explored. These concern imagining the future as time, as a challenge, as a destination, as an answer, and as a judgment.     

In our ivory towers? The research-practice gap in management accounting

This study reports on an investigation of 64 senior management accounting academics from 55 universities in 14 countries about the extent to which academic management accounting research does, and should inform practice. Drawing on the diffusion of innovations theory as a point of departure, and based on evidence obtained from a questionnaire survey and subsequent interviews, our findings reveal the prevalence of two broad schools of thought. One school, represented by the majority of senior academics, holds that there is a significant and widening ‘gap’ between academic research and the practice of management accounting, and that this gap is of considerable concern. In contrast, the other school holds that a divide between academic management accounting research and practice is appropriate, and that efforts to bridge this divide are unnecessary, untenable or irrelevant. From this empirical evidence, we advance a conceptual framework distinguishing between the ‘type’ of academic research undertaken, and the ‘users’ of academic research, and on the basis of this framework, contend that framing the relationship between academic research and practice as a ‘gap’ is potentially an oversimplification, and directs attention away from the broader but fundamental question of the role and societal relevance of academic research in management accounting.