Switching of biologic disease modifying anti-rheumatic drugs in patients with rheumatoid arthritis in a real world setting

Objectives:

This study examined total healthcare costs and rates of patients with rheumatoid arthritis (RA) who switch biologic disease-modifying anti-rheumatic drug (bDMARD) therapy in a real world setting.

Methods:

A retrospective longitudinal analysis was conducted in patients with RA using IMS PharMetrics Plus database from 1/1/2004 to 3/31/2010. The first-line cohort included patients newly initiated on abatacept or the tumor necrosis factor-alpha inhibitors (anti-TNFs) adalimumab, etanercept, or infliximab, with 12 months of continuous follow-up. The second-line cohort included patients initiating a bDMARD with evidence of a different bDMARD within the previous 2 years and with 12 months of continuous follow-up. Switching was defined as a different bDMARD claim within a 200% gap in days supply from the previous bDMARD claim. Non-switchers stayed on their bDMARD in the follow-up period. Monthly total healthcare costs for switchers and non-switchers and rates of bDMARD switching were examined. Switch rates for each bDMARD were also compared.

Results:

First-line switchers had significantly higher monthly total healthcare costs after the switch than non-switchers ($3759 vs $2343; p?p?Limitations:

There are no clinical data available in this database and, therefore, this study did not examine the clinical drivers of healthcare costs and switch rates.

Conclusions:

Monthly total healthcare costs were higher for bDMARD switchers following the switch compared to non-switchers. Patients on abatacept switched less frequently than patients on anti-TNFs. This study highlights the need to identify patients who are likely to switch in order to ensure they receive the appropriate therapy which may improve outcomes and decrease healthcare costs.     

Examining the Cognitive and Affective Trust-Based Mechanisms Underlying the Relationship Between Ethical Leadership and Organisational Citizenship: A Case of the Head Leading the Heart?

In this paper, we investigate the trust-based mechanisms underlying the relationship between ethical leadership and followers’ organisational citizenship behaviours (OCBs). Based on three-wave survey data obtained from 184 employees and their supervisors, we find that ethical leadership leads to higher levels of both affective and cognitive trust. In addition, we find support for a three-path mediational model, where cognitive trust and affective trust, in turn, mediate the relationship between ethical leadership and follower OCBs. That is to say, we found that ethical leadership leads to the development of cognitive trust, which subsequently influences the development of affective trust. Affective trust, in turn, induces followers to exhibit OCBs as a means of reciprocating the leader’s favourable behaviour. Our findings suggest that both affective and cognitive trust plays an important role in the social exchange processes that underlie the relationship between ethical leadership and the discretionary behaviour of followers.     

New product deployment: The moderating influence of economic institutional context

We compare the determinants of new product deployment across transition and nontransition economy environments to show the importance of variance in economic institutional context. We argue that the expected positive relationships of institutional development, resource levels, and competitive pressure to new product deployment all weaken in transition economy contexts. Hypotheses are tested with survey data of over 7,000 firms in 7 industries from 33 countries. Copyright © 2013 John Wiley & Sons, Ltd.     

Dynamic adjustment in the US beef market with imports

This paper hypothesizes that while there are important qualitative differences in domestic beef and imported beef, beef and cattle imports also represent attempts by the US beef processing and wholesale sector to adjust to short-run changes in supply and demand. Dynamic production theory is applied to the problem to test for this adjustment process, and presents a production theory approach to meat trade that has previously been included in demand functions. The results of this analysis suggest that the method used provides a reasonable and appropriate representation of the import behavior of the US processing and wholesale beef sector.     

Strategic public land use assessment and planning in Victoria,Australia: Four decades of trailblazing but where to from here?

While various attempts have been made to establish strategic environmental assessment (SEA) processes and institutions in various jurisdictions within Australia, the success of these often short lived attempts at institutional approaches for managing public land use conflict has been patchy. The experience in the State of Victoria has been somewhat different, with public land use assessment and planning having been informed by a series of independent statutory bodies since 1970 (the Land Conservation Council, Environment Conservation Council, and Victorian Environmental Assessment Council). These SEA bodies have played a major role in mediating environmental conflict over public land use, and have significantly contributed to the increased size and coverage of Victoria's protected area system. However, while there has always been a statutory body in operation, the roles and responsibilities of these bodies have been subject to significant legislative change, with existing bodies replaced by new bodies in 1997 and 2001. Justifications for these reforms included changing circumstances and new understandings about environmental management, as well as changing views about public administration. As a way of contributing to enhancing the design of institutions and processes for strategic environmental assessment, this paper provides an assessment of Victoria's approach and discusses possible future directions.     

A Blotto game with multi-dimensional incomplete information

We examine a multi-dimensional incomplete information Colonel Blotto game in which each player’s n-tuple of battlefield valuations is drawn from a common n-variate joint distribution function that is uniform on the non-negative orthant of the surface of a sphere.     

A Uniform Price Auction for Conservation Easements in the Canadian Prairies

This paper describes the application of a uniform price auction with a hidden reserve price in a field project aimed at discovering Canadian landowners’ willingness to accept compensation for placing conservation easements on their lands. This is the only project of this kind in Canada to date, and one of the few worldwide. The paper discusses the design of the auction, describes its implementation, and presents its results. The bids received in the auction conformed with known factors affecting opportunity costs and willingness to accept. The information from this auction was successful in guiding a long-term easement procurement program.     

Spatial aspects of ticket scalping

We develop a simple insurance model of the secondary market for tickets to account for some of the observed spatial patterns of prices. Beyond ticket markets the model draws attention to the existence of subtle insurance fees in market prices that may be incorrectly attributed to breakdown of the law of one price or attributed solely to a cost‐based rationale. Copyright © 2010 John Wiley & Sons, Ltd.     

Financial integration and emerging markets capital structure

This paper investigates the impact of country-level financial integration on corporate financing choices in emerging economies. Examining 4477 public firms from 24 countries, we find that corporate leverage is positively related to credit market integration and negatively related to equity market integration. As integration proceeds to higher levels, high-growth firms seem to obtain more debt than low-growth firms; large firms seem to obtain more debt - especially long-term debt - and issue more equity than small firms. Also, there is evidence that firms are able to borrow more funds in countries with more efficient legal systems during integration process.