Subsidizing (and taxing) business procurement

This paper studies the effect of a subsidy (or tax) on a market where a downstream manufacturer uses a competitive tender to procure inputs from upstream suppliers. Subsidizing input production can result in input price decreases that are greater than the effective decrease in marginal costs. That is, overshifting occurs. When the size of the subsidy is not too large, the downstream firm can enjoy an increase in profits greater than the government expenditure on the subsidy. A relatively weak sufficient condition for these results to hold is that suppliers earn a positive profit margin on the marginal unit sold, before taking into account any subsidy payment. Stronger sufficient conditions, tailored to each result, are provided.     

Evaluation of medical costs associated with use of new oral anticoagulants compared with standard therapy among venous thromboembolism patients

Objective:

This study evaluated differences in medical costs associated with clinical end-points from randomized clinical trials that compared the new oral anticoagulants (NOACs), dabigatran, rivaroxaban, apixaban, and edoxaban, to standard therapy for treatment of patients with venous thromboembolism (VTE).

Research design and methods:

Event rates of efficacy and safety end-points from the clinical trials (RE-COVER, RE-COVER II, EINSTEIN-Pooled, AMPLIFY, Hokusai-VTE trial) were obtained from published literature. Incremental annual medical costs among patients with clinical events from a US payer perspective were obtained from the literature or healthcare claims databases and inflation adjusted to 2013 costs. Differences in total medical costs associated with clinical end-points for the NOACs vs standard therapy were then estimated. One-way and Monte Carlo sensitivity analyses were carried out.

Results:

A lower rate of major bleedings was associated with use of any of the NOACs vs standard therapy. Except for dabigatran, use of NOACs was also associated with a lower rate of recurrent VTE/death. As a result of the reduction in clinical event rates, the overall medical cost differences were ?$146, ?$482, ?$918, and ?$344 for VTE patients treated with dabigatran, rivaroxaban, apixaban, and edoxaban, respectively, vs patients treated with standard therapy.

Conclusions:

When any of the four NOACs are used instead of standard therapy for acute VTE, treatment medical costs are reduced. Apixaban is associated with the greatest reduction in medical costs, which is driven by medical cost reductions associated with both efficacy and safety end-points. Further evaluation may be needed to validate these results in the real-world setting.     

Expenditure function estimates of the efficiency and distributive impact of indirect taxes in the United Kingdom

This paper uses the expenditure function to consider the efficiency and distributional impact of indirect taxes in the United Kingdom. Estimates of the parameters of the Linear Expenditure System of demand equations are employed to measure the compensating variation and equivalent variation costs of taxes on households in different income groups. In addition, distributional weights are used to consider the overall impact of different taxes and tax changes on social welfare. Finally we consider other types of demand system estimates which might be used in this kind of exercise.     

The economic burden of tuberous sclerosis complex in UK patients with renal manifestations: a retrospective cohort study in the clinical practice research datalink (CPRD)

Background: Tuberous sclerosis complex (TSC) is a multi-system genetic disorder in which renal manifestations occur in ～50% of children and 80% of adults. Since these often present alongside other manifestations, renal TSC is likely to incur significant costs. This study aims to quantify healthcare resource use (HCRU) and costs for renal TSC patients in the UK.

Methods: TSC patients in the Clinical Practice Research Datalink (CPRD) linked to Hospital Episodes Statistics were identified from January 1987–June 2013. Clinical data were extracted over the entire history and costs were reported over the most recent 3-year period. HCRU was compared with a matched comparator cohort. Incremental costs were reported and the key cost drivers by primary manifestation category were identified by regression modeling.

Results: A total of 79 renal TSC patients were identified with manifestations including chronic kidney disease stage 3–5 (with prevalence increasing with age) and renal angiomyolipoma. Renal TSC patients consistently reported greater HCRU than the comparator. Inpatient hospitalizations were more frequent for renal TSC patients (3.2 vs 1.6), but length of stay was comparable; however, 70.9% of renal TSC patients recorded no kidney-related procedures ever and averaged <1 test per year in the 3-year period. Average costs for renal TSC patients were nearly 3-fold greater than the comparator (£15,162 vs £5672). Costs increased with additional manifestation categories (£3600: only renal; £27,531: renal with ≥4 additional manifestation categories [25% of patients]). Additional nervous system and dermatology/psychiatric manifestations significantly (p?Conclusions: Renal TSC patients have greater HCRU than the general CPRD population, likely to result from progression of renal disease and additional manifestations; however, surveillance for disease progression appears to be deficient. Inadequate monitoring may contribute to a lack of co-ordinated care and increased healthcare-associated costs. Efforts should be made to follow the TSC guidelines to effectively monitor and treat patients.     

Perception of marital roles in purchase decision processes: A cross-cultural study

Following the approach of the classic 1974 marital-role influence study of Davis and Rigaux, the present study focuses on differences in decision making (i.e., joint, husband dominated, wife dominated) across 24 product categories as a function of two key factors. These factors are stage of the decision process (i.e., problem recognition, information search, and the final decision) and culture (People’s Republic of China and the United States). The Jacobson Marital-Role Egalitarianism Scale is included to further assess individual differences in husband and wife traditionality-modernism. The major findings are that emphasis on joint, husband-dominated, and wife-dominated decisions vary by stage and by stage-culture interaction. Practical implications are presented with suggestions for future research. He graduated from the University of Georgia in 1985 with a Ph.D. in marketing. His research interests include global strategic market planning and cross-cultural research issues and methodologies. He has published in such journals asJournal of Advertising Research, Industrial Marketing Management, Journal of the Academy of Marketing Science, Columbia Journal of World Business, International Marketing Review, Journal of Business Strategy, andJournal of Consumer Marketing. He graduated with honors in 1986 from the University of Mississippi with a Ph.D. in marketing. His research interests include cross-cultural consumer behavior and emotional responses to advertising stimuli. He has published in such journals asJournal of Advertising, Journal of Advertising Research, Journal of Public Policy and Marketing, Psychology and Marketing, Journal of Health Care Marketing, andInternational Marketing Review. He graduated from the University of Mississippi in 1986 with a Ph.D. in marketing. His research interests focus on cross-cultural consumer behavior. He has published in such journals asJournal of Advertising, Journal of Business Ethics, Journal of Health Care Marketing, Psychology and Marketing, and theInternational Journal of Purchasing and Materials Management.     

A dyadic study of interpersonal information search

Although interpersonal word-of-mouth communication, by definition, takes place between two people, rarely has the phenomenon of word of mouth been studied using both members of the dyad. Building on the literature, this article offers a model of active interpersonal information search that is tested by using a method in which information seeker and source perceptions were obtained. Source characteristics were important determinants of interpersonal influence, but seeker characteristics also played an important role. Interestingly, it proved useful to distinguish between demographic and attitudinal homophily of seeker and source as the former was inversely and the latter directly related to interpersonal influence. Mary C. Gilly is an associate professor in the Graduate School of Management and associate dean of Graduate Studies at the University of California, Irvine. Her Ph.D. is in marketing from the University of Houston. Her research interests include the unintended effects of marketing actions, such as the effects of advertising on employees. She also has interests in services marketing, such as customer service, including consumer complaint handling, and cross-cultural service encounters. Her work has been published in theJournal of Marketing, theJournal of Consumer Research, theJournal of Business Research, and other academic journals. John L. Graham is a professor in the Graduate School of Management at the University of California, Irvine. His Ph.D. is in marketing from the University of California, Berkeley. His primary research interests regard international marketing, international business negotiations, and structural equations modeling. His work has been published in theJournal of Marketing, theJournal of Consumer Research, Marketing Science, theJournal of International Business Studies, Management Science, and other academic journals. Mary Finley Wolfinbarger is an associate professor at California State University, Long Beach and is doing research on the topics of internal marketing and gift giving. She teaches Marketing Principles and Marketing Research. She received her Ph.D. in marketing from the University of California, Irvine. Her work has appeared in theJournal of Marketing and other academic journals. Laura J. Yale came to Fort Lewis College in 1991. She holds degrees in Hotel, Restaurant, and Travel Administration from the University of Massachusetts, Amherst, and received her Ph.D. from the University of California, Irvine. She teaches a variety of courses in Marketing and Travel and Tourism Administration, including Marketing Research, International Marketing and Services. Her industry experience and most of her research interest are in the services sector, particularly the tourism industry. She is on sabbatical leave this academic year, writing an introductory textbook on the tourism industry. She will return to teaching in September 1998.     

Distributional assumptions and a test of the dual labor market hypothesis

Recent application of the switching regression model to allocate workers into the primary and secondary labor markets is considered to be the best solution to the classification problem of the empirical testing of the dual labor market theory. In such models, normality of the error terms is assumed. This paper adopts the switching regression model to test the dual labor market theory by assuming different distributions of the error terms. The test results strongly support the dual labor market theory regardless of the assumption one makes about the error terms. However, the results indicate that different distribution can lead to different percentage distributions of workers in the two segments. In particular, the normal distribution generates more workers in the primary segment than the non-normal distributions. Therefore, care must be taken not to generalize the type of industries or occupations that fall under the primary and secondary segments. First version received: October 2000/Final version received: March 2002 RID="*" ID="*"  I would like to thank Kevin Lang, Robert Marshall, and two anonymous referees for their helpful comments. I am grateful for comments received from the session participants of the Western Economic Association International Conference, San Francisco, CA, June 28–July 2, 1996, and the Midwest Economic Association Conference, Kansas City, 1997. I thank George Bonney, the Chief Statistician of Fox Chase Cancer Center, Philadelphia for his comments. Any remaining errors are my responsibility. I gratefully acknowledge financial support from Penn State Research and Development Grant, 1995.