Cost comparison of continued anticoagulation with rivaroxaban versus placebo based on the 1-year EINSTEIN-Extension trial efficacy and safety results

Aims: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (vs placebo) after 6–12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo, based on the EINSTEIN-EXT event rates.

Methods: Total healthcare cost was calculated as the sum of treatment and clinical event costs from a US managed care perspective. Treatment duration and event rates were obtained from the EINSTEIN-EXT study. Adjustment on treatment duration was made by assuming a 10% non-adherence rate. Drug costs were based on wholesale acquisition costs. Cost estimates for clinical events (i.e. recurrent deep vein thrombosis [DVT], recurrent pulmonary embolism, major bleeding, clinically relevant non-major bleeding) were determined from the literature. Results were examined over a ±20% range of each cost component and over 95% confidence intervals (CIs) of event rate differences in deterministic (one-way) and probabilistic sensitivity analyses (PSA).

Results: Total healthcare cost was $1,454 lower for rivaroxaban-treated (vs placebo-treated) patients in the base-case, with a lower clinical event cost fully offsetting drug cost. The cost savings of recurrent DVT alone (–$3,102) was greater than drug cost ($2,723). Total healthcare cost remained lower for rivaroxaban in the majority (73%) of PSA (cost difference [95% CI]?=?–$1,454 [–$2,396, $1,231]).

Limitations: This study was conducted over the 1-year observation period of the EINSTEIN-EXT trial, which limited “real-world” applicability and examination of long-term economic impact. Assumptions on drug and clinical event costs were US-based and, thus, not applicable to other healthcare systems.

Conclusions: Total healthcare costs were estimated to be lower for patients continuing rivaroxaban therapy compared to those receiving placebo in VTE patients who had completed 6–12 months of VTE treatment.     

Fixed-Term Contracts and Labor Market Duality in France

The French labor market is segmented between permanent and temporary workers. The second category has difficulty in getting an open-ended contract. This paper aims at depicting workers on short-term contracts and shows the consequences on their professional career are negative and significant. A large part of the wage gap between permanent and temporary workers remains unexplained by observable characteristics. They receive less on-the-job training and their likelihood of obtaining a stable job is lower than 30% after 1 year and a half. They have also a higher probability of being the adjustment variable in case of an economic negative shock. These different findings show the importance of using public policies to encourage transitions from fixed-term to permanent employment and reducing labor-market duality.     

Integrated bio-economic models as tools to support land-use decision making: a review of potential and limitations

Bio-economic modelling has become a useful tool for anticipating the outcomes of policies and technologies before their implementation. Advances in mathematical programming have made it possible to build more comprehensive models. In an overview of recent studies about bio-economic models applied to land-use problems in agriculture and forestry, we evaluated how aspects such as uncertainty, multiple objective functions, system dynamics and time have been incorporated into models. We found that single objective models were more frequently applied at the farm level, while multiple objective modelling has been applied to meet concerns at the landscape level. Among the objectives, social aspects are seldom represented in all models, when being compared to economic and environmental aspects. The integration of uncertainty is occasionally a topic, while stochastic approaches are more frequently applied than non-stochastic robust methods. Most multiple-objective models do not integrate uncertainty or sequential decision making. Static approaches continue to be more recurrent than truly dynamic models. Even though integrating multiple aspects may enhance our understanding of a system; it involves a tradeoff between complexity and robustness of the results obtained. Land-use models have to address this balance between complexity and robustness in order to evolve towards robust multiple-objective spatial optimization as a prerequisite to achieve sustainability goals.     

Information and Knowledge as Antecedents of Consumer Attitudes and Intentions to Buy and Recommend Fair-Trade Products

The authors propose and empirically test a causal model to understand how the availability of fair-trade information and consumer knowledge about this issue affect consumers’ attitudes and intentions toward fair-trade products. The model is built upon the attitude-behavior paradigm and the premises of agency theory. It is tested through structural equation modeling with a sample of 292 Spanish consumers. The findings are that consumers do not have good knowledge about fair trade and that this is significantly determined by the lack of information about this in the market. It is also observed that consumers’ perceptions about the availability of fair-trade information have negative effects on their concern about this issue and that such information as is available is not effective in reducing consumer skepticism. The research represents an extension of previous fair-trade literature because the role of information and communication in improving consumer attitudes and buying intentions has rarely been explored in the case of ethical products.     

A Review of New Evaluation Models for Strategic Communication: Progress and Gaps

After identification of “stasis” in evaluation of strategic communication including public relations and corporate communication despite intensive focus for more than 40 years, recent initiatives in measurement and evaluation on three continents highlight a number of important advances in theory and practice. Although studies have identified a lack of standards and a narrow focus on “activities” and “outputs” in traditional evaluation models and literature, a two-year international study, which examined a number of recently developed evaluation frameworks and models and accompanying implementation guidelines, identifies several new concepts and dimensions in evaluation, along with some remaining gaps for further research. Based on content analysis of evaluation literature, interviews, and ethnography, this article reports four key findings of recent research and explains how these can contribute to theory-building and practice to transform the planning, implementation, and evaluation of public relations and corporate, government, organizational and marketing communication.     

Do pensions foster education? An empirical perspective

The paper examines the effect of population ageing on public education spending. On the one hand, ageing is expected to have a negative effect on education, as an increasing number of retirees results in ‘intergenerational conflict’ and, hence, the condemnation of education expenditure. On the other hand, ageing, in combination with pay-as-you-go pension systems, offers incentives for the working-age generation to invest in the public education of the young in order to ‘reap’ the benefits (that is, higher income tax/contributions) of their greater future productivity. Empirical evidence derived from the application of a fixed effects approach to panel data for OECD countries shows that the increasing share of elderly people has a non-linear effect on education spending. This indicates a certain degree of intergenerational conflict. Nevertheless, we find that future population ageing, which reinforces the mechanism linking public education and pensions, reflects positively on education expenditure. Furthermore, by disaggregating total education expenditure by educational levels, we observe that this effect is led by levels of non-compulsory education, probably as a reflection of the direct connection to labor productivity.     

Antecedents and outcomes of digital influencer endorsement: An exploratory study

The advertising and marketing literature have established that celebrity endorsements constitute an effective way to enhance attitudes toward brands and increase purchase intents. However, there are no relevant studies on digital influencers. This study addresses the research gap by examining the effect of digital influencers' attractiveness and the effect of the congruence between a digital influencer and a brand on consumer attitudes and purchase intentions. By applying structural equation modeling to a sample of 307 followers of digital influencers, a model was tested and group analysis was performed for two categories (“entertainment & video games” and “fashion & beauty”). The results show that both brand attitudes and purchase intentions are influenced by the digital influencer's attractiveness (which includes both likeability and familiarity) and by the congruence between the digital influencer and the brand. This study makes several contributions to both theory and practice, which are highlighted in this paper.     

Easing the assessment of emerging technologies in technology observatories. Findings about patterns of dissemination of emerging technologies on the internet

This paper considers the Web as a big data container that can be used by Technology Observatories and administrations to track emerging issues and more specifically emerging technologies. It considers information that is available on the Internet for free from different sources, and proposes a framework that can be useful to characterise them and to detect patterns of dissemination. This framework is made up of 30 metrics obtained from different kinds of sources (general web, patents, scholars?…). Some of them are obtained directly as the number of hits retrieved by queries on a search engine, and other ones calculated by means of ratios. This paper contains the development of a complete case that utilises this framework to characterise emerging technologies included in the well-known Hype Cycle for Emerging Technologies, in this case the 2015 release¹ and to analyze patterns of dissemination of these technologies on the Internet.