Cost-effectiveness model of abiraterone plus prednisone,cabazitaxel plus prednisone and enzalutamide for visceral metastatic castration resistant prostate cancer therapy after docetaxel therapy resistance

Abstract

Aims: Among patients diagnosed with prostate cancer, 10–20% will develop castration-resistant prostate cancer (CRPC) within 5?years; for 70%, CRPC will metastasize, mostly to the lungs and/or liver. We performed a cost-effectiveness model comparing abiraterone plus prednisone (ABI?+?PRD), cabazitaxel plus prednisone (CAB?+?PRD) and enzalutamide (ENZ) for visceral metastatic CRPC post-docetaxel therapy resistance.

Methods: A three-state (Progression-Free, Progression, Death) lifetime Markov model was constructed to compare ABI?+?PRD, CAB?+?PRD, and ENZ from a United States healthcare payer perspective (2019?US$; discount rate 3%/yr.). Effectiveness was measured in life-years (LYs) and quality-adjusted life years (QALYs). Inputs included treatment costs, grade III/IV adverse events with incidence ≥5%, physician follow-up, lab and imaging tests. Phase III trial Kaplan-Meier curves were extrapolated to estimate overall survival and Progression-Free transition probabilities. Incremental cost-effectiveness ratios (ICERs) and utility ratios (ICURs), probabilistic sensitivity analyses (PSAs) and cost-effectiveness acceptability curves at willingness-to-pay (WTP) thresholds were estimated.

Results: Models estimated 3-year overall survival rates of 1.3% for patients treated with ABI?+?PRD, 16.2% for CAB?+?PRD, and 13.2% for ENZ. Estimated Progression-Free rates at 1.5?years were 0.51% for ABI?+?PRD, 0.27% for CAB?+?PRD, and 14.47% for ENZ. LYs and QALYs were 1.20 and 0.58 respectively for ABI?+?PRD, 1.48 and 0.56 for CAB?+?PRD, and 1.58 and 0.79 for ENZ. Total treatment costs were: $115,433 for ABI?+?PRD, $85,337 for CAB?+?PRD and $109,213 for ENZ. CAB?+?PRD and ENZ dominated ABI?+?PRD due to higher LYs gained. Incremental QALYs for ENZ vs. CAB?+?PRD were larger than incremental LYs. The ICUR for ENZ was $103,674/QALY compared to CAB?+?PRD.

Conclusions: This analysis found ENZ provided greater LYs and QALYs than both ABI?+?PRD and CAB?+?PRD, at a lower cost than ABI?+?PRD, but at a higher cost compared to CAB?+?PRD. For patients with visceral mCRPC after docetaxel therapy resistance, ENZ was cost-effective 92% of the time with a WTP threshold of $100,000/QALY.     

What do they know? The effects of outside director acquisition experience on firm acquisition performance

This article contributes to the literature on board effectiveness by being perhaps the first to systematically examine how the nature of outside directors' prior experience, and resulting expertise, will influence the performance of a focal firm's strategic initiatives. Our theoretical model is grounded in the psychological literature on expertise and its role in group decision making effectiveness. We focus on outside director expertise in acquisition decision making, and its implications for the performance of the acquisitions of a focal firm. Our conceptual framework indicates that directors will develop expertise in making particular kinds of acquisition decisions (e.g., related or unrelated acquisitions or acquisitions in specific industries or product markets) through their past experiences at other firms with decisions about those specific types of acquisitions, and we predict that this experience and expertise will have positive effects on the performance of a focal firm's acquisitions. We extend our theoretical model to consider the conditions under which relevant director experience will prove most beneficial. Our model predicts that outside director acquisition expertise will deliver the greatest benefits when the focal firm's board is independent from management. We find empirical support for all of our hypotheses. In considering how and when director experience and resulting expertise may influence the performance of corporate acquisitions, our theory and results help to highlight a potential second main focus for research on the long‐standing question of what factors render boards of directors effective. Copyright © 2008 John Wiley & Sons, Ltd.     

Advancing community resilience research and practice: moving from “me” to “we” to “3D”

Abstract

Research and practice aimed at enhancing community resilience to disasters such as hurricanes have focused primarily on the survival of individuals and the development of social capital and networks. Less consideration has been given to the dynamics of social-ecological conditions that can govern post-disaster outcomes. This article provides a rationale for moving research and practice towards an adaptive systems framework, drawing on the cascading challenges that Gulf of Mexico coastal communities have endured since the 2010 Deepwater Horizon (DWH) oil spill. The adaptive approach recognizes that, in some situations, crises can highlight avenues for improvement, where greater resilience can be achieved by addressing the dynamic context of a disaster. We discuss implications for clarifying interdependencies, bridging the science-society gap, and making course corrections through iterative processes. We also highlight how the approach might foster policy addressing global challenges such as changing climate conditions, rapid urbanization, and disease pandemics.     

Testing the impact of job‐related variables on a utility judgment training criterion beyond background and affective reaction variables*

We tested the incremental impact of a job‐related set of variables for explaining a utility judgment training effectiveness variable, that is, course completion skill preparedness, beyond background and course‐related variables. Our respondents were two different emergency medical service samples, 415 basics and 742 paramedics, from the 2008 US Longitudinal Emergency Medical Technician Attributes and Demographic Study. Extending earlier research into the training of US emergency medical services staff, we developed scales for measuring two course‐related affective reaction variables, quality of course materials and quality of lead instructor. We found for both samples that the quality of course materials and quality of lead instructor variables each significantly explained course completion skill preparedness variance beyond controlled‐for background variables. We also found that the set of job‐related variables explained further, additional variance and that job satisfaction was positively related to course completion skill preparedness for both samples. The limitations of the study and future research ideas are discussed.     

Managerial Aspirations and Suspect Leaders: The Effect of Relative Performance and Leader Succession on Organizational Misconduct

Journal of Business Ethics - Explanations of organizational misconduct frequently point to declining firm performance and/or the actions of unethical or suspect leaders. Evidence that...     

Capabilities and (Missed) Opportunity for Women’s Entrepreneurship in Kuwait

Abstract

Kuwait offers a powerful context for investigating the entrepreneurial cultures developing in Gulf countries in response to the concurrent trends of pursuing economic diversification and efficiency, and the constraints posed by cultural narratives that maintain inequality between the sexes. Bringing a capabilities lens to the analysis of entrepreneurship promotion programs means shifting from a focus on meeting basic human needs to ensuring capabilities development. To begin, we discuss the capabilities approach to entrepreneurship with a focus on the necessity/opportunity classification. Next, we review the entrepreneurship ecosystem in Kuwait, including its focus on opportunity entrepreneurs and the legal, economic, and sociocultural framework in which they operate. After considering the impact of Kuwait’s gender-blind approach on women’s entrepreneurship, we conclude with some suggestions for strengthening Kuwait’s potential for capability expansion through entrepreneurship.     

TRADITION AND FASHION IN CONSUMER CHOICE: BAGGING THE SCOTTISH MUNROS

Evidence is growing that in many markets consumers select not simply on the basis of the perceived attributes of products, but their preferences are modified by the behaviour of others. Economists have paid relatively little attention to such markets. We consider evidence from the activity of hill-walking. The Munros are a list of Scottish hills over 3000 feet in height. We analyse completions of both the Munros themselves, and the Munro Tops, a difficult and time-consuming extension of the Munros. The classic Bass diffusion model incorporates the imitation of others as a part of the behavioural rules used by consumers in making choice. We extend the Bass model to be able to apply it to long-term case studies where substantial changes over time in the population making choices at any given point have to be taken into account. The Munros are a particular illustration of this, but the extension can be used in other situations where such population changes are important. Our results show that Top completions are dominated by the 'fashion' component, suggesting there was a cohort among which Tops completions became fashionable, but which has not been sustained. Both our extended model and the standard model can account for this. In contrast, our extension is needed to explain why Munro completions have remained close to their peak level for a decade now, a fact for which the standard Bass model is unable to account.     

Overlooked issues in the conceptualization and measurement of counterproductive work behavior

The current paper addresses three important yet generally overlooked issues regarding the conceptualization and measurement of counterproductive work behaviors (CWBs). First, we argue that the field would benefit from the adoption of situation-specific CWB measures that are tailored to the organization or occupation being studied. Such an approach would ensure that CWB measures include sample-relevant behaviors and exclude irrelevant behaviors. Second, we discuss several potential sub-dimensions of CWBs that should be examined in future research. These sub-dimensions include: 1) legal vs. illegal activities, 2) hostile vs. instrumental aggression, and 3) task-related vs. non-task-related counterproductive behaviors. Finally, we consider the relevance of the bandwidth-fidelity principle to the measurement of CWBs.     

Earnings Management and Annual General Meetings: The Role of Managerial Entrenchment

We examine earnings management around the annual general meeting (AGM) and assess the influence of managerial entrenchment. Consistent with prior research, we show positive and statistically significant abnormal returns surrounding AGMs regardless of the level of managerial entrenchment. We find evidence of significant earnings manipulation primarily among entrenched managers. Specifically, they manage abnormal accruals downward two quarters prior to the AGM and significantly increase abnormal accruals in the quarter immediately before the AGM. Our evidence is consistent with AGMs triggering managers to disseminate information in a manner that shapes the market's perception of the firm.