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.     

Contagion of network products in small-world networks

We formulate a model in which agents embedded in an exogenous social network decide whether to adopt a new network product or not. In the theoretical part of the paper, we characterize the stochastically stable equilibria for complete networks and cycles. For an arbitrary network structure, we develop a novel graph decomposition method to characterize the set of recurrent communication states, which is a superset of stochastically stable equilibria of the adoption game presented in our model. In the simulation part, we study the contagion process of a network product in small-world networks that systematically represent social networks. We simulate a generalization of the Morris (Rev Econ Stud 67(1):57–78, 2000) Contagion model that can explain the chasm between early adopters and early majority. Our numerical analysis shows that the failure of a new network product is less likely in a highly cliquish network. In addition, the contagion process reaches to steady state faster in random networks than in highly cliquish networks. It turns out that marketers should work with mixed marketing strategies, which will result in a full contagion of a network product and faster contagion rates with a higher probability.

     

Social media affordances in entry‐level employees’ socialization: employee agency in the management of their professional impressions and vulnerability during early stages of socialization

This study examined how entry‐level employees interacted with social media during three stages of organizational socialization. They navigated between four different media affordances (persistence, editability, visibility, and association) while experiencing them as both enabling and constraining in different socialization stages. Qualitative interview data analysis revealed during anticipatory socialization, job applicants realized visibility and persistence in relation to institutional and individualized socialization. During encounter, new employees managed personal and professional life boundaries carefully against the association and visibility affordances. Although some participants used both public and enterprise social media for obtaining job‐related information and understanding coworkers and company culture, during metamorphosis, most interviewees adopted passive information seeking strategies and experienced a paradoxical tension between the enabling and constraining affordances of social media. Findings are discussed with regards to employees’ exertion of agency in managing their professional impressions and coping with high levels of uncertainty and vulnerability during early stages of socialization.     

A conceptual model and research agenda for bidding,planning and delivering Major sport events that lever human rights

In this conceptual article, the authors propose a framework for how progressive human rights outcomes may be obtained in the context of bidding, planning and implementing major sport events (MSEs) through the implementation of four pathways, including good governance, the democratic participation of stakeholders, the formalisation of human rights agendas and the deployment of sensitive urban development. The authors argue that there is a need for adherence to internationally recognised standards, such as the Universal Declaration of Human Rights and the United Nations Guiding Principles on Business and Human Rights if rhetorical statements from MSE awarding bodies and host organisers are to be accountable to a wider set of actors. If researchers and practitioners want to address some of the critical issues related to human rights and MSEs, it is imperative that key actors working in the rights sphere are involved in shaping the research agenda and monitoring its implementation. Academics need to take a proactive approach aimed at achieving both theoretically grounded and practically relevant solutions, with engagement occurring over an extended period of time. This approach, avowedly political and concerned with genuine action, is a key way in which MSE stakeholders can be held to account for their actions in regard to human rights.     

Terror per Capita

Studies on the correlates of terrorism usually analyze total numbers of attacks or victims per country. However, what we may ultimately care about in terms of policy recommendations is the likelihood of any individual being subject to the respective phenomenon. Thus, we propose and explore a simple alternative measure of terrorism: terror per capita. Studying terror per capita across 162 countries from 1970–2015, the associated correlates differ substantially in terms of sign, levels of statistical significance, and magnitude from those when analyzing total terror. We illustrate two cases in point, serving as proof of concept. First, democracy, often associated with more total terror, emerges as a marginally negative predictor of terror per capita. Second, a larger share of Muslims in society is associated with a positive and statistically significant link to total terror, but emerges as a negative predictor of terror per capita. We find similar changes in sign and statistical relevance for GDP per capita and language fractionalization as correlates of terrorism. Depending on the policy question, studying terror per capita can greatly enhance our understanding of terrorism drivers, especially when analyzing data across countries with vastly differing population sizes.     

The Great Recession,Austerity and Inequality: Lessons from Ireland

The advent of the Great Recession and the widespread adoption of fiscal austerity policies have heightened concern about inequality and its effects. We examine how the distribution of income in Ireland—a country which experienced one of the most severe economic contractions—has evolved over the years 2008 to 2013. Standard cross‐sectional analysis of the income distribution shows broad stability in the Gini coefficient and in decile shares, with one main exception: the share of the bottom decile fell sharply, with the largest fall in average incomes being for that group. Longitudinal analysis shows that the falls in the average income for the bottom decile were not due to decreasing income for those remaining in the bottom decile, but to falls in income from those initially located in higher deciles. The extent of redistribution through taxes and transfers increased strongly, as measured by the Reynolds‐Smolensky index, which rose from 0.20 before the onset of the crisis to 0.27 in 2013. Analysis indicates that about three‐quarters of this increased redistribution is due to automatic stabilisers and one‐quarter to discretionary policy changes.     

LEADERSHIP IN CLIMATE CHANGE MITIGATION: CONSEQUENCES AND INCENTIVES

Initiatives in favor of unilateral action on climate change are frequently challenged by concerns over free riding. Nevertheless, we observe an increasing number of unilateral efforts at different administrative levels and in different parts of the world. Previous academic literature described various individual mechanisms where emissions abroad may increase or decrease as a reaction to unilateral emission reductions. In this paper, we collect a comprehensive set of both positive and negative reactions and analyze them in stylized models. This allows us to identify the most important characteristics that determine the potential of a leader to boost mitigation efforts abroad. We find that this potential depends on (i) a strong ability to generate knowledge through leadership, (ii) a high degree of credibility in the international community, and (iii) a similar economic structure to the most important emitters. While most effects are difficult to quantify, this comprehensive assessment suggests that leakage effects resulting from unilateral mitigation may well be outweighed by positive reactions.     

The Impact of Employment on Parental Coresidence

We examine the extent to which parents use housing and shared living arrangements as a form of risk‐sharing for their adult children, using detailed data on children and parents in the Health and Retirement Study for 1998–2012. On average, a young man moving from full‐time to nonemployment raises the likelihood of coresiding with a parent by 1.5 percentage points; moving from full‐time employment to being part‐time employed raises the likelihood of coresiding with a parent by 2 percentage points. The implied elasticity of parental coresidence with respect to the son's income is ‐1.1; for daughters, the elasticity is ‐0.5.     

CEO internal experience and voluntary disclosure quality: Evidence from management forecasts

Internally‐promoted CEOs should have a deep understanding of their firm's products, supply chain, operations, business climate, corporate culture, and how to navigate among employees to get the information they need. Thus, we argue that internally‐promoted CEOs are likely to produce higher quality disclosure than outsider CEOs. Using a sample of US firms from the S&P1500 index from 2001 to 2011, we hand‐collect whether a CEO is hired from inside the firm and, if so, the number of years they worked at the firm before becoming CEO. We then examine whether managers with more internal experience issue higher quality disclosures and offer three main findings. First, CEOs with more internal experience are more likely to issue voluntary earnings forecasts than those managers with less internal experience as well as those managers hired from outside the firm. Second, CEOs with more internal experience issue more accurate earnings forecasts than those managers with less internal experience as well as those managers hired from outside the firm. Finally, investors react more strongly to forecasts issued by insider CEOs than to those issued by outsider CEOs. In additional analysis, we find no evidence that these results extend to mandatory reporting quality (i.e., accruals quality, restatements, or internal control weaknesses), perhaps because mandatory disclosure is subjected to heavy oversight by the board of directors, auditors, and regulators. Overall, our findings suggest that when managers have work experience with the firm prior to becoming the CEO, the firm's voluntary disclosure is of higher quality.