Explaining divorce rate determinants: new evidence from Spain

This article examines the main determinants of divorce rates in Spain for the period 1995 to 2010. According to the results, the so-called Express Divorce Law (passed in 2005) seems to be positively associated with divorce rates in the short term. Income level and growth, female employment rate, and the proportion of foreign population are also positively related to divorce rates. However, as expected, the percentage of conservative vote seems to have a negative impact.     

Cost-effectiveness of currently recommended direct-acting antiviral treatments in patients infected with genotypes 1 or 4 hepatitis C virus in the US

Objective: This study compared the cost-effectiveness of direct-acting antiviral therapies currently recommended for treating genotypes (GT) 1 and 4 chronic hepatitis C (CHC) patients in the US.

Methods: A cost-effectiveness analysis of treatments for CHC from a US payer’s perspective over a lifelong time horizon was performed. A Markov model based on the natural history of CHC was used for a population that included treatment-naïve and -experienced patients. Treatment alternatives considered for GT1 included ombitasvir/paritaprevir/ritonavir?+?dasabuvir?±?ribavirin (3D?±?R), sofosbuvir?+?ledipasvir (SOF/LDV), sofosbuvir?+?simeprevir (SOF?+?SMV), simeprevir?+?pegylated interferon/ribavirin (SMV?+?PR) and no treatment (NT). For GT4 treatments, ombitasvir/paritaprevir/ritonavir?+?ribavirin (2D?+?R), SOF/LDV and NT were compared. Transition probabilities, utilities and costs were obtained from published literature. Outcomes included rates of compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC) and liver-related death (LrD), total costs, life-years and quality-adjusted life-years (QALYs). Costs and QALYs were used to calculate incremental cost-effectiveness ratios.

Results: In GT1 patients, 3D?±?R and SOF-containing regimens have similar long-term outcomes; 3D?±?R had the lowest lifetime risks of all liver disease outcomes: CC =?30.2%, DCC = 5.0?%, HCC = 6.8%, LT =?1.9% and LrD =?9.2%. In GT1 patients, 3D?±?R had the lowest cost and the highest QALYs. As a result, 3D?±?R dominated these treatment options. In GT4 patients, 2D?+?R had lower rates of liver morbidity and mortality, lower cost and more QALYs than SOF/LDV and NT.

Limitations: While the results are based on input values, which were obtained from a variety of heterogeneous sources—including clinical trials, the findings were robust across a plausible range of input values, as demonstrated in probabilistic sensitivity analyses.

Conclusions: Among currently recommended treatments for GT1 and GT4 in the US, 3D?±?R (for GT1) and 2D?+?R (for GT4) have a favorable cost-effectiveness profile.     

Long-term health economic benefits of sensor-augmented pump therapy vs continuous subcutaneous insulin infusion alone in type 1 diabetes: a UK perspective

Aims/hypothesis:

Continuous subcutaneous insulin infusion (CSII) is an important treatment option for type 1 diabetes patients unable to achieve adequate glycemic control with multiple daily injections (MDI). Combining CSII with continuous glucose monitoring (CGM) in sensor-augmented pump therapy (SAP) with a low glucose-suspend (LGS) feature may further improve glycemic control and reduce the frequency of hypoglycemia. A cost-effectiveness analysis of SAP?+?LGS vs CSII plus self-monitoring of blood glucose (SMBG) was performed to determine the health economic benefits of SAP?+?LGS in type 1 diabetes patients using CSII in the UK.

Methods:

Cost-effectiveness analysis was performed using the CORE diabetes model. Treatment effects were sourced from the literature, where SAP?+?LGS was associated with a projected HbA_1c reduction of ?1.49% vs ?0.62% for CSII, and a reduced frequency of severe hypoglycemia. The time horizon was that of patient lifetimes; future costs and clinical outcomes were discounted at 3.5% and 1.5% per annum, respectively.

Results:

Projected outcomes showed that SAP?+?LGS was associated with higher mean quality-adjusted life expectancy (17.9 vs 14.9 quality-adjusted life years [QALYs], SAP?+?LGS vs CSII), and higher life expectancy (23.8 vs 21.9 years), but higher mean lifetime direct costs (GBP 125,559 vs GBP 88,991), leading to an incremental cost-effectiveness ratio (ICER) of GBP 12,233 per QALY gained for SAP?+?LGS vs CSII. Findings of the base-case analysis remained robust in sensitivity analyses.

Conclusions/interpretation:

For UK-based type 1 diabetes patients with poor glycemic control, the use of SAP?+?LGS is likely to be cost-effective compared with CSII plus SMBG.     

Experimental evidence that quorum rules discourage turnout and promote election boycotts

Many democratic decision making institutions involve quorum rules. Such rules are commonly motivated by concerns about the “legitimacy” or “representativeness” of decisions reached when only a subset of eligible voters participates. A prominent example of this can be found in the context of direct democracy mechanisms, such as referenda and initiatives. We conduct a laboratory experiment to investigate the consequences of the two most common types of quorum rules: a participation quorum and an approval quorum. We find that both types of quora lead to lower participation rates, dramatically increasing the likelihood of full-fledged electoral boycotts on the part of those who endorse the Status Quo. This discouraging effect is significantly larger under a participation quorum than under an approval quorum.     

Before ‘Independence’ Arrived: Interdependence in Energy Relations between Lithuania and Russia

This paper analyses energy relations concerning natural gas between Lithuania and Russia. Contrary to the existing literature, which stresses Lithuanian energy dependence, this paper argues that there had been interdependence between the two countries even before Lithuania underwent diversification at the end of 2014. The paper develops an analytical framework that examines: (a) physical energy relations, (b) the dominance of the energy agenda in mutual relations, and (c) the influence of the European Union. The analysis shows that while Lithuania was dependent on Russian supplies of natural gas, Russia was also dependent on Lithuania as a transit country of gas to Kaliningrad, a Russian enclave. Although Russia has shown a much higher willingness to employ an energy weapon than Lithuania, its efforts to exercise pressure on Lithuania have been negatively affected by the Baltic state’s position as a transit country. The European Union has played a crucial role as its pre-accession requirements and internal energy market rules have significantly influenced the energy relationship between the two countries.     

Identifying the Transition from Efficient-Market to Herding Behavior: Using a Method from Econophysics

We test whether “detrended fluctuation analysis” (DFA)—an econophysics method—identifies the transition from efficient-market trading to herding behavior and the rise of the NASDAQ dot.com stock market bubble. DFA divides a time series into “segments” of varying lengths and then tests whether power-law distributions exist within the segments. A power-law distribution of stock-price changes within a segment indicates herding behavior and the start of the dot.com bubble. The clarity of the transition indication depends on both segment lengths and segment starting dates. Our findings show that DFA can be used to identify the beginning of stock-market bubbles but not the beginning of crashes.     

Accounting for Skill Premium Patterns: Evidence from the EU Accession

In this article, we decompose the joint and individual contributions of tariff reductions, productivity changes and capital deepening to account for the skill premium patterns of the transition economies that joined the European Union (EU) in 2004. To conduct our accounting analysis, we construct an applied general equilibrium model with skilled and unskilled labor, and combining Social Accounting Matrices, Household Budget Surveys and the EU KLEMS Growth and Productivity Accounts database, we calibrate it to match Hungarian data, a transition economy where the skill premium consistently increased between 1995 and 2005. We find that capital deepening coupled with capital‐skill complementarity is the main force behind the rise in the skill premium.     

A New Approach to the Study of Jobless Recoveries

This article is concerned with the measurement of jobless recoveries and the elements that may explain their emergence. We first introduce a measure that maps the various elements that define a jobless recovery into a single number that we label the jobless recovery depth. We then construct a database of 389 state‐level observations and study the cross‐sectional variations that emerge. We find that jobless recoveries in the United States are not a nation‐wide phenomena, but a local event confined within a cluster of states that expands slowly between 1975 and 2015. We find the state‐level evidence to be consistent with theories that link jobless recoveries to unusually long expansionary periods, less dynamic labor markets, and the advent of the great moderation. The evidence is not consistent with theories that link them to decreases in union power, increases in income inequality, or increases in health care costs.     

What Do Central Banks Know about Inflation Factors?

We offer a novel methodology for assessing the quality of central bank monetary policy reports. We evaluate their economic content by comparing verbally reported inflation factors with factors identified from a simple new Keynesian model. Positive correlations indicate that the reported inflation factors were similar to the model-identified ones, marking high-quality inflation reports. Although sample bank reports on average identified inflation factors correctly, the degree of forward-looking reporting varied.