A budget impact analysis of lenalidomide in multiple myeloma Egyptian patients

Abstract

Introduction

The aim of this study was to estimate the budget impact of lenalidomide and dexamethasone (RD) versus bortezomib, cyclophosphamide and dexamethasone (VCD) in newly diagnosed multiple myeloma (NDMM) and relapsed refractory (RR) MM patients, from the perspective of the Egyptian Ministry of health (MoH).     

Cost-effectiveness of sorafenib versus best supportive care in advanced hepatocellular carcinoma in Egypt

Background: In light of constrained budgets and the need to fund efficient treatment options, this study set out to assess the cost-effectiveness of sorafenib as a first-line treatment of hepatocellular carcinoma (HCC) compared to best supportive care (BSC) from the military hospital perspective in Egypt.

Methods: A decision analytic Markov model simulated disease progression with clinical parameters and utility values derived from published data. Data on direct medical costs were collected from the local healthcare system or payer. Costs and effects were discounted at 3.5% annually and reported in USD using purchasing power parity adjustments. Deterministic and probabilistic sensitivity analyses were conducted.

Results: Mortality occurred less frequently in the sorafenib group (sorafenib group: 99.96%, BSC group: 99.99%). The total quality-adjusted life years (QALYs) of the sorafenib cohort were estimated to be 46.24 compared with 42.27 for the BSC cohort, which resulted in an incremental gain of 3.96 QALYs. The total costs for the sorafenib and BSC cohorts were USD 4,229,940 and USD 3,092,886, respectively (incremental cost = $1,137,054), resulting in an incremental cost-effectiveness ratio (ICER) of USD 286,776 per QALY gained for the sorafenib cohort. One-way sensitivity analyses that addressed the uncertainty of the BSC estimates indicated that the progression-free survival for BSC and utility value of progression had the greatest effects on the results.

Conclusion: This study concluded that sorafenib does offer increased survival and quality-of-life at an increased cost but at an ICER that exceeds the nationally accepted cost-effectiveness threshold. The findings support healthcare decision-making of the efficient allocation of healthcare system resources to improve the health of the Egyptian population. Whether sorafenib is cost-effective in specific sub-groups with additional risk factors needs to be addressed in future studies.     

The Gilt-Equity Yield Ratio and the Predictability of UK and US Equity Returns

A number of financial variables have been shown to be effective in explaining the time-series of aggregate equity returns in both the UK and the US. These include, inter alia , the equity dividend yield, the spread between the yields on long and short government bonds, and the lagged equity return. Recently, however, the ratio between the long government bond yield and the equity dividend yield – the gilt-equity yield ratio – has emerged as a variable that has considerable explanatory power for UK equity returns. This paper compares the predictive ability of the gilt-equity yield ratio with these other variables for UK and US equity returns, providing evidence on both in-sample and out-of-sample performance. For UK monthly returns, it is shown that while the dividend yield has substantial in-sample explanatory power, this is not matched by out-of sample forecast accuracy. The gilt-equity yield ratio, in contrast, performs well both in-sample and out-of-sample. Although the predictability of US monthly equity returns is much lower than for the UK, a similar result emerges, with the gilt-equity yield ratio dominating the other variables in terms of both in-sample explanatory power and out-of-sample forecast performance. The gilt-equity yield ratio is also shown to have substantial predictive ability for long horizon returns.     

Inflation and Economic Growth: Evidence from the Southern African Development Community

In this paper, we investigate the role of inflation rates in determining economic growth in 15 sub‐Saharan African countries, which are all members of the Southern African Development Community, between 1980 and 2009. The results, based on panel time‐series data and analysis (we use the fixed effects and fixed effects with instrumental variables estimators to account for heterogeneity and endogeneity in thin panels), suggest that inflation has had a detrimental effect to growth in the community. We highlight that inflation has offset the Mundell–Tobin effect and consequently reduced the much needed economic activity in the community, and also the importance of an institutional framework conducive to a stable macroeconomic environment as a precondition for development and prosperity in the community.     

The Difference a Smile Makes: Effective Use of Imagery by Children’s Nonprofit Organizations

ABSTRACT

Which emotions are most appealing to donors in nonprofit outreach materials? Previous studies have shown that in print and television materials, images depicting negative emotions lead to increases in donor response. In this study, we examined whether images of negative affect in children in social media appeals lead to increased information sharing compared to positive or neutral images of children. We analyzed Facebook posts from 2016 from 2 large children’s nongovernmental organizations, UNICEF USA and Save the Children US, and examined the relationship between the type of emotion in the image and the number of likes, comments, and shares that the post received. We found differences in the responses according to the organization sending the message and the affect of the children depicted. For Save the Children US, negative images, specifically sad and fearful images, generated significantly more likes, shares, and comments. For UNICEF USA, there was no difference in information sharing for positive, neutral, or negative images. Findings from this study demonstrate that negative emotional imagery of children can affect social media engagement with nongovernmental organizations, but this effect appears to be inconsistent.     

Applications of the behavioural homogeneity evaluation framework: The predictive ability of consumer involvement for international food market segmentation

Abstract

This article proposes a framework of alternative international marketing strategies, based on the evaluation of intra- and inter-cultural behavioural homogeneity for market segmentation. The framework developed in this study provides a generic structure to behavioural homogeneity, proposing consumer involvement as a construct with unique predictive ability for international marketing strategy decisions. A model-based segmentation process, using structural equation models, is implemented to illustrate the application of the framework.     

Do we need a global VAR model to forecast inflation and output in South Africa?

This study determines whether the global vector autoregressive (GVAR) approach provides better forecasts of key South African variables than a vector error correction model (VECM) and a Bayesian vector autoregressive (BVAR) model augmented with foreign variables. The article considers both a small GVAR model and a large GVAR model in determining the most appropriate model for forecasting South African variables. We compare the recursive out-of-sample forecasts for South African GDP and inflation from six types of models: a general 33 country (large) GVAR, a customized small GVAR for South Africa, a VECM for South Africa with weakly exogenous foreign variables, a BVAR model, autoregressive (AR) models and random walk models. The results show that the forecast performance of the large GVAR is generally superior to the performance of the customized small GVAR for South Africa. The forecasts of both the GVAR models tend to be better than the forecasts of the augmented VECM, especially at longer forecast horizons. Importantly, however, on average, the BVAR model performs the best when it comes to forecasting output, while the AR(1) model outperforms all the other models in predicting inflation. We also conduct ex ante forecasts from the BVAR and AR(1) models over 2010:Q1–2013:Q4 to highlight their ability to track turning points in output and inflation, respectively.     

Salesforce decisions: A Markovian approach

This paper reports on the development, application, and evaluation of a Markov model used for macro sales force planning and control. The model portrays the succession of levels of sales force members from application to join the sales force, through all possible states, including possibilities of termination due to promotion, firing, and voluntary departures. The impact of several decision states such as recruiting, promotion, and training are then assessed, and the implications are evaluated through the use of the data from two large pharmaceutical firms. Several uses of the model are illustrated and the impact of managerial decisions on costs and profits are shown. The uses of the model for sales force design are also discussed.