Economic impact of switching from metoprolol to nebivolol for hypertension treatment: a retrospective database analysis

Objective:

To estimate the real-world economic impact of switching hypertensive patients from metoprolol, a commonly prescribed, generic, non-vasodilatory β₁-blocker, to nebivolol, a branded-protected vasodilatory β₁-blocker.

Methods:

Retrospective analysis with a pre–post study design was conducted using the MarketScan database (2007–2011). Hypertensive patients continuously treated with metoprolol for ≥6 months (pre-period) and then switched to nebivolol for ≥6 months (post-period) were identified. The index date for switching was defined as the first nebivolol dispensing date. Data were collected for the two 6-month periods pre- and post-switching. Monthly healthcare resource utilization and healthcare costs pre- and post-switching were calculated and compared using Wilcoxon test and paired t-test. Medical costs at different years were inflated to the 2011 dollar.

Results:

In total, 2259 patients (mean age: 60 years; male: 52%; cardiovascular [CV] disease: 37%) met the selection criteria. Switching to nebivolol was associated with statistically significant reductions in the number of all-cause hospitalization (?33%; p?p?p?p?p?Conclusions:

This real-world study suggests that switching from metoprolol to nebivolol is associated with an increase in medication costs and significant reductions in hospitalizations and outpatient visits upon switching, resulting in an overall neutral effect on healthcare costs. These results may be interpreted with caution due to lack of a comparator group and confounding control caused by design and limitations inherent in insurance claims data.     

Clear,conspicuous, and concise: Disclosures and Twitter word-of-mouth

Regulatory bodies in the United States and the United Kingdom recently issued revised guidelines concerning the use of endorsements and testimonials in marketing efforts. Of specific interest within these guidelines is the disclosure of a material connection when brand communications are sent within social media platforms such as Twitter. The findings of quantitative and qualitative survey data analysis indicate that consumers may be misled by current disclosure conventions. Managerial implications, policy recommendations, and suggestions for future research are presented in light of these findings.     

Clio in the business school: Historical approaches in strategy,international business and entrepreneurship

On the back of recent and significant new debates on the use of history within business and management studies, we consider the perception of historians as being anti-theory and of having methodological shortcomings; and business and management scholars displaying insufficient attention to historical context and privileging of certain social science methods over others. These are explored through an examination of three subjects: strategy, international business and entrepreneurship. We propose a framework for advancing the use of history within business and management studies more generally through greater understanding of historical perspectives and methodologies.     

Partnership at work and worker participation: an NHS case study

This article considers issues of workplace union strategy in a study of a National Health Service hospital trust in which the focus of the investigation is the ‘employee voice’ gains, or losses, arising from partnership and worker participation. The impact of government policy on local management and, in turn, employees’ opportunities to participate in organisational decision making is therefore the main theme explored in this analysis.     

Promoting Efficient Rural Financial Intermediation

Although governments have traditionally used subsidized creditprograms to promote agricultural growth, this approach has generallyfailed to improve incomes and alleviate poverty in rural areas.It has also led to the mistaken belief that rural credit programscannot be profitable. A new approach seeks to raise standardsof living in rural areas by casting the government in a veryd role—one of setting a favorable legal andpolicy environmentfor rural financial markets and addressing spec market failurescost effectively through well-designed and self-sustaining interventions.There is evidence that this approach can be highly successful.The Village Bank system of Bank Rakyat Indonesia has shown thatfinancial services can be extended to millions of low-incomerural clients without relying on subsidies. Indeed, the programhas generated enormous profits for the bank by using simple,innovative, and largely replicable techniques.      

TRENDS IN INEQUALITY USING CONSUMPTION-EXPENDITURES: THE U.S. FROM 1960 TO 1993

While much of the evidence suggests that there was an increase in inequality in the U.S. during the 1980s, the reasons are less evident. Using the U.S. Consumer Expenditure Survey data, we find that the inequality of consumption-expenditures, as well as the inequality of other measures of resources, widened considerably during the 1980s. While previous studies suggest that increasing inequality is mainly due to increases in within group inequality, we show that by decomposing inequality by the interaction of family type and education almost three-fourths of the increase in inequality is accounted for by changes in inequality between groups and by shifts in the population.     

Optimal fiscal and monetary policy under sticky prices

This paper studies optimal fiscal and monetary policy under sticky product prices. The theoretical framework is a stochastic production economy. The government finances an exogenous stream of purchases by levying distortionary income taxes, printing money, and issuing nominal non-state-contingent bonds. The main findings of the paper are: First, for a miniscule degree of price stickiness (i.e., many times below available empirical estimates) the optimal volatility of inflation is near zero. Second, small deviations from full price flexibility induce near random walk behavior in government debt and tax rates. Finally, price stickiness induces deviation from the Friedman rule.     

Determinants of the levels and changes in non‐executive director compensation

This study examines the economic and director‐specific determinants of non‐executive director (NED) compensation in the Australian setting. We find that NED compensation is associated with firm size, complexity, growth, risk and liquidity. It is also associated with director reputation, experience, connectedness and the directors' involvement with the firm. The additional compensation paid to the chairperson is positively associated with their prior experience and negatively associated with NED reputation and involvement. We find inconclusive evidence on the association between changes in NED compensation and firm performance.