Preferences for improvements in attributes associated with basal insulin: a time trade-off and willingness-to-pay survey of a diabetic and non-diabetic population in Sweden

Objective: Apart from improved health outcomes, treatment convenience per se may have a value to individuals. This is sometimes referred to as process utility and can be estimated in terms of willingness-to-pay (WTP) or quality-adjusted life-years (QALYs). Previous research has produced multiple studies on QALY gains and WTP estimates of insulin-related attributes. There are, however, significant variations between studies, and it is not clear to what extent the value is a reflection of the true preferences or a consequence of the methodological approach. The aim of this study is to estimate the preferences for treatment attributes associated with basal insulin (administration frequency, administration flexibility, and treatment-induced weight gain) using both QALYs—elicited using time trade-off (TTO) and WTP—among a sample of the Swedish general population and among a sample of the Swedish diabetes population.

Methods: Data was collected using web-based surveys which were distributed to members of internet panels. The WTP survey presented five hypothetical scenarios with an offer to pay the incremental cost to receive basal insulin with improved attributes. The TTO survey presented six hypothetical scenarios where the respondent could choose between living for the rest of his/her life with diabetes and receiving treatment with a basal insulin with certain attributes or live for a shorter time with full health. The scenarios were combined with either a basal or a basal–bolus treatment regimen. Results from the TTO analysis were translated into monetary estimates using a threshold value of SEK500,000 per QALY.

Results: In total, 2012 responses were included. The ratings of the attributes were almost identical, irrespective of method for the general population, while it differed to some extent for the diabetes population. The methods produced the same value for flexibility, but the estimates generated with the TTO approach were higher for one less injection and avoided weight gain. The general population assigned a higher utility gain to convenience attributes, while the diabetes population assigned a higher utility gain to avoiding weight gain.

Limitations: About a quarter of the respondents did not accept the scenario in the WTP survey, i.e. protesters.

Conclusions: The ranking of the attributes was generally independent of evaluation method, but the TTO method resulted in similar or higher values compared to the WTP method.     

A European view on the legitimacy of accounting procedures: Towards a deliberative-accountability framework for analysis

Accounting rules affect fundamental areas of social interaction encompassing groups that have diverse and conflicting interests regarding financial reporting. In the absence of a coherent social choice theory, concepts of legitimacy can be used to assess the acceptance of accounting standard-setting processes and their resulting norms. In this paper, we analyze the standard-setting process in Europe. Accounting rules in Europe are developed in a two-stage process involving both private standard-setting and public rule-making. From a structural perspective, the European Union (EU) is well positioned to develop legitimate accounting procedures. However, the original purpose and the ensuing legitimacy of its control mechanism are jeopardized when EU structures are used and sometimes abused for policy formation and the creation of EU-IFRS.     

Test–Retest Reliability of Choice Experiments in Environmental Valuation

The paper presents the results of the first test–retest study on choice experiments in environmental valuation. In a survey concerning landscape externalities of onshore wind power in central Germany, respondents answered the same five choice sets at two different points in time. Each choice set comprised three alternatives described by five attributes, and the time interval between the test and the retest was eleven months. The analysis takes place at three different levels, investigating choice consistency at the choice task level and repeatability of the latent construct utility at the level of parametric models as well as at the level of willingness-to-pay estimates. At the choice task level we observed 59?% identical choices. The parametric analysis shows that the test and retest estimates are not equal, even when we control for scale, that is, differences in the error variance. However, comparing the marginal willingness-to-pay estimates among test and retest reveals only a statistically significant difference for one of the attributes. Overall, this indicates a moderate test–retest reliability taking into account that consistency at the choice task level overlooks the stochastic nature of the process underlying discrete choice experiments.     

Predicting monetary policy with federal funds futures prices

In theory, prices of current‐month federal funds futures contracts should reflect market expectations of near‐term movements in the federal funds rate and thus the Federal Reserve's funds rate target. This article shows that futures‐based proxies for funds rate expectations have weak predictive power for the average funds rate using daily data but are more successful in predicting the average funds rate and the funds rate target around target changes and meetings of the Federal Open Market Committee. However, the futures‐based expectations have a systematic bias related to the last days of the month and, in particular, calendar months. © 2001 John Wiley & Sons, Inc. Jrl Fut Mark 21:377–391, 2001     

Measuring to understand intangible performance drivers

The present qualitative study explores what eleven Swedish organizations have systematically worked at to increase the understanding of the importance of intangibles as performance drivers. The present analysis is accomplished using a combination of evolutionary theory, knowledge-based theory and organizational learning. The results indicate that assets in an accounting sense seem to be of less interest than perceptions of activities that enable future performance. These “enablers” are often customer and employee perceptions of individual, organizational and relational competence. The way for the firms to ascertain a continuous organizational learning process with respect to the value creation chain is to measure intangibles as well as to maintain organizational routines that ensure the transformation of measurement results into action.     

The strategic impact of external networks: subsidiary performance and competence development in the multinational corporation

This paper explores the importance of relational embeddedness in external networks as a strategic resource for performance and competence development in multinational corporations (MNCs). Two different types of relational embeddedness at the subsidiary level—business embeddedness and technical embeddedness—are proposed to have an influence on the subsidiary's market performance as well as its importance for competence development in the MNC. Using data on 97 Swedish MNC subsidiaries, five hypotheses are tested in a LISREL model analysis. The results suggest that technical embeddedness has a positive impact on both the subsidiary expected performance and its role in the development of products and production processes in the MNC. Indirectly, through external technical embeddedness, external business embeddedness also influences the sister units' product and process development and subsidiary market performance. Copyright © 2002 John Wiley & Sons, Ltd.     

On heterogeneity in non-life insurance. Part II

Abstract

Extract

While in some linear estimation problems the principle of unbiasedness can be said to be appropriate, we have just seen that in the present context we will have to appeal to other criteria. Let us first consider what we get from the maximum likelihood method. We do not claim any particular optimum property for this estimate of the risk distribution: it seems plausible however that one can prove a large sample result analogous to the classical result on maximum likelihood estimation.