Cost-utility of albiglutide versus insulin lispro,insulin glargine,and sitagliptin for the treatment of type 2 diabetes in the US

Objective To compare the cost-utility of the glucagon-like peptide-1 receptor agonist albiglutide with those of insulin lispro (both in combination with insulin glargine), insulin glargine, and the dipeptidyl peptidase-4 inhibitor sitagliptin, representing treatments along the type 2 diabetes treatment continuum.

Methods The Centre for Outcomes Research and Effectiveness (CORE) Diabetes Model was used for the cost-utility analysis. Data from three Phase 3 clinical trials (HARMONY 6, HARMONY 4, and HARMONY 3) evaluating albiglutide for the treatment of patients with type 2 diabetes were used for the baseline characteristics and treatment effects. Utilities and costs were derived from published sources.

Results Albiglutide treatment was associated with an improvement in mean quality-adjusted life expectancy of 0.099, 0.033, and 0.101 years when compared with insulin lispro, insulin glargine, and sitagliptin, respectively. Over the 50-year time horizon, mean total costs in the albiglutide arm were $4332, $2597, and $2223 more than in the other respective treatments. These costs resulted in an incremental cost-utility ratio of $43,541, $79,166, and $22,094 per quality-adjusted life-year (QALY) gained for albiglutide vs insulin lispro, insulin glargine, and sitagliptin, respectively. At a willingness-to-pay threshold of $50,000 per QALY gained, there was a 53.0%, 41.5%, and 67.5% probability of albiglutide being cost-effective compared with the other respective treatments.

Limitations This analysis was an extrapolation over a 50-year time horizon based on relatively short-term data obtained during clinical trials. It does not take into account potential differences between the respective treatments in adherence and persistence that can influence both effects and costs.

Conclusions Albiglutide represents a reasonable treatment option for patients with type 2 diabetes based on its cost-utility, relative to insulin lispro, insulin glargine, and sitagliptin.     

Customer equity management as formative second-order construct

Despite intensive discussions about customer equity, little research addresses how to manage customer equity from a firm's perspective. Recent literature proposes various concepts of customer equity management but does not feature an empirical study that identifies and quantifies activities that aim explicitly to maximize customer equity. In the current study, the authors develop a formative measurement instrument for customer equity management as a second-order construct that indicates how intensively firms orient their customer management toward customer value and equity. The study presents a complete process for conceptualizing and operationalizing a formative second-order construct, including a thorough literature review, intensive qualitative research, and a quantitative study with 92 customer equity managers. On the basis of this process, the authors model customer equity management as a function of three formative dimensions - customer equity analysis, customer equity strategy, and customer equity actions - measured by several formative indicators. The resulting formative operationalization satisfies the criteria for evaluating formative indexes.     

A transformative service research agenda: a study of workers’ well-being

Interest in workers’ well-being is mounting – a key driver being the growing recognition that well-being is linked to performance. Utilizing a transformative service research (TSR) agenda, this study examines how people management practices impact the well-being of hospitality and retail workers. Comparing the experiences of permanent and precarious workers, we find it is not employment practices per se that promulgate feelings of insecurity and inferiority; rather, it is the attributions ascribed to them. This has practical implications. Most notably, some of the deleterious effects of precarious employment might be mitigated where careful attention is paid to the motives underlying an organization’s people management practices. Theoretically, TSR offers a more expansive lens for understanding the social exchange occurring in both employment relationships and service encounters, thus contributing significantly to knowledge on mutual gains theories. These findings and their implications are discussed in detail in the paper.     

Patients’ preferences for the treatment of anxiety and depressive disorders: a systematic review of discrete choice experiments

Abstract

Introduction: Matching available mental health services to patients’ preferences, as well as is possible, may increase patient satisfaction and help increase adherence to certain treatments. This study systematically reviewed discrete-choice experiments (DCEs) on patients’ preferences for treatment of depressive and anxiety disorders and assessed the relative importance of outcome, process and cost attributes to improve the current and future treatment situations.

Methods: A systematic literature review using PubMed, EMBASE and PsychInfo was conducted to retrieve all relevant DCEs published up to 15 April 2019, eliciting patient preferences for treatment of depressive and anxiety disorders. Data were extracted using an extraction sheet, and attributes were classified into outcome, process and cost attributes. The relative importance of each attribute category was then assessed, and studies were evaluated according to their reporting quality, using validated checklists.

Results: A total of 11 studies were identified for qualitative analysis. All studies received an aggregate score of 4 on the five-point PREFS checklist (Purpose, Respondents, Explanation, Findings and Significance). Most attributes were outcome related (52%), followed by process (42%) and cost (6%) attributes. Comparing the attribute categories and summing up the relative importance weights for each category within the studies, process attributes were ranked as most important, followed by cost and outcome attributes.

Conclusions: In this systematic review, heterogeneous results were observed regarding the inclusion and framing of different attributes across studies. Overall, patients considered process and cost attributes to be more important than outcome attributes. Outcomes and process are important for patients, and thus clinicians should be particularly aware of this and take patients’ preferences into account, although the attribute importance may depend on chosen attributes and related levels.     

Venture Idea Assessment (VIA): Development of a needed concept,measure, and research agenda

To address challenges constraining prior research on evaluation of entrepreneurial projects, we develop the concept of Venture Idea Assessment (VIA) and validate an instrument to capture it. VIA concerns the assessment of Venture Ideas (VI) unbundled from assessment of any agents with whom they may be associated. The assessment can be performed by anybody at any stage of the venture development process, not just by potential founders at its outset. We develop and validate a parsimonious VIA measure across six empirical studies using a broad set of assessors and VIs using interviews, experiments and surveys following real-world start-up processes and decisions. In a research agenda we outline how the VIA platform—the concept and its operationalization—can be employed in novel research across various streams of entrepreneurship research.     

Small business tax policy and informality: evidence from Georgia

Using a panel of administrative data and regression discontinuity analysis, this paper examines how the introduction of preferential tax regimes for Georgian micro- and small businesses in 2010 affected formal firm creation and tax compliance. The results show that the new tax regime for micro-businesses increased the number of newly registered firms by 27–41 % below the eligibility threshold during the first year of the reform, but not in subsequent years. We do not find an effect of the new tax regime for small businesses on formal firm creation in any year. Policy makers are often also concerned about abuse risks stemming from differentiated tax treatment of micro- and small businesses. The analysis in this paper reveals reduced tax compliance among small taxpayers for multiple years after the reform and among micro-business taxpayers only during the first year of the reform.     

Gender differences in the impact of banking services: evidence from Mexico

This paper examines the effects of providing financial services to low-income individuals on entrepreneurial activity, employment, and the income levels of men and women. We exploit cross-time and cross-municipality variation in the opening of Banco Azteca in Mexico to measure these effects with a difference-in-difference strategy. This bank opened over 800 branches simultaneously in 2002, focusing on low-income clients. Our results show that this led to an increase in the number of informal business owners among men and to an increase in wage-earning opportunities for women. Average income levels also increased, with this increase being twofold higher for women than for men.     

Collecting Event Histories with TrueTales:Techniques to Improve Autobiographical Recall Problems in Standardized Interviews

This article deals with the challenges autobiographical recall processes present to validity of events and their dates in the collection of life histories in standardized interviews. Effective interviewing techniques should support the idiosyncratic cognitive structure and the reconstructive memory processes of autobiographical memory by allowing to flexibly explore the interconnections between memories. We describe the techniques and strategies of interviewing and data recording used in the German Life History Study, namely modularization, forward recall and single case data edition. We introduce TrueTales, a CATI- Program designed to support memory and communication in the interview, and results of its experimental evaluation. TrueTales personalizes instructions, questions and probes and permits controlled flexibility in dealing with individual biographies and recall strategies. Working with a calendar-based time-line, it yields more complete, consistent and valid event histories. Finally, we discuss implications for standardized interviewing practices and the concept of standardization.