A budget impact analysis of budesonide/formoterol in patients with mild asthma in Egypt

Abstract

Background: The aim of this study is to estimate the budget impact of budesonide/formoterol fixed dose combination (FDC) vs salbutamol, both used as needed, in mild asthma patients, from the perspective of the Health Insurance Organization (HIO).

Methods: A static budget impact model was developed to assess the impact of budesonide/formoterol FDC entry on HIO budget over a 3-year period in Egyptian settings. Direct medical costs, including the costs of asthma medications, exacerbations, and management of side-effects, were obtained from HIO cost data. Population data were obtained from the World Bank and supplemented with local studies, and the rates of exacerbations, adverse effects, and number of sick leave days were elicited from the SYGMA 1 trial. Scenario analyses from a societal perspective and deterministic sensitivity analyses were conducted.

Results: The total costs (drug and non-drug costs) for managing mild asthma patients from the HIO perspective were estimated to be EGP8.563 billion before budesonide/formoterol entry compared to EGP5.525 billion post-entry, leading to a total budget savings of EGP3.038 billion after 3?years. This total budget saving included an increase in drug costs (EGP104 million) and a decrease in non-drug costs (EGP3.143 billion). Drug costs were higher in the budesonide/formoterol group than in the salbutamol group, but this cost was offset by reductions in non-drug costs, resulting in a reduction in the total costs of healthcare resources. At the societal level, the total budget savings after including the indirect costs was expected to be EGP5.976 billion after 3?years of budesonide/formoterol entry.

Conclusion: Budesonide/formoterol in mild asthma instead of salbutamol produces better patient outcomes and decreases total costs, with increases in drug cost offset by reductions in non-drug costs due to fewer exacerbations. Budesonide/formoterol is a budget saving option for guideline-directed treatment, from the economic perspective of the payer and the health perspective of the patient.     

Differences in consumer price knowledge between Germany and Finland

Abstract

Price knowledge studies are a key to understanding behavioural pricing strategies. Consumer price knowledge is an ongoing concern in the literature. It is also generally acknowledged that price awareness is subject to cross-cultural differences. This is important because the retailer market is dominated by global players who use standardized marketing-mix instruments. However, there are no studies about price knowledge between countries. This study examines differences in price knowledge between German and Finnish consumers. The results show that Finnish consumers were able to give at least some price estimate for a product more often, but the estimates of German consumers were more accurate. Due to data limitations of our study more research is needed about cross-cultural price knowledge.     

The ‘amelioration’ of child labor, ‘a modest proposal’

More than 317 million children between the age of 5 and 17 are working in the world. Child labor is a persistent phenomenon, even though its incidence has subsided with economic development. In this paper, we conduct a panel study of 101 countries from 1980 to 2004 where child labor is proxied by the labor force participation of children aged 10–14. We look at the relationships between child labor and investments in human capital, foreign direct investments, countries’ openness to trade, and credit market constraints. We depart from the contributions of cross-country studies by employing a fixed effects instrumental variable (FE-IV) panel data model by employing a fixed effects instrumental variable (FE-IV) panel data model to account for unobserved heterogeneity and endogeneity of child labor and individual country-specific effects. We find support for the conclusions of the above-mentioned studies: countries that trade more and have a higher stock of foreign direct investment have less child labor. More generally, we find that trade openness, investments in human capital, and financial development are associated with a reduction of child labor. Child labor persists but tailored policies on trade, investment, and financial reform can lessen child labor along with economic growth, improvements in health, and rising standards of living.     

Trade protection and tax evasion: Evidence from Kenya,Mauritius, and Nigeria

We examine the effect of trade protection rates on evasion in three African countries Kenya, Mauritius, and Nigeria. In capturing the effect of trade protection on tariff evasion, we use a much improved measure of trade protection (MAcMap-HS6 2001 and 2004). For two of these countries, this dataset allows the novelty of using variation in trade protection across product, time, and trading partners leading to significantly refined estimates of evasion elasticity relative to existing studies on tariff evasion. We find a robust evidence for positive elasticity of evasion with respect to tariffs in Kenya and Nigeria with relatively weaker evidence for Mauritius. Our results match the rankings of countries in institutional quality. Greater responsiveness of evasion to the level of tariffs is established in Nigeria (comparatively weak institutional quality) vis-à-vis Kenya, and in Kenya vis-à-vis Mauritius (comparatively good institutional quality). This pattern is preserved even when focusing on same set of trading partners and same set of imported products for the three countries. This result is robust to controlling for protection on related products (that creates incentives/ opportunities for evasion) and also for degree of differentiation of the product and some other characteristics.     

SME growth in the service sector: A taxonomy combining life-cycle and resource-based theories

The approach to the life-cycle theory has been used as an analytical tool of the firms' growth. Several researchers argue that organisations move across several development stages where different problems are found resulting from different management styles and priorities, and resources. This research aims to develop an empirical taxonomy of small medium enterprise (SME) growth in the service sector based on life-cycle and resource-based theories. The data were submitted to bivariate and multivariate analyses to develop and test an empirical life-cycle model. It was possible to conclude that the firms could be clustered in three life-cycle stages. Some implications and future researches are addressed.     

Investigating the persuasive impact and underlying processes of interactive magazine ads in a real-life setting

ABSTRACT

This study tests a theoretical framework to explain the persuasive impact of interactive magazine ads on consumers’ ad and brand attitudes. To obtain realistic (unforced) responses, a field experiment was conducted with a one-factor (interactive vs. non-interactive magazine ad) between-subjects design (N = 98). Results showed that, although they rarely used it, participants positively evaluated the presence of an interactive feature in a digital magazine ad. Furthermore, parallel-mediation analyses revealed that the interactive magazine ad was perceived as more interactive and more surprising than the non-interactive ad, which ultimately positively impacted consumers’ attitudes towards the magazine. A second real-life setting experiment (N = 121) confirmed and extended these findings by revealing that the mediation effects were even stronger when consumers had used the interactive feature (vs. only seen). In addition, the relationship between interactive magazine ads and consumers’ attitudinal responses was explained slightly better by ‘perceived surprise’ than by ‘perceived interactivity.’     

Framing social marketing as a system of interaction: A neo-institutional approach to alcohol abstinence

Abstract

We employ Giddens’ structuration theory to gain insights into the interaction between upstream/midstream and downstream social marketing perspectives. This is conducted through thirteen phenomenological interviews with informants who stand outside of the practice of alcohol consumption through their voluntary engagement in one month of sobriety. Our study identifies the ‘modalities’ located at the intersection between individual actions and the institutions of alcohol. By identifying these ‘modalities’, we conceptualise social marketing in interaction, which incorporates the institutional orders of domination, signification and legitimation, and the individual actions of power, communication and sanction. Specific domains of interventions are identified, namely marketplace offerings and promotional techniques, social grouping and positional status and rituals and traditions, through which social marketers can enact social change.     

Impact of firm heterogeneity on direct and spillover effects of FDI: Micro-evidence from ten transition countries

This paper presents a comparative study of the importance of direct technology transfer and spillovers through FDI on a set of 10 transition countries, using a common methodology and appropriate methods to account for selection and simultaneity correction. This paper considers by far the largest firm level dataset (more than 90,000 firms) used by any study on the spillover effects of FDI. The main novelty of the paper is the explicit control for various sources of firm heterogeneity when accounting for different effects of FDI on firm performance. This work shows that the heterogeneity of firms in terms of absorptive capacity, size, productivity and technology levels affect the results. Controlling for these variables leads to some interesting results, which contrast with the previous empirical work in the field. We find that horizontal spillovers have become increasingly important over the last decade, and they may even become more important than vertical spillovers. Positive horizontal spillovers are equally distributed across size classes of firms, while negative horizontal spillovers seem to be more likely to accrue to smaller firms. Moreover, positive horizontal spillovers seem more likely to be present in medium or high productivity firms with higher absorptive capacities, while negative horizontal spillovers are more likely to affect low to medium productivity firms. These findings suggest that both direct effects from foreign ownership as well as the spillovers from foreign firms substantially depend on the absorptive capacity and productivity level of individual firms. In addition, these results show that foreign presence may also affect smaller firms to a larger extent than larger firms, but this impact may be in either direction.     

Assessing the nonlinear nature of the effects of R&D intensity on growth of SMEs: a dynamic panel data approach

Based on a sample of Portuguese SMEs for the period 1999–2006 and using two step estimation, namely probit regressions and dynamic estimators, this study makes two important contributions to the literature: (i) identification of a quadratic relationship between R&D intensity and SME growth that takes the form of a U, and so R&D intensity is a stimulating factor of SME growth for high levels of R&D intensity; being a restrictive factor of SME growth for low levels of R&D intensity; and (ii) the growth of SMEs seems to be dependent on the nonlinear effects associated with distinct levels of R&D intensity. The nonlinear effects identified suggest that Portuguese SMEs with high levels of R&D intensity more easily find an efficiency scale and are more dependent on internal financing and short-term debt as sources for funding growth, compared to the case of Portuguese SMEs with lower levels of R&D intensity.     

Measures of departure from symmetry

Abstract

1. Many different measures of skewness have been proposed. The textbook of Albert Waugh ¹ Elements of Statistical Method. New York and London 1938. for instance presents six different measures of skewness. Other measures of skewness have been proposed by Lindeberg ² Skandinavisk Aktuarietidsskrift. Vol. 7. (1925) p. 106. and Lenz ³ Erna Weber: Einführung in die Variations- nnd Erblichkeitsstatistik. München 1935. p. 92. . All these measures are zero when the distribution is symmetric, but any of them may be zero also when the distribution is unsymmetric. I shall here present some measures of skewness which are zero when and only when the distribution is symmetric.