Background: Non-vitamin K antagonist oral anticoagulants (NOACs) have been included in international guidelines as important alternatives to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (NVAF). Meanwhile, in the Netherlands, NOACs are widely used next to VKAs. The objective of this study is to estimate the cost-effectiveness of treatment with rivaroxaban compared to VKAs in NVAF and VTE patients in the Netherlands, using data from international prospective observational phase IV studies.
Methods: Two models were developed to represent NVAF and VTE patients, populated with patients from the XANTUS (NCT01606995) and XALIA (NCT01619007) international prospective observational studies. The 1-year cost-effectiveness of rivaroxaban use, compared to VKAs, was explored in a population consisting of NVAF and VTE patients (base case) as well as for four scenarios with sub-populations: NVAF patients only, VTE patients only, NVAF patients with unstable international normalized ratio (INR), and NVAF patients using an INR self-measuring device.
Results: In the base case, rivaroxaban saved €72,350 and gained 21 quality-adjusted life-years (QALYs) in a simulation of 2,000 patients over the use of VKAs. Ergo, rivaroxaban was dominant over VKAs. The probabilistic sensitivity analysis showed a probability of 85% for rivaroxaban being dominant and 100% at a willingness-to-pay threshold of €20,000/QALY. Rivaroxaban appeared to be dominant in all scenarios as well, except for the NVAF-patients-only scenario where the incremental cost-effectiveness ratio (ICER) was €157/QALY.
Conclusions: In patients with NVAF or VTE, rivaroxaban treatment is likely to be cost-effective and a potentially cost-saving alternative to VKA in the Netherlands. 相似文献
It is well documented that individuals do not spend the Supplemental Nutrition Assistance Program (SNAP) benefits smoothly over the month after receipt. Rather, recipients spend a disproportionate share of benefits at the beginning of the benefit month. This has costs for recipients and stores. There is also evidence that other income streams, such as Social Security and paychecks, are not spent smoothly. The presence of these other income streams may bias estimates of the effects of this SNAP cycle on consumption for working SNAP beneficiaries and those who receive other government benefits. We use data from United States Department of Agriculture's National Household Food Acquisition and Purchase Survey to explore how the SNAP cycle is affected by accounting for these other income streams. We find suggestive evidence that the cycle is more pronounced for workers who are paid on a weekly or monthly basis, but little evidence that cycles in other income streams mitigate or exacerbate the SNAP cycle. 相似文献
Gentrification in China is intertwined with urban redevelopment, which causes the large‐scale displacement of rural–urban migrants from ‘villages in the city’ (ViCs). Because of the informality of ViCs, migrant renters have very insecure tenancy and during redevelopment they are treated as a negligible (‘invisible’) social group. As they are very difficult to locate after displacement, they are also literally invisible to researchers. To make the invisible visible, this study traced a sample of displaced migrants from Huangbeiling village in Shenzhen. The focus was on the displacement process and on identifying the consequences for the displaced. We found various forms of displacement during the redevelopment process. Nearby ViCs were prioritized by displaced migrants to minimize as much utility loss as possible. However, they generally suffer from decreased proximity, increased living costs, and the loss of social networks and job opportunities. Remarkably, some choose to return to the gentrifying village, enduring displacement in situ caused by increasing rents, drastic physical neighbourhood changes and declining liveability, in exchange for retaining their original social and economic networks. Large‐scale urban redevelopment is causing the rapid shrinkage of informal housing. Recognizing and addressing the housing needs of this impoverished social group is a matter of urgency. 相似文献
I explain the ubiquitous use of graduated punishments by studying a repeated public good game in which a social planner imperfectly monitors agents to detect shirkers. Agents’ cost of contributing is private information and administering punishments is costly. Using graduated punishments can be optimal for two reasons. It increases the price of future wrongdoing (temporal spillover effect) and it can lead to bad types revealing themselves (screening effect). The temporal spillover effect is always present if graduated punishments prevail, but screening need not occur if agents face a finite horizon. Whether or not a screening effect is exploited has a substantial impact on both outcomes and actual punishments. If the temporal spillover effect is sufficiently strong, then first‐time shirkers are merely warned. 相似文献
Meta-analysis has become the conventional approach to synthesizing the results of empirical economics research. To further improve the transparency and replicability of the reported results and to raise the quality of meta-analyses, the Meta-Analysis of Economics Research Network has updated the reporting guidelines that were published by this Journal in 2013. Future meta-analyses in economics will be expected to follow these updated guidelines or give valid reasons why a meta-analysis should deviate from them. 相似文献
AbstractHR managers have different beliefs about the nature, value, and instrumentality of talent—referred to as ‘talent philosophies’. In line with cognitive psychology, we reason that talent philosophies are similar to mental models that influence how HR managers interpret and use talent management (TM) practices within their organizations. In this article, we explore the prevalence of four different talent philosophies (exclusive/stable; exclusive/developable; inclusive/stable; inclusive/developable) in a sample of 321?HR managers. We then explore how talent philosophies relate to organizational context (i.e. size, ownership form, multinational orientation) as well as to HR managers’ perceptions of their organization’s TM practices. Cluster analysis corroborated the presence of the four talent philosophies in our dataset. All four talent philosophies were represented almost equally often in the overall dataset. Organizational size was found to be related to talent philosophies, such that HR managers who worked in smaller organizations were more likely to hold an inclusive talent philosophy. We also found support for the relationship between talent philosophies and perceptions of the exclusiveness or inclusiveness of the organization’s definition of talent, and its degree of workforce differentiation. Contrary to expectations, results did not support a link between talent philosophies and perceived talent identification criteria. 相似文献
Business schools are the “nurseries” of the corporate world. This article offers an empirical analysis of the business student ethos on the basis of research conducted at three Dutch universities. A theoretical framework in the tradition of virtue ethics and dubbed “moral ethology” is used to identify the values business schools convey to their students. The central research question is: What types of ethos do Dutch business students have? Forty-three undergraduate students participated in Q-methodological research, a mixed qualitative–quantitative small-sample method. Five different types of ethos were generated: Do-Good Managers, Market Managers, Searching Managers, Balancing Managers, and Radical Market Managers. Some general characteristics that apply to all the types of ethos were identified, such as the search for efficiency. It is argued that business schools should pay much more attention to the values that are endorsed in both life and business and should help students to address situations in which values are neglected. 相似文献