A cost-effectiveness analysis of celecoxib compared with diclofenac in the treatment of pain in osteoarthritis (OA) within the Swedish health system using an adaptation of the NICE OA model

Objectives:

Celecoxib for the treatment of pain resulting from osteoarthritis (OA) was reviewed by the Tandvårds- och läkemedelsförmånsverket–Dental and Pharmaceutical Benefits Board (TLV) in Sweden in late 2010. This study aimed to evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib plus a proton pump inhibitor (PPI) compared to diclofenac plus a PPI in a Swedish setting.

Methods:

The National Institute for Health and Care Excellence (NICE) in the UK developed a health economic model as part of their 2008 assessment of treatments for OA. In this analysis, the model was reconstructed and adapted to a Swedish perspective. Drug costs were updated using the TLV database. Adverse event costs were calculated using the regional price list of Southern Sweden and the standard treatment guidelines from the county council of Stockholm. Costs for treating cardiovascular (CV) events were taken from the Swedish DRG codes and the literature.

Results:

Over a patient’s lifetime treatment with celecoxib plus a PPI was associated with a quality-adjusted life year (QALY) gain of 0.006 per patient when compared to diclofenac plus a PPI. There was an increase in discounted costs of 529kr per patient, which resulted in an incremental cost-effectiveness ratio (ICER) of 82,313kr ($12,141). Sensitivity analysis showed that treatment was more cost effective in patients with an increased risk of bleeding or gastrointestinal (GI) complications.

Conclusions:

The results suggest that celecoxib plus a PPI is a cost effective treatment for OA when compared to diclofenac plus a PPI. Treatment is shown to be more cost effective in Sweden for patients with a high risk of bleeding or GI complications. It was in this population that the TLV gave a positive recommendation. There are known limitations on efficacy in the original NICE model.     

A framework of successful organizational practices in Western multinational companies operating in Russia

Russian organizations have undergone significant changes since the 1990s. A new generation of Russian managers has come to the fore in Russia, who are eager to learn and open to Western knowledge. In turn, Western multinationals have also learned the fundamentals of doing business in Russia. How these developments are reflected in today's operations of Western multinationals in Russia remains – albeit with a few exceptions – largely unexplored in the academic literature. To address this gap, this paper explores what are the organizational practices and how do Western multinationals utilize them when striving to succeed in today's Russia. Based on two explorative case studies and 64 personal interviews with top and line managers it identifies four organizational practices, such as management training, corporate culture management, intercultural and linguistic training, and HRM practices, and two internalization mechanisms, such as boundary spanning, and reliance on local competence. The analysis elucidates important changes that have occurred in Western-Russian business relations and underscores important practical implications.     

Potential and recognized boundary spanners in multinational corporations

Boundary spanners play an important role in multinational corporations (MNC), yet it is unclear who these valuable individuals are and why certain individuals, and not others, perform this role. We advance a ‘recognition’ perspective based on whether and how relevant others on both sides on the boundary experience positive impact. A dynamic integrated mixed method analysis of 118 individuals involved in headquarters-subsidiary interactions in four MNCs, shows that only a minority are ‘recognized boundary spanners’, experienced by others to positively impact intergroup relations. We identify different categories and mechanisms of recognition, and make a methodological contribution by integrating qualitative and quantitative analysis.     

SICK PAY INSURANCE AND SICKNESS ABSENCE: SOME EUROPEAN CROSS-COUNTRY OBSERVATIONS AND A REVIEW OF PREVIOUS RESEARCH

All European countries have some form of compulsory insurance against the loss of income due to temporary disability. The insurance schemes vary widely between countries both in terms of measurable entities (such as the compensation level) as well as in unmeasurable traits concerning the actual implementation of the programs. In this paper we use European Labour Force Survey data to study how the measurable differences in the programs is associated with differences in absence rates. We also summarize the theoretical literature on insurance principles in this field. Based on the empirical literature we then discuss how different forms of incentives may affect the work absence rate.     

Housing prices and tenure choice with asymmetric taxes and progressivity

This paper studies the effects of tax schedule changes on prices and tenure choice in the housing market. It is shown that, given the present asymmetric treatment of owner-occupants vs. renters, an increase in the degree of progressivity is likely to lead to an increasein the prices of both owner-occupied and rental housing. A numerical example indicates that the effects may be quite large. Equilibrium prices are calculated based on the actual Swedish income tax schedules for 1971 and 1979. According to these simulations the tax changes that took place between these years caused the price of owner-occupied houses to increase by around 30 percent, and the rent level to increase by 2 or 3 percent.     

Revisiting a Social Constructionist Approach to Crisis Communication– Investigating Contemporary Crises in China

ABSTRACT

The current study provides a social constructionist approach to crisis communication in the Chinese context. Crisis communication is viewed as a form of strategic communication, involving multiple stakeholders in situations that are dependent on context, space and time. This approach provides a much-needed path for investigating and understanding crisis communication practices in contemporary China. The distinct Chinese context for crisis communication, with both an authoritarian government structure and a digital transformation of society, challenges theories originally developed in the Western countries. To address this issue, this study proposes a three-theme analytical framework to examine crisis communication practices in the Chinese context: (1) an audience (or stakeholder) orientation—focusing sense-making, (2) a proactive and interactive approach—focusing communication, and (3) a community—focused approach—focusing a long-range precrisis perspective.     

Trust and Brand Recovery Campaigns in Crisis: Findus Nordic and the Horsemeat Scandal

The aim of this study is to describe and analyze a transboundary crisis, focusing on crisis communication from the perspective of an involved major corporation. More concretely, the intent is to increase understanding of how Findus Nordic in Sweden managed the crisis communication response and repair of its trust and corporate brand during and after the horsemeat scandal in 2013. The case study is based on a theoretical framework that consists of three theories or concepts: transboundary crisis, image repair strategy, and rhetorical arena. Findus Nordic followed its corporate values and applied a consistent image repair strategy: denial and blame shifting towards the supplier Comigel in an extremely multivocal arena. This strategy was supplemented with responsibility evasion. Towards the end of the public crisis, Findus Nordic used the crisis as an opportunity to recover their position and started a campaign that had a positive impact on trust and the corporate brand. The launch of the campaign was very fast and might have been dangerous. However, according to the analysis, the success of the campaign may be explained as a consequence of its sensemaking and auto-communicative approach.     

To be an independent thinker: an intellectual portrait of Staffan Burenstam Linder *

Abstract

The essay provides a portrait of the life and works of Staffan Burenstam Linder (1931–2000), one of Sweden's most renowned economists, the originator of the so-called Linder Thesis and of The Harried Leisure Class. It provides a critical account of all his major works and at the same time follows his career as an economist and a politician. The essay ends with an overall evaluation of his intellectual contribution.     

Squeezing the Last Drop Out of Your Suppliers: An Empirical Study of Market‐Based Purchasing Policies for Generic Pharmaceuticals

We study the effect of the degree of exclusivity for the lowest bidder on the average price of generic pharmaceuticals in the short and long terms. Our results indicate that a 1‐percentage‐point gain in market share of the lowest bidder reduces average costs by 0.2% in the short term and 0.8% in the long term, but also reduces the number of firms by 1%. We find that reducing the number of firms has a strong positive (and hence counteracting) effect on average prices, a 1% reduction raising prices by approximately 1%.