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
ABSTRACTIn this study, we apply the dynamic network slack-based measure data envelopment analysis model (DNSBM) to measure the efficiency of Taiwanese banks during the period 2005–11. Using the network structure, we define intellectual capital creation capability as one of the production stages. In order to capture the dynamics of the transformation process, the nonperforming loans and loan loss reserves are defined as carryover items. This study offers sufficient information for managers to understand not only the overall performance of their banks but also the efficiency of each production stage and the dynamic changes of the overall and divisional efficiencies. 相似文献
We use data envelopment analysis (DEA) efficiency scores to show that clustering municipalities into encompassing regional clusters improves spending efficiency of single stand-alone municipalities. We propose a new geographic aggregation based on municipalities-to-municipalities commuting flows, defined using hierarchical cluster analysis. Our example for Portugal shows that from an output-oriented perspective between 83% and 98% of municipalities would increase their efficiency scores, while from an input-oriented perspective between 86% and 98% of municipalities would also be better off in terms of efficiency. Then using a linear regression model, we find that population increases positively affects the efficient scores (via scale economies). Also, increases in the share of high-educated and poorer residents leads to higher efficiency scores. 相似文献
This paper contributes to debates about the appropriate characterisation of heterogeneous investment types and to what extent different investment motives affect the responsiveness to corporate taxation. In particular, we employ and refine a methodology to better evaluate the tax elasticity of investment types. Using a combination of both firm‐specific information and sector‐specific information from input–output tables, we discuss how to classify investment as non‐related, horizontal, vertical and complex types. First, we point out to what extent the resulting classification depends on assumptions made by the researcher. Second, we employ an ample set of classifications and find that non‐related investment reacts stronger to corporate taxation, whereas horizontal investment is less responsive, though, significant negative tax semi‐elasticities turn out for the subset of manufacturing industries. To address inherent characteristics of vertical and complex investment, we extend the methodology and find that, by and large, stronger business motives reduce the tax responsiveness of investment to a larger extent. Given the current debates about substantial corporate tax reforms, it is all the more important to recognise that corporate tax effects can vary fundamentally between countries, driven by country‐specific differences in their composition of industries and investment types. 相似文献
The objective of this study is to provide a direct estimate of the degree of persistence of measures of nominal and real house prices for the US economy, covering the longest possible annual sample of data, namely 1830–2013. The estimation of the degree of persistence accommodates for non-linear (deterministic) trends using Chebyshev polynomials in time. In general, the results show a high degree of persistence in the series along with a component of non-linear behaviour. In general, if we assume uncorrelated errors, non-linearities are observed in both nominal and real prices, but this hypothesis is rejected in favour of linear models for the log-transformation of the data. However, if autocorrelated errors are permitted, non-linearities are observed in all cases, and mean reversion is found in the case of logged prices, though given the wide confidence intervals, the unit root null hypothesis cannot be rejected in these cases. 相似文献
In this article we specify a model of millet prices in the three West African countries of Burkina Faso, Mali, and Niger. Using data obtained from USAID’s Famine Early Warning Systems Network (FEWS NET) we present a unique regional millet price forecasting model that takes advantage of the panel nature of our data and accounts for the distance of rural markets from capital cities. Another novel aspect of our analysis is our use of the Normalized Difference Vegetation Index (NDVI) to detect and control for variation in conditions for productivity. We find that including NDVI information significantly improves price forecasts. 相似文献