The cost-effectiveness of solifenacin vs. trospium in the treatment of patients with overactive bladder in the German National Health Service

Objective:

To carry out a cost–utility analysis comparing initial treatment of patients with overactive bladder (OAB) with solifenacin 5?mg/day versus either trospium 20?mg twice a day or trospium 60?mg/day from the perspective of the German National Health Service.

Methods:

A decision analytic model with a 3 month cycle was developed to follow a cohort of OAB patients treated with either solifenacin or trospium during a 1 year period. Costs and utilities were accumulated as patients transitioned through the four cycles in the model. Some of the solifenacin patients were titrated from 5?mg to 10?mg/day at 3 months. Utility values were obtained from the published literature and pad use was based on a US resource utilization study. Adherence rates for individual treatments were derived from a United Kingdom general practitioner database review. The change in the mean number of urgency urinary incontinence episodes/day from after 12 weeks was the main outcome measure. Baseline effectiveness values for solifenacin and trospium were calculated using the Poisson distribution. Patients who failed second-line therapy were referred to a specialist visit. Results were expressed in terms of incremental cost–utility ratios.

Results:

Total annual costs for solifenacin, trospium 20?mg and trospium 60?mg were €970.01, €860.05 and €875.05 respectively. Drug use represented 43%, 28% and 29% of total costs and pad use varied between 45% and 57%. Differences between cumulative utilities were small but favored solifenacin (0.6857 vs. 0.6802 to 0.6800). The baseline incremental cost–effectiveness ratio ranged from €16,657 to €19,893 per QALY.

Limitations:

The difference in cumulative utility favoring solifenacin was small (0.0055–0.0057 QALYs). A small absolute change in the cumulative utilities can have a marked impact on the overall incremental cost-effectiveness ratios (ICERs) and care should be taken when interpreting the results.

Conclusion:

Solifenacin would appear to be cost-effective with an ICER of no more than €20,000/QALY. However, small differences in utility between the alternatives means that the results are sensitive to adjustments in the values of the assigned utilities, effectiveness and discontinuation rates.     

法制环境、管理者能力与企业债务契约

本文从管理者能力的视角出发,选取2010-2018年沪、深A股上市公司为样本,实证分析了管理者能力对债务契约的影响及其影响路径。研究证明:管理者能力越强,企业的债务期限结构越短、债务融资成本越低。进一步研究发现,在不同的法制环境中,二者的关系存在异质性,即管理者能力对债务期限结构、债务融资成本的影响在法制环境较高的地区较为显著。本文丰富了企业债务契约的影响因素,探寻了管理者能力影响债务期限结构、债务融资成本的路径。     

Beta and firm age

We document a robust pattern of beta declining over the age of a firm. We find that changes in systematic risk via firm characteristics and life-cycle stages are insufficient to explain this pattern. Moreover, standard proxies for the quantity and quality of information also explain this pattern only partially. To fully explain this pattern we rely on the increasingly important role of familiarity in financial decision making: familiarity is a determinant of beta and firm age is a proxy for the degree of familiarity that investors feel toward individual stocks. To illustrate the implication of our findings, we document that when we control for firm age there is support for the CAPM and its use as an input for the cost of equity capital calculation.     

Politically connected boards,family and business group affiliations,and cost of capital: Evidence from Indonesia

We investigate the effect of politically connected boards (both supervisory boards [SBs] and boards of directors [BODs]) on cost of debt and equity capital of listed companies in Indonesia which has established a two-tier corporate governance system. The results, based on 250 firms, suggest that companies with politically connected SBs experience lower cost of debt and equity capital, whereas politically connected BODs have no association with cost of either debt or equity. Furthermore, we find that family firms and firms belonging to business groups with politically connected SBs enjoy lower cost of debt and equity capital. Our main results are robust to alternative measures and to tests for endogeneity.     

Basel regulations and banks’ efficiency: The case of the Philippines

Using stochastic frontier analysis, this paper has examined the impact of Basel II on the cost efficiency of Philippine commercial banks from 2001 to 2011. The overall mean cost efficiency estimate is 0.75, indicating substantial inefficiencies in the banks averaging to 25% of total costs. Findings show that higher capital requirement tends to improve the cost efficiency but more powerful supervisors can adversely affect the efficiency of the banks. The other potential correlates that may help explain the efficiency of the banks are risk and asset quality and bank-specific variables. From a policy perspective, this study is informative to policymakers on the general direction in which to proceed with reforms (i.e., maintain higher capital requirements, curtail powerful supervisors, and enhance private monitoring) and in identifying factors that could contribute to banks’ efficiency especially in light of the newly implemented Basel III in the country. In effect, this paper also assesses the readiness of the banks toward the implementation of Basel III.     

Stock liquidity and managerial short-termism

We examine whether stock liquidity exacerbates or mitigates managerial short-termism. Utilizing earnings management as a proxy for managerial short-termism, we establish three major findings. First, firms with liquid stocks engage in less accrual-based and real earnings management. Second, the effect of stock liquidity on earnings management is amplified for firms with high levels of managerial pay-for-performance sensitivity. Third, the positive association between the intensity of earnings management and firm cost of capital is evident only for firms with low stock liquidity. Our findings are consistent with the threat of blockholder exit as the main governance channel through which stock liquidity discourages opportunistic earnings management and mitigates managerial short-termism.     

城镇就业市场上劳动力工资扭曲程度测度

本文利用CHIPS2007数据库，基于随机前沿模型对我国城镇就业市场上劳动力的工资扭曲程度进行测度。研究结果表明：（1）在城镇就业市场上，由于工资扭曲现象的存在，劳动力实际获得的工资要比他们的边际生产率低45％～60％；（2）已婚、子女个数较少、本地、拥有失业保险、男性、大中型企业的劳动力工资扭曲程度要低于未婚、子女个数较多、外来、没有失业保险、女性、小型企业的劳动力；（3）中低工资水平的劳动力工资扭曲程度要比高工资水平的劳动力严重，且中低工资水平劳动力工资扭曲程度的方差更大。由此，本文提出推进就业市场的市场化改革，完善就业市场信息网络，从而减轻劳动力工资扭曲程度。     

Staff turnover costs: In search of accountability

The nature of staff turnover accounting procedures in a labour intensive context has been examined by conducting interviews with twenty eight managers in large three to five star hotels and two theme parks. It was found that the main staff turnover accountability procedures adopted involve monthly departmental reporting of staff turnover percentage levels and also the conduct of exit interviews. A degree of staff turnover costing was noted, although this practice was not extensively applied. Most interviewees supported the notion of allocating staff turnover costs to those operating departments experiencing the turnover. A muted form of this practice was observed in one hotel, however most interviewees had never contemplated or heard of the practice. Agency theory has been utilized as a framework for structuring a range of observed and potential staff turnover accountability relationships.     

Impact of quality on estimations of hotel efficiency

This paper provides empirical evidence on the impact of output quality on hotel efficiency. It demonstrates how ignoring quality can lead to erroneous efficiency estimates. The study uses stochastic frontier methodology and the model proposed by Battese and Coelli (1995) to estimate the efficiency of 838 hotels in Spain in the period 2009–2013. The key advantage of this methodology is its ability to estimate efficiency and identify factors that explain differences in efficiency in a single-stage sampling procedure. Estimates of cost efficiency, which only include the costs of higher quality, are compared to those of profit efficiency, which not only consider costs but also the revenues generated by higher quality. Results show that quality has a negative impact on cost efficiency and a positive one on profit efficiency. Thus, hotel management should implement strategies that increase the value of their services as a way to achieve sustainable competitive advantages.     

Modelling airline flight cancellation decisions

In order to predict airline responses to Traffic Management Initiatives (TMIs), and reveal the underlying preference structures that shape these responses, we study US domestic airlines’ cancellation decisions in response to the Federal Aviation Administration (FAA)’s TMIs, in particular, to Ground Delay Programs (GDPs). By observing the actual flight-cancellation choices made by airline dispatchers, the airlines’ cancellation utility functions can be inferred through the use of binary choice models. The model captures how delays to a given flight and potential delay savings to other flights affect flight cancellation decisions. We also find larger, fuller, less frequent, shorter-distance, and spoke-bound flights are less likely to be cancelled, and that there is inter-airline variation in flight cancellation behaviour.