Orderly exits from adjustable pegs and exchange rate bands

This paper examines the exit process from adjustable pegs and exchange rate bands, and the role of capital flows in these exits. It dwells on the experience of various countries, including Chile, Colombia, Egypt, Israel, India, Poland, and Yemen. It begins by identifying conditions under which exits are sought. Next, it discusses the prerequisites for a successful exit, factors affecting the pace of exit, and the nature of the post‐exit regime. It then examines the behavior of private capital flows, interest rates, and official reserves before and after three successful exits (Chile, India, and Poland), and draws broad policy lessons.     

Making things stick: enforcement and compliance

Environmental rules and regulations are only useful insofaras firms can be persuaded to comply with them in full or inpart. We survey the rapidly growing literature on the enforcementaspects of environmental policy. The difficulties facing anyregulatory agency are likely to be exacerbated by informationproblems, penalty constraints, and the evasion efforts of firms,and we emphasize the role that recent innovative approachesto implementation can play in bolstering more traditional enforcementinstruments.     

The box spread arbitrage conditions: theory, tests, and investment strategies

This paper develops and tests arbitrage bounds for a combinationof two option spread positions known as a box spread. This strategyinvolves the simultaneous use of four options and creates aposition that is equivalent to riskless lending. The no-arbitrageconditions are compared to existing arbitrage bounds and aretested using Chicago Board Options Exchange data.     

Cost-effectiveness of pembrolizumab for the adjuvant treatment of resected high-risk stage III melanoma in the United States

Abstract

Aims: To evaluate the cost-effectiveness of adjuvant pembrolizumab relative to observation alone following complete resection of high-risk stage III melanoma with lymph node involvement, from a US health system perspective.

Materials and methods: A Markov cohort model with four health states (recurrence-free, locoregional recurrence, distant metastases, and death) was developed to estimate costs, life-years, and quality-adjusted life-years (QALYs) associated with pembrolizumab vs observation over a lifetime (46-year) horizon. Using a parametric multi-state modeling approach, transition probabilities starting from recurrence-free were estimated based on patient-level data from KEYNOTE-054 (NCT02362594), a direct head-to-head phase 3 trial. Post-recurrence transition probabilities were informed by real-world retrospective data and clinical trials in advanced melanoma. Health state utilities and adverse event-related disutility were derived from KEYNOTE-054 trial data and published literature. Costs of drug acquisition and administration, adverse events, disease management, and terminal care were estimated in 2018?US dollars. Deterministic and probabilistic sensitivity analyses were conducted to assess robustness.

Results: Over a lifetime horizon, adjuvant pembrolizumab and observation were associated with total QALYs of 9.24 and 5.95, total life-years of 10.54 and 7.15, and total costs of $489,820 and $440,431, respectively. The resulting incremental cost-effectiveness ratios (ICERs) for pembrolizumab vs observation were $15,009/QALY and $14,550/life-year. Across the range of input values and assumptions tested in deterministic sensitivity analyses, pembrolizumab ranged from being a dominant strategy to having an ICER of $57,449/QALY vs observation. The ICER was below a willingness-to-pay threshold of $100,000/QALY in 90.2% of probabilistic simulations.

Limitations: Long-term extrapolation of outcomes was based on interim results from KEYNOTE-054, with a median follow-up of 15?months.

Conclusions: Based on common willingness-to-pay benchmarks, pembrolizumab is highly cost-effective compared with observation alone for the adjuvant treatment of completely resected stage III melanoma in the US.     

合理利用国际公约降低贷款利息支出——以哈萨克斯坦国际项目合作为例

随着中哈两国政治经济合作的日益加深,在哈中资企业的发展规模不断扩大。由于哈国银行的贷款利率较高,为节省利息支出,中资企业经常到国际市场上借贷。银行获得利息收入须缴纳相应的税款,但银行一般都要求借款人承担预提税,并将此作为贷款的一个基本条件。根据哈国税法,境外法人金融企业在哈国获得的利息收入需要支付15%的所得税,其他服务费用的所得税税率为20%。在适用国际公约之后,利息支出可享受所得税税率优惠。为此,借款企业须注意贷款人是否在避税港注册,并避免恶意使用纳税国际公约,另外还要按照程序要求及时办理境外纳税人的国民证明材料。     

Business Cycles,Economic Crises,and the Poor

This paper examines whether output contractions associated with downturns and crises have an asymmetric effect on poverty. Several potential sources of asymmetry are identified first. A vector auto-regression model (involving the output gap, unemployment, real wages, and the poverty rate) is then used to test whether the initial cyclical position of the economy, and the magnitude of the initial drop in the output gap in a downturn, matter in assessing the impact of output shocks on poverty. Empirical results for Brazil indicate that poverty shows less sensitivity to output shocks when the economy is initially in a downturn.     

Cost-effectiveness of ceritinib in previously untreated anaplastic lymphoma kinase-positive metastatic non-small cell lung cancer in the United States

Aims: To assess the cost-effectiveness of first-line ceritinib vs crizotinib and platinum doublet chemotherapy for anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) from a US third-party payer’s perspective.

Materials and methods: A partitioned survival model with three health states (stable disease, progressive disease, death) was developed over a 20-year time horizon. Ceritinib’s efficacy inputs (progression-free and overall survival) were estimated from ASCEND-4; parametric survival models extrapolated data beyond the trial period. The relative efficacy of ceritinib vs chemotherapy was obtained from ASCEND-4, the relative efficacy of ceritinib vs crizotinib was estimated using a matching-adjusted indirect comparison based on ASCEND-4 and PROFILE 1014. Drug acquisition, treatment administration, adverse event management, and medical costs were obtained from publicly available databases and the literature, and inflated to 2016?US dollars. Treatment-specific stable-state utilities were derived from trials and progressive-state utility from the literature. Incremental costs per quality-adjusted life year (QALY) were estimated for ceritinib vs each comparator. Cost-effectiveness was assessed based on US willingness-to-pay thresholds. Deterministic and probabilistic sensitivity analyses were performed to test model robustness.

Results: In the base case, first-line ceritinib was associated with total direct costs of $299,777 and 3.28 QALYs (from 4.61 life years gained [LYG]) over 20 years. First-line crizotinib and chemotherapy were associated with 2.73 and 2.41 QALYs, 3.92 and 3.53 LYG, and $263,172 and $228,184 total direct costs, respectively. The incremental cost per QALY gained was $66,064 for ceritinib vs crizotinib and $81,645 for ceritinib vs chemotherapy. In the first 2 years following treatment initiation, ceritinib dominated crizotinib by conferring greater health benefits at reduced total costs. Results were robust to deterministic and probabilistic sensitivity analyses.

Limitations: In the absence of head-to-head trials, an indirect comparison method was used.

Conclusions: Ceritinib is cost-effective compared to crizotinib and chemotherapy in the treatment of previously untreated ALK-positive metastatic NCSLC in the US.