Cost comparison of continued anticoagulation with rivaroxaban versus placebo based on the 1-year EINSTEIN-Extension trial efficacy and safety results

Aims: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (vs placebo) after 6–12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo, based on the EINSTEIN-EXT event rates.

Methods: Total healthcare cost was calculated as the sum of treatment and clinical event costs from a US managed care perspective. Treatment duration and event rates were obtained from the EINSTEIN-EXT study. Adjustment on treatment duration was made by assuming a 10% non-adherence rate. Drug costs were based on wholesale acquisition costs. Cost estimates for clinical events (i.e. recurrent deep vein thrombosis [DVT], recurrent pulmonary embolism, major bleeding, clinically relevant non-major bleeding) were determined from the literature. Results were examined over a ±20% range of each cost component and over 95% confidence intervals (CIs) of event rate differences in deterministic (one-way) and probabilistic sensitivity analyses (PSA).

Results: Total healthcare cost was $1,454 lower for rivaroxaban-treated (vs placebo-treated) patients in the base-case, with a lower clinical event cost fully offsetting drug cost. The cost savings of recurrent DVT alone (–$3,102) was greater than drug cost ($2,723). Total healthcare cost remained lower for rivaroxaban in the majority (73%) of PSA (cost difference [95% CI]?=?–$1,454 [–$2,396, $1,231]).

Limitations: This study was conducted over the 1-year observation period of the EINSTEIN-EXT trial, which limited “real-world” applicability and examination of long-term economic impact. Assumptions on drug and clinical event costs were US-based and, thus, not applicable to other healthcare systems.

Conclusions: Total healthcare costs were estimated to be lower for patients continuing rivaroxaban therapy compared to those receiving placebo in VTE patients who had completed 6–12 months of VTE treatment.     

EVA,not EBITDA: A New Financial Paradigm for Private Equity Firms

Private equity firms have boomed on the back of EBITDA. Most PE firms use it as their primary measure of value, and ask the managers of their portfolio companies to increase it. Many public companies have decided to emulate the PE firms by using EBITDA to review performance with investors, and even as a basis for determining incentive pay. But is the emphasis on EBITDA warranted? In this article, the co‐founder of Stern Stewart & Co. argues that EVA offers a better way. He discusses blind spots and distortions that make EBITDA highly unreliable and misleading as a measure of normalized, ongoing profitability. By comparing EBITDA with EVA, or Economic Value Added, a measure of economic profit net of a full cost‐of‐capital charge, Stewart demonstrates EVA's ability to provide managers and investors with much more clarity into the levers that are driving corporate performance and determining intrinsic market value. And in support of his demonstration, Stewart reports the finding of his analysis of Russell 3000 public companies that EVA explains almost 20% more than EBITDA of their changes in value, while at the same time providing far more insight into how to improve those values.     

The Impact of Employment on Parental Coresidence

We examine the extent to which parents use housing and shared living arrangements as a form of risk‐sharing for their adult children, using detailed data on children and parents in the Health and Retirement Study for 1998–2012. On average, a young man moving from full‐time to nonemployment raises the likelihood of coresiding with a parent by 1.5 percentage points; moving from full‐time employment to being part‐time employed raises the likelihood of coresiding with a parent by 2 percentage points. The implied elasticity of parental coresidence with respect to the son's income is ‐1.1; for daughters, the elasticity is ‐0.5.     

A Bayesian analysis of a variance decomposition for stock returns

We apply Bayesian methods to study a common vector autoregression (VAR)-based approach for decomposing the variance of excess stock returns into components reflecting news about future excess stock returns, future real interest rates, and future dividends. We develop a new prior elicitation strategy, which involves expressing beliefs about the components of the variance decomposition. Previous Bayesian work elicited priors from the difficult-to-interpret parameters of the VAR. With a commonly used data set, we find that the posterior standard deviations for the variance decomposition based on these previously used priors, including “non-informative” limiting cases, are much larger than classical standard errors based on asymptotic approximations. Therefore, the non-informative researcher remains relatively uninformed about the variance decomposition after observing the data. We show the large posterior standard deviations arise because the “non-informative” prior is implicitly very informative in a highly undesirable way. However, reasonably informative priors using our elicitation method allow for much more precise inference about components of the variance decomposition.     

The approximation capabilities of the minflex-Laurents,translog, and generalized Leontief forms

This paper compares the approximation capabilities of the minflex-Laurents translog and minflex generalized Leontief cost functions with their translog and generalized Leontief counterparts in Monte Carlo experiments. The minflex Laurent specifications generally provided closer approximations to underlying technical and economic parameters. Imposition of nonlinear restrictions on some of the parameters of the minflex Laurent models yielded measurable improvement in estimated elasticities of substitutions, returns to scale, and rates of technical change.The refereeing process of this paper was handled through E. Appelbaum.     

Software innovativeness: outcomes on project performance, knowledge enhancement, and external linkages

The purpose of this study is to investigate the relationship between product innovativeness and groups of outcomes flowing from the computer software product development process and the associated knowledge acquisition process. Data from interviews of managers in 94 software projects are analysed, and three groups of outcomes are measured: project performance, knowledge enhancement, and the strengthening of linkages to external actors/sources. The high innovative products show higher project performance for all measures of project performance compared with low innovative products. Similar results were found for all measures of personnel knowledge enhancement outcomes. Changes in the importance of linkages to nine different external sources of knowledge used by the firms during the knowledge acquisition process, also show some positive outcomes with respect to rising innovativeness levels. Strengthening of external linkages is found for 66% of the investigated linkages between one or two innovativeness levels. Of these, the linkages to hardware manufacturers, co-operation partners, and universities and other research institutions show strengthening when high innovativeness products are compared with low-level products. As the project performance and knowledge enhancement outcomes are due, in part, to knowledge gained within linkages to external actors/sources, managers could consider whether giving special attention to managing these linkages would be a winning innovation strategy for their particular firm.     

The Quality of Smallholder Coffee in South Sumatra: The Production of Low-Quality Coffee as a Response to World Demand 1

Improving the quality of Indonesia's coffee exports has been a priority of government and the Association of Indonesian Coffee Exporters for some years. Efforts to achieve this objective have, however, been hampered by misconceptions about the reasons why coffee producers and traders at each point in the marketing network do not deliver a higher quality product. The research reported here shows that price premia for higher quality coffee are not large enough to encourage greater quality enhancement. The world market for low to medium grades, used in the production of instant coffee, is much larger than that for high-quality coffee, and this preference is transmitted in the form of low incentives to improve the product. Failure to understand this has led to government policies which at best do not solve the quality problem and at worst exacerbate it.     

Industrial property letting: Traditional v radical approaches

Following the earlier article on GLC and GLEB property letting, this contribution argues that an industrial lettings policy is inadequate for the promotion of good employment practices and sector strategy.     

Dividend Omissions and Intraindustry Information Transfers

We examine potential information transfers from companies that announce dividend omissions to their industry rivals. Specifically, we examine the abnormal stock returns and abnormal earnings forecast revisions of rivals after a company makes a dividend‐omission announcement. Our results show negative and significant abnormal stock returns and negative and significant abnormal forecast revisions for rival companies in response to the announcement, and a significant and positive relation between the two. We conclude that a dividend‐omission announcement transmits unfavorable information across the announcing company's industry that affects cash flow expectations and ultimately stock prices.