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.     

Multigroup validation of the service quality,customer satisfaction and performance links in higher education

The notion of ‘students as customers’ continues to be prominent, yet is insufficiently explored, especially from the standpoint of various stakeholders. To address this inadequacy, the present study employs a multigroup analysis of the service profit chain (SPC) model in higher education (HE). Its purpose is to examine the complete SPC model regarding stakeholder perceptions in order to inform its validation and implementation. A cross-sectional survey was employed in order to enable multigroup comparison of a comprehensive research model on subsamples of employees and students by means of structural equation modeling (SEM). Results provide support for the proposed SPC model within the sample of vocational colleges. Besides strongly linked constructs (quality–satisfaction–loyalty), some notable weaknesses (cracked ‘satisfaction mirror’) are found. Multigroup analysis also indicates some important differences between employees and students. Implications are provided for strategic service management in HE, which should acknowledge the differences among stakeholder perceptions.     

中国现阶段的工业品市场营销模式初探

随着中国市场经济的快速发展、科技水平的提高以及中国加入WTO,工业品的市场竞争将更加激烈。对于中国现阶段的工业品来讲,由于行业、企业、产品特点及销售对象不同,各公司的营销策略各有不同,尤其对市场营销模式需要进一步探索。     

Foreign banks in Japan: A study of a Japanese deregulation process

The deregulation of foreign banks in Japan, although corresponding in broad outline to world-wide trends, has diverged substantially in many particulars from patterns seen elsewhere. It has tended to be excruciatingly slow and piecemeal and to have been of minimal benefit to foreign banks. A review of this process leads to the conclusion that these characteristics result from organisational and political-bureaucratic factors inherent to the Japanese style of government which is, in turn, partially a reflection of Japanese culture. Although these non-economic factors have influenced the specific pattern of change, its overall direction appears to have been consistent with the broader national interest.The authors wish to acknowledge financial support from the Social Science and Humanities Research Council of Canada, the Florsheimer Center for Policy Studies, and the Krueger Center for Financial Research.     

Tourism as an alternative source of regional growth in Portugal: a panel data analysis at NUTS II and III levels

The role of tourism is of vital economic importance, particularly for small countries with a privileged geographical location and favourable weather conditions. This paper examines the importance of tourism as a conditioning factor for higher regional growth in Portugal by employing the conditional convergence hypothesis of Barro and Sala-i-Martin, associated with the endogenous growth theory. The panel data estimation approach provides evidence of the positive impact of tourism (through the accommodation capacity) on the growth in per-capita income among the Portuguese regions, increasing the rate of convergence. Therefore, tourism can be considered as an alternative source for stimulating higher regional growth in Portugal, if the supply characteristics of this sector are improved.     

缩小东西部差距,应当对西部实行税收特别优惠政策

一、缩小东西部差距需要对西部实施税收特别优惠政策从1999年至今西部大开发战略已实施近5年了。5年来,西部地区GDP平均每年增长10%以上,固定资产投资每年增长20%以上,累计吸收外商直接投资近100亿美元。但西部与东部增长率的差距仍呈逐年扩大趋势。据2004年南宁西部论坛提供的     

陕西民间资金流失问题研究

摘要：游离于国家计划之外的民间资金由于不受国家监管，流动的隐蔽性极强。在趋利动机的支配下，必然出现资金流向高利润率地区，从而出现经济不发达地区民间资金的大量流出。虽然西部大开发战略已实施四年有余，陕西民间资金却出现了向外流失的现象，找出其流出的渠道和原因，引导民间资金回流、支持陕西经济发展是目前急需解决的问题。