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.     

Relative-to-rival corporate philanthropy,product market competitiveness,and stakeholders

Unlike most of the literature that examines the relationship between corporate philanthropy and financial performance, this study investigates the mechanisms through which corporate socially responsible behaviors produce financial outcomes. We propose that corporate philanthropy improves corporate competitiveness by eliciting positive responses from stakeholders, who assess a firm’s philanthropic contribution in relation to its rivals to determine what level of support they wish to provide to the firm. We predict that a firm’s philanthropy relative to its rivals has a positive effect on its product market competitiveness, and that this positive effect is moderated by three conditions that influence stakeholder response: stakeholder attention to philanthropy, its perceived legitimacy, and expectations of corporate giving. Our predictions are generally supported by our analyses. Overall, this paper shows that strategic philanthropy has a quantitative dimension, and firms obtain the market competitiveness associated with corporate philanthropy by integrating their rivals’ positions into their decision making.     

Costs and potential funding of expanded public pension coverage in Asia

Public pension burdens in most emerging Asian economies are still relatively small. However, there are a number of reasons to believe that they will increase markedly in the coming years. First, many Asian economies will face rapidly ageing populations, which will raise pension and other old‐age‐related spending dramatically. Second, as economies develop, political pressures to expand the coverage of public pensions and raise pension benefits will likely increase. The first objective of this paper is to identify the potential fiscal burden of public pensions in 23 emerging Asian economies, based on econometric models and forecasts of GDP and demographic trends. Using two different methodologies yields estimated increases in the average share of public pension expenditures in GDP of 1.0 percentage point and 3.6 percentage points by 2030 compared with current levels. We believe the latter estimate is more realistic. The second objective is to recommend policies to provide adequate funding for public pension needs, including enhancing the efficiency of social insurance programs, improving the balance of revenues and expenditures, implementing more explicit fiscal rules and frameworks, and establishing stronger fiscal surveillance at the national and regional levels.     

Should the Pre‐Notification of Mergers Be Compulsory in Australia?

Australia is unusual among the world's antitrust jurisdictions in not making the pre‐notification of mergers compulsory. However, if the parties are concerned that the Australian Competition and Consumer Commission (ACCC) is likely to object to the merger, there are strong incentives for them to notify the ACCC as the regulator has developed a strong reputation for imposing heavy costs on parties that fail to notify such mergers. The result is a system of quasi‐compulsory notification that creates the strongest incentives for parties to notify the ACCC of those proposals to which it is most likely to object. This study analyses data extracted from the ACCC's merger database and the empirical results are consistent with this characterisation. Mergers reported voluntarily by the parties are found to experience longer delays to completion, and are more likely to be challenged by the ACCC, when compared with a sample of all other mergers assessed by the regulator. The results suggest that non‐compulsory notification allows the parties themselves to pre‐sort the proposed merger vis‐à‐vis its interest to the ACCC.     

灌区配套与节水改造的设计体会

伊犁河流域现有灌溉面积678万亩。其中列入国家级大型灌区的有5个,现有灌溉面积为424万亩,在工程建设中的主要设计体会有：制定经济合理的规划设计方案,设计遵循因地制宜、统筹兼顾的原则,建筑物设计新颖别致、运行方便,尽量利用原有结构改建、降低工程造价,因地制宜规划设计渠道,为高寒地区湿陷性黄土地带渠道建设总结经验。     

American Labor and Europa's Recovery

On the morrow of President Truman's election the newspapers announced that the first person the President had received was the President of the powerful American syndical organisation known throughout the world under the name of C.I.Q. (Congress of Industrial Organizations). We know that this organisation as well as the other central organisation, the American Federation of Labour, had unequivocally taken up its stand in favour of Truman's candidacy. As the legislative elections had at the same time given the majority to the Democratic Party it was immediately declared on all hands that trade-unionism was going to exert considerable influence on American policy. These facts conferred a great importance on the memorandum addressed by Mr. Philipp Murray, in November 1947, to President Truman; a memorandum which was officially communicated by the C.I.O. to the International Trades Unions Conference for the recovery and reconstruction of Europe held in London on the 9th and 10th of March, 1948. We are especially pleased to put this document, which constitutes a declaration of principles of tie utmost interest, before the readers of the Annals.     

精馏过程的节能和优化设计的探讨

精馏过程的节能,对于减少能源消耗,降低生产成本和保护环境具有十分重要的意义.在精馏过程中可以采用最适宜回流比操作和最佳进料状态,使用中间冷凝器和中间再沸器,高效精馏、热泵精馏.合理安排多组分物料分离流程,直接利用过程热量及开发应用高效换热器等措施.本文从最佳回流比R的选择、进料温度及进料状态的确定等方面,详细的分析了在精馏塔的设计过程中,如何实现设计的优化问题,以实现节能降耗.     

我国汽车回收产业现状及市场前景分析

1我国报废汽车回收拆解业基本情况 1.1报废汽车的市场管理 我国报废汽车的市场管理始于20世纪80年代初期,当时汽车保有量刚刚超过200万辆.1980年,为了节约能源,原国家计委、国家经委、国家能源委和交通部、国家物资总局遵照国务院指示精神,联合下发<关于印发〈载重汽车更新试行办法)的通知>(计综[1980]666号)的文件,规定了汽车更新和回收手续,明确"回收部门接收旧车后,应及时解体作废钢铁处理.不得用旧零、部件拼装汽车变卖."     

The value of tax benefits and the cost of liquidating versus selling failed thrift institutions

This paper examines the 205 insolvent thrifts that were resolved in 1988 and assesses the cost savings obtained by selling 179 of the institutions through assisted acquisitions rather than liquidating them. It is hypothesized that the cost savings were determined by factors related both to the future viability of the acquired institution and the particulars of the deal arranged by the Federal Home Loan Bank Board and the Federal Savings and Loan Insurance Corporation. The added value by selling a thrift is determined primarily by the level of core deposits obtained by the acquired thrift. However, the branch structure and purchased mortgage-servicing rights should also add franchise value to the firm. In addition to these factors, the analysis accounts for the tax benefits and other regulator forbearances associated with the deals. Other characteristics of the deals are also considered. It is found that core deposits, tax benefits, purchased mortgage-servicing rights, average branch size, and type of acquirer, as well as some other factors, were significant determinants of the cost savings obtained through selling an institution rather than liquidating it.