Cost-effectiveness analysis of rivaroxaban for treatment and secondary prevention of venous thromboembolism in the Netherlands

Background: Until recently, standard treatment of venous thromboembolism (VTE) concerned a combination of short-term low-molecular-weight heparin (LMWH) and long-term vitamin-K antagonist (VKA). Risk of bleeding and the requirement for regular anticoagulation monitoring are, however, limiting their use. Rivaroxaban is a novel oral anticoagulant associated with a significantly lower risk of major bleeds (hazard ratio?=?0.54, 95% confidence interval?=?0.37–0.79) compared to LMWH/VKA therapy, and does not require regular anticoagulation monitoring.

Aims: To evaluate the health economic consequences of treating acute VTE patients with rivaroxaban compared to treatment with LMWH/VKA, viewed from the Dutch societal perspective.

Methods: A life-time Markov model was populated with the findings of the EINSTEIN phase III clinical trial to analyze cost-effectiveness of rivaroxaban therapy in treatment and prevention of VTE from a Dutch societal perspective. Primary model outcomes were total and incremental quality-adjusted life years (QALYs), as well as life expectancy and costs.

Results: Over a patient’s lifetime, rivaroxaban was shown to be dominant, with health gains of 0.047 QALYs and cost savings of €304 compared to LMWH/VKA therapy. Dominance was robustly present in all sensitivity analyses. Major drivers of the differences between the two treatment arms were related to anticoagulation monitoring (medical costs, travel costs, and loss of productivity) and the occurrence of major bleeds.

Conclusion: Rivaroxaban treatment of patients with venous thromboembolism results in health gains and cost savings compared to LMWH/VKA therapy. This conclusion holds for the Dutch setting, both for the societal perspective, as well as the healthcare perspective.     

Environmental impacts of changes to healthier diets in Europe

Food consumption causes, together with mobility, shelter and the use of electrical products, most life cycle impacts of consumption. Meat and dairy are among the highest contributors to environmental impacts from food consumption. A healthier diet might have less environmental impacts. Using the E3IOT environmentally extended input output database developed in an EU study on Environmental Impacts of Products (EIPRO), this paper estimates the difference in impacts between the European status quo and three simulated diet baskets, i.e. a pattern according to universal dietary recommendations, the same pattern with reduced meat consumption, and a ‘Mediterranean’ pattern with reduced meat consumption. Production technologies, protein and energy intake were kept constant. Though this implies just moderate dietary shifts, impact reductions of up to 8% were possible in reduced meat scenarios. The slightly changed food costs do not lead to significant first order rebound effects. Second order rebounds were estimated by applying the CAPRI partial equilibrium model. This analysis showed that European meat production sector will most likely respond by higher exports to compensate for losses on the domestic meat market. Higher impact reductions probably would need more drastic diet changes.     

Business incomes in rural Nicaragua: the role of household resources,location, experience and trust

This paper analyses the determinants of business income for rural households in Nicaragua. A sample of 1030 households was studied in order to assess the importance of material and behavioural factors that influence income from business activity. The households are involved in manufacturing, trade, services or have a mixture of businesses. They generally have a low income and asset value. Households supplement their income from wages and agricultural activities. To estimate non-farm business income per employed person we analyse the impact of resources, location, entrepreneurial experience and trust. Our results show that household resources and entrepreneurial experience are significant determinants for business income in all sectors. Trust is also important, particularly generalized trust. The contribution of other forms of trust, such as institutional trust, depends on the sector in which households participate.     

How does earnings management influence investor’s perceptions of firm value? Survey evidence from financial analysts

Survey evidence shows CFOs to believe that earnings management can enhance investor valuation of their firms. This evidence raises the question of correspondence between the beliefs of CFOs and investors. Surveying financial analysts to gain insight into how earnings management influences investor perception of firm value, we find analysts’ and CFOs’ beliefs to be generally consistent. We find that analysts perceive meeting earnings benchmarks and smoothing earnings to enhance investor perception of firm value and all earnings management actions to reach a benchmark, save share repurchases, to be value destroying. CFOs, however, are reluctant to repurchase shares, preferring to use techniques viewed by analysts as value destroying (e.g., reductions in discretionary spending). Analysts’ inability to unravel such techniques perhaps explains CFOs’ preferences.     

Notes for Contributors

One aspect of globalisation is the convergence of income, media and technology, which in turn is expected to lead to homogeneous consumer behaviour. This convergence thesis is increasingly questioned. With converging national wealth there still is substantial variation of consumer behaviour across nations, which is not disappearing. Variation is found in all aspects of consumer behaviour: in consumption of packaged goods, in usage and ownership of durable goods, and in media behaviour. With disappearing differences of GNP per capita, culture is a powerful explaining variable. This paper provides evidence of divergence of consumer behaviour rather than convergence, it describes the influence of culture, how cultural variables can explain variance of consumption, and presents the consequences for international brand management and for global advertising.     

Advancing the Business and Human Rights Agenda: Dialogue,Empowerment, and Constructive Engagement

As corporations are going global, they are increasingly confronted with human rights challenges. As such, new ways to deal with human rights challenges in corporate operations must be developed as traditional governance mechanisms are not always able to tackle them. This article presents five different views on innovative solutions for the relationships between business and human rights that all build on empowerment, dialogue and constructive engagement. The different approaches highlight an emerging trend toward a more active role for corporations in the protection of human rights. The first examines the need for enhanced dialogue between corporations and their stakeholders. The next three each examine a different facet of empowerment, a critical factor for the respect and protection of human rights: empowerment of the poor, of communities, and of consumers. The final one presents a case study of constructive corporate engagement in Myanmar (Burma). Altogether, these research projects provide insight into the complex relationships between corporate operations and human rights, by highlighting the importance of stakeholder dialogue and empowerment. All the five projects were presented during the Second Swiss Master Class in Corporate Social Responsibility, held in Lausanne, Switzerland on December 12, 2008. The audience for this conference, which examined business and human rights, was composed of researchers, governmental representatives, and business and non-governmental organization practitioners.     

Precarious postdocs: A comparative study on recruitment and selection of early-career researchers

This paper investigates how the recruitment and selection for project-based postdoc positions are organised in the current academic landscape characterised by increasing temporary research funding and how principal investigators construct the ‘ideal’ postdoc. Our findings are based on a qualitative comparative multiple-case study in Social and Natural Sciences departments of universities in four European countries. This study contributes to the literature on the neoliberal university and academic staff evaluation by using a systemic, power-sensitive approach that examines how postdocs enter the academic system and how manifestations of precarity are exacerbated. Our critical analysis reveals three manifestations of precarity that the current academic system creates for postdocs, related to control, contracts, and careers. We discuss the effects for individual postdocs and their careers and the quality of knowledge production in public funded higher education institutions.     

Convergence and divergence in consumer behavior: implications for international retailing

Converging technology and disappearing income differences across countries will not lead to homogenization of consumer behavior. Rather, consumer behavior will become more heterogeneous because of cultural differences. As consumer incomes converge across countries, the manifestation of value differences will become stronger. This phenomenon makes it increasingly important to understand values of national cultures and their impact on consumer behavior. Retailing strategies for one country cannot be extended to other countries without adaptation. Hofstede’s model of national culture is applied to understand differences in consumer behavior across countries. Examples are provided of consumption differences, their relationships with culture discussed, and selected implications for international retailing management detailed.     

The impact of creative media advertising on consumer responses: two field experiments

Abstract

Creative media (CM) advertising is an advertising strategy wherein a non-traditional medium is creatively used for advertising purposes. This novel advertising strategy is gaining marketers’ interest; however, little is known about its persuasive effects on consumers’ cognitive, affective and behavioural responses and the processes that underlie them. Therefore, to convey a genuine experience to consumers, two field experiments with a one-factor (advertising type: creative vs. traditional) between-subjects design were conducted within a supermarket context. Results showed that creative (vs. traditional) media ads not only improve consumers’ affective and behavioural responses but also consumers’ cognitive responses. Even though no mediations were found through perceived surprise or perceived persuasive intent, results do provide evidence for the notion that perceived humor and perceived value are the underlying mechanisms through which affective and behavioural responses to creative media advertising can be explained.