When does economic model type become a decisive factor in health technology appraisals? Learning from the expanding treatment options for relapsing–remitting multiple sclerosis

Objectives: Specific economic model types often become de facto standard for health technology appraisal over time. Markov and discrete event simulation (DES) models were compared to investigate the impact of innovative modeling on the cost-effectiveness of disease-modifying therapies (DMTs) in relapsing–remitting multiple sclerosis (RRMS). Fingolimod was compared to dimethyl fumarate (DMF; in highly active [HA] RRMS), alemtuzumab (in HA RRMS) and natalizumab (in rapidly evolving severe RRMS). Comparator DMTs were chosen to reflect different dosing regimens.

Materials and methods: Markov and DES models used have been published previously. Inputs were aligned in all relevant respects, with differences in the modeling of event-triggered attributes, such as relapse-related retreatment, which is inherently difficult with a memoryless Markov approach. Outcomes were compared, with and without different attributes.

Results: All results used list prices. For fingolimod and DMF, incremental cost-effectiveness ratios (ICERs) were comparable (Markov: £4206/quality-adjusted life year [QALY] gained versus DES: £3910/QALY gained). Deviations were observed when long-term adverse events (AEs) were incorporated in the DES (Markov: £25,412 saved/QALY lost, versus DES: £34,209 saved/QALY lost, fingolimod versus natalizumab; higher ICERs indicate greater cost-effectiveness). For fingolimod versus alemtuzumab, when relapse-triggered retreatment was included in the DES, large cost differences were observed (difference between incremental cost is £35,410 and QALY is 0.10).

Limitations: UK payer perspective, therefore societal approach was not considered. Resource utilization and utilities for both models were not derived from the subpopulations; as the focus is on model type, input limitations that apply to both models are less relevant.

Conclusions: Whilst no model can fully represent a disease, a DES allows an opportunity to include features excluded in a Markov structure. A DES may be more suitable for modeling in RRMS for health technology assessment purposes given the complexity of some DMTs. This analysis highlights the capabilities of different model structures to model event-triggered attributes.     

The Search for a Good Measure of Magazine Readership: The TGI-Simmons Controversy

Magazine readership has been important to the advertising field for a long time. Interested parties have included agencies, clients and the magazines. With the introduction of Target Group Index (TGI) the routine use of W. R. Simmons and Associates syndicated services has been questioned as well as what “readership” really means.

This project attempts to accomplish three objectives: (1) develop a few normative standards for measuring magazine readership. (2) compare TGI and Simmons in terms of their performance against these standards, (3) develop some reasoning for where there are, in some cases, substantial discrepancies between results that are designed to measure the same construct. The authors wish to thank Dr. Alan D. Fletcher of the Department of Advertising, University of Tennessee, for his helpful comments.     

Greenwash: Corporate Environmental Disclosure under Threat of Audit

We develop an economic model of “greenwash,” in which a firm strategically discloses environmental information and an activist may audit and penalize the firm for disclosing positive but not negative aspects of its environmental profile. We fully characterize the model's equilibria, and derive a variety of predictions about disclosure behavior. We rationalize conflicting results in the empirical literature, finding a nonmonotonic relationship between a firm's expected environmental performance and its environmental disclosures. Greater activist pressure deters greenwash, but induces some firms to disclose less about their environmental performance. Environmental management systems discourage firms with poor expected environmental performance from greenwashing, which may justify public policies encouraging firms to adopt them.     

Correlated equilibrium existence for infinite games with type-dependent strategies

Under study are games in which players receive private signals and then simultaneously choose actions from compact sets. Payoffs are measurable in signals and jointly continuous in actions. This paper gives a counter-example to the main step in Cotter?s [K. Cotter, Correlated equilibrium in games with type-dependent strategies, J. Econ. Theory 54 (1991) 48-69] argument for correlated equilibrium existence for this class of games, and supplies an alternative proof.     

Divas of the Wassoulou Sound: Transformations in the Matrix of Cultural Production,Globalization, and Identity

This paper examines the role of popular music performance in a context of urban change, globalization, and gender. Through an in-depth examination of the Malian music style Wassoulou and its reigning star Oumou Sangaré, issues of gender, interpretation, and cultural production are discussed. Ethnographic data presented indicate that wassoulou performance provides much needed space for Malian youth to negotiate changing notions of identity and community without openly challenging the status quo of women and youth in traditional Mande social hierarchy. These new identities convey multiple and sometimes paradoxical symbolic meaning for Malian and world-music listeners. Viewing vocal performance in Mali as a verbal mode of communication and social display, wassoulou divas are particularly excellent sites for the study of emergent identities in the context of globalization.     

Equilibria of price-setting and quantity-setting duopolies

The relation between equilibria of output-setting and price-setting duopolies is investigated using the Inverse Function Theorem. The region that equilibria of the former occupy in relation to equilibria of the latter is found. A minimum of assumptions about the market functions are made.     

The Impact of Consumers’ Need for Uniqueness and Nationality on Generation Y's Retail Patronage Behaviors: Investigating American and Taiwanese Consumers

ABSTRACT

Generation Y (Gen Y) consumers are now one of the most influential buying segments in U.S. history. This article empirically assesses the extent to which American Gen Y consumers and same-aged Taiwanese consumers’ need for uniqueness serves as a meaningful discriminant across retail patronage behaviors for branded apparel products. Results indicate a great deal of similarity between the two cultures’ need for uniqueness. Empirical findings reveal that consumers’ need for uniqueness does influence retail patronage behaviors. The implications of the similarities and differences between American Gen Y consumers and their Taiwanese counterparts serve as potential managerial mechanisms for building and sustaining retail patronage in a globalization era.     

Global influences on UK manufacturing prices: 1970-2000

We introduce the first consistent series of domestic-product and related import price indices at the industry level for the UK, using the data to analyse both domestic and international determinants of UK manufactured product prices. Foreign influences on UK prices in domestic markets are always present, but domestic cost movements dominate. We show that the pass-through of world-price, tariff and exchange rate changes into product prices is partial in general and varies markedly between product categories. Standard tariff and exchange rate theories overstate price responses to global pricing determinants and fail to allow for variation between industrial sectors. Such theories can mislead when used for policy analysis and prediction.