Karligash Kenjegalieva

Varenicline in the management of smoking cessation: a single technology appraisal.

This paper presents a summary of the submissions evidence for the clinical effectiveness and cost-effectiveness of varenicline for smoking cessation included four studies of varenicline (one of which was commercial-in-confidence) and a meta-analysis of varenicline versus nicotine replacement therapy (NRT), bupropion and placebo. Two controlled trials of 12 weeks of varenicline versus sustained-release bupropion and placebo suggested that varenicline results in a statistically significant improvement in the odds of quitting at 12 weeks [odds ratio (OR) for quit rate during last 4 weeks of the study: 1.90-1.93 (p < 0.001) varenicline versus bupropion; 3.85 (p < 0.001) varenicline versus placebo). The ORs for sustained abstinence (weeks 9-52) for varenicline versus bupropion were 1.77 (p = 0.004) and 1.46 (p = 0.057), and for varenicline versus placebo were 2.66-3.09 (p < 0.01). A placebo-controlled maintenance trial examined whether a further 12 weeks of varenicline would maintain the rate of abstinence among those successfully treated on one 12-week course [OR = 2.48 at week 24 for varenicline versus placebo (p < 0.001)]. The meta-analysis suggested that varenicline was superior to placebo and bupropion at 1 year and 3 months. Based on indirect comparisons, varenicline was reported to be superior to NRT when compared with placebo or all controls at 1 year and 3 months. The submission presented a state transition model to estimate the incremental cost-effectiveness of varenicline compared with bupropion, NRT and placebo. The model suggests that varenicline dominates bupropion, NRT and placebo.Treatment efficacy was based on a pooled analysis of 1-year quit rates from the varenicline clinical trials. Assuming a willingness-to-pay threshold range of 20,000-30,000 pounds per quality-adjusted life-year gained, the probabilistic sensitivity analysis suggests that the probability that varenicline produces the greatest amount of net benefit is 0.70. Weaknesses of the manufacturers submission include the assumption that only a single quit attempt using a single smoking cessation intervention is made, the presence of multiple computational errors and a limited sensitivity analysis. In conclusion, varenicline is likely to be clinically and cost-effective for smoking cessation assuming that each user makes a single quit attempt. The key area of uncertainty concerns the long-term experience of subjects who have remained abstinent from smoking beyond 12 months. The guidance issued by the National Institute for Health and Clinical Excellence in July 2007 states that varenicline is recommended within its licensed indications as an option for smokers who have expressed a desire to quit smoking and that varenicline should normally be prescribed only as part of a programme of behavioral support.

Comparative analysis of banking production frameworks in eastern european financial markets

This paper performs comparative analysis of the non-radial Russell output technical efficiency measures of 13 Eastern European banking systems assuming a banking production with risk as an undesirable output and where output components can be negative. This is analysed utilizing three modelling specifications; the intermediation, production and profit methodologies. Along with distribution and inter-distribution mobility analysis of the efficiency scores across alternative methodologies, we also estimate and statistically compare the distributions of estimated efficiency scores using the bootstrap-based Simar-Zelenyuk-adapted-Li test. The results suggest that although the efficiency levels differ across the approaches, change in positions of the banks relative to the mean is not substantial across the three methodologies.

Productivity Growth Decomposition Using a Spatial Autoregressive Frontier Model

A new spatial decomposition of total factor productivity growth into direct (own) and indirect (spillover) components is set out. We then apply the decomposition in the context of a spatial autoregressive production frontier analysis of 40 European countries over the period 1995–2008.

Productivity changes and risk management in Indonesian banking: a Malmquist analysis

In this study, we utilize a nonparametric efficiency measurement approach which combines the Semi-Oriented Radial Measure–Data Envelopment Analysis (SORM–DEA) approach for dealing with negative data (Emrouznejad et al., 2010) with the Slacks-Based Efficiency Measures (SBM) of Tone (2001, 2002) to analyse productivity changes for Indonesian banks over the period Q1 2003 to Q2 2007. The first part of the analysis showed that average productivity changes for the Indonesian banking industry tended to be driven by technological progress rather than by frontier shift, although a relatively stable pattern was exhibited for most of the period. With respect to the risk management analysis, most of the balance sheet variables were shown to have had the expected impact on Risk Management Efficiency (RME), with the state-owned grouping exhibiting the highest degree of RME and the listed and Islamic banks outperforming their nonlisted and conventional bank counterparts, respectively. A strategy based on the gradual adoption of newer technology, with a particular focus on internal risk management enhancement, seems to offer the highest potential for boosting the productivity of the financial intermediary operations of Indonesian banks.

Efficiency of transition banks: inter-country banking industry trends

This study investigates the trend of X-(in) efficiencies across Eastern European 2004-accession countries’ banking industries over the period 1999 to 2003. We use Data Envelopment Analysis (DEA) estimators to obtain proxies for X-(in)efficiencies and we then analyse the inter-country industry differences using the methodology of Simar and Zelenyuk (2007) and the impact of country-specific environmental conditions, following Simar and Wilsons (2007) truncated regression with bootstrap methodology. Overall, the results suggest that Eastern European banking had considerable scope for X-efficiency improvements. However, the results also demonstrate that the efficiency gap between the sample countries declined over the period, and fewer environmental factors contributed to the difference in the banking efficiency levels.

A Spatial Autoregressive Production Frontier Model for Panel Data: With an Application to European Countries

In this paper we merge techniques from the e¢ ciency literature with spatial econometric techniques. In particular, we combine calculation of e¢ ciency from the unit speci…c eects with the spatial autoregressive model to develop a spatial autoregressive frontier model for panel data. Features of the modeling include time-varying e¢ ciency and estimation of own and spillover returns to scale. The model is applied to aggregate production in European countries over the period 1995 2008. Among other things, we …nd that production in the sample average country is characterized by increasing returns to scale when we allow for returns to scale spillovers from other countries, and constant returns when these spillovers

Bank performance and the financial crisis: evidence from Kazakhstan

During the first phase of the financial crisis in 2008/09, after Iceland and Belgium, Kazakhstan experienced the most significant bank failures as a share of bank system assets. Using rich monthly data for virtually the entire Kazakh banking industry for the period March 2007–December 2010, Stochastic Frontier Analysis (SFA) is used to fit several functions (cost, revenue, standard profit, alternative profit and input distance). Among other things, we estimate the effects of two measures of the quality and risk of the loan portfolio on the industry best practice frontiers and bank inefficiencies. We find that an increase in the volume of bad loans as a ratio of total lending has a desirable effect on the cost, input-distance and alternative profit frontiers, all of which is consistent with the ‘skimping’ hypothesis.

Determinants of Bank Efficiency in the Transition Economies in Europe: A Comparison of Frontier Techniques with Panel Data

This study investigates the evolution of banking efficiency of post-communist new EU member countries over a time span 1998 to 2003. In these transition economies major strides were taken during this period to establish functioning market economies and financial systems for their EU membership in 2004. In light of the EU enlargement, it is significant to examine whether significant efficiency improvements were achieved in their banking systems. Adopting the approach by Sickles (2005), we employ a wide range of non-parametric, semi-parametric and parametric tools to evaluate output efficiency of transition banking. In addition, we analyse the impact of several macroeconomic, banking sector specific and bank specific factors on banking efficiency. The results show that the efficiency estimators are sensitive to the choice of utilized methodology. The impact of the various factors however, is relatively stable among the measurement techniques except the impact of macroeconomic factors.

A spatial productivity index in the presence of efficiency spillovers: Evidence for U.S. banks, 1992–2015

We present the methodology for a new spatial decomposition of total factor productivity (TFP) growth. The relevant literature is underdeveloped as there is just one short study which proposes a partial spatial TFP growth decomposition. We develop this literature in four respects. The first two developments are methodological to go from a partial decomposition to a complete one. First, we augment the partial decomposition with a cost efficiency spillover growth component. Second, we introduce own and spillover allocative efficiency growth components. Third, we provide a more detailed coverage of the spatial decomposition of TFP growth. Fourth, in contrast to the traditional application to geographical areas (e.g., countries) in the relevant literature, we apply our decomposition using firm level data, which suggests that there can be an important role for spatial productivity analysis in OR. Our application is to large U.S. banks over the period 1992–2015. Among other things, we find for the average large U.S. bank that TFP growth since the financial crisis has become much more dependent on the bank itself and less so on spatial spillovers.

Relative Winners and Losers from Efficiency Spillovers in Africa: Implications for Regional Integration and Income Inequality

Studies that have analyzed the efficiency of developing countries have estimated non-spatial frontier models. We extend this approach by accounting for spatial dependence among African countries. In particular, we estimate a spatial Durbin stochastic production frontier model. We also make novel use of the efficiency scores from our spatial model to suggest a direction for regional integration policy for Africa that policy makers can consider. A previous suggestion to promote regional integration and income growth in Southern Africa has been to use South Africa as a regional integration hub and to encourage other countries in the region to improve economic links with the hub. We continue with this line of enquiry and although we conclude that there are currently no African countries that are ideal candidates to be a regional integration hub, we suggest three other countries that policy makers may consider using as hubs in the future. We therefore suggest that it would be prudent to consider implementing policies to expedite the readiness of these countries to act as integration hubs.