Nadia Di Paola

Home Therapy with Plasma-Derived C1 Inhibitor: A Strategy to Improve Clinical Outcomes and Costs in Hereditary Angioedema

Background: Attacks of hereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE) are commonly treated in the emergency department. Self-administration is emerging as an effective treatment option. In this study, we assessed the impact of home therapy with plasma-derived C1 esterase inhibitor (pdC1-INH) concentrate on treatment outcomes and costs. Methods: This is an observational study in C1-INH-HAE patients who switched to home therapy with pdC1-INH (Berinert®) after learning intravenous self-infusion in a training course at a center in Southern Italy. Before starting home therapy and after the first year of home therapy, patients were interviewed about their treatment and outcomes during the prior 12 months. Annual costs were analyzed by cost minimization from the Italian health care payer perspective and the societal perspective. Outcomes and costs before and after the switch to home therapy were compared. Results: The training course was attended by 36 participants, 17 (47.2%) of whom decided to switch to home therapy. This therapy was associated with a significant decrease in the mean annual number of hospitalizations (16.8 vs. 2.1, p = 0.003) and missed work/school days (20.3 vs. 7.1, p = 0.037) compared to conventional treatment. The times from symptom onset to treatment administration and from treatment administration to symptom improvement/resolution were not significantly different between the two strategies. The mean annual per-patient costs decreased with home therapy from EUR 30,010.57 to EUR 26,621.16 (11.3% saving) and from EUR 29,309.34 to EUR 26,522.04 (9.5% saving) from the societal and payer perspective, respectively. Conclusions: Home therapy with pdC1-INH is a feasible strategy for the management of C1-INH-HAE and may result in cost savings.

Management dell’innovazione in agricoltura e relazioni di canale in una prospettiva teorica "grounded"

Literature recognizes innovation as a positive phenomenon, capable of creating value. The research analyzes the innovative dynamics as regards fresh unprocessed horticultural products, and outlines some of their developmental and diffusion trajectories. By using the Grounded Theory Methodology, the research intends to generate theory through the description and understanding of processes, while maintaining a considerable degree of flexibility. The paper shows that innovation may change some of the distribution channel orders, but that the structural constraints of the supply chain in certain circumstances may act by inhibiting these changes, sometimes to the point of influencing the outcome of the innovation process.

Hi-tech start-ups: legitimacy challenges and funding dynamics

ABSTRACT Studies on the legitimacy challenges faced by hi-tech start-ups are still scarce, leaving room for research, and policymaking debate. Legitimacy issues may become difficult to face for hi-tech firms in comparison with other start-ups, because they work in an extreme environment where the technological challenges are at the edge of the scientific possibility. The paper proposes a conceptual model to grasp the relevance of three legitimacy drivers of the hi-tech start-ups for investment decisions. We investigated the ability of 30 hi-tech start-up firms to obtain financial resources from the US investors, employing a set-theoretic approach and carried out fuzzy-set Qualitative Comparative Analysis. Our findings clarify that the funding decisions of US investors are driven by the location of headquarter and R&D of hi-tech start-ups and by the educational experience of the founders. Our study has significant theoretical, practical, and policymaking implications.

Inbound open innovation in biopharmaceutical firms: unpacking the role of absorptive capacity

ABSTRACT In this study, we extend recent attempts to clarify the role of antecedents of absorptive capacity in realising purposive inflows of external knowledge in the biopharmaceutical industry. By assuming that internal R&D resources contribute to absorptive capacity as a multidimensional concept, we propose a framework for the integrated analysis of the interactions between the different antecedents of absorptive capacity and inbound open innovation of biopharmaceutical firms. Our analysis relies on a set-theoretic approach and uses fuzzy-set qualitative comparative analysis (fsQCA) to study a set of selected Italian biopharmaceutical firms. The analysis reveals that biopharmaceutical companies with a diversified R&D business domain and an extended entrepreneurial scientific network are likely to adopt an inbound open innovation strategy.ABSTRACTIn this study, we extend recent attempts to clarify the role of antecedents of absorptive capacity in realising purposive inflows of external knowledge in the biopharmaceutical industry. By assuming that internal R&D resources contribute to absorptive capacity as a multidimensional concept, we propose a framework for the integrated analysis of the interactions between the different antecedents of absorptive capacity and inbound open innovation of biopharmaceutical firms. Our analysis relies on a set-theoretic approach and uses fuzzy-set qualitative comparative analysis (fsQCA) to study a set of selected Italian biopharmaceutical firms. The analysis reveals that biopharmaceutical companies with a diversified R&D business domain and an extended entrepreneurial scientific network are likely to adopt an inbound open innovation strategy.

Value co-creation in healthcare: evidence from innovative therapeutic alternatives for hereditary angioedema

BackgroundOur research focuses on the co-creation of value in healthcare with reference to a case of hereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE). Our work is mainly based on the concept of value co-creation in healthcare. The aim of this study is to assess the impact of an alternative treatment strategy – self-administration – by focusing on treatment outcomes and costs to understand if innovative therapeutic solutions can create value for patients and healthcare systems.MethodsThis paper compares home-based and hospital-based therapeutic strategies (independent of treatment type) with a cost minimization analysis. It encompasses compliance issues and focuses on both payer and societal perspectives, also benefiting from an operationalization of the service-dominant logic model for healthcare delivery. Data were collected over a 6-month period (August 2014–January 2015) through monthly patient interviews. Archival data were used for variable measurement.ResultsThirty-nine out of 62 patients enrolled in the study, experienced at least one HAE attacks, equally distributed between home and hospital-based strategies. No evidence of correlation between therapeutic strategy and disease severity score (p = 0.351), compliance (p = 0.399), and quality of life (p = 0.971), were found. Total direct cost per attack amounts to € 1224 for home-based strategy with respect to € 1454 for hospital-based strategy, with a savings of € 230. The economic advantage of the home-based strategy almost doubles if the societal perspective was considered due to a further savings of €169 (less missed work/school days and no travel expenses).ConclusionsOur study suggests that home-based therapies represent a feasible strategy for managing C1-INH-HAE and may result in lower costs and increased value for both patients and the healthcare systems. The findings are relevant to the debate on and extend the extant literature to provide a broader view of value co-creation dynamics for home-based therapies in healthcare and their positive effects. The insights are relevant to practitioners and policy makers.

Accountants’ hybridization and juridification: a critical reflection on the fight against organized crime

Policy-makers and regulators are increasingly focusing on fighting organized crime. Preventing criminal organizations infiltrating an economy involves multiple groups of professionals operating in complex regulatory environments. This paper looks at whether the current regulations for the management of assets seized from organized crime are adequate. The focus is on the Italian setting, and the research included interviews with accountants, judges and police officers involved in the management of seized entities. The results have application worldwide.

Technology venturing and universities: A key driver for sustainable development

We present here an overview of the research entrepreneurship phenomenon, with particular reference to the academic spin-off companies. Actually, they usually contain high levels of innovation, but often lack entrepreneurial orientation and managerial competences. Therefore, we put forward the idea that spin-off companies need further attention from the managerial point of view, in order to unveil their full potential as regards the social and economic development contribution. After a short review of the scientific literature of strategic management and entrepreneurship, we discuss about the importance of the innovation ecosystems and of the Universities in particular in order to unveil and actively exploit the entrepreneurial potential of the academic researchers, and finally disclose some positive effects in terms of sustainable development. We finally propose a multi-dimensional taxonomy of the academic spin-off companies. After refining and testing it, researchers and practitioners might improve their capability to understand in depth this kind of ventures and their contribution to the sustainable development and growth.