Cost-Utility Analysis to Control Campylobacter on Chicken Meat—Dealing with Data Limitations

The current article describes the economic evaluation of interventions to control Campylobacter on chicken meat by means of a cost-utility analysis. Apart from the methodology used, the main focus of this article is on data gaps and assumptions made, and their impact on results and conclusions. The direct intervention costs, the relative risk, the disease burden (expressed in disability-adjusted life years (DALYs)), and the costs of illness for the various interventions are necessary inputs for the cost-utility analysis. The cost-utility ratio (CUR) -- the measure for efficiency -- is expressed in net costs per avoided DALY. Most data gaps were of a biological order, but for some interventions, information on costs was also scarce. As a consequence, assumptions had to be made, which had some impact on the estimated CUR. A higher (lower) incidence of Campylobacter infections associated with chicken meat, higher (lower) effectiveness, and lower (higher) intervention costs, respectively, would result in absolute better (worse) CUR estimates. By taking the perspective of all consumers eating Dutch chicken meat, rather than only the Dutch society, absolute better CUR estimates could be obtained. Indirect costs or a shift toward non-Dutch chicken meat would both result in higher CUR estimates. Despite the assumptions made, three interventions showed for most of the applied sensitivity analyses relatively favorable CUR estimates: limiting fecal leakage during processing, carcass decontamination by dipping in a chemical solution, and the phage therapy. However, all three do have some clauses.     

Value Creation and the Alliance Experiences of Dutch Companies

This paper examines the effect on the market valuation of large Dutch companies following the announcements of international strategic alliances during the period 1985–1992. The effects are distinguished by type of alliance and country of origin of the partnering firms. While international strategic alliances are generally found to have a positive effect on a company’s market value, strategically and culturally distant foreign partners generate a strong negative effect. The results underscore the importance of conducting a strategic, operational and cultural audit of the partnering companies and the envisaged partnership. The audit needs to be taken as a starting point in developing the essential co-operation skills to make the alliance work and should become integrated within a comprehensive performance scorecard.