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Importance: Understanding the profitability of pharmaceutical companies is essential to formulating evidence-based policies to reduce drug costs while maintaining the industry's ability to innovate and provide essential medicines.Objective: To compare the profitability of large pharmaceutical companies with other large companies.Design, Setting, and Participants: This cross-sectional study compared the annual profits of 35 large pharmaceutical companies with 357 companies in the S&P 500 Index from 2000 to 2018 using information from annual financial reports. A statistically significant differential profit margin favoring pharmaceutical companies was evidence of greater profitability.Exposures: Large pharmaceutical vs nonpharmaceutical companies.Main Outcomes and Measures: The main outcomes were revenue and 3 measures of annual profit: gross profit (revenue minus the cost of goods sold); earnings before interest, taxes, depreciation, and amortization (EBITDA; pretax profit from core business activities); and net income, also referred to as earnings (difference between all revenues and expenses). Profit measures are described as cumulative for all companies from 2000 to 2018 or annual profit as a fraction of revenue (margin).Results: From 2000 to 2018, 35 large pharmaceutical companies reported cumulative revenue of $11.5 trillion, gross profit of $8.6 trillion, EBITDA of $3.7 trillion, and net income of $1.9 trillion, while 357 S&P 500 companies reported cumulative revenue of $130.5 trillion, gross profit of $42.1 trillion, EBITDA of $22.8 trillion, and net income of $9.4 trillion. In bivariable regression models, the median annual profit margins of pharmaceutical companies were significantly greater than those of S&P 500 companies (gross profit margin: 76.5% vs 37.4%; difference, 39.1% [95% CI, 32.5%-45.7%]; P < .001; EBITDA margin: 29.4% vs 19%; difference, 10.4% [95% CI, 7.1%-13.7%]; P < .001; net income margin: 13.8% vs 7.7%; difference, 6.1% [95% CI, 2.5%-9.7%]; P < .001). The differences were smaller in regression models controlling for company size and year and when considering only companies reporting research and development expense (gross profit margin: difference, 30.5% [95% CI, 20.9%-40.1%]; P < .001; EBITDA margin: difference, 9.2% [95% CI, 5.2%-13.2%]; P < .001; net income margin: difference, 3.6% [95% CI, 0.011%-7.2%]; P = .05).Conclusions and Relevance: From 2000 to 2018, the profitability of large pharmaceutical companies was significantly greater than other large, public companies, but the difference was less pronounced when considering company size, year, or research and development expense. Data on the profitability of large pharmaceutical companies may be relevant to formulating evidence-based policies to make medicines more affordable. [ABSTRACT FROM AUTHOR]

Background: Underage binge drinking is a serious health concern that is likely influenced by the neighbourhood environment. However, longitudinal evidence has been limited and few studies have examined time-varying neighbourhood factors and demographic subgroup variation.Methods: We investigated neighbourhood influences and binge drinking in a national cohort of US 10th grade students at four times (2010-2014; n = 2745). We estimated odds ratios (OR) for past 30-day binge drinking associated with neighbourhood disadvantage, personal and property crime (quartiles), and number of liquor, beer and wine stores within 5 km, and then evaluated whether neighbourhood associations differ by age, sex and race/ethnicity.Results: Neighbourhood disadvantage was associated with binge drinking before 18 [OR = 1.54; 95% confidence interval (1.14, 2.08)], but not after 18 years of age. Property crime in neighbourhoods was associated with a higher odds of binge drinking [OR = 1.54 (0.96, 2.45)], an association that was stronger in early adulthood [4th vs 1st quartile: OR = 1.77 (1.04, 3.03)] and among Whites [4th vs 1st quartile: OR = 2.46 (1.03, 5.90)]. Higher density of liquor stores predicted binge drinking among Blacks [1-10 stores vs none: OR = 4.31 (1.50, 12.36)] whereas higher density of beer/wine stores predicted binge drinking among Whites [one vs none for beer: OR = 2.21 (1.06, 4.60); for wine: OR = 2.04 (1.04, 4.03)].Conclusions: Neighbourhood conditions, particularly those related to economic circumstances, crime and alcohol outlet density, were related to binge drinking among young adults, but associations varied across age and individual characteristics. [ABSTRACT FROM AUTHOR]

Using dual-entitlement theory as the guide, we conducted a survey of economists from the National Bureau of Economic Research asking them a series of questions about the fairness of drug prices in the United States. Public opinion surveys have repeatedly shown that the public perceives drug prices to be unfair, but economists trained in laws of supply and demand may have different perceptions. Three hundred and ten senior economists responded to our survey. Forty-five percent agreed that drug prices were unfair when people, specifically low-income individuals, could not afford their prescription medications. Sixty-five percent oppose a dollar threshold, or upper limit, on drug prices. The economists recommend the most promising policy change would be to provide the government additional negotiating power and price controls would moderately impact investment in pharmaceutical research and development. [ABSTRACT FROM AUTHOR]

Purpose: The use of radioprotectors and radiomitigators could improve the therapeutic index of radiation therapy. With the intention of accelerating translation of radiation-effect modulators (radioprotectors and mitigators), the Radiation Research Program and SBIR (Small Business Innovation Research) Development Center within the National Cancer Institute issued 4 Requests for Proposals (RFPs) from 2010 to 2013. Twelve SBIR contract awards in total were made in response to the 4 RFPs from September 2011 through September 2014. Here, we provide an update on the status of SBIR contract projects for the development of radiation-effect modulators.Methods and Materials: To assess the status of research and development efforts under the 4 RFPs on radiation-effect modulators, we searched PubMed for research articles, google.com for published abstracts, clinicaltrials.gov for ongoing or completed clinical trials, and company websites for press releases and other news. All information obtained and reported here is publicly available and thus protects the intellectual property of the investigators and companies.Results: Of the 12 SBIR projects funded, 5 (42%) transitioned successfully from phase 1 to phase 2 SBIR funding, and among the Fast-Track contracts, this rate was 100% (3 of 3). The Internet search identified 3 abstracts and 6 publications related to the aims of the SBIR contracts. One-third of the companies (4 of 12) have successfully launched a total of 8 clinical trials to demonstrate the safety and efficacy of their investigational agents. Two drugs are in clinical trials for their indication as a radioprotector, and 2 drugs are under evaluation for their anticancer properties (an immunomodulator and a small molecule inhibitor).Conclusions: The National Cancer Institute's SBIR has provided pivotal funding to small businesses for the development of radioprotectors and radiomitigators, which resulted in multiple early-phase clinical trials. Longer follow-up is needed to determine the full impact of these novel therapeutics that enter clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: We described the population of daily smokers purchasing cigarettes on Indian reservations (IRs), estimated the rates of cigarette purchasing on IRs for diverse populations of daily smokers in the U.S., and assessed the trends in the period from 2010-11 to 2014-15.Methods: We used the 2010-11 and 2014-15 Tobacco Use Supplement to the Current Population Survey data for adult daily smokers as well as additional information, e.g., state excise tax on tobacco (n = 33,871).Results: Daily smokers who purchased cigarettes on IRs were primarily 45+ years old, non-Hispanic (NH) White, resided in a state with an IR, paid less than $4.50 per pack, and purchased cigarettes in the state of their residency. The majority of purchases on IRs were made in New York (28%), Oklahoma (14%), Washington (10%), Arizona (9%), and Florida (6%). The rate of purchasing cigarettes on IRs decreased from 4% in 2010-11 to 3% in 2014-15 (p = 0.012). The rates were higher for females than males (OR = 1.23, CI = 1.09:1.40) and heavy than non-heavy smokers (OR = 1.35, CI = 1.17:1.55). Higher state excise tax on tobacco, on average, was associated with purchasing cigarettes on IRs.Conclusions: The rate of purchasing cigarettes on IRs is relatively low and has decreased in recent years. However, the rates differ across sociodemographic factors of daily smokers, including the state of residency and purchase. Purchasing cigarettes on IRs at lower prices can affect smokers' intentions to quit and can reduce federal and state efforts toward a tobacco-free nation. [ABSTRACT FROM AUTHOR]

Objective: We evaluated the effects of outlet and small area level malt liquor policies on crime in 10 U.S. cities and hypothesized that more restrictive malt liquor policies would be associated with greater reductions in crime.Method: We used a pooled time-series study design (i.e., panel regression) with comparison areas to test our hypothesis. Quarterly crime rates in targeted areas were compared 3 years before and after policy adoption. Four crime outcomes were analyzed: Selected Part II crimes, assaults, vandalism/property damage, and disorderly conduct. Both the presence and absence of a malt liquor policy (yes, no) and degree of restrictiveness of the malt liquor policy were assessed using a newly created measure of malt liquor policy restrictiveness developed by the investigators. Results were analyzed using a series of linear mixed models.Results: Adoption of malt liquor policies was not associated with Part II selected crimes. For individual crimes (e.g., assaults, vandalism, disorderly conduct), we found mixed results as more restrictive malt liquor policies were significantly associated with decreases as well as increases in crime. In general, the evaluated policies were considered to be not highly restrictive.Conclusions: Our findings suggest that malt liquor policies at the outlet or small area level alone may not be sufficient to reduce crime associated with malt liquor use. Policies that are more restrictive or cover larger areas than assessed in the current study may be required to have an independent effect on crime outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether enrollment in high-deductible health plans (HDHPs) led enrollees to choose lower-priced providers for office visits and laboratory tests.Study Setting: Claims data from more than 40 large employers.Study Design: We compared the change in price for office visits and laboratory tests for enrollees who switched to HDHPs versus enrollees who remained in traditional plans. We estimated separate models for enrollees who changed providers versus those who remained with the same provider to disentangle the effects of HDHPs on provider choice and negotiated prices.Data Collection: Claims data from 2004 to 2010 on 1.8 million enrollees.Principal Findings: After enrollment in HDHPs, 28 percent of enrollees changed physicians for office visits (compared to 19 percent in the Traditional Plan group, p < .01); however, this did not result in a statistically significant reduction in price for office visits. About 25 percent of enrollees changed providers for laboratory tests (compared to 23 percent in the Traditional Plan group, p < .01), resulting in savings of about $2.09 or a 12.8 percent reduction in price per laboratory test. We found that HDHPs had lower negotiated prices for office visits but not for laboratory tests.Conclusions: High-deductible health plan enrollment may shift enrollees to lower cost providers, resulting in modest savings. [ABSTRACT FROM AUTHOR]

Don't let the burmper baby crop fool you. There are undercurrents in the population boom which are not so good for business. Among them are the prospect of a smaller labor force, an imbalance of youngsters and old folks to self-supporting adults, skyrocketing land values, permanent traffic jams, and continual migrations of a restless people still going west or leaving farms to try their luck in the big cities. [ABSTRACT FROM AUTHOR]

This article explores the question of whether Government can influence business stability. The author considers the issue of political planning of production, employment, and distribution of income, outlined in Barbara Wootton's work "Plan or No Plan." The author argues that this sort of planning could be detrimental to business. The author addresses concerns about the U.S. Employment Act of 1946, which he claims will neither provide sound economic policy, nor serve the greater interests of business. The article follows the path of economic policy as it relates to business, the weaknesses of the 1946 legislation, and the role of the Council of Economic Advisors.

Multiple state attorneys generals have entered assurances of voluntary compliance (AVCs) with numerous national retail chains as an application of consumer protection laws to help prevent tobacco sales to minors. Little is known about the effectiveness of AVCs in reducing the violations of tobacco retailers for underage sales. We collected inspection data involving minors (n=53,832) on tobacco retailers in 2015 and 2016 from the Food and Drug Administration (FDA) compliance check database. Inspections on 13 national retail chains were classified into four categories: gas stations from oil companies, convenience stores, pharmacy stores, and supermarkets. Multilevel logistic regression models were performed to examine the effectiveness of AVCs, adjusted for state tobacco control policies, state youth smoking rates, and socio-economic status (SES) at census tracts. Overall the Retail Violation Rate for sales to minors (RVRm) significantly varied by retail category from 7.7% in pharmacy stores to 18.9% in gas stations from oil companies. Retailers that entered an AVC had lower odds of underage sales violations in convenience stores (aOR=0.75, 95% CI [0.61-0.93]) and supermarkets (aOR=0.74, 95% CI [0.59-0.93]). For gas stations from oil companies and pharmacy stores, there were no significant differences in RVRm between stores with an AVC and stores without an AVC. We found that entering into AVCs is associated with fewer retail violations of underage sales for convenience stores and pharmacy stores. Continued efforts to strengthen the enforcement of AVCs and to expand AVCs to more states and other retail chains may improve youth tobacco control. [ABSTRACT FROM AUTHOR]

Drug-specific clinical and health economic and outcomes research (HEOR) publications have amassed, but their effect on drug sales is largely unknown. We estimated the impact of publications on pharmaceutical sales in 3 markets (statins, rheumatoid arthritis, and asthma drugs) with varying generic competition. An event-study approach with fixed effects and difference-in-fixed-effects modeling was used to estimate the causal effects of drug-specific publications on subsequent quarter's drug-specific sales and volume. High-impact clinical and HEOR publications have significant positive effects on sales (mediated through price) and volume in the statin market (high generic competition). High-impact clinical publications have a significant positive effect on sales (mediated through volume) in low-generic competition market (asthma). The effects of publications in the rheumatoid arthritis market (no generic competition) on sales were null. Manufacturers' investment in clinical and HEOR publications needs to be strategic and should be anticipated and complemented by public investments in such studies. [ABSTRACT FROM AUTHOR]

Objective: In the United States, excessive alcohol consumption is responsible for 88,000 deaths annually and cost $249 billion, or $2.05 per drink, in 2010. Specific excise taxes, the predominant form of alcohol taxation in the United States, are based on the volume of alcohol sold rather than a percentage of price and can thus degrade over time because of inflation. The objective of this study was to describe changes in inflation-adjusted state alcohol excise taxes on a beverage-specific basis.Method: State-level data on specific excise taxes were obtained from the Alcohol Policy Information System and the Tax Foundation. Excise tax rates were converted into the tax per standard U.S. drink (14 g of ethanol) for beer, wine, and distilled spirits, and converted into 2015 dollars using annual Consumer Price Index data.Results: Across U.S. states, the average state alcohol excise tax per drink in 2015 was $0.03 for beer, $0.05 for distilled spirits, and $0.03 for wine. From 1991 to 2015, the average inflation-adjusted (in 2015 dollars) state alcohol excise tax rate declined 30% for beer, 32% for distilled spirits, and 27% for wine. Percentage declines in state excise taxes since their inception were more than twice as large as those from 1991 to 2015.Conclusions: In 2015, average state specific excise taxes were $0.05 or less per standard drink across all beverage types and have experienced substantial inflation-adjusted declines. [ABSTRACT FROM AUTHOR]

In an influential article published in the American Sociological Review in 2009, Herring finds that diverse workforces are beneficial for business. His analysis supports seven out of eight hypotheses on the positive effects of gender and racial diversity on sales revenue, number of customers, perceived relative market share, and perceived relative profitability. This comment points out that Herring's analysis contains two errors. First, missing codes on the outcome variables are treated as substantive codes. Second, two control variables--company size and establishment size--are highly skewed, and this skew obscures their positive associations with the predictor and outcome variables. We replicate Herring's analysis correcting for both errors. The findings support only one of the original eight hypotheses, suggesting that diversity is nonconsequential, rather than beneficial, to business success. [ABSTRACT FROM AUTHOR]

Background: Taxes on sugar-sweetened beverages (SSBs) meant to improve health and raise revenue are being adopted, yet evaluation is scarce. This study examines the association of the first penny per ounce SSB excise tax in the United States, in Berkeley, California, with beverage prices, sales, store revenue/consumer spending, and usual beverage intake.Methods and Findings: Methods included comparison of pre-taxation (before 1 January 2015) and first-year post-taxation (1 March 2015-29 February 2016) measures of (1) beverage prices at 26 Berkeley stores; (2) point-of-sale scanner data on 15.5 million checkouts for beverage prices, sales, and store revenue for two supermarket chains covering three Berkeley and six control non-Berkeley large supermarkets in adjacent cities; and (3) a representative telephone survey (17.4% cooperation rate) of 957 adult Berkeley residents. Key hypotheses were that (1) the tax would be passed through to the prices of taxed beverages among the chain stores in which Berkeley implemented the tax in 2015; (2) sales of taxed beverages would decline, and sales of untaxed beverages would rise, in Berkeley stores more than in comparison non-Berkeley stores; (3) consumer spending per transaction (checkout episode) would not increase in Berkeley stores; and (4) self-reported consumption of taxed beverages would decline. Main outcomes and measures included changes in inflation-adjusted prices (cents/ounce), beverage sales (ounces), consumers' spending measured as store revenue (inflation-adjusted dollars per transaction) in two large chains, and usual beverage intake (grams/day and kilocalories/day). Tax pass-through (changes in the price after imposition of the tax) for SSBs varied in degree and timing by store type and beverage type. Pass-through was complete in large chain supermarkets (+1.07¢/oz, p = 0.001) and small chain supermarkets and chain gas stations (1.31¢/oz, p = 0.004), partial in pharmacies (+0.45¢/oz, p = 0.03), and negative in independent corner stores and independent gas stations (-0.64¢/oz, p = 0.004). Sales-unweighted mean price change from scanner data was +0.67¢/oz (p = 0.00) (sales-weighted, +0.65¢/oz, p = 0.003), with +1.09¢/oz (p < 0.001) for sodas and energy drinks, but a lower change in other categories. Post-tax year 1 scanner data SSB sales (ounces/transaction) in Berkeley stores declined 9.6% (p < 0.001) compared to estimates if the tax were not in place, but rose 6.9% (p < 0.001) for non-Berkeley stores. Sales of untaxed beverages in Berkeley stores rose by 3.5% versus 0.5% (both p < 0.001) for non-Berkeley stores. Overall beverage sales also rose across stores. In Berkeley, sales of water rose by 15.6% (p < 0.001) (exceeding the decline in SSB sales in ounces); untaxed fruit, vegetable, and tea drinks, by 4.37% (p < 0.001); and plain milk, by 0.63% (p = 0.01). Scanner data mean store revenue/consumer spending (dollars per transaction) fell 18¢ less in Berkeley (-$0.36, p < 0.001) than in comparison stores (-$0.54, p < 0.001). Baseline and post-tax Berkeley SSB sales and usual dietary intake were markedly low compared to national levels (at baseline, National Health and Nutrition Examination Survey SSB intake nationally was 131 kcal/d and in Berkeley was 45 kcal/d). Reductions in self-reported mean daily SSB intake in grams (-19.8%, p = 0.49) and in mean per capita SSB caloric intake (-13.3%, p = 0.56) from baseline to post-tax were not statistically significant. Limitations of the study include inability to establish causal links due to observational design, and the absence of health outcomes. Analysis of consumption was limited by the small effect size in relation to high standard error and Berkeley's low baseline consumption.Conclusions: One year following implementation of the nation's first large SSB tax, prices of SSBs increased in many, but not all, settings, SSB sales declined, and sales of untaxed beverages (especially water) and overall study beverages rose in Berkeley; overall consumer spending per transaction in the stores studied did not rise. Price increases for SSBs in two distinct data sources, their timing, and the patterns of change in taxed and untaxed beverage sales suggest that the observed changes may be attributable to the tax. Post-tax self-reported SSB intake did not change significantly compared to baseline. Significant declines in SSB sales, even in this relatively affluent community, accompanied by revenue used for prevention suggest promise for this policy. Evaluation of taxation in jurisdictions with more typical SSB consumption, with controls, is needed to assess broader dietary and potential health impacts. [ABSTRACT FROM AUTHOR]

Objective: To evaluate associations between changing energy prices and US hospital patient outcomes.Methods: Generalized estimating equations were used to analyze relationships between changes in energy prices and subsequent changes in hospital patient outcomes measures for the years 2008 through 2014. Patient outcomes measures included 30-day acute myocardial infarction, heart failure, and pneumonia mortality rates, and 30-day acute myocardial infarction, heart failure, and pneumonia readmission rates. Energy price data included state average distillate fuel, electricity and natural gas prices, and the US average coal price. All of the price data were converted to 2014 dollars using Consumer Price Index multipliers.Results: There was a significant positive association between changes in coal price and both short-term (P = 0.029) and long-term (P = 0.017) changes in the 30-day heart failure mortality rate. There was a similar significant positive association between changes in coal price and both short-term (P <0.001) and long-term (P = 0.002) changes in the 30-day pneumonia mortality rate. Changes in coal prices also were positively associated with long-term changes in the 30-day myocardial infarction readmission rate (P < 0.001). Changes in coal prices (P = 0.20), natural gas prices (P = 0.040), and electricity prices (P = 0.040) were positively associated with long-term changes in the 30-day heart failure readmission rate.Conclusions: Changing energy prices are associated with subsequent changes in hospital mortality and readmission measures. In light of these data, we encourage hospital, health system, and health policy leaders to pursue patient-support initiatives, energy conservation programs, and reimbursement policy strategies aimed at mitigating those effects. [ABSTRACT FROM AUTHOR]

Objective: Building on the extensive research literature demonstrating that increasing alcohol prices reduces excessive alcohol consumption and related harms, this article presents the results of a 50-state review of local authority to tax alcohol in the United States.Method: Between 2013 and 2015, legal databases and government websites were reviewed to collect and analyze relevant statutes, ordinances, and case law. Results reflect laws in effect as of January 1, 2015.Results: Nineteen states allow local alcohol taxation, although 15 of those have one or more major restrictions on local authority to tax. The types of major restrictions are (a) restrictions on the type of beverage and alcohol content that can be taxed, (b) caps on local alcohol taxes, (c) restrictions on the type of retailer where taxes can be imposed, (d) restrictions on jurisdictions within the state that can levy taxes, and (e) requirements for how tax revenue can be spent.Conclusions: The number and severity of restrictions on local authority to tax alcohol vary across states. Previous research has shown that increases in alcohol taxes can lead to reduced excessive alcohol consumption, which provides public health and economic benefits. Taxes can also provide funds to support local prevention and treatment services. Local alcohol taxes therefore present an important policy opportunity, both in states that restrict local authority and in states where local authority exists but is underused. [ABSTRACT FROM AUTHOR]

The article discusses the value of pharmaceuticals in the U.S. health system. The concept of value is salient in the pharmaceutical market for several reasons, including grant of monopoly to drug manufacturers, competition between payers and between pharmaceutical manufacturing firms, and the value of reputation in the market all serve as checks that limit low-value medications.

The article discusses research regarding rural grocery storeowners' perceptions of their communities, their business practices, and factors that influence their sustainability and the ability to support healthy food choices in Nebraska as of 2016. According to the article, storeowners reported on strategies that they employ to remain competitive by focusing on customer service and product quality. The public health aspects of obesity in America are examined, along with small U.S. stores.

Objectives. To describe, and provide a nomenclature and taxonomy for classifying, the economic sectors and functional assets that could be mobilized as partners in an intersectoral health system. Methods. MAPSCorps (Meaningful, Active, Productive Science in Service to Community) employed local youths to conduct a census of all operating assets (businesses and organizations) on the South Side of Chicago, Illinois, in 2012. We classified assets by primary function into sectors and described asset and sector distribution and density per 100 000 population. We compared empirical findings with the Institute of Medicine's (IOM's) conceptual representation and description of intersectoral health system partners. Results. Fifty-four youths mapped a 62-square-mile region over 6 weeks; we classified 8376 assets into 23 sectors. Sectors with the most assets were food (n = 1214; 230/100 000 population), trade services (n = 1113; 211/100 000), and religious worship (n = 974;185/100 000). Several large, health-relevant sectors (2499 assets) were identified in the region but not specified in the IOM's representation. Governmental public health, central to the IOM concept, had no physical presence in the region. Conclusions. Local youths identified several thousand assets across a broad diversity of sectors that could partner in an intersectoral health system. Empirically informed iteration of the IOM concept will facilitate local translation and propagation. [ABSTRACT FROM AUTHOR]

Introduction: Higher tobacco taxes reduce tobacco use. On military installations, cigarettes and other tobacco products are sold tax-free, keeping prices artificially low. Pricing regulations in the military specify that tobacco should be within 5% of the local most competitive price, but prices still average almost 13% lower than those at local Walmarts.Methods: To gain insight into policy leaders' ideas and positions on military tobacco pricing, we interviewed members of the Department of Defense (DoD) Addictive Substances Misuse Advisory Committee and the Advisory Committee on Tobacco about tobacco pricing policies (n = 12).Results: Participants frequently lacked specific knowledge of details of military pricing policy, and the impact higher prices might have on military tobacco use. Most participants thought tobacco should not be sold at military stores, but many also felt that this policy change was unlikely due to tobacco industry pressure, and DoD reliance on tobacco profits to support Morale, Welfare, and Recreation funds.Conclusions: Achieving a tobacco-free military will require changing pricing policy, but this study suggests that for effective implementation, military leadership must also understand and articulate more clearly the rationale for doing so.Implications: Previous work has found that adherence to military tobacco pricing policy is inconsistent at best. This study suggests that lack of knowledge about the policy and conflicting pressures resulting from the funding stream tobacco sales represent extend to high level military policy leaders. Without clearer information and direction, these leaders are unlikely to be able to establish and implement better tobacco pricing policy. [ABSTRACT FROM AUTHOR]

Introduction: Smoking rates and tobacco-related health problems vary by race and ethnicity. We explore whether cigarette prices, a determinant of tobacco use, differ across racial and ethnic groups, and whether consumer behaviors influence these differences.Methods: We used national Tobacco Use Supplement data from 23 299 adult smokers in the United States to calculate average reported cigarette pack prices for six racial and ethnic groups. Using multivariate regression models, we analyzed the independent effect of race and ethnicity on price, and whether these effects changed once indicators of carton purchasing, menthol use, Indian reservation purchase, and state market prices were incorporated.Results: American Indians and whites pay similar amounts and report the lowest prices. Blacks, Hispanics, and Asians reported paying $0.42, $0.68, and $0.89 more for a pack of cigarettes than whites. After accounting for differences in consumer behaviors, these gaps shrunk to $0.27, $0.29, and $0.27, respectively, while American Indians paid $0.38 more than whites. Pack buying was associated with $0.99 higher per-pack prices than carton buying, which was most common among whites. Additionally, people who purchased off an Indian reservation reporting paying $1.54 more than those who purchased on reservation.Conclusions: Average reported cigarette prices vary by race and ethnicity, in part due to differences in product use and purchase location. Tobacco price policies, especially those that target low prices for multipack products or on Indian reservations may increase the prices paid by whites and American Indians, who smoke at the highest rates and pay the least per pack.Implications: This study examines differences in reported prices paid by different racial and ethnic groups, using recent, national data from the United States. Results indicating that racial and ethnic groups that smoke at the highest rates (American Indians and whites) also pay the least are consistent with evidence that price is a key factor in cigarette use. Additional analysis finds that cigarette purchasing behaviors, especially carton buying and purchasing on Indian reservations, partially account for the documented price differences, and suggest that policies focused on bulk purchases (carton, multipack) and reservation prices have strong tobacco control potential. [ABSTRACT FROM AUTHOR]

Importance: Single cigarettes, which are sold without warning labels and often evade taxes, can serve as a gateway for youth smoking. The Family Smoking Prevention and Tobacco Control Act of 2009 gives the US Food and Drug Administration (FDA) authority to regulate the manufacture, distribution, and marketing of tobacco products, including prohibiting the sale of single cigarettes. To enforce these regulations, the FDA conducted over 335,661 inspections between 2010 and September 30, 2014, and allocated over $115 million toward state inspections contracts.Objective: To examine differences in single cigarette violations across states and determine if likely correlates of single cigarette sales predict single cigarette violations at the state level.Design: Cross-sectional study of publicly available FDA warning letters from January 1 to July 31, 2014.Setting: All 50 states and the District of Columbia.Participants: Tobacco retailer inspections conducted by FDA (n = 33 543).Exposures For Observational Studies: State cigarette tax, youth smoking prevalence, poverty, and tobacco production.Main Outcomes and Measures: State proportion of FDA warning letters issued for single cigarette violations.Results: There are striking differences in the number of single cigarette violations found by state, with 38 states producing no warning letters for selling single cigarettes even as state policymakers developed legislation to address retailer sales of single cigarettes. The state proportion of warning letters issued for single cigarettes is not predicted by state cigarette tax, youth smoking, poverty, or tobacco production, P = .12.Conclusions and Relevance: Substantial, unexplained variation exists in violations of single cigarette sales among states. These data suggest the possibility of differences in implementation of FDA inspections and the need for stronger quality monitoring processes across states implementing FDA inspections. [ABSTRACT FROM AUTHOR]

Background: Tobacco use is markedly higher among lesbian, gay, and bisexual populations than heterosexuals. Higher density of tobacco retailers is found in neighborhoods with lower income and more racial/ethnic minorities. Same-sex couples tend to live in similar neighborhoods, but the association of this demographic with tobacco retailer density has not been examined.Methods: For a national sample of 97 US counties, we calculated the number of tobacco retailers per 1000 persons and rates of same-sex couples per 1000 households in each census tract (n = 17 941). Using spatial regression, we examined the association of these variables in sex-stratified models, including neighborhood demographics and other environmental characteristics to examine confounding.Results: Results from spatial regression show that higher rates of both female and male same-sex couples were associated with a higher density of tobacco retailers. However the magnitude of this association was small. For female couples, the association was not significant after controlling for area-level characteristics, such as percent black, percent Hispanic, median household income, the presence of interstate highways, and urbanicity, which are neighborhood correlates of higher tobacco retailer density. For male couples, the association persisted after control for these characteristics.Conclusion: Same-sex couples reside in areas with higher tobacco retailer density, and for men, this association was not explained by neighborhood confounders, such as racial/ethnic composition and income. While lesbian, gay, and bisexual disparities in tobacco use may be influenced by neighborhood environment, the magnitude of the association suggests other explanations of these disparities remain important areas of research. [ABSTRACT FROM AUTHOR]

Background: A growing body of evidence indicates that the density of tobacco retail outlets around the home residence may influence tobacco use among youth and adults. The purpose of this study was to examine the impact of neighborhood tobacco retail outlet density on young adult initiation of different tobacco product types.Methods: Cross-sectional data from a 2013 nationally representative sample of young adults aged 18-34 was examined in relation to a 2012 geocoded listing of all outlets likely to sell tobacco in the United States. Separate multivariable logistic regression analyses examined associations between neighborhood outlet density and past 6 months first use of cigarettes, non-cigarette combustible products, and noncombustible products among adults aged 18-24 and 25-34.Results: Outlet density was significantly associated with recent initiation of cigarettes and other combustibles, but this impact varied for younger and older groups. Increased density was significantly associated with a higher likelihood of initiating cigarette use among adults aged 25-34 (OR = 3.75, 95% CI = 1.18, 11.90), and of initiating non-cigarette combustible use among 18-24 year olds (OR = 3.16, 95% CI = 1.03, 9.74). There was no impact of outlet density on recent noncombustible product initiation among either group.Conclusion: This study is the first to examine the impact of tobacco outlet density on young adult initiation of cigarettes and other tobacco products. Findings demonstrate that residential neighborhood outlet density is associated with recent initiation of combustible products and this effect varies by product type and age. The tobacco outlet environment may be a critical factor in promoting young adult tobacco use initiation. [ABSTRACT FROM AUTHOR]

The article explores the differences in business strategies deployed in health information exchange (HIE) that are financially sustainable against those not using the lens of institutional and strategic management theories. It refers to HIEs as organizations devoted to electronically transferring patients' medical data between providers to improve the delivery of care which evolved as private extensions of the electronic health record systems and as independent community-based organizations.

News that the CEOs of Amazon, Berkshire Hathaway, and JPMorgan Chase are coming together to combat high health care costs has been met with anticipation and skepticism. This commentary speculates on how these business giants might apply a Six Sigma approach to achieve the cost containment that has so far eluded the U.S. health care system. [ABSTRACT FROM AUTHOR]

Organizations are increasingly subject to rating and ranking by third-party evaluators. Research in this area tends to emphasize the direct effects of ratings systems that occur when ratings give key audiences, such as consumers or investors, more information about a rated firm. Yet, ratings systems may also indirectly influence organizations when the collective presence of more rated peers alters the broader institutional and competitive milieu. Rated firms may be more responsive to ratings systems when surrounded by more rated peers, and ratings may generate diffuse or spillover effects even among unrated firms. We test these arguments by analyzing how rated and unrated firms change their pollution behavior when more firms in their peer group are rated on environmental performance. Results indicate that the presence of more rated peers is often associated with emissions reductions. This relationship varies, however, by whether a firm was rated, whether the rating was positive or negative (if rated), and, often, features of the competitive and regulatory environment. [ABSTRACT FROM PUBLISHER]

The article discusses the U.S. tea industry and its consumption in the U.S. and the rest of the world. Topics discussed include increased total retail sales of bagged, loose and concentrated teas in the U.S., the absence of commercial enterprise, trade association or governmental agency that tracks diverse distribution channels through which tea is sold and the primary factors that catalyzes U.S. demand for tea including health & wellness trends, media coverage and evolving retail environment.

We examine the emergence and proliferation of payday lenders, fringe businesses that provide small short-term, but high-cost loans. We link the organizational dynamics of these businesses to two trends in consumer lending in the United States: the continuing consolidation of mainstream financial institutions; and the expansion of such institutions in the provision of financial services regarded as similar to payday loans. We explain the coexistence in mature industries of large-scale organizations in the market center and smaller specialists in the periphery by testing and extending the organizational model of resource partitioning. Our focus is on two under-examined aspects of the model: the dynamic underlying the partitioning process, and the conditions under which the market remains partitioned. The empirical analysis covers payday lenders, banks, and credit unions operating in Wisconsin between 1994 and 2008. [ABSTRACT FROM PUBLISHER]

Aims This study aims to compare the average price of liquor in the United States between retail alcohol outlets in states that have a monopoly ('control' states) with those that do not ('licence' states). Design A cross-sectional study of brand-specific alcohol prices in the United States. Setting We determined the average prices in February 2012 of 74 brands of liquor among the 13 control states that maintain a monopoly on liquor sales at the retail level and among a sample of 50 license-state liquor stores, using their online-available prices. Measurements We calculated average prices for 74 brands of liquor by control versus license state. We used a random-effects regression model to estimate differences between control and license state prices-overall and by alcoholic beverage type. We also compared prices between the 13 control states. Findings The overall mean price for the 74 brands was $27.79 in the license states [95% confidence interval ( CI): $25.26-30.32] and $29.82 in the control states (95% CI: $26.98-32.66). Based on the random-effects linear regression model, the average liquor price was approximately $2 lower (6.9% lower) in license states. Conclusions In the United States monopoly of alcohol retail outlets appears to be associated with slightly higher liquor prices. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the possibility that small businesses can create more jobs quickly than large corporations, and may help to retard crimes against people, property, and society in the U.S. It explores other benefits of small business activity aside from job creation. It investigates the relationship between economic cycles and crime, which said to influence business activity and performance, particularly their effect on small business. It uses correlation analysis to examine the said theory.

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The article examines how federal regulations pertaining to enterprise in the U.S. have economically and politically impacted businesses within the nation. Numerous indicators suggest that the cost for businesses of complying with regulations is rapidly growing. A study conducted by Weidenbaum Center Forum director Melinda Warren and her colleague Susan Dudley examined what amount is spent annually by U.S. federal regulatory agencies on regulatory activities. The author examines the potential for excessive regulation to impede competitiveness, thereby jeopardizing America’s status as a global leader. The Council of Competitiveness is discussed as a positive mechanism for balancing policy and business.

Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. As of March 16, 2020, 14 991 people have been infected with severe acute respiratory syndrome coronavirus 2, and 853 people have died from COVID-19. 4996 people have recovered.[2] The economic loss caused by the spread of COVID-19 in Iran coincides with the ever-highest politically induced sanctions against the country. Given the COVID-19 pandemic and its alarming outcomes in Iran,[9] the international community must be obliged to stand against the sanctions that are hurting millions of Iranians. [Extracted from the article]

Background: Previously published research by the authors found that returns on research and development (R&D) for drugs introduced into the US market in the 1970s and 1980s were highly skewed and that the top decile of new drugs accounted for close to half the overall market value. In the 1990s, however, the R&D environment for new medicines underwent a number of changes including the following: the rapid growth of managed-care organisations; indications that R&D costs were rising at a rate faster than that of overall inflation; new market strategies of major firms aimed at simultaneous launches across world markets; and the increased attention focused on the pharmaceutical industry in the political arena.Objective: The aim of this study was to examine the worldwide returns on R&D for drugs introduced into the US market in the first half of the 1990s, given that there have been significant changes to the R&D environment for new medicines over the past decade or so.Results: Analysis of new drugs entering the market from 1990 to 1994 resulted in findings similar to those of the earlier research - pharmaceutical R&D is characterised by a highly skewed distribution of returns and a mean industry internal rate of return modestly in excess of the cost of capital.Conclusions: Although the distribution of returns on R&D for new drugs continues to be highly skewed, the analysis reveals that a number of dynamic forces are currently at work in the industry. In particular, R&D costs as well as new drug introductions, sales and contribution margins increased significantly compared with their 1980s values. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the impact of economic culture and social capital in the business success of African American entrepreneurs in Cleveland, Ohio. Literature review; Development of research design; Findings; Conclusion and recommendations.

This paper empirically examines the impact of the US stock market on Australian economic activity as one explanation of the strong correlation in the Australian and US business cycles. It is found that both the US and Australian share markets appear to have a significant impact on Australian activity. [ABSTRACT FROM AUTHOR]

Presents information on a study which assessed the contemporary relevance of the Ricardian model, a theory of comparative advantage, for United States trade. Reassessment of the Ricardian model; Bilateral comparative advantage and trade patterns; Conclusion.

Detailed analysis of the statistics of merchandise trade between Brazil and the United States reveals extensive underpricing of exports and overpricing of imports, which has the effect of transferring large amounts of money out of Brazil and into the United States. Previous studies called attention to this possibility without being able to demonstrate convincingly the extent and amount of the practice. This paper reports the results of a systematic investigation of U.S. customs data at its most disaggregate level to document the amount of capital flows which may be hidden in commodity trade. Using deviations from average prices within commodity classes to identify abnormal prices produces conservative estimates of the amount of capital flight from Brazil to the United States of between $2 to $4 billion in 1995 alone, which would be between 10%-20% of total commodity trade between the countries in that year. Some suggestions are developed for using the results to more closely monitor international transactions in order to reduce this amount. [ABSTRACT FROM AUTHOR]

This study analyzes the interactive effects of oligopoly pricing, state taxation, and anti-smoking regulations on retail cigarette prices by state, using panel data for the 50 US states between 1960 and 1990. The results indicate that cigarette producers do price-discriminate by state, though the effect is not large relative to the final retail price. There are two further results: (1) state taxes are more than passed on - a 1-cent state tax increase results in a price increase of 1.11 cents, and (2) sellers offset state and local anti-smoking laws with lower prices, thereby blunting effects of the regulations. [ABSTRACT FROM AUTHOR]

This study finds that the mean IRR for 1980-84 U.S. new drug introductions is 11.1%, and the mean NPV is 22 million (1990 dollars). The distribution of returns is highly skewed. The results are robust to plausible changes in the baseline assumptions. Our work is also compared with a 1993 study by the OTA. Despite some important differences in assumptions, both studies imply that returns for the average NCE are within one percentage point of the industry's cost of capital. This is much less than what is typically observed in analyses based on accounting data. [ABSTRACT FROM AUTHOR]

Examines the reporting system of the Commodity Futures Trading Commission in the United States. Implications of market surveillance; Analysis on the interpretation of litigation system; Amendment of the Commodity Exchange Act of 1974; Emphasis on confidentiality of large trader reports.

This paper contains estimates of the determinants of the commodity composition of U.S. trade flows and of price-cost margins in U.S. domestic manufacturing in a simultaneous context. Above-competitive profits in U.S. manufacturing appear to provide a powerful incentive to import competition. These imports, in turn, provide a check on the ability of domestic firms to earn monopoly rents. The estimates indicate that failure to account for imports leads to a substantial under-estimation of the impact of market structure on price-cost margins. The linkages between exports and domestic market conditions appear to be of second-order importance. [ABSTRACT FROM AUTHOR]

Examines growth opportunities for business in the United States. Demographic shifts which will affect consumer oriented goods and service industries; Effect of technological changes on competition in the business and industrial sectors; Effect of shifts in government spending.

Broadway attendance during an average week in February of 1963 was only 20 per cent better than it had been in 1933. Yet over the same period, spending on the performing arts more than tripled, ticket sales for spectator sports more than doubled, and real per capita GNP advanced 160 per cent. The purpose of this paper is to determine why the demand for seats to the most professional, most polished, and most popular legitimate theatre in the United States should have grown so slowly. In the process, elasticity estimates of the relationship between income-quantity, income-quality, price-quantity and cash costs-quantity are derived. From these figures, computed from cross-sectional data and from time-series data, a reasonably clear understanding of the theatre's problems emerges. The cross-sectional data were developed in April of 1962 by means of a survey of theatregoers conducted by the author. Questionnaires were inserted in all Playbills distributed in seven Broadway houses. A total of 18 performances were involved. The form requested only one member of a family to answer. Those replying were asked to drop the completed copy in one of several large boxes in the lobby and near the exits.

Discusses the involvement of the business sector in agrarian movement in the United States from 1879 to 1920. Issue on monopoly and unregulated power of the railroads in the 19th century.