Property Manager Awareness of Service Innovation, Decision-Making Factors and Personal Traits - Empirical Analysis Based on Hunan Property Managers' 214 Questionnaires

Abstract Iran's strategy with respect to Saudi Arabia is a key factor in the complex balance of power of the Middle East as the Iranian–Saudi rivalry impacts the dynamics of peace and conflict across the region from Yemen to Syria, Lebanon, Iraq and Bahrain. What is Iranian strategic thinking on Saudi Arabia? And what have been the key factors driving the evolution of Iranian strategy towards the Kingdom? In what marks a substantive shift from its previous detente policy, we argue that Tehran has developed a new containment strategy in response to the perceived threat posed by an increasingly prox-active Saudi Arabia in the post-Arab Spring period. Incorporating rich fieldwork and interviews in the Middle East, this article delineates the theoretical contours of Iranian containment and contextualizes it within the framework of the Persian Gulf security architecture, demonstrating how rational geopolitical decision-making factors based on a containment strategy, rather than the primacy of sectarianism or domestic political orientations, shape Iran's Saudi strategy. Accordingly, the article traces Iranian strategic decision-making towards the Kingdom since the Islamic Revolution of 1979 and examines three cases of Iran's current use of containment against Saudi Arabia in Syria, Yemen and Qatar.

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Determinants of Managed Entry Agreements in the context of Health Technology Assessment: a comparative analysis of oncology therapies in four countries

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462321000039 ◽

2021 ◽

Vol 37 ◽

Author(s):

Olina Efthymiadou ◽

Panos Kanavos

Keyword(s):

Decision Making ◽

Health Technology Assessment ◽

Technology Assessment ◽

Best Practice ◽

Health Technology ◽

Future Research ◽

Best Practice Guidelines ◽

Chi Squared ◽

Decision Making Factors ◽

Managed Entry Agreements

Abstract Background Managed Entry Agreements (MEAs) are increasingly used to address uncertainties arising in the Health Technology Assessment (HTA) process due to immature evidence of new, high-cost medicines on their real-world performance and cost-effectiveness. The literature remains inconclusive on the HTA decision-making factors that influence the utilization of MEAs. We aimed to assess if the uptake of MEAs differs between countries and if so, to understand which HTA decision-making criteria play a role in determining such differences. Methods All oncology medicines approved since 2009 in Australia, England, Scotland, and Sweden were studied. Four categories of variables were collected from publicly available HTA reports of the above drugs: (i) Social Value Judgments (SVJs), (ii) Clinical/Economic evidence submitted, (iii) Interpretation of this evidence, and (iv) Funding decision. Conditional/restricted decisions were coded as Listed With Conditions (LWC) other than an MEA or LWC including an MEA (LWCMEA). Cohen's κ-scores measured the inter-rater agreement of countries on their LWCMEA outcomes and Pearson's chi-squared tests explored the association between HTA variables and LWCMEA outcomes. Results A total of 74 drug-indication pairs were found resulting in n = 296 observations; 8 percent (n = 23) were LWC and 55 percent (n = 163) were LWCMEA. A poor-to-moderate agreement existed between countries (−.29 < κ < .33) on LWCMEA decisions. Cross-country differences within the LWCMEA sample were partly driven by economic uncertainties and largely driven by SVJs considered across agencies. Conclusions A set of HTA-related variables driving the uptake of MEAs across countries was identified. These findings can be useful in future research aimed at informing country-specific, “best-practice” guidelines for successful MEA implementation.

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