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Did earnings inequality in the Federal Republic of Germany increase from the 1960s to the 1980s?
(1996)
Background: 15-20% of all patients initially diagnosed with colorectal cancer develop metastatic disease and surgical resection remains the only potentially curative treatment available. Current 5-year survival following R0-resection of liver metastases is 28-39%, but recurrence eventually occurs in up to 70%. To date, adjuvant chemotherapy has not improved clinical outcomes significantly. The primary objective of the ongoing LICC trial (L-BLP25 In Colorectal Cancer) is to determine whether L-BLP25, an active cancer immunotherapy, extends recurrence-free survival (RFS) time over placebo in colorectal cancer patients following R0/R1 resection of hepatic metastases. L-BLP25 targets MUC1 glycoprotein, which is highly expressed in hepatic metastases from colorectal cancer. In a phase IIB trial, L-BLP25 has shown acceptable tolerability and a trend towards longer survival in patients with stage IIIB locoregional NSCLC.
Methods: This is a multinational, phase II, multicenter, randomized, double-blind, placebo-controlled trial with a sample size of 159 patients from 20 centers in 3 countries. Patients with stage IV colorectal adenocarcinoma limited to liver metastases are included. Following curative-intent complete resection of the primary tumor and of all synchronous/metachronous metastases, eligible patients are randomized 2:1 to receive either L-BLP25 or placebo. Those allocated to L-BLP25 receive a single dose of 300 mg/m2 cyclophosphamide (CP) 3 days before first L-BLP25 dose, then primary treatment with s.c. L-BLP25 930 mug once weekly for 8 weeks, followed by s.c. L-BLP25 930 mug maintenance doses at 6-week (years 1&2) and 12-week (year 3) intervals unless recurrence occurs. In the control arm, CP is replaced by saline solution and L-BLP25 by placebo. Primary endpoint is the comparison of recurrence-free survival (RFS) time between groups. Secondary endpoints are overall survival (OS) time, safety, tolerability, RFS/OS in MUC-1 positive cancers. Exploratory immune response analyses are planned. The primary endpoint will be assessed in Q3 2016. Follow-up will end Q3 2017. Interim analyses are not planned.
Discussion: The design and implementation of such a vaccination study in colorectal cancer is feasible. The study will provide recurrence-free and overall survival rates of groups in an unbiased fashion. Trial Registration EudraCT Number 2011-000218-20
To sum up our findings we come to the following statements. - During the period from 1973 to 1993 inequality of the personal distribution of equivalent pre-government income increased to some extent, as was to be expected given the enormous rise in unemployment. - Inequality of post-government income also increased slightly, but was much lower than inequality of pre-government income due to the equalizing effect of the German tax and transfer system. - In 1993 inequality of pre-government income was higher, and inequality of post-government income was considerably lower in East Germany than in West Germany; the West German tax and transfer system that was transferred to East Germany after reunification - with some additional but temporary minimum regulations - seems to have had a stronger equalizing effect in the East than in the West. - A decomposition into three age groups, the young and the middle-aged group sub-divided further according to whether household members were affected by unemployment, showed that within-groups inequality explained by far more of overall inequality than between-groups inequality. - The relative positions of the two young groups as well as of the middle-aged group with unemployed members deteriorated with respect to their equivalent pre-government and post-government incomes. - During the first period with rising unemployment (1973 to 1978), the development of within-groups inequality and of between-groups inequality contributed to about the same extent to the increase of overall inequality of pre-government income. But this was fully compensated by the tax and transfer system as there were only a negligible change in inequality of equivalent net income and very slight effects of the (four) components of change which nearly compensated each other. - During the last period from 1988 to 1993 the equalizing effect of the German tax and transfer system seems to have weakened, at least in the western part of Germany. The increase in inequality of equivalent net income is mainly due to developments of within group inequalities.
Revised version of a paper presented at the Conference "The Distribution of Economic Well-Being in the 1980s - an International Perspective", June 21 - 23, 1993, in Fiskebäckskil, Sweden. This paper sketches changes in the distribution of well-being during the period from 1972 to 1991 against the background of West Germany's economic and demographic development, and compares the distribution of well-being in East Germany before and after reunification. We rely on equivalent income of persons as the main indicator to measure well-being, but we also look at the distribution of gross wage income of workers and employees. Estimates of the Federal Statistical Office referring to the mesolevel of average equivalent income of socio-economic groups as well as various distributional measures computed by us at the micro-level are used to gauge changes of the distribution. The computations are based on two sets of micro-data available to us, the official Income and Consumption Surveys (1973, 1978 and 1983), and the German Socio-economic Panel (1983 to 1990 for West Germany, 1990, 1991 for East Germany). At the meso-level we find substantial changes in the relative welfare positions of the ten socio-economic groups distinguished, but a nearly constant ranking of the groups during the whole period under review. At the micro-level our computations indicate slight increases in the inequality of gross earnings during both decades. The distribution of well-being as measured by equivalent income of persons seems also to have become slightly more unequal during the whole period but the changes are very small, and partly reversed during subperiods. A decomposition of overall inequality by occupational status of the heads of household using the Theil measure shows that more than 80 percent of overall inequality is due to within-group inequality with rising tendency. This result is mitigated a little when dis aggregating the heterogeneous group of not gainfully employed with regard to the main income source of the household.