Enhancing affordability and profit in a non-cooperative, coordinated, hypothetical pediatric vaccine market via sequential optimization.

This study considers a hypothetical global pediatric vaccine market where multiple coordinating entities make optimal procurement decisions on behalf of countries with different purchasing power. Each entity aims to improve affordability for its countries while maintaining a profitable market for vaccine producers. This study analyzes the effect of several factors on affordability and profitability, including the number of non-cooperative coordinating entities making procuring decisions, the number of market segments in which countries are grouped for tiered pricing purposes, how producers recover fixed production costs, and the procuring order of the coordinating entities.

Key considerations when using health insurance claims data in advanced data analyses: an experience report.

Health claims have become a popular source of data for healthcare analytics, with numerous applications ranging from disease burden estimation and policy evaluation to drug event detection and advanced predictive analytics. Independent of the application, a researcher utilising claims information will likely encounter challenges in using the data, which include dealing with several coding systems and coding irregularities. We highlight some of these challenges and approaches for successful analysis that may reduce implementation time and help in avoiding common pitfalls.

Where Do the Salt and Water Go? A Case of Profound Hyponatremia.

Treatment of profound hyponatremia is challenging. Severe symptoms mandate correction by 4 to 6 mEq/L within hours, but with risk factors for osmotic demyelination, daily correction should be <8 mEq/L. With a therapeutic window this narrow, clinicians would like to know how serum sodium (SNa) concentration will respond to their therapy.

Scheduling internal medicine resident rotations to ensure fairness and facilitate continuity of care.

Completing a residency program is a requirement for medical students before they can practice medicine independently. Residency programs in internal medicine must undergo a series of supervised rotations in elective, inpatient, and ambulatory units. Typically, a team of chief residents is charged to develop a yearly rotational schedule.

Determining the optimal vaccine vial size in developing countries: a Monte Carlo simulation approach.

Outreach immunization services, in which health workers immunize children in their own communities, are indispensable to improve vaccine coverage in rural areas of developing countries. One of the challenges faced by these services is how to reduce high levels of vaccine wastage. In particular, the open vial wastage (OVW) that result from the vaccine doses remaining in a vial after a time for safe use -since opening the vial- has elapsed.

An analysis of the pediatric vaccine supply shortage problem.

In 2002, several factors resulted in pediatric vaccine manufacturers not being able to produce a sufficient number of vaccines to vaccinate all the children in the United States according to the Recommended Childhood Immunization Schedule. The resulting vaccine supply shortage resulted in thousands of children not being fully immunized according to this schedule, and hence, created an unnecessary risk for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention responded to this crisis by using pediatric vaccine stockpiles to mitigate the impact of future shortages.

Stockpile levels for pediatric vaccines: how much is enough?

In recent years, several factors have led to pediatric vaccine manufacturers experiencing vaccine production interruptions that resulted in vaccine supply shortages. One unfortunate consequence of such events is that not all children in the United States could be vaccinated on time, as set forth by the Recommended Childhood Immunization Schedule, and hence, created the potential for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention (CDC) have responded to such events by releasing vaccine supplies from the national pediatric vaccine stockpiles, which were designed to mitigate the impact of vaccine production interruptions.