Current challenges for assessing the long-term clinical benefit of cancer immunotherapy: a multi-stakeholder perspective.

Immuno-oncologics (IOs) differ from chemotherapies as they prime the patient's immune system to attack the tumor, rather than directly destroying cancer cells. The IO mechanism of action leads to durable responses and prolonged survival in some patients. However, providing robust evidence of the long-term benefits of IOs at health technology assessment (HTA) submission presents several challenges for manufacturers.

Switching costs in competitive health insurance markets: The role of insurers' pricing strategies.

Our article deals with pricing strategies in Swiss health insurance markets and focuses on the relationship between basic and supplementary insurance. We analyzed how firms' pricing strategies (i.e.

A French Value Set for the EQ-5D-5L.

Objective: The objective of this study was to develop a French value set for the EQ-5D-5L, for academic and clinical research, and for regulatory requirements for price-setting of drugs and medical devices.

Method: This study used the standardized valuation protocol developed by EuroQol, using computer-assisted personal interview software. A representative sample of 1048 French residents were interviewed by a market research company, under the supervision of the research team.

The contribution of real-world evidence to cost-effectiveness analysis: case study of Dabigatran etexilate in France.

Objective: The goal of this study was to assess the differences between an ex ante and an ex post cost-effectiveness analysis of Dabigatran etexilate vs VKAs for the prevention of thromboembolic events in non-valvular atrial fibrillation patients and to draw lessons on the design and use of real-world data for decision making.

Methods: The same model was used to calculate the cost-effectiveness ratio using two sets of parameters. One set included the efficacy and safety outcomes data from RE-LY, the pivotal trial comparing Dabigatran to warfarin; cost data came from an ex ante publication.

Self-assertive interdependence in Arab culture.

Arabs represent a major cultural group, yet one that is relatively neglected in cultural psychology. We hypothesized that Arab culture is characterized by a unique form of interdependence that is self-assertive. Arab cultural identity emerged historically in regions with harsh ecological and climatic environments, in which it was necessary to protect the survival of tribal groups.

A simple approximation algorithm for the diameter of a set of points in an Euclidean plane.

Approximation algorithms with linear complexities are required in the treatments of big data, however, present algorithms cannot output the diameter of a set of points with arbitrary accuracy and near-linear complexity. By introducing the partition technique, we introduce a very simple approximation algorithm with arbitrary accuracy ε and a complexity of O(N + ε-1 log ε-1) for the cases that all points are located in an Euclidean plane. The error bounds are proved strictly, and are verified by numerical tests.

Patient preference for chronic obstructive pulmonary disease (COPD) treatment inhalers: a discrete choice experiment in France.

Objectives: Understanding inhaler preferences may contribute to improving adherence in COPD patients and improving long-term outcomes. This study aims to identify and quantify preferences for convenience-related inhaler attributes in French moderate-to-severe COPD patients, with discrete choice experiment (DCE) methodology.

Methods: Attributes were defined from a literature search, clinician and patient interviews: shape, dose insertion, dose preparation, dose release, dose confirmation, dose counter and reusability.

Cost-effectiveness analysis of the SAPIEN 3 TAVI valve compared with surgery in intermediate-risk patients.

Objective: Transcatheter aortic valve implantation (TAVI) has become the therapy of choice for treating severe aortic stenosis in patients at high-risk for surgery or where it is considered too risky to attempt. This uptake varies across geographies however, and its cost or value has frequently been cited as the reason for this. We sought to evaluate the potential cost and clinical impact of TAVI in intermediate risk patients from a French collective perspective.

Health related quality of life in patients with community-acquired pneumococcal pneumonia in France.

Background: Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France.

Methods: A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge.

Decomposition methods for the two-stage stochastic Steiner tree problem.

A new algorithmic approach for solving the stochastic Steiner tree problem based on three procedures for computing lower bounds (dual ascent, Lagrangian relaxation, Benders decomposition) is introduced. Our method is derived from a new integer linear programming formulation, which is shown to be strongest among all known formulations. The resulting method, which relies on an interplay of the dual information retrieved from the respective dual procedures, computes upper and lower bounds and combines them with several rules for fixing variables in order to decrease the size of problem instances.

The Essential Elements of a Risk Governance Framework for Current and Future Nanotechnologies.

Societies worldwide are investing considerable resources into the safe development and use of nanomaterials. Although each of these protective efforts is crucial for governing the risks of nanomaterials, they are insufficient in isolation. What is missing is a more integrative governance approach that goes beyond legislation.

Resource Use and Costs of Dengue: Analysis of Data from Phase III Efficacy Studies of a Tetravalent Dengue Vaccine.

A tetravalent dengue vaccine (CYD-TDV) has recently been approved in 12 countries in southeast Asia and Latin America for individuals aged 9-45 years or 9-60 years (age indication approvals vary by country) living in endemic areas. Data on utilization of medical and nonmedical resources as well as time lost from school and work were collected during the active phase of two phase III efficacy studies performed in 10 countries in the Asia-Pacific region and Latin America (NCT01373281; NCT01374516). We compared dengue-related resource utilization and costs among vaccinated and nonvaccinated participants.

Development of an instrument evaluating the impact of surgeon-patient relationship in patients on sick leave.

: To date, no specific instruments exist to measure the quality of the patient-surgeon relationship despite its potential to influence clinical and economic outcomes in patients undergoing surgery for musculoskeletal disorders (MSDs). : The objective was to develop and validate an instrument to assess the quality of the patient-surgeon relationship, taking into account the return to work after functional restoration surgery. : The instrument development was based on literature review, cognitive interviews and expert examinations.

Cost-Effectiveness Analysis of Afatinib versus Gefitinib for First-Line Treatment of Advanced EGFR-Mutated Advanced Non-Small Cell Lung Cancers.

Introduction: The irreversible ErbB family blocker afatinib and the reversible EGFR tyrosine kinase inhibitor gefitinib were compared in the multicenter, international, randomized, head-to-head phase 2b LUX-Lung 7 trial for first-line treatment of advanced EGFR mutation-positive NSCLCs. Afatinib and gefitinib costs and patients' outcomes in France were assessed.

Methods: A partitioned survival model was designed to assess the cost-effectiveness of afatinib versus gefitinib for EGFR mutation-positive NSCLCs.

Unlocking the potential of established products: toward new incentives rewarding innovation in Europe.

: Many established products (EPs - marketed for eight years or more) are widely used off-label despite little evidence on benefit-risk ratio. This exposes patients to risks related to safety and lack of efficacy, and healthcare providers to liability. Introducing new indications for EPs may represent a high societal value; however, manufacturers rarely invest in R&D for EPs.

Costs associated with community acquired pneumonia in France.

Objectives: Pneumocost is a prospective study that aimed at documenting the costs of the management of patients hospitalized with a pneumococcal pneumonia and the post-discharge costs during a 6-month period in the French context.

Methods: Billing data were used to document hospital costs. Resource use during the follow-up period was collected through phone interviews at month 1, 3 and 6.

Costs of perennial allergic rhinitis and allergic asthma increase with severity and poor disease control.

Background: Perennial allergic rhinitis (PAR) represents a global and public health problem, due to its prevalence, morbidity, and impact on the quality of life. PAR is frequently associated with allergic asthma (AA). Costs of PAR with or without AA are poorly documented.

Keys to successful implementation of a French national quality indicator in health care organizations: a qualitative study.

Background: Several countries have launched public reporting systems based on quality indicators (QIs) to increase transparency and improve quality in health care organizations (HCOs). However, a prerequisite to quality improvement is successful local QI implementation. The aim of this study was to explore the pathway through which a mandatory QI of the French national public reporting system, namely the quality of the anesthesia file (QAF), was put into practice.

Endogenous Technology Adoption and Medical Costs.

Despite the claim that technology has been one of the most important drivers of healthcare spending growth over the past decades, technology variables are rarely introduced explicitly in cost equations. Furthermore, technology is often considered exogenous. Using 1996-2007 panel data on Swiss geographical areas, we assessed the impact of technology availability on per capita healthcare spending covered by basic health insurance whilst controlling for the endogeneity of health technology availability variables.

Recurrent Wheezing in Infants: A Population-Based Study.

Recurrent wheezing (RW) has a significant impact on infants, caregivers, and society, but morbidity and related medical resource utilization (MRU) have not been thoroughly explored. The burden of RW needs to be documented with population-based data. The objective was to assess the characteristics, medical management, and MRU of RW infants identified from national claims data.

CAPECO: Cost evaluation of community acquired pneumonia managed in primary care.

Background: Estimating the economic burden of community acquired pneumonia (CAP) managed in ambulatory setting is needed in France since no data are available.

Method: A retrospective study (CAPECO) was conducted based on a prospective French study describing patients with suspected CAP managed in primary care (CAPA). The aim of the CAPECO study was to estimate and explain medical costs of a disease episode in CAP patients only followed in ambulatory care and in hospitalised patients.

Economic Impact of Gene Expression Profiling in Patients with Early-Stage Breast Cancer in France.

Background And Aims: The heterogeneous nature of breast cancer can make decisions on adjuvant chemotherapy following surgical resection challenging. Oncotype DX is a validated gene expression profiling test that predicts the likelihood of adjuvant chemotherapy benefit in early-stage breast cancer. The aim of this study is to determine the costs of chemotherapy in private hospitals in France, and evaluate the cost-effectiveness of Oncotype DX from national insurance and societal perspectives.

Weep and get more: When and why sadness expression is effective in negotiations.

Although recently some research has been accumulated on emotional expressions in negotiations, there is little research on whether expressing sadness could have any effect in negotiations. We propose that sadness expressions can increase the expressers' ability to claim value in negotiations because they make recipients experience greater other-concern for the expresser. However, only when the social situation provides recipients with reasons to experience concern for the expresser in the first place, will recipients act on their other-concern and, eventually, concede more to a sad expresser.