Cost-Effectiveness of Axicabtagene Ciloleucel for Adult Patients With Relapsed or Refractory Follicular Lymphoma in the United States.

OBJECTIVES: The results of a recent single-arm trial (ZUMA-5) of axicabtagene ciloleucel (axi-cel) for relapsed/refractory (r/r) follicular lymphoma (FL) demonstrated high rates of durable response and tolerable toxicity among treated patients. To quantify the value of axi-cel compared with standard of care (SOC) to manage r/r FL patients who have had at least 2 prior lines of systemic therapy (3L+), a cost-effectiveness model was developed from a US third-party payer perspective. METHODS: A 3-state partitioned-survival cost-effectiveness model was developed with a lifetime horizon. Patient-level analyses of the 36-month ZUMA-5 (axi-cel) and SCHOLAR-5 (SOC) studies were used to extrapolate progression-free and overall survivals. After 5 years of survival, an estimated 40% of the modeled population was assumed to experience long-term remission based on literature. Results include the incremental cost-effectiveness ratio (ICER) measured as incremental cost per quality-adjusted life year (QALY) gained. One-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analyses were performed. All outcomes were discounted 3% per year. RESULTS: Axi-cel led to an increase of 4.28 life-years, 3.64 QALYs, and a total cost increase of $321 192 relative to SOC, resulting in an ICER of $88 300 per QALY. Across all parameters varied in the one-way sensitivity analysis, the ICER varied between $133 030 and $67 277. In the probabilistic sensitivity analysis, axi-cel had a 99% probability of being cost-effective across 5000 iterations using a $150 000 willingness-to-pay threshold. CONCLUSIONS: Given the robustness of the model results and sensitivity analyses, axi-cel is expected to be a cost-effective treatment in 3L+ r/r FL.

Following community norms or an internal compass? The role of prospective leaders' social category membership in the differential effects of authentic and ethical leadership on stereotype threat.

Increasing racial diversity in organizations remains a challenge, as stereotype threat undermines the performance and career aspirations of minority group members during job recruitment. The present study examines how prospective leaders can leverage their influence on their followers' identities to mitigate the stereotype threat Black individuals face in this context. We explore the effects of two moral leadership styles (ethical vs. authentic) on stereotype threat in the context of recruitment. Specifically, we investigate whether prospective leaders' ingroup status moderates the relationship between ethical versus authentic leadership styles and candidates' stereotype threat during the selection process and candidates' willingness to join the organization. To this end, we conducted four experiments with Black residents of Brazilian favelas (impoverished neighborhoods), two of which included real-world job recruitment processes and physiological measures of stress (i.e., salivary cortisol and blood pressure). The results indicate that when the prospective leaders are from the outgroup, displaying ethical leadership by relying on community norms is more helpful in reducing Black candidates' threat and, in turn, promotes willingness to apply for the job. In contrast, when the leader is from the ingroup, displaying authentic leadership by emphasizing the importance of an internal moral compass is more helpful in reducing threat, and this effect is mediated by the identity process of inclusion of the leader in the self. Overall, the present study suggests that prospective direct supervisors have the critical ability to reduce stereotype threat, which can negatively affect Black applicants and their desire to join organizations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Cost-Effectiveness of Vaccination of Older Adults with an MF59®-Adjuvanted Quadrivalent Influenza Vaccine Compared to Standard-Dose and High-Dose Vaccines in Denmark, Norway, and Sweden.

Individuals aged 65 years and above are at increased risk of complications and death from influenza compared with any other age group. Enhanced vaccines, as the MF59®-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose quadrivalent influenza vaccine (HD-QIV), provide increased protection for older adults in comparison to the traditional standard-dose quadrivalent influenza vaccines (SD-QIV). This study aimed to assess the cost-effectiveness of aQIV compared to SD-QIV and HD-QIV in Denmark, Norway, and Sweden for adults aged ≥65 years. A static decision tree model was used to evaluate costs and outcomes of different vaccination strategies from healthcare payer and societal perspectives. This model projects that compared to SD-QIV, vaccination with aQIV could prevent a combined total of 18,772 symptomatic influenza infections, 925 hospitalizations, and 161 deaths in one influenza season across the three countries. From a healthcare payer perspective, the incremental costs per quality adjusted life year (QALY) gained with aQIV versus SD-QIV were EUR 10,170/QALY in Denmark, EUR 12,515/QALY in Norway, and EUR 9894/QALY in Sweden. The aQIV was cost saving compared with HD-QIV. This study found that introducing aQIV to the entire population aged ≥65 years may contribute to reducing the disease and economic burden associated with influenza in these countries.

Political orientation and support for social distancing during the COVID-19 pandemic: evidence from Brazil / Orientación política y apoyo al aislamiento social durante la pandemia de COVID-19: evidencia de Brasil / Orientação política e apoio ao isolamento social durante a pandemia da COVID-19: evidências do Brasil

Abstract Social distancing practices have been widely recommended to curb the COVID-19 pandemic. However, despite the medical consensus, many citizens have resisted adhering to and/or supporting its implementation. While this resistance may stem from the non-negligible personal economic costs of implementing social distancing, we argue that it may also reside in more fundamental differences in normative principles and belief systems, as reflected by political orientation. In a study conducted in Brazil, we test the relative importance of these explanations by examining whether and how support for social distancing varies according to self-identified political orientation and personal economic vulnerability. Results show that while economic vulnerability does not influence support for social distancing, conservatives are systematically less supportive of these practices than liberals. Discrepancies in sensitivity to threats to the economic system help explain the phenomenon.

Resumen Las prácticas de aislamiento social se han recomendado ampliamente para contener la propagación de la pandemia de COVID-19. Sin embargo, a pesar del consenso médico, muchos ciudadanos se han resistido a adherirse y/o apoyar su implementación. Si bien esta resistencia puede provenir de costos económicos personales no despreciables en la implementación del aislamiento social, argumentamos que también puede residir en diferencias más fundamentadas en principios normativos y sistemas de creencias, reflejados en la orientación política. El artículo prueba, mediante una encuesta realizada en Brasil, la importancia relativa de estas explicaciones al examinar si y de qué manera el apoyo al aislamiento social varía de acuerdo con la orientación política declarada y la vulnerabilidad económica personal. Los resultados muestran que, si bien la vulnerabilidad económica no influye en el apoyo al aislamiento social, los conservadores apoyan dichas prácticas sistemáticamente menos que los liberales. Las diferencias de sensibilidad ante las amenazas al sistema económico ayudan a explicar el fenómeno.

Resumo Práticas de isolamento social têm sido amplamente recomendadas para conter a propagação da pandemia da COVID-19. No entanto, apesar do consenso médico, muitos cidadãos têm resistido a aderir e/ou apoiar a sua implementação. Enquanto essa resistência pode ter origem nos custos econômicos individuais não desprezíveis de implementar o isolamento social, argumentamos que ela também pode residir em diferenças mais fundamentais nos princípios normativos e sistemas de crenças, refletidos na orientação política. Em um estudo conduzido no Brasil, testamos a importância relativa dessas explicações ao examinar se e como o apoio ao isolamento social varia de acordo com orientação política autodeclarada e vulnerabilidade econômica pessoal. Os resultados mostram que enquanto a vulnerabilidade econômica não influencia o apoio ao isolamento social, indivíduos que se consideram de direita apoiam sistematicamente menos tais práticas do que aqueles que se consideram de esquerda. Diferenças em suas sensibilidades a ameaças ao sistema econômico ajudam a explicar o fenômeno.

An estimate of the public health impact and cost-effectiveness of universal vaccination with a 9-valent HPV vaccine in Germany.

INTRODUCTION: Since 2007, the German Standing Vaccination Committee recommends HPV vaccination for girls aged 12-17 with a 2- (Cervarix®) or 4-valent (Gardasil®) vaccine. A 9-valent vaccine (Gardasil 9®) recently received a European market authorization in 2015. METHODS: A dynamic transmission model was calibrated to the German setting and used to estimate costs and QALYs associated with vaccination strategies. RESULTS: Compared to the current vaccination program, the 9-valent vaccine extended to boys shows further reductions of 24% in the incidence of cervical cancer, 30% and 14% in anal cancer for males and females, as well as over a million cases of genital warts avoided after 100 years. The new strategy is associated with an ICER of 22,987€ per QALY gained, decreasing to 329€ when considering the vaccine switch for girls-only. CONCLUSION: Universal vaccination with the 9-valent vaccine can yield significant health benefits when compared to the current program.

Gold on paper-paper platform for Au-nanoprobe TB detection.

Tuberculosis (TB) remains one of the most serious infectious diseases in the world and the rate of new cases continues to increase. The development of cheap and simple methodologies capable of identifying TB causing agents belonging to the Mycobacterium tuberculosis Complex (MTBC), at point-of-need, in particular in resource-poor countries where the main TB epidemics are observed, is of paramount relevance for the timely and effective diagnosis and management of patients. TB molecular diagnostics, aimed at reducing the time of laboratory diagnostics from weeks to days, still require specialised technical personnel and labour intensive methods. Recent nanotechnology-based systems have been proposed to circumvent these limitations. Here, we report on a paper-based platform capable of integrating a previously developed Au-nanoprobe based MTBC detection assay-we call it "Gold on Paper". The Au-nanoprobe assay is processed and developed on a wax-printed microplate paper platform, allowing unequivocal identification of MTBC members and can be performed without specialised laboratory equipment. Upon integration of this Au-nanoprobe colorimetric assay onto the 384-microplate, differential colour scrutiny may be captured and analysed with a generic "smartphone" device. This strategy uses the mobile device to digitalise the intensity of the colour associated with each colorimetric assay, perform a Red Green Blue (RGB) analysis and transfer relevant information to an off-site lab, thus allowing for efficient diagnostics. Integration of the GPS location metadata of every test image may add a new dimension of information, allowing for real-time epidemiologic data on MTBC identification.