Cost-effectiveness analysis of COVID-19 vaccination in Poland

IntroductionTo assess the potential value of the Comirnaty COVID-19 vaccination in Poland.Material and methodsMarkov model with 1-week cycles was used to estimate patient events, direct medical costs, utilities and cost-effectiveness for one year with and without implementing the Comirnaty vaccine in Poland. The incremental cost per quality-adjusted life-year (QALY) gained vs. no vaccine was calculated for the general population as well as for selected age-groups.ResultsIn the base case analysis the incremental cost per QALY gained associated with vaccinating the whole population amounted 6,249 PLN. For individuals aged 60-69 and >80 vaccination proved to be less costly and more effective than no vaccination. The incremental cost per QALY gained when vaccinating individuals aged 40-49 and 30-39 amounted 28,135 PLN and 67,823 PLN, respectively. In the general population and in younger subpopulations the incremental cost-effectiveness ratio was most sensitive to the vaccine effectiveness, vaccine price and SARS-CoV-2 infection rates.ConclusionsWhen prioritization is required due to supply constraints, vaccination of elderly is justified as it allows to achieve highest number of QALY gained and generates savings to the health care system. Continual update of the model concerning vaccine real-life effectiveness and epidemic course is required to refine the prioritisation scheme in the future.

Adverse Effect of Social Media Addiction on Life Effectiveness of Adolescents: An Approach towards Mental Health and Mood Modifications

Objective: The prime intent of this study was to determine the adverse effect of social media addiction on adolescent’s life effectiveness, studying in grade 8th to 12th in Delhi NCR, India. Materials and Methods: The psychometric properties of the Bergen social media Addiction Scale and Life Effectiveness Questionnaire by James Neill were evaluated, additionally examining the factor structure utilizing the Partial least squares-based Structural Equation Modeling (SEM) amongst n = 968 adolescents. The hypothesized inverse relationship between the two scales is tested using the person correlation examination. Results: Adolescence’s life effectiveness, dimensions of time management, self-confidence, emotional control, and achievement motivation were significantly adversely (negatively) related to Facebook Addiction. Implications: The over-use of social media will trigger failure in education and social relationships, health and well-being concerns, provoking life disruption. The reasonable usage of online media requires ethos, attention, and awareness on how to utilize them effectively. We can propel students by bringing issues to light.

Real-Life Effectiveness and Safety of Baricitinib as Adjunctive to Standard-of-Care Treatment in Hospitalized Patients With Severe Coronavirus Disease 2019

Background Therapeutic options for hospitalized patients with severe coronavirus disease 2019 (sCOVID-19) are limited. Preliminary data have shown promising results with baricitinib, but real-life experience is lacking. We assessed the safety and effectiveness of add-on baricitinib to standard-of-care (SOC) including dexamethasone in hospitalized patients with sCOVID-19. Methods This study is a 2-center, observational, retrospective cohort study of patients with sCOVID-19, comparing outcomes and serious events between patients treated with SOC versus those treated with SOC and baricitinib combination. Results We included 369 patients with sCOVID-19 (males 66.1%; mean age 65.2 years; median symptom duration 6 days). The SOC was administered in 47.7% and combination in 52.3%. Patients treated with the combination reached the composite outcome (intensive care unit [ICU] admission or death) less frequently compared with SOC (22.3% vs 36.9%, P = .002). Mortality rate was lower with the combination in the total cohort (14.7% vs 26.6%, P = .005), and ICU admission was lower in patients with severe acute respiratory distress syndrome (29.7% vs 44.8%, P = .03). By multivariable analysis, age (odds ratio [OR] = 1.82, 95% confidence interval [CI] = 1.36–2.44, per 10-year increase), partial pressure of oxygen/fraction of inspired oxygen ratio (OR = 0.60, 95% CI = .52–0.68, per 10 units increase), and use of high-flow nasal cannula (OR = 0.34; 95% CI, .16–0.74) were associated with the composite outcome, whereas baricitinib use was marginally not associated with the composite outcome (OR = 0.52; 95% CI, .26–1.03). However, baricitinib use was found to be significant after inverse-probability weighted regression (OR = 0.93; 95% CI, .87–0.99). No difference in serious events was noted between treatment groups. Conclusions In real-life settings, addition of baricitinib to SOC in patients hospitalized with sCOVID-19 is associated with decreased mortality without concerning safety signals.

Anti-CGRP monoclonal antibodies in chronic migraine with medication overuse: real-life effectiveness and predictors of response at 6 months

Background In daily practice, anti-CGRP monoclonal antibodies (MAbs) may be useful in chronic migraine (CM) with medication overuse (MO), but data is limited. We evaluated their effectiveness in a real-life clinical cohort. Methods This is a prospective study conducted in CM patients with and without medication overuse treated with monthly MAbs during 6 months (erenumab/galcanezumab). We collected headache characteristics, including acute medication intake, through an electronic diary. We compared patients (1) with and without MO at baseline, (2) with and without ongoing MO after treatment, defining MO resolution as < 10 or 15 days/month of acute medication intake, according to analgesic type, during the 6-month treatment. Results Of 139 CM patients completing 6-month treatment with anti-CGRP MAbs, 71.2% (99/139) had MO at baseline. After 6 months, patients with and without MO at baseline had significant and similar proportions of ≥50% reduction in migraine days/month (MO: 63.6% vs. non-MO: 57.5%, p = 0.500). 60.6% (60/99) no longer satisfied MO definition. Reduction in headache frequency compared to baseline occurred in both MO-ongoing and MO-resolution group, although those who stopped overusing had a greater improvement (headache days/month: − 13.4 ± 7.6 vs. -7.8 ± 7.2, p < 0.0001). No differences in MO resolution were observed according to the MAbs used. Baseline lower pain severity was associated with MO resolution (OR [95%]:0.236[0.054–0.975]; p = 0.049). Conclusions In real-life anti-CGRP MAbs are as effective in CM patients with MO as in patients without it and facilitate MO cessation. Reduction in headache frequency and acute medication days/month occurs regardless of whether patients stop overusing or not.