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Objectives: Given the lack of a value framework for assessing health technologies in Asian settings, a value framework incorporating multiple-criteria decision analysis for new drugs under universal healthcare coverage in Taiwan was established., Methods: The development process included (1) the adoption of 5 value domains (ie, Overall clinical benefit, Disease burden, Alignment with patient concerns, Economic value, and Feasibility of adoption into the health system) and 26 corresponding indicators, derived from the literature and expert discussions; (2) the creation of separate weighting schemes for 3 drug types-new oncology, new orphan, and other new drugs-based on inputs from multiple stakeholders (n = 86) using various weighting methods; and (3) the application of the value framework to cases of new oncology drugs., Results: Overall clinical benefit had the highest preference weight, irrespective of drug type, (ie, mean values [95% CIs] for new oncology, new orphan, and other new drugs: 32.5 [30.4-34.6], 30.6 [28.1-33.1], and 30.6 [28.7-32.6], respectively), weighting method, and stakeholder type. The 5 domain-derived weights (from the point allocation method) were comparable to the 26 indicator-derived weights (from the direct rating method), suggesting that the value framework with a short-form (domain-derived) weighting scheme is sufficient to support decision making under time and resource constraints., Conclusions: A country-specific value framework incorporating multiple-criteria decision analysis for new drugs was developed in an Asian setting under universal healthcare coverage. It allows multiple stakeholders to systematically appraise all drug value attributes and provides a structured process for adapting and refining value assessments., Competing Interests: Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section. Dr Hsiao is an editor for Value in Health and had no role in the peer-review process of this article., (Copyright © 2025. Published by Elsevier Inc.)

Background: With the widespread introduction of newborn screening for cystic fibrosis (CF), there has been considerable emphasis on the need to develop objective markers of lung health that can be used during infancy. We hypothesised that in a newborn screened (NBS) UK cohort, evidence of airway inflammation and infection at one year would be associated with adverse structural and functional outcomes at the same age., Methods: Infants underwent lung function testing, chest CT scan and bronchoscopy with bronchoalveolar lavage (BAL) at 1 year of age when clinically well. Microbiology cultures were also available from routine cough swabs., Results: 65 infants had lung function, CT and BAL. Mean (SD) lung clearance index and forced expiratory volume in 0.5 s z-scores were 0.9(1.2) and -0.6(1.1) respectively; median Brody II CF-CT air trapping score on chest CT =0 (interquartile range 0-1, maximum possible score 27). Infants isolating any significant pathogen by 1 yr of age had higher LCI z-score (mean difference 0.9; 95%CI:0.4-1.4; p = 0.001) and a trend towards higher air trapping scores on CT (p = 0.06). BAL neutrophil elastase was detectable in 23% (10/43) infants in whom BAL supernatant was available. This did not relate to air trapping score on CT., Conclusions: In this UK NBS cohort at one year of age, lung and airway damage is much milder and associations between inflammation, abnormal physiology and structural changes were at best weak, contrary to our hypothesis and previously published reports. Continued follow-up will clarify longer term implications of these very mild structural, functional and inflammatory changes., Competing Interests: Declaration of Competing Interest Dr. Brody reports grants and personal fees from Vertex Pharmaceuticals, outside the submitted work. Dr. Carr reports personal fees and other from Vertex Pharmaceuticals, other from Chiesi Pharmaceuticals, personal fees from Actavis Pharmaceuticals, other from Pharmaxis Pharmaceuticals, outside the submitted work. Dr Davies reports personal fees from Chiesi Pharmaceuticals, outside the submitted work. All other authors report no other potential competing interests., (Copyright © 2020. Published by Elsevier B.V.)