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B Methods and materials: b A static cohort model that incorporates costs and health outcomes associated with influenza was used to evaluate influenza burden during an average influenza season in Romania. B Background: b Although the preventative health policy recommends annual influenza vaccination coverage of 75% for the high risk groups, Romania lags much behind this target, the highest coverage being in the over 65 years old, and reached around 20% in 2018. Results correspond to reported infections attributable to influenza and not lab-confirmed influenza. [Extracted from the article]

Since 2013, manufacturers are requested to submit to the French economic and public health assessment committee (CEESP) a pharmacoeconomic evaluation of all innovative products claiming an added clinical benefit (ASMR) level <=III with a substantial impact on healthcare expenditures. All available CEESP opinions for cardiology/diabetology indications published until May 2019 were reviewed. [Extracted from the article]

Le risque ne se résume pas à la connaissance de sa probabilité d’occurrence et de la gravité des dommages occasionnés. Il s’agit d’une construction sociale et de nombreux éléments vont contribuer à sa perception et à son acceptabilité. Ces éléments sont étudiés depuis une vingtaine d’années. Certains d’entre eux influencent sa perception comme l’effroyabilité, la non-familiarité ; le nombre de personnes exposées, d’autres son acceptabilité comme les perceptions individuelles, les facteurs sociaux, l’éthique et l’équité. Leur connaissance permet de mieux comprendre l’évolution de la perception et de l’acceptabilité du risque en général et du risque transfusionnel en particulier. [Copyright &y& Elsevier]

Quadrivalent influenza vaccine (QIV), containing both B-lineage strains, is expected to demonstrate superior effectiveness when the circulating B strain does not correspond to the one contained in trivalent influenza vaccine (TIV). The incremental cost per QALY gained when using QIV over TIV would be 77,932 TRY from a payer perspective and 73,953 TRY from a societal perspective. Cost-utility ratios were sensitive to assumptions used for vaccine effectiveness, level of mismatch, and cost of QIV. [Extracted from the article]

Abstract: The precautionary principle first appeared in France during the health crisis following the contamination of patients with HIV via blood transfusion. This study analyses whether the risk associated with blood transfusion was taken into account early enough considering the context of scientific uncertainty between 1982 and 1985. The aim was to evaluate whether a precautionary principle was applied and whether it was relevant. First, we investigated the context of scientific uncertainty and controversies prevailing between 1982 and 1985. Then we analysed the attitude and decisions of the French authorities in this situation to determine whether a principle of precaution was applied. Finally, we explored the reasons at the origin of the delay in controlling the risk. Despite the scientific uncertainties associated with the potential risk of HIV contamination by transfusion in 1983, we found that a list of recommendations aiming to reduce this risk was published in June of that year. In the prevailing climate of uncertainty, these measures could be seen as precautionary. However, the recommended measures were not widely applied. Cultural, structural and economic factors hindered their implementation. Our analysis provides insight into the use of precautionary principle in the domain of blood transfusion and, more generally, medicine. It also sheds light on the expectations that health professionals should have of this principle. The aim of the precautionary principle is to manage rather than to reduce scientific uncertainty. The principle is not a futile search for zero risk. Rather, it is a principle for action allowing precautionary measures to be taken. However, we show that these measures must appear legitimate to be applied. This legitimacy requires an adapted decision–making process, involving all those concerned in the management of collective risks. [Copyright &y& Elsevier]

En France, le principe de précaution a fait irruption dans le champ de la santé publique à travers la transfusion sanguine, sans qu’il y ait eu une réflexion préalable quant à sa définition, son objectif, ses modalités d’application et ses conséquences. La question de la pertinence de son application reste entière. Cette étude réalisée à partir d’entretiens avec des acteurs de la transfusion sanguine a pour objectif d’établir les représentations qu’ils ont de l’application du principe de précaution dans ce champ particulier et des conséquences en termes de gestion des risques et des droits des patients. À partir de ces représentations, les éléments favorables et défavorables à l’application du principe de précaution sont analysés. À l’issue de l’analyse, il apparaît que le principe de précaution relève d’une confusion. Il est plus perçu comme une protection pour le décideur que pour le malade, et poussé à l’extrême il pourrait être préjudiciable à la logique médicale. Cependant, il apparaît aussi porteur d’éléments qui renouvellent et font évoluer la gestion du risque transfusionnel. [Copyright &y& Elsevier]

The fluocinolone acetonide 0.2 g/day implant (FAc) is effective in improving visual acuity in patients with chronic diabetic macular oedema (cDMO) but is associated with worsening of cataract. The existing Markov model was designed to assess costs and QALYs over lifetime in patients treated with FAc implant, compared to usual care (UC), consisting of laser photocoagulation and anti-VEGFs from the UK NHS perspective. The FAc implant is a cost-effective treatment for cDMO in patients with symptomatic cataract. [Extracted from the article]

Since 2013, innovative products claiming an added clinical benefit (ASMR) level <=III with a substantial impact on healthcare expenditures (>=€20 million the second year) are evaluated by the French economic and public health assessment committee (CEESP). Overall, 38 CEESP opinions out of 88 opinions published on the HAS website were based on cancer treatment assessment (43%), including 14 in hematology (37%), with 71% of them being intended for first inscription (10/14). [Extracted from the article]