Background: Chikungunya fever is an important infectious disease transmitted by the bite of Aedes genus mosquitoes infected with the Chikungunya Virus (CHIKV). Information about consumers' willingness to pay (WTP) for a hypothetical vaccine against CHIKV can help discussions about prices and funding in countries with limited resources. Methods: Cross-sectional study among adult residents of Minas Gerais, Brazil, asking if they were willing to pay the price for a hypothetical chikungunya vaccine defined by the authors with an effective protection of 80% and the possibility of local and systemic side-effects. Residents were provided with information if not familiar with the virus. .90 (720.00BRL). We included this aspect due to issues with any anchoring effect. Results: 496 individuals were interviewed. Among these, 23 were excluded. Most of the respondents were female (57.3%), had completed at least high school (90.7%), were employed (87.7%) and had private health insurance (62.6%). The median value of the WTP was US$ 31.17 (120.00 BRL) for a unique dose vaccine. There was a statistical significant correlation with monthly family income and access to private health insurance. Conclusion: This study can contribute to decision-making about potential prices for a CHIKV vaccine when it becomes available in Brazil. We also showed the anchoring effect as a possible influence on consumers' WTP in studies with similar techniques. Finally, we encourage the development of a chikungunya virus vaccine to benefit the Brazilian population.

Introduction:The new coronavirus pandemic has appreciably impacted on morbidity and mortality as well as having appreciable economic impact worldwide. New vaccines are a potential way forward to reduce transmission rates and their subsequent impact. In Brazil vaccines are being distributed via the public sector. In the future, vaccines will be available in the private market. Information about consumers' willingness to pay (WTP) for a hypothetical vaccine against SARS CoV-2 can help future price setting discussions. Methods: A cross-sectional study was conducted with consumers in the five regions of Brazil regarding the willingness to pay (WTP) for a hypothetical vaccine against SARS CoV-2 with a 50% efficacy. Results: A total of 1402 individuals over 18 years of age who declared not having COVID-19 at the time of the survey were interviewed. The acceptability for this hypothetical vaccine was 80.7%. In addition, the amount of WTP by Brazilian consumers for a hypothetical SARS CoV-2 vaccine was estimated at US$ 22.18(120.00 BRL). Conclusion: This study can contribute to decision-making to inform potential pricing for a hypothetical SARS CoV-2 vaccine.

Background: Quadrivalent cell-based influenza vaccines (QIVc) avoid egg-adaptive mutations and can be more effective than traditional quadrivalent egg-based influenza vaccines (QIVe). This analysis compared the cost-effectiveness of QIVc and QIVe in Argentinian populations < 65 years old from the payer and societal perspectives. Methods: A static decision tree model compared the costs and health benefits of vaccination with QIVc vs. QIVe using a one-year time horizon. The relative vaccine effectiveness of QIVc vs. QIVe was assumed to be 8.1% for children and 11.4% for adults. An alternative high egg-adaptation scenario was also assessed. Model inputs were sourced from Argentina or the international literature. Deterministic and probabilistic sensitivity analyses were performed. Results: Compared to QIVe, QIVc would prevent 17,857 general practitioner visits, 2418 complications, 816 hospitalizations, and 12 deaths per year. From the payers’ perspective, the incremental cost-effectiveness ratio per quality-adjusted life years gained was USD12,214 in the base case and USD2311 in the high egg-adaptation scenario. QIVc was cost-saving from the societal perspective in both scenarios. Conclusions: QIVc in Argentina would be cost-effective relative to QIVe. The potential health benefits and savings would be even higher in high egg-adaptation seasons.

Several countries maintain universal health coverage, which implies responsibility to organize delivery formats of healthcare services and products for citizens. In Brazil, the health system has a principle of universal access for more than 30 years, but many deficiencies remain and the country observes a day practice for those seeking judicial decisions to determine provision of healthcare.

Objective To evaluate factors related to liver graft survival with a focus on immunosuppressive schemes based on calcineurin inhibitors (tacrolimus or cyclosporine). Methodology This study was carried out through an open cohort constructed by deterministic and probabilistic matching through three databases of the SUS with assessment of liver graft survival from 2000 to 2015 in Brazil. From this first cohort, a second cohort was constructed by pairing 1: 1 to more precisely assess the effect of the immunosuppressive scheme on graft survival. The Kaplan-Meier method and was used to estimate the probability of survival. Cox’s model of proportional risks was used to assess factors related to graft loss. Result We found 12,687 patients in the Full cohort and 470 patients in the Matched cohort. The overall graft survival rates at 1, 5, 10, and 16 years were 72.6, 63.3, 52.8, and 45.3%, respectively. Patients younger had a longer graft survival than older ones. In the Full cohort, male patients had a higher survival rate than female ones. Therapeutic schemes based on tacrolimus were more prevalent and had a better survival rate when compared to schemes that used cyclosporine. Tacrolimus without association with antiproliferative agents or rapamycin inhibitors was the therapeutic scheme associated with greater survival rate in both cohorts (HR = 0.81, 95% CI = 0.72–0.91), (HR = 0.50, 95% CI = 0.30–0.85). In addition, white-skinned patients had longer survival rate in both cohorts (HR = 0.55, 95% CI = 0.50–0.61 and HR = 0.50, 95% CI = 0.34–0.75). On the other hand, patients who a greater time ratio without using an immunosuppressant had lower graft survival rate (HR = 6.46, 95% CI = 5.05–8.27 and HR = 6.57, 95% CI = 2.66–16.22). Conclusion This 16-year cohort showed that the older age and the greater time ratio without using an immunosuppressant are risk factors for liver graft loss. White-skinned patients and tacrolimus-based regimens, especially tacrolimus without other immunosuppressants, are factors of better prognosis to the graft.