Background New therapies that do not reach patients in need, have not achieved their goal. Drug and Therapeutics Committees in hospitals ensure access to patients by compiling a formulary on rational grounds. An evolving landscape of innovative molecules challenges timely formulary adaptation after national reimbursement. Aim To integrate national reimbursement reports in the hospital\'s appraisal, thereby promoting access for patients without delay. Method For 2019, the rationale for new molecules at Ghent University Hospital, Belgium, was compared with the public assessment report of the National Institute for Health and Disability Insurance, assessing a medicine in a specific indication following a reimbursement request by the manufacturer. Decision criteria (therapeutic value and cost) between matching medicines in both databases (national & hospital) were retrospectively compared [no (%), mean (SD)]. Results Two-hundred public reports and 30 formulary decisions were analysed (with antineoplastic & immunomodulating as most prevalent class: 41.0% resp. 36.7%). National decision often concerned hospital-only medicines (89; 44.5%) without patient co-payment (101; 50.5%). Of 13 matched medicines (same indication), time delay between national decision and formulary admission was on average 3.1 (SD 2.3) months. Comparative analysis showed that assessment in both committees was mostly based on the efficacy endpoints of Randomised Controlled Trials. Literature used in hospital appraisals was of more recent publication date: + 0.78 (SD 2.2) years. Using public reports as a horizon scan could enable quick identification of new indications. Conclusion To speed up patient access, the scientific evidence of national reimbursement reports can be used for the purpose of hospital formulary decisions.

Infant adoption has been reported in a variety of primate taxa both in captive and natural settings. Adoption by females may be adaptive by increasing inclusive fitness via shared genes between adoptive mother and adoptee or by providing valuable maternal practice which, in turn, may increase the female\'s future reproductive success. Others have argued that adoption may be non-adaptive and the result of a general attraction toward infants. Our study examines a unique case of adoption by an adult female Angola black and white colobus monkey (Colobus angolensis palliatus) who adopted an extra-group infant alongside her own biological infant. We compare infant behaviors and mother-infant interactions between biological infant and adoptee and then compare both biological infant and adoptee behavioral profiles to those of infants under normal circumstances. Data were collected from July 2014 to June 2015 on three habituated groups in the Diani Forest of Kenya. Scan sampling and pooled data were used to create daily and monthly behavioral profiles for the biological infant and adoptee, as well as a mean monthly profile of four infants under normal circumstances. Data include time spent (1) clinging to mother/adoptive mother, (2) clinging to another individual, (3) behaving independently, and (4) behaving in close proximity to mother/adoptive mother. Initially, the adoptee struggled to achieve behavioral profiles consistent with those of the biological infant and normal colobus infants of the same age as he spent significantly more time moving independently and significantly less time clinging to the adoptive mother. After the mysterious death of the biological infant in mid-January 2015, the adoptee assumed a behavioral profile similar to that of infants under normal conditions. This case does not support adaptive hypotheses for adoption (i.e., inclusive fitness or learning to mother). Instead, because the biological infant died, possibly due to the presence of the adoptee, we argue that this case of infant adoption was non-adaptive. Ultimately, this adoption appears to have been an outcome of the adoptee\'s persistent desire to be cared for and the female\'s strong propensity to engage in allomaternal behavior.