UNASSIGNED: As the societal value of vaccines is increasingly recognized, there is a need to examine methodological approaches that could be used to integrate these various benefits in the economic evaluation of a vaccine.
UNASSIGNED: A literature review and two expert panel meetings explored methodologies to value herd immunity, health spillover effects (beyond herd immunity), impact on antimicrobial resistance, productivity and equity implications of vaccines.
UNASSIGNED: The consideration of broader benefits of vaccines in economic evaluation is complicated and necessitates technical expertise. Whereas methodologies to account for herd immunity and work productivity are relatively well established, approaches to investigate equity implications are developing and less frequently applied. Modelling the potential impact on antimicrobial resistance not only depends on the multi-faceted causal relationship between vaccination and resistance, but also on data availability.
UNASSIGNED: Different methods are available to value the broad impact of vaccines and it is important that analysts are aware of their strengths and limitations and justify their choice of method. In the future, we expect that an increasing number of economic evaluations will consider the broader benefits of vaccines as part of their base-case analysis or in sensitivity analyses.

In this study, the health impacts of improving access to treatment with axicabtagene ciloleucel (axi-cel) was assessed in patients with relapsed/refractory diffuse large B-cell lymphoma after ≥2 lines of therapy in Spain. A partitioned survival mixture cure model was used to estimate the lifetime accumulated life years gained (LYG) and quality-adjusted life years (QALYs) per patient treated with axi-cel versus chemotherapy. Efficacy data were extracted from the ZUMA-1 trial for axi-cel and from the SCHOLAR-1 study for chemotherapy. In the base case, the incremental outcomes of axi-cel versus chemotherapy were evaluated in a cohort of 187 patients treated with CAR T-cell therapies, as reported by the \"Spanish National Health System Plan for Advanced Therapies\", and in the alternative scenario in the full eligible population based on epidemiological estimates (n = 490). Taking those currently treated with axi-cel, compared with chemotherapy, axi-cel provided an additional 1341 LYGs and 1053 QALYs. However, when all eligible patients (n = 490) were treated, axi-cel provided an additional 3515 LYs and 2759 QALYs. Therefore, if all eligible patients were treated with axi-cel rather than those currently treated as per the registry (n = 187), there would have been an additional 303 patients treated, resulting in an additional 2173 LYGs and 1706 QALYs in total. The lack of access in Spain has led to a loss of a substantial number of LYGs and QALYs, and efforts should be made to improve access for all eligible patients.

This paper is the introduction to a topical collection on \"Changing Values and Energy Systems\" that consists of six contributions that examine instances of value change regarding the design, use and operation of energy systems. This introduction discusses the need to consider values in the energy transition. It examines conceptions of value and value change and how values can be addressed in the design of energy systems. Value change in the context of energy and energy systems is a topic that has recently gained traction. Current, and past, energy transitions often focus on a limited range of values, such as sustainability, while leaving other salient values, such as energy democracy, or energy justice, out of the picture. Furthermore, these values become entrenched in the design of these systems: it is hard for stakeholders to address new concerns and values in the use and operation of these systems, leading to further costly transitions and systems\' overhaul. To remedy this issue, value change in the context of energy systems needs to be better understood. We also need to think about further requirements for the governance, institutional and engineering design of energy systems to accommodate future value change. Openness, transparency, adaptiveness, flexibility and modularity emerge as new requirements within the current energy transition that need further exploration and scrutiny.

UNASSIGNED: The need for rehabilitation in South Africa has doubled between 1990 and 2017 and is expected to increase in the coming years. However, the rehabilitation needs of South Africans (and globally) remain largely unmet. Establishing a common understanding of the value of rehabilitation can inform clinical practice and policymaking to achieve Universal Health Coverage (UHC).
UNASSIGNED: This study aims to explore the value of rehabilitation services in South Africa\'s public healthcare sector by gathering perspectives from stakeholders. The goal is to inform policy decisions related to the implementation of National Health Insurance (NHI) in South Africa.
UNASSIGNED: The study used a phenomenological approach and interpretivist paradigm. Semi-structured interviews were conducted face-to-face, online, or telephonically with 12 stakeholders from various rehabilitation sectors. The value of rehabilitation was analysed and categorised into five main categories: context, service delivery, patient outcomes, economic and financial components, and collaboration within and between sectors.
UNASSIGNED: The value of rehabilitation was found to be multifaceted, because of the varying health, economic, and social challenges faced by many South Africans.
UNASSIGNED: The study identified components of value-based rehabilitation that should be prioritised in the proposed NHI of South Africa. Future research should explore all stakeholder perspectives, including patients, and provide empirical evidence of rehabilitation\'s economic and societal value.
UNASSIGNED: We highlight priority areas that are central to the value of rehabilitation in South Africa and other low- and middle-income countries (LMICs). Tailoring rehabilitation services to patient and community needs is crucial for achieving value-based care. Given South Africa\'s commitment to the United Nations Convention on the Rights of Persons with Disabilities, prioritising rehabilitation remains essential.

Interventional radiology (IR) is a unique specialty that incorporates a diverse set of skills ranging from imaging, procedures, consultation, and patient management. Understanding how IR generates value to the healthcare system is important to review from various perspectives. IR specialists need to understand how to meet demands from various stakeholders to expand their practice improving patient care. Thus, this review discusses the domains of value contributed to medical systems and outlines the parameters of success. IR benefits five distinct parties: patients, practitioners, payers, employers, and innovators. Value to patients and providers is delivered through a wide set of diagnostic and therapeutic interventions. Payers and hospital systems financially benefit from the reduced cost in medical management secondary to fast patient recovery, outpatient procedures, fewer complications, and the prestige of offering diverse expertise for complex patients. Lastly, IR is a field of rapid innovation implementing new procedural technology and techniques. Overall, IR must actively advocate for further growth and influence in the medical field as their value continues to expand in multiple domains. Despite being a nascent specialty, IR has become indispensable to modern medical practice.

OBJECTIVE: To segregate imaging expenditures from claims data by resource utilization bands (RUBs) and underlying conditions to create an \"expenditure map\" of pediatric imaging costs.
METHODS: A Claims data for children enrolled in a commercial value-based plan were categorized by RUB 0 non-user, 1 healthy user, 2 low morbidity, 3 moderate morbidity, 4 high morbidity, & 5 very high morbidity. The per member per year (PMPY) expense, total imaging spend, and imaging modality with the highest spend were assessed for each RUB. Diagnosis categories associated with high imaging costs were also evaluated.
RESULTS: There were 40,022 pediatric plan members. 14% had imaging-related claims accounting for approximately $2.8 million in expenditures. Member distribution and mean PMPY expenditure RUB was respectively: RUB 0 (3,037, $0), RUB 1 (6,604, $7), RUB 2 - 13,698, $27), RUB 3 - 13,341, $87), RUB 4 (2,810, $268), RUB 5 (532, $841). RUB 3 had the largest total imaging costs at $1,159,523. The imaging modality with the greatest mean PMPY expense varied by RUB with radiography highest in lower RUBs and MRI highest in higher RUBs. The top 3 diagnoses associated with the highest total imaging costs were developmental disorders ($443,980), asthma ($388,797), and congenital heart disease ($294,977) and greatest mean PMPY imaging expenditures malignancy/leukemia ($3,100), transplant ($2,639), and tracheostomy ($1,661).
CONCLUSIONS: Expense mapping using claims data allows for a better understanding of the distribution of imaging costs across a covered pediatric population. This tool may assist organizations in planning effective cost-reduction initiatives and learning how imaging utilization varies by patient complexity in their system.

Memories are not only stored for personal recall, but also to communicate knowledge to others in service of adaptive decision-making. Prior research shows that goals to share information can change which content is communicated in memory as well as the linguistic style embedded in this communication. Yet, little is known as to how communication-related alterations in memory narration drive differences of value processing in listeners. Here, we test how memory communication alters multi-featural recall for complex events and the downstream consequence on value estimations in naïve listeners. Participants recalled a memory of playing an exploratory videogame at a 24-h delay under instructions to either share (i.e., social condition) or recall (i.e., control condition) their memory. Sharing goals systematically altered the content and linguistic style of recall, such that narrators from the social condition were biased towards recall of non-episodic details and communicated their memories with more clout, less formality, and less authenticity. Across two independent samples of naïve listeners, these features differentially influenced value estimations of the video game. We found that greater clout was associated with greater enjoyment while listening to memories (hedonic value), and that greater inclusion of non-episodic details resulted in greater willingness to purchase the video game (motivational drive). These findings indicate that sharing an experience as a story can change the content and linguistic tone of memory recall, which in turn shape perceived value in naïve listeners.

The health sector has prioritized the physical health of vulnerable Generation X individuals at high Coronavirus risk. Despite vaccination efforts, both infected and healthy people continue facing health threats. Unlike other industries devastated by COVID-19, wearable fitness technology equipment (WFTE) is essential for health-focused individuals. This research examined customers\' intention to use WFTE using an adapted Technology Acceptance Model (TAM) framework. A key contribution is the inclusion of perceived health risk and its impact on WFTE value perceptions and usage attitudes post-pandemic. The study gathered qualitative data from coronavirus patients and survey data from 513 participants. Structural equation modeling analysis supported the theoretical model. While the standard TAM evaluated intent to use WFTE, this study uniquely examined how WFTE\'s functional, hedonic, and symbolic value shapes its perceived value. Perceived health risk was found to significantly impact perceived WFTE value and usage attitudes after the pandemic recovery. Findings offer managerial implications to boost WFTE adoption among the vulnerable Generation X demographic.

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OBJECTIVE: We have developed a new patient-centered, preference-based generic health-outcome measure, Château-Santé Base (CS-Base), which is based on a novel multiattribute preference response (MAPR) measurement framework. This study aimed to generate a first utility set for the CS-Base, making it suitable for use in health-economic evaluations.
METHODS: CS-Base comprises 12 health attributes: mobility, vision, hearing, cognition, mood, anxiety, pain, fatigue, social functioning, daily activities, self-esteem, and independence, each with 4 levels. Our methodology to generate utilities for the CS-Base was 2-fold. First, we derived coefficients from patient MAPR data to calculate CS-Base values. Subsequently, these were normalized to a 0.0 to 1.0 utility scale, in which 0.0 signifies dead. The dead position was estimated using general population data from a discrete choice experiment (discrete choice experiment + dead), using a division-value strategy, which localize the position of states better or worse than dead.
RESULTS: We analyzed MAPR data from 3222 patients and discrete choice experiment + dead data from 1995 respondents. All MAPR coefficients were negative, logically ordered, and significantly different from the reference level. The dead position was denoted by a division value of -148.385. Utility values spanned from -0.071 to 1.0, and only 53 of 16 777 216 states were deemed worse than dead.
CONCLUSIONS: This study introduced the first CS-Base utility set, underlining a 2-step utility derivation method. This method, blending societal and patient views, surpasses traditional preference-based approaches, yielding firmer results. However, improvement of the normalization procedure is expected. Estimating CS-Base utilities is an ongoing process that gains precision over time.