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Which costs and benefits to consider in economic evaluations of healthcare interventions remains an area of much controversy. Unrelated medical costs in life-years gained is an important cost category that is normally ignored in economic evaluations, irrespective of the perspective chosen for the analysis. National guidelines for pharmacoeconomic research largely endorse this practice, either by explicitly requiring researchers to exclude these costs from the analysis or by leaving inclusion or exclusion up to the discretion of the analyst. However, the inclusion of unrelated medical costs in life-years gained appears to be gaining support in the literature. This article provides an overview of the discussions to date. The inclusion of unrelated medical costs in life-years gained seems warranted, in terms of both optimality and internal and external consistency. We use an example of a smoking-cessation intervention to highlight the consequences of different practices of accounting for costs and effects in economic evaluations. Only inclusion of all costs and effects of unrelated medical care in life-years gained can be considered both internally and externally consistent. Including or excluding unrelated future medical costs may have important distributional consequences, especially for interventions that substantially increase length of life. Regarding practical objections against inclusion of future costs, it is important to note that it is becoming increasingly possible to accurately estimate unrelated medical costs in life-years gained. We therefore conclude that the inclusion of unrelated medical costs should become the new standard.

The recent Russian invasion of Ukraine has had significant effects on the global economy. The purpose of study is to display how Russia's aggression and the international sanctions imposed have affected the European economy, especially the petrol and gas market. Albeit the goal of sanctions was to press and hurt Russia, seems to harm in equal to the European economies mainly through immediate effects on the supply of energy. If the war in Ukraine lasts, estimated that the energy prices will stay high, and the European governments will feel uncertain about the available quantity and adequacy of energy resources.

With the inexorable aging of the global populace, neurodegenerative diseases (NDs) like Alzheimer’s disease (AD), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS) pose escalating challenges, which are underscored by their socioeconomic repercussions. A pivotal aspect in addressing these challenges lies in the elucidation and application of biomarkers for timely diagnosis, vigilant monitoring, and effective treatment modalities. This review delineates the quintessence of biomarkers in the realm of NDs, elucidating various classifications and their indispensable roles. Particularly, the quest for novel biomarkers in AD, transcending traditional markers in PD, and the frontier of biomarker research in ALS are scrutinized. Emergent susceptibility and trait markers herald a new era of personalized medicine, promising enhanced treatment initiation especially in cases of SOD1-ALS. The discourse extends to diagnostic and state markers, revolutionizing early detection and monitoring, alongside progression markers that unveil the trajectory of NDs, propelling forward the potential for tailored interventions. The synergy between burgeoning technologies and innovative techniques like -omics, histologic assessments, and imaging is spotlighted, underscoring their pivotal roles in biomarker discovery. Reflecting on the progress hitherto, the review underscores the exigent need for multidisciplinary collaborations to surmount the challenges ahead, accelerate biomarker discovery, and herald a new epoch of understanding and managing NDs. Through a panoramic lens, this article endeavors to provide a comprehensive insight into the burgeoning field of biomarkers in NDs, spotlighting the promise they hold in transforming the diagnostic landscape, enhancing disease management, and illuminating the pathway toward efficacious therapeutic interventions.

Trastuzumab (Herceptin®) is a monoclonal antibody approved for the treatment of breast cancer that overexpresses human epidermal growth factor receptor 2 (HER2). Well designed clinical trials in women with early breast cancer have demonstrated that 1 years’ therapy with adjuvant intravenous trastuzumab (a loading dose followed by 6 mg/kg every 3 weeks or 2 mg/kg weekly) significantly improves disease-free survival and overall survival compared with observation (subsequent to chemotherapy) or chemotherapy alone in women with HER2-positive disease. In the HERA trial, disease-free survival was estimated to improve by 6.3% at 3 years in the trastuzumab group compared with the observation group. Trastuzumab is generally well tolerated. The most common adverse events are infusion-related symptoms, such as fever and chills, which usually occur with administration of the first dose. Cardiotoxicity occurs in a small proportion of patients receiving trastuzumab, particularly when coadministered with anthracyclines, and cardiac assessment is recommended for all patients at baseline and at 3-monthly intervals. In modelled cost-effectiveness analyses based on data from clinical trials in patients with HER2-positive early breast cancer, adjuvant trastuzumab was predicted to be cost effective from a healthcare payer or societal perspective in several countries. Incremental costs per QALY or life-year gained with trastuzumab administered subsequent to or concurrent with chemotherapy compared with chemotherapy alone were consistently within accepted local thresholds for cost effectiveness. Sensitivity analyses demonstrated that these results remained generally robust to plausible changes in key model assumptions. In conclusion, in patients with HER2-positive early breast cancer, the addition of adjuvant trastuzumab is clinically effective in improving disease-free survival. Available pharmacoeconomic data from several countries, despite some inherent limitations, support the use of adjuvant trastuzumab for 1 year as a cost-effective treatment relative to chemotherapy alone in this patient population.

Abstract Background Using immune checkpoint inhibitors (IO) is a promising approach to maximize clinical benefits for patients with non-small cell lung cancer (NSCLC). PD-L1 expression serves as a predictive factor for treatment outcomes with IO. However, the high cost of this treatment creates significant barriers to access. Substantial evidence demonstrates the sustained clinical benefits experienced by patients who respond to immunotherapy. While IOs show promise in NSCLC treatment, their high cost poses access barriers. Aim This study focused on a prospective cost analysis conducted at a high-specialty health facility to assess the economic implications of implementing a risk-sharing agreement (RSA) for atezolizumab in NSCLC. Methods The study included 30 patients with advanced NSCLC, with the pharmaceutical company funding the initial cycles. If patients responded, a government program covered costs until disease progression. Results A median progression-free survival of 4.67 months across populations, rising to 9.4 months for responders. The 2-year overall survival rate for the response group was 64%, significantly higher than for non-response. Without an RSA, a total treatment cost of $881 859.36 ($29 395.31/patient) was reported, compared to $530 467.12 ($17 682.24/patient) with an RSA, representing a 40% cost reduction. In responders, the average cost per year of life per patient dropped by 22%. Risk-sharing, assessed through non-parametric tests, showed a statistically significant difference in pharmacological costs (P < .001). Conclusion Implementing RSAs can optimize resource allocation, making IO treatment more accessible, especially in low-income countries. This study focused on a prospective cost analysis conducted at a high-specialty health facility to assess the economic implications of implementing a risk-sharing agreement for atezolizumab in non-small cell lung cancer.

Societal Impact Statement Trees play vital roles in many of the world's ecosystems while providing many benefits to people. New evidence indicates that a third of tree species are threatened with extinction, representing a tree extinction crisis. Here we demonstrate how tree species extinction will lead to the loss of many other plants and animals and significantly alter the world's ecosystems. We also show how tree extinction will negatively affect billions of people through loss of livelihoods and benefits. We highlight a series of urgent actions needed to avert an ecological, cultural and socio‐economic catastrophe caused by widespread extinction of tree species. Summary Trees are of exceptional ecological importance, playing a major functional role in the world's ecosystems, while also supporting many other plants, animals and fungi. Many tree species are also of direct value to people, providing a wide range of socio‐economic benefits. Loss of tree diversity could lead to abrupt declines in biodiversity, ecosystem functions and services and ultimately ecosystem collapse. Here we provide an overview of the current knowledge regarding the number of tree species that are threatened with extinction, and the threats that affect them, based on results of the Global Tree Assessment. This evidence suggests that a third of the world's tree species are currently threatened with extinction, which represents a major ecological crisis. We then examine the potential implications of tree extinctions, in terms of the functioning of the biosphere and impacts on human well‐being. Large‐scale extinction of tree species will lead to major biodiversity losses in other species groups and substantially alter the cycling of carbon, water and nutrients in the world's ecosystems. Tree extinction will also undermine the livelihoods of the billions of people who currently depend on trees and the benefits they provide. This warning to humanity aims to raise awareness of the tree extinction crisis, which is a major environmental issue that requires urgent global attention. We also identify some priority actions that need to be taken to reduce the extinction risk of tree species and to avert the ecological and socio‐economic catastrophe that will result from large‐scale extinction of tree species. Summary Los árboles tienen roles vitales en muchos de los ecosistemas del planeta, y a su vez proveen muchos beneficios para la gente. Nueva evidencia indica que un tercio de las especies de árboles están en riesgo de extinción, representando una crisis de extinción de árboles. Acá nosotros ilustramos cómo la extinción de árboles puede resultar en la pérdida de muchas especies de plantas y animales, y alterar significativamente los ecosistemas del planeta. También mostramos como la extinción de árboles afectará negativamente a miles de millones de personas por la pérdida de modos de vida y beneficios. Nosotros resaltamos una serie de acciones urgentes para evitar la catástrofe ecológica, cultural y socio‐económica causada por la masiva extinción de especies de árboles. Summary Les arbres jouent un rôle vital dans de nombreux écosystèmes du monde, tout en offrant de nombreux avantages au peuple. De nouvelles preuves indiquent qu'un tiers des espèces d'arbres sont menacées d'extinction, ce qui représente une crise d'extinction des arbres. Ici, il est demontré comment l'extinction des espèces d'arbres entraînera la perte de nombreuses plantes et animaux et modifiera considérablement les écosystèmes mondiaux. Nous montrons également comment l'extinction des arbres affectera négativement des milliards de personnes par la perte de moyens de subsistance et d'avantages. Nous soulignons une série d'actions urgentes nécessaires pour éviter une catastrophe écologique, culturelle et socio‐économique causée par l'extinction généralisée des espèces d'arbres. Trees play vital roles in many of the world's ecosystems while providing many benefits to people. New evidence indicates that a third of tree species are threatened with extinction, representing a tree extinction crisis. Here we demonstrate how tree species extinction will lead to the loss of many other plants and animals and significantly alter the world's ecosystems. We also show how tree extinction will negatively affect billions of people through loss of livelihoods and benefits. We highlight a series of urgent actions needed to avert an ecological, cultural and socio‐economic catastrophe caused by widespread extinction of tree species.

Bovine tuberculosis (bTB) is endemic and has a substantial impact on the livestock sector in Ethiopia and other low and middle-income countries (LMICs). With a national emphasis on dairy farm intensification to boost milk production and spur economic growth, the incidence of bTB is anticipated to rise. However, Ethiopia, like other LMICs, lacks a comprehensive national bTB control strategy due to the economic and social infeasibility of traditional test-and-cull (TC) approaches. To inform the development of such a strategy, we evaluated the effectiveness and feasibility of TC and test-and-segregation (TSg) strategies for bTB control on Ethiopian dairy farms. A TC approach was used at Farm A [N = 62; comparative cervical test (CCT) > 4 mm, starting prevalence 11.3%] while TSg was implemented at Farm B (N = 45; CCT > 4 mm, prevalence 22.2%), with testing intervals of 2–4 months. Both strategies achieved a reduction in bTB prevalence to 0%, requiring seven rounds of TC over 18 months at Farm A, and five rounds of TSg over 12 months at Farm B’s negative herd. The results show that adopting more sensitive thresholds [CCT > 0 mm or single cervical test (SCT) > 2 mm] during later rounds was pivotal in identifying and managing previously undetected infections, emphasizing the critical need for optimized diagnostic thresholds. Cost analysis revealed that TC was approximately twice as expensive as TSg, primarily due to testing, labor, and cow losses in TC, versus construction of new facilities and additional labor for TSg. This underscores the economic and logistical challenges of bTB management in resource-limited settings. Taken together, our study highlights an urgent need for the exploration of alternative approaches including TSg and or vaccination to mitigate within herd transmission and enable implementation of bTB control in regions where TC is not feasible.

We analyze the dynamic interaction between technological improvements and the influence that these innovations have on the financial sector, which is an essential area in the digital age. The research investigates the increasing confluence of digital technology and financial operations from the perspective of methodology, with a particular emphasis on the larger socio-economic consequences of this evolution. The most significant aspects, including sociological, legal, and technical effects, are investigated in great detail in order to provide a comprehensive perspective on the current transitions. A comprehensive review of recent technological advancements and the ways in which these advancements have resonated through financial operations and strategies is the main topic of this article. Additionally, the article looks into the more fundamental financial implications of these technical advancements, going beyond the surface-level changes that have occurred. The results highlight the complicated connections that exist between the progression of technology and the financial sector, emphasizing how digitalization impacts financial procedures. The study offers a significant contribution by offering a clear and comprehensive view of the innovative implications that technology has had in the financial sector. The discussion on digital transformation is enriched as a result of this, and it sheds light on the significant impact that digital transformation has had not just on the financial sector but also on the larger economic structure.

Ophiocordyceps sinensis is a vital and unique traditional medicine native to the Tibetan Plateau (TP) and its adjacent regions. Its habitat has significantly diminished in recent years due to commercial harvesting and climate change. Although studies on the habitat of O. sinensis have been conducted, the impact of climate change on its future habitat and economy remains unclear. This study utilizes a comprehensive dataset on O. sinensis occurrences and employs a multi‐model approach (constructed by Classification Tree Analysis [CTA], Flexible Discriminant Analysis [FDA], Generalized Boosted Model [GBM], Generalized Linear Models [GLM], Multivariate Adaptive Regression Splines [MARS], Random Forest [RF], and MaxEnt models) to simulate its potential suitable habitat distribution on the TP under current and future climate change scenarios (SSP1‐2.6 and SSP5‐8.5). Through this modeling process, we examined the primary environmental factors influencing its distribution. Our results indicated that China produces 91.9% of the world's O. sinensis, with over 82% of this production concentrated in Sichuan, Tibet, and Qinghai Provinces. Altitude, warmest quarter precipitation, coldest quarter mean temperature, and herbaceous vegetation cover accounted for 90% of the variation in the distribution of O. sinensis. The suitable habitat was primarily concentrated at altitudes of 3500–4500 m above sea level and was expected to shift to higher altitudes in the future. The predicted habitats under different emission scenarios vary. Under the low emission scenario (SSP1‐2.6), there was a slight increase in suitable habitat, with a 0.14% increase by the 2050s and a 0.65% increase by the 2100s. Conversely, under the high emission scenario (SSP5‐8.5), there was a notable decrease in suitable habitat, with a projected 4.32% reduction by the 2050s and a 5.34% reduction by the 2100s. Additionally, the production of O. sinensis was expected to increase by 0.2%–5.2% under SSP1‐2.6 and decrease by 0.5%–7.2% under SSP5‐8.5 in the main production areas in China. These findings provide a theoretical basis for the conservation and sustainable harvest of O. sinensis, which is crucial for future conservation efforts, maintaining ecological balance, and supporting the sustainable socio‐economic development of local communities. Ophiocordyceps sinensis, a key traditional medicine from the Tibetan Plateau, is losing habitat due to overharvesting and climate change. This study shows that China, producing 91.9% of the global supply, will see suitable habitats shift to higher altitudes. The economic impact includes a potential production increase under low emissions but a significant decrease under high emissions, threatening local economies.

Manufacturing industries are vital for economic development, but they cause significant environmental damages. As there are scarce research studies for this industrial sector from developing countries, this article reports a comprehensive environmental and economic analyses for cutlery manufacturing in Pakistan. SimaPro 9.5 was used as a modelling software tool, while ReCiPe 2016 methods were used to evaluate various midpoint and endpoint environmental impacts. Various economic indicators were used to evaluate the economic performance of different alternative scenarios. The results revealed that injection molding process, due to its energy-intensive nature caused the most environmental impacts as compared to other manufacturing processes. Global warming and terrestrial ecotoxicity were the most affected impact categories with values of 11.8 kg CO 2 eq and 12.0 kg 1,4-DCB, respectively. Meanwhile, at endpoint level, human health category was most damaged as compared to others. Based on technical process intervention and energy transition, four different alternative scenarios were developed. In comparison with baseline scenario, the alternative scenario with double-cavity mold resulted in a reduction of more than 30% for various impact categories. The other three alternatives were grounded on the use of solar energy (50% or 100%) and injection mold with double or single cavity. Overall, the alternative scenario with 50% solar energy and double-cavity mold was the best solution that showed more than 50% reduction in most of the impact categories, less than 3-year payback time, 2.12 million (Pakistani Rupees) net present value, and 36.3% of return on investment. This study clearly shows the importance of renewable energy resources and simple changes in process technology for improving sustainability performance. The relevant stakeholders can effectively use the results and methodology of this study as a reference and guide for future research and practical interventions, especially in developing countries. Graphical abstract