The effect of PD-L1 testing on the cost-effectiveness and economic impact of immune checkpoint inhibitors for the second-line treatment of NSCLC

Background: Immune checkpoint inhibitors improve outcomes compared with chemotherapy in lung cancer. Tumor PD-L1 receptor expression is being studied as a predictive biomarker. The objective of this study was to assess the cost-effectiveness and economic impact of second-line treatment with nivolumab, pembrolizumab, and atezolizumab with and without the use of PD-L1 testing for patient selection. Design: We developed a decision-analytic model to determine the cost-effectiveness of PD-L1 assessment and second-line immunotherapy versus docetaxel. The model used outcomes data from randomized clinical trials (RCTs) and drug acquisition costs from the United States. Thereafter, we used epidemiologic data to estimate the economic impact of the treatment. Results: We included four RCTs (2 with nivolumab, 1 with pembrolizumab, and 1 with atezolizumab). The incremental quality-adjusted life year (QALY) for nivolumab was 0.417 among squamous tumors and 0.287 among non-squamous tumors and the incremental cost-effectiveness ratio (ICER) were $155 605 and$187 685, respectively. The QALY gain in the base case for atezolizumab was 0.354 and the ICER was $215 802. Compared with treating all patients, the selection of patients by PD-L1 expression improved incremental QALY by up to 183$98 421. Patient selection also reduced the budget impact of immunotherapy. Conclusion: The use of PD-L1 expression as a biomarker increases cost-effectiveness of immunotherapy but also diminishes the number of potential life-years saved.info:eu-repo/semantics/publishedVersio

Argumentation-Based Contract Monitoring in Uncertain Domains

Publisher PD

Properties of the Social Discount Rate in a Benthamite Framework with Heterogeneous Degrees of Impatience

This paper derives the properties of the discount rate that should be applied to a public-sector project when the affected population has heterogeneous degrees of impatience. We show that, for any distribution of discount rates, the social discount rate has the following properties: it decreases over time, it is lower than the average of the discount rates in the population, and it converges to the discount rate of the most patient individual in the economy. These properties hold for both constant and decreasing individual discount rates. Finally, we evaluate how changes in the distribution of individual discount rates affect the social discount rate.social discount rate; hyperbolic discounting; cost-benefit analysis

The Politics of Commerce : The Congress of Chambers of Commerce of the Empire, 1886-1914

Peer reviewedPublisher PD

A tool to aid redesign of flexible transport services to increase efficiency in rural transport service provision

This research was supported by the Research Councils UK Digital Economy programme award (reference: EP/G066051/1) to the dot.rural Digital Economy Hub, at the University of Aberdeen.Peer reviewedPublisher PD

Effects of deleting cannabinoid receptor-2 on mechanical and material properties of cortical and trabecular bone

Acknowledgements We thank Dr J.S. Gregory for assistance with Image J and Mr K. Mackenzie for assistance with Micro-CT analysis. Funding ABK was funded by a University of Aberdeen, Institute of Medical Sciences studentship and the Overseas Research Students Awards Scheme.Peer reviewedPublisher PD

The role of bot squads in the political propaganda on Twitter

Social Media are nowadays the privileged channel for information spreading and news checking. Unexpectedly for most of the users, automated accounts, also known as social bots, contribute more and more to this process of news spreading. Using Twitter as a benchmark, we consider the traffic exchanged, over one month of observation, on a specific topic, namely the migration flux from Northern Africa to Italy. We measure the significant traffic of tweets only, by implementing an entropy-based null model that discounts the activity of users and the virality of tweets. Results show that social bots play a central role in the exchange of significant content. Indeed, not only the strongest hubs have a number of bots among their followers higher than expected, but furthermore a group of them, that can be assigned to the same political tendency, share a common set of bots as followers. The retwitting activity of such automated accounts amplifies the presence on the platform of the hubs' messages.Comment: Under Submissio

Supporting Catholic Education through Effective School/University Partnerships: Two Models from the 2012 Catholic Higher Education Collaborative Conference

This essay was developed from a panel presentation by Henk and Maney, as well as other key professional colleagues, delivered at the 2012 CHEC Conference. The essay describes the formation and initial work of a consortium of five institutions of higher education in the greater Milwaukee area, including Alverno College, Cardinal Stritch University, Marian University, Marquette University, and Mount Mary College

Discounting Rules for Risky Assets

This paper develops a rule for calculating a discount rate to value risky projects. The rule assumes that asset risk can be measured by a single index (e.g., beta), but makes no other assumptions about specific forms of the asset pricing model. It treats all projects as combinations of two assets: Treasury bills and the market portfolio. We know how to value each of these assets under any theory of debt and taxes and under any assumption about the slope and intercept of the market line for equity securities. Our discount rate is a weighted average of the after-tax return on riskless debt and the expected return on the portfolio, where the weight on the market portfolio is beta.