Assessing the impact of COVID-19 passes and mandates on disease transmission, vaccination intention, and uptake: a scoping review.

PURPOSE: Policymakers have struggled to maintain SARS-CoV-2 transmission at levels that are manageable to contain the COVID-19 disease burden while enabling a maximum of societal and economic activities. One of the tools that have been used to facilitate this is the so-called "COVID-19 pass". We aimed to document current evidence on the effectiveness of COVID-19 passes, distinguishing their indirect effects by improving vaccination intention and uptake from their direct effects on COVID-19 transmission measured by the incidence of cases, hospitalizations, and deaths. METHODS: We performed a scoping review on the scientific literature of the proposed topic covering the period January 2021 to September 2022, in accordance with the PRISMA-ScR guidelines for scoping reviews. RESULTS: Out of a yield of 4,693 publications, 45 studies from multiple countries were retained for full-text review. The results suggest that implementing COVID-19 passes tends to reduce the incidence of cases, hospitalizations, and deaths due to COVID-19. The use of COVID-19 passes was also shown to improve overall vaccination uptake and intention, but not in people who hold strong anti-COVID-19 vaccine beliefs. CONCLUSION: The evidence from the literature we reviewed tends to indicate positive direct and indirect effects from the use of COVID-19 passes. A major limitation to establishing this firmly is the entanglement of individual effects of multiple measures being implemented simultaneously.

Prescription opioids and economic hardship in France.

This paper studies how opioid analgesic sales are empirically related to socioeconomic disparities in France, with a focus on poverty. This analysis is made possible using the OpenHealth database, which provides retail sales data for opioid analgesics available on the French market. We exploit firm-level data for each of the 94 departments in Metropolitan France between 2008 and 2017. We show that increases in the poverty rate are associated with increases in sales: a one percentage point increase in poverty is associated with approximately a 5% increase in mild opioid sales. Our analysis further shows that opioid sales are positively related to the share of middle-aged people and individuals with basic education only, while they are negatively related to population density. The granularity and longitudinal nature of these data allow us to control for a large pool of potential confounding factors. Our results suggest that additional interventions should be more intensively addressed toward the most deprived areas. We conclude that a combination of policies aimed at improving economic prospects and strictly monitoring access to opioid medications would be beneficial for reducing opioid-related harm.

Confirmed COVID-19 Cases per Economic Activity during Autumn Wave in Belgium.

Some occupational sectors, such as human health and care, food service, cultural and sport activities, have been associated with a higher risk of SARS-CoV-2 infection than other sectors. To curb the spread of SARS-CoV-2, it is preferable to apply targeted non-pharmaceutical interventions on selected economic sectors, rather than a full lockdown. However, the effect of these general and sector-specific interventions on the virus circulation has only been sparsely studied. We assess the COVID-19 incidence under different levels of non-pharmaceutical interventions per economic activity during the autumn 2020 wave in Belgium. The 14-day incidence of confirmed COVID-19 cases per the Statistical Classification of Economic Activities in the European Community (NACE-BEL) sector is modelled by a longitudinal Gaussian-Gaussian two-stage approach. This is based on exhaustive data on all employees in all sectors. In the presence of sanitary protocols and minimal non-pharmaceutical interventions, many sectors with close contact with others show considerably higher COVID-19 14-day incidences than other sectors. The effect of stricter non-pharmaceutical interventions in the general population and non-essential sectors is seen in the timing of the peak incidence and the width and height of the post-peak incidence. In most sectors incidences returned to higher levels after the peak than before and this decrease took longer for the health and care sector. Sanitary protocols for close proximity occupations may be sufficient during periods of low-level virus circulation, but progressively less with increasing circulation. Stricter general and sector-specific non-pharmaceutical interventions adequately decrease COVID-19 incidences, even in close proximity in essential sectors under solely sanitary protocols.

[What is the fair price of innovative therapy?] / L'innovation thérapeutique, à quel prix ?

TITLE: L'innovation thérapeutique, à quel prix ? ABSTRACT: Comment préserver l'accessibilité aux nouveaux médicaments pour tous les patients qui en ont besoin ? La question se pose à la lumière des prix exorbitants auxquels les thérapies géniques, mais aussi les biothérapies et de nouvelles molécules chimiques, sont commercialisées. L'analyse montre qu'à court/moyen terme, l'arrivée sur le marché d'un nombre croissant de nouveaux traitements à haute valeur ajoutée mais à des prix très élevés deviendra insoutenable pour les organismes payeurs qui sous-tendent notre système de santé. Les arguments de rentabilité invoqués par les sociétés pharmaceutiques pour justifier les prix proposés sont à tout le moins contestables, d'autant plus qu'ils ne sont pas documentés de façon transparente et que cette industrie jouit déjà de marges bénéficiaires considérables, en comparaison de celles d'autres secteurs du monde économique. Quant aux promesses de guérison définitive assurée par certains traitements, il faudra encore attendre quelques années pour en vérifier le fondement. À l'aube d'une réforme qui apparaît incontournable, nous formulons plusieurs propositions pour faire avancer le débat, en particulier : (1) mettre en œuvre la résolution avancée par plusieurs états membres de l'Organisation mondiale de la santé (OMS) pour assurer la transparence des coûts de développement des nouveaux médicaments ; (2) imposer une clause de prix raisonnable dans les accords qui régissent le transfert de technologies entre les institutions académiques soutenues par des fonds publics et les entreprises privées ; (3) instituer une instance européenne commune de négociation des prix des médicaments adaptée aux conditions socioéconomiques de chaque pays ; (4) conditionner le remboursement des traitements innovants à leur commercialisation par des entreprises - ou des filiales de celles-ci - répondant à des normes certifiant leur responsabilité sociétale et (5) développer en Europe des partenariats public-privé à but non lucratif, pour la création de quelques unités de production de biothérapies et thérapies géniques. L'objectif général de ces mesures serait de fixer un cadre qui permette de définir des prix qui garantissent un juste retour de l'investissement public vers le système de santé tout en assurant pour les entreprises un profit d'un niveau conforme au marché et une incitation suffisante à investir dans les domaines prioritaires pour la santé publique.