Using an economic simulation model to identify key drivers of profitability and estimate the environmental sustainability impact of immunization against gonadotropin-releasing factor (GnRF) in male and female pigs intended for market.

An existing model was used to identify key drivers of profitability and estimate the impact on environmental sustainability when immunizing finishing pigs against GnRF with Improvac®. The model estimated performance and economic differences between immunized (IM) and non-IM pigs from the perspective of producers and packers, based on two recent meta-analyses in male and female pigs. It was populated with data from 9 countries in four continents (Europe, Asia, North and Latin-America). One-way sensitivity analyses (OWSA) were used to define key drivers of profitability. When changing the country specific input data over a range of ±20%, most OWSA did not reverse the mathematical sign of incremental net return between IM and non-IM pigs as calculated in base case analyses. Only the difference in feed conversion rate between IM and untreated female pigs was a key driver of profitability. The parameters with the highest impact on outcomes were similar across countries and expectable (feed costs), or explainable (parameters with statistical differences between IM and non-IM pigs in meta-analyses). In both single-gender herds, Improvac® reduced the environmental impact of pig production by improving feed efficiency (FE), the key driver of environmental burden. In a 50/50 mixed gender herd, IM pigs consumed less feed and gained more weight in 7 out of 9 countries; in the other two countries the FE calculated for the additional weight gain in IM pigs was >1.00, i.e., each additional kilogram of weight gain was associated with less than one additional kilogram of feed consumed.

The efficacy of a modified live virus vaccine Fostera® PRRS against heterologous strains of porcine reproductive and respiratory syndrome virus: A meta-analysis.

Porcine reproductive and respiratory syndrome virus (PRRSV) is currently one of the most economically important health challenges in the global swine industry. The primary aim of this study was to evaluate the overall efficacy of a modified live virus vaccine Fostera® PRRS (F-PRRS) compared to no vaccination as reported in published studies, using meta-analytic techniques. Additionally, we aimed to evaluate the potential impact of age at vaccination and F-PRRS cross-protection against different genetically distanced PRRS strains. In total, 20 papers fulfilled the predefined inclusion criteria. Vaccinated pigs had on average 38.52 g/d higher daily weight gain and a 65% lower mortality (relative risk = 0.35) compared to non-vaccinates. F-PRRS reduced the maximum macroscopic lung lesion score on average by 16.82% points and the maximum viral load in serum by 1.36 log10 PRRSV RNA copies. Vaccination at 1 day and 21 days of age was similarly effective, and the pathogenic PRRS strain(s) used for challenge or being endemic in field studies (PRRSV-1, PRRSV-2, or PRRSV-1 & -2) did not significantly influence the outcomes. Our findings confirm the effectiveness of F-PRRS against heterologous PRRSV infection.

The effect of immunization against gonadotropin-releasing factor in market gilts: Meta-analyses of parameters relevant for pig producers, pork packers and retailers/consumers.

The vaccine against gonadotropin releasing factor (GnRF), Improvac®, has recently emerged as an option for rearing market gilts up to heavier harvest weights. Improvac's® temporary suppression of the ovarian function and gonadal hormones results in greater feed intake and better welfare from avoidance of sexual behavioral problems. Based on 22 published articles, our meta-analysis has quantified the effect of immunizing gilts against GnRF on parameters relevant for pig producers, pork packers and retailers/consumers. The meta-analyses included growth performance and final harvest parameters, general carcass traits and yield of valuable meat, meat and fat quality parameters. Primary analyses considered studies without ractopamine, subgroup and additional analyses assessed the impact of co-variates. From the perspective of pig producers, primary analyses showed that immunized (IM) gilts have significantly (P < 0.001) increased average daily gain (+45.1 g/day) and daily feed intake (+0.19 kg/day), higher final live weight (+4.0 kg) and more backfat (+2.8 mm). From the perspective of the pork packers, IM gilts have heavier carcasses (+3.2 kg; P < 0.001), whereas dressing percentage is similar. IM gilts are less lean (-1.5% units; P < 0.001) and have 0.21% units more intramuscular fat (P = 0.001). The yield of ham, shoulder, and loin is similar, whereas the yield of belly is significantly higher (+0.28 kg; P < 0.001). There are no differences in meat quality parameters (color, pH24, and drip loss) between IM gilts and untreated gilts, whereas a lower iodine value in IM gilts indicates an improved fat quality. Further subgroup and additional analyses confirmed the validity of our meta-analysis.

The effect of immunization against gonadotropin-releasing factor on growth performance, carcass characteristics and boar taint relevant to pig producers and the pork packing industry: A meta-analysis.

Meta-analysis was used to compare pigs immunocastrated (IC) with Improvac® versus physically castrated (PC) or entire male (EM) pigs. Performance and carcass data as most relevant for producers and packers were analyzed and the risk of boar taint was assessed by comparing the number of pigs exceeding the consumer thresholds of detection (ToD) for skatole and androstenone. A total of 78 articles fulfilled pre-defined inclusion criteria. Compared to PC pigs, IC pigs have a higher average daily gain (ADG; +32.54 g/day, P < 0.0001) and more favorable feed conversion ratio (FCR; -0.234 kg/kg, P < 0.0001), higher live weight and percentage lean, and lower hot carcass weight (HCW) and dressing percentage. Compared to EM pigs, IC pigs have a higher ADG (+65.04 g/day, P < 0.0001), FCR (+0.075 kg/kg, P < 0.0001), live weight and HCW, and a similar dressing percentage. Conventionally raised IC pigs yield more valuable meat compared to PC (+0.628 kg) and EM (+1.385 kg) pigs. Heavy IC pigs (HCW > 97.7 kg) destined for the production of high-quality cured products gain approximately 0.3 kg more ham than their PC counterparts, with backfat and intramuscular fat still fulfilling the requirements for high-quality cured products. The risk of exceeding the ToD for skatole and androstenone is similar in IC and PC pigs, but significantly higher in EM pigs. Results from our meta-analyses confirm growth performance advantages of IC pigs compared with PC or EM pigs, and reveal a higher gain of valuable meat and a similar risk of boar taint as estimated for PC pigs.

Cost-effectiveness analysis of quadrivalent influenza vaccination in at-risk adults and the elderly: an updated analysis in the U.K.

OBJECTIVE: To update an earlier evaluation estimating the cost-effectiveness of quadrivalent influenza vaccination (QIV) compared with trivalent influenza vaccination (TIV) in the adult population currently recommended for influenza vaccination in the UK (all people aged ≥65 years and people aged 18-64 years with clinical risk conditions). METHODS: This analysis takes into account updated vaccine prices, reference costs, influenza strain circulation, and burden of illness data. A lifetime, multi-cohort, static Markov model was constructed with seven age groups. The model was run in 1-year cycles for a lifetime, i.e., until the youngest patients at entry reached the age of 100 years. The base-case analysis was from the perspective of the UK National Health Service, with a secondary analysis from the societal perspective. Costs and benefits were discounted at 3.5%. Herd effects were not included. Inputs were derived from systematic reviews, peer-reviewed articles, and government publications and databases. One-way and probabilistic sensitivity analyses were performed. RESULTS: In the base-case, QIV would be expected to avoid 1,413,392 influenza cases, 41,780 hospitalizations, and 19,906 deaths over the lifetime horizon, compared with TIV. The estimated incremental cost-effectiveness ratio (ICER) was £14,645 per quality-adjusted life-year (QALY) gained. From the societal perspective, the estimated ICER was £13,497/QALY. A strategy of vaccinating only people aged ≥65 years had an estimated ICER of £11,998/QALY. Sensitivity analysis indicated that only two parameters, seasonal variation in influenza B matching and influenza A circulation, had a substantial effect on the ICER. QIV would be likely to be cost-effective compared with TIV in 68% of simulations with a willingness-to-pay threshold of <£20,000/QALY and 87% with a willingness-to-pay threshold of <£30,000/QALY. CONCLUSIONS: In this updated analysis, QIV was estimated to be cost-effective compared with TIV in the U.K.

[Pharmacoeconomics in uro-oncology: the concept of QALYs]. / Pharmakoökonomie in der Uroonkologie : Das "QALY-Konzept"

The QALY (quality-adjusted life year) is often used in pharmacoeconomic evaluations. It combines the two dimensions 'quality of life' and 'life expectancy' into one index. Quality of life is expressed as a utility, corresponding to a value between 0 (death) and 1 (perfect health). Life expectancy is then multiplied by the utility corresponding to the quality of life of the respective life time. Accordingly, 1 QALY corresponds to 1 year in perfect health (1 year multiplied by utility 1) or 2 years with a quality of life reduced by 50% (2 years multiplied by utility 0.5). Results of pharmacoeconomic evaluations are often reported as additional costs in relation to the added value of a new treatment, expressed as cost per additional QALY gained for the patient with the new therapeutic intervention. The main advantage of the QALY concept is its validity for all patients and indications. And the use of benefit measures which are not restricted to a specific indication is most important for resource allocation, i.e. to avoid that varying amounts of money are paid for the same health benefit in different disease areas.

[Pharmacodynamic and pharmacokinetic aspects of the non-inflammatory non-steroidal agent meloxicam in dogs]. / Aspekte der Pharmakodynamik und Pharmakokinetik des nicht-steroidalen Antiphlogistikums Meloxicam beim Hund.

The pharmacodynamics of non-steroidal anti-inflammatory drugs (NSAIDs) are for the most part well-understood. All NSAIDs inhibit the enzyme cyclooxygenase (COX), and for this reason prostaglandin synthesis. Two isoforms of COX could be isolated. COX-1 is detectable in most tissues on a constant level and is responsible for the synthesis of prostaglandins with cytoprotective effects. COX-2 is induced through inflammation and supports the inflammatory process by producing pro-inflammatory prostaglandins. The desired effects of NSAIDs are related to inhibition of COX-2, whereas inhibition of COX-1 has been linked to the typical side-effects of NSAIDs, especially in the stomach and kidney. The great differences between effects and side-effects in the numerous substances can be explained because of different interactions of the NSAIDs on COX-1 and COX-2. In various test systems meloxicam has been shown to be a preferential inhibitor of COX-2. There are also large differences between the individual NSAIDs with regard to pharmacokinetics. Meloxicam is completely absorbed from the gastrointestinal tract and has an elimination half-life of 24 hours in the dog. It is excreted in faeces and urine. The metabolites, detectable in urine are biologically inactive and do not influence the prostaglandin synthesis in the kidney. In the underlying study, plasma concentration of meloxicam was determined after a subcutaneous injection of 0.2 mg/kg b. w. (day 1) followed by oral treatment of 0.1 mg/kg b. w. (days 2-14). The results confirm the recommended dosage regime of meloxicam with its initial loading dose and the subsequent maintenance dose. This dosing regime results in a very favourable curve of concentrations with a very rapidly attained steady state after roughly two days, without accumulation even in long-term treatment.