Human monkeypox virus (MPXV) infection is a recently declared public health emergency of international concern by the World Health Organization. Besides, there is scant literature available on the use of antivirals in MPXV infection. This systematic review compiles all evidence of various antivirals used on their efficacy and safety and summarizes their mechanisms of action. A review was done of all original studies mentioning individual patient data on the use of antivirals in patients with MPXV infection. Of the total 487 non-duplicate studies, 18 studies with 71 individuals were included. Tecovirimat was used in 61 individuals, followed by cidofovir in seven and brincidofovir (BCV) in three individuals. Topical trifluridine was used in four ophthalmic cases in addition to tecovirimat. Of the total, 59 (83.1%) were reported to have complete resolution of symptoms; one was experiencing waxing and waning of symptoms, only one (1.8%) had died, and the others were having a resolution of symptoms. The death was thought unrelated to tecovirimat. Elevated hepatic panels were reported among all individuals treated with BCV (leading to treatment discontinuation) and five treated with tecovirimat. Tecovirimat is the most used and has proven beneficial in several aggravating cases. No major safety concerns were detected upon its use. Topical trifluridine was used as an adjuvant treatment option along with tecovirimat. BCV and cidofovir were seldom used, with the latter often being used due to the unavailability of tecovirimat. BCV was associated with treatment discontinuation due to adverse events.

Background: Cost-effectiveness is a tool to maximize health benefits and to improve efficiency in healthcare. However, efficient outcomes are not always the most equitable ones. Distributional cost-effectiveness analysis (DCEA) offers a framework for incorporating equity concerns into cost-effectiveness analysis. Objective: This systematic review aims to outline the challenges and limitations in applying DCEA in healthcare settings. Methods: We searched Medline, Scopus, BASE, APA Psych, and JSTOR databases. We also included Google Scholar. We searched for English-language peer-reviewed academic publications, while books, editorials and commentary papers were excluded. Titles and abstract screening, full-text screening, reference list reviews, and data extraction were performed by the main researcher. Another researcher checked every paper for eligibility. Details, such as study population, disease area, intervention and comparators, costs and health effects, cost-effectiveness findings, equity analysis and effects, and modelling technique, were extracted. Thematic analysis was applied, focusing on challenges, obstacles, and gaps in DCEA. Results: In total, 615 references were identified, of which 18 studies met the inclusion criteria. Most of these studies were published after 2017. DCEA studies were mainly conducted in Europe and Africa and used quality health-adjusted measurements. In the included studies, absolute inequality indices were used more frequently than relative inequality indices. Every stage of the DCEA presented challenges and/or limitations. Conclusion: This review provides an overview of the literature on the DCEA in healthcare as well as the challenges and limitations related to the different steps needed to conduct the analysis. In particular, we found problems with data availability, the relative unfamiliarity of this analysis among policymakers, and challenges in estimating differences among socioeconomic groups.

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Introduction: In 2017, the National Health Policy recommended the introduction of Ayushman Bharat to promote Universal Health Coverage (UHC), with the aim of providing comprehensive, need-based, and equitable healthcare services to the Indian population. The scheme comprises two primary components: the creation of 1,50,000 Health and Wellness Centres (HWCs) and the implementation of the Pradhan Mantri Jan Arogya Yojana (PM-JAY). These initiatives aim to enhance infrastructure related to comprehensive primary healthcare, maternal and child healthcare, non-communicable diseases, and improved drug delivery and diagnostic services. Out of 28 states and 8 Union territories in India, Delhi, Odisha, and West Bengal have not implemented the AB-PMJAY scheme. Telangana joined the scheme in May 2021, and each state has adopted different models to accommodate their healthcare requirements. Objective: The study elicits the various aspects of Ayushman Bharat, the scheme’s evolution throughout different timelines and its future prospects. Conclusion: The Ayushman Bharat scheme has played an enormous role in achieving comprehensive healthcare system by leveraging various technologies and digital health methods. During the pandemic, the rates of utilization have changed, and Ayushman Bharat is anticipated to contribute significantly to achieve UHC in the future.