Pain represents an international burden and a major socio-economic public health problem. New findings, detailed in this review, suggest that adenosine plays a significant role in neuropathic and inflammatory pain, by acting on its metabotropic adenosine receptors (A₁AR, A_2AAR, A_2BAR, A₃AR). Adenosine receptor ligands have a practical translational potential based on the favorable efficacy and safety profiles that emerged from clinical research on various agonists and antagonists for different pathologies. The present review collects the latest studies on selected adenosine receptor ligands in different pain models. Here, we also covered the many hypothesized pathways and the role of newly synthesized allosteric adenosine receptor modulators. This review aims to present a summary of recent research on adenosine receptors as prospective therapeutic targets for a range of pain-related disorders.

This paper compares a homogeneous group of countries in terms of capacity and technology, where we picked income as indicator for capacity and technology. We study the case of the Hashemite Kingdom of Jordan. We apply radical data envelopment analysis to 36 middle income countries where we calculate constant returns to scale technical efficiency and variable returns to scale technical efficiency to show the health care sector efficiency in Jordan. Using different factors for input first we studied healthcare expenditure per capita then as percent of GDP and public expenditure as percent of GDP and private as percent of GDP, and last was the number of beds per 1000 population and physicians per 1000 population all to the same output life expectancy. The results show that there is inefficiency in health care expenditure. The inefficiency mainly is shown by two major findings, first the lack of utilization of resources. Secondly, the public-sector inefficiency. The output is justifiable for many challenges faced the health sector in the year of the study one of which is the Syrian refuges crisis. We shed light on factors causing the inefficiency where modifications could yield substantial efficiency gains. As for the mix between public and private sectors and the quality and utilization and distribution of the real resources, nevertheless adding health economists to the management staff for there is a managerial inefficiency.

Background: Non-small cell lung cancer (NSCLC) treatment costs significantly impact healthcare systems. This study analyzes direct costs and cost drivers of perioperative and adjuvant systemic treatments for stage I–II NSCLC from Jordanian healthcare providers’ perspective using micro-costing methodology. Methods: We employed micro-costing to analyze direct medical expenses including drug acquisition, preparation, administration, pre/post-medications, diagnostics, labor, and wastage costs for perioperative regimens used in stage I–II NSCLC. International guidelines defined therapeutic regimens, while drug prices were extracted from Jordan Food and Drug Administration’s database. Published data and surveys quantified micro-costs. Results: Among 26 assessed regimens (2 targeted therapy, 10 chemotherapy, 10 chemo-immunotherapy, 4 immunotherapy), targeted/immunotherapy agents significantly increased costs. Chemotherapy regimen cost differences ranged from $633.68 (squamous) to $1,763.91 (non-squamous) per cycle. Antineoplastic agents were primary cost drivers, highest for Durvalumab (98.72% of cycle cost). Laboratory costs comprised up to 50.73% in chemotherapy and 7.24% in immunotherapy regimens. Wastage contributed up to 10.36% of total cycle costs. Average administration cost was $35 per cycle. Maximum cycle costs were: targeted therapy (Osimertinib) $7,206.44, immunotherapy (Durvalumab) $9,057.71, immune-chemotherapy (Durvalumab-Carboplatin-Pemetrexed) $11,358.43, and chemotherapy (Carboplatin-Pemetrexed) $2,300.72. Conclusion: Our results highlight the substantial economic impact and cost variability among treatment regimens. This variability presents opportunities for cost reduction through careful selection of therapeutically equivalent regimens based on pricing and toxicity profiles. The findings emphasize the need for comprehensive and precise cost analysis to inform healthcare policies and clinical practices. Future research should focus on cost-effectiveness analyses of these expensive agents to ensure value for money, support evidence-based decision-making, and strengthen price negotiations with suppliers.

Objectives: The purpose of this study was to present data regarding the most cost-effective vaccine for preventing COVID-19-related deaths. Methods: A mass immunization campaign using mRNA and inactivated COVID-19 vaccines was compared to no vaccination in a cost-effectiveness analysis. A hypothetical population of Jordanians aged 18 and over in 2021 was used to create a decision-tree model from the provider’s point of view. The main result was the prevention of COVID-19-related deaths. Government reports, observational primary costing studies employing the micro-costing approach, systematic reviews, and secondary data analysis at the national level were the sources of the model’s inputs. To take uncertainty into consideration, scenario analysis and one-way sensitivity analysis (OWSA) were performed. Results: mRNA vaccination, inactivated vaccination, and no vaccination strategies have corresponding total costs of 339,035,352.00 JOD, 643,192,339.62 JOD, and 1,110,731,145.64 JOD. It is anticipated that these strategies will result in 952, 6,505, and 29,324 deaths, respectively. The inactivated strategy’s incremental cost-effectiveness ratio (ICER) is 20,489.01 JOD per death averted, whereas the mRNA strategy’s is 27,199.20 JOD per death averted, making it the dominant strategy. The ICER was 54,773.45 JOD saved for every extra mortality prevented when comparing mRNA to the inactivated approach. When compared to the other techniques, the mRNA strategy maintained its dominance throughout alterations in the analysis, as demonstrated by the OWSA and the worst-case scenario analysis, suggesting robust outcomes. Conclusion: The mRNA vaccination strategy outperformed the inactivated vaccine and no-vaccination strategies in this study’s context in terms of preventing COVID-19 mortalities.

The prevalence of smoking among Jordanian females has risen significantly from 10.1% in 2000 to 12.8% in 2022. (Who smokes more, men or women? - Our World in Data), it is imperative to recognize the global scope of this issue, which encompasses both genders. Furthermore, it is vital to discern potential sex-specific variations in the health and economic consequences of smoking cessation. This study aims to investigate the cost-effectiveness of smoking cessation interventions specifically tailored for Jordanian women. This study employs a pharmacoeconomic analysis to evaluate the potential cost effectiveness of JFDA-approved smoking cessation medications within the context of Jordanian women. The analysis focused primarily on a comparative assessment of two registered medications in Jordan, varenicline and nicotine replacement therapy (NRT), encompassing nicotine patches and lozenges. These interventions are juxtaposed against a control group representing the current standard practice of medical counseling with no medication use from the Ministry of Health’s payer perspective. For a cohort comprising 82,512 Jordanian female smokers seeking to quit, the varenicline regimen yielded a gain of 13,151 life years compared with the 7,265 life years gained with the NRT regimen compared with the no-intervention scenario. The cost per life-year gained was found to be JD 1,689.50 ($ 2383.3) for varenicline and JD 1,892.48. ($2669.63) for NRT. The sensitivity analysis confirmed the robustness of the findings. The notably high cost-effectiveness of smoking cessation interventions in females underscores the importance of tailoring approaches to address the needs of female smokers who express an intention to quit. This research highlights the imperative of offering smoking cessation aids to facilitate efforts to quit smoking.