Summary: Sickle cell disease (SCD) with vaso‐occlusive pain crisis (VOC) significantly impacts patient well‐being and often results in extensive healthcare resource utilization. This study assessed the VOC burden, its management and its impact on patients' quality of life (QoL). A cross‐sectional observational study was conducted between November 2021 and June 2022, including 1000 SCD patients from high‐prevalence states in India. Data on demographics, clinical characteristics, VOC severity, management and QoL were collected. The study revealed that 33.5% of patients reported at least one VOC episode during the study period. In the year prior to their enrolment, 836 (83.60%) patients reported at least one VOC episode, with an equal proportion of 407/487 (83.6%) adults and 429/513 (83.6%) paediatric patients, reducing their QoL across all domains compared to patients without VOC. Of these, 469/1000 patients (46.9%) experienced ≥3 VOC episodes. Additionally, 764/1000 (76.40%) patients managed their VOCs at healthcare facilities, with 501/1000 (50.1%) requiring inpatient admissions. Further, 71.80% of patients received Hydroxyurea (HU) therapy. The study depicts the severity of the Arab–Indian haplotype in Indian SCD patients visiting healthcare settings based on high VOC burden. This highlights the urgent need for better management strategies and resource allocation for these patients.

Objectives: Cervical cancer accounts for 10 percent of cancer deaths among women in India. The human papillomavirus (HPV) vaccine can protect against infection but it is not included in India’s universal immunisation programme. This study aimed to assess the demand and willingness to pay for the HPV vaccine among mothers of adolescent daughters. Methods: We conducted a contingent valuation exercise involving a hospital-based cross-sectional study to assess the demand for an HPV vaccine among mothers of adolescent daughters, their willingness to pay and its determinants. Participants were recruited at a tertiary care civil hospital in the city of Gurgaon in North India, and data was collected from December 2018 to February 2019. A questionnaire was administered to obtain demographic and awareness indicators. Payment cards were used to elicit the willingness to pay amount. Results: Out of 319 respondents, 79% were willing to pay for the vaccine. The mean maximum willingness to pay was INR 629 (USD 35), which was less than the vaccine market price of INR 2000–3000 (USD 117–175) per dose. Participant age and number of children significantly influenced demand, while family income and awareness of cervical cancer influenced willingness to pay for the HPV vaccine. Participants were willing to spend between 3% and 34% of their monthly income on the vaccine. Conclusions: High demand and low willingness to pay for the HPV vaccine indicate low value perception of the health outcome among mothers of adolescent children in India. A strategy aimed at a price reduction of the vaccine and increasing its demand through improved awareness is important. At the same time, subsidising the vaccine in the short run is needed.

Background: Sickle cell disease (SCD) with vaso-occlusive pain crisis (VOC) has a major impact on healthcare resource utilisation and poses a significant financial burden for the patients. This study examines the economic implications of managing VOC in individuals with SCD in India, from the perspectives of patients, healthcare system and society. Methods: This cross-sectional, observational study included 1000 patients with SCD across 14 centres enrolled from November 2021 to June 2022. Data were collected systematically using a structured electronic case record form. Employing a cost-of-illness approach, the study assessed the economic impact of SCD and VOC management, including assessing patient/caregiver costs, healthcare provider costs and societal burdens extrapolated to the larger SCD population in India. Findings: Patients incurred substantial out-of-pocket expenses, with a median (IQR) annual expenditure of INR 22 080/US$267 (IQR: INR 36 990/US$447.7), representing 14.65% (26.53) of their annual household income. Overall, catastrophic healthcare expenditure (CHE) for total annual average SCD care with VOC management was experienced by 624 patients (62.40%). Moreover, 334 patients (33.4%) experienced CHE of >25% of the annual household income. Patients with SCD with VOC had significantly higher median annual healthcare expenditures and used a higher median percentage of their yearly household income on healthcare compared with those without VOC (19.82% vs 6.08%; p<0.001). Cost incurred by healthcare providers for VOC management in different healthcare facilities (outpatient department/emergency department/intensive care unit) was similar across different reimbursed facilities (government tertiary care hospitals, non-governmental organisation-operated healthcare centres and government-subsidised healthcare setups). The estimated societal burden for VOC management in 1 year for 1000 patients visiting different healthcare facilities was around INR 35 119 074 (~US$0.42 million). Interpretation: These findings highlight the considerable economic strain on both patients and healthcare providers in SCD and VOC management, which is similar to the other non-communicable diseases emphasising the urgent need for targeted interventions to improve financial hardships among patients. Funding: The study was funded by Novartis Healthcare Private Limited.

The COVID-19 pandemic has had a profound and far-reaching impact on global health, resulting in significant morbidity and mortality across populations. Long term post COVID-19 conditions can include neurological symptoms, chronic fatigue, and mental health disorders, which collectively contribute to a deterioration in health-related quality of life. This study aims assess long-term HRQoL using EuroQol (EQ 5D 5L) among COVID-19 patients in community settings. This study conducted a multicentric, community-based cross-sectional design to assess the long-term HRQoL among patients who have recovered from COVID-19. The study included participants aged above 18 years from two cities Delhi and Bhubaneswar. Descriptive statistics of categorical variables were presented in frequency and percentage, while continuous variables were presented in mean ± SD. The censored regression analysis has been performed by reporting beta coefficients and significance by (p < 0.05). The EQ-5D-5L index scores indicated a mean of 0.89 (95% CI 0.87, 0.91) for Delhi, compared to a lower mean score of 0.66 (95% CI 0.62, 0.71) for Bhubaneswar. Age was negatively correlated with health states, showing a crude coefficient of − 0.003 (95% CI − 0.005, 0.001) with a significant p value of 0.002, although the adjusted coefficient was − 0.002 (95% CI − 0.005, 0.001), indicating a loss of significance when controlling for other factors. The emphasizes the health-related quality of life of the COVID-19 recovered patients and challenges in their daily living. The study descriptively highlighting the quality-of-life and in association with age, educational status, marital status, health insurance availability, and treatment setting.

Background: Effective public health interventions need to be assessed for efficiency in order to optimize results and justify investments especially under conditions of uncertainty and resource constraints. The COVID-19 pandemic has presented unprecedented situations where decisions had to be taken based on limited evidence available in order to save human lives. Vaccines have been identified to be the mainstay of the public health response to the pandemic. In India, nine vaccines have been granted emergency use authorization (EUA) and are being delivered through multiple modes. Efficiency of vaccine delivery needs to be established to maximize results and formulate policy in long run. Methods: This study will be conducted in Delhi and Bhubaneshwar. Two systematic reviews, a cross-sectional community survey and a complete economic evaluation using a decision tree model will be carried out to meet the study objectives. Data will be captured through computer assisted personal interviewing (CAPI) using CS pro software. Outcomes will be measured in lives saved and quality adjusted life years (QALYs) gained by vaccination. This will be the first study providing a detailed cost of COVID-19 vaccination and treatment segregated by government or private provider Conclusions: The study would establish the relative efficiency of each vaccine granted EUA over the other by their individual modes of delivery.

Background: Increased vehicular traffic is associated with higher levels of air and noise pollution which in turn causes high morbidity and mortality. Governments, including Delhi have invested high amounts in setting up and running public transport systems in order to rationalize road usage and limit vehicles on road. This study proposes to assess the willingness of the citizens to give up their private vehicles in favor of public transport and will provide specific policy recommendations. Methods: This study will be conducted in Delhi/NCR along the Delhi metro route. A systematic review and cross-sectional community survey will be carried out to meet the study objectives. Data will be captured through computer aided personal interviews (CAPI) using contingent valuation methods (CVM). This study will provide information on the perceptions and attitudes of commuters towards the current public transport system and the economic value placed by them on private transportation and provide an estimate of the welfare gain associated with it. Specific objective wise outputs have been framed. This will be the first study using contingent valuation methods (CVM) in a similar setting in India. Conclusions: The result will provide an evaluation of the public transport system of Delhi NCR from a user perspective. The willingness to pay values will provide a monetary value to the health benefits arising from shift from private to public modes of transport along with workable models of interventions for policy makers.