We also observe that not updating CMI, mainly for the hospitals that had increased it in the last years: i) creates problems of solvability or sustainability; ii) decreases funding for hospitals that treat more complex patients; iii) generates incentives to select patients ("adverse selection"); and iv) hurts equity funding among hospitals.
Adverse selection arises when individuals select insurance policies based in part on their personal health when their health is not fully reflected in premium differences.
In this section, the current data on the activity of immune checkpoint inhibitors in NSCLC are reviewed, followed by separate sections on the incidence and management of select adverse events (adverse events with potential immunologic etiologies that require more frequent monitoring and/or unique intervention) observed with these therapies.
At each CORRONA registry visit patients and physicians record data on disease severity and activity, RA and other medications, adverse events, quality of life, selected laboratory and imaging results, and socio-demographic information.
Although most select adverse events with immunotherapies are of low grade, select adverse events can occur with rapid onset, and prompt medical attention is critical to the management of immune-related events.
Although select adverse events may not be a familiar concept in oncology clinics, most select adverse events can be managed with awareness and action, and immunotherapy may be maintained or reinitiated following resolution of immune-related adverse events.
13 These select adverse events were generally reversible, although three patients (9%) discontinued therapy owing to treatment-related adverse events.
86, 87 Any potential select adverse event should be treated with a high level of concern.
In clinical studies, select adverse events were reported in approximately 40%60%% of patients, including 3%20%% patients with grades 3 or 4. Select adverse events were reversible in most cases; however, some adverse event-related deaths occurred.
12 Glucocorticoid administration for select adverse events is usually continued on a slow taper following recovery to reduce recurrence.
