O ensino médico orientado para a comunidade constitui um dos fundamentos do preparo de futuros profissionais para o trabalho nos serviços de saúde e permite formação ampla para atendimento nos diversos níveis de cuidado. A instituição do programa mais médicos permitiu distribuição de profissionais em regiões com maior necessidade e mudanças nos processos de trabalhos na atenção básica. O curso de medicina da Universidade Federal do Amapá (UNIFAP) iniciou em 2015 atividades de inserção de alunos nas equipes de saúde com profissionais do programa. Este estudo visou identificar as percepções dos acadêmicos de medicina sobre a experiência de aprendizado na comunidade durante acompanhamento de equipes de saúde da família do programa mais médicos. Realizou-se estudo qualitativo através da técnica do grupo focal com voluntários da quarta série de graduação de medicina. O estudo constatou que alunos tiveram percepções positivas sobre a atuação dos médicos acompanhados, principalmente pela valorização da relação médico paciente e atendimento holístico. Entretanto, houve identificação de necessidade de atualização dos protocolos brasileiros de atendimento na atenção primária. Os discentes mudaram visão preconcebida sobre a baixa qualidade profissional do programa e passaram a aceitar melhor a experiência. A observação da realidade estrutural de postos de saúde foi considerada causa importante para que médicos evitem trabalhar no interior ou regiões isoladas. Os achados auxiliam no aprofundamento das discussões sobre políticas de provimento de médicos e sua interação com o ensino, ainda assim novos estudos precisam ser estimulados para avaliar outros aspectos e impactos ocasionados por esse tipo de programa.

likelihood of suicide, absenteeism, and the hospitalisation rate. The reimbursement of Seroquel XR® could generate annual budget savings of PLN 8.6 million ( 2150 thousands Euro), if Seroquel XR® were used in 31% of quetiapine-treated patients with schizophrenia. The maximum savings resulting from the reimbursement of quetiapine prolonged release tablets (Seroquel XR®) could amount to PLN 27.6 million (6900 thousands Euro) per year. CONCLUSIONS: The reimbursement of Seroquel XR® with the reimbursement limit at the level of the reimbursement limit for normal tablets of quetiapine is profitable for the state budget -it will not only bring budgetary savings, but also allow patients to return to active life, which is crucial in the case of schizophrenia. OBJECTIVES:To estimate the economic consequences of replacing Seroquel (the normal tablets of quetiapine) with Seroquel XR® in the treatment of bipolar disorder in Poland. METHODS: Based on the established model of the economic consequences of bipolar disorder treatment, we calculated the cost of treating bipolar disorder with quetiapine in Poland. Expenditures for the purchase of medicines, hospital costs and the costs of lost productivity were highlighted. The analysis was performed from a societal perspective, taking into account the Payer's perspective, in three-year time horizon. RESULTS: The use of Seroquel XR® will decrease hospitalisation rate and length of hospitalisation, what will reduce direct costs of bipolar disorder treatment by PLN 645 thousands (161 thousands Åuro). The use of Seroquel XR® will increase the population of patients who comply with the recommended treatment, which will reduce the likelihood of suicide, absenteeism, and the disability pension. The budget savings related to indirect costs reduction are estimated at PLN 15,3 million (3825 thousands Euro). Moreover, the reimursement of Seroquel XR® would decrease the social transfers by PLN 157,6 thousands (39,4 thousands Euro) in comparison to current scenario. CONCLUSIONS: The reimbursement of Seroquel XR® with the reimbursement limit at the level of the reimbursement limit for normal tablets of quetiapine is profitable for the state budgetit will not only bring budgetary savings, but also allow patients to return to active life, which is crucial in the case of bipolar disorder. OBJECTIVES:The objective of this exploratory analysis was to assess the costeffectiveness of quetiapineXR as monotherapy compared to other key drug treatments in MDD patients, who have failed on previous therapy. METHODS: A Markov Model with one week cycles was used to assess the cost effectiveness of quetiap-ineXR treatment over 52 weeks. Key outcomes were: response rates, costs and Incremental Cost-Effectiveness Ratios (ICERs) for second line monotherapy. The

costs in intraoperative changes of the surgical plan and reductions in unnecessary surgery associated with the use of PV-MRI. Results from the previous study VALUE, which showed that no patient with PV required additional imaging tests as part of a Phase IV, confirm the results obtained in the present analysis (resulting in even slightly lower cost than the total cost of diagnosis using PV-MRI).OBJECTIVES: Cervical cancer incidence in Serbia has been identified as one of the highest in Europe, showing slow but steady increase during the last decade. Despite the National Programme for Prevention of Cervical Cancer that has recently been established, an organised Pap screening is far from full implementation. This study aims to assess the effectiveness and cost effectiveness of absolute adherence to the proposed policy compared to the current practice. METHODS: A Markov model simulating the natural history of cervical cancer was developed. Calibration was performed using country specific data, sourcing incidence and mortality from Serbian cancer registries. Accordingly, the screening algorithm incorporated in the model was based on the local guidelines. We followed a hypothetical cohort of 100,000 15-year old girls until the end of their lifetime. Subsequently, the actual cytological screening practice covering only 20% of the targeted population was compared to a scenario of absolute adherence to the national screening programme. A discount rate of 1.5% for health and 4% for cost outcomes was applied. RESULTS: The natural history model showed that limited benefit is currently being achieved from cytological screening. The hypothetical cohort analysis indicated that absolute guidelines adherence would result in 422 deaths averted and an incremental cost effectiveness ratio (ICER) of 3272 €/LYG. The ICER estimate did not exceed the national annual GDP (3857 €/capita) -a commonly used informal threshold. CONCLUSIONS: This research identified that full adherence to the screening policy is very likely to be cost effective. In general, the low screening coverage that has been observed appeared as the most serious obstacle to the prevention of cervical cancer. The new methods in cervical cancer prevention, however, such as HPV vaccination and HPV testing, require further pharmacoeconomic assessment.

Introduction: Malignant neoplasms are considered a public health problem due to the high rates of morbidity and mortality presented worldwide, particularly those associated with breast cancer.

average age was 54 years (standard deviation ϩ 11 years, range 17-85 years) with the majority being female (78%), white (87%), having a some college education or more (73%) and having health insurance (87%). Approximately 58% of patients reported medication nonadherence. No significant differences were observed between adherent and nonadherent patients with regard to age, sex, race, insurance status, condition, or number of medications taken. Reasons significantly associated with nonadherence were forgetting, don't like to take pills/give injection, cost of medication, symptoms improved so stopped taking medication, side effects too severe, and poor knowledgeable about their medications. CONCLUSIONS: Medication nonadherence is common and patient reported reasons for nonadherence include motivational factors, lack of understanding or knowledge, and treatmentrelated characteristics. Interventions that motivate, educate and individualize drug therapy according to patients' preferences and affordability may improve adherence.