that vildagliptin 50 mg bid and sitagliptin 100 mg qd are equivalent is 99.3%. The result of a sensitivity analysis showed that the probability of the two drugs remaining equivalent remains high (>90%) over a wide range of MCIDs. CONCLUSIONS: This innovative method has the potential to improve understanding of equivalence (or non-inferiority) between drugs for multiple stake-holders.

Objectives: To evaluate treatment sequences and associated costs among patients with relapsed/refractory multiple myeloma (RRMM). MethOds: Patients with RRMM between January 2007 and September 2013 were identified from US MarketScan databases. Outcomes included treatment regimen per line (L; 2-4L), sequences of treatment regimens, and cost per line and of progression (2L vs > 2L). All-cause and MM-specific monthly costs captured inpatient, outpatient, emergency department, and drug-related costs, adjusted for censoring. Results: 4449 MM patients initiated a 2L regimen, of whom 38% (n= 1696) progressed to 3L and 15% (n= 689) progressed to 4L. Median follow-up was 14 months (range 1-83). The most frequent 2L regimens were lenalidomide (18%), lenalidomide-dexamethasone (12%), bortezomib-dexamethasone (12%), bortezomib-lenalidomide-dexamethasone (10%), and bortezomib (7%). Of patients whose prior therapy included an immunomodulatory drug (IMiD) (n= 1752), bortezomib-dexamethasone was the most common 2L regimen (17%); for those with no prior IMiD exposure (n= 2697), lenalidomide was the most common 2L (23%). Median time to start of 3L was 5.8 months. Among the 27% of lenalidomide 2L patients who progressed to 3L, 64% had bortezomib-based regimens in 3L. Among the 47% of bortezomib-dexamethasone 2L patients who progressed to 3L, 63% had lenalidomide-based regimens in 3L. MM-specific costs were highest for all patients during the first year of 2L: $122,960 versus $74,573 (12-24 mths), $68,940 (24-36 mths), $59,327 (36+ mths). Drug-related costs accounted for 39-62%, and were dependent on regimen and treatment line. During 0-36 mths, MM-specific costs after progression from 2L were higher by $122,823 compared with costs incurred on 2L. cOnclusiOns: In this study of RRMM patients, 38% progressed to subsequent treatment lines, with variability in 2L regimens and treatment sequences. Highest costs were incurred during the first 12 months of follow-up. The cost of managing progressive disease in RRMM is high, as observed by the difference in costs before and after progression. PCN119 TreaTmeNT STraTegieS, healTh Care reSourCe uSe aNd CoSTS of aggreSSive hiSTologiCal TyPeS of NoN-hodgkiN lymPhomaS iN The Slovak rePubliC. reSulTS from The CroSS-SeCTioNal Survey iN The haemaTology-oNCologiCal CeNTerS

BackgroundGranulomatosis with polyangiitis (GPA), an ANCA-related vasculitis, is a severe condition that can result in organ damage and death.ObjectivesThe objective was to describe the clinical and economic burden of patients with GPA in the US.MethodsA retrospective claims-based cohort study was conducted using MarketScan® Commercial and Medicare Supplemental Databases in the period of 2009-2013. Inclusion criteria were: ≥2 claims with an ICD-9-CM diagnosis code for GPA (446.4), with date of first claim defined as index date; ≥18 years old at index date; and continuous enrollment for 12 months after index date. Incident cases were defined as patients with 12 months of continuous enrollment prior to index date with no diagnosis code for GPA. Major relapse-related events were defined via input from a clinical expert. Patient characteristics, all-cause and GPA-specific healthcare resource use and costs (inflated to US$ 2013) were reported. Descriptive analyses of all outcomes were stratified by incident and prevalent GPA cases.Results2784 patients met the study criteria (2215 prevalent cases, 569 incident cases). Mean age was 56.4 years, study population was 54% female, and post-index Charlson Comorbidity Index was 1.6. The most common physician specialty on the index date for GPA patients was primary care (26%), followed by rheumatology (24%). The most common post-index relapse-related diagnosis was acute or chronic renal failure (31%), followed by lung disease (8%). 12% of patients had at least one major relapse-related event in the post-index period. 25% of the patients had ≥1 hospitalization for any cause in the post-index period (22% GPA-related hospitalization). Among patients with ≥1 hospitalization, the mean number of inpatient admissions was 1.8 (1.7 GPA-related inpatient admissions). 32% of patients had ≥1 emergency room visit (7% GPA-related emergency room visits), and all patients had an outpatient visit or service (Figure). Mean total all-cause annual cost was $41,400. Mean total GPA-related annual cost was $24,319. On average, 58.7% of all–cause costs per GPA patient was associated with GPA.ConclusionsIn the US, GPA is associated with significant healthcare resource use and is an important driver of cost of care. Reducing the risk of relapse can contribute to the decrease the clinical burden and total healthcare costs for this population. Future studies are needed to explore whether similar trends are seen in other countries.Disclosure of InterestK. Raimundo Employee of: Genentech, Inc., A. Farr Employee of: Truven Health Analytics which performs consulting work for pharmaceutical companies, including Genentech, Inc., G. Kim Employee of: Truven Health Analytics which performs consulting work for pharmaceutical companies, including Genentech, Inc., G. Duna Employee of: Genentech, Inc.

Objectives: To describe the impact of add-back therapy on adherence and surgery rates among endometriosis patients starting leuprolide acetate (LA) therapy. Hormonal add-back therapy is used in conjunction with LA treatment of endometriosis patients to reduce potential side effects associated with LA gonadotropin releasing hormoneagonist effects. MethOds: Truven Health MarketScan Commercial Encounters database was used to identify women aged 18-49 with endometriosis (ICD-9-CM code 617. xx) who initiated LA (index date) in 2005-2011. Women with 12 months of continuous enrollment pre-and post-index and no evidence of endometriosis-related surgeries pre-index or up to 30 days post-index, no pre-index use of estrogen or non-contraceptive hormones and no diagnoses of uterine fibroids, malignant neoplasms, infertility, or pregnancy were included in the analysis. Proportion of patients adherent to LA, measured by Medication Possession Ratio (MPR)≥ 0.80, and time to endometriosis-related surgery in the post-index period were compared between patients with no add back therapy, patients who used norethindrone/norethindrone acetate (NETA) add-back and patients who used other add-back (estrogens, progestins, or combinations) using logistic and Cox Proportional Hazard regression models controlling for demographics, comorbidities and pain medication use. Results: Final study sample included 3,114 women with mean age 36.9 years. The majority of women did not use add-back (n= 1,965, 63.1%) while 22.9% used LA with NETA (n= 713) and 14% used other add-back (n= 436). NETA patients had higher likelihood of being adherent to LA than other addback patients (OR= 1.4, 95% CI (1.1, 1.8)) or non-add-back patients (OR= 2.2, 95% CI (1.8, 2.6)). NETA patients had lower surgery rate in the 12-months post-index compared to other add-back (HR= 0.62, 95% CI (0.46, 0.83) or non-add-back patients (HR= 0.72, 95% (CI 0.57, 0.91)). cOnclusiOns: Use of add-back therapy, particularly norethindrone/ NETA add-back, was associated with improved adherence to LA and reduced rates of endometriosis-related surgery, which has substantial economic and patient burden.Objectives: To assess parents' knowledge and practice about childhood immunization, and to determine the impact of their knowledge and practice on their children immunization status. MethOds: Children immunization timeliness was evaluated using a retrospective cohort study design. The data were collected from ten public clinics in the state of Pahang, the largest state in peninsular Malaysia. Immunization related information was collected from the child's immunization record card obtained from the parents. Parents' knowledge and practice was evaluated using a prospective cross-sectional study design by answering validated knowledge and practice questionnaire. Data were analyzed using SPSS version 20.0. Mean and median for the total knowledge and practice score were calculated. Parents' knowledge and practice was dichotomized into adequate and inadequate using median split method. Chi-square test wa...

Among AS patients receiving their first biologic, disease severity differed within 5EU, with patients in the UK with relatively higher burden and poorer treatment response. Impact of specific biologic treatments on the observed patterns warrants further scrutiny.