IntroductionDaclatasvir and Asunaprevir (DCV/ASV) have recently been approved for the treatment of chronic hepatitis C virus infection. In association, they are more effective and safer than previous available treatments, but more expensive. It is unclear if paying for the additional costs is an efficient strategy considering limited resources.MethodsA Markov model was built to estimate the expected costs in Chilean pesos (CL$) and converted to US dollars (US$) and benefits in quality adjusted life years (QALYs) in a hypothetic cohort of naive patients receiving DCV/ASV compared to protease inhibitors (PIs) and Peginterferon plus Ribavirin (PR). Efficacy was obtained from a mixed-treatment comparison study and costs were estimated from local sources. Utilities were obtained applying the EQ-5D survey to local patients and then valued with the Chilean tariff. A time horizon of 46 years and a discount rate of 3% for costs and outcomes was considered. The ICERs were estimated for a range of DCV/ASV prices. Deterministic and probabilistic sensitivity analyses were performed.ResultsPIs were extendedly dominated by DCV/ASV. The ICER of DCV/ASV compared to PR was US$ 16,635/QALY at a total treatment price of US$ 77,419; US$11,581 /QALY at a price of US$ 58,065; US$ 6,375/QALY at a price of US$ 38,710; and US$ 1,364 /QALY at a price of US$ 19,355. The probability of cost-effectiveness at a price of US$ 38,710 was 91.6% while there is a 21.43% probability that DCV/ASV dominates PR if the total treatment price was US$ 19,355. Although the results are sensitive to certain parameters, the ICER did not increase above the suggested threshold of 1 GDP per capita.ConclusionsDCV/ASV can be considered cost-effective at any price of the range studied. These results provide decision makers useful information about the value of incorporating these drugs into the public Chilean healthcare system.

A225 ombitasvir/dasabuvir) +/-ribavirin compared with Harvoni® (sofosbuvir/ledipasvir) in the United States. METHODS: A cost-effectiveness Markov model, based on previous HCV models, had 13 health states: 8 disease progression states (F0-F4, decompensated cirrhosis, hepatocellular carcinoma, and liver transplant), 3 sustained virologic response states, and 2 mortality states (liver-related and nonliver-related death). Transition rates were obtained from previous models. Adverse events, treatment-related disutility, and efficacy rates were based on phase 3 clinical trials. Baseline patient characteristics were derived from AbbVie 3D phase 3 clinical trials. Treatment durations were 24 weeks for GT1a experienced cirrhotic patients with AbbVie 3D and 8 weeks for 26% of GT1 treatment naïve patients with Harvoni. Direct medical costs were based on a systematic literature review and drug costs were based on December 2014 Red Book. The model was run over a lifetime horizon, discounting at 3% annually. Outcomes were measured in quality-adjusted life-years (QALYs). Probabilistic simulation analysis (PSA) was conducted by varying all parameters simultaneously. RESULTS: AbbVie 3D resulted in discounted lifetime costs per patient of $99,753 and 16.20 QALYs. Harvoni resulted in lifetime costs of $108,430 and 16.18 QALYs. With lower costs (-$8,677) and higher QALYs (0.02), AbbVie 3D dominated Harvoni. AbbVie 3D was superior in 98.4% of PSA simulations when QALYs were valued at $100,000 each. CONCLUSIONS: With higher QALYs and lower costs, AbbVie 3D dominated Harvoni in GT1-HCV-infected patients.OBJECTIVES: Evaluate the cost-effectiveness of universal rotavirus vaccination of children below age of five years old in the Philippine setting METHODS: We developed an age-stratified dynamic transmission model which compared four settings (baseline of no vaccine with 34% exclusive breastfeeding rate (EBR), two-dose monovalent vaccine (RV1), three-dose pentavalent vaccine (RV5), and no vaccine with 80% EBR) in the Philippine population over a 5-year time horizon. Model parameters such as cost and vital statistics were Philippine specific and other parameters such as vaccine efficacy and utility were extrapolated from literature. Univariate one-way and multivariate probabilities sensitivity analyses were conducted. RESULTS: Compared to baseline, the model showed that vaccination could lead to significant reduction in rotaviral morbidity and mortality in the 0 to < 5 age group as well as inducing herd immunity in the older groups. The incremental cost-effectiveness ratios (ICER) of vaccination versus baseline from a societal perspective were US$ 13,184/DALY for RV1 and US$ 11,836/ DALY for RV5; these are higher than the the current government cost-effectiveness threshold equal to the Philippine GNI per capita of US$ 3,134. Comparing 80% EBR to baseline, ICER is US$ 256,417/DALY. ICERs were sensitive to changes in case fatality, proportion of diarrhea cases due to rotavirus, and vaccine efficacy. The vaccine was cost-effective in less tha...

The impact on the health budget ranges between 0.3% and 0.71% the first year and decreases to less than 0.15% from the second year considering the price assessed price range.

A 3 4 7 -A 7 6 6 end of the 1st year of prophylaxis. Current rate taken as for 15.06.2016 is 1$ = 66,09 RUB. ConClusions: In the context of pharmacoeconomic analysis it is preferable to use lipegfilgrastim for prophylaxis of febrile neutropenia compared to other G-CSFs (pegfilgrastim, filgrastim, lenograstim), as it allows to increase the number of patients who responded to prophylaxis of febrile neutropenia while reducing costs as compared to other granulocyte colony-stimulating factor drugs.objeCtives: Romanian public health policies must combine information about effective interventions for treatment of recurrent malignant glioma with information about costs' interventions. Methods: Costs of providing health interventions were comparing using the actual Romanian reimbursement list. We compared two treatments for demonstrate that each additional year of life gained from these interventions are equal performing a survival-gain analysis. Cost-effectiveness for the treatment (bevacizumab+irinotecan or dendritic cell immunotherapy-DCI) was estimated using an outcome indicator, survival-gain, that is defined as the difference between observed and predicted mOS. Effectiveness' differences were concluded using the Mann-Whitney-Wilcoxon Test. Results: The survival gain analysis consisted in identifying fourteen clinical studies with patients with recurrent malignant glioma that received a standard treatment with bevacizumab+irinotecan vs. a very expensive, non-existing treatment in Romania with DCI. The two interventions weren't defined relative to adverse health events, only with reported median overall survival declared in the included studies. A total of 381 patients were included in our systematic review with 302(79.26%) of them receiving bevacizumab+irinotecan while 79(20.74%) received DCI. 233(77.15%) of the patients receiving bevacizumab plus irinotecan were diagnosed with glioblastoma, while only 69(22.85%) of the patients having grade III gliomas. In the DCI group, 58(73.41%) of the patients had GB while 21(26.59%) patients had grade III gliomas. In comparison, the studies following the bevacizumab+irinotecan protocol reported a mean survival-gain of -0.02±2.00 while the mean survival-gain was -0.01±4.54 for DCI group. We found that DCI compared with bevacizumab plus irinotecan does not improve statistically survival-gain (p= 0.535). The costs for a 14 days of treatment with bevacizumab and irinotecan are approx. 2023Euro, whereas DCI that is not avaible in Romania costs about tens of thousands. ConClusions: These comparisons of different interventions for the same disease is a clear indication that more health gain is possible by spending resources on the treatment with bevacizumab+irinotecan.