Objectives: Anti-cancer chemotherapeutic pharmaceutical agents have some toxic effects to normal cells. Therefore, the main factors to increase therapeutic effects are to destroy cancer cells specifically and appropriate dosage of anticancerous agents. Cancer cells are have being studied in many ways by using cell culture technologies in developed countries. We aimed to determine the chemosensitivity of colorectal cancer cases. MethOds: From February 2013 through February 2014, Histoculture drug response assay data were obtained from 6 colorectal cancer surgical specimens held in State Central Hospital. Cultures and culture media were prepared by R. Hoffmans methods. We examined chemosensitivities of the tissue to carboplatin, irinotecan, doxorubicin, 5-fluorouracil and oxalaplatin. Cutoff inhibition rates were determined with each drug for colorectal cancer and were used to calculate predictabilities for chemosensitivity responses. We also prepared double samples from the culture and made histologic and cytologic analysis. Results: The evaluability of the histoculture drug response assay was at 83,3%. Predictability including true-positive and true-negative rates of 83,3% and 100% was observed. cOnclusiOns: Cancer cells deaths are dependent from dosages of the candidate medications and it shows it is possible to use drug sensitivity methods in oncologic clinical practice.

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data collection is used for the same resource items. Methods: Articles citing 38 trial-based resource use instruments catalogued in the MRC-funded Database of Instruments for Resource Use Measurement (www.DIRUM.org) were identified using Google Scholar, ISI Web of Science and Scopus, and screened according to resource use measure usage. Data were extracted on: the method of administration, resources measured, rates of return and the nature of the other methods of resource use measurement. Results: A total of 146/1503 citations met the screening criteria. Nearly all (143/146) used resource use instruments derived from Beecham and Knapp's Client Service Receipt Inventory. Most instruments relied on patient-or proxy-recall (126/146) generally administered during researcher interviews. Primary and secondary care usage were the most widely asked items (136/146) with 75 using no supplementary supporting data such as from hospital notes. Twelve studies compared one or more method of data collection for the same resource items with 8 indicating good agreement between medical records and patient/carer recall, 1 indicating the greater reliability of case notes and 3 were not evaluable. ConClusions: Resource use instruments based on patient recall are valuable complements to other methods and essential for certain items (e.g. out of pocket costs, non-medical costs). However, there remains inappropriate use in circumstances where more objective measures are available.

Objectives: Pegvisomant is an established and effective medication for patients with acromegaly, who have had an inadequate response to surgery, radiation therapy or treatment with somatostatin analogues. Currently pegvisomant is not included in the Vital and Essential Drug List (VEDL) in Russia, which limits access to this therapy for patients with limited treatment options. This pharmacoeconomic evaluation compared pegvisomant with best supportive care (BSC) from the Russian healthcare system perspective. Methods: Markov model of acromegaly progression on pegvisomant or BSC was developed. Model included 3 states: normal level of IGF-I concentration, elevated level of IGF-I concentration and death. Transition probabilities between the first two states were derived from the 12-week randomized clinical trial that compared three pegvisomant regimens vs placebo. After 12 weeks we assumed no transitions between normal and elevated IGF-I concentration states and only considered mortality, which was higher in the elevated IGF-I concentration state, according to earlier meta-analysis. Costs of medication and patient monitoring were considered. We used a lifetime time horizon and calculated incremental cost-effectiveness ratio (ICER) as difference in costs of pegvisomant vs BSC derived by difference in life-years gained (LYG). Results: Pegvisomant was associated with 26.65 LYG vs 21.60 LYG on BSC. Yearly medication costs of pegvisomant were US$44,524 per patient. Lifetime medical costs associated with pegvisomant treatment were US$496,971 per patient. ICER for pegvisomant vs BSC was US$98,318 per one LYG. This value is within the actual ICER range for antineoplastic drugs, approved for the VEDL in 2017 in Russia. Sensitivity analyses showed that results were robust to variations in model assumptions. Conclusions: Pegvisomant is a cost-effective option of acromegaly treatment, compared to BSC, and should be recommended for inclusion into VEDL in Russia.

NICE willingness to pay threshold range. For both models, results were very sensitive to changes in the small estimated incremental health benefit (0.0195 versus 0.0434 quality-adjusted life-years). Intrinsic differences between both modelling approaches contributed to differences in results. Data availability issues limited replication efforts. Model execution in the cohort-level model was near-instant. Conclusions: Were a cohort-based, non-DICE modelling approach submitted by the manufacturer in TA494, this research suggests the NICE recommendation would have likely been the same. However, the model execution issues faced by the ERG and affecting committee deliberations would have been avoided. Given the number of health states required to approximate the analysis in a cohort-level model, a non-DICE patientlevel approach directly capturing patient heterogeneity may have been more apt.