IntroductionBipolar disorder is a chronic disease characterized by periods of mania or hypomania, depression, or a combination of both (mixed state). Because bipolar disorder is one of the leading causes of disability, it represents an important economic burden on society. Asenapine (ASE) is a new second-generation antipsychotic developed and approved for the treatment of manic or mixed episodes associated with bipolar disorder. The objective of the present study was to assess the cost-effectiveness of ASE compared to olanzapine (OLA) in the treatment of patients experiencing mixed episodes associated with bipolar I disorder in the context of the Italian National Health Service (NHS).MethodsA pharmacoeconomic model was developed to simulate the management of Italian bipolar I patients with mixed episodes over a 5-year time horizon by combining clinical parameters with resource utilization. An expert panel of Italian psychiatrists and health economists was responsible for adapting a UK model to the Italian context. The primary outcome measure of the economic evaluation was the incremental cost effectiveness ratio, where effectiveness is measured in terms of quality adjusted life-years gained. Scenario analyses, sensitivity analyses, and a probabilistic sensitivity analysis were performed to test the robustness of the model.ResultsThis pharmacoeconomic model showed that ASE resulted to be dominant over OLA; in fact, ASE was associated with lower direct costs (derived largely by the savings from hospitalizations avoided) and also generated a better quality of life. Results were robust to changes in key parameters; both scenario analyses and sensitivity analyses demonstrated model reliability.ConclusionsResults from this study suggest that the management of bipolar I patients with mixed episodes using ASE as alternative to OLA can lead to cost saving for the Italian NHS and improve patients quality of life.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-014-0139-3) contains supplementary material, which is available to authorized users.

In 2008, Public Procurement Law (PPL) was amended to implement and regulate e-Procurement in Turkey. Non-private, public purchaser hospitals are obliged to enter tender results of their medical device purchases into e-procurement system (EPS) to be eligible for a reimbursement by the Social Security Institution (SSI) in Turkey. Objectives of this research are to examine the impact of the EPS that is currently being used for medical device purchases in Turkey since 2011; and to investigate how the system is being used to define ceiling prices for reimbursement, concurrently assessing the quality and quantity of data uploaded by hospitals. EPS data is downloaded on a GMDN basis from Turkish National Database for Medical Devices, (TITUBB) which is an e-catalogue system that was launched to provide barcode level product registration, search and the e-procurement results. In accordance with the objectives, assessment is conducted on more than ten GMDNs and results are utilized to see the effect of EPS on pricing, comparing the prices on officially published SSI positive lists. Our study shows that a lowest price detected on EPS could be set as the reimbursement price, as was the case for the product; aortic stent graft, contralateral limb, where a defined SSI positive list price was reduced after determination of a lower price on EPS, on account of a mispriced tender record. An extrapolation while searching out the reimbursement prices is needed instead of SSI's calculations based on merely a retrospective and detection of lowest price practice. Effectiveness of this policy depends on resolving the weaknesses of EPS data in terms of quality and quantity; a misdated tender or a mispriced product could be a ground for an erroneous price setting and tenders that are not recorded at all or deferred might lead to incomplete EPS data to define reimbursement prices. disease-sPecific sTudies menTal HealTH -clinical outcomes studies PmH1 THe risk of meTabolic disorders in PaTienTs TreaTed wiTH asenaPine or olanzaPine: a real world daTa sTudy conducTed in iTaly and sPainObjectives: Second-generation antipsychotic drugs, knows as Atypical Antipsychotics, have a better tolerability than conventional antipsychotics but it has reported that its usage lead to a substantial weight gain, an increase risk of dyslipidemia and type 2 diabetes mellitus. In this article authors assessed the risk of metabolic adverse events associated with Asenapine in comparison with those associated with Olanzapine by studying real world data. MethOds: The study was a retrospective analysis based on data extracted from Italian and Spanish Cegedim Stategic Data Longitudinal Patient Data databases. Patients were divided in two cohorts (Asenapine and Olanzapine) according to the inclusion criteria and data from these patients were analyzed starting from 2009 up to 2013. Diabetes and dyslipidemia registrations have been searched in order to assess the risk of developing metabolic adverse events. Results: The retrospective analysis showed a lower risk of devel...