A195in a hypothetical ten-million member health plan over a 3-year horizon. Estimates of plan cancer rates and utilization of HEC and MEC therapies were derived from epidemiological and market data. Treatment costs were computed using standard prescribing dosages, U.S. drug cost listings and simple reimbursement and dispensing assumptions. Uptake of NEPA was calculated at 5% a year for 3 years, and competing antiemetic therapies were reduced proportionately based on initial share assumptions. RESULTS: A total of 54,000 patients with cancer were identified in the model scenario. Of these, 9,882 (18.3%) would receive HEC and 3,949 (7.3%) would receive MEC requiring combination therapy, for a total of 13,830 eligible for NEPA. Cost of CINV prevention prior to the adoption of NEPA was estimated at $40.96 million. Following adoption of NEPA, cumulative costs were reduced by nearly $652K by the end of year 3. Calculations using PMPM estimates showed cumulative savings of $0.002 in year 1, $0.004 in year 2, and $0.005 in year 3. CONCLUSIONS: Results of the model indicate that adoption of NEPA for the prevention of CINV may have a relatively neutral impact on a U.S. health plan budget. Additionally, these estimates do not include savings from a potential reduction in the overall rate of CINV.

diseases are a public health priority in Colombia. The aim of this study was to estimate the difference of cases and costs from serotype coverage of pneumococcal conjugated vaccines of 10 and 13 serotypes (PCV10 and PCV13, respectively) in population under 5 years old in Colombia. Methods: A deterministic model was built for a cohort of children born in 2011. The probabilities of incidence, mortality and sequelae of pneumonia, meningitis, sepsis, and acute otitis media and clinical effectiveness of PCV10 and PCV13 for this population, were determined through a systematic literature review. Vaccination scheme 2+1 was included, herd effect of 42% and population coverage of 84.09% was assumed for both vaccines. The differences between the evaluated vaccines were estimated in terms of opportunity costs and net profit. The study was conducted from the perspective of third-party payers and a time horizon of 5 years. Costs were expressed in 2012 USD (exchange rate US$1 = $1798.23 COP). Results: A cohort of 652,611 children was assumed. Model showed a higher protection with PCV13 in comparison to PCV10. With PCV13 a difference of 98 prevented deaths for meningitis, pneumonia and sepsis was observed.

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A87emergency cases were young people under 40 years old. Male patients (53.9%) were more than female patients. The frequency of emergency visit is 2.7 average per year, male patients get 3.0 visits more than female 2.4 visits. About 33.9% of patients at one's own expense. Diseases in the top five were respiratory disease, trauma, digestive system diseases, circulation system disease, urinary diseases, respectively. Respiratory disease was the leading member in the spectrum, accounting for 25.5%. Poisoning patients account for 1.6% of all emergency cases. Wounded patients mostly centralized from May to August, and the bottom periods of the treatment time appeared in midnight (0:00 -6:00), accounting for 5.5%. CONCLUSIONS: Composition of emergency disease spectrum and characteristics of time distribution can help to develop new prevention and treatment strategies for improving quality and increase efficiency. The treatment for respiratory disease headed the list of emergency disease spectrum need to optimize medical resourse utilization and process improvement.

MCO) due to the severity of the conditions and their minimal budet impact. However, as interest by pharmaceutical companies, competition, and spend in the orphan drug category grows, payers are likely to look for ways to reduce or contain the cost. This is particularly true among pharmacy benefit products where payers have more effective utilization management tools at their disposal when compared to medical benefit products. Methods: This research assessed the Wholesale Acquisition Cost (WAC) of all non-oncology FDA designated pharmacy benefit orphan drugs that were launched 2004-2014 and plotted these against disease prevalence. The extent of payer management for these products was determined for the most common formulary design of 6 MCOs (2 national, 2 regional, and 2 integrated). Results: Stronger payer management of pharmacy benefit orphan drugs has emerged in select conditions where multiple labeled competitors with comparable levels of efficacy and material price differences exist, regardless of disease prevalence. The most common type of management introduced was either a 'preferred product' or 'step edit'. Integrated plans introduced stronger management more frequently when compared to national and regional plans. ConClusions: Given the increased payer spend in the orphan drug category, payers have begun to manage products in areas where cost savings can be achieved without sacrificing outcomes, irrespective of rare disease prevalence. In disease areas where multiple product options do not exist, payer management tended to be minimal, and typically only required a confirmation of a disease diagnosis through a Prior Authorization. While integrated health systems tend to have the tightest control on orphan products given their close physician relationships, national and regional plans have also begun to implement a similar level of control for select products.