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Objectives: To evaluate the cost-effectiveness of treating relapsed/refractory multiple myeloma (RRMM) with carfilzomib, lenalidomide plus dexamethasone (KRd) compared to lenalidomide plus dexamethasone (Rd) and with carfilzomib plus dexamethasone (Kd) versus bortezomib plus dexamethasone (Vd) from a Colombian third-party payer perspective. Methods: An economic model was developed to estimate the treatment acquisition costs relative to treatment outcomes for KRd versus Rd and Kd versus Vd in the treatment of RRMM. Efficacy data were based on the ASPIRE and ENDEAVOR head-to-head pivotal trials comparing the therapies of interest. Only treatment acquisition costs were considered and were obtained from local price databases and expressed in local currency. Results were expressed as incremental cost per incremental month of duration of response (DOR), progression free survival (PFS) and overall survival respectively. A threshold of 3 times GDP per capita (63M COP) was considered to assess the comparative cost-effectiveness of each intervention. A scenario considering no drug wastage was also explored. Results: Both combinations with carfilzomib (KRd and Kd) were cost-effective (,3 times GDP per capita) compared to Rd and Vd respectively. For Kd versus Vd, ICERs ranged between 37.19M COP and 53.33M COP, with median DOR being the scenario with the lowest ICER, followed by median PFS. For KRd versus Rd, median PFS provided the most cost-effective scenario followed by median OS, within a 52.95M to 62.26M COP ICER range. When no drug wastage was considered, ICERs were lower by 19% across all outcomes compared to the base case analysis. Conclusions: Carfilzomib is likely to be a cost-effective treatment option for RRMM patients from a third-party payer perspective in Colombia, attributable to its demonstrated superior clinical profile. Further analysis including other direct medical costs, discounts and survival estimate variations is warranted to assess additional foreseeable gains/savings.

OBJECTIVES:To estimate the cost-effectiveness of maintenance therapy with oral erlotinib (150mg/day) and BSC compared with BSC, in patients with advanced nonsmall-cell lung cancer (NSCLC) EGFR WT and stable disease after completing four cycles of first-line platinum-based chemotherapy. METHODS: A Markov model including three health states (progression free survival, progression and death) was developed to evaluate the cost per life year gained (LYG) of maintenance treatment with erlotinib vs BSC from the Spanish National Healthcare System perspective. Clinical data inputs were based on the SATURN trial results. Resource utilization related to each health state was estimated by a Spanish Expert Panel. Drug and unitary costs were obtained from a Spanish database (€, 2012). The annual discount rate applied was 3.0% for cost and outcomes. The simulation was carried out over a 5 year time horizon and one-way deterministic and probabilistic sensitivity analyses were conducted to assess the uncertainty around key input values. RESULTS: In the prespecified subset of patients with EGFR WT and stable disease, the annual cost per patient of erlotinib and placebo, including supportive care and adverse events costs, was 23,912€ and 13,969€, respectively. Erlotinib also achieved a mean gain of 1.40 life-years compared with the 1.12 LYG with placebo. The incremental cost-effectiveness ratio of erlotinib relative to placebo was calculated to be 35,265 € per LYG. Sensitivity analyses confirmed the robustness of the results. CONCLUSIONS: In patients with advanced NSCLC EGFR WT and stable disease after 4 cycles of chemotherapy, maintenance treatment with erlotinib is a therapeutic option that increases survival of patients and may be cost-effective vs BSC in Spain.

ments. In addition, diabetic patients with low education level cost 2.341€ cost more on average in comparison to better educated patients. ConClusions: T2DM is an expensive to treat disease and in the era of limited resources and escalating costs it is critical to implement sound public health policies in order to achieve patient's good glycemic control and consequently less burden to health care budgets.

The analyses estimated the comparative efficacy of ipilimumab and vemurafenib in the absence of head-to-head patient-level data for all trials and proportional hazards in overall survival.