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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.

A843body mass index (BMI) ≥ 30. 62.2% of respondents reported taking steps to lose weight. These respondents were more likely to be female, of higher socioeconomic status, and more knowledgeable about their health (all p< .05). Among respondents who were trying to lose weight, only 27.5% had consulted a specialist. The primary reason for weight loss was to improve health (60.8%). Despite these intentions, success was limited. Only 34.3% reported having lost weight in the past 6 months (43.3% reported gaining weight) and the mean weight change was 0.5 kilograms (SD = 7.3). The most common treatments used for weight loss included exercise and dieting; 27.6% and 17.1% of respondents have used an over the counter (OTC)/herbal product and a prescription medication, respectively. Discontinuation rates were high with these treatments, as only between 28.0% and 48.8% of respondents who ever used OTC/ herbal products and prescription medications, were currently using those methods. Mean monthly out-of-pocket costs for OTC and prescription medications (combined) did not vary by socioeconomic status. ConClusions: The majority of respondents were taking steps to lose weight, employing a variety of strategies. Unfortunately, success of these strategies was limited. Additional weight loss treatments and increased obesity management advice may help improve weight loss success.

Objectives: This study aims to evaluate the impact of cancer and its treatment on HbA1c-values among individuals with colorectal cancer (CRC) using glucose lowering drugs (GLDs). MethOds: Patients with primary CRC (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) were selected from the Eindhoven Cancer Registry and linked to the PHARMO Database Network including out-patient pharmacy and clinical laboratory data. Patients with more than two years of GLDs use prior to cancer diagnosis were included. Linear mixed effects models were conducted to evaluate changes in HbA1c for colon cancer (CC) and rectal cancer (RC) patients in the four years around CRC diagnosis. Results: Of all CRC patients (n= 4,714), 294 (6%) GLDs users with CC and 144 (3%) with RC were selected. In the crude model, mean HbA1c at cancer diagnosis was 6.9% (51.6 mmol/ mol) among CC patients and 7.1% (53.5 mmol/mol) among RC patients. Among CC patients, HbA1c decreased with 0.12% per year (p= 0.0002) before cancer diagnosis in the adjusted model and after diagnosis it increased with 0.12% per year (p= 0.02). In subgroup analyses, effects on HbA1c were more pronounced in users of anti-anaemic preparations, these preparations are suggested to interfere with HbA1c. Among RC patients, HbA1c decreased before diagnosis with 0.18% per year (p= 0.0006), whereas after diagnosis it changed not-significantly. cOnclusiOns: Among users of GLDs, HbA1c decreased with 0.12%-0.18% (1-2 mmol/mol) per year before CRC diagnosis. Only among CC patients, HbA1c increased after diagnosis (0.12% per year; 1.3 mmol/mol). In (un)diagnosed cancer patients the HbA1c measure to visualise glycaemic control might be influenced by anti-anaemic preparations.Objectives: Castration resistant prostate cancer (CRPC), which occurs in 10-20% of patients with prostate cancer (PC), has had a historically poor prognosis. However, there are a number of emerging treatment options. The aim of this study was to describe the real-world treatment patterns of CRPC in Japan. MethOds: A retrospective chart review of patients with mCRPC (N= 445) was conducted from December 2014 to February 2015 with urologists (N= 176) from online physician panels. Charts from the most recent patient visits meeting the inclusion criteria were used. Patient demographics, health history, healthcare resource use, treatment information, and clinical outcomes were entered into an online data collection form. Results: Patients (N= 445) were an average of 73.57 years old (SD= 8.34), had been diagnosed with PC for 5.12 years (SD= 6.22), and had been castration resistant for 2.31 years (SD= 1.98). Androgen deprivation therapy was used among 43.64% of patients in 1st line and 40.68% in 4th line. Enzalutamide and abiraterone were also common, though more so in later lines because of their recent availability (used among 14.46% and 8.73%, respectively, of patients in 1st line and 40.68% and 20.34%, respectively, in 4thline). NSAIDs and opioids were used frequently for pain management. The prese...