BackgroundAcute coronary syndrome (ACS) is defined as a “group of clinical symptoms compatible with acute myocardial ischemia”, representing the leading cause of death worldwide, with a high clinical and financial impact. In this sense, the development of economic studies assessing the costs related to the treatment of ACS should be considered.ObjectiveTo evaluate costs and length of hospital stay between groups of patients treated for ACS undergoing angioplasty with or without stent implantation (stent+ / stent-), coronary artery bypass surgery (CABG) and treated only clinically (Clinical) from the perspective of the Brazilian Supplementary Health System (SHS).MethodsA retrospective analysis of medical claims of beneficiaries of health plans was performed considering hospitalization costs and length of hospital stay for management of patients undergoing different types of treatment for ACS, between Jan/2010 and Jun/2012.ResultsThe average costs per patient were R$ 18,261.77, R$ 30,611.07, R$ 37,454.94 and R$ 40,883.37 in the following groups: Clinical, stent-, stent+ and CABG, respectively. The average costs per day of hospitalization were R$ 1,987.03, R$ 4,024.72, R$ 6,033.40 and R$ 2,663.82, respectively. The average results for length of stay were 9.19 days, 7.61 days, 6.19 days and 15.20 days in these same groups. The differences were significant between all groups except Clinical and stent- and between stent + and CABG groups for cost analysis.ConclusionHospitalization costs of SCA are high in the Brazilian SHS, being significantly higher when interventional procedures are required.

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.

It is estimated that the prevalence of moderate-to-severe SA (apnoeahypopnoea index > 15/h) is 10%. Approximately 11% of SA patients have comorbid COPD, which worsens sleep quality and desaturations. This study investigated the effects of PAP therapy on all-cause mortality and cost of illness (COI) in patients with SA and COPD in Germany. A statutory health insurance (SHI) perspective was taken. Methods: A total of > 4 million individuals covered by the SHI database were analysed (≈5% of the German SHI population). PAP therapy was initiated in 4,068 patients with SA (PAP group). Propensity score matching was used to define a control group (CG) of 4,068 SA patients matched for age, sex, risk factors/aetiology, region and medication who received usual care (no PAP). Of these, 1,300 patients in the PAP group and 1,192 patients in the CG had comorbid COPD. This subgroup of patients was followed for 3 years after initiation of PAP therapy. Results: Total COI was higher in the PAP group versus CG in the first year of follow-up (€ 8,697 vs € 6,999, p< 0.0001). However, during the second and third year the difference in COI between the PAP and CG was smaller (year 2: € 7,340 vs € 7,316, p< 0.0048; year 3: € 6,847 vs € 6,714, p< 0.001). PAP recipients had a significantly lower 3-year mortality rate compared with CG (8.2% vs 11.7%, p< 0.001; relative risk reduction 30.1%). ConClusions: SA patients with COPD treated with PAP showed significantly reduced mortality and morbidity. Total COI was higher in PAP recipients versus CG over the first 3 years of follow-up, but the difference between groups decreased over time. A follow-up period of ≥ 5 years may be required to show beneficial economic outcomes in SA patients receiving PAP therapy.

scenarios when compared to PCV13 alone [-328 (-1.6%) to 2,268 (9,2%) and from -10,145 (-8.9%) to 3,972 (4%) for IPD and NBPP respectively]. From a budget impact standpoint, none of the scenario was found in favor of PCV13. Under conservative vaccination coverage assumptions, the total incremental budget impact if PCV13 replace PPV23 for the immunocompetent population ranged from € 39.8 million to € 69.3 million. ConClusions: With the epidemiological changes of pneumococcal diseases and the wider serotype coverage of PPV23, vaccination of at risks adults with PPV23 remains the optimal one strategy from a public health perspective. Moreover, in the current health budget constraint, PCV13 alone is found to be associated with a significant impact on budget, whereas the health benefits are limited.objeCtives: This study aimed to evaluate the impact of pneumonia, meningitis and sepsis and the how they represent the costs for patients 50 years and older in the Brazilian Private Health System. Methods: An administrative claims database containing over 18 million lives was used to identify episodes of pneumonia, meningitis and sepsis, in all ages, between Oct/2010 and Dec/2013. The episodes were identified using ICD-10 codes of A40.3; B95.3; G00.1; J13; J15; J15.0; J15.3; J15.4; J15.8; J15.9; J18; J18.0; J18.9; J20.2 and P23.3 for pneumonia, A40; A40.0; A40.1; A40.8; A40.9; A41.8; A41.9; P36; P36.0 and P36.1 for sepsis, G00 and G00.9 for meningitis. Patients aged ≥ 50 years were identified and all-cause costs were extracted and grouped according to the 3 disease conditions. Results: A total of 70,850 patients were identified (pneumonia: 68,717; sepsis: 1,745; meningitis: 388, representing 96.99%, 2.46% and 0.55% respectively). Different diseases disproportionately affected the populations. For pneumonia, 11.71% of episodes were in the ages 50+. Meningitis and sepsis represents 5.15% and 42.35%, respectively. The cost burden was also different by disease. Pneumonia had 56.95% of costs incurred by age 50+. For sepsis and meningitis, 75.8% and 15.53% of the costs were incurred by age 50+, respectively. ConClusions: Pneumonia, meningitis, and sepsis and its associated costs disproportionately affect the population in the Brazilian private health system. In particular, proportion of all pneumonia from patients age 50+ was only 11.71%, yet, the majority of expenditure (56.95%) for pneumonia patients is in the ages 50+. Pneumonia prevention strategies, including vaccinations, targeting adults age 50+, could potentially reduce health care costs associated with this condition.

A407patients received medical services to the value of 927 million Euro or 14.2% of total reimbursed lump-sums (6.53 billion Euros) in Austria. 224 million Euros fall upon medical tumour therapy. With regard to monoclonal antibody therapies, 56 million Euros was refunded. ConClusions: The current development in modern cancer therapies leads to efficient treatment pathways expressed in higher survival rates, reduced hospital days and an improved quality-of-life.