In the Netherlands, CSII represents a cost-effective option in patients with type 2 diabetes who continue to have poorly-controlled HbA1c despite optimization of MDI. Since the ICER falls below the willingness-to-pay threshold of EUR 80,000 per QALY gained, CSII is likely to represent good-value for money in the treatment of poorly-controlled T2D patients compared with MDI.

Objectives: To evaluate the short-(first year) and long-term (second year) cost of cardiovascular events (CVEs) in Belgium. MethOds: The analysis included myocardial infarction (MI, excluding revascularization), unstable angina (UA, excluding revascularization), heart failure (HF), ischemic/hemorrhagic stroke (IS/HS) and transient ischemic attack (TIA). Coronary revascularization procedures (weighted average of coronary artery bypass grafting [CABG] and percutaneous coronary intervention [PCI]) were also evaluated. Index hospitalization costs (year 2012) as well as re-hospitalization costs up to 2 year after the index hospitalization were derived from the Belgian IMS real-world Hospital Disease Database (HDD). Other follow-up costs (rehabilitation, outpatient visits and ambulatory resource use [tests, imaging and drugs]) over 2 years were assessed by an independent 2-round expert-panel in 2014 (5 cardiologists, 6 neurologists). Costs of fatal CVEs were evaluated through the HDD. The combined perspective of public health care payer and patient was applied. Costs (€ in 2014) were calculated as unit costs (official listings) multiplied by the number of resources used. Results: Total costs in the first year after CVEs ranged between

I501, I509, I110, I130 and I132. For each hospitalization, a weighted disease related group (DRG) cost (€ , 2012) was calculated. No discount rate was applied. Results: If 100,000 patients are treated with sacubitril/valsartan, about 4,500 deaths and 39,000 hospitalizations may be avoided over 5 years. From a DRG perspective those avoided hospitalizations may lead to cost savings of about 130m€ . From a hospital budget perspective this may lead to a 10m€ avoided budget deficit. Indeed, there was a difference between weighted DRG cost (3,329€ ) and costs incurred in the national cost study (Etude Nationale de Coûts à méthodologie Commune) for HF hospitalizations (3,591€ ). The budget deficit corresponds to this difference multiplied by the number of avoided hospitalizations. ConClusions: From the French hospital perspective, sacubitril/valsartan introduction in HF treatment strategy has the potential to generate substantial savings and to minimize budget deficit. An analysis from a broader perspective (including drugs costs) should be conducted.

No abstract

en Français : Le développement des greffes haplo-identiques amène à un recours de plus en plus important aux donneurs apparentés : de 2005 à 2015, ce recours s'est accru de 291%. Audelà des coûts financiers moins importants, le don intrafamilial présente également l'avantage d'une disponibilité plus rapide du donneur, évitant ainsi des risques de rechute avant la procédure. En dépit des recommandations existantes, on constate une diversité des pratiques dans les différents centres français quant aux modalités organisationnelles de prise en charge, aux critères de recrutement, qualification et suivi des donneurs apparentés. La Société Française de Greffe de Moelle et Thérapie Cellulaire a fait des propositions concernant le consentement et les critères de non-qualification des donneurs apparentés de cellules souches hématopoïétiques. Un livret a été conçu par un groupe multidisciplinaire afin de faciliter l'information sur le don et sur l'allogreffe. Dans le présent article, prenant en compte à la fois les impératifs médicaux de surveillance et les contraintes organisationnelles des centres greffeurs, nous proposons des recommandations pour le suivi des donneurs apparentés. Quelques outils (documents d'information, questionnaires) sont présentés. Mots clés: donneur apparenté, suivi post-don, allogreffe de cellules souches hématopoïetiques, standardization prise en charge. Résumé en anglais The development of haplo-identical transplants brings to an increased resort to related donation: from 2005 till 2015, this resort increased by 291 %. Beyond the less important financial costs, the related donation also presents the advantage of a faster availability of the donor, avoiding risk of relapse before the procedure. In spite of the existing recommendations, we notice a diversity of the practices among French centers as for the organizational modalities of care, for recruitment criteria, qualification and follow-up of related donors.