In the United States (US), incidence of total hip arthroplasty (THA) and THA revision procedures is increasing due to an aging population, longer life expectancy, and increasing prevalence of osteoarthritis (OA). We conducted a retrospective cohort study to estimate the clinical and economic burden of THA revisions in a Medicare population. MethodS: We identified persons aged ≥ 65 in the Medicare 5% Standard Analytic Files who underwent THA for OA between January 1, 2009 and September 30, 2010. Defining a revision as ≥ 1 medical claim for a revision procedure following discharge from the THA hospitalization, we used the Kaplan-Meier method to calculate 5-year cumulative revision risk (CRR) through September 30, 2015. Medicare expenditures were calculated for the revision episode of care (inpatient stay plus 90-day global period for Medicare bundled payment). Using a 6.22% compound annual growth rate from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, we estimated the number of THAs to be performed in 2018-2027 and calculated the 10-year projected savings to Medicare for a 1% CRR reduction. ReSultS: Among 7,820 eligible patients, mean age was 74.4 years, with 62.4% female. CRR was 4.2% at 5 years, with 30.8% of revisions occurring within 90 days of the THA. At least 25% of revision patients had a complication. Mean (median) episode-of-care expenditures were $39,274 ($36,157). Conservatively (using median episode-of-care expenditures), if it were to achieve a 1% absolute CRR reduction, Medicare could realize savings of $697 million over 10 years; or $985 million when including Medicare Advantage, which represented 29.2% of 2016 Medicare payments. ConCluSionS: Strategies to reduce the risk of THA revision -such as the use of implant constructs with lower CRR and valuebased payment models -are needed to achieve Medicare payment reductions while maintaining or improving quality of care for Medicare beneficiaries.

A117(e.g. cough). The more complex concepts of 'chest heaviness' and 'chest tightness' were experienced by participants of all ages, but were rarely reported spontaneously by the younger children. ConClusions: There was consistency in the symptoms reported by children and adults but younger children were less likely to spontaneously report the more complex symptoms. Using age-appropriate language, pictograms and creative tasks can help elicit content from younger children.

Self-monitoring has been shown to improve adherence across a range of behaviors. This study demonstrated a significant positive association between participant medication self-monitoring and claims-based medication adherence. Medication adherence increased as selfmonitoring became more frequent, demonstrating a dose-response association. This study shows that digital health programs such as YDHA can be leveraged to support medication adherence.

were carried out by drug/technology sponsors (Group-1) or independent evaluators (Group-2). These were then bucketed into one of the following based on the key reporting measure used: 1) absolute difference, 2) per patient utilizing the drug/technology, 3) per disease-prevalent plan population, and 4) per overall plan population. ReSultS: Of the 255 studies analyzed, a third in both Group-1 (n= 193) and Group-2 (n= 62) showed an incremental budget impact, while the remaining showed savings. When reporting an increased budget, as many as 60% of Group-1 chose the largest base (per plan population) versus only 22% of Group-2. In contrast, 15% were reported only in absolute terms by Group-1 versus 61% of Group-2. When reporting savings however, there was little difference between the groups-51% and 46% respectively reported absolute savings. ConCluSionS: The choice of reporting measures was inconsistent, and appeared to be biased by the nature of the evaluators. Within Group-1, the measures were chosen to amplify (in case of savings) or understate (in case of incremental budget) the magnitude of the impact. There is good basis to put in place guidelines to standardize reporting measures, to both remove evaluator bias, and to allow decision-makers to more easily compare different evaluations.

Objectives: To evaluate health utility scores and associated predictors in an actively employed population of Herpes Zoster (HZ) patients with and without work time loss (WTL). MethOds: Pooled analysis of the prospective, observational MASTER cohort studies, conducted in 8 countries across North America, Latin America and Asia. A total of 428 HZ patients engaged in full or part time work were included. WTL, defined as missing ≥ 1 partial or full work day, and job effectiveness, reported on a scale of 0-100%, were evaluated with the Work and Productivity Questionnaire (WPQ). The Pearson product-moment correlation was used to assess the correlation between job effectiveness and Health Related Quality of Life (HRQoL). Mixed models with repeated measures assessed the relationship between HZ-related WTL over a 6-month follow-up period, and HRQoL, as evaluated by the EQ-5D. Additional predictors of HRQoL were also identified. Results: Overall, 57.7% of respondents reported WTL. Mean (SD) percent job effectiveness of patients in the WTL group was significantly lower compared to non-WTL (NWTL) patients at baseline [50.3 (31.6) vs. 71.4 (27.8); p < 0.001]. Patients in the WTL group also reported lower health utility scores at baseline and overall than their NWTL counterparts, with WTL identified as an independent negative predictor of both the EQ-5D summary scores and the EQ-5D VAS (p < 0.001). Decrease in job effectiveness was negatively associated with HRQoL overall (p < 0.001). Predictors of lower HRQoL were worst ZBPI pain score category, the presence of HZ complications and country income category (predictor of EQ-5D VAS only). cOnclusiOns: HZ adversely impacts the work and productive life of actively employed individuals. In turn, HZ-related reductions in job effectiveness and work time are associated with a negative effect on HRQoL.