Backgrounds and objectives: Increasing use of oral anticancer treatments (OATs) in oncology is modifying the treatment paradigm for cancer. Nonetheless, available data on the pattern of use of OATs and its evolution over time are limited. The objective of this study was to describe the patterns of use of OATs in France from 2004 to 2012.

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Objectives: Two SGLT-2 inhibitors, CANA and DAPA, are recommended in the UK for combination therapy in T2DM. Through an insulin-independent mechanism of action, SGLT-2 inhibitors improve glucose levels, blood pressure, and weight with a low inherent risk of hypoglycaemia. The cost-effectiveness of using CANA or DAPA in combination with MET was evaluated in patients inadequately controlled with MET monotherapy, from the perspective of the UK NHS. MethOds: The ECHO-T2DM model was used to estimate 40-year outcomes and costs associated with using CANA (100mg or 300mg) versus DAPA 10mg in dual therapy. HbA1c efficacy estimates were obtained from a Network Meta-Analysis (NMA). Analyses of pooled data from trials investigating CANA dual therapy (with MET) were used for parameters unavailable in the NMA (i. e., SBP, LDL, HDL and AEs). A broad set of sensitivity analyses were performed. Results: Both doses of CANA were associated with more QALYs (0.01,0. 03 for 100mg and 300mg, respectively) and higher costs (£101, £594, respectively). The associated incremental cost-effectiveness ratios (ICERs) were £7,423 and £17,734, respectively; both below the willingness-to-pay for QALY threshold in the UK. The key driver of the result for CANA 300mg was the greater HbA1c efficacy versus DAPA 10mg, and for CANA 100mg, a lower need for insulin rescue since CANA (but not DAPA) can be used in persons with moderate renal impairment. The ICERs were robust under all scenarios tested. Only use of UK-specific and not clinical trial patient characteristics substantively impacted the results; none reversed the interpretation of CANA as cost-effective versus DAPA. cOnclusiOns: SGLT-2 inhibitors reduce HbA1C, body weight, and blood pressure, and thus the risk of micro-and macrovascular complications. Economic simulations suggest that both doses of CANA are cost-effective versus DAPA in dual therapy treatment of T2DM (with MET) in the UK.

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A425initial analysis of the first 18 months of the SPA scheme indicated that the length of gefitinib therapy was at least that anticipated by NICE. This study aims to validate the length of therapy in a larger cohort with up to 3 years follow-up. Methods: The SPA administrative database contained information on packs (30-days therapy/pack) dispensed to patients from September 2009 to December 2012. This retrospective study included patients registered on the database prior to the end of 2012, fulfilling NICE eligibility criteria and receiving at least 3 packs for which the NHS was invoiced. Patients were considered censored if they had ≥ 1 pack recorded in the last 3 months of the database. Median time to treatment cessation was estimated from a Kaplan-Meier curve of packs supplied to patients and the mean number of packs dispensed per patients from a parametric failure time model. Results: 883/1160 registered patients met the study eligibility criteria (460/883 censored). These 883 patients, for whom the NHS was invoiced the single fixed payment, received a median of 13 packs 95%CI [12,14], equivalent to 12.8 months to treatment cessation. A mean of 19.4 95%CI[18.0, 21.0] packs were dispensed per patient. ConClusions: The results of this observational study confirm the average length of gefitinib therapy and mean number of packs dispensed in the SPA scheme exceed that assumed by NICE.