To assess efficacy and safety of dornase alfa in the treatment of cystic fibrosis (CF) in children and adults. METHODS: Systematic review of Medline, Em-Base, CENTRAL and clinicaltrials.gov databases was conducted. The references from relevant articles and abstracts from conferences were also examined to identify any additional studies. Each full-text article was critically appraised with use of the Jadad Scale. Clinical practice and CF treatment procedures in Poland were consulted with clinical experts. Placebo and treatment without dornase were identified as potential comparators. Changes in FEV 1 , FVC, and FEF 25%-75% , exacerbation of respiratory symptoms, body mass change, use of drugs, number of days spent at home due to CF, hospitalizations (number and length), ambulatory visits, quality of life, mortality rate, treatment acceptance by patient and safety were assessed and compared based on the review results. RESULTS: Among 294 reports found, 17 publications concerning 12 randomized clinical trials were included in the analysis. The meta-analysis of available data regarding changes in FEV 1 after 1, 3, 6 months and 1 and 2 years showed better results with dornase therapy. The use of dornase also improved pulmonary function measured in FVC. Exacerbations of respiratory symptoms were less frequent (by 20% when dornase alpha was administered once daily and by 34% when administered twice daily), which resulted in fewer hospitalizations. Patients treated with dornase required less frequent courses of intravenous antibiotics and spent fewer days at home due to CF. Safety analysis showed a higher risk of rash, voice alteration and pharyngitis with dornase. Mortality was similar among groups. CONCLUSIONS: Dornase alfa is an effective (improves respiratory function, reduces CF symptoms, dyspnea and respiratory system exacerbations) and safe therapeutic option.

likelihood of suicide, absenteeism, and the hospitalisation rate. The reimbursement of Seroquel XR® could generate annual budget savings of PLN 8.6 million ( 2150 thousands Euro), if Seroquel XR® were used in 31% of quetiapine-treated patients with schizophrenia. The maximum savings resulting from the reimbursement of quetiapine prolonged release tablets (Seroquel XR®) could amount to PLN 27.6 million (6900 thousands Euro) per year. CONCLUSIONS: The reimbursement of Seroquel XR® with the reimbursement limit at the level of the reimbursement limit for normal tablets of quetiapine is profitable for the state budget -it will not only bring budgetary savings, but also allow patients to return to active life, which is crucial in the case of schizophrenia. OBJECTIVES:To estimate the economic consequences of replacing Seroquel (the normal tablets of quetiapine) with Seroquel XR® in the treatment of bipolar disorder in Poland. METHODS: Based on the established model of the economic consequences of bipolar disorder treatment, we calculated the cost of treating bipolar disorder with quetiapine in Poland. Expenditures for the purchase of medicines, hospital costs and the costs of lost productivity were highlighted. The analysis was performed from a societal perspective, taking into account the Payer's perspective, in three-year time horizon. RESULTS: The use of Seroquel XR® will decrease hospitalisation rate and length of hospitalisation, what will reduce direct costs of bipolar disorder treatment by PLN 645 thousands (161 thousands Åuro). The use of Seroquel XR® will increase the population of patients who comply with the recommended treatment, which will reduce the likelihood of suicide, absenteeism, and the disability pension. The budget savings related to indirect costs reduction are estimated at PLN 15,3 million (3825 thousands Euro). Moreover, the reimursement of Seroquel XR® would decrease the social transfers by PLN 157,6 thousands (39,4 thousands Euro) in comparison to current scenario. CONCLUSIONS: The reimbursement of Seroquel XR® with the reimbursement limit at the level of the reimbursement limit for normal tablets of quetiapine is profitable for the state budgetit will not only bring budgetary savings, but also allow patients to return to active life, which is crucial in the case of bipolar disorder. OBJECTIVES:The objective of this exploratory analysis was to assess the costeffectiveness of quetiapineXR as monotherapy compared to other key drug treatments in MDD patients, who have failed on previous therapy. METHODS: A Markov Model with one week cycles was used to assess the cost effectiveness of quetiap-ineXR treatment over 52 weeks. Key outcomes were: response rates, costs and Incremental Cost-Effectiveness Ratios (ICERs) for second line monotherapy. The

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costs in intraoperative changes of the surgical plan and reductions in unnecessary surgery associated with the use of PV-MRI. Results from the previous study VALUE, which showed that no patient with PV required additional imaging tests as part of a Phase IV, confirm the results obtained in the present analysis (resulting in even slightly lower cost than the total cost of diagnosis using PV-MRI).OBJECTIVES: Cervical cancer incidence in Serbia has been identified as one of the highest in Europe, showing slow but steady increase during the last decade. Despite the National Programme for Prevention of Cervical Cancer that has recently been established, an organised Pap screening is far from full implementation. This study aims to assess the effectiveness and cost effectiveness of absolute adherence to the proposed policy compared to the current practice. METHODS: A Markov model simulating the natural history of cervical cancer was developed. Calibration was performed using country specific data, sourcing incidence and mortality from Serbian cancer registries. Accordingly, the screening algorithm incorporated in the model was based on the local guidelines. We followed a hypothetical cohort of 100,000 15-year old girls until the end of their lifetime. Subsequently, the actual cytological screening practice covering only 20% of the targeted population was compared to a scenario of absolute adherence to the national screening programme. A discount rate of 1.5% for health and 4% for cost outcomes was applied. RESULTS: The natural history model showed that limited benefit is currently being achieved from cytological screening. The hypothetical cohort analysis indicated that absolute guidelines adherence would result in 422 deaths averted and an incremental cost effectiveness ratio (ICER) of 3272 €/LYG. The ICER estimate did not exceed the national annual GDP (3857 €/capita) -a commonly used informal threshold. CONCLUSIONS: This research identified that full adherence to the screening policy is very likely to be cost effective. In general, the low screening coverage that has been observed appeared as the most serious obstacle to the prevention of cervical cancer. The new methods in cervical cancer prevention, however, such as HPV vaccination and HPV testing, require further pharmacoeconomic assessment.

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