The calculation approach (HC vs FC) can have a substantial impact on the estimates. Incorporation of productivity losses into decision-making for healthcare interventions would need to carefully consider which approach is most appropriate for Singapore.

liposomal encapsulation of cytarabine and daunorubicin that delivers a synergistic drug ratio. Compared with 7+3, CPX-351 improves overall survival in older adults with untreated high-risk or secondary AML and differs in its mode of administration. The purpose of this study was to estimate health state utilities associated with AML treatment strategies. Methods: In time trade-off interviews with a 1-year time horizon, participants from the UK general population (London, Edinburgh) valued 12 health states drafted based on literature and clinician interviews. To identify disutility associated with chemotherapy, two types of induction and four types of consolidation were added to an otherwise identical health state describing AML in temporary remission. The decrease in utility when adding these treatment regimens represents the disutility of each type of induction/consolidation. Five additional health states were valued to estimate utilities associated with other AML treatments. Results: 200 participants completed interviews. Mean (SD) utilities were 0.55 (0.31) for pre-treatment AML and 0.66 (0.29) for AML in temporary remission. The addition of any chemotherapy to one year of temporary remission significantly decreased utility (P < 0.0001). Induction had a mean disutility of-0.11 with CPX-351 and-0.15 with 7+3. Mean disutility for consolidation ranged from-0.03 with outpatient CPX-351 to-0.11 with inpatient 5+2. Utilities were also assessed for other AML treatments (e.g., BMT, low-intensity regimens). ConClusions: Induction and consolidation chemotherapy were consistently associated with decreases in health state utility values, but consistently less disutility was seen with CPX-351 versus 7+3 across treatment phases. These utilities may be useful in cost-utility models comparing the value of AML treatments.

The aim of this study was to assess the indirect costs, health-related quality of life, and clinical characteristics of patients with ulcerative colitis (UC) measured by an UC disease activity index in Poland. MethOds: A questionnaire survey was conducted among patients with UC. The Patient Simple Clinical Colitis Activity Index (P-SCCAI) was used to assess disease activity and the modified Work Productivity and Activity Impairment Questionnaire was used to assess productivity loss. Demographic data (age, sex, work status, disease onset, place of living) were also collected. Quality of life was presented as utility calculated using the EQ-5D-3L questionnaire. Indirect costs were assessed using the human capital approach, and both absenteeism and presenteeism were taken into account. Results: The analysis was performed based on the answers of 225 adult patients with UC. The mean patient age and age at disease onset were 33.03 years (SD: 9.89) and 26.37 years (SD: 8.88), respectively. In the whole study group, the mean P-SCCAI score was 8.45 and the mean utility was 0.8612. The corresponding values for the group of working patients were 8.17 and 0.8740. Utility was significantly higher among patients with disease in remission compared with those with active disease (0.94 vs 0.83, p< 0.05). A similar association was observed among working patients with UC. The mean number of working hours missed due to the disease was 210.96 per year and mean on-the-job productivity loss was 19.57%. The average annual indirect costs of absenteeism and presenteeism per working person were 7,504 PLN (1,795 Euros) and 10,082 PLN (2,412 Euros), respectively. cOnclusiOns: UC reduces the quality of life of patients as well as their productivity associated both with absenteeism and presenteeism. The greater the disease activity, the greater the indirect costs and the lower the utility. PSY61 comPrehenSive evaluation of the DiSeaSe BurDen aSSociateD With hemoPhilia a in china

A729descriptive statistics. Study lasted from January to October 2016. Results: The average age of 102 patients who participated in the study was 31.69±11.53. 10 (9.8%) of the patients were on once daily medications, 89 (87.3%) on twice daily while 3 (2.9%) were on thrice daily. Whereas 83 (81.4%) were on monotherapy, 16 (15.7%) were on dual therapy, and 3 (2.9%) on polytherapy. Adherence was high in 9 (8.8%) of the patients while 63.3 (91.2%) were non-adherent. The level of seizure control was good in 19 (18.6%), fair in 46 (45.1%) and poor in 37 (36.4). The factors affecting adherence from the study were side effect of drugs 34 (33.3%), lack of knowledge about the illness 34 (33.3), cost of medication 17 (16.7%) and forgetfulness 17 (16.7%). Physicians admitted they assessed patients' adherence through assessment of patients' condition 68%, pill count 17%, and patients' interview 100%. All the physicians admitted to emphasize adherence to therapy before and after prescribing. ConClusions: Patients adherence to anticonvulsant therapy in the facility was poor. Non-adherence was associated with preventable factors bordering on the patients and health care providers.

The increase of obesity has become a major public-health concern. Morbid obesity is associated with comorbidities, reduced quality-of-life and death. Metabolic surgery (MS) is the most effective treatment against obesity. The aim of this study was to evaluate the costs and outcomes of MS, based on hospital-records (2014) of two Austrian specialized centers. MS was compared with no-surgery in patients with a BMI≥ 30 kg/m2. At baseline 39.4% of patients exhibit diabetes, 77.9% CVD, 35.3% hyperlipidemia and 35% are depressed. MethOds: MS was documented retrospectively over one year follow-up to collect resource utilization data of 177 patients (21 Roux-en-Y Gastric bypass, 21 Sleeve Gastrectomy and 135 One Anastomosis Gastric bypass). A cohort-simulation-model was developed to simulate the long-term consequences of diabetes including diabetic-complications, CVD, hyperlipidemia, depression, myocardial-infarction and stroke over a 20 year time-horizon. The model includes thirteen health-states to describe the long-term follow-up. Probabilities and utilities were derived from literature. Direct medicalcosts from published sources were used and expressed in 2017€ from the payer's perspective. QALYs, LYs and total costs were discounted at 5% p.a. Monte-Carlo simulation accounted for uncertainty. Results: MS leads to costs of 37,501 € per patient and 9.88 QALYs (14.72LY) over a 20 year time-horizon. No MS is associated with 60,482 € and 7 QALYs (14.22LY). Total cost saving for MS amounts to 22.981 € per patient and a QALY gain of 2.88. Operated persons exhibit cost-savings for complications of 31,165 € , which offsets procedure costs including reoperations (10,080 € ). Over 20 years MS is able to save -656 patient-years with diabetes (-3.7 per patient), -608 patient-years with CVD (-3.4 per patient), -161 patient-years with hyperlipidemia (-0.90 per patient) and -157 patient-years with depression (-0.89) per patient. cOnclusiOns: MS is associated with substantial savings in long-term health-care costs, expected health-benefits and reduced onset of complications. MS significantly increases the quality-of-life.