Objectives: To conduct a cost-effectiveness analysis of panitumumab plus mFOL-FOX6 versus bevacizumab plus mFOLFOX6 as first-line treatment (FLT) of metastatic colorectal cancer (mCRC) patients with wild-type RASin the Greek health care setting. MethOds: An existing Markov model consisting of seven health states was adapted from the public third-party-payer perspective. Both efficacy and safety data considered in the model were extracted from the PEAK trial and other published studies. Utility values were also extracted from the literature. Direct medical costs consisting of drug-acquisition costs for FLT, administration costs, subsequent therapy costs and other medical costs were incorporated into the model and reflect the year 2014. Primary outcomes were patient survival (life-years), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) per QALY gained. Probabilistic sensitivity analysis (PSA) was conducted to account for uncertainty and variation in the parameters of the model. Results: The analysis showed that panitumumab plus mFOLFOX6 produced greater discounted survival and quality adjusted survival by 0.87 LYs and 0.65 QALY benefit in relation to bevacizumab plus mFOLFOX6. The total lifetime cost was € 75,200 and € 52,736 for panitumumab and bevacizumab plus mFOLFOX6, respectively. This difference was mainly attributed to the higher acquisition cost of panitumumab compared to bevacizumab during the pre-progression health state (€ 32,223 and € 14,730 respectively). Incremental analysis showed that panitumumab plus mFOLFOX6 was more effective and more costly than bevacizumab plus mFOLFOX6 resulting in an ICER equal to € 34,644 per QALY gained. PSA revealed that the probability of panitumumab plus mFOL-FOX6 being cost-effective over bevacizumab plus mFOLFOX6 was 81.5% at the predetermined threshold of € 51,000 per QALY gained (3 times the GDP per capita of Greece). cOnclusiOns: The results suggest that panitumumab plus mFOLFOX6 may be a cost-effective alternative relative to bevacizumab plus mFOLFOX6 as FLT of mCRC patients with wild-type RASin Greece.

objeCtives: To assess the feasibility and VOI of conducting a definitive RCT to determine whether invasive urodynamic testing (IUT) is cost-effective compared with clinical assessment in women prior to surgery for stress (SUI) or stress predominant mixed urinary incontinence (MUI) and to rehearse the economic evaluation for a definitive RCT. Methods: Cost-utility analysis was performed alongside a pilot RCT. 222 participants were randomised to receive IUT ('IUT' arm) or clinical assessment ('no IUT' arm) before surgery. Health service resource use, costs, utility values (from EQ-5D-3L and SF-12) and quality-adjusted life years (QALYs) were calculated. Expected value of sampling information (EVSI) analysis was used to determine the expected net gain (ENG) of additional information and the optimal sample size needed to maximise ENG in a future trial. Results: At 6 months the average cost incurred in the 'IUT' arm was £154 less than the 'no IUT' arm (95% bootstrapped CI -315 to 24) and there was no evidence of a difference in effects (-0.019 QALYs, 95% bootstrapped CI -0.0258 to 0.0133). 'IUT' generated an incremental cost per QALY of £8090. A stochastic analysis showed that at a zero-willingness to pay threshold the IUT was 96% likely to be cost-effective. The VOI analysis suggested there would be added value from additional research to confirm which treatment is more efficient. The ENG was estimated to be £91m and to maximise ENG a sample size of 105 complete cases in each treatment arm is required. ConClusions: There was no significant difference in QALYs between study arms, the 'no IUT' arm incurred a higher average cost but only short-term NHS costs were considered. Our results should be interpreted with caution due to the limitations within our analysis. The EVSI analysis confirmed that there is additional value to be gained from a definitive study in this area.objeCtives: To investigate the preference among individuals practicing clean intermittent catheterization (CIC) on a daily basis for urinary catheters that can reduce the frequency of urinary tract infections (UTIs). Methods: A questionnaire was sent by e-mail to 769 catheter users from Germany, Italy, Sweden, the UK and the USA through a database held by Wellspect HealthCare. The participants were asked to assume a situation in which they use their current catheter but have the choice to switch to a similar catheter, which hypothetically would reduce the frequency of UTIs including possible complications. Either every fourth or every second UTI could be avoided. The participants' willingness-to-pay for the new catheter was collected by letting them choose to spend either one of eleven explicit monthly amounts from € 0-€ 100 or any other amount in an open answer. The participants also reported their UTI frequency. Only individuals stating that they were "certain" or "very certain" regarding their answers were included in the analyses. Results: 429 (response rate 56%) individuals returned the questionnaire, of which 278 (65%) were certain or very certain...

with filgrastim/lenograstim (0.340, 0.316, 0.410 for TC, AC-T, FEC-D, respectively). PP with pegfilgrastim was cost-effective versus SP with pegfilgrastim across all chemotherapy schemes (ICERs per FN event avoided: € 7,472, € 18,017 and € 9,996 for TC, AC-T and FEC-D, respectively). SP with pegfilgrastim was cost-effective versus no prophylaxis. All other treatment strategies were excluded from the analysis via extended dominance or were dominated by a less expensive and more effective strategy. For instance, PP and SP with lipegfilgrastim was found to be dominated by PP and SP with pegfilgrastim.These results held for patients with stage II and III BC. ConClusions: Our analysis finds PP with pegfilgrastim to be a cost-effective option for chemotherapy-induced FN in patients with BC in Greece.

literatures that related to the financial implications of air pollution on human's health. Methods: The databases used to find the relevance articles were PubMed, Scopus and Web of Science. Online databases were searched until April 2017. Searching strategies were done using MesH terms and identified keywords for each databases. The articles were limited to English language and journal articles only. Articles on indoor air pollution or from review papers, proceedings and reports were excluded from this review. From initial search of 2095 articles, 268 duplicate articles were removed. After reviewing titles and abstracts, 36 articles fulfilled our inclusion and exclusion criteria to be included in this review. Results: Effects of air pollution on health cause significant increased in healthcare utilization. For every increased in particulate matter 10-2.5, there were 0.3% to 3.7% increased in hospital admissions and outpatient visits due to air pollution related illnesses. The effects were more prominent in short-term, high level of particulate matter exposures. The financial implications of haze on health were measured using cost of illness (COI) and willingness to pay (WTP) approaches. It was calculated from either provider's perspective, patient's perspective or combination of both. The financial implication of haze on health measured using WTP was higher because it included preventing, averting, mitigating and utility loss due to illness. The ratio of monetary values of economic impact of air pollution on health calculated using WTP to COI were ranging from 1.5:1 to 9:1. ConClusions: The monetary burden due to the economic loss and increase in healthcare expenditure was very significant. We need to allocate appropriate resources to reduce air pollution level and to meet the healthcare demand associated with it.

Background: transplantation of human organs and tissues saves many lives and restores essential functions in combination of high measurable quality indicators. In spite of the fact that organ transplants have saved thousands of lives and greatly improved the quality of life of thousands more, regrettably many people will not benefit from this therapeutic procedure. Methods: this review is based on economic evaluation studies published since 2000 and reviews published since 1987 for kidney, liver, lung, heart, pancreas, and small bowel transplantations that were conducted in 2010. Results: empirical evidence showed that the costs of organ transplantations have generally decreased over time due to improvements in medicine, while survival and quality of life have improved. This indicates that the cost-effectiveness of transplantation has also improved over this period. Conclusions: cost effectiveness studies on organ transplantations could contribute to the efforts of policy makers in maximising societal health benefits by managing society’s scarce resources. The differences between EU country are not only associated with different legal procedures but are also associated with social, organizational and several other factors.