A61164 ±. 22 for WTP £0,0. 81±0.16 for £ 1 to 49,. 81±15 for £ 50 to 99,. 76±. 16 for £100 to 199,. 79± for £ 200 to 299,. 71±. 19 for £300 or more. Patients spent a mean of 50±134 minutes (HDSS = 2), 65±119 minutes (HDSS = 3) and 161±293 minutes (HDSS = 4) for daily management of hyperhidrosis. WTP showed the lowest correlation to disease severity. ConClusions: The current study underscores the multidimensionality of the burden of hyperhidrosis, with all aspects showing greater impairment with greater disease severity. Health utility and daily time spent in managing the condition offered significant discrimination of patients.objeCtives: To assess psoriasis patients' subjective expectations regarding their future health-related quality of life (HRQOL) and life-expectancy, and to explore variables associated with under-or overestimating behaviour. Methods: A crosssectional questionnaire survey of adult moderate to severe psoriasis patients was carried out. Patients were asked to indicate the age they expect themselves to live. HRQOL expectations were measured by the EQ-5D descriptive system for 6 months ahead and for future ages of 60,70,80 and 90, respectively. Current health state was evaluated with EQ-5D and visual analogue scale (EQ VAS), Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI). Results: Overall 167 patients (71% males) were included in the analysis with mean age of 50.38±12.35 years, mean EQ-5D, EQ VAS, DLQI and PASI scores were 0.71±0.30,65.3±21.08,5. 89±7.10 and 7.82±10.13, respectively. Currently 56% of the patients were on biological therapy. Patients expected 0.1±0.23 mean improvement in EQ-5D scores within 6 months (p< 0.001); inverse or palmoplantar psoriasis, and using only topical treatment or initiation of the first biological at the time of the survey were likely associated with higher expectations. Males overestimated their life-expectancy by 2.94±11.86 years whereas females underestimated by 5.23±9.34 years (p< 0.001) compared to the gender-and age-matched statistical life-expectancy. Expected mean EQ-5D scores for ages from 60 to 90 were: 0.56±0.48,0. 38±0.50,0. 15±0.55, and -0.17±0.54 (p< 0.001), respectively that are lower than the general population norms in Hungary. Both for 6 months ahead and older ages, expected EQ-5D correlated moderately with current EQ-5D and EQ VAS and only weakly with DLQI and PASI (p< 0.05). ConClusions: Patients expected considerable improvement in their HRQOL for the near future and large-scale deterioration for older ages. Exploring unrealistic expectations might help to prevent dissatisfaction with treatment benefits and to improve compliance.

OBJECTIVES: Acromegaly is a rare disease with an estimated incidence of 2.5 cases per million (cpm) and a prevalence of 50-60 (cpm) per year according to Spanish national data. Somatuline Autogel (Ipsen property) and Sandostatin LAR (Novartis property) are associated with similar efficacy and together they represent more than 90% of long-acting somatostatin analogs sales in Spain. Somatuline Autogel has been approved of an injection extended dosing interval for 6 or 8 weeks with the dose of 120mg. This study is aimed to estimate the potential budgetary consequences of increasing the use of Somatuline Autogel in the treatment of acromegaly in Spain. METHODS: A budget impact model was developed to compare annual treatment costs of acromegaly patients with either Somatuline Autogel and Sandostatin LAR, including drug acquisition costs and administration costs. Disease prevalence and IMS sales data were used to estimate total number of patients using both treatments, and the potential budget impact of increasing Somatuline Autogel was calculated under different scenarios based on the proportion of patients using different dose ranges. RESULTS: Overall treatment costs were 11,857€ and 12,165€ per patient/year for Somatuline Autogel and Sandostatin LAR respectively (monthly treatment), as a result of the higher acquisition cost and administration costs of the latter. Furthermore, assuming that 30% of patients with Somatuline Autogel may benefit of the extended dose interval (every 6 or 8 weeks), mean cost savings per patient may rise to 2,019€ (10,147€ vs. 12,165€). When applying these patient-level cost savings with Somatuline Autogel to total treated patients, acromegaly treatment costs could be reduced by 0.3 M€ to 1.

Three additional sub-states: without exacerbation, mild and severe exacerbation were considered. The effectiveness of treatment options and utilities for each health state were taken from the literature. Only direct health care costs were considered. Disease management and exacerbation costs were obtained from the literature. Drug costs were calculated based on ex-factory prices with mandatory 7.5% rebate. All costs were updated to € 2012. A 3% annual discount rate on costs and health outcomes was applied. Incremental ratios in terms of cost per life-year gained (LYG) and cost per quality-adjusted life-year gained (QALY) of the most effective therapy versus the comparator were calculated. One-way sensitivity analyses were performed modifying the following parameters: time horizon (10 years, lifetime), discount rate (0%, 5%), drug costs (±10%, ±20%) and utilities (±10%). Probabilistic sensitivity analysis (PSA) was also performed. Results: At 5 years, glycopyrronium bromide accounted a total cost of € 2,225.18 compared to € 2,374.81 accounted for tiotropium bromide. Glycopyrronium bromide yielded higher health benefits (4,321 LYG and 3,388 QALY) than tiotropium bromide (4,315 LYG and 3,377 QALY). In all oneway sensitivity analyses performed and in 100% of PSA simulations (1,000 iterations), glycopyrronium bromide compared to tiotropium bromide remained as a dominant strategy. ConClusions: Glycopyrronium bromide therapy in COPD patients is associated to less costs and higher health benefits than tiotropium in Spain.

Objectives: Endobronchial valve therapy (EBV) is an innovative treatment that has been shown to be safe and effective in selected subgroups of patients with severe emphysema. The objective of our study was to assess the cost-effectiveness of valve treatment in the German health care system when compared to medical management. MethOds: Clinical data from a subset of the Endobronchial Valve for Emphysema Palliation Trial (VENT) provided information about clinical events, health-related quality of life, and disease staging through 12 months. This information was subsequently used as input to a previously published Markov model to project longer-term disease progression, mortality, and health resource utilization. From this combined analysis, we computed the 5-year and 10-year incremental cost-effectiveness ratio (ICER) in euros per quality-adjusted life year (QALY). Costs and effects were discounted at 3% per year. Results: EBV therapy led to clinically meaningful disease restaging at 12 months (37.8% of cohort improved staging, compared to 0% in control). Over 5 years, EBV was projected to increase survival from 66.4% to 70.7%, and to add 0.22 QALYs. Costs were estimated to increase by € 10,299, resulting in an ICER of € 46,322/QALY. Over 10 years, 0.41 QALYs were gained at additional cost of € 10,425, yielding an ICER of € 25,142/QALY. cOnclusiOns: Our model-based analysis suggests that EBV leads to clinically meaningful changes in disease staging and progression when compared to medical management, with resulting gains in unadjusted and quality-adjusted life expectancy. Relative to the acknowledged willingness-to-pay threshold of € 50,000/QALY, our results indicate EBV is a cost-effective therapy in the German health care system.