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screening may reduce the annual number of stillbirths by up to 2,900, neonatal deaths by up to 1,100, the annual incidence of congenital syphilis by up to 1,450 and avert up to 130,000 DALYs at an incremental annual direct medical cost of US$ 5.9 million. The three relatively high prevalence countries of Brazil, Colombia and Haiti, account for over half of the total DALYs that could potentially be averted, whereas Chile and Cuba have already adopted universal screening. ConClusions: Use of ICS tests for antenatal syphilis screening is highly cost-effective in low and middle income countries in Latin America. Antenatal programs should either expand access or maintain full access to syphilis screening using the ICS test.

OBJECTIVES:The choice of anticoagulant strategy in PCI affects the costs of treatment for patients with AMI. Given the economic constraints of a fixed per-case payment based on DRGs in Germany, anticoagulant strategy must not only offer medical benefits for the patient but also be economically acceptable for hospitals. Therefore the in-hospital costs of using different anticoagulants in a real-world setting are highly relevant from a hospital perspective. Based on administrative hospital data the purpose of this study was to determine the economic impact of routinely used anticoagulant strategies in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in Germany. METHODS:We analyzed in a real-world scenario administrative routine data from 1409 patients undergoing PCI for AMI in two high-volume german PCI centers. In-hospital costs of contemporary antithrombotic strategies, in detail 1) unfractionated heparin (UFH) monotherapy (nϭ953); 2) UFH ϩ glycoprotein IIb/IIIa receptor inhibitor (GPI; nϭ337); or 3) bivalirudin (nϭ119) were calculated based on the observed resource utilization. RESULTS: Baseline characteristics were well balanced and clinical outcomes were similar for all groups though not powered for difference. Total length of stay (LOS) and time spent in ICU was lowest with bivalirudin. Therefore in-hospital costs were lowest with bivalirudin (UFH: 3807,2€ Ϯ 2235,98€; UFHϩGPI: 4643,15Ϯ 4662,48€; bivalirudin: 3461,82€ Ϯ 1301,96€). CONCLUSIONS: Compared with UFH monotherapy and UFH ϩ GPI, the use of bivalirudin among patients undergoing PCI for AMI in Germany results in a shorter ICU and total LOS and appears to reduce in-hospital costs.

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52,448) for MTX, U$ 93,992 (89,366Ϫ98,982) for abatacept, and $73,100 (68,539Ϫ 81,877) for infliximab. The total QALYs gained(discounted) by MTX, abatacept, and infliximab during the same period were: 2.96 (2.89Ϫ3.03), 4.05 (3.85Ϫ4.30) and 3.26 (3.16Ϫ3.39) respectively. The Incremental Cost-Effectiveness Ratio was U$ 39,980 (36,649Ϫ45,011) for Abatacept compared to MTX compared to U$ 77,790 (62,369Ϫ98,124) per QALY gained with infliximab. CONCLUSIONS: The use of abatacept is more costϪeffective than the use of infliximab, both compared to MTX, in patients with Rheumatoid Arthritis with IR MTX in Venezuela.