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Objectives: To estimate the incremental cost-effectiveness ratio (ICER) of dualmobility cups (MBH) when used instead of conventional cups (FBH) to help reduce dislocation rates following total hip replacement (THR) in France. MethOds: A Markov model simulated two cohorts of patients: one with MBH and one with FBH. Three different states of health were considered: "stable", "dislocation/revision" and "death". The model adopted a collective perspective and the time horizon of the model was lifetime. Dislocation/revision rates were estimated using two different sources: literature review and expert opinions (analysis 1) and analysis of the PMSI (French hospital database) of Patients having one THR in 2009 followed through the end of 2012 (analysis 2). Costs considered were hospitalization costs (reduction/ revision for dislocation performed in acute care unit and care in rehabilitation units), valued using the National Scale Costs with Common methodology (ENCC). Outpatients' costs were considered for patients going back home after hospitalization and valued by expert opinions and literature data. The model estimated the number of dislocations/revisions for each cohort and differences between the two groups in terms of QALY gained, costs and cost-effectiveness ratio. Deterministic and probabilistic sensitivity analyses (PSA) were conducted. Results: In analysis 1 for a 100,000 THR cohort, 4,626 dislocations and 1,243 revisions were avoided. Total number of QALY gained was 894 and total economic gain € 44.7 million. In analysis 2, 3, 176 dislocations and 854 revisions were avoided for an economic gain of € 30.7 million and a gain of 611 QALY. Reported to 100,000 THR, the economic gain per MBH cup was € 447 or € 307. PSA estimated the mean ICER to € -55,693 per QALY gained. cOnclusiOns: Because of the current rules of tariffs used in France and given the absence of additional costs associated with the use of DM prosthesis, this strategy can be considered dominant in THR.

Although there have been improvements in the detection and treatment of breast cancer (BC) it remains the most common cancer in women and one of the leading causes of death. In Western Europe and North America, breast cancer is the leading cause of death among women aged 35 to 54 years (20%), and the second leading cause of death in women aged over 55 years exceeded only by cardiovascular diseases. Breast cancer incidence increases with age, beginning from 40 years, with a peak at 60 to 65 years. The objective of this study was to determine, from the pharmacoeconomic point of view, the preferred treatment regimen (Kadcyla, lapatinib + capecitabine, trastuzumab + capecitabine, capecitabine) Kadcyla, trastuzumab emtansine, lapatinib, capecitabine, trastuzumab, pharmacoeconomics, clinical and economic analysis. IntroductionBreast cancer (BC) is a malignant tumor that starts in the epithelial cells that line the glandular ducts and lobules [1-4.7]. Although there have been improvements in the detection and treatment of breast cancer (BC) it is now the most common cancer in women and one of the leading causes of death. In Western Europe and North America, breast cancer is the leading cause of death among women aged 35 to 54 years (20%), and the second leading cause of death in women aged over 55 years exceeded only by cardiovascular diseases [8]. Breast cancer incidence increases with age, beginning from 40 years, with a peak at 60 to 65 years. The highest female mortality rates are noted at the age of 40 to 49 years -27.3%, 50 to 59 years -25.4%, 30 to 39 years -20%, and 60 to 69 years -17%. Female mortality structure changed only at the age of 70 years and older: stomach cancer is the first (15.8%) and breast cancer is the second (12.3%) leading cause of death [8].In 2013, in Russia there were 57,307 newly diagnosed cases of breast cancer, and in 31.9% of cases the disease was diagnosed at III-IV stage. The total number of patients diagnosed with breast cancer was 562,053 persons. At the same time, the mortality rate remains high during the first year of diagnosis -3.7% [5].The objective of this study is to determine, from the pharmacoeconomic point of view, the preferred treatment regimen (Kadcyla, lapatinib + capecitabine, trastuzumab + capecitabine, capecitabine), used in the treatment of HER2-positive breast cancer, on the basis of comparison of costeffectiveness ratio, safety and life quality.To achieve this objective, the following tasks were solved: 1. Collection and analysis of clinical practice data regarding the treatment of HER2-positive BC in the treatment groups being compared (Kadcyla, lapatinib + capecitabine, trastuzumab + capecitabine, capecitabine). 2. Selection of the criteria for evaluating the effectiveness of Kadcyla, lapatinib + capecitabine, trastuzumab + capecitabine, capecitabine in the treatment of BC. 3. Cost analysis of the compared regimens used in the treatment of HER2-positive BC. 4. Use of the following methods in this pharmacoeconomic study: costeffectiveness analysis...

Medline, PubMed, and EMBASE to identify full economic evaluations that compared different treatment strategies in postmenopausal women with primary breast cancer. Quality and modelling methodologies of included studies were assessed and summarised. Results: All the 31 included studies assessed surgery and none assessed PET as the initial treatment. Most included economic studies used a Markov model with life-time horizon and 1-year cycle length. Nine studies which included sub-group analysis for older women (over 65 years old) used similar economic models and transition states with younger women (50 to 65 years old). The key disease-related health states were disease-free, recurrence, and death. Recurrence was mostly separated into loco-regional and distant recurrence. ConClusions: This systematic review can inform the design of an economic model comparing PET with surgery as initial treatment in older women based on the following assumptions: (1) health states are applicable across age groups; (2) transition states for modelling surgery in the literature are transferable to model the same treatment for older women; (3) metastasis transition states including progression, progression-free, and death can be used to model the PET pathway. Future study will validate this model by using a longitudinal dataset of older women with primary breast cancer, and synthesize data from different data sources to populate this economic model. PCN138Cost EffECtivENEss of CEtuximab iN 1st-LiNE trEatmENt of ras WiLd-tyPE mEtastatiC CoLorECtaL CaNCEr iN sCotLaNd: a summary of thE submissioN to thE sCottish mEdiCiNEs CoNsortium objeCtives: Colorectal cancer is the third most common cancer in Scotland, with nearly 4,000 cases reported in 2011 and 5.2% increase in incidence in the previous 10 years. Recent studies have shown that a subgroup of metastatic colorectal cancer (mCRC) patients with wild-type (wt) RAS (KRAS and NRAS exons 2,3, 4) expressing tumours are likely to have enhanced response to anti-EGFR treatment compared to patients with mutant RAS exons (2,3, 4) . RAS biomarkers aid identification of the patient group that is likely to benefit the most from anti-EGFR treatment such as cetuximab and therefore allow more efficient use of NHS Scotland resources. A New Product Assessment Form was submitted to the Scottish Medicines Consortium with the aim of demonstrating the latest improved outcomes in RAS wt mCRC patients (versus KRAS wt) treated with cetuximab in combination with chemotherapy and its cost effectiveness compared to currently available treatments. Methods: A state-transition Markov cohort model was developed to simulate patient outcomes and costs for first and subsequent lines of treatment including the long-term survival after a successful curative resection of liver metastases. Results: The model estimated an incremental 0.28 life-years gained (LYG) with cetuximab + FOLFIRI compared to FOLFIRI alone and an incremental 0.32 LYG with cetuximab + FOLFOX compared to FOLFOX alone. The model was most sensitive to length...

Objective. The study objective is to analyze data of territorial subjects of the Russian Federation on idiopathic pulmonary arterial hypertension (IPAH) – nosology included in the list of life threatening and chronic advanced rare (orphan) diseases leading to the reduction in life expectancy of citizens or to their disability.Methods: Based on regulatory legal acts and federal patients registry we have analyzed morbidity and mortality, level of satisfaction with medicines supply and medicines supply expenses for patients with IPAH.Results: Criteria of level of satisfaction with drugs availability in patients with rare (orphan) diseases are suggested. Satisfaction with medicines supply is measured up against indicators and objectives of “Strategies for drug supply for the population of the Russian Federation for the period up to 2025 and a plan for its implementation”.Conclusions: The need for further improvement of regulations of orphan diseases sphere, i.e. revision of their list and regional programs creation, is justified.