Pharmacotherapeutic decisions are increasingly constrained in all clinical settings by the costs of drug treatment and medical care. Some biotech therapies (e.g., Avastin, Cerzyme, Herceptin, Gleevec, Erbitux) can cost from $10,000 to more than $100,000 per treatment episode. In 1996 the average drug treatment cost for advanced colon cancer was $500, and the average patient survival was 11 months. In 2006 the average drug treatment cost for such patients was $250,000, and the average patient survival was 24 months.(1) It is apparent that we are quickly arriving at a situation in which the determinants of medical decision making are not simply the clinical risks and benefits of treatment options but also how these are balanced against the economic costs of therapy.

A273 from remission, progression to long-term adverse outcomes (cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, end-stage liver disease) and commonly observed side effects (anemia, neutropenia and rash) along with a gradient of their severity. Model inputs were determined from a review of the published literature and phase II or III clinical trials. Clinical trials estimates were converted to risk ratios to facilitate comparison. Costs were inflated to 2013 US dollars. Costs and quality adjusted life years were discounted at standard rate of 5%. Sensitivity analyses were performed to assess model sensitivity and address uncertainty. Results: Relative to treatment with PR only, response-guided triple therapy with BOC+PR was the most cost effective therapy (ICER $28,723/QALY) followed by responseguided triple therapy with TVR+PR (ICER $64,569/QALY). PR treatments with SIM or SOF were dominated by BOC+PR. The model was sensitive to variations in costs of initial drug therapy and likelihood of attaining SVR. ConClusions: Addition of protease inhibitors to PR therapy improves health outcomes. Response-guided regimen BOC+PR was found to be cost-effective for treating newly diagnosed genotype 1 HCV patients. Shortening of PR therapy guided by a rapid virologic response may help reduce overall costs. Robust sensitivity analyses can help in overcoming the challenge of sparse data availability.

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A59 the multiplier effect. This novel approach highlighted the unique characteristics of Alzheimer's disease with particular focus on the additional costs and societal impact stemming from caring for a patient with Alzheimer's. Future cost effectiveness studies need to consider these additional impacts when quantifying their results and potential benefit to the health care system. Approaches to modelling long term disease impact must therefore be expanded to consider the wide reaching societal impact of Alzheimer's disease to the direct health care costs.