ABSTRACT

A527 burse different essential medicine causing inequity to access essential medicines. Federal ministry of health tried to unify essential list in 10 different cantons by Order from 2011 but this has never been fully implemented by all 10 cantonal HIFs. In Republic of Srpska (RS) there is one HIF, and 3rd administrative part Brcko District (BD) has its own HIF. Methods: We compered average reimbursed prices from main HIFs in B&H for most commonly proscribed primary care medicines based on 2014 Annual report on medicines utilization issued by Agency for medicines of B&H. Average prices have been taken into account since different presentation of the same INN (dosage and number of units in pack) are reimbursed. All prices are expressed in EUR and represents prices paid by HIF. Results: Comparing Federal MoH proposed reimbursed prices and prices from RS HIF s it is noted that prices are higher in RS (+20% on average) except in case of bisoprolol. The highest difference is for atorvastatin (+39%). Prices in BD are on average lover for-14% vs Federal prices and-43% vs RSHIF prices. There are high differences among cantonal RB prices comparing to Federal proposal and among main 3 cantons. Atorvastatin is not reimbursed in Tuzla and Zenica Canton, while rosuvastatin is not reimbursed in Tuzla Canton and BD. Also different copayment levels are introduced at cantonal HIF level causing additional inequalities. ConClusions: Different prices cause inequity to access essential medicines for inhabitants living in different administrative regions. It also impact market indifferences. Implementation of unified and centralized pricing system would positively impact on access to medicines and HIFs spending.

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burden is important in informing health care planning and policy development. This study was conducted to describe the NHS costs associated with AF management in routine UK clinical practice. METHODS: A retrospective observational study of 825 patients with AF was undertaken in 8 UK primary care practices in 2010. Data were collected from the clinical records of all eligible, consenting patients, for a period of up to 3 years. The first 12 weeks following diagnosis was defined as the 'initiation phase'; the period after week 12 was defined as the 'maintenance phase'. RESULTS: Mean (SD) total cost of AF management was £947/€1,153/ 1,476USD (£1,098/€1,337/$1,711) per patient in the initiation phase and £469/€571/ $731 (£597/€727/$930) per patient year in the maintenance phase. Inpatient admissions and secondary care attendances accounted for 83% of total initiation phase and 64% of total maintenance phase costs. Significant variables contributing to high cost in the initiation phase were co-morbid hypertension and lower patient age, although only accounting for 5% of cost variability. Significant variables in the maintenance phase (18% of cost variability) were co-morbid congestive or structural heart disease and diabetes, and day-care attendances, ECGs and hospitalisations in the initiation phase. Mean maintenance phase costs were higher for patients managed by practices providing anticoagulation services (£555/€676/$865) than patients receiving secondary care anticoagulation (£421/€513/$656, pϭ0.002). CONCLUSIONS:The study confirms that inpatient admissions and secondary care attendances contribute most to total AF management costs. None of the variables analysed accounted for much variability in the total cost of AF management, suggesting that it is often not possible to predict which patients will be high NHS resource users. Future work should focus on how to safely reduce avoidable hospital admissions. OBJECTIVES:Studies estimating the cost of treating patients suffering from the Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) have not been conducted in Greece. The aim of this study was to investigate the annual cost of patients with OSAHS and identify the potential economic burden to the patients treated. METHODS: A retrospective study was conducted in the sleep laboratory of Sotiria Chest Hospital in Athens from January 1, 2008 to December 31, 2008. A sample of 340 subjects was screened for OSAHS. Diagnosis was confirmed after polysomnography. Health resources' consumption was derived from patients' analytical records, the annual visits in the sleep laboratory and the purchase of the ventilation devices (CPAP, BiPAP). Outpatient visits' costs included labor costs, overheads, consumables related to the OSAHS patients. The bottom-up approach and the patients' perspective have been used. RESULTS: A total of 262 males and 78 females, mean aged 55,9 (ϮSD12,4) years participated in this study. Overall mean annual cost reaches approximately €1.685,90 per patient out of which 15% is paid by NHS, 64% by social fund...

and it concluded in April 2012. Socioeconomic costs per patient were calculated. Costs were divided in 4 categories: direct health care costs (drugs, medical visits, exams, material), direct non-health care formal costs (professional carers, social services), direct non-health care informal costs (unpaid carers) and indirect costs (patient's and carer's productivity loss). Both patients and their carers completed a generic scale EQ-5D to measure HRQOL. RESULTS: A total of 697 patients and their carers responded the questionnaire, 28% affected by Cystic Fibrosis, 21% by Scleroderma and 11% by X-Fragile Syndrome. For most of the diseases an important part of the total costs were the direct non-health care informal costs, i.e. time of patient's main carer and other unpaid carers. Total annual cost per patient oscillated between 20.000 € (Haemophilia) and 200.000 € (Mucopolysaccharidosis). Regarding the HRQOL measured by EQ-5D, the most affected patients were those with Mucopolysaccharidosis and Duchenne Muscular Distrophy, which correlated with the HRQOL of their carers and total costs. CONCLUSIONS: Besides results on costs and HRQOL presented, the main outcome of BURQOL-RD is an integrated and harmonized set of instruments to assess and monitor socioeconomic burden and HRQOL of patients affected by rare diseases and their carers. The tools developed by BURQOL-RD will also improve RD awareness and literacy among European citizens.