costs, we assumed that a treatment was provided to every patient who visited the dentist according to the national dental cavities guideline, all related costs were obtained from the SOAT fare manual 2011 reported by the government. We multiplied the treatment cost for each patient by the total number of dental visits to obtain the third-payer cost. We calculated from the patient´s perspective the lost output as a result of a reduction of productivity due to dental cavities, using DALYs, multiplied by the 2011 current GDP divided by the working-age population. RESULTS: The Economic impact for 2011 was USD 67.018.016. This is the result of adding the third-payer cost of USD 56.234.161 plus the patient cost of USD 10.783.855. CONCLUSIONS: With this first approximation to the economic impact of dental cavities the government can design cost-effective oral health policies to reduce its prevalence for Colombia's population. The cost of dental cavities represents 0.02% of 2011 current GDP, this means that on average there is an expenditure of USD 1.46 for each Colombian citizen to treat dental cavities. Those numbers shows the importance to generate permanent public policies to improve the Colombians´ oral health.

Objectives: Asthma is one of the most common long term medical conditions and an important contributor to the burden of illness. People with asthma experience poor life satisfaction and require a range of health services to manage their condition. There is a need to assess the instruments by disease concept and interpret the dimension scores. The aim of this systematic review is to assess the impact of severe asthma on the quality of life (QoL). MethOds: A systematic search was conducted of the relevant published evidence from Embase and MEDLINE. Search limits were: articles in English, in human and published since year 2005. Retrieved citations were screened by two independent reviewers according to inclusion criteria: severe asthma and baseline QoL data either measured on generic scale or disease-specific scale. Results: A total 29 studies met the inclusion criteria. The majority of studies were observational (14 studies) while seven studies had cross-sectional design. The majority of studies were conducted in adult population (18 studies) while few studies were conducted in children (5 studies). Asthma Quality of Life Questionnaire (AQLQ) was the most frequently used scale among the included studies, assessed in 13 studies followed by St. George's Respiratory Questionnaire (SGRQ) in six studies. Seven studies reported total AQLQ data with mean scores ranging from 3.1-4.8, which reflect poor QoL. Across these domains, scores assessed on AQLQ -symptoms and AQLQ -activity limitations were lower as compared to AQLQ -emotional function and AQLQenvironmental stimuli. Data also suggested that patients with severe asthma have rapid deterioration in overall health status as compared to patients with mildmoderate asthma. cOnclusiOns: Patients with severe asthma had lower total QoL scores as assessed through different scales, indicating worse QoL. Symptoms and activity limitations are the two main domains that potentially affect the QoL in patients with severe asthma.

OBJECTIVES: To inform a multiple technology appraisal to be conducted by the National Institute for Health and Care Excellence on the use of agents that inhibit sodium-glucose co-transporter 2 (SGLT2), canagliflozin was assessed as monotherapy treatment for T2DM. METHODS: A systematic literature review identified 36 trials, which were used to perform a Bayesian NMA to estimate the relative efficacy (HbA1c, weight, and systolic blood pressure [SBP]) of canagliflozin monotherapy at 26±4 weeks compared to dipeptidyl peptidase-4 inhibitors (DPP-4s), sulphonylurea, pioglitazone, and SGLT2 inhibitors. Networks of evidence had treatment-and dosespecific nodes for DPP-4s, pioglitazone, and SGLT2 inhibitors. Relative efficacy was evaluated based on absolute differences and Bayesian probabilities (P), where 30%< P > 70% were chosen to indicate a smaller and larger effect, respectively. RESULTS: Results presented here focus on comparisons to the most relevant anti-hyperglycaemic therapies in the UK; sitagliptin, gliclazide, pioglitazone, dapagliflozin 10mg, and empagliflozin 10mg/25mg. Canagliflozin 300mg was associated with greater reductions in HbA1c (Δ -0.29 to -0.52) versus all comparators. Canagliflozin 100mg conferred reductions in HbA1c at least as large as other comparator (Δ -0.03 to -0.26). Canagliflozin was associated with larger reductions in weight (kg) versus all comparators (Δ -0.41 to -7.03), except for canagliflozin 100mg versus empagliflozin 25mg, where the reduction was similar (Δ -0.19). Canagliflozin 300mg was associated with larger reductions in SBP (Δ -1.06 to -6.29) versus all comparators. Canagliflozin 100mg was associated with greater reductions in SBP versus empagliflozin 10mg, pioglitazone, and sitagliptin (Δ -1.11 to -4.60) and provided comparable reductions in SBP versus dapagliflozin 10mg and empagliflozin 25mg (Δ 0.65 and -0.31). CONCLUSIONS: The results of this NMA suggest that canagliflozin 300mg monotherapy was associated with consistently greater HbA1c and SBP reductions versus all comparators, relevant to UK prescribing habits; while canagliflozin 100mg was at least similar. Weight reductions were larger for both doses of canagliflozin compared to all comparators.

Objectives: Delayed-release dimethyl fumarate (DMF; also known as gastroresistant DMF) and fingolimod are oral disease-modifying treatments for relapsing-remitting multiple sclerosis (RRMS). Direct comparisons of these agents are not possible due to a lack of head-to-head trials. In this study, comparative effectiveness research was conducted by indirectly comparing efficacy outcomes at 2 years with DMF or fingolimod treatment of RRMS in Phase 3 studies. MethOds: Individual patient data from the DEFINE and CONFIRM studies of DMF (pooled) and aggregate data from the FREEDOMS and FREEDOMS II studies of fingolimod (pooled using random effects meta-analysis) were utilised. Only results using the approved dosage of DMF (240 mg twice daily) and fingolimod (0.5 mg once daily) are reported. Matching-adjusted indirect comparison was conducted as described in Signorovitch et al (2010). Patients in the pooled DMF trials were weighted such that their average baseline characteristics (age, gender, time from onset of symptoms, Expanded Disability Status Scale score, number of relapses in previous year) matched those reported for patients in pooled fingolimod trials. After matching, weighted efficacy outcomes for patients treated with DMF were compared with summary efficacy outcomes for patients treated with fingolimod. Results: After matching, all baseline characteristics were balanced between the pooled DMF trials and the pooled fingolimod trials. At 2 years, annualised relapse rate ratio (95% confidence interval [CI]) for DMF vs placebo was 0.52 (0.43, 0.62) and for fingolimod vs placebo was 0.48 (0.42, 0.55). Twelve-week confirmed disease progression hazard ratio (95% CI) for DMF vs placebo was 0.70 (0.57, 0.85) and for fingolimod vs placebo was 0.76 (0.61, 0.95). Additional data, including comparison of DMF vs fingolimod, will be presented. cOnclusiOns: In a matching-adjusted indirect comparison, the efficacy of DMF was similar to that of fingolimod on clinical measures of relapse and disability progression.

Novartis Pharmaceuticals UK Ltd, Surrey, UK.