Surveys (NHANES) from 2005 to 2016. The prevalence of CVD among smokers was ascertained from the prevalence of four constituent conditions -congestive heart failure, coronary heart disease, angina pectoris, and heart attack. The predictors of CVD among smokers were investigated using multivariate survey logistic regression models. Results: 7,063 participants with mean age of 42.8 years who were current smokers and responded to the CVD questionnaire were considered in this analysis. The prevalence of CVD increased from 6.0% to 9.6% through the period from 2005 to 2016. Most significant increase in prevalence was seen in patients with respiratory diseases (from 10.8% to 19.2%), in obese patients (from 9.8% to 12.5%), and in binge drinkers (from 3.1% to 6.3%). The prevalence of CVD has also increased in the population with higher income (from 3.4% to 6.7%), and other than non-Hispanic whites (from 6.2% to 10.9%). The likelihood of CVD was higher among the elderly ($60years) (OR=5.07, CI=3.81-6.76), males (OR=1.35, CI=1.04-1.76), and respondents with ,400%-FPL (OR=1.84, CI=1.18-2.88). The likelihood of CVD was also higher among patients ailing with respiratory diseases (OR=3.39, CI=2.70-4.27), with diabetes (OR=2.84, CI=2.11-3.81), and with obesity (OR=1.54, CI=1.23-1.94). The proportion of patients suffering with one CVD disorder only who used a CV drug rose from 73% to 83% over the study period. Conclusions: The increase in prevalence of CVD among, both at an overall level and in certain subpopulations will be of concern to policy makers and clinical practitioners alike.

two infliximab biosimilars were launched in the United Kingdom, both subsequently recommended for use by the National Institute for Health and Care Excellence1. In November 2015, NHS-England released data on usage of infliximab by Acute Trust and by brand (both biosimilars and the reference product). In this study, we analyse and compare infliximab prescription rates between 157 Acute Trusts across 4 regional areas within England. MethOds: Acute Trusts were categorised according to usage of infliximab brands and geographical location. Data were analysed using descriptive statistics on Excel 2010. Results: Out of 157 Acute Trusts, 70(45%) prescribed the reference and at least one of the biosimilar brands. 65(41%) prescribed the reference only, while prescription percentages were not reported for 22(14%) Trusts. Of the 70 biosimilar-prescribing Trusts 40(57%) did not have biosimilar prescription rates exceeding 20%, while for 14(20%) rates were between 20-40%, for 7(10%) rates were between 40-60%, and finally for 9(13%) the biosimilar infliximab prescription rate exceeded 60%. The London and South-of-England regions had the highest percentages of biosimilar-prescribing Trusts, with 59%(16/27) and 58%(22/38) respectively. North-of-England had the lowest with only 22%(11/49) of Trusts in this region prescribing biosimilar infliximab. cOnclusiOns: Although biosimilar infliximab has been available for less than a year, it has been prescribed in 45% of Acute Trusts across England. By providing the latest prescribing trends of biosimilar infliximab, this study provides insight into the widely varying prescribing practices of biosimilars in Acute Trusts. Differences between regions may also reflect differences in offered prices per brands or differences in incidence rate of targeted diseases. Further studies targeting clinical guidelines and formularies may provide in-depth understanding of utilising biosimilars in medical practice. RefeRences: 1. NICE (2015) Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy. NICE Technology appraisal guidance 329.

This study documents trends in risk-adjusted quality and cost for a variety of surgical procedures, and explores innovation in treatment among Medicare beneficiaries from 2002 through 2011. Methods: We consider 11 classes of surgery, characterized by AHRQ's Clinical Classification System; the surgical classes studied range from tracheostomy to heart valve procedures to colorectal resection to wound debridement. For each surgical class, we assess trends in treatment costs and health outcomes among Medicare beneficiaries receiving these procedures during hospital stays. Quality was defined as rate of 30-day survival with the avoidance of unplanned readmissions, while costs include hospital costs and concurrent physician and ancillary services. Quality and costs are adjusted for patient severity based on demographics, comorbidity, and community context. Surgical innovations are operationalized as clinically distinctive procedures with nonexistent or limited use in 2002, identified using ICD-9 procedure codes. Results: Analysis found significant and positive quality growth for 6 surgical classes: heart valve procedures (3.49%), CABG (2.00%), gastrostomy (5.32%), tracheostomy (5.01%), wound debridement (2.78%), and excision of lysis peritoneal adhesions (1.68%). Preliminary analysis also found significant and negative cost trends for 3 surgical classes: tracheostomy (-15.05%), PTCA (-11.11%) and wound debridement (-9.69%). In addition, significant cost increases were observed for gastrostomy (5.51%), colorectal resection (4.06 %), and exploratory laparotomy (30.72 %). Substantial treatment innovation occurred with respect to surgical procedures utilized for colorectal resection. Conclusions: In 2 out of 11 surgical classes, the quality of surgical care improved while treatment costs declined. Four other surgical classes exhibited either a cost decrease or quality improvement. While cost increased for 3 other surgical classes, only 1 of them was associated with improved quality of care. In the remaining 2 surgical classes, there was no significant change in quality or cost. These trends were associated with measurable innovation in treatment for only one surgical class.

s263 and 15 of 16 comorbidities. In multivariate analyses age was not an independent risk factor for increased utilization, however patient comorbidities and diseaserelated complications did increase utilization. ConClusions: Hospital resource utilization is high in MFS patients, especially those < 18 years old. Disease-related complications and patient comorbidities drive resource use.

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