4081 Background: BTCs are a group of relatively rare malignancies comprised of intrahepatic cholangiocarcinoma (CCA), extrahepatic CCA, and gallbladder cancer. The first-line standard of care of gemcitabine and cisplatin (GC) has remained unchanged for the past decade, highlighting the need for novel therapies. The TOPAZ-1 trial demonstrated improved progression-free (PFS) and overall survival (OS) with durvalumab added to GC. This trial-based economic evaluation estimated the cost-effectiveness/utility of DGC versus GC from a US payer perspective. Methods: A three state partitioned survival model (Progression-free, Progressed, Death) was developed to compare costs and overall survival outcomes associated with both treatments. PFS and OS curves were digitized, and parametric functions fitted. A 5-year time horizon with a 3% discount rate/year was considered. Costs of treatment (average sales price), administration, and monitoring parameters were sourced from Centers for Medicare & Medicaid Services databases; costs of adverse event management (grade 3/4 with rate ≥ 5%) were sourced from prior BTC economic evaluations. Life years (LY), quality adjusted life years (QALY), incremental cost-effectiveness and utility ratios (ICER/ICUR) were estimated in a base case (BCA) and probabilistic sensitivity analyses (PSA). A cost-effectiveness acceptability curve (CEAC) was plotted to determine the probability of either treatment being cost-effective over the other at different willingness to pay (WTP) thresholds. Results: Exponential regression was used to extrapolate DGC and GC survival curves. As shown in the table, the BCA (PSA) shows an incremental cost of DGC over GC of 131,350 (131,212), incremental LY of 0.38 (0.38), and incremental QALY of 0.26 (0.28). The BCA and (PSA) ICERs reveal an additional 345,658 (345,295) per LY gained (g) and an additional 505,192 (468,614) per QALYg. The CEAC curve shows that DGC treatment has a 50% probability of being cost-effective at a WTP threshold value of 525,000 and 100% probability at a threshold of 1,375,000 or above. Conclusions: This economic evaluation demonstrates that, in the setting of advanced BTC, DGC is associated with a slight improvement in LY and QALY, yet at a marked incremental cost, requiring a very high WTP threshold. [Table: see text]

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Pharmacists promote vaccinations and challenge misconceptions about vaccine hesitancy, yet pharmacists’ knowledge of vaccine confidence has not been assessed. The objective of this study was to compare pharmacists’ knowledge of coronavirus disease 2019 (COVID-19) vaccine confidence before and after a live continuing education (CE) session. This pretest–posttest study evaluated the differences before and after a live CE session on COVID-19 vaccine confidence provided to pharmacists at a nationwide health technology company. Participants’ total pretest and posttest scores were compared using paired t-tests, while pretest and posttest scores for each item were compared using chi-squared tests. A Bonferroni correction was applied, resulting in an alpha level of 0.005. A total of 279 pharmacists participated in this study. After the CE session, mean knowledge scores increased (5.2 ± 1.5 to 7.4 ± 1.35, p < 0.0001). After the CE session, there was no significant increase in pharmacists’ knowledge about the approach that is not recommended when discussing vaccination beliefs with a patient (71.3% to 77.4%, p = 0.099), determinants of vaccine uptake (83.9% to 87.8%, p = 0.182), and social determinants of health that can influence vaccination rates (93.6% to 96.4%, p = 0.121). There was a significant change in pre- and posttest knowledge for the remaining seven items.

This study assessed the knowledge of e-cigarettes/vapes among a sample of student pharmacists. A 22-item cross-sectional electronic questionnaire was administered to all third- and fourth-year student pharmacists enrolled at one college of pharmacy in the United States (N = 256). Data were collected over six weeks in March/April 2022. One point was assigned for each correct knowledge item; points were then summed to create a total knowledge score for each person. Differences in the proportion of students who correctly answered each knowledge item were compared between year groups using a chi-square test, while differences between year groups for total knowledge score were compared using a two-sample t-test. The a priori alpha level was 0.05. Fifty students (third year = 30, fourth year = 20; female = 60%) completed the survey. Students’ e-cigarettes/vapes knowledge varied depending on the item. There was no statistically significant difference between third- and fourth-year students for total mean knowledge scores (third year = 12.5 ± 3.3, fourth year = 11.2 ± 3.1, p = 0.1780) or for each knowledge item, except for items 10 and 20. In conclusion, the findings from this survey of student pharmacists at one college of pharmacy in the United States indicate a need for more education around e-cigarettes/vapes for student pharmacists so that they are better able to counsel patients on their use.