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Surgery accounts for the majority of hospitalizations, nearly 40% of their total costs, and 75% of overall charges and reimbursements. Therapy that decreases the number of surgical hospitalizations should substantially reduce inpatient Crohn's disease costs, as well as overall costs.

Over a 10-year period, the DES model yielded average total discounted per-patient costs of $10 212, $46 783, and $26 837 and quality-adjusted life-years (QALYs) of 6.742, 6.781, and 6.792 for PBO/ALN, TPTD/ALN, and ABL/ALN, respectively. Compared with TPTD/ALN, ABL/ALN accrued higher QALYs at lower cost and produced an incremental cost-effectiveness ratio (ICER) of $333 266/QALY relative to PBO/ALN. In high-risk women, ABL/ALN also had more QALYs and less cost over TPTD/ALN and yielded an ICER of $188 891/QALY relative to PBO/ALN. Conclusion and Relevance: ABL is a dominant treatment strategy over TPTD. In women with PMO at high risk of fracture, ABL is an alternative cost-effective treatment.

A139outputs include total costs (Singapore dollars (SGD); 1 SGD=0.82 USD), IFIs avoided, life-years saved, and incremental cost-effectiveness of posaconazole versus fluconazole/ itraconazole. A probabilistic sensitivity analysis (PSA) was conducted, where probabilities of IFI, IFI-related death, and 100-day other cause mortality were assigned beta distributions from trial data. RESULTS: Total costs of prophylaxis with fluconazole/ itraconazole and posaconazole were SGD 4,475 and SGD 4,999, respectively. Corresponding health outcomes were 0.11 and 0.05 IFIs and 2.44 and 2.51 life-years. Incremental cost-effectiveness ratios for posaconazole were SGD 8,150 per IFI avoided and SGD 7,526 per life-year saved. Posaconazole was cost-effective compared to fluconazole/ itraconazole in 94% of PSA simulations at a threshold of SGD 80,000 (commonly cited threshold in Singapore). CONCLUSIONS: Use of posaconazole in place of fluconazole/ itraconazole for prevention of IFIs in a high-risk neutropenic population is costeffective at a willingness-to-pay threshold of SGD 80,000 per life-year saved in Singapore.

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