CONTEXT: Sexual dysfunctions can have origins in physical, psychological and psychosocial factors. OBJECTIVE: To describe the frequency of erectile dysfunction (ED) and female inhibition of sexual desire (ISD) in a Brazilian sample, and to estimate the risks of these dysfunctions. TYPE OF STUDY: Non-random survey. SETTING: Ten Brazilian cities. METHODS: 2,835 subjects (53% women) aged over 18 years answered a questionnaire about their general health and sex life. The chi-squared test and multivariate logistic regression were used. Values of p < 0.05 were considered significant. RESULTS: The women's average age was 36.6 years (± 13.3) and the men's was 39.5 (± 13.3). 14.7% of men presented moderate/complete ED and 34.6% of women presented ISD. Depression was mentioned by 16.8% of men and 29.7% of women. The chances of having ED and ISD were higher for subjects who had had lower school attainment. Lack of a job and depression gave rise to 1.5 times (95% CI: 1.0 - 2.3) and 1.9 times (95% CI: 1.2 - 3.0) greater chances of ED respectively. Compared with men aged up to 25 years, those aged 41-60 had 1.9 times (95% CI: 1.0 - 3.4) and those aged 61 and over had 5.4 times (95% CI: 2.3 - 12.6) greater risk of ED. For women, lack of a job gave rise to 1.5 times (95% CI: 1.1 - 1.9) greater chance of ISD; depression was not associated with higher risk. Compared with women aged up to 25 years, those aged 41-60 and 61 or over had, respectively, 2.9 times (95% CI: 2.0 - 4.1) and 7.5 times (95% CI: 3.0 -18.6) greater risk of ISD. DISCUSSION: Increasing unemployment has affected the whole population, but especially those with lower levels of school attainment. Such levels are positively linked with presence of sexual dysfunctions. CONCLUSION: Lack of jobs, age and low school attainment are risks for the sexual dysfunctions studied. Depression increased the risk of ED but not female ISD.

OBJECTIVE: There have been many studies investigating paraphilias and sexual compulsion, but thus far little data about prevalence of unusual sexual practices that are subthreshold for these diagnoses. The associations between unconventional sexual behavior and sociodemographic and health parameters were investigated. METHOD: A cross-sectional study of 7,022 individuals (45.4% of women) was carried out using a selfadministered questionnaire that compared individuals carrying at least one reference of unconventional sexual behavior (group 1) with individuals without such reference (group 2). RESULTS: Women's mean age was 35.0 vs. 35.9 years (p < 0.05) and men's mean age was 36.5 vs. 37.8 years (p < 0.05) being lower in group 1 than in group 2, respectively. More men (52.3%) than women (30.4%) (p < 0.001) presented unconventional sexual behavior. Fetishism (13.4%) and voyeuristic behavior (13.0%) were more frequent. Unconventional sexual behavior was associated with male gender, single or separated marital status, black or mulatto race, elementary and high school educational level, history of posttraumatic stress disorder treatment, alcohol dependence, emergency contraception, difficulty at the beginning of sexual life, sexual violence, bisexuality, and performance of anal or oral intercourse. CONCLUSION: Unconventional sexual behaviors are important because they are associated with poorer health status and lower educational levels.

37.2% for high cost-sharing; pϽ0.001). CONCLUSIONS: Patients in plans with no cost-sharing have greater adherence and are less likely to discontinue treatment in the 12-month period following DMT initiation. These results suggest that patients with MS are sensitive to the financial costs associated with DMT and may make treatment decisions based on this burden. Manufacturer co-pay assistance programs designed to reduce patient financial burden were not considered in this analysis. Therefore, these results may underestimate the effects of benefit design on medication adherence and persistence. OBJECTIVES:Since launch, HTA agencies from Germany, France and UK have repeatedly reviewed the use of Alzheimer's disease (AD) treatments and issued recommendations, which have changed over time. The aim of this study was to understand the drivers of agency decisions and whether these too have changed over time. METHODS: We reviewed HTA appraisals by IQWIG, HAS and NICE for three acetylcholinesterase inhibitors (AChEI) donepezil, galantamine, rivastigmine and memantine, an NMDA receptor antagonist from marketing authorisation to today and identified arguments leading to recommendations. RESULTS: Between 1997 and 2002, the EMA approved donepezil, rivastigmine and galantamine for mild to moderate AD and memantine for moderate to severe AD. We identified 2 multiple technology assessments (MTA) and 3 single technology assessments (STA) by IQWIG, 1 MTA and 16 STAs from HAS and 3 MTAs from NICE. Germany: IQWIG ascribed the AChEI class a modest clinical benefit. Following two negative assessments of memantine, the decision was reversed based on post-hoc analysis of initial registration studies. France: HAS initially assigned all treatments an important clinical added value (AMSR II) acknowledging high innovation. Later HAS reviewed the compounds in a new comparative setting (after withdrawal of tacrine) and assigned only a minor clinical added value (ASMR IV). UK: NICE recommended AChEIs in 2001, restricted their use in 2006 and in 2011 again recommended them, while memantine received two negative recommendations followed by a positive recommendation. The last review was based on additional data from randomized clinical trials and the Assessment Group's model demonstrating delay to institutionalisation. CONCLUSIONS: The agencies revised assessments based on post-marketing data. Differing national approaches led to different decisions: IQWIG emphasises patient relevant benefit, HAS the clinical added value versus similar medicinal products and NICE cost-effectiveness. Although agency decisions changed, decision drivers were consistent across evaluations. OBJECTIVES:To quantify annual drug costs and hospitalization rates (HR) of adult refractory focal epilepsy patients in Germany. METHODS: We retrospectively estimated the annual HR and medication for refractory focal epilepsy patients based on the NeuroTransData epilepsy database (input from 79neurologists, 34centers, 1240patients). Inclusion criteria (at least 1year of disease histo...

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