A 3 4 7 -A 7 6 6 were taken into account, together with resulting costs and (dis)utilities. Results were specified for subgroups in scenario analyses: NVAF + VTE patients (base case); NVAF and VTE patients separately; unstable NVAF patients with TTR (time in therapeutic range) < 60%. A probabilistic sensitivity analysis (PSA) was performed to investigate the influence of parameter uncertainty on the incremental cost-effectiveness ratio (ICER). Results: For the analyzed subgroups the use of rivaroxaban was cost saving and provided health gains compared to treatment with VKAs. Cost savings were highest for VTE patients, followed by unstable NVAF patients. Health gains were approximately the same for each subgroup at 0.023-0.026 quality adjusted life-years (QALY) per patient. ConClusions: From a healthcare payers perspective in the Dutch setting, rivaroxaban treatment is likely to be dominant over current standard therapy with VKAs, for the prevention of stroke in patients with (unstable) NVAF and treatment of (r)VTE.

ObjectiveS: To assess the cost-effectiveness of therapist guided Internet delivered cognitive behavioral therapy (i-CBT) compared to treatment as usual (TAU) in the management of functional abdominal pain disorders (FAPDs). MethOdS: Ninety children aged 8-12 years, with a diagnosis of irritable bowel syndrome, functional dyspepsia, or functional abdominal pain were randomized to either a treatment consisting of 10 weeks of therapist-guided i-CBT or TAU. The health outcome measure was Paediatric Quality of Life Inventory (PedsQL) scores at baseline and post treatment. The scores on the PedsQL were mapped onto the Child Health Utility 9D (CHU9D) to estimate QALYs. Resource use data were collected using the Treatment Inventory of Costs in Psychiatric Patients (TiC-P) at baseline, 6 weeks and 10 weeks. Cost data for week 6 and week 10 were summed up to estimate the cumulative cost of resource use over the treatment period. We conducted a cost-utility analysis from a societal perspective using regression techniques to assess the mean differences in costs and QALYs between the treatment arms over time. ReSultS: I-CBT resulted in 0.0181 QALYs gained while TAU was associated with deterioration in HRQoL, -0.0006 QALYs. The incremental health gain resulted in 0.0187 QALYs between i-CBT and TAU arms. The mean intervention cost was 177.33 USD. There was a significant reduction in the healthcare resource use of -155.50 USD in the i-CBT arm compared to the TAU arm. Total mean societal cost to participants randomized to the i-CBT and TAU arms was 2750 USD and 3976 USD respectively, resulting in an incremental cost difference of -1173 USD (1050 USD). The intervention was found to be approximately 86% cost-effective/saving at a willingness to pay of zero. cOncluSiOnS: I-CBT is a cost-saving approach compare with TAU. It saves about 1200 USD per participant over a ten weeks period and thus presents a worthy investment.

S33cancer from the perspective of the public health institutions in Mexico, in comparison with low or high energy linear accelerators. MethodS: A cost minimization analysis was carried out, because there is no statistically significant difference in safety and efficacy between the Mobile Electron Accelerator for intraoperative radiotherapy and radiotherapy with high or low energy accelerators (Fastner, et al., 2014). The total cost of each device was calculated, which included: the cost of the device, the cost of adapting spaces for its use, the cost of the guarantee and maintenance policy. The total cost was compared during a time horizon of 15 years (useful life of the device). It was also compared the equivalent annual cost and the cost per session. The discount rate was 5%.

follow-up). The EQ-5D-3L index scores were calculated using the UK preference weights. The mean utility values and UPDRS scores were comparable between the two treatment arms in the trial, and thus patient-level data were pooled for analysis, as the treatment effect was not statistically significant. The data were analyzed using a mixed-effect model with repeated measures. Candidate predictors were informed by a previous SLR conducted to identify published studies that reported the association between utilities and PD severity (Chandler 2018). Results: The average decline in utilities per year was 0.018 and mean utilities at baseline, year 3, and year 6 were 0.81, 0.76, and 0.70, respectively. The significant predictors of utility values included gender and UPDRS I, II, III, and IV. Age was excluded from the multivariate model as it was not statistically significant after adjusting for UPDRS scores. The statistical model performed well in validation analyses-average predicted EQ-5D-3L utilities were compared with the average observed scores for each year post-baseline and were within +/-0.01 at all visits. Conclusions: The predictive equation for utilities captures the impact of non-motor and motor-related aspects of the disease as all four UPDRS subscales were identified as significant predictors.

individuals, 18-63 years of age, with at least 18 months of continuous eligibility and a primary care or emergency department visit for LBP. Baseline covariates were captured in in the six-month period prior to their initial LBP diagnosis (index date) and opioid use was captured in the 12-month follow up period. Long-term opioid use was defined as at least 90 days of opioid use. PT and chiropractic were assessed in the 30-day period after index date. Multivariable logistic regression models were estimated to explore the influence of PT and chiropractic care adjusted for patient demographics and comorbidities. Results: 40,929 individuals met inclusion/exclusion criteria. Average age was 41 years, 64.5% were female and 79.9% had commercial health insurance coverage. PT and chiropractic care was used by 5.4% and 5.9% of the sample, respectively. Any opioid use after LBP diagnosis was observed in 54.3% of subjects, 4.4% used opioids long-term. PT was not associated with any opioid use (OR: 1.07; 95% CI: 0.98-1.18) or long-term opioid use (OR: 1.19; 95% CI: 0.97-1.45). Persons who received chiropractic care were less likely to be prescribed an opioid (OR: 0.88; 95% CI: 0.80-0.97) or to use opioids long-term (OR: 0.56; 95% CI: 040-0.77). Conclusions: Utilization of PT or chiropractic care in early management of back pain was low. Chiropractic care but not PT was associated with a lower likelihood of opioid use and long term opioid use.