Heart failure (HF) significantly worsens the patient quality of life and leads to the disability of their significant part, as well as increases the risk of death, which in turn causes economic damage.Aim. To assess the annual socio-economic impact of HF in Russia.Material and methods. To assess the socio-economic impact of HF, a model was developed, which assessed the number of HF patients seeking medical care (data from the epidemiological studies), the number of those with disabilities and the mortality rate among them. We also evaluated the costs of drug therapy (data from the government procurement reports) and hospitalization (data from the compulsory health insurance tariffs), social benefits due to disability, and death impact on the gross domestic product. Data on the prescription rate, hospitalizations and mortality was obtained from Russian registries of patients with cardiovascular diseases. Using the foreign study, the costs of family caregiving were also calculated.Results. According to modeling data, there are 7,1 million people with HF seeking medical care in Russia. In this case, the annual economic impact of HF in the context of government spending, is RUB 81,86 billion, including medical costs of RUB 18,6 billion, direct nonmedical costs of RUB 47,1 billion, and indirect costs of RUB 16,2 billion. The impact of family caregiving is RUB 72,4 billion. In the structure of medical expenses, 73,6% is hospitalization costs, while the main costs of drug therapy are borne by patients, since only a part of them (19,6%) receive the necessary medications within assistance programs. In patients with HF with reduced ejection fraction, medical costs are 56% higher than in patients with HF with preserved ejection fraction.Conclusion. HF causes significant economic burden to the state. Improving the healthcare system for this category of patients, including preferential drug provision, will reduce HF-related mortality, the healthcare system costs and, accordingly, reduce the economic impact on the state and society.

The cost of UP attributable to use of unreliable contraception in Russia is substantial. Policies encouraging use of reliable contraceptive methods could reduce the burden of UP.

with breast cancer in the UK NHS. METHODS: A previously published decision tree model was populated and developed with the Vial et. al. and Brown et. al. trial data to assess the cost-effectiveness of using branded Taxotere ® versus its generic counterpart docetaxel from the UK NHS perspective. RESULTS: If the branded Taxotere ® was promoted as the first-line therapy, it would cost the UK NHS £411.54 per vial per patient with 0.434 QALY (Quality-Adjusted Life Years) gain compared to £412.98 with 0.418 QALY gain if the generic docetaxel was promoted instead and failed the therapy. Although the acquisition cost of docetaxel is more than 50% less than that of Taxotere ® , promoting the generic docetaxel based on its lower acquisition cost, only, would result in increasing the total health care cost compared to Taxotere ® . CONCLUSIONS: Based on the decision tree model generated in this study, promoting the branded Taxotere ® is more cost-effective compared to its generic counterpart docetaxel. This should be considered for implementation in practice and for future guidelines. OBJECTIVES:To estimate which is the dominant treatment between the only two drugs that had been able to demonstrate overall survival (OS) improvements in patients with metastatic castrate resistant prostate cancer (mCRPC) that have progressed on or after docetaxel treatment, and that were approved by the EMA in 2011 (AA by accelerated procedure): cabazitaxel (CBZ) and abiraterone acetate (AA),. METHODS:We replicated the methodology most commonly used by Spanish hospitals to estimate the cost-efficacy of oncologic drugs (OS gains and incremental costs vs. those of comparators) by: (i) taking the perspective of the Spanish NHS (ii) estimating treatment costs based on the product labels (i.e. main medication, comedication, premedication, and primary prophylaxis) at ex-factory prices, and the cost of administering such medications; and (iii) the OS data from the respective pivotal phase III trials: for CBZ vs. mitoxantrone ϩ prednisone (MP) OS was 15.1 vs. 12.7 months. For AA vs. placebo ϩ prednisone (PP) OS was 15.8 vs. 11.2. Input for the base case analysis comes from Phase III randomized clinical trials and from publicly available cost data. Sensitivity analysis was performed on: (i) length of treatment; (ii) median OS; and (iii) G-CSF usage and drug administration costs. RESULTS: In our base case scenario the cost per cycle of CBZ was 4,711.52€ vs. 78.20€ for MP. The cost per cycle of AA was 3,179.26€ vs. 11.85€ for PP. Treatment costs difference for CBZ vs. MP is 27,799.93€ (range 13,665.36€ -46,646.01€) and for AA vs. PP is 25,386.71€ (range 12,669.65€ -38,103.76€). OS gain is 2.4 months for CBZ and 4.6 months for AA. CONCLUSIONS: In Spain, based on local hospital methodology, AA would be the dominant alternative (higher OS gain and lower incremental cost) to treat mCRPC patients that have progressed on or after a docetaxel based regime.

The number of cases of head and neck (H&N) cancer diagnosed in the UK has been increasing in recent years. These cancers often require complex surgical treatments and extensive rehabilitation. OBJECTIVES: To use data from the Hospital Episode Statistics (HES) database to estimate the costs incurred by English NHS hospitals due to treatment of H&N cancers, with a particular focus on oral cavity, oropharyngeal and laryngeal cancers. METHODS: Inpatient admissions for H&N cancer between the years 2006/07 to 2010/11 were retrospectively analysed. Data was obtained from HES, a database covering English hospital activity, with inpatient episodes aggregated into spells of care associated with a specific Healthcare Resource Group (HRG). The HRGs were linked to costs from the UK National Tariff in order to calculate the average annual and per patient payments for inpatient treatment of H&N cancer, as per the NHS Payment by Results framework. Where necessary, costs were supplemented by expert opinion and other published cost estimates. RESULTS: Payments to NHS hospitals in England for inpatient stays due to H&N cancer are estimated to cost on average £57.1 million per year. The main driver of costs are the disproportionately high number of male cases, the costs of which are £12,517,235, £13,327,351 and £16,185,743 for oral cavity, oropharyngeal and laryngeal cancer, respectively. This translates to respective inpatient costs per male of £5,354, £6,926, and £6,693. Despite similar costs per female inpatient, the average annual payments for inpatient care were approximately £7,579,905, £4,337,947 and £3,166,535, for oral cavity, oropharyngeal and laryngeal cancers. CONCLUSIONS: Based on inpatient treatment alone, H&N cancers place a significant economic burden on English NHS hospitals. This, however, is far less than the total burden of treatment as a large proportion is delivered in the outpatient setting. Further research is currently underway to quantify this total burden. OBJECTIVES:To characterize resource utilization and associated costs of patients receiving systemic therapy outside of a clinical trial for unresectable stage III and IV metastatic melanoma in Brazilian Healthcare System, and to compare results across the public and private health systems. METHODS: A retrospective study was A419

OBJECTIVES:To estimate the costs associated with juvenile idiopathic arthritis (JIA) for Russia in 2009. METHODS: We used the standard cost of illness (COI) method adopting the viewpoint of the payers (national and regional governments). The data was obtained from the national statistics, registries, expert panel interviews and literature. The costs were calculated for the total population of JIA patients in Russia in 2009. We calculated direct medical costs (based on national reimbursement rates and regional data on drug costs), non-medical costs (social benefits expenditures) and indirect costs -productivity loss due to the necessity of providing care for patients by parents. Indirect costs were assessed using friction costs method. RESULTS: The total costs of JIA in Russia in 2009 was 1.175 billion RUR (€28,48 mln), or 76,013 RUR (€1843) per patient per year. The highest per person costs were attributed to patients with systemic JIA -189,489 RUR (€4594), the lowest -with oligoarticular type of JIA (40,223 RUR (€975)).The costs for handicapped child were 3.9 times higher than for those without disability, mostly because of different social benefits. The direct medical costs accounted for 31,5% of total spending, direct non-medical costs -for 55,6%, and indirect costs -for 12,8%. The share of direct non-medical costs in the overall spending was lower in less severe patients: 58.3% for the systemic JIA, 57.7% for the polyarticular and 46.4% for the oligoarticular type of JIA. Direct nonmedical costs represented 75.8% of total costs for handicapped child versus 42.8% in patient without such status. CONCLUSIONS: JIA represents significant social and economic burden for the state. The costs for handicapped child are several times higher than for the one without disability due to social benefits payments.