- Email: [email protected]
Cost Per Responder Analysis of Sucrofferric Oxhydroxide Versus Sevelamer Carbonate in Patients on Hemodialysis in Europe
A518
VA L U E I N H E A LT H 1 9 ( 2 0 1 6 ) A 3 4 7 – A 7 6 6
€ 4’288, with € 1’760 for hospitalisations; drugs cost was € 1’806 - 6% of which for antihypertensives - and ambulatory care services amounted to € 722. Conclusions: The reported higher incidence of dialysis - and a lower mean age - highlight the severity of PKD connected to the autosomal dominant type, that eventually leads to an annual burden for NHS of about € 45’000 for each ADPKD dialysed patients. PUK9 Oab in Poland - This is Time for A Change Borowiack E1, Borowiack M1, Garbacka M1, Jarosz J1, Kowalska Kędziora M1, Nowotarska A1, Raczyńska G1, Jankowska E2 1NUEVO HTA CLP, Cracow, Poland, 2USP Zdrowie, Warszawa, Poland
Objectives: Despite the high prevalence of overactive bladder (OAB) in ageing population, this issue is not sufficiently noticed by health policy makers in Poland. According to current estimates, urinary incontinence affects more than 16.3% of people in Poland, but reimbursement of effective therapy is possible only after painful for the patient, unnecessary according to clinical guidelines urodynamic testing. Cost-of-illness analyses showed the huge economic burden related to OAB for public healthcare systems, patients and society, secondary to both direct and indirect costs. The objective of this study was to assess the scale of the problem in terms of costs in Poland. Methods: A decision model was used to estimate the cost of the treatment of all OAB patients from the Polish National Health Fund (NFZ), patient and the societal perspectives, using a one-year horizon. Outcomes included direct medical costs (urodynamic testing, drugs, outpatient visits, incontinence products) and lost productivity (employers only). Results: The overall cost associated with OAB was greater than € 11 (from the NFZ perspective) and € 276 million from the patient perspective (which includes € 270 million for incontinence products). Given that most people with OAB do not seek medical treatment (9 years to first visit) it is not surprising that self-management is a very large cost. From the societal perspective, including direct medical and indirect costs (i.e., lost productivity), current overall spending on OAB management is € 1 billion. Lost productivity costs due to OAB are very significant (72% of the overall cost from the societal perspective). Conclusions: Taking into account the costs incurred for the treatment of patients with OAB and limited patient access to effective drugs, there is a need for action by the Polish decision-makers in the area of OAB. PUK10 Cost-Effectiveness Analysis of Sucroferric Oxyhydroxide in Treatment of Hyperphosphatemia in Patients with Chronic Kidney Disease Ugrekhelidze D, Yagudina R, Kulikov A I.M. Sechenov First Moscow State Medical University, Moscow, Russia
Objectives: To assess the cost-effectiveness of sucroferric oxyhydroxide compared with sevelamer carbonate, sevelamer hydrochloride, calcium carbonate, calcium acetate, calcium acetate+magnesium carbonate in patients with hyperphosphatemia with chronic kidney disease in Russia for 1-year period. Methods: A decision tree was used to simulate the effects of medicinal drugs. The data on drugs efficacy (measured as survival for 1 year) was obtained from available clinical trials. The following costs were taken into account: the cost of drug therapy of hyperphosphatemia, cost for treatment of cardiovascular complications of chronic kidney disease, cost of drug therapy of anemia and secondary hyperparathyroidism in chronic kidney disease, costs for treatment of chronic kidney disease. As a result cost-effectiveness ratio (CER) of phosphate binders was calculated. Results: Therapy with sucroferric oxyhydroxide and sevelamer carbonate and hydrochloride leads to the equal 1-year survival as 88% (according to Florian S. Gutzwiller,2015), therapy with calcium carbonate, calcium acetate and calcium acetate+magnesium carbonate results in 66 % survival according to the meta-analysis by Jamal S.A. The calculated CER per 1 % of survival per year was lowest for sucroferric oxyhydroxide – 1 663 679 RUB/25173 $ in comparison with sevelamer carbonate - 1 723 277 RUB/26098 $, sevelamer hydrochloride - 1 723 299 RUB/26098 $, calcium carbonate – 2 381 086 RUB/36061 $, calcium acetate – 2 286 086 RUB/34 622 $, calcium acetate+magnesium carbonate – 2 416 638 RUB/36 599 $. Current rate taken as for 15.06.2016 is 1$ = 66,09 RUB. Conclusions: The choice of sucroferric oxyhydroxide instead of other phosphate binders in Russian healthcare conditions is considered cost-effective in patients with hyperphosphatemia with chronic kidney disease. PUK11 Estimating The Economic and Clinical Benefits of Mirabegron Versus Antimuscarinics for The Treatment of Overactive Bladder (OAB) in The United Kingdom (UK) Nazir J1, Berling M2, McCrea C3, Fatoye F4, Hakimi Z5, Wagg A6 1Astellas Pharma Europe Ltd, Surrey, UK, 2Parexel International, Stockholm, Sweden, 3Parexel International, London, UK, 4Manchester Metropolitan University, Manchester, UK, 5Astellas Pharma Europe B.V., Leiden, The Netherlands, 6University of Alberta, Edmonton, AB, Canada
Objectives: Antimuscarinic agents and mirabegron, a β 3-adrenoceptor agonist, are widely used to treat the symptoms of OAB. Compared to antimuscarinics, mirabegron has similar efficacy, is associated with better persistence and has a lower incidence of anticholinergic side effects. Through the use of real-world data, this study estimated the costs associated with OAB management in the UK. Methods: A 1-year economic analysis was performed using a Markov model with monthly cycles. Patients entered the model and initiated treatment with mirabegron, fesoterodine, oxybutynin extended release (ER), oxybutynin intermediate release (IR), solifenacin, tolterodine ER/IR or trospium ER/IR. Patients either persisted on treatment and were controlled, switched to another treatment, had minimally-invasive surgery or were uncontrolled. Model inputs included the proportion of patients with incontinence, 12-month persistence data, the probability of switching treatment and both direct costs (e.g. acquisition costs, resource use) and indirect costs (e.g. loss of working time). A one-way sensitivity analysis determined the influence of persistence and switching on findings. Results: For a cohort of 100 patients, mirabegron treatment resulted in greater persistence compared with antimuscarin-
ics (48.6% vs 23.4–36.0%) and a smaller proportion of patients switched (13.2% vs 16.4–19.7%). Treatment with mirabegron resulted in fewer healthcare visits (282 vs 290–299), reduced pad use (68,632 vs 72,840–77,636) and fewer work hours lost (32.6 vs 42.4–53.5/patient) compared with antimuscarinics. The estimated total annual cost of mirabegron treatment per patient was £1,168.17 (£3.20/day) compared with £1,280.66–1,449.24 (£3.51–3.97/day) for antimuscarinics. Sensitivity analysis confirmed the robustness of the model. Conclusions: In the UK, superior persistence with mirabegron compared to antimuscarinics is associated with lower resource use, fewer work hours lost, and an overall reduction in total costs. These data suggest that mirabegron provides clinical and economic benefits compared with antimuscarinics in management of OAB from a societal perspective. PUK12 Cost Per Responder Analysis of Sucrofferric Oxhydroxide Versus Sevelamer Carbonate in Patients on Hemodialysis in Europe Connolly M1, Kotsopoulos N2, Vrouchou P3, Dubois E3, Walpen S3 of Groningen, Groningen, The Netherlands, 2Global Market Access Solutions, SaintPrex, Switzerland, 3Vifor Fresenius Medical Care Renal Pharma, Glattbrugg, Switzerland 1University
Objectives: Sucroferric oxyhydroxide (SFOH) is a novel non calcium, iron based phosphate binder indicated for the control of serum phosphorus (sPhos) levels in adult chronic kidney disease (CKD) patients on hemodialysis (HD) or peritoneal dialysis (PD). A retrospective database analysis of SFOH among in-center HD patients who switched from sevelamer carbonate (SEV) to SFOH, showed that, after 6 months, patients switching from SEV with in-range sPhos (3.5-5.5 mg/dl) increased from 14.1% to 27.9% (98% increase) whilst pill burden decreased from 10.1 pills with SEV to 3.9 pills with SFOH suggesting lower cost per patient responding with SFOH. The objective of this study was to assess and compare the 6-monhtly cost per responder for SFOH versus SEV in Europe. Methods: Acquisition costs per pill of SFOH and SEV were estimated based on official list prices, weighted for local market shares. Treatment costs were estimated based on the observed daily pill intake, obtained from the retrospective data analysis. Number needed to treat (NNT) to achieve inrange sPhos (3.5-5.5 mg/dl) were estimated and subsequently the 6-monthly costs per responder were estimated for SFOH and SEV. Results: The estimated NNT was 3.6 and 7 for SFOH and SEV, respectively. SFOH consistently attained in-range sPhos (3.5-5.5 mg/dl) at a lower 6-monthly cost per patient compared to SEV. The 6-monthly cost per responder for SFOH and (SEV) were: Austria: € 4,511 (€ 23,319); France: € 3,699 (€ 13,416); Germany: € 4,194 (€ 17,279); Italy: € 4,755 (€ 14,054); Spain: € 3,503 (€ 15,307); UK € 6,355 (€ 25,381); Switzerland: € 7,612 (€ 25,258). SFOH appeared to attain in-range sPhos (3.5-5.5 mg/dl) with considerable 6-monthly cost-savings per patient responding ranging from € 9,299 (Italy) to € 19, 026 (UK). Conclusions: SFOH appears to have a favorable NNT and to attain the clinical target of in-range sPhos at a lower cost compared to SEV suggesting favorable cost-effectiveness. PUK13 Cost-Effectiveness of Combination Therapy with Dutasteride/ Tamsulosin: An Analysis Based on Conduct Trial Vallejo-Aparicio LA1, Miñana López B2, Brenes FJ3, Molero JM4, Fernández-Pro A5, Huerta A1, Cozar JM6 1GlaxoSmithKline, Tres Cantos (Madrid), Spain, 2Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain, 3CAP Badalona-6 Llefià Badalona, Barcelona, Spain, 4Centro de Salud San Andrés, Madrid, Spain, 5Centro de Salud de Menasalbas, Toledo, Spain, 6Hospital Universitario Virgen de las Nieves, Granada, Spain
Objectives: to estimate the Incremental Cost-Effectiveness Ratio (ICER) of dutasteride/tamsulosin combination therapy (DUT/TAM) vs. Watchful Waiting plus escalation to tamsulosin (WW+TAM) clinical practice, in treatment-naïve moderate Benign Prostatic Hyperplasia (BPH) patients from the Spanish National Healthcare System (NHS) perspective. Methods: This analysis was based on CONDUCT trial, which compared the symptomatic improvement of initial treatment with DUT/ TAM vs. WW+TAM on a 24-month period. A previously published markov model in BPH was modified to reflect specific CONDUCT trial design. Model structure has 9 health-states based on patient’s symptoms level, progression events and surgery occurrence, with two time-horizons, 2-year (CONDUCT study duration) and lifetime. Target population was treatment-naïve men ≥ 50 years old, with a moderate BPH diagnosis and at risk of progression; In the WW+TAM arm, only the group of patients who escalated to active treatment with tamsulosin at any moment of CONDUCT study duration (WW+TAM(Escalated)) was analyzed. Effectiveness was measured as Quality-Adjusted-Life-Years(QALYs), and utility data were obtained from a literature review. Resource use was based on Spanish common clinical practice. Unit direct costs (treatments, patient’s regular monitoring and complications management) were obtained from Spanish published data (€ 2015). A discount rate of 3% was applied for both costs and outcomes. Deterministic and ProbabilisticSensitivity-Analyses(PSA) were conducted to verify the robustness of the base-case results. Results: In the base-case, the ICERs were € 17,434 and € 21,234 from 2-year and lifetime-horizon respectively. Deterministic results ranged from € 13,945 up to € 20,924, and from € 13,749 up to € 25,518, in the 2-year and lifetime horizons analyses respectively. According to the PSA, the probability of DUT/TAM being cost-effective was 90% at a willingness to pay of € 30,000/QALY. Conclusions: DUT/TAM could be considered as a cost-effective alternative within the Spanish NHS as an initial treatment for BPH naïve moderate patients at risk of progression, compared with WW+TAM(Escalated) clinical practice. PUK14 Antibiotic Treatment of Uncomplicated Urinary Tract Infection In Women: A Comparative Cost-Effectiveness Study Sadler S1, Holmes M2, Holden S3, Sadler S4, Jha S4, Thokala P2 1Sheffield University, Sheffield, UK, 2University of Sheffield, Sheffield, UK, 3Nottingham University Hospital, Nottingham, UK, 4Sheffield Teaching Hospitals, Sheffield, UK
Objectives: Assess the relative cost-effectiveness of the three antibiotics recommended in England for first-line treatment of uncomplicated urinary tract infection
VA L U E I N H E A LT H 1 9 ( 2 0 1 6 ) A 3 4 7 – A 7 6 6
€ 4’288, with € 1’760 for hospitalisations; drugs cost was € 1’806 - 6% of which for antihypertensives - and ambulatory care services amounted to € 722. Conclusions: The reported higher incidence of dialysis - and a lower mean age - highlight the severity of PKD connected to the autosomal dominant type, that eventually leads to an annual burden for NHS of about € 45’000 for each ADPKD dialysed patients. PUK9 Oab in Poland - This is Time for A Change Borowiack E1, Borowiack M1, Garbacka M1, Jarosz J1, Kowalska Kędziora M1, Nowotarska A1, Raczyńska G1, Jankowska E2 1NUEVO HTA CLP, Cracow, Poland, 2USP Zdrowie, Warszawa, Poland
Objectives: Despite the high prevalence of overactive bladder (OAB) in ageing population, this issue is not sufficiently noticed by health policy makers in Poland. According to current estimates, urinary incontinence affects more than 16.3% of people in Poland, but reimbursement of effective therapy is possible only after painful for the patient, unnecessary according to clinical guidelines urodynamic testing. Cost-of-illness analyses showed the huge economic burden related to OAB for public healthcare systems, patients and society, secondary to both direct and indirect costs. The objective of this study was to assess the scale of the problem in terms of costs in Poland. Methods: A decision model was used to estimate the cost of the treatment of all OAB patients from the Polish National Health Fund (NFZ), patient and the societal perspectives, using a one-year horizon. Outcomes included direct medical costs (urodynamic testing, drugs, outpatient visits, incontinence products) and lost productivity (employers only). Results: The overall cost associated with OAB was greater than € 11 (from the NFZ perspective) and € 276 million from the patient perspective (which includes € 270 million for incontinence products). Given that most people with OAB do not seek medical treatment (9 years to first visit) it is not surprising that self-management is a very large cost. From the societal perspective, including direct medical and indirect costs (i.e., lost productivity), current overall spending on OAB management is € 1 billion. Lost productivity costs due to OAB are very significant (72% of the overall cost from the societal perspective). Conclusions: Taking into account the costs incurred for the treatment of patients with OAB and limited patient access to effective drugs, there is a need for action by the Polish decision-makers in the area of OAB. PUK10 Cost-Effectiveness Analysis of Sucroferric Oxyhydroxide in Treatment of Hyperphosphatemia in Patients with Chronic Kidney Disease Ugrekhelidze D, Yagudina R, Kulikov A I.M. Sechenov First Moscow State Medical University, Moscow, Russia
Objectives: To assess the cost-effectiveness of sucroferric oxyhydroxide compared with sevelamer carbonate, sevelamer hydrochloride, calcium carbonate, calcium acetate, calcium acetate+magnesium carbonate in patients with hyperphosphatemia with chronic kidney disease in Russia for 1-year period. Methods: A decision tree was used to simulate the effects of medicinal drugs. The data on drugs efficacy (measured as survival for 1 year) was obtained from available clinical trials. The following costs were taken into account: the cost of drug therapy of hyperphosphatemia, cost for treatment of cardiovascular complications of chronic kidney disease, cost of drug therapy of anemia and secondary hyperparathyroidism in chronic kidney disease, costs for treatment of chronic kidney disease. As a result cost-effectiveness ratio (CER) of phosphate binders was calculated. Results: Therapy with sucroferric oxyhydroxide and sevelamer carbonate and hydrochloride leads to the equal 1-year survival as 88% (according to Florian S. Gutzwiller,2015), therapy with calcium carbonate, calcium acetate and calcium acetate+magnesium carbonate results in 66 % survival according to the meta-analysis by Jamal S.A. The calculated CER per 1 % of survival per year was lowest for sucroferric oxyhydroxide – 1 663 679 RUB/25173 $ in comparison with sevelamer carbonate - 1 723 277 RUB/26098 $, sevelamer hydrochloride - 1 723 299 RUB/26098 $, calcium carbonate – 2 381 086 RUB/36061 $, calcium acetate – 2 286 086 RUB/34 622 $, calcium acetate+magnesium carbonate – 2 416 638 RUB/36 599 $. Current rate taken as for 15.06.2016 is 1$ = 66,09 RUB. Conclusions: The choice of sucroferric oxyhydroxide instead of other phosphate binders in Russian healthcare conditions is considered cost-effective in patients with hyperphosphatemia with chronic kidney disease. PUK11 Estimating The Economic and Clinical Benefits of Mirabegron Versus Antimuscarinics for The Treatment of Overactive Bladder (OAB) in The United Kingdom (UK) Nazir J1, Berling M2, McCrea C3, Fatoye F4, Hakimi Z5, Wagg A6 1Astellas Pharma Europe Ltd, Surrey, UK, 2Parexel International, Stockholm, Sweden, 3Parexel International, London, UK, 4Manchester Metropolitan University, Manchester, UK, 5Astellas Pharma Europe B.V., Leiden, The Netherlands, 6University of Alberta, Edmonton, AB, Canada
Objectives: Antimuscarinic agents and mirabegron, a β 3-adrenoceptor agonist, are widely used to treat the symptoms of OAB. Compared to antimuscarinics, mirabegron has similar efficacy, is associated with better persistence and has a lower incidence of anticholinergic side effects. Through the use of real-world data, this study estimated the costs associated with OAB management in the UK. Methods: A 1-year economic analysis was performed using a Markov model with monthly cycles. Patients entered the model and initiated treatment with mirabegron, fesoterodine, oxybutynin extended release (ER), oxybutynin intermediate release (IR), solifenacin, tolterodine ER/IR or trospium ER/IR. Patients either persisted on treatment and were controlled, switched to another treatment, had minimally-invasive surgery or were uncontrolled. Model inputs included the proportion of patients with incontinence, 12-month persistence data, the probability of switching treatment and both direct costs (e.g. acquisition costs, resource use) and indirect costs (e.g. loss of working time). A one-way sensitivity analysis determined the influence of persistence and switching on findings. Results: For a cohort of 100 patients, mirabegron treatment resulted in greater persistence compared with antimuscarin-
ics (48.6% vs 23.4–36.0%) and a smaller proportion of patients switched (13.2% vs 16.4–19.7%). Treatment with mirabegron resulted in fewer healthcare visits (282 vs 290–299), reduced pad use (68,632 vs 72,840–77,636) and fewer work hours lost (32.6 vs 42.4–53.5/patient) compared with antimuscarinics. The estimated total annual cost of mirabegron treatment per patient was £1,168.17 (£3.20/day) compared with £1,280.66–1,449.24 (£3.51–3.97/day) for antimuscarinics. Sensitivity analysis confirmed the robustness of the model. Conclusions: In the UK, superior persistence with mirabegron compared to antimuscarinics is associated with lower resource use, fewer work hours lost, and an overall reduction in total costs. These data suggest that mirabegron provides clinical and economic benefits compared with antimuscarinics in management of OAB from a societal perspective. PUK12 Cost Per Responder Analysis of Sucrofferric Oxhydroxide Versus Sevelamer Carbonate in Patients on Hemodialysis in Europe Connolly M1, Kotsopoulos N2, Vrouchou P3, Dubois E3, Walpen S3 of Groningen, Groningen, The Netherlands, 2Global Market Access Solutions, SaintPrex, Switzerland, 3Vifor Fresenius Medical Care Renal Pharma, Glattbrugg, Switzerland 1University
Objectives: Sucroferric oxyhydroxide (SFOH) is a novel non calcium, iron based phosphate binder indicated for the control of serum phosphorus (sPhos) levels in adult chronic kidney disease (CKD) patients on hemodialysis (HD) or peritoneal dialysis (PD). A retrospective database analysis of SFOH among in-center HD patients who switched from sevelamer carbonate (SEV) to SFOH, showed that, after 6 months, patients switching from SEV with in-range sPhos (3.5-5.5 mg/dl) increased from 14.1% to 27.9% (98% increase) whilst pill burden decreased from 10.1 pills with SEV to 3.9 pills with SFOH suggesting lower cost per patient responding with SFOH. The objective of this study was to assess and compare the 6-monhtly cost per responder for SFOH versus SEV in Europe. Methods: Acquisition costs per pill of SFOH and SEV were estimated based on official list prices, weighted for local market shares. Treatment costs were estimated based on the observed daily pill intake, obtained from the retrospective data analysis. Number needed to treat (NNT) to achieve inrange sPhos (3.5-5.5 mg/dl) were estimated and subsequently the 6-monthly costs per responder were estimated for SFOH and SEV. Results: The estimated NNT was 3.6 and 7 for SFOH and SEV, respectively. SFOH consistently attained in-range sPhos (3.5-5.5 mg/dl) at a lower 6-monthly cost per patient compared to SEV. The 6-monthly cost per responder for SFOH and (SEV) were: Austria: € 4,511 (€ 23,319); France: € 3,699 (€ 13,416); Germany: € 4,194 (€ 17,279); Italy: € 4,755 (€ 14,054); Spain: € 3,503 (€ 15,307); UK € 6,355 (€ 25,381); Switzerland: € 7,612 (€ 25,258). SFOH appeared to attain in-range sPhos (3.5-5.5 mg/dl) with considerable 6-monthly cost-savings per patient responding ranging from € 9,299 (Italy) to € 19, 026 (UK). Conclusions: SFOH appears to have a favorable NNT and to attain the clinical target of in-range sPhos at a lower cost compared to SEV suggesting favorable cost-effectiveness. PUK13 Cost-Effectiveness of Combination Therapy with Dutasteride/ Tamsulosin: An Analysis Based on Conduct Trial Vallejo-Aparicio LA1, Miñana López B2, Brenes FJ3, Molero JM4, Fernández-Pro A5, Huerta A1, Cozar JM6 1GlaxoSmithKline, Tres Cantos (Madrid), Spain, 2Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain, 3CAP Badalona-6 Llefià Badalona, Barcelona, Spain, 4Centro de Salud San Andrés, Madrid, Spain, 5Centro de Salud de Menasalbas, Toledo, Spain, 6Hospital Universitario Virgen de las Nieves, Granada, Spain
Objectives: to estimate the Incremental Cost-Effectiveness Ratio (ICER) of dutasteride/tamsulosin combination therapy (DUT/TAM) vs. Watchful Waiting plus escalation to tamsulosin (WW+TAM) clinical practice, in treatment-naïve moderate Benign Prostatic Hyperplasia (BPH) patients from the Spanish National Healthcare System (NHS) perspective. Methods: This analysis was based on CONDUCT trial, which compared the symptomatic improvement of initial treatment with DUT/ TAM vs. WW+TAM on a 24-month period. A previously published markov model in BPH was modified to reflect specific CONDUCT trial design. Model structure has 9 health-states based on patient’s symptoms level, progression events and surgery occurrence, with two time-horizons, 2-year (CONDUCT study duration) and lifetime. Target population was treatment-naïve men ≥ 50 years old, with a moderate BPH diagnosis and at risk of progression; In the WW+TAM arm, only the group of patients who escalated to active treatment with tamsulosin at any moment of CONDUCT study duration (WW+TAM(Escalated)) was analyzed. Effectiveness was measured as Quality-Adjusted-Life-Years(QALYs), and utility data were obtained from a literature review. Resource use was based on Spanish common clinical practice. Unit direct costs (treatments, patient’s regular monitoring and complications management) were obtained from Spanish published data (€ 2015). A discount rate of 3% was applied for both costs and outcomes. Deterministic and ProbabilisticSensitivity-Analyses(PSA) were conducted to verify the robustness of the base-case results. Results: In the base-case, the ICERs were € 17,434 and € 21,234 from 2-year and lifetime-horizon respectively. Deterministic results ranged from € 13,945 up to € 20,924, and from € 13,749 up to € 25,518, in the 2-year and lifetime horizons analyses respectively. According to the PSA, the probability of DUT/TAM being cost-effective was 90% at a willingness to pay of € 30,000/QALY. Conclusions: DUT/TAM could be considered as a cost-effective alternative within the Spanish NHS as an initial treatment for BPH naïve moderate patients at risk of progression, compared with WW+TAM(Escalated) clinical practice. PUK14 Antibiotic Treatment of Uncomplicated Urinary Tract Infection In Women: A Comparative Cost-Effectiveness Study Sadler S1, Holmes M2, Holden S3, Sadler S4, Jha S4, Thokala P2 1Sheffield University, Sheffield, UK, 2University of Sheffield, Sheffield, UK, 3Nottingham University Hospital, Nottingham, UK, 4Sheffield Teaching Hospitals, Sheffield, UK
Objectives: Assess the relative cost-effectiveness of the three antibiotics recommended in England for first-line treatment of uncomplicated urinary tract infection