TRENDS IN COSTS FOR HEPATITIS C IN A SOUTHWESTERN POPULATION

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the private payer perspective.  Conclusions: The results suggest that VATS may provide an optimized allocation of resources, once complication and hospitalization costs may be reduced by this approach PMD23 COST-EFFECTIVENESS AND BUDGET IMPACT ANALYSIS ON THE USE OF CHLORHEXIDINE GLUCONATE SPONGE TO PREVENT INFECTIONS RELATED TO CENTRAL VENOUS CATHETER IN COLOMBIA Gamboa O 1, Gil A M 1, Lozano T 1, Leon E 1, Gamboa C 1, Fuentes J C 1, Andrade P C 2, Cabra H A 3, CortesCortés J 4 1Instituto para la Evaluación de la Calidad y la Atención en Salud (IECAS), Bogota, Colombia, 2Johnson & Johnson Medical, Bogota, Colombia, 3Johnson & Johnson Medical, México DF, Mexico, 4Universidad Nacional de Colombia, Bogota, Colombia .

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Objectives: Infections resulting from the use of central venous catheter (CVC) constitute a priority scenario, given the high incidence rates, their health effects, and the costs associated with their treatment.  Methods: Cost-effectiveness and budget impact analyzes were conducted, from the perspective of Colombian healthcare system, on the use of chlorhexidine gluconate sponge in preventing infections related to CVC, compared to standard practice. A decision model was designed which included infectious events associated to CVC (colonization, bacteremia and death). A one-year time horizon was used, including direct costs related to the device use and management of infectious events due to the use of CVC. Considered time horizon (less than one year), thus no annual discount rate was used. Incremental cost effectiveness ratio (ICER) was calculated and deterministic and probabilistic sensitivity analyzes were performed. For the budget impact analysis (BIA) a time horizon of three years was applied and two scenarios were constructed depending on the device market share (20%, 50% and 80% and 30%, 60% and 100%).  Results: The use of chlorhexidine gluconate sponge was the most effective strategy and also the least expensive option, dominating standard practice. According to the cost-effectiveness analysis, the device avoided 51 cases of infection, 269 cases of colonization and 9 deaths in ICU patients, in a period of 1 year. According to the results of the BIA, the median of savings ranged from 92,327 to 455,714 million Colombian pesos in a percentage of technology use in patients with CVC of 20% and 100% respectively.  Conclusions: Chlorhexidine gluconate sponge resulted in a dominant alternative from the perspective of Colombian healthcare system. It generates savings of resources due to the decrease in events of infections associated with the use of CVC. PMD24 TRENDS IN COSTS FOR HEPATITIS C IN A SOUTHWESTERN POPULATION Hollenbeak C 1, Rochat A 2, Turner B J 2 1Penn State University, Hershey, PA, USA, 2University of Texas Health Science Center, San Antonio, TX, USA .

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Objectives: Undiagnosed hepatitis C virus (HCV) infection is a serious public health issue in the United States, particularly among adults born between 1945 and 1965 (baby boomers). The Centers for Disease Control and Prevention (CDC) recommends that all baby boomers receive screening for HCV. Little is known about the trends in costs after these individuals are screened. The purpose of this study was to compare average cumulative costs between individuals with a positive HCV test relative to those with a negative HCV test in a cohort of baby boomers screened for HCV.  Methods: Data came from the electronic medical records and cost accounting database of a large, academic health care system in the Southwest. We included all patients in the health system screened between 01/01/05-06/01/15. Costs for all encounters with the health care system were then obtained for all years following screening, including emergency department visits, office visits, and inpatient visits. Prescription drug costs were not included. Costs were adjusted to 2014 US dollars and averaged on a monthly basis to account for censoring. Monthly averages were then accumulated.  Results: During the study period 3,860 baby boomers were screened for HCV. The population characteristics reflected the geographic location; they were largely female (54.8%) and Hispanic (71.7%). Of patients screened, 17% tested positive for HCV by PCR. Patients with a HCV+ tests had lower average cumulative costs up to one year ($2,170 vs. $4,124), but this difference shrank gradually (5-year: $9,120 vs. $9,745) and surpassed the costs of HCV- patients by nine years.  Conclusions: In a baby boomer population in the Southwest, the average cumulative costs of healthcare for patients who screen positive for HCV were not substantially different from those of patients who screen negative. These results may change if prescription drug costs were included and when chronic disease is identified. PMD25 COST-COMPARISON OF TWO TRABECULAR MICRO-BYPASS STENTS VERSUS SELECTIVE LASER TRABECULOPLASTY OR MEDICATIONS ONLY FOR INTRAOCULAR PRESSURE CONTROL FOR PATIENTS WITH OPEN-ANGLE GLAUCOMA Berdahl J P 1, Khatana A K 2, Katz L J 3, Herndon L 4, Layton A J 5, Yu T M 5, Bauer M J 6, Cantor L B 7 1Vance Thompson Vision, Sioux Falls, SD, USA, 2Cincinnati Eye Institute, Cincinnati, OH, USA, 3Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA, 4Duke Eye Center, Durham, NC, USA, 5Quorum Consulting, Inc, San Francisco, CA, USA, 6Glaukos Corporation, Laguna Hills, CA, USA, 7Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA .

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Objectives: Patients with open-angle glaucoma (OAG) whose intraocular pressure was not adequately controlled by one medication have several alternate treatment options. This analysis evaluated the direct costs in the US of unilateral eye treatment with two trabecular micro-bypass stents (two stents) compared to selective laser trabeculoplasty (SLT) or medications only over 5 years post-initiation.  Methods: A population-based, annual state-transition, probabilistic, cost-of-care model was used to assess OAG-related direct costs over 5 years. Patients were modeled to initiate treatment in year zero with two stents, SLT, or medications only. In years 1 through 5, patients could remain on initial treatment or move to another

treatment option(s), or filtration surgery. Treatment strategy change probabilities were identified by a clinician panel. Direct costs were included for drugs, procedures, and complications.  Results: The projected average cumulative cost at 5 years was lower in the two-stent treatment arm ($4,024) compared to the SLT arm ($4,040) or medications only arm ($5,066). Initial year zero costs were higher with two stents ($2,674) than with SLT ($829) or medications only ($806). Average marginal annual costs in years 1 through 5 were $270 for two stents, $642 for SLT, and $852 for medications only. The cumulative costs difference between two stents versus SLT or medications only decreased over time, with breakeven by 5 or 3 years post-initiation, respectively. By year 5, cumulative savings with two stents over SLT or medications only was $16 or $1,042, respectively.  Conclusions: Despite higher costs in year zero, annual costs thereafter were lowest in the two-stent treatment arm. Five-year cumulative costs in the two-stent treatment arm were approximately equivalent to the SLT arm, and showed savings compared to the medications only arm. Two-stent treatment may reduce OAG-related health resource use, leading to direct savings, especially over medications only or at longer time horizons. PMD26 COMPARABLE ANALYSIS OF PRICES FOR THE FINAL RESTORATIVE STAGE OF DENTAL IMPLANTATION IN UKRAINE Got S , Uhryn M , Zaliskyy O , Zaliska O Danylo Halytsky Lviv National Medical University, Lviv, Ukraine .

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Objectives: Althought, dental implantation is an expensive treatment, it significantly improves the quality of patients’ life. With the new esthetic standards in implant dentistry, it is important that new techniques be developed to meet increasing demands. We conducted our research to study the best price-quality relationship for dental implant suprastructures (abutments and crowns) made of different materials.The objective of the present study was to analyze and compare prices for the final stage of dental implantation depending on the material of dental abutment and crown at seven private dental clinics in Ukraine.  Methods: We compared and analyzed the costs of the final stage of dental implantation which was conducted in 7 private dental clinics in Ukraine during the period of 6 month (1 June 2015 – 30 November 2015). For that purpose we selected five leading manufacturers which produce dental abutments and crowns. Prices for the technologies and materials were set by the Administration of each Dental clinic. Statistical analysis of the costs was performed by a computer program x7 2009.  Results: The prices for the final stage of implantation in private dental clinics were used for the comparative cost calculation of technologies with implant suprastructures made of four different materials: zirconia, titanium, titanium nitride and PEEK. According to our research the most accessible on costs and widespread technology was conducted with titanium. Ukrainian patients pay out-of-pocket for dental implantation and the main task of stakeholders is to provide the most effective services.  Conclusions: The most expensive was the final stage of implantation with zirconia abutments and crowns (p < 0,5) and the most accessible on costs and widespread technology was conducted with titanium implant suprastrucutures (p < 0,001). Also we revealed that patients in Ukraine were highly motivated to pay for dental implantation in order to get the best esthetical result. PMD27 A PROPENSITY SCORE MATCHED COMPARISON OF TRANSFUSION RISK AND DISCHARGE DESTINATION FOLLOWING PRIMARY TOTAL HIP ARTHROPLASTY WITH A SALINE-COUPLED BIPOLAR SEALER Nichols C I , Kimball C C , Vose J G Medtronic Advanced Energy, Portsmouth, NH, USA .

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Objectives: This retrospective matched cohort study evaluated clinical and cost outcomes among patients undergoing primary total hip arthroplasty (THA) with vs. without use of a saline-coupled bipolar sealer (SCBS).  Methods: Using the MedAssets Research Services™ database, two cohorts were identified: THA with SCBS (Cases), THA without SCBS (Controls). Patients were > 18 years old, undergoing primary THA, without fracture of the lower limb, and with continuous health plan enrollment over the study period. Each Case patient was matched to three Controls using an exact propensity score matching algorithm. Covariates included: age group, gender, coexisting clinical characteristics (i.e. Charlson score and obesity); hospital size, hospital teaching status, and geographic region.  Results: Post-match, there were 1,967 Cases and 5,901 Controls for analysis. Patients were predominantly female, with mean age of 64 years. Incidence of transfusion was significantly lower in the Case cohort (3.0% vs. 4.5%, P= 0.005); use of tranexamic acid (TXA) was also greater in the Case cohort (24.3% vs. 17.7%, P< 0.001). Transfusions were significantly lower among patients without TXA use in the Case cohort vs. Controls (3.1% vs. 5.2%, P= 0.001). Mean length of stay was significantly shorter in in the Case cohort (3.8 vs. 4.1 days, P< 0.001), and Cases were 17.3% more likely to be discharged home with no home health services versus Controls (35.3% vs. 18.0%, P< .001). Mean total index hospitalization costs (SD) for the Case and Control cohorts were $18,319 ($8,456) and $17,033 ($7,971), P =  .004, respectively.  Conclusions: Use of SBCS was associated with a significant reduction in transfusion and increased proportion of patients discharged home. While hospitalization cost was significantly higher in the Case cohort, total episode cost is mitigated by the greater proportion of patients discharged home. In the current era of Medicare bundled payments future research on post-discharge costs of care is warranted. PMD28 COSTING OF ADA-RECOMMENDED SELF-MONITORING OF BLOOD GLUCOSE: EARLY RESULTS FROM A NORTHERN INDIAN CITY COUPLET Deshwal S , Barola A , Tiwari P National Institute of Pharmaceutical Education and Research (NIPER), S.A.S. Nagar (Mohali), Punjab, India .

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Objectives: Self monitoring of blood glucose (SMBG) is vital in management of diabetes. American Diabetes Association’s 2016 Standards of Medical Care in Diabetes recommends as many as 6-10 times daily SMBG for patients on intensive insulin