Budget Impact Analysis of Enstilar® for The Treatment of Psoriasis In Italy

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VA L U E I N H E A LT H 2 0 ( 2 0 1 7 ) A 3 9 9 – A 8 1 1

Chronic plaque shows maximum frequency and topical steroids and Antihistamines were broadly prescribed medications. PSS7 Acne Vulgaris: Prevalence, Clinical forms and its Management in Pharmacy Students from Bahawalpur, Pakistan Rasool F1, Khan HM2, Waheed A2, Akhtar N3 1THE UNIVERSITY OF THE PUNJAB, LAHORE. PUNJAB, Pakistan, 2Islamia University Bahawalpur, The Islamia University of Bahawalpur, Pakistan, 3The Islamia University of Bahawalpur, Bahawalpur, Pakistan

Objectives: Acne is a common skin disorder, commonly prevalent in younger adults and characterized with papules, cysts and skin scar. Acne is often reported to result in psychological distress, low self-esteem and reduced quality of life. The prevalence and management of acne varies among countries according to gender, ethnicity and age group mostly due to hereditary causes, social behaviors, and environmental factors. The data on acne prevalence, distribution of clinical forms of acne in Pakistan is still limited. There is a need to its study prevalence, sociodemographic factors and gender preference associated with management of acne in local population. To determine prevalence and distribution of clinical forms of acne among students of pharmacy at Islamia University of Bahawalpur, Pakistan. Further, to explore a relationship between its prevalence sociodemographic factors, geographical location and life style.  Methods: A cross sectional study was conducted on students in Pharmacy department the Islamia University of Bahawalpur. A self-administered questionnaire was administered to a representative number of students representing the whole population.  Results: Overall, 83.45% were females aged 20-25 years. Individuals with oily skin type were most likely affected (62%) with acne while 80% of participants affected by some form of acne. In our sample mild (55.8 %), moderate (28.5 %) papular-pustular and severe comedonal (4%) were most prevent affecting mostly the face. Only 2.4% had sought doctors’ advice, and 18.4% tried some form of medical treatment, out of which 1 1.7% used topical treatment and 6.7% used oral treatment.  Conclusions: Our study found that acne and its associated complications are highly prevalent in younger adults in Bahawalpur, Pakistan. While, only third of participants sought medical help, and lack of preference or knowledge to treat the illness. These findings emphasize the need of educating the local youth and improve their awareness about acne treatments. PSS8 Prognostic and Treatment Effect Modifying Baseline Factors for Visual Functioning Response in Non-Infectious Uveitis of the Posterior Segment Treated with Intravitreal Sirolimus Lescrauwaet B1, Miserocchi E2, Duchateau L3, Thurau S4 1Xintera Ltd, Cambridge, UK, 2San Raffaele Scientific Institute, Milan, Italy, 3Ghent University, Merelbeke, Belgium, 4Ludwig-Maximilians-Universität München, Munich, Germany

Objectives: Studying prognostic and treatment effect modifying variables permits targeting interventions towards high-risk groups. We explored the prognostic effect of baseline characteristics on visual functioning response (VFR) and effect modification in subgroups differentiated by baseline characteristics of SAKURA Study 1 subjects with active non-infectious uveitis of the posterior segment (NIU-PS).  Methods: Phase 3 SAKURA Study 1 randomized 347 subjects 1:1:1 to intravitreal sirolimus doses of 44 μ g, 440 μ g, or 880 μ g, administered on Days 1, 60, and 120. Based on principal component analysis, the most relevant visual function (VF) measures from the National Eye Institute Visual Function Questionnaire and best-corrected visual acuity variable were selected. Subjects were defined as a VF responder if their response at month 5 on any of the selected VF measures exceeded the threshold for minimal important difference. The effect of prognostic and treatment effect modifying categorical baseline variables on VFR was tested using univariate logistic regression.  Results: Baseline characteristics with positive prognostic value for VFR included non-panuveitis (P= 0.003), unilaterality (P= 0.028), non-white (P= 0.020), and idiopathic etiology (P= 0.032). VFR rate difference between the 440 µg and 44 µg group were 18.3% in the non-panuveitis versus -16.5% in the panuveitis subgroup (P= 0.029), 33.4% in the unilateral versus -5.1% in the bilateral subgroup (P= 0.018), and 14.5% in the non-white versus 1.1% in the white subgroup (P= 0.011).  Conclusions: This exploratory analysis revealed non-panuveitis, unilateral manifestation, idiopathic NIU-PS and non-white race to have positive prognostic value. The effect of sirolimus 440 μ g on VFR differed in subgroups with positive compared to poor prognosis defined by race, anatomic location and laterality of NIU-PS.

SENSORY SYSTEMS DISORDERS – Cost Studies PSS9 Budget Impact Analysis of Enstilar® for The Treatment of Psoriasis In Italy Lanati EP, Orlando VL MA Provider Srl, Milano, Italy

Objectives: The objective of this study was to perform a Budget Impact Analysis (BIA) assessing the introduction of Enstilar® for the treatment of psoriasis into the Italian market. Enstilar® is a fixed combination foam (calcipotriene and betamethasone dipropionate) approved for the treatment of psoriasis vulgaris in adult patients. The Standard of Care is Dovobet® Gel, indicated for the topical treatment of mild to moderate psoriasis.  Methods: BIA compared two different scenarios: Scenario 1 without the fixed combination foam vs. Scenario 2 with the introduction of Enstilar®. Population data were obtained from IMS database and OsMed report 2015. The time horizon was 3 years from the introduction of Enstilar®. Total number of patients was the same for the two Scenarios, because the model allows the switch of patients from current treatments: Dovobet® Gel, mono-component therapies, topical corticosteroids and systemic therapies (DMARDs and Biologics). The

perspective of the Italian National Healthcare Service was considered.  Results: The study showed that the introduction of Enstilar®, thanks to its incremental efficacy and shorter therapy cycle compared to other topical agents (4 weeks with Enstilar® compared to 8 weeks with Dovobet® Gel), generates savings for the Italian NHS equal to 4.926.537 € , 5.076.094 €  and 6.465.717 €  respectively in year 1, 2 and 3 over the total expenditure of 215.254.963 € , 224.089.975 €  and 232.924.987 €  related to the year 1, 2 and 3 in the first scenario.  Conclusions: The present study indicates that the introduction of Enstilar® improves the adherence to the therapy thanks to its rapid onset of action and generates significant savings for the Italian NHS. Indeed, because of its incremental efficacy, Enstilar may reduce or delay the use – sometimes inappropriate – of systemic therapies. PSS10 The Impact of The Rads Assessment: Can Fewer Injections With Intravitreal Aflibercept Translate To Lower Overall Treatment Burden and Costs In Wamd When Compared With Intravitreal Ranibizumab? Eriksson M1, Hagelund L2, Olsen J2, Heemstra H3, Carrasco J3 1Bayer AB, Solna, Sweden, 2Incentive A/S, Holte, Denmark, 3Bayer

Consumer Care AG, Basel,

Switzerland

Objectives: Intravitreal aflibercept (IVT-AFL) and ranibizumab have proven to be effective in treating neovascular age-related macular degeneration. Despite their effectiveness, debate is ongoing on how to maximize treatment outcomes while optimizing resource use. The Danish Council for the Use of Expensive Medicines (RADS) has concluded that, in the Danish setting, 17% fewer IVT-AFL injections than ranibizumab injections are required to reach similar treatment outcomes during first year of treatment. This study assessed, from the Danish perspective, the impact on the non-drug costs associated with different frequency for injections with IVTAFL and ranibizumab.  Methods: We performed an analysis applying the RADS guidelines. The analysis focused on healthcare resource use & direct healthcare costs. Administration costs in the hospital were estimated using national tariffs. Costs for preparation of medication from vials were taken into account.  Results: The 17% lower number of required injections for IVT-AFL translates to 6 injections for IVT-AFL in the first year compared to 7 injections for ranibizumab. The lower number of visits resulted in total costs of 8267 DKK for patients treated with IVT-AFL and 9530 DKK for ranibizumab treated patients. Costs for preparation of vials added 64 DKK for IVT-AFL in the first year. Costs for patients’ transport to the hospital were 3570 DKK for IVT-AFL compared to 4164 DKK for ranibizumab. Total non-drug cost savings for IVT-AFL treatment were 1794 DKK per patient in the first year.  Conclusions: For the same outcome, IVT-AFL was associated with a reduced treatment burden, fewer injections, and less use of resources in Denmark. The reduction in resource utilization resulted in lower non-drug costs compared to ranibizumab, a potential savings of 1794 DKK per patient treated. Impact on resource utilization with IVT-AFL may be considered in addition to the savings in drug costs of one fewer injection. PSS11 Cost-Effectiveness Comparison Between Biobrane and Suprathel for Partial Thickness Burn Treatment for Austria Wahler S1, Wurzer P2, Kamolz L2, Müller A3 1St. Bernward GmbH, Hamburg, Germany, 2Medical University of Graz, Graz, Austria, 3Analytic Services GmbH, München, Germany

Objectives: The current treatment of partial-thickness burns includes the wound coverage with many different materials and techniques. One is a polylactide-based temporary skin substitute (Suprathel®), another consist of porcine collagen type I and is a bi-layer, semi-permeable biosynthetic wound dressing (Biobrane®). Given limited resources and the up rise of evidence based decision making, there is little guidance about the costs, the cost-consequences and the cost-effectiveness of different coverage options of burn injuries. This study is comparing Biobrane and Suprathel for the cost situation in Austria in partial-thickness burn patients with a TBSA of 15%.  Methods: A literature review identified relevant publications about both covering methods and the health states in question. Those health states include successful healing, duration of healing, infected and non-infected delayed healing and necessity of surgery, pain, and number of dressing changes. Where applicable these health states were combined with cost data from Austria for the development of a decision tree model using Tree Age®. The model computed a point estimate for the C/E ratio for the treatment alternatives. In addition, the statistical error of the C/E and incremental cost-effectiveness ratio (ICER) was assessed by a probabilistic sensitivity analysis (PSA).  Results: The incremental cost-benefit ratio for Suprathel in comparison with Biobrane was negative for Austria. One way sensitivity analysis confirmed the robustness of the model. Thus, the use of Suprathel consumed less resources than the use of Biobrane. Drivers were the lower effort for additional dressings with Suprathel®, less analgesia, less use of the operation room and a shorter length of stay.  Conclusions: It could be demonstrated that Suprathel was cost-effective over Biobrane, given an Austrian grid of in-hospital costs. The study was limited due to the fact that only few micro costing data available for burns injuries in both countries. Thus, further research will be needed to confirm this result. PSS12 Cost Comparison of Licensed Intravitreal Therapies For Diabetic Macular Edema That Responds Insufficiently To Intravitreal AntiVegf – A German 3 Year Cost Model Neubauer AS1, Subert J2, Haritoglou C3, Ulbig MW4 1Institute for Health- and Pharmaeconomics (IfGPh), Muenchen, Germany, 2Alimera Sciences, Berlin, Germany, 3Eye Hospital Herzog-Carl-Theodor, Muenchen, Germany, 4Technical University Munich, Klinikum rechts der Isar, Muenchen, Germany

Objectives: In treating center-involving diabetic macular edema (DME), there are patients that will require intensive and still respond insufficiently to