Drug-Safety Program Impact In The Emergency Frequency At Patients With Persistent Severe Asthma

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potential anti-fibrotic efficacy through induction of Nrf2 which in turn modulated anti-inflammatory molecules to reduce pathogenesis of BLM-induced pulmonary fibrosis. PRS2 Drug-Safety Program Impact In Hospitalization Persistent Severe Asthma Patients Estrada JI1, Restrepo AM1, Giraldo PA1, Abad JM2, Serna JA1, Segura AM3 IPS, Medellin, Colombia, 2SURA EPS, Medellin, Colombia, 3CES University, Medellin, Colombia

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Introduction: persistent severe asthma represent a high cost to health system. Among patients with asthma, represent more than 50% of health’s care spend. This outcome is mainly due to high frequency at use of hospitalizations and urgencies. In one year, the patient’s proportion that use those services could be more than 52%.  Objectives: Determine the impact generated by a drug-safety program on the hospitalization of the target population.  Methods: Paired samples study (1 year before and after). Recruitment period was between May 2013 and June 2015 in Antioquia, Valle, Atlantico and Cundinamarca. Population was diagnosed with persistent severe asthma; they started pharmacological treatment with Omalizumab and education every month by a pharmacist from a drug-safety program (post-test). Education was focus on medication correct use and pharmacological adherence importance. Dependent variables were hospitalization proportion and hospitalization rate. Absolute and relative frequencies were used, summary measure (central tendency, scatter and position). Normality test were performed (Kolmogorov-Smirnov) and association test (t-Wilcoxon y McNemar). Confidence interval 95% and standard error 5% were used.  Results: The evaluated population (n: 237) predominated for being adherent (85%), use correctly medication (90%), women gender (70%), adults (36 [IR 19-54] years), workers (37%) or students (27%), with low schooling level (77% ≤  high school) and low socio-economic level (85% ≤  3), from urban area (95%) from Antioquia department (91%). 14.8% presented at least 1 hospitalization before and 8% after (P-value: 0.008). Hospitalizations number per each 100 patients was 21 before and 12 after (P-value: 0.012).  Conclusions: Ensuring the correct usage and sufficient adherence of Omalizumab contributed to decrease of hospitalization frequency and rate. PRS3 Drug-Safety Program Impact In The Emergency Frequency At Patients With Persistent Severe Asthma Estrada JI1, Restrepo AM1, Giraldo PA1, Serna JA1, Abad JM2, Segura AM3 IPS, Medellin, Colombia, 2SURA EPS, Medellin, Colombia, 3CES University, Medellin, Colombia

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Objectives: Determining the impact generated by a drug-safety program on the emergency frequency of the target population.  Methods: A paired samples study was conducted (1 year before and after). The recruitment period was between May 2013 and June 2015 in Antioquia, Valle, Atlántico and Cundinamarca. The population was diagnosed with persistent severe asthma. They started a pharmacological treatment with Omalizumab and education courses every month from a pharmacist of the drug-safety program (post-test). This Education was focused at proper medication usage and the importance of pharmacological adherence. Dependent variables were emergency proportion and emergency rate (number activities per each 100 patients). Absolute and relative frequencies were used, summary measure (central tendency, scatter and position). Normality test were performed (Kolmogorov-Smirnov) and association test (t-Wilcoxon y McNemar). Confidence interval 95% and standard error 5% were used.  Results: The evaluated population (n: 237) predominated for being adherent (85%), use medication correctly (90%), adults (36 [IR 19-54] years), workers (37%) or students (27%), with low schooling level (77% ≤  high school) and low socio-economic level (85% ≤  3), from urban area (95%) from Antioquia department (91%). The 21% of patients had at least 1 emergency before and 14% after (p value: 0.045). Emergencies number per each 100 patients were 40 before and 24 after (p value: 0.04).  Conclusions: Ensuring the correct usage and sufficient adherence of Omalizumab can contributed to the decrease proportion and emergencies rate of patients that assisted to emergencies service by asthma associated causes.

RESPIRATORY-RELATED DISORDERS – Cost Studies PRS5 Estimating the Financial Impact of Introducing Glycopyrronium Bromide in the Treatment of Chronic Obstructive Pulmonary Disease (Copd) From the Perspective of Public Payer of São Paulo (Sp) – Brazil Suzuki C, Lopes N Novartis Biociências SA, Sao Paulo, Brazil

Objectives: To evaluate the financial impact of including glycopyrronium bromide for the treatment of COPD patients from the perspective of the Public Pharmaceutical Assistance Program of SP State, over five years.  Methods: An Excel-based model was developed to estimate the investment required for the inclusion of glycopyrronium, as an additional alternative of long-acting anticholinergic (LAMA) therapy in SP, by comparing two scenarios: “without-glycopyrronium” versus “with-glycopyrronium”. The eligible population was based on the estimate of patients currently receiving tiotropium, the only LAMA available in this program. The annual growth rate of 4% was adopted based on the tiotropium acquisition from SP in the last two years. A gradual penetration of glycopyrronium was assumed: 10%, 15%, 20%, 25%, 30%. Only drug costs were considered: BRL3.10 per capsule of tiotropium and BRL5.08 per unit of glycopyrronium (1BRL= 0,32USD; 30/ Jan/2017). No annual discount rate was applied in the base case scenario. To test the uncertainties, other scenarios were evaluated: glycopyrronium cost (+10%), glycopyrronium uptake (5% below and above the rate adopted in the base case) and an

annual discount rate of 5%.  Results: According to the drug prices registries, the State contract of tiotropium bromide considers the total of 29,082,295 doses to be acquired during 2017. Based on the recommended dosage of tiotropium, this total amount is equivalent to one year of treatment of approximately 40,392 patients with COPD. The base case results showed a potential savings which can reach BRL19 million in 5 years or BRL4 million per year. In all scenarios tested in the sensitivity analysis, the introduction of glycopyrronium into the public health system of SP generated cumulative savings of at least BRL10 million in 5 years or BRL2 million annually.  Conclusions: The introduction of glycopyrronium could generate savings for this health system, equivalent to 10,252 additional patients could be treated with glycopyrronium in 5 years. PRS6 Budget Impact Analysis of Indacaterol/Glycopyrronium in the Treatment of Chronic Obstructive Pulmonary Disease (Copd) in Colombia Patino A1, Karpf E1, Londoño D2 1Novartis Colombia, Bogota, Colombia, 2Fundacion Santa Fe de Bogota, Bogota, Colombia

Objectives: To conduct an analysis of the budget impact switching Chronic obstructive pulmonary disease (COPD) patients to indacaterol/glycopyrronium.  Methods: A budget impact model was developed to compare costs with and without the introduction of indacaterol/glycopyrronium to the Health Benefit Plan for treatment of COPD patients. This analysis was developed from the adaptation of the results of a cost-effectiveness model for indacaterol/glycopyrronium. The impact of indacaterol/glycopyrronium use was estimated for a time horizon of five years of inclusion into the benefits plan.  Results: Total cumulative budget impact in pesos (COP) when including indacaterol/glycopyrronium within the benefits plan for treatment of COPD patients generates savings of COP $15,072,064,821, which represents savings of 0.04% on 2017 UPC (Capitation Payment Unit). On the other hand, the use of indacaterol/glycopyrronium represents savings of $1,898,016,167 (7.18% of the scenario without indacaterol/ glycopyrronium) regarding costs of pneumonia given by 389 pneumonia events avoided. Exacerbation costs are reduced in $3,287,567,467 (3,8% of the scenario without indacaterol/glycopyrronium) given by a reduction of 19,019 non-severe exacerbations and 792 severe exacerbations. The budget impact of drug costs is $9,887,071,187. Conclusions: Inclusion of indacaterol/glycopyrronium in the benefits plan results in 389 avoided pneumonias, 19,019 avoided non-severe exacerbations and 792 avoided severe exacerbations over 5 years, translating to savings of $15,072,064,821, which produce a total cumulative budget impact of 0.04% of the UPC. The switch to indacaterol/glycopyrronium reduces the costs of exacerbations and pneumonia in the context of the Colombian healthcare system which represents a better quality of life for COPD patients, and a continuous improvement in health results regarding COPD. PRS7 Quality of Life and Economic Burden Among Chronic Obstructive Pulmonary Disease (Copd) Patients in Japan Kubota K1, Igarashi A2, Saito Y3, Oyamada M4, Miyata T4 1Yokohama City University, Yokohama, Japan, 2University of Tokyo, Tokyo, Japan, 3Kyoto University School of Public Health, Kyoto, Japan, 4Health and Global Policy Institute, Tokyo, Japan

Objectives: Chronic Obstructive Pulmonary Disease (COPD) is known to have a devastating disease burden on patients. Previous researches indicates that increased severity of COPD is associated with deterioration of quality of life (QOL), but few studies had been conducted for the association between COPD severity and QOL as well as the economic burdens. This study aims to investigate the association between COPD severity and QOL, and to estimate the economic burden on COPD among Japanese people.  Methods: A web-based survey was conducted in July 2013 among registered monitors of a survey company. 1,354 respondents were enrolled (diagnosed COPD group were 315, potential-diagnosed COPD were 519, and non-diagnosed COPD were 520). 109 respondents were excluded because of contradicting answer, leaving 1,245 effective respondents. A multiple regression analysis was conducted to assess the association between the COPD status (i.e., diagnosed vs non-diagnosed, and potential-diagnosed vs non-diagnosed) and demographic characteristics (i.e., gender and age), QOL scores (measured by EQ-5D), as well as comorbidities (i.e., cancer, stroke, heart diseases, and depression). Perpatient medical care expense and productivity losses due to COPD (both absenteeism and presenteeism ) are also captured to estimate overall economic burden with COPD.  Results: Mean QOL score for diagnosed and non-diagnosed group were 0.81 and 0.91. Mean medical care expence per patient were JPY63,252. Multiple regression analysis showed that diagnosed COPD was negatively related to QOL scores after adjusting for demographic characteristics and medical history (β  =  -0.067, p =  0.02). The total amount of medical cost for COPD patients were JPY167bil. (USD1.5bil.) and JPY123bil. was accounted for the productivity lost, summing up a total loss of JPY289.9bil.  Conclusions: COPD is associated with low QOL among Japanese people, and casting an economic burden of around 300 billion yen. These results suggest that COPD’s policy-level control in Japan is needed to promote like Western countries. PRS8 Análise De Custo-Efetividade Do Tratamento Diretamente Observado Da Tuberculose Gomes MP1, Nunes AA2, Sarti FM3, Ruffino Netto A1 1Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, Brazil, 2University of São Paulo, Ribeirão Preto, Brazil, 3University od São Paulo, São Paulo, Brazil

Objectives: Conduzir uma análise custo-efetividade de tratamento diretamente observado (TDO) da tuberculose, comparando estratégias de tratamento sob perspectiva da sociedade.  Methods: Avaliação econômica completa do tratamento de pacientes com tuberculose via administração de medicamentos com acompanhamento de visitador sanitário (VS), contemplando microcusteio parcial por meio