ORITAVANCIN IS ASSOCIATED WITH IMPROVED ECONOMIC OUTCOMES VERSUS DALBAVANCE IN PATIENTS WITH ACUTE BACTERIAL SKIN AND SKIN STRUCTURE INFECTIONS TREATED IN A HOSPITAL OPAT SETTING: RESULTS FROM AN OBSERVATIONAL DATABASE

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developed to estimate costs for antiretroviral drugs, adverse event management, and HIV care for individuals initiating first-line therapy. Head-to-head efficacy and safety data (discontinuation rates, mean CD4+ cell-count changes, adverse event incidence) up to 96 weeks for RAL, ATV/r, and DRV/r were obtained from the ACTG 5257 clinical trial. Antiretroviral drug costs were based on wholesale acquisition costs. Adverse event management costs and HIV care costs, stratified by CD4+cellcount range, were obtained from published sources and inflated to 2014 US dollars. Outcomes were discounted at 3.0% per year. Probabilistic sensitivity analysis (PSA) and scenario analyses were conducted.  Results: At 96 weeks, RAL was associated with lower antiretroviral drug costs and adverse event costs and similar HIV care costs when compared with either ATV/r or DRV/r. Total costs were $70,121 for RAL, $76,829 for ATV/r, and $76,148 for DRV/r. The PSA showed that the 95% confidence interval for the mean total cost of RAL was lower than and did not overlap with those of ATV/r or DRV/r. Scenario analyses found RAL to have the lowest cost over a range of modeling assumptions.  Conclusions: RAL has the lowest per-person cost compared with two other common first-line regimens, DRV/r and ATV/r, each used in combination with TDF/FTC, for treatment-naive adults with HIV-1 infection in the US. These results were found to be robust in sensitivity and scenario analyses. This economic evidence further complements the known clinical benefits of RAL as reported in the ACTG 5257 clinical trial. PIN20 DIRECT ECONOMIC BURDEN AND OUTCOMES AMONG PATIENTS WITH CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII INFECTION OR COLONIZATION Huang W 1, Zong Z 1, Qiao F 1, Chen Y 2, Yin W 1, Dong P 2, Lin J 1 1West China Hospital, Sichuan University, Chengdu, China, 2Pfizer Investment Co., Ltd., Beijing, China .

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Objectives: Carbapenem-resistant Acinetobacter baumannii (CRAB) is one of the most common multidrug resistant bacteria in China, causing significant problems in many hospitals, especially in intensive care units (ICU). This studies aims to evaluate the direct hospitalization costs, length of stay (LOS) and mortality among patients with CRAB infection or colonization in a 50-bed general ICU of a 4300-bed teaching hospital in China.  Methods: A matched case-control (1:1) study was conducted to compare the differences in economic costs and outcomes between patients with CRAB infection or colonization and those without CRAB from 2012 to 2014. Case and control patients were matched on the basis of age, the principal diagnosis and APACHE II score. A subgroup analysis for patients with CRAB bacteremia was also performed. Between-group differences were tested using the non-parametric Wilcoxon signed-rank test.  Results: A total of 301 (60.08%) of 501 eligible patients were identified for the study and matched with appropriate control patients. The mortality for cases and controls were 27.24% and 14.29%, respectively (P< 0.001). Compared with control group, case group had significantly longer LOS (37 vs 21 days; P< 0.001), longer length of ICU stay (25 vs 11 days; P< 0.001), higher total hospitalization costs (RMB 168,217.54 vs 77,870.50; P< 0.001) and higher out-of-pocket costs (RMB 121,861.19 vs 48,501.22; P< 0.001). In the subgroup analysis, the case subgroup had significantly higher mortality (36.36% vs 9.09%, P= 0.02), longer length of ICU stay (21 vs 12 days; P= 0.02), higher total hospitalization costs (RMB 231,010.55 vs 124,091.91; P< 0.01) and higher out-of-pocket costs (RMB 163,892.74 vs 77,286.03; P< 0.01) compared with its controls.  Conclusions: Patients with CRAB infection or colonization may pose significant burden on current Chinese healthcare system, as it is associated with higher mortality, longer hospital stay and more costs than those without CRAB. PIN21 DIRECT INPATIENT COSTS OF INTRA-ABDOMINAL INFECTIONS IN A TEACHING HOSPITAL IN CHINA Zhen X, Dong H Zhejiang Univerisity, Hangzhou, China .

Objectives: In recent years, there has been a worldwide increase in infections caused by antimicrobial resistant pathogens, also has been observed among intraabdominal infections (IAIs). Our objective was to compare the direct inpatient costs of antimicrobial resistance in intra-abdominal infections.  Methods: The hospital records of 78 inpatients who diagnosed with IAIs, were randomly and retrospectively reviewed in a teaching hospital in Zhejiang province in China in 2015. We obtained length of stay (LOS), demographic data, intensive care unit (ICU) stay, antimicrobial agents, and total and specific direct inpatient costs. We divided into three groups according to the situation of pathological examinations: no inspection, inspection before initial antimicrobial agents, and inspection after initial antimicrobial agents.  Results: There were 19 inpatients without pathological examination, 16 inpatients with inspection before initial antimicrobial agents, and 35 inpatients with inspection after antimicrobial agents. The median LOS was shorter for no inspection (8.0 days) and inspection before initial antimicrobial agents (13.0 days) and inspection after initial antimicrobial agents (16.5 days). For total costs and antimicrobial costs, the inpatients with inspection after initial antimicrobial agents had higher economic burden (P< 0.01).  Conclusions: This was a major concern that antimicrobial resistance resulted in huge costs to individuals and society. And we have to increase the rate of inspection before initial antimicrobial agents. PIN22 ORITAVANCIN IS ASSOCIATED WITH IMPROVED ECONOMIC OUTCOMES VERSUS DALBAVANCE IN PATIENTS WITH ACUTE BACTERIAL SKIN AND SKIN STRUCTURE INFECTIONS TREATED IN A HOSPITAL OPAT SETTING: RESULTS FROM AN OBSERVATIONAL DATABASE Fan W , Armstrong S , Plent S The Medicines Company, Parsippany, NJ, USA .

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Objectives: Traditionally, acute bacterial skin and skin structure infection (ABSSSI) patients have been admitted to the hospital in order to receive 7-10 days of IV antibiotic therapy at a cost to hospitals of $7000-$10,000. Newer antibiotics such as

once-only oritavancin and once-weekly dalbavancin facilitate treatment of many patients in the Outpatient Parenteral Antimicrobial Therapy (OPAT) setting. The objective of this analysis was to assess the costs, from a hospital perspective, of treating ABSSSI at the OPAT setting with either oritavancin or dalbavancin.  Methods: The Premier Research Database was used to identify all patients treated for ABSSSI who received at least one dose of oritavancin or dalbavancin in the outpatient setting between July 1, 2014 and June 30, 2015. ABSSSI was identified through ICD-9 codes; patients who had infections other than ABSSSI were excluded. Due to the lag in new drug data entry, drug costs for oritavancin and dalbavancin were not available for all hospitals; a standard WAC of $2,900 was applied for oritavancin patients, $4960 for two doses of dalbavancin and $2,980 for one dose. All other costs were from ABSSSI Premier cost data. Charlson comorbidity score (CCI) was calculated from ICD-9 data.  Results: A total of 95 oritavancin and 89 dalbavancin outpatients were identified. Oritavancin patients had a mean CCI score of 1.85 compared to 1.55 for dalbavancin but were younger (51.1 vs 55.4 years old). 68.5% of dalbavancin patients received both doses. Total costs for oritavancin patients were 34% lower, $3,283 vs. $4,983. Excluding drug costs, costs of drug administration and other services were also lower for oritavancin, $383 vs. $914.  Conclusions: This analysis suggests that cost of outpatient ABSSSI treatment is lower than previously published costs for inpatient treatment. Further, treatment with oritavancin is less expensive than dalbavancin. PIN23 ECONOMIC IMPACT OF MULTI-MORBIDITY IN COMMUNITY-ACQUIRED PNEUMONIA: EXPERIENCE IN ARGENTINA Giglio N 1, Micone P 2, Fernandez F 3, Peralta M 3 1Hospital de Ninos Ricardo Gutierrez Ciudad de Buenos Aires Argentina, Buenos Aires, Argentina, 2Hospital Carlos Durand Ciudad de Buenos Aires Argentina, Buenos Aires, Argentina, 3AudiRED SRL, Buenos Aires, Argentina .

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Objectives: In terms of probability to suffer all cause community-acquired pneumonia (CAP), rates in immunocompetent persons with multi-morbidity (MM), defined as the presence of ≥ 1at-risk (AR) conditions , such as chronic cardiovascular and/or respiratory diseases, diabetes, etc., were generally similar than rates in immunocompromised persons high-risk (HR) conditions, according to the Advisory Committee on Immunization Practices (ACIP) definitions. The objective of this study is to compare the mean costs of CAP between adults ≥ 50 years≥ 1at-risk (AR) conditions and subjects without risk conditions or high-risk (HR) conditions.  Methods: Direct medical costs were assessed. Resources utilization from inpatients all causes CAP were obtained from an Argentinean health insurance database by searching for ICD-10 (January 1st-2010-December 31st, 2014). Results are presented in US dollars, (exchange rate of 1 US$= 8.70 Argentine pesos February 2015). The mean differences in cost between CAP and the 95% confidence interval were generated across 10.000 bootstrap. Evaluation of the differences in the average cost and determination of the likely to have occurred by chance was reported by different models.  Results: The estimated mean costs associated with CAP in patients without risk factors (n= 737), with 1 AR conditions (n= 687), with 2 AR conditions (n= 504), with ≥ 3 AR conditions (n= 232), and with HR conditions(n= 66); were USD 3.966,25 (CI 3.642,454.290,04); USD 4.711,27 (CI 4.263,79-5.158,74); USD 5.075,30 (CI 4.540,42-5.610,23); USD 5.715,14 (CI 4.826,77- 6.603,51); and USD 4.663,99 (CI 3.501,63- 5.826,3), respectively.  Conclusions: Significant cost differences were found between subjects without risk factors and those with ≥  2 AR conditions. The co-occurrence of AR conditions, has been associated with a significant increase in CAP costs (1AR<  2AR<  ≥ 3AR). Our results demonstrated that prevention and early treatment for CAP might reduce the highest cost not only in immunocompromised patients (HR) but also in adult subjects (≥ 50y) with MM. PIN24 ECONOMIC IMPACT OF HEALTH CARE RESOURCE UTILIZATION PATTERN AMONG PATIENTS DIAGNOSED WITH GENITAL WARTS IN PANAMÁ (EDGE STUDY) Pascale J 1, Lutz M 2, Rosado-Buzzo A A 3, Garcia-Molliendo L 3, Navarro R 3, Luna-Casas G 3, Cedraro S 4, Monsanto H 5, Lozano F 6 1Gorgas Memorial Institute for Health Studies, panama, Panama, 2MSD Caribbean Region, San José, Costa Rica, 3Links and Links, Mexico City, Mexico, 4MSD Central America and Dominican Republic, Costa del Este, Panama, 5Merck & Co., Carolina, PR, Puerto Rico, 6MSD Caribbean Region, Carolina, PR, Puerto Rico .

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Objectives: Genital warts (GW) cause significant psychological morbidity and substantial healthcare costs. There is no published data regarding costs of GW in Panamá. The objective of this study was to describe the patterns of healthcare resource utilization (PHRU) and associated costs in males and females with GW in Panama.  Methods: We undertook a descriptive study that used a series of questions in a Delphi panel to establish consensus on the PHRUs of GW in Panama. The panel consisted of 12 experts (gynecologists, urologists and dermatologists) from the Social Security health system in Panama. The implementation took 5 weeks, during which the panel members received and responded to a structured questionnaire during the first round; received and reviewed data aggregated from all the responses; and responded once more to the questionnaire during a second round. The questionnaire was based on a series of questions about the resources used in the treatment of GW, taking into account demographic data, diagnostic tests, treatment options, clinical guidelines, adverse events and complications of the current treatments, and number of outpatient visits. The questionnaire was developed from previously published studies that used a similar methodology. The costs for treatment and care (in US dollars, 2015) were obtained from the public oncology hospital, “Instituto Oncológico Nacional” and from the non-profit health clinic, “Asociación Panameña para el Planeamiento de la Familia”.  Results: In females the cost per episode of GW was $466.76. The highest costs were seen in laboratory exams ($282.32) and in pharmacological treatment ($166.03). In males the cost per episode was $365.89. The highest costs were also obtained in laboratory exams ($188.93) and in pharmacological treatment ($163.40).  Conclusions: These findings underscore the importance of implementing public health