The Comparative Pharmacoeconomic Analysis Of Using Absorb Bioresorbable Vascular Scaffold System For Patients With St Segment Elevation Myocardial Infarction (STEMI)

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adherence for 2+ medications; (3) trabeculectomy performed after two failed medications; 4) 25-year horizon.  Results: Across scenarios, incremental costs ranged from $1,679 (earlier trabeculectomy) to $2,215 (medication-usage only); incremental QALYs were 0.057 to 0.148. ICERs were $12,517/QALY (earlier trabeculectomy), $32,033/QALY (25-year horizon), $38,505/QALY (lower adherence), and $43,015/ QALY (COMPASS medication-benefit only). In univariate sensitivity analysis, model results were most sensitive to assumptions on medication use trends but remained robust.  Conclusions: Given results across likely real-world treatment scenarios, this analysis indicates a supraciliary microstent + cataract surgery may be costeffective to manage mild-to-moderate POAG in Canada. PMD77 Cost-Effectiveness of A Direct Aspiration First Pass Technique (ADAPT) For Thrombectomy Revascularization of Large Vessel Occlusion In Acute Ischemic Stroke (French Health Ministry Prme 16-0020) Soilly AL1, Kossi DS2, Leherle A1, Orng E1, Labreuche J3, Blanc R1, Piotin M1, Lapergue B4, Baffert S1 1Rothschild Foundation, Paris, France, 2Fondation Ophtalmologique Adolphe de Rothschild, Paris, France, 3University of Lille, Lille, France, 4Hôpital Foch, University Versailles Saint Quentin en Yvelynes, Suresnes, France

Objectives: To estimate the cost-effectiveness of Direct Aspiration First Pass Technique (ADAPT) versus mechanical thrombectomy with a Stent Retriever (SR) procedure in acute ischemic stroke from a French healthcare providers perspective.  Methods: The cost-effectiveness study was carried out from a prospective, randomized and multicenter clinical trial including 8 French hospitals. Medical and costs data were collected prospectively relating to the initial procedure from the onset symptom to the best recanalization. The direct medical costs data were collected by micro-costing and analytical accounting. The primary outcome is the modified score Rankin scale (mRS) of independent at three-months (score 0-2). Economic acceptability for community of this new technique is analyzed by measuring the Incremental Cost-Effectiveness Ratio (ICER). Sensitivity analyses were performed.  Results: We include 381 eligible patients (192 allocated to ADAPT and 189 allocated to SR) from October 2015 to October 2016. The mean hospital costs were € 8372 in ADAPT group, and € 8069 in SR group (p-value =  0.49). The percentage of independent patients at 3 months was 55.17 % in ADAPT group, and 62.06 % in SR group (p-value =  0.23). The resulting ICER reveals the need to invest € 4389 in order to achieve an additional percentage of independence with the innovative strategy compared to the standard strategy.  Conclusions: Based on randomized trial, we demonstrate that ADAPT is not more efficient compared to SR. We will then consider the cost per QALY (mapping mRS into EQ-5D) at 12-months. PMD78 Cost-Effectiveness of Easypod™ Device Versus Other Somatotropin Delivery Techniques In Egypt In Treatment of Growth Hormone Deficiency Elashmawy AA1, Anwar GM1, Elsedfy H2, El Kholy MS2, Hana MA1, Hafez MF1, Hassan MM1, Salem M2, Salah Metwaly N1, Amr NH2, Hamza RT2, Tawfik S3, Abdelghaffar S1, Rafik R4, Raed M5, Anan I5 1Cairo University, Cairo, Egypt, 2Ain Shams University, Cairo, Egypt, 3Military Medical Academy, cairo, Egypt, 4Merck, Cairo, Egypt, 5Accsight, Cairo, Egypt

Objectives: Normalization of height in childhood and adolescence with growth hormone deficiency (GHD) is possible via the use of the recombinant human growth hormone somatotropin. Different injection techniques were developed including easypod™ device, prefilled pens (PP), and the regular subcutaneous syringe (SCS). The aim of this study is to determine whether injecting somatotropin using easypod™ device is a cost-effective treatment option in Egyptian children born with GHD.  Methods: A Markov decision-tree model was used to calculate the relative costs and health benefits associated with each delivery technique over the treatment period (treatment with somatotropin 0.025 mg/kg/day from ages 5 to 13 years) for a number of simulated children born with GHD using patients charts records data. A wastage model was developed to include the difference in wastage among the various techniques. Estimates of patient height were derived from published literature, as was the proportion of patients achieving normal height through somatotropin treatment. Health care resources and drug costs associated with each of the treatment arms were considered, and cost-effectiveness was estimated as discounted (3.5% per annum) Egyptian pounds (EGP) per centimeter-height (cmH) gained.  Results: Somatotropin delivery using easypod™ device was associated with an additional (5.15) cmH gained, at an incremental cost per cmH gained of (-13,021 EGP), compared with somatotropin PP. This means easypod™ device dominates. Versus delivery via SCS, easypod™ device resulted in additional (5.76) cmH gained at an incremental cost of (69,099 EGP). This equates to an incremental cost of (11,990 EGP) per cmH gained - below the widely accepted cost-effectiveness threshold in Egypt of (70,000 EGP).  Conclusions: In this model, somatotropin delivery using easypod™ device was a cost-saving option compared with somatropin PP, and a cost-effective one if compared with somatropin SCS. The use of somatropin easypod™ device represents reasonable value for money for the treatment of GHD in Egyptian children. PMD79 The Comparative Pharmacoeconomic Analysis Of Using Absorb Bioresorbable Vascular Scaffold System For Patients With St Segment Elevation Myocardial Infarction (STEMI) Krysanova V1, Krysanov I2, Ermakova V1 University, Moscow, Russia, 2Institute of Medical and Social Technologies, Moscow National University of Food Production, Moscow, Russia

1Sechenov

Objectives: Bioresorbable stents are novel devices designed to overcome the longterm limitations of permanent stent implantation. The main aim of this study was to perform cost-effectiveness analysis of using Absorb bioresorbable vascular scaffold (BVS) system for patients with STEMI.  Methods: Analysis of the published clinical

trials was conducted to evaluate efficacy and safety of using Absorb BVS system for patients with STEMI. Taking into account the hypothesis of superior effectiveness of Absorb BVS system for patients with STEMI for pharmacoeconomic analysis was chosen “cost-effectiveness” analysis. MS Excel based model was performed to asses 2 strategies: strategy 1- patients with primary percutaneous coronary intervention (PPCI) with Absorb BVS system; strategy 2 - patients received thrombolytic therapy in the hospital. The 1 LYG and 1 surviving patient were included into the model as the effectiveness criteria. Direct costs included emergency, inpatient and outpatient treatment, rehabilitation and cost of PPCI with Absorb BVS system. All the direct costs were calculated from the Russian healthcare system perspective.  Results: According to published trials the using of Absorb BVS system for patients with STEMI did not lead to different rates of composite patient-oriented and device-oriented adverse events. Strategy 1 has a higher efficiency - the proportion of survivors at 1 year will be the maximum – 92.7%, as well as the LYG – 5.4. Application of strategy 1reduces the total cost of reperfusion therapy for all patients with STEMI, the difference amounted to $273,537. According to the CER for 1 LYG and for 1 surviving patient was optimal strategy 1, the difference amounted to $50 and $297, respectively (rate for June 2017).  Conclusions: Using Absorb BVS system during reperfusion in patients with STEMI was effective and economically justified treatment option. PMD80 Cost-Utility Analysis of A Novel Breath-Triggered Aerosol Inhaler Which Has Been Designed To Reduce The Critical Handling Error of Insufficient Inspiratory Effort Forster R1, Ratcliffe A2, Lewis M2, Crossley A2, Lopez Bastida J3, Dunlop W1 International Ltd, Cambridge, UK, 2Adelphi Values Ltd, Bollington, UK, 3Universidad Castilla-La Mancha, Toledo, Spain

1Mundipharma

Objectives: Up to 70–80% of patients use their inhalers incorrectly (GINA 2017). Approximately 40% of the GINA-defined Step-3+ UK population inhale ICS/LABA through dry-powder inhalers (DPIs). DPIs require forceful inhalation for optimal drug delivery. The CRITIKAL study (Price et al. 2017) found a statistically significant association between ‘insufficient inspiratory effort’ and increased risk of uncontrolled asthma and exacerbations requiring hospitalisation. A cost-utility analysis was developed to explore the societal and economic impact of an ICS/LABA breathtriggered aerosol inhaler which does not require forceful inhalation for actuation, compared with DPIs budesonide/formoterol and fluticasone/salmeterol.  Methods: A Markov model simulated patients switching between controlled and uncontrolled health states over one-year; each associated with different utility values (GOAL study, Briggs et al. 2006). The analysis assumed all inhalers had the same drug efficacy. The CRITIKAL study provided the relative risk of a patient having uncontrolled asthma and making an ‘insufficient inspiratory effort’ error – these data were applied to the transition probabilities. All other DPI-related errors assessed were not statistically significantly associated with asthma control. The analysis assumed the breath-triggered device lacked this critical handling error and had the same price as each comparator. Indirect costs were explored. Base-case analysis included direct costs: emergency room visits (£138), physician visits (£36) and hospitalisation/ day (£401.63).  Results: The breath-triggered device dominated both budesonide/ formoterol and fluticasone/salmeterol over one-year and resulted in direct cost savings of £98 and £142 with 0.0117 and 0.0169 additional QALYs, respectively. The breath-triggered device had the highest probability (100%) of being cost-effective at a £20,000/QALY threshold. One-way sensitivity analyses showed that the key factor driving variance was the relative risk of patients moving to an uncontrolled state for each comparator.  Conclusions: The analysis demonstrated the economic and societal costs of ‘insufficient inspiratory effort’ and the potential benefit of introducing an effective intervention to eliminate this error. PMD81 Cost Effectiveness of Universal Neonatal Hearing Screening With Otoacoustic Emissions And/Or Automated Auditory Brainstem Response, For The Detection Of Bilateral Congenital Hearing Loss And Early Treatment, In Newborns Without Risk Factors, In Colombia Medina Torres YA1, Diaz Rojas JA2, Gamboa Garay OA3 1Instituto para la Evaluación de la Calidad y Atención en Salud-IECAS, Bogotá, Colombia, 2Universidad Nacional de Colombia, Bogotá D.C., Colombia, 3Universidad de la Sabana, Bogotá, Colombia

Objectives: To evaluate the cost-effectiveness of neonatal hearing screening with otoacoustic emissions (OAEs), automated auditory brainstem response (AABR) and OAEs+AABR, compared among themselves and with the absence of a hearing screening program, for the early detection and treatment of moderate, severe, or profound bilateral congenital deafness in newborns with no risk factors, from the Colombian National Health System perspective.  Methods: For the cost-effectiveness analyses, a decision tree was developed to represent the process of detection, diagnosis and treatment of congenital hearing loss. The operational characteristics of tests were obtained and estimated by Heidari et al. (2015), and effectiveness of early treatment was obtained from Fulcher (2012) and Yang (2015); these studies were identified through systematic literature searches. The costs were derived from tariff manuals and expert consultation. Outcome included was DALYs averted. An expectation of lifetime horizon was used and costs and benefits were discounted at 5%. Deterministic and probabilistic sensitivity analysis were performed.  Results: Universal neonatal hearing screening is more costly; however, prevents a greater number of DALYs in the population compared to the absence of a screening program. The cost per DALY averted/person with each test compared with the nonscreening was COP $28,612,500 with AABR, COP 34,077,391.30 with OAEs+AABR and COP 77,995,774.65 with OAEs. Comparing the two dominant strategies (AABR versus OAEs+AABR), the AABR was cost-effective using the threshold of willingness to pay of three times GDP/capita.  Conclusions: AABR is a cost-effective strategy for universal neonatal hearing screening in Colombia. However, with a willingness to pay