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ISPOR - In-Person and Virtual Poster Session 1
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2.066h-.523l.465-2.533c.116-.533.174-.733-.29-.667l.116-.333zM140.272 41.733c-.058.534.348.6.812.6.407 0 .93-.2.987-.6.058-.4-.232-.533-.754-.6-.523-.066-1.161-.266-1.161-.866 0-.8.754-1.2 1.509-1.2.638 0 1.219.333 1.103 1h-.465c.058-.4-.29-.534-.696-.534-.406 0-.929.2-.929.667 0 .267.29.4.755.467.638.066 1.277.266 1.103 1.133-.116.733-.813 1-1.568 1.067-.696 0-1.277-.267-1.16-1.067h.464v-.067z"></path></g> </g> </g> </g> </svg></a></div> </div> </div> <div id="top-utility" class="flex-center"> <div id="Header_TBB0D3FF1011_Col01" class="sf_colsIn" data-sf-element="Top Utility" data-placeholder-label="Top Utility"> <div > <div class="sfContentBlock sf-Long-text" ><a class="button back" href="/conferences-education/conferences/upcoming-conferences/ispor-2022">ISPOR 2022 Home</a></div> </div> </div> <div class="js-element is-hidden mg-site-search"> <button type="button" class="search__close"> <span class="glyphicon glyphicon-remove"></span> </button> <input name="q" type="text" 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All accepted research abstracts will be published in the Society’s journal, Value in Health, and available in both the ISPOR Presentations Database and at the website.</p>--></div> </div> </div> <div id="Main_C010_Col01" class="sf_colsIn col-md-4 pr-0 text-right" data-sf-element="Column 2" data-placeholder-label="Column 2"> <div > <div class="sfContentBlock sf-Long-text" ><!--<a class="button primary" href="https://www.ispor.org/conferences-education/conferences/upcoming-conferences/ispor-europe-2020/program/program">Back to Program</a>--></div> </div> </div> </div> <div class="row" data-sf-element="Row"> <div id="Main_C006_Col00" class="sf_colsIn col-md-12" data-sf-element="Column 1" data-placeholder-label="Column 1"> <script> window.mgConfexProgramConfig = window.mgConfexProgramConfig || {}; window.mgConfexProgramConfig.dateLinks = [{"url":"https://www.ispor.org/conferences-education/conferences/past-conferences/ispor-2022/program/posters/poster-detail/intl2022-3459","activeClass":"active","title":"In-Person and Virtual Poster Session 1","date":"Mon, May 16"},{"url":"https://www.ispor.org/conferences-education/conferences/past-conferences/ispor-2022/program/posters/poster-detail/intl2022-3460","activeClass":"","title":"In-Person and Virtual Poster Session 2","date":"Mon, May 16"},{"url":"https://www.ispor.org/conferences-education/conferences/past-conferences/ispor-2022/program/posters/poster-detail/intl2022-3461","activeClass":"","title":"In-Person and Virtual Poster Session 3","date":"Tue, May 17"},{"url":"https://www.ispor.org/conferences-education/conferences/past-conferences/ispor-2022/program/posters/poster-detail/intl2022-3462","activeClass":"","title":"In-Person and Virtual Poster Session 4","date":"Tue, May 17"},{"url":"https://www.ispor.org/conferences-education/conferences/past-conferences/ispor-2022/program/posters/poster-detail/intl2022-3463","activeClass":"","title":"In-Person and Virtual Poster Session 5","date":"Wed, May 18"}]; </script> <script> window.confexData = [{"title":"Examining Geographical Variability of Opioid Use Disorders with Health Facts® Database","id":"bbb578d2-8c38-49fc-8dfa-0081e6642c0c","sessionCode":"RWD29","topDisplay":"<b><u>Liu Y</u></b><sup>1</sup>, Sahil S<sup>1</sup>, Farr S<sup>2</sup>, Hagle H<sup>1</sup><br><sup>1</sup>The University of Missouri - Kansas City, Kansas City, MO, USA, <sup>2</sup>Saint Luke's Health System, Kansas City, MO, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong><strong> </strong>The objectives were (1) to describe the frequency of patient encounters with opioid use disorders (OUDs) by census divisions; and (2) to identify how census divisions impact patients’ reduced encounters of OUDs.</p> <strong> </strong></p> <strong>Methods: </strong>Using Health Facts® database, patient encounters were included if the patient (1) was 18 years old or greater; (2) had an index encounter; (3) survived at least 30 days after the discharge. The encounter of an OUD was based on ICD-10 codes. The date at which a patient first had an OUD encounter was the index date. For the first objective, the unit of analysis was a patient encounter. Patient characteristics were age, gender, marital status, race, health insurance coverage, discharge disposition, and patient type. Facility characteristics were care setting, medical specialty, census region, census division, urban vs. rural, acute vs. non-acute, and teaching hospital status. For the second objective, the unit of analysis was a patient. Patients were examined one year prior to through one year after the index date. A logistic regression was used to determine the likelihood of reduced encounters over time, conditional upon selected patient and facility characteristics.</p> <strong> </strong></p> <strong>Results: </strong>A total of 265,643 patient encounters were identified, and Census Division 6 (East South Central) was associated with the highest frequency of OUDs among 9 census divisions. In the logistic regression (n=10, 762), among facility characteristics, emergency room, psychiatry, Census Division 3 (East North Central), Census Division 4 (West North Central), and urban areas were significant positive predictors, whereas Census Division 8 (Mountain) was a significant negative predictor.</p> <strong> </strong></p> <strong>Conclusions: </strong>Census Division 6 was associated with the highest frequency of OUDs. Compared with Census Division 6, Census Divisions 3 and 4 had a significantly positive impact on fewer encounters of OUDs, whereas Census Division 8 had a significantly negative impact.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114698","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Promises of AI-Assisted Patient Monitoring Methods","id":"6a7f34aa-6b16-4df5-a394-00961b73dbcf","sessionCode":"RWD9","topDisplay":"Barbier S<sup>1</sup>, Hasni M<sup>2</sup>, Aroui K<sup>2</sup>, Tournier C<sup>3</sup>, Wojciechowski P<sup>4</sup>, <b><u>Francois C</u></b><sup>5</sup>, Toumi M<sup>6</sup>, Bakhutashvili A<sup>7</sup><br><sup>1</sup>Creativ-Ceutical, LYON , 69, France, <sup>2</sup>Creativ-Ceutical, Tunis, 11, Tunisia, <sup>3</sup>Creativ-Ceutical, Lyon, France, <sup>4</sup>Creativ-Ceutical, Krakow, MA, Poland, <sup>5</sup>Aix-Marseille University, Paris, France, <sup>6</sup>Creativ-Ceutical, Paris, France, <sup>7</sup>MARCO POLO, Luxembourg, Luxembourg","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>The development of efficient, portable and connected sensors allows for the remote and potentially real-time monitoring of patients, in the context of clinical trials or routine practice. AI methods applied on those data have the potential to detect abnormalities and recognize personalized patterns. Our objective is to review existing AI solutions and their usefulness. <p><b>METHODS: </b>A search strategy was implemented in MEDLINE and EMBASE via OVID, based on a previously developed search filter for AI, covering the period since 2020. Titles and abstracts were screened. It was completed by a grey literature search on specialized media, relevant conferences websites and research reports. <p><b>RESULTS: </b>The search yields 524 hits and 268 articles were selected after screening. Additionally, 45 publications from grey literature were reviewed. AI-assisted monitoring solutions span over signal processing technics, smart display and consolidation of narratives, and prediction of events. In most published studies in theoretical settings, AI methods outperformed classical approaches, but the applications in real-life are less accurate than expected. They offer the advantages of providing good results in remote settings, with long-term and personalized follow-up, even with off-the-shelf devices, but are limited by the currently modest size of the training datasets and the complexity of medical situations. Accuracy is expected to improve as the quantity, quality and diversity of available data increases. <p><b>CONCLUSIONS: </b>Refinement of AI and hardware can help improving clinical measurements and outcomes with comprehensive and real-time monitoring. Several solutions are already giving satisfying results, and there is a large pipeline promising solutions developed in academia still to be further assessed.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporrwd9promises-of-ai-assisted-monitoring-methodschecked-pdf.pdf?sfvrsn=ba4510b6_0","title":"ISPOR_RWD9_Promises of AI-assisted monitoring methods_checked.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116938","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Systematic Review of Preference Elicitation Techniques Used in Valuing Children's Health-Related Quality-of-Life","id":"ca45d69e-d27d-4252-8939-00ad5a80421b","sessionCode":"EE14","topDisplay":"<b><u>Bailey C</u></b><sup>1</sup>, Howell M<sup>2</sup>, Raghunandan R<sup>2</sup>, Salisbury A<sup>2</sup>, Devlin N<sup>3</sup>, Howard K<sup>2</sup>, Viney R<sup>4</sup><br><sup>1</sup>University of Melbourne, Carlton, VIC, Australia, <sup>2</sup>University of Sydney, Sydney, NSW, Australia, <sup>3</sup>University of Melbourne, Melbourne, VIC, Australia, <sup>4</sup>University of Technology Sydney, Sydney, Australia","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b></p> Valuing children’s health states for use in economic evaluations is important globally, and particularly so for jurisdictions where cost-utility analysis is the preferred analysis for decision making. However, there remains debate about the approaches to elicitation of values. The main objectives of this paper were to identify and describe methods used to value children’s health states and determine the specific considerations required when using the methods.</p> <strong><p><b>METHODS</strong>: </b></p> We undertook a systematic search of electronic databases to identify studies published in English since 1990 that used preference elicitation methods to value child and adolescent (under 18 years-of-age) health states. Eligibility criteria comprised valuation studies for child-specific patient-reported outcome measures (PROMs) and child health states defined in other ways, and methodological studies of valuation approaches with or without a value set algorithm.</p> <strong><p><b>RESULTS</strong>: </b></p> We identified 77 eligible studies. Data were extracted for country, aims, condition (general population or clinically specific), sample size, age, perspective and source of values. Studies were evaluated using narrative synthesis methods and classified into three groups: 1) comparing elicitation methods (n=30); 2) comparing perspectives (n=23); and 3) no comparisons presented (n=26). The studies varied considerably in methods and reporting. Methods included time trade-off, standard gamble, visual analogue scale, rating/ranking, discrete choice experiments, best worst scaling and willingness to pay. Perspectives included adults’ own values, adults valuing a child (own, other, hypothetical), and child/adolescent valuing own or another child.</p> <strong><p><b>CONCLUSIONS</strong>: </b></p> Differences in reporting limited about which methods are most suitable for eliciting preferences for children’s health; however, there was some evidence that children gave lower values to health states than either adults’ values for comparable states from their own perspective or adult/parents’ values for children. Challenges in analysing the data suggests that reporting guidelines are required to improve reporting consistency.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116643","diseases":[{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Efficacy and Safety of First-Line Treatments for Patients with Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer: A Systematic Review and Indirect Treatment Comparison","id":"9c7c2cc6-73f3-4d6a-800a-01374361dfd4","sessionCode":"CO26","topDisplay":"Yu Y<sup>1</sup>, Zhu F<sup>2</sup>, Zhang W<sup>2</sup>, <b><u>Lu S</u></b><sup>1</sup><br><sup>1</sup>Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China, <sup>2</sup>Takeda Pharmaceutical Company, Shanghai, China","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong> To evaluate the relative efficacy and safety of brigatinib compared with other ALK inhibitors for the first-line treatment of <em>ALK</em>-positive non-small cell lung cancer (NSCLC) patients.</p> <strong>Methods:</strong> A systematic review with eligible randomized controlled trials (RCT) was conducted from Jan 2010 to Oct 2021. Outcomes evaluated by indirect treatment comparison (ITC) using Bucher method included progression free survival (PFS), overall survival (OS), objective response rate (ORR), and safety.</p> <strong>Results: </strong>10 RCTs assessing crizotinib, ceritinib, alectinib, brigatinib, ensartinib, and lorlatinib were included and included 2,831 patients.</p> <ul style=\"list-style-type: disc;\"> <li>Brigatinib significantly prolonged independent review committee assessed PFS compared with crizotinib (HR=0.48, 95% CI: 0.35 to 0.66) and ceritinib (HR=0.41, 95% CI: 0.26, 0.65); and had a comparable PFS compared with alectinib and ensartinib. Subgroup analysis of brain metastases patients and Asian patients yielded similar results to the above.</li> <li>Brigatinib significantly reduced the risk of death compared with crizotinib (HR=0.50, 95% CI: 0.28, 0.87) after adjusting for treatment crossover in crizotinib arm. No significant differences were observed in OS between brigatinib and other next generation ALK-inhibitors: alectinib, ensartinib, and lorlatinib.</li> <li>Brigatinib was associated with better ORR than crizotinib (OR=1.73, 95% CI: 1.04, 2.88), and comparable with other ALK<em>-</em>inhibitors.</li> <li>For patients with any brain metastases at baseline, brigatinib had significantly superior effects in intracranial ORR than crizotinib (OR=11.75, 95% CI: 4.19, 32.91) and ceritinib (OR=31.5, 95% CI: 6.02, 164.73).</li> <li><span style=\"text-decoration: line-through;\"></span>The incidence of grade ≥3 AEs of brigatinib is comparable to ceritinib, ensartinib and lorlatinib. Brigatinib also significantly delayed time to worsening in the EORTC QLQ-C30 GHS/QOL than crizotinib (HR=0.69; 95% CI: 0.49, 0.98)</li> </ul> <strong>Conclusion: </strong>Brigatinib was superior to crizotinib and ceritinib in PFS and intracranial ORR, and had comparable efficacy and safety profile with other 2<sup>nd</sup> generation ALK<em>-</em>inhibitors in first-line treatments for patients with <em>ALK</em>-positive NSCLC.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor2022posteralk-nma-pdf.pdf?sfvrsn=ec2f86ba_0","title":"ISPOR2022_POSTER_ALK NMA.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114539","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Olaparib As Maintenance Therapy for Women with Ovarian Cancer and Homologous Recombination Deficiency in Brazil: What Clinical and Cost Data Have Highest Impact on Cost-Effectiveness Analysis?","id":"bf0cf0fe-38a1-49db-90ea-01baa4a39fee","sessionCode":"EE50","topDisplay":"<b><u>Okumura L</u></b><sup>1</sup>, Massaoka MH<sup>1</sup>, Areas I<sup>1</sup>, Licursi C<sup>1</sup>, Mihai A<sup>2</sup>, Ryan J<sup>3</sup><br><sup>1</sup>AstraZeneca, Cotia, Brazil, <sup>2</sup>AstraZeneca, Cambridge, UK, <sup>3</sup>AstraZeneca, Cambridge, CAM, UK","locationCode":"","description":"\r\n\t<div><strong>Introduction</strong>: In Brazil, it is estimated that OC(ovarian cancer) impacts 7/100,000 habitants every year. Until recently, platinum-based therapies were considered standards of care and few innovations could significantly reduce disease progression or survival status(PFS). PARPi(Poly ADP-ribose polymerase inhibitor), such as olaparib, has shown to improve PFS by 51% compared to placebo in first-line maintenance scenario. This result was significantly better in homologous-recombination deficiency(HRD+). New oncology drugs require significant resource allocation, so we assessed which parameters have highest impact on cost-effectiveness analysis(CEA) of olaparib as maintenance therapy for women with HRD+OC, in the Brazilian private health care system.</p> <strong>Methods</strong>: 4-state Partitioned Survival Decision Analytic model was used to assess maintenance strategies for patients with HRD+ status OC: olaparib-bevacizumab(OLA-BEVA) versus bevacizumab(BEVA). Clinical parameters for modelling were retrieved from PAOLA-1 trial and comprised: PFS, overall survival, adverse events and treatment discontinuation. Costs considered in the model included: drugs, adverse events, health care resource use and subsequent therapy and others. Parameters with highest impact on CEA were determined by one-way sensitivity analysis(OWSA) and probabilistic sensitivity analysis(PSA). 5% discount was applied according to local guidelines. Cost-effectiveness threshold was set at 3xgross domestic product (GDP)/capita (R$120,000).</p> <strong>Results:</strong> OLA-BEVA was the strategy with highest QALY (quality-adjusted life years), in comparison to BEVA (6.12vs4.33) and with incremental costs (R$129,483). The incremental cost-effectiveness ratio(ICER) was R$72,442/QALY, which can be considered cost-effective when the threshold is R$120,000/QALY. According to OWSA, the clinical data and costs with highest sensitivity were: mortality, first and second disease progression costs. Adverse events were likely to affect less the final ICER. PSA suggested that base case results were robust.</p> <strong>Conclusion:</strong> For women with HRD+OC, OLA-BEVA was considered a cost-effective treatment. Disease progression and survival were variables with highest impact in the model, suggesting that choosing treatments with best progression free survival results might promote better resource allocation in Brazil.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115037","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Costs Analysis, Effectiveness and Safety Associated with Chimeric Antigen Receptor (CAR)-T Cell Therapy: Results from a Portuguese Comprehensive Cancer Center","id":"c9b07815-3281-4cc2-a407-024beec15e9d","sessionCode":"CO20","topDisplay":"Chacim S<sup>1</sup>, Monjardino T<sup>2</sup>, Cunha JL<sup>2</sup>, Medeiros P<sup>2</sup>, <b><u>Redondo P</u></b><sup>1</sup>, Bento MJ<sup>1</sup>, Mariz JM<sup>1</sup><br><sup>1</sup>IPO Porto, Porto, Portugal, <sup>2</sup>IPO Porto, Porto, 13, Portugal","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Healthcare costs analyses from CAR-T cell therapy are highly relevant to determine whether and how to offer patients these highly personalized immunotherapy. This study describes CAR-T cell therapy effectiveness, safety and costs in the real-life setting of a Portuguese Comprehensive Cancer Center.</p> <p><b>METHODS: </b>Retrospective descriptive study of patients with refractory or relapsed aggressive diffuse large B-cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma (PMBCL) and transformed follicular lymphoma (TFL) referred to CAR-T cell therapy (May/19-February/21). Data was obtained from clinical/administrative records. Rates of response to treatment, toxicity and survival were analyzed by the intention-to-treat. Demographic and clinical characteristics were evaluated using descriptive statistics. Survival was calculated using Kaplan-Meier. Direct medical costs, overall and stratified by inpatient-care, outpatient-care, and diagnostic-therapeutic procedures (DTP), were derived based on resources used by application of unit costs (2017 Price Tables of the Portuguese National Health Service, hospital costing system and Portuguese medicines agency).</p> <p><b>RESULTS: </b>Twenty patients were included (median age 49.5y; 55%male; 70%DLBCL; 50% with primary refractory disease history). Best overall and complete response rates were 81.3% and 56.3%, respectively. Median overall (OS) and progression-free survivals were 9.2 and 7.3 months; 12-month OS rate was 42.6% (95%CI:23.2-78.3). In 18 patients infused with CAR-T cells (65%Axicabtagene-ciloleucel, 35%Tisagenlecleucel; 2 patients not infused due to disease progression), 12-month OS rate was 49.0% (95%CI:27.7-86.6). Grade≥3cytokine release syndrome and neurotoxicity occurred in 5.6% and 11.1% of patients, respectively. Median total cost was 355.165€/patient; CAR-T cell drug expenses accounted for 97% of the overall cost. Excluding CAR T-cell acquisition cost (344.498€), inpatient-care, DTP and outpatient-care contributed to 57%, 38% and 5% of the overall cost/patient, respectively. CAR-T cells total cost, including adverse events management expenses, was 7.176.196€, or 286.238€ when excluding its acquisition cost.</p> <p><b>CONCLUSIONS: </b>Our findings highlight the heavy economic burden of CAR-T cell therapy driven by drug acquisition costs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114905","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Budget Impact of Introducing Monocyte Distribution Width (MDW) As a Screening Tool for Sepsis in China","id":"29ab2736-ac88-4015-b0ce-030185c50a6c","sessionCode":"EE93","topDisplay":"Xu X<sup>1</sup>, <b><u>Liu X</u></b><sup>2</sup><br><sup>1</sup>Southwestern University of Finance and Economics, Chengdu, China, <sup>2</sup>UCLA, LOS ANGELES, CA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> To estimate the economic impact of introducing monocyte distribution width (MDW) to sepsis screening from an emergency department’s perspective and a patient’s perspective in China.</p> <p><b>METHODS: </b> A model was developed to assess the difference in total healthcare costs and per patient per year (PPPY) costs before and after adding MDW to the standard sepsis screening approach in an emergency department in China (a hypothetical one million patients). The model evaluated screening fees, hospitalization costs, labor costs of doctors and nurses, and other hospital operating costs for one year. Costs were estimated in 2021 Chinese yuan. The prevalence of sepsis and costs were obtained from published sources and expert opinions. Time to antibiotic use and hospitalization duration for the standard of care (SoC, i.e., regular blood work) and the inclusion of MDW to SoC were calculated using clinical trial data (data on file). In the base case, the market share of MDW was assumed to be 80% in year one according to market research.</p> <p><b>RESULTS: </b> In the base case, 206,000 patients had sepsis among the hypothetical one million patients. The inclusion of MDW in the sepsis screening decreased the healthcare budget by ¥0.66 billion from an emergency department’s perspective and ¥3,794 PPPY from a patient’s perspective. The budget decrease was mainly due to shorter time to antibiotic use and shorter hospitalization duration by adding MDW to the SoC (SoC+MDW vs. SoC: time to antibiotic use, 2.07 vs. 3.95 hours; hospitalization duration, 10.01 vs. 11.46 days). Results were the most sensitive to time to antibiotic use.</p> <p><b>CONCLUSIONS: </b> The inclusion of MDW in the sepsis screening offers an efficacious approach with a decrease in the healthcare budget from both an emergency department’s perspective and a patient’s perspective in China.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-ispor-2022-mdw-v4-pdf.pdf?sfvrsn=c998a780_0","title":"Poster ISPOR 2022 MDW v4.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114556","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Incidence and Survival of Patients with Hepatocellular Carcinoma in the United States from 2008 to 2018","id":"8a2a430e-4f30-40e5-8700-03f7a3b81458","sessionCode":"EPH4","topDisplay":"Hait A<sup>1</sup>, Agrawal N<sup>2</sup>, <b><u>Chaudhuri M</u></b><sup>1</sup>, Kathe N<sup>1</sup><br><sup>1</sup>Complete HEOR Solutions (CHEORS), North Wales, PA, USA, <sup>2</sup>Complete HEOR Solutions (CHEORS), Philadelphia, PA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Hepatocellular Carcinoma (HCC) is the most prevalent primary liver cancer in adults, and it is one of the fastest-rising causes of cancer-related deaths in the US. This study examined the incidence and survival rates for HCC in recent years.</p> <strong><p><b>METHODS: </b></strong> We identified patients with HCC (using ICD-O3: C22.0 and histological codes 8170-8175) among patients aged ≥ 20 years between 2008-2018, using the Surveillance, Epidemiology, and End Results (SEER) database. Annual, age-adjusted incidence rates of HCC per 100,000 individuals were calculated by age, sex, and race/ethnicity. Cancer-specific 5-year survival rates (5-YSR) were examined using the Kaplan Meier method.</p> <strong><p><b>RESULTS: </b></strong> A total of 73,168 HCC patients were identified between 2008-2018 using the SEER. Most of these patients were male (77%), aged between 60-69 years (37%), non-Hispanic whites (50%), and with localized tumor stage (50%). The overall incidence and 5-YSR of HCC patients were 9.3 [standard error [SE]=0.03] per 100,000 person-years (PY), and 24.3% (SE=0.27), respectively. The overall incidence among men (15.2 per 100,000 PY, SE=0.07) was at least thrice as high as the incidence among women (4.1 per 100,000 PY, SE=0.03). Patients aged ≥ 60 years (27.1 per 100,000 PY; SE=0.12) had a higher incidence than younger patients. The overall 5-YSR was lower in men (23.5%; SE=0.30) as compared to women (27.3%; SE=0.58). HCC incidence rate was highest among non-Hispanic American Indian/Alaskan Native (16.3 per 100,000 PY; SE=0.56), and the 5-YSR was highest among non-Hispanic Asians/Pacific Islanders (31.6%; SE=0.71). The overall incidence rate of HCC increased by 18% between 2008 to 2014, with a peak in 2014 (9.8 per 100,000 PY; SE=0.12), and gradually declined thereafter.</p> <strong><p><b>CONCLUSIONS: </b></strong> The HCC incidence and survival rates vary by sex and race/ethnicity. Despite the recent decrease in HCC incidence rates, the overall rates remain high, with a significant need to reduce the disease burden.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/eph4arunimahaitpdf-pdf.pdf?sfvrsn=98a7a270_0","title":"EPH4_ArunimaHait_PDF.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116770","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Commercial Payer and Rare Disease Patient Stakeholder Perspectives on Incorporation of Direct Patient Input on Value of Medicines in Payer Formulary Decision-Making Process in the U.S.","id":"42d8bba0-5e54-4a4d-99a4-04805198d3e8","sessionCode":"PCR31","topDisplay":"<b><u>Narayanan S</u></b><br>Avant Health, Bethesda, MD, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Assess payer and rare disease (RD) patient perception towards payer reputation, patient-centricity, orphan drug (OD) value, and incorporation of patient perspectives on value of ODs in drug formulary decision-making process in the U.S. </p> <p><b>METHODS: </b> In-depth qualitative telephone interviews with 24 payer and patient stakeholders. Participating payers included Managed Care Organizations and Pharmacy Benefit Managers; RD patient group included patient advocates, adult patients with RD and parents of children with RD. </p> <p><b>RESULTS: </b> Across all stakeholders, corporate reputation (41%), loyalty (32%), trust (18%) and credibility (16%) were most frequently cited in relation to customer perception of payers in the U.S; 44%/86% of patients/payers respectively identified payers as patient-centric; 41% of patients noted payers to be economically driven, instead of being patient-centric. 88% and 82% of patients noted their lack of knowledge of payer formulary committee composition and its decision-making process respectively. Patients identified several OD attributes delivering value, and 29% noted OD as invaluable/outstanding; 86% of payers noted OD value is low or hard to define. 88% of patients stressed the importance of considering patient input in formulary decisions, and 86% of payers indicated their skepticism/undesirability in considering patient-input, while both stakeholders noted benefit of patient-input in reflecting OD benefit/risk/overall-impact, supporting value judgments. Patients (53%) and payers (71%) noted negative perceptions payers hold towards direct patient-input prevents payer consideration of patient-input. Patients noted surveys/interviews/focus groups/written-correspondence, while payers noted patient advocates as key sources of patient-input. Mandatory review of patient-input and preference data, and incorporation of patient-input in formulary review materials were noted as ideal ways to incorporate patient-input; such action is considered to enhance payer’s patient-centricity, credibility, trust and reputation.</p> <p><b>CONCLUSIONS: </b> Formulating a mechanism to formally incorporate patient-input in payer formulary decision-making process could benefit payers by enhancing customer perception of payer’s patient-centricity and reputation, influencing credibility, trust and customer retention.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/narayananmonarch-posterfinal-online-upload-pdf.pdf?sfvrsn=2749c902_0","title":"Narayanan_Monarch Poster_Final online upload.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115629","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Visualizing Network Meta-Analyses is not Trivial - A Novel Take on the Network Diagram","id":"8908a17b-b3b7-4e2b-8bc3-053d9e60ebf1","sessionCode":"MSR5","topDisplay":"<b><u>Popoff E</u></b>, Powell L, Johnston K<br>Broadstreet Health Economics & Outcomes Research, Vancouver, BC, Canada","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Traditionally, feasibility assessments and results for network meta-analyses (NMAs) have been characterized using network diagrams (often repeated per outcome to reflect differential outcome reporting), trial and patient characteristic summaries, pairwise outcome results, and treatment rankings. This can lead to challenges in interpreting and presenting an NMA, given the need for numerous distinct summary figures to convey the underlying methods and results. There is a need for visualization frameworks that concisely describe several network features simultaneously.</p> <p><b>METHODS: </b> Hypothetical sets of trials were used to construct these visualizations. Instead of solid circles used to represent nodes, the node was reimagined where the treatment name comprises the upper half circle of the node and wedges containing a single SUCRA ranking for each outcome comprise the bottom half circles. Traditional trial labels were expanded, allowing for averaged patient characteristics to be displayed underneath. Typically, for any given network of <em>T</em> treatments and <em>O</em> outcomes, there can be up to <em>T</em>*(<em>T</em> – 1)*<em>O</em>/2 unique comparisons. SUCRA wedges offer a simple approach of summarizing this information.</p> <p><b>RESULTS: </b> These visualizations provide a concise but comprehensive summary of relevant study features and network structure and a summary of assessed outcomes, suitable for executive summaries and presentations. SUCRAs serve a dual purpose of both treatment rankings and outcome reporting, while patient characteristics express the amount of heterogeneity present in the network. Limitations of this approach include difficulty visualizing non-star-shaped networks where trial labels need to be repeated, and the omission of measures of dispersion.</p> <p><b>CONCLUSIONS: </b> This visualization technique presents a novel way to communicate the inputs and outputs of NMAs. This technique works best for star-shaped networks and adaptations may be required for other geometries or applications outside NMAs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/popoffpowelljohnston-v1-pdf.pdf?sfvrsn=a0a89dfc_0","title":"Popoff_Powell_Johnston_ v1.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114916","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Chimeric Antigen Receptor (CAR) T-Cell Therapy: Complement or Substitute to Stem Cell Transplantation?","id":"e168e9b4-9db9-4e01-a2f7-05d45a4dd289","sessionCode":"HSD15","topDisplay":"McBride K, <b><u>Snyder S</u></b><br>Qualia Bio, Playa Vista, CA, USA","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE:</strong> CAR T therapy has emerged as an effective therapy for large B-cell lymphoma (LBCL) and may shift the current treatment paradigm. The study objective was to evaluate whether providers performing hematopoietic cell transplantation (HCT), which has been the standard of care, are likely to substitute HCT procedures with CAR T or have higher uptake of CAR T. <strong data-stringify-type=\"bold\"> </strong> <strong data-stringify-type=\"bold\"><p><b>METHODS</strong>: </b>Data were from the CMS 100% Medicare Fee-for-Service Inpatient and Outpatient files, 2019-2020. Patients receiving CAR T or stem cell transplantation (autologous or allogeneic HCT) were selected for study inclusion. Descriptive statistics were performed, stratified by procedure and year. Trends in utilization were analyzed using Pearson correlation, and logistic regression was used to evaluate likelihood of CAR T uptake.</p> <strong data-stringify-type=\"bold\"><p><b>RESULTS</strong>: </b>Between 2019 and 2020, 971 CAR T procedures were performed among 79 providers, and 858 HCT procedures were performed among 131 providers. The mean number of CAR T procedures per provider was 12.3, and the mean number of HCT procedures was 6.5. From 2019 to 2020, the proportion of HCT providers performing at least 1 CAR T procedure increased from 57% to 66%. Uptake of CAR T among HCT centers was significantly correlated with the number of HCT procedures performed: in 2020, for every additional HCT procedure, the likelihood of CAR T procedure increased by 79% (p<0.01). Providers with above average HCT utilization (>6.5) were also more likely to have higher number of CAR T procedures: providers with >6.5 HCT procedures, on average, had 16.1 CAR T procedures between 2019 and 2020; and providers with ≤6.5 HCT procedures had 6.4 CAR T procedures.</p> <strong data-stringify-type=\"bold\">CONCLUSION</strong> Study findings indicate that providers performing a high number of HCT procedures are more likely to adopt CAR T. Health system investments in new therapies may, in turn, contribute to the adoption of future novel therapies.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117877","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Effect of Preoperative Chest Physiotherapy on Oxygenation and Lung Functions Among Cardiac Surgery Patients: A Randomized Controlled Study","id":"5b90b4ec-c717-4ebe-80c6-06c35850c2c3","sessionCode":"CO13","topDisplay":"Shahood H<sup>1</sup>, Pakai A<sup>2</sup>, Kiss R<sup>3</sup>, Bory É<sup>3</sup>, Szilágyi N<sup>3</sup>, Sándor A<sup>3</sup>, <b><u>Boncz I</u></b><sup>3</sup>, Verzár Z<sup>3</sup><br><sup>1</sup>University of Pécs, vienna, Austria, <sup>2</sup>University of Pécs, Pécs, ZA, Hungary, <sup>3</sup>University of Pécs, Pécs, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: This study aimed to assess the preoperative chest physiotherapy effects of on oxygenation and lung functions among patients undergoing open heart surgeries.</p> <strong>Methods</strong>:A randomized controlled study was made at the Clinical Centre, Heart Institute, University of Pécs, Hungary. This study was conducted in the period between 04.2019 and 10.2019. 100 adult patients with planned open heart surgery were blindly and randomly allocated into two groups by using prepared opaque sealed envelopes, containing either number 1 or number 2; one group included patients who underwent the intervention in the form of home chest physiotherapy program for one week preoperative in addition to the traditional postoperative program, and the other group included patients who underwent only the traditional postoperative program. Exclusion criteria were Patients with a history of strokes, musculoskeletal disorders, or psychological disorders. The numerical data were presented as mean (standard deviation), while the categorical data were presented as a percentage. Chi-square test, T-test (unpaired) and ANOVA test were performed with the help of the SPSS 22.0 and (P<0.05).</p> <strong>Results</strong>:A total of 100 people underwent open heart surgery were included in the trial and had preoperative chest physiotherapy (n = 45) or not (n = 55) .The patients' age ranged between 40 and 83 years. The main type of operation in the study patients was coronary artery bypass graft (64%). No significant differences were noted between both study groups in the preoperative outpatient clinic and day 0 respiratory functions measurements (FVC, FEV1)or O2 saturation (P > .05), while Significant differences regarding the same measures in the postoperative 7 days measurements (P<0.05) were evident. The postoperative hospital stay length ranged from 7 to 20 days, with a high significant increase noted in group 2.</p> <strong>Conclusions</strong>: Preoperative chest physiotherapy is effective in improving respiratory functions following the open heart surgery.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/shahood-co13the-effect-of-preoperative-chest-physiotherapy-on-oxygenation-pdf.pdf?sfvrsn=1123b4b6_0","title":"Shahood _CO13_The Effect of Preoperative Chest Physiotherapy on Oxygenation ....pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116888","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Bayesian Approach for Handling Missing Items in Trial-Based Cost-Effectiveness Analysis with Multi-Item Questionnaires","id":"5b124d44-facf-4711-b1b9-074d17683082","sessionCode":"MSR15","topDisplay":"<b><u>Ling X</u></b><sup>1</sup>, Gabrio A<sup>2</sup>, Mason A<sup>3</sup>, Baio G<sup>4</sup><br><sup>1</sup>University College London, London, UK, <sup>2</sup>Maastricht University, Maastricht, LON, Netherlands, <sup>3</sup>London School of Hygiene & Tropical Medicine, London, UK, <sup>4</sup>University College London, London, LON, UK","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Cost-effectiveness analyses (CEAs) alongside longitudinal randomised controlled trials (RCTs) often use multi-item questionnaires to collect data at multiple follow-ups, and are generally characterised by non-negligible proportions of incomplete outcome data. As routine trial-based CEAs typically aggregate costs and effects data into cross-sectional measures, researchers are motivated to apply standard missing data methods (e.g. multiple<span> </span>imputation) at the most aggregated level (i.e. total costs or QALYs) rather than the disaggregated level (i.e. questionnaire items). Handling missingness at item-level can make full use of all observed information to produce more reliable estimates for CEAs compared to imputing at aggregated levels. However, this approach is challenging and reviews show it is rarely implemented in the CEA context. The purpose of this research is to build a Bayesian model using existing trial data and explore the impact of performing imputation at item-level in CEAs using multi-item questionnaires alongside RCTs with longitudinal follow-ups.</p> <p><b>METHODS: </b>We develop a Bayesian model to address practical problems brought by missing items in trial-based CEAs outcome data. Our model is motivated by a RCT that used multi-item questionnaires to collect costs and utility data for children or young people with chronic tic disorder. The model makes full use of all available information and addresses typical issues arising in trial-based CEA data analysis based on multi-item questionnaires. These include: the longitudinal structure of the data, different levels and types of missing outcome data, and the correlation between the outcomes. We demonstrate the benefits of our modelling approach using the trial data and assess the robustness of cost-effectiveness results to a range of plausible missing data assumptions.</p> <p><b>RESULTS: </b>To be added once the analysis has been completed (expected May 2022).</p> <p><b>CONCLUSIONS: </b>To be added (expected May 2022).</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporbayesianmissingdataincea29apr22-pdf.pdf?sfvrsn=60ad99f6_0","title":"ISPOR_BayesianMissingDataInCEA_29Apr22.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115944","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"COVID-19 and the Use of Antenatal Care Services in Côte d'Ivoire, an Africa South of the Sahara's Country","id":"eb1f70fe-68e0-4d9a-8e59-0780d5493d91","sessionCode":"HPR2","topDisplay":"<b><u>Attia-Konan AR</u></b><sup>1</sup>, Meless DFR<sup>2</sup>, Koffi K<sup>3</sup>, Kouame J<sup>4</sup>, Male MF<sup>5</sup>, Pongathie AS<sup>5</sup><br><sup>1</sup>Université Félix Houphouët Boigny, Abidjan, 01, CÔTE D'IVOIRE, <sup>2</sup>Institut National d'Hygiène Publique, Abidjan, Côte d'Ivoire, <sup>3</sup>Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire, <sup>4</sup>Université Félix Houphouët Boigny, NOGENT SUR OISE, 60, France, <sup>5</sup>Direction de l'informatique et de l'information sanitaire, Abidjan, Côte d'Ivoire","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: According to WHO Africa, the COVID-19 pandemic has impacted key health services in Africa, raising concerns that some of the major health problems will worsen. The objective of this study is to describe the effects of COVID-19 on the use of antenatal care services in Côte d'Ivoire.</p> <strong>Methods</strong>: This is a before-and-after evaluation that covered the years 2018, 2019, and 2020 from March to December. Data were obtained from the national DHIS2 information system. Antenatal Consultation (ANC) utilization data. The 1st ANC realized in the 1st trimester of pregnancy (ANC<sub>1</sub>), the number of ANC1 performed regardless of the month of pregnancy (ANC<sub>1T</sub>), and the 4th ANC (ANC<sub>4</sub>), which indicates the continuity of prenatal care, were extracted from the database. Welch's test was used to compare ANC by year and the significance of the test was set at 5%. </p> <strong>Result</strong>: The mean number of ANC<sub>1</sub> per health facility and per month in 2018, 2019, and 2020 was 11.11; 10.85; and 10.76, respectively. The mean number of ANC<sub>1T</sub> was lower in 2020 than in 2018 (p=0.03983) but not statistically different in 2019 (p=0.6176). The mean ANC<sub>1T</sub> per facility was lower in 2020 (30.94) than in 2019 (31.68, p=0.0416)) and 2018 (33.98, p<0.001). No effect of COVID-19 was found on ANC<sub>4</sub> (2018: 13.17 , p=0.2662; 2019: 13.18, p=0.6233; 2020: 13.39). Tracking ANC each month revealed a 5% decrease in ANC<sub>1T</sub> utilization between March and April 2020 immediately following the containment action while in 2019 and 2018 for the same period an 18% increase was observed.</p> <strong>Conclusion</strong>: The containment measures following COVID19 aggravated the underutilization of antenatal care services revealing the need for a comprehensive management of health issues taking into account vulnerable populations such as pregnant women.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/attiaposterhpr2ispor22-pdf.pdf?sfvrsn=b7a8a489_0","title":"ATTIA_POSTER_HPR2_ISPOR22.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117731","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Epidemiological Disease Burden of Polycystic Ovary Syndrome Based on Real-World Health Insurance Claims Data","id":"b0c4114b-4418-4af9-94be-07b551148094","sessionCode":"EPH10","topDisplay":"<b><u>Pónusz-Kovács D</u></b><sup>1</sup>, Elmer D<sup>2</sup>, Csákvári T<sup>3</sup>, Kajos L<sup>1</sup>, Pónusz R<sup>1</sup>, Kovács B<sup>3</sup>, Endrei D<sup>3</sup>, Boncz I<sup>3</sup>, Bódis J<sup>3</sup><br><sup>1</sup>University of Pécs, Pécs, BA, Hungary, <sup>2</sup>University of Pécs, Pécs, PE, Hungary, <sup>3</sup>University of Pécs, Pécs, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Polycystic ovary syndrome (PCOS) is a highly prevalent disorder, representing the single most common endocrine-metabolic disorder in reproductive-aged women. The aim of our study was to determine the epidemiological disease burden of polycystic ovary syndrome in Hungary.</p> <strong>Methods</strong>: Data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), for the year 2019. Database included annual number of patients number of cases and the prevalence of the utilization according to age groups in 100,000 inhabitants. The following health insurance treatment categories were included into our study: general practice care, home care, in- and outpatient care, medical imaging, laboratory diagnostics, pharmaceuticals and medical aids. Patients with polycystic ovary syndrome were identified with the following code of the International Classification of Diseases 10<sup>th</sup> revision: E2820.</p> <strong>Results</strong>: The highest number of patients was in the outpatient care (12,832 women), followed by general practice care (6,876 women), and laboratory diagnostics (4,287 women). The mean age of the patients was 29.3 years in outpatient care. Based on the number of patients related to the outpatient care the prevalence was 251.3 among 100,000 women. Additionally the age specific prevalence per 100,000 women was the highest within age group of 20-29 years (1,137.2 women) and 30-39 years (579.1 women).</p> <strong>Conclusions</strong>: The results showed that the highest number of patients was in outpatient care in 2019. The prevalence of endometriosis showed significant differences by age groups. The most affected age group was women aged 20-29, which was 6.1 times higher than number of patient of 40-49 years age group.Thus the early diagnosis and medical interventions are important as the disease can significantly reduce a patient's quality of life and decrease the success of childbearing.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/kovacsd-e2820epidprint140x9020220421final-pdf.pdf?sfvrsn=e37ddceb_0","title":"KOVACSD-E2820_EPID_PRINT_140x90_20220421_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117188","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Patient Characteristics and Healthcare Resource Utilization of Patients with Pyruvate Kinase Deficiency in a United States Electronic Health Record Database","id":"802039bd-da44-4840-a936-07c9b4e6de74","sessionCode":"RWD25","topDisplay":"<b><u>Higa S</u></b><sup>1</sup>, Zagadailov E<sup>1</sup>, Anderson A<sup>2</sup>, Seare J<sup>2</sup>, Burton T<sup>2</sup><br><sup>1</sup>Agios Pharmaceuticals, Inc., Cambridge, MA, USA, <sup>2</sup>Optum Life Sciences, Eden Prairie, MN, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Pyruvate kinase (PK) deficiency is a rare, inherited disorder caused by autosomal recessive mutations in the <em>PKLR</em> gene. There are no approved pharmacotherapies for PK deficiency. This study used data from a a large US electronic health record (EHR) database to <span>summarize the clinical characteristics and healthcare resource use (HCRU) of </span>patients with PK deficiency.</p> <strong><p><b>METHODS: </b></strong> Patients with ≥1 PK deficiency-related diagnosis code (ICD-9: 282.3, 282.9; ICD-10: D55.2, D55.8, D55.9, D58.9, E74.4) and ≥1 provider note from 01/01/2007–12/31/2019 were reviewed. Patients with a documented diagnosis of PK deficiency and ≥12 months of follow-up after the index date (defined as the earliest date with a PK deficiency-related diagnosis code) were included. Patient characteristics and HCRU were analyzed descriptively.</p> <strong><p><b>RESULTS: </b> </strong>Forty patients met the inclusion criteria (mean [SD] age: 27 [22] years, 60.0% male, mean [SD] follow-up: 5.1 [2.7] years). During the 12-month follow-up period, 8 patients (20.0%) received a transfusion, of whom 4 had ≥6 transfusions, and 23 patients (57.5%) had a hemoglobin (Hb) result, of whom 11 had at least 1 Hb result <10 g/dL during that year. The majority of patients (80%) had at least 1 ambulatory care visit (median: 8 visits), and 22.5% of patients had at least 1 emergency room visit (median: 1 visit) during the 12-month follow-up period. Seven of 40 patients (17.5%) had at least 1 inpatient admission during the 12-month follow-up period, with a median length of stay of 6 days.</p> <strong><p><b>CONCLUSIONS: </b> </strong>This study is the first to describe HCRU of patients with PK deficiency using EHR data in the United States. Although the cohort sample is small and the study was conducted in an open system database, the results suggest moderate-to-severe anemia and substantial HCRU in patients with PK deficiency.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-optum-poster29aprilfinal-pdf.pdf?sfvrsn=27b65f38_0","title":"ISPOR Optum poster_29April_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114988","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Costs of Treating Hereditary Angioedema (HAE) Attacks with C1 Inhibitors in Four European Countries","id":"5f64780a-ec64-4cb7-9f54-095c89d03daf","sessionCode":"EE39","topDisplay":"<b><u>Tutein Nolthenius J</u></b><sup>1</sup>, Figueiredo R<sup>2</sup>, Wood S<sup>3</sup>, Whalen JD<sup>4</sup><br><sup>1</sup>Pharming Technologies BV, Amsterdam, NH, Netherlands, <sup>2</sup>Pharming Technologies BV, Leiden, Netherlands, <sup>3</sup>Pharming Technologies BV, Beaconsfield, UK, <sup>4</sup>Pharming Technologies BV, London, UK","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Hereditary angioedema (HAE) is a rare genetic disease caused by the deficiency or dysfunction of C1 esterase inhibitor (C1-INH), and characterized by recurring episodes of severe swelling, commonly affecting the skin, gastrointestinal tract, or upper airway (which can be life-threatening). Frequency and severity of attacks vary. Replacement C1-INH therapies provide effective relief; however, there is a lack of comparative data on economic outcomes.</p> <p><b>METHODS: </b> Acquisition costs for human plasma-derived and recombinant C1-INH were collected from public databases for the UK, Netherlands, Czech Republic, and Bulgaria. Attack rates and the mean number of doses required to control each attack were collected from published studies; data from randomized controlled studies were analysed separately from real-world and open-label studies. Cost per attack was estimated considering the distribution of patient weights and labelled dose regimens.</p> <p><b>RESULTS: </b> The proportion of patients requiring multiple doses to control an attack ranged from 9.1% to 63.8% in randomized studies and 0.2% to 30.9% in real-world studies. In general, recombinant C1-INH was less expensive than plasma-derived options, due to lower re-dosing rates. In the analysis using randomized studies, average savings per patient per attack (and per year) were £712 (£19,151) in the UK, €264 (€7,095) in the Netherlands, €469 (€12,610) in Czech Republic, and €312 (€8,391) in Bulgaria. In the analysis using real-world studies, average savings per patient per attack (and per year) were £447 (£12,036) in the UK, €61 (€1,640) in the Netherlands, €288 (€7,735) in Czech Republic, and €166 (€4,454) in Bulgaria. </p> <p><b>CONCLUSIONS: </b> Based on published studies and drug prices, treatment with recombinant C1-INH may provide savings when compared with plasma-derived products and require fewer repeat doses to control an HAE attack. In addition to the economic impact of re-dosing, future analyses should consider the humanistic impact of rapid control of attacks.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/costs-of-treating-hereditary-angioedema-attacks15-18may2022ispor-pdf.pdf?sfvrsn=db23d36b_0","title":"Costs of Treating Hereditary Angioedema Attacks_15-18May_2022_ISPOR.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117936","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Economic Burden of Disease in Patients with Exudative Age-Related Macular Degeneration Using Common Data Model in South Korea","id":"3f6919c7-b89a-41b2-a3eb-09c3edeeecef","sessionCode":"EE49","topDisplay":"<b><u>Choi K</u></b><sup>1</sup>, Park SJ<sup>2</sup>, Han S<sup>3</sup>, Suh HS<sup>4</sup><br><sup>1</sup>Pusan national university, Seoul, South Korea, <sup>2</sup>Seoul National University Bundang Hospital, Gangnam-gu, South Korea, <sup>3</sup>Kyung Hee University, Austin, TX, USA, <sup>4</sup>Kyung Hee University, Seoul, Korea, Republic of (South)","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>We aimed to analyze economic burden of patients with exudative age-related macular degeneration (eAMD) in South Korea.</p> <p><b>METHODS: </b>This study is a single center cohort study using Observational Medical Outcome Partners-Common Data Model in Seoul National University Bundang hospital. Treatment group was defined as patients with eAMD diagnosis by ophthalmologist and anti-vascular endothelial growth factor or verteporfin between August 1, 2009, and July 31, 2017. The control group was patients who visited the hospital for any diagnoses, but not eAMD in the same period. We excluded cancer patients in both groups. Propensity score matching was performed by LASSO in ATLAS. To estimate economic burden, we used exponential conditional model (ECM) with log link function and gamma family distribution. For covariates, we included dummy variable for eAMD group, demographic data, pre-index cost, and unbalanced covariates in propensity score model. Outcomes were total medical cost, reimbursement cost, non-reimbursement cost, and out-of-pocket expense for two years.</p> <p><b>RESULTS<span>: </b>After 1:4 propensity score matching, there were 783 patients in eAMD group and 2,918 in non-eAMD group. Total medical cost estimated by ECM was $4,671 in eAMD group and $1,293 in non-eAMD group in first year. In the second year, total medical cost was $2,603 in eAMD group and $1,080 in non-eAMD group. Compared to non-eAMD group, total medical costs in eAMD group were 3.56 times and 2.64 times higher in first year and second year, respectively. Reimbursement cost, and non-reimbursement cost were also higher in eAMD group. In eAMD group, out-of-pocket expense was $1,230 in first year and $856 in the second year.</span></p> <p><b>CONCLUSIONS: </b>Economic burden for patients with eAMD was higher than that with non-eAMD for two years in South Korea. As eAMD is a severe intractable disease that can progress to blindness with high burden of disease, management strategy for eAMD patients is needed.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ee49kyungseonchoiposter-pdf.pdf?sfvrsn=92bc4c61_0","title":"EE49_KyungseonChoi_Poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117879","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"The Definition, Economic, and Social Implications of Being \"Legally Blind\": A Comparison across Countries","id":"b06d686f-415a-417b-bb60-0a619cd65f86","sessionCode":"EE67","topDisplay":"Chivers M<sup>1</sup>, Hashim M<sup>2</sup>, <b><u>Li N</u></b><sup>2</sup><br><sup>1</sup>PRIMA Consulting, Fleet, Hampshire, UK, <sup>2</sup>Janssen Global Commercial Strategy Organization, Raritan, NJ, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>People may be classified as vision-impaired or blind according to threshold levels of sight loss, with associated social and macro-economic consequences. We sought to understand these national statutory definitions and their impact on economic and patient burden, including variation by country.</p> <strong> </strong></p> <p><b>METHODS: </b> Blindness definitions and associated implications were identified from the World Health Organization, national government websites, health insurers, patient advocacy groups, and regulators in Brazil, Canada, France, Germany, Italy, Japan, Mexico, Spain, the US, and the UK.</p> </p> <p><b>RESULTS: </b> Across all countries, visual field and visual acuity were included in blindness definitions, but threshold values for these parameters varied. Visual field thresholds for blindness varied from <10˚to 30˚, with a visual field threshold of 10˚used most frequently. Visual acuity thresholds for blindness varied from 20/200 Snellen (logarithm of the minimum angle of resolution (logMAR) 1.00) to 8/200 Snellen (logMAR 1.40), with 20/200 used most frequently. Multiple categories of vision impairment are defined in Germany, Japan, and the UK. In every country assessed, people registered as blind are eligible for tax exemptions (e.g., property tax) and welfare benefits; income tax reductions apply in all except Spain. The threshold visual acuity required for driving was typically 20/40 Snellen (0.3 logMAR). Similarly, visual field requirements for driving were specified in four countries (>120˚ to 150˚ uninterrupted horizontal field), and regulations in all other countries assessed suggest that any visual field defect results in driving disqualification.</p> </p> <p><b>CONCLUSIONS: </b> Statutory blindness definitions, including thresholds of visual acuity and visual field, vary considerably by country. Blindness classification is associated with the societal costs of tax exemptions, tax reductions, and welfare payments. People with visual field loss are affected at an earlier stage due to driving disqualification.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115416","diseases":[{"id":"8cf105fc-7473-4125-8f3a-33de42667e72","parentId":"00000000-0000-0000-0000-000000000000","title":"Sensory System Disorders","urlName":"Sensory-System-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Access Barrier or Opportunity? Evolving Trends in NRDL Listings in China","id":"0cb7290b-6293-4c5e-9c64-0a9f747c4b69","sessionCode":"HTA11","topDisplay":"<b><u>Macaulay R</u></b><sup>1</sup>, Leong KW<sup>2</sup><br><sup>1</sup>Precision Advisors, London, UK, <sup>2</sup>Precision Advisors, London, LON, UK","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> The National Reimbursement Drug List (NRDL, established in 2000), in which included medicines are reimbursed by public insurance, is the main route to market access in China. Since 2017, NRDL’s scope has been expanded to cover innovative patented drugs and has been updated in 4 consecutive years. Since 2020, manufacturers can submit applications for formal review. Currently governed by the National Healthcare Security Administration (NHSA), negotiation rules state that manufacturers can provide two tender prices, and the process automatically terminates if the second price exceeds NHSA’s base price by 15%. This research evaluates trends in NRDL outcomes over time.</p> <span><p><b>METHODS: </b> NRDL listings (2017</span>–<span>2021) were identified and key information extracted (31-Dec-2021). </span></p> <p><b>RESULTS: </b> The total number of medicines included in the NRDL increased by 11%, from 2571(2017) to 2860(2021). An average of 161 new medicines were added per year (range: 74[2021]–375[2017]), 51% of which were ‘Western’ medicines (i.e. non-traditional Chinese medicines). Negotiation success rates for new medicines was 77% (range: 59%[2019]–94%[2018]). However, the average price cut negotiated was 55% and has risen from 44% in 2017 to 62% in 2021. Further, the proportion of negotiated medicines developed by multinational manufacturers dropped from 61% in 2017 to 43% in 2021.</p> <p><b>CONCLUSIONS: </b> Since 2017, the NRDL has provided a route for public reimbursement of innovative patented drugs in the very large market represented by China. However, the trends over time are for increasingly steeper price cuts being demanded alongside an increasing focus on domestically-manufactured medicines. Pursuing NRDL public reimbursement poses significant questions for multi-national pharmaceutical companies in terms of the discounts required, volume/revenue potential, and launch sequencing considerations. To optimize access to the Chinese market, manufacturers should closely monitor evolving NRDL trends and the domestic landscape, validate price-access trade-offs, and be prepared with a tailored negotiation strategy.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116857","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Utility Analysis of Dapagliflozin in Patients with Chronic Kidney Disease in Panama","id":"70ce96ab-6b35-47f7-8261-0b29c9ff686c","sessionCode":"HTA5","topDisplay":"<b><u>Ordoñez J</u></b><sup>1</sup>, Valdes R<sup>2</sup>, Courville K<sup>2</sup>, Pérez R<sup>2</sup>, Ordóñez A<sup>3</sup>, Hidalgo Godínez J<sup>4</sup>, Villalobos K<sup>4</sup><br><sup>1</sup>True Consulting, Medellín, ANT, Colombia, <sup>2</sup>Caja de Seguridad Social de Panamá, Ciudad de Panamá, Panama, <sup>3</sup>True Consulting, Medellín, Colombia, <sup>4</sup>AstraZeneca CAC, San José, Costa Rica","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong> Chronic kidney disease (CKD) is a high-cost chronic disease with costly complications, like hemodialysis, peritoneal dialysis, and cardiovascular diseases (CVDs). This study evaluated dapagliflozin cost-utility in patients with CKD in Panama.</p> <strong>Method:</strong> A Markov model was developed considering five states: CKD, end-stage renal disease (ESRD), CVDs, ESRD and CVDs simultaneously, and death. The base case is an adult with or without type 2 diabetes who had an estimated glomerular filtration rate of 25-75 ml/minute per-1.73m2 of the body-surface area and a urinary albumin-to-creatinine ratio of 200-5000. Perspective is from the third payer; comparators are dapagliflozin or no treatment. Outcomes are ESRD, CVDs, ESRD and CVDs, and death and are expressed in Quality Adjusted Life Years (QALYs). There are three-time horizons, 12, 24, and 32 months, based on the efficacies of the pivotal clinical trial of dapagliflozin in CKD. Willingness-to-Pay (WTP) used was three times the gross domestic product per capita (USD 36,807).</p> <strong>Results:</strong> At 12 months follow-up, the dapagliflozin strategy costs $1,021 and generates 0.982 QALYs, and without treatment, cost is $1,031 and generates 0.966 QALYs. At 24 months, the dapagliflozin strategy costs $2,339 and generates 1.90 QALYs, and without treatment, it is $2,282 and generates 1.85 QALYs. At 36 months, dapagliflozin strategy costs $3,660 and generates 1.90 QALYs, and without treatment, it is $3,325 and generates 1.85 QALYs. At 12 months, dapagliflozin is a dominant strategy (cheaper and more efficacy); the Incremental Cost-Effectiveness Ratio (ICER) at 24 months is $1,053; and at 32 months, $2,524 per additional QALY gained. Willingness-to-pay curves estimate that the probability that dapagliflozin is the best treatment strategy at 12 months is 96.3%, at 24 months, 94.5%, and at 32 months, 96.3%.</p> <strong>Conclusion:</strong> Dapagliflozin is a cost-saving treatment in the first year and highly cost-effective for treating CKD after the first year in Panama.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117310","diseases":[{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Real-World Biomarker Testing Rates Among Patients with with Advanced Non-Small Cell Lung Cancer in the United States","id":"1d2e6c20-0488-4489-9208-0c71fef941b3","sessionCode":"EPH19","topDisplay":"<b><u>Vieira MC</u></b><sup>1</sup>, Kelton JM<sup>2</sup>, Lamarre N<sup>3</sup>, Abraham A<sup>3</sup>, Duncan K<sup>4</sup>, Krulewicz S<sup>2</sup><br><sup>1</sup>Pfizer Inc, Boston, MA, USA, <sup>2</sup>Pfizer, Inc., Collegeville, PA, USA, <sup>3</sup>Genesis Research, Hoboken, NJ, USA, <sup>4</sup>Pfizer Inc, New York, NY, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Testing for activating genomic mutations is recommended in all patients with advanced non-small cell lung cancer (aNSCLC), including ALK, BRAF, KRAS, EGFR, ROS1, as well as PD-L1 expression, to support optimal treatment decisions. Current real-world testing patterns of biomarkers in aNSCLC are not well known and testing rates may be lower than expected despite clinical guideline recommendations. The objective of this study was to measure real-world aNSCLC biomarker testing rates and characterize patient and clinical characteristics associated with testing. </p> <p><b>METHODS: </b> A retrospective analysis of patients diagnosed with aNSCLC between January 2011–July 2021 was performed using data from the Flatiron Health aNSCLC database. Included patients were ≥18 years old, had ≥2 visits in the Flatiron Network, and had ≥2 months of continuous follow-up from the date of advanced diagnosis.</p> <p><b>RESULTS: </b> 56,972 patients met the eligibility criteria. Testing rates increased from 2011 to 2021 for all biomarkers (37% to 83% for ALK; 7% to 79% for BRAF; 20% to 76% for KRAS; 48% to 85% for EGFR; 6% to 81% for ROS1; 3% to 82% for PD-L1). 14,512 (26%) patients were tested for all 6 biomarkers at some point during the study period. In 2019-2021, a significant trend of lower testing rates was observed among patients who were male, older (³65), or had higher ECOG performance status (2+) at advanced diagnosis. Most tests occurred prior to initiation of first treatment regimen (ALK: 74%, BRAF: 72%, KRAS: 69%, EGFR: 75%, ROS1: 73%, PD-L1: 79%). Median time from aNSCLC diagnosis to first biomarker test ranged from 0.6 – 1 month.</p> <p><b>CONCLUSIONS: </b> Biomarker testing rates increased over time. Although there have been improvements in biomarker testing rates, a gap of ~15-25% testing remains for patients with aNSCLC.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115859","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Updated Evidence on the Use of Solid Oral Dosage Forms in Adults with Neurological Disorders and Swallowing Difficulties: A Scoping Review","id":"78d0254f-2b03-4363-b661-0ca74c6590f8","sessionCode":"CO9","topDisplay":"Ferreira-Neto C<sup>1</sup>, Andrade RA<sup>1</sup>, <b><u>Tonin F</u></b><sup>2</sup>, Wiens A<sup>3</sup><br><sup>1</sup>State University of Ponta Grossa, Ponta Grossa, Brazil, <sup>2</sup>Federal University of Paraná, Curitiba, PR, Brazil, <sup>3</sup>Federal University of Paraná, Curitiba, Brazil","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> To synthetize the evidence on the available interventions aimed at the effective and safe use of solid oral dosage forms (SODFs) in adult patients with neurological disorders and swallowing difficulties and to identify potential gaps in the literature.</p> <p><b>METHODS: </b> This scoping review was performed following Joanna Briggs Institute recommendations and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Systematic searches were conducted in PubMed, Scopus, SciELO (March-2021). Peer-reviewed observational studies assessing the effect of SODFs in patients with any type of neurological disorder and swallowing difficulties in healthcare settings were included. According to the Medicine Optimization Recommendations of the National Institute for Health and Care Excellence, eligible interventions were classified as targeting patients, healthcare organizations, or healthcare professionals.</p> <p><b>RESULTS: </b> Overall, n=11 studies were included (six analytical studies, three case reports and two mixed-methods intervention studies). Patients’ age ranged from 57 to 91 years; most of them were women with Parkinson's disease (n=6 studies; 54.5%) or dementia (n=3 studies; 27.3%). All studies evaluated tablets; n=6 provided data on hard gelatin capsules and n=4 assessed dispersible or disintegrating dosage forms. A total of 26 interventions were reported being the most prevalent medication review (9/26; 35%), followed by medicines-related models of organizational and cross-sector working (4/26; 15%). In most studies, interventions were performed by physicians (n=8; 72.7%) and targeted patients during hospitalization (n=7; 63.6%). Interventions’ duration ranged from 55 minutes to 6 months. At least 20 different outcomes were evaluated. Patient's swallowing of SODFs preferences was analyzed only by n=5 (45.5%) studies.</p> <p><b>CONCLUSIONS: </b> The implementation of specific protocols for using SODFs in patients with swallowing difficulties and neurological disorders is not a standard practice. Further studies on this field are needed to support the use of effective and safe oral therapy for these patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116378","diseases":[{"id":"dc752772-538c-4933-b6a5-3b5b6d079673","parentId":"00000000-0000-0000-0000-000000000000","title":"Geriatrics","urlName":"Geriatrics"},{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Lost Therapeutic Benefit of Delayed LDL-C Control and Cost-Effectiveness Analysis of Lipid-Lowering Intensification","id":"e51eb910-34c5-4ea1-a148-0cc9acbea8ce","sessionCode":"EE217","topDisplay":"<b><u>Marquina C</u></b><sup>1</sup>, Zomer E<sup>1</sup>, Talic S<sup>2</sup>, Morton J<sup>2</sup>, Lybrand S<sup>3</sup>, Thomson D<sup>3</sup>, Liew D<sup>2</sup>, Ademi Z<sup>2</sup><br><sup>1</sup>Monash University, Melbourne, Australia, <sup>2</sup>Monash University, Melbourne, VIC, Australia, <sup>3</sup>Amgen Australia, North Ryde, Australia","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Attainment of low-density lipoprotein cholesterol (LDL-C) therapeutic goals in statin-treated patients remains suboptimal. We quantified the health and economic impact of achieving LDL-C control at different time points.</p> <strong>Methods: </strong>We developed a lifetime Markov cohort model (n = 1,000) to estimate the effect on coronary heart disease (CHD) of attaining LDL-C control with no delay (i.e., immediately after a high LDL-C level diagnosis) compared to ten years delay. The effect of LDL-C attainment was tested using either high-intensity statins or combination lipid-lowering treatment (statins plus ezetimibe or proprotein convertase subtilisin/kexin type 9 inhibitors [PCSK9i]). LDL-C levels were extracted from an Australian primary care cohort treated with low/moderate intensity statins, and LDL-C goal attainment was set at 2 mmol/L, as per Australian guidelines. The effect of LDL-C reduction on CHD risk was assumed to proportional to lifetime exposure and derived from Mendelian randomisation data. Outcomes of interest included events prevented, quality-adjusted life years (QALYs), healthcare and productivity costs, and incremental cost-effectiveness ratios (ICER). All outcomes were annually discounted by 5%.</p> <strong>Results: </strong>Over the cohort lifetime horizon, achieving immediate LDL-C control with high intensity statins would double the QALYs gained per person compared to achieving control after 10 years (0.04 vs 0.02 QALYs/person). For statins + ezetimibe, the gains would be 0.11 vs. 0.04 QALYs per per-person, while for statins + PCSK9i the gains would be 0.18 and 0.11 QALYs per-person. From a healthcare perspective, the model yielded cost saving ICERs for both high intensity statins and statins + ezetimibe, while for PCSK9i the ICER remained above the willingness-to-pay threshold.</p> <strong>Conclusions: </strong>Delaying attainment of LDL-C targets translates into a lost therapeutic benefit and a waste of resources. Urgent policies are needed to improve LDL-C goal attainment in patients treated with lipid-lowering therapy.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116691","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Value-Based Pricing of an Ebola Vaccine in Resource-Constrained Countries Based on Cost-Effectiveness Analysis","id":"1e073048-031b-4106-9099-0ec27ff8f1a2","sessionCode":"EE58","topDisplay":"<b><u>Obeng-Kusi M</u></b>, Erstad B, Roe D, Abraham I<br>University of Arizona, Tucson, AZ, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Pricing, affordability, and access are important deliberations around infectious disease interventions. Determining a fair price that not only incentivizes development but ensures value and access for patients is critical given the increasing global health crisis. Using ebola virus disease (EVD) as exemplar, we aim to elucidate the estimation of a value-based price (VBP) for a vaccine package and to consider how the price compares across selected countries that have experienced EVD outbreaks.</p> <strong>Methods: </strong>Using a dynamic transmission model, we assessed the cost-effectiveness of a vaccine package – composed of the vaccine, storage, maintenance, and administration - for vaccination toward herd immunity in 4 countries affected with EVD (Democratic Republic of Congo, Liberia, Sierra Leone, Uganda). Based on the cost-effectiveness metrics and using willingness-to-pay thresholds equal to varying percentages of the Gross Domestic Product (GDP), we demonstrated how a VBP is calculated using an adaptation of the “QALY-capped” approach.</p> <strong>Results: </strong>The VBP for the vaccine is directly proportional to both cost-effectiveness and GDP per capita- with higher cost-effectiveness and higher GDP per capita resulting in higher price ceilings compared to lower cost-effectiveness and lower GDP.</p> <strong>Conclusion: </strong>Despite the concerns with the “QALY-cap” approach, we illustrated that it is an easily comprehensible method for determining the VBP of a vaccine using a cost-effectiveness analysis. Choice of data, population characteristics, disease dynamics, and others are among factors that need to be considered when comparisons are made across countries.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/vbp-of-ebola-vaccine-package-pdf.pdf?sfvrsn=cef9682d_0","title":"VBP of ebola vaccine package.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115004","diseases":[{"id":"5b196821-963c-48d3-9e67-cc2da312735d","parentId":"00000000-0000-0000-0000-000000000000","title":"Vaccines","urlName":"Vaccines"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Predictors on the Characteristics of Medication-Related Queries to a Drug Information Service in the Philippines","id":"26f7c7f9-7261-422c-b80e-12040859a536","sessionCode":"HSD10","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b> The study aims to identify the predictors on the characteristics of medication-related queries to a drug information service in the Philippines.</p> <strong><p><b>METHODS</strong>: </b> All queries from July to October 2020 were evaluated and categorized based on their general characteristics. These categories were tested for association and correlation using available information collected through the telepharmacy service database. Heteroskedasticity was checked using Huber-White heteroskedasticity-consistent standard errors. Multinomial logistic regression was done to estimate the effect of predictor variables on each medication-related query category using log odds to measure the outcome. The drug recommendation category was used as the base outcome (obs=150).</p> <strong><p><b>RESULTS</strong>: </b> Pearson correlation shows that the choice of category of queries is weakly positively correlated with disease (0.2217; p=0.05), while the patient’s age is weakly positively correlated with their disease (0.2665; p=0.05) and consulting for themselves (0.1210; p=0.05). Furthermore, regression analysis shows that for one-unit increase in age there is a 1.69% increase in asking drug information (p=0.083), 2.95% increase in asking about herbal and food supplements (p=0.003) and a 19.24% decrease asking about nonpharmacologic recommendations (p=0.003) than requesting for drug recommendations in the drug information service. While a one-unit increase in disease status would increase the log odds of asking about medication safety questions like adverse drug reactions and drug interactions by 273.11% (p=0.000), drug substitution by 274.53% (p=0.030) and questions about drug purchases by 464.79% (p=0.036) than requesting for drug recommendations.</p> <strong><p><b>CONCLUSIONS</strong>: </b> The result of the study suggests that age and disease status of patients are major predictors of the type of queries that clients inquire through the telepharmacy drug information service. Further investigation must be done to analyze other sociodemographic characteristics of clients to describe the role of these variables on the characteristics of queries that are provided to the platform.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114473","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"97c2e725-3c74-4625-997f-a72378c5a557","parentId":"00000000-0000-0000-0000-000000000000","title":"Generics","urlName":"Generics"},{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Information Seeking and Preventive Behavior during the COVID-19 Pandemic","id":"926ad84c-8c36-4185-9c28-12210ae8540a","sessionCode":"EPH35","topDisplay":"<b><u>Park T</u></b><sup>1</sup>, Ju I<sup>2</sup>, Ohs J<sup>3</sup>, Hinsley A<sup>4</sup>, Muzumdar J<sup>1</sup><br><sup>1</sup>St. John's University, Queens, NY, USA, <sup>2</sup>Purdue University, West Lafayette, IN, USA, <sup>3</sup>Saint Louis University, St. Louis, MO, USA, <sup>4</sup>Texas State University, San Marcos, TX, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> During the pandemic, individuals in social isolation used social media to seek COVID-19 information and communicate with each other. The purpose of this study was to examine factors that determine how COVID-19 information on social media was processed to promote preventive behavior and information seeking related to this disease.</p> <strong>Methods:</strong> Based on health behavioral theories, we hypothesized that individuals searching COVID-19 information on social media were likely to engage in preventive behavior and seek further information through increased perceived risk, affective response (i.e., anxiety and fear), and personal risk communication. We considered information-seeking assessment as a moderator in the prediction of information-seeking intention. Data were collected from U.S. adults using an online survey platform. Multivariate linear regressions were conducted in a hierarchical fashion while controlling for numerous covariates.</p> <strong>Results:</strong> A total of 314 responses were included in our analyses. Respondents’ mean age was 48.2±18.4 years and about half (55.1%) were females. Our results showed that frequent search of COVID-19 information on social media shaped individuals’ perceived risk (regression coefficient (b) = 0.3714, 95% CI [0.2407, 0.5021]), which then provoked affective responses (b = 0.8543, 95% CI [0.7418, 0.9668]). Such emotional responses induced their communication with close others (e.g., family, friends) or a clinician about the risk, transmission, and prevention of the disease (b = 0.2906, 95% CI [0.2023, 0.3789]). This communication influenced their engagement in risk mitigation strategy such as preventive behavior (b = 0.4979, 95% CI [0.3873, 0.6084]). Notably, individuals were less likely to seek information if they were not comfortable with information seeking (b = - 0.0021, 95% CI [-0.0053, -0.0002]).</p> <strong>Conclusions:</strong> Considering the influence of social media on health behavior, interventions aimed at enhancing consumers’ critique of health information is critical. The study findings also suggest the importance of effective interpersonal communication about public health crisis.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115372","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Feasibility of Identifying Alopecia Areata Cases in an Atopic Dermatitis Population","id":"0bd97ce9-6053-429a-a4ab-1234e9fdbf9b","sessionCode":"EPH26","topDisplay":"<b><u>Ramasubramanian R</u></b><sup>1</sup>, Campos A<sup>2</sup>, Marcus A<sup>3</sup>, Wong C<sup>4</sup><br><sup>1</sup>University of Minnesota Twin Cities, Tarrytown, NY, USA, <sup>2</sup>University of South Florida, Tampa, FL, USA, <sup>3</sup>Regeneron Pharmaceuticals, Westfield, NJ, USA, <sup>4</sup>Pfizer Inc., Brooklyn, NY, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Literature indicates that the risk of Alopecia Areata (AA) among Atopic Dermatitis (AD) patients is higher than the general population. However, studies control for confounding variably and one study suggests bidirectionality between AA and AD. The present study evaluates the feasibility of studying AA among AD patients in administrative claims databases.</p> <p><b>METHODS: </b>The databases, IQVIA PharMetrics and Optum Clinformatics, with a study period between January 1, 2015, and December 31, 2020 were used. Inclusion criteria were: age 7 and above, and continuous enrollment with a gap of no more than 30 days. AD patients were defined as having ≥2 AD diagnoses (ICD-10 code:L20.X) at least 30 days apart. In non-AD cohorts (control cohort), AD patients were excluded. AA was defined as one AA diagnosis (ICD-10 code:L36.X). Incidence rates (IRs) were calculated for each cohort. To address potential misclassification of incident AA cases, two lookback periods were used to exclude prevalent cases (one-year lookback from 2015 and lookback from 2006-2015). Time was censored at first occurrence of AA, end of continuous enrollment with a gap of no more than 180 days, or end of study.</p> <p><b>RESULTS: </b>The IRs for AA (one-year lookback period) in PharMetrics were 257.9 (95%CI: 245.5, 271.0) and 111.2 (95%CI: 108.7, 113.8) per 100,000 person-years in the AD and non-AD cohort, respectively. The 2006-2015 lookback period showed 229.3 (95%CI: 217.6, 241.7) and 100.0 (95%CI: 97.6, 102.5) per 100,000 person-years in the PharMetrics AD and non-AD cohort, respectively. The Clinformatics results indicated a similar pattern.</p> <p><b>CONCLUSIONS: </b>Alopecia Areata crude IRs were higher in the AD cohort compared to the non-AD cohort and decreased upon increasing the lookback period from one to nine years. Evaluating AA in claims among AD patients is feasible when bidirectionality and stratifying IRs by potential confounders are addressed.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporalopecia0426-pdf.pdf?sfvrsn=27268e26_0","title":"ISPOR_Alopecia_0426.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116910","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Economic Evaluation of Vortioxetine in the Treatment of Major Depressive Disorder of Patients Who Have Failed Treatment with Selective Serotonin Reuptake Inhibitors","id":"973444e4-c2c1-4f00-91d3-130a6127b486","sessionCode":"EE90","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong><span>Objective:</span></strong><span> The aim of this study is to determine the cost-effectiveness of vortioxetine versus duloxetine and venlafaxine in adults with major depressive disorder (MDD) who have failed treatment with selective serotonin reuptake inhibitors (SSRIs) from the perspective of the National Health System (NHS) of Mexico.</span></p> <strong><span>Methods:</span></strong><span> We conducted a systematic review (SR) in PubMed, Cochrane, LILACS and Imbiomed databases to evaluate the efficacy and safety of vortioxetine compared to duloxetine and venlafaxine. Afterward, we performed a complete cost-effectiveness economic evaluation using a decision tree model with the information obtained in the SR. The outcome measure was the percentage of patients who did not drop out due to adverse events (Baldwin et al., 2016). The time horizon was eight weeks, in which we consider the use of resources associated with the interventions evaluated and the adverse events presented. The direct medical costs were considered and obtained from NHS purchasing portals in Mexico. Additionally, a budget impact analysis was conducted to calculate the financial impact of the inclusion of vortioxetine as a treatment option in the NHS for adult patients with MDD who have failed treatment with SSRIs.</span></p> <strong><span>Results:</span></strong><span> Vortioxetine has an tolerability measure of 93.4% and an average cost per patient of $ 1,937.98. Duloxetine and venlafaxine have an tolerability measure of 91.2% and 85.8% and an average cost per patient of $1,961.80 MXN and $2,279.25 MXN, respectively. When calculating the Incremental Cost-Effectiveness Ratio, vortioxetine represents a \"dominant\" choice compared to duloxetine and venlafaxine. In a period of 5 years, the inclusion of vortioxetine would imply an average saving of $163,566 MxN. </span></p> <strong><span>Conclusions:</span></strong><span> When considering the percentage of patients who did not drop out due to adverse events, vortioxetine represents a \"dominant\", efficient and savings option for the Mexican NHS.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117777","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Microbiological Examination of Nurses' Hand Hygiene","id":"e05506fb-36a3-4093-b67b-14b875b8ab2e","sessionCode":"HSD11","topDisplay":"Szunomár S<sup>1</sup>, Ömböli G<sup>1</sup>, Turcsán J<sup>1</sup>, Wirthné-Gyergyák K<sup>1</sup>, Far G<sup>1</sup>, Kovács A<sup>1</sup>, Stromájer-Rácz T<sup>2</sup>, Pakai A<sup>3</sup>, <b><u>Boncz I</u></b><sup>1</sup>, Takács K<sup>1</sup><br><sup>1</sup>University of Pécs, Pécs, Hungary, <sup>2</sup>University of Pécs, Kaposvár, Hungary, <sup>3</sup>University of Pécs, Pécs, ZA, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Research on nosocomial infections dates back hundreds of years, but is still of paramount importance today, as it poses a threat to patients and places a burden on the health care system. It is extremely important to introduce effective, constructive solutions to reduce the incidence of infections through continuous research.</p> <strong>Methods</strong>: Our prospective, cross-sectional, quantitative, qualitative analysis was performed between June and November 2019 during 3 microbiological sampling occasions, at the University of Pécs II. Department of Internal Medicine and Nephrology Centre. Nurses working in the ward and inpatient care, were included in the research. Nurses who weren't in patient care were excluded. Non-random, convenience sampling method was used. A total of 86 microbiological samples from hands were examined. Descriptive statistics and T-test were performed using IBM SPSS 24.0. The confidence interval was determined to be 95% (p≤0.05).</p> <strong>Results:</strong> Following strains were identified from nurses’ hands and nursing counter surfaces: MRSA, <em>S. aureus</em>, <em>S. saprophyticus</em>, <em>P. aeruginosa</em>, <em>E. coli</em>, <em>Enterococcus</em>, <em>P. vulgaris</em> and <em>C. glabrata</em>. We found that the condition of hand hygiene before disinfection significantly improved in the case of samples taken after disinfection (n = 86): in the case of positive / negative culture test (p = 0.006), in the presence of colony counts (p = 0.01) and in terms of microbial diversity (p = 0.004).</p> <strong>Conclusions:</strong> The results were significant, however, nurses need to pay more attention to proper disinfection and cleaners to cleanliness in order to control nosocomial infections. Results supports the importance of frequent training of hand hygiene techniques. With the continuous improvement of nursing hand hygiene, a significant improvement can be achieved, which will result in the reduction of health care-associated infections in the long run.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117273","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Comparisons of Encoding Techniques for Categorical Features in Linear Regression Models","id":"13897b7a-1cd2-4ffe-b426-14d0fa071850","sessionCode":"MSR14","topDisplay":"<b><u>Sun W</u></b>, Cai Y, Liu Y<br>IQVIA, Philadelphia, PA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> In healthcare research, data contains many types of categorical variables, such as race, country, zip code, from low to high number of levels in each category. However, aforementioned categorical features need to encode into numeric forms before applying machine learning algorithms. Therefore, it is critical to find a suitable encoding method for coefficient estimation and prediction. In this study, we investigate three commonly used encoding methods and compare them in coefficient estimation, feature selection, and prediction in linear regression analysis.</p> <p><b>METHODS: </b> We compare label encoding, one-hot encoding, and target leave-one out encoding for low (n_level=5) and high number (n_level=50) of levels in categorical variables under balanced and unbalanced synthetic data designs. We apply three different machine learning algorithms (ordinary least squares (OLS), Bayesian ridge and logistic regression) on datasets from the regression and binary classification settings.</p> <p><b>RESULTS: </b> In the low-level (n_level=5) settings with continuous outcomes, all three methods can identify the true important features, and target encoding achieves the smallest mean absolute error (MAE) for both the coefficients estimation and prediction. For binary classification, label encoding fails in detecting true features and the prediction accuracy is around 50%. In the OLS regression scenario, the coefficients derived from one-hot encoding shift far away from the true value, especially for the imbalanced settings. In the high-level settings (n_level=50), target encoding outperforms the other two methods with the smallest prediction MAE, stable coefficients estimation and feature selection. One-hot encoding has relatively low prediction MAE, however, could not identify the true important features under the imbalanced settings and the coefficient estimations are not stable. Label-encoding is not able to identify the true important features and has the largest prediction MAE.</p> <p><b>CONCLUSIONS: </b> Target leave one out encoding outperforms other traditional methods in terms of both coefficient estimation and prediction performance, under both low and high number of categories.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115653","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Classical and Connectionist AI: A New in silico approach to COVID-19 Drug Discovery","id":"f554660e-102c-4d19-b492-157159b42946","sessionCode":"MT4","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> Although the global vaccination programme for COVID-19 is progressing, it will not eradicate the virus. It is vital that the medical community furthers its understanding of the pathobiology of COVID-19 and develops treatments. Since the onset of the pandemic over 40 000 articles have been published. To help researchers extract the information needed for drug development from this research corpus and to understand it in the context of other sources of biomedical data, we developed a unified knowledge representation.</p> <strong>Methods</strong></p> Using the TypeDB database, we developed a knowledge graph of the biological domain, that through logical inference, enables new relationships between entities to be identified. Entities text-mined from the CORD-19 corpus by machine learning were semantically enriched using SemMedDB and ingested along with datasets from <a href=\"https://www.uniprot.org/\">Uniprot</a>, <a href=\"https://dgidb.org/\">DGldb</a>, <a href=\"https://www.proteinatlas.org/\">Human Protein Atlas</a>, <a href=\"https://reactome.org/\">Reactome</a>, <a href=\"https://www.disgenet.org/\">DisGeNET</a> .</p> <strong>Results</strong></p> We ingested 13 587 publications and identified 28 513 paragraphs that mentioned COVID-19-related entities of interest such as genes, proteins, drugs and coronaviruses. Across all data sources, 253 540 entities were included in our knowledge graph, resulting in 2 282 950 relations.</p> <strong>Conclusions</strong></p> The Bio Covid knowledge graph enables users to query and analyse large amounts of data from structured and unstructured sources. Using classical artificial intelligence, connections between entities can be inferred, and in contrast to machine learning techniques (connectionist AI), the reasons and sources of this inference identified. Bio Covid will support study of the mechanisms of coronaviral infection, the immune response, and help find targets for the development of treatments more efficiently, thus providing clinical and economic benefits.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"dda9555e-19ab-4405-936c-34532e5825c6","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Technologies","urlName":"medical-technologies"}],"categoryIds":["dda9555e-19ab-4405-936c-34532e5825c6"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115974","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"An Overview of Optimisation Studies on COVID-19 and Its Economic Benefits in India","id":"43427afe-8200-4d52-95c4-159a0d232d2b","sessionCode":"EE20","topDisplay":"<b><u>Harika E</u></b><sup>1</sup>, Roy M<sup>2</sup><br><sup>1</sup>IIHMR Bangalore, Bangalore, KA, India, <sup>2</sup>Institute of Health Management Research, Bangalore, Bangalore, India","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> As COVID-19 is a multifaceted problem, it cannot be studied from a single perspective or framework, and neither can the related optimisation models. Optimisation studies in the context of COVID-19 have been used for many aspects of the pandemic and are used over policies for disease control, that could tackle the disease more efficiently.This can deal with the uncertainties on the initial conditions and controlling the spread of the disease.</p> <strong><p><b>METHODS: </b></strong> Different frameworks are being proposed to capture the ethos of analysing COVID-19 and the relevant optimisation models .These are: 1)microscale vs. macroscale perspective; 2)early stages vs. later stages perspective; 3)aspects with direct vs. indirect relationships to COVID-19; 4)compartmentalised perspective.This studies include optimisation of screening testing strategies, prediction, prevention and control, resource management ,vaccination prioritisation, and decision support tools.</p> <strong><p><b>RESULTS: </b></strong> To limit scope of review, only optimisation studies related to the prediction and control of COVID-19 and formal optimisation techniques or machine-learning approaches are utilised, mainly focussing on public health.</p> <strong><p><b>CONCLUSIONS: </b></strong> This study identifies the current gaps and major challenges that impede the closure of these gaps and provides some insights into future research directions. This review is conducted to understand the economic benefit of optimisation studies to COVID patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-poster-3-pdf.pdf?sfvrsn=82737d23_0","title":"ISPOR Poster-3.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117563","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Health-Related Quality of Life (HRQOL) of Patients with Transplant-Ineligible Newly Diagnosed Multiple Myeloma (TIE NDMM) and Relapsed/Refractory Multiple Myeloma (RRMM) in Phase III Randomized Controlled Trials (RCTS): A Targeted Literatur ...","id":"1846f610-d7b2-4c32-b8e5-18de9db9ffaf","sessionCode":"PCR30","topDisplay":"<b><u>Charu R</u></b>, Manupati R, Singh JA, Rai MK, Gautam R, Kalsey MS, Prasanna R<br>EVERSANA, Mumbai, India","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE: </strong>The burden of multiple myeloma on patients’ HRQoL is significant and PROs should be considered for evaluating treatment patterns. This targeted review studies HRQoL in patients with TIE NDMM and RRMM receiving daratumumab combination regimens.</p> <strong><p><b>METHODS</strong>: </b>We conducted a targeted search using PubMed, Cochrane and CT.gov databases. Regimens containing daratumumab (D) in combination with lenalidomide and dexamethasone (Rd), bortezomib and dexamethasone (Vd) and bortezomib, melphalan and prednisone (VMP) were selected from year 2011 to 2021.</p> <strong><p><b>RESULTS</strong>: </b>We identified 251 articles and those not pertaining to inclusion criteria were excluded. Four open-label, phase III RCTs reporting daratumumab combination regimens in TIE NDMM and RRMM patients were included. HRQoL was measured using EORTC QLQ-C30 and the EQ-5D-5L instruments in all four trials. For two RCTs with TIE NDMM patients, a total of 1443 patients were enrolled comparing D-Rd (n=368) with Rd (n=369) in MAIA and D-VMP (n=350) with VMP (n=356) in ALCYONE. Both trials showed evidence of HRQoL benefits for daratumumab combination versus respective comparators and maintained meaningful improvements in global health status (GHS), function and symptoms scales. For two RCTs with RRMM patients, a total of 1068 patients were evaluated comparing D-Rd (n=386) with Rd (n=383) in POLLUX trial and D-Vd (n=251) with Vd (n=247) in CASTOR trial. In POLLUX trial, mean changes from baseline were significantly greater in D-Rd group, however the magnitude of PRO change suggested no meaningful clinical impact on HRQoL. In CASTOR trial, no significant between-group differences were observed for the first eight cycles of therapy, after which PROs result for D-Vd group only showed improvements in GHS, pain and VAS scales from baseline.</p> <strong>CONCLUSION: </strong>Treatment of TIE NDMM and RRMM with daratumumab in combination has shown encouraging results in the improvement of HRQoL, however further research is suggested to strengthen the findings.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/pcr30-mahendra-kumar-rai-poster-pdf.pdf?sfvrsn=eb79a0cd_0","title":"PCR30 Mahendra Kumar Rai Poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116788","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Assessment of the French National Experimentation for Incentivising Hospital Prescriptions of Adalimumab Biosimilars Delivered in Retail Pharmacies","id":"083d277e-8479-4059-9989-19c5a44bb06b","sessionCode":"HPR12","topDisplay":"<b><u>Tano M</u></b><sup>1</sup>, Degrassat Theas A<sup>2</sup>, Ribault M<sup>3</sup>, Paubel P<sup>2</sup><br><sup>1</sup>Faculty of Pharmacy, Paris University, Paris, France, <sup>2</sup>General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP) ; Law and Health Economics Department, Faculty of Pharmacy & Health Law Institute (INSERM UMR S1145) University of Paris, Paris, France, <sup>3</sup>General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Regarding the low penetration of biosimilars drugs in the French market, the government introduce two incentives to increase biosimilar use. First, the “general case” redirects 20% of the price difference between reference product and its biosimilar to hospitals for every biosimilar delivered in community pharmacy from these hospital’s prescriptions. Second, the “experimental case” increases the premium to 30% by specifically targeting prescribing hospital clinical units for every biosimilar delivered in community pharmacy from these clinical unit’s prescriptions. The experimentation started in October-2018 and concerned etanercept and insulin glargine. It was then extended to adalimumab in April-2019. Our study aimed to compare the efficacy of both incentives for adalimumab biosimilars after 19 months.</p> <p><b>METHODS: </b> We used IQVIA Xponent data to evaluate public hospitals’ prescriptions. The number of adalimumab boxes delivered in retail pharmacies was given on a monthly basis and was linked to the corresponding hospital’s prescription. The comparison between hospitals in the experimentation and the others was assessed by a double difference method.</p> <p><b>RESULTS: </b> Among the 39 hospitals studied in the “experimental case”, 95% were public. They were compared to 208 other hospitals (“general case”) of which 83% were public. Before the experiment, in March 2019, the mean rate of adalimumab biosimilars was 10.3% for hospitals in the experimental case and 8.3% for those in the general case. These mean rates continuously increased and were respectively of 38.6% and 29.8% in October 2020. The double difference estimator (6.2%) was not significant.</p> CONCLUSION: Contrary to the same experiment for etanercept<sup>1</sup>, we cannot conclude to an advantage of incentivising clinical care units to increase the use of adalimumab biosimilars. However, both experimentation and marketing of adalimumab’s biosimilars is more recent and there is still room for improvement. A new assessment should be done in May-2022 at the end of the experimentation.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-adalimumab---ispor---may-2022-vf-pdf.pdf?sfvrsn=21411f95_0","title":"Poster adalimumab - Ispor - may 2022 vf.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114921","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Effects of Pharmacist Interventions on Pain Intensity: Systematic Review and Meta-Analysis of Randomized Controlled Trials","id":"555ef0c6-2714-4e6c-a785-19c972d6c8e7","sessionCode":"CO25","topDisplay":"<b><u>Veettil SK</u></b><sup>1</sup>, Darouiche G<sup>1</sup>, Sawangjit R<sup>2</sup>, Cox N<sup>1</sup>, Lai NM<sup>3</sup>, Chaiyakunapruk N<sup>1</sup><br><sup>1</sup>University of Utah, Salt Lake City, UT, USA, <sup>2</sup>Mahasarakham University, Maha Sarakham, Thailand, <sup>3</sup>Taylor's University, Subang Jaya, Malaysia","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Pharmacists can play an important role in pain management. This review aims to summarize the effect of any type of pharmacist intervention, whether led by a pharmacist or in a supportive role, on pain intensity over time in individuals with pain of any etiology. </p> <strong><p><b>METHODS: </b> </strong>Three electronic databases (Medline, Embase, and CENTRAL) were searched from inception until the end of May 2021 to identify randomized controlled trials (RCTs) which reported the effect of pharmacist interventions on pain intensity. Two reviewers independently extracted data and evaluated study quality. The analyses used a random-effects models and the Grading of Recommendations Assessment, Development and Evaluation to rate the certainty of the evidence. The primary outcome was reduction in pain intensity and presented as standardized mean differences (SMD).</p> <strong><p><b>RESULTS: </b> </strong>Twelve RCTs including 1,710 participants were included. Pooled estimate of 12 studies demonstrated a statistically significant reduction in pain intensity compared to control (SMD: −0.22; [95% CI, −0.31 to −0.12]; I<sup>2</sup> = 0%; low certainty). The intervention was more effective when a pharmacist delivered a combination of services comprising educational interventions, medication review, and pharmaceutical care services (SMD: −0.24; [95% CI, −0.35 to −0.13]; I<sup>2</sup> = 0%; moderate certainty). For educational interventions alone, no significant difference was observed (SMD: −0.15; [95% CI, −0.45 to 0.15]; I<sup>2</sup> = 47.6%; low certainty). Pharmacist intervention was also effective in reducing pain intensity for patients with cancer-related pain (SMD: −0.76; [95% CI, −1.17 to −0.36]; I<sup>2</sup> = 0%; moderate certainty).</p> <strong><p><b>CONCLUSIONS: </b> </strong>There is some promising evidence to suggest that multicomponent pharmacist interventions including medication review or any other pharmaceutical care services, rather than merely educational interventions, are beneficial in reducing pain intensity, particularly in chronic pain patients. High-quality RCTs are required to confirm the clinical significance of this findings before advocating for its widespread implication in clinical practice.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115893","diseases":[{"id":"f2cabca2-ce06-433e-903c-56285673ffc3","parentId":"00000000-0000-0000-0000-000000000000","title":"Musculoskeletal Disorders","urlName":"Musculoskeletal-Disorders"},{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Evolving Role of Disease-Level Patient Experience in Health Technology Assessment (HTA) and Regulatory Decision-Making","id":"163c00fa-f3a8-4771-a13a-1a4f09d0c008","sessionCode":"PCR6","topDisplay":"<b><u>Hudzik A</u></b><sup>1</sup>, Sandman K<sup>2</sup>, Pham S<sup>3</sup><br><sup>1</sup>University of North Carolina, boston, MA, USA, <sup>2</sup>AESARA, Acton, MA, USA, <sup>3</sup>AESARA, Chapel Hill, NC, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Understanding the disease-level patient experience is increasingly important to HTA and regulatory agencies when evaluating new therapies.<span> </span>Disease-level patient experience expands on evidence collected in clinical trials, covering areas including unmet need in the disease state and patient preferences.<span> </span>This review compared the role and usage of disease-level patient experience across several HTA bodies and regulatory agencies.</p> <strong><p><b>METHODS: </b> </strong>The latest patient experience guidance from FDA (2021 draft guidance), EMA (2014 revised framework), ICER (2021 Patient Engagement Program), and NICE (2013 Patient and Public Involvement Policy) were analyzed for how patient experience is defined, how and by whom it is collected, how it is used in product evaluation, and guidance development process.</p> <strong><p><b>RESULTS: </b> </strong>All four agencies defined patient experience as including perspectives from patients, caregivers, and advocacy groups.<span> </span>FDA specifies that sponsors collect disease-level patient experience, while the other three agencies themselves gather input.<span> </span>NICE and ICER collect patient experience via surveys; EMA includes patients on committees and for scientific consultations; FDA does not specify how to collect disease-level patient experience.<span> </span>EMA, which solicits patient input throughout the drug evaluation process, is piloting a program to gather qualitative patient experience, which it currently does not explicitly utilize, to support product assessments.<span> </span>FDA proposes to utilize patient experience in benefit:risk assessment, recommending early sponsor engagement to ensure appropriate collection.<span> </span>ICER and NICE currently utilize disease-level patient experience to provide greater context on treatment landscapes, potentially impacting their recommendations.<span> </span>FDA and EMA guidance indicates a role for disease-level patient experience in product assessments without specifying how the evidence is used.</p> <strong><p><b>CONCLUSIONS: </b> </strong> While there is a need for greater specificity and transparency in how disease-level patient experience is utilized in regulatory and HTA processes, manufacturers should consider collecting robust disease-level patient experience data that illuminates disease context to support regulatory and reimbursement decision-making.<span> </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/aesara-p03-disease-level-patient-experience-poster-pdf.pdf?sfvrsn=7095ea9c_0","title":"AESARA P03 Disease level patient experience poster .pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116384","diseases":[{"id":"df9240d9-f266-47e0-ba0b-a11dfd152ae4","parentId":"00000000-0000-0000-0000-000000000000","title":"Biologics and Biosimilars","urlName":"biologics-and-biosimilars"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Systematic Review of Ntrk Fusion Prevalence across Cancer Types to Predict Impact of Histology Independent Cancer Treatment","id":"543d4e85-96a6-4a6a-9c5e-1ae223be9908","sessionCode":"EPH33","topDisplay":"<b><u>O'Haire S</u></b><sup>1</sup>, Franchini F<sup>2</sup>, Kang YJ<sup>3</sup>, Steinberg J<sup>3</sup>, Fox S<sup>4</sup>, Desai J<sup>4</sup>, IJzerman M<sup>5</sup><br><sup>1</sup>The University of Melbourne, Parkville, VIC, Australia, <sup>2</sup>The University of Melbourne, Melbourne, VIC, Australia, <sup>3</sup>The University of Sydney, Sydney, NSW, Australia, <sup>4</sup>Peter MacCallum Cancer Centre, Melbourne, VIC, Australia, <sup>5</sup>University of Melbourne, Melbourne, VIC, Australia","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> NTRK gene fusions are rare mutations found across cancer types, detectable through various molecular tests. Identifying patients with these mutations for targeted treatments presents a costly challenge for the healthcare system, with population rates unknown. We performed a systematic literature review of NTRK fusion prevalence across cancer types to understand the variation in rates, to inform effective population diagnostic screening and scale of potential therapeutic uptake.</p> <strong>Methods</strong></p> We searched Medline, Embase and Cochrane databases on April 1, 2021. Studies reporting NTRK fusion rates in solid tumour cohorts were included. Further criteria were English language, publication post-2010 and minimum sample size. Cohorts selected based on fusion status and abstracts were excluded. Study bias and quality were assessed using two adapted checklists for evaluating prevalence studies<em>.</em></p> <strong>Results </strong></p> A total of 159 studies were included to inform NTRK fusion prevalence, with 17 pan-cancer estimates and 429 estimates for specific cancer types (including 36 paediatric cohorts). Adult pan-cancer estimates ranged from 0.03% to 0.70%, with higher rates reported based on RNA assays<em>. </em>Across common cancers, rates were consistently <1% for studies with sufficient sample size. Higher rates were seen in common cancers for cohorts with driver mutation exclusion, colorectal cancers with microsatellite instability, and rare morphological subtypes. Overall, NTRK fusions were identified across 79 different cancers. Zero NTRK fusions were found for 187 (43.5%) cancer type estimates, but only a minority of these had sufficient sample size and high sensitivity testing. No studies were free from external validity bias; reporting of cohort demographics was lacking in 39% of studies.</p> <strong>Conclusions</strong></p> Current evidence affirms NTRK fusion positive cancers are rare and widely distributed. Rarity increases the complexity of implementing efficient population screening, while small-scale, heterogeneous data confound prediction of health system impact. Further large-scale, standardised genomic data are needed to characterise NTRK fusion epidemiology.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor2022ntrkposter-pdf.pdf?sfvrsn=e4bb6d2d_0","title":"ISPOR_2022_NTRK_Poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115469","diseases":[{"id":"e32f673e-b410-4126-9261-86abf08a0554","parentId":"00000000-0000-0000-0000-000000000000","title":"Personalized and Precision Medicine","urlName":"personalized-and-precision-medicine"},{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"The Effect of Weight Loss on Hypothalamus Structure and Function in Obese Individuals: A Systematic Literature Review and Meta-Analysis","id":"22dc2cf3-7967-4ef5-861a-1b45122c2ea7","sessionCode":"MSR18","topDisplay":"<b><u>Gedda DUK</u></b><sup>1</sup>, Mekary RA<sup>2</sup>, Devi S<sup>3</sup>, Yadav N<sup>4</sup>, Chawla S<sup>5</sup>, Doucette J<sup>6</sup>, Moura LD<sup>7</sup>, Velloso LA<sup>8</sup><br><sup>1</sup>M.C.P.H.S University, Boston, MA, USA, <sup>2</sup>MCPHS Univeristy, Boston, MA, USA, <sup>3</sup>Kings College London, Boston, MA, USA, <sup>4</sup>MCPHS University, Jersey City, NJ, USA, <sup>5</sup>Faculty of Life Sciences and Medicine, King’s College London, London, UK, <sup>6</sup>MCPHS University, Boston, MA, USA, <sup>7</sup>University of Campinas, Limeira, Brazil, <sup>8</sup>University of Campinas, San Paulo, Brazil","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Obesity (body mass index (BMI) ≥ 30 kg/m<sup>2</sup>) is usually presented with structural and functional hypothalamic dysfunction. However, it is currently unclear whether weight loss can modify these hypothalamic changes. We, therefore, aimed to conduct a systematic review and meta-analysis to determine the effect of body mass reduction in obese individuals on hypothalamic structure and function.</p> <p><b>METHODS: </b> PubMed, Embase and Cochrane databases were searched through 11/2020 for studies that evaluated the change in hypothalamic structure and function after weight loss. Qualitative and quantitative analyses were performed on reported magnetic resonance imaging techniques, medio-basal hypothalamus T2-relaxation time, blood oxygen level dependent (BOLD) contrast, voxel-based morphometry (VBM), and biomarkers including glucose, insulin, leptin, ghrelin, and interleukins. Mean differences pre- vs. post-weight loss and 95% confidence intervals (CI) were pooled using random-effects models.</p> <p><b>RESULTS: </b> Thirteen pre-post studies were included, of which six accounted for the meta-analysis. A favorable decrease in T2-relaxation time (one study) and BOLD contrast showed a favorable change in neural and functional activity of the hypothalamus after weight loss (four studies), with higher peak activities after surgical weight loss (two studies). No difference was found in VBM in the gray matter density of the hypothalamus after surgical weight loss (one study). Pooled mean differences pre- vs. post-surgical weight loss revealed a decrease of 8.53 mg/dl (95% CI: 5.17, 11.9; six studies) in glucose; 7.73 pmol/l (95% CI: 5.07, 10.4; four studies) in insulin; 15.5 ng/ml (95% CI: 9.40, 21.6; four studies) in leptin, 142.9 pg/ml (95% CI: 79.0, 206.8; two studies) in ghrelin, and 9.43 pg/ml (95% CI: -6.89, 25.7; two studies) in IL6.</p> <p><b>CONCLUSIONS: </b> Our results demonstrated that weight reduction in obesity escalated the activity of hypothalamus and upregulated body homeostasis along with improved markers related to metabolic regulation.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hypoispor2022dg-pdf.pdf?sfvrsn=fcf65ce1_0","title":"Hypo_ISPOR_2022_DG.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116670","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"bde7079b-7db2-4006-9dbf-54d654e04fc7","parentId":"00000000-0000-0000-0000-000000000000","title":"Surgery","urlName":"Surgery"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Utility of Artificial Intelligence in Systematic Literature Reviews for Health Technology Assessment Submissions","id":"4b40a70a-9244-4371-9092-1b6402fed469","sessionCode":"SA3","topDisplay":"<b><u>Cichewicz A</u></b><sup>1</sup>, Burnett H<sup>1</sup>, Huelin R<sup>1</sup>, Kadambi A<sup>2</sup><br><sup>1</sup>Evidera, Waltham, MA, USA, <sup>2</sup>Evidera, San Mateo, CA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: The use of artificial intelligence (AI) may alleviate additional time and effort needed to conduct robust, fully comprehensive systematic literature reviews (SLRs) intended for submission to health technology assessment (HTA) bodies. This study aimed to determine the ability of AI to accurately identify relevant studies on costs, healthcare resource use (HCRU), economic evaluations (EE), and patient-reported outcomes (PRO).</p> <strong>Methods</strong>: Title/abstract screening from previously completed SLRs (2008-2018) on costs/HCRU, EE, and PRO in attention-deficit/hyperactivity disorder were replicated using DistillerSR AI reviewer. Sets of 50 and 150 references from each SLR were used to train the AI reviewer. Screening decisions for 3,201 references were compared between AI and human reviewers.</p> <strong>Results</strong>: With training sets of 50 references –completed as a calibration exercise by the human reviewers– approximately 77% of AI screening decisions were accurate and the AI correctly screened most (62-83%) records originally missed by human reviewers. However, several exclusions made by the AI were references that were ultimately included in the SLRs by human reviewers. These exclusion errors occurred most often with EE (85.7%) followed by costs/HCRU (58.3%), and PRO (46.8%). Increasing the training sets to 150 references improved the accuracy of AI screening to 84% for costs/HCRU and EE, and increased its ability to correctly identify EE (exclusion errors reduced to 30%). The accuracy did not improve for PRO, although AI was less likely to exclude studies that should have been included in the SLR.</p> <strong>Conclusions</strong>: Larger training sets impacted the ability of AI to accurately identify EE and cost/HCRU studies, but to a lesser extent for PRO. While this study assessed AI as a single reviewer in a small sample, the results suggest AI may be best utilized as a second reviewer or in conjunction with other DistillerSR AI capabilities to offset the human screening burden.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/cichewicz-et-al-ispor-2022-pdf.pdf?sfvrsn=339c8272_0","title":"Cichewicz et al ISPOR 2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116574","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Economic Evaluation of COVID-19 Vaccines: A Targeted Literature Review","id":"f3963424-0848-4595-9c15-1b9f7f998209","sessionCode":"EE7","topDisplay":"Addae A, Ramjee L, <b><u>Tremblay G</u></b><br>Cytel, Inc., Waltham, MA, USA","locationCode":"","description":"\r\n\t<div><b><span data-contrast=\"auto\"><p><b>OBJECTIVES: </b></span></b><span data-contrast=\"auto\"> The COVID-19 pandemic became a public health threat requiring the rapid development and distribution of vaccines around the world to help combat the virus. The objective of this study was to review and summarize published economic evaluations of COVID-19 vaccines with the aim of aiding the development of future models.</span><span data-ccp-props=\"{\"201341983\":0,\"335559739\":160,\"335559740\":259}\"> </span></p> <b><span data-contrast=\"auto\"><p><b>METHODS: </b></span></b><span data-contrast=\"auto\"> PubMed, Google Scholar, Cochrane Library, and other databases were searched from August 2021 to November 2021 to identify published literature of economic evaluations of COVID-19 vaccines. The studies identified were critically appraised and relevant data on the interventions and comparators, populations, perspectives, costs, utilities, time horizons, model structures, model types, and model outcomes from the included studies were extracted. </span><span data-ccp-props=\"{\"201341983\":0,\"335559739\":160,\"335559740\":259}\"> </span></p> <b><span data-contrast=\"auto\"><p><b>RESULTS: </b></span></b><span data-contrast=\"auto\"> A total of 14 economic evaluations were identified through the targeted review including studies from the United States, Turkey, the United Kingdom, Taiwan, Spain, South Africa, Ukraine, and Denmark. Evaluation of the studies found that a 1-year time horizon was modeled in most studies. Analyses were mostly conducted from a healthcare payer perspective; however, in some studies, the societal perspective was included. Dynamic state transition (semi-Markov) models or decision tree models were utilized in the studies identified. A common structure of health states was observed with most models including the states: susceptible, infected, recovered, and dead. The infected state was often split into several sub-states to account for varying degrees of symptom severity. Across all the studies reviewed, COVID-19 vaccines were estimated to be a cost-effective use of public resources. Among the key drivers of the model outcomes identified in the studies were the cost of the vaccines, vaccine effectiveness, vaccine coverage, and time horizon used. </span><span data-ccp-props=\"{\"201341983\":0,\"335559739\":160,\"335559740\":259}\"> </span></p> <b><span data-contrast=\"auto\"><p><b>CONCLUSIONS: </b></span></b><span data-contrast=\"auto\"> This research aids future economic evaluations of COVID-19 vaccines by providing an overview of previously published models, including methodologies and parameter inputs used. </span><span data-ccp-props=\"{\"201341983\":0,\"335559739\":160,\"335559740\":259}\"> </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ramjeeispor-us-ee7042022approved-pdf.pdf?sfvrsn=4971a835_0","title":"Ramjee_ISPOR US EE7_042022_approved.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116046","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Stroke Rehabilitation Treatment Preferences of Chinese Physicians and Patients during the COVID-19 Pandemic: A Discrete Choice Experiment","id":"60645dcf-2d06-406d-a1dd-1c36fd07ea67","sessionCode":"PCR16","topDisplay":"<b><u>Feng G</u></b><sup>1</sup>, Hao D<sup>1</sup>, Liu T<sup>2</sup>, Fang X<sup>1</sup>, Yan N<sup>1</sup>, Chen Q<sup>1</sup>, Huang F<sup>1</sup>, Jian T<sup>1</sup>, Zhong Q<sup>3</sup>, Wu Y<sup>1</sup>, Yuan L<sup>1</sup>, Ming WK<sup>4</sup><br><sup>1</sup>Jinan University, Guangzhou, 44, China, <sup>2</sup>Jinan University, TAI PO N.T, Hong Kong, <sup>3</sup>Jinan University, Hong Kong, 91, China, <sup>4</sup>City University of Hong Kong, Hong Kong, Hong Kong","locationCode":"","description":"\r\n\t<div><strong><span><p><b>OBJECTIVES: </b></span></strong><span> Exploring physicians' and patients' preferences for stroke rehabilitation treatment during the pandemic and the differences between preferences.</span></p> <strong><span><p><b>METHODS: </b></span></strong><span> We designed an online questionnaire to survey participants in hospitals. The selected attributes included 'Acceptable hospital distances,' 'Acceptable hospital grades,' 'Duration of each treatment,' 'Main treatment methods,' 'Total acceptable length of treatment,' and 'Total cost of treatment(¥).' After data collection was completed, we built a multinomial logit model and a latent class model. We performed subgroup analysis to observe their treatment preferences and willingness to pay and to see whether the difference in preferences between them was statistically significant.</span></p> <strong><span><p><b>RESULTS: </b></span></strong><span> In the logit model, we found that people wanted 30 days of exercise therapy or physical therapy at a university-affiliated hospital that was close to home and inexpensive, with the shortest possible total treatment time. The highest preference weight was the level at which the total treatment cost was zero. In the subgroup analysis, we found that physicians and patients did not have the same concerns, with physicians focusing on 'Main treatment method' and 'Total cost of treatment(¥),' while patients were more concerned with 'Acceptable hospital distances' and 'Acceptable hospital grades,' and this difference between them was statistically significant.</span></p> <strong><span><p><b>CONCLUSIONS: </b></span></strong><span> These results confirmed what physicians and patients think, which could also give us an idea of the weight of their preferences for rehabilitation treatment. Physicians should take treatment preferences into account when treating patients, as this will help improve patients' compliance and further improve the effectiveness and safety of clinical care, which also help stroke patients to some extent and provide the scientific basis and sound advice to Chinese health authorities.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/117346guanrui-fengposter-pdf.pdf?sfvrsn=8a31ca11_0","title":"117346_Guanrui Feng_poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117346","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Standardizing Pro-CTCAE Analyses and Output: Must Have, Helpful to Have, and Easy to Understand","id":"2637ed99-cd8c-4554-ae83-1cfeef248675","sessionCode":"PCR22","topDisplay":"Skaltsa K<sup>1</sup>, <b><u>Shaw J</u></b><sup>2</sup>, Hawryluk E<sup>3</sup>, Bean SE<sup>3</sup>, Reaney M<sup>4</sup><br><sup>1</sup>IQVIA, Barcelona, B, Spain, <sup>2</sup>Bristol-Myers Squibb, Lawrenceville, NJ, USA, <sup>3</sup>IQVIA, New York, NY, USA, <sup>4</sup>IQVIA, Reading, UK","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Patient-reported treatment experiences are increasingly important in oncology drug development and clinical practice. The Patient Reported Outcomes – Common Terminology Criteria for Adverse Events (PRO-CTCAE<sup>TM</sup>) was developed to explore patient perceptions of symptomatic effects. Although analyzing and presenting data consistently across drugs/clinical programs/sponsors is beneficial for decision making, there is no definitive guidance on how to analyze or present PRO-CTCAE™ data. While the Food and Drug Administration (FDA) has presented a framework for describing and visualizing PRO-CTCAE™ data, numerous questions remain, including: “What is the appropriate denominator in calculating incidence?”; “How should missing data be summarized?”; and “Which graphical presentation is easiest to interpret?”. <strong><p><b>METHODS: </b></strong> Based on a review of the literature; the authors own experiences in analyzing, interpreting, and presenting PRO-CTCAE™ data; and post-hoc exploration of trial data, key questions to ask of PRO-CTCAE™ data have been considered. <strong><p><b>RESULTS: </b></strong> We recommend a standard set of 26 questions related to completion rates, evolution of symptom experiences, and treatment effects, as well as associated analyses and graphical presentations to inform regulatory/payer decision making and support clinical interactions. Three levels of recommended analyses are specified to answer these key questions: (1) Core analyses to inform messaging to regulators, payers, and sponsor teams; (2) Contextual/supportive analyses to facilitate messaging derived from core analyses; (3) Additional analyses for communicating with patients and clinicians. Each analysis should produce a combination of tables and graphical presentations. A variety of presentation modalities, including stacked bar charts, line graphs, pie charts and Kaplan Meier curves, are recommended depending on the key question. <strong><p><b>CONCLUSIONS: </b></strong> An iterative approach was taken to propose a list of PRO-CTCAE™ questions, analyses and data presentations that should resonate with regulators and payers and support interactions between patients and clinicians. We propose consistency between sponsors in analyzing and presenting PRO-CTCAE™ data to facilitate review and comparison.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115027","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Reexamination of Drug Costs for Cetuximab and Panitumimab in Metastatic Colorectal Cancer: Assessing the Influence of Drug Vial Splitting","id":"1b500f4d-4dfb-4e54-b0eb-1e1cd8047a39","sessionCode":"EE84","topDisplay":"<b><u>Puskuru S</u></b><sup>1</sup>, Rittenhouse B<sup>2</sup>, Kallich JD<sup>1</sup>, Eguale T<sup>1</sup><br><sup>1</sup>MCPHS University, Boston, MA, USA, <sup>2</sup>MCPHS University, Winchester, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> A 2017 cost-effectiveness analysis (CEA) of cetuximab, panitumumab and best supportive care indicated neither drug was cost-effective. A patient of average height and weight (70 kg and 162 cm) was assumed to use drug quantity needed (discarding the remainder of any unused vial) but assigned an entire vial’s cost. An alternative assumption is that groups of patients are dosed together, allowing vial sharing and thereby reducing cost. As cetuximab is dosed based on a combination of height and weight - body surface area (BSA) and panitumumab by weight, this assumption and dosing differences could lead to differences in total drug cost by treatment.</p> <p><b>METHODS: </b> Dosing was 6mg/kg and 500mg/m<sup>2</sup> for panitumumab and cetuximab respectively. Drug costs per session were re-assessed without drug wastage and scaled to a quarterly figure to compare with original costs. This analysis is limited to drug costs per quarter for patients in the model as the interaction of drug cost with other costs in the model is complex and not yet fully determined.</p> <p><b>RESULTS: </b> For panitumumab the average patient needed 5 vials and wasted 80 mg. For cetuximab, 9 vials were needed (25 mg wastage). Using the wasted drug on another patient showed differential effect on the two drug costs. Per treatment, panitumumab savings were $216.34 and cetuximab’s were $41.68. Quarterly drug costs declined by $1298 and $250, respectively.</p> <p><b>CONCLUSIONS: </b> This research shows a potential benefit from a patient group dosing strategy which differs by drug for the average patient. It is also clear that variation from the average patient height and weight will have variable implications on total drug costs and quantitative CEA results. It is not yet clear if the qualitative CEA conclusions would vary or if treating different body type patients with different drugs based on different CEA conclusions is practical.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporposterpresentation-pdf.pdf?sfvrsn=af8bebcb_0","title":"ISPOR_poster_presentation.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114897","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Health-Related Quality of Life (HRQOL) Among Chinese Population during the COVID-19 Pandemic: The Role of Socio-Demographic Factors and Loneliness","id":"9079b57c-e578-4696-bd15-1edc2fe95c3c","sessionCode":"EPH6","topDisplay":"<b><u>Wong E</u></b><sup>1</sup>, Li J<sup>1</sup>, Yuen S<sup>2</sup>, Lai AHY<sup>3</sup>, Cheung AWL<sup>1</sup>, Yau PSY<sup>1</sup>, Yeoh EK<sup>1</sup><br><sup>1</sup>The Chinese University of Hong Kong, Hong Kong, 91, China, <sup>2</sup>Leiden University, Leiden, Netherlands, <sup>3</sup>The Hong Kong Polytechnic University, Hong Kong, China","locationCode":"","description":"\r\n\t<div>Background</p> The infection control policy affected people’s well-being during COVID-19, especially those vulnerable population. The study aimed to explore the factors, including socio-demographic characteristics and loneliness, associated with health-related quality of life (HRQoL) among Hong Kong Chinese population under the pandemic.</p> Methods</p> A cross-sectional questionnaire survey was conducted between June and December 2020 among adult Chinese population during the 2<sup>nd</sup> wave of COVID-19 in Hong Kong (HK). Due to the social distancing measures, most of the questionnaires were filled in via online platforms with the rest being administrated in person. HRQoL was measured by Hong Kong validated EQ-5D-5L instrument (EQ-5D-5L HK). Loneliness was measured by a single item question regarding the frequency of the participant reporting feeling lonely and subjective social status (SSS) was measured by the MacArthur Scale of Subjective Social Status.</p> Results</p> A total of 503 responses were collected. The HRQoL score of the respondents was significantly lower than the refer norms profile among local population. The findings identified that a younger age, single, a higher subjective social status, and a lower level of loneliness were significantly associated with better HRQoL. Moreover, these factors may also interact with each other to influence HRQoL. Specifically, older participants reported lower HRQoL than younger participants especially when they report a higher level of loneliness.</p> Conclusions</p> The present study found that some groups of population may face extra vulnerabilities during the pandemic in terms of declined HRQoL. Reducing loneliness can be protective of the HRQoL during the pandemic, especially among older people. It provides useful information for policy-makers to provide effective services to help people recover from the global pandemic.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporelizaposterhrqol20220422final-pdf.pdf?sfvrsn=fb9d3d50_0","title":"ISPOR_ElizaPoster_HRQoL_20220422Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117519","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Characteristics and Outcomes in Hospitalizations of Children 1-4 Years of Age with Influenza-like Illness in 2016-2019","id":"dd8771d8-707f-43ea-af55-20d388413f9f","sessionCode":"CO23","topDisplay":"<b><u>Banuelos R</u></b>, Clark LA, Rizzo E, Belk K<br>Lumen Value & Access, New York City, NY, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b></p> To characterize hospitalizations and outcomes of children aged 1 to 4 with influenza-like illness (ILI) from viruses including Respiratory syncytial virus (RSV), Influenza, human metapneumovirus (hMPV), parainfluenza (PIV), Adenovirus, and Rhinovirus.</p> <strong><p><b>METHODS</strong>: </b></p> This analysis used data from the 2016-2019 Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS). Hospitalizations for children 1 to 4 years of age with a single virus were identified using ICD-10 codes. In-hospital mortality, length of stay in days (LOS), and cost-to-charge ratio adjusted charges (costs) were analyzed using nested multivariable regression models. Models were adjusted for patient and hospital characteristics, and number of Feudtner’s Chronic Comorbidity Categories. All summaries and models accounted for hospital NIS-weights.</p> <strong><p><b>RESULTS</strong>: </b></p> A weighted total of 172,705 hospitalizations were identified. RSV and Influenza accounted for 58.3% and 21.9% followed by Adenovirus (10%), while hMPV, PIV, and Rhinovirus made up 7%, 1.6%, and 1.3%, respectively. Overall median (Q1-Q3) costs were $4,208 ($2,229-$8,717) and LOS of 1.84 (0.74-3.52). PIV had the largest costs and LOS of $8,580 ($3,769-$19,280) and 2.92 (1.41-6.37) followed by hMPV with LOS=2.86 (1.52-5.16), and costs=$6,920 ($3,672-$14,595).</p> Overall weighted mortality was 530 (0.3%), of which RSV and Adenovirus were present in 63.2%. Asthma was present in 25.6% hospitalizations, of which 3.8% were with acute exacerbation. Top outcomes included bronchiolitis (53.0%), acute respiratory failure (18.7%) and viral pneumonia (16.4%).</p> <span>The adjusted odds ratio (aOR) of mortality for Adenovirus and hMPV were aOR=2.98 [95% CI=(1.67-5.30)] and aOR=2.54 [95% CI=(1.39-4.64)], respectively. Adjusted mean costs ranged from $3,980-$5,957 and adjusted mean LOS ranged from 2.37-3.15, with PIV having the largest in both.</span><span> </span></p> <strong><p><b>CONCLUSIONS</strong>: </b></p> ILI from common and less frequently reported viral pathogens resulted in significant increases in respiratory disorders, LOS and costs. PIV was associated with greater costs and longer LOS, while Adenovirus and hMPV were associated with increased odds of mortality.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116931","diseases":[{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Contemporary Total Cost of Care Among Medicare Patients with Primary and Recurrent Clostridioides Difficile Infection","id":"1ee7c57f-d1f0-4487-b0e0-20e3d8cbfff1","sessionCode":"EE6","topDisplay":"Amin A<sup>1</sup>, <b><u>Guo A</u></b><sup>2</sup>, Teigland C<sup>3</sup>, Mohammadi I<sup>3</sup>, Schablik J<sup>4</sup>, Reveles K<sup>5</sup><br><sup>1</sup>University of California, Irvine, CA, USA, <sup>2</sup>Ferring Pharmaceuticals, Inc., Parsippany, NJ, USA, <sup>3</sup>Avalere Health, an Inovalon Company, Washington, DC, USA, <sup>4</sup>Avalere Health, an Inovalon Company, Roxboro, NC, USA, <sup>5</sup>The University of Texas at Austin, San Antonio, TX, USA","locationCode":"","description":"\r\n\t<div><b>OBJECTIVE</b>: We evaluated mortality and total healthcare costs among contemporary Medicare patients with primary CDI (pCDI) and recurrent CDI (rCDI), as well as the main drivers of the costs.</p> <b><p><b>METHODS: </b></b> Using 100% Medicare Parts A, B, and D claims between 2009-2017, we identified patients aged ≥65, continuously enrolled for 12-months with no evidence of CDI prior to index CDI and up to 12-months post-index. Total costs of care were calculated as per-patient-per-month (PPPM) overall and separately for patients with CDI-linked death, defined as patients whose most proximal healthcare visit on or near date of death had CDI in primary/secondary diagnosis field.</p> <b><p><b>RESULTS: </b></b> Of 497,489 CDI patients included, 42.8% overall died within 12 months after index CDI. Mortality rates increased with recurrences for deaths that were CDI-linked (pCDI 2.7%, 1rCDI 16.4%, 2rCDI 30.9%, 3+rCDI 50%). CDI was a primary contributing diagnosis to 50% of the deaths in patients with 3+ recurrences. Mean (SD) PPPM costs for pCDI patients who died was $29,150 ($33,256) versus $6,348 ($7,117) for those who survived, and PPPM costs for patients with CDI-linked death was $24,883 ($16,435). Mean PPPM costs in patients with any recurrence was $35,767 for rCDI patients who died versus $7,959 who survived, and $28,443 for CDI-linked death. Costs were driven largely by inpatient stays (41%-75% of total cost); 99.9% of patients with recurrence and CDI-linked death were hospitalized, with 52.7% requiring intensive care, and 77.9% readmitted at least once.</p> <b>CONCLUSION</b><strong>: </strong>Despite currently available treatments, CDI patients had substantial mortality and costs. Costly hospitalizations and readmissions requiring intensive patient care resulted in 3.5x higher monthly costs in rCDI patients who died than patients who survived. New treatments reducing CDI recurrences are needed to improve economic/clinical burden and mortality.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/20220422-ispor-poster-cost-finalpdf-pdf.pdf?sfvrsn=f5014b72_0","title":"20220422 ISPOR Poster Cost FINAL_PDF.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115383","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Pharmacoeconomics of COVID-19; Effects on Access to Medicines and Universal Health Coverage in Nigeria","id":"5fee39b8-ce6b-41f4-b0c5-2107d11ba80c","sessionCode":"HPR13","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> The COVID-19 pandemic has affected global health and other issues including medicines pricing which in turn affects access to medicines. In Nigeria, many essential medicines and commodities rumored to provide preventive/curative effects on COVID-19 were affected by significant price increase. Hence, this study assessed the effects of the pandemic on price of pharmaceuticals and the implications on access to medicines.</p> <strong>Methods</strong></p> Descriptive survey was used to assess the effects of the pandemic on price of certain medications in 170 community and retail pharmacies in Abuja Nigeria.<span> The Statistical Package for Social Sciences was used for data analysis. </span></p> <strong>Results</strong></p> All community pharmacies assessed reported increase in price of some medications rumored to be effective against COVID-19 especially Hydroxychloroquine, Azithromycin, Vitamin C and Zinc. As much as 500% increase in cost of these medications and face masks was reported during the first lockdown period. All facilities reported that price hikes affected other essential medicines like antimalarials. All facilities reported that price increase has persisted.</p> <strong>Conclusions</strong></p> The pandemic led to increase in price of pharmaceuticals in Nigeria and this has implications for health coverage and affordability of medicines. This fosters inequities in access to medicines and have significant pharmacoeconomic implications for millions of Nigerians, majority of whom pay out of pocket for their health and medicines needs. This is further worsened by a paucity of price regulation and monitoring mechanisms. Considering measures for better pricing policy and regulation, strengthening supply chains, and creating buffers for possible future pandemics/epidemics is key to ensuring that vulnerable populations are not disenfranchised from accessing essential medicines. Pharmacoeconomic institutions like ISPOR should consider pharmacoeconomic capacity building in LMICs to enhance the research-to-policy process and engage with government and relevant stakeholders to build pharmacoeconomic stability and pricing regulatory mechanisms thus improving access to medicines and universal health coverage.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114537","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Evaluating the Impact of Weighted Sample Size on Matching Adjusted Indirect Treatment Comparisons between Trials with Time-to-Event Outcome: A Simulation Study","id":"da758396-a4bf-4468-8bdc-210d138e3ec8","sessionCode":"MSR7","topDisplay":"Ho HY, <b><u>Tremblay G</u></b>, Daniele P<br>Cytel, Inc., Waltham, MA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong><span>Matching-adjusted indirect comparisons (MAICs) are a popular method of population-adjusted indirect treatment comparison used to support health technology assessment submissions. MAICs rely on a propensity score approach that rescales the weight of patients in the index trial to a target population. We sought to explore the impact of approaches used to rescale weights on the results of MAICs.</span></p> <strong><p><b>METHODS: </b> </strong>Data were simulated for two single-arm studies from Weibull distributions varying three experimental factors: binary vs continuous covariates, level of imbalance between trials, and strength of effect treatment effects. <span>Each patient from the target study population was assigned a weight of 1. The index study population was adjusted and assigned weights </span>based on a method-of-moments logistic regression. Three approaches were considered for rescaling the MAIC weights: (1) <span>raw weights; (2) effective sample size (ESS); (3) maximum rescaled weights equal to 1 (M1). </span>A weighted Cox regression with treatment as regressor was fit and bias, root mean square error (RMSE), and coverage probability were estimated for each scaling technique over 2,000 iterations.</p> <strong><p><b>RESULTS: </b> </strong>The weighted samples sizes using raw and ESS approaches were negatively correlated with the level of imbalance between the index and target trials ranging from a 3%–80% reduction. The M1 weighted sample size was up to 75% smaller than the raw and ESS methods, suggesting that MAICs rely on assigning weights substantially larger than 1 to patients to achieve a balanced population. The bias and RMSE from all population-adjusted analyses were 60% smaller than the naïve comparisons; however, a further decrease in bias between 2%–10% was observed using the M1 approach.</p> <strong><p><b>CONCLUSIONS: </b> </strong>The weighted sample size of the adjusted individual patient data had a marginal impact on MAIC results. Further simulation studies should be conducted to identify the optimal scaling strategy.</p> <strong></strong></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hoispor-us-msr7042022approved-pdf.pdf?sfvrsn=8a7ea564_0","title":"Ho_ISPOR US MSR7_042022_approved.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116356","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Retrospective US Claims Database Analysis of the Impact of Fremanezumab on Migraine-Related Health Care Utilization and Costs in Patients with Potential Acute Medication Overuse","id":"7f93fc77-dabd-4075-8cc5-230904adcb48","sessionCode":"EE19","topDisplay":"Buse DC<sup>1</sup>, Driessen MT<sup>2</sup>, Krasenbaum LJ<sup>3</sup>, Seminerio MJ<sup>4</sup>, Carr K<sup>4</sup>, <b><u>Ortega M</u></b><sup>3</sup>, Packnett E<sup>5</sup><br><sup>1</sup>Albert Einstein College of Medicine, New York, NY, USA, <sup>2</sup>Teva Pharmaceuticals, Amsterdam, Netherlands, <sup>3</sup>Teva Branded Pharmaceutical Products R&D, Inc., West Chester, PA, USA, <sup>4</sup>Teva Branded Pharmaceutical Products R&D, Inc., Parisppany, NJ, USA, <sup>5</sup>IBM Watson Health, Cambridge, MA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Real-world data are limited on use of fremanezumab, a fully-humanized monoclonal antibody (IgG2Δa) that targets calcitonin gene-related peptide (CGRP), in migraine patients with acute medication overuse (AMO). This retrospective US claims database analysis evaluated migraine-related healthcare resource utilization (HCRU) and costs for patients with potential AMO initiating fremanezumab treatment.</p> <strong><p><b>METHODS: </b></strong> Adult patients (≥18 years) initiating fremanezumab treatment between September 1, 2018–June 30, 2019 (date of earliest claim=index date) were identified from the IBM/MarketScan Commercial and Medicare supplemental database, a US-based retrospective database of healthcare service and outpatient prescription data from a convenience sample of individuals with employer-sponsored health insurance. Other inclusion criteria were 12 months of continuous database enrollment pre-index, ≥6 months of data post-index, and evidence of pre-index common comorbidities, AMO, or difficult-to-treat migraine (DTTM) (defined by inadequate response to multiple prior migraine preventive treatment classes). Migraine-related HCRU and costs were analyzed in a subgroup with potential AMO (NSAIDs, acetaminophen, or aspirin, ≥15 pills/month; triptans, ergots, opioids, or combination medications, ≥10 pills/month) in the 90 days pre-index.</p> <strong><p><b>RESULTS: </b></strong> 46% (1,458/3,193) of patients with comorbidities, AMO, or DTTM who initiated fremanezumab during the study period had potential AMO. Post-index versus pre-index, mean(SD) migraine-related HCRU per-patient-per-month (PPPM) was significantly lower for migraine-related acute medication claims (1.33[0.98] vs 1.50[0.99], <em>P</em><0.001) and outpatient office visits (0.35[0.33] vs 0.37[0.32], <em>P</em>=0.013) and was lower for neurologist office visits (0.14[0.18] vs 0.15[0.17]; <em>P</em>=0.236). Mean(SD) migraine-related costs PPPM were significantly lower post-index versus pre-index for neurologist office visits ($17[23] vs $19[23]), outpatient office visits ($41[44] vs $46[45]), and acute medications ($114[287] vs $139[287], all <em>P</em><0.001). Excluding fremanezumab costs, overall migraine-related healthcare costs PPPM were also lower ($561[1,142] vs $602[994], <em>P</em>=0.156).</p> <strong>CONCLUSION:</strong> Migraine patients with potential AMO initiating fremanezumab treatment had statistically significant reductions in migraine-related HCRU and costs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115552","diseases":[{"id":"df9240d9-f266-47e0-ba0b-a11dfd152ae4","parentId":"00000000-0000-0000-0000-000000000000","title":"Biologics and Biosimilars","urlName":"biologics-and-biosimilars"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Chemoprevention for Familial Adenomatous Polyposis with Non-Steroid Anti-Inflammatory Drugs: A Systematic Review and Network Meta-Analysis","id":"2ca6c146-8d89-478c-8705-23bb4fc966bc","sessionCode":"CO11","topDisplay":"<b><u>Chen HL</u></b>, Tai SY, Fan WC, Hao SY, Tsai HY, Huang WH, Chang HM<br>Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>The aim of this study was to compare the preventive effect on adenoma progression of non-steroidal anti-inflammatory drugs (NSAIDs) among patients with familial adenomatous polyposis (FAP).</p> <p><b>METHODS: </b>A comprehensive literature search was performed from Pubmed, Embase and Clinical-Trials.gov. 'Familial adenomatous polyposis', ‘non steroid antiinflammatory drug’ and ‘randomized controlled trial’ were used as search key words and percentage change from baseline in polyps number and size were regarded as efficacy indicators. Network meta analysis (NMA) was conducted to estimate the indirect comparisons among NSAIDs based on frequentist framework with contrast-based model. Treatment rank was presented by the surface under cumulative ranking curve (SUCRA). The larger SUCRA, the higher likelihood that an intervention with the better efficacy.</p> <p><b>RESULTS: </b>In terms of polyp number, treatment with sulindac produced more reduction percentage than other NSAIDs (compared to Aspirin, percentage difference =-102.30%, 95% CI (-129.18%,-75.42%), compared to high dose celecoxib, percentage difference = -101.50%, 95% CI (-125.60%, -77.40%), compared to low dose celecoxib, percentage difference =-117.60%, 95% CI (-141.73%, -93.47%)).Regarding the SUCRA ranking, sulindac was associated with the best ranking for polyp number reduction (SUCRA=100%), followed by high dose celecoxib (63.4%), aspirin(61.4%), low dose celecoxib (25.2%) and placebo (5%). In terms of polyp size, sulindac also produced noticeable reduction rate than others (compared to Aspirin:percentage difference = -61.45%, 95% CI (-73.14%, -49.16%), compared to high dose celecoxib, percentage difference =-49.20%, 95% CI (-56.96%, -41.44%), compared to low dose celecoxib: percentage difference= -65.30%, 95% CI (73.16%, -57.44%)). The probability of sulindac had the highest SUCRA (SUCRA=100%) in reduction of polyp size, followed by high dose celecoxib (SUCRA=74.8%), aspirin(SUCRA=44.6%), low dose celecoxib (SUCRA=30.6%) and placebo (SUCRA =1%).</p> <p><b>CONCLUSIONS: </b>Our NMA results revealed that sulindac had better efficacy in polyps burden control and provided better preventive effect of tumor development.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115706","diseases":[{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"The Voice of the Regulator: How FDA Appraises Clinical Outcome Assessments in Supplemental Submissions for Expanded Indications","id":"41c9c81a-3f18-46d2-9d4a-245945930d74","sessionCode":"PCR27","topDisplay":"<b><u>Meyers O</u></b><sup>1</sup>, de la Motte A<sup>2</sup><br><sup>1</sup>IQVIA, New York, NY, USA, <sup>2</sup>IQVIA, Merchantville, NJ, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>FDA makes significant public information accessible through its website and databases. In particular, to learn about the role of clinical outcome assessments (COA) data in regulatory review and approval of marketing applications, Drugs@FDA is a comprehensive source. The limitation is that while all updates to the label are posted, typically only the medical reviews of the original marketing application are accessible. Reviews covering label expansion data from supplemental submissions are not readily available. The aim of this project is to review and compare multiple methods to better understand current FDA perspectives on patient experience data.</p> <p><b>METHODS: </b>Cemiplimab-rwlc was selected as a test case because two indications were added to the label in early 2021. Several methods for sourcing information about COAs in the associated label expansion trials and the evaluation of COA data by FDA were implemented. Any information available on the public FDA website was recorded. Additionally, a Freedom of Information Act (FOIA) request was generated for redacted FDA medical reviews. Finally, searches of both peer-reviewed and “gray” literature such as medical congress abstracts were conducted. </p> <p><b>RESULTS: </b>An understanding of how the manufacturer prioritized and implemented COAs could be gleaned from public information on the internet, including meeting abstracts and corporate press releases. Insights into how FDA Reviewers appraised the COA instruments used in the trial, the endpoints selected, and the data submitted were not readily available. Lastly, use of the FOIA mechanism proved impractical for the present study due to time and costs.</p> <p><b>CONCLUSIONS: </b>FDA aims to be as transparent as possible in the context of the regulatory-commercial nature of their remit and generally makes information available to the public in a way that is straightforward and reasonable. In the case of supplemental indications, skilled researchers may pursue other avenues, but the information will invariably be incomplete.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117233","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Differences in Guidance on Pro Evidentiary Requirements across Key European HTA Agencies","id":"6e54d1f9-f7d9-4060-8819-24e98fc5c021","sessionCode":"HTA9","topDisplay":"<b><u>Chassany O</u></b><sup>1</sup>, van Engen A<sup>2</sup>, Lai L<sup>3</sup>, Borhade K<sup>4</sup>, Ravi M<sup>4</sup>, Harnett J<sup>5</sup>, Chen CI<sup>5</sup>, Quek RGW<sup>5</sup><br><sup>1</sup>Patient-Reported Outcomes Unit, Université de Paris, Paris, 75, France, <sup>2</sup>IQVIA, Amsterdam, NH, Netherlands, <sup>3</sup>IQVIA, Reading, UK, <sup>4</sup>IQVIA, Bangalore, India, <sup>5</sup>Regeneron Pharmaceuticals, Tarrytown, NY, USA","locationCode":"","description":"\r\n\t<div><span><strong><p><b>OBJECTIVES: </b></strong> To assess the requirements for consideration of PRO evidence for systemic anticancer therapies across four key European HTA agencies.</span></p> <span><strong><p><b>METHODS: </b></strong> Guidance documents from IQWiG/G-BA, HAS and NICE were reviewed to identify the details provided on PRO evidence requirements. Following the review of guidance documents, 20 case studies for solid and hematological cancer indications in the past 5 years were prespecified for in-depth analysis to understand HTA agencies’ views and critiques of PRO evidence across five categories: (1) Guidance on choice of PRO instruments, (2) Acceptability of PRO evidence from open-label studies, (3) Level of missing data, (4) Clinically meaningful threshold, (5) Guidance on use of PRO data in cost effectiveness assessment.</span></p> <span><strong><p><b>RESULTS: </b></strong> IQWiG provides the most detailed methodological PRO guidance including those of analytical methods. Level of details available in HAS guidance is mainly on methodological conditions for acceptance of PRO evidence. PRO related details in NICE guidance is limited to a preference for EQ-5D instrument to derive utility values for economic modelling. The in-depth analysis showed that HAS rejected the PRO evidence in 17 out of 19 selected oncology case studies citing methodological issues such as open label studies, lack of multiplicity adjustment and high percentage of missing data. In contrast, PRO evidence led to added benefit ratings in 7 out of 20 selected oncology case studies assessed by G-BA and IQWiG. Oncology case studies assessed by NICE reflected what was provided in the guidance with a focus on utilities derived primarily from the EQ-5D instrument.</span></p> <span><strong>CONCLUSION:</strong> Different levels of guidance availability and acceptability of PRO evidence across four key HTA agencies were observed. There is an opportunity for increased clarity in issuing assessment criteria and improved harmonization of PRO evidence requirements across agencies.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/iqviaregeneron-payer-pro---ispor-2022-postervsubmission-pdf.pdf?sfvrsn=36b430de_0","title":"IQVIA_Regeneron_ Payer PRO - ISPOR 2022 poster_vSubmission.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116212","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost Minimization Analysis of Antibiotics Used for Respiratory Tract Infection in a Tertiary Care Teaching Hospital","id":"a8efb14b-8162-470d-8c2a-271272a47c73","sessionCode":"EE63","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To perform the cost-minimization analysis (CMA) and prescription auditing of antibiotics used in respiratory tract infections (RTI)</p> <p><b>METHODS: </b>A prospective observational study was carried out in the Pulmonology department for six months. Patients who were diagnosed with an RTI and prescribed at least one antibiotic were included in the study. All the necessary patient information was collected and well documented for analysis. Prescription auditing was carried out and medications were categorized according to the WHO -ATC system. Cost minimization analysis of antibiotics was carried out by calculating the percentage cost difference using the formula: Cost of the branded drug- Cost of generic drug / Cost of generic drug * 100. Branded medication prices were obtained from the hospital pharmacy whereas generic prices from Jan Aushadhi scheme <span>of Govt. of India. </span></p> </p> <p><b>RESULTS<span>: </b>A total of 50 patients’ prescriptions were included in this study with an average age of 47.86 ± 9.7 years among them [n=29, 58%] were female. The majority of them were diagnosed with lower respiratory tract infection with the most common class of antibiotics prescribed was cephalosporin antibiotics [n=25, 43.1%] followed by macrolide antibiotics [n=15, 25.8%]. The oral route of administration was most preferred[n=40,68.9%] over injectables. A huge cost variation was evident between the cost of generic and branded antibiotics of which the highest cost variation was observed with Linezolid infusion 600mg/300ml (541.72%) Tab. Clarithromycin (234.47%) Tab. Cephalexin (227.51%) while Ceftriaxone 500mg vial (12.35%) and Tab. Levofloxacin (57.63%) shows the least variation. </span></p> <p><b>CONCLUSIONS: </b>By performing CMA, it highlights the importance of generic medication use in reducing the health economic burden of society. Patients’ medication adherence and quality of life can be improved by the implementation of medication cost-related national-level policies and guidelines.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115243","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Completeness and Concordance between Electronic Medical Records (EMR) and Submitted Insurance Claims in German Hospitals Utilizing Percutaneous Left Ventricular Assist Devices (PLVADS): Considerations for Outcomes Research","id":"e0b271b6-22f2-48c7-b939-289b1f43c22a","sessionCode":"MT3","topDisplay":"Werner N<sup>1</sup>, <b><u>Unterkofler J</u></b><sup>2</sup>, Warich B<sup>3</sup>, Brand T<sup>3</sup>, Richter A<sup>3</sup>, Klesius A<sup>3</sup>, Tsintzos SI<sup>3</sup>, Lewalter T<sup>4</sup><br><sup>1</sup>Heart Center Trier, Trier, Germany, <sup>2</sup>Abiomed Europe GmbH, Aachen, NW, Germany, <sup>3</sup>Abiomed Europe GmbH, Aachen, Germany, <sup>4</sup>Internistisches Klinikum Munich South, Munich, Germany","locationCode":"","description":"\r\n\t<div><span><strong><p><b>OBJECTIVES: </b></strong></span><span> Real-World Evidence (RWE) are being used to assess medical technologies. Within the context of complex conditions that challenge traditional research designs, RWE research supports the safety, efficacy, and long-term effectiveness of innovations. Nevertheless, little is known on exactly how many and how well various covariates are captured in systems designed originally for financial needs instead of clinical research. Failure to appropriately differentiate records can lead analyses to inappropriate conclusions. We sought to understand any loss of information in the submitted insurance claims when compared with EMR data of patients treated with PLVADs in two major German hospitals.</span></p> <span><strong><p><b>METHODS: </b> </strong></span><span>Six consecutive clinical cases were extracted from EMR systems encompassing the patient discharge letter, the catheterization lab protocol, any internal and external transfer letters, laboratory values, medication administered, Intensive Care Unit (ICU) records and data from the device controller. These pilot cases were then compared with the coder submitted claim and assessed for completeness and concordance. </span></p> <span><strong><p><b>RESULTS: </b></strong></span><span> 22 key patient history variables were identified all of which were available in claims. 12 ECG-based required indicators could be approximated. CAD severity scores, echocardiography findings and peri-procedural characteristics were essentially unavailable. Diagnostic and procedural concordance ranged 70.59-75%. Additional missing information related to timing of diagnoses in acute settings, and out-of-hospital medication regimens. </span></p> <span><strong><p><b>CONCLUSIONS: </b></strong></span><span> Fidelity of German claims data remains moderately high and is acceptable in this complex therapy area. However, a high amount of data elements cannot directly be captured in claims and, thus, care must be undertaken to additionally collect and match patients correctly. Analysing the timing of various procedures and peri-procedural complications using the time-stamp information available is vital to define appropriate subgroups. We provide a list of cardiovascular risk factors, procedural characteristics, ICU admission and lab values that should be available for constructing reliable control groups.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"dda9555e-19ab-4405-936c-34532e5825c6","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Technologies","urlName":"medical-technologies"}],"categoryIds":["dda9555e-19ab-4405-936c-34532e5825c6"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/posterunterkofler14082-pdf.pdf?sfvrsn=8c3cbe43_0","title":"Poster_Unterkofler_14082.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117473","diseases":[{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Racial Differences in Physical Activity Among Cancer Survivors","id":"b312df96-af7a-4763-abe5-28b88100257c","sessionCode":"EPH37","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Cancer care is no longer focused on treating the disease alone, but it also entails comprehensive health and wellbeing of cancer survivors. Physical activity (PA) is recognized as a key cancer management component . Guidelines prescribe ≥150 minutes moderate-intensity or ≥ 75 minutes of vigorous-intensity PA per week. Although the extent of general adherence to said recommendation has already been assessed, racial differentials remain unknown. This study explores racial differences in PA uptake among cancer survivors (lung, breast, colorectal, prostate, ovarian, and lymphoma), and examines the salient factors that impart a potential disparity in order to inform policymakers.</p> <strong><p><b>METHODS: </b></strong> Using the National Health Interview Survey (NHIS) data from 2009 to 2018, lung, breast, colorectal, prostate, ovarian, and lymphoma cancer survivors were identified, and their level of PA measured. Descriptive statistics, bivariate, and multivariable logistic regression analyses were used to examine the factors associated with adherence to recommended PA levels adjusting for potential confounders. The Fairlie decomposition was used to identify characteristics associated with PA differentials among races.</p> <strong><p><b>RESULTS: </b></strong> Of the 13,425 cancer survivors identified, only 36.44% adhered to PA recommendations. The majority of adherents were Whites, non-Hispanics, aged 65+, had at least high school education, current drinkers, and “never” smokers. PA adherence among Blacks was significantly lower than Whites (adjusted odds ratio: 0.79; 95%CI: 0.66 - 0.93). Decomposition analysis showed that this inequality was rooted primarily in differences in education, family income-to-poverty-ratio, alcohol use, and BMI.</p> <strong><p><b>CONCLUSIONS: </b> </strong>Findings from the study could help inform behavioral PA interventions as part of standard cancer care targeted specifically for different racial groups, and thus promote the adoption and adherence of PA and improve health outcomes among minority cancer survivors.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114809","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Development and Content Evaluation of a Novel Osteoporotic Vertebral Fracture Patient-Reported Outcome Questionnaire","id":"ce038f1f-9492-41f6-b252-28e8543e9447","sessionCode":"PCR14","topDisplay":"Yeh E<sup>1</sup>, Su S<sup>2</sup>, Banderas B<sup>2</sup>, Chatterton K<sup>2</sup>, <b><u>Dickie G</u></b><sup>2</sup><br><sup>1</sup>Amgen Inc., Thousand Oaks, CA, USA, <sup>2</sup>Adelphi Values, Boston, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> The goal was to evaluate the content validity of a novel patient-reported outcome (PRO) questionnaire, developed from a literature review, among patients who experienced a vertebral fracture (VF) due to osteoporosis. The questionnaire assesses the patient VF experience of pain and impact on activities of daily living (ADL).</p> <p><b>METHODS: </b> In 2021, hybrid concept elicitation (CE) and cognitive debriefing (CD) interviews, approved by an institutional review board, were conducted via telephone with non-hospitalized adults (≥50 years) diagnosed with osteoporosis, who had ≥1 symptomatic, low-to-no trauma VF sustained within 36 weeks prior to enrollment. During CE, participants described their experience with VF. During CD, participants provided feedback on the questionnaire’s comprehensibility, relevance, and comprehensiveness. Interviews were conducted in waves; interim results informed revisions between waves. Recordings were transcribed and analyzed.</p> <p><b>RESULTS: </b> Twenty subjects (75.0% female, mean age=67.8 years) from four clinical sites in the United States participated across six waves (based on availability of the patients) with 7, 2, 2, 5, 1, and 3 participants in each wave, respectively. Saturation analysis demonstrated adequacy of sample size using CE data. Participants spontaneously reported 11 symptoms, with pain the most frequently reported (n=20, 100%). Forty impact concepts were reported, with sitting for long periods of time (n=15, 75%) and performing household chores (n=13, 65%) most frequently reported. During CD, revisions were made including the addition of one item assessing sleep impact. The final questionnaire has 24 items: five assessing dimensions of pain; 19 assessing ADL impact. Most patients (75–100% across items) reported no interpretation issues for the questionnaire instructions, items, or response options. All participants (n=20, 100%) reported the questionnaire was easy to complete and relevant to their VF.</p> <p><b>CONCLUSIONS: </b> Results demonstrate that the questionnaire is content valid based on direct patient input and can be used to measure patient experience of VF.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/prob-pos-013576-ispor-us-poster-v10-final-4may2022-pdf.pdf?sfvrsn=9e7881d7_0","title":"ProB-POS-013576 ISPOR US Poster v1_0 FINAL 4May2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115231","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"To Wait or Not to Wait: Foregone Option Value for Cell and Gene Therapies","id":"6191c91e-315f-447c-b04e-296eef6c1493","sessionCode":"HPR3","topDisplay":"Wake M, Tzaras D, <b><u>Carr D</u></b><br>Precision Advisors, London, UK","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To explore the concept of option value with regards to cell and therapies and to evaluate the current and future trends in utilizing the concept in health technology assessment (HTA) and in pricing and reimbursement settings.</p> <p><b>METHODS: </b>We conducted a targeted online literature review to identify articles reporting on option value and further refined the search for cell and gene therapies. We abstracted the results and summarised key themes before a working session to uncover current utilization of the concept and generate hypotheses on the future outlook.</p> <p><b>RESULTS: </b>Option value is the concept that by receiving a certain medicine at an initial time, opportunity opens up to receive other medicines later on. Most of the literature focuses within oncology, where increased survival outcomes are compounded through successive lines of treatment. The option value concept for cell and gene therapies was given prominence by the Institute of Clinical and Economic Research (ICER), who included it in their Adapted Value Assessment Framework (November 2019). One element of option value that is enhanced for cell and gene therapies is the potential disadvantage for therapies that, if not successful, could reduce or even preclude the potential effectiveness of future treatments. This has pricing and reimbursement implications since, provided patients could have foregone the first treatments to wait for subsequent better ones, the value obtained would be less overall, for the patient and for the payer or healthcare service.</p> <p><b>CONCLUSIONS: </b>Option value related to cell and gene therapies is an as yet underappreciated concept that could be utilized proactively by payers, as well as manufacturers of alternative chronically administered or bridging treatments, to ‘devalue’ current options through horizon scanning and lobbying. The inclusion of foregone option value in HTA and pricing models may, however, be an opportunity for more sustainable pricing and requires further exploration.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117155","diseases":[{"id":"b4b5ee81-b2a7-41c0-a6c2-a07276633d66","parentId":"00000000-0000-0000-0000-000000000000","title":"Genetic, Regenerative and Curative Therapies","urlName":"genetic-regenerative-and-curative-therapies"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Mortality from Ischaemic Heart Disease Among Men in Hungary By County","id":"93abfb11-2907-4144-b846-2ad904175bf0","sessionCode":"EPH13","topDisplay":"Németh N<sup>1</sup>, <b><u>Boncz I</u></b><sup>1</sup>, Horváth L<sup>1</sup>, Csákvári T<sup>1</sup>, Pónusz R<sup>2</sup>, Elmer D<sup>3</sup>, Endrei D<sup>1</sup><br><sup>1</sup>University of Pécs, Pécs, Hungary, <sup>2</sup>University of Pécs, Pécs, BA, Hungary, <sup>3</sup>University of Pécs, Pécs, PE, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Ischaemic heart disease (IHD) is one of the leading causes of mortality. Our aim was to analyse regional mortality rates due to ischaemic heart disease among men, in Hungary, by county.</p> <strong>Methods</strong>: Data were derived from the Public Health Analysis Centre Information System covering the years 2014-2018. We examined the regional mortality of those cases where the main care-justifying diagnosis was ischaemic heart disease. Cases with the codes I20-I25 in the international classification of diseases were taken into account using the standardized mortality rates for the 0-X-year population in men.</p> <strong>Results</strong>: According to data for the years 2014-2018, SHH value of mortality associated with ischaemic heart disease fell between 76-131% in Hungary among men. The most favourable values were found in Baranya county (76%) followed by Vas county (79%). In men, the standardised death rate was the highest in Borsod-Abaúj Zemplén (131%) and Békés counties (131%) followed by Jász-Nagykun-Szolnok county (130 %) and Nógrád county (127%).</p> <strong>Conclusions</strong>: Significant differences were detected in the occurrence of ischaemic heart disease among counties which may in certain cases be associated with the socioeconomic situation of the given area.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/nemethneph13poszterprint140x9020220421final-pdf.pdf?sfvrsn=57e71751_0","title":"NemethN_EPH13_poszter_PRINT_140x90_20220421_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116804","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Association between Adherence and Worsening Heart Failure Events in an Employed Population","id":"5fd63f37-58db-4d07-be45-2b4ee8e9bb75","sessionCode":"CO16","topDisplay":"<b><u>Nguyen J</u></b><sup>1</sup>, Yang A<sup>1</sup>, Moeller P<sup>1</sup>, Goldfarb N<sup>2</sup>, Whellan D<sup>1</sup><br><sup>1</sup>Thomas Jefferson University, Philadelphia, PA, USA, <sup>2</sup>Greater Philadelphia Business Coalition on Health, Philadelphia, PA, USA","locationCode":"","description":"\r\n\t<div><b><span data-contrast=\"auto\">Objectives</span></b></p> <span data-contrast=\"auto\">Heart failure (HF) is an important concern for employers because of its increasing prevalence, morbidity, mortality and cost. The purpose of this study is to describe the heart failure population in an employed population and the association between pharmacotherapy adherence and developing worsening heart failure events (WHFEs). </span><span data-ccp-props=\"{}\"> </span></p> </p> <b><span data-contrast=\"auto\">Methods</span></b></p> <span data-contrast=\"auto\">This is a retrospective analysis utilizing pharmacy and medical claims from a multi-employer claims database provided by Gallagher (benefits consultant). Claims from 01/01/2019 - 06/30/2020 were analyzed. First quarter of 2019 was used for identification, claims from quarters two and three were used to determine HF medication adherence (proportion of days covered), and the remaining three quarters were used to assess outcomes (claims indicating hospitalization or intravenous diuretic usage). Patients 18 to 64 years old, diagnosis of HF, and receiving pharmacotherapy for HF were included in the study. Patients were excluded if they had end stage HF, amyloidosis, heart transplant, left ventricular assist device, or congenital heart disease. </span><span data-ccp-props=\"{}\"> </span></p> <span data-ccp-props=\"{}\"> </span></p> <b><span data-contrast=\"auto\">Results</span></b></p> <span data-contrast=\"auto\">Of the 1718 patients eligible for study, 170(9.9%) developed worsening HF during the outcome period. In the overall population, median patient age was between 55-59, and 61.9% were female. The median adherence during the 183-day index period for those with a valid prescription for beta-blockers was 0.85(IQR 90-179, n= 1381), ACEi/ARBs was 0.69(IQR 63-170, n=1543), aldosterone antagonists was 0.83(IQR 90-176, n=526), and angiotensin-receptor neprilysin inhibitors (ARNIs) was 0.90(IQR 105-182, n=292). Increased adherence was associated with greater odds of hospitalization for ARNIs (OR 1.002, p=0.047) and aldosterone antagonists (OR 1.002, p=0.032) for each day of increased days medication available.</span><span data-ccp-props=\"{\"335559740\":259}\"> </span></p> <span data-ccp-props=\"{}\"> </span></p> <b><span data-contrast=\"auto\">Conclusion</span></b></p> <span data-contrast=\"auto\">In this analysis, adherence was highest in ARNIs and lowest in ACEi/ARBs, and is associated with an increased likelihood of WHFE. The findings suggest using claims data to define adherence may not be a useful predictor of WHFE in the short-term. </span><span data-ccp-props=\"{}\"> </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116096","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Understanding the Treatment Attributes That impact Medication-Taking Behaviors with Diabetes Therapies in People with Type 2 Diabetes: A Pragmatic Review","id":"d8f8ad60-3175-43a5-81ae-2c4a3f640252","sessionCode":"PCR34","topDisplay":"<b><u>Sims T</u></b><sup>1</sup>, Boye K<sup>2</sup>, Robinson S<sup>3</sup>, Kennedy-Martin T<sup>3</sup><br><sup>1</sup>Eli Lilly and Company, Indianapolis, IN, USA, <sup>2</sup>Eli Lilly and Company, Greenwood, IN, USA, <sup>3</sup>KMHO Limited, Brighton, UK","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE: </strong>To identify and review studies that attempted to understand directly from the perspective of people with type 2 diabetes (T2D), treatment-related attributes that are associated with their medication-taking behaviors.</p> <strong><p><b>METHODS: </b> </strong>Bibliographic databases (EMBASE, PUBMED) were searched for studies (Jan 2005–May 2021) wherein a person with T2D (PwD) directly expressed the treatment-related attributes associated with their decision to initiate, adhere to, or discontinue a T2D medication. Studies reporting attributes associated with oral antidiabetes drugs or injectables (not insulin) were eligible. Studies that did not explicitly explore the link between attributes and behaviors (e.g. most discrete choice experiments [DCE]), were excluded, as were those interrogating electronic medical records or claims databases.</p> <strong><p><b>RESULTS: </b> </strong>6464 studies were identified of which 16 met inclusion criteria and were included. Studies were conducted across several countries (USA most frequently, n=8 including three multi-country studies). The impact of treatment attributes was described on initiation (n=3), adherence (n=11), and discontinuation (n=4), with some studies evaluating multiple behaviors. Studies employed structured questionnaires (n=10), qualitative approaches (n=4), or DCE explicitly exploring the link to medication-taking behavior (n=2). Attributes were solicited via both closed- (n=10) and open-ended questioning (n=6). Across studies, a range of factors including glycemic efficacy (n=9), weight change (n=9), dosing frequency (n=9), hypoglycemia (n=8), gastrointestinal adverse events (n=8), complexity (n=6), route (n=3), and injection-site reactions (n=2) were reported as having an influence on medication-taking behaviors. Of the studies that used structured questionnaires, nine reported the proportion of PwD indicating that individual attributes influenced behavior; two included Likert scales to help determine the impact level of different attributes.</p> <strong><p><b>CONCLUSIONS: </b> </strong>This review identified several PwD-reported treatment-related attributes that influence medication-taking behavior. Such insights gained directly from PwD could help to inform treatment decisions, facilitate shared decision-making and PwD engagement, and may potentially improve medication adherence and clinical outcomes.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/tx-attributesispor-postersent-to-lilly19-april-pdf.pdf?sfvrsn=9793448c_0","title":"Tx Attributes_ISPOR Poster_sent to Lilly_19 April.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114810","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Economic Evaluation of Dapagliflozin for the Treatment of Patients with Heart Failure and Reduced Ejection Fraction in Mexico","id":"11a7e7cc-d913-49e0-8c8a-2c8046a639d0","sessionCode":"EE59","topDisplay":"Carmona M<sup>1</sup>, <b><u>Buritica MP</u></b><sup>2</sup><br><sup>1</sup>AstraZeneca, Ciudad de México, Mexico, <sup>2</sup>AstraZeneca, Mexico, Mexico","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong> Quantify the expected health costs and benefits of dapagliflozin use in addition to the standard of care for the treatment of adult patients with heart failure and reduced ejection fraction (HFrEF), from the perspective of Mexico’s Public Health System.</p> <strong>Methods:</strong> Dapagliflozin is indicated in patients with NYHA class I, II, III or IV heart failure, who are on standard therapy and yet are symptomatic and have an ejection fraction of 40% or less, so its direct comparator was sacubitrilo/valsartan. According to the evidence collected through a systematic review, a network meta-analysis concluded that there was no statistically significant difference in outcomes like hospitalization for heart failure (HF) or cardiovascular (CV) death between dapagliflozin and sacubitril/valsartan, both in addition to recommended therapy. Therefore a cost minimization analysis was performed from the perspective of the Mexican public health system. The annual cost of drugs was estimated through the recommended doses. Sensitivity analyzes and a budget impact analysis (BIA) were conducted.</p> <strong>Results:</strong> The use of dapagliflozin for the treatment of adult patients with HFrEF represents annual savings per patient of 68.1% compared to sacubitril/valsartan. BIA shows an average annual saving of 0.22% in the medicines and pharmaceuticals budget of the public health system in Mexico. Sensitivity analyses suggest that the conclusions of the base case are robust.</p> <strong>Conclusions:</strong> Dapagliflozin is now transforming the approach of treating patients with HFrEF, as it has shown positive results in terms of reducing hospitalizations due to HF or CV death. Considering the serious problem of morbidity and mortality related to this disease and the costs for the health system, patients and family members, it is important to have innovative therapies that can generate savings, in that sense, dapagliflozin has proven to be an efficient treatment for HFrEF.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116905","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Health Economic Evidence for Adjuvant Chemotherapy in Stage II and III Colorectal Cancer: A Systematic Review","id":"d4b0ffab-233b-444c-ad37-2d94c28abf52","sessionCode":"EE94","topDisplay":"<b><u>To YH</u></b><sup>1</sup>, Gibbs P<sup>1</sup>, Tie J<sup>1</sup>, IJzerman M<sup>2</sup>, Degeling K<sup>2</sup><br><sup>1</sup>Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia, <sup>2</sup>The University of Melbourne, Melbourne, VIC, Australia","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>To appraise the health economic evidence for adjuvant chemotherapy (AC) strategies in stage II and III colorectal cancer (CRC) and to identify the limitations of available evidence that might inform further research.</p> <em> </em></p> <strong>Method: </strong>A systematic review of published economic evaluations was undertaken. Four databases were searched and full-text publications in English were screened for inclusion. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Checklist was used to assess the quality of included evaluations, and a narrative synthesis was performed to summarise the evidence.</p> <em> </em></p> <strong>Results: </strong>Thirty-nine studies were identified, stratified by cancer stage and AC strategies. Reporting quality was high, with evaluations reporting 89% of relevant CHEERS checklist items on average. The majority (90%) were full economic evaluations, with 56% being cost-utility analyses (CUA). AC was found to be cost-effective compared to no AC for both stage II and III CRC. Oral and oxaliplatin-based AC was cost-effective for stage III. Three months of CAPOX was cost-effective compared to 6-months in high-risk stage II and stage III CRC. Preliminary evidence suggests that biomarker approaches to AC selection in stage II, such as the use of circulating tumor DNA, are also cost-effective. Notably, assessment of quality-adjusted life years (QALYs) were reliant on a small number of non-contemporary health-utility (HUV) studies as few AC trials collected utility data. Only 31% of studies considered societal costs.</p> <em> </em></p> <strong>Conclusions: </strong>Published economic evaluations consistently support the use of AC in stage II and III colorectal cancer. Biomarker-driven approaches to patient selection have great potential to be cost-effective, but more robust clinical and economic evidence is warranted. Patient surveys embedded into clinical trials that collect utility data and societal costs would allow more accurate estimation of QALYs that account for contemporary patient experiences with the interventions under investigation including disutility from toxicities and reduce underestimation of costs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115874","diseases":[{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Reasons for Non-Adherence with Antidepressants Using the Medication Adherence Reasons Scale in European Union and United States","id":"fce9474a-a1dc-4f77-a062-30fe39b7d679","sessionCode":"PCR13","topDisplay":"Unni E<sup>1</sup>, <b><u>Gupta S</u></b><sup>2</sup>, Sternbach N<sup>3</sup><br><sup>1</sup>Touro College of Pharmacy, New York, NY, USA, <sup>2</sup>Cerner Enviza, Flemington, NJ, USA, <sup>3</sup>Cerner Enviza, Malvern, PA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong><strong>:</strong> Depression affects an estimated one in 15 adults (6.7%) in any year. Approximately 50% of primary care patients discontinue antidepressant therapy within six months of initiation. The study objective was to determine the extent and reasons for non-adherence with antidepressants in the United States (US) and European Union (EU). </p> <strong>Methods</strong><strong>:</strong> Data from the National Health and Wellness Study (NHWS), a self-administered, internet-based cross-sectional survey of US adults in 2019 and 5 EU countries (France, Germany, UK, Italy, and Spain) in 2020 was included. NHWS participants who self-reported taking daily prescription medication(s) to treat depression responded to the 19 reasons for non-adherence and one global item in the Medication Adherence Reasons Scale (MAR-Scale). MAR-Scale measures non-adherence “in the past 7 days”, on an 8-point scale ranging from 0 days to 7 days. Frequencies were used to identify the reasons for non-adherence.</p> <strong>Results</strong><strong>:</strong> NHWS data had 4230 patients from the EU and 7506 patients from the US that reported taking a daily antidepressant. Based on the MAR-Scale, 46.10% of patients reported non-adherence to at least one reason in the EU, and 42.86% in the US. The most common reason for non-adherence in the EU was concern about long-term effects (23.92%) and possible side effects from the medicine (20.40%). In the US, though simple forgetfulness (20.86%) was the major reported reason for non-adherence, patients reported the lowest mean number of days (2.15 days/a week) missing medication for that reason. Non-adherence lasted longer due to lack of beliefs in needing medicines anymore, 4.06 days/a week in the US and 3.32 days/a week in the EU.</p> <strong>Conclusion</strong><strong>:</strong> With antidepressants, further interventions are needed to educate the patients about the need for the medicines and to lessen their concerns about long-term effects and possible side effects from the medicines.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/mar-scale-draft-5-final-pdf.pdf?sfvrsn=6b469de5_0","title":"MAR Scale-Draft 5-FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116599","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Cost-Effectiveness Analysis Comparing Obesity Drug Treatments from a U.S. Payer Perspective","id":"fced4b96-2aaa-40b5-87b5-319ff6306b9d","sessionCode":"EE2","topDisplay":"<b><u>Gómez-Lumbreras A</u></b><sup>1</sup>, Tan MS<sup>2</sup>, Villa Zapata L<sup>3</sup>, Ilham S<sup>2</sup>, Earl JC<sup>2</sup>, Malone DC<sup>2</sup><br><sup>1</sup>University of Utah, Barcelona, B, Spain, <sup>2</sup>University of Utah, Salt Lake City, UT, USA, <sup>3</sup>Mercer University College of Pharmacy, Atlanta, GA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> U.S. obesity prevalence is among the highest in the world. Obesity is related to multiple comorbidities including cardiovascular diseases and diabetes. With the aim of elucidating the most cost-effective treatment for weight loss, we conducted a cost-effectiveness model comparing indicated pharmacologic treatments for obesity.</p> <p><b>METHODS: </b> A decision-analytic Markov model was developed from a U.S. healthcare system payer perspective comparing semaglutide, liraglutide, naltrexone plus bupropion (NpB) and phentermine plus topiramate (PpT). The population of interest included individuals of 45 years or older using national estimates of BMI distribution from NHANES (mean BMI 37.1, SD=4.9 and 36.8, SD=4.9 women and men, respectively). The model incorporates the risk of cardiovascular complications (acute myocardial infarction, coronary heart disease, congestive heart failure, stroke) and diabetes. The primary health states included are BMI<25 (normal), BMI 25-30 (overweight) and BMI>=30 (obese). BMI specific utility values and disutilities for cardiovascular and diabetes were used to calculate quality adjusted-life-years (QALYs). Endpoints included costs, QALYs, and incremental cost‐effectiveness ratios (ICERs) with a willingness‐to‐pay (WTP) threshold of $150,000/QALY. Results were analyzed at a life time horizon and a 3% discount rate. Probabilistic sensitivity analysis was conducted.</p> <p><b>RESULTS: </b> PpT had the lowest cost ($94,252) followed by NpB ($94,280), liraglutide ($325,694) and semaglutide ($431,632). Semaglutide and liraglutide had the highest effectiveness with 30.564 and 30.451 QALYs respectively. PpT and NpB had 30.376 and 30.316 QALYs, respectively. Among the four obesity treatments, PpT was the most cost-effective strategy. The ICER was $1,794,700 per QALY compare to semaglutide. The cost-effectiveness acceptability curve indicated there was no WTP values where other therapies had a higher probability of being cost-effective than PpT.</p> <p><b>CONCLUSIONS: </b> This analysis suggests that among pharmacological treatments for obesity, PpT has the lowest cost and provides nearly as many QALYs as liraglutide and semaglutide, and more than NpB.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117875","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Accessibility of Essential Medicines for Children in Sichuan Province of China: a Cross-Sectional Study","id":"9d73105e-6566-4f42-8b3d-3214f84daf21","sessionCode":"EPH38","topDisplay":"<b><u>Chen Z</u></b><sup>1</sup>, Li S<sup>2</sup>, Choonara I<sup>3</sup>, Lingli Z<sup>2</sup><br><sup>1</sup>West China Second University Hospital, Sichuan University, Chengdu, 51, China, <sup>2</sup>West China Second University Hospital, Sichuan University, Chengdu, MI, China, <sup>3</sup>Academic Division of Child Health, Derbyshire Children's Hospital, University of Nottingham, Derby, UK","locationCode":"","description":"\r\n\t<div><strong><b>Objective</b></strong><strong>:</strong> This study aimed to assess the accessibility of EMs for children in the public sector of Sichuan Province of China, based on availability, affordability, and price.</p> <strong><b><span>Methods</span></b></strong><strong><b><span>:</span></b></strong> We adopted the modified WHO/HAI standardization methodology to measure the availability, affordability, and prices of 30 EMs for children in 20 public hospitals in nine regions of the Sichuan Province, China. Availability was expressed as the percentage of medicine outlets that stocked surveyed medicines on the day of data collection, and prices were expressed as median price ratio (MPR). Affordability was assessed as the number of Sichuan Province’s daily wages required for the lowest-paid government unskilled worker (USD 11.0310 per day) to purchase one standard treatment of an acute disease or treatment for chronic disease for a month.</p> <strong><b><span>Results</span></b></strong><strong><b><span>:</span></b></strong> The mean availability of originator brands (OBs) and lowest priced generics (LPGs) were 9.7% and 46.5% in the public sector. Only 3 MPRs of OBs could be calculated, ranging from 0.55 to 13.37, and the MPRs of LPGs in the public sector ranged from 0.07 to 25.05, with a median MPR of 4.28. 2 OBs and 11 LPGs were priced at more than 1.5 times their international reference prices in the public sector, most of which were injections. Except for cefazolin injection and ceftriaxone injection, most LPGs were affordable for the treatment of childhood diseases in the public sector, as they each cost one or less than one daily wage for the lowest-paid unskilled government worker.</p> <strong><b><span>Conclusion</span></b></strong><strong><b><span>s:</span></b></strong> The availability of children’s essential medicines was low in surveyed public sector in Sichuan Province, which was similar to previous studies in other provinces of China. The price of most medicines surveyed was higher than their IRPs. The affordability of most surveyed LPGs was reasonable, except for ceftriaxone injection and cefazolin injection.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114518","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Budget Analysis of Etonogestrel Subdermal Contraceptive Implant (ESI) Compared to Levonorgestrel Intrauterine Device (LNG-IUD) Reimbursed on the Brazilian Private Health Insurance and Plans","id":"7a245f60-a14a-4424-be00-325126cdd9d8","sessionCode":"EE76","topDisplay":"Crespi S<sup>1</sup>, Brito N<sup>2</sup>, Picoli R<sup>3</sup>, Ramires Y<sup>4</sup>, <b><u>Bueno RL</u></b><sup>5</sup><br><sup>1</sup>Organon & Co, Jersey City, NJ, Brazil, <sup>2</sup>Cerner Envisa, Barueri, Brazil, <sup>3</sup>Cerner Envisa, São Paulo, SP, Brazil, <sup>4</sup>Universidade Federal do Paraná, Fazenda Rio Grande, PR, Brazil, <sup>5</sup>University 9 of July, São Paulo, SP, Brazil","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To estimate the budget analysis of Etonogestrel Subdermal Contraceptive Implant (ESI) Compared to Levonorgestrel Intrauterine device (LNG-IUD) Reimbursed on the Brazilian Private Health Insurance and Plans.</p> <p><b>METHODS: </b>A 5-year cost comparison of ESI versus LNG-IUD was performed. The population was based on women at childbearing age enrolled at Private Health Insurance and Plans as from June/21 official databases of National Regulatory Agency for Private Health Insurance and Plans (ANS). Based on market research from IQVIA for 2020 (excluding Pandemic effect) total market growth achieve 7% per year. Products have been marketed for more than 10 years, so sales report sent to CMED was used as a basis to estimate the market uptake ranging from 7% in the 1<sup>st</sup> year till 27% in the last year of analysis. Costs of contraception and failures included device, drugs, exams and medical management (physician visits, procedures and hospitalizations) were from official ANS's databases or follow agency guidance. A sensitivity analysis of 20% were conduct.</p> <p><b>RESULTS: </b>The cost-ratio shows a potential reduction in favors of ESI (R$ 1.737,43/patient), in a sectorial perspective the ESI coverage leads to a cost-avoidance of R$ 17,4 million in the first year and a total of savings of R$ 187,5 million in the time of analysis, even considering ESI reinsertions from the 3<sup>rd</sup> year and beyond. The results are sensitive to market uptake for ESI with savings range from R$ 153 to 222 million.</p> <p><b>CONCLUSIONS: </b>Adding ESI to the current reimbursed contraceptive basket on the Brazilian Private Health Insurance and Plans allows a more efficient budget allocation, higher initial acquisition costs were offset within 1 year. Moreover, new entrants tend to increase competition and open space for increase efficiency gains.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/bim-ispor-bueno-pdf.pdf?sfvrsn=48f4e268_0","title":"BIM-ISPOR-BUENO.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116709","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Real-World Symptom Severity Reported By Genomically-Tested Gastric Cancer Patients in the United States between 2014-2017","id":"c6ba61b6-19fd-4c04-bb1b-3268088edafb","sessionCode":"PCR33","topDisplay":"<b><u>Conner T</u></b><sup>1</sup>, Arguello R<sup>2</sup>, Gyory T<sup>2</sup>, Hauser R<sup>3</sup><br><sup>1</sup>Vidence LLC, San Antonio, TX, USA, <sup>2</sup>Vidence LLC, Boca Raton, FL, USA, <sup>3</sup>Vidence LLC, Allen, TX, USA","locationCode":"","description":"\r\n\t<div><strong><u><p><b>OBJECTIVES: </b></u></strong> While recent advances in gastric cancer treatment have the potential to extend overall survival, patient reports of disease symptoms, treatment toxicities, and quality of life are critical outcome measures. This study sought to assess patient-reported symptoms in a real-world cancer treatment setting from 2014-2017 to serve as a comparator to patients receiving novel therapies after 2017.</p> <strong><u><p><b>METHODS: </b></u></strong> This retrospective, observational study utilized de-identified data from five Cancer Treatment Centers of America (CTCA). Adults (≥ 18 years) with gastric or gastroesophageal junction cancer who received full panel genome sequencing between 2014-2017 were included. Standard of care at CTCA is to provide electronically administered surveys of 17 common symptoms scored from 0-10 (0=not present, 10=the worst imaginable) to patients at every visit.</p> <strong><u><p><b>RESULTS: </b></u></strong> Among 39 patients included in analyses, average age at diagnosis was 51 years (SD=10.9), 49% were male, and 62% were metastatic at diagnosis. Seven (18%) patients had ARID1A, 6 (15%) had ERBB2, 4 (10%) had ERBB3, 2 (5%) had EGFR, 4 (10%) had KRAS, 5 (13%) had PIK3CA, and 18 (46%) had TP53 gene alterations. Fifteen patients had PD-L1 testing in 2017, and of those, 8 (53%) had expression <u>></u>1%. The five most severe symptoms reported within 12 months of diagnosis were fatigue (mean score=6.1, SD=2.6), lack of appetite (mean=6.0, SD=3.4), bowel discomfort (mean=5.7, SD=3.2), disturbed sleep (mean=5.0, SD=3.3), and drowsiness (mean=4.9, SD=2.7).</p> <strong><u><p><b>CONCLUSIONS: </b></u> </strong>This study highlights the most burdensome symptoms among gastric cancer patients with known gene alterations in a real-world setting, prior to the introduction of immune checkpoint inhibitor (ICI) and other novel therapies. As new drugs that target gene alterations and PD-L1 expression become available, further research is needed to assess impact of therapies on patient-reported outcomes.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117186","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness of Intravenous Antibiotics Therapy for Children with Acute Gastroenteritis in a Secondary Care Hospital in South India","id":"ed0e8c6d-54bf-4db2-919b-3298ac15206b","sessionCode":"EE3","topDisplay":"<b><u>Issac A</u></b><sup>1</sup>, Kochuparambil J<sup>2</sup><br><sup>1</sup>Mary Queen's Mission Hospital, Adoor, India, <sup>2</sup>Mary Queen's Mission Hospital, Kanjirappally, India","locationCode":"","description":"\r\n\t<div><strong><span style=\"color: #0e101a;\">OBJECTIVE</span></strong><span data-preserver-spaces=\"true\"><span style=\"color: #0e101a;\">: Acute Gastroenteritis is a common ailment affecting children contributing towards various direct costs, indirect costs, and symptom-associated decreased quality of life. Antibiotics are not advocated as a mainstay of treatment. Although it is widely prescribed in Kerala due to poor recourses for differential diagnosis. So, we aimed to compare the Cost-effectiveness of IV Antibiotics therapy for children with acute gastroenteritis in a secondary care hospital in South India.</span></span></p> <p style=\"margin: 0in; margin-bottom: .0001pt; text-align: justify;\"><strong><span data-preserver-spaces=\"true\"><span style=\"color: #0e101a;\"><p><b>METHODS: </b></span></span></strong><span data-preserver-spaces=\"true\"><span style=\"color: #0e101a;\"> A prospective observational study was undertaken for 6 months in the medical pediatric ward with inclusion criteria of age 6 months – 6 years; diagnosis of acute gastroenteritis; at least 3-4 reported episodes of vomiting/diarrhea 24 hours before hospital admission. Children were randomly allocated on a 1:1 ratio to either oral rehydration therapy or oral rehydration therapy plus antibiotic course. The direct medical cost was calculated from the cost of antibiotics and their consumables along with the cost for increased length of stay. Indirect costs include additional rent and loss of pay from the work of the parents accompanying the children. The clinical outcome observed for the study is the days taken to resolve all symptoms.</span></span></p> <p style=\"margin: 0in; margin-bottom: .0001pt; text-align: justify;\"><strong><span data-preserver-spaces=\"true\"><span style=\"color: #0e101a;\">RESULT</span></span></strong><span data-preserver-spaces=\"true\"><span style=\"color: #0e101a;\">: In total, 60 children were included for randomization. Both the treatments arms showed only a slight difference in the proportion of children whose symptoms resolved within 5 days from 2.9% to 6.5% with an odds ratio of 0.9 (95% confidence interval [CI] = 0.2 to 0.6). Total mean costs in the Antibiotic group were 72.5% higher than the other group and the total incremental mean costs for an additional child free of symptom in 5 days was 650 INR (95% CI).</span></span></p> <p style=\"margin: 0in; margin-bottom: .0001pt; text-align: justify;\"><strong><span data-preserver-spaces=\"true\"><span style=\"color: #0e101a;\">CONCLUSION:</span></span></strong><span data-preserver-spaces=\"true\"><span style=\"color: #0e101a;\"> The use of Antibiotics in minor ailments without clinical evidence can lead to an additional economic burden and also contribute to antibiotic resistance.</span></span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116786","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Factors Associated with Prescribing of Teriflunomide and Dimethyl Fumarate Versus Fingolimod in Multiple Sclerosis","id":"e8db374f-b6a5-4f17-958e-33b0afe73499","sessionCode":"HSD13","topDisplay":"<b><u>Earla JR</u></b><sup>1</sup>, Hutton GJ<sup>2</sup>, Aparasu RR<sup>3</sup><br><sup>1</sup>University of Houston, College of Pharmacy, Fords, NJ, USA, <sup>2</sup>Baylor College of Medicine Medical Center, McNair Campus, Houston, TX, USA, <sup>3</sup>University of Houston, College of Pharmacy, Houston, TX, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b> The oral Disease-Modifying Agents (DMA) provided additional options to neurologists beyond injectable DMAs for Multiple Sclerosis (MS). This study examined the factors associated with prescribing teriflunomide (TER) and dimethyl fumarate (DMF) compared to fingolimod (FIN) in patients with MS.</p> <strong><p><b>METHODS: </b> </strong>A retrospective longitudinal study was conducted involving adults (≥18 years) with MS from the 2015–2019 IBM MarketScan Commercial Claims. Patients with MS were identified based on the ICD-9/10-CM:340/G35 diagnosis and a DMA prescription. Patients were classified as FIN-, TER- and DMF-users based on their first DMA prescription with one year of washout period. Multinomial logistic regression was used to determine the 12-month baseline predisposing, enabling, and need factors associated with prescribing of TER and DMF versus FIN for MS.</p> <strong><p><b>RESULTS: </b> </strong>The study cohort consisted of 2,556 MS patients; 51.53% initiated with DMF, followed by teriflunomide (24.26%) and fingolimod (24.22%). Multinomial logistic regression revealed that compared to young adults (18-34 years), older adults (≥35 years) had a 2–9 fold higher likelihood to be prescribing with TER and DMF than FIN. Patients from the West had lesser odds of prescribing TER, whereas those from the Northeast had higher odds of prescribing DMF compared to FIN. Patients with HMO insurance had lesser odds of prescribing TER than FIN. Mood disorders were associated with higher odds, and eye disorders had lesser odds of prescribing TER and DMF relative to FIN. Cancer, heart diseases, and nutritional deficiencies had lesser odds, and other neurological disorders had higher odds of prescribing DMF than FIN. Baseline neurologist visit was associated with reduced odds of prescribing TER and DMF compared to FIN.</p> <strong><p><b>CONCLUSIONS: </b> </strong>The study found that DMF is the most prescribed oral DMA for MS. Patients’ predisposing (age group and region), enabling (insurance), and need factors (comorbidities and neurologist consultation) influenced the selection of specific DMA.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022--earla-jr-et-al-factors-associated-with-prescribing-oral-dmas-pdf.pdf?sfvrsn=e956672_0","title":"ISPOR 2022 _ Earla JR et al_ Factors Associated with prescribing oral DMAs.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115838","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"},{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Patients' Experiences with Shared Decision Making about Implantable Medical Device Surgery: Results of a Cross-Sectional Survey in Hungary","id":"ef89e22d-6f8f-479d-8d79-340941e059a1","sessionCode":"MT7","topDisplay":"Péntek M<sup>1</sup>, Kozlovszky M<sup>1</sup>, Weszl M<sup>2</sup>, Kuti J<sup>1</sup>, Hölgyesi Á<sup>3</sup>, Tóth B<sup>1</sup>, Czere J<sup>1</sup>, Baji P<sup>4</sup>, Kovács L<sup>1</sup>, Gulácsi L<sup>1</sup>, <b><u>Zrubka Z</u></b><sup>5</sup><br><sup>1</sup>Óbuda University, Budapest, Hungary, <sup>2</sup>Semmelweis University, Budapest, PE, Hungary, <sup>3</sup>Semmelweis University, Budapest, Hungary, <sup>4</sup>Corvinus University of Budapest, Budapest, PE, Hungary, <sup>5</sup>Corvinus University of Budapest, Budapest, Hungary","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> We aimed to assess patients’ involvement in and experiences with decision making regarding implantable medical device (IMD) surgery.</p> <p><b>METHODS: </b> A cross-sectional survey was performed in August 2021 involving 1400 persons aged 40+ representative for the Hungarian general population. Health-related quality of life and digital health literacy were measured by the EQ-5D-5L and eHEALS questionnaires, respectively. Respondents who have had hip, knee, spine, tooth, breast implant, intraocular lens, dental bone graft, pacemaker, artificial cardiac valve, stent, abdominal mesh or continuous glucose monitor implantation in 2020/2021 were inquired retrospectively for their experiences with decision making regarding their IMD surgery. Respondents completed the 9-itemShared Decision Making Questionnaire (SDM-Q-9) and four questions of the patient reported experience measure (PREM) endorsed by the OECD. Descriptive statistics were performed, Spearman’s rho correlations were analysed between SDM-Q-9 and EQ-5D-5L, eHEALS scores.</p> <p><b>RESULTS: </b> Altogether 70 patients (female 60%) were involved with mean (SD) age of 60.1 (12.4) years, 47.1% had tertiary educational level; EQ-5D-5L index score was 0.80 (0.25), eHEALS was 27.9 (5.5). The average SDM-Q-9 score was 34.7 (SD 8.7; minimum: 16, maximum: 45); the lowest score was obtained on item 7 (‘My doctor and I thoroughly weighed the different treatment options’). The share of patients indicating ‘Yes, definitely’ on the PREM questions were as follows: the doctor spent enough time with the consultation 60.3%; the doctor provided easy-to-understand explanations 58.8%; the patient had opportunity to raise questions 64.7%; the patient was involved in the decision 57.4%. Only 33.8% indicated that the quality of the consultation was excellent. No significant correlations were found between SDM-Q-9, and EQ-5D-5L, eHEALS scores.</p> <p><b>CONCLUSIONS: </b> This small retrospective empirical study suggests that patients undergoing IMD surgery may have substantial unmet needs regarding the decision process. Further prospective studies are encouraged to confirm our results and analyse the explanatory factors in depth.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"dda9555e-19ab-4405-936c-34532e5825c6","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Technologies","urlName":"medical-technologies"}],"categoryIds":["dda9555e-19ab-4405-936c-34532e5825c6"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor2022meddevsdmfinal-pdf.pdf?sfvrsn=462b31b1_0","title":"ISPOR_2022_Meddev_SDM_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116377","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Impact of Formulary Adoption of Sacubitril/Valsartan on Medication Uptake and Adherence Among Medicare Patients with Chronic Heart Failure (CHF)","id":"a5f6b0d4-63a6-4470-8196-352f341c00a7","sessionCode":"PCR9","topDisplay":"<b><u>Ferro C</u></b><sup>1</sup>, Dieguez G<sup>1</sup>, Nguyen C<sup>2</sup>, Caplen M<sup>1</sup>, Shen X<sup>3</sup><br><sup>1</sup>Milliman, Inc., New York, NY, USA, <sup>2</sup>Novartis Pharmaceuticals Corporation/Baylor Scott and White Health/The University of Texas at Austin, Austin, TX, USA, <sup>3</sup>Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Sacubitril/Valsartan (SAC/VAL) is the preferred renin-angiotensin-aldosterone system inhibitor (RAASi) for treatment of adult CHF. This study aimed to assess impacts of formulary adoption of SAC/VAL on uptake and adherence as well as overall utilization of RAASi in Medicare patients with CHF. <p><b>METHODS: </b> Retrospective cohort study using Medicare administrative claims data. The “exposed” group included patients with CHF enrolled in Part D prescription drug plans (PDPs) that adopted SAC/VAL on their formulary in March 2016 (“intervention”). The “control” group included patients with CHF enrolled in PDPs with no coverage of SAC/VAL throughout 18-month follow-up. To control for patient selection, analysis was limited to non low-income subsidy patients enrolled in “exposed” or “control” plans for the entire analysis period pre- and post-intervention. Chi-squared and t- tests were performed to compare the uptake of SAC/VAL within 6, 12, and 18 months post-intervention, 12-month medication adherence among new SAC/VAL users, and overall utilization of RAASi. <p><b>RESULTS: </b> For the “exposed” and “control” groups, we identified 111,826 and 12,595 patients, respectively. The groups had comparable demographic and risk profiles (mean age: 79 vs. 81 years; 52% vs. 53% female; mean risk score: 2.2 vs. 2.3). SAC/VAL uptake rates per 1,000 patients with CHF were higher for the “exposed” vs. “control” group: 4.0 vs. 2.9 at 6 months, 9.1 vs. 6.9 at 12 months, and 14.9 vs. 11.7 at 18 months (p-values: .08, .01, .01). Mean 12-month SAC/VAL proportion of days covered for new users was similar (72% vs. 70%; p-value: .72) and overall use of RAASi was slightly higher (63% vs. 61% of patients with CHF; p-value: <0.0001) for the “exposed” and “control” groups. <p><b>CONCLUSIONS: </b> We observed slightly higher uptake of SAC/VAL and overall use of RAASi between groups following SAC/VAL addition to formulary, with minimal differences in SAC/VAL adherence.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/formulary-adoption-of-sacval-pdf.pdf?sfvrsn=dd884801_0","title":"Formulary Adoption of SACVAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116516","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Oversight of Artificial Intelligence in Medicine: A Review of Frameworks","id":"fce9759b-8930-4480-bbd9-366dd3ad20e5","sessionCode":"MT6","topDisplay":"<b><u>Crossnohere N</u></b><sup>1</sup>, Elsaid M<sup>1</sup>, Paskett J<sup>1</sup>, Bose-Brill S<sup>1</sup>, Bridges J<sup>2</sup><br><sup>1</sup>The Ohio State University, Columbus, OH, USA, <sup>2</sup>Ohio State University College of Medicine, Columbus, OH, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Artificial intelligence (AI) is rapidly expanding in medicine even while lacking formal oversight. We sought to identify and describe considerations for the oversight of AI in medicine. We also explored where along the translational process (i.e. AI development, reporting, evaluation, implementation, and surveillance) these considerations were targeted.</p> <p><b>METHODS: </b>We conducted a targeted review of frameworks for the oversight of AI in medicine. The search included key topics such as ‘artificial intelligence,’ ‘machine learning’, ‘guidance as topic’, ‘implementation science’, ‘medical device legislation’, and ‘evaluation study,’ and spanned the time period 2014-2021. Frameworks were included if they described translational considerations for AI. The included frameworks were summarized descriptively. Content analysis was used to identify considerations for the oversight of AI in medicine. An evaluation matrix methodology was used to map each consideration across the different translational stages for each framework.</p> <p><b>RESULTS: </b>Six frameworks were included in the review, and were either published as peer reviewed journal articles or white papers from consortium and professional organizations. Content analysis of the frameworks revealed five overarching considerations related to the oversight of AI in medicine, including: transparency, reproducibility, ethics, effectiveness, and engagement. All frameworks included discussions regarding transparency, reproducibility, ethics, and effectiveness, while only half of frameworks discussed engagement. The evaluation matrix revealed that frameworks were most likely to report AI considerations for the translational stage of development, and least likely to report considerations for the translational stage of surveillance.</p> <p><b>CONCLUSIONS: </b>Frameworks provided broad guidance for the oversight of AI in medicine, but notably offered less input on the role engagement approaches for oversight, and for and any strategies for general surveillance stage of translation. Identifying and optimize strategies for engagement is essential to ensure that AI can meaningfully benefit patients and other end-users.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"dda9555e-19ab-4405-936c-34532e5825c6","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Technologies","urlName":"medical-technologies"}],"categoryIds":["dda9555e-19ab-4405-936c-34532e5825c6"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117232","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Real-World Data on Hospitalizations Profile and Costs of Endometrial Cancer from the Perspective of Brazilian Private Health System: An Analysis from 2015 to 2019","id":"210a422d-a792-4276-9cb0-378998d7ea93","sessionCode":"RWD17","topDisplay":"<b><u>Santana P</u></b><sup>1</sup>, Alemar M<sup>2</sup>, Rodrigues L<sup>3</sup>, Bernardino G<sup>1</sup><br><sup>1</sup>GlaxoSmithKline, Rio de Janeiro, RJ, Brazil, <sup>2</sup>GSK, Rio de Janeiro, Brazil, <sup>3</sup>GlaxoSmithKline, Rio de Janeiro, Brazil","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE:</strong> In Brazil, it is estimated 6,540 new cases of Endometrial cancer (EC) occur per year. The objective was to analyze the hospitalizations profile and costs of EC in the private health system from 2015 to 2019.</p> <p><b>METHODS: </b> The number of EC (ICD-10 54.1) hospitalizations and its associated costs were obtained from the <em>Agência Nacional de Saúde </em>(ANS) database, according to the modalities of health maintenance organization (HMO): self-management (AG), medical cooperative (CM), philanthropy (FT), group medicine (MG) and specialized health insurance (SS). The hospitalization rates (events per 100,000 women) were calculated using the total number of women from ANS. Costs (in Brazilian currency, BRL) were adjusted to 2021 using the official inflation rate (IPCA – IBGE Consumer Price Index). The analysis used descriptive statistics.</p> <p><b>RESULTS: </b> There were 3,727 hospitalizations related to EC in the period, with an average of 745 (SD 136) per year. This represented a total cost of 44,523,370.47 BRL and a mean of 10,608,191.00 BRL (SD 1,890,460.00) per year. There was a 67% increase in the hospitalization rate and 60% in the hospitalization costs. The HMO with the highest number of hospitalizations in 2019 was CM (362) and with the highest rate was FT (7.9) followed by AG (4.3). The rank in hospitalization costs in 2019 was: MG (4,319,891.04 BRL), CM (4,000,493.85 BRL), AG (2,026,579.86 BRL), SS (1,443,017.53 BRL) and FT (296,692.31 BRL). FT and CM presented the highest increase in the period for both hospitalization rates (306% and 150%, respectively) and costs (237% and 197%, respectively). SS was the only HMO with a decrease: -31% in the hospitalization rates and -36% in costs.</p> <strong>CONCLUSION:</strong> These data suggest that EC imposes an economic burden on the Brazilian private healthcare system, and it has increased over the past 5 years in most HMO modalities.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115124","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Agitation in Autism: Rising Concerns within Major Markets","id":"d28eeb53-3031-4f48-a40e-38d03c05c17e","sessionCode":"SA10","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong>BACKGROUND: </strong>Patients with autism spectrum disorder (ASD) can present with momentary behaviors of acute agitation or challenging behaviors like oppositional activities, along with more severe behaviors such as dangerous self-injuries or aggressions. Often referred to as crisis behaviors, these are hard to predict and can be difficult to manage.</p> <strong><p><b>OBJECTIVES: </b></strong> To outline the burden of the disease, current standard of care, and unmet needs for the treatment of agitation in autism</p> <strong><p><b>METHODS</strong>: </b> Secondary literature search was limited to English publications over the last 10 years</p> <strong><p><b>RESULTS: </b></strong> Agitation is associated with negative outcomes for children with ASD and their caregivers, including decreased quality of life. A 2011 study in the US demonstrated that 56% of individuals with ASD (n=1,380) directed aggression toward caregivers and 32% directed aggression toward non-caregivers. Another study that among 299 hospitalized autism patients, 37 of them had one or more episodes of agitation and the per hospitalization number of episodes of agitation ranged from 1 – 32. The National Institute for Healthcare and Excellence (NICE) has established a guideline that recommends an initial psychosocial approach followed by use of antipsychotics, the former failing. Risperidone and Aripiprazole are the only 2 drugs that are approved by the USFDA for use in the treatment of agitation in autism but are associated with various side effects on long-term use. Some pipeline therapies in Phases II-III of clinical trials were identified which could potentially change the treatment landscape.</p> <strong><p><b>CONCLUSIONS: </b></strong> Agitation in autism is a cardinal concern and there is a need for research to identify the epidemiological patterns of the disease, primarily since children in their prime are most affected and is associated with a significant burden. Additionally, there is a need for more therapeutic guidelines and alternatives for this segment of patients to improve their quality of life.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117790","diseases":[{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Randomized Clinical Trial Replication for Cardiovascular Outcomes of EMPA-Reg Trial: Retrospective Cohort Study","id":"454f9fe9-0b7a-41e0-8868-390527400acb","sessionCode":"RWD12","topDisplay":"Oh JM, Kim IW, <b><u>Jang H</u></b><br>Seoul National University, Seoul, Korea, Republic of (South)","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> In this study, we aimed to check to what extent findings from existing RCTs can be replicated in the RWD study by analyzing in the transparent and reproducible processes those would be acceptable to regulators. <strong>Methods: </strong>This study used a cohort study design to assess the effect of empagliflozin versus placebo on cardiovascular safety outcomes. EMPA-REG OUTCOME trial (NCT01131676) was selected to target for replication. The inclusion/exclusion criteria and follow up method were applied as same with RCT. Major adverse cardiovascular events (MACEs) (all-cause death, myocardial infarction, and stroke) were used as primary outcomes. <strong>Results: </strong>We followed-up (median, 2.7 years) 23,126 matched patients with type 2 diabetes mellitus (11,563 empagliflozin users and 11,563 sitagliptin users). Empagliflozin was related with a significantly decreased risk of MACEs [adjusted HR 0.87, 95% confidence interval (CI) 0.79–0.96]. The predefined estimate agreement, regulatory agreement, and standardized difference for RCT duplication were achieved [EMPA-REG OUTCOME: adjusted HR 0.86, 95% (CI) 0.74–0.99]. <strong>Conclusions:</strong> Our study results suggest that RWD results can replicate RCT results satisfactorily and have the potential for providing evidence for future regulatory decision-making.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/2022-ispor-poster-pdf.pdf?sfvrsn=f44c0ad0_0","title":"2022 ISPOR poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116951","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Use of Pharmacotherapy or Surgery for Women Diagnosed with Uterine Fibroids (UF) and Heavy Menstrual Bleeding (HMB) in a Predominantly African American (AA) Population in the US between 2010-2019","id":"29ab8f7b-8b61-4cfe-a5ae-393ecdf4bb71","sessionCode":"RWD7","topDisplay":"<b><u>Lickert C</u></b><sup>1</sup>, Stokes ME<sup>2</sup>, Dufour R<sup>3</sup>, Pruett J<sup>4</sup>, Tilney R<sup>5</sup><br><sup>1</sup>Myovant Sciences Inc., FLOSSMOOR, IL, USA, <sup>2</sup>Evidera, St-Laurent, QC, Canada, <sup>3</sup>Myovant Sciences, Inc, Brisbane, CA, USA, <sup>4</sup>Myovant Sciences, Inc., Brisbane, MA, USA, <sup>5</sup>Evidera, Waltham, MA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Uterine Leiomyomas (fibroids) are common, benign tumors. In the US, approximately 70% of White and more than 80% of AA women are diagnosed with UF by age 50. Marked differences exist in disease presentation, severity, treatment, and outcomes for AA compared with White women. This study describes the treatment selection for women with incident UF and HMB in a predominantly AA population.</p> <strong>Methods: </strong>Using IBM-Watson’s MarketScan® Multi-state Medicaid claims database (2010-2019), a retrospective analysis examined baseline demographics, pre-index comorbidities, and treatment (e.g., surgery, hormone-based therapies) of women with incident UF and HMB. The index date was date of the first claim with a UF diagnosis. Women were required to be continuously enrolled ≥12 months pre- and ≥ 12 months post-index. Descriptive analyses of post-index treatment patterns and Cox regressions of time to treatment post UF diagnosis were performed using baseline characteristics as covariates.</p> <strong>Results: </strong>24,129 women, [69.5% AA, 30.5% White (W)] were included. The mean (SD) age of the two groups was similar (AA:39.6 ± 7.11 years; W:40.2 ± 7.23 years). AA women were more likely to receive hormone-based therapy (42.4% vs 38.5%, p, 0.0001). Fewer AA women had a hysterectomy (AA:32.0% vs W:46.8%, p<0.0001). Cox regression models indicated that AA women were more likely to receive hormone-based therapy (HR=1.2, 95% CI: 1.130, 1.264, p<0.0001) and less likely to have a hysterectomy (HR=0.6, 95%CI: 0.579, 0.632, p<0.0001) than W women following a diagnosis for UF.</p> <strong>Conclusions: </strong>In this Medicaid population, selection of UF treatment differed between AA and W women. Previous studies showed a different pattern of care for AA women. Further analyses are needed to determine if these differences are socially meaningful.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/lickertposterispor-2022finalid-116631-pdf.pdf?sfvrsn=6d53e31f_0","title":"Lickert_Poster_ISPOR 2022_FINAL_ID 116631.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116631","diseases":[{"id":"4f6b0298-31b6-4189-b6aa-63a92e080d5a","parentId":"00000000-0000-0000-0000-000000000000","title":"Reproductive and Sexual Health","urlName":"reproductive-and-sexual-health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Emulating the Grade Trial Using Real-World Data","id":"4497e2a0-941e-4e79-a255-39eba78f4a5c","sessionCode":"CO32","topDisplay":"<b><u>Deng Y</u></b><sup>1</sup>, Polley E<sup>2</sup>, Ross J<sup>3</sup>, Shah ND<sup>1</sup>, McCoy R<sup>1</sup><br><sup>1</sup>Mayo Clinic, Rochester, MN, USA, <sup>2</sup>The University of Chicago, Chicago, IL, USA, <sup>3</sup>Yale University, New Haven, CT, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES</p>: </b>To emulate the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) using real-world data prior to its publication.</p> <p><b>METHODS</p>: </b>We applied GRADE trial criteria to claims and laboratory data from OptumLabs Data Warehouse (OLDW) from 1/25/2010 to 6/30/2019. The study population was comprised of patients ≥30 years old with hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) 6.5-8.5% on metformin monotherapy who started glimepiride, liraglutide, sitagliptin, or insulin glargine and met GRADE eligibility criteria. The primary outcome was time to HbA<sub>1c</sub> ≥7.0% and secondary outcomes were other metabolic, microvascular, macrovascular, and safety outcomes specified by GRADE. Propensity score (PS) weighting was used to emulate randomization of the groups, which were then compared using Kaplan-Meier estimate and Cox proportional hazards regression.</p> <p><b>RESULTS</p>: </b>We identified 8252 patients (19.7% of adults with diabetes who started the study drugs in OLDW) meeting GRADE eligibility criteria (glimepiride arm=4318, liraglutide arm=690, sitagliptin arm=2993, glargine arm=251). The glargine arm was excluded from analyses due to small sample size. Median times to primary metabolic failure were 364 (95% CI, 347-382) days for glimepiride, 741 (471-1171) days for liraglutide, and 342 (300-370) days for sitagliptin. Liraglutide was associated with lower risk of primary metabolic failure compared to glimepiride (HR 0.57 [0.43-0.77]) and sitagliptin (HR 0.56 [0.42-0.76]). Results were consistent for secondary metabolic failure (HbA<sub>1c</sub> ≥7.5% after reaching primary outcome). There were no significant differences among treatment groups for other secondary outcomes.</p> <p><b>CONCLUSIONS</p>: </b>In this emulation of the GRADE trial, liraglutide was significantly more effective at improving glycemic control than glimepiride or sitagliptin.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115858","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Practice of Use of Food Supplements in Cancer Patients","id":"e1f22660-d518-4f1c-bc4c-3a5d3b103e0b","sessionCode":"PCR18","topDisplay":"Töltösi E<sup>1</sup>, Boncz I<sup>2</sup>, Endrei D<sup>2</sup>, <b><u>Kívés Z</u></b><sup>3</sup><br><sup>1</sup>Baxter Hungary Kft., Budapest, Hungary, <sup>2</sup>University of Pécs, Pécs, Hungary, <sup>3</sup>University of Pécs, PÉCS, BA, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: The use of complementary therapies is significant among cancer patients. The aim of the research was to find out what additional therapies are used by patients diagnosed with cancer. Besides, what kind of factors influence their choice between medicines and how much financial burden this means for them.</p> <strong>Methods</strong>: Quantitative cross-sectional research was performed among non-randomized patients (n=111) in Hungary. We applied a questionnaire survey, groups of questions: sociodemographic data, disease characteristics, dietary supplements used, information shared with physicians, source of information, costs, impact assessment. In addition to the descriptive statistical analysis χ<sup>2</sup>-test, Independent samples t-test, ANOVA were applied (p<0.05) with SPSS software.</p> <strong>Results</strong>: The mean age was 49.8 years. 33.4% use high doses of vitamins C and D, herbs that are considered effective. 48.6% inform the treating physician about the preparations used. Economically active people are significantly (p=0.006) less likely to use any additional treatment or consult a naturopath than inactive people. This may be related to the price of the preparations. Avemar is used by 68.5%, Aloe vera 56.8% and 52% use variations of cannabidiol (CBD). Among the reasons for use, the answer “I wanted to try everything that could help” was most often indicated by 74.2% (69 people). 25.2% spend 15.56 USD on different treatments and 27.9% spend more than 77.6 USD on alternative therapies. Those who spend between 15-30 USD per month are significantly (p=0.019) less satisfied (53.1%) with the outcome of treatment (satisfied with 20%). The most important sources of information are the physician (88.3%) and the Internet (55.9%).</p> <strong>Conclusions</strong>: Interviewed mostly started alternative therapies because they wanted to try everything that could help. Traditional treatments are thought to be too “mechanical” or frustrated with traditional treatments. Most of them spend more than 77 USD on alternative treatments in a month.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/kivestoltosipcr18poszter20220421final-pdf.pdf?sfvrsn=ce3d5617_0","title":"Kives_Toltosi_PCR18_poszter_20220421_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116527","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Evaluation of the Cost in Patients with Chronic Obstructive Pulmonary Disease (COPD) Within the Public Health Perspective in Mexico","id":"5cf96ab1-c0d1-4c09-8596-3a74c8dbcebe","sessionCode":"EE26","topDisplay":"Zenteno RDJ<sup>1</sup>, Lemus Rangel R<sup>2</sup>, Martínez Pacheco V<sup>3</sup>, Guzman Vazquez S<sup>4</sup>, <b><u>Soto Molina H</u></b><sup>3</sup>, Juarez K<sup>3</sup>, Marin Aguilar MM<sup>3</sup><br><sup>1</sup>Instituto Nacional de Enfermedades Respiratorias (INER), Mexico city, Mexico, <sup>2</sup>Hospital General Dr. Gaudencio González Garza, Centro Medico Nacional \"La Raza\" IMSS., Ciudad de México, Mexico, <sup>3</sup>HS Estudios Farmacoeconómicos S.A. de C.V., Mexico city, Mexico, <sup>4</sup>Agencia Mexicana de Evaluación de Tecnologías Sanitarias AC, Iztapalapa, Mexico","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong> To estimate the cost of care of patients with chronic obstructive pulmonary disease (COPD) with stable disease and exacerbations in Mexico.</p> <strong>Methods:</strong> A cost of care analysis of COPD patients was performed from an institutional point of view. Only average direct medical costs per patient, adjusted by GOLD classification, were estimated. Resource utilization was obtained from a panel of medical experts belonging to the National Health System in Mexico, using Delphi methodology, where the therapeutic options, recommended doses, as well as the use of hospital resources in the treatment of controlled patients and patients with exacerbations by Gold classification, used in their clinical practice, were validated. Costs were obtained from public health sources. The costing was carried out using the micro-costing technique and a time horizon of 1 year was considered; the results are expressed in USD.</p> <strong>Results:</strong> The average cost of diagnosis was $1,255.99 USD. The estimated average cost of patients with COPD in control was $1,500.36, $2,157.59, $3,442.05 and $5,109.57 for Gold 1,2,3 and 4 categories respectively, on the other hand, the average cost of patients with exacerbation for each category was $1,164.42, $3,460.41, $9,199.12 and $23,717.99 respectively. The results show that there is an increase in costs with increasing disease severity category and treatment of exacerbations accounts for most of the economic burden.</p> <strong>Conclusions:</strong> The difference in costs between categories was due to the cost of hospitalizations, intensive care, and oxygen use. Timely diagnosis of COPD and medical care to keep patients in control in the first categories of the disease, maintain them stable and prevent exacerbations would represent a reduction in the burden of the disease for the public sector.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117844","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Healthcare Resource Utilization of Cervical Cancer in the Brazilian Public Healthcare System: A Claim Database Study","id":"ae54e59a-7a35-42d6-ab55-3caa75e16b88","sessionCode":"EE53","topDisplay":"<b><u>Borba MA</u></b><sup>1</sup>, Birck M<sup>2</sup>, Gomes MM<sup>2</sup>, Julian G<sup>2</sup>, Batista PDM<sup>1</sup>, Almeida M<sup>1</sup>, Rego MADC<sup>1</sup>, Nadalin M<sup>1</sup>, Rodrigues AN<sup>3</sup><br><sup>1</sup>MSD Brazil, São Paulo, Brazil, <sup>2</sup>IQVIA, São Paulo, Brazil, <sup>3</sup>Universidade Federal de Minas Gerais, Belo Horizonte, Brazil","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>To evaluate the healthcare resource utilization (HCRU) by patients with cervical cancer (CC) treated at the Brazilian public healthcare system (SUS, <em>Sistema Único de Saúde</em>).</p> <strong><p><b>METHODS: </b> </strong><span>This real-world retrospective study used DATASUS datasets (~75% population coverage). Female aged </span>≥<span>18 years with claims of CC (ICD-10 C53.*) were identified from January/2014-December/2020. Patient’s follow-up comprises from index date (first claim of C53) to last information available. Non-advanced (stage 1 and 2) and advanced (stage 3 and 4) disease were evaluated. Domains of HCRU includes hospitalization, chemotherapy (CT), radiotherapy (RT) and other outpatient procedure. </span></p> <strong><p><b>RESULTS: </b> </strong><span>A total of 206,861 women were included - median age at index of 49.5 years (interquartile range [IQR] 38-61), majority white (44%) and mixed (43%) color, residing in the southeast region (41%) and northeast (29%). Patients’ median follow-up was of 1.1 years (IQR 0.17-2.84). About 44% had stage classification documented, being 39% had non-advanced and 61% advanced CC. About 72% are known to had treatment: 27% only surgical procedure, 18.6% RT+CT, and 8.5% surgery+RT+CT. Patients submitted to CT increased with staging, reaching 85% in stage 4, with a median per patient of 5 (3-8) and per patient per month (PPPM) 1.20 (1.20-1.20). About 90% stage 1 <em>vs</em> 67% stage 4 patients had RT, both with a median PPPM of 1.50 (1.50-1.50). Of stage 4-patients, 45% were hospitalized and 95% had outpatient procedures, with a median PPPM of 0.11 (IC95% 0.11-0.11) and 0.96 (0.93-0.98), respectively. Lower HCRU was observed for stage 1: 39% were hospitalized (0.05 PPPM [0.05-0.05]) and 94% had outpatient procedure (0.54 [0.53-0.55]). </span></p> <strong><p><b>CONCLUSIONS: </b> </strong><span>HCRU increases with staging, and because many people are diagnosed at advance stage in Brazil, CC impose an important economic burden. This data highlights the need for preventive and screening approaches to be more effective, moving towards the goal of eradicating CC.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/msdcervicalisporposter20220405updated-pdf.pdf?sfvrsn=85f738cf_0","title":"MSD_cervical_ISPORposter_20220405_UPDATED.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114926","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness of Anti-BCMA CAR T-Cell Therapy in Triple-Class Refractory Multiple Myeloma","id":"38705823-5ff0-4fde-8ec2-3ce0c3184880","sessionCode":"EE41","topDisplay":"Barnes JI<sup>1</sup>, Frosch ZA<sup>2</sup>, Garfall AL<sup>3</sup>, Vogl D<sup>3</sup>, <b><u>Lin J</u></b><sup>3</sup><br><sup>1</sup>University of Washington, Seattle, WA, USA, <sup>2</sup>Fox Chase Cancer Center, Philadelphia, PA, USA, <sup>3</sup>University of Pennsylvania, Philadelphia, PA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Idecabtagene vicleucel (ide-cel), an anti-BCMA chimeric antigen receptor T-cell (CAR-T) therapy (list price $419,500), was approved in 2021 by the US FDA for triple-class refractory multiple myeloma (MM). Another anti-BCMA CAR T-cell therapy, ciltecabtagene autoleucel (cilta-cel), is undergoing FDA review. We evaluated the cost-effectiveness of ide-cel and cilta-cel (assuming price parity with ide-cel).</p> <strong><p><b>METHODS: </b></strong> A partitioned survival model evaluated ide-cel and cilta-cel in triple-class relapsed/refractory MM from a US health-payer perspective over a lifetime horizon. Comparators included conventional therapies, belantamab mafodotin-blmf, selinexor-dexamethasone, and salvage autologous stem-cell transplantation. Main outcomes were life-years, lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio. Future costs and benefits were discounted at 3% per year. We assumed a cost-effectiveness threshold of $150,000/QALY and used probabilistic analyses with 10,000 simulations to evaluate uncertainty.</p> <strong><p><b>RESULTS: </b></strong> Ide-cel increased life expectancy by 0.96 years and cost $672,122/QALY gained (95% UI, $498,146-1,008,033) compared with conventional therapy. Cilta-cel increased life expectancy by 2.26 years and cost $295,897/QALY gained (95% UI, $147,591-436,745) compared with conventional therapy. Both CAR T-cell therapies exceeded the cost-effectiveness threshold when compared with the other therapies. Although CAR-T increased life expectancies, because virtually all patients ultimately progress, the high cost of subsequent standard myeloma care ($312,000/year) worsened the overall cost-effectiveness of CAR-T: large price reductions to $32,462 (ide-cel) and $120,850 (cilta-cel) are necessary to meet a $150,000/QALY threshold. If the cost of subsequent care were lowered to conventional cost-effectiveness thresholds, more modest price reductions to $188,802 (ide-cel) and $324,739 (cilta-cel) are needed.</p> <strong><p><b>CONCLUSIONS: </b></strong> Ide-cel and cilta-cel are projected to substantively increase life expectancy, but neither is cost-effective at current prices. To meet a $150,000/QALY threshold, the price of ide-cel and cilta-cel need to be reduced by 55% and 23% respectively, and improvements in the cost-effectiveness of subsequent multiple myeloma care are also needed.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117720","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Implications and Economic Impact of Applying International Guidelines to the Management of High Risk T2DM Patients in India","id":"5a035148-8f94-4192-a62a-3d46230ff1d8","sessionCode":"EE85","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>SGLT-2i’s and DPP-IVi's are recommended as preferred add-on OAD’s after metformin among T2DM patients with ASCVD, HF, CKD. They generally many folds costlier than other OAD’s. This is a simulatory analysis to assess the relative cost escalation and risk reduction with their hypothetical substitution / addition in prescriptions of high risk patients. <strong><p><b>METHODS: </b> </strong>A simple simulatory cost effectiveness analysis was performed using prescriptions of T2DM patients with established CV or renal disease or having high risk factors. SGLT-2i’s and DPP-IVi's with proven benefits / safety were substituted or added in place of other OADs. Increments in treatment costs were calculated, and anticipated decrease in hazards were extrapolated from CVOTs and real world studies. The ICERs (incremental cost effectiveness ratios) were calculated. <strong><p><b>RESULTS: </b> </strong>Prescriptions of 351 patients with mean age of 58.04 ± 8.67 years were analysed. Upon calculating the ICERs, additional cost to prevent one all cause death with dapagliflozin substitution is INR 37,33,220 - 1,43,58,538.5, INR Rs 22,23,326.09 with empagliflozin substitution, and INR 80,69,818.18 with canagliflozin substitution. The ICER for prevention of hospitalisation for HF (hHF) with dapagliflozin substitution is INR 74,66,440 – 81,15,695.65, INR 40,107,05.88 with empagliflozin, and INR 55,48,000 with canagliflozin. and INR 55,48,000 with canagliflozin. To prevent a 3P MACE event, INR 1,16,66,312.5 would be needed with dapagliflozin substitution, and INR 31,46,861.54 and INR 38,59, 478.26 with empagliflozin and canagliflozin respectively. Incremental costs for various outcomes were further higher with addition of SGLT-2i’s along with substitution with sitagliptin / linagliptin. The number needed to treat and patient years of treatment to prevent one event were calculated too. <strong>CONCLUSION:</strong> The incremental costs of prescribing SGLT-2i’s and DPP-IVi's per event reduction are very high for most outcomes considering Indian socioeconomic context; interpretations are subjective in terms of perceived value of an event prevention.</p> <strong> </strong></div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116368","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Reimbursement Needs Associated with Vaginal Birth and Caesarean-Section in Patients with and without Obesity: Drugs in Chile","id":"27e6df37-b9f9-4545-b6cc-3e75832ebc88","sessionCode":"HPR16","topDisplay":"<b><u>Lenz R</u></b><sup>1</sup>, Hernández K<sup>2</sup>, Quiroz Carreño J<sup>3</sup><br><sup>1</sup>Postgraduate Director, Full Professor Public Health Institute Universidad Andrés Bello, Consultant Lenz Consultores, Santiago, RM, Chile, <sup>2</sup>Lenz Consultores, Independencia, RM, Chile, <sup>3</sup>Universidad de Chile, Lenz Consultores, Santiago, RM, Chile","locationCode":"","description":"\r\n\t<div><strong><u>Introduction:</u></strong> The prevalence of obesity reaches 32.3% in women of reproductive age. Obesity is associated with comorbidities that could increase reimbursement needs related to the treatment of these patients during vaginal birth (VB) or cesarean section (CS).</p> <strong><u>Objective:</u></strong> To estimate additional reimbursement needs associated with VB and CS in Chile patients with and without obesity.</p> <strong><u>Methodology:</u></strong> Exploration of four public hospital open-access databases Diagnosis Related Groups (DRGs), based on local reimbursement and payment rules (DRG weight, DRG base price per cluster). Reimbursement needs were estimated from the public health insurance perspective (2020 CLP currency). Inpatient data was retrieved for 2018, 2019, and 2020.</p> <strong><u>Results:</u></strong> From a total of n=39,733 hospital discharges analyzed, 24.97% reported obesity in ICD-10 codes. Of the total records, 75.40% were classified as minor severity (of which 19.32% had an obesity registry), 18.56% moderate severity (25.92% with registered obesity), and 6.05% as greater severity (22.93% registered obesity). Significant differences in severity between subgroups with and without obesity were found (p-value<0.001). Cases with reported obesity showed a higher CS rate (51.60% versus 37.90%) and moderate severity (23.36% versus 16.96%). Cases of VB and CS with reported obesity are 9.18% (CLP 78,896) more expensive on average (14% maximum) than those without obesity. All hospitals report excess days of hospital stay in patients with obesity. For VB, bed days ranged from +0.12 to +0.429, and for CS, from -0.02 to +0.45 days.</p> <strong><u>Conclusion:</u></strong> It is necessary to increase the accuracy of obesity registration in the Chilean experience due to its role in reflecting additional reimbursement needs. All the transfers explored for VB and CS care were associated with higher average reimbursement needs for women who suffer from obesity, longer days of stay, and greater complexity.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115938","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"},{"id":"4f6b0298-31b6-4189-b6aa-63a92e080d5a","parentId":"00000000-0000-0000-0000-000000000000","title":"Reproductive and Sexual Health","urlName":"reproductive-and-sexual-health"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cross-Sectional Analysis of Nurses' Musculoskeletal Health","id":"faacad3c-573e-4726-ac7d-3f4fa73c75d7","sessionCode":"PCR20","topDisplay":"Gál C<sup>1</sup>, Keczeli V<sup>2</sup>, Miszory E<sup>2</sup>, Alföldi Z<sup>2</sup>, <b><u>Csákvári T</u></b><sup>2</sup>, Máté O<sup>2</sup>, Boncz I<sup>2</sup>, Pakai A<sup>3</sup><br><sup>1</sup>Markusovszky University Hospital, Szombathely, VA, Hungary, <sup>2</sup>University of Pécs, Pécs, Hungary, <sup>3</sup>University of Pécs, Pécs, ZA, Hungary","locationCode":"","description":"\r\n\t<div><strong>Introduction: </strong>Several international studies have already shown that a high proportion of healthcare workers - including nurses - have work-related musculoskeletal disorders. The aim of this study was to assess the work-related musculoskeletal disorders among nurses with internationally accepted and applied standardized questionnaires.</p> <strong>Material and method: </strong>Our cross-sectional research was performed in a Hungarian hospital, in September of 2020. Using a non-randomized, convenience sampling, we distributed 150 self-administered questionnaires among nurses working in eleven different inpatient wards. Out of the 150 questionnaires, 123 were returned, but we were only able to use the results of 101 questionnaires in our research (n=101). The self-administered, anonymous questionnaire included questions on general socio-demographic factors, work and current health status, and which factors may have contributed to the development of the musculoskeletal problems. We measured the nurses’ working ability, comorbidities, and personal factors with the Work Ability Index. To assess musculoskeletal disorders, we used the Nordic Musculoskeletal Questionnaire, with our supplementary questions.</p> <strong>Results: </strong>16.83% of the examined nurses had excellent, 48.51% good, 31.68% moderate and 2.97% poor work ability. Musculoskeletal problems were most common in the lower back, followed by the shoulders, cervical and thoracic spine. The most important risk factor for the occurrence of these musculoskeletal disorders was the lifting and moving of immobile patients. This was followed by the care of a significant number of patients in a day, and labour shortages.</p> <strong>Conclusion: </strong>This study points out that a significant proportion of the nurses (93.07%) experienced at least one kind of musculoskeletal pain or discomfort within 12 months prior to the survey. It can be stated that there is a significant relationship between the work ability and the musculoskeletal problems among the examined nurses (p<0.001).</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116603","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Changes in COVID-19 Treatment Patterns over the Course of 2020","id":"8ae98d2b-6de2-46b4-bd07-404b79c2ebdd","sessionCode":"HSD5","topDisplay":"<b><u>Turner BA</u></b>, Winer-Jones J, Maresca A<br>TriNetX, LLC, Cambridge, MA, USA","locationCode":"","description":"\r\n\t<div>OBJECTIVE: This retrospective medical chart review explores how COVID-19 care patterns in the US changed over the course of 2020.</p> <p><b>METHODS: </b> We captured data from 409 patients hospitalized with laboratory-confirmed COVID-19 on or after February 1, 2020 across three healthcare organizations. Patients were stratified into 3 groups based on month of first COVID-19 hospitalization: early (February-April), middle (May-August), and late (September-December). Medications (azithromycin [sole therapy], corticosteroids [dexamethasone and methylprednisolone], hydroxychloroquine, remdesivir, and tocilizumab), procedures, and mortality outcomes were captured from the medical chart and reported descriptively. Up to three lines of therapy (LOTs) were captured.</p> <p><b>RESULTS: </b> Patients were on average 62.5 (SD: 17.2) years old, 57.3% were male, and 69.5% were White. Overall, 75 were hospitalized in the early period, 223 in the middle period, and 111 in the late period. In Early 2020, azithromycin (30.7%) and hydroxychloroquine (28.0%) were the most common first LOTs, and 69.6% of patients who started on azithromycin switched or were augmented with hydroxychloroquine. Corticosteroids were the most common first LOT in middle (34.5%) and late (67.6%) 2020, and 27.3% (middle) and 45.3% (late) of patients who started on corticosteroids were augmented with remdesivir. The number of unique drug combinations decreased from 8 and 10 in early and middle 2020, respectively, to 6 in late 2020. Use of any invasive mechanical ventilation (32.0%) and prone ventilation specifically (12.0%) were most common in early 2020. Clinical trial enrollment was most common in mid 2020 (14.3%). The frequency of chest x-rays was steady at 0.4-0.5 scans per day. Overall, 61 (14.9%) patients died due to COVID-19, but the mortality rate decreased from 26.7% in early 2020 to 9.9% in late 2020.</p> <p><b>CONCLUSIONS: </b> Treatment patterns evolved over the course of 2020 with the most variation in care observed 4-7 months after the arrival of SARS-CoV-2 in the US.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-covid-19-chart-review-posterfinal-pdf.pdf?sfvrsn=e70bb411_0","title":"ISPOR COVID-19 Chart review poster_final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116420","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Subsidized Screening and Lifestyle Management of Gestational Diabetes Mellitus in Rural China: A Multi-Centre, Randomized Controlled Trial","id":"4fee2670-a542-4f2e-ae19-413f7e952f8c","sessionCode":"CO29","topDisplay":"<b><u>Xu T</u></b><sup>1</sup>, Xia Q<sup>2</sup>, Fang H<sup>3</sup><br><sup>1</sup>capital medical univerisity, beijing, China, <sup>2</sup>Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia, <sup>3</sup>peking univerisity, beijing, China","locationCode":"","description":"\r\n\t<div><strong><span>Background </span></strong><span>The burden of gestational diabetes mellitus (GDM) is escalating, and the control rate is poor in rural China. This study assessed the effectiveness of a GDM subsidy program on promoting GDM screening and management in rural China.</span></p> <strong><span>Methods</span></strong><span> This study was a multicenter, randomized controlled trial launched at antenatal clinics of 6 rural hospitals from 3 provinces in China. Pregnant women were recruited in the 24-28<sup>th</sup> week of gestation between 1<sup>st</sup> September 2018 and 30<sup>th</sup> September 2019. We randomly assigned participants to either the intervention group [with subsidized care] or the control group [with usual care]. The primary outcomes were maternal and neonatal complications. We reported binary measurements as risk ratios with 95% confidence intervals (CIs), and continuous measurements as mean differences with 95% CIs. </span></p> <strong><span>Findings </span></strong>A total of 3294 pregnant women were recruited(intervention group:1649; control group:1645),<span> and followed up by delivery for more than 95% of participants. The rates of GDM screening were high in both the intervention (97.2 % [1602/1649]) and control groups (94.5% [1555/1645]). Pregnant women in the intervention group had lower energy intake and more physical activity times than those in the control group (<em>P values </em><0.05). The percentage of doctor visits with glucose retests for the GDM patients in the intervention group was significantly higher than that in the control group (1.5 vs. 0.4 visits; <em>P</em><0.01). The percentage of pregnant women in the intervention group suffering from composite maternal and neonatal complications was lower than that in the control group (38.6% vs. 42.0%, <em>P</em>=0.05), and the difference was more evident in GDM subset (38.8% vs. 48.6%, <em>P</em>=0.03). </span></p> <strong>Interpretation</strong> In rural China, a subsidized GDM screening and lifestyle management program by incentivizing both pregnant women and medical staff led to improved maternal and neonatal outcomes versus usual care.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116765","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Co-Prescribing of Opioids and Psychotropic Medications Among Medicare-Enrolled Older Adults on Long-Term Opioid Therapy","id":"3e542c98-87b4-4491-9398-428eac8280e7","sessionCode":"SA9","topDisplay":"<b><u>Maharjan S</u></b><sup>1</sup>, Bhattacharya K<sup>2</sup>, Yang Y<sup>3</sup>, Bentley J<sup>3</sup>, Ramachandran S<sup>3</sup><br><sup>1</sup>The University of Mississippi, Kirtipur, BA, Nepal, <sup>2</sup>Center for Pharmaceutical Marketing and Management, University, MS, USA, <sup>3</sup>University of Mississippi, Oxford, MS, USA","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>This study assessed trends in co-prescribing of opioids with psychotropic medications (COOP) and characterized COOP patterns among Medicare-enrolled older adults with chronic non-cancer pain (CNCP) on long-term opioid therapy (LTOT).</p> </p> <strong>Methods:</strong> A retrospective cohort study was conducted using 2012-2018 5% national sample of Medicare administrative claims data. Eligible beneficiaries were continuously enrolled and had no claims with a diagnosis of cancer or hospice use, and ≥2 claims with diagnoses for CNCP conditions within a 30-day period in the 12 months prior to the index date (LTOT initiation). COOP was defined as an overlap between opioids and any class of psychotropic medication (anti-depressants, benzodiazepines, antipsychotics, anticonvulsants, muscle relaxants and nonbenzodiazepine hypnotics) based on their prescription fill dates and days of supply following index date in a given year. The rate of COOP, the co-prescribing intensity (co-prescribing days/total opioid prescription days), average dose, and formulation of the opioids prescribed were calculated for each calendar year.</p> </p> <strong>Results:</strong> The eligible study population of individuals on LTOT was 2,384 in 2013 and 2,016 in 2018. The rate of COOP among eligible beneficiaries decreased from 75.25% in 2013 to 69.03% in 2015, and then increased to 71.43% in 2018. Among eligible beneficiaries with at least one day of COOP, the co-prescribing intensity with any class of psychotropic medications showed minimal variation throughout the study period, ranging between 78.57% in 2013 and 75.55% in 2018. Across all the years, the co-prescribing intensity was found to be highest with antidepressants (2013: 51.91% and 2018: 52.61%) followed by benzodiazepines (2013: 28.18% and 2018: 20.42%) and nonbenzodiazepine hypnotics (2013: 14.49% and 2018: 10.60%).</p> </p> <strong>Conclusion:</strong> High rates of COOP among older adults with CNCP who initiated LTOT were observed. Future research should investigate the driving factors of COOP and safety associated with various patterns of use.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/coop-ispor-2022-poster-pdf.pdf?sfvrsn=8164387c_0","title":"COOP ISPOR 2022 poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117503","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"dc752772-538c-4933-b6a5-3b5b6d079673","parentId":"00000000-0000-0000-0000-000000000000","title":"Geriatrics","urlName":"Geriatrics"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Impact of Empagliflozin in Reducing Hospitalization Rates in Type 2 Diabetes Mellitus Patients with Chronic Heart Failure","id":"50517b93-b348-4705-be4d-42c4b5b05854","sessionCode":"EE78","topDisplay":"<b><u>Yagudina R</u></b>, Kulikov A, Serpik V, Protsenko M, Kopeyka K<br>Sechenov First Moscow State Medical University (Sechenov University), Moscow, MOW, Russia","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Type 2 diabetes mellitus patients (T2DM) with chronic heart failure (CHF) are at higher risk of hospitalization for HF, nonfatal myocardial infarction (MI) and renal replacement therapy (RRT). The results of the EMPA-REG OUTCOME study presented convincing evidence that the use of empagliflozin in these patients can significantly reduce the frequency of such hospitalizations. The aim of this study was to compare the clinical and economic impact of empagliflozin in combination with standard of care (SoC) vs SoC in reducing the frequency of hospitalizations in T2DM patients with CHF. <p><b>METHODS: </b> All adult Russian T2DM patients with CHF were considered the target population totaling 106,988 people. Data from the EMPA-REG OUTCOME trial was employed to predict the number of cardiovascular and renal events that can be prevented using empagliflozin with SoC instead of placebo with SoC. The methodology described by Fleurence and Hollenbeak was used to estimate the one-year occurrence probability. This analysis was conducted from the perspective of the Russian healthcare system and costs data was derived from Russian national sources. Exchange rate was: 1 USD = 73,50 Ruble. <p><b>RESULTS: </b> The modelling data indicates that relative to SoC, empagliflozin with SoC yielded fewer cardiovascular and renal-related hospitalizations. The use of empagliflozin with SoC in T2DM patients with CHF will allow to prevent an additional 4482 CHF-related hospitalizations, 2239 nonfatal MI-related hospitalizations and 961 RRT-related hospitalizations in 2022-2024. Significant health care budget savings can be achieved due to the decrease in the number of hospitalizations: 3,454,208 USD in 2022, 5,199,346 USD in 2023, 6,857,673 USD in 2024. <p><b>CONCLUSIONS: </b> This analysis suggests that adding empagliflozin to standard therapy in T2D patients with CHF may provide a more effective use of healthcare resources by preventing additional hospitalizations.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-116158-pdf.pdf?sfvrsn=eace7764_0","title":"Poster-116158.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116158","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Persistence to Treatment with Initially Prescribed Antiplatelet Agents for the Onset of Acute Coronary Syndrome","id":"f6a7b029-b9e4-47b4-bc29-42ca9e537bba","sessionCode":"HSD119","topDisplay":"<b><u>Kim K</u></b><br>University of Illinois at Chicago, Chicago, IL, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Oral antiplatelet agent (OAA) is a medication class that reduces complications after the onset of acute coronary syndrome (ACS). The addition of 3rd-generation OAAs (3G-OAA: prasugrel and ticagrelor) on top of the historic standard strategy, clopidogrel, has enabled physicians to contemplate switching among therapies for specific clinical and financial circumstances. This study aimed to describe the persistence on and switching from the initially prescribed OAA after the onset of ACS.</p> <strong><p><b>METHODS: </b></strong> This was a retrospective analysis of standardized healthcare records from nine healthcare systems participating in the Greater Plains Research Collaboratives. Patients included in this study were hospitalized with a diagnosis of ACS between July 2009 and June 2019. The analytic cohort included patients who had a prescription record for one of the three OAAs within seven days of the ACS discharge. OAA switching over the 180 days from the initial OAA prescription was classified into three categories, escalation (switching from clopidogrel to 3G-OAA), de-escalation (switching from 3G-OAA to clopidogrel), and conversion (switching between the two 3G-OAAs).</p> <strong><p><b>RESULTS: </b></strong> A total of 12,929 patients receiving an OAA for ASC were identified. Clopidogrel dominated the initial OAA prescription with 81% (n=10,497) of the identified patients receiving clopidogrel as a first-line option. A 43% of the initial 3G-OAA prescription switched to an alternative before the end of the 180-day follow-up. Of the patients who switched their OAA, the respective proportions of the escalation, d-escalation, and conversion were 29%, 68%, and 3%.</p> <strong>CONCLUSION:</strong> Despite the superior efficacy of 3G-OAAs from clinical trial data, clopidogrel remained the preferred choice over the last decade. A substantial proportion of patients de-escalated their OAA strategy. Further investigation into the reasons for the premature discontinuation of 3G-OAA is warranted.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117170","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Critical Appraisal of Real-World Evidence on the Clinical and Economic Outcomes Associated with Stent Use in Critical Limb Ischemia","id":"fa391837-b7c1-42ca-a500-43d6a328b974","sessionCode":"SA1","topDisplay":"<b><u>Williams A</u></b><sup>1</sup>, Rojanasarot S(<sup>1</sup>, McGovern A<sup>1</sup>, Jaff MR<sup>2</sup><br><sup>1</sup>Boston Scientific, Marlborough, MA, USA, <sup>2</sup>Boston Scientific, Maple Grove, MN, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b></p> Given the significant burden of critical limb ischemia (CLI), endovascular interventions with stent use remains challenging. Recognizing methodological and practical limitations which exist in conventional clinical trials, real-world evidence (RWE) is increasingly adopted in research for CLI management. This study assessed the quality and the comprehensiveness of RWE on the clinical and economic outcomes associated with below-the-knee (BTK) drug-eluting stents (DES) and bare-metal stents (BMS) in CLI patients.</p> <b><p><b>METHODS</b>: </b></p> A systematic literature review was conducted to identify RWE studies on DES and BMS published in the United States between January 2011 and September 2021. A critical appraisal of studies was performed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist and the Critical Appraisal Skills Programme (CASP) assessment tool for cohort studies.</p> <strong><p><b>RESULTS</strong>: </b></p> Of the 42 RWE studies identified, 8 (6 clinical and 2 economic) were critically analyzed: 67% (4) met the STROBE criteria for addressing confounders. The CASP tool highlighted: 1) study design issues (external validity), 2) limited information on the strategies to minimize selection, and 3) low external validity of the study findings. The STROBE checklist showed: 1) study design issues, 2) missing data not addressed, 3) limited information to minimize systematic bias and confounders, 4) missing flow chart of included and excluded participants, and 5) threats to external validity due to the choice of database.</p> <strong><p><b>CONCLUSIONS</strong>: </b></p> This appraisal demonstrates that eligible RWE studies are well-designed, powered, and offer reliable evidence to discern a statistical difference to clinicians and payers on the clinical and economic outcomes of BTK DES and BMS in CLI patients. However, the evidence supporting the economic outcomes of BTK stents is limited. Since payers rely on economic studies to enhance resource decision-making, there is a need for more healthcare economic data on the value of endovascular interventions for the treatment of CLI.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-postercritical-appraisal-clifinal-pdf.pdf?sfvrsn=c9ada768_0","title":"ISPOR Poster_Critical Appraisal CLI_Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115044","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Diabetes and the COVID-19 Epidemic in Algeria: Prevalence and Characteristics of Patients Diagnosed during the First 6 Months of the Epidemic.","id":"d3e3b9b6-6478-4d1e-9e14-46a81cae1992","sessionCode":"EPH3","topDisplay":"<b><u>Tebaibia A</u></b><sup>1</sup>, Mammeri A<sup>1</sup>, Brahimi H<sup>1</sup>, Ammi M<sup>1</sup>, AitSaid N<sup>2</sup>, Lebdjiri M<sup>2</sup>, Grine S<sup>2</sup>, Tagzout D<sup>1</sup>, Hadjene L<sup>2</sup>, Bradaia H<sup>2</sup>, Hamrour F<sup>1</sup>, Hocine O<sup>1</sup>, Hamouni M<sup>2</sup>, Toudji N<sup>2</sup>, Aouadi M<sup>2</sup>, Khedairia I<sup>2</sup>, Djafour W<sup>2</sup>, Bouriah A<sup>2</sup>, Belkadi A<sup>2</sup>, Bouabana F<sup>2</sup><br><sup>1</sup>Faculty of Medicine, University Algiers 1, Algeria., Algiers, Algeria, <sup>2</sup>Department of Internal Medicine, El Biar Hospital, Algiers, Algeria, Algiers, Algeria","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Several studies have shown that covid-19 can be more severe in diabetic patients than in the general population. We aimed to describe the prevalence and the clinical characteristics of diabetic patients with covid-19 compared to the general population.</p> <strong><p><b>METHODS: </b></strong> We conducted a prospective observational monocentric study at the University Hospital of El-Biar in Algiers between April and September 2020. A pre-established questionnaire identified demographic characteristics, comorbidities, symptoms and diagnosis tools.</p> <strong><p><b>RESULTS: </b></strong> A total of 1008 patients with covid-19 were included, 51% were male, the mean age was 52 years old. Diabetic population consisted on 236 (23,41%) patients most of them with type 2 diabetes (n=235), with a mean age over 50 years. Interestingly, type 2 diabetes was newly diagnosed in 37 (4%) patients. Covid-19 was diagnosed by PCR test in 52.5% (529) of patients while computed tomography (CT) scan was performed in 92.8% (935) of patients. Among the severe forms (CT damage >50% and/or oxygen therapy) 29,6% were presented by diabetic patients. Covid-19-related complications were present in 7.5% of nondiabetic patients and in 11% of diabetic patients. A total of 15 patients were admitted to the intensive care unit, among them 4 were diabetics (1.7%). The average hospital stay was the same for both populations (10 days). A higher mortality was observed in the diabetic population (2.1%) compared to the non-diabetics (0.6%).</p> <strong><p><b>CONCLUSIONS: </b> </strong>In this monocentric study conducted in Algiers, the prevalence of diabetes is higher in patients with covid-19 (23.4%) compared to the general population.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117666","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Reproduction of Control Groups in Two Global RCTs of Anti-Cancer Drugs Using Health Insurance Claims Data in Japan","id":"963b267d-5637-4ac7-bd12-473450e131c8","sessionCode":"RWD15","topDisplay":"<b><u>Tateyama M</u></b><sup>1</sup>, Takeshima T<sup>2</sup>, Iwasaki K<sup>2</sup><br><sup>1</sup>Milliman, Inc., Chiyoda-ku, Tokyo, Japan, <sup>2</sup>Milliman, Inc., Tokyo, Japan","locationCode":"","description":"\r\n\t<div><span><p><b>OBJECTIVES: </b> A control group of clinical trial using real-world data (RWD) is desirable and ethically sound. Challenges include internal validity. As the first step to verify the internal validity, we tried to reproduce the control groups in the past two RCTs using RWD and evaluate the difference of the outcomes between them on each of the two RCTs. </span><span><p><b>METHODS: </b> We selected the KEYNOTE-426 phase III trial of pembrolizumab for renal cell carcinoma and VIALE-A phase III trials of venetoclax for acute myelogenous leukemia. Overall survival (OS) was one of the endpoints of all the two trials. We reproduced the control groups using health insurance claims data, one of RWD, provided by DeSC Healthcare Inc. Kaplan–Meier OS curves reproduced by RWD and the control group of original RCTs were compared. The survival time in the KEYNOTE-426 trial were examined at the point of 60%. </span><span><p><b>RESULTS: </b> OS curves of original control groups were between upper and lower limits of 95% confidence interval (CI) of OS curves of reproduced control groups in the KEYNOTE-426 trial. The 60% survival time in the reproduced and original control groups in the KEYNOTE-426 trial was 26.1 months (95% CI;18.8-32.7) and 30 months. In the VIAL-A trial, the OS curve of original control group was not between upper and lower limits of 95% CI of OS curve of the reproduced one. </span><span><p><b>CONCLUSIONS: </b> Though significant difference was found between original OS curves and those produced by RWD in the VIAL-A trial, it was not found in the KEYNOTE-426 trial. Furthers studies are needed to judge the credibility of the control group using RWD.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/rwd15poster-presentation-for-ispor-dc-2022-pdf.pdf?sfvrsn=92357ffd_0","title":"RWD15_poster presentation for ISPOR DC 2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115438","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Does Specialty Drug Coverage Vary between Health Plans' Medical and Pharmacy Benefit Policies?","id":"e175e03e-13b2-4fd8-8ffb-47e65751397a","sessionCode":"HPR1","topDisplay":"<b><u>Levine A</u></b><sup>1</sup>, Kauf T<sup>2</sup>, O'Sullivan AK<sup>2</sup>, Strand L<sup>2</sup>, Chambers JD<sup>1</sup><br><sup>1</sup>Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA, <sup>2</sup>Alkermes, Inc, Waltham, MA, USA","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong> Health plans often cover specialty drugs in both their medical and pharmacy benefit policies. We examined the consistency of plans’ medical and pharmacy drug coverage policies.</p> <strong>Methods:</strong> We used the Specialty Drug Evidence and Coverage (SPEC) Database, which includes specialty drug coverage policies issued by 17 of the largest US commercial health plans (policies were current August 2020). We included plans that issued both medical and pharmacy policies. We then identified drugs with “medical-pharmacy policy pairs,” i.e., drugs for which plans issued both a medical and a pharmacy policy. For these pairs, we compared plans’ policies while accounting for the following coverage criteria: patient subgroups (patients must meet certain clinical criteria), prescriber requirements (a specialist must prescribe the drug), and step therapy protocols (patients must first fail alternative treatments). We considered medical-pharmacy policy pairs to be inconsistent if coverage criteria differed, e.g., the medical policy included a prescriber requirement but the pharmacy policy did not.</p> <strong>Results:</strong> We identified 1619 medical-pharmacy policy pairs (representing 287 drugs across 8 plans). Eighty-seven percent of pairs were consistent (1401/1619), and 13% were inconsistent (218/1619). Inconsistency was most often due to differences in plans’ application of step therapy protocols (184/219), followed by prescriber requirements (37/219) and patient subgroups (24/219). Twenty-nine pairs (of 219) were inconsistent in multiple ways. For 116/219 inconsistent pairs, a plan’s pharmacy policy was more restrictive than its medical policy. Plans varied widely with respect to the proportion of their medical-pharmacy policy pairs that were consistent (range 6% to 100%).</p> <strong>Conclusions:</strong> Commercial health plans’ medical and pharmacy specialty drugs coverage policies tended to be consistent, although we found that coverage criteria differed in important ways in 13% of the medical-pharmacy policy pairs. Inconsistent medical and pharmacy policies complicate, and potentially hinder, patients’ access to specialty drugs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116485","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Z-Code Documentation to Identify Social Determinants of Health Among Medicaid Beneficiaries in Texas","id":"46041819-20cb-4469-939a-4910e7f90b87","sessionCode":"RWD10","topDisplay":"<b><u>Heidari E</u></b><sup>1</sup>, Zalmai R<sup>2</sup>, Brown CM<sup>3</sup>, Richards K<sup>3</sup><br><sup>1</sup>University of Texas at Austin, Austin, TX, USA, <sup>2</sup>University of North Texas Health Science Center, Austin, TX, USA, <sup>3</sup>The University of Texas at Austin College of Pharmacy, Texas Center for Health Outcomes Research and Education (TxCORE), Austin, TX, USA","locationCode":"","description":"\r\n\t<div>Introduction: Social determinants of health (SDoH) are non-medical factors that impact individuals’ health. The importance of integrating SDoH data in healthcare is increasingly recognized by stakeholders. SDoH can be documented in healthcare claims data using International Classification of Disease (ICD) 10 th revision codes Z55 – Z65. The objective of this study was to describe the documentation of SDoH Z-codes amongst Medicaid beneficiaries in Texas. Methods: Texas Medicaid medical and enrollment data files were provided by the Texas Health and Human Services Commission. Texas Medicaid insures approximately 4 million people each year. Beneficiaries with at least one claim associated with an ICD-10 code of Z55-Z65 between January 2016 and December 2019 were identified. Those 65+ years of age and others dually eligible for Medicare and Medicaid were excluded. Descriptive analyses were performed. Results: SDoH Z-code documentation was associated with ~1.2 million claims for 181,136 unique Medicaid beneficiaries. SDoH Z-code utilization increased over the years: 40,879 individuals in 2016, 42,668 in 2017, 46,281 in 2018, and 51,308 in 2019. Females (54.3%) and Hispanics (48%) comprised a majority of the beneficiaries with these codes, with an average age of 14.2±13.4 years. Beneficiaries with the most frequent SDoH documentation resided in Harris (17.0%), Bexar (8.7%), and Dallas (8.1%) Counties. Attention-deficit hyperactive disorder (11.8%) and depressive disorders (5.2%) were the most frequent diagnoses associated with SDoH documentation. Nearly 40% of beneficiaries (N=68,478, 37.8%) had documentation of “problems related to upbringing” (Z62). This was followed by “problems related to primary support group including family circumstances” (Z63) (N=42,378, 23.4%) and “problems related to education and literacy” (Z55) (N=28,848, 15.9%). Conclusion: A steady increase in SDoH Z-code documentation was observed amongst Texas Medicaid beneficiaries from 2016 to 2019, but represented a relatively small proportion of beneficiaries. Given the significance of SDoH in health outcomes, these codes are likely underutilized.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114848","diseases":[{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Eliciting Unreported Subgroup-Specific Survival in Randomized Controlled Trials (RCTS): A Non-Parametric Linear Optimization Approach","id":"59e5100c-884b-4bc9-abf6-49f1f22a11b1","sessionCode":"MSR12","topDisplay":"<b><u>Alagoz O</u></b><sup>1</sup>, Srinivasan S<sup>2</sup>, Xiao H<sup>3</sup>, Singh P<sup>4</sup>, Gricar J<sup>5</sup>, Dixon M<sup>5</sup>, Kim I<sup>6</sup>, Kurt M<sup>5</sup><br><sup>1</sup>University of Wisconsin-Madison, Madison, WI, USA, <sup>2</sup>University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, <sup>3</sup>Bristol Myers Squibb, Lawrence Township, NJ, USA, <sup>4</sup>Bristol Myers Squibb, New York, NY, USA, <sup>5</sup>Bristol Myers Squibb, Lawrenceville, NJ, USA, <sup>6</sup>Bristol Myers Squibb, Livingston, NJ, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Survival heterogeneity across subgroups play a critical role in the evaluation of reimbursement dossiers by health technology assessment agencies. This study offers an optimization-based approach to elicit unreported subgroup-specific Kaplan-Meier (KM) curves using aggregate level data from RCTs.</p> <p><b>METHODS: </b>We used reconstructed survival data from both trial arms, reported hazard ratios (HRs) between two mutually exclusive and exhaustive subgroups, and total number of deaths in each of these subgroups to formulate a linear optimization problem where the variables indicated patients’ likelihoods of belonging to either of the subgroups in each arm. Patients in each arm were partitioned between the subgroups with an objective of minimizing the gap between the reported and predicted HRs for both subgroups. Ties among multiple optimal solutions were broken in favor of the assignments whose 95% confidence intervals (CIs) yielded the closest match to the reported 95% CIs of the HRs for both subgroups. We tested the predictive performance of our approach in a case study consisting of 11 distinct RCTs from advanced stage gastrointestinal tumors. The clinical publications analyzed for data extraction were published between 2009-2021 with reported KM-curves for overall survival for 64 subgroups in total.</p> <p><b>RESULTS: </b>Across all 64 subgroups, predicted survival curves laid within the 95% CIs of reported survival curves 83% of the time. Predicted medians and restricted mean survival times (RMSTs) were within the 95% CIs of their reported counterparts for all subgroups in 4 studies, and overall in 49 and 47 subgroups (out of 64), respectively. While the average absolute gap between the predicted and reported RMSTs was 9% across all 64 subgroups, in the aforementioned 4 studies it was less than 3% for all subgroups.</p> <p><b>CONCLUSIONS: </b>Our distribution-free, validated and scalable framework can aid better-informed decisions involving indirect comparisons of subgroups by translating aggregate-level comparative effectiveness data into direct survival information.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporpostersubgroupsurvivalfinal56-pdf.pdf?sfvrsn=67a5222d_0","title":"ISPOR_Poster_Subgroup_Survival_Final_5_6.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115409","diseases":[{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Translation, Cross-Cultural Adaptation and Psychometric Testing of a Yoruba Version of the EQ-5D Questionnaire in Patients with Musculoskeletal Disorders","id":"26220990-c831-4cf9-a9ae-4a9e2044a315","sessionCode":"EE23","topDisplay":"<b><u>Fatoye F</u></b><sup>1</sup>, Gebrye T<sup>2</sup>, Fatoye C<sup>2</sup>, Oyewole O<sup>3</sup>, Akinfala A<sup>3</sup>, Ojelade T<sup>3</sup>, Mbada C<sup>4</sup><br><sup>1</sup>Manchester Metropolitan University, Manchester, LIN, UK, <sup>2</sup>Manchester Metropolitan University, Manchester, LAN, UK, <sup>3</sup>Obafemi Awolowo University, Ile-Ife, Nigeria, <sup>4</sup>Obafemi Awolowo University, Ile-Ife,, Nigeria","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>The EQ-5D is a self-administered questionnaire which necessitates its existence and adaptation in different languages. This study aimed to translate, cross-culturally adapt, and determine the reliability and validity of the Yoruba version of the EQ-5D questionnaire.</p> <p><b>METHODS: </b>Following the International Quality of Life Assessment (IQOLA) project guidelines, the EQ-5D-5L questionnaire was first translated from the English version following a sequence of forward translation, reconciliation and harmonization, backward translation, reconciliation of problematic items. A total of 113 individuals with musculoskeletal disorders were recruited to test the validity of the Yoruba translated version of the EQ-5D-5L (EQ-5D-Yor). A seven-day test-retest reliability of the EQ-5D-Yor was carried out among 109 of the respondents. Convergent and discriminant validity of the EQ-5D-Yor were determined using the Yoruba version of the SF-12 (SF-12-Y) and Visual Analogue Scale (VAS). Data was analyzed using descriptive and inferential statistics of Pearson/Spearman correlation, Intra-Class Correlation, Cronbach alpha and multi trait scaling analysis. Alpha level was set as p < 0.05.</p> <p><b>RESULTS: </b>The construct validity of the EQ-5D-Yor yielded Spearman rho ranging from 0.438 to 1.000, with the EQ-VAS having the highest co-efficient (r = 1.000; p = 0.001). The convergent validity of the EQ-5D-Yor index with SF-12-Y yielded no significant correlations (p < 0.05), except the physical functioning scale (r = -0.709, p = 0.001). On the other hand, the divergent validity of the EQ-5D-Yor index with VAS yielded a weak correlation, (r = 0.016). The Intra-class Correlation Coefficient and Cronbach alpha for the test-retest reliability of the EQ-5D-Yor were 1.000 and 0.968. The confirmatory factor analysis showed the factor loadings were poor when including VAS in the model.</p> <p><b>CONCLUSIONS: </b>The EQ-5D-Yor has acceptable validity and reliability and can be used as a valid tool in economic evaluation studies to assess health benefits in terms of quality adjusted life years among Yoruba speaking population.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114992","diseases":[{"id":"f2cabca2-ce06-433e-903c-56285673ffc3","parentId":"00000000-0000-0000-0000-000000000000","title":"Musculoskeletal Disorders","urlName":"Musculoskeletal-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Relationship between BMI and Healthcare Costs in a Commercial and Medicare Population","id":"51ac5b8c-74a8-4a71-a4ae-4cc98fa897c7","sessionCode":"HSD17","topDisplay":"<b><u>Cherry L</u></b><sup>1</sup>, Magar R<sup>2</sup><br><sup>1</sup>AHRM Inc., Buffalo, NY, USA, <sup>2</sup>AHRM Inc., Raleigh, NC, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Obesity has become a significant health concern due to the prevalence and co-morbidities associated with it. Prior research shows anti-obesity medications are safe and effective as a treatment. This study aims to assess the relationship between body-mass index (BMI) and healthcare costs, and understand how often anti-obesity drugs are denied. <strong><p><b>METHODS: </b></strong> A retrospective database analysis was performed using 2020 pharmacy and medical reimbursement data for adults 18 and over from New Hampshire. The data set contains commercial and Medicare supplement claims from large payers within the state and includes payments made by insurance companies and members. Pharmacy claims were analyzed to determine how frequently four anti-obesity medications (AOM) were denied. Medical claims were evaluated to assess the relationship between BMI and healthcare costs. Medical claims were included in the analysis if they contained an ICD-10 code for BMI and were categorized into four cohorts (non-obese, Class 1 obesity, Class 2 obesity, Class 3 Obesity). The medical and pharmacy data were analyzed at a claim level so a person could appear multiple times in the data.<strong> <p><b>RESULTS</strong>: </b> 4,588 pharmacy claims contained one of four AOMs being evaluated. Overall denial rate for these medications was 64.0% ranging from 58.9% to 70.3%. 60,415 claims included an ICD-10 code for BMI. The average medical claim cost was almost double when comparing non-obese ($1,243) to obese ($2,439) claims. As the class level of obesity increased so too did average medical claims costs (Class 1 - $1942, Class 2 - $2,138, Class 3 - $2,970).<p><b>CONCLUSIONS: </b> Health insurance payers frequently deny AOMs despite the higher cost of healthcare for obese individuals. Benefit plans should increase coverage AOMs for individuals who are indicated<strong> </strong>as overall costs are likely to be higher than reported here as indirect cost were not evaluated.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117818","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"a8f24b83-49b5-4fe2-a4a3-b30e5a263bb3","parentId":"00000000-0000-0000-0000-000000000000","title":"Nutrition","urlName":"Nutrition"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Financial Savings Associated with a Novel Bioprosthetic Engineered to Extend Device Durability Versus Mechanical Aortic Valve Replacements","id":"06e5f6ec-c052-4109-999e-4e20ff0fc230","sessionCode":"EE22","topDisplay":"<b><u>Keuffel E</u></b><sup>1</sup>, Reifenberger M<sup>2</sup>, Marfo G<sup>2</sup>, Nguyen TC<sup>3</sup><br><sup>1</sup>Health Finance and Access Initiative, Bryn Mawr, PA, USA, <sup>2</sup>Edwards Lifesciences, Irvine, CA, USA, <sup>3</sup>University of California San Francisco, San Francisco, CA, USA","locationCode":"","description":"\r\n\t<div>Objective: Our study quantifies savings associated with surgical aortic valve replacement (SAVR) using a novel bioprosthesis engineered to extend device durability relative to mechanical valves.</p> Methods: Our economic model uses epidemiological and cost inputs from the literature, outcomes databases and clinical trials. It tracks three hypothetical patient cohorts (novel bioprosthesis SAVR, standard bioprosthesis SAVR and mechanical SAVR). Probabilities of key health outcomes (mortality, reoperation, hemorrhage, thromboembolism and endocarditis) are estimated annually through year 15. The COMMENCE trial provides incidence rates for novel bioprosthesis through year 5. Long-run tissue valve studies and novel tissue valve bench top studies support estimates for years 5-15. Relative risks are used to estimate clinical events for mechanical SAVR. Anti-coagulation monitoring (ACM) costs are included. Clinical event and ACM input costs (2020 USD) are sourced from claims data or published estimates. The discount rate and inflation are both three percent. We conduct extensive sensitivity analyses and a Monte Carlo simulation version of the model is forthcoming.</p> Results: Through year 5, novel tissue valves saved $8,864 in morbidity and anti-coagulation monitoring costs relative to mechanical valves per SAVR surgery. Most savings are derived from reduced ACM costs ($7,155 or 81% of savings) and lower bleeding costs ($1,383 or 16% of savings). In a similar model, savings associated with standard tissue valves (vs. mechanical valvues) are $6,585 after 5 years. At year 15, net savings for the novel tissue valve are $20,505. If the reoperation relative risk (in relation to mechanical valves) increases after year five accumulated 15-year savings associated with the novel bioprosthetic valve decline.</p> Conclusions: Our model suggests that novel bioprosthetic valves reduce future costs relative to mechanical valves. Reoperation and ACM costs are key factors driving the savings estimates. Prospective studies which measure costs directly would help verify the magnitude of savings over time.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115677","diseases":[{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Systemic Antineoplastic Treatment Utilization Among Patients with Advanced HER2- Breast Cancer across Large Community Health Systems in the US","id":"73e4140d-0484-4fed-a174-4e776987b041","sessionCode":"RWD21","topDisplay":"<b><u>Lorenzo R</u></b>, Pomerantz D, Wolf F, Sommers C, Brown T, Rioth M, Wolfe T, Lerman M, Sanchez N<br>Syapse, San Francisco, CA, USA","locationCode":"","description":"\r\n\t<div><span style=\"font-weight: 400;\"><p><b>OBJECTIVES: </b> Community health systems (CHS) in the US play a large role in the care of patients with cancer, with over 50% of patients with cancer cared for in CHS. The systemic treatments used among patients with advanced HER2- breast cancer seen in these CHS are not widely published. This analysis describes the systemic treatment utilization across a sample of CHS. <p><b>METHODS: </b> A retrospective analysis was performed utilizing the Syapse Learning Health Network<sup>TM</sup> (LHN), an electronic medical record (EMR) derived database that collects cancer care data from multiple settings within CHS across 33 states, 450+ hospitals and from patients cared for by 1,900+ oncologists. Patients </span><span style=\"font-weight: 400;\">></span><span style=\"font-weight: 400;\">18 yo, diagnosed with advanced breast cancer stages (IIIB+) from January 1, 2017 through December 10</span><span style=\"font-weight: 400;\">, 2021,</span><span style=\"font-weight: 400;\"> were identified from the Syapse LHN using ICD-10 codes. Data utilized for this analysis included both structured data (set EMR fields like sex and birth date) and unstructured data (e.g. physician notes) validated by Syapse’s Certified Tumor Registrars and then descriptively summarized. <p><b>RESULTS: </b> </span><span style=\"font-weight: 400;\">2,875</span><span style=\"font-weight: 400;\"> patients from the LHN with advanced HER2- breast cancer (stage IIIB+) were included in the analysis. </span><span style=\"font-weight: 400;\"> 2,019 patients (70%) received antineoplastic systemic treatment; in the 1L setting 59% received chemotherapy, 43% received hormone therapy and 21% received targeted therapy. Agents included: cyclophosphamide,37%; doxorubicin, 34%; paciltaxel, 24%; letrozole, 21%; palbociclib, 14%; anastrozole,13%; carboplatin, 8%; and docetaxel, 7%. </span><span style=\"font-weight: 400;\"><p><b>CONCLUSIONS: </b> Consistent with management guidelines, HER2- patients with advanced breast cancer treated within CHS were most likely to receive chemotherapy in the 1L setting. Further analysis is necessary to better understand management decisions for this group of patients cared for within CHS.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022-breast-her2-negative-trx-v1final-pdf.pdf?sfvrsn=2a73be5c_0","title":"ISPOR 2022 Breast HER2 Negative Trx v1_Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115861","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Toward Real-World Reproducibility: A Systematic Review and Meta-Analysis of Common Rwd/Rwe Protocol Components","id":"b32d5217-b3d4-4304-b5ee-4fd62c981cd6","sessionCode":"SA4","topDisplay":"Shields A<sup>1</sup>, <b><u>Lareau C</u></b><sup>1</sup>, Somerday M<sup>1</sup>, Johnson H<sup>1</sup>, Borgogno J<sup>2</sup>, Wilson A<sup>3</sup><br><sup>1</sup>Asclepia Group, Chapel Hill, NC, USA, <sup>2</sup>Parexel International, Billerica, MA, USA, <sup>3</sup>Parexel International, Waltham, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES<span style=\"font-weight: 400;\">: </b>Use of real-world data/real-world evidence (RWD/RWE) in the life sciences is accelerating. The FDA has issued draft guidance for the conduct of real-world data-driven studies in clinical development. However, RWD </span><i><span style=\"font-weight: 400;\">protocol development standards</span></i><span style=\"font-weight: 400;\"> lag, leading to heterogeneity of findings and consequent unreliability of results. The need to address challenges has become urgent due to increasing importance of reliable evidence generation in the COVID-19 pandemic. We performed a systematic review of published RWD protocols to understand current practices to support improvement in standards frameworks.</span></p> <p><b>METHODS<span style=\"font-weight: 400;\">: </b>We extracted protocols referencing RWD from clinicaltrials.gov. We defined essential real-world study concepts and mapped them to standard discrete protocol components. We summarized these components, including but not limited to: objectives, operational definitions of endpoints, inclusion/exclusion criteria, patient identification algorithms, schematics, extract/transform/load (ETL) methods, common data model (CDM), safety, analysis, and machine learning (ML)/artificial intelligence (AI). We identified areas of harmonization and disagreement, as well as missing components.</span></p> <p><b>RESULTS<span style=\"font-weight: 400;\">: </b>The search identified 220 real-world protocols. Despite substantial harmonization in some areas, particularly those components typical to all research studies, there was considerable disagreement regarding the representation of RWD objectives, RWD inclusion/exclusion criteria, data management, ETL, CDM, ML/AI, study design, and statistical analysis. In many cases, studies did not include real-world-specific elements at all. Quantification and statistical attribution of heterogeneity is ongoing.</span></p> <p><b>CONCLUSIONS<span style=\"font-weight: 400;\">: </b>Incorporating best practices and harmonization of protocol development methods and reporting may lead to improved quality, consistency, and reproducibility of studies. The primary limitation of this study was that “real-world” was neither sensitive nor specific as a search term as it is often used imprecisely. Follow-up surveillance studies will quantify and evaluate the impact of improved standards, encompassing all registered observational studies.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117840","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Utility Analysis of Dapagliflozin in Patients with Chronic Kidney Disease in Dominican Republic","id":"ea55b81a-73b4-45ff-93d4-4ffe1f9cc4c6","sessionCode":"EE31","topDisplay":"<b><u>Ordoñez J</u></b><sup>1</sup>, Diná E<sup>2</sup>, Álvarez G<sup>3</sup>, Rojas L<sup>4</sup>, Ordóñez A<sup>5</sup>, Hidalgo Godínez J<sup>6</sup>, Villalobos K<sup>6</sup><br><sup>1</sup>True Consulting, Medellín, ANT, Colombia, <sup>2</sup>Hospital Metropolitano de Santiago, Santiago, Dominican Republic, <sup>3</sup>Sociedad Latinoamericana de Nefrología e Hipertensión, Santo Domingo, Dominican Republic, <sup>4</sup>Hospital Plaza de la Salud, Santo Domingo, Dominican Republic, <sup>5</sup>True Consulting, Medellín, Colombia, <sup>6</sup>AstraZeneca CAC, San José, Costa Rica","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong> Chronic kidney disease (CKD) is a high-cost chronic disease with costly complications, like hemodialysis, peritoneal dialysis, and cardiovascular diseases (CVDs). This study evaluated dapagliflozin cost-utility in patients with CKD in Dominican Republic.</p> <strong>Method:</strong> A Markov model was developed considering five states: CKD, end-stage renal disease (ESRD), CVDs, ESRD and CVDs simultaneously, and death. The base case is an adult with or without type 2 diabetes who had an estimated glomerular filtration rate of 25-75ml/minute per-1.73m2 of the body-surface area and a urinary albumin-to-creatinine ratio of 200-5000. Perspective is from the third payer; comparators are dapagliflozin or no treatment. Outcomes are ESRD, CVDs, ESRD and CVDs, and death and are expressed in Quality Adjusted Life Years (QALYs). There are three-time horizons, 12, 24, and 32 months, based on the efficacies of the pivotal clinical trial of dapagliflozin in CKD. Willingness-to-Pay (WTP) used was three times the gross domestic product per capita (USD 21,805).</p> <strong>Results:</strong> At 12 months of follow-up, the dapagliflozin strategy costs $921 and generates 0.982 QALYs, and without treatment, the cost is $704 and generates 0.966 QALYs. At 24 months, the dapagliflozin strategy costs $2,069 and generates 1.90 QALYs, and without treatment, it is $1,595 and generates 1.85 QALYs. At 36 months, dapagliflozin strategy costs $3,210 and generates 1.90 QALYs, and without treatment, it is $2,339 and generates 1.85 QALYs. At 12 months, the Incremental Cost-Effectiveness Ratio is $13,485; at 24 months, $8,742; and at 32 months, $6,434 per additional QALY gained. Willingness-to-pay curves estimate that the probability that dapagliflozin is the best treatment strategy at 12 months is 69.8%, at 24 months, 82.1%, and at 32 months, 88.4%</p> <strong>Conclusion:</strong> Dapagliflozin is a highly cost-effective strategy for treating CKD in Dominican Republic. Patients with dapagliflozin have less life-threatening and costly complications than those who do not receive it.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117338","diseases":[{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Mortality and Health Care Utilization Trends of Diabetes Mellitus: Comparing Hungary to OECD Average","id":"47b21fcc-8c94-4f5e-941c-5075c7e62fb8","sessionCode":"EPH11","topDisplay":"<b><u>Csákvári T</u></b><sup>1</sup>, Elmer D<sup>2</sup>, Németh N<sup>1</sup>, Zoltán V<sup>3</sup>, Boncz I<sup>1</sup><br><sup>1</sup>University of Pécs, Pécs, Hungary, <sup>2</sup>University of Pécs, Pécs, PE, Hungary, <sup>3</sup>University of Pécs, Zalaegerszeg, ZA, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Incidence and prevalence of chronic diseases are ever-increasing, causing QoL deterioration, and even premature mortality among <65-year-olds. Our aim was to assess diabetes mortality and health care utilization trends of Hungary and comparing them to OECD average.</p> <strong>Methods</strong>: A quantitative, descriptive study was carried out. Data were derived from OECD Health Statistics database. The following indicators were selected to analysis: diabetes mellitus deaths between 2000-2019, and related hospital discharges between 2004-2019 (standardised, per 100,000 population). OECD average was calculated based on countries who reported data in each year. Besides descriptive statistics, joinpoint regression method was used, changes in trend were assessed with the annual percent change (APC) (p<0.05). JoinPoint 4.9.0.0 software was used for calculating results.</p> <strong>Results</strong>: Diabetes mortality increased from 24.50/100,000 to 25.70/100,000 in Hungary, while OECD average decreased 25.12/100,000 to 22.77/100,000 between 2000-2019. After a decreasing trend, (APC<sub>2006-2009</sub>: -9.18) a slight increase was shown (APC<sub>2017-2019</sub>: 0.70) in Hungary. Average mortality within OECD significantly decreased between 2003-2013 (APC<sub>2003-2013</sub>: -1.78; p<0.05) and 2016-2019 (APC<sub>2016-2019</sub>: -6.21; p<0.05). Number of discharged patients with diabetes was 462.70/100,000 in 2004 and 198.80/100,000 in 2019, while OECD averages were 165.43/100,000 and 120.38/100,000 respectively. Average trend of OECD members has started to decrease significantly since 2008 (APC<sub>2008-2019</sub>: -2.32; p<0.05), while Hungary showed a decreasing tendency since 2006 (APC<sub>2006-2019</sub>: -6.96; p<0.05).</p> <strong>Conclusions</strong>: We found great differences between Hungary and OECD averages regarding the assessed indicators. Reducing the occurrence of preventable diseases is of great importance of health policy, as diabetes care results in a significant surplus of expenditure and burden for the society.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/csakvariposzteroecddiabetesvirtual20220421final-pdf.pdf?sfvrsn=7beab086_0","title":"Csakvari_poszter_OECD_DIABETES_VIRTUAL_20220421_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116798","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Trends in Rheumatology Patient Care and Practice Operations Pre- and Post-COVID-19 Pandemic","id":"2c09aed3-db01-4d91-a159-52d56a6203db","sessionCode":"HSD16","topDisplay":"<b><u>Savill K</u></b><sup>1</sup>, Klink A<sup>2</sup>, Brown-Bickerstaff C<sup>3</sup>, Jeune-Smith Y<sup>2</sup>, Feinberg B<sup>2</sup><br><sup>1</sup>Cardinal Health, EL DORADO HILLS, CA, CA, USA, <sup>2</sup>Cardinal Health, Dublin, OH, USA, <sup>3</sup>Cardinal Health, Alexandria, VA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b> Advances in the field of rheumatology and increasing demands from the aging population have notably impacted trends in rheumatology practice over the past decade. However, arguably one of the most impactful factors on medical practice in the past couple of years has been the COVID-19 pandemic, which has affected medical care across specialties and settings. This research aims to gain insights into trends in rheumatology patient care and the financial health and operations of community rheumatology practices from pre- vs. post-pandemic years.</p> <strong><p><b>METHODS</strong>: </b> Web-based surveys regarding rheumatology clinic operations and patient care were conducted between July and September 2021 among rheumatologists from community- and hospital-based practices throughout the U.S. Data were described using descriptive statistics.</p> <strong><p><b>RESULTS</strong>: </b> While the majority (84%, n=73) of 87 responding rheumatologists reported conducting no patient visits via telemedicine before the pandemic, 93% (n= 81) reported conducting some patient visits via telemedicine post-pandemic. The majority (57%, n=50) reported that the financial health of their practice was about the same or better at the time of survey in comparison to before the pandemic, and 79% (n=69) reported seeing similar levels or more new patient referrals in comparison to before the pandemic. Less than half of rheumatologists (42%, n=37) indicated that the pandemic had only a temporary impact or had very little impact on patient care. Mental health support (83%), medication adherence support (61%), and support navigating insurance coverage/managed care (55%) were the top three cited gaps or unmet needs in patient care exposed by the COVID-19 pandemic.</p> <strong>CONCLUSION</strong>: While findings from this study indicate that the pandemic has impacted rheumatology patient care, including, notably, a shift towards conducting more visits in telemedicine settings, the majority of participating rheumatologists indicated that the financial health of their practice and patient referrals were similar to or higher than pre-pandemic years.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/savillisporrheumtrendsposterfinal-pdf.pdf?sfvrsn=f21a7632_0","title":"Savill_ISPOR_Rheum_TrendsPoster_final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117315","diseases":[{"id":"747104b6-9723-4895-a3d6-28d8c37172e3","parentId":"00000000-0000-0000-0000-000000000000","title":"Systemic Disorders/Conditions","urlName":"Systemic-Disorders-Conditions"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Real-World Evidence of Adverse Kidney Outcomes for Intravitreal Use of Vascular Endothelial Growth Factor (VEGF) Inhibitors Among Patients with Diabetic Retinopathy","id":"bbc4eeef-0bc0-48cf-a5b4-53e50e91d73c","sessionCode":"EPH21","topDisplay":"<b><u>Chen NC</u></b>, Kane-Gill S, Suh K<br>University of Pittsburgh, Pittsburgh, PA, USA","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>Studies of kidney injury following use of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections among patients with diabetic retinopathy have mixed results and are limited by sample size and study design. Our objective was to determine whether intravitreal use of anti-VEGF agents was associated with adverse kidney outcomes compared to treatment with traditional laser photocoagulations. <strong>Methods:</strong> Adult patients with diabetic retinopathy and use of intravitreal anti-VEGF injections or laser photocoagulation were identified from January 2011, through December 2020 in large nationally representative database of administrative and electronic health record information for commercially insured and Medicare/Medicaid Advantage patients. Outcomes assessed included diagnosis of new chronic kidney disease (CKD), worsening CKD, and a composite endpoint of hospitalization or death using survival analyses. We applied inverse probability treatment weighting using propensity scores and adjusted for demographics, comorbidities, CKD stages at baseline and number of antidiabetic medications. <strong> Results:</strong> A total of 2,566 patients met the inclusion criteria, with 1,392 patients receiving intravitreal anti-VEGF injections and 1,174 patients receiving laser photocoagulation. Patients in the anti-VEGF group had a 33% higher hazard for newly developed CKD compared to patients in the laser group after adjustment (95% CI: 1.10, 1.60). There was no significant difference in worsening of pre-existing CKD in these two groups (HR=0.93; 95% CI: 0.77, 1.33). Patients treated with intravitreal anti-VEGF injections had significantly higher hazards for hospitalizations and mortality compared to those treated with laser photocoagulation (HR=1.17; 95% CI: 1.04, 1.31). <strong>Conclusions: </strong>While use of anti-VEGF intravitreal injections was not associated with worsening CKD compared to laser photocoagulation, patients without pre-existing CKD had a higher risk of developing newly diagnosed CKD. These results continue to question the effects anti-VEGF injections have on adverse kidney outcomes.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116559","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Adverse Outcomes Associated with Concurrent Gabapentin, Opioid, and Benzodiazepine Utilization: A Nested Case-Control Study","id":"dde177be-2918-4a26-832e-543e8aff4429","sessionCode":"EPH2","topDisplay":"<b><u>Olopoenia A</u></b><sup>1</sup>, Camelo Castillo W<sup>2</sup>, Qato DM<sup>3</sup>, Adekoya A<sup>4</sup>, Palumbo F<sup>2</sup>, Sera L<sup>5</sup>, Simoni-Wastila L<sup>2</sup><br><sup>1</sup>Cerner Enviza, NORTH KANSAS CITY, MO, USA, <sup>2</sup>University of Maryland School of Pharmacy, Baltimore, MD, USA, <sup>3</sup>Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA, <sup>4</sup>Johns Hopkins, Baltimore, MD, USA, <sup>5</sup>University of Maryland, Baltimore, Baltimore, MD, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Little is known about co-utilization of gabapentin (GABA), opioids (OP), and benzodiazepines (BZD) and associated public health outcomes. Given this, our goal was to examine the association between concurrent utilization of gabapentin (GABA), opioids (OP), and benzodiazepines (BZD) and respiratory depression, opioid and substance-related overdose. </p> <p><b>METHODS: </b> Using Medicare CCW Data, 2013-2016, we conducted a nested case control study to examine adverse consequences associated with concurrent GABA, OP, and BZD utilization in a disabled Medicare population. Cases and controls were Fee-for-service disabled beneficiaries who had a diagnosis of acute pain (AP), chronic pain (CP) or mental health conditions (MH) and received GABA, OP or BZD. Cases with respiratory depression, opioid or substance-related overdose were matched with up to 4 controls on socio-demographics, year of cohort entry and disease risk score. Primary exposure was concurrent medication utilization defined as an overlap of at least one day in prescriptions for GABA, OP and BZD. </p> <p><b>RESULTS: </b> Across all cohorts, majority of cases and controls were under 65, female, dually eligible and had prior histories of pain and mental health conditions. GABA+OP+BZD use was associated with increased odds of respiratory depression [AOR(95%CI)―AP: 1.35 (1.19-1.52), CP:1.24 (1.11-1.38) and MH: 1.16 (1.02-1.32)], opioid related overdose [AP: 1.43 (1.04-1.98), CP: 1.47 (1.07-2.00) and MH: 1.44 (1.04-2.00)], and substance related overdose[AP: 1.77 (1.26-2.50), CP: 1.70 (1.24-2.34) and MH: 1.92 (1.31-2.82)].While there were cohort differences in the association between GABA+OP and both respiratory depression and opioid-related overdose, GABA+OP and GABA+BZD use were associated with significantly higher odds of substance-related overdose across all clinical cohorts.</p> <p><b>CONCLUSIONS: </b> Among Medicare disabled beneficiaries, concurrent utilization of gabapentin, opioids, and benzodiazepines is associated with multiple adverse outcomes. Given this, it is imperative that the benefits and risks of co-prescribing these medications be comprehensively examined.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-abstract2-pdf.pdf?sfvrsn=20b02f12_0","title":"ISPOR abstract_2.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116609","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"f2cabca2-ce06-433e-903c-56285673ffc3","parentId":"00000000-0000-0000-0000-000000000000","title":"Musculoskeletal Disorders","urlName":"Musculoskeletal-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Comparing Change in Medical Expenditure for Type 2 Diabetes Mellitus Patients with High Versus Low Adherence to Treatment Guidelines: A Retrospective Longitudinal Propensity Score-Matched Analysis","id":"e781f962-36c6-4c2c-9aa6-5450381c3868","sessionCode":"HSD6","topDisplay":"<b><u>Lewing B</u></b><sup>1</sup>, Zakeri M<sup>2</sup>, Contreras J<sup>3</sup>, Sansgiry SS<sup>1</sup><br><sup>1</sup>University of Houston, College of Pharmacy, Houston, TX, USA, <sup>2</sup>University of Houston, College of Pharmacy, Pearland, TX, USA, <sup>3</sup>University of Maryland Baltimore, Baltimore, MD, USA","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>This study compared economic outcomes of Type 2 Diabetes Mellitus (T2D) patients with low adherence to American Diabetes Association (ADA) treatment guidelines to those with high adherence.</p> </p> <strong>Methods: </strong>This retrospective study used most recently available (2016-2018) longitudinal Medical Expenditure Panel Survey data to identify adults with T2D. ADA Standards of Diabetes Care guidelines were used to identify and define 10 processes of T2D care. High adherence was defined as adherence to nine or more processes of care and low adherence was defined as adherence to six or fewer. A propensity score model was developed using factors including patient, system, and physician variables, matching T2D patients 1:1 with low adherence to treatment guidelines to similar patients with high adherence. After matching, cohorts were followed for one year, comparing change in all-cause medical expenditure using t-test. Variables that were significantly imbalanced after matching were controlled for using logistic regression. Analyses completed using SAS version 9.4, with significance set at 0.05.</p> </p> <strong>Results:</strong> There were 1,619 adults with T2D that met study inclusion criteria, representing 15,781,346 individuals. Of those, 197(12.17%) were identified as low adherence and 826(51.02%) were identified as high adherence. After matching, each cohort had 195 individuals. Post matching, those with low adherence to treatment guidelines had significantly higher change in all-cause medical expenditure (mean(SE)) of $4,031($600) versus those in the high adherence group -$128($987) (<em>p</em><0.001). After adjusting for imbalanced variables, those with low adherence still had an average increase in medical expenditure of $3542($1604) (<em>p</em>=0.0285).</p> </p> <strong>Conclusions: </strong>Non-adherence to treatment guidelines during T2D care is an extensive issue with significant economic burden. Those who had low adherence to ADA treatment guidelines had significantly higher change in medical expenditure in the following year, compared to those with high adherence. These findings emphasize the importance of adequate care during the management of T2D.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/benjaminispor2022pdf-pdf.pdf?sfvrsn=2a3b5102_0","title":"Benjamin_ISPOR_2022_PDF.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116130","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Development of an Administrative Claims and Electronic Medical Record-Based Algorithm to Classify Systemic Disease Severity Among Patients with Sjogren's Syndrome in an Integrated Delivery Network in the United States","id":"42d3d0d1-69e0-4d39-bc0d-55180ef01215","sessionCode":"CO4","topDisplay":"<b><u>Ndife B</u></b><sup>1</sup>, Pivneva I<sup>2</sup>, Patel S<sup>1</sup>, Rossi C<sup>2</sup>, Duna G<sup>1</sup>, Lawrence M<sup>1</sup>, Signorovitch J<sup>3</sup><br><sup>1</sup>Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, <sup>2</sup>Analysis Group, Inc., Montreal, QC, Canada, <sup>3</sup>Analysis Group, Inc., Boston, MA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Sjögren’s syndrome (SjS) systematic disease activity cannot be ascertained in administrative claims and/or electronic medical records (EMR). Prediction algorithms to classify patients with moderate-to-severe systemic activity using claims/EMR were evaluated.</p> <strong>Methods: </strong>A retrospective chart review was used to identify adult patients with SjS in a US integrated delivery network and assess disease severity using EULAR’s Sjögren's Syndrome Disease Activity Index (ESSDAI). Patients with ESSDAI scores ≥5 and <5 were considered to have moderate-to-severe and low systemic SjS severity, respectively. Demographic and 12-month baseline clinical predictors of moderate-to-severe SjS were obtained from linked claims/EMR prior to first ESSDAI assessment. Predictors included healthcare resource utilization (HRU; i.e., inpatient/outpatient/emergency room days), EMR (i.e., laboratory testing), comorbidities, number of specialist visits (e.g., rheumatologist), and medications. Logistic regression modeled the predicted probability of having moderate-to-severe SjS. Discrimination was assessed using the receiver operating curves (ROC) and positive/negative predictive values (PPV/NPV). Calibration was assessed using Hosmer-Lemeshow (HL) goodness-of-fit.</p> <strong>Results: </strong>Data from 213 patients were collected (mean age 59.6 years, 92% female). Based on chart review, 19 patients (8.9%) had moderate-to-severe SjS (i.e., gold standard). Three models were identified with high discrimination and were well-calibrated: Model 1: Comorbidities, specialists, and medications (ROC=0.886; HL p-value=0.93); Model 2: HRU, specialists, and medications (ROC=0.907; HL p-value=0.96); Model 3: HRU, EMR, specialists, and medications (ROC=0.939; HL p-value=0.88). Using 0.50 predicted probability cut-off, for Models 1 to 3, sensitivity ranged from 11% to 58%, specificity 97% to 99%, PPV 33% to 72% and NPV 92% to 96%.</p> <strong>Conclusions: </strong>Overall, these prediction models, particularly including EMR data, were successful in ruling out patients with moderate-to-severe systemic disease activity. Given the heterogeneity of SjS, low sample size and sensitivity, and increased likelihood of model overfitting, random forests will be implemented to rank-order importance of predictors and develop a more parsimonious model.</p> <strong>Sponsorship:</strong> Novartis</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114617","diseases":[{"id":"747104b6-9723-4895-a3d6-28d8c37172e3","parentId":"00000000-0000-0000-0000-000000000000","title":"Systemic Disorders/Conditions","urlName":"Systemic-Disorders-Conditions"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Implications of Cure Fractions on Costs of Cancer Care: An Innovative Application to Multi-Cancer Early Detection (MCED) Economic Modeling","id":"d95ff1f1-3ae8-46b8-a603-56894186b3a5","sessionCode":"MSR4","topDisplay":"Hathaway C, Shah N, <b><u>Tyson C</u></b>, Cohain A, Li Y<br>Exact Sciences Thrive LLC, Cambridge, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES<span>: </b>Cost-effectiveness modeling of MCED should account for variations in curative potential by cancer stage. Mixture cure models are widely used to extrapolate long-term survival in heterogeneous oncological populations. This work evaluates such methodology in the context of MCED modeling and the cost implications.</span></p> <p><b>METHODS<span>: </b>Cure fractions (proportion of patients cured of disease) by cancer type and stage were determined utilizing mixture cure models and SEER relative survival. We estimated uncured survival based on CDC life tables and SEER observed survival for ages 50-74 and U.S. demographic distributions across many cancer types targeted by MCED tests. We created a scenario to derive the potential economic impact of cure fractions when modeling MCED by tabulating 10-year cancer-attributable costs (initial, continuing, and end-of-life) across a static diagnosed population. The cured population included five years of continuing costs in addition to initial costs, while the uncured population also included end-of-life and continuing costs for the remaining duration of survival. Without cure fraction, all costs were tabulated as uncured using SEER observed survival. </span></p> <p><b>RESULTS<span>: </b>Cure fractions varied by cancer stage and type – greater for earlier stages (61.7% local mean versus 2.7% distant mean) and cancers with higher 5-year survival (93.0% for local breast versus 12.9% for local liver). The example scenario showed reductions in cancer-attributable costs incorporating cure fraction compared to no cure fraction: 26.5%, 9.45%, and 0.5% for local, regional, and distant, respectively. All cancers showed cost reductions after implementing cure fractions, ranging from 39.7% (kidney) to 9.1% (liver).</span></p> <p><b>CONCLUSIONS<span>: </b>Detecting cancers at earlier stages increases the fraction of the population that may be cured. MCED health economic modeling can use mixture cure models to estimate different costs between cured and uncured populations. Cured cost reduction will vary by cancer type and stage and is correlated to screening effectiveness and cancer aggressiveness.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/cure-fractions-mced-modelingispor-2022-final-pdf.pdf?sfvrsn=d7a4c859_0","title":"Cure-Fractions-MCED-Modeling_ISPOR-2022-Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117378","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Completeness of Real-World Data (RWD) in Chimeric Antigen Receptor T-Cell Therapy (CAR-T) for Relapsed/Refractory (R/R) Diffuse Large B-Cell Lymphoma (DLBCL) in United States (US) Community Oncology/Hematology Practices (CH/OS)","id":"b473bfda-19ac-416d-a385-56f1ff42a467","sessionCode":"CO5","topDisplay":"<b><u>Feinberg B</u></b><sup>1</sup>, Klink A<sup>2</sup>, Balanean, MPH A<sup>2</sup>, Schuler T<sup>3</sup>, McAllister L<sup>2</sup>, Liassou D<sup>2</sup>, Gajra A<sup>2</sup>, Porter D<sup>4</sup><br><sup>1</sup>Cardinal Health Specialty Solutions, ATLANTA, GA, USA, <sup>2</sup>Cardinal Health Specialty Solutions, Dublin, OH, USA, <sup>3</sup>Cardinal Health Specialty Solutions, Issaquah, WA, USA, <sup>4</sup>Cell Therapy and Transplant Program, Hematology Oncology Division and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong></p> CAR-T can be dramatically effective for some patients with R/R DLBCL. Currently, however, access has been limited to major academic centers. Moreover, many patients who could benefit from CAR-T may not have appropriate access or receive timely referral. To broaden access, CAR-T may become available in the cH/O setting, from which RWD describing the treatment journey are lacking. To explore feasibility of c/HO-administered CAR-T and identify critical deficiencies, we assessed completeness of and cH/O access to patient CAR-T outcomes data.</p> <strong><p><b>METHODS: </b></strong></p> A retrospective, observational, multicenter chart review was conducted of 65 adults with R/R DLBCL referred by 13 US cH/Os and receiving CAR-T in 2019. The referring cH/Os abstracted relevant clinical decision-making data (events and dates), which were assessed for completeness.</p> <strong><p><b>RESULTS: </b></strong></p> Initial and R/R DLBCL diagnoses and dates were reported for 100% of patients (N=65), and 100% of the 23 patients who relapsed post-CAR-T had relapse dates available. All patients had regimens and dates of first-line therapy initiation. Data availability for lymphodepletion was 100%. Proportions of patients having specific events surrounding CAR-T were reported for referral (100%), leukapheresis (43%), and first cH/O visit post-CAR-T (100% unless not occurred). 21 patients (32%) underwent allogeneic stem cell transplantation (ASCT). 24 patients (37%) were hospitalized post-CAR-T (setting reported for 55%), median length of stay was 18 days, and 5% of patients had emergency visits.</p> <strong>CONCLUSION:</strong></p> Access to RWD describing episodes of care for CAR-T in cH/O practice can be instrumental in understanding CAR-T across diverse patient populations and lay the groundwork for considering administration in a community setting. Timely, agile data resources for clinical decision-making will be needed to ensure optimal outcomes in this setting. Universal methods ensuring access to appropriate data collection, management, and assessment by cH/Os will speed dissemination of this novel therapy beyond major academic centers.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispordlbclcartposter1v3-pdf.pdf?sfvrsn=ca0ddb3d_0","title":"ISPOR_DLBCL_CART_Poster1_V3.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117502","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Proposed Framework for Evaluating Continuity of Data Coverage in Electronic Health Record and Administrative Claims Data in Real-World Evidence (RWE) Studies","id":"deef8fb4-04a1-488a-b734-580070c00ae5","sessionCode":"SA7","topDisplay":"Amirian ES<sup>1</sup>, Dye J<sup>2</sup>, Wilson T<sup>1</sup>, Espirito J<sup>1</sup>, Robert N<sup>3</sup>, <b><u>Bian J</u></b><sup>4</sup><br><sup>1</sup>Ontada, The Woodlands, TX, USA, <sup>2</sup>Ontada, Atlanta, GA, USA, <sup>3</sup>Ontada, Irving, TX, USA, <sup>4</sup>Ontada, Ivring, TX, USA","locationCode":"","description":"\r\n\t<div>Regulators have demonstrated increasing interest in and receptiveness to leveraging RWE for decision-making processes. Addressing continuity of coverage (e.g., enrollment and disenrollment) as relevant to data availability in candidate real-world data (RWD) sources is discussed in the FDA’s 2020 RWE guidance documents, but this topic has received little attention in the RWE-related methodological literature. Although there are considerations specific to the research question and the nuances of each data source, the development of customizable evaluation frameworks and planning tools can facilitate the conduct of clear, cogent analyses that demonstrate whether the candidate RWD source has the requisite coverage and comprehensiveness over time to be utilized for regulatory-grade studies.</p> In this conceptual paper, we provide a high-level framework for examining continuity of coverage related to data availability/comprehensiveness in EHR and administrative claims data. We also discuss analytic coverage assessment strategies specific to major components of study design (i.e., research question, study period/temporal anchors, and population).</p> Issues related to data coverage can arise in any phase of the study period when using EHR or claims data. For example, in retrospective cohort studies, the pre-index period may include a baseline covariate assessment window, eligibility assessment window, and washout periods, but data may be unavailable or inadequate to assess medical history. Conversely, in the follow-up period, some patients may reach an outcome during the study period, while others are lost-to-follow-up or otherwise censored, and the data may fail to represent the outcome. Describing patterns related to differential loss to follow-up is <em>one</em> important component of assessing coverage. Though challenging, linkage of multiple data sources to obtain a more comprehensive profile of each patient’s journey is possible through technological solutions, such as HIPAA-compliant tokenization approaches. We describe opportunities to identify and mitigate issues arising from lack of data continuity.</p> <em></em></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporconceptpaperbian-pdf.pdf?sfvrsn=74bca037_0","title":"ISPOR_Concept_Paper_Bian.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116980","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Real-World Evidence of the Effect of Continuous Subcutaneous Insulin Infusion Vs Multiple Daily Injections on HBA1C in 25,000 Adults with Type 1 Diabetes: A Quasi-Experimental Study","id":"de7c5b81-cc1b-46c1-a69d-5857669d1c5e","sessionCode":"CO18","topDisplay":"<b><u>Madsen K</u></b><sup>1</sup>, Olsen KR<sup>2</sup>, Kjær T<sup>2</sup><br><sup>1</sup>University of Southern Denmark | Steno Diabetes Center Copenhagen, Herlev, 84, Denmark, <sup>2</sup>University of Southern Denmark, Odense, 83, Denmark","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> The use of continuous subcutaneous insulin infusion (CSII) is a widely used therapeutic strategy for achieving near-normal blood glucose for people with type 1 diabetes (T1D). Clinical trials have shown that CSII can improve glycated hemoglobin (HbA1c) compared with multiple daily injections (MDI). However, whether this is the case in the real world remains largely unresolved. Thus, the objective of this study was to estimate the effect of CSII on HbA1c compared with MDI, using real-world population data.</p> <strong>Methods</strong></p> A quasi-experimental, longitudinal study from 2010-2020 of all people with T1D in Denmark was designed based on prospectively collected, register-based data. All living adult individuals with T1D were identified using a validated algorithm and were available for inclusion in the final cohort. The cohort was open, i.e., new individuals entered the cohort upon diagnosis with T1D. CSII users were distinguished from MDI users algorithmically based on procedure codes for CSII and CSII-specific prescribed insulin.</p> The identification strategy to estimate the average treatment effect of the treated (ATT) of CSII exploited the longitudinal and treatment-staggered data structure by using a doubly robust difference-in-differences estimator. Event study analyses were conducted, and heterogeneity effects were examined for sex, age, education, HbA1c at treatment initiation and continuous glucose monitor (CGM) use.</p> <strong>Results</strong></p> An ATT of -3.54mmol/mol (95%CI: -4.15 – -2.94) was identified for HbA1c; event study analysis revealed the largest decrease within the first year of treatment, which then stabilized. Decreases were largest among women, the relatively older, those with high HbA1c at treatment initiation, and CGM users.</p> <strong>Conclusions</strong></p> On average, CSII therapy results in decreased HbA1c compared with MDI, particularly within the first year of therapy. Compared to clinical trials, however, the decease is smaller in magnitude. Importantly, not everyone benefits the same as evident in subgroup analyses.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporposterfinal-pdf.pdf?sfvrsn=5a2d2b68_0","title":"ISPOR_poster_final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116330","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Addressing the Challenge of Sample Size in Rare Disease: Expanding the Use of Health Plan Claims in Patients with Only Medical Coverage, Lacking Corresponding Prescription Insurance Coverage","id":"a54b5654-cf9f-4898-be1a-587ae9a06579","sessionCode":"RWD19","topDisplay":"<b><u>Wade R</u></b><sup>1</sup>, Gorritz M<sup>2</sup>, He J<sup>2</sup><br><sup>1</sup>IQVIA, Crozet, VA, USA, <sup>2</sup>IQVIA, Plymouth Meeting, PA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b></p> Health plan claims databases can contain substantial numbers of patients with only medical coverage, that is, without corresponding prescription drug coverage. This may occur when prescription coverage is not purchased, or such coverage is acquired from another source such as with Medicare Part D programs. Health outcomes research on these patients is severely limited without prescription utilization information. This study examines the ability to conduct research on such patients by linking their medical claims to an open-source prescription claims database.</p> </p> <strong><p><b>METHODS</strong>: </b></p> A retrospective cohort study using the PharMetrics Plus database (P+) identified patients >=18 years old with >=2 medical claims >=30 days apart for gastrointestinal (GI-NET) or pancreatic neuroendocrine tumors (P-NET) between 1/1/2013-7/31/2020. Continuous medical enrollment for 12 months prior and 1 month after the first such claim in P+ was required. Patients with other primary tumor types were excluded, the remaining were linked to the IQVIA open-source claims database (LRxDx). The number of patients eligible for study with combined medical/pharmacy coverage in P+ and those with medical coverage only were evaluated</p> </p> <strong><p><b>RESULTS</strong>: </b></p> Of 33,388 patients meeting the GI-NET/P-NET requirement, 26,079 had continuous medical and pharmacy eligibility, and 6,838 of those met all eligibility requirements (GI-NET n=2,177, P-NET n=4,661). When considering patients with medical coverage only, an additional 3,372 met all eligibility requirements, an increase of 49% in the potential study population (n=10,210). The linkage rate to LRxDx was 80% (n=8,177) for a population increase of 19.6% (GI-NET n=2,623, P-NET n=5,554). In the final population, 92% (n=7,492) of the patients had at least one pharmacy claim.</p> </p> <strong><p><b>CONCLUSIONS</strong>: </b></p> This study demonstrates that studies using health plan data having patients with medical coverage only can be expanded by merging with open source claims, perhaps most useful in rare diseases where sample size is critical.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/net-poster-ispor-115589final20220422-pdf.pdf?sfvrsn=ca2b2ebc_0","title":"NET poster ISPOR 115589_final_20220422.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115589","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Impact of the COVID-19 Pandemic and Lockdowns on the Health-Related Quality of Life of People Living with Multiple Sclerosis in Australia","id":"89a87419-0462-4cb0-9c56-58b6489a1894","sessionCode":"PCR15","topDisplay":"<b><u>Henson G</u></b><sup>1</sup>, van der Mei I<sup>1</sup>, Taylor BV<sup>1</sup>, Blacklow P<sup>2</sup>, Claflin SB<sup>1</sup>, Palmer AJ<sup>1</sup>, Hurst C<sup>1</sup>, Campbell JA<sup>1</sup><br><sup>1</sup>University of Tasmania, Hobart, TAS, Australia, <sup>2</sup>University of Tasmania, Sandy Bay, TAS, Australia","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> People living with multiple sclerosis (PwMS) in metropolitan Victoria, Australia experienced a 112-day, COVID-19 related lockdown in mid-2020. This lockdown severely limited civilian movement and access to services. Contemporaneously, Australian PwMS elsewhere experienced minimal restrictions. The resulting natural experiment was exploited by this study, which assessed the associations between lockdowns, COVID-19 related adversity, and health-related quality of life (HRQoL).</p> <strong><p><b>METHODS: </b></strong> Data (quantitative and qualitative) were extracted from Australian MS Longitudinal Study surveys, which included the AQoL-8D multi-attribute utility instrument and a specialised COVID-19 questionnaire. This COVID-19 questionnaire required participants to indicate levels of COVID-19 related adversity across several health dimensions. Ordered probits were used to identify variables contributing to higher adversity rankings. Multiple regression was applied to determine the impact of adversity on HRQoL, defined using AQoL-8D health state utilities (HSUs). Qualitative data were examined thematically.</p> <strong><p><b>RESULTS: </b></strong> n=1666 PwMS (average age 58.5y; 79.8% female; typical of MS-related studies) entered the study, with n=369 (22.0%) exposed to the 112-day lockdown. The lockdown was strongly associated with higher adversity rankings, as was disability severity, relapse-onset phenotypes, and lower age (p<0.01 for all variables). Higher adversity rankings were associated with reduced HSUs. Participants reporting major adversity, across measured health dimensions, had HSUs 0.163 (p<0.01) lower than participants reporting no adversity and were more likely (OR:2.36, p<0.01) to report a clinically significant HSU reduction, before versus during the COVID-19 pandemic. A clinically significant decrease in HSU was defined as Δ>0.08, based on the literature. Additionally, COVID-19 adversity pertaining to emotional wellbeing was predominant in its association with reduced HSUs (β=-0.065, p<0.01). Themes in qualitative data supported quantitative findings.</p> <strong><p><b>CONCLUSIONS: </b></strong> This study demonstrated that COVID-19 related adversity can substantially reduce the HRQoL of PwMS. Directing resources to ameliorate instances of this effect should be a public health priority, with psychological interventions being paramount.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115191","diseases":[{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Assessment of Knowledge, Attitude, and Practice about Hepatitis B Among Patients in a Tertiary Care Hospital","id":"808b91ce-ebaf-4a1d-93fc-59283cd21eb1","sessionCode":"PCR25","topDisplay":"<b><u>Mathew M</u></b><sup>1</sup>, Choudhary RP<sup>2</sup>, Jose R<sup>3</sup>, K S<sup>3</sup>, Antony SC<sup>3</sup><br><sup>1</sup>Amrita School of Pharmacy, Kochi, KL, India, <sup>2</sup>Sarada Villas College of Pharmacy, Mysuru, KL, India, <sup>3</sup>The Oxford College of Pharmacy, Bangalore, India","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To assess the knowledge, attitude, and practice about hepatitis B among patients in a tertiary care hospital</p> <p><b>METHODS: </b>A cross-sectional observational study was carried out over a period of six months involving the inpatients of 18 -59 years of both genders excluding the patient with severe illness and liver transplantation, pediatrics, and geriatrics. The validated KAP questionnaires about hepatitis B were administered, which consisted of 10 knowledge, 8 attitude, and 6 practiced items. A detailed analysis of KAP on Hepatitis B was conducted and scores were documented finally descriptive analysis was performed.</p> <p><b>RESULTS: </b>A total of 82 patients were included, with equal gender distribution with an average age of 41 ±3.147 years. About 57 [69. 2%] patients were literate and with low socioeconomic status [n=50, 60. 97%]. The average overall KAP was found to be 16.65± 6.726 out of 40 points of which majority were having poor knowledge (n=53,64. 6%), moderate attitude (n=64,78%), poor practice(n=64,78%) and with poor overall KAP scores(n=55,67.07%). More than half of the patients (n= 48,58.53%) are completely unaware of this disease condition. The socio-economic status (p-value=0. 0315) and educational level (p-value =0. 0015) were found to be statistically significant risk factors that influence overall KAP scores.</p> <p><b>CONCLUSIONS: </b>The majority of patients had poor knowledge, practice, and average attitude regarding Hepatitis B. Education and socioeconomic status had a statistically significant risk association on the overall KAP score. Implementation of mass immunization campaigns and fostering proper public awareness programs can enlighten the public about the disease and thereby limit the spread of infectious hepatitis diseases to a greater extent.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116730","diseases":[{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"},{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cohort Optimizer, a Software Solution That Uses Real-World Data and AI to Optimize Criteria of Oncology Trials","id":"19e29677-9f94-420f-8879-59a199712702","sessionCode":"RWD27","topDisplay":"<b><u>Bhandari S</u></b><sup>1</sup>, Mann J<sup>1</sup>, Hajela R<sup>2</sup>, Govil V<sup>2</sup>, Greatti Y<sup>1</sup>, Maguire R<sup>1</sup>, Powers J<sup>1</sup>, Southwick S<sup>1</sup>, Mueller J<sup>1</sup><br><sup>1</sup>ConcertAI, Cambridge, MA, USA, <sup>2</sup>ConcertAI, Bengaluru, India","locationCode":"","description":"\r\n\t<div><h2>Background:</h2> Recent work demonstrates that many clinical trial criteria negatively affect enrollment without significantly improving the health of the cohort. We developed a software solution, Cohort Optimizer (CO) that uses Real-World Data (RWD) and AI to modify criteria to improve the size, overall survival, and diversity of the cohort. Unlike many proposed solutions which only eliminate criteria, CO optimizes the cohort by intelligently relaxing or tightening criteria.</p> </p> <h2>Methods:</h2> CO allows the user to assign priorities to each characteristic of the cohort—size, overall survival, and diversity. CO estimates characteristics using ConcertAI’s RWD that includes 5.4 million individuals, gathered from oncology clinics throughout the US. After imputing missing patient characteristics, CO calculates the size, survival statistics, and diversity of the baseline cohort and candidate cohorts. To efficiently search through the high-dimensional space of criteria and arrive at a recommendation, CO uses an evolutionary algorithm and a custom fitness function.</p> </p> As validation, we implemented CO on 15 oncological clinical trials, translated into the Observational Medical Outcomes Partnership Common Data Model. For all trials, we prioritized total enrollment over survival and diversity, while ensuring that the overall survival of the recommended cohort be no less than 95% of the survival of the baseline cohort. </p> <h2>Results:</h2> On average, our modifications increased patient counts by 75.64% compared to the baseline, without significant sacrifices in either survival or diversity. Much of the changes in these cohorts were attributable to relaxation (not outright elimination) of the ECOG criterion.</p> </p> <h2>Conclusion:</h2> Our method indicates that one can increase patient enrollment without compromising the overall health of the cohort. We demonstrate the value of RWD in estimating how changes to criteria affect the characteristics of its associated cohort. Given representative data, we believe our solution can be applied in clinical trials beyond oncology.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-poster-v3-1-041222-pdf.pdf?sfvrsn=264656e9_0","title":"ISPOR Poster v3.1 041222.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115270","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Applicability of Willingness to Pay Thresholds for Oncology Drugs: A Review of Submissions Made to the Canadian Agency for Drugs and Technologies in Health","id":"18c37b61-e815-4333-a1ab-59e95a503958","sessionCode":"HTA4","topDisplay":"<b><u>Balijepalli C</u></b><sup>1</sup>, Mynzhassarova A<sup>1</sup>, Gullapalli L<sup>1</sup>, Paul Roc N<sup>2</sup>, Barakat S<sup>2</sup><br><sup>1</sup>Pharmalytics Group, Vancouver, BC, Canada, <sup>2</sup>AbbVie Corporation, Saint-Laurent, QC, Canada","locationCode":"","description":"\r\n\t<div><strong>Objective</strong>: Canadian Agency for Drugs and Technologies in Health (CADTH) has no established incremental cost-effectiveness ratio (ICER) threshold for reimbursement purposes. However, a willingness to pay (WTP) threshold of $50,000 per Quality Adjusted Life Year (QALY) is viewed favourably for both oncology and non-oncology products. We aimed to review the submissions of cancer drugs made to CADTH from January 2016 to June 2021, to understand the applicability of willingness to pay thresholds acceptable for CADTH.</p> <strong>Methods</strong>: Reimbursement review reports of oncology pharmaceuticals and oncology gene therapies were obtained from CADTH to extract data for clinical and economic evidence. Clinical benefit was calculated as an absolute gain in median progression free survival (PFS) and median overall survival (OS).</p> <strong>Results</strong>: A total of 128 unique submissions were identified. Of all submissions, 78 had a base-case ICER of >$50,000/QALY (median: $133,140/QALY) with a clinical benefit of 4.8 months of median OS gain and 7.1 months of median PFS gain for the drugs that reported the data. These drugs were recommended for reimbursement, conditional on cost-effectiveness being improved to an acceptable level. Of the drugs reporting data on price reduction with a base-case ICER of >$50,000/QALY (n=24), nearly 70% submissions were recommended based on a price reduction of at least 70% to meet the $50,000/QALY threshold. The price reductions were even higher for recently recommended drugs. Of all submissions, 24 with a base-case ICER of >$50,000/QALY (median: $171,086/QALY) were not recommended mainly due to lack of clinical benefit.</p> <strong>Conclusion:</strong> This analysis suggests that the WTP threshold used by CADTH is frequently leading to highly challenging implementation of economic recommendation for novel therapies in oncology. This highlights the limitations of the QALY/WTP threshold-based approach to effectively inform the decision-makers to optimally secure access for patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117121","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Budget Impact Analysis of the Incorporation of Tiotropium Bromide Monohydrate-Olodaterol Hydrochloride in Chronic Obstructive Pulmonary Disease in the Chilean Public Health Sector","id":"a3af2a48-96db-4f1c-83d7-5a4d24115c09","sessionCode":"EE17","topDisplay":"Lenz R<sup>1</sup>, <b><u>Paredes D</u></b><sup>2</sup>, Hernández K<sup>3</sup>, Paez L<sup>4</sup><br><sup>1</sup>Postgraduate Director, Full Professor Public Health Institute Universidad Andrés Bello, Consultant Lenz Consultores, Santiago, RM, Chile, <sup>2</sup>Associate Professor Universidad Andrés Bello - Instituto de Salud Pública, Consultant - Lenz Consultores, Santiago, RM, Chile, <sup>3</sup>Lenz Consultores, Independencia, RM, Chile, <sup>4</sup>Lenz Consultores, Chile, RM, Chile","locationCode":"","description":"\r\n\t<div>Introduction: One in 20 deaths were from Chronic Obstructive Pulmonary Disease (COPD) in 2015. The TONADO 1 and 2 studies demonstrated that Tiotropium-Olodaterol significantly improved lung function and symptoms compared to monocomponents.</p> Objective: To estimate the budget impact of incorporating Tiotropium-Olodaterol for COPD in the Chilean public healthcare system.</p> Methods: Budget Impact Analysis following the ISPOR 6-step approach. A Markov model of 2-health and 1-transition states was used for a 5-year horizon (one-year cycle). Direct costs (CLP) were estimated from national open-access databases and Diagnosis-Related Groups data. The simulated scenario modeled the incorporation of Tiotropium-Olodaterol for a proportion of cases based on their GOLD subgroup, considering its addition into the pool of existent standard of care (SoC) drugs in GOLD C and D subgroups, and its effect on exacerbations requiring outpatient and inpatient services.</p> Results: The inclusion of Tiotropium-Olodaterol results in 45,340 avoided exacerbations over a 5-year horizon. The most significant effects were observed in GOLD D, for whom, based on local medical prescription behavior, would receive the drug in a proportion of 90%, compared to 70% in GOLD C. The total cost of including Tiotropium-Olodaterol to SoC at five years reaches CLP$ 78,7 million in GOLD C patients and CLP$ 300,0 million in GOLD D (including emergency care for exacerbations, costs of adverse reactions, and hospitalizations needs). After five years, the incremental cost of this therapy is CLP$ -5,2 million (-1.4%), representing savings for the payer. After five years, an annual incremental cost per patient was estimated at CLP$ -15,645.</p> Conclusions: The effect on the rate of exacerbations offsets the higher costs of Tiotropium-Olodaterol, and it is the variable with the greatest impact on the analysis. The use of Tiotropium-Olodaterol would be related to savings for the Chilean public health system.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115768","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Patient-Reported Outcomes (PRO) Following Sintilimab Plus Platinum and Gemcitabine As First-Line Treatment for Advanced or Metastatic Squamous NSCLC: A Randomized, Double-Blind, Phase 3 Study (ORIENT-12)","id":"5f1fdad4-42a6-4721-92d7-5ad189d4403e","sessionCode":"PCR7","topDisplay":"<b><u>Zhou C</u></b><sup>1</sup>, Gao G<sup>1</sup>, Fan Y<sup>2</sup>, Liu L<sup>3</sup>, Zhang L<sup>4</sup>, Cang S<sup>5</sup>, Zhou J<sup>6</sup>, Li B<sup>7</sup>, Yang Y<sup>8</sup>, Li J<sup>8</sup><br><sup>1</sup>Shanghai Pulmonary Hospital, Shanghai, China, <sup>2</sup>Zhejiang Cancer Hospital, Zhejiang, China, <sup>3</sup>The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, <sup>4</sup>Peking Union Medical College Hospital, Beijing, China, <sup>5</sup>Henan provincial people’s hospital, Henan, China, <sup>6</sup>The First Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China, <sup>7</sup>Beijing Chest Hospital of Beijing Capital Medical University, Beijing, China, <sup>8</sup>Lilly Suzhou Pharmaceutical Co. Ltd., Shanghai, China","locationCode":"","description":"\r\n\t<div><strong>Background</strong></p> In ORIENT-12 trial, sintilimab plus gemcitabine and platinum provided a significant and clinically meaningful PFS improvement comparing to placebo plus gemcitabine and platinum in Chinese patients with advanced/metastatic squamous NSCLC. This abstract summarizes PRO results.</p> <strong>Methods</strong></p> 357 participants were randomized (179 in sintilimab and 178 in placebo arm). PRO was assessed using LCSS and QLQ-C30 before the first dose, at each imaging evaluation and end-of-treatment visit. Clinically meaningful differences were defined as ≥10 points on a 0-100 scale, except for LCSS three-item global index (3-IGI; ≥30 points). Deterioration was defined as the onset of ≥10-point increase from baseline. P-value <0.05 was considered statistically significant.</p> <strong>Results</strong></p> PRO compliance rates maintained high until week 30 Baseline scores for each item were similar between arms. During the overall treatment period, QLQ-C30 scores were maintained regardless of the addition of sintilimab [Least square mean changes from baseline (95%CI): sintilimab: -1.04 (-3.42, 1.33); placebo: -0.74 (-3.33, 1.85); Between-group difference (95%CI): -0.30 (-3.81, 3.22)]; LCSS total score, 3-IGI, and average symptom burden index were maintained for both groups. LCSS composite endpoint and respiratory symptoms endpoint showed statistically significant improvement at week 6 and 12 for both arms, but changes did not reach a clinically meaningful difference. Sintilimab arm showed a numerical trend towards delayed deterioration across most LCSS and QLQ-C30 items. Notably, sintilimab arm showed significantly delayed in pain and major symptoms in QLQ-C30, as well as blood in sputum (Median: 56.9 vs 44.9 weeks, HR: 0.56; 95% CI: 0.37, 0.84, p=0.006) and painful sensations (Median: 49.1 vs 44.0 weeks, HR: 0.65; 95% CI: 0.44, 0.95, p=0.027) in LCSS.</p> <strong>Conclusion</strong></p> The addition of sintilimab to chemotherapy treatment maintained the quality-of-life and delayed the main symptoms deterioration compared to placebo. The data support sintilimab plus platinum and gemcitabine as first-line treatment for advanced/metastatic squamous NSCLC.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114647","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Updating Nice Evidence Standards Framework for the Effectiveness and Economic Impact of Digital Health Technologies","id":"b9b23e46-9a77-4da6-ad16-5b7eac0a8285","sessionCode":"HTA13","topDisplay":"<b><u>Wolfram V</u></b>, Unsworth H, Dillon B<br>National Institute of Health and Care Excellence, Manchester, UK","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> NICE’s evidence standards framework (ESF) was published in 2019 to help innovators and commissioners understand what good levels of evidence for digital health technologies (DHTs) look like. Since then, these technologies have evolved with many now utilising artificial intelligence. Also, regulators have started to develop clearer regulation criteria for medical device software. NICE therefore is updating the ESF to reflect these developments and improve its useability. Here we present the foundations of the updated framework.</p> <strong>Methods</strong></p> We used an agile and iterative methodology to revise the structure and content of the ESF. This involved a review of the regulatory and HTA landscape for DHTs; iterative engagement with stakeholders through feedback on earlier ESF versions and a series of workshops followed by a public consultation on the draft standards </p> <strong>Results</strong></p> We updated the ESF classification system from a function-based taxonomy to an intended-use classification consisting of 9 categories that are grouped in 3 tiers based on risk to the end user. The highest tier is designed to align with the regulatory framework so most DHTs in this tier will be medical devices, In the revised ESF we integrated the effectiveness and economic standards into one set of standards and restructured the evidence domains and contextual questions using a modular approach. We simplified the structure of the ESF to include a single level instead of minimum and best practice levels. Additional questions are integrated in specific evidence domains to identify technologies which need to meet a higher evidence standard. The modular structure of the framework should improve the usability of the ESF and allow it to be used as an interactive tool. </p> <strong>Conclusions</strong></p> The updated ESF is a comprehensive tool for developers and evaluators to assess the value of digital health technologies for health and care providers.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117129","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Direct and Indirect Costs of Multiple Sclerosis in China","id":"ef55bed7-e7e2-44ed-a9cf-5c30e08e76e1","sessionCode":"EE62","topDisplay":"Jia Y<sup>1</sup>, Qiao X<sup>2</sup>, <b><u>HU M</u></b><sup>2</sup><br><sup>1</sup>Fudan University, Shanghai, 31, China, <sup>2</sup>Fudan University, Shanghai, China","locationCode":"","description":"\r\n\t<div><strong>O</strong><strong>BJE</strong><strong>CTIVES: </strong>Multiple sclerosis (MS) is a chronic disabling neurological disease affecting both physical and mental functions, resulting in impaired quality of life for patients and their caregivers. Although studies in Western countries have demonstrated that MS imposes considerable direct and indirect costs on healthcare systems and societies, empirical research in China is limited regarding the economic burden of MS. This study aimed to describe the direct and indirect costs due to MS in China, stratified by Expanded Disability Status Scale (EDSS) score.</p> <strong><p><b>METHODS: </b> </strong>The analysis was conducted using data from the Adelphi MS Disease Specific Program, a point-in-time survey of neurologists and rehabilitation specialists and their MS patients in China, between June and September 2021. Demographic information, employment status, and healthcare resource utilization during the previous 12 months were collected. Costs were calculated by combining survey data and unit expenditure extracted from official expenditure databases. Generalized linear models (GLMs) with log link and gamma distribution were used to model the association between current EDSS score and costs (presented as percentage increase per EDSS from baseline cost), adjusting for age, sex, and insurance type.</p> <strong><p><b>RESULTS: </b> </strong>679 patients with EDSS scores were included in the analysis (female 66.9%; mean age 43.2 years, SD 13.1). GLM analysis showed that increased EDSS score was significantly associated with increasing direct medical costs (+16.9%, p<0.001, baseline RMB 32387.95), including cost of hospitalization (+23.0%, p=0.057), tests (+5.94%, p<0.001), symptomatic treatment (+12.9%, p=0.005), and concomitant conditions (+30.4%, p<0.001). Increasing EDSS score was also significantly associated with rising direct non-medical costs (+46.5%, p<0.001, baseline RMB 1622.342) and indirect costs (+34.3%, p<0.001, baseline RMB 23156.23).</p> <strong><p><b>CONCLUSIONS: </b> </strong>Increasing EDSS scores were significantly associated with a rise in direct and indirect costs. This suggests interventions that can reduce disability progression in MS could help save downstream costs and lessen societal burden.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-ms-poster-v1-1-widescreen-pdf.pdf?sfvrsn=7e2173da_0","title":"ISPOR MS poster v1.1 widescreen.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117905","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Significance of Primary Care Regulations in Reducing the Risk of Unmet Health Needs","id":"1e21b3ed-0178-4d94-ae59-5d8d50897ec9","sessionCode":"HPR4","topDisplay":"<b><u>Shrestha D</u></b><br>Hankuk University of Foreign Studies, Seoul, 41, Korea, Republic of (South)","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> </p> The concave relationship between income and health suggest lowered effectiveness of healthcare measures for an additional dollar of income. Increased unmet health needs during financial crises have been very concerning for the European OECD countries, and thus finding measures to address increasing unmet health needs is pivotal. This study aims to examine the significance of primary care regulations in mitigating the adverse effects of long-term unemployment during financial crises. </p> <p><b>METHODS: </b> </p> The data for 20 high-income European OECD countries (2006 – 2013), extracted from Eurostat, were analyzed using panel data analysis, and the variables for different cross-sections over a time span were observed using random effects and fixed effects model(s). F-test, calculated using R<sup>2</sup> values adjusted for number of covariates in different models, was used to test the nested models and results were analyzed using Stata-v11. </p> <p><b>RESULTS: </b> </p> While long-term unemployment resulting from financial crises is associated, strongly and positively, with unmet health needs for all levels of income (<em>p </em>< 0.05 to <em>p </em>< 0.01); primary care regulations – a key determinant of primary healthcare – is associated, strongly but negatively, with unmet health needs. The unmet health needs decreased from 0.52, 0.37, 0.29 and 0.24 percent across the first, second, third and fourth income-quintiles to 0.21, 0.16, 0.15 and 0.14 percent, respectively, compared to the countries without the practice of primary care regulations. However, the magnitude of effects of primary care regulations gradually decreased with increasing income. </p> <p><b>CONCLUSIONS: </b> </p> During a financial crisis, primary care regulations can mitigate the adverse effects of long-term unemployment, such as unmet health needs. The presence of primary care regulations as the first point of contact controls patients’ access to tertiary care, significantly, facilitating to meet most of the health issues at the primary level. However, such mitigating effects gradually diminish with increasing income.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115885","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Pregnancy Outcomes of Serotonin-Norepinephrine Reuptake Inhibitors (SNRI): Analysis of FDA Adverse Event Reporting System (FAERS) Database (2012-2021)","id":"82ed8f4f-71c6-466b-b1cd-5f21e1000a73","sessionCode":"EPH8","topDisplay":"<b><u>Alyami F</u></b>, Guo JJ<br>University of Cincinnati, James L. Winkle College of Pharmacy, Cincinnati, OH, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> The use of Serotonin-Norepinephrine Reuptake Inhibitors (SNRI) during pregnancy is a controversial issue as SNRIs can affect the development of the fetus negatively. There is relatively limited information regarding the impact of SNRIs among women during their pregnancy. The objective of the study was to describe the most commonly reported pregnancy adverse events (AEs) related to SNRIs as reported in the FDA Adverse Event Reporting System (FAERS) database.</p> <strong>Methods: </strong>The primary data source was the publicly available FAERS database. The study design was a retrospective descriptive study from 2012 to 2021. Number of pregnancy related adverse events AEs was calculated for each SNRI. Analysis was performed for six groups of MedDRA Preferred Terms (PTs) - Spontaneous Abortion, Induced Abortion, Stillbirth, Congenital Malformation, Ectopic Pregnancy, and Low Birth Weight. Descriptive statistics was used to describe number of pregnancy adverse events AE reports and most frequently reported pregnancy adverse events.</p> <strong>Results: </strong>The total number of pregnancy related adverse events for all SNRI included in the study was (3618); Venlafaxine (2514), Duloxetine (1064), Desvenlafaxine (36), Milnacipran (4) and Levo-milnacipran (2). The most commonly reported pregnancy related AEs was congenital malformation (2377, [65%]) followed by spontaneous abortion (920, [25%]) and low birth weight (140, [3.9%]). The least common pregnancy related AE was stillbirth followed (82, [2.3%]) by ectopic pregnancy (20, [0.5%]). There were 613 patients outcomes associated with pregnancy related AEs, including 110 (18%) deaths, 60 (9.8%) disability, 274 (44.7%) hospitalizations and 169 (27.6%) life-threatening events. Out of 613 outcomes , 80% (496) outcomes were represented by congenital malformation AEs involving the usage of Venlafaxine, Duloxetine and Desvenlafaxine.</p> <strong>Conclusions:</strong> Therapeutic risk management is crucial for SNRI use during pregnancy since they are considered as high-risk population. Further studies are warranted to establish a causal relationship between SNRI use and pregnancy related AEs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/fatimah-alyami-ispor-2022-pdf.pdf?sfvrsn=98805cc_0","title":"Fatimah Alyami ISPOR 2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117752","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Comparison of Three Network Meta-Analysis Methods Based Non-Ph in a Cost-Effectiveness Considering Recurrent and Metastatic Head and Neck Squamous Cell Carcinoma","id":"1acf1740-49cb-44be-bdba-5f7311ff57e7","sessionCode":"MSR13","topDisplay":"<b><u>Feng Hao S</u></b><br>Peking University Health Science Center, Bei jing, China","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Network meta-analysis (NMA) of time-to-event outcomes often relies on pooling of hazard ratios (HR). However, in immuno-oncology, there is increasing evidence of time-dependent treatment effects and violation of proportional hazard (PH) assumption within trials. This study assessed the impact of three network meta-analysis methods on the economic evaluation result of two immunotherapies for second-line treatment of recurrent and metastatic head and neck squamous cell carcinoma (R/M HNSCC).</p> <p><b>METHODS: </b> A cost-effectiveness, partitioned survival model was built from the chinese healthcare system perspective. Three NMA approachs (piecewise exponential model、Parametric Survival Curves、Fractional Polynomials) were constructed and the results compared. one-way sensitivity analysis,and probabilistic sensitivity analysis were performed to test the uncertainty of the model.</p> <p><b>RESULTS: </b> The results of NMA based on parametric survival curves and fractional polynomials showed that nivolumab was a dominant treatment protocol compared pembrolizumab for second-line treatment of R/M HNSCC in china .The result of NMA based on piecewise exponential model shows that the ICER of nivolumab versus pembrolizumab for second-line treatment of R/M HNSCC was 11307.89 CNY /QALY, lower than 1 time per capita GDP. One-way sensitivity analysis shows that the price of the two PD-1 had the most important impact on the ICER changes. Probabilistic sensitivity analysis shows the model structure is stable and robust.</p> <p><b>CONCLUSIONS: </b> The statistical approachs for NMA of survival data may greatly affect the ICER and associated uncertainty when used in economic evaluations. NMA using nonproportional hazards may provide improved survival estimates when the PH assumption is violated. However, deciding on the right approach for evidence synthesis of TTE outcomes is not straightforward. It is important to consider a wide range of factors, not just model fit. A considered holistic approach to model selection, including consideration of prior belief, can improve decision making.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116264","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"A Review of Analyses Evaluating the Economic Impact of Oral Versus Intravenous Formulations","id":"e1083056-6e57-4f63-8714-5f7a754f8326","sessionCode":"EE60","topDisplay":"Ronquest NA<sup>1</sup>, Paret K<sup>1</sup>, Lucas A<sup>1</sup>, Ciepielewska M<sup>2</sup>, <b><u>Hagan M</u></b><sup>3</sup><br><sup>1</sup>RTI Health Solutions, Research Triangle Park, NC, USA, <sup>2</sup>Mitsubishi Tanabe Pharma America, Inc., Jersey City, NJ, USA, <sup>3</sup>Mitsubishi Tanabe Pharma America, Inc., Rockaway, NJ, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Drug formulations can have an impact on not only patients’ quality of life and disease outcomes, but also costs of care. We illustrate key cost considerations when conducting the economic evaluation of introducing oral formulations as an alternative to intravenous (IV) medications.</p> <strong><p><b>METHODS: </b></strong> A structured literature review was conducted using the PubMed database to examine methods used for quantifying the economic impact of introducing an oral pharmaceutical formulation as an alternative to IV medication. To illustrate the methods described in this review, a cost-calculator model was developed as a case study to quantify the impact of introducing an oral formulation of an existing IV medication for amyotrophic lateral sclerosis (ALS).</p> <strong><p><b>RESULTS: </b></strong> We identified 12 published evaluations of oral and IV formulations from 9 countries across a variety of disease areas. The studies used cost-effectiveness (n=9), cost-minimization (n=2), and cost-calculation (n=1) models. All 12 evaluations reported outcomes from the payer perspective, and societal perspectives were also incorporated in 3 of them. One study that incorporated the societal perspective, reported the indirect costs to be nearly 70% of the overall costs. Further, our case study estimated over 600 hours would be lost annually for patients with ALS and their family members due to IV administration and maintenance. When estimating the costs of a formulation choice, only a subset of the identified studies accounted for the effects of safety (n=5) or efficacy (n=4) differences on treatment costs. Many studies that omitted these aspects did not include rationale for their decisions.</p> <strong><p><b>CONCLUSIONS: </b></strong> We found significant design variations in published models that estimated the impact of an additional formulation option on the treatment costs to payers and the society. Models need to be accompanied with clear descriptions and assumptions on how different formulations may affect healthcare costs from the selected perspectives of the model.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115002","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Economic Burden of Adverse Events Associated with Erythropoiesis-Stimulating Agents for the Treatment of Anemia Among Chronic Kidney Disease Patients in Taiwan","id":"0b330db9-dcb1-468a-a8d5-5f9b100e818a","sessionCode":"EPH30","topDisplay":"<b><u>Guan ST</u></b><sup>1</sup>, Chen HM<sup>2</sup>, Hsiao FYS<sup>3</sup><br><sup>1</sup>Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, TPE, Taiwan, <sup>2</sup>Health Data Research Center, National Taiwan University, Taipei, Taiwan, <sup>3</sup>Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan","locationCode":"","description":"\r\n\t<div><strong>Objective </strong></p> Erythropoiesis-stimulating agent (ESA) is effective in treating renal anemia but at the expense of increased risks for adverse events (AEs) which incur a substantial economic burden. However, this issue is yet well researched. This study aims to estimate the economic burden of AEs associated with ESA therapy among chronic kidney disease (CKD) patients from Taiwan’s healthcare perspective.</p> </p> <strong>Method</strong></p> Using Taiwan’s National Health Insurance Research Database, we identified incident CKD patients who used ESA between 2009 and 2017 as our study subjects. We further categorized them into non-dialysis (NDD), dialysis dependent (DD), and incident dialysis (ID) groups based on their dialysis status. All eligible study subjects needed to have at least one year of follow-up. Crude incidences of admissions for AEs (including deep vein thrombosis, hypertensive emergency, vascular access thrombosis) and associated costs (U.S. dollars) were examined.</p> </p> <strong>Result</strong></p> A total of 942,723 incident CKD patients were identified, of which 94.28% were in the NDD group (n=888,785; mean age 64.8 ± <span>16.3 years), 2.54% in the DD group (n=23,959; mean age 64.8 </span>± <span>16.3 years), and 3.18% in the ID group (n=29,979; mean age 62.5 </span>± <span>12.5 years). </span></p> Hypertensive emergency was the most frequently identified AE across all three groups although the incidences varied in different groups (21.83%, 5.81%, 8.46% in the NDD, DD, ID groups, respectively).</p> Nevertheless, deep vein thrombosis ($10628.31) incurred the largest costs in the DD group, and vascular access thrombosis incurred the largest costs in the NDD ($7936.49) and the ID ($8509.46) group.</p> </p> <strong>Conclusion</strong></p> Hypertensive emergency was the most frequently identified AE across all three groups although the incidences varied in different groups. However, deep vein thrombosis incurred the largest costs in the DD group, and vascular access thrombosis incurred the largest costs in both the NDD and the ID group.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/eph30st-guanv1-pdf.pdf?sfvrsn=dbf56a1f_0","title":"EPH30_ST Guan_v1.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115602","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"CAR-T Treatment Costs Beyond Therapy Acquisition Costs in Multiple Myeloma Patients","id":"d214f410-0ba2-4b7e-bb94-61470300aa76","sessionCode":"EE70","topDisplay":"Jagannath S<sup>1</sup>, <b><u>Joseph N</u></b><sup>2</sup>, Crivera C<sup>3</sup>, Jackson CC<sup>4</sup>, Valluri S<sup>5</sup>, Cost P<sup>5</sup>, Phelps H<sup>5</sup>, Slowik R<sup>5</sup>, Klein TM<sup>6</sup>, Smolen L<sup>6</sup>, Yu X<sup>6</sup>, Cohen A<sup>7</sup><br><sup>1</sup>Icahn School of Medicine at Mount Sinai, New York, NY, USA, <sup>2</sup>Janssen Scientific Affairs, LLC, Phoenixville, PA, USA, <sup>3</sup>Janssen Scientific Affairs, LLC, Horsham, PA, USA, <sup>4</sup>Janssen R&D, Raritan, NJ, USA, <sup>5</sup>Janssen Global Services, LLC, Raritan, NJ, USA, <sup>6</sup>Medical Decision Modeling Inc., Indianapolis, IN, USA, <sup>7</sup>University of Pennsylvania, Philadelphia, PA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b> Chimeric antigen receptor T (CAR-T) cell therapies are newly developed treatments for relapsed refractory multiple myeloma (RRMM) patients who have been triple-class exposed (i.e., proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies during treatment). CAR-T acquisition costs are known and readily available, however other costs associated with CAR-T therapy, such as the required pre-, peri-, and post-infusion costs are unknown. This study estimated healthcare costs related to CAR-T therapy (i.e., costs separate from CAR-T therapy acquisition) for RRMM patients.</p> <strong><p><b>METHODS</strong>: </b> Clinical trial data and published literature were used to identify the components (and costs) of pre-, peri-, and post-infusion processes associated with CAR-T. Pre-infusion costs included evaluation, apheresis, bridging therapy, and conditioning therapy costs. Inpatient or outpatient infusion costs, separate from CAR-T therapy acquisition costs, were included in peri-infusion costs. One-hundred-day post-infusion monitoring costs, other infusion monitoring costs required in the first year, and costs associated with managing serious adverse event (AE) associated with the CAR-T therapy were quantified as post-infusion costs. AEs that required prolonged hospitalization or resulted in death were classified as serious AEs.</p> <strong><p><b>RESULTS</strong>: </b> The estimated costs of the pre- and peri-infusion components of CAR-T therapy for RRMM patients, excluding CAR-T therapy acquisition costs, totaled $22,865. The most expensive component of the combined pre- and peri-infusion costs was bridging therapy ($16,370) followed by inpatient infusion ($3,215), conditioning therapy ($3,168), and apheresis ($112). Post-infusion costs were found to vary among CAR-T therapies.</p> <strong><p><b>CONCLUSIONS</strong>: </b> This study quantified the overall estimated healthcare costs associated with the use of CAR-T treatment among triple-class exposed RRMM patients. Results from the analysis provide valuable, holistic information required by healthcare decision-makers to make informed choices.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/13083p1car-twraparoundcostssubmitted-pdf.pdf?sfvrsn=21a08f6f_0","title":"13083_P1_CAR-T_WraparoundCosts_Submitted.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116628","diseases":[{"id":"b4b5ee81-b2a7-41c0-a6c2-a07276633d66","parentId":"00000000-0000-0000-0000-000000000000","title":"Genetic, Regenerative and Curative Therapies","urlName":"genetic-regenerative-and-curative-therapies"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Health-Economics of Empagliflozin Use and Cardiovascular Outcomes in Diabetes-Care, across Public-Health Setting in India","id":"c72448ec-6faa-431f-a3b2-614f9ffc7871","sessionCode":"EE36","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE</strong><strong>: </strong>Cardiovascular mortality is leading cause of premature deaths in Indian adult-population. A national health-policy goal aims to achieve 25% reduction in premature deaths, by 2025. Interventions aimed at patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), are essential for this goal. Treatment with empagliflozin is indicated as well as recommended for such use. This research aims to assess cost-implications of empagliflozin use in patients with T2DM and CVD, across major public-health settings in India.</p> <strong><p><b>METHODS: </b> </strong>A budget-impact analysis was performed in representative institutional settings of:</p> <ul> <li>Central Government Health Scheme (CGHS)</li> <li>Defence</li> <li>State-government (representative medical-colleges from West-Bengal state)</li> <li>Railways</li> <li>Employee State Insurance Corporation (ESIC)</li> </ul> Primary analysis was based on the following assumptions:</p> <ul> <li>Patients: Similar to EMPA-REG OUTCOME study participants</li> <li>Treatment-duration: 3-years</li> <li>Outcomes: Total cardiovascular and kidney events</li> <li>Clinical-benefit: As observed in EMPA-REG OUTCOME study</li> <li>Disease-burden and resource-utilization: As determined for each institution, with validation from respective care-providers</li> <li>Cost-savings with the use of empagliflozin, were estimated</li> </ul> <strong><p><b>RESULTS: </b> </strong>Relative cost-savings of 3.4-5.1% were observed with empagliflozin use, across different institutional settings, as follows:</p> <ul> <li>State-government: 3.4%</li> <li>Railways: 3.5%</li> <li>ESIC: 4.4%</li> <li>Defence: 5.1%</li> <li>CGHS: 5.1%</li> </ul> Incremental relative cost-savings were observed over treatment-duration, ranging from 0.6-2.6% in first year, to 6.0-7.6% in third year.</p> In sensitivity analysis that excluded recurrent major cardiovascular events, relative cost-savings of 2.6-4.4% were observed.</p> Empagliflozin use resulted in per-patient cost-savings, across the different institutional settings, as follows:</p> <ul> <li>CGHS: INR 11,965</li> <li>Defence: INR 11,890</li> <li>ESIC: INR 9,962</li> <li>Railways: INR 7,529</li> <li>State-government: INR 7,128</li> </ul> Per-patient cost-savings of INR 7-12 thousand, represents 1.2 to 2.1 times the value of national per-capita health-expenditure.</p> <strong><p><b>CONCLUSIONS: </b> </strong>This analysis supports cost-effective adoption of empagliflozin across Indian public healthcare settings, for optimizing access to patients with T2DM and CVD, as well as significant cost-savings in institutional health-expenditure for such patients.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117651","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"e32f673e-b410-4126-9261-86abf08a0554","parentId":"00000000-0000-0000-0000-000000000000","title":"Personalized and Precision Medicine","urlName":"personalized-and-precision-medicine"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Rising Risk: A New Dimension to Consider When Building Predictive Risk Models at Blue Cross and Blue Shield of Louisiana","id":"d822732c-dcd0-4954-89ce-648b5999629e","sessionCode":"MSR2","topDisplay":"<b><u>Cannon C</u></b>, Holloway J, Ouyang J, Vicidomina B, Nigam S<br>Blue Cross Blue Shield of Louisiana, Baton Rouge, LA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Health plans expend effort to try and predict the less than 1% of their members who will need extra support in order to maintain their health status by avoiding hospitalizations and emergency department visits. In care coordination, low risk predicts low cost and acuity while high risk forecasts increased cost and acuity. However, this definition of risk leaves out members who have improved or declined in health status over time.</p> <strong>Methods: </strong>Blue Cross and Blue Shield of Louisiana (BCBSLA) has taken an innovative approach to risk scoring by adding a “rising risk” dimension to their predictive models. The dimension “rising risk” classifies risk scores across rising or falling traditional risk categories. BCBSLA creates the “rising risk” dimension by taking a member’s standardized risk of hospitalization over a 12-month period and fitting a line through those points (creating a slope). Members are then assigned into one of three model categories: low risk, medium to high risk, and high to very high risk. For each of the three categories, a member can be rising, flat or falling.</p> <strong>Results</strong>: Majority of members will not change rising risk levels over time but a subset of members will be deemed a “rising risk”. These members (low, medium-high, high-very high) appear to have the highest medical per member per month (PMPM) costs. When stratifying members by those enrolled in disease management (DM) programs by participation status, DM at medium and low-risk categories. By adjusting the slope thresholds, BCBSLA can identify select members to act on within each risk category, which maximizes care and reduces costs.</p> <strong>Conclusions: </strong>The benefit of “rising risk” is that it contributes additional and unique information about a member’s health status. This knowledge can lead to quicker interventions that will maximize care and reduce costs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117735","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Systematic Review on the Economic Burden of Pneumonia Among Adults Aged 50 and Older","id":"cd57af42-ae66-45db-8808-6545f3340167","sessionCode":"EE83","topDisplay":"<b><u>Tu S</u></b><sup>1</sup>, Jing D<sup>1</sup>, Guo Y<sup>1</sup>, Zhou T<sup>1</sup>, Zhu S<sup>2</sup>, Chen Y<sup>1</sup>, Ming J<sup>3</sup><br><sup>1</sup>Fudan University, Shanghai, China, <sup>2</sup>Pfizer Investment Co. Ltd., Beijing, China, <sup>3</sup>IQVIA China, Shanghai, China","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To determine the economic burden of <span>pneumonia</span> among adults aged 50 and older.</p> <p><b>METHODS: </b>We exhaustively searched MEDLINE, EMBASE, Web of Science and Cochrane Library for primary studies published from January 2010 to December 2020, which investigated the economic burden of pneumonia in aged adults. Data on number of cases, direct and indirect costs were extracted and descriptively summarized. Risk of bias were assessed.</p> <p><b>RESULTS: </b>Seven studies were included from the 5,562 searched citations. Two of them reported evidence from middle-income economies while the others reported evidence from high income regions. Five of the included studies were cost-of-illness studies while the others were economic evaluations.<span> All of the five studies reported the perspectives used national health system perspective for economic investigations.</span></p> <span>The reported direct medical costs per case for hospitalized </span><span>pneumococcal pneumonia were lower in middle-income economies (US$ 1,021 to 1,902) than that in high-income regions (US$ 1,982 to 7,707) while indirect costs per case for hospitalized </span><span>pneumococcal pneumonia were very close (US$ 217 in </span><span>Brazil vs 222 in USA.). The reported direct cost per case for hospitalized Pneumococcal pneumonia in Korea (US$ 1,982) was lowest among the high-income regions. In cost-of-illness studies, regional economic burdens of pneumonia were calculated by multiplying the numbers of cases with mean costs of inpatients/ outpatients.</span></p> </p> <p><b>CONCLUSIONS<span>: </b>The evidence on economic burden of pneumonia among aged adults were scarce. The limited reports showed lower direct medical costs per case for hospitalized pneumococcal pneumonia in middle income countries, which could be attributed to the lower labor costs of health professionals and service procedures. Across high-income regions, where treatment guidelines were commonly introduced, direct costs of hospitalized pneumococcal pneumonia varied a lot, which could be partially related to the varieties in the standardization and qualities of health care services.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116373","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Real-World Treatment Patterns and Healthcare Costs Among Patients with Adhesive Capsulitis in the United States","id":"36cd2be0-1783-42b2-ba4f-655230e06d12","sessionCode":"EE37","topDisplay":"Tse J<sup>1</sup>, Banerji T<sup>1</sup>, Wang EJ<sup>1</sup>, Near A<sup>1</sup>, <b><u>Davis J</u></b><sup>2</sup>, Hurley D<sup>3</sup><br><sup>1</sup>IQVIA, Cambridge, MA, USA, <sup>2</sup>Endo Pharmaceuticals Inc., Wallingford, PA, PA, USA, <sup>3</sup>Endo Pharmaceuticals Inc., Malvern, PA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Data on the economic burden of adhesive capsulitis (AC) in the United States are lacking. This study described surgery utilization and healthcare costs in patients newly diagnosed with AC.</p> <p><b>METHODS: </b> Adults aged ≥18 years with ≥1 AC diagnosis code were identified in the IQVIA PharMetrics® Plus database between January 1, 2016 to March 15, 2018; the first observed diagnosis was the index date. Patients were required to have 12 months of continuous enrollment before the index date (baseline), 24 months of follow-up after the index date, ≥1 additional AC diagnosis ≥30 days after the index date, and no diagnoses of acute calcific tendonitis/bursitis, shoulder arthrosis, shoulder bursitis, cervicalgia, cervical disc disorder, or rotator cuff tear during follow-up. Baseline patient characteristics, 24-month follow-up treatment patterns, and 12-month follow-up healthcare costs were described.</p> <p><b>RESULTS: </b> Among 10,729 AC patients, the majority were female (65.1%) and the mean (SD) age was 54.2 (9.2) years. Approximately half (50.2%) of all patients had evidence of risk factors for AC during baseline, including diabetes, hypertension, thyroid disease, and other comorbidities. Most patients (87.8%) had their last claim with AC diagnosis within 12 months after index. 859 patients (8.0%) had evidence of ≥1 AC-related surgery over 24-month follow-up, including shoulder manipulation under anesthesia (70.9% of surgical patients), arthroscopic capsular release (33.6%), and capsular contracture release (0.3%). 43.8% (N=376) of patients with surgery had subsequent physical or occupational therapy and/or corticosteroid injection. Mean (SD) 12-month total all-cause healthcare costs per patient were $11,968 ($24,358) for the entire AC cohort and $18,559 ($24,633) among the subgroup with surgery. Of patients with surgery anytime during 24-month follow-up, the mean total surgical cost per patient was $2,375 ($6,206).</p> <p><b>CONCLUSIONS: </b> In this real-world cohort of patients with AC, surgery is frequently followed by additional treatments to manage symptoms, which suggests unresolved AC.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/iqvia-endo-acispor-poster20220421-pdf.pdf?sfvrsn=dc7a5a5b_0","title":"IQVIA Endo AC_ISPOR Poster_20220421.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117067","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"The Cost-Effectiveness of Atidarsagene Autotemcel for the Treatment of Metachromatic Leukodystrophy (MLD) in France","id":"df4469f0-5903-4173-985c-65b4710ce57b","sessionCode":"EE24","topDisplay":"<b><u>Pang F</u></b><sup>1</sup>, Dean R<sup>2</sup>, Jensen I<sup>3</sup>, Tehard B<sup>4</sup>, Roze S<sup>5</sup>, Olaye A<sup>6</sup>, Bean K<sup>7</sup>, Miller B<sup>8</sup><br><sup>1</sup>Orchard Therapeutics Ltd, London, Great Britain, <sup>2</sup>Precision Xtract, Boston, MA, USA, <sup>3</sup>Precision Health Economics & Outcomes Research, Boston, MA, USA, <sup>4</sup>Vyoo agency, Paris, France, <sup>5</sup>VYOO Agency, Lyon, 69, France, <sup>6</sup>Orchard Therapeutics, London, UK, <sup>7</sup>Orchard Therapeutics Ltd, London, UK, <sup>8</sup>Precision HEOR, Grafton, MA, USA","locationCode":"","description":"\r\n\t<div>Metachromatic leukodystrophy (MLD) is an ultra-rare neurodegenerative disease which leads to motor and cognitive decline and premature death. The aim of this study was to determine the cost-effectiveness of a definitive <em>ex vivo</em> gene therapy, atidarsagene autotemcel (arsa-cel), compared to best supportive care for the treatment of MLD from the French perspective.</p> A <em>de novo</em> cost-effectiveness model based on a 7-state partitioned-survival model was developed for pre-symptomatic patients with Late Infantile (LI; predicted age at symptom-onset ≤30 months) and Early Juvenile (EJ; predicted age at symptom-onset 30 months to <7 years) variants. Health states were defined by Gross Motor Function Classification (GMFC-MLD) (LI and EJ) and Development Quotient (DQ) scores (EJ only) at three cognitive levels (normal/mild, moderate, and severe). Health state transitions were based on patient-level data from arsa-cel clinical trials. A lifetime time horizon and collective perspective were used. Resource use and clinical assumptions beyond the trial duration were derived through structured expert elicitation. Costs were from a variety of sources including the French national databases on Hospital costs (PMSI), Biological Procedures (NABM) and official tariffs for medical visits (AMELI). Utilities to derive quality of life of the health states were from a vignette study based on time trade-off valuations of health state descriptions. Caregiver utilities were based on EQ5D-5L from an international caregiver survey including French respondents. Model validation was conducted with extensive scenario and sensitivity analyses.</p> For the combined MLD population (comprising LI and EJ), base case analysis indicated that arsa-cel is associated with incremental gains in excess of 28 QALYs (discount rate of 2.5% for first 30 years then 1.5%).</p> There are no official cost-effectiveness thresholds in France. However, the study shows that arsa-cel has comparable or better cost-effectiveness estimates than other drugs for rare diseases that are currently funded by the French health system.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116325","diseases":[{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Clinical and Economic Outcomes of Patients with Multiple Rib Fractures Treated Operatively Vs. Non–Operatively — a US Hospital Database Analysis","id":"50d06765-46a0-4941-9d3f-689addb06455","sessionCode":"EE203","topDisplay":"Shiroff AM<sup>1</sup>, Wolf S<sup>2</sup>, <b><u>Vanderkarr M</u></b><sup>3</sup>, Wu A<sup>4</sup>, Galvain T<sup>5</sup>, A M<sup>6</sup>, Holy C<sup>7</sup><br><sup>1</sup>Perelman School of Medicine, Philadelphia, PA, USA, <sup>2</sup>Synthes GmbH, Zuchwil, Switzerland, <sup>3</sup>DePuy Synthes, Inc., Bay Village, OH, USA, <sup>4</sup>Johnson and Johnson Medical Devices, West Chester, PA, USA, <sup>5</sup>Johnson & Johnson Medical Limited, lyon, 69, France, <sup>6</sup>Mu Sigma, Bengaluru, India, <sup>7</sup>Medical Device Epidemiology, Johnson & Johnson, Somerville, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Treatment for multiple rib fractures (MRF) may include surgical rib fixation (SRF) or non-operative care. Recent meta-analyses have demonstrated that SRF results in faster recovery and lower long-term complication rates. Our study evaluated characteristics, treatments and immediate post-operative outcomes of MRF patients with and without SRF.</p> <p><b>METHODS: </b> All patients with inpatient hospitalization with a diagnosis of MRF in the PREMIER hospital database from 10/1/2015 to 09/01/2020 were identified. Demographics, comorbidities (as per Elixhauser comorbidity index (ECI), injuries at index (categorized by first 2 digit of ICD-10 diagnostic code), abbreviated injury scale (AIS) and injury severity scores (ISS), and provider characteristics (hospitals size, urban vs. rural, teaching status) were determined for all patients. Patients were excluded from the cohort if they had a thorax AIS < 2 (low severity patient) or a Glasgow coma score < 8 (extreme high severity patient). Two cohorts were created based on presence of SRF at index. Patients were matched using direct matching on AIS thorax and thorax injuries, and propensity score matching (PSM, method: nearest neighbor, caliper = 0.2) on other demographic, comorbid and injury diagnoses.</p> <p><b>RESULTS: </b> After matching, 2,340 patients were analyzed, 1,170 with and without SRF (average age: 61.6 (standard deviation (SD): 16.0); Elixhauser: 2.6 (SD: 2.1); ISS: 8.74 (SD: 3.9). Major thorax and lung injuries included pneumothorax (22.5%), lung contusion (26.1%), pleural effusion (14.1%). Key comorbidities included hypertension (42.9%) and chronic pulmonary disease (21.7%). Home or home health discharge was observed in 72.1% patients with SRF versus 67.6% patients without SRF (p<0.0001). Admission to skilled nursing facilities (SNF) was 14% greater in patients without SRF vs with SRF.</p> <p><b>CONCLUSIONS: </b> Despite added surgical healthcare utilization, MRF patients who received SRF had a greater home or home health discharge rate, and lower SNF discharge rate, compared to matched MRF patients without SRF.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/vanderkarrmatrixrib21apr2022-v3-pdf.pdf?sfvrsn=e8dc62ef_0","title":"VANDERKARR_MATRIXRIB_21APR2022 V3.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116375","diseases":[{"id":"bde7079b-7db2-4006-9dbf-54d654e04fc7","parentId":"00000000-0000-0000-0000-000000000000","title":"Surgery","urlName":"Surgery"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Real-World Reductions in Migraine-Related Health Care Resource Utilization and Costs for Patients Initiating Fremanezumab: A 12-Month Retrospective US Claims Analysis","id":"1d88c763-d0d8-4ac4-890c-68db4ee752f6","sessionCode":"EE57","topDisplay":"Driessen MT<sup>1</sup>, <b><u>Krasenbaum LJ</u></b><sup>2</sup>, Ramirez-Campos V<sup>2</sup>, DiEgidio R<sup>2</sup>, Tian M<sup>2</sup>, Seminerio MJ<sup>3</sup><br><sup>1</sup>Teva Pharmaceuticals, Amsterdam, Netherlands, <sup>2</sup>Teva Branded Pharmaceutical Products R&D, Inc., West Chester, PA, USA, <sup>3</sup>Teva Branded Pharmaceutical Products R&D, Inc., Parsippany, NJ, USA","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE</strong></p> Fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), is approved for preventive treatment of migraine in adults. This retrospective analysis assessed baseline patient characteristics and migraine-related health care resource utilization (HCRU) and costs in US patients with migraine 12 months before and 12 months after initiating fremanezumab treatment.</p> <strong><p><b>METHODS</strong>: </b></p> Eligible adults (≥18 years) identified from the IBM Marketscan Commercial and Medicare database (index period for cohort identification: September 1, 2018–March 31, 2019) included patients with ≥1 pharmacy claim for fremanezumab (the date of the earliest claim was the index date), ≥1 migraine diagnosis (within 12 months prior to the index date), and continuous enrollment for 12 months before (pre-index) and after (post-index) the index date. The study period was September 2017–March 2020. Patients pregnant during the study period were excluded.</p> <strong><p><b>RESULTS</strong>: </b></p> Of the eligible patients (n=2,354) identified, most had episodic migraine (54%) and were female (86%); the mean (standard deviation [SD]) age was 45.4 (11.6) years. Significant 12-month pre-index to 12-month post-index HCRU reductions were observed in the mean (SD) number of migraine-related emergency room (ER) visits (0.21 [0.80] to 0.15 [0.96]) and total migraine-related outpatient visits (4.87 [5.24] to 4.38 [5.02]; both <em>P</em><0.0001). Significant reductions in the mean (SD) number of migraine-related acute medication prescription claims were also seen (10.57 [10.69] to 9.30 [10.46]; <em>P</em><0.0001). 12-month pre-index versus 12-month post-index cost comparisons showed statistically significantly differences in migraine-related outpatient costs ($2,573.71 [6,453.37] vs $2,485.70 [7,112.81]), migraine-related acute medication costs ($1,346.46 [3,124.83] vs $1,123.21 [3,156.91]), and migraine-related ER costs ($292.41 [1,280.84] vs $292.18 [3,405.24]; all <em>P</em><0.0001). No significant differences in migraine-related inpatient visits or costs were found.</p> <strong><p><b>CONCLUSIONS</strong>: </b></p> Fremanezumab is associated with statistically significant reductions in migraine-related HCRU and costs in the 12 months after first fremanezumab treatment initiation.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115536","diseases":[{"id":"df9240d9-f266-47e0-ba0b-a11dfd152ae4","parentId":"00000000-0000-0000-0000-000000000000","title":"Biologics and Biosimilars","urlName":"biologics-and-biosimilars"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"When Is a Simple Model Good Enough? Towards Greater Use of Formal Methods for Evaluating Structural Uncertainty in Cost-Effectiveness Analysis","id":"fa588573-9dd5-4b52-9f2a-69a2ad2cd24a","sessionCode":"EE81","topDisplay":"Bryning S<sup>1</sup>, Grimsey Jones F<sup>2</sup>, <b><u>Pollit V</u></b><sup>2</sup>, Brennan A<sup>1</sup><br><sup>1</sup>University of Sheffield, Sheffield, UK, <sup>2</sup>Symmetron Ltd, London, UK","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Whilst methods to formally account for structural uncertainty are not mandated by health technology assessment (HTA) guidelines, appreciation of their importance is growing and was raised in a recent HTA methods consultation. Health economists and decision makers need to understand if developing a more complex model is worthwhile to reduce decision uncertainty. This research tests and enhances published methods to assess structural uncertainty.</p> <p><b>METHODS: </b>A published discrepancy approach that assesses structural uncertainty was modified to be more efficient and pragmatic. This modified approach was applied in a simple Markov model to determine the value of a more complex model, given structural uncertainty as to the impact of disease progression. Discrepancy terms reflecting structural uncertainties were located within the model and were included within probabilistic sensitivity analysis and value of information analysis. To validate the approach, expected results of the simple model (with structural uncertainty accounted for) were compared to those of a more complex version.</p> <p><b>RESULTS: </b>The modified method when used in a simple model approximated the conclusions of a more complex model, suggesting the method could be used to indicate the value of building a more complex model. However, absolute costs and QALYs did not converge to the same extent as incremental outputs, suggesting that there is scope to increase robustness. Measures of the importance of the structural uncertainty were highly sensitive to assumptions about correlation. Specifying and accounting for correlation remains a key challenge in robustly accounting for structural uncertainty.</p> <p><b>CONCLUSIONS: </b>The modified discrepancy approach has potential for investigating the source, and impact, of structural uncertainty on model results and indicating the value of reducing such uncertainty. Further research is needed to establish the method’s robustness and further understand the impact of correlation.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116896","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Population Discordance in Economic Evaluations of Polygenic Risk Scores","id":"9cf2e05d-c326-4156-8f40-6a9db7767186","sessionCode":"EE97","topDisplay":"<b><u>Rivers Z</u></b><sup>1</sup>, Luczak T<sup>2</sup>, Smith H<sup>3</sup>, Veenstra D<sup>4</sup>, Ramsey SD<sup>1</sup><br><sup>1</sup>Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, <sup>2</sup>Fairview Pharmacy Services, Minneapolis, MN, USA, <sup>3</sup>Baylor College of Medicine, Houston, TX, USA, <sup>4</sup>University of Washington, Seattle, WA, USA","locationCode":"","description":"\r\n\t<div>Introduction:</p> Polygenic risk scores (PRS) aggregate variants at multiple genetic loci to calculate the likelihood of developing a specific disease. These scores are developed using databases of individuals who have undergone testing, most from European ancestry. This may reduce accuracy for patients of underrepresented ancestral backgrounds. Economic models assessing the value of PRS without exploring the accuracy when used in a diverse population may inaccurately estimate the value of testing, leading to inappropriate coverage, reimbursement, and clinical implementation decisions. We conducted a scoping review examining population discordance in published PRS models.</p> Methods:</p> We searched PubMed and EMBASE using terms related to PRS and economic evaluation through November 30<sup>th</sup>, 2021. Snowball sampling identified additional manuscripts from references. Data were extracted using a standardized template<span>. </span><span>We </span><span>used race and ethnicity as a surrogate for genetic ancestry, </span><span>identifying</span><span> population discordance when </span><span>authors did not state race or ethnicity of the population modeled, or when the population model</span><span>ed did not </span><span>match</span><span> the race or ethnicity</span><span> of the population used to derive PRS</span><span>.</span></p> Results:</p> We identified 11 papers or preprints. Oncology (8 73%), glaucoma (1, 9%), nephropathy (1, 9%), and cardiovascular disease (1, 9%) were represented.<span> All </span><span>models</span><span> exhibited population discordance</span><span>, </span><span>with </span>most<span> papers using a PRS developed in a subset of the population and extrapolating findings to </span><span>the entire population</span><span>.</span> No papers included adjustments for discordance in their primary analysis, while one paper included adjustments in sensitivity analyses.</p> Conclusion:</p> Economic analysis of PRS to date have not explicitly address discordance between the populations used to develop the score and used in the model. Future modeling approaches should be transparent about this difference and characterize the impact of PRS performance on clinical and economic utility in diverse populations.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor2022prs-pdf.pdf?sfvrsn=e6b9431b_0","title":"ISPOR2022PRS.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115835","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"b4b5ee81-b2a7-41c0-a6c2-a07276633d66","parentId":"00000000-0000-0000-0000-000000000000","title":"Genetic, Regenerative and Curative Therapies","urlName":"genetic-regenerative-and-curative-therapies"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Real-World Triptan Utilization Patterns for Acute Treatment of Migraine Among 15 Million Commercially Insured Lives","id":"a9340356-9df2-4cc9-bfdf-6b26ce707f01","sessionCode":"RWD13","topDisplay":"<b><u>Burke J</u></b><sup>1</sup>, Eckwright D<sup>1</sup>, Shewale A<sup>2</sup>, Burslem K<sup>3</sup>, Gleason P<sup>4</sup><br><sup>1</sup>Prime Therapeutics, Eagan, MN, USA, <sup>2</sup>AbbVie, Little Rock, AR, USA, <sup>3</sup>AbbVie, Madison, NJ, USA, <sup>4</sup>Prime Therapeutics, Bloomington, MN, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Migraine is a disabling disease impacting quality of life, productivity, and health care costs. Triptans are recommended as initial therapy for moderate/severe acute treatment of migraine. Limited real-world data assessing triptan utilization patterns among new initiators is available prior to approval of calcitonin-gene-related peptide inhibitors (CGRPs).<strong> </strong>The objectives are to describe new triptan initiators’ utilization, treatment switch and discontinuation, patterns in commercially insured members using claims data.</p> <strong>Methods:</strong> Integrated medical and pharmacy claims for 15 million commercially insured members =/>18 years were queried for triptan claims from Jan 2017 to Jun 2019. Members were required to have continuous enrollment 12 months before and 24 months after their first (index) triptan claim; an ICD-10-CM code on a medical claim for migraine (G43.xxx), and no triptan claim in the previous 12 months. The index triptan, the number of claims for the index and all triptans, and the total number of different triptans in the post period were identified. The proportion and time to switching were also determined.</p> <strong>Results: </strong>25,483 members met criteria; mean age 41 years and 85% female. Sumatriptan (n=14,211; 55.8%) and rizatriptan (n=7,034; 27.6%) were the most common index triptans. In the 12- and 24-months post-index: mean (sd) total index triptan fills were 2.5 (2.5) and 3.7 (4.5); however, 50.6% and 41.8% did not refill index triptan prescription; and only 9.7 % and 14.3% tried more than one triptan, with mean (sd) days to switch of 262 (210).</p> <strong>Conclusions</strong>: Half of commercial members new to triptan therapy did not refill their index triptan prescription; and only 1 in 10 used two or more triptan agents within 12 months. Similar patterns were observed at 24 months. These low triptan refill and switch rates can inform stakeholders on formulary placement and management decisions for the new CGRP acute migraine class.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116415","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Does a Mother's Previous Experience with COVID-19 Infection Change Her Intention to Vaccinate Her Children","id":"479cef91-56ae-43ee-adc6-6b3ec9b865aa","sessionCode":"EPH20","topDisplay":"<b><u>Zakeri M</u></b><sup>1</sup>, Li J<sup>1</sup>, Essien EJ<sup>2</sup>, Sansgiry SS<sup>1</sup><br><sup>1</sup>University of Houston, College of Pharmacy, Houston, TX, USA, <sup>2</sup>University of Houston, Houston, TX, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> During the COVID-19 pandemic, this study aimed to understand how mother’s previous experience with COVID-19 infection was associated with future intention to vaccinate their children against COVID-19.</p> <strong><p><b>METHODS: </b></strong> An online survey was administered during March 2021 before any vaccine was available for children. Mothers who had at least one child between 3-15 years old were recruited. Participants’ age, marital status, race, educational level, previous COVID-19 infection experience, and future intention to vaccinate children were obtained. Based on previous involvement with COVID-19 infection, participants were categorized into two groups (at least one healthcare worker among the household/ no healthcare workers among the household). Participants were also categorized into two groups based on the incidence of COVID-19 infection among the household (at least one of the household members/ none of the household members). Chi-square test and adjusted logistic regression were carried out for comparison.</p> <strong><p><b>RESULTS: </b></strong> Majority of the 595 participants were 31-40 years old (55.46%), White (72.1%), and married (90.25%). Overall, 38.3% indicated they did not intend to use the COVID-19 vaccine for their children. Mothers’ age (older), higher level of education, and being married or in a cohabiting relationship were associated with higher intention to vaccinate (p<.05). Among mothers who had no intention to vaccinate, 21.05% had experienced COVID-19 infection in the household while 17.71% of intended mothers had COVID-19 infection experience in the household. Multivariable logistic regression analysis revealed that presence of a healthcare worker among the household was associated with higher intention for vaccination (OR=1.50, 95%CI=1.04-2.16). But surprisingly, past COVID-19 infection among the household members was not associated with higher intention to vaccinate (OR=0.85 95%CI=0.55-1.31).</p> <strong><p><b>CONCLUSIONS: </b></strong> COVID-19 infection experience was not associated with higher intention for children’s vaccination. However, the presence of healthcare workers among the household was associated with higher intention to vaccinate children against COVID-19.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/covid-poster-pdf.pdf?sfvrsn=a39cbbdf_0","title":"COVID poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115425","diseases":[{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"},{"id":"5b196821-963c-48d3-9e67-cc2da312735d","parentId":"00000000-0000-0000-0000-000000000000","title":"Vaccines","urlName":"Vaccines"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"RAPID C-19: Achievements and Challenges of a Collaborative Response to the COVID-19 Pandemic in the UK","id":"59cffd19-07bd-466e-bf21-6b75f8bcf692","sessionCode":"HTA2","topDisplay":"<b><u>Greenwood A</u></b><sup>1</sup>, Brett A<sup>1</sup>, Umeweni N<sup>1</sup>, Upadhyaya S<sup>2</sup><br><sup>1</sup>National Institute for Health and Care Excellence, Manchester, UK, <sup>2</sup>National Institute for Health and Care Excellence, London, UK","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>This review explores the achievements and challenges of the research to access pathway for investigational drugs for COVID-19 (RAPID C‑19). This UK multi-agency initiative includes the National Institute for Health and Care Excellence (NICE), the National Institute for Health Research (NIHR), the Medicines and Healthcare products Regulatory Agency, NHS England and NHS Improvement and the Devolved Administrations. It aims to get effective treatments for COVID‑19 to patients quickly and safely.<strong> <p><b>METHODS: </b> </strong>NICE, working with the NIHR Innovation Observatory, identifies potentially promising treatments for COVID-19. Supported by the Scottish Medicines Consortium, NICE prepares briefings which summarise the evidence for the treatments and the key ongoing clinical trials. RAPID C-19’s oversight group meets regularly to critically appraise the latest evidence and consider the next steps needed to enable rapid patient access. If the evidence of benefit is robust, the group can then act quickly to make these treatments available promptly through expedited access mechanisms. <strong><p><b>RESULTS: </b></strong> RAPID C-19 has considered briefings on 76 potential treatments to date, and continues to monitor the emerging evidence on these. Patients have had access to treatments within days of trials reporting clinical benefit, for example, dexamethasone, remdesivir, hydrocortisone, tocilizumab, sarilumab and neutralising monoclonal antibodies. Challenges have included acting on immature evidence in the context of uncertainty and the urgent need for treatments, and the evolving nature of the pandemic (for example, new variants emerging). Despite these, RAPID C-19 has responded quickly and effectively to the needs of the healthcare system.<strong> <p><b>CONCLUSIONS: </b> </strong>Key healthcare agencies successfully work together in RAPID C‑19 to bring effective COVID-19 treatments to patients as quickly as possible. This model of collaboration could work in non-COVID settings and in other countries to speed access to beneficial treatments for patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/rapid-c-19-achievements-and-challenges-pdf.pdf?sfvrsn=600f313c_0","title":"Rapid C-19 achievements and challenges.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115361","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Adjusting Survival Data for Treatment Crossover in the ELEVATE-TN Trial By Using a Historical Cohort of Patients Treated with Chemoimmunotherapy in Front-Line Chronic Lymphocytic Leukemia","id":"11c70d99-d56e-4496-aa06-6c78e0226d26","sessionCode":"CO22","topDisplay":"<b><u>Gaitonde P</u></b><sup>1</sup>, Liljas B<sup>2</sup>, Miranda P<sup>2</sup><br><sup>1</sup>AstraZeneca, ROCKVILLE, MD, USA, <sup>2</sup>AstraZeneca, Gaithersburg, MD, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Acalabrutinib (A) is a next-generation Bruton tyrosine kinase inhibitor (BTKi) approved for chronic lymphocytic leukemia (CLL) treatment. ELEVATE-TN trial interim data (~47 months median follow-up [FU]) did not show survival benefit for A±obinutuzumab (O) versus chlorambucil+obinutuzumab (C+O) despite significantly superior progression-free survival (PFS). One explanation is C+O-to-A patient crossover (39%), which may have provided added C+O overall survival (OS) benefit. We evaluated OS by adjusting for crossover using a historical C+O cohort.</p> <p><b>METHODS: </b>The CLL11 trial demonstrated superior PFS and OS for C+O versus C and C+rituximab in first-line CLL prior to BTKi availability. Therefore, OS data for BTKi-naïve C+O patients were digitized and compared with A±O from ELEVATE-TN. Individual patient datasets were used to plot Kaplan-Meier (KM) curves and calculate hazard ratios (HR) using Cox regression in R software. To validate our hypothesis (impact of crossovers on relative survival benefit), we compared 28-month FU data, where we observed lower OS HRs (non-significant). CLL11 and ELEVATE-TN trials enrolled patients with similar baseline characteristics; however, this analysis did not account for within-trial heterogeneity.</p> <p><b>RESULTS: </b>There was a statistically significant reduction in risk of death with all 3 ELEVATE-TN treatments versus CLL-11 C+O: A+O versus C+O<sub>CLL11</sub> (HR=0.23 [95% CI=0.12-0.42, p=0.001]); A versus C+O<sub>CLL11</sub> (HR=0.43 [95% CI=0.27-0.70, p<0.05]); C+O versus C+O<sub>CLL11</sub> (HR=0.44 [95% CI=0.27-0.71, p<0.05]). In an additional analysis with 28-month FU comparing ELEVATE-TN arms with C+O from CLL-11, KM curves for C+O overlapped (HR=0.79 [95% CI=0.42-1.47], p>0.05), indicating no difference. However, HRs for A+O versus C+O<sub>CLL11</sub> (HR=0.39 [95% CI=0.18-0.84]) and for A versus C+O<sub>CLL11</sub> (HR=0.48 [95% CI=0.24-0.99]) were statistically significant.</p> <p><b>CONCLUSIONS: </b>The non-statistically significant OS for A±O versus C+O was likely due to treatment crossover. Conducting a treatment-switching analyses was challenging due to immature OS data; however, this analysis supports the hypothesis that crossover to A bolstered ELEVATE-TN C+O OS.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115222","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"An Updated Review of FDA Warning and Untitled Letters for Clinical Outcome Assessment Claims between 2013 and 2020","id":"67db6561-f87d-4b34-be42-6ca3caf0a0b7","sessionCode":"HPR9","topDisplay":"Sams L<sup>1</sup>, Slagle A<sup>2</sup>, <b><u>Symonds T</u></b><sup>3</sup>, Antonova J<sup>4</sup><br><sup>1</sup>Clinical Outcomes Solutions Ltd, Folkestone, UK, <sup>2</sup>Aspen Consulting, LLC, Philadelphia, PA, USA, <sup>3</sup>Clinical Outcomes Solutions Ltd, Folkestone, Kent, KEN, UK, <sup>4</sup>Gilead Sciences, Foster City, CA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> The FDA communicates violations to manufacturers through warning letters (WLs) and untitled letters (ULs). Symonds et.al. (2006), reported that in 2006-2012, 19% (n = 41) of the 213 issued letters contained information about patient-reported outcome (PRO) infringements, with the most common being “PRO measure was not fit for purpose”. This study updates the prior review to 2013-2020 and expands it to clinical outcome assessment (COA) measures.</p> <p><b>METHODS: </b> WLs and ULs issued between January 2013 and December 2020 by the Office of Prescription Drug Promotions (OPDP) were sourced from the FDA website. The text of each letter was reviewed for COA violation and, if present, their type(s).</p> <p><b>RESULTS: </b> In 2013-2020, the FDA issued 20 WLs and 61 ULs, with 5 WLs (25%) and 15 ULs (25%) including COA violations. Fourteen (2 WLs, 12 ULs) violations referenced efficacy and 9 (3 WLs, 6 ULs) referenced broad patient experience (eg, administration, convenience, adherence). The most common violation was related to study design or interpretation of results (95%), which included the following issues: patient-reported claims in the absence of PRO assessment (63%), insufficient study type to support conclusions (47%), and broadening of claims beyond what was collected in the trial (21%).</p> <p><b>CONCLUSIONS: </b> Overall, the number of WLs and ULs issued declined from 2006-2012 to 2013-2020. Although the reason for reduction is not fully evident, it could have resulted from increased awareness of the WL and UL practice. However, this review still identified that 25% of letters mentioned COA infringements (22% with PRO issues), comparable to 19% identified by Symonds et.al (2006). The level of infringement remains similar despite decreases in the absolute number of WL and ULs. This may be due to increased FDA attention to patient-focused drug development.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/gl1015-fda-letter-review-poster-v1-0-pdf.pdf?sfvrsn=62030022_0","title":"GL1015 FDA Letter Review Poster v1.0.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116395","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"A Review of Cost Effectiveness Analysis (CEA) of Immuno-Oncologic Therapies for Squamous Cell Carcinoma Head and Neck Cancer (SCCHN): Lessons Learned","id":"ff7985bb-d4b0-4979-b2a8-6ccb0cebcb9d","sessionCode":"EE38","topDisplay":"<b><u>Chheda J</u></b><sup>1</sup>, Ambegaonkar AJ<sup>2</sup><br><sup>1</sup>APPERTURE LLC, Boston, MA, USA, <sup>2</sup>APPERTURE LLC, Marlboro, NJ, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Immuno-oncologic therapies have been approved to treat variety of cancer types and have significantly improved quality of life and overall survival of all patients. For SCCHN, nivolumab and pembrolizumab are approved after platinum-based chemotherapy. Decision makers are developing cost-effectiveness of IO therapies. This study is a targeted review of published CEA models and understand the variations in model specifications and results.</p> </p> <strong><p><b>METHODS: </b></strong></p> A literature review was performed to identify all primary CEA publications using IO for recurrent/metastatic SCCHN cancer patients. Data for inclusion in this review were identified from PubMed, Embase and Google scholars search engines from Jan 2010 to August 2021.</p> </p> <strong><p><b>RESULTS: </b></strong></p> Search results identified 10 CEAs that met the criteria for full text which included Cost-effectiveness study model with at least one IO treatment in adult R/M SCCHN patients published between 2017 and 2021. Nivolumab (n=5) and pembrolizumab (n=5) models were published from 5 different countries USA (n=4), Switzerland (n=1), Canada (n=1), China (n=3), Argentina (n=1). All models relied on the Checkmate 114 (nivolumab), KEYNOTE-48 (pembrolizumab) and one study on KEYNOTE-40 for their effectiveness and utility data. Three models used a time-horizon of ≤ 5 years whereas seven models used a time horizon of ≥ 10 years. Nine models used parametric survival modeling for long-term extrapolation based on RCT data. All models identified health state utilities from published literature and clinical trials. Standard discount rate of 3% per annum were applied except one model using 1.5%. Besides total population analysis, five models conducted subgroup analysis in PD-L1 expression patients. There was no consistency in CEA results across the markets and CE thresholds.</p> </p> <strong><p><b>CONCLUSIONS: </b></strong> CEA models for IO therapies in SCCHNC demonstrate variable results across markets and research entities. Policy decisions on IO coverage and reimbursement needs to factor the underlying methodological variations and ensure fit for purpose.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117893","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Sociodemographic and Clinical Characteristics of Patients with Atopic Dermatitis in Colombia:Preliminary Results of Rendac","id":"2a224202-456e-4aa4-bae7-6cd648322031","sessionCode":"EPH23","topDisplay":"<b><u>Alvis Zakzuk N</u></b><sup>1</sup>, Fierro-Lozada JD<sup>2</sup>, Sanchez Zapata MJ<sup>2</sup>, Victoria Chaparro AM<sup>3</sup>, Cera - Coll CV<sup>2</sup>, Moyano L<sup>1</sup>, Castillo-Molina D<sup>2</sup>, Covo-Camacho SA<sup>4</sup>, Alvis Guzman N<sup>5</sup><br><sup>1</sup>ALZAK Foundation, Grupo de Investigación ALZAK, Cartagena, BOL, Colombia, <sup>2</sup>Fundación para la Investigación en Dermatología - FUNINDERMA, Bogota, CUN, Colombia, <sup>3</sup>Centro Médico Farallones, Cali, Colombia, <sup>4</sup>Universidad del Rosario, Bogotá, Colombia, <sup>5</sup>ALZAK Foundation- Universidad De La Costa, Barranquilla, Colombia","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>We aim to describe the sociodemographic and clinical characteristics and treatment patterns of patients with Atopic Dermatitis (AD) in Colombia, due to the lack of epidemiological information about this dermatitis in our country</p> <p><b>METHODS: </b>An observational, descriptive, and cross-sectional study was carried out. The data used was from the first phase of the National Registry of Patients with Atopic Dermatitis in Colombia (RENDAC, for its acronym in Spanish). This data was collected between July and September 2021. Absolute and relative frequencies were estimated. In addition, we estimated contingency tables using the SCORAD variable, which shows the level of severity of the AD.</p> <p><b>RESULTS: </b>A total of 644 patients were analyzed, 345 were women (53.6%) and 390 were under 18 years (60.6%). Respecting social variables, we found that 81.5% live in urban areas (n=524), and 60.9% (n=392) have health care access through a privacy health insurance company. In 235 patients (36.5%) was found other skin comorbidities. The 27,5% of patients (n=177) had severe AD and are treated mainly with high potency topical corticoid and systemic treatment.</p> <p><b>CONCLUSIONS: </b>After one-year, RENDAC show mainly patients of young age, female, belonging to urban areas and being affiliated to a privacy health insurance company. It is necessary to enlarge this sample to really understand the epidemiological behavior of AD in Colombia.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-rendac-ispor-2022-pdf.pdf?sfvrsn=58389e47_0","title":"Poster rendac-ISPOR 2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116129","diseases":[{"id":"df9240d9-f266-47e0-ba0b-a11dfd152ae4","parentId":"00000000-0000-0000-0000-000000000000","title":"Biologics and Biosimilars","urlName":"biologics-and-biosimilars"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Deployment of Balanced Scorecard in Health Care Organizations: Is It Beneficial? A Systematic Review","id":"5b00d0c9-9d82-4f0d-8ae2-6de8900fb1b2","sessionCode":"HSD9","topDisplay":"<b><u>Amer F</u></b><sup>1</sup>, Hammoud S<sup>2</sup>, Khatatbeh H<sup>2</sup>, Lohner S<sup>2</sup>, Boncz I<sup>2</sup>, Endrei D<sup>2</sup><br><sup>1</sup>University of Pécs, Pécs, BA, Hungary, <sup>2</sup>University of Pécs, Pécs, Hungary","locationCode":"","description":"\r\n\t<div><span><p><b>OBJECTIVES</span>: </b>Balanced Scorecard (BSC) has been implemented to improve the performance of organizations since 1992. To the best of the researchers' knowledge, no previous systematic review has performed a rigorous methodological approach to figure out the impact of BSC implementation in Health Care Organizations (HCO). This research intended to assess the impact of implementing the BSC on Health Care Workers' (HCW) satisfaction, patient satisfaction, and financial performance.</p> <span> <p><b>METHODS</span>: </b>This systematic review was prepared in accordance with PRISMA guidelines, and the authors customized the search strategy for PubMed, Embase, Cochrane, Google Scholar databases, and Google's search engine. The obtained studies were screened by two authors. The extracted impacts from each study were plotted on a bar figure per each outcome measure. The Risk of Bias (RoB) was assessed using the ROBINS-I and Cochrane (RoB 2) tools.</p> <span><p><b>RESULTS</span>: </b>Out of 4031 studies, the researchers included 20 studies that measured the impact of BSC on the intended outcome measures. Among them, it was found that 17 studies measured the impact of the BSC on patient satisfaction, seven studies measured the impact on HCW satisfaction, and 12 studies measured the impact on financial performance. BSC implementation demonstrated positive outcomes for patient satisfaction and the financial performance of HCOs. However, only a mild impact was demonstrated for effects related to HCW satisfaction. Moreover, many of the studies reflected a high RoB.</p> <span><p><b>CONCLUSIONS</span>: </b>This review provides managers and policymakers with evidence to support utilizing BSC in the health care sector. However, it is worth noting that the high RoB may have affected the impacts on the three primary outcomes measured. As such, this reflects the necessity for further focus on reducing the RoB in the future implementations. Lastly, we recommend researchers to measure the real and current impact of implementing BSC in HCO during the pandemic.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hsd9fatenamer-pdf.pdf?sfvrsn=8fef8a91_0","title":"HSD9_FatenAmer.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114523","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness of Esketamine Nasal Spray Compared to Intravenous Ketamine for Patients with Treatment-Resistant Depression in the US Utilizing Clinical Trial Efficacy and Real-World Effectiveness Estimates","id":"96e2bb4c-9f2f-4946-9110-6dfd9d83ccc1","sessionCode":"EE51","topDisplay":"<b><u>Brendle M</u></b><sup>1</sup>, Robison R<sup>2</sup>, Malone DC<sup>1</sup><br><sup>1</sup>University of Utah, Salt Lake City, UT, USA, <sup>2</sup>Novamind, Draper, UT, USA","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong> The aim of our study was to estimate the incremental cost, benefits, and cost-effectiveness of esketamine nasal spray relative to intravenous ketamine for treatment-resistant depression (TRD) in the United States.</p> <strong>Methods: </strong>We used a Markov model with a 1-month cycle length to assess the cost-effectiveness ratios (ICER) of esketamine relative to ketamine for adults with TRD. Four health states were utilized (TRD, non-response/relapse, response, and all-cause mortality). We estimated the percentage of the cohort in each health state, quality-adjusted life years (QALYs), costs, and ICERs of esketamine relative to ketamine over a 3-year time horizon, from both the payer and patient perspectives. We ran the model using efficacy data from clinical trials and real-world effectiveness (RWE) data from a private outpatient psychiatric clinic. We performed one-way and probabilistic sensitivity analyses.</p> <strong>Results: </strong>Over a 3-year time horizon utilizing clinical trial efficacy, 10% more of the cohort was in response for ketamine compared to esketamine (+0.05 QALYs). Utilizing patient-level efficacy, 1.5% more of the cohort was in response for ketamine compared to esketamine (+0.01 QALY). Using clinical trial efficacy, esketamine costs were $176,320 higher (payer perspective) or $42,532 lower (patient perspective) than for ketamine. With RWE, esketamine costs were $172,919 higher (payer perspective) or $47,606 lower (patient) than for ketamine. Esketamine was dominated by ketamine under the payer perspective. For the patient perspective, base-case ICERs were above $150,000/QALY threshold. The probability that esketamine being cost-effective compared to ketamine was 0.0055 (clinical trial efficacy) and 0.35 (RWE).</p> <strong>Conclusions: </strong>In this decision analytic model evaluating esketamine versus ketamine for TRD, we found that esketamine is unlikely to be cost-effective under a payer perspective. Under a patient perspective, esketamine has similar effectiveness and is less costly compared to ketamine due to insurance coverage and manufacturer assistance program covering most of the cost of esketamine.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116016","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Quality of Life and Burden on Infant and Caregiver Due to Lower Respiratory Tract Infection: A Pilot Prospective Observational Study in the Duke University Health System","id":"6b3ad3d3-441d-450b-8741-6e65b16939d9","sessionCode":"PCR10","topDisplay":"<b><u>Hariharan D</u></b><sup>1</sup>, Veerunaidu Subbiah SK<sup>2</sup>, Glaser E<sup>2</sup>, Crown WH<sup>2</sup>, Fisher KM<sup>3</sup>, Wood CT<sup>3</sup>, Malcolm WF<sup>3</sup>, Nelson CB<sup>4</sup>, Shepard D<sup>5</sup><br><sup>1</sup>Brandeis University, Allston, MA, USA, <sup>2</sup>Brandeis University, Waltham, MA, USA, <sup>3</sup>Duke University School of Medicine, Durham, NC, USA, <sup>4</sup>Sanofi Pasteur, Swiftwater, PA, USA, <sup>5</sup>Brandeis University, WELLESLEY HILLS, MA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> This pilot study aimed to quantify the quality of life (QoL) of infants with lower respiratory tract infections (LRTI) and their caregivers.</p> <strong>Methods:</strong> Infants <1yr with a probable LRTI index encounter (T0) in the Duke University Health System were enrolled between January-May 2021. We used WHO criteria for LRTI surveillance and respiratory syncytial virus (RSV) testing. A telephone survey assessed infants' and caregivers' QoL (mean±SEM) pre-onset, at T0, and 7(T7) and 14(T14) days later overall, and by setting and RSV-testing. A validated 0(worst)-100(perfect health) scale was used.</p> <strong>Results: </strong>The distribution by setting of enrolled infants was: inpatient 7/36(19%), emergency department 6/36(17%) and outpatient 23/36(64%). Twenty (56%) infants were tested for RSV with 11/20(55%) RSV-positive and 9/20(45%) RSV-negative. Overall, the infants’ average QoL decreased significantly from pre-onset (90.8±2.3) to T0 (75.0±3.0,p<0.0001), and then improved to near pre-onset levels by T7 (T7:88.9±2.3) and T14 (91.0±1.7). Caregivers reported similar overall patterns (pre:89.6±3.0, T0:82.5±3.3, T7:89.9±2.2, T14:90.8±2.5). Notably, average pre-onset QoL was <100 overall and in each setting. Compared to other settings, QoL among outpatient infants decreased the most from pre-onset to T0 (pre:90.9±3.1, T0:73.3±4.0, T7:87.7±3.4, T14:89.5±2.4). Among outpatients, tested infants averaged lower T0-QoL (66.4±5.3) than untested infants (79.6±5.4). Furthermore, the RSV-negative sub-group had the lowest pre-onset QoL with a substantial decrease at T0 and the least subsequent improvements in QoL (pre: 89.0±9.8, T0: 59.0±9.9, T7:73.0±11.5, T14:82.0±5.6). Caregivers’ QoL showed similar patterns.</p> <strong>Conclusions: </strong>LRTI causes substantial decreases in QoL for LRTI infants and their caregivers. In the outpatient setting, RSV testing was more likely among LRTI infants with lower QoL. Some infants had relatively lower pre-onset QoL, larger decreases in QoL and recovered QoL more slowly from illness, suggesting susceptibility to LRTI and/or co-existing stressors. While previous research covered only hospitalized premature infants, this pilot study includes non-hospitalized LRTI cases and merits wider replication.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/dhwanihariharanqolpcr10isporposterfinal-pdf.pdf?sfvrsn=d9e5fe3e_0","title":"Dhwani_Hariharan_QOL_PCR10_ISPOR_poster_final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117198","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"},{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Cost Effectiveness Analysis of Emergency Departments Compared to Urgent Care Centers Among Medicare Beneficiaries","id":"db7e14ce-eb2c-4b05-bd4c-6f8b46aed615","sessionCode":"EE54","topDisplay":"<b><u>Abdelmalek M</u></b><sup>1</sup>, Mallow P<sup>2</sup><br><sup>1</sup>Xavier University, Cincinatti, OH, USA, <sup>2</sup>Xavier University, Cincinnati, OH, USA","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE:</strong> In the United States, there are gaps in patients’ ability to access primary care facilities in a timely manner. As a result, emergency departments (EDs) are reported to be operating beyond capacity. Simultaneously, urgent care center (UCC) capacity continues to increase annually. This study examined the cost-effectiveness of EDs compared to UCCs for four non-emergent conditions that are commonly presented by Medicare participants: upper respiratory infections, urinary tract infections (UTI), sprains and strains, and contusions.</p> <strong><p><b>METHODS: </b></strong> ED visits, hospitalization rates and discharges were obtained from the 2018 Healthcare Cost and Utilization Project. Evaluation and monitoring (E/M) and facility costs were derived from the CMS Medicare Physician Fee Schedule, while the percentage of unnecessary ED visits was determined through the Billings algorithm. The difference between the costs of an ED and a UCC visit followed by hospitalization was used as a measure of incremental costs. For incremental effectiveness, the discrepancy of being discharged from the ED compared to a UCC was determined. Uncertainty was tested through a one-way sensitivity analysis with a ±25% variation in costs and a ±10% variation in outcomes. A probabilistic sensitivity analysis (PSA) was performed using a gamma distribution for costs and a beta distribution for outcomes over 300 iterations.</p> <strong><p><b>RESULTS: </b></strong> The cost-effectiveness analysis produced favorable ICERs for UCCs compared to EDs. The one-way sensitivity analysis showed a 16.7% reduction and a 13.6% increase in the ICER with the lower and upper variations, respectively. The PSA results indicated 87.3%, 99.3%, 97.3% and 92% of the model iterations were cost effective for respiratory, UTI, sprains/strains and contusions, respectively, upon incorporation of a WTP threshold.</p> <strong>CONCLUSION: </strong>UCCs can cost-effectively fill the void of backlogged primary and low to mid-acuity emergency needs. This benefit can be tapped through the integration of UCCs in the mainstream healthcare system.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/mkaispor-pdf.pdf?sfvrsn=1018de2e_0","title":"MKA_ISPOR.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115239","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Moving from Static to Dynamic Economic Assessments: The Process of Migrating Economic Models to a Web Environment","id":"da973d8e-1483-47c2-83be-703e9baf6325","sessionCode":"MSR9","topDisplay":"<b><u>Whittington M</u></b><sup>1</sup>, Topachevskyi O<sup>2</sup>, Volovyk A<sup>2</sup><br><sup>1</sup>Institute for Clinical and Economic Review, Boston, MA, USA, <sup>2</sup>Digital Health Outcomes LLC, Kyiv, Ukraine","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>An economic assessment is traditionally static in that it provides estimates based on the best available evidence for a one time snapshot. The objective of this abstract is to describe the process used to migrate an economic model developed in Microsoft Excel to a user-friendly and modifiable web environment.</p> <p><b>METHODS: </b>In 2020, the Institute for Clinical and Economic Review (ICER) launched ICER Analytics™, a cloud-based program that includes the ICER Interactive Modeler™. The Interactive Modeler is a web environment that is running on the “eModels Platform” developed by Digital Health Outcomes, LLC and includes the cost-effectiveness and budget impact models used in ICER reviews. Within the ICER Interactive Modeler, users can change model inputs to examine the influence of those real-time changes on results.</p> <p><b>RESULTS<span>: </b>First, a standardized modeling template was developed to serve as a bridge between the Excel file and web-based model inputs and result displays. This template includes a standard location of all model inputs and outcomes to allow for a systematic transition from the Excel environment to the web environment. Then, procedures for migrating the Excel template to the web environment were established. These include converting the template in JavaScript to run in a V8 browser engine, uploading the template to the web environment, building user-modifiable input tables, and mapping to dynamic result displays. Performance optimization is conducted to reduce loading times. Finally, a comprehensive review process is initiated that involves comparing the default results in the web environment to the Excel file and examining each change in input and its respective results change. These steps have been developed and implemented for 21 models in 19 disease areas used in ICER reviews. </span></p> <p><b>CONCLUSIONS<span>: </b>The migration of these Excel files to the web environment allows for ongoing updates to the model evidence to produce dynamic economic assessment findings. </span></p> <span> </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115513","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Probabilistic Cost-Effectiveness Analysis of Venetoclax and Obinutuzumab As a First-Line, 12-Month, Fixed Duration Therapy in Chronic Lymphocytic Leukemia (CLL) in Canada","id":"bc9f1e5d-e1cf-4216-98ae-704d9dc3719e","sessionCode":"EE12","topDisplay":"Chatterjee A<sup>1</sup>, van de Wetering G<sup>2</sup>, Goeree R<sup>3</sup>, Owen C<sup>4</sup>, Barakat S<sup>5</sup>, <b><u>Manzoor B</u></b><sup>6</sup>, Sail K<sup>7</sup><br><sup>1</sup>OPEN Health, York, UK, <sup>2</sup>OPEN Health, Rotterdam, Netherlands, <sup>3</sup>Goeree Consulting Ltd., Mount Hope, ON, Canada, <sup>4</sup>Foothills Medical Centre, Calgary, AB, Canada, <sup>5</sup>AbbVie Corporation, Saint-Laurent, QC, Canada, <sup>6</sup>AbbVie Inc., CHICAGO, IL, USA, <sup>7</sup>AbbVie Inc., North Chicago, IL, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>To assess the cost effectiveness of venetoclax + obinutuzumab (VENCLAXTA® + GAZYVA®), (Ven+O) for the frontline treatment of CLL (1L CLL) in Canada from a publicly funded healthcare system perspective.</p> <strong>Methods:</strong> A partitioned survival analyses (PartSA) model was developed with three health states: progression free, progressed, and death. A cycle length of 28 days and a time horizon of 10 years was used for the model. VEN+O treatment for a fixed duration of 12 months was compared to G + Chlorambucil (GClb), Fludarabine plus Cyclophosphamide plus Rituximab (FCR), Bendamustine plus Rituximab (BR), Chlorambucil plus Rituximab (Clb+R), Ibrutinib (Ibr) and Acalabrutinib. The population in the model included both unfit and overall 1L CLL patients, two subgroups were also assessed (patients with del17p/TP53 mutations and patients without del17p/TP53 mutations). Survival data extrapolated from the CLL14 trial were used to populate the model. Uncertainty was assessed via one-way sensitivity analyses, probabilistic analyses (PA), and scenario analyses.</p> <strong>Results:</strong> Based on the PA, unfit 1L CLL patients receiving VEN+O were estimated to incur costs of $217,727 [confidence interval (CI): $170,725, $300,761] (Del(17p)/TP53: $209,102 [CI: $159,698, $386,190], Non-Del(17p)/TP53: $217,732 [CI: $171,232, $299,063]) and accrue 4.96 [CI: 4.04, 5.82] quality-adjusted-life-years (QALYs) (Del(17p)/TP53: 3.11 [CI: 2.00, 4.20], Non-Del(17p)/TP53: 5.04 [CI: 4.05, 5.92]). GClb, BR, Clb+R, and Ibr accrued less QALYs and higher costs, VEN+O was the dominant treatment option. Acalabrutinib showed higher QALY gain and substantially higher costs compared to VEN+O, leading to an incremental-cost-effectiveness-ratio (ICER) of $2,139,180/QALY gained and therefore not a cost-effective option. PA shows that at a willingness-to-pay of $50,000/QALY gained, VEN+G has 98% probability of being cost-effective.</p> <strong>Conclusion</strong>: VEN+G is a cost-effective treatment option for unfit 1L CLL patients and provides excellent value to the healthcare system in Canada.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/44950-ispor-2022-pce-analysis-v1-pdf.pdf?sfvrsn=4e831e74_0","title":"44950 ISPOR 2022 PCE Analysis v1.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115408","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Patient Reported Outcome Measure for Giant Cell Arteritis: Cross-Sectional Validation Study","id":"b6308fdd-d584-471f-9adf-715bd6bdffb0","sessionCode":"CO7","topDisplay":"Ndosi M<sup>1</sup>, Almeida C<sup>1</sup>, Dawson J<sup>2</sup>, Dures E<sup>1</sup>, Greenwood R<sup>3</sup>, Guly C<sup>3</sup>, Mackie S<sup>4</sup>, <b><u>Churchman D</u></b><sup>5</sup>, Robson J<sup>1</sup><br><sup>1</sup>University of West England, Bristol, UK, <sup>2</sup>University of Oxford, Oxford, UK, <sup>3</sup>University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK, <sup>4</sup>University of Leeds, Leeds, UK, <sup>5</sup>Oxford University Innovation, Oxford, OXF, UK","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES<span class=\"spelle\">: </b><span style=\"font-family: 'Open Sans',sans-serif; color: black;\">Giant cell arteritis (GCA) presents in people over the age of 50 with cranial, ocular, and large vessel vasculitis. This study aims to validate a disease-specific patient reported outcome (PRO) measure for patients with GCA, to capture the impact of GCA and its treatment on health-related quality of life.</span></span><span style=\"font-family: 'Open Sans',sans-serif; color: black;\"></span></p> <p style=\"background: white;\"></p> <p style=\"background: white;\"><p><b>METHODS: </b>This cross-sectional study included UK patients (n=<span>428, mean age (SD) of 74.2 (7.2), 285 (67%) female)</span> with clinician-confirmed GCA; diagnosed within the last three years or flaring within the last year. Patients completed the 40 candidate GCA-PRO items, the EQ5D-5L, CAT-PROM5 and self-report of disease activity. Rasch and factor analysis were used to determine internal validity and factor structure. Item reductions were based on clinical importance, Rasch model fit, and redundancy. Tests of validity included comparison of the GCA-PRO (i) in participants with ‘active disease’ versus patients ‘in remission’ (known groups validity) and (ii) with EQ5D-5L and CAT-PROM5 scores (convergent validity).</p> </p> <p><b>RESULTS<span>: </b>After the initial analysis (40 items), ten items were deleted, and two response categories collapsed to ensure overall fit to the Rasch model. This resulted in a final PRO comprising a 30-item scale with a 4-response category structure. </span></p> <span>Factor analysis confirmed four factors (domains): Acute symptoms (8 items), Activities of daily living (7 items), Psychological (7 items) and Participation (8 items), all of which individually fitted the Rasch model (X<sup>2</sup> = 25.219, DF=24, p=0.394 including reliability [Person Separation Index, PSI=0.828]), (construct validity). </span></p> <span>Each domain correlated, at least moderately, with EQ5D-5L and CAT-PROM5 scores (Spearman’s Correlation Coefficients 0.44 to 0.78) (convergent validity). The new GCA-PRO discriminated between patients with active disease and remission (known groups validity).</span></p> <p><b>CONCLUSIONS: </b>The 30-item GCA-PRO demonstrates internal and external validity in measuring health-related quality of life in people with GCA.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/gca-pro-ispor-may-2022v1-pdf.pdf?sfvrsn=d1a5f2a4_0","title":"GCA-PRO ISPOR May 2022_v1.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115550","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Examining the Effect of Infection Prevention and Control Awareness Among Nurses on Patient and Family Education: A Cross-Sectional Study","id":"5c4643ca-4ac6-43ca-9b75-71b43fb90331","sessionCode":"HSD20","topDisplay":"<b><u>Hammoud S</u></b><sup>1</sup>, Amer F<sup>2</sup>, Kocsis B<sup>1</sup><br><sup>1</sup>University of Pécs, Pécs, Hungary, <sup>2</sup>University of Pécs, Pécs, BA, Hungary","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>The significance of patient engagement in infection prevention and control (IPC) remains to be stressed as a means of improving patient safety. This study aimed to determine nurses’ awareness on IPC, assess patient and family education on IPC, and examine the effect of nurses’ IPC awareness on patient and family education. </p> <p><b>METHODS: </b>A multi-site, cross-sectional study was conducted among 566 nurses in Hungary. Nurses responded to a validated questionnaire of three parts including demographics, IPC awareness; healthcare-associated infections, hand hygiene (HH), and standard precautions (SP), and patient and family education. The cut-off level for acceptable awareness score was set at 70%. Mann-Whitney U and Kruskal-Wallis tests were used to compare the difference in IPC awareness across demographics. Chi-Square test was used to compare the difference in IPC patient and family education across demographics and IPC acceptable/non-acceptable awareness groups. A logistic regression analysis was done to identify independent predictors of acceptable awareness for each IPC area.</p> <p><b>RESULTS: </b>Of all nurses, 91.7% were females. Acceptable scores were reached in overall IPC awareness (16.69 ± 2.504) and SP (10.11 ± 1.509) only. Holding a university nursing degree was a significant predictor of acceptable awareness in all IPC areas. Nurses educated patients and family members the most on HH (71.9%) and the least on the reason for isolation (36.9%). Nurses with acceptable awareness educated patients more than those with non-acceptable awareness but, the differences were only significant for respiratory hygiene (<em>P</em>= 0.001) and the reason for isolation (<em>P</em>= 0.019).</p> <p><b>CONCLUSIONS: </b>The study shows acceptable scores of IPC overall awareness and SP among Hungarian nurses, and highlights a low level of patient and family education on IPC. Nursing leaders are encouraged to enhance the culture that is based on nurses-patients partnership and to develop reminders to emphasize the importance of engaging patients in IPC.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hsd20saharhammoud-pdf.pdf?sfvrsn=58b68872_0","title":"HSD20_SaharHammoud.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114522","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of COVID19 on Mental Health - Focus on Depression & Anxiety","id":"62a9348a-28e8-4e50-a66a-7312ec415614","sessionCode":"EPH28","topDisplay":"<b><u>Yahiaoui S</u></b><sup>1</sup>, Schmid R<sup>2</sup>, Dubourvieux L<sup>1</sup>, Beillat M<sup>3</sup>, Kennedy SH<sup>4</sup><br><sup>1</sup>Servier International, Paris, France, <sup>2</sup>Servier International, Suresnes, 75, France, <sup>3</sup>Servier International, Suresnes, France, <sup>4</sup>University of toronto, Toronto, ON, Canada","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b></p> The COVID-19 crisis has taken a toll on the wellbeing of the population.</p> This targeted literature review was performed to assess the impact of COVID19 pandemic on the occurrence of depression and anxiety and to identify vulnerable subgroups.</p> <strong><p><b>METHODS</strong>: </b></p> On July 18<sup>th</sup>, 2021, a comprehensive search was conducted in PubMed and SCOPUS databases to identify relevant articles. Inclusion and exclusion criteria were outlined in a PICO format. A weighting criteria tool was applied to refine the selection.</p> Studies were separated into two time periods (early and later pandemic phases) in relation to COVID19 onset. The outcomes were occurrence rates of depression and anxiety, subsequently referred to as “MDE and MDD” and “anxiety disorders and GAD”. Data were retrieved for the general population and stratified by continent. The median rate was calculated for studies that only indicated confidence intervals. Vulnerable subgroup rates were compared to the available general population data. </p> <strong><p><b>RESULTS</strong>: </b></p> Of the 422 articles identified, 20 met our inclusion criteria. In the early-pandemic phase, the highest rates of major depression and anxiety in the general population were observed in America (Argentina: MDD=33.7%; USA: GAD= 33.6%) while the lowest were in Europe (Czech Republic: MDE =11.8%; GAD= 12.8%). Some Asian countries revealed higher depression and anxiety rates than European countries.</p> In the later-pandemic phase, rates of depression and anxiety were generally increased compared to the early-pandemic phase. In comparison with the pre-pandemic phase, the population mental health worsened notably during the pandemic especially on vulnerable populations. Among these, are healthcare professionals, younger population and people with a prior COVID19 infection or a pre-existing mental illness.</p> <strong>CONCLUSION: </strong>COVID19 pandemic is associated with a persisting psychological burden even at a later-pandemic phase. According to our findings, US has the highest mental health burdens followed by England and some Asian countries.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114863","diseases":[{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"A Cost of Control Analysis of Once-Weekly Subcutaneous Semaglutide Versus Dulaglutide for Bringing Patients to Treatment Targets in China","id":"c3d4ee61-2e0f-4fef-bf8d-7367b234a74a","sessionCode":"EE79","topDisplay":"<b><u>Zhen R</u></b><sup>1</sup>, Gu Z<sup>2</sup>, Shen Y<sup>3</sup>, Chen L<sup>2</sup><br><sup>1</sup>China State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Beijing, 11, China, <sup>2</sup>The Research Center of National Drug Policy & Ecosystem,China Pharmaceutical University, Nanjing, China, <sup>3</sup>Novo Nordisk (China) Pharmaceuticals Co., Ltd, Beijing, China","locationCode":"","description":"\r\n\t<div><strong>Introduction</strong>: In the SUSTAIN 7 randomized controlled trial, once-weekly subcutaneous semaglutide (OW) subcutaneous (s.c.) 0.5mg was associated with greater reduction in glycated hemoglobin (HbA<sub>1c</sub>) and body weight in people with type 2 diabetes mellitus (T2DM) comparing dulaglutide 1.5mg. The present study estimated the annual cost per patient achieving HbA<sub>1c</sub> treatment targets and weight loss responses with OW s.c. semaglutide and dulaglutide in the Chinese healthcare system setting over a one-year period.</p> <strong>Methods</strong>: The proportions of patients achieving single and composite endpoints related to glycemic control, body weight, and hypoglycemia outcomes were taken from SUSTAIN 7. The annual cost included medication cost and needle cost. Cost of control was calculated as the annual cost per patient of each medication, expressed in 2020 RMB (CNY), divided by the proportion of patients achieving each endpoint.</p> <strong>Results</strong>: OW s.c. semaglutide 0.5mg was more effective at bringing patients to each of the endpoints and showed lower costs of control for all modeled endpoints. The cost per patient achieving the triple composite endpoint was CNY 9,598 with OW s.c. semaglutide 0.5mg and CNY 13,395 with dulaglutide 1.5mg, representing a 40% larger cost with dulaglutide 1.5mg. For each patient achieving an endpoint of HbA<sub>1c</sub>≤6.5%，HbA<sub>1c</sub>＜7%, ≥1.0% HbA<sub>1c</sub> reduction with≥3.0% weight loss, weight loss≥5% and weight loss≥10%, the cost would be 32%, 28%, 92%, 86% and 121% larger with dulaglutide 1.5mg than with OW s.c. semaglutide 0.5mg, respectively.</p> <strong>Conclusions</strong>: OW s.c. semaglutide 0.5mg provides better value for money than dulaglutide 1.5mg for the treatment of people with T2DM in China.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/cost-of-controlfinal-pdf.pdf?sfvrsn=1358353d_0","title":"cost of control_final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115322","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Economic Burden of Schizophrenia in the United States: A National Level Analysis","id":"0afa1f72-2082-425c-a5e7-7498a9974c1e","sessionCode":"RWD24","topDisplay":"Zaki S<sup>1</sup>, <b><u>Agrawal N</u></b><sup>2</sup>, Paul R<sup>2</sup>, Kathe N<sup>2</sup>, Aparasu R<sup>3</sup><br><sup>1</sup>Complete HEOR Solutions (CHEORS), VADODARA, GJ, India, <sup>2</sup>Complete HEOR Solutions (CHEORS), North Wales, PA, USA, <sup>3</sup>University of Houston, Houston, TX, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Schizophrenia is associated with considerable disability and a high healthcare burden. This study evaluated marginal healthcare expenditure among schizophrenia patients in the US using the Medical Expenditure Panel Survey (MEPS).</p> <p><b>METHODS: </b> A cross-sectional study was conducted using the 2012-2019 MEPS, a nationally representative survey of noninstitutionalized individuals in the US. The study sample included (≥ 18 years), with (using ICD-9-CM codes: 295.xx and 298.xx, and ICD-10-CM code: F20.xx). The annual health expenditures involving various healthcare components were compared for patients with and without schizophrenia. Generalized Linear Model (GLM) with gamma distribution, log link, and Inverse Probability of Treatment Weighting (IPTW) was employed to compare the annual healthcare expenditures among the study groups.</p> <p><b>RESULTS: </b> The study identified 463 patients, representing 0.47 million schizophrenia patients in the US with an overall prevalence of 1.82%. Most of these patients were 18-34 years old (31.62%), male (59%), non-Hispanic whites (66%), never married (50%), non-smokers (58%), and belonged to the low-income category (67%). The mean Charlson Comorbidity Index (CCI) score was 0.79 (SE=0.07). The total annualized expenditure among the schizophrenia cohort was estimated to be $9.23 billion. The adjusted annual mean total costs among patients with schizophrenia ($19,539 [SE=$1,592]) were significantly higher than those without schizophrenia ($9,925 [SE=$ 179]) with incidence rate ratio (IRR) of 1.97 (95% CI:(1.68,2.31); p-value < 0.001). Prescribed medicines were the largest drivers of the total annual expenditures among patients with schizophrenia (Mean: $6,580 [SE=$551]) compared to non- schizophrenia patients (Mean: $2,816 [SE=$76]).</p> <p><b>CONCLUSIONS: </b> This study highlighted a considerable economic burden among patients with schizophrenia, especially prescription costs. Given the high prescription burden, future therapeutic approaches are needed to address the economic burden of schizophrenia.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/rwd24sabazakipdf-pdf.pdf?sfvrsn=d26c83bf_0","title":"RWD24_SabaZaki_PDF.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115722","diseases":[{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"},{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Factors Associated with Unsuccessful Treatment Outcomes Among Smear Positive Tuberculosis Patients in Hospital Pulau Pinang, Malaysia: A Retrospective Study","id":"2b7792ce-ee28-4c85-8235-74d2482fa953","sessionCode":"CO3","topDisplay":"<b><u>Khan AH</u></b><sup>1</sup>, Yaghi ARA<sup>1</sup>, Harun SN<sup>1</sup>, Hyder Ali IAB<sup>1</sup>, Ahmad R<sup>2</sup><br><sup>1</sup>Universiti Sains Malaysia, Penang, Malaysia, <sup>2</sup>The Islamia University of Bahawalpur, Pakistan., Bahawalpur, Pakistan","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>According to WHO, tuberculosis (TB) is one of leading cause of mortality. The mortality rate in Malaysia is accelerating due to high transmission of TB. To control TB, determination of associated factors of unsuccessful treatment outcomes is necessary. This study was aimed to investigate the factors associated with unsuccessful treatment outcomes in smear TB patients.</p> <p><b>METHODS: </b>A retrospective study was conducted in Hospital Pulau Pinang in Malaysia. Records of 351 confirmed smear-positive TB patients were reviewed from 2014-2020. Data analysis was performed in SPSS 21 using Cox regression for univariate and multi variate analysis.</p> <p><b>RESULTS: </b>A 78.7% of the study population were male with mean age of (49.5 <u>+</u> 16.4). 46(20.8%) patients died, 21(9.5%) had Multidrug Resistant Tuberculosis (MDR-TB), 1(0.5%) patient failed the treatment and 2(0.9%) patients default the treatment. Univariate Cox regression analysis showed certain variables which include smoking, drinking, high levels of white blood cells and urea, receiving separated therapy during the intensive phase of treatment, history of TB and multidrug resistant have significant relation with unsuccessful outcomes. The final results of multivariate Cox regression analysis indicated levels of white blood cells (<em>p-value= .031</em>, HR= 1.058, 95% CI= 1.005 - 1.113) and urea (<em>p-value= .021</em>, HR= 1.028, 95% CI= 1.004 - 1.052) were positively associated while hemoglobin levels (<em>p-value= .002</em>, HR= .800, 95% CI= .697 - .919) and no history of TB (<em>p-value= .036</em>, HR= .511, 95% CI= .272 - .959) were negatively correlated with unsuccessful outcomes. Treatment success rate was 68.3%.</p> <p><b>CONCLUSIONS: </b>In this study, high levels of white blood cells and urea were major risk factors of unsuccessful treatment outcomes. Smear positive TB patients with high levels of white blood cells and urea should be monitored intensively. Our study has shared insightful results on the risk factors associated with unsuccessful treatment outcomes.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116794","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Understanding the Patient Experience of Erythropoietic Protoporphyria and X-Linked Protoporphyria: A Qualitative Study","id":"4facc595-b192-4e5e-bfc5-76ba90a606ea","sessionCode":"PCR11","topDisplay":"<b><u>Whalley D</u></b><sup>1</sup>, Belongie K<sup>2</sup>, Frangiosa T<sup>2</sup>, Krasa H<sup>2</sup>, Mladsi DM<sup>3</sup>, Twiss J<sup>1</sup>, Wolowacz S<sup>1</sup><br><sup>1</sup>RTI Health Solutions, Manchester, UK, <sup>2</sup>Mitsubishi Tanabe Pharma Group, Jersey City, NJ, USA, <sup>3</sup>RTI Health Solutions, Research Triangle Park, NC, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> Erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) are rare, genetic disorders of the heme metabolic pathway that cause cutaneous photosensitivity. Study objectives were to explore the patient experience of living with EPP/XLP and potential benefits of treatment outcomes as part of a vignette health-utility estimation study to quantify the quality-of-life impact of EPP/XLP.</p> <strong>Methods:</strong> Semistructured qualitative interviews were conducted with patients recruited from patient organizations, clinicians, and patient advocates in the United States (US) and United Kingdom (UK). Interview data were analysed using content analysis.</p> <strong>Results:</strong> 8 EPP/XLP patients (4 US, 4 UK; 4 females; mean [range] age, 38.8 [24-52]; mean [range] time to prodrome, 12.9 [1.5-30] minutes), 2 clinicians, and 2 patient advocates were interviewed. Most frequently reported initial prodromal symptoms after sunlight exposure were tingling (n=10), itching (n=9), and mild burning (n=8). Key symptoms of a full phototoxic reaction were intense burning (n=12) and excruciating, relentless pain (n=11). The reported impact of EPP/XLP was wide reaching, and patients described being in a constant state of alert and anxiety: “...there was always pain and fear and anxiety and then the constant sensation that I was putting other people out, feeling like a burden.” Phototoxic reactions were reported as typically lasting 2‑7 days, during which time patients are completely debilitated. Between reactions, key impacts of living with EPP/XLP included restricted participation in outdoor activities, impaired relationships, social isolation/withdrawal, and detriments to mental health. Perceived potential benefits of 30-90 minutes of additional light tolerance included reduced anxiety; increased freedom to participate in normal, everyday activities; and greater opportunities for life experiences.</p> <strong>Conclusions: </strong>The interviews provided key insights into the patient experience of living with EPP/XLP and the wide-reaching detriments to quality of life. Treatments that result in modest increases in light-exposure tolerance have the potential to significantly improve patients’ lives.</p> <strong></strong></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/6070whalleyispor-posterfinaldigital-pdf.pdf?sfvrsn=f1a95303_0","title":"6070_Whalley_ISPOR Poster_FINAL_Digital.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115214","diseases":[{"id":"747104b6-9723-4895-a3d6-28d8c37172e3","parentId":"00000000-0000-0000-0000-000000000000","title":"Systemic Disorders/Conditions","urlName":"Systemic-Disorders-Conditions"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Assessing Patient Reported Outcomes and Perceptions to Incorporate Real-World Patient Perspective in Oncology Treatment","id":"126688e3-ea05-4a49-bbca-777c24d9a439","sessionCode":"PCR1","topDisplay":"<b><u>Galaznik A</u></b><sup>1</sup>, Dudley W<sup>2</sup>, Garcia C<sup>1</sup>, Wujcik D<sup>3</sup><br><sup>1</sup>Carevive Systems, Miami, FL, USA, <sup>2</sup>University of North Carolina, Greensboro, Greensboro, NC, USA, <sup>3</sup>Carevive Systems, Inc, FRANKLIN, TN, USA","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE</strong>: Remote monitoring platforms can enable patient centricity in routine care, thereby systematically bringing patient perspectives to the treatment experience. The objective of this study is to assess patient-reported outcomes and treatment preferences in a real-world treated oncology population, and how this information can be routinely gathered at point-of-care. <strong>METHODOLOGY: </strong>The patient cohort (n=275) was derived from users of PROmpt<sup>®</sup>, an application for remote patient reporting and provider symptom management, employed in routine care in 30+ integrated cancer treatment centers. Patients were enrolled (1/8/19-11/1/21) at treatment initiation and provided with weekly surveys. Baseline characteristics assessed included frailty, patient quality-of-life (QoL) preferences, perception of cancer curability and treatment concerns. Results were descriptively assessed overall and stratified by solid versus hematologic malignancies, frailty and curability perception. Statistical differences were assessed using Pearson Chi-square, Likelihood Ratios and Linear-by-Linear associations. <strong><p><b>RESULTS: </b> </strong>With respect to frailty, the cohort was 63% fit, 22% intermediate, and 14% frail. 64% felt their cancer was curable. The majority (>90%) prioritized quality-of-life over length-of-life. Differences in QoL preference by fitness level were not statistically significant (98%, 88%, 82% respectively), although some directional preference towards QoL for fit patients was seen in linear-by-linear association. Results were also comparable between solid tumors and hematologic malignancies (90% vs 88% respectively) as well as by perception of curability vs non-curability of disease (88% vs 8=94%). Among concerns reported at baseline, most were pertained to understanding and selection of treatment, followed by cost and scheduling management, with no significant differences between solid tumors and hematologic malignancies. <strong>CONCLUSION: </strong>Overall results demonstrate the feasibility of gathering patient perspectives such as QoL preference, perceptions of curability, and treatment concerns in routine practice.While overall baseline differences did not vary significantly between groups, future research will explore changes in patient preferences and concerns over time as treatment progresses.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117766","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Flexibility in Water and on Land over 50 Years","id":"76aa7fa8-6416-422d-ad96-7855215cb52d","sessionCode":"CO15","topDisplay":"Miszory E<sup>1</sup>, Járomi M<sup>1</sup>, Borbély N<sup>2</sup>, Horváth L<sup>3</sup>, Verzár Z<sup>1</sup>, Ferenczy M<sup>2</sup>, <b><u>Boncz I</u></b><sup>1</sup>, Pakai A<sup>4</sup><br><sup>1</sup>University of Pécs, Pécs, Hungary, <sup>2</sup>University of Pécs, Szombathely, Hungary, <sup>3</sup>University of Pécs, Szombathely, VA, Hungary, <sup>4</sup>University of Pécs, Pécs, ZA, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: The adaptations of the human body resulting from the aging process especially loss of flexibility can increase the risk of falls. The purpose of this study was to give task-oriented training to over 50 years patients in water and on land and compare their flexibility.</p> <strong>Methods</strong>: <span>Our study was performed in Zala county (Hungary)</span> <span>in 2019</span>. A total of 20 patients received progressive training for 60 minutes, three times a week, for 12 weeks. They were randomly divided into an in-water training group (avarage age:64.7±6.15,90% woman) and an on-land training group (avarage age:64.7±3.02,100% woman). Individuals were recruited from the local community via open invitations. At study entry, none of them had limited mobility (walking requiring the use of walkers or canes). <span>Exclusion criteria were severe vestibular, auditory, and visual impairment;</span> <span>unstable cardiopulmonary disease;</span> <span>operation over the past six months. Upper (Back Scratch Test) and lower limb (Chair sit and Reach) f</span>lexibility assessment tests were measured. Using the IBM SPSS Statistics Version 22 program, descriptive and mathematical statistics (<span>two-sample paired t test)</span> were calculated (p<0.05).</p> <strong>Results</strong>: In the right side Back Scratch Test, there was a significant growth in-water training group (p<0,0062), and the on-land group (p=0.0055), while the left side did not have a significant change (p>0.05). Based on the results of the Chair Sit and Reach test, the lower extremity flexibility only improved within the in-water training group significantly, with the right leg (p=0.003) and left leg (p=0.004). Although the flexibility test showed a greater improvement in the in-water training group, this can not be justified (p>0.05).</p> <strong>Conclusions</strong>: The training <span>had a significant effect on flexibility, regardless of whether it was performed in water or land.</span> <span>Exercise can minimize the harmful effects of aging and improve the functionality, which reduces the likelihood of accidents.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/miszoryeco15flexibility-in-water-and-on-land-over-50-years-pdf.pdf?sfvrsn=633c1101_0","title":"MiszoryE_CO15_Flexibility in water and on land over 50 years.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117230","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Claims-Based Algorithms to Identify Persons with Severe Hemophilia A","id":"a75f60c3-3c64-4a9c-bc8c-7bbda6af059a","sessionCode":"EPH25","topDisplay":"Khairnar R<sup>1</sup>, Mahajerin A<sup>2</sup>, Shapiro AD<sup>3</sup>, Sidonio R<sup>4</sup>, Okolo A<sup>3</sup>, <b><u>Decker-Palmer M</u></b><sup>1</sup>, Patel A<sup>1</sup>, Gibbs SN<sup>5</sup>, Campos C<sup>5</sup>, Broder M<sup>5</sup>, Yermilov I<sup>5</sup><br><sup>1</sup>Genentech, Inc., South San Francisco, CA, USA, <sup>2</sup>Children’s Hospital of Orange County, Orange, CA, USA, <sup>3</sup>Indiana Hemophilia & Thrombosis Center, Indianapolis, IN, USA, <sup>4</sup>Children’s Hospital of Atlanta, Emory University, Atlanta, GA, USA, <sup>5</sup>Partnership for Health Analytic Research (PHAR), LLC, Beverly Hills, CA, USA","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong> Hemophilia A (HA) is characterized as severe, moderate, or mild based on level of endogenous factor (F) VIII activity. ICD-10 diagnosis codes for HA do not differentiate by disease severity. Herein, we develop claims-based algorithms to identify persons with severe HA among those with HA.</p> <strong>Methods:</strong> Retrospective review of medical records at three geographically-dispersed HA treatment centers was conducted from 01/20-07/21 to include 100 male patients with HA (53 severe), without von Willebrand disease. Cognitive interviews with hematologists identified variables in medical records that could inform HA severity in healthcare claims. Variables were grouped into distinct concept groups (symptoms of HA (SH), treatment of symptoms of HA (TS), treatment of HA (TH), and side-effects of treatment of HA (SE). Concept groups were tested individually, and in combination to identify algorithms with high sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). To account for the evolving treatment landscape, separate algorithms with or without HA treatment were identified.</p> <strong>Results:</strong> Mean age of the sample was 27.7 years. Using medical records as benchmark, the candidate algorithms with HA treatment included TH alone (FVIII prophylaxis [≥50 units of FVIII/kg/week for 45 weeks/year] OR emicizumab use OR central venous catheter placement/removal) with 92.5% sensitivity, 66.0% specificity, 75.4% PPV, and 88.6% NPV. The candidate algorithm without HA treatments included SH (non-traumatic intracranial hemorrhage OR arthropathy OR hemarthrosis) OR TS (≥2 joint replacements OR ≥10 physical therapy visits OR ≥90-day opioid supply OR ≥2 COX-2 inhibitor prescriptions) with 52.8% sensitivity, 70.2% specificity, 66.7% PPV, and 56.9% NPV.</p> <strong>Conclusions:</strong> The algorithm with HA treatments demonstrated satisfactory sensitivity and specificity, increasing confidence in its ability to identify severe HA patients in healthcare claims. Future research should focus on developing a satisfactory algorithm without HA treatments as the HA treatment landscape continues to evolve.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hemophilia-claims-algorithm-ispor-2022-poster22apr2022-pdf.pdf?sfvrsn=f1abd533_0","title":"Hemophilia claims algorithm ISPOR 2022 poster_22Apr2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115962","diseases":[{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Dental Preventive Screenings and Caries Prevalence in the Age Group of 13-15","id":"1c36b96f-4469-41d2-ab1d-7d8369139a50","sessionCode":"PCR19","topDisplay":"Hegedűs B<sup>1</sup>, Rácz V<sup>2</sup>, Sugár M<sup>2</sup>, Rozmann N<sup>2</sup>, Karácsony I<sup>3</sup>, Komlósi K<sup>3</sup>, <b><u>Boncz I</u></b><sup>2</sup>, Pakai A<sup>4</sup><br><sup>1</sup>University of Pécs, Kaposvár, Hungary, <sup>2</sup>University of Pécs, Pécs, Hungary, <sup>3</sup>University of Pécs, Szombathely, Hungary, <sup>4</sup>University of Pécs, Pécs, ZA, Hungary","locationCode":"","description":"\r\n\t<div><span>Objective: </span><span>The aim of our study was to investigate 13-15 year olds' oral hygiene knowledge, dental</span> <span>hygiene habits, dental examination concerns and attitudes.</span></p> <span>Methods:</span><span> The cross-sectional, quantitative study was conducted between November 2020 and February 2020 at the Tinódi Lantos Sebestyén Primary School in Szigetvár, Hungary. Nonrandom, purposive sampling, children aged 13-15 years were selected as the target group (n=87). Exclusion criteria were wearing braces. In addition to our socio-demographic questions, a self-administered questionnaire was used to assess attitudes, dental status and knowledge level. Descriptive statistics, two-sample t-test, chi-square test and logistic regression were used (p<0.05) using Microsoft Excel 2013 and SPSS 24.</span></p> <span>Results: </span><span>the average age of respondents was 14±0.694 years (min=13 years, max=15 years). Our</span> <span>questionnaire was completed by 49 girls (54%) and 38 boys (44%). Girls' toothbrushing habits was</span> <span>more favorable than boys' (p=0.000). Children's dental hygiene status was influenced by area</span> <span>(p=0.036). There was no significant association between dietary habits and dental status (p>0.05)</span> <span>and between socio-demographics, level of fear and level of knowledge (p>0.05).</span></p> <span>Conclusions: </span><span>higher knowledge may not always lead to the right attitude and good oral care </span><span>habits. The majority of children have good oral hygiene knowledge, but do not</span> <span>apply this knowledge appropriately when eating and caring for their teeth. There is an </span><span>opportunity for the health educator to improve these habits in the context of health education </span><span>classes.</span></p> <span> </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hegeduspcr19dental-preventive-screenings-and-caries-prevalence-in-the-age-group-of-13-15-pdf.pdf?sfvrsn=f3ec93a6_0","title":"Hegedus_PCR19_Dental Preventive Screenings and Caries Prevalence in the Age Group of 13-15.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116946","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Comparing the Cost-Effectiveness of the Otago Exercise Programme Among Older Women and Men: A Secondary Analysis of a Randomized Controlled Trial","id":"cf7e8a36-c283-4639-a974-7e27c5395dfa","sessionCode":"EE34","topDisplay":"<b><u>Davis J</u></b><sup>1</sup>, Hsu CL<sup>1</sup>, Barha C<sup>2</sup>, Jehu DA<sup>3</sup>, Chan P<sup>2</sup>, Ghag C<sup>2</sup>, Jacova P<sup>2</sup>, Adjetey C<sup>4</sup>, Dian L<sup>2</sup>, Parmar N<sup>2</sup>, Madden K<sup>2</sup>, Liu-Ambrose T<sup>2</sup><br><sup>1</sup>University of British Columbia, Kamloops, BC, Canada, <sup>2</sup>The University of British Columbia, Vancouver, BC, Canada, <sup>3</sup>Augusta University, Augusta, GA, USA, <sup>4</sup>University of British Columbia, Kelowna, BC, Canada","locationCode":"","description":"\r\n\t<div><strong>Objective:</strong><span> Using stratified analyses, we examined the cost-effectiveness of the OEP, from a health care system perspective, among women and men who have previously fallen.</span></p> <strong>Methods:</strong> <span>This study was a secondary stratified analyses (by women and men), of a 12-month prospective economic evaluation of a randomized clinical trial (OEP compared with usual care). Three hundred and forty four community-dwelling older adults (≥70; 172 OEP (110 women; 62 men), 172 usual care (119 women; 53 men)) who sustained a fall in the past 12 months and received a baseline assessment at the Vancouver Falls Prevention Clinic, Canada (<a href=\"http://www.fallsclinic.ca\">www.fallsclinic.ca</a>) were included. A gender by OEP/usual care interaction was examined for the falls incidence rate ratio (IRR). Outcome measures stratified by gender included: falls IRR, incremental cost-per fall prevented (ICER), incremental cost per quality adjusted life year (QALY, ICUR) gained, and mean total health care resource utilization costs. </span></p> <strong>Results:</strong><span> Men were frailer that women at baseline. Men incurred higher mean total healthcare costs $6794 (SD: $11906)). There was no significant gender by OEP/usual care interaction on falls IRR. The efficacy of the OEP did not vary by gender. The adjusted IRR for the OEP group demonstrated a 39% (IRR: 0.61, CI: 0.40-0.93) significant reduction in falls among men but not women (32% reduction (IRR: 0.69, CI: 0.47-1.02)). The ICER showed the OEP was effective in preventing falls and less costly for men, while it was costlier for women by $42. The ICUR showed the OEP did not impact quality of life. </span></p> <strong>Conclusion:</strong><span> Future studies should explore gender factors (i.e., health seeking behaviours, gender related frailty) that may explain observed variation in the cost-effectiveness of the OEP as a secondary falls prevention strategy.</span></p> <strong>Trial Registrations:</strong> ClinicalTrials.gov Protocol Registration System</p> Identifier: NCT01029171; URL: <span><a href=\"https://clinicaltrials.gov/ct2/show/NCT01029171\">https://clinicaltrials.gov/ct2/show/NCT01029171</a></span></p> Identifier: NCT00323596; URL: <span><a href=\"https://clinicaltrials.gov/ct2/show/NCT00323596\">https://clinicaltrials.gov/ct2/show/NCT00323596</a></span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114843","diseases":[{"id":"dc752772-538c-4933-b6a5-3b5b6d079673","parentId":"00000000-0000-0000-0000-000000000000","title":"Geriatrics","urlName":"Geriatrics"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Quality of Life and Health Utility Values in Patients with Diabetic Retinopathy – a Targeted Literature Review","id":"b6644ea7-cf69-4b18-9342-7e741b36677e","sessionCode":"PCR35","topDisplay":"Goli N<sup>1</sup>, Kumar N<sup>1</sup>, <b><u>Wang X</u></b><sup>2</sup><br><sup>1</sup>ICON plc, Bangalore, KA, India, <sup>2</sup>ICON plc, Taby, AB, Sweden","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> To report the recent literature evidence on health-related quality of life (HRQoL) and health utilities in patients with diabetic retinopathy (DR). </p> <p><b>METHODS: </b> A literature search was conducted in Embase and Medline to identify English-language articles published between 2017 and November 2021, using “diabetic retinopathy” medical terms and HRQoL and health utility terms. Clinical trials and observational studies were of interest. </p> <p><b>RESULTS: </b> After removing duplicates, 189 citations were identified through databases and grey literature searches. Finally, 11 studies were included. Included studies were conducted across China (4), Brazil (1), Ecuador (1), Iran (1), Taiwan (1), Thailand (1), UK (1), and not reported (1). The study designs were cross-sectional (7), questionnaires (2), case-control (1), and case series (1). HRQoL reported by using EQ-VAS (4), SF-36 (1), and SF-12v2 (1) and health utilities reported by using EQ-5D (6), SF-6D (1), time trade-off (TTO) (2), and standard gamble (SG) (1) across the studies.</p> The mean and median EQ-5D VAS scores ranged from 67.3 to 79.9 and 65 to 75, respectively. The mean SF-36 scores of physical functioning and general health were 75.60 and 56.53, respectively. The mean PCS and MCS SF-12v2 scores for sight-threatening DR were 41.12 and 52.94, respectively. The mean EQ-5D utilities ranged from 0.356 (diabetic bilateral blindness) to 0.971 (unilateral DR); vision-threatening DR (VTDR) has poorer health (0.658 to 0.80) than non-VTDR (0.801 to 0.87). The mean SF-6D utilities for sight-threatening DR and non-proliferative DR were 0.828 and 0.865, respectively. The mean TTO utility value was 0.924 in DR patients; showed increased health in 3-month postoperative cataract surgery (0.72) compared with preoperative (0.58). The mean SG utility value was 0.30 in patients with DR.</p> <p><b>CONCLUSIONS: </b> These findings suggest that diabetic retinopathy is associated with poorer quality of life in vision-threatening and bilateral conditions compared with non-VT and unilateral.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/pcr35xuanhandout-pdf.pdf?sfvrsn=427d5026_0","title":"PCR35_Xuan_Handout.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116316","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Perception of Access to Healthcare of Patients with Obesity in Chile: A Patient Survey","id":"777d8a4d-fdf3-472a-a8b9-8075da487779","sessionCode":"PCR21","topDisplay":"Lenz R<sup>1</sup>, <b><u>Hernández K</u></b><sup>2</sup>, Pinto M<sup>3</sup>, Alvarado P<sup>3</sup><br><sup>1</sup>Postgraduate Director, Full Professor Public Health Institute Universidad Andrés Bello, Consultant Lenz Consultores, Santiago, RM, Chile, <sup>2</sup>Lenz Consultores, Independencia, RM, Chile, <sup>3</sup>Public Affairs IPSOS Institut de Publique Sondage d'Opinion Secteur, Santigo, Chile","locationCode":"","description":"\r\n\t<div><strong><u><span>Introduction:</span></u></strong><span> In Chile, 34.4% of the population suffers from obesity, which is 15 percentage points higher than the OECD average. Despite its prevalence, no structured care for obesity is provided, but only for its comorbidities. </span></p> <strong><u><span>Objective:</span></u></strong><span> To identify obesity-related patient access barriers within the healthcare system (primary, secondary, and tertiary level).</span></p> <strong><u><span>Methods:</span></u></strong><span> Self-applied perception survey, of quantitative approach and non-probabilistic quota sampling design. Dimensions were validated by experts (Delphi method). Eligibility criteria: Adults (18 years old or more) and BMI</span>>30.</p> <strong><u><span>Results:</span></u></strong><span> A total sample of 600 respondents was achieved: women (57%), from all socioeconomic stratum (SES), beneficiaries of private (25%) and public insurance (70%), with national representativity. </span></p> <span>According to survey respondents, 77% of patients were aware of their diagnosis, while 23% do not recognize obesity as a disease, 39% believed that obesity and diabetes are the same condition or failed to identify differences (25% in highest SES versus 54% in lowest SES p-value<0.001).</span></p> <span>Only 45% of patients received indication of background treatments (lifestyle, diets). Additionally, 49% reported not receiving specific obesity treatments (55% in public insurance p-value<0.001). </span></p> <span>Of those who were offered treatment, 84% had some difficulty following medical instructions, 26% felt they were not achieving results and discontinued treatment (35% in women p-value<0.001), 33% could not afford the prescribed diet (39% in women p-value=0.01), and 56% believe that the offered treatment does not meet their needs. Regarding to success in the obesity treatments, 32% perceived little successful, and 23% as unsuccessful (31% in women p-value<0.001). </span></p> <span>Moreover, 36% have felt stigmatized by healthcare professionals’ attitudes towards obesity (45% in women p-value<0.001).</span></p> <strong><u><span>Conclusion:</span></u></strong><span> There are obesity treatment access barriers within the Chilean healthcare system, and barriers were higher amongst women, public insurance beneficiaries, and low-income patients. Patients report not being advised to obtain treatment and being stigmatized.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115932","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"},{"id":"a8f24b83-49b5-4fe2-a4a3-b30e5a263bb3","parentId":"00000000-0000-0000-0000-000000000000","title":"Nutrition","urlName":"Nutrition"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Chronic Kidney Disease in Type 2 Diabetes in Colombia: A Cost of Illness Analysis","id":"869220c9-cc91-4af9-aec4-807ec9c42911","sessionCode":"EE16","topDisplay":"Mayorga W<sup>1</sup>, Lopez DS<sup>1</sup>, Patiño A<sup>2</sup>, Zuluaga JR<sup>2</sup>, Alvarado A<sup>3</sup>, Marrugo R<sup>2</sup>, <b><u>Lopez C</u></b><sup>2</sup><br><sup>1</sup>Numeris, Bogotá, Colombia, <sup>2</sup>Bayer, Bogotá, CUN, Colombia, <sup>3</sup>Bayer, Bogota, CUN, Colombia","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Estimate direct and indirect costs of Chronic Kidney Disease (CKD) in Type 2 Diabetes (T2D) in Colombia, focused on indirect costing based on public information around productivity loss. </p> <p><b>METHODS: </b> A macro-costing method was implemented that consisted of analyzing secondary information sources, such as SISPRO system, that has the costs of the health benefits plan of the contributory healthcare regime, and DANE household survey, in order to obtain information on direct and indirect costs by disease stage (Normoalbuminuria, Microalbuminuria, Macroalbuminuria, End-stage renal disease {ESRD-} and death). Both direct medical costs related to healthcare system and related to household were estimated. For indirect costs, Disability-Adjusted Life Years (DALY) and a reference of average labor income per worker were used. Finally, the estimated costs were normalized to 2021 prices using the Consumer´s Price Index CPI in health.</p> <p><b>RESULTS: </b> Using an exchange rate of $3,756.67 Colombian pesos per US dollar (USD), the direct annual cost per patient was $91.75 USD for microalbuminuria, $448.06 USD for macroalbuminuria and $8,047.35 USD for ESRD. Healthcare system costs for micro and macroalbuminuria were $62.38 USD and $5,329.21 USD for ESRD. Out-of-pocket expenses were $29.38 USD, $385.69 USD, and $2,718.14 USD for microalbuminuria, macroalbuminuria and ESRD, respectively. Regarding indirect costs, $498.31 USD for macroalbuminuria and $2,765.16 USD for ESRD.</p> <p><b>CONCLUSIONS: </b> CKD in T2D generates large costs for households, the health system and society. Regarding households, it represents a high level of out-of-pocket expenses compared to the average labor income, which increases in more advanced stages of the disease.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-ee16-pdf.pdf?sfvrsn=38c6c1c0_0","title":"Poster EE16 .pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115839","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Budget Impact Analysis of Empagliflozin for Treatment of Patients with Type 2 Diabetes Mellitus at Increased Cardiovascular Risk in Tertiary Hospital, Riyadh, Saudi Arabia","id":"0e0fa215-528d-4557-b843-80e7f7b4a25d","sessionCode":"EE98","topDisplay":"<b><u>Alhawwashi S</u></b><sup>1</sup>, Alqahtani S<sup>1</sup>, Alyahya, S<sup>2</sup><br><sup>1</sup>SECURITY FORCES HOSPITAL, RIYADH, Saudi Arabia, <sup>2</sup>Health Affairs, Aseer Region, Abha, Saudi Arabia","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> To evaluate the financial consequences of Empagliflozin use from the health care payer perspective.</p> <strong><p><b>METHODS</strong>: </b> Budget impact analysis (BIA) was performed from a payer perspective: Tertiary hospital in Riyadh, Saudi Arabia. Costs of Empagliflozin was calculated for patients with an average duration of treatment 52 weeks. The target population was determined using hospital statistical data, and clinical evaluation data.</p> <strong><p><b>RESULTS: </b></strong> Over 5 years after the addition of the drug to the hospital formulary and from the health care payer perspective “pharmacy budget\", we estimated the minimum population eligible for treatment to be 220 in all 5 years, with an estimated uptake rate of 30 % in year 1 and 100% in year 5. The gross impact on the pharmacy budget was estimated to be SAR 201,600.00 in year 1 and SAR 443,520.00 in year 5. Dapagliflozin 10 mg was assumed to be an alternative; the net medicines budget impact is expected to be SAR 158,400.00 in year 1 and SAR 348,480.00 in year 5.</p> <strong><p><b>CONCLUSIONS: </b></strong> Empagliflozin is effective in the case of reduced cardiovascular events rate and improving patient outcome. The clinical benefits of empagliflozin as add-on to hospital formulary for type 2 DM patients with increased CV risk come at a reasonable cost for hospital pharmacy budget.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117945","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Application of Validated Algorithms for Identifying Incident Breast Cancer Among Individuals with Atopic Dermatitis","id":"510564d9-cd1d-4fb6-bf43-8371c4efa9a8","sessionCode":"SA2","topDisplay":"<b><u>Campos A</u></b><sup>1</sup>, Ramasubramanian R<sup>2</sup>, Wong C<sup>3</sup>, Marcus A<sup>4</sup><br><sup>1</sup>University of South Florida, Tampa, FL, USA, <sup>2</sup>University of Minnesota Twin Cities, Minneapolis, MN, USA, <sup>3</sup>Pfizer Inc., Brooklyn, NY, USA, <sup>4</sup>Regeneron Pharmaceuticals, Westfield, NJ, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Breast cancer (BC) continues to be a public health burden and has higher incidence (BCI) in certain disease populations. Currently, BCI and Atopic Dermatitis (AD) studies produce mixed findings. Administrative data may assist in detangling this relationship. However, use of validated algorithms (VAs) for administrative data targeting the general population may not be reliable in certain disease indications. Therefore, we explored BCI VA reliability in both the general population and an AD population.</p> <p><b>METHODS: </b>Published VAs from 1992 to 2018 were compared based on sensitivity, specificity, positive and negative predictive value, and study population. Two VAs were chosen; one included both procedural and diagnostic codes, while the other only included diagnostic. IQVIA Pharmetrics and Optum Clinformatics databases from 2014 to 2019 were used for VA implementation. BCI rates (IR) per 100,000 person-years were calculated. This was replicated in an AD only cohort defined ≥2 AD diagnoses at least 30 days apart (ICD10: L20.X).</p> <p><b>RESULTS: </b>For general population estimates in Pharmetrics 4,408 and 380 incident cases were identified using the procedural and diagnostic VA, respectively. The diagnostic VA IR was 184.67 cases (95%CI: 179.07,190.44), while the procedural VA IR was 17.25 cases (95%CI: 15.61,19.08). In the AD population 312 and 17 incident cases were identified using the diagnostic VA and procedural VA, respectively. The IR for the AD population varied from 7.90 (4.96,12.96) to 145.35 (130.11, 162.41) BCI cases. Similar IRs were calculated from Clinformatics.</p> <p><b>CONCLUSIONS: </b>The two VAs provided significantly different IRs, in both data sources, which diverged from the Surveillance, Epidemiology, and End Results (SEER) general population estimates and expected AD-specific population estimates. This suggests limitations with the use of claims data and the algorithms themselves. Researchers should carefully consider their data source and indicated population when adopting previously validated algorithms in their studies.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116889","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"},{"id":"747104b6-9723-4895-a3d6-28d8c37172e3","parentId":"00000000-0000-0000-0000-000000000000","title":"Systemic Disorders/Conditions","urlName":"Systemic-Disorders-Conditions"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Evaluating the Economic Burden of Acute Myeloid Leukemia in Canada","id":"3df2580a-8fcf-4525-bce4-837334f41570","sessionCode":"EE33","topDisplay":"Beauchemin C<sup>1</sup>, Dodat F<sup>1</sup>, Au Y<sup>2</sup>, Evans WK<sup>3</sup>, Paulson K<sup>4</sup>, Schuh AC<sup>5</sup>, Storring J<sup>6</sup>, <b><u>Lachaine J</u></b><sup>7</sup><br><sup>1</sup>PeriPharm Inc., Montreal, QC, Canada, <sup>2</sup>AbbVie Corporation, Saint Laurent, QC, Canada, <sup>3</sup>McMaster University, Hamilton, ON, Canada, <sup>4</sup>University of Manitoba, Winnipeg, MB, Canada, <sup>5</sup>Princess Margaret Cancer Centre, Toronto, ON, Canada, <sup>6</sup>McGill University Health Centre, Montreal, QC, Canada, <sup>7</sup>Université de Montréal, Montreal, QC, Canada","locationCode":"","description":"\r\n\t<div><strong>Background</strong></p> Acute myeloid leukemia (AML) represents a significant burden for patients, their families and the healthcare system. This study estimated the total cost of illness associated with a new diagnosis of AML in Canada.</p> <strong>Methods</strong></p> The economic burden of AML was estimated using an incidence-based model, analyzing different types of AML cases in Canada. Direct and indirect costs were calculated using scientific literature and the advice of four Canadian practising hemato-oncologists and one oncologist experienced in health technology assessment in Canada. Patients were categorized as fit or unfit depending on their eligibility for intensive chemotherapy and according to age, performance status and cytogenetic markers.</p> <strong>Results</strong></p> The total average cost of AML per patient is estimated to be $178,073 with a cost of $210,983 and $145,163 for fit and unfit patients, respectively. The costs related to treatment represent half of the total average cost (52%), followed by the cost of hematopoietic stem cell transplantation (23%), best supportive care (16%), productivity loss (6%) and wastage (4%).</p> <strong>Conclusions</strong></p> For patients with AML, the costs associated with fit patients are substantially higher than that of unfit patients. Hospitalization and best supportive care costs are key cost drivers of the total costs of fit and unfit patients, respectively. This study highlights that AML is associated with a significant economic burden in Canada and that cost varies considerably depending on the clinical characteristics of the patients and the type of AML.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117249","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness of COVID-19 Vaccination in Colombia: A Micro-Simulation Modelling Analysis","id":"188bc473-4587-4186-bec2-83deb35d1644","sessionCode":"EE71","topDisplay":"Castañeda-Orjuela C<sup>1</sup>, <b><u>Alvis-Zakzuk N</u></b><sup>2</sup>, Diaz-Jimenez D<sup>3</sup>, Alvis-Guzman N<sup>4</sup><br><sup>1</sup>INSTITUTO NACIONAL DE SALUD, Bogotá, Colombia, <sup>2</sup>Universidad de la Costa-CUC, Barranquilla, Colombia, <sup>3</sup>Instituto Nacional de Salud, Bogotá, Colombia, <sup>4</sup>Universidad de la Costa, Cartagena, BOL, Colombia","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>To model the dynamics of the COVID-19 pandemic including new VOCs and vaccines and estimate the cost-effectiveness of the vaccination program in Colombia.</p> <strong>Methods:</strong> We developed a SEIARHUDSq micro-simulation model through nine exhaustive and mutually exclusive states: susceptible, exposed, symptomatic-infected, asymptomatic-infected, recovered, hospitalized general ward, Intensive Care Unit, death, and sequela. SEIARHUDSq was run with data reported up to October 21, 2021, and adjusted as a system of differential equations based on epidemiological (cases, deaths, VOCs, vaccine effectiveness, etc.) and economic (vaccines prices and administration, direct medical costs of states, etc.) inputs obtained from national sources and systematic literature reviews. DALYs and ICERs showed the burden of COVID-19 and the cost-effectiveness of the vaccination program. Two scenarios, in addition to do-nothing, were modelled for infection rates (Beta) estimated by an agnostic model: 1) Beta=0.4 and 2) Beta=0.5, for 70 and 90% of vaccination coverages. The effect of the vaccines (Pfizer, Moderna, Sinovac, AstraZeneca, and Janssen) was assumed 14 after their application. Willingness-to-pay was set as one GDP per capita (US$5,376). We reported costs in American dollars (1$US=COP$3,702).</p> <strong>Results: </strong>In Do-nothing scenario the DALYs ranges between 2.3 and 2.4 million. By vaccinating the population, the burden of disease decreased to under 2.15 million DALYs. If 70% of the population were vaccinated, direct medical and vaccination costs (including administration) would be between US$2.1-2.4 billion for a Beta of 0.4-0.5, respectively (net costs). Costs would vary between US$2.3 and 2.4 billion at 90% simulated coverage. COVID-19 vaccination in Colombia have been cost-effective for Beta=0.4 scenario (ICER 70% coverage: US$995.5; ICER 90% coverage: US$1,837) and for Beta=0.5 (ICER 90% coverage: US$1,792). The scenario for Beta=0,5 (ICER 70% coverage) was dominated.</p> <strong>Conclusion: </strong>COVID-19 vaccination in Colombia, prioritizing elderly and population with comorbidities, has been highly cost-effective in most of the modeled scenarios.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116753","diseases":[{"id":"5b196821-963c-48d3-9e67-cc2da312735d","parentId":"00000000-0000-0000-0000-000000000000","title":"Vaccines","urlName":"Vaccines"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Sex-Based Differences in Risk of Serious Events with Individual Cholinesterase Inhibitors Use in Older Adults with Dementia: A Medicare Study","id":"dcf9c3a1-83c1-45d0-8bf3-84420b1a2992","sessionCode":"RWD18","topDisplay":"<b><u>Masurkar P</u></b><sup>1</sup>, Chatterjee S<sup>2</sup>, Sherer JT<sup>3</sup>, Chen H<sup>3</sup>, Johnson ML<sup>3</sup>, Aparasu RR<sup>3</sup><br><sup>1</sup>University of Houston College of Pharmacy, Wylie, TX, USA, <sup>2</sup>Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, houston, TX, USA, <sup>3</sup>University of Houston, College of Pharmacy, Houston, TX, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> There is limited research evaluating the safety of Cholinesterase inhibitors (ChEIs) based on real-world data. Additionally, the moderating effect of sex on outcomes is not well-studied in dementia. This study evaluated the sex-based effects on the risk of serious events with individual ChEIs in older adults with dementia.</p> <p><b>METHODS: </b> This was a retrospective cohort study of patients ≥65 years with a dementia diagnosis using 2013-2015 Medicare claims data. Patients were selected with incident use of ChEIs, namely donepezil, galantamine, or rivastigmine, with a six-month washout period. The primary outcome of interest was serious events defined as Emergency Department visits, inpatient hospitalizations, or death within six months of ChEI initiation. Cumulative incidence functions curves, Gray’s test, and Fine and Gray’s proportional sub-distribution hazard model with inverse probability of treatment weighting(IPTW) generated using generalized boosted models(GBM) were used to assess sex-based effects on the risk of serious events across individual ChEIs.</p> <p><b>RESULTS<strong>: </b></strong> The study included 767,684 older adults with dementia who were incident users of ChEIs (donepezil 79.42%, rivastigmine 17.67 %, galantamine 2.91%). There were 68.29% women and 31.70% men in the cohort. Fine and Gray’s proportional sub-distribution hazard model revealed that Rivastigmine(aHR 1.14; 95% CI, 1.09-1.18) and galantamine(aHR 1.52; 95% CI, 1.26 - 1.75) were associated with an increased risk of serious events compared to donepezil. However, sex-based interaction effects with ChEIs were significant. The stratified analysis found that women using rivastigmine (aHR 1.18; 95% CI, 1.06 - 1.31) were at increased risk of serious events compared to women using donepezil. Men using galantamine (aHR 1.71; 95% CI, 1.17-2.51) were at increased risk of serious events compared to men using donepezil.</p> <p><b>CONCLUSIONS: </b> This study found that the risk of serious events differs across sex. The study findings highlight the moderation effect of sex on ChEIs to assist providers in delivering personalized care in dementia</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117069","diseases":[{"id":"dc752772-538c-4933-b6a5-3b5b6d079673","parentId":"00000000-0000-0000-0000-000000000000","title":"Geriatrics","urlName":"Geriatrics"},{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"},{"id":"e32f673e-b410-4126-9261-86abf08a0554","parentId":"00000000-0000-0000-0000-000000000000","title":"Personalized and Precision Medicine","urlName":"personalized-and-precision-medicine"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Economic Impact of Trilaciclib for Chemotherapy-Induced Myelosuppression (CIM) in Extensive-Stage Small Cell Lung Cancer (ES-SCLC): Economic Evaluation from the Provider and Patient-Caregiver Perspectives in the United States","id":"e7c4945b-b850-4bd0-a9af-8454b97177ff","sessionCode":"EE30","topDisplay":"<b><u>Abraham I</u></b><sup>1</sup>, Xue W<sup>2</sup>, Chen X<sup>2</sup>, Zhou J<sup>2</sup>, Huang H<sup>3</sup><br><sup>1</sup>University of Arizona, Tucson, AZ, USA, <sup>2</sup>Analysis Group, Inc., Boston, MA, USA, <sup>3</sup>G1 Therapeutics, Inc., Research Triangle Park, NC, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b><strong>:</strong> Commonly manifested as neutropenia, anemia, and thrombocytopenia, CIM is a major complication of systemic chemotherapy. We evaluated the economic impact of trilaciclib, a first-in-class breakthrough therapy that protects multiple hematopoietic lineages simultaneously against CIM in adult patients with ES-SCLC receiving platinum/etoposide- or topotecan-containing chemotherapy from both US provider and patient-caregiver perspectives. <strong><p><b>METHODS: </b> </strong>An economic model for both perspectives estimated the impact of administering trilaciclib prior to first- and second-line chemotherapy in patients with ES-SCLC over a 3-year time horizon, comparing “with” and “without” trilaciclib scenarios. Clinical and cost inputs (inflation-adjusted to 2021) were derived from published literature and trilaciclib clinical trial data. Model outcomes included number of grade 3/4 myelosuppressive adverse events (AEs), healthcare resource use, prophylaxis and AE management costs, and total costs (provider perspective), and productivity loss and out-of-pocket costs (patient-caregiver perspective). Estimated total costs per trilaciclib-eligible patient were compared between “with” and “without” scenarios. <strong><p><b>RESULTS: </b> </strong>The “with” trilaciclib scenario was estimated to reduce myelosuppressive AEs over a 3-year period (events avoided per patient: 0.42 for neutropenia, 0.02 for febrile neutropenia, 0.06 for anemia, and 0.14 for thrombocytopenia) and healthcare resource use (events avoided per patient: 0.28 for outpatient visits, 0.04 for red blood cell transfusion, 0.05 for platelet transfusion, 0.51 for hospitalization, and 0.28 for emergency room visits) compared with the “without” scenario. From the provider perspective, the projected total cost savings associated with the introduction of trilaciclib were $952, $3111, and $4592 per patient in years 1-3, respectively. The projected cost savings from the patient-caregiver perspective were $336, $1099, and $1621 per patient in years 1-3, respectively. <strong><p><b>CONCLUSIONS: </b> </strong>The findings suggest that the use of trilaciclib prior to chemotherapy in patients with ES-SCLC can be cost-beneficial owing to fewer myelosuppressive AEs, less healthcare resource use, and lower costs for both US provider and patient-caregiver perspectives.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116448","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Burden of Ventilator-Associated Pneumonia Based on Time on a Mechanical Ventilator: A Retrospective Analysis of the MIMIC IV Database","id":"162c9008-29ef-4b15-b4d6-884f43fd022f","sessionCode":"EPH34","topDisplay":"<b><u>Kayser S</u></b><sup>1</sup>, Dang TQ<sup>2</sup>, Koloms K<sup>3</sup>, Piston K<sup>3</sup><br><sup>1</sup>Hillrom, Batesville, IN, USA, <sup>2</sup>University of Minnesota, Twin Cities, MN, USA, <sup>3</sup>Hillrom, Chicago, IL, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> To examine ICU prevalence of Ventilator-Associated Pneumonia (VAP) and how prevalence increases with time on a mechanical ventilator (MV). To analyze economic and clinical outcomes associated with VAP controlling for time on MV. </p> <p><b>METHODS: </b> Retrospective analysis of patients 18 years+ in the MIMIC IV database. The analysis was based on administrative claims and electronic medical records data. ICU patients with ICD-10 codes were included. VAP was defined by J95.851 ICD-10 diagnosis code. Time on MV was defined by three ICD-10 procedure codes: 5A1935Z, 5A1945Z, 5A1955Z. The relationship between VAP and the following outcomes were examined among patients with MV while controlling for time on MV: length of stay (LOS), ICU LOS, discharge location, and death. Patients that died were excluded from analyzing LOS.</p> <p><b>RESULTS: </b> Of the 69,211 adult ICU patients, 6,376 patients had MV, for a MV prevalence of 9.2%. Of those MV patients, 705 had an ICD-10 diagnosis code for VAP, for a VAP prevalence of 11.1%. VAP prevalence was 1.1% for patients with MV <24 hours, 5.3% for patients with MV between 24 and 96 hours, and 39.2% for patients with MV >96 hours (χ<sup>2</sup>=578, p<0.001). Controlling for time on MV, MV patients with VAP had an average additional LOS of 98 hours (p<0.001) and an average additional ICU LOS of 93 hours (p<0.001) than MV patients without VAP. Paradoxically, MV patients with VAP had lower mortality rates (OR: 0.63, p<0.001), but were substantially more likely to be transferred to a long-term acute care hospital (OR: 1.81, p<0.001).</p> <p><b>CONCLUSIONS: </b> This study demonstrated that VAP is a common nosocomial infection and the likelihood of VAP increased substantially with time on MV. Strategies to prevent the occurrence of VAP may reduce overall hospital LOS, ICU LOS, and transfers to long-term acute care.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115073","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of Mergers and Acquisitions on the Financial Performance of Pharmaceutical Companies","id":"23047e6e-6489-4744-b213-89514a350c7f","sessionCode":"EE32","topDisplay":"<b><u>Marston JR</u></b>, Price G<br>City University of Seattle, Seattle, WA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> Mergers and acquisitions (M&As) have been widely used as a business strategy to replenish the acquiror’s product pipeline and to compensate for the potential steep revenue loss due to expiring patents in the pharmaceutical industry. However, evidence of the impact of M&As on pharmaceutical companies’ financial outcomes has been inconsistent. The purpose of this study was to assess the financial outcomes of M&As on the largest pharmaceutical companies in the US.</p> <strong>Methods: </strong>The secondary financial data of the study companies were obtained from the Securities and Exchange Commission public database of filings. A convenient sample of the highest-value pharmaceutical M&As that were pursued by US acquirers between 2000 and 2017 was selected. The analyses were conducted in two steps. First, a case-by-case descriptive analysis was conducted to compare the percentage change in each financial ratio before and after the M&As. Then the group average of each financial ratio for the study M&As was compared between the pre- and post-M&A group. The statistical differences between the pre- and post-M&A average ratios of the sample were tested using paired sample t-tests.</p> <strong>Results:</strong> Twelve M&As were studied. The results showed that the debt-to-equity ratio increased, and the quick ratio decreased numerically after the M&As. The operating margin of the sample decreased significantly after the M&As. Most companies experienced a transition where the operating margin decreased immediately after the M&As due to the expanded operating costs, and rebounded in the second year following the M&As. However, some companies managed to contain the operating costs after the M&As; thus, increased the operating margin immediately after the M&As.</p> <strong>Conclusion:</strong> The results of this study provided data-informed evidence for economists, marketing personnel, and other professionals who are interested in the pharmaceutical industry on the financial viability of pharmaceutical M&As as a potential remedy for expiring patents.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117528","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Using Customized PRO Profiles to Evaluate Expected Patient Quality of Life Outcomes","id":"68623d96-9f4d-4456-a6a6-8968e5b68324","sessionCode":"PCR8","topDisplay":"<b><u>Iaconangelo C</u></b><sup>1</sup>, McManus S<sup>2</sup>, Serrano D<sup>1</sup>, Barnes B<sup>1</sup><br><sup>1</sup>OPEN Health Group, Bethesda, MD, USA, <sup>2</sup>OPEN Health Group, Atlanta, GA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Patient Reported Outcomes (PROs) are routinely employed in patient-focused drug development programs. However, PRO data are often under-utilized. Better approaches could employ trial data to describe expected patient outcomes. The objective of this work was to present a method for leveraging PRO-based patient profiles to project and thereby anticipate expected patient outcomes.</p> <p><b>METHODS: </b>A model-based approach to analyzing PRO scores allows for a more tailored approach to evaluating outcomes of interest. To demonstrate this approach, we analyzed PRO data from a Phase 3 trial of patients with prostate cancer randomized to either Hypofractionated 3D-CRT/MRT (experimental arm) or Conventionally Fractionated 3D-CRT/MRT (comparator arm). The outcome of interest was the difference between treatment arms on the Expanded Prostate cancer Index Composite (EPIC) urinary domain scores, defined on the sum of responses to 12 items. A longitudinal regression model was fit to EPIC scores at 6, 12, 24, and 60 months post-baseline. Patient profile variables (baseline EPIC urinary scores, treatment arm, age, race, clinical T-stage, and Gleason score) were included as predictors. For a particular patient profile of interest, expected EPIC urinary score at 6 months was estimated, as well as associated 95% confidence intervals.</p> <p><b>RESULTS: </b>To illustrate the approach, a single profile is presented here. At baseline, a patient receiving the experimental treatment, EPIC urinary score 98.0, age 57, white, clinical T-stage T2, Gleason score 6, could be expected to report an EPIC urinary score of 94.3 (92.06, 96.00) at 6 months. One subject matched this profile and their EPIC score was 93.8 at 6 months, which was 0.53% lower than 94.3, indicating accuracy of proposed procedure. This corresponds to ~1-category decrease on two of the 12 domain items (i.e., a decrease in symptom severity).</p> <p><b>CONCLUSIONS: </b>Well-established statistical methods can improve clinician understanding of patient-profile-specific expected outcomes.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor2022using-customized-pro-profilesposterfinal-pdf.pdf?sfvrsn=6f320515_0","title":"ISPOR2022_Using Customized PRO Profiles_Poster_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115290","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"An Overview of New Payment System for Innovative Medical Technologies in Korea","id":"662a425a-60a2-4436-b1e1-8aea5195e1ab","sessionCode":"HPR6","topDisplay":"<b><u>Choi H</u></b><br>HIRA, Wonju city, 42, South Korea","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>This article provides an overview of new payment schemes for Innovative medical technologies (IMT) to be applied in January 2022 in Korea.</p> <p><b>METHODS: </b>We wrote paper by extracting important matters from contents determined by task force to develop new payment scheme on IMT in Health Insurance Review and Assessment Service and from conclusion drawn through full consultation with relevant government agencies and stakeholder.</p> <p><b>RESULTS: </b>The IMT refers to technologies that has substantial potential such as technological innovation, patient’s needs among technologies that have been recognized for safety but still lack of evidence for effectiveness. The IMT is allowed for certain period (up to 5 years) at specific institution designated by minister of health and notified by law. After being announced as IMT, it’s temporarily registered through preliminary registration. The preliminary registration is not official but the technologies can accumulate evidence during that period after then they can request for final listing through health technology assessment for identifying effectiveness. If restriction on patient’s selection (higher medical significance or no alternatives in the list) occurred in preliminary enrollment period, 10% of coinsurance is applied and non-reimbursement is applied for the rest and preliminary code will be assigned to manage separately from existing system. The IMT undergo re-evaluation to confirm its effectiveness to be final listing after end of preliminary registration. So far, 3 applications have been made in 3D printing surgery guides, stem cell therapy, and genetic testing for prognosis prediction. Even in the case of digital therapeutics, if efficacy cannot be proven after approval by the Ministry of Food and Drug Safety, there is possibility that it will be reviewed in category of IMT.</p> <p><b>CONCLUSIONS: </b>Introduction of IMT is expected to improve benefit on patients such as early introduction of new technologies and to improve potential of recovery in absence of alternative treatment.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022-posterhpr6-pdf.pdf?sfvrsn=1a3f8d5f_0","title":"ISPOR 2022 POSTER_HPR6.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114956","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cause and Cure: Weighing the Prospective Impact of Cures 2.0 ACT Breakthrough Device Coverage on a Linked US Regulatory and Payer Framework","id":"bbff82c8-c205-4016-bede-8b9a73b009de","sessionCode":"HPR15","topDisplay":"<b><u>Stewart R</u></b><br>Evidera, Inc., Tucson, AZ, USA","locationCode":"","description":"\r\n\t<div><span><strong><p><b>OBJECTIVES: </b></strong> </span>To evaluate the impact on US commercial payer health plan access decision-making of proposed guaranteed temporary coverage and reimbursement of all Breakthrough Device Designation (BDD)-assigned products for Medicare beneficiaries for up to 4 years following FDA approval, as part of Title IV of the Cures 2.0 Act legislation.</p> <span><strong> <p><b>METHODS: </b></strong> </span>The study employed mixed quantitative-qualitative primary research methodology to solicit aggregate insights. Forced-choice surveys were distributed to medical directors (n=10) representing national and regional plans, including 1 integrated delivery network. Following collection of survey data, individual interviews were conducted with each responder, centered on structured narratives where directors assessed prospective access and coverage of hypothetical BDD devices with profiles based on existing BDD-assigned products.</p> <strong><p><b>RESULTS: </b> </strong>Consensus payer decision-maker feedback indicates that potentially relaxed Medicare coverage standards will not drive corresponding reduced clinical evidence requirements for commercial payers; as a result, excluding Medicare advantage patients, commercial plan beneficiaries are unlikely to see increased access to BDD products without manufacturer investment in compelling efficacy and safety data from rigorous studies. Particularly for invasive therapies, most surveyed payers suggest that long-term outcomes and comparative trials may still be needed to obtain favorable coverage and reimbursement for innovative technologies. In contrast, financially sensitive payers, such as IDNs, may also accept health economic data, including preliminary evidence, offering an opportunity to further expand early access to BDD therapies before more mature data is available.</p> <span><strong><p><b>CONCLUSIONS: </b></strong> </span>Although pending legislative updates via Cures 2.0 may increase short-term Medicare utilization of new devices, diagnostics, and digital interventions, widespread access for non-Medicare patients will continue to be primarily gated by traditionally robust demonstrations of product value.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117924","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness of Tenofovir/Lamivudine/Efavirenz Versus Tenofovir/Lamivudine/Dolutegravir for Preventing Mother-to-Child Transmission of HIV in Nigeria","id":"b89fca99-74c1-44ab-8bea-8c63576c69f1","sessionCode":"EE10","topDisplay":"<b><u>Ndai A</u></b><sup>1</sup>, Guo Y<sup>2</sup>, Jiao T<sup>2</sup>, Aroza R<sup>2</sup>, Park H<sup>3</sup>, Shao H<sup>2</sup>, Vouri SM<sup>4</sup><br><sup>1</sup>University of Florida, Gainesville , FL, USA, <sup>2</sup>University of Florida, Gainesville, FL, USA, <sup>3</sup>Center for Drug Evaluation & Safety, Department of Pharmaceutical Outcomes and Policy, Gainesville, FL, USA, <sup>4</sup>University of Florida, College of Pharmacy, Gainesville, FL, USA","locationCode":"","description":"\r\n\t<div><strong>Introduction:</strong> The World Health Organization (WHO) recommended using Tenofovir/Lamivudine/Dolutegravir (TLD) over Tenofovir/Lamivudine/Efavirenz (TLE) in pregnant women living with HIV. Albeit TLD is cheaper than TLE, studies have reported safety concern among pregnant women. This study aimed to evaluate the cost-effectiveness of TLD vs. TLE to prevent mother-to-child transmission of HIV in pregnant women in Nigeria.</p> <strong>Methods:</strong> We developed a Markov model to estimate health outcomes (Disability-Adjusted Life Years (DALY)) of TLD vs. TLE in all HIV-positive pregnant women needing antiretroviral from a payer’s perspective. Effectiveness data were derived from published studies and sources (risk of transmission with TLE (0.07%) and TLD (0.00%)). Three health states of children born to HIV-infected mothers were included: healthy, HIV-infected (vertical transmission), and death (stillbirth and neonatal death). The annual cost of TLD, TLE, and antiretroviral for pediatrics were $66, $69, and $236, respectively. The Willingness-To-Pay (WTP) per DALY averted was estimated using WHO-CHOICE at the GDP/capita ($2097). Costs discounted at an annual rate of 3%. Outcomes were modeled for 5 years, incremental cost-effectiveness ratios (ICERs) were calculated for TLD compared to TLE.</p> <strong>Results:</strong> Our study included 147,942 women. The total cost of TLE and TLD was $104 and $101 per patient. Compared to TLE, TLD averted 296 vertical transmission of HIV infection and 118 neonatal deaths, but increased stillbirth by 122. TLD was a dominant choice over TLE, with $24 per DALYs averted for their children. Results from sensitivity analysis show that our conclusion is robust to parameter uncertainties.</p> <strong>Conclusion:</strong> Our results suggest that use of TLE over TLD for pregnant women living with HIV will improve the health of children born to HIV-infected mothers with reductions in cost in Nigeria.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ndaiispor-2022-pdf.pdf?sfvrsn=58767b4_0","title":"NDAI_ISPOR 2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116043","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"A Simulation Modeling Study to Support Personalized Breast Cancer Prevention and Early Detection in High-Risk Women","id":"5e216da6-49c1-454b-8ea4-8d37690689da","sessionCode":"EPH15","topDisplay":"<b><u>Jayasekera J</u></b><sup>1</sup>, Zhao A<sup>2</sup><br><sup>1</sup>Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA, <sup>2</sup>Georgetown University, Washington, DC, USA","locationCode":"","description":"\r\n\t<div><b>Purpose: </b>To provide personalized outcomes associated with screening and risk-reducing medication among women who are at high-risk of developing breast cancer (i.e., 5-year risk greater than or equal to 3%).</p> <p class=\"p2\"><b>Methods: </b>We used a discrete-event simulation model of breast cancer natural history to evaluate the outcomes of annual mammography and risk reducing medication among high-risk women. The model that follows millions of women from birth to death and captures the variability in distributions of each event. Each simulated woman is assigned a cohort-specific life expectancy which is used to select a date of breast cancer death. We used large observational and clinical trial data to derive input parameters for the model. We compared model outcomes for screening alone vs. screening with a 5-year course of risk reducing medication. We modeled various screening strategies including annual or biennial screening starting at ages 35, 40, 45 and stopping at ages 65 and 74 years. Model outcomes for each strategy included, the benefits of risk-reducing drugs (avoiding breast cancer) and screening (breast cancer stage, breast cancer-specific survival), and harms of screening (false positives, overdiagnosis). We also conducted sensitivity analysis to estimate the effects of uncertainty in model inputs or assumptions on results.</p> <p class=\"p2\"><b>Results: </b>We found that risk reducing medication could result in an additional 28% decrease in invasive breast cancer incidence, 20% decrease in stage IV diagnosis, and a 30% decrease in breast cancer death compared to screening alone starting at age 35. However, potential breast density changes due to risk reducing medication among high-risk women could result in a 19% increase in false positive screening results compared to screening alone. The results varied by the starting age of screening.</p> <p class=\"p2\"><b>Conclusions: </b>Simulation modeling is useful in assessing the relative benefits and harms of screening and risk reducing medication in high-risk women</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/final-poster2022-pdf.pdf?sfvrsn=bf6555a6_0","title":"FINAL POSTER_2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114540","diseases":[{"id":"e32f673e-b410-4126-9261-86abf08a0554","parentId":"00000000-0000-0000-0000-000000000000","title":"Personalized and Precision Medicine","urlName":"personalized-and-precision-medicine"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Rural Women's Perception Regarding Urinary Tract Infection (UTI) during Pregnancy Based on Health Belief Model in Chakwal, Pakistan","id":"c7c8b4d0-2960-41a4-9d4d-8d6a9e090fa7","sessionCode":"PCR5","topDisplay":"<b><u>Sundus A</u></b><sup>1</sup>, Azhar S<sup>2</sup>, Batool S<sup>3</sup>, Ahmed J<sup>4</sup>, Tariq I<sup>1</sup>, Chaudhry B<sup>2</sup><br><sup>1</sup>University of Sargodha, Sargodha, Pakistan, <sup>2</sup>University of Sargodha, Sargodha, PB, Pakistan, <sup>3</sup>District headquarter (DHQ) hospital, Chakwal, Chakwal, Pakistan, <sup>4</sup>University of Sargodha, Quetta, Pakistan","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> This study provides a data which can be used as a baseline for the development of educational interventions in accordance of the health beliefs of rural women regarding UTI and its sensitivity. </p> <p><b>METHODS: </b> To assess the perception of rural women regarding urinary tract infections during pregnancy based on health belief model constructs which are perceived sensitivity, severity, benefits, barriers, cues to action and self-efficacy. This study used an analytic, cross-sectional, questionnaire-based study design from the hospitals of 4 Tehsils of district Chakwal, Punjab. We distributed 350 questionnaires by convenient sampling out of which 247 pregnant women responded showing response rate 70.5%.</p> <p><b>RESULTS: </b> Majority of respondents were n=243 (98.4%) married women and housewives n=192 (77.7%) attended up to intermediate college n=103 (41.7), were in their first trimester n=108 (43.7%) with more than one parity n=163 (66%). Positive perceived susceptibility with highest mean (3.25), positive perceived severity with highest mean (3.43), and strongest believe of benefit with highest mean (3.51), negative perceived barrier with the least weighted mean of (2.23), highest weighted mean of 3.16 suggesting positive cues to actions and greatest mean of 3.26, indicating positive attitude towards self-efficacy. The majority of respondents believe that having a UTI is terrible. The weighted mean shows that majority of the respondents perceived that they can avoid having UTI by prenatal checkups (<strong>3.39</strong>), drinking 2-3 liters of water (<strong>3.49</strong>), washing the sexual organ before (<strong>3.43</strong>) and after (<strong>3.51</strong>) intercourse and by eating fruits rich in vitamin C they can recover quickly from having UTI (<strong>3.47</strong>).</p> <p><b>CONCLUSIONS: </b> </p> The study concludes that rural women perception regarding infection susceptibility due to pregnancy and severity is found to be positive showing their concern regarding healthy life. Rural women perceive strong beliefs regarding benefits of hygiene practices and good diet to combat the infection and an optimistic behavior towards self-efficacy.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116391","diseases":[{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A USRDS Retrospective Cohort Study: Epidemiology, Treatment Modalities, and Burden of End-Stage Kidney Disease Attributed to Immunoglobulin A Nephropathy","id":"bdbe4117-cc04-45f6-861d-8dc8c680fdb5","sessionCode":"EE55","topDisplay":"<b><u>Bensink M</u></b><sup>1</sup>, Goldschmidt D<sup>2</sup>, Taiji R<sup>2</sup>, Zhou J<sup>2</sup>, Wang K<sup>3</sup>, Lieblich R<sup>4</sup>, Bunke M<sup>3</sup><br><sup>1</sup>Travere Therapeutics Inc., Brisbane, QLD, Australia, <sup>2</sup>Analysis Group, Inc., Boston, MA, USA, <sup>3</sup>Travere Therapeutics Inc., San Diego, CA, USA, <sup>4</sup>VJA Consulting, Walnut Creek, CA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Characterized by increased production of inflammatory cytokines that damage the glomerular filtration barrier resulting in proteinuria and hematuria, immunoglobulin A nephropathy (IgAN) leads to end-stage kidney disease (ESKD). This study describes epidemiology, treatment modalities, resource burden, and mortality of ESKD attributed to IgAN in the United States (US).</p> <strong>Methods</strong>: We used United States Renal Data System (USRDS) data which includes all patients receiving dialysis or kidney transplant. Patients registered in USRDS in 2008-2018 with IgAN as the primary ESKD cause were included (USRDS registration date as index date). Annual prevalence and incidence of ESKD-attributed IgAN were evaluated. Patient characteristics and treatment modalities during the 12-months after index (follow-up) were described. For the subgroup with Medicare at index and during follow-up, healthcare resource utilization during follow-up was described.</p> <strong>Results</strong>: From 2008-2018, an average of 920 IgAN patients progressed to ESKD annually, with approximately 12,400 IgAN patients requiring ESKD care annually (average incidence and period prevalence rates of 2.9 and 39.3 per million US population, respectively). Of 10,101 patients in the final cohort, median age at index was 47 years, 66% male, 76% white, 14% Asian, and 54% employed 6 months prior. 85% started on dialysis, mostly in-center hemodialysis; 15% received a kidney transplant at ESKD registration. During 12-month follow-up, an additional 13% received a kidney transplant. Among 1,510 patients with Medicare coverage, resource burden was high, with 72% requiring hospitalization and 64% visiting an emergency room (ER). Five-year survival for the final cohort was 83% (95% Confidence Interval: 82% to 84%).</p> <strong>Conclusion</strong>: Although rare, IgAN-attributed ESKD in the US is associated with substantial burden to patients and the healthcare system. Safe, effective, and approved therapies for IgAN would significantly improve the lives of patients and reduce substantial burden to the healthcare system.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117008","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Economic Evauation of Adalimumab Biosimilars and JAK Inhibitors for the Treatment of Moderate-to-Severe Rheumatoid Arthritis","id":"eb6a97a7-f6ef-470b-bf30-8dd8e8e59a20","sessionCode":"EE87","topDisplay":"Rickard I<sup>1</sup>, Carmona E<sup>2</sup>, Lessing T<sup>3</sup>, Furrer M<sup>2</sup>, <b><u>Keady S</u></b><sup>4</sup><br><sup>1</sup>Biogen, Maidenhead, UK, <sup>2</sup>Biogen International HQ, Baar, Switzerland, <sup>3</sup>Biogen, Munich, Germany, <sup>4</sup>Biogen International HQ, London, LON, UK","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b></p> To determine the cost effectiveness of adalimumab biosimilars, an anti TNF biologic and current licensed Janus kinase (JAK) inhibitors for the treatment of moderate-to-severe Rheumatoid Arthritis (RA).</p> <strong>METHOD</strong></p> A treatment sequence age-dependent Markov model was developed to compare the cost effectiveness of adalimumab biosimilars versus JAK inhibitors (upadacitinib, filgotinib, tofacitinib and baricitinib). Model outcomes were based on 10,000 simulations with ACR20, ACR50 and ACR70 probabilities determined from SELECT COMPARE, FINCH 1, ORAL STANDARD, RA-BEAM and RA-BUILD studies. Patients not achieving ACR20 at week 24 were deemed to have had an inadequate response to treatment and the patient assessed to move to supportive care for the lifetime model time horizon. Unit costs were taken from publicly available databases with adalimumab biosimilar discounting based on current market dynamics.</p> <strong><p><b>RESULTS</strong>: </b></p> Incremental QALY’s per patient were calculated to be 0.14 (tofacitinib), 0.09 (baricitinib), 0.07 (filgotinib) and 0.04 (upadacitinb). Examples of incremental costs per patient within the JAK arms at list price and with a 30% discount were determined to be for the UK: £13,603/£8,166 (Tofacitinib), £32,848/£21,634 (baricitinib), £31,901/£20,970 (filgotinib) and £27,495/£17,883 (upadacitinb). For Spain, the incremental cost per patient was €10,947/€5,423 (Tofacitinib), €29,715/€18,561 (baricitinib) and €24,404/€14,843 (Upadacitinib). In all scenario’s, the Incremental Cost-Effectiveness Ratio’s (ICER’s) for adalimumab were dominant.</p> <strong><p><b>CONCLUSIONS</strong>: </b></p> Adalimumab biosimilars continue to be a cost-effective option in the treatment of moderate-to severe RA. The uptake and use of adalimumab biosimilars continue to increase the affordability and therefore possible access to treatments for patients suffering from this chronic long-term condition.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ee87keadyispor-2022-pdf.pdf?sfvrsn=39f3d546_0","title":"EE87_Keady_ISPOR 2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116806","diseases":[{"id":"df9240d9-f266-47e0-ba0b-a11dfd152ae4","parentId":"00000000-0000-0000-0000-000000000000","title":"Biologics and Biosimilars","urlName":"biologics-and-biosimilars"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"f2cabca2-ce06-433e-903c-56285673ffc3","parentId":"00000000-0000-0000-0000-000000000000","title":"Musculoskeletal Disorders","urlName":"Musculoskeletal-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Racial Disparities in Colorectal Cancer Outcomes: How Community Health Workers Can Increase Screening Uptake in the US","id":"a99245f9-bee2-42d7-833a-8dda489fe694","sessionCode":"EPH7","topDisplay":"<b><u>Rizzo E</u></b><sup>1</sup>, Malek Pascha V<sup>2</sup>, Gilardino R<sup>3</sup>, Belk K<sup>1</sup><br><sup>1</sup>Lumen Value & Access, New York City, NY, USA, <sup>2</sup>Lumen Value & Access, Buenos Aires, B, Argentina, <sup>3</sup>Lumen Value & Access - A Healthcare Consultancy Group Co., Dubendorf, ZH, Switzerland","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES<span class=\"NormalTextRun CommentStart SCXW162495300 BCX0\">: </b>Analyze</span><span class=\"NormalTextRun SCXW162495300 BCX0\"> and evaluate the impact of</span><span class=\"NormalTextRun SCXW162495300 BCX0\"> community health workers (CHW) </span><span class=\"NormalTextRun SCXW162495300 BCX0\">in increasing</span><span class=\"NormalTextRun SCXW162495300 BCX0\"> colorectal cancer (CRC) screening for Black men. </span><span class=\"NormalTextRun SCXW162495300 BCX0\">Secondly, to</span><span class=\"NormalTextRun SCXW162495300 BCX0\"> </span><span class=\"NormalTextRun SCXW162495300 BCX0\">encourage private</span><span class=\"NormalTextRun SCXW162495300 BCX0\"> </span><span class=\"NormalTextRun CommentStart SCXW162495300 BCX0\">payers</span><span class=\"NormalTextRun SCXW162495300 BCX0\">’ </span><span class=\"NormalTextRun SCXW162495300 BCX0\">invest</span><span class=\"NormalTextRun SCXW162495300 BCX0\">ment in </span><span class=\"NormalTextRun SCXW162495300 BCX0\">robust screening program</span><span class=\"NormalTextRun SCXW162495300 BCX0\">s that</span><span class=\"NormalTextRun SCXW162495300 BCX0\"> will reduce </span><span class=\"NormalTextRun SCXW162495300 BCX0\">medium</span><span class=\"NormalTextRun SCXW162495300 BCX0\">-</span><span class=\"NormalTextRun SCXW162495300 BCX0\">to long</span><span class=\"NormalTextRun SCXW162495300 BCX0\">-</span><span class=\"NormalTextRun SCXW162495300 BCX0\">term costs</span><span class=\"NormalTextRun SCXW162495300 BCX0\">, </span><span class=\"NormalTextRun SCXW162495300 BCX0\">improve outcomes</span><span class=\"NormalTextRun SCXW162495300 BCX0\">,</span><span class=\"NormalTextRun SCXW162495300 BCX0\"> and decrease racial disparities in </span><span class=\"NormalTextRun SCXW162495300 BCX0\">CRC</span><span class=\"NormalTextRun SCXW162495300 BCX0\"> mortality.</span></p> <p><b>METHODS<span class=\"NormalTextRun SCXW72547305 BCX0\">: </b>We performed a scoping se</span><span class=\"NormalTextRun SCXW72547305 BCX0\">a</span><span class=\"NormalTextRun SCXW72547305 BCX0\">r</span><span class=\"NormalTextRun SCXW72547305 BCX0\">ch </span><span class=\"NormalTextRun SCXW72547305 BCX0\">in PubMed, using: “</span><span class=\"NormalTextRun SCXW72547305 BCX0\">c</span><span class=\"NormalTextRun SCXW72547305 BCX0\">olorectal</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">c</span><span class=\"NormalTextRun SCXW72547305 BCX0\">ancer</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> screening</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">”</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">,</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">“</span><span class=\"NormalTextRun SCXW72547305 BCX0\">r</span><span class=\"NormalTextRun SCXW72547305 BCX0\">acial disparities</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">”</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">,</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">“</span><span class=\"NormalTextRun SCXW72547305 BCX0\">outcomes</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">”</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">,</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">“</span><span class=\"NormalTextRun SCXW72547305 BCX0\">cost-effectiveness</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">”</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">,</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">and </span><span class=\"NormalTextRun SCXW72547305 BCX0\">“</span><span class=\"NormalTextRun SCXW72547305 BCX0\">c</span><span class=\"NormalTextRun SCXW72547305 BCX0\">ommunity </span><span class=\"NormalTextRun SCXW72547305 BCX0\">h</span><span class=\"NormalTextRun SCXW72547305 BCX0\">ealth </span><span class=\"NormalTextRun SCXW72547305 BCX0\">w</span><span class=\"NormalTextRun SCXW72547305 BCX0\">orker</span><span class=\"NormalTextRun SCXW72547305 BCX0\">s</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">”</span><span class=\"NormalTextRun AdvancedProofingIssueV2 SCXW72547305 BCX0\">.</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">Search</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> was</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> limited to </span><span class=\"NormalTextRun SCXW72547305 BCX0\">publications</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> in the last 10 years in </span><span class=\"NormalTextRun SCXW72547305 BCX0\">English</span><span class=\"NormalTextRun SCXW72547305 BCX0\">.</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">P</span><span class=\"NormalTextRun SCXW72547305 BCX0\">revalence</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> and cost data w</span><span class=\"NormalTextRun SCXW72547305 BCX0\">ere </span><span class=\"NormalTextRun SCXW72547305 BCX0\">collected from the Centers f</span><span class=\"NormalTextRun SCXW72547305 BCX0\">or</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> Disease </span><span class=\"NormalTextRun SCXW72547305 BCX0\">Control </span><span class=\"NormalTextRun SCXW72547305 BCX0\">and Prevention </span><span class=\"NormalTextRun SCXW72547305 BCX0\">website</span><span class=\"NormalTextRun SCXW72547305 BCX0\">.</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">CRC-screening costs</span><span class=\"NormalTextRun CommentStart SCXW72547305 BCX0\">,</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">care </span><span class=\"NormalTextRun SCXW72547305 BCX0\">for the disease</span><span class=\"NormalTextRun SCXW72547305 BCX0\">,</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span><span class=\"NormalTextRun SCXW72547305 BCX0\">and</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> implementation of a CHW program</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> were collected</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> from </span><span class=\"NormalTextRun SCXW72547305 BCX0\">these</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> sources</span><span class=\"NormalTextRun SCXW72547305 BCX0\">.</span><span class=\"NormalTextRun SCXW72547305 BCX0\"> </span></p> <p><b>RESULTS<span data-contrast=\"auto\">: </b>81 articles were reviewed, and 18 were included. The CRC rate per 100,000 White (WM) and Black (BM) men was 47.5/40.7; The mortality was 21.3/15.5, 1.3-fold higher among BM than WM. </span><span data-contrast=\"auto\">Black people were four times more likely to be diagnosed at advanced stages, incurring greater treatment and societal costs.</span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559739":160,"335559740":259}\"> </span></p> <span data-contrast=\"auto\">Medicare covers two-thirds of CRC treatments, leaving one-third to private payers or Medicaid. In 2018, only 66.0% BM and 69.5% WM were up-to-date with recommended screenings despite screening being a cost-effective prevention. People covered by private insurance were only 61% up-to-date. </span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559739":160,"335559740":259}\"> </span></p> <span data-contrast=\"auto\">CHW collaboration with providers and payers has been shown to be a cost-effective way to increase screening uptake for other conditions across the United States. CHWs have greater economic impact when addressing preventable health issues than managing advanced diseases and the cost of these programs is low. </span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559739":160,"335559740":259}\"> </span></p> <p><b>CONCLUSIONS<span class=\"NormalTextRun SCXW127311693 BCX0\">: </b>Integrating CHWs into existing healthcare system</span><span class=\"NormalTextRun SCXW127311693 BCX0\">s</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> is shown to be </span><span class=\"NormalTextRun SCXW127311693 BCX0\">cost</span><span class=\"NormalTextRun SCXW127311693 BCX0\">-effective an</span><span class=\"NormalTextRun SCXW127311693 BCX0\">d</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> </span><span class=\"NormalTextRun SCXW127311693 BCX0\">a </span><span class=\"NormalTextRun SCXW127311693 BCX0\">sustainable way to expand</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> access to</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> health</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> </span><span class=\"NormalTextRun SCXW127311693 BCX0\">services</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> and reduce racial disparities</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> in outcomes</span><span class=\"NormalTextRun SCXW127311693 BCX0\">.</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> </span><span class=\"NormalTextRun SCXW127311693 BCX0\">Funding CHW</span><span class=\"NormalTextRun SCXW127311693 BCX0\">s</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> programs that increase CRC </span><span class=\"NormalTextRun SCXW127311693 BCX0\">screening among Black men </span><span class=\"NormalTextRun SCXW127311693 BCX0\">is potentially cost-effective </span><span class=\"NormalTextRun SCXW127311693 BCX0\">and </span><span class=\"NormalTextRun SCXW127311693 BCX0\">c</span><span class=\"NormalTextRun SCXW127311693 BCX0\">ould</span><span class=\"NormalTextRun SCXW127311693 BCX0\"> reduce racial disparities in </span><span class=\"NormalTextRun SCXW127311693 BCX0\">outcomes</span><span class=\"NormalTextRun SCXW127311693 BCX0\">.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117469","diseases":[{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"An Adaptation of the RAND/UCLA Modified Delphi Panel Method in the Time of COVID-19","id":"1cf331d0-9994-4a82-9dbf-8f68e26530dc","sessionCode":"MSR10","topDisplay":"<b><u>Broder M</u></b>, Gibbs SN, Yermilov I<br>Partnership for Health Analytic Research (PHAR), LLC, Beverly Hills, CA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b> The RAND/UCLA modified Delphi panel method is a formal group process that systematically and quantitatively combines expert opinion and evidence to arrive at consensus, which traditionally includes an in-person meeting. Experts (physicians, advocates) meet in-person to discuss results of a first-round survey before repeating the survey. The COVID-19 pandemic made in-person meetings impossible. In this study, we examine the impact on achieving consensus when moving from in-person to virtual panel meetings.</p> <strong> </strong></p> <strong><p><b>METHODS</strong>: </b> We conducted 5 virtual panels over 13 months and compared them to 4 pre-pandemic in-person panels. We report the number of panelists, meeting duration, items rated, and percent disagreement in first- and second-round surveys.</p> </p> <strong><p><b>RESULTS</strong>: </b> Both the in-person and virtual panels included a mean of 11 panelists. Panelists joined virtual meetings for 6-7 hours across 2-4 hour sessions. In-person meetings lasted 6-9 hours plus up to 10 hours of travel. Panelists rated a mean of 488 and 453 items in the virtual and in-person panels, respectively. Disagreement was higher in first-round surveys (range 13-67% virtual, 34-67% in-person) than in second-round surveys (range 1-32% virtual, 10-43% in-person). Mean decreases in disagreement were 19% (virtual) and 27% (in-person).</p> </p> <strong>CONCLUSION</strong>: We maintained certain aspects of the panel method (e.g., review of existing evidence, number of panelists, number of survey items) and found similar decreases in disagreement between first- and second-round surveys. We engaged a diverse group of experts, including those with busy clinic schedules who may not have traveled to an in-person meeting. While we completed panel discussions in less time virtually, we were unable to recreate the social interactions that built rapport among panelists during in-person meetings. Transitioning from in-person to virtual meetings was not without challenges, but there were also unexpected advantages. This virtual Delphi panel method can be an effective and efficient alternative for researchers and clinicians.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/delphi-panels-in-the-time-of-covid---ispor-2022-poster-pdf.pdf?sfvrsn=c7b44eb6_0","title":"Delphi panels in the time of COVID - ISPOR 2022 Poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115310","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Comparing Self-Reported Presenteeism with Objectively Measured Direct and Indirect Costs, Lost Time and Comorbidity Assessments for Employees with Agency for Healthcare Research and Quality Skin Conditions","id":"1bd06399-d000-4256-a89d-90b5758a2b83","sessionCode":"EPH27","topDisplay":"<b><u>Brook R</u></b><sup>1</sup>, Beren IA<sup>2</sup>, Kleinman NL<sup>2</sup>, Drnach AA<sup>3</sup>, Schaneman JA<sup>2</sup>, Rosenberg EM<sup>3</sup><br><sup>1</sup>Better Health Worldwide/NPRT/NASP, Newfoundland, NJ, USA, <sup>2</sup>Workpartners, LLC, Loveland, CO, USA, <sup>3</sup>Workpartners, LLC, Pittsburgh, PA, USA","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>Assess whether employees with skin conditions (SCs) self-assessed presenteeism (SAP) matches measured absence and healthcare costs and the relationship between SAP and comorbidity risk using the Charlson Comorbidity Index (CCI) and Workpartners’ Human Capital Risk Index (HUI).</p> <strong>Methods</strong>: Retrospective analysis of Workpartners RRDb (2012—2019). For each year, employees who completed the Health Productivity Questionnaire [HPQ] or Web MDs' SAP survey were checked for claims with ICD-9/-10 codes within the Agency for Healthcare Research and Quality’s (AHRQ) SC categories. Employees had continuous eligibility for the calendar year they completed a survey and were included each year eligible. Analysis focused on the # of employees completing the survey, with each condition, and each cohorts’ medical and prescription costs, and lost days and costs due to leaves for: sick leave, short-/long-term disability (STD/LTD), and workers’ compensation (WC), the CCI and the HUI. Condition based information is reported as a percent of the study average. Claims start year initiated.</p> <strong>Results: </strong>Employees with SCs completed >70,000 surveys, SAPs ranged from 13.8%(S.E.=0.6%,N=594) for chronic ulcers to 14.3%(S.E.=0.1%,N=12496) for tissue-infections. Employees had average risk adjustment scores [HUI of 3.3 (72.9% of overall average) and CCI 0.86 (75.4%)], annual mean medical [$12169(62.9% of average)] and prescription [$4185 (94.9% of average] costs. Employees with chronic ulcers had the highest medical $25,514 (S.E.=$2194), Rx $6820 (S.E.=$583) and STD $1081 (S.E.=$204) costs and STD days 15.7 (S.E.=1.9). Tissue infections had the highest LTD costs/days and WC costs. Other skin disorders used the most WC days. Individual employees HUI and CCI were highly correlated (Pearson’s=0.6203,Spearman’s=0.4784). Correlation with costs was high and significant (all <em>P</em><0.0001) for CCI (Pearson’s=0.3481,Spearman’s=0.3543) and higher for HUI (Pearson’s=0.5333,Spearman’s=0.7756).</p> <strong>Conclusions</strong>: SAP scores among employees with skin conditions reflected a larger than average impact compared with other conditions. The HUI performed better at predicting outcomes compared with the CCI.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115527","diseases":[{"id":"747104b6-9723-4895-a3d6-28d8c37172e3","parentId":"00000000-0000-0000-0000-000000000000","title":"Systemic Disorders/Conditions","urlName":"Systemic-Disorders-Conditions"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Assessment of Value Based Price (VBP) for a Multi-Cancer Early Detection (MCED) Test in a Medicare Population","id":"cf0dc85d-1c48-40e8-89ad-91194f13c521","sessionCode":"EE5","topDisplay":"Tafazzoli A<sup>1</sup>, Shaul A<sup>2</sup>, Ye W<sup>1</sup>, Chavan A<sup>1</sup>, <b><u>Kansal A</u></b><sup>3</sup><br><sup>1</sup>Evidera, Bethesda, MD, USA, <sup>2</sup>Evidera, Bethesda, USA, <sup>3</sup>GRAIL LLC, Piedmont, CA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b> Medicare beneficiaries account for more than half of new cancer cases in the US annually, with cancer the leading cause of death in this population. Cancer detection at earlier stages with MCED testing along with standard of care (SoC) could improve survival outcomes and lower treatment costs, but is expected to increase screening costs. This modeling study explores key drivers of the potential range of VBP for MCED testing in a Medicare population.</p> <strong><p><b>METHODS: </b> </strong>A Markov model compared annual MCED plus SoC with SoC alone in a Medicare population (adults aged 65-79). Nineteen solid cancer groupings representing 80% of total cancer incidence were considered in the model. Model outcomes included costs, life-years (LYs) and quality adjusted life-years (QALYs) per person in the population over their lifetime, and were discounted 3% annually. MCED test activity was based on Klein et al (2021). SEER informed incidence and survival data by stage at detection, while SEER-Medicare data informed resource use and treatment costs. False positives caused additional workups and lower quality of life. VBP was estimated for willingness-to-pay (WTP) thresholds of $50,000/QALY and $150,000/QALY.</p> <strong><p><b>RESULTS: </b></strong> Testing with MCED increased LYs and QALYs by 0.10 and 0.10, respectively. The proportion of cancers detected at stage IV decreased from 21.6% to 12.5% and resulted in $2,006 less cancer-related treatment and diagnosis costs than SoC alone, excluding cost of MCED screening test. The VBP for MCED test ranged from $730/test to $1,771/test, at WTP thresholds of $50,000/QALY to $150,000/QALY respectively. Sensitivity analyses indicated that VBP in this population is sensitive to the number of clinically significant cancers detected, but relatively insensitive to changes in treatment cost and burden associated with false positives.</p> <strong><p><b>CONCLUSIONS</strong>: </b> The addition of MCED testing to SoC in a Medicare population improves survival and lowers treatment costs as compared with SoC alone.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/heor-tafazzoli-ispor-2022-cost-effectiveness-of-galleri-in-65-20apr22-pdf.pdf?sfvrsn=d39b7b02_0","title":"HEOR Tafazzoli ISPOR 2022 Cost Effectiveness of Galleri in 65 20Apr22.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116056","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Demographic Characteristics and Initial Diagnostic Staging of Patients with HER2+ Breast Cancer across Large Community Health Systems in the US","id":"e0c196b5-5067-4618-9797-9162f15a86b6","sessionCode":"RWD20","topDisplay":"<b><u>Lorenzo R</u></b>, Pomerantz D, Wolf F, Sommers C, Brown T, Rioth M, Wolfe T, Lerman M, Sanchez N<br>Syapse, San Francisco, CA, USA","locationCode":"","description":"\r\n\t<div><span style=\"font-weight: 400;\"><p><b>OBJECTIVES: </b> Community health systems (CHS) in the US play a large role in the care of patients with cancer, with over 50% of patients with cancer cared for in CHS. The profile of patients with HER2+ breast cancer seen in CHS within the US is not widely published. This analysis describes the demographic and diagnostic staging characteristics of patients with HER2+ breast cancer treated across a sample of CHS. <p><b>METHODS: </b> A retrospective analysis was performed utilizing the Syapse Learning Health Network</span><sup><span style=\"font-weight: 400;\">TM</span></sup><span style=\"font-weight: 400;\"> (LHN), an electronic medical record (EMR) derived database that collects cancer care data from multiple care settings within CHS across 33 states, 450+ hospitals and cared for by 1,900+ community oncologists. Patients aged </span><span style=\"font-weight: 400;\">></span><span style=\"font-weight: 400;\">18 yo at breast cancer diagnosis from January 1, 2010 - December 3</span><span style=\"font-weight: 400;\">, 2021 </span><span style=\"font-weight: 400;\">were identified from the </span><span style=\"font-weight: 400;\">LHN</span><span style=\"font-weight: 400;\"> using ICD-10 codes. Data utilized for this analysis included both structured data (EMR fields like sex and birth date) and unstructured data (e.g. physician notes) validated by Syapse’s Certified Tumor Registrars and then descriptively summarized. <p><b>RESULTS: </b> </span><span style=\"font-weight: 400;\">9,996</span><span style=\"font-weight: 400;\"> patients from the Syapse LHN were included in this analysis. Patient demographics included: median age of 59 yo at diagnosis with </span><span style=\"font-weight: 400;\">72% </span><span style=\"font-weight: 400;\">being >50 yo; 99% female;</span><span style=\"font-weight: 400;\"> with race including 77%</span><span style=\"font-weight: 400;\"> White, 16% Black, 4% Asian,</span><span style=\"font-weight: 400;\"> 3</span><span style=\"font-weight: 400;\">% other; </span><span style=\"font-weight: 400;\">5</span><span style=\"font-weight: 400;\">% of Hispanic/Latino ethnicity. </span><span style=\"font-weight: 400;\">9,075 </span><span style=\"font-weight: 400;\">patients (91%) had stage at diagnosis; </span><span style=\"font-weight: 400;\">86% diagnosed in the early stages (0 - IIIA) and 14% diagnosed</span><span style=\"font-weight: 400;\"> in the advanced stages (IIIB+) of breast cancer. <p><b>CONCLUSIONS: </b> Patients with HER2+ breast cancer treated in community health systems within the LHN tend to be middle aged, menopausal or post menopausal based age, and with most diagnosed at early stages of disease. Additional analysis is planned to provide further insight into clinical characteristics and treatment patterns of patients with HER2+ breast cancer treated within CHS.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022-breast-her2-postive-ds-v2final-pdf.pdf?sfvrsn=128984b9_0","title":"ISPOR 2022 Breast HER2 Postive DS v2_Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115842","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of Specialty Pharmacy Collaboration with Rheumatology Clinics to Improve the Achievement of Treat-to-Target Goals in Patients with Rheumatoid Arthritis","id":"895c62a8-ec79-4ec7-9c72-94ca41bef0f9","sessionCode":"HSD4","topDisplay":"<b><u>Yu A</u></b>, Ritenour A, Martin T, Li D<br>Baylor Scott & White Health, Temple, TX, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>In rheumatoid arthritis (RA), the use of RAPID3 assessments to meet treat-to-target goals is endorsed by the 2021 ACR guidelines. In November 2020, the Baylor Scott & White Specialty Pharmacy implemented a new service that included more frequent collection of RAPID3 scores and standardized provider communication for patients co-managed by a Baylor Scott & White Rheumatology Clinic. The objective of this study was to evaluate the impact of this new service on RA disease activity.</p> <strong><p><b>METHODS: </b> </strong>RA patients with a first fill date for a new biologic medication, referred to as the index date, from January 2020 through November 2020 were included in the pre-intervention group and patients with an index date from December 2020 through May 2021 were included in the post-intervention group. Before the new service started, patients were followed under a protocol of less frequent RAPID3 assessments that occurred every six months; once the service began, patients were followed using an algorithm in which patients with higher disease activity were contacted more frequently. All RAPID3 scores were collected from the specialty pharmacy’s clinical tracking software. Descriptive statistics were performed.</p> <strong><p><b>RESULTS: </b> </strong>86% of patients in the pre-intervention group (n=7) compared with 100% of patients in the post-intervention group (n=10) had high/moderate disease activity at baseline. Within a 6-month follow-up period in both groups, the percentage of high/moderate disease activity patients decreased by 30% in the post-intervention group and remained the same in the pre-intervention group.</p> <strong><p><b>CONCLUSIONS: </b> </strong>Disease activity scores improved in RA patients participating in more frequent collection of RAPID3 score and standardized provider communication by the specialty pharmacy, although this analysis is limited by the small sample size. These results support the positive impact increased specialty services may have on patient health outcomes; pharmacies should continue to expand and track outcomes of these initiatives.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/yu-ispor-rapid3-poster-pdf.pdf?sfvrsn=c24b2f8c_0","title":"Yu ISPOR RAPID3 Poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117558","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Patient and Caregiver Views on Novel Measures of the Value of Health Interventions","id":"77e62920-0e0d-40e7-ba65-9500a18c678f","sessionCode":"PCR12","topDisplay":"<b><u>Voehler D</u></b>, Neumann PI, Ollendorf D<br>Tufts Medical Center, Boston, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Increased use of cost-effectiveness analysis (CEA) in the US has provoked questions regarding the appropriateness of traditional methods for fully capturing health technology value. Researchers have explored the feasibility of integrating novel value measures (e.g., value of hope, scientific spillovers). We investigated patient and caregiver views on the importance of both traditional and novel domains of value, and assessed whether views differed according to participant characteristics. <p><b>METHODS: </b> We conducted a web-based survey of adult patients managing a chronic condition, or caregivers of a patient with chronic illness. Participants rated 13 domains of value on a 5-point Likert scale (0=Not Important, 5=Very Important) and also ranked each domain they rated as important or very important. <p><b>RESULTS: </b> Our sample population (n=63) was primarily comprised of patients (65%) and was mostly female (60%), aged between 35-54 years (54%), and managing only one chronic condition (68%). Approximately 70% and 30% of participants were recruited from general disease advocacy and patient activist networks, respectively. Scientific spillovers (mean: 3.87), equity (3.83), and costs (3.81) were rated the most important value domains, while adherence-improving factors and fear of contagion were rated lowest. Caregivers rated most value domains slightly higher than did patients, although differences were not significant. Compared to participants recruited via general disease advocacy networks, participants recruited from patient activist networks rated nearly all value domains as significantly more important (p<0.05) . In multivariate logistic regression predicting a 4 or 5 rating for any domain, patient status (OR: 0.66; 95% CI: 0.47, 0.93) and patient activist recruitment (OR: 3.88; 95% CI: 2.61, 5.79) were critical predictors. <p><b>CONCLUSIONS: </b> Patients and caregivers vary in their consideration of the importance of novel domains of value. Policymakers should be cognizant of the perspectives that these stakeholders bring to assessment of both traditional and novel value domains.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/voehlerisporposter-pdf.pdf?sfvrsn=ea64b48e_0","title":"Voehler_ISPOR_Poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114867","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Real-World Patient Persistence: A Comparison of Prostaglandin Analogs Used for the Treatment of Open-Angle Glaucoma or Ocular Hypertension","id":"bdd720f3-7a6c-4ef8-ba42-95218727dd4e","sessionCode":"HSD8","topDisplay":"Laforty C<sup>1</sup>, <b><u>Feener S</u></b><sup>2</sup>, Grover P<sup>3</sup>, Sharma A<sup>3</sup>, Barbeau M<sup>2</sup><br><sup>1</sup>IQVIA Inc., Toronto, ON, Canada, <sup>2</sup>Bausch Health, Canada Inc, Laval, QC, Canada, <sup>3</sup>IQVIA Inc., Kirkland, QC, Canada","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b> Prostaglandin analogs (PGAs) are recommended as first-line therapy to lower intraocular pressure among glaucoma patients. Patients with lower rates of persistence could potentially have a higher risk of developing progressive visual loss. This study aims to compare persistence on latanoprostene bunod, latanoprost, bimatoprost, travoprost, and Beta Blockers, within a 12-month analysis period.</p> <strong><p><b>METHODS</strong>: </b> Anonymized patient-level data for reimbursed drug transactions, from the IQVIA Canadian Private Drug Plan (PDP) and Ontario Drug Benefit (ODB) databases, was used to index patients on their first claim for specific products during a 12-month period. Patients were followed for 3, 6, and 12 months. Persistence was measured from index to first observed significant gap in therapy (days supplied of claim with an allowable grace period of 90 days) and output as a Kaplan-Meier curve.</p> <strong><p><b>RESULTS</strong>: </b> From a cohort of 37,271 patients (latanoprostene bunod n = 1,315, bimatoprost n = 12,135, travoprost n = 5,136, latanoprost n = 9,864, Beta Blockers n = 7,592), those indexing on latanoprostene bunod demonstrate significantly higher persistence at 3, 6 and 12 months (62.28 %, 45.48 %, 32.40 % respectively, p<0.001) compared to bimatoprost (57.04 %, 41.34 %, 27.63 %, respectively), travoprost (49.38 %, 30.86 %, 17.00 %, respectively), and beta blockers (34.46 %, 18.48 %, 8.56 % respectively). Persistence among patients initiating on latanoprostene bunod is similar to those initiating all other PGAs combined (59.21 %, 43.65 %, 30.05 % at 3, 6 and 12 months, respectively).</p> <strong><p><b>CONCLUSIONS</strong>: </b> In the Canadian population studied, persistence on latanoprostene bunod was better compared to other key PGAs and Beta Blockers. Strategies that support improved persistence and compliance with PGAs could prevent vision loss among patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116114","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Aspects Affecting Quality of Life in Patients with Rare Disease and Their Carers: Are Current Utility Instrument Capturing Enough?","id":"5cd1263c-5c37-473e-ba97-95aaf469fc3a","sessionCode":"EE65","topDisplay":"<b><u>Martin M</u></b>, Damera V<br>Evidera/PPD, London, UK","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Treatments for rare diseases are assessed by payers based on their ability to provide value-for-money, as the collective impact of these drugs represents a substantial part of the medication budget. Their value is often measured through cost-effectiveness assessments that are based on health utilities measured using generic instruments (e.g. EQ-5D) that may not adequately capture the full burden on patients and their caregivers/families.</p> <p><b>METHODS: </b> We carried out a systematic search of English language publications (16 Nov 2021) from 2000, and no geographical restrictions were applied. The searches were conducted in Medline, Embase, and Cochrane via the OVID platform. Targeted selection of abstracts and full texts identified publications that focused on patient and carer-relevant quality of life dimensions that are not typically captured by conventional generic quality of life (QOL) instruments.</p> <p><b>RESULTS: </b> 1,103 abstracts were retrieved and 31 full text articles were selected for in-depth review. Many rare diseases are diagnosed in childhood, and the burden of care and social stigma on patients, their carers/parents and their families is substantial. Aspects related to mental and medical support for carers and the future of their children, including schooling is something that affects parents’ quality of life. One study reported that mothers and fathers predict lower QOL compared to their children who rate their quality of life more positively. This can have implications for using parents as a proxy for QOL assessment. Most studies focused on childhood diseases and there was little published evidence on adolescent and adult rare disease patients. Aspects not captured by current utility instruments include parental stress, medication side-effects, hope and risk preferences, social functioning and stigma, cognition, education and expectations for the future.</p> <p><b>CONCLUSIONS: </b> Current utility instruments do not capture all patient/caregiver-relevant health aspects and therefore may underrepresent the true value offered by potential new treatments.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116238","diseases":[{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"},{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Machine Learning-Based Prediction of the Time to Next Treatment in Relapsed/Refractory Multiple Myeloma Patients from Real-World-Data","id":"94a4503a-387e-4515-b290-95b4be8f9a18","sessionCode":"RWD11","topDisplay":"<b><u>Azarias G</u></b><sup>1</sup>, Merker L<sup>2</sup>, Schilling S<sup>2</sup>, Strobel K<sup>2</sup>, Kellermann L<sup>2</sup>, Wischlen S<sup>1</sup><br><sup>1</sup>CancerDataNet GmbH, Basel, Switzerland, <sup>2</sup>OncologyInformationService, Freiburg, Germany","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> There are multiple new treatment options available for relapsed/refractory Multiple Myeloma (rrMM) improving the outcomes in this incurable malignancy. Here, we investigated if Real World Data (RWD) on rrMM patients allow for characterizing and predicting clinical outcomes.</p> <p><b>METHODS: </b> We leveraged RWD database from 2400 rrMM patients who completed second line of treatment between 2004 and 2021, in representative sample of 107 German clinical sites. We developed Python-based data transformation scripts to handle multicollinearity, missing values, hidden missing values and outliers to optimize the dataset. Descriptive statistics, based on the chi-square test and interactive dashboards allowed to determine variables characterizing rrMM patient cohorts. We cross-validated several feature importance methods and submitted the datasets to an auto-ML platform to predict the Time to Next Treatment (TTNT) between the second and third line of treatment, or the remission period (refractory/relapsed patient).</p> <p><b>RESULTS: </b> From identified variables with impact on treatment outcomes, our script determined a series of variable subsets which allowed to keep the highest number of patients, while containing no missing values. A series of datasets were generated with specific numbers of variables and patients. For each dataset, Our models (notably XGBoost and neural network models) allowed the prediction of patient-specific TTNT, with a precision from 3 to 6 months, and remission duration as refractory/relapsed patient with an accuracy from 70 to 85%.</p> <p><b>CONCLUSIONS: </b> Our study demonstrates the feasibility to use RWD to predict the duration of remission in rrMM patients. Our work aims to develop digital tools to better identify potentially patients with poor outcomes and opens therapeutic perspectives for this patient population with a high treatment need.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115407","diseases":[{"id":"e32f673e-b410-4126-9261-86abf08a0554","parentId":"00000000-0000-0000-0000-000000000000","title":"Personalized and Precision Medicine","urlName":"personalized-and-precision-medicine"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness Analysis of Liraglutide for the Treatment of Obesity in Mexico","id":"b4f0a364-234e-492f-9019-965e6c9f0073","sessionCode":"EE77","topDisplay":"<b><u>Valdez-Huerta R</u></b><sup>1</sup>, Moreno D<sup>2</sup>, Paladio Hernández JÁ<sup>3</sup><br><sup>1</sup>Novo Nordisk, Mexico City, DF, Mexico, <sup>2</sup>Novo Nordisk, CDMX, MEX, Mexico, <sup>3</sup>CEO JAPHealthEcs Consulting, Cuautitlán Izcalli, MEX, Mexico","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>In Mexico, obesity is the main public health concern and obesity-related conditions represent a very high costs for the Mexican public health system. Liraglutide 3mg is associated with significant and sustained weight loss and improves related complications. The objective of this study is to determine the cost-effectiveness of Liraglutide 3.0mg vs orlistat and no-treatment in Mexico.</p> <strong>Methods: </strong>A cost-effectiveness analysis was conducted by means of a Discrete Event Simulation model, which emulates different health states that cover the possible complications associated with obesity, such health states are dependent on the weight loss achieved and therefore have a substantial impact on health care resources and costs. The costs are presented in USD. The population aimed is adults from 18-60 years old with initial BMI≥35 and at least 2 complications onset. This study was conducted from the Mexican institutional perspective. Outcomes measure costs and complications years avoided. A probabilistic sensitivity analysis (first order Monte Carlo Simulation, 1,000 interactions) was developing to assess the robustness of the case base results.</p> <strong>Results: </strong>Liraglutide 3.0 mg is associated to less cost when compared to orlistat and no-treatment ($177,503 vs $18,146 and $192,382 respectively) and it leads to savings ($4,642.82 compared to orlistat and $14,878.97 no-treatment). The efficacy results shows that Liraglutide 3.0 mg are associated to less years with complications (17.6 vs 19.02 and 22.3). The cost-effectiveness base case analysis indicates that Liraglutide 3.0mg is a dominant alternative (more effectiveness, less cost). The results of the probabilistic sensitivity analysis showed to be consistent to the base case analysis. Liraglutide 3.0mg is a dominant alternative.</p> <strong>Conclusions: </strong>Obesity imposes a large economic burden. In patients from 18-60 years old with initial BMI≥35 and at least 2 complications onset, Liraglutide 3.0mg shows important benefits regarding obesity complications avoided that generate important savings for the Mexican public sector.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114964","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Epidemiological Disease Burden of Endometriosis Based on Real-World Health Insurance Claims Data in Hungary in 2019","id":"c45b2a99-48d4-46a7-a235-98652f43fe03","sessionCode":"EPH14","topDisplay":"<b><u>Kajos L</u></b><sup>1</sup>, Elmer D<sup>2</sup>, Csákvári T<sup>3</sup>, Pónusz R<sup>1</sup>, Pónusz-Kovács D<sup>1</sup>, Kovács B<sup>3</sup>, Endrei D<sup>3</sup>, Boncz I<sup>3</sup>, Bódis J<sup>3</sup><br><sup>1</sup>University of Pécs, Pécs, BA, Hungary, <sup>2</sup>University of Pécs, Pécs, PE, Hungary, <sup>3</sup>University of Pécs, Pécs, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Endometriosis is a chronic inflammatory disease which affects 2-10% of women of reproductive age. The prevalence of endometriosis among women aged 15-49 years worldwide was estimated at 1.7 billion in 2010. According to studies, the number of patients who visited the hospital for endometriosis is increasing, constituting a significant burden on patients, society and the healthcare system. The aim of our study was to determine the epidemiological disease burden of endometriosis.</p> <strong>Methods</strong>: Data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), for the year 2019. Data analysed included annual patient numbers, case numbers and prevalence of care utilisation per 100,000 population according to age groups. The following health insurance treatment categories were included into our study: general practice care, home care, in- and outpatient care, medical imaging, laboratory diagnostics, pharmaceuticals and medical aids. Patients with endometriosis were identified with the following code of the International Classification of Diseases 10<sup>th</sup> revision: N8090.</p> <strong>Results</strong>: The highest patient number was found in outpatient care (6,827 women), followed by general practice care (4,770 women), and pharmaceutical reimbursement (3,237 women). The average age of the patient was 37.8 years, calculated according to the patient number of pharmaceutical reimbursement. Based on patient numbers relating to pharmaceuticals, prevalence for 100,000 women was 63,5 patients. We found the highest prevalence in the age-group 30-39 (1,475 women) and 40-49 (1,117 women)</p> <strong>Conclusions</strong>: The results show that the highest number of patients was in outpatient care. The prevalence of endometriosis showed significant differences by age group distribution. The most affected age group was women aged 30-39. The diagnosis of endometriosis is usually delayed for years after the first symptoms appear. Early diagnosis is important as the disease can significantly reduce a patient's quality of life.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/kajos-et-aleph14epidemiological-disease-burden-of-endometriosis-pdf.pdf?sfvrsn=c7ee75c9_0","title":"KAJOS et al_EPH14_Epidemiological disease burden of endometriosis.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117079","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Mapping of Hand Hygiene Habits of Nurses","id":"8cf48a62-c917-4bb9-a719-997395cbc293","sessionCode":"CO14","topDisplay":"Papp B<sup>1</sup>, Ferenczy M<sup>2</sup>, Szabó L<sup>1</sup>, Karácsony I<sup>2</sup>, Turcsán J<sup>1</sup>, Takács K<sup>1</sup>, Boncz I<sup>1</sup>, <b><u>Pakai A</u></b><sup>3</sup><br><sup>1</sup>University of Pécs, Pécs, Hungary, <sup>2</sup>University of Pécs, Szombathely, Hungary, <sup>3</sup>University of Pécs, Pécs, ZA, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> Healthcare associated infections are a major problem worldwide and a challenge for the healthcare system. Intensive care units may be at increased risk of nosocomial infections, therefore the aim of our study was to assess hand hygiene practices of nurses in intensive care units during a primary study and to assess the extent of change in a post-training follow-up study in order to improve the hand hygiene techniques.</p> <strong>Methods:</strong> A cross-sectional qualitative study was conducted between July and September 2019 among nurses working in the Central Intensive Care Unit (CICU), the Pediatric Intensive Therapy Unit (PITU) of the Department of Infancy and Pediatrics (NICU) and the Perinatal Intensive Care Center (PIC) of a county hospital, selected on the basis of non-random convenience sampling. We excluded those who had not attended hand hygiene education and those with other health care qualifications (N=36). Structured observation was used to record areas of hands that were not properly disinfected. Descriptive and mathematical statistics (χ2 test, t-test) were used using MS Excel (p<0.05).</p> <strong>Results:</strong> Significantly fewer failures were documented in the PIC group after education (PIC: 17 vs. CICU: 53; p=0.003). There was no difference when analyzing the control test scores of the PIC and PITU groups (PIC: 17 vs. PITU: 26; p=0.11). For all three groups, fewer error scores were recorded when comparing primary and control test scores (PIC: 42 vs. 17; PITU: 61 vs. 26; CICU: 78 vs. 53), so the compliance rate was significantly higher after training (PIC: p=0.03; PITU: p=0.008; CICU: p=0.004).</p> <strong>Conclusions:</strong> Hand hygiene education was effective in the intensive care units, with the PIC group having a higher hand hygiene compliance rate compared to the CICU group.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/papp-b-et-alco14mapping-of-hand-hygiene-habits-of-nurses-pdf.pdf?sfvrsn=1d45a94e_0","title":"Papp B. et al_CO14_Mapping of Hand Hygiene Habits of Nurses.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117239","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Use of Machine Learning in Electronic Health Records Disease Analysis: An Updated Perspective","id":"ee147f71-00fb-470c-9276-99c1195cbf39","sessionCode":"RWD6","topDisplay":"Cossio CM<sup>1</sup>, <b><u>Gilardino R</u></b><sup>2</sup><br><sup>1</sup>Universitat de Barcelona, Barcelona, Spain, <sup>2</sup>HE-Xperts Consulting LLC, Miami, FL, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES<span style=\"font-weight: 400;\">: </b>In recent years, there has been an increase in the automatic analysis of electronic health records (EHR) for the screening of diseases or the outcomes measurement. However, little has been done to assess the diversity of algorithms, databases, and analysis protocols. We aim to determine the global extend of machile learning (ML) use in screening diseasses by analyzing structure, demographics and clinical characteristics of EHR employed in previous analysis</span></p> <p><b>METHODS<span style=\"font-weight: 400;\">: </b>We did a scoping search in PUBMED and Scholar GOOGLE employing the terms: “Electronic Health Recors”, “EHR”, “Machile Learning” and “ML”. Publications until September 20021 with english language were selected following relevancy order. The following variables were analyzed:</span><span style=\"font-weight: 400;\"> number of patient records, data structure, demographics and therapeutic areas or medical specialties. Continuous variables are presented as mean, and categorical data in percentages. </span></p> <p><b>RESULTS<span style=\"font-weight: 400;\">: </b>540 articles were foun</span><span style=\"font-weight: 400;\">d, of whom 117 were included, mostly published between 2005 to 2015. 97% recorded number of patients (mean 12,2646), 50% included sex and age only as demographical data. 48% included institutional review approval. 97% employed structured records and 30% employed structured and unstructured records (UR). UR were analyzed mainly with Natural Language Programming (NLP). The most frequent medical specialties or therapeutic ares included </span><span style=\"font-weight: 400;\">were cardiovascular and psychiatry and hypertension and diabetes were most frequent comorbid conditions. </span></p> <p><b>CONCLUSIONS: </b>We found a lack of standardization in the reporting methodologies and dataset analysis. <span style=\"font-weight: 400;\">Changes in data protection, including GDPR compliant, including more demographic data and UR are tactics that could improve ML approaches in EHR, especially in collecting outcomes. Moreover, broad epidemiological information could help to indicate if the lack of processed features is due to intrisic issues related to regiona health systems or if its is related to a lack of database coverage.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/rw6cossio-cm-pdf.pdf?sfvrsn=1629b686_0","title":"RW6_Cossio CM.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117783","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Perceived Risk of COVID-19 and Its Association with Preparedness and Preventive Practices: A Latent Class Segmentation Analysis","id":"141225de-ce95-49c7-93d7-9b2ee80799cd","sessionCode":"EPH32","topDisplay":"Mgbere O<sup>1</sup>, Iloanusi S<sup>1</sup>, Yunusa I<sup>2</sup>, Iloanusi NJR<sup>3</sup>, <b><u>Gohil S</u></b><sup>1</sup>, Essien EJ<sup>1</sup><br><sup>1</sup>University of Houston, Houston, TX, USA, <sup>2</sup>University of South Carolina, Columbia, SC, USA, <sup>3</sup>General Hospital, Onitsha, Anambra State, Nigeria","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> COVID-19 risk perception is a risk factor that influences the pandemic spread. Understanding the potential behavioral responses to COVID-19, including preparedness and adoption of preventive measures can inform interventions to curtail its spread. We assessed the self-perceived risk of COVID-19 and its association with preparedness, and preventive practices among residents of a densely populated city in Nigeria.</p> <strong>Methods:</strong> We used data from a cross-sectional survey conducted among residents (n=140) of Onitsha City, Nigeria in March 2020 before the government-mandated lockdown. We applied a latent class analysis (LCA) to systematically segment participants into the most likely distinct risk clusters using the iterative Expectation-Maximization algorithm. Furthermore, we used bivariate and multivariable logistic regression models to determine the associations between knowledge, attitude, preventive practice, perceived preparedness, misconception, COVID-19 information gap, and self-perceived and LCA-based COVID-19 risks.</p> <strong>Results:</strong> Majority of sample population (60.7%) had good knowledge and did not perceive themselves as being at risk of contracting COVID-19. Three-quarter of the participants (74.6%, <em>p</em><.0001) experienced COVID-19 related information gaps, while 62.9% (<em>p</em><0.05) of the participants had some misconceptions about the disease. Conversely, most participants (66.4%, <em>p</em><0.0001) indicated that they were prepared for the COVID-19 pandemic. Using the LCA, we identified three distinct risk clusters (<em>p</em><.0001) namely, <em>prudent/low-risk takers</em>, <em>skeptics/high-risk takers</em> and <em>carefree/very high-risk takers</em> with prevalence rates (<em>γ</em><sub><em>c</em></sub>) of 47.5% (95%CI:40.0-55.0), 16.2% (95%CI:11.4-20.9) and 36.4% (95%CI:28.8-43.9), respectively. We recorded a significant negative agreement between self-perceived risk and LCA-based segmentation of COVID-19 risk (Kappa Coefficient=-0.218±0.067, <em>p</em><0.01). Only knowledge, attitude, and perceived need for COVID-19 information significantly (<em>p</em><u><</u>0.05) predicted COVID-19 preventive practices.</p> <strong>Conclusions:</strong> The clustering patterns highlight the impact of modifiable risk behaviors on the COVID-19 preventive practices. Consequently, clusters with individuals at high risk of contracting COVID-19 would benefit from multi-component interventions delivered in diverse settings to improve the population response to the pandemic.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114674","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Evaluation of Health State Utility Values (HSUV) Used in Health Technology Assessment (HTA) Submissions for Rare Diseases","id":"5b591284-7928-4197-b76b-9bb612437a6b","sessionCode":"HTA6","topDisplay":"<b><u>Tran JTA</u></b><sup>1</sup>, Musat M<sup>2</sup>, Richard ME<sup>1</sup><br><sup>1</sup>Cytel, Inc., Waltham, MA, USA, <sup>2</sup>Cytel, Inc, Waltham, MA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Health state utility values (HSUVs) are a measure of preference for a health state on a scale of 0 to 1, with 0 indicating death and 1 representing perfect health. Obtaining HSUVs may be difficult in rare diseases due to inherent challenges such as small sample size, higher HSUVs with patient experiencing the condition, and absence of valid mapping algorithms for specific health-related quality of life measures (HRQoL). We aimed to investigate the range of sources of HSUVs and their appropriateness per health agencies.</p> <strong><p><b>METHODS: </b> </strong>Health technology assessments (HTAs) from National Institute for Health and Care Excellence (NICE), Canadian Agency for Drugs and Technologies in Health (CADTH), Pharmaceutical Benefits Advisory Committee (PBAC), and Scottish Medicines Consortium (SMC) were reviewed to identify therapies included in the essential drugs for rare diseases for which a cost-utility analysis (CUA) was available.</p> <strong><p><b>RESULTS: </b> </strong>Of the 223 drugs for rare diseases, 17 were evaluated by all four agencies and 12 had a CUA. Sources of HSUVs were EQ-5D from pivotal trial (1/12), EQ-5D from pivotal trial supplemented with literature (1/12; except PBAC), vignettes (3/12), HSUV survey in healthy population supplemented with literature (1/12), proxy efficacy outcome in pivotal trial mapped to EQ-5D supplemented with literature (1/12), values from literature in a proxy population (3/12), and HRQoL questionnaire mapped on EQ-5D in a proxy population (2/12). NICE highlighted that HSUVs introduced significant uncertainty in the economic model in 8/12 assessments, but ultimately accepted them due to limited alternatives. CADTH commented similarly concerning HSUVs in 10/12 HTAs, PBAC in 9/12, and SMC in 7/12.</p> <strong><p><b>CONCLUSIONS: </b></strong> Though the HTA agencies recognized the limitations of HSUVs in rare disease assessments, in most instances, this did not influence the acceptability of the economic model. None of the HTAs were rejected solely because of HSUVs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/tranispor-us-hta62022-pdf.pdf?sfvrsn=66cb7f83_0","title":"Tran_ISPOR US HTA6_2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116474","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness of Lisinopril and Carvedilol for Prevention of Trastuzumab-Induced Cardiotoxicity in US Adults with Early-Stage Breast Cancer","id":"0bede25c-ce63-44fb-81e1-9d3610a8830a","sessionCode":"EE199","topDisplay":"<b><u>Wang Y</u></b><sup>1</sup>, Huang Y<sup>2</sup>, Diaby V<sup>1</sup>, Shao H<sup>1</sup><br><sup>1</sup>University of Florida, Gainesville, FL, USA, <sup>2</sup>University of Florida, GAINESVILLE, FL, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> The clinical efficacy of lisinopril and carvedilol in reducing trastuzumab-induced cardiotoxicity (CTX) among patients with early-stage breast cancer (eBC) previously received anthracyclines has been demonstrated through the randomized controlled trial. This study aimed to assess the cost-effectiveness of lisinopril and carvedilol (Coreg CR) in US adults with eBC receiving trastuzumab, compared with no treatment.</p> </p> <strong>Methods</strong></p> We developed a Markov model to simulate trajectories for patients between 3 health states: CTX-free, asymptomatic CTX, and symptomatic CTX. The transition probabilities were derived from the original trial report. The utilities and costs were obtained from the published literature. Costs were standardized to the 2021 US dollars using the consumer price index for medical supply. The simulation time horizon was 2 years, with a cycle length of 3 months. The annual discount rate for the cost and utility was 3%. The model estimated the incremental cost-effectiveness ratio (ICER) of lisinopril and carvedilol versus no treatment, respectively, from a health system perspective. We performed one-way and probabilistic sensitivity analyses (PSA) to assess the robustness of the results.</p> </p> <strong>Results</strong></p> The incremental effectiveness and cost of lisinopril versus placebo were 0.09 QALY and $74, resulting in an ICER of $790/QALY. The incremental effectiveness and cost of carvedilol versus placebo were 0.05 QALY and $6,591, resulting in an ICER of $125,545/QALY. These results are sensitive to lisinopril’s and carvedilol’s price and the cost of treating symptomatic CTX for both lisinopril and carvedilol cohorts. At a willingness-to-pay threshold (WTP) of $50,000/QALY, lisinopril was cost-effective in 94% of 1,000 iterations and carvedilol (Coreg CR) was cost-effective in 43% of 1,000 iterations, compared with no prophylaxis.</p> </p> <strong>Conclusions</strong></p> Based on a WTP of $50,000/QALY, lisinopril is a cost-effective prophylaxis against trastuzumab-induced CTX for US eBC patients. The price is a major impact factor for carvedilol’s economic efficiency.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115831","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Assessing the Changes of Spa Hotel Demand in Hungary between 2012 and 2019","id":"35635953-6bbb-455f-b0de-9d7682f2c90f","sessionCode":"HSD12","topDisplay":"Komáromy M<sup>1</sup>, Tóth B<sup>2</sup>, <b><u>Csákvári T</u></b><sup>3</sup>, Zoltán V<sup>1</sup>, Boncz I<sup>3</sup><br><sup>1</sup>University of Pécs, Zalaegerszeg, ZA, Hungary, <sup>2</sup>University of Pécs, Zalaegerszeg, Hungary, <sup>3</sup>University of Pécs, Pécs, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: In general, the demand for medical tourism is influenced by several factors. The first is an aging population with a growing health problem and discretionary income and leisure. The second is changes in health behaviours that focus on disease prevention. Research seeks the answer to the changes in the demand for medical tourism in recent years in spa hotels.</p> <strong>Methods</strong>: We conducted secondary research, based on official statistics of the Hungarian Central Statistical Office. We examined the number of beds available, the number of accommodation providers operating, guest traffic and the number of overnight stays. Due to the Covid-19 pandemic, data for the year 2020 were not taken into account, so we are examining the period between 2012 and 2019 for spa hotels in Hungary.</p> <strong>Results</strong>: During the period 2012-2019, the average proportion of spa hotels among hotels was 3.32 %. The guest turnover of the spa hotels increased by 360,000 in the period under review, a growth of 51,000 was an average annual. During this period in 2677 increased rentable beds in the hotel spa, which represents 3.39 % of the average annual capacity growth. The distribution of the number of guest nights in spa hotels compared to hotels and commercial accommodation was the lowest in 2013 and the highest in 2015. The distribution of guest nights in spa hotels could be increased to a greater extent compared to hotels than compared to commercial accommodation.<strong></strong></p> <strong>Conclusions</strong>: Overall, the demand side of tourism responded positively to the recent developments of spa tourism. Among foreigners and domestic people, the spa hotels of the settlements affected by medical tourism are becoming increasingly popular.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/komaromyisporposzter20220421final-pdf.pdf?sfvrsn=2c200f37_0","title":"Komaromy_ISPOR_poszter_20220421_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116814","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Price and Volume Changing Trends of Medicines Based on Index Analysis: An Empirical Case from Shanghai","id":"c5a3455d-d4a4-4ec6-ba0a-9eab68d51c1b","sessionCode":"HPR5","topDisplay":"Jiang H, Chen W, <b><u>LIU X</u></b><br>Fudan University, Shanghai, China","locationCode":"","description":"\r\n\t<div><strong><b><p><b>OBJECTIVES: </b> </b></strong>Price and volume changing trends of medicines has become a focus of attention from a global perspective. This is especially true in China because of a series of drug reforms initiated in recent years, such as nationwide bulk procurement of medicines. This study aims to compile the drug purchase price index and volume index, which is applied to present their dynamic changes of prices and volumes and to reflect overall supply of medicines in Shanghai. <p><b>METHODS: </b> Based on the database of Shanghai Sunshine Medical Procurement All-In-One, Laspeyres price index and Pascal purchase volume index was calculated monthly and annually by using Western medicines purchase records during 2018 and 2020, which were uploaded from all the medical institutions in Shanghai.<strong><b> </b></strong></p> <strong><b><p><b>RESULTS: </b></b></strong> Compared with the previous year, the price index of medicines and those covered by the basic medical insurance schemes were 93.3 and 93.1 respectively in 2019, while they were 95.8 and 95.6 in 2020. Monthly price index declined significantly in March 2019, April 2020 and November 2020, for the new purchase prices were implemented in these months. Meanwhile, annual procurement volume had limited changes with monthly fluctuations. Prices of those drugs not covered by the medical insurance fell slightly, and their volumes dropped sharply after the COVID-19 outbreak.</p> <strong><b> <p><b>CONCLUSIONS: </b></b></strong> Prices of medicines maintained a downward trend in stability with limited procurement volume changes in Shanghai. The empirical case of price index and volume index of medicines in Shanghai has verified the feasibility of its application in drug price monitoring and management. It has also provided strong evidence for policy decision-making and evaluation.<strong><b> </b></strong></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-poster-20220422-liu-xiaojie-pdf.pdf?sfvrsn=a2dfad_0","title":"ISPOR poster 20220422 Liu Xiaojie.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117897","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Metformin Use Is Associated with Reduced Incidence of Invasive Pneumococcal Disease after a Pneumococcal Vaccine in Adults with Type 2 Diabetes: A Retrospective Cohort Study","id":"cf47a1ab-42b8-4504-a4f2-9f8e6c1b28be","sessionCode":"EPH29","topDisplay":"<b><u>Bandy S</u></b><sup>1</sup>, Black CA<sup>2</sup>, Anderson A<sup>2</sup>, Lipscomb J<sup>2</sup>, Benavides R<sup>3</sup>, Lee G<sup>2</sup><br><sup>1</sup>The University of Texas at Austin, San Antonio, TX, USA, <sup>2</sup>The University of Texas at Austin, Austin, TX, USA, <sup>3</sup>The University of Texas Health at San Antonio, San Antonio, TX, USA","locationCode":"","description":"\r\n\t<div><strong>Objective</strong>: Metformin, a first-line agent for type 2 diabetes mellitus (T2DM) has been shown to have immunomodulating properties in vaccine efficacy, aging and infections, including pneumonia. This study evaluated whether metformin-use associated with lower risk for invasive pneumococcal disease (IPD) post receipt of a pneumococcal vaccine (PNV).</p> <strong>Methods</strong>: This was a retrospective U.S. cohort analysis of a third-party medical and pharmacy claims database from 2009 to 2019. Adults 18 years of age and older who received a PNV and were continuously enrolled for more than 1 year before and after PNV administration were included. Diagnosis of IPD requiring hospitalization was determined using ICD-9/10-CM codes. Metformin-use was defined as more than 90 days of claim with fill within 30 days prior to PNV. Demographics, PNV type/year, medications, and co-morbidities were covariates. Multivariable logistic-regression models were conducted, stratified by metformin-use and T2DM.</p> <strong>Results</strong>: Overall, 600,132 adults were included. The median age was 65 years and 45.1% were males. Approximately 24% of individuals with T2DM (n=155,308) were metformin-users compared to 1.6% of those without T2DM (n=444,824). Metformin-use was independently associated with lower risk of IPDs post-PNV (aOR 0.878, 95% CI 0.826-0.933). This protective effect was likely driven by individuals with T2DM using metformin vs. non-users (aOR 0.812, 95% CI 0.760-0.867). In contrast, among those without T2DM, there were no differences in IPD (aOR 0.989, 95%CI 0.852-1.148). The median (IQR) days to event was shorter post-PNV among metformin-users vs. non-users [495 (276-870) vs. 548 (276-1170), p<0.001].</p> <strong>Conclusion:</strong> Metformin-use was associated with a reduced risk of IPDs after receiving PNVs, particularly among those with T2DM. These results add to the sparse data highlighting the immunomodulatory effects of metformin and its potential role in vaccine-care, aging and preventative medicine.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022-abstract-bandy-pdf.pdf?sfvrsn=1aef9399_0","title":"ISPOR 2022 Abstract Bandy.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114790","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"},{"id":"5b196821-963c-48d3-9e67-cc2da312735d","parentId":"00000000-0000-0000-0000-000000000000","title":"Vaccines","urlName":"Vaccines"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Insurance Coverage and Pregnancy-Related Mortality and Miscarriage in Hospital Admissions Among Pregnant Women","id":"967f3ce6-4ded-4dc7-8dc7-a0b7d0ca450e","sessionCode":"EPH24","topDisplay":"<b><u>Tran P</u></b>, Shaya FT<br>University of Maryland Baltimore, Baltimore, MD, USA","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE</strong>: Evidence is mounting on suboptimal maternal health, pointing to a relation with access to care, possibly mediated by insurance coverage status. In this study, we assessed the association between insurance coverage and pregnancy-related outcomes in hospital admissions among pregnant women over the course of three years.</p> <strong><p><b>METHODS</strong>: </b> This retrospective cohort study used discharge medical record abstract and billing data in Maryland from 2017-2019. The diagnosis was identified through the International Classification of Diseases tenth revision-Clinical Modification diagnostic codes. We built logistic regression models to identify factors associated with hospital admissions with adverse pregnancy-related outcomes (either mortality or miscarriage), considering different types of primary insurance coverage (Medicare, Medicaid, commercial insurance, or self-pay, donor, and other), and controlling for age, residency status, race, nature of hospital admissions, major hospital service assigned, and comorbidity (high-risk pregnancy, hypertension, and diabetes).</p> <strong><p><b>RESULTS: </b> </strong>Between 2017 and 2019, out of 207,016 hospital admissions among pregnant women ages 14-45 in Maryland, 587 resulted in maternal mortality or miscarriage (28 per 10,000 admissions). Half of the admissions among pregnant women were covered by Medicaid, and about 44% by commercial insurance. Pregnant women with Medicare coverage (66 per 10,000 admissions) or without health insurance (53 per 10,000 admissions) were more likely than pregnant women with commercial insurance (22 per 10,000 admissions) to have admissions with adverse pregnancy-related outcomes. After controlling for demographic and clinical covariates, admissions for pregnant women without insurance coverage were more likely to result in adverse pregnancy-related outcomes than admissions for women with commercial insurance (OR=1.94, 95%CI: 1.40 - 2.67, p<0.001).</p> <strong><p><b>CONCLUSIONS</strong>: </b> Our analysis highlights the association between type of insurance coverage, and hospital admissions with pregnancy-related outcomes, namely maternal mortality or miscarriage, possibly suggesting the need for stepped up approaches for prenatal care, customized to populations by type of insurance.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/eph24phuongtranpdf-pdf.pdf?sfvrsn=a46f2c45_0","title":"EPH24_PhuongTran_pdf.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114542","diseases":[{"id":"4f6b0298-31b6-4189-b6aa-63a92e080d5a","parentId":"00000000-0000-0000-0000-000000000000","title":"Reproductive and Sexual Health","urlName":"reproductive-and-sexual-health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Annual Health Insurance Treatment Cost of Female Infertility of Other Origin Based on Real-World Health Insurance Claims Data","id":"efb4515c-fa3b-4e5f-a5c4-a1090ccfaeeb","sessionCode":"EE28","topDisplay":"<b><u>Pónusz-Kovács D</u></b><sup>1</sup>, Elmer D<sup>2</sup>, Csákvári T<sup>3</sup>, Kajos L<sup>1</sup>, Pónusz R<sup>1</sup>, Kovács B<sup>3</sup>, Sebestyén A<sup>3</sup>, Bódis J<sup>3</sup>, Boncz I<sup>3</sup><br><sup>1</sup>University of Pécs, Pécs, BA, Hungary, <sup>2</sup>University of Pécs, Pécs, PE, Hungary, <sup>3</sup>University of Pécs, Pécs, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Female infertility is a global medical condition that could be caused by various disorders of the reproductive system. Female infertility constitutes a significant and growing burden on patients, health care systems and the society. Our aim was to determine the annual costs of the health insurance system related to the female infertility of other origin in Hungary.</p> <strong>Methods</strong>: Data were derived from the financial database of the Hungarian National Health Insurance Fund Administration Hungary for the year 2019. Data analyzed included annual health insurance costs, number of patients and cost distribution calculated for age groups. The following cost categories were included into the study: general practice care, home care, in- and outpatient care, medical imaging, laboratory diagnostics, pharmaceuticals and medical aids. Cases with female infertility of other origin were identified with the following code of the International Classification of Diseases 10<sup>th</sup> revision: N9780.</p> <strong>Results</strong>: In 2019 the NHIFA the spent 749.47 million Hungarian Forints (HUF) for the treatment of patients with female infertility, 2.58 million American Dollars (USD), or 2.3 million Euros (EUR). The highest number of patients was in outpatient care (3,780 women). Inpatient care (52.4% of total health insurance costs), utilization of pharmaceuticals (43.3%) and outpatient care (3.0%) were the main cost drivers, while all other forms of medical care amounted to 1.2% in women. Annual health care treatment cost per patient was 196,273 HUF (682 USD/609 EUR) according to number of patients related to outpatient care. The highest annual health insurance costs were found in the ‘30-39’ and ‘40-49’ age groups.</p> <strong>Conclusions</strong>: The utilization of inpatient care was the major cost driver, which was 1.21 times higher than the utilization of pharmaceuticals and 17.39 times higher as the costs of outpatient care in 2019. The proportion of cost showed significant difference among age groups.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/kovacsd-n9780costprint140x9020220421final-pdf.pdf?sfvrsn=983e3f67_0","title":"KOVACSD-N9780__COST_PRINT_140x90_20220421_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117261","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Using Natural Language Processing of Unstructured EMR Data to Describe Canadian Patients with ASCVD","id":"437d9053-605f-4c6e-b445-a1a5a3347924","sessionCode":"HSD23","topDisplay":"<b><u>Bandukwala T</u></b><sup>1</sup>, Leblond F<sup>2</sup>, Lavoie AL<sup>3</sup>, Leiter LA<sup>4</sup>, Mancini GBJ<sup>5</sup>, Rojas-Fernandez C<sup>2</sup><br><sup>1</sup>Ensho Health, Toronto, ON, Canada, <sup>2</sup>Novartis Pharmaceuticals Canada Inc, Montreal, QC, Canada, <sup>3</sup>University of Saskatchewan, Regina, SK, Canada, <sup>4</sup>St. Michael's Hospital., Toronto, ON, Canada, <sup>5</sup>University of British Columbia, Vancouver, BC, Canada","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> In Canada, descriptive studies of patients with ASCVD have hitherto utilized traditional epidemiological methods. Such studies are often time and labor intensive. The advent of electronic medical records (EMRs) and natural language processing (NLP) methods represent a novel and potentially more efficient method. Using NLP tools for data extraction, we describe selected characteristics of Canadian patients with ASCVD in a real-world setting.</p> <strong>Methods</strong></p> De-identified electronic health records of patients (n=9415) with ASCVD and with <u>></u>1 physician visit between June 2016 to November 2019 were selected for automated chart review using the Apollo EDC System by Ensho Health. Structured and unstructured documents were queried for clinical characteristics of interest using NLP.</p> <strong>Results</strong></p> Patients had a mean (SD) age of 69(11) years; 48.8% were ≥ 70 years, and 70.4% were male. Mean (SD) BMI was 29 (6.3) kg/m<sup>2</sup>; mean BP was 131/75 mm Hg. Coronary artery, cerebrovascular, and peripheral artery disease were present in 91.5%, 15.5% and 7.9% of patients, respectively. Hypertension, diabetes, obesity, chronic kidney disease and FH were present in 67%, 30%, 23%, 11%, 2% of patients, respectively. Statins and ezetimibe were documented in 35% and 6% of patients, and PCSK9i, bile acid sequestrants, fibrates and niacin in <1%. Statin intolerance was documented in 8% of patients. LDL-C values were available in 55% of patients, with a mean of 2.0 (1.0) mmol/L; Lp(a) was measured in 0.7% of patients (median of 27 mg/dL). Our findings are consistent with contemporary studies using traditional epidemiological methods.</p> <strong>Conclusions</strong></p> NLP was a feasible method for conducting this study and produced similar results to contemporary literature. Like manual chart reviews, NLP allows for detailed sample description and analyses, yet it appears to be a more efficient method for large samples, and potentially more granular than using currently available administrative databases in Canada.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114820","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Comparing Alternative Paliperidone Formulations for Relapse Prevention in Patients with Schizophrenia: A Cost-Utility Analysis","id":"648f3eb9-b4d0-410d-97e5-a6e09960130c","sessionCode":"EE27","topDisplay":"<b><u>Wang HM</u></b><sup>1</sup>, Chang SH<sup>2</sup>, Vouri SM<sup>3</sup>, Shao H<sup>2</sup><br><sup>1</sup>University of Florida, Gainesville, FL, USA, <sup>2</sup>University of Florida College of Pharmacy, Gainesville, FL, USA, <sup>3</sup>University of Florida, College of Pharmacy, Gainesville, FL, USA","locationCode":"","description":"\r\n\t<div>Discontinuation or poor adherence to antipsychotics in patients with schizophrenia may lead to relapses. Compared with daily administered antipsychotics (e.g., paliperidone extended-release (ER)), long-acting injectable antipsychotics (LAI) can improve medication adherence, resulting in a lower risk of relapse. Paliperidone palmitate, a new form of LAI, can be administered monthly (PP1M), three monthly (PP3M), or six-monthly (PP6M). While proven effective in improving compliance, the economic value of administering this high-cost treatment is unknown. This study compared the cost-effectiveness across PP6M, PP3M, PP1M, and paliperidone ER.</p> A Markov model was developed to simulate a cohort of patients with schizophrenia transitioning through the stable state, relapse with hospitalization, relapse without hospitalization, and death on a quarterly basis over a 3-year time horizon. Costs for paliperidone formulations were estimated using their average wholesale price, and costs for treating complications were estimated from previous literature. All costs were estimated from the U.S. healthcare system perspective and standardized to 2021 U.S. dollars. Quality-adjusted life-years (QALYs) were estimated using data from randomized controlled trials and previous literature. All input parameters varied from 75 to 125% of their base-case value in the sensitivity analyses.</p> Paliperidone ER is the most cost-effective when compared with PP1M (INB -$19,770), PP3M (INB -$522), and PP6M (INB -$19,470). When focusing on LAIs, PP3M is dominant compared with PP1M or PP6M. One-way sensitivity analyses show that PP3M may be cost-effective over paliperidone ER under certain circumstances, and the comparison between PP1M and PP6M remains inconclusive.</p> Paliperidone LAIs are not cost-effective compared with paliperidone ER, suggesting that their benefits may not outweigh the high administration costs. Among paliperidone LAIs, PP3M has a preferable economic value over PP1M and PP6M. However, this conclusion is drawn based on results from clinical trials and might not be generalizable to real-world settings.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-pdf.pdf?sfvrsn=8af1ce8e_0","title":"ispor.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114670","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Association between Patient-Physician Communication and Perceived Mental Health Status Among United States Adults with Cancer","id":"d4432563-1a76-45fb-a794-a71156ee609b","sessionCode":"RWD5","topDisplay":"<b><u>Choi B</u></b>, Axon D<br>University of Arizona, Tucson, AZ, USA","locationCode":"","description":"\r\n\t<div>Objectives: Patient-physician communication can facilitate clinical decision making and improved health outcomes. Cancer patients have specific needs including mental health assessment. However, little is known about the relationship patient-physician communication and self-perceived mental health status. This study assessed the association between patient-physician communication and self-perceived mental health status among United States (US) adults with cancer.</p> Methods: Provider-physician communication was evaluated using four variables: being respected (respect), being listened to (listen), spending enough time with physician (time), and sufficient explanations (explain). Using 2019 Medical Expenditure Panel Survey (MEPS) data, we conducted four logistic regression models (respect, listen, time, explain) for good (vs. poor) mental health, adjusted for potential risk factors identified in the literature. Eligible individuals were alive, aged 18-84, reported data on patient-physician communication and mental status. Weighted estimates were analyzed while accounting for complex survey data. The a priori alpha level was 0.05.</p> Results: Among 25,374,384 individuals with cancer, 89.9% (95% confidence interval [CI]=87.6-90.9%) reported good perceived mental health while 9.1% (95%CI=9.1-12.4%) reported poor perceived health status. Typically, in all four models, patient-physician communication was not statistically associated with mental health status. Other factors associated with greater odds of reporting good mental health in all four models included: age 18-44 vs. 54-84 (adjusted odds ratio[AOR]=0.1, 95%CI=0.1-0.3), age 45-64 vs. 65-84 (AOR=0.6, 95%CI=0.4-0.9), low vs. high income level (AOR=0.4, 95%CI=0.2-0.6), no physical limitation vs. physical limitation (AOR=3.4, 95%CI=2.3-5.2), and no limitation from pain vs.limitation from pain (AOR=1.8, 95%CI=1.1-3.0).</p> Conclusions: Out of 25 million US adult cancer patients, about 2.2 million reported having poor self-perceived mental health. Although patient-provider communication was not associated with mental health status in this population, several factors were identified as risk factors for poor mental health. Further research is warranted to improve understanding of mental health status among US cancer adult patients.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114572","diseases":[{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"The Effect of Non-Pharmacological Intervention on Healthcare Utilization and Expenditures in Patients with Diabetes Mellites","id":"02ad120c-917f-45d8-8ceb-a721b9706091","sessionCode":"EE1","topDisplay":"<b><u>Alfaifi A</u></b><sup>1</sup>, Althemery A<sup>2</sup>, Lai L<sup>3</sup>, Asiri SA<sup>1</sup>, Barnawi AAO<sup>1</sup><br><sup>1</sup>Prince Sattam bin Abdulaziz University, Al-Kharj, 01, Saudi Arabia, <sup>2</sup>Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia, <sup>3</sup>Nova Southeastern University, Ft. Lauderdale, FL, USA","locationCode":"","description":"\r\n\t<div><strong>Background</strong></p> Physical activity (PA) and diet modification (DM) can control patients’ glycemic levels and decrease glycated hemoglobin. This study explored the prevalence of diabetic patients who integrate a non-pharmacological intervention into their therapy, and its effect on healthcare utilization and expenditures.</p> <strong>Methods</strong></p> A quasi-experimental design approach was conducted. Subjects included patients who reported being diagnosed with diabetes and reported treating it with diet modification or physical activity on the 2019 Medical Expenditure Panel Survey. Physical activity was defined as moderate to vigorous physical exercise 5 times per week. DM was defined as healthy eating that results in reduced glucose levels. A series of weighted statistical tests were conducted, and all analyses were performed using SAS 9.4.</p> <strong>Results</strong></p> An estimated 26.3 million people reported a diagnosis of diabetes mellitus in the United States in 2019, of which 12.1 million (46%) did not include either DM or PA in their therapy. Those who did not include non-pharmacological interventions had more total healthcare expenditures (M = $ 18428, SE = 1932.87) compared with those who included both (M = $ 15134, SE = 1684.31), p<.0001. Moreover, there was a significant difference in prescribed medicine utilization per year for those who did not include DM and PA (M = 45.8, SE = 2.7) and patients who were physically active and on DM (M = 33.5, SE = 1.3).</p> <strong>Conclusions</strong></p> Patients with diabetes who adhere to a non-pharmacological intervention in their therapy showed significantly lower utilization and expenditures. Being active and a healthy diet are imperative for patients with diabetes. They can successfully help delay or prevent the progression of diabetes and consequently reduce the cost and utilization associated with diabetes.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115877","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Utility Estimates for Treatment in Primary Hyperoxaluria Type 1","id":"49b18f85-2ec1-4535-bbe3-a78121436be2","sessionCode":"PCR17","topDisplay":"<b><u>de Freitas H</u></b><sup>1</sup>, Hubig L<sup>1</sup>, Lombardelli S<sup>2</sup>, Danese D<sup>2</sup>, Lloyd A<sup>1</sup><br><sup>1</sup>Acaster Lloyd Consulting Ltd, London, UK, <sup>2</sup>Alnylam Pharmaceuticals, Cambridge, MA, USA","locationCode":"","description":"\r\n\t<div><strong><span><p><b>OBJECTIVES: </b></span></strong><span> Primary hyperoxaluria type 1 (PH1) is a rare genetic disorder characterized by hepatic overproduction of oxalate. Excretion of excess oxalate by the kidneys leads to recurrent kidney stones, nephrocalcinosis, progressive kidney disease, and multiorgan damage from systemic oxalosis. Patients progressing to or presenting with kidney failure require invasive approaches such as dialysis and liver and/or kidney transplantation. There is currently little evidence about the impact of PH1 on health-related quality of life (HRQoL). This study aimed to understand the burden of PH1 on patients by eliciting utilities to support future economic evaluations. </span><strong><span><p><b>METHODS: </b></span></strong><span> A targeted literature review and interviews with one pediatric and one adult PH1 clinical expert (n=2) informed the development of health state vignettes describing the impact of PH1. PH1 states were defined based on chronic kidney disease (CKD) stages in adults and children. A post-combined liver and kidney transplant (CLKT) health state was also developed. The health states were valued by members of the UK general public using the EQ-5D-5L and time trade-off (TTO) methods. </span><strong><span><p><b>RESULTS: </b></span></strong><span> One hundred participants valued the health states; (50% male, mean age 41 years). Scores were lowest for CKD5 child (EQ-5D-5L=-0.05, TTO=0.33) and adult states (</span>EQ-5D-5L=0.02,<span> TTO=0.39</span>), <span>with large decrements observed between the early CKD stages and the dialysis states (CKD4 and CKD5). CLKT scores were comparable to those of the early CKD stages (1-3b) in both adult and child states. </span><strong><span><p><b>CONCLUSIONS: </b></span></strong><span> This study yielded a novel set of utility values in PH1. Mean EQ-5D-5L and TTO and ratings followed a similar pattern, although EQ-5D-5L values were consistently lower. The results demonstrate the considerable impact on HRQoL associated with PH1, with this impact being greatest as the disease advances and dialysis is required. These data can be used in future economic evaluations of treatments to inform decision-making.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-vignette-poster04-21-22final-pdf-pdf.pdf?sfvrsn=5913eeed_0","title":"ISPOR Vignette Poster_04-21-22_Final.pdf.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114525","diseases":[{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"},{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"A Systematic Review and Meta-Analysis of Factors Affecting Health Technology Assessments in Healthcare","id":"dd8d9aff-8655-4a17-8180-a786f634e328","sessionCode":"HTA14","topDisplay":"<b><u>Wang Y</u></b><sup>1</sup>, Qiu T<sup>1</sup>, Nikodem M<sup>2</sup>, François C<sup>1</sup>, Toumi M<sup>1</sup><br><sup>1</sup>Aix-Marseille University, Marseille, France, <sup>2</sup>Creativ-ceutical, Krakow, Poland","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong><strong>: </strong>This review aims to provide an overview of the direction and magnitude of different factors impacting health technology assessments (HTAs) in healthcare.</p> <strong>Methods: </strong>Ovid Medline and Embase databases were searched for studies from inception to 2 July 2020. Studies were included if they conducted the multivariable analysis of HTA decisions. Meta-analysis was performed to investigate the impacts of factors on HTA decisions when the factors were investigated in at least a quarter of included agencies.</p> <strong>Results:</strong> Thirty-nine studies were identified including 7,696 decisions from fifteen HTA agencies. Eleven factors were investigated in more than 4 agencies and analyzed by meta-analysis further. Among them, three factors were identified as the significant factors for decision making in over half of investigated agencies: superior comparative efficacy and accepted clinical evidence as the positive factors, and high incremental cost-effectiveness ratio (ICER) as a negative factor. Seven factors were identified as significant factors by meta-analysis after pooling the decisions from the different agencies, where absence of alternatives, superior comparative efficacy, active comparator, high quality of clinical evidence and accepted clinical evidence were found as the positive factors, and oncology indication and high ICER were found as the negative factors.</p> <strong>Conclusions: </strong>Despite the different reimbursement systems, comparative efficacy, accepted clinical evidence and high incremental cost-effectiveness ratio are mostly identified to be important factors across the different agencies. The impacts of factors reflecting the equity principle, such as disease severity and orphan drugs, are limited especially in the agencies which emphasize the criterion of cost-effectiveness.</p> <strong>Keywords: </strong>Factor; health technology assessment; decision making; healthcare</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hta14a-systematic-review-and-meta-analysis-of-factors-affectingchecked-pdf.pdf?sfvrsn=79fa8bf3_0","title":"HTA14_A Systematic Review and Meta-Analysis of Factors Affecting_checked.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117206","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"A Step-By-Step Guide for Causal Study Design When Estimating Treatment Effects Using Real-World Data","id":"75f32523-4473-40b2-ad54-aa619cc0420f","sessionCode":"MSR11","topDisplay":"Hoffman S<sup>1</sup>, Gangan N<sup>1</sup>, Chen X<sup>1</sup>, Smith JL<sup>1</sup>, Tave A<sup>1</sup>, Yang Y<sup>1</sup>, Dosreis S<sup>2</sup>, <b><u>Grabner M</u></b><sup>1</sup><br><sup>1</sup>HealthCore, Inc., Wilmington, DE, USA, <sup>2</sup>University of Maryland School of Pharmacy, Baltimore, MD, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Causal inference (CI) in observational research is growing more important, driven by the need for generalizable and rapidly delivered real-world evidence (RWE) to inform regulatory, payer, and patient/provider decision-making. Existing methodological literature on this topic is rich but can be complex and daunting to navigate. We describe a framework to approach these methods with confidence.</p> <p><b>METHODS<span style=\"font-family: 'Arial',sans-serif;\">: </b>A team with diverse training and research backgrounds developed a visual “step-by-step guide to causal study design,” and corresponding glossary, after a comprehensive review of CI literature. During this process, we identified and addressed key conceptual issues that researchers should be aware of to develop confidence in implementing CI methods.</span></p> <p><b>RESULTS: </b>We describe eight steps in causal study design. Step 1: Define an explicitly causal research question. Step 2: Decide on a “first treatment carried forward” (analogous to “intention to treat”) or an “as-treated” (analogous to “per protocol”) outlook. Step 3: Define the population for the counterfactual contrast, e.g., average treatment effect in the entire study population or in the treated. Step 4: Select a measure of effect, e.g., rate or risk, difference or ratio. Together, steps 2-4 define the study estimand. Step 5: Develop a directed acyclic graph for the research question and estimand to clarify the causal pathway. Step 6: Identify potential biases, e.g., immortal time. Step 7: Select appropriate design elements and statistical methods to evaluate and address potential biases. Step 8: Conduct sensitivity analyses to assess robustness of the methods used and quantify remaining biases, e.g., unmeasured confounding. </p> <p><b>CONCLUSIONS: </b>We identified and described key conceptual issues of importance to researchers who design CI studies, and created a visually appealing, user-friendly resource to help researchers clearly define and navigate these issues. This guidance serves to enhance the quality and thus the impact of RWE from observational research.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/healthcore-umb-us-ispor-2022-causality-poster-fv-pdf.pdf?sfvrsn=bd8e5d4e_0","title":"HealthCore-UMB US ISPOR 2022 Causality Poster FV.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114706","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness Analysis of Hemodialysis Vs. Peritoneal Dialysis Among Patients with End-Stage Renal Disease","id":"adfe5731-55d3-4f7c-846d-aaceae7123b6","sessionCode":"EE80","topDisplay":"<b><u>Aroza R</u></b><sup>1</sup>, Ndai A<sup>2</sup>, Alkhuzam K<sup>1</sup>, Shao H<sup>1</sup>, Jiao T<sup>1</sup><br><sup>1</sup>University of Florida, Gainesville, FL, USA, <sup>2</sup>University of Florida, Gainesville , FL, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> Patients with end-stage renal disease (ESRD) require dialysis or transplantation to maintain patients’ lives. Hemodialysis (HD) and Peritoneal Dialysis (PD) are two major treatment modalities. The use of HD is more prevalent than PD in many countries. This study aimed to assess the cost-effectiveness of hemodialysis vs. peritoneal dialysis in patients with ESRD from the payers’ perspective.</p> <strong>Methodology: </strong>A Markov Model was built to predicts the transitional between ESRD and death using data from existing literature. The cost for ESRD and death were from previously published data. Quality-adjusted-life-years (QALYs) for ESRD and death were estimated using data from existing literature. The simulation was conducted over 14 years, with both QALY and cost discounted at an annual rate of 3%. Incremental Net Benefit (INB) for (PD vs. HD) was calculated based on a Willingness to Pay (WTP) of $ 50,000/QALY.</p> <strong>Results:</strong> Mortality rate was higher in patients receiving HD (94%) than patients receiving PD (89%). From the perspective of payers’, the total cost was lower among the patients receiving PD ($858,443) as compared to patients receiving HD ($1,082,730). Upon calculating QALY, PD provided better effectiveness (5.46 QALYs) than HD (4.66 QALYs). After calculating the INB ($264,701), PD was found to be cost-effective as compared to HD at WTP $50,000. Sensitivity analysis (using 20% range) showed PD was more cost-effective at WTP $60,000 and $40,000, however, the results were insensitive to the INB.</p> <strong>Conclusion:</strong> Based on the values for total cost and QALY, it was observed that PD was found to be more cost saving compared to HD. Evidence provided in this study could help policymakers with regard to prioritizing dialysis modalities.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116117","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Real World Evidence for the Impact of COVID-19 Pandemic on the Incidence of Multiple Myeloma in Germany","id":"61128489-8e37-44cc-b5b6-ab014e9e818d","sessionCode":"RWD26","topDisplay":"<b><u>Schilling S</u></b><sup>1</sup>, Azarias G<sup>2</sup>, Merker L<sup>1</sup>, Strobel K<sup>1</sup>, Wischlen S<sup>2</sup>, Kellermann L<sup>1</sup><br><sup>1</sup>OncologyInformationService, Freiburg, Germany, <sup>2</sup>CancerDataNet GmbH, Basel, Switzerland","locationCode":"","description":"\r\n\t<div><strong><span><p><b>OBJECTIVES</span>: </b></strong><span> The dramatic surge in in-patient care induced by the SARS-CoV-2 (COVID-19) pandemic caused a reduction of non-urgent visits in clinics. Owing to general contact limitations, even patient visits in practices were avoided. Yet, delaying diagnostics prevents timely diagnosis and treatment of cancer patients, thereby worsening their prognosis. Due to distinct symptomatic heterogeneity, Multiple Myeloma (MM), an incurable malignancy of older population, requires early patient-physician interactions. Here, we aim to determine the impact of COVID pandemic on the incidence of newly diagnosed MM patients (NDMM) in Germany.</span></p> <strong><span><p><b>METHODS</span>: </b></strong><span> We leveraged a RWD database from 4031 NDMM patients from 107 clinical sites in Germany between 2018 and 2021. We retrieved 7-day COVID-19 incidences in Germany as reported by Robert Koch Institute. The moving averages of incidences in NDMM and COVID-19 were investigated. The correlation between the NDMM incidence and time before and during COVID period were statistically assessed using Spearman’s correlation tests and Kruskal-Wallis test. </span></p> <strong><span><p><b>RESULTS</span>: </b></strong><span> Between 2018 and 2019, before the COVID pandemic (R² = 0.23 / r = 0.48, p< 10<sup>-3</sup>), the incidence of NDMM increased, mainly owing to the demographic development. With the beginning of the COVID pandemic in March 2020, a significant decrease in NDMM patient incidence was observed (Spearman correlation coefficient: r = -0.59). Furthermore, the rapid and significant fall of NDMM incidence was apparent from the second COVID wave (October 2020) onwards (median of NDMM patients per day: 2018 = 2.7 / 2019 = 3.1 / 2020 = 3.0 / 2021 = 2.2; Kruskal-Wallis H test (3) = 408,29, p<10<sup>-3</sup>).</span></p> <strong><span><p><b>CONCLUSIONS</span>: </b></strong><span> The COVID-19 pandemic has significantly altered the time point of diagnosis for NDMM patients. This fact is likely to have an impact on the characteristics and prognosis of NDMM patients in the future. </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117686","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Clinical Experiences of Type 2 Diabetes (T2DM) Patients Initiating Oral Semaglutide","id":"0daf26cf-06c5-4d37-bf04-abba11d7be37","sessionCode":"CO30","topDisplay":"<b><u>Dunn TJ</u></b><sup>1</sup>, Swift C<sup>1</sup>, Guesnier A<sup>1</sup>, Noone J<sup>1</sup>, Willey V<sup>2</sup><br><sup>1</sup>Novo Nordisk Inc., Plainsboro, NJ, USA, <sup>2</sup>HealthCore, Inc., Wilmington, DE, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Characteristics of patients prescribed new medications often evolve over time after their market launch. To explore this, our analysis described baseline demographic and clinical characteristics as well as antidiabetic medication use in T2DM patients initiating oral semaglutide from its introduction in the US in a commercially-insured/Medicare Advantage population. </p> <strong><p><b>METHODS: </b></strong> Patients with T2DM newly initiating oral semaglutide between 9/20/2019-8/31/2020 were identified using the HealthCore Integrated Research Database in quarterly segments (index as first claim). Patients were included with at least 1 pharmacy claim for oral semaglutide during the study period, 90 days or more of pre-index and post-index enrollment, 1 or more HbA1c laboratory test results, and 1 or more claim with a diagnosis for type 2 diabetes.</p> <strong><p><b>RESULTS: </b> </strong>Four quarterly refreshes were included, totaling 2,763 T2DM patients. Endocrinologists were the largest group of early prescribers of semaglutide (34.7% at baseline) but decreased in later cohorts (21.9% at last refresh) and proportion of primary care physician prescribers increased over time (33.1% to 43.6%). The most common anti-diabetic medications, prior to oral semaglutide initiation, included metformin and sodium-glucose cotransporter-2 (SGLT2) inhibitors, with no changes over time. The most common non-anti-diabetic medications included antihypertensives, lipid lowering therapy, and antidepressants, with antihypertensive use rates increasing over time and antidepressants decreasing. Most patients had an HbA1c level above 7% (roughly 70%), increasing to roughly 80% in the last cohort. The most common comorbidities at index included hypertension, dyslipidemia, hyperglycemia, obesity, and sleep apnea, with these trends also staying stable except for hyperglycemia, which decreased over time.</p> <strong>CONCLUSION: </strong>After launch, the population initiating oral semaglutide experienced changes in demographic, clinical characteristics, and baseline treatment experience. It is important to understand and monitor the evolving characteristics of these patients, ensuring they have access to the appropriate medications they require at the time they need it most.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/co30dunnoralsemaglutideispor-pdf.pdf?sfvrsn=8530812c_0","title":"CO30_Dunn_oral_semaglutide_ISPOR.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117402","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of Therapeutic Inertia on Healthcare Outcomes for Patients with Type 2 Diabetes Mellitus","id":"c248d8bf-8350-4676-b107-ac2d55de4c54","sessionCode":"RWD4","topDisplay":"Matian J<sup>1</sup>, <b><u>Goldenberg A</u></b><sup>2</sup>, McCombs JS<sup>3</sup>, Kim R<sup>3</sup>, Xuan S<sup>4</sup>, Choe J<sup>3</sup>, Chen J<sup>5</sup>, Gu B<sup>6</sup><br><sup>1</sup>USC School of Pharmacy, Los Angeles, CA, USA, <sup>2</sup>USC School of Pharmacy, Calabasas, CA, USA, <sup>3</sup>University of Southern California, Los Angeles, CA, USA, <sup>4</sup>University of Southern California, Simi Valley, CA, USA, <sup>5</sup>University of Southern California, LOS ANGELES, CA, USA, <sup>6</sup>University of Southern California, Arcadia, CA, USA","locationCode":"","description":"\r\n\t<div><span style=\"font-weight: 400;\"><p><b>OBJECTIVES: </b> Therapeutic inertia is the failure of health-care providers to initiate or intensify therapy when therapeutic goals are not reached. Few studies have compared insulin initiation delay times with their expected negative effect on health outcomes. Our study quantifies the effects of delaying the start of insulin for patients with Type 2 Diabetes Mellitus (T2DM) on future A1c values, medical costs, and development of new T2D-related complications. <p><b>METHODS: </b> Retrospective paid claims data from 2008 to 2019 was retrieved from the OPTUM database including data on prescriptions fill history, lab values, hospitalizations, and patient demographics. Based on the American Diabetes Association (ADA) guidelines, insulin is recommended for patients who have an A1C greater than 10%. Patients matching this criteria were selected and insulin delay time was defined as the time between the initiation of insulin and the patient’s first recorded A1C above 10%. Patients were then grouped by months of delay up to 1 year to compare outcomes. Differences in healthcare costs and the risk of developing vascular complications were compared across patients depending on their delay category. </span><span style=\"font-weight: 400;\"><p><b>RESULTS: </b> An initial 1% sample of the OPTUM file revealed that most patients who exceed an A1c > 10 do not initiate insulin at any time in their post data. Additionally, patients treated with insulin within 3 months of A1c > 10 appeared to be 'sicker' with medical costs prior to their A1C >10 exceeding $12,000 while the other groups who delayed more than 3 months had prior medical costs around $5,000. Finally, the group that never initiated insulin had fewer events post regardless of the baseline from which this is measured. CONCLUSION: Patients are delaying starting insulin until they have an event. Our plans are to better document the risk of events and the costs associated with this behavior.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/t2d-insulin-theraputic-inertia-poster-pdf.pdf?sfvrsn=cbfbcf4e_0","title":"T2D Insulin Theraputic Inertia Poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117599","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab Vs. Pembrolizumab Plus Chemotherapy for the First-Line Treatment of Non-Squamous, Advanced Non-Small Cell Lung Cancer in the USA","id":"b879e9fc-43b5-411c-b749-ac82a6d47bf4","sessionCode":"EE35","topDisplay":"<b><u>Chen J</u></b><sup>1</sup>, Velcheti V<sup>2</sup>, Padula W<sup>3</sup><br><sup>1</sup>University of Southern California, LOS ANGELES, CA, USA, <sup>2</sup>New York University Langone, New York, NY, USA, <sup>3</sup>University of Southern California, Los Angeles, CA, USA","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>Immunotherapy used with or without chemotherapy has demonstrated significant clinical outcomes for non-small cell lung cancer (NSCLC) patients. The CheckMate-227 trial has shown that nivolumab plus ipilimumab indicates significant survival benefits as first-line treatment for non-squamous, advanced NSCLC patients. The KeyNote-189 trial has also concluded that pembrolizumab plus chemotherapy achieves efficacy for patients with the same disease characteristics as in CheckMate-227. The paper studied the cost-effectiveness of nivolumab plus ipilimumab vs. pembrolizumab plus chemotherapy as the first-line treatment for non-squamous, advanced NSCLC for adult patients from the US payer’s perspective.</p> <strong>Methods: </strong>A Markov model was built to analyze the cost-effectiveness of nivolumab plus ipilimumab in the first-line treatment of metastatic NSCLC. The health outcomes were estimated in quality-adjusted life-years (QALYs) and were obtained from the literature. The cost information was from Veteran Affairs (VA) catalogue Federal Supply Schedule (FSS) price in 2021. In addition to the base case incremental cost-effectiveness ratio (ICER) and incremental net monetary benefit (INMB), probabilistic and one-way sensitivity analyses were also conducted to examine the impact of uncertainties on the results.</p> <strong>Results: </strong>In the base case, the incremental costs and QALYs in the nivolumab plus ipilimumab group were ($87, 795.30) and (0.13) for advanced NSCLC patients regardless of PD-L1 expression, which led to an ICER of $674, 610.82 per QALY and an INMB of $68, 273.98. When parameters varied from the deterministic estimates, the INMB results were the most sensitive around the utility of progressive disease state for both groups. The probability sensitivity analysis showed that using a willingness-to-pay threshold of $150,000 per QALY, the probability of nivolumab plus ipilimumab being cost-effective was 87.3%.</p> <strong>Conclusions: </strong>Nivolumab plus ipilimumab was not found to be cost-effective at the willingness to pay threshold of $150,000 per QALY as compared with pembrolizumab plus chemotherapy for non-squamous, metastatic NSCLC patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/nsclc-cea-poster-ispor-pdf.pdf?sfvrsn=15cd5512_0","title":"NSCLC CEA Poster ISPOR.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116652","diseases":[{"id":"1f4acdfa-d73f-497b-9d7d-52ecfb7ff010","parentId":"00000000-0000-0000-0000-000000000000","title":"Alternative Medicine","urlName":"Alternative-Medicine"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Health Utility Instruments and Mitochondrial Disease with Associated Seizures","id":"b034b6de-ca11-40f4-8469-acbbe61e23bd","sessionCode":"PCR2","topDisplay":"<b><u>Smith AB</u></b><sup>1</sup>, Hanbury A<sup>1</sup>, Bromilow T<sup>1</sup>, Buesch K<sup>2</sup><br><sup>1</sup>York Health Economics Consortium (YHEC), York, UK, <sup>2</sup>PTC Therapeutics Switzerland GmbH, Steinhausen, Switzerland","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Mitochondrial disease with associated seizures (MDAS) is a metabolic condition affecting both adults and children. In addition to neurological problems, MDAS is characterised by muscle disorders, vision and/or hearing problems. There have been few studies to-date that have explored the impact of MDAS on health-related quality of life (HRQoL), particularly in terms of preference-based measures (PBM) to derive health utility values for use in economic evaluations of MDAS. The aim of this study was to determine whether, if any, PBMs had been used in the literature to evaluate HRQoL in MDAS. </p> <p><b>METHODS: </b> A pragmatic literature review was undertaken of the PubMed and Ovid databases in order to identify studies that had included PBMs used in MDAS in both adult and paediatric populations. Key search terms included “mitochondrial disease”, “health utilities”, and “paediatric”. A gap analysis of three commonly used PBMs (EQ-5D, CHU-9D and HUI3) was also undertaken to determine whether these instruments capture the primary signs and symptoms of MDAS.</p> <p><b>RESULTS: </b> The literature search identified 124 potentially relevant articles. Following a review of the abstracts and full text screening, 4 eligible studies were selected for data extraction. These studies included a total of 84 paediatric patients. None of the reviewed articles had included a preference-based utility measure. The most frequently used instrument was the Newcastle Paediatric Mitochondrial Disease Scale (n=3 studies). There was little overlap between the main symptoms of MDAS and the 3 main PBMs: muscle weakness and movement disorders were potentially covered by the instruments. Only the HUI3 had items capturing vision and hearing problems, as well as learning disabilities.</p> <p><b>CONCLUSIONS: </b> This study demonstrated that no PBMs have been utilised to assess HRQoL in MDAS. Future work is required to determine health utilities associated with levels of MDAS in order to evaluate potential treatments of the condition.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115754","diseases":[{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Prevalence and Risk Factors of Post COVID-19 Condition in Previously Hospitalized Patients in Bolivar, Colombia: An Observational Study","id":"b68e8cc9-6f6d-4168-961e-acea78a6e37e","sessionCode":"EPH22","topDisplay":"Lozano A<sup>1</sup>, Salcedo Mejía F<sup>1</sup>, <b><u>Alvis Zakzuk N</u></b><sup>1</sup>, Fernandez Mercado JC<sup>2</sup>, Jerez Arias M<sup>3</sup>, Zakzuk Sierra J<sup>1</sup>, Alvis Guzman N<sup>4</sup>, Dueñas C<sup>5</sup><br><sup>1</sup>ALZAK Foundation, Grupo de Investigación ALZAK, Cartagena, BOL, Colombia, <sup>2</sup>MUTUALSER EPS, University of Cartagena Clínica Crecer, Cali, VAC, Colombia, <sup>3</sup>Fundación SERSOCIAL, Cartagena, Colombia, <sup>4</sup>ALZAK Foundation- Universidad De La Costa, Barranquilla, Colombia, <sup>5</sup>Universidad de Cartagena, Cartagena de Indias, Colombia","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To estimate the prevalence and risk factors of post-COVID-19 condition after at least three months of hospital discharge in a retrospective cohort of patients from a health insurance company (Mutual SER EPS) living in the north of Bolivar, a department of Colombia.</p> <p><b>METHODS: </b>Clinical and sociodemographic data were collected from 181 COVID-19 patients who were hospitalized in the ward or intensive care unit (ICU) between March-2021 to August-2021. Patients who agreed to participate were evaluated by a structured telephone interview to identify persistent or new symptoms after at least three months of hospital discharge. Associations between at least one symptom and clinical and sociodemographic characteristics at admission were assessed through bivariate and multivariate logistic regression using a stepwise Akaike information criterion (AIC) selection. Adjusted odds ratios (aOR) are reported.</p> <p><b>RESULTS: </b>Mean age of patients was 56 years (SD: 17 years), 50.8% (n=92) were women and 23.2% (n=42) were previously admitted to ICU. One-hundred-three patients (56.9%) had at least one comorbidity; being hypertension (36.5%), type 2 diabetes mellitus (18.2%) and heart disease (8.28%) the most common. The presence of at least one symptom after three months of hospital discharge was reported by 141 (77.9%) patients. Most frequently symptoms were fatigue (54.1%), joint pain (45.3%), dyspnea (43.1%), sleep disorders (36.5%), chest pain (30.4%), and anorexia (30.4%). Symptoms were significantly more frequent in women (aOR: 2.45, 95% CI 1.14-5.29, p=0.02) and ICU admitted patients (aOR: 3.10, 95% CI 1.02-9.45 p=0.05), but were not associated with age, having comorbidities, or a previous long hospital stay. </p> <p><b>CONCLUSIONS: </b>As reported in other studies, in Bolivar -Colombia, the presentation of post COVID-19 symptoms is frequent in previously hospitalized patients. Being a women and ICU admission are potential risk factors for post COVID-19 condition.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-prevalencia-secuelas-covid-jz-pdf.pdf?sfvrsn=fac5d706_0","title":"poster prevalencia secuelas COVID JZ.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117548","diseases":[{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"},{"id":"f2cabca2-ce06-433e-903c-56285673ffc3","parentId":"00000000-0000-0000-0000-000000000000","title":"Musculoskeletal Disorders","urlName":"Musculoskeletal-Disorders"},{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Indirect Treatment Comparison between Daprodustat and Roxadustat in Non-Dialysis Patients with Anemia Associated with Chronic Kidney Disease: An Analysis of Energy/Fatigue as Measured by the SF-36 Vitality Score","id":"c45be294-2b2b-4add-8c9d-ad1c023e878a","sessionCode":"CO2","topDisplay":"Singh A<sup>1</sup>, <b><u>Sackeyfio A</u></b><sup>2</sup>, Lopes RD<sup>3</sup>, Kovesdy CP<sup>4</sup>, Dasgupta I<sup>5</sup>, Wheeler DC<sup>6</sup>, Cases A<sup>7</sup>, Wiecek A<sup>8</sup>, Mallett S<sup>9</sup>, Ballew N<sup>10</sup>, Israni RK<sup>11</sup>, Keeley T<sup>9</sup>, Garcia-Horton V<sup>12</sup>, Ayyagari R<sup>13</sup>, Refoios Camejo R<sup>9</sup>, Johansen KL<sup>14</sup><br><sup>1</sup>Brigham and Women's Hospital; Harvard Medical School, Boston, MA, USA, <sup>2</sup>GlaxoSmithKline plc., Stevenage, Hertfordshire, UK, <sup>3</sup>Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA, <sup>4</sup>University of Tennessee Health Science Center, Memphis, TN, USA, <sup>5</sup>University Hospitals of Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK, <sup>6</sup>Department of Renal Medicine, University College London, London, UK, <sup>7</sup>Anemia Working Group Spanish Society of Nephrology, Madrid; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain, <sup>8</sup>Department of Nephrology, Endocrinology and Metabolic Diseases, Silesian University School of Medicine, Katowice, Poland, <sup>9</sup>GlaxoSmithKline plc., Brentford, London, UK, <sup>10</sup>GlaxoSmithKline, Collegeville, PA, USA, <sup>11</sup>GlaxoSmithKline plc., Collegeville, PA, USA, <sup>12</sup>Analysis Group Inc., New York, NY, USA, <sup>13</sup>Analysis Group Inc., Boston, MA, USA, <sup>14</sup>Hennepin Healthcare, University of Minnesota, Minneapolis, MN, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Prolyl hydroxylase inhibitors (PHIs) are oral agents that might increase availability of anemia treatment options for patients with chronic kidney disease (CKD). The 36-Item Short Form (SF-36) Vitality score is a patient-reported measure of energy/fatigue – common and important outcomes in patients with CKD. Direct comparative evidence on health-related quality of life from randomized controlled trials (RCTs) between PHIs has not been identified. We conducted an indirect treatment comparison (ITC) of changes in SF-36 Vitality score observed in placebo-controlled RCTs of daprodustat and roxadustat.</p> <p><b>METHODS: </b>Four pivotal Phase III, double-blind, placebo-controlled RCTs evaluating either daprodustat (ASCEND-NHQ [submitted for publication]) or roxadustat (ALPS, ANDES, OLYMPUS) in anemic non-dialysis CKD patients were identified. Aggregate data for pre‑specified SF-36 Vitality score endpoints – change from baseline to week 28 in ASCEND‑NHQ, and from baseline to the average across weeks 12 to 28 for the three roxadustat RCTs – were used in our analyses. Posterior probability distribution estimates and pairwise comparisons were generated using Bayesian Markov Chain Monte Carlo methods with non-informative priors. A 95% credible interval (CrI) for mean least squares mean (LSM) difference in change in SF-36 Vitality score between treatments above zero demonstrated superiority.</p> <p><b>RESULTS: </b>In pairwise comparisons, respective posterior mean LSM differences for daprodustat (5.37, 95% CrI 0.78, 9.93) and roxadustat (0.67, 95% CrI 0.02, 1.32) demonstrated significantly improved SF-36 Vitality score relative to placebo, and daprodustat demonstrated a significantly improved SF-36 Vitality score relative to roxadustat (4.70, 95% CrI 0.08, 9.31).</p> <p><b>CONCLUSIONS: </b>Our analyses suggest superiority of daprodustat compared with roxadustat for the SF-36 Vitality score, which could be important to patients with anemia of CKD. A potential limitation of this ITC is the differences in timepoints of SF-36 Vitality endpoints across studies; however, our analyses used pre-specified endpoints that considered dosing algorithms and expected hemoglobin rate of rise from PHIs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116255","diseases":[{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Economic Evaluation on the Use of Standard Lyophilized Bacterial Lysates for Recurrent Respiratory Infections Prevention in Pediatric Patients","id":"9282bc68-902f-4288-9e7c-ad37da4a8064","sessionCode":"EE25","topDisplay":"<b><u>Soto Molina H</u></b><sup>1</sup>, Agramonte Hevia J<sup>2</sup>, Del Rosal y Hermosillo A<sup>2</sup>, González JF<sup>2</sup>, Frias Gasga AE<sup>1</sup>, Escobar Y<sup>3</sup>, Martinez V<sup>4</sup>, Sámano Martínez E<sup>5</sup>, Ramos J<sup>6</sup><br><sup>1</sup>HS Estudios Farmacoeconómicos S.A. de C.V., Ciudad de México, Mexico, <sup>2</sup>Grünenthal de Mexico S.A. de C.V., Ciudad de México, DF, Mexico, <sup>3</sup>HS Estudios Farmacoeconómicos S.A. de C.V., Mexico City, EM, Mexico, <sup>4</sup>HS Estudios Farmacoeconómicos S.A. de C.V., Mexico city, Mexico, <sup>5</sup>HS Estudios Farmacoeconómicos S.A. de C.V., Ciudad de México, DF, Mexico, <sup>6</sup>HS Estudios Farmacoeconómicos S.A. de C.V., México, Mexico","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>To develop a complete economic evaluation on the use of bacterial lysates for upper recurrent respiratory infections (URRI) prevention in pediatric patients from the Mexican national public health system.</p> <strong> </strong></p> <strong>Methods: </strong>A cost- effectiveness analysis was performed considering the difference in frequency of URRI reported on a meta-analysis by Yin et al in 2018. The analysis was performed through a decision tree model with a 6-months temporal horizon. Additionally, a budget impact analysis was developed to validate the financial impact of treatment inclusion to Mexico’s health system. The clinical information was obtained through an exhaustive search of different databases for pediatric population with the objective of evaluating the efficacy and safety of the standard lyophilized bacterial lysates in comparison with routine therapy for the management of URRI validated through an expert panel based on the Delphi method.</p> </p> <strong>Results:</strong> The standard lyophilized bacterial lysates showed a significant reduction on the frequency of URRI in pediatric patients (mean difference [MD] =-2.33, 95% CI) versus the comparator. In a 6-month period, the standard lyophilized bacterial lysates generated an average cost per patient of $22,966.36 MxN vs $43,879.26 MxN of the proposed comparator. When estimating the incremental cost-effectiveness ratio, it was observed that the standard lyophilized bacterial lysates is the dominating option due to its improved efficacy and a lower average cost per patient. The budget impact analysis showed that the inclusion of the standard lyophilized bacterial lysates would generate annual average savings of $582,378,921.10 MxN in 5 years for Mexico’s national health system.</p> </p> <strong>Conclusions: </strong>When considering the difference in URRI frequency in the pediatric population as an outcome evaluator, the standard lyophilized bacterial lysates are a dominant and efficient option for Mexico’s national health system.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115621","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of Value-Based Insurance Design on Medication Adherence in Patients with Asthma and/or COPD in an Employee Health Plan: An Interrupted Time Series Analysis","id":"bb804159-5d90-4375-9cc8-ada1ecbff16b","sessionCode":"CO28","topDisplay":"<b><u>Reynolds T</u></b><sup>1</sup>, Yu A<sup>2</sup>, Rascati K<sup>3</sup>, Godley P<sup>1</sup><br><sup>1</sup>Baylor Scott & White Health, Temple, TX, USA, <sup>2</sup>Baylor Scott & White Health, Austin, TX, USA, <sup>3</sup>The University of Texas at Austin, Austin, TX, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Value-Based Insurance Design (VBID) is intended to incentivize the use of services that are most cost-effective for patient care. One strategy is to reduce patient cost-sharing of medications that are crucial for chronic disease, such as inhalers for asthma and/or chronic obstructive pulmonary disease (COPD). Recently, several benefit changes have been introduced into an employee health plan for a large health system in Texas, including co-pay reductions, deductible elimination, and income-based premium subsidies. This study evaluated the impact of these interventions.</p> <strong>Methods</strong>: This retrospective, longitudinal study evaluated the impact of a series of benefit changes on medication adherence (PDC, proportion of days covered) using an interrupted time series analysis. Four contiguous study segments were examined between January 1, 2014, and December 31, 2020. This study used existing data from pharmacy claims, pharmacy eligibility, and electronic health records for asthma and/or COPD patients insured through an employee health plan. Adherence to each maintenance inhaler class was evaluated independently (ICS, inhaled corticosteroid; LABA, long-acting beta agonist).</p> <strong>Results</strong>: For 469 patients with an ICS-containing inhaler prescription fill, PDC was initially decreasing by 0.0043 (p=0.0005) per month. Immediately after flat co-pay implementation, a PDC increase of 0.0712 (p=0.0147) occurred, and PDC continued to increase by 0.0068 (p=0.0020) per month.</p> For 339 patients with a LABA-containing inhaler prescription fill, PDC was initially decreasing by 0.0038 (p=0.0029) per month. Immediately after flat co-pay implementation, a PDC increase of 0.0718 (p=0.0180) occurred, and PDC continued to increase by 0.0067 (p=0.0035) per month.</p> No other interventions had a significant impact on ICS or LABA PDC.</p> <strong>Conclusions</strong>: The introduction of a flat co-pay was associated with an increase in adherence for patients using ICS- or LABA-containing maintenance inhalers. Co-pay reductions appear to be more impactful overall when compared with deductible elimination or premium subsidies in this population.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-poster-cpl-asthmacopd-v2-pdf.pdf?sfvrsn=eb24aae8_0","title":"ISPOR Poster CPL AsthmaCOPD v2.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116488","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Changes in Demographic and Clinical Characteristics of Patients with Type 2 Diabetes (T2DM) Initiating Subcutaneous Semaglutide","id":"c7e5e6f7-2bc0-4072-b38a-ade17bdc36df","sessionCode":"CO94","topDisplay":"<b><u>Dunn TJ</u></b><sup>1</sup>, Swift C<sup>1</sup>, Guesnier A<sup>1</sup>, Noone J<sup>1</sup>, Willey V<sup>2</sup><br><sup>1</sup>Novo Nordisk Inc., Plainsboro, NJ, USA, <sup>2</sup>HealthCore, Inc., Wilmington, DE, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Characteristics of patients prescribed new medications often evolve over time after market launch. To explore this, our analysis described baseline demographic and clinical characteristics as well as antidiabetic medication use in T2DM patients initiating subcutaneous semaglutide over time from its introduction in the US in a commercially-insured/Medicare Advantage population. </p> <strong><p><b>METHODS: </b></strong> T2DM patients initiating subcutaneous semaglutide between 2/1/2017-3/31/2020 were identified using HealthCore Integrated Research Database in quarterly segments (index as first claim). Patients were included with ≥1 year of pre-index enrollment and ≥1 T2DM claim. Patients were stratified based on prior glucagon-like peptide 1 receptor agonist (GLP-1) use (experienced/naïve). Baseline demographic, clinical and antidiabetic medication use characteristics were descriptively reported.</p> <strong><p><b>RESULTS: </b></strong> Eight quarterly refreshes were included, totaling 31,031 T2DM patients (20,272 GLP-1 naïve, 10,759 GLP-experienced). Most patients in both groups were prescribed semaglutide by endocrinologists at baseline, with this trend slowly decreasing over time and PCPs becoming the primary prescribers during later quarters. The most common anti-diabetic medications in both groups, prior to subcutaneous semaglutide initiation, were metformin (77.6% at baseline) and sodium-glucose cotransporter-2 (SGLT2) inhibitors (41.3%), with SGLT2 inhibitor rates slowly decreasing. Most patients had HbA1c levels above 7% in both groups (66.2-74.0% GLP-1 experienced patients, 73.7-83.5% GLP-1 naïve), with no significant trends. Non-anti-diabetic medications prescribing rates were high in both groups, including antihypertensives (79.9-81.7%) and lipid lowering therapy (71.9-73.7%). Roughly 34% of patients were prescribed antidepressants (35.5% among GLP-1 experienced, 32.9% GLP-1 naïve). The most common comorbidities included hypertension, dyslipidemia, hyperglycemia, obesity, and sleep apnea, with trends also staying stable.</p> <strong>CONCLUSION:</strong> After launch, the T2D population initiating subcutaneous semaglutide experienced changes in baseline demographics, clinical characteristics, and antidiabetic treatment use. Continuous monitoring of these trends ensures that, as these provider types and patient subgroups evolve, prescribing healthcare practitioners have the most up-to-date and relevant information to managing T2DM.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/co94dunnsubcusemaglutideispor-pdf.pdf?sfvrsn=e379951c_0","title":"CO94_Dunn_subcu_semaglutide_ISPOR.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117753","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Venetoclax in Combination with Azacitidine Is Cost-Effective Vs. AZA for the Treatment of Newly Diagnosed Acute Myeloid Leukemia: A Canadian Perspective","id":"bfc7b5d8-6001-4bc4-8803-ade7c6d3524e","sessionCode":"EE46","topDisplay":"Guinan K<sup>1</sup>, Mathurin K<sup>1</sup>, Au Y<sup>2</sup>, Schuh AC<sup>3</sup>, Bui CN<sup>4</sup>, Chai X<sup>5</sup>, <b><u>Lachaine J</u></b><sup>6</sup><br><sup>1</sup>PeriPharm Inc., Montreal, QC, Canada, <sup>2</sup>AbbVie Corporation, Saint Laurent, QC, Canada, <sup>3</sup>Princess Margaret Cancer Centre, Toronto, ON, Canada, <sup>4</sup>AbbVie Corporation, North Chicago, IL, USA, <sup>5</sup>Analysis Group, Inc., Boston, MA, USA, <sup>6</sup>University of Montreal, Montreal, QC, Canada","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Treatment of acute myeloid leukemia (AML) has traditionally involved intensive chemotherapy (IC); thus, there remains an unmet need for approximately 50% of AML patients deemed unfit or ineligible for IC. This Canadian study evaluates the economic impact of venetoclax in combination with azacitidine (Ven+Aza) for the treatment of patients with newly diagnosed AML who are 75 years or older, or who have comorbidities that preclude IC.</p> <strong><p><b>METHODS: </b> </strong>A lifetime partitioned survival model was developed to assess the cost-effectiveness of Ven+Aza compared to Aza alone. Health states included event-free survival, progressive/relapsed disease, and death. Efficacy parameters were based on the VIALE-A trial. Analyses were conducted from Ministry of Health (MoH) and societal perspectives. Cost components included initial and subsequent treatment, subsequent hematopoietic stem cell transplantation, management of adverse events, medical costs associated with health states (i.e., hospitalization, blood transfusion, and ongoing monitoring) and terminal care. From a societal perspective, costs associated with productivity loss were also considered.</p> <strong><p><b>RESULTS: </b></strong> Over a lifetime horizon, Ven+Aza was associated with a gain of 1.65 quality-adjusted life years (QALYs) compared to Aza alone. From a MoH perspective, Ven+Aza and Aza alone were associated with total costs of $204,305 and $82,333, respectively, resulting in an incremental cost-utility ratio (ICUR) of $73,841/QALY for Ven+Aza vs. Aza alone. From a societal perspective, Ven+Aza and Aza were associated with total costs of $177,510 and $77,955, respectively, resulting in an ICUR of $60,269/QALY. According to a willingness-to-pay threshold of $100,000/QALY, Ven+Aza was a cost-effective alternative compared to Aza alone in 98.8% and 99.7% of Monte Carlo simulations, from MoH and societal perspectives, respectively.</p> <strong><p><b>CONCLUSIONS: </b></strong> This economic evaluation demonstrates that, in comparison to Aza alone, Ven+Aza is a cost-effective strategy for the treatment of patients with newly diagnosed AML who are deemed unfit for IC.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117006","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Alignment with Services Providers was the Single Most Challenging Change in the Brazilian National Agency for Private Healthcare System (ANS) Value-Based Healthcare (VBHC) Project.","id":"87338417-675c-4446-86bf-aeb56cffdcda","sessionCode":"HPR7","topDisplay":"Bernz I<sup>1</sup>, Francisquini F<sup>2</sup>, Pedro GO<sup>3</sup>, <b><u>Nita M</u></b><sup>1</sup><br><sup>1</sup>MAPESolutions, SÃO PAULO, SP, Brazil, <sup>2</sup>FGV Fundação Getúlio Vargas, SÃO PAULO, Brazil, <sup>3</sup>MAPESolutions, Sao Paulo, Brazil","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE:</strong> Brazilian National Agency for private healthcare system (ANS) makes the regulation for private healthcare system in Brazil. ANS, since 2019, is running the pilot value-based new payment models project. In total, 13 projects were selected by ANS. The goals of this analysis are to identify key operationalization process challenges for implementing new value-based payments models in Brazil, according with the managers of private healthcare plans participating in the projects.<strong> METHODOLOGY: </strong>We interviewed managers participating in the Value-Based Payment Models by ANS. Data collection was through semi-structured interviews carried out during 2021. 12 managers were invited to participate in the interview, being applied with 8 managers. The key questions were: “Was there a need for internal alignments? / What were the key steps and areas involved for external alignments? \" For data analysis, Bardin's content analysis was chosen. Data validation was performed using the defriefing technique.<strong> <p><b>RESULTS: </b></strong> The key elements identified were related with project construction processes: 23% reported 1) challenges (difficulties) with a) healthcare services providers (52%), including negotiating and mindset change, b) IT management (38%), including integrating the ANS claims database with health plan database, c) Agreement with service providers (10%). In more details, 2) the alignment with the provider is related to the team (54%) and process (46%). Furthermore, 3) 21% mentioned a positive perceptions about the project, including the focus on patients (35%) and support from ANS (23%)., Also, 15% referred to the needs of the projects, including processes (32%) – regulation and auditing, culture (26%) – paradigm shift, people (26%) – knowledge and support from board of director, and investment (16%). Finally, 15% referred the internal alignments with the team: administrative (58%) and care (42%). <strong>CONCLUSION: </strong>Our research suggests that the alignment with the provider and IT structure are the most sensitive areas.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114777","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Applied Machine Learning to Real World Data to Predict Mortality Among Patients with COPD","id":"a54bd2bb-341f-46d8-b216-aef5924d80af","sessionCode":"MSR3","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> To apply machine learning (ML) algorithms to real-world data to predict mortality among patients with moderate-to-severe COPD monitored in the Brazilian public health system.</p> <p><b>METHODS: </b> Individuals with COPD treated to a referral public outpatient clinic in Salvador, Northeast of Brazil, between June 2011 and January 2012 who presented a post-bronchodilator FEV<sub>1</sub>/FVC ratio < 0.7 and post-bronchodilator FEV<sub>1</sub> < 80% of predicted, as measured by spirometry. The outcome variable was the occurrence of death within seven years of the COPD patient entry in the cohort study, and the predictors were 21 variables related to the patient’s demographic, socioeconomic, and clinical profile. The algorithms were trained in a random sample of 70% of patients, and 30% were left for performance assessment. Four ML methods were used to predict the mortality, including logistic regression, extreme gradient boosting (XGBoost), random forest and k-nearest neighbor. The best model was selected through the assessment of the area under the ROC curve (AUC).</p> <p><b>RESULTS: </b> Among 257 patients (68 ± 11 years old, 67.7% men, 73.5% GOLD III and IV) in the analysis, 74 (28.8%) died. Two models (logistic regression; and XGBoost) presented AUC ROC greater than 0.70. The logistic regression model was the best performing model (AUC: 74.0%; accuracy: 79.5%; recall: 31.6%; precision: 66.7% and F1: 0.42). The top variables in terms of variable importance for the 2 algorithms were non-adherence to treatment, hospitalization due to COPD in the last year, the presence of symptoms (mMRC ≥ 2) and duration of COPD.</p> <p><b>CONCLUSIONS: </b> These findings suggest that the logistic regression-based algorithms are relatively more effective in the prediction of mortality of COPD. The application of ML techniques to real-world data can yield useful predictive models to support clinical decision making.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117516","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Psychometric Evaluation of the Health Care Provider HIV/AIDS Stigma Scale (HPASS) Using Rasch Analysis","id":"4c7d082c-b806-4001-bdaa-af05a2510e04","sessionCode":"PCR32","topDisplay":"<b><u>Goswami S</u></b><sup>1</sup>, Barnard M<sup>2</sup>, Bynum LA<sup>3</sup>, Thompson S<sup>4</sup>, Kang M<sup>5</sup><br><sup>1</sup>University of Mississippi, University, MS, USA, <sup>2</sup>Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, MS, USA, <sup>3</sup>Belmont University College of Pharmacy, Nashville, MS, USA, <sup>4</sup>North Dakota State University, Fargo, MS, USA, <sup>5</sup>University of Mississippi, School of Applied Sciences, University, MS, USA","locationCode":"","description":"\r\n\t<div><strong>Introduction:</strong> Pharmacists play an important role in caring for individuals with HIV/AIDS. However, stigma in healthcare settings can be a deterrent to providing appropriate care. This study assessed psychometric properties and convergent validity of Health Care Provider HIV/AIDS Stigma Scale (HPASS) among pharmacy students in the United States (U.S.) using Rasch analysis.</p> <strong>Methods:</strong> Students enrolled in four U.S. universities were administered the survey (N=203). Rasch analysis was conducted for each HPASS subscale to assess dimensionality, model-data fit, item difficulty, person’s stigma level, distribution items and persons across item-person map and rating scale function using the rating scale model. Convergent validity evidence was established by comparing Pearson’s correlation coefficients between HPASS subscales and AIDS Attitude Scale (AAS) (Avoidance and Empathy subscales).</p> <strong>Results:</strong> All the items fit the respective subscales well except Item 15[Infit Mnsq=2.50, Outfit Mnsq=4.09] and Item 13 [Infit MnSq=1.52, Outfit MnSq=1.56] in the Prejudice subscale which were misfit and therefore removed. The 6-point rating scale did not perform satisfactorily for any of the three HPASS subscales. Item difficulty ranges were wide[Stereotyping(–5 to 0.8 logits), Discrimination(-6 to 1 logits), Stereotyping(-5 to 0.4 logits)]. Items in all three subscales were biased towards measuring higher levels of stigma. Person separation index was satisfactory(Stereotyping=2.2; Discrimination=2.06; Prejudice=2.17), as was person separation reliability(Stereotyping=0.83; Discrimination=0.81; Prejudice=0.83). Convergent validity was established by showing significant correlations between HPASS subscales and AAS–Avoidance(p<.001) and AAS-Empathy(p<0.001).</p> <strong>Conclusion:</strong> Modifying or removing misfit items of HPASS and exploring alternate rating scales for HPASS subscales will help better assess HIV/AIDS related stigma among pharmacy students. Having a validated scale that measures different dimensions of stigma among pharmacy students will enable the use of this scale routinely in pharmacy curriculum to assess education related unmet needs and allow tailoring of the training modules to accommodate the same.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117523","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Health and Economic Outcomes of Botulinum Toxin-a Products for Adult Patients with UPPER LIMB Spasticity in a Real-World Setting","id":"fc527cf9-4c4f-408e-8f00-b15a260ecc6f","sessionCode":"EE69","topDisplay":"Jacinto J<sup>1</sup>, Ashford S<sup>2</sup>, Fheodoroff K<sup>3</sup>, <b><u>Danchenko N</u></b><sup>4</sup>, Calvi-Gries F<sup>5</sup>, Bourhis Y<sup>6</sup>, Whalen JD<sup>7</sup>, Pietri G<sup>8</sup>, Turner-Stokes L<sup>9</sup><br><sup>1</sup>Centro de Medicina de Reabilitaçãode Alcoitão, Estoril, France, <sup>2</sup>Northwick Park Hospital, London, France, <sup>3</sup>Gailtal-Klinik, Hermagor, Austria, Hermagor, France, <sup>4</sup>Ipsen, Boulogne-Billancourt, 75, France, <sup>5</sup>Ipsen, Boulogne-Billancourt, France, <sup>6</sup>ICON, Lyon, France, <sup>7</sup>Ipsen Biopharm Ltd, Slough, UK, <sup>8</sup>Data Pyxis Ltd., St Albans, HRT, UK, <sup>9</sup>King’s College London, Harrow Middlesex, UK","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Botulinum toxin A (BoNT-A) can enable achievement of treatment goals in upper limb spasticity (ULS). However, real-world data are limited. We examine health and economic outcomes of BoNT-A in ULS in the real-world.</p> <strong>Methods: </strong>ULIS III (NCT02454803) was a multicenter, non-interventional, prospective, 2-year study in ULS on abobotulinumtoxinA (aboBoNT-A), onabotulinumtoxinA (onaBoNT-A), or incobotulinumtoxinA (incoBoNT-A). Patients changing BoNT-A during follow-up were excluded from this analysis. Response was defined as ≥10-point increase in cumulated GAS-T at the last visit versus baseline. Improvement ≥the minimal clinically important difference (MCID of 0.074) in quality of life (QoL) was assessed with EQ-5D-5L (US, Australia). Annual treatment costs in 2021<span style=\"text-decoration: line-through;\">€</span> were estimated for France, Italy, Portugal. Multivariate logistic regression of response and linear regression of annual treatment costs evaluated the effect of BoNT-A on health and economic outcomes.<strong> </strong></p> <strong>Results: </strong>828 patients provided cumulated GAS-T score data (555 aboBoNT-A, 196 onaBoNT-A, 77 incoBoNT-A). Response rates with onaBoNT-A over the study period were significantly lower than those with aboBoNT-A (adjusted OR 0.47[0.33-0.68]) and no significant difference was found between aboBoNT-A and incoBoNT-A (p=0.864). A favorable response to BoNT-A was associated with higher likelihood of clinically significant improvement in QoL; improvement in excess of the MCID was observed in 46% of responders versus 30% of non-responders at last study visit (versus baseline). A significant reduction in annual treatment costs was observed between aboBoNT-A and incoBoNT-A in France (adjusted cost difference -€592.54 [p<0.001] with vial sharing, -€541.09 [p<0.001] without, N=88), with no significant difference in Italy or Portugal; aboBoNT-A and onaBoNT-A costs were not significantly different in three countries.</p> <strong>Conclusions: </strong>These real-life data suggest aboBoNT-A can be cost-effective in ULS. At similar treatment costs, aboBoNT-A was associated with a higher responder rate than onaBoNT-A, which may be linked to improved QoL. AboBoNT-A was also cost-saving versus incoBoNT-A in France.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117071","diseases":[{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness Analysis of Motixafortide on Top of G-CSF for Stem Cell Mobilization for Autologous Bone Marrow Transplantation in Patients with Multiple Myeloma","id":"e426453b-8b77-4aa7-b244-b1b5be3659b8","sessionCode":"EE56","topDisplay":"<b><u>Lamotte M</u></b><sup>1</sup>, DiPersio JF<sup>2</sup>, Siegel DS<sup>3</sup>, Meron H<sup>4</sup>, Serlin PA<sup>4</sup>, Gerlier L<sup>1</sup><br><sup>1</sup>IQVIA, Zaventem, VBR, Belgium, <sup>2</sup>Washington University School of Medicine, Saint Louis, MO, USA, <sup>3</sup>Hackensack University Medical Center, Hackensack, NJ, USA, <sup>4</sup>BioLineRx, Modi'in, Israel","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b> The GENESIS trial demonstrated that motixafortide (M) + G-CSF (G, growth factor) mobilized significantly more stem cells for autologous transplantation (ASCT) in patients with multiple myeloma (MM) versus G alone. This study analyzed resource use (HRU) alongside the GENESIS trial and used the findings to assess cost-effectiveness of M+G vs G. <strong><p><b>METHODS: </b> </strong>HRU items collected included number of drug doses, number of apheresis sessions in primary and rescue mobilization, percentage of patients needing rescue mobilization, hospitalization for conditioning, ASCT and serious adverse events. 2021 Medicare unit costs and drug wholesale acquisition cost were used. The de novo cost-effectiveness model has two parts: a 6-month decision tree describing management of patients undergoing ASCT populated with GENESIS clinical and HRU data followed by a lifetime Markov model (alive-dead). Maintenance costs including subsequent therapy lines were based on large US claims databases. Published utility scores in MM were applied. A disutility was deducted per mobilization/apheresis day. Discounting of 3%/year was applied. Sensitivity analyses were performed to identify key drivers. <strong><p><b>RESULTS: </b> </strong>Patients receiving M+G needed less drug doses and less apheresis sessions, achieved significantly more optimal mobilization in ≤4 days (96.3% vs. 47.6%) and required less rescue therapy (1.3% vs. 23.8%). More patients in M+G vs G underwent ASCT. The model yielded a QALY gain of 0.06 (5.56 vs. 5.50, respectively) and cost savings of $6,152 with M+G vs G (total savings $19,024 minus $12,872 for motixafortide cost, assuming $12,000/vial). Thus, M+G is dominant vs G. Key drivers were probability of undergoing ASCT, of having successful and shorter time to engraftment, and long-term maintenance costs. M+G was dominant in half of the simulations. <strong><p><b>CONCLUSIONS: </b></strong> The trial findings, combined with model estimates, suggest that upfront use of M+G in ASCT is a cost-effective option in the US, based on usual willingness-to-pay values.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116306","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Costs after Diagnosis of COVID-19 in Beneficiaries of a Telemedicine Service from a Healthcare Provider in Southern Brazil: A Real-World Study","id":"5551d0bb-42a1-419b-b6c9-b1bce2c87729","sessionCode":"EE11","topDisplay":"Lind J<sup>1</sup>, Netto H<sup>2</sup>, Aguiar BF<sup>1</sup>, <b><u>Böger B</u></b><sup>3</sup>, Santos J<sup>1</sup>, Ramos MP<sup>1</sup>, Rocha J<sup>2</sup><br><sup>1</sup>Unimed Curitiba, Curitiba, Brazil, <sup>2</sup>Unimed Curitiba, Curitiba, PR, Brazil, <sup>3</sup>Universidade Federal do Paraná, Curitiba, Brazil","locationCode":"","description":"\r\n\t<div>The aim of this study was to analyze all costs of beneficiaries appointmented in a telemedicine service of a health care provider in the State of Paraná- Brazil. We performed a real-world, retrospective chart review using data from the health insurance company database (South region in Brazil) to identify patients with COVID-19 who performed a medical consult by the telemedicine service between May 2020 and May 2021, until 12 months after diagnosis of Covid-19. Demographic, clinical data and costs (currency quote: US$ 1= R$ 5.69) of exams and treatments/hospitalization were extracted. Descriptive statistics were conducted with results reported as percentage. A total of 195 patients tested positive for Covid-19, 7 were excluded because they had no recorded costs, so we included 188 patients who used the telemedicine service during the period. Of these, 61.70% (n=116) patients were female and 29.8% (n=56) were between 31 and 40 years old. The average cost per patient after Covid-19 was USD 1,594.02 (total USD 322,784.17). 9% (n=17) of the patients required hospitalization, and of these 41.2% (n=7) were hospitalized from 1 to 7 days. Most of resources were consumed during the second quarter of 2021 with post-Covid-19 patients (USD 157,663.41). In addition, among the expenditure, the most used specialty was the general hospital, begetting a cost of USD 134,131.57 in the period. There is a high economic impact for health care providers after diagnosis of Covid-19, it may be associated to the late symptoms and complications of the disease, and that this can impact both private and public health. The knowledge of costs after Covid-19 and its consequences in different population profiles can help in the development of a comprehensive approach for better decision-making and strategic planning in the organization of care networks and the programming of health actions.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116413","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Antidepressant and Antianxiety Medication Dispensing Among Women with Psychiatric Disorders after Benign Hysterectomy","id":"395a31fc-a356-41dc-a67b-b1ecc3238359","sessionCode":"RWD23","topDisplay":"<b><u>Ishiwata R</u></b><sup>1</sup>, AlAshqar A<sup>2</sup>, Miyashita-Ishiwata M<sup>1</sup>, Borahay M<sup>1</sup><br><sup>1</sup>Johns Hopkins University, Baltimore, MD, USA, <sup>2</sup>Yale University, New Haven, CT, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>To characterize the dispensing patterns of Antidepression(AD) and Antianxiety (AA) medications among women with psychiatric disorders before and after hysterectomy for benign indications.</p> <strong><p><b>METHODS: </b></strong> This is a retrospective cohort study of patients who underwent hysterectomy for benign indications from January 2011 to December 2016 using the IBM MarkertScan<sup>®</sup> Research Database. Inclusion criteria included reproductive age women (≤ 50 years); enrollment for ≥1 year prior to and 1 year following hysterectomy; at least 1 depressive or anxiety disorder diagnosis; and at least 1 dispensing of AD/AA medications. We measured monthly adherence (proportion of days covered (PDC)>=0.8) and persistence to AD/AA medications (days until a 45-day gap in therapy) over 12 months after hysterectomy. Group-based trajectory modeling was used to identify dispensing trajectory groups by clustering similar patterns of monthly AD/AA medications dispensing over 6 months before and 12 months after hysterectomy. Multinomial logistic regression was used to identify factors associated with individual dispensing trajectory patterns.</p> <strong><p><b>RESULTS: </b> </strong>Among 11,607 women, six dispensing trajectory groups were identified: 1) Continuously high (27.0%); 2) Continuously moderate (21.9%); 3) Continuously low (17.9%); 4) Low high (10.0%); 5) Moderate low (9.8%); 6) Low moderate (13.4%). Compared with the continuously high dispensing group, younger age and no history of mood disorder were clinical predictors of low dispensing. The discontinuation rate at 3 months was higher at 88.6% in the continuously low dispensing group and at 66.5% in the continuously low-moderate dispensing group compared to 3.7%, 13.5%, 18.5%, and 42.5% in the continuously-high, low-high, continuously-moderate, and moderate-low dispensing groups, respectively.</p> <strong><p><b>CONCLUSIONS</strong>: </b> The results provided 6 distinct patterns of dispensing of AD/AA medications over 18 months. Age and mood disorder were significant predictors of low dispensing pattern among the cohorts. Patients in the low-moderate and continuously low dispensing groups had higher risk of discontinuation and reinitiating the treatment compared with the other groups.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116000","diseases":[{"id":"bde7079b-7db2-4006-9dbf-54d654e04fc7","parentId":"00000000-0000-0000-0000-000000000000","title":"Surgery","urlName":"Surgery"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Impact of Clinical Pharmacy Interventions on Health and Economic Outcomes in Type 2 Diabetes: A Systematic Review and Meta-Analysis","id":"b9795c3c-54f3-4b83-8b79-b25ee6db764d","sessionCode":"HSD25","topDisplay":"<b><u>Desse T</u></b><sup>1</sup>, Vakil K<sup>2</sup>, MC Namara K<sup>3</sup>, Manias E<sup>4</sup><br><sup>1</sup>Deakin University, Melbourne, VIC, Australia, <sup>2</sup>Deakin university, Melbourne, VIC, Australia, <sup>3</sup>Deakin University, Geelong, VIC, Australia, <sup>4</sup>Deakin University, Kew, VIC, Australia","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>There is lack of synthesized evidence on the effectiveness of clinical pharmacy interventions on clinical outcomes like adverse events (AEs) and mortality, and economic outcomes of diabetes at hospital settings. The aim of this study was to examine the effectiveness of clinical pharmacy interventions on health and economic outcomes of patients with type 2 diabetes in hospital settings.</p> <strong><p><b>METHODS: </b></strong> MEDLINE, EMBASE, PsycInfo, CINAHL, COCHRANE Library were searched from 1990 to November 2020. We included randomized controlled and non‐randomized controlled trials, cohort, and controlled before‐after studies. Meta-analyses were undertaken for randomized controlled studies. Primary outcomes were glycosylated hemoglobin A1c (HbA1c), all-cause mortality, major cardiovascular events, AEs, quality of life, and economic outcomes.</p> <strong><p><b>RESULTS: </b></strong> We retrieved 11,853 studies of which 44 studies (n=8623 patients) were included in the review. Of these, 29 randomized controlled studies were included in the meta-analyses (n=4055 patients). Clinical pharmacy interventions significantly reduced HbA1c levels (standardized mean difference (SMD) −0.52, P < 0.001) and AEs compared to usual care. No eligible studies reported major cardiovascular events as outcomes. One study examined effectiveness of the interventions on all-cause mortality and no significant difference in all-cause mortality between intervention and usual care groups was reported. The interventions significantly improved quality of life, and significantly reduced costs of diabetes care including medical costs, costs of laboratory tests, cost of medications compared to usual care in both developed and developing countries.</p> <strong><p><b>CONCLUSIONS: </b></strong> Clinical pharmacy interventions showed effectiveness in diabetes control, reduction of AEs and costs of care compared to usual care. The effectiveness of the interventions on economic outcomes in developing countries has implications on improving diabetes care and reducing cost of care as prevalence of medication therapy problems in these countries is high. Future trials are warranted to establish whether such interventions have an impact on major cardiovascular outcomes.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114781","diseases":[{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Integrated Twin Compression Screw Nail (ITCS)* Compared to Single Helical Blade Nail (SHB)** Results in Significantly Reduced Post Acute Costs in Patients with Intertrochanteric Hip Fractures","id":"e64ecbc6-f1cc-4d04-a8e9-b2bee31a480b","sessionCode":"RWD14","topDisplay":"<b><u>Nherera L</u></b><br>Smith + Nephew, Fort Worth, TX, USA","locationCode":"","description":"\r\n\t<div><strong>Introduction: </strong>Intertrochanteric fractures account for almost 50% of hip fractures and 44% of all hip fracture costs in the US. Intramedullary nails are used for the fixation of these fractures. This study aimed to assess the differences in inpatient costs for patients treated with ITCS compared SHB in US hospitals.</p> <strong>Methods: </strong>We conducted a retrospective cohort study using PREMIER database from January 2017 to July 2019. All hospital inpatient admissions hip fracture diagnosis (DRG codes 480, 481, 482 or ICD codes for displaced or non-displaced) were included if they received either ITCS or SHB device. The primary endpoint was total inpatient cost calculated as continuous variables using generalized estimating equation models (supply, surgical, implant, recovery room and miscellaneous costs). Propensity matching was used to control for patients’ demographics, clinical and providers’ characteristics.</p> <strong>Results: </strong>After matching 2,564 and 11,473 patients treated with ITCS and SHB respectively were included with a mean age of 79 years. Total costs per patient were $16,927 (SD $7,690) for ITCS and $17,641 (SD $7,721) for SHB resulting in statistically significant cost savings of $714 (95% CI $383 to $1,044) in favor of ITCS. More patients treated with ITCS were discharged to home and skilled nursing facilities while fewer patients were discharged to rehabilitation centres (differences not statistically significant). Furthermore, patients treated with ITCS are more likely to require less opioid use measured by morphine equivalent mean 115.74mg vs 119.18mg p=0.20.</p> <strong>Conclusions:</strong> ITCS is estimated to reduce the inpatient costs compared to SHB in patients with intertrochanteric fractures. Further benefits are seen in opioid use and discharge destinations although these differences are not statistically significant. More evidence is needed to access if these hold in the longer term.</p> </p> *ITCS- InterTAN™ Smith + Nephew, Memphis TN</p> **SHB- Proximal Femoral Nail Antirotation (TFNA)™ DePuy Synthes, West Chester, PA</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117308","diseases":[{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"},{"id":"f2cabca2-ce06-433e-903c-56285673ffc3","parentId":"00000000-0000-0000-0000-000000000000","title":"Musculoskeletal Disorders","urlName":"Musculoskeletal-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Evidence Levels in Nice Medical Technologies Guidance on Digital Health Technologies","id":"936b72ed-075a-4774-bb77-b2f4855efc2a","sessionCode":"MT2","topDisplay":"<b><u>Dillon B</u></b>, Brookfield R, Wang YY, Latimer L<br>National Institute for Health and Care Excellence, Manchester, UK","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> NICE’s evidence standards framework (ESF) for digital health technologies (DHTs) describes expected health technology assessment evidence levels for the commissioning of these technologies in the NHS. NICE's medical technologies evaluation programme (MTEP) develops guidance on medical devices and diagnostics which are claimed to be cost saving for the NHS. Medical technologies guidance has been published on 5 DHTs. Here we present a summary of the evidence for each technology and compare it with the evidence levels suggested in the ESF.</p> <strong>Methods</strong></p> Guidance development for the DHTs was based on the existing NICE MTEP process and methods which aim to evaluate the clinical effectiveness and economic impact of the technology. Consideration of the ESF evidence levels is not part of the existing process. Two reviewers assessed the evidence for each technology published in the NICE committee papers compared with the relevant ESF levels.</p> <strong>Results</strong></p> The 5 DHT’s with NICE medical technologies guidance include 3 diagnostics, 1 therapeutic and 1 self-management tool.</p> The clinical evidence available shows that all 5 DHTs reviewed had clinical studies to demonstrate their effectiveness. Most of the technologies had multiple studies with different designs, settings and outcomes. In some cases the studies did not include the appropriate population or comparator or were not of high quality.</p> In general the economic evidence was weaker and there was uncertainty about the claimed cost savings for some technologies. This was usually related to a lack of knowledge of the resource consequences associated with including the technology in the care pathway.</p> <strong> </strong><strong>Conclusions</strong></p> In general there is good alignment between the suggested evidence levels in the ESF and the evidence available for technologies with NICE guidance. However we noted the guidance development process does not include assessment of a budget impact model as suggested by the ESF.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"dda9555e-19ab-4405-936c-34532e5825c6","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Technologies","urlName":"medical-technologies"}],"categoryIds":["dda9555e-19ab-4405-936c-34532e5825c6"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117059","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Comparison of Clinical Profile and Outcome of Patients Admitted with Moderate and Severe COVID-19 Illness in the First and Second Wave of COVID-19 in a Tertiary Care Centre in South India","id":"fbe5f3f1-3c94-4988-a574-b327320199cd","sessionCode":"CO1","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>This study describes the clinical features and course of the patients admitted with COVID-19 illness between the first and second wave of COVID-19 in a tertiary care center in South India.</p> <p><b>METHODS: </b>This is a cross sectional study with case record analysis of the patients admitted with moderate and severe COVID -19 illness in a tertiary care centre in South India. Patients admitted between 1<sup>st</sup> August 2020 to 30<sup>th</sup> November 2020 were considered to be affected in the first wave and those admitted between 30<sup>th</sup> April 2021 to 30<sup>th</sup> July 2021 were considered to be in the second wave of COVID-19. The symptoms, comorbidities, clinical profile, severity, laboratory parameters, need for assisted ventilation, medications used and outcome were compared between the two-time frames.</p> <p><b>RESULTS: </b>A total of 123 patients’ data was analysed in each wave. In Covid first wave, 72 (58%) patients had fever, while 64(52%) patients had fever in Covid second wave. In the first wave 5 (4%) patients had diarrhoea, 4 (3.2%) patients had vomiting. Whereas in second wave, 43 (34%) patients had diarrhoea, 25 (20 percent) patients had vomiting(P<0.001). It was seen in the present study that, more number of patients in the age group of 31 to 40 years had more serious illness and adverse outcomes in second wave compared with patients in first wave where age group of 51-60 years were more seriously affected. In the first wave 31 patients (25%) required non-invasive ventilation(NIV), while 79 patients (64%) required NIV in second wave(P<0.001)</p> <p><b>CONCLUSIONS: </b>The patients with COVID-19 illness in the second wave presented with many non-respiratory symptoms like vomiting, diarrhoea, joint pains. The patients who had severe illness in the second were comparatively younger that the patients of the first wave. The requirement of ventilatory support and immunosuppressants were more in the second wave.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116250","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Hidradenitis Suppurativa: Trends in Real-World Treatment Patterns in the United States","id":"3daa7c9d-9dd4-4c8f-9bd5-b3e9be86f131","sessionCode":"HSD2","topDisplay":"<b><u>Althoff AG</u></b><sup>1</sup>, Rasouliyan L<sup>1</sup>, Kumar V<sup>1</sup>, Long S<sup>1</sup>, Zema C<sup>2</sup>, Rao MB<sup>1</sup><br><sup>1</sup>OMNY Health, Atlanta, GA, USA, <sup>2</sup>Zema Consulting, Huntsville, AL, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> The objective of this research was to characterize real-world treatment patterns among hidradenitis suppurativa (HS) patients in diverse healthcare delivery settings in the United States (US).</p> <strong><p><b>METHODS: </b></strong> Patients from 6 specialty dermatology networks and 4 integrated delivery networks within the OMNY Health Database with any indication of HS (diagnosis code: L73.2) from 2014-2021 were included. Demographic characteristics were tabulated at first HS diagnosis. Percentages of patients with prescriptions or procedures for the following treatments were computed: topical clindamycin (TC), systemic antibiotics and immunomodulators (SAI), adalimumab, incision/drainage, excision, laser, and photodynamic therapy. Secular trends in annual treatment patterns were described.</p> <strong><p><b>RESULTS: </b></strong> Across all years, a total of 24,933 HS patients with prescription and procedure data were included. Distributions of gender (77% female), race (70% White, 21% Black, 9% Other among known categories), age (13% ≥ 61 years, 76% 21-60 years, 11% ≤ 20 years), and region (65% South, 17% Midwest, 14% West, 3% Northeast) were as expected. Among the 14% of patients with valid body mass index values, 59% were obese, 23% were overweight, and 18% were healthy/underweight. Patient percentages ranged from 42% to 53% for TC and from 43% to 69% for SAI. From 2014 to 2021, adalimumab use increased from 1% to 12% while incision/drainage procedures decreased from 10% to 5%. Laser surgeries decreased steadily from 18% in 2017 to 10% in 2021. Photodynamic therapy and excision procedures were both negligible over the observation period.</p> <strong><p><b>CONCLUSIONS: </b></strong> Results provide insights into real-world treatment patterns for HS within a diverse set of US healthcare settings. Adalimumab use has increased steadily since the Food and Drug Administration approval for the treatment of HS, while incision/drainage procedures have declined. As new treatments are developed and introduced, future analyses would be helpful to understand uptake of therapies and prescription patterns among HS patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117547","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"8cf105fc-7473-4125-8f3a-33de42667e72","parentId":"00000000-0000-0000-0000-000000000000","title":"Sensory System Disorders","urlName":"Sensory-System-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Update of the Health Technology Assessment Progress in Ukraine: Implementation and Impact in 2021","id":"a12b4999-d5ba-4d98-ad23-b5d0d5e34bdc","sessionCode":"HTA10","topDisplay":"<b><u>Piniazhko O</u></b><sup>1</sup>, Babenko M<sup>2</sup>, Lobas M<sup>2</sup>, Khmelovska M<sup>2</sup>, Serediuk V<sup>2</sup>, Malyshevska I<sup>2</sup>, Masheiko A<sup>2</sup>, Romanenko I<sup>2</sup>, Kahveci R<sup>3</sup>, Kosyachenko K<sup>4</sup><br><sup>1</sup>State Expert Center (SEC) of Ministry of Health, Lviv, Ukraine, <sup>2</sup>State Expert Center of the Ministry of Health of Ukraine, Kyiv, Ukraine, <sup>3</sup>USAID's SAFEMed, Management Sciences for Health, Kyiv, Ukraine, <sup>4</sup>Bogomolets National Medical University, Kyiv, Ukraine","locationCode":"","description":"\r\n\t<div><b><p><b>OBJECTIVES: </b></b><span style=\"font-weight: 400;\"> A significant stage in the development of HTA in Ukraine was the approval of the first Decree №1300 “On the approval of the procedure for the state HTA” by the Cabinet of Ministers of Ukraine on 23 December, 2020 and the approval of the first HTA Guideline “The state health technology assessment for medicines” by the Order of the MoH of Ukraine №593 on 29 March, 2021. The study aims to provide a review of HTA progress in 2021 in Ukraine.</span></p> <b><p><b>METHODS: </b></b><span style=\"font-weight: 400;\"> Precise data analysis was conducted to obtain analytics on HTA conclusions published in open access in Ukraine in 2021.</span></p> <b><p><b>RESULTS: </b></b><span style=\"font-weight: 400;\"> Decree №1300 outlines the process of the state HTA conducting, while the first HTA Guideline provides stakeholders with updated methodological recommendations for planning and conducting HTA. Moreover, in 2021 leading HTA experts of the HTA Department developed a training program for industry representatives. All these efforts by the HTA Department lead to the following main results in 2021: 40 dossiers and MoH requests were submitted, of which for 25 assessments of medicines with conclusions were prepared. The total number includes 27 dossiers for the state HTA for expertise and 13 MoH requests. 25 conclusions which include 14 conclusions with recommendations for MoH based on company submissions and 11 conclusions under the abbreviated procedure at the request of MoH were developed. As a result of the work done in context of state HTA by full and abridged procedure, 9 amendments to the NEML and 2 amendments to the nomenclature were done.</span></p> <b><p><b>CONCLUSIONS: </b> </b><span style=\"font-weight: 400;\">The approval of the first Decree №1300 and the first HTA Guideline, together with training sessions for stakeholders, lead to successful practical implementation of the state HTA in Ukraine in 2021 and use HTA recommendations in the decision making process to improve patient access to medicines.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-isporhta-results19-04-update-pdf.pdf?sfvrsn=709b940e_0","title":"Poster ISPOR_HTA results_19.04 _update.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116810","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Barriers and Facilitators of Reporting Adverse Drug Reaction Among Hospital Pharmacists in Nigeria and USA","id":"226a12a8-e73f-4292-8b7c-b6168c7041f0","sessionCode":"HSD24","topDisplay":"<b><u>Temedie-Asogwa T</u></b>, Khalid J, Zakeri M, Sansgiry SS<br>University of Houston, College of Pharmacy, Houston, TX, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Good pharmacovigilance practice requires complete and consistent reporting of adverse drug reaction (ADR). Although pharmacovigilance has gained popularity over the years, ADR under-reporting remains a huge concern across countries globally. Improving ADR reporting requires understanding of influences on reporting practice. This study aims to assess differences in the barriers and facilitators of ADR reporting among hospital pharmacists in Nigeria and USA.</p> <strong><p><b>METHODS: </b></strong> An online survey was conducted among hospital pharmacists in Nigeria and USA. Barriers and facilitators of ADR reporting was assessed using a 46-item pre validated questionnaire. Qualtrics was used to create and distribute the questionnaire through email, whatsapp and facebook. Participants’ demographic characteristics were explored using descriptive statistics. Inferential statistics (Wilcoxon-Man-Whitney test) was performed to compare responses from the two groups with a priori significant value set at 0.05.</p> <strong><p><b>RESULTS: </b></strong> The overall respondents consisted of 77 (67.5%) of pharmacists from Nigeria and 37 (32.5%) from USA. Eighty-three (72.8%) respondents were females and 48 (42.1%) between 31-40 years of age. Both groups, similarly perceived barriers and facilitators of ADR reporting. However, differences existed on certain individual-level and system-level barriers perceived by pharmacists from Nigeria and USA. Out of the 16 barriers, Nigerian pharmacists had higher scores on busy schedule (p=0.001), insufficient knowledge/skills in detecting/reporting ADRs (p<0.001), lack of reporting forms (p<0.001) and deficiencies in institutional ADR reporting systems (p<0.001). Although not significant across groups, pharmacists believed that facilitators such as receiving more trainings on pharmacovigilance (33.3%) and availability of ADR reporting mobile-app (23.3%) might facilitate better ADR reporting.</p> <strong><p><b>CONCLUSIONS: </b> </strong>Individual/system-level barriers of ADR reporting were more evident in hospital pharmacists from Nigeria compared to USA. Designing and implementing country-specific strategies may help to mitigate knowledge-related barriers and motivate pharmacists. Development of a phone app might improve ADR reporting rates among hospital pharmacists in both Nigeria and USA.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117850","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"},{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Cluster Analytical Approach to Identify Insomnia Subtypes and Their Relationship with Healthcare Resource Utilization Outcomes","id":"ed680851-1bff-45d1-a594-b69cb9c2da54","sessionCode":"RWD1","topDisplay":"<b><u>Gandhi AB</u></b><sup>1</sup>, Wickwire EM<sup>2</sup>, Qato DM<sup>3</sup>, Vesselinov RM<sup>2</sup>, Slejko JF<sup>4</sup>, Onukwugha E<sup>1</sup><br><sup>1</sup>University of Maryland School of Pharmacy, Baltimore, MD, USA, <sup>2</sup>University of Maryland School of Medicine, Baltimore, MD, USA, <sup>3</sup>Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA, <sup>4</sup>University of Maryland, Baltimore, MD, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Insomnia is a heterogenous condition with respect to underlying risk factors, presentation of symptoms, comorbidities, and disease course. The present research explored the impact of insomnia heterogeneity on healthcare resource utilization (HcRU) outcomes.</p> <p><b>METHODS: </b> We used Optum’s de-identified Integrated Claims-Clinical dataset to identify individuals aged 18-64 with insomnia between 2009-2018 and quantified HcRU outcomes over a 1-year follow up period. A k-modes clustering algorithm with a Jaccard coefficient similarity measure was used to identify clinically relevant insomnia subtypes based on sociodemographic, comorbidity, behavioral, life event, family history, medication use, vital sign, and insomnia symptom-related characteristics. An optimum cluster solution was chosen based on clinical interpretability and significance. We quantified the association between cluster membership and binary HcRU outcomes (proportion with a hospitalization; proportion with an emergency department [ED] visit) using logistic regression models. We utilized count regression models for all other HcRU outcomes (i.e., physician office visits, non-physician outpatient visits, prescription drug fills). </p> <p><b>RESULTS: </b> A total of 17,124 individuals with insomnia met the study inclusion criteria. Five insomnia subtypes were identified: ‘Obesity and hypertension’ (28.6%), ‘Mental health conditions and chronic pain’ or ‘pain_ment_health’ (25.4%), ‘Older age, high comorbidity burden, and fatigue’ or ‘older_age’ (24.6%), ‘Substance use disorders’ (5.2%), and ‘Overweight status, alcohol use, and low comorbidity burden’ or ‘overweight’ (16.2%). Relative to the reference cluster ‘overweight’, individuals in the ‘older_age’ cluster displayed a higher adjusted odds ratio (AOR) for inpatient visits (AOR: 1.73; 95% CI: 1.48, 2.03) and a higher incidence rate ratio (IRR) for prescription drug fills (IRR: 1.50; 95% CI: 1.39, 1.61). Relative to the reference cluster, individuals in the ‘pain_ment_health’ cluster displayed higher odds (AOR: 1.81; 95% CI: 1.61, 2.03) of having an ED visit.</p> <p><b>CONCLUSIONS: </b> Insomnia heterogeneity was associated with increased HcRU, including clusters characterized by older age, high comorbidity burden, chronic pain, and fatigue.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115471","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Modeling Survival of People with Cystic Fibrosis (PWCF) Aged ≥6 Years Heterozygous for the F508DEL Mutation with a Minimal Function Mutation (F/MF) in Brazil Treated with Elexacaftor/Tezacaftor/Ivacaftor and Ivacaftor (ELX/TEZ/IVA)","id":"0b147b2c-dd02-4d82-b371-b7d519de5f00","sessionCode":"MSR6","topDisplay":"<b><u>Ghizzi Pedra G</u></b><sup>1</sup>, Daly C<sup>2</sup>, Pinto LA<sup>3</sup>, Lopez A<sup>4</sup>, Vega-Hernandez G<sup>1</sup>, Rubin JL<sup>4</sup><br><sup>1</sup>Vertex Pharmaceuticals (Europe) Limited, London, UK, <sup>2</sup>Vertex Pharmaceuticals (Europe) Limited, London, LON, UK, <sup>3</sup>Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, <sup>4</sup>Vertex Pharmaceuticals Incorporated, Boston, MA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> ELX/TEZ/IVA is a breakthrough therapy targeting the underlying cause of cystic fibrosis that is currently not available in Brazil. ELX/TEZ/IVA has been shown to substantially improve lung function and nutritional outcomes. Although survival projections are available in non-Brazilian settings, the potential long-term impact of ELX/TEZ/IVA on Brazilian pwCF is of interest given regional variation in survival. Here we estimate survival in Brazilian <em>F</em>/MF pwCF aged ≥6 years receiving ELX/TEZ/IVA+best supportive care (BSC) versus BSC-alone.</p> <strong><p><b>METHODS: </b></strong> A validated lifetime person-level simulation model was used to estimate survival in <em>F</em>/MF pwCF aged ≥6 years (mean age, 20.1 years) in Brazil with and without ELX/TEZ/IVA+BSC treatment. Clinical efficacy inputs were derived from ELX/TEZ/IVA Phase 3 studies that included <em>F</em>/MF pwCF (NCT03691779, NCT03525444). Lifetime outcomes were also evaluated separately for cohorts initiating ELX/TEZ/IVA+BSC during ages 6-11 and ≥12 years to understand impacts of early treatment initiation. To evaluate nearer-term benefits of ELX/TEZ/IVA in<em> F</em>/MF pwCF aged ≥6 years, an alternative scenario was run using a 10-year time horizon.</p> <strong><p><b>RESULTS: </b></strong> ELX/TEZ/IVA+BSC was projected to increase median survival in <em>F</em>/MF pwCF aged ≥6 years by 35.4 years versus BSC-alone (67.6 versus 32.2 years). The incremental median predicted survival benefit increased to 42.1 years in the cohort initiating ELX/TEZ/IVA+BSC during ages 6-11 years (72.3 versus 30.2 years with BSC-alone). In the 10-year alternative scenario, 89% of pwCF receiving ELX/TEZ/IVA+BSC were projected to be alive 10 years post-treatment initiation versus 72% receiving BSC-alone.</p> <strong><p><b>CONCLUSIONS: </b></strong> Based on these simulations, ELX/TEZ/IVA+BSC is projected to substantially increase survival in Brazilian <em>F</em>/MF pwCF aged ≥6 years. Initiating treatment earlier leads to even greater projected survival benefits; model projections suggest that initiation during ages 6-11 years may add upwards of 4 decades of survival benefit versus BSC-alone, allowing achievement of near-normal life expectancy. Results should be confirmed with real-world data, when available.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/pedraispor2022poster-pdf.pdf?sfvrsn=71d2789b_0","title":"Pedra_ISPOR_2022_poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115163","diseases":[{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Risk Factors for Amputation in Japanese Patients with Critical Limb Ischemia Based on a Claims Database Analysis","id":"39f6575a-6217-4cb0-ab1c-b7e5965885c6","sessionCode":"EPH36","topDisplay":"Takashima K<sup>1</sup>, <b><u>Takeshima T</u></b><sup>2</sup>, Tateyama M<sup>3</sup>, Iwasaki K<sup>2</sup><br><sup>1</sup>Boston Scientific Japan K.K., Tokyo, Japan, <sup>2</sup>Milliman, Inc., Tokyo, Japan, <sup>3</sup>Milliman, Inc., Chiyoda-ku, Tokyo, Japan","locationCode":"","description":"\r\n\t<div><span><p><b>OBJECTIVES: </b> Critical limb ischemia (CLI) is the most severe clinical manifestation of peripheral artery disease that can increase the risk of amputation. We investigated the incidence of amputation and its risk factors in patients with CLI.</span></p> <span><p><b>METHODS: </b> This claims-based study used a Japanese database including data from acute care hospitals (April 2008</span>–<span>September 2020). The index date was defined as the date after 3 months of the first CLI diagnosis to exclude the patients who were scheduled to have amputations at diagnosis time. Patients who underwent vasodilation, thrombus ablation, or bypass implantation during the baseline period were excluded. The time to amputation was examined by the Kaplan–Meyer analysis. We estimated the hazard ratio (HR) for amputation by a proportional hazard analysis with a stepwise method using the age at index, sex, presence of dialysis, calcified lesion, diabetes, chronic obstructive pulmonary disease, dementia, hypertension, dyslipidemia, cardiovascular disease, and chronic kidney disease (CKD) during baseline period as explanatory variables.</span></p> <span><p><b>RESULTS: </b> The database included 7,916 patients with CLI, of which 1,263 (average [standard deviation] age: 75.6 [12.1] years, women: 38%) were selected. The cumulative incidence of amputation after 3 years from index was approximately 11%. Among the explanatory variables, dialysis, diabetes, hypertension, and CKD were selected by the stepwise method. Dialysis showed the highest HR (2.69, p < 0.01) followed by CKD (1.97, p = 0.04), and diabetes (1.82, p = 0.02). The HR of hypertension was lower than 1 (0.47, p < 0.01). Percentages of patients with hypertension and dialysis at index were 60% and 18%, respectively.</span></p> CONCLUSION: CKD, dialysis, and diabetes were suggested as risk factors for amputation in CLI patients. Relatively low risk was suggested for hypertension. It could be explained by the fact that hypertensive patients were majority of non-dialysis CLI patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor2022posterdraft20220415-pdf.pdf?sfvrsn=7e3a9194_0","title":"ISPOR2022_poster_draft20220415.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115540","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Annual Health Insurance Treatment Cost of Female Infertility Associated with Male Factors Based on Real-World Health Insurance Claims Data","id":"ba90a3d2-4b2b-4f25-8990-b8fb0ba36068","sessionCode":"EE29","topDisplay":"<b><u>Pónusz-Kovács D</u></b><sup>1</sup>, Elmer D<sup>2</sup>, Csákvári T<sup>3</sup>, Kajos L<sup>1</sup>, Pónusz R<sup>1</sup>, Kovács B<sup>3</sup>, Sebestyén A<sup>3</sup>, Bódis J<sup>3</sup>, Boncz I<sup>3</sup><br><sup>1</sup>University of Pécs, Pécs, BA, Hungary, <sup>2</sup>University of Pécs, Pécs, PE, Hungary, <sup>3</sup>University of Pécs, Pécs, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Female infertility constitutes a significant and growing burden on patients, health care systems and the society. Our aim was to determine the annual costs of the health insurance system related to the female infertility associated with male factors in Hungary.</p> <strong>Methods</strong>: Data were derived from the financial database of the NHIFA, for the year 2019. Data analyzed included annual health insurance costs, patient numbers and cost distribution calculated for age groups. The following cost categories were included into the study: general practice care, home care, in- and outpatient care, medical imaging, laboratory diagnostics, pharmaceuticals and medical aids. “Patients with female infertility associated with male factors” were identified with the following code of the International Classification of Diseases 10<sup>th</sup> revision: N9740.</p> <strong>Results</strong>: In 2019, the Hungarian National Health Insurance Fund Administration spent 952.13 million Hungarian Forints (HUF) on the treatment of patients with female infertility associated with male factors, 3.27 million American Dollars (USD), or 2.92 million Euros (EUR). The highest patient numbers were in inpatient care (1,562 women). Inpatient care (82.5% of total health insurance costs) the utilization of pharmaceuticals (16.9%) and outpatient care (0.4%) were the main cost drivers, while all other forms of medical care amounted to 0.2% in women. Annual health care treatment costs per patient was 606,558 HUF (2,097 USD/1,874 EUR) according to number of patients related to inpatient care. The highest annual health insurance costs were found in the ‘30-39’ and ‘40-49’ age groups.</p> <strong>Conclusions</strong>: The utilization of inpatient care was the major cost driver, which was 4.86 times higher than the utilization of pharmaceuticals and 179.83 times as much as the costs of outpatient care in 2019. The proportion of the costs related to the treatment showed significant differences among age groups.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/kovacsd-n9740costprint140x9020220421final-pdf.pdf?sfvrsn=c8068882_0","title":"KOVACSD-N9740_COST_PRINT_140x90_20220421_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117201","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Medication Utilization Patterns of Novel Hormonal Therapies for the Management of Metastatic Castration-Resistant Prostate Cancer","id":"84578b38-3f9f-4774-bf20-b9459593759f","sessionCode":"PCR26","topDisplay":"<b><u>Shukla N</u></b><sup>1</sup>, Barner JC<sup>2</sup>, Rascati K<sup>3</sup>, Doshi G<sup>4</sup>, Park C<sup>5</sup><br><sup>1</sup>The University of Texas at Austin, AUSTIN, TX, USA, <sup>2</sup>The University of Texas at Austin College of Pharmacy, Texas Center for Health Outcomes Research and Education (TxCORE), Austin, TX, USA, <sup>3</sup>The University of Texas at Austin, Austin, TX, USA, <sup>4</sup>US Oncology Network, McKesson Specialty Health, Houston, TX, USA, <sup>5</sup>The University of Texas at Austin, Austin, Texas, TX, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Adherence to oral novel hormonal therapies (NHTs) impacts clinical and economic outcomes, but little is known regarding real-world adherence in the US.<sup> </sup>The objectives were to compare medication adherence between abiraterone acetate (ABI) and enzalutamide (ENZ) users and to determine patient demographic and clinical characteristics associated with adherence.</p> <strong>Methods: </strong>This retrospective secondary analysis of 2013- 2017 Humana Medicare medical and prescription included: continuously enrolled men >65 yrs old with prostate cancer (PCa) as the primary cancer, one inpatient or one outpatient PCa diagnosis, and at least one prescription for ABI or ENZ. Index date was defined as the date of NHT initiation. Patients were followed 6 months pre- and 12 months post-index. Dependent variables included medication adherence rate measured using proportion of days covered (PDC) and proportion of patients with PDC≥0.80. Independent variables included index NHT type (primary predictor) and demographic and clinical characteristics (covariates). Statistical analyses were performed using t-test, chi-square test, and multiple logistic regression.</p> <strong>Results: </strong>Among included patients (N=1,254), t-test showed no significant difference in mean adherence (73.1±29.3 vs. 71.8±31.3; p=0.440) and chi-square test showed no significant difference in the proportion of adherent (PDC≥0.80) patients (55.1% vs. 56.4%;p=0.630) between ABI and ENZ users, respectively. The overall multivariable logistic regression model was statistically significant (p<0.001) with the following significant findings regarding adherence (PDC≥0.80): 71-74 age-group versus ≥85 age-group (Odds Ratio (OR)=2.023; 95%CI:1.373-2.981;p=0.007), and initiating NHT in 2014 versus 2016 (OR=2.031; 95%CI:1.468-2.809;p=0.001) were associated with higher odds of being adherent, while having >1 type of metastases was associated with lower odds of being adherent (OR=0.407; 95%CI:0.261-0.635;p=0.010), after controlling for covariates.</p> <strong>Conclusion: </strong>While the proportion of adherent patients overall was suboptimal, they did not differ between ABI and ENZ users. Strategies should be implemented to promote medication adherence among PCa patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115175","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"},{"id":"4f6b0298-31b6-4189-b6aa-63a92e080d5a","parentId":"00000000-0000-0000-0000-000000000000","title":"Reproductive and Sexual Health","urlName":"reproductive-and-sexual-health"},{"id":"747104b6-9723-4895-a3d6-28d8c37172e3","parentId":"00000000-0000-0000-0000-000000000000","title":"Systemic Disorders/Conditions","urlName":"Systemic-Disorders-Conditions"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness Analysis of Risk Scoring Model in Population-Based Oral Cancer Screening Program of Taiwan","id":"0442b744-7a87-4fd2-84ce-ba4efbf843f3","sessionCode":"EE88","topDisplay":"<b><u>Hu SH</u></b><sup>1</sup>, Hsieh HM<sup>2</sup><br><sup>1</sup>Master Program in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung City, KHQ, Taiwan, <sup>2</sup>Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Age-standardized incidence rate of oral cancer (OC) in Taiwanese males remains high globally. Although free population-based oral mucosa examination (OME) is provided in Taiwan, late diagnoses and low survival rates of OC are still critical public health concerns. This study aimed to estimate the potential lifetime cost-effectiveness of the risk scoring model (RSM), a novel prediction strategy additional with OME simultaneously or consequently, in the OC screening program of Taiwan.</p> <strong><p><b>METHODS: </b> </strong>We focused on high-risk subjects for OC, defined as Taiwanese aged over 30 years with any smoking or betel nut chewing habits. Three alternative strategies were compared with the non-screening strategy from payer's and societal perspectives, including 1) OME only; 2) RSM followed by OME; 3) RSM and OME simultaneously. Microsimulation models were conducted, and the disease progressions of OC in 100,000 subjects with various sex, age and oral-habit conditions were simulated using TreeAge Pro Healthcare 2021. A one-year cycle length with an annual discount rate of 3% was applied. All the costs were presented in 2020 New Taiwan dollar (NT$). The primary outcome was lifetime incremental cost-effectiveness ratio (ICER), expressed in additional costs per quality-adjusted life year (QALY) gain.</p> <strong><p><b>RESULTS: </b> </strong>The ICERs of each screening strategy ranged from -NT$256,212/QALY to -NT$268,535/QALY in the payer's perspective. From the societal perspective, the ICERs ranged between -NT$291,506/QALY and -NT$302,929/QALY. Performing RSM and OME simultaneously showed lower incremental costs and higher incremental QALYs, which brought the most cost-effectiveness due to increasing screening sensitivity from 77.1% to 96.6%. It also demonstrated the highest probability of being cost-effective in the cost-effectiveness acceptability curve.</p> <strong><p><b>CONCLUSIONS: </b> </strong>All the screening strategies were cost-saving compared to the non-screening group, especially performing RSM and OME simultaneously. Public policy may consider cooperating RSM with the current OC screening program to improve screening efficiency and achieve early detection of cancer.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/posterszuhan-hucea-pdf.pdf?sfvrsn=4da508b9_0","title":"Poster_SzuHan Hu_CEA.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115747","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Health Insurance Treatment Cost of Female Infertility Associated with Anovulation Based on Real-World Health Insurance Claims Data in 2019 in Hungary","id":"fe593241-c350-42dc-8da8-ba83efeea370","sessionCode":"EPH12","topDisplay":"<b><u>Elmer D</u></b><sup>1</sup>, Csákvári T<sup>2</sup>, Kajos L<sup>3</sup>, Pónusz R<sup>3</sup>, Pónusz-Kovács D<sup>3</sup>, Kovács B<sup>2</sup>, Sebestyén A<sup>2</sup>, Bódis J<sup>2</sup>, Boncz I<sup>2</sup><br><sup>1</sup>University of Pécs, Pécs, PE, Hungary, <sup>2</sup>University of Pécs, Pécs, Hungary, <sup>3</sup>University of Pécs, Pécs, BA, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>More than 10% of the world’s population is affected by infertility which might have social, psychological and economic consequences both for the individual and society. Our aim was to determine the annual health insurance treatment cost of female infertility associated with anovulation in Hungary.</p> <strong>Methods:</strong> Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA), for the year 2019. Data analysed included annual health insurance costs, patient numbers and cost distribution calculated for age groups. The following cost categories were included into the study: general practice care, home care, in- and outpatient care, medical imaging, laboratory diagnostics, pharmaceuticals and medical aids. Patients with female infertility associated with anovulation were identified with the following code of the International Classification of Diseases 10<sup>th</sup> revision: N97.0.</p> <strong>Results: </strong>In 2019, the NHIFA spent 100.86 million Hungarian Forints (HUF) on the treatment of patients with female infertility associated with anovulation which equals to 347.00 thousand American Dollars (USD), or 309.99 thousand Euros (EUR). The highest patient numbers were in use of pharmaceuticals (1,952 women) and outpatient care (1,952 women). Pharmaceuticals (60.8% of total health insurance costs), acute inpatient care (27.3%) and outpatient care (6.7%) were the main cost drivers, while all other forms of medical care amounted to 5.2%. The annual health care treatment cost per patient was 51,668 HUF (178 USD/159 EUR).</p> <strong>Conclusions: </strong>Use of pharmaceuticals was the major cost driver in the treatment of female infertility associated with anovulation. Distribution of the annual health care treatment cost per patient of use of pharmaceuticals showed a significant difference among age groups. It was the highest in the ‘40-49’ age group.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/elmerdprinteph1220220421final-pdf.pdf?sfvrsn=709fb407_0","title":"ElmerD_PRINT_EPH12_20220421_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117103","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"},{"id":"4f6b0298-31b6-4189-b6aa-63a92e080d5a","parentId":"00000000-0000-0000-0000-000000000000","title":"Reproductive and Sexual Health","urlName":"reproductive-and-sexual-health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Economic Burden of Severe Haemophilia a without Inhibitors Among Adults with Health Insurance Coverage in the United States: Insights from the \"Cost of Haemophilia across the US: A Socioeconomic Survey\" CHESS US and CHESS US+ Studies","id":"bd631c9e-db78-4945-8f90-bafc0ed3840e","sessionCode":"EE21","topDisplay":"Ferri Grazzi E<sup>1</sup>, Blenkiron T<sup>2</sup>, O'Hara J<sup>3</sup>, <b><u>Chen E</u></b><sup>4</sup>, Hinds D<sup>4</sup>, Burke T<sup>2</sup><br><sup>1</sup>HCD Economics, The Innovation Centre, Sissa Trecasali (PR), Italy, <sup>2</sup>HCD Economics, The Innovation Centre, Daresbury, UK, <sup>3</sup>Faculty of Health and Social Care, University of Chester, Chester, UK, <sup>4</sup>BioMarin Pharmaceutical Inc., Oakland, CA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong></p> Severe hemophilia A (SHA) is a congenital bleeding disorder characterized by severe and repeated bleeding without prophylactic Factor VIII (FVIII) and associated with high treatment costs. This analysis aims at quantifying societal costs associated with SHA without inhibitors among insured adults in the United States.</p> </p> <strong>Methods </strong></p> Cross-sectional data on insured adults with SHA without inhibitors from the ‘Cost of Haemophilia across the US: a Socioeconomic Survey’ (CHESS US), a physician-reported database, and a separate patient-reported database (CHESS US+) were used to quantify: 1) Direct medical cost (DMC), including healthcare utilization and FVIII costs based on physician-reported data, 2) Direct non-medical cost (DNMC) (e.g., disability entitlement, formal and informal caregiving) and 3) indirect cost (IC), including labor market outcomes based on patient-reported data. Mean (SD) annual costs are reported in 2017 US$ (year data was collected) and summarized by FVIII therapy regimen (on-demand or prophylaxis) and insurance type (private or government insurance).</p> </p> <strong>Results</strong></p> DMC (N=281) was $493,152 (±$740,396). Among prophylaxis patients (N=209), DMC was $656,707 (±$795,009) with FVIII cost ($639,895[±$796,876]) accounting for 97% of DMC, and hospitalizations representing the largest non-drug cost. DNMC (N=241) was $5,655 (±$18,573), and primarily driven by disability entitlement ($1,916[±$5,689]) and homecare ($2,970[±$16,116]. IC was $8,832 (±$17,616), predominantly driven by early retirement ($6,047[±$16,384]). Prophylaxis patients (N=193) incurred similar DNMC ($6,213[±$19,583]) and IC ($9,529[±$18,249]). While DMC was similar between patients with private and government insurance, DNMC and IC were fourfold higher in government-insured patients.</p> </p> <strong>Conclusion </strong></p> FVIII cost, particularly among prophylaxis patients, remains the predominant cost-driver from both healthcare system and societal perspectives. DNMC and IC also represent important sources of societal cost, affecting patients, government programs and society, accounting for approximately $15,000 a year. Improved personalized care, care coordination, and development of new treatment options may help to reduce healthcare system and societal cost burden.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/chess-us-societal-posterispor-2022pdf-pdf.pdf?sfvrsn=25f45121_0","title":"CHESS US Societal poster_ISPOR 2022_PDF.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116434","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Sintilimab Plus Chemotherapy for First-Line Treatment of Advanced or Metastatic Nonsquamous Non-Small-Cell Lung Cancer (AMNSQNSCLC): A Systematic Literature Review (SLR) and Network Meta-Analysis (NMA)","id":"465d4f21-02e5-4f0f-9ad6-be41299a92ad","sessionCode":"CO19","topDisplay":"<b><u>Garassino M</u></b><sup>1</sup>, Brnabic A<sup>2</sup>, Stefaniak V<sup>3</sup>, Belger M<sup>4</sup>, Gruver K<sup>3</sup>, Chen JV<sup>5</sup>, Souri S<sup>5</sup>, Molife C<sup>3</sup>, Blumenschein G<sup>6</sup><br><sup>1</sup>University of Chicago, Chicago, IL, USA, <sup>2</sup>Eli Lilly and Company, Croydon, NSW, Australia, <sup>3</sup>Eli Lilly and Company, Indianapolis, IN, USA, <sup>4</sup>Eli Lilly and Company, Bracknell, UK, <sup>5</sup>Medical Decision Modeling Inc., Indianapolis, IN, USA, <sup>6</sup>MD Anderson Cancer Center, Houston, TX, USA","locationCode":"","description":"\r\n\t<div><strong><span>Background</span></strong><span>: </span>In ORIENT-11, addition of sintilimab to first-line chemotherapy demonstrated improved progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) in Chinese patients with AMnsqNSCLC. This SLR and NMA compared the efficacy and safety of sintilimab+pemetrexed+platinum versus FDA-approved and NCCN-recommended immune checkpoint inhibitor combinations (ICIs) for first-line treatment of AMnsqNSCLC.</p> <span> </span></p> <strong><span>Methods</span></strong><span>: </span>SLR followed the PRISMA guideline. Eligible studies were phase 2 and 3 RCTs published in English between 1991 and September 2021 comparing efficacy or safety of ICIs with other treatments for AMnsqNSCLC without EGFR/ALK mutations. Bayesian fixed and random effects NMA with independent baseline models were used, and chemotherapy was the common comparator. PFS, OS, ORR, and exposure-adjusted adverse events(AEs) were the key outcomes analyzed. Hazard ratios(HR)<1.0, odds ratios(OR)>1.0, and median exposure-adjusted rate difference(D)>0 favored the reference treatment, sintilimab+pemetrexed+platinum.</p> <span> </span></p> <strong><span>Results</span></strong><span>: </span>After screening 6,418 records, 11 RCTs involving a total of 4,979 eligible patients regardless of PD-L1 status were included in the primary evidence network. ICIs with chemotherapy were generally superior to chemotherapy alone. For PFS, pembrolizumab+pemetrexed+platinum(HR 0.96 [95% Credible Interval: 0.71-1.30]) and atezolizumab+bevacizumab+platinum+nab-paclitaxel(0.83 [0.57-1.19]) were not significantly different to sintilimab+pemetrexed+platinum. Sintilimab+pemetrexed+platinum had significantly better PFS compared to atezolizumab+platinum+nab-paclitaxel(0.57[0.40-0.82]) and nivolumab+ipilimumab+pemetrexed+platinum(0.66[0.48-0.92]). Sintilimab+pemetrexed+platinum was not significantly different for OS: atezolizumab+bevacizumab+platinum+nab-paclitaxel(0.85[0.59-1.23]), atezolizumab+platinum+nab-paclitaxel(0.81[0.56-1.17]), pembrolizumab+pemetrexed+platinum(1.08[0.79-1.47]), nivolumab+ipilimumab+pemetrexed+platinum(0.95[0.67-1.34]), and nivolumab+ipilimumab(0.83[0.61-1.13]). Rate of Grade≥3 AEs(D range:-0.35-0.84) and ORR(OR range:0.73-1.91) were comparable across ICIs.</p> <span> </span></p> <strong><span>Conclusions</span></strong><span>: </span><span>This NMA showed that sintilimab+pemetrexed+platinum was associated with comparable efficacy and safety versus standard-of-care ICIs in the US, further supporting the favorable benefit/risk profile of ICI versus chemotherapy among patients with previously untreated AMnsqNSCLC and no <em>EGFR</em> or <em>ALK</em> mutations. The results may aid clinical decision-making and future cost-effectiveness evaluation of ICIs in the absence of head-to-head evidence from RCTs. </span></p> <span> </span></p> <span> </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor2022layout42122submitted-pdf.pdf?sfvrsn=937f343f_0","title":"ISPOR2022_Layout_4_21_22_submitted.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115126","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Findings from the 2021 International Society for Pharmacoeconomics and Outcomes Research Student Interest Survey","id":"0cddeee7-d87a-4493-81e7-be59c6cdf166","sessionCode":"OP2","topDisplay":"<b><u>Radwan R</u></b><sup>1</sup>, Riaz M<sup>2</sup>, Zalamai R<sup>3</sup>, Pathan U<sup>4</sup>, Toth J<sup>5</sup><br><sup>1</sup>Department of Pharmacotherapy and Outcomes Science,Virginia Commonwealth University School of Pharmacy, Richmond, VA, USA, <sup>2</sup>Department of Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA, <sup>3</sup>Health Outcomes Division, College of Pharmacy, The University of Texas, Austin, TX, USA, <sup>4</sup>Pharmaceutical Health Services and Research department, School of Pharmacy, University of Maryland, Baltimore, MD, USA, <sup>5</sup>Department of Pharmacy Administration, University of Mississippi, Oxford, MS, USA","locationCode":"","description":"\r\n\t<div><strong><span><p><b>OBJECTIVES: </b> </span></strong><span>The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) student interest survey is distributed annually to active student ISPOR members. In this study, we describe the findings from the 2021 student interest survey.</span></p> <strong><span><p><b>METHODS: </b> </span></strong><span>The survey was administered via SurveyMonkey from October 1, 2021, to December 25, 2021. An invitation email with the survey was sent to all active student ISPOR members. Reminder emails were sent every 4 weeks to encourage participation. Survey responses were extracted in Microsoft Excel and descriptive statistics were used to summarize the collected data.</span></p> <strong><span><p><b>RESULTS: </b> </span></strong><span>A total of 125 members completed the survey, with most respondents from North America (47.2%) and enrolled in a Ph.D. program (51.2%). Many respondents had not previously attended an ISPOR conference (51.0%) but plan to attend the virtual/hybrid ISPOR 2022 conference (52.0%). During the pandemic, student engagement with ISPOR’s student network/resources was neutral (30.8%) to moderate (29.9%), with time constraints (67.5%) being a main barrier. For virtual/hybrid ISPOR meetings and webinars, respondents reported interest in economic evaluation topics (56.0%), with live training (79.3%), by speakers with academic (49.0%) or pharmaceutical industry (49.0%) backgrounds. Of all social media outlets, most respondents followed ISPOR on LinkedIn (53.0%) and reported a preference for posts regarding internship/job opportunities (86.3%). Many respondents were unaware of the ISPOR Career Center or internship/fellowship database (57.9%) but reported interest in an internship/fellowship showcase during the ISPOR Annual Meeting (80.0%). Not knowing the benefits of having an ISPOR chapter (46.2%) was the main reason for not being a member of an ISPOR student chapter</span></p> <strong><span><p><b>CONCLUSIONS: </b> </span></strong><span>To meet student needs, an emphasis on showcasing Health Economics and Outcomes Research-related job/internship opportunities on multiple ISPOR platforms may be beneficial. Additionally, to encourage student membership and involvement, a greater awareness of the benefits associated with ISPOR chapter membership may be necessary.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"bb8fd992-de86-4d1a-8bec-f6e2c928db96","parentId":"00000000-0000-0000-0000-000000000000","title":"Organizational Practices","urlName":"organizational-practices"}],"categoryIds":["bb8fd992-de86-4d1a-8bec-f6e2c928db96"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116898","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Multicriteria Decision Analysis (MCDA) to Identify Criteria for Guiding Decision Making for Post-Menopausal Osteoporosis Treatment in the Brazilian Public Healthcare System","id":"b1249789-bf8d-4334-8ce7-bea72246efff","sessionCode":"HPR11","topDisplay":"<b><u>Mensor L</u></b><sup>1</sup>, Rosim MP<sup>2</sup>, Marchesan T<sup>3</sup>, Rigo D<sup>2</sup>, Sallum F<sup>4</sup>, Murta Amaral L<sup>5</sup><br><sup>1</sup>Amgen Biotecnologia do Brasil, Santana de Parnaíba , SP, Brazil, <sup>2</sup>Amgen Biotecnologia do Brasil, São Paulo, Brazil, <sup>3</sup>Amgen Biotecnologia do Brasil, São Bernardo do Campo, SP, Brazil, <sup>4</sup>MCDA Solutions, Rio de Janeiro, RJ, Brazil, <sup>5</sup>ORIGIN Health Intelligence, Rio de Janeiro, RJ, Brazil","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To identify criteria for prioritizing osteoporosis treatments in postmenopausal women at very high fracture risk, based on the preferences of three groups of stakeholders: medical specialists, representatives of patient associations and healthcare managers (HM).</p> <p><b>METHODS: </b>A literature review identified criteria for technology prioritization for the patient population of interest and was validated among participants. Three representatives from each group indicated preferences and weights among the validated criteria using the Analytic Hierarchy Process methodology in a MCDA panel.</p> <p><b>RESULTS: </b>The key categories identified in the panel were efficacy (clinical, new vertebral, non-vertebral and hip fracture, and bone mineral density), safety (clinically significant adverse events and tolerability), convenience (adherence and dosing convenience) and economics (incremental cost-effectiveness ratio, cost per responder, budget impact and socioeconomic impact). New hip fracture and clinical fractures appeared in the top five criteria for all groups. All fracture types, especially new hip fracture (weight 26.11%), and adverse events (14.64%) were the main criteria for medical specialists. Similar results were observed for patient associations, with any factures weighted most highly (25.09% to 10.61%) whilst economic criteria received the lowest weights (1.21% to 0.98%), below dosing convenience (4.29%). Economic category was prioritized only for the HM group (48.46%).</p> <p><b>CONCLUSIONS: </b>Although weights varied across each group of stakeholders, reflecting different preferences and perspectives, treatment efficacy was prioritized for all. It is noteworthy that economic criteria have a high impact on decision making from the HM perspective but other criteria, such as dosing convenience, could have higher weight in health technologies assessment process, including patient preferences. These results have the potential to assist decision making and treatment prioritization for women with postmenopausal osteoporosis at very high risk of fracture.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-id116943-lucianamensor-pdf.pdf?sfvrsn=378e522_0","title":"Poster ID116943 LucianaMensor .pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116943","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"A New Model of Psychotherapeutic Intervention for People with Cancer and Their Families","id":"efa24964-eed6-4ce1-988f-c061a6a12722","sessionCode":"OP1","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> A cancer diagnosis could mean a disruption in the mental health of the patient and their families, when emotions like fear, angst, wrath, guilt, and anguish appear. Therefore, personalized support is important, providing tools and resources to develop personal coping skills. Amid the global pandemic that erupted in 2020, activities that promoted emotional expression and empathy were created and encouraged to help patients validate their feelings. The following analysis was carried out with the intention of creating a study framework that promoted awareness and support for patients and their needs.</p> <p><b>METHODS: </b> We developed a patient accompaniment program with an innovative conceptual framework: our therapeutic team made direct contact with the patient and their family, avoiding waiting times and managing to provide an immediate response so that they feel accompanied from the moment of diagnosis. The number of individual meetings was between 8 and 10 sessions, with a great deal of flexibility according to the needs of each person. At the same time, we provided weekly supervision and constant monitoring of all professionals in an interdisciplinary manner with the aim of humanizing and transforming the quality of life of the patient and his or her family.</p> <p><b>RESULTS: </b> Through this modality, the program reached 16 provinces of Argentina, 15 countries, and had already supported more than 850 people. We counted on a great team of professional volunteers who accompanied us in getting involved with the patients and making them active participants. This group of professionals was constituted by 30 teachers, 6 psychopedagogues, 14 counselors; 25 psychologists; 13 psycho-oncologists; and 1 psychiatrist.</p> <p><b>CONCLUSIONS: </b> The many bureaucratic barriers to accessing treatment reflect patient dissatisfaction and justify the development of tools that promote awareness and support for patients, considering all their needs in a holistic and as humane approach as possible.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"bb8fd992-de86-4d1a-8bec-f6e2c928db96","parentId":"00000000-0000-0000-0000-000000000000","title":"Organizational Practices","urlName":"organizational-practices"}],"categoryIds":["bb8fd992-de86-4d1a-8bec-f6e2c928db96"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115756","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Disparities and Trends of COVID-19 Epidemiology in EU-5 Countries across Pandemic Waves: A Targeted Literature Review (TLR)","id":"285f787c-cd3f-42f9-b181-c0ae75aa7074","sessionCode":"EPH31","topDisplay":"<b><u>Kamra S</u></b><sup>1</sup>, Venkateswara Rao J<sup>2</sup>, Mandlik R<sup>3</sup>, Dabral S<sup>3</sup>, Pagidigummula R<sup>3</sup>, Hyderboini R<sup>3</sup>, Sirumalla Y<sup>2</sup>, Chidirala S<sup>3</sup>, Goyal R<sup>4</sup><br><sup>1</sup>IQVIA, Gurugram, HR, India, <sup>2</sup>IQVIA, Mumbai, India, <sup>3</sup>IQVIA, Mumbai, DL, India, <sup>4</sup>IQVIA, Gurugram, India","locationCode":"","description":"\r\n\t<div><strong><span>Aim: </span></strong><span>To assess the disparity in epidemiology of COVID-19 during the first and second waves of pandemic in EU-5 countries.</span></p> <strong><span>Methods:</span></strong><span> Embase and Medline were searched from Dec-2019 to June-2021 for articles assessing the epidemiology of COVID-19 in EU-5 countries during first wave and second wave of pandemic. A single reviewer screened and extracted data for targeted literature review. </span></p> <strong><span>Results:</span></strong><span> Of 3189 records screened, nine studies (n=73,525) were included which focused on Spain (n=3), Italy (n=3), Germany (n=1), UK (n=1), and France (n=1). The first wave occurred between March-August 2020, February-September 2020, March-June 2020, and February-July 2020 in UK, Italy, Spain, and Germany, respectively. The second wave existed between September-October 2020, July-October 2020, February-April 2020, and July-December 2020 in Italy, Spain, France and Germany, respectively. The cumulative incidence of COVID-19 infections in Spain was significantly higher during second wave than first wave (679 vs. 387/100,000). However, the case fatality rate was lower in second wave than in first wave (0.15 vs. 0.025). Also, the fatality rate was significantly higher in first wave compared to second wave (24% vs. 13.2%) in Spain and in the UK (32.3% vs. 16.4%). While there was no significant difference in mortality between the two waves in Germany (18% vs 20%). Limited data for only first wave was available for France. The peak incidence of cases was recorded between March-April 2020 in France, the COVID-19 related mortality during first wave was 20%. </span></p> <strong><span>Conclusion:</span></strong><span> COVID-19 incidence was higher during the second wave in Italy, while the fatality rate was higher in the first wave in Italy, UK, and Spain. However, time frame of COVID waves varied across the countries/studies despite its colloquial use. Therefore, future studies are required to reach a consensus on wave definition and explore the disparities between the pandemic waves’ definitions.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/disparities-and-trends-of-covid-19-epidemiology-in-eu5-countries-pdf.pdf?sfvrsn=1403eb91_0","title":"Disparities and Trends of COVID 19 Epidemiology in EU5 Countries.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116833","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Global Prevalence of Burnout Among Pharmacists: A Systematic Review and Meta-Analysis","id":"5eac131f-e2d2-41b3-8184-c1ea15f31c4f","sessionCode":"HSD1","topDisplay":"Teoh SL, <b><u>Yong ASJ</u></b>, Kow CS<br>School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Burnout is an occupational phenomenon caused by poorly managed chronic stress. In healthcare setting, it may increase medication errors which are associated with patient harm. Therefore, estimating the prevalence of burnout among pharmacists which is currently unknown is important for health policy implications. This review aimed to estimate the global prevalence of burnout among pharmacists.</p> <p><b>METHODS: </b> Databases (MEDLINE, Embase, PsycInfo and AMED) were searched to identify published studies from inception that investigated prevalence of burnout among pharmacists working in any healthcare settings globally using Maslach Burnout Inventory (MBI) measure which includes three subcomponents (i.e., emotional exhaustion, depersonalization, and personal accomplishment). The prevalence estimates of burnout (i.e., high risk of burnout in at least one subcomponent of MBI) experienced by pharmacists were pooled using a random effects model. The criteria of sample selection from a modified version of the Newcastle-Ottawa Scale were used to assess the quality of included studies.</p> <p><b>RESULTS: </b> Nine studies met the inclusion criteria. They were conducted in North America (5/9), Europe (2/9), Australia (1/9) and Asia (1/9). Seven studies recruited at least 300 respondents and with sample who were truly representative of the populations. The pooled prevalence of burnout from nine studies was 0.48 (95% confidence interval (CI): 0.30, 0.66). High heterogeneity was observed (I2=99.6%, p<0.01). Meta-regression did not show significant difference in the continents where the studies were conducted nor the workplace of pharmacists (hospital, community, or both). Higher prevalence of burnout was found in North America with a pooled prevalence of 0.60 (95% CI: 0.50, 0.69) and in Asia with 0.62 (95% CI: 0.58, 0.69).</p> CONCLUSION: Almost one in two pharmacists experienced burnout globally. Further studies should investigate the causes of the high burnout rate to maintain pharmacists’ quality of work-life and to avoid any negative impacts to the professional services received by patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/poster-burnout-final-pdf.pdf?sfvrsn=ae2b024b_0","title":"Poster Burnout final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115919","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Patient Demographics, Clinical Characteristics, Treatment Patterns, and Survival Outcomes Associated with First-Line Treated Un-Resectable Advanced, Metastatic and Recurrent Esophageal Squamous Cell Carcinoma in the U.S.","id":"c8713cd9-d5ea-45ae-89f0-c1ec5ec63e09","sessionCode":"CO21","topDisplay":"<b><u>Navaratnam P</u></b><sup>1</sup>, Friedman HS<sup>2</sup>, Zhang Y<sup>3</sup>, Gricar J<sup>4</sup><br><sup>1</sup>DataMed Solutions LLC, New York, NY, USA, <sup>2</sup>DataMed Solutions LLC, New York City, NY, USA, <sup>3</sup>Bristol Myers Squibb, Princeton, NJ, USA, <sup>4</sup>Bristol Myers Squibb, Lawrenceville, NJ, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Treatment patterns and survival outcomes among real-world first-line (1L) treated un-resectable advanced recurrent or metastatic esophageal squamous cell carcinoma (ESCC) patients in the U.S. were evaluated.</p> <p><b>METHODS: </b> Patients diagnosed with esophageal cancer between 1/1/2012, and 12/31/2020, were identified in the Flatiron database, a US EMR database representing 265 oncology clinics. Both recurrent (i.e., post-resective surgery stage 1-3 with recurrent disease) and un-resectable denovo patients (i.e., metastatic stage 4) were identified. Descriptive statistics of patient demographics, clinical characteristics, and treatment patterns over the index and post-index periods were generated. Kaplan-Meier survival curves were used to estimate median overall survival (mOS) for both 1L treated and best supportive care (BSC) patients.</p> <p><b>RESULTS: </b> A total of 356 ESCC patients (58 recurrent, 298 denovo patients) were identified. 73% (n=259) received 1L chemotherapy, and 97 were untreated BSC. The treated ESCC patients’ mean age was 66.3 ± 9.2 years and were mostly male (69.5%) and white (56%). The most common 1st line regimen was carboplatin + paclitaxel (38%), followed by FOLFOX (24%). 32.4% of these 1L patients went on to second-line, and of these, 32.1% went on to third-line. Females were more likely than males to be on 1L carboplatin+paclitaxel (46% vs 34%) and more likely to move on to 2L (39% vs 29%). More recent index years (>2017) saw a shift toward fluoropyrimidine + platinum 1L use over taxane+ platinum (38% vs 22%). First-line ESCC patients had a mOS of 8.5 (7.6 - 10.1) months, whereas BSC patients had a mOS of 4.1 (3.0 - 5.2 ) months.</p> <p><b>CONCLUSIONS: </b> In this 1L ESCC patient population, mOS was 8.5 months, which was more than double the mOS of the untreated BSC patients of 4.1 months. Deploying more effective treatments in the 1L setting may extend mOS among treatment-eligible patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/final-heor-ec1l-txos-usclean-pdf.pdf?sfvrsn=f7b66e75_0","title":"FINAL.HEOR.EC1L.TxOS.US_CLEAN.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116121","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The OPUF Tool: A New Type of Online Survey for Creating Value Sets for the EQ-5D-5L on the Societal-, Group-, and Individual Person Level","id":"8680acdd-3185-47e3-8ea2-c445a82a9288","sessionCode":"PCR28","topDisplay":"<b><u>Schneider P</u></b><sup>1</sup>, Brazier JE<sup>1</sup>, Devlin N<sup>2</sup>, van Hout B<sup>1</sup><br><sup>1</sup>University of Sheffield, Sheffield, UK, <sup>2</sup>University of Melbourne, Melbourne, VIC, Australia","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b></p> <span style=\"font-weight: 400;\">We recently reported on the development of a new method, called OPUF, for deriving value sets (=QALY-weights) for the EQ-5D-5L instrument. In contrast to established methods, such as time trade-off or discrete choice experiments, the OPUF approach does not require hundreds of respondents, but allows estimating utility functions for small groups and even on the individual person level. </span></p> <span style=\"font-weight: 400;\">The objective of this study was to apply the OPUF approach in a large, representative sample of the UK population. We demonstrate how EQ-5D-5L value sets can be constructed on the subgroup and on the individual level.</span></p> </p> <strong><p><b>METHODS</strong>: </b></p> <span style=\"font-weight: 400;\">The OPUF approach is based on previous work by Devlin et al. (2019). It combines different compositional preference elicitation techniques into a new type of online survey. The survey broadly consists of three valuation steps: dimension weighting, level rating, and anchoring. A demo version of the EQ-5D-5L OPUF survey is available at: </span><a href=\"https://eq5d5l.me\"><span style=\"font-weight: 400;\">https://eq5d5l.me</span></a><span style=\"font-weight: 400;\">.</span></p> </p> <b><p><b>RESULTS</b>: </b></p> <span style=\"font-weight: 400;\">Data from 874 participants from the UK were included in the analysis. </span><span style=\"font-weight: 400;\">On average, it took participants nine minutes to complete the survey. </span></p> <span style=\"font-weight: 400;\">For each participant, we constructed a personal EQ-5D-5L value sets. Their validity were assessed against three discrete choice experiments: personal value sets predicted participants’ choices with an accuracy of 78.5%. </span></p> <span style=\"font-weight: 400;\">On the group level, we found that preferences systematically differed with respect to various characteristics. However, the variability of preferences within each subgroup was substantial. Overall, group characteristics explained only a small proportion of the variance. </span><span style=\"font-weight: 400;\">We also aggregated the preferences across all participants to derive an alternative EQ-5D-5L social value set for the UK.</span></p> <span style=\"font-weight: 400;\"></span></p> <b><p><b>CONCLUSIONS</b>: </b></p> <span style=\"font-weight: 400;\">The newly developed OPUF approach allowed us to construct EQ-5D-5L value sets on the social-, group-, and individual person level, and to explore the</span><span style=\"font-weight: 400;\"> heterogeneity of preferences in an unprecedented level of detail. </span><span style=\"font-weight: 400;\">We see several potential future applications for the OPUF approach.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115278","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Economic Modelling of Gene Therapies Based on the Comparison of Two Independent Models Assessing Voretigene Neparvovec for RPE65 - Mediated Inherited Retinal Dystrophy","id":"d18c6335-e2a5-451e-8bf5-c44a070154e7","sessionCode":"EE82","topDisplay":"Janik J<sup>1</sup>, Paterak E<sup>2</sup>, Pochopien M<sup>1</sup>, <b><u>Aballea S</u></b><sup>3</sup>, Toumi M<sup>4</sup><br><sup>1</sup>Creativ-Ceutical, Krakow, Poland, <sup>2</sup>Creativ-Ceutical, Kraków, Poland, <sup>3</sup>Creativ-Ceutical, Rotterdam, Netherlands, <sup>4</sup>Creativ-Ceutical, Paris, France","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Two different cost-effectiveness models for voretigene neparvovec (Luxturna<strong><sup>®</sup></strong>) for RPE65 – Mediated Inherited Retinal Dystrophy have been considered in independent evaluations by the Institute for Clinical and Economic Review (ICER) and by National Institute for Health and Care Excellence (NICE). The models differed in structure, parameters, assumptions, and results. We sought to compare these models, analyze the use of alternative models for each evaluation and check the impact of key inputs and assumptions of the model results.</p> <p><b>METHODS: </b> We replicated both models with the use of MS Excel and VBA for applications. The replicated models were validated by comparing their results with published information. The ICER model was further adapted to the UK and the model assessed by NICE was run from the US perspective. Next, several model inputs and assumptions were varied to test their impact on the model results. </p> <p><b>RESULTS: </b> The outcomes of replicated models were well aligned with published data. It was proved that the use of an alternative model from perspective of a given country could change the results of economic evaluation, however, the conclusions regarding the cost-effectiveness of voretigene neparvovec remind the same. The assumptions regarding discounting, methods of survival extrapolation, duration of treatment effect, estimation of visual acuity/visual field, utility sources and methods as well as rate of residual treatment effect had significant impact on the results of both models. </p> <p><b>CONCLUSIONS: </b> The way of modelling can differ between countries and impact the economic evaluation. This is of particular importance for gene therapies.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ee82economicmodellingofgenetherapiesbasedonthecomparisonchecked2804-002-pdf.pdf?sfvrsn=9f94c4f0_0","title":"EE82_Economic_modelling_of_gene_therapies_based_on_the_comparison_checked_2804 (002).pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116216","diseases":[{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Clinical and Economic Outcomes of Adult Limb Spasticity Treatment with Botulinum Toxin-a (BONT-A) Products: A Single-Center Non-Interventional Retrospective Study","id":"d5cb2ef5-05ff-4445-9574-c5856d96c81a","sessionCode":"CO6","topDisplay":"<b><u>Bezzina C</u></b><sup>1</sup>, Degtiar V<sup>2</sup>, Danchenko N<sup>3</sup>, Calvi-Gries F<sup>4</sup>, Davis B<sup>2</sup>, Engmann E<sup>2</sup>, Guyon E<sup>2</sup>, Lecanuet S<sup>3</sup>, Whalen JD<sup>5</sup><br><sup>1</sup>North Staffordshire Rehabilitation Centre Midlands Partnership NHS Foundation Trust Haywood Hospital, Staffordshire, UK, <sup>2</sup>Ipsen, Slough, UK, <sup>3</sup>Ipsen, Boulogne-Billancourt, 75, France, <sup>4</sup>Ipsen, Boulogne-Billancourt, France, <sup>5</sup>Ipsen Biopharm Ltd, Slough, UK","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Effective limb spasticity (LS) treatment combines physiotherapy and BoNT-A. The North Staffordshire Rehabilitation Centre (UK) initiated LS patients on onabotulinumtoxinA (onaBoNT-A) prior to 2017; after, patients were initiated on abobotulinumtoxinA (aboBoNT-A). This study describes real-world outcomes of BoNT-A treatment, pre- and post-2017.</p> <strong><p><b>METHODS: </b> </strong>This study assessed treatment outcomes with aboBoNT-A vs. onaBoNT-A in toxin-naïve adult LS patients. Assessments consisted of patients’ routine visits at 6 weeks(±2 weeks) and at 12 weeks(±4 weeks) after the first injection. Outcomes included Goal Attainment Scaling [GAS], patient satisfaction on a Likert scale, and cost per responder (based on response rate, average dose, and UK drug unit costs). Treatment response was defined as achievement or overachievement of all therapeutic goals.</p> <strong><p><b>RESULTS: </b></strong> Treatment groups had comparable demographic and clinical characteristics. In the aboBoNT-A group (N=54), 55.6% patients had lower limb (LL) spasticity, 35.2% upper limb (UL) spasticity, and 9.3% LL+UL spasticity. In the onaBoNT-A group (N=60), the split was 50.0%, 38.3%, and 11.7%, respectively. Mean doses of aboBoNT-A and onaBoNT-A were 718.8±410.7U and 194.8±87.9U in UL, and 689.7±449.9U and 186.4±97.9U in LL, respectively. In the overall population, doses of aboBoNT-A and onaBoNT-A were 753.7±457.3U and 206.0±98.8U. At Week 6, proportions of patients achieving or overachieving all therapeutic goals (GAS) were 56.4% [40.8%-72.0%] on aboBoNT-A and 37.5% [22.5%-52.5%] on onaBoNT-A. Week 12 proportions were 40.9% [20.4%-61.5%] and 33.3% [17.9%-48.7%]. Patient satisfaction at Week 6 was reported as \"much better\" by 44.1% [27.4%-60.8%] and 29.3% [15.3%-43.2%] of patients on aboBoNT-A and onaBoNT-A, respectively. AboBoNT-A safety was consistent with the regulatory label. Week 6 total costs per responder estimates on the overall study cohort on aboBoNT-A vs onaBoNT-A were £411.60 vs £759.18; Week 12 totalled £567.58 vs. £854.93.</p> <strong><p><b>CONCLUSIONS: </b> </strong>These data suggest switching a hospital practice from onaBoNT-A to aboBoNT-A could improve clinical outcomes, patient satisfaction, and efficiency.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117146","diseases":[{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Defining and Measuring Health System Pressure: A Conceptual Framework and Application to RSV and C. Difficile Infections","id":"0a017af4-e817-439c-bd41-c7314f467a4b","sessionCode":"EE52","topDisplay":"<b><u>Neri M</u></b><sup>1</sup>, Brassel S<sup>1</sup>, Schirrmacher H<sup>1</sup>, Steuten L<sup>2</sup>, Shea KM<sup>3</sup>, Stoychev S<sup>3</sup>, Albuquerque de Almeida F<sup>3</sup>, Charos A<sup>4</sup>, Ben Mehidi I<sup>4</sup>, Schley K<sup>5</sup><br><sup>1</sup>Office of Health Economics, London, UK, <sup>2</sup>OHE, City, University of London, London, UK, <sup>3</sup>Pfizer Inc, New York, NY, USA, <sup>4</sup>Pfizer ltd, Tadworth, UK, <sup>5</sup>Pfizer Deutschland GmbH, Berlin, Germany","locationCode":"","description":"\r\n\t<div>Objectives: Since the COVID-19 pandemic, the potential for vaccines to reduce pressure on health care systems has received much attention. However, evaluation of how vaccination may impact health system pressure is hindered by lack of a formal definition and measurement framework. We developed an approach for defining health system pressure and measuring its impact in healthcare settings and applied this approach to respiratory syncytial virus (RSV) and Clostridioides difficile (C. difficile) infections.</p> Methods: We conducted a targeted literature review and assessed hospital guidelines for prevention and control of RSV and C. difficile infections in hospital settings in Germany, Italy, and the UK. The definition and framework were tested via semi-structured interviews among healthcare professionals.</p> Results: Health system pressure can be generally defined as resource utilisation given a pre-set usable capacity. Its impact can be measured as the opportunity cost of actions taken to prevent or mitigate pressure. Actions to prevent or mitigate pressure due to RSV or C difficile can be classified by their impact on staff (labour resources), stuff (non-labour resources and materials), and structure capacity. Increased staffing needs drive RSV pressure during the RSV respiratory season and are considered to be extremely likely and extremely costly by 75% of the interviewees. C. difficile pressure is driven by the activation of outbreak-induced infection control protocols, which are likely to affect every capacity dimensions according to over 60% of the interviewees, and lead to large costs of infrastructure needed to isolate patients. In general, actions to mitigate pressure are associated with higher costs than actions used to prevent pressure before it occurs.</p> Conclusions: This research describes a novel definition and framework for health system pressure. Further development and application of this framework may enable HTA bodies to describe and measure the potential impact of vaccination on health care systems.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117012","diseases":[{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Demographic Characteristics and Initial Diagnostic Staging of Patients with Bladder Cancer across Large Community Health Systems in the US","id":"a45d3d41-df54-427a-842a-c8c01ddbed19","sessionCode":"RWD22","topDisplay":"<b><u>Lorenzo R</u></b><sup>1</sup>, Pomerantz D<sup>2</sup>, Wolf F<sup>2</sup>, Brown T<sup>2</sup>, Rioth M<sup>2</sup>, Wolfe T<sup>2</sup>, Lerman M<sup>2</sup>, Sanchez N<sup>2</sup><br><sup>1</sup>Syapse, Palm Beach Gardens, FL, USA, <sup>2</sup>Syapse, San Francisco, CA, USA","locationCode":"","description":"\r\n\t<div><span style=\"font-weight: 400;\"><p><b>OBJECTIVES: </b> Community health systems (CHS) in the US play a large role in the care of patients with cancer, with over 50% of patients with cancer cared for within CHS. The profile of patients with bladder cancer seen in CHS within the US is not widely published. This analysis describes the demographic and diagnostic staging characteristics of patients with bladder cancer across a sample of CHS.</span></p> <span style=\"font-weight: 400;\"><p><b>METHODS: </b> A retrospective analysis was performed utilizing the Syapse Learning Health Network</span><sup><span style=\"font-weight: 400;\">TM</span></sup><span style=\"font-weight: 400;\"> (LHN), an electronic medical record (EMR) derived database that collects cancer care data from multiple care settings within CHS across 33 states, 450+ hospitals and from patients cared for by 1,900+ oncologists. Patients aged </span><span style=\"font-weight: 400;\">></span><span style=\"font-weight: 400;\">18 yo at bladder cancer diagnosis were identified from the </span><span style=\"font-weight: 400;\">LHN</span><span style=\"font-weight: 400;\"> using ICD-10 codes. Data utilized for this analysis included both structured data (EMR fields like sex and birth date) and unstructured data (e.g. physician notes) validated by Certified Tumor Registrars and descriptively summarized.</span></p> <span style=\"font-weight: 400;\"><p><b>RESULTS: </b> 18,277 patients from the Syapse LHN were included in the analysis. 99% of patients were initially diagnosed with bladder cancer after January 1, 2010. Patient demographics included: median age of 73 yo at bladder cancer diagnosis; 73% male; race including 90% White, 7% Black or African American, 1% Asian; and 3% with Hispanic/Latino ethnicity. 14,872 (81%) patients had stage at diagnosis available, with stage distribution including: 0 - 44%; I - 26%; II - 15%; III - 7%; and IV - 8%.</span></p> <span style=\"font-weight: 400;\"><p><b>CONCLUSIONS: </b> As expected, a large majority of patients diagnosed with bladder cancer in CHS are men, with diagnosis at an advanced age</span><span style=\"font-weight: 400;\">.</span><span style=\"font-weight: 400;\"> A majority of patients were diagnosed with stage 0 or I disease. Additional analysis is planned to provide further insight into diagnostic and treatment patterns of patients with bladder cancer treated within these CHS.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022-bladder-ds-v2final-pdf.pdf?sfvrsn=7b84035a_0","title":"ISPOR 2022 Bladder DS v2_Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116528","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Healthcare Access through Community-Based Health Insurance Among Senegalese Migrants","id":"26498508-957b-4162-8b6e-c9af7129f901","sessionCode":"EE64","topDisplay":"<b><u>Diop Wayal M</u></b><br>university of Granada, Granada, GR, Spain","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE: </strong>This study evaluates the determinants of healthcare access financing and the role of a particular class of informal financing known as tontine, a community-based health insurance among Senegalese immigrants.</p> <strong>METHOD: </strong>A mixed methodology was used. A cross-sectional survey was first administered to Senegalese immigrants (n = 277), and they were asked about their visits to the doctor, use of emergency services, and hospitalization. A phenomenological approach was then used with key informants (n = 28). In the interviews, additional information, such as barriers and role and contribution of tontine to accessibility, was explored.</p> <strong><p><b>RESULTS: </b> </strong>In the previous year, 57% had visited a doctor and 41% an emergency department. The main reasons for hospitalization was pregnancy (32.5%) and surgery (30%). At least 25% of the sample reported having never visited the doctor. Language difficulties, time constraints, and undocumented migrant status were major barriers to accessibility. Also, Senegalese migrants consider that public health care does not take into account the importance for them to follow treatment close to their relatives or to have the alternative of traditional medicines. The tontine helps to protect the most vulnerable people such as undocumented immigrants and allows financing services of cultural importance</p> <strong>DISCUSSION: </strong>Since the literature on this topic is limited, and undocumented migrants are often underrepresented in conventional health surveys, the results of this study provide new evidence on the use and access to health services of this population group. Also, the results of this study help to understand the functions and contributions of a type of health financing existing in the immigrant community for its consideration in decision-making on health policy at both the national and international levels.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/114934","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Association of Pimavanserin with Mortality Compared to Quetiapine for Parkinson's Disease Psychosis in Medicare Beneficiaries: 2016-2018","id":"807ebd02-a522-41ae-b850-c9f4ab88c238","sessionCode":"CO10","topDisplay":"<b><u>Alipour Haris G</u></b>, Brown JD, Armstrong M, Okun MS<br>University of Florida, Gainesville, FL, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Pimavanserin is the only antipsychotic approved for Parkinson’s disease psychosis (PDP). Like other antipsychotics, it carries a warning for increased mortality risk but the relative safety of treatment alternatives has not been assessed. The objective of this analysis was to compare mortality risk among new users of pimavanserin versus quetiapine for PDP in Medicare beneficiaries in long-term care (LTC) and community-dwelling settings.</p> <p><b>METHODS: </b> This retrospective cohort study identified new users of pimavanserin and quetiapine from a 15% national sample of Medicare fee-for-service claims between May 1, 2016, and September 30, 2018. Users were required to have diagnosis for psychosis, hallucinations, or delusions to rule-out other indications for quetiapine. All-cause mortality was modeled in a proportional hazard regression model adjusting for patient characteristics. Follow-up was censored at discontinuation, switch, death, disenrollment, or end of the study period.</p> <p><b>RESULTS: </b> There were 358 pimavanserin users and 711 quetiapine users in the LTC cohort and 462 and 1,032 in the community-dwelling cohort. The groups were well balanced in measured demographic and clinical characteristics. The adjusted HR (95% CIs) at 90, 180, and 365-days for pimavanserin versus quetiapine users were 0.71 (0.29-1.76), 0.83 (0.44-1.57), and 0.98 (0.62-1.54) in LTC users. In community users, the adjusted HRs (95% CIs) were 0.88 (0.52-1.49), 0.79 (0.52-1.05), and 0.90 (0.66-1.24) in community users.</p> <p><b>CONCLUSIONS: </b> There were no differences in mortality for antipsychotic-naïve pimavanserin and quetiapine users with PDP. Discussions of medication safety should include evidence on the relative safety of treatment alternatives to better inform clinical decision-making.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/pimavansering-pdf.pdf?sfvrsn=8f026ecb_0","title":"Pimavanserin_G.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116038","diseases":[{"id":"dc752772-538c-4933-b6a5-3b5b6d079673","parentId":"00000000-0000-0000-0000-000000000000","title":"Geriatrics","urlName":"Geriatrics"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Improved Patient Reported Satisfaction and Outcomes in the Pulmonary Arterial Hypertension (PAH) BREEZE Clinical Trial","id":"630eb2b8-7bc5-45ed-a0b4-ca020d88a20a","sessionCode":"PCR29","topDisplay":"El-Kersh K<sup>1</sup>, Restrepo-Jaramillo R<sup>2</sup>, Spikes L<sup>3</sup>, Smith P<sup>4</sup>, Deng C<sup>4</sup>, Wu B<sup>4</sup>, <b><u>Classi P</u></b><sup>4</sup><br><sup>1</sup>University of Nebraska Medical Center, Omaha, NE, USA, <sup>2</sup>Tampa General Hospital, Tampa Bay, FL, USA, <sup>3</sup>University of Kansas Health System, Kansas City, KS, USA, <sup>4</sup>United Therapeutics, Durham, NC, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> The primary objective of the BREEZE clinical trial was to evaluate the safety and tolerability of treprostinil inhalation powder via a dry-powder inhaler (DPI) in PAH patients treated with treprostinil inhalation solution via a nebulizer (NEB). This analysis focused on patient reported outcomes.</p> <p><b>METHODS: </b> Two patient questionnaires were included as secondary endpoints: 1) The Preference Questionnaire for Inhaled Treprostinil Devices (PQ-ITD) and 2) The PAH Symptoms and Impact Questionnaire (PAH-SYMPACT). The PQ-ITD was administered at week 0 and week 3 and provides twelve statements on device satisfaction allowing for five responses from “strongly disagree” to “strongly agree”. The PAH-SYMPACT is a validated PAH questionnaire focused on four domains: cardiopulmonary symptoms, cardiovascular symptoms, physical impacts, and cognitive/emotional impacts, and was administered at weeks 0, 3, and 11. For continuous outcomes the paired t-test was used and for categorical outcomes the Cochran-Mantel-Haenszel test was used.</p> <p><b>RESULTS: </b> 51 patients enrolled in the BREEZE study and switched from inhaled treprostinil via the NEB to DPI. Mean (SD) age was 55.9 years (13.4) and 84.3% of patients were female. Mean (SD) time since first PAH diagnosis was 8.7 (6.5) years. 95.7% of patients reported overall satisfaction with DPI compared to 31.4% for the NEB (p<0.001). Patients reported satisfaction with specific aspects of the DPI such as size of inhaler (95.7%), ease of use (97.8%) and number of breaths required (93.5%); all items statistically significant compared to NEB (p<0.001). For the PAH-SYMPACT, mean changes from baseline were improved for all domain scores. Significant improvements for physical impacts were observed at week 3 (mean change -0.14, p=0.044) and week 11 (mean change -0.21, p=0.043) and for cognitive/emotional impacts at week 3 (mean change -0.17, p=0.005).</p> <p><b>CONCLUSIONS: </b> PAH patients in the BREEZE study reported high satisfaction with DPI and showed improvement in quality of life.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115497","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness and Cost-Utility of a Digital Wellness Intervention for Managing Depression and Anxiety: An Employer Perspective","id":"9c7af167-f604-472e-98ca-ca6d421a2cd5","sessionCode":"EE8","topDisplay":"<b><u>Mohandas A</u></b><sup>1</sup>, Tak CR<sup>2</sup>, Kavelaars R<sup>3</sup>, Powell T<sup>4</sup><br><sup>1</sup>Happify Health, TUSTIN , CA, USA, <sup>2</sup>Blue Mountain Health Outcomes, LLC, Arden, NC, USA, <sup>3</sup>Happify Health, New York, NY, USA, <sup>4</sup>Happify Health, Saratoga Springs, NY, USA","locationCode":"","description":"\r\n\t<div><b>Objectives: </b><span style=\"font-weight: 400;\">To examine the cost-effectiveness and cost-utility for employers of a digital wellness intervention (DWI) for managing depression and anxiety relative to psychoeducation. </span></p> <b>Methods: </b><span style=\"font-weight: 400;\">A Markov model of 10,000 hypothetical individuals was created for a DWI (Happify Health) and psychoeducation to estimate costs (2019 USD), quality-adjusted life years (QALYs) and effectiveness. Four depression-related health states (none, mild, moderate, severe) were used, with a sub-distribution of anxiety levels (none, mild/moderate, severe) within each state. Effectiveness was defined as the proportion of people with severe depression who moved to milder depressive states and QALYs. Efficacy data from a RCT that compared a DWI to psychoeducation in people with moderate to severe depression (PHQ>9) was used. Direct medical costs, productivity loss costs and health utilities (short Form (SF)-6D) were estimated from Kantar’s 2019 National Health and Wellness Survey (NHWS) for each depression and concurrent anxiety level. Health utilities were converted into QALYs. Individuals were cycled through each intervention over 6 months, with cycle lengths of two months. Incremental cost-effectiveness ratios (ICER) and net monetary benefit (NMB) were estimated at a willingness-to-pay threshold of $150,000. Deterministic and two-way sensitivity analysis (SA) explored the impact of parameter uncertainty. Probabilistic SA estimated joint uncertainty. Data were analyzed in TreeAge Pro 2021 (TreeAge Software, Williamstown, MA).</span></p> <b>Results: </b><span style=\"font-weight: 400;\">The DWI was cost-effective vs. psychoeducation with an ICER of -$24,437 per QALY gained. With respect to reducing severe depression, the DWI had incremental-effectiveness of 0.00480 and cost $108</span> <span style=\"font-weight: 400;\">relative to psychoeducation, resulting in an ICER of $22,479</span><span style=\"font-weight: 400;\">. </span><span style=\"font-weight: 400;\">The DWI was cost-effective in reducing severe symptoms when costs were $100-$360. The NMB was favorable in 50% of simulations under both measures.</span></p> <b>Conclusion: </b><span style=\"font-weight: 400;\">With respect to reduction of severe depression and QALYs, the</span> <span style=\"font-weight: 400;\">DWI was cost-effective vs. psychoeducation and its introduction to employees could benefit employers. </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115506","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Using Multi-State Modelling for Health Economic Evaluations","id":"dc02de06-0d5c-4bcc-a85f-ca990671d867","sessionCode":"EE96","topDisplay":"<b><u>Yi Y</u></b><sup>1</sup>, Hirst A<sup>2</sup><br><sup>1</sup>Adelphi Values Ltd, Bollington, CHE, UK, <sup>2</sup>Adelphi Values Ltd, Bollington, UK","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Partitioned survival models (PSM) and state transition models (STM) are the most common modelling approaches in health technology appraisals (HTAs) for treatment of chronic, progressive, and non-communicable diseases including cancers. Due to limitations of PSMs, the NICE DSU TSD19 recommended STMs using multi-state modelling (MSM) techniques (June 2017). This study aimed at reviewing the use of MSM in NICE HTAs. <strong><p><b>METHODS: </b></strong> A review of NICE TAs since June 2017 and all HSTs was performed to identify economic models which used MSM. Information was extracted on: justification for MSM; data sources to inform transition probabilities (TP); MSM for TP estimation and extrapolation; software used; feedback from Evidence Review Groups (ERGs). <strong><p><b>RESULTS: </b></strong> Economic models in 14 of 308 NICE TAs used MSM (12 TAs used MSM within STMs; two TAs (in cancers) used a hybrid model structure consisting of both PSM and MSM). Two of 16 HSTs used MSM within STMs. MSM was used in STMs to estimate TP for each transition reflecting explicit disease process and treatment as well as covariate effects therefore to improve transparency around process underlying TP estimation and extrapolation and to facilitate meaningful sensitivity analysis. In the majority of HTAs, ERGs accepted MSM as appropriate to represent disease progression, with the main concerns being inappropriate implementation, including data used and survival model selection. For HSTs, MSM was criticised as being overly complex and may ‘over fit’ data. <strong><p><b>CONCLUSIONS: </b></strong> There is a growing but limited number of models for NICE HTAs using MSM. As a modelling approach for consideration in cancer and other chronic, progressive, non-communicable diseases, MSM is feasible to implement, acceptable to HTA bodies and should be used more to inform decision making on cost effectiveness. HTA guidelines on the appropriate use of MSM and research on MSM using published survival data are urgently needed.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-poster-on-msm-v20-pdf.pdf?sfvrsn=e24a0717_0","title":"ISPOR poster on MSM v2_0.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116381","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Description of Pharmacogenetics for Patients with Hepatitis C Virus in the Kingdom of Saudi Arabia: A Single Center Perspective","id":"45eeb32f-4875-4cae-ad99-cc38d61334f4","sessionCode":"EPH1","topDisplay":"<b><u>Althemery A</u></b><sup>1</sup>, Alturaiki A<sup>2</sup>, Alanazi RH<sup>2</sup>, Almotairi NH<sup>2</sup>, AL Ammari M<sup>3</sup>, Alghamdi H<sup>3</sup>, AlThiab K<sup>3</sup><br><sup>1</sup>Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia, <sup>2</sup>King Abdulaziz Medical City - National Guard Health Affairs, Riyadh, Saudi Arabia, <sup>3</sup>King Abdulaziz Medical City - NGHA, Riyadh, Saudi Arabia","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Over 71 million people are living with hepatitis C virus (HCV) globally. HCV is an RNA virus that can be classified into different types of genotypes and can lead to multiple complications, including liver cirrhosis, hepatocellular carcinoma, and death. HCV treatments are effective but highly dependent on the HCV genotype and subtype. There are few studies describing the HCV genotype in the Middle East, in particular, Saudi Arabia. This study aims to describe the genotypes of patients with HCV living in Saudi Arabia and their associated treatments.</p> <p><b>METHODS: </b> The study was conducted at National Guard Hospital in Riyadh. All adults (18 years and older) diagnosed with HCV who started direct‐acting antiviral agents were identified from the pharmacy records. The relevant clinical factors, including patients’ characteristics, comorbid conditions, treatments, and HCV genotypes, were collected. The baseline viral counts were collected and converted into log algorithm values. The sample size was determined using G*Power analysis software, while all analyses were conducted using R: A language and environment for statistical computing.</p> <p><b>RESULTS: </b> A total of 387 patients with HCV were identified, out of which 28.42% were genotype 1, 65.8% were genotype 4, and 5.78% had mixed genotype 1&4. The majority of those patients were elderly (M = 61.4 SD = 0.8). The majority of patients received sofosbuvir (294 patients), ledipasvir <span>)</span>200), ribavirin (190), and paritaprevir (93).</p> CONCLUSION: It was shown that HCV genotype 4 was predominant in Saudi Arabia, unlike findings in the United States and Northern Europe, where genotype 1 predominates. Future studies are needed to evaluate the effectiveness of direct‐acting antiviral agents with their targeted genotypes.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/althemery-ispor22-poster-pdf.pdf?sfvrsn=490fac8e_0","title":"Althemery ISPOR22 poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115913","diseases":[{"id":"df9240d9-f266-47e0-ba0b-a11dfd152ae4","parentId":"00000000-0000-0000-0000-000000000000","title":"Biologics and Biosimilars","urlName":"biologics-and-biosimilars"},{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Bayesian Joint Models for Cost-Effectiveness Analyses Based on Clustered Participant Data, with Implementation in Stan","id":"d5ad4bd5-4276-4f53-85b3-cf88aa9a0a43","sessionCode":"EE42","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES</strong>: </b>Economic evaluations of empirical participant data are frequently complicated by irregularly distributed and correlated observations, which are not well approximated by normal distributions. Things get even more difficult when observations are clustered within higher level units (e.g., hospitals) or the participant (i.e., repeated measurements). Therefore, we develop a flexible Bayesian approach to jointly model costs and effectiveness of two competing interventions with a multilevel structure.</p> <strong><p><b>METHODS</strong>: </b>We model costs and effectiveness through Gamma and Beta distributions, respectively, and account for the dependency between the two by adding the effects as a predictor for the costs. The varying intercepts for the clusters in the regression equations are modelled through a bivariate normal distribution. We use G-computation to estimate treatment effects on costs and utilities. To compare the performance of our approach to a frequentist alternative (linear mixed model combined with cluster bootstrapping), we simulate 2000 datasets consisting of 400 participants and 40 clusters. Performance of both models is assessed in terms of bias, variance and coverage probability with respect to the effect sizes defined in the simulation.</p> <strong><p><b>RESULTS</strong>: </b>We ran a preliminary simulation with high intraclass correlation, negative correlation of patient-level costs and effects, and positive correlation of cluster effects on both outcomes. The analysis shows that the Bayesian model exhibits a minimal bias for estimated costs, but smaller errors and higher coverage probability. We will explore different scenarios where we vary the parameters of the simulations and assess whether the results are robust to such changes.</p> <strong><p><b>CONCLUSIONS</strong>: </b>Our Bayesian approach is able to handle multiple statistical complexities at once and performs better than a comparable frequentist model. Since it very important that economic evaluations in health care produce precise and reliable estimates, we believe that this paper is a valuable addition to the literature. We provide a full implementation in R and Stan.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117554","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Assessment of Public Knowledge and Attitude Towards Antibiotic Use and Antibiotic Resistance: A Community Pharmacy-Based Study","id":"5eb8be33-c08c-459f-afb9-d10ef94f031f","sessionCode":"EPH16","topDisplay":"Isah A<sup>1</sup>, Aina A<sup>1</sup>, <b><u>Ben-Umeh K</u></b><sup>2</sup>, Egbuemike C<sup>1</sup>, Onyekwum A<sup>1</sup>, Umoru D<sup>1</sup>, Ezechukwu C<sup>1</sup><br><sup>1</sup>University of Nigeria, Nsukka, Nigeria, <sup>2</sup>University of Utah, Salt Lake City, UT, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> The abuse and misuse of antibiotics is a major public health concern in Nigeria and many other parts of the world. This is not just specific to hospital settings, but also seen in community retail pharmacies across the country. This explains the trend in antibiotic resistance in Nigeria. Hence, the aim of the study was to access the knowledge and attitude of the Nigerian public towards antibiotic use and antibiotic resistance, and their predictors.</p> <p><b>METHODS: </b> A cross-sectional questionnaire-based survey was carried out between July and September 2021 in 5 community retail pharmacy outlets in Lagos and Abuja. A nationally representative sample of male and female adults aged 18 years and above were used for the survey. The collated questionnaires were coded into and analysed using IBM Statistical Products and Services Solution Version-25. Appropriate descriptive and inferential statistics were conducted on the data, with <em>p </em>< 0.05 being considered statistically significant.</p> <p><b>RESULTS: </b> Responses were generated from 964 clients who visited the selected community retail pharmacies within the study duration. About 64% and 50% of the respondents identified chlorpheniramine maleate and levonogestrel respectively as antibiotics. In addition, over half (58.3%) of the respondents posited that antibiotics should be taken immediately after unprotected sexual intercourse to prevent sexually transmitted diseases (STDs), while 55.3% said malaria is caused by bacteria. The level of education (p= 0.007) and the respondents’ area of residence (p=0.028) were good predictors of their knowledge of antibiotic use and resistance, while sex (p= 0.008) and level of education (p= 0.006) were predictors of attitude.</p> CONCLUSION: Majority of the respondents had good knowledge of antibiotic use and resistance, while there was no significant difference between respondents who had poor and good attitudes. We found the level of education, sex, and area of residence as predictors among the sociodemographic factors.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/keneispor2022poster-pdf.pdf?sfvrsn=b2c54e56_0","title":"KENE_ISPOR2022_POSTER.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117895","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"97c2e725-3c74-4625-997f-a72378c5a557","parentId":"00000000-0000-0000-0000-000000000000","title":"Generics","urlName":"Generics"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Budget Impact Analysis of Favipiravir (AVIGAN®) for the Treatment of Patients with Confirmed Infection with SARS-COV2 in Mexico","id":"be335aaf-1bd6-4b94-a077-d1253e0ae504","sessionCode":"EE43","topDisplay":"<b><u>Paladio Hernández JÁ</u></b><sup>1</sup>, Godina-Ortiz BA<sup>2</sup>, Lara-Terrazas A<sup>3</sup><br><sup>1</sup>Independent Consultant, Cuautitlán Izcalli, EM, Mexico, <sup>2</sup>japHealthEconomics, Cuautitlán Izcalli, EM, Mexico, <sup>3</sup>Landsteiner Scientific, CDMX, DF, Mexico","locationCode":"","description":"\r\n\t<div>Objective</p> The novel coronavirus (SARS-CoV-2) outbreak began in late December 2019, declared a pandemic on March 11, 2020, rapidly spread worldwide, critically impacting public health. As new treatments become available, healthcare professionals worldwide develop treatment algorithms to maximize patient benefit and minimize the impact on healthcare resources. Due to the urgency of the situation, a number of already approved and marketed drugs are being tested for repurposing, including Favipiravir. This study aims to evaluate the Budget Impact of favipiravir plus supportive treatment (ST) compared to only ST in Mexico to treat COVID-19 mild to moderate patients. </p> Methods</p> A Budget Impact Analysis was developed to assess the difference in the annual current government health expenditure versus a new scenario where Favipiravir is included and increases its market share (from 30% year one to 70% year 5). Currently, there are not COVID-19 tretaments approved in Mexico’s formulary. So, for this scenario, this model assumes 70% of ST is indicated in COVID-19 patients (year 1). Costs (2022 USD) are presented each 100,000 patients. Favipiravir efficacy indicates that hospital length is reduced versus only SC. The total cost for each alternative is compose from medications, hospital stay and laboratory studies. The time horizon is 5 years. The results are presented for the main public health institutions in Mexico.</p> Results</p> In the current scenario, supportive treatment for 100,000 patients represents 4.45% of the total government health expenditure in year 1. For 5 years, in average, the BI is 4.42%. in the new scenario, In year 1 (30% use of Favipiravir) the BI is 3.40%, the BI average in the 5 years of study is 2.85%.</p> Conclusions</p> Data shows that early initiation of Favipiravir as recommended will have positive consequences. Favipiravir efficacy is associated to a lower hospital stay on comparison to supportive care.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117355","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness of Comprehensive Genomic Profiling in Patients with Non-Small Cell Lung Cancer for the Colombian Health System","id":"d0c5a25d-9338-4040-b64d-d18a00a4dfe1","sessionCode":"EE73","topDisplay":"Gamboa Ó<sup>1</sup>, Bonilla C<sup>2</sup>, Quitian Reyes D<sup>3</sup>, <b><u>Torres G</u></b><sup>4</sup>, Buitrago G<sup>5</sup>, Cardona AF<sup>6</sup><br><sup>1</sup>Universidad Nacional de Colombia, Bogotá D.C., Colombia, <sup>2</sup>Instituto Nacional de Cancerología, Fundación Colombiana de Cancerología Clínica Vida, Bogota, CUN, Colombia, <sup>3</sup>Productos Roche S.A., Bogotá, Colombia, <sup>4</sup>Universidad Nacional de Colombia, BOGOTA, CUN, Colombia, <sup>5</sup>Universidad Nacional de Colombia, Hospital Universitario de Colombia, Bogotá, D.C., Colombia, <sup>6</sup>ONCOLGroup/FICMAC, Bogotá, Colombia","locationCode":"","description":"\r\n\t<div><strong>INTROCUTION: </strong>The use of Comprehensive Genomic Profiling (CGP) and target therapies are associated with substantial improvements in clinical outcomes among patients with Non-Small Cell Lung Cancer (NSCLC). However, the costs of CGP may increase the financial pressures of NSCLC on health systems worldwide, especially in low- and middle-income countries. This study aims to estimate the cost-effectiveness of CGP compared to current genomic tests in patients with NSCLC from the perspective of the Colombian Health System.</p> <strong><p><b>METHODS: </b> </strong>To estimate the costs and benefits of CGP and its comparators: (1) immunohistochemistry (IH) and Real-time Polymerase Chain Reaction (RT-PCR) and (2) Fluorescence in Situ Hybridization (FISH), we developed a two-stage cohort model with a lifetime horizon. In the first stage, we made up a decision tree that calculated the probability of receiving each therapy (approved by the National Institute of Drug and Food Monitoring in Colombia) as a result of identifying a specific, actionable target. In the second stage, we developed a partitioned survival model that estimated the time spent at each health state. Only direct costs were included. Incremental cost-effectiveness ratios (ICERs) were calculated for Life-Years (LY) and Quality-Adjusted Life Years (QALYs) gained. All costs were expressed in 2019 international dollars (INT$).</p> <strong><p><b>RESULTS: </b> </strong>The use of CGP is associated with additional gains of 0.06 LYs and 0.04 QALYs compared to current genomic tests. ICERs for CGP ranged from INT$ 861 to INT$ 7,848, depending on the outcome and the comparator. Sensitivity analyses show that the cost-effectiveness decision was sensitive to prices of CGP above INT$ 7,170 per test. These results are robust to most deterministic and probabilistic sensitivity analyses.</p> <strong><p><b>CONCLUSIONS: </b> </strong>CGP is highly cost-effective in patients with NSCLC from the perspective of the Colombian Health System (societal willingness-to-pay threshold of INT$ 15,630 to INT$ 46,890).</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115433","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Reliability of Charting the Clinical Course of Chronic Hyperkalemia Treatment through an Ontology-Based Protocol Applied to Prior Authorization Drug Review Notes","id":"c878f551-3d9b-465f-ae58-d327b16237bb","sessionCode":"HSD14","topDisplay":"<b><u>Qualls J</u></b><sup>1</sup>, Patel S<sup>2</sup>, Sauer B<sup>3</sup><br><sup>1</sup>George E. Wahlen Department of Veterans Affairs Medical Center and University of Utah, Salt Lake City, UT, USA, <sup>2</sup>Department of Veterans Affairs, Salt Lake City, UT, USA, <sup>3</sup>University of Utah, Salt Lake City, UT, USA","locationCode":"","description":"\r\n\t<div><span class=\"header1\"><p><b>OBJECTIVES: </b>The Veterans’ Health Administration requires Prior Authorization Drug Review (PADR) evaluations for restricted formulary medications based on established criteria for use. The purpose of this study was to be able to characterize a clinical course using a combination of PADR notes and a developed ontology for treating chronic hyperkalemia, and non-treatment-related factors resulting in a physician’s request for the restricted-formulary agent patiromer, a newer agent for the treatment of chronic hyperkalemia. </span></p> <span class=\"header1\"><p><b>METHODS: </b>This was a descriptive study of an inter-rater agreement utilizing a Kappa (K) coefficient analysis. Veterans were included that had a successful request for patiromer. An electronic ontology was developed based on established <em>criteria for use</em> documentation, which included initiation, modification, or discontinuation of specific therapeutic strategies and lifestyle modifications. Non-treatment factors identified included approval due to shortage of the standard of care, sodium polystyrene sulfonate (SPS), and continuation of therapy from non-VHA sources.</span></p> <span class=\"header1\"><p><b>RESULTS: </b>Three hundred and seventy-two Veteran notes were identified for review. An analysis of the primary treatment, SPS, found almost perfect inter-rater agreement (K= 0.856±0.027). Substantial agreement was found when identifying Loop diuretics (K=0.757±0.042), Renin-Angiotensin-Aldosterone System (RAAS) agents (0.708±0.056), and lifestyle modification (K=0.634±0.048). Moderate agreement was found for thiazide diuretics (K=0.459±0.151), and fair agreement for non-RAAS (K=0.361±0.156). For non-treatment factors, we found an almost perfect agreement for approval based on a continuation of previous patiromer therapy (K=0.815±0.604) and for identifying a shortage of SPS (K=0.911±0.025).</span></p> <span class=\"header1\"><p><b>CONCLUSIONS: </b>Our protocol demonstrates high reliability for identifying treatment therapies attempted to address chronic hyperkalemia as well as non-treatment factors influencing the approval of a restricted formulary medication. This approach may offer benefits to identifying treatment and administrative or logistical hurdles to disease management, but further research needs to be done to determine the generalizability of this approach to other restricted formulary agents, such as oncologic therapies.</span></p> </p> </p> <span class=\"header1\"> </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-may-2022-pdf.pdf?sfvrsn=45f17ee6_0","title":"ISPOR May 2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117138","diseases":[{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Chronic Rhinosinusitis with Nasal Polyps (CRSwNP): A Cost-of-Illness Study in Brazilian Private Healthcare Settings","id":"8696f861-8291-4e32-9ced-d3372f702092","sessionCode":"EE74","topDisplay":"Silva D, <b><u>Santana P</u></b>, Baisch EQ, Gazzotti MR, Bernardino G<br>GSK, Rio de Janeiro, RJ, Brazil","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> To understand the standard of care (SoC) and estimate resource utilization and costs related to chronic rhinosinusitis with nasal polyps (CRSwNP), from the private payer’s perspective in Brazil. <strong><p><b>METHODS: </b> </strong>Resource use and cost in a 5-year time horizon were estimated based on microcosting approach. To validate disease management and SoC therapies in the country, an expert panel was held, composed of five otorhinolaryngologists from different Brazilian states. Microcosting was segmented in disease evaluation and diagnosis, conservative drug treatment step, first surgical approach, subsequent surgeries, minor and major surgical complications. Since healthcare plans (HMO) are not obligated to reimburse oral outpatient drugs, an alternative scenario was built which excluded out-of-pocket costs. Only direct medical costs were considered from Private Healthcare System perspective. Biological drugs were not considered in the analysis as they do not yet represent a national reality. Unit costs were obtained from Brazilian official price lists, in 2021 Brazilian Real (BRL) values (1BRL=US$5,64). <strong><p><b>RESULTS: </b></strong> All patients were assumed to stay on drug treatment throughout the 5-year period. Eighty percent of all CRSwNP patients needs at least one surgery and 30% needs two or more surgeries. The average time between first and second surgeries is 3 years, and, from second to third, 2 years. All patients use intranasal steroids. For acute manifestations, oral steroids and antibiotics are prescribed for all patients. Estimated total cost per patient was 94,285.20BRL for the 5-year horizon and the main cost component was drug treatment (48,860BRL [51.8% of the total]), followed by first surgical approach (22,891BRL [24.3%]), and subsequent surgeries (17,228BRL [18.3%]). Out-of-pocket costs represented 15.1% of total medical cost. In the alternative scenario excluding out-of-pocket costs, 80,045BRL were spent in 5 years. <strong><p><b>CONCLUSIONS: </b></strong> The economic burden of CRSwNP is substantial, mainly driven by drugs and surgical procedures. Funding: GSK (218071).</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115123","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Short-Term Cost-Effectiveness of Using Mobile Stroke Unit VS. Standard Ambulance for Patients with Suspected Stroke","id":"6a26f3fa-c9e0-4aa4-9a4c-d413b01e604a","sessionCode":"EE47","topDisplay":"<b><u>Sangha K</u></b><sup>1</sup>, White T<sup>2</sup>, Malhotra A<sup>3</sup>, Boltyenkov A<sup>4</sup>, Katz JM<sup>2</sup>, Sanelli PC<sup>2</sup><br><sup>1</sup>Siemens Healthineers, Malvern, PA, USA, <sup>2</sup>Northwell Health, Manhasset, NY, USA, <sup>3</sup>Yale School of Medicine, New Haven, CT, USA, <sup>4</sup>Siemens Medical Solutions USA Inc., Malvern, PA, USA","locationCode":"","description":"\r\n\t<div><strong>Introduction</strong></p> Mobile stroke units (MSUs) have the potential to improve time-sensitive stroke care delivery by appropriate triage of patients with large-vessel-occlusion (LVO) to comprehensive stroke centers (CSCs) for endovascular treatment (EVT) and non-LVO patients to primary stroke centers (PSCs). The purpose of this study was to determine the cost-effectiveness of MSU when compared to the standard ambulance (SA) transport of suspected stroke patients to the appropriate hospital.</p> <strong>Methods</strong></p> A discrete event simulation (DES) model was developed. DES is a method of simulating disease pathway as sequence of events in time. The population included patients ≥18 years with suspected stroke symptoms including ischemic or hemorrhagic stroke, lacunar infarcts and stroke mimics. Patients were categorized into three health states based on 90-day modified Rankin scale (mRS) scores: good outcome (mRS score 0-2), poor outcome (mRS score 3-5), or death (mRS score 6). The cost-effectiveness analysis was conducted from the healthcare institution’s perspective with 90-days and 1-year time horizons.</p> <strong>Results </strong></p> Baseline DES results indicated that MSU was less costly (by $2233) with higher effectiveness of 0.03 additional QALYs gained over 90 days than SA with the incremental cost-effectiveness ratio (ICER) of $104,495. When the time horizon was expanded to 1-year, MSU remained less costly (by $2021) but with the same effectiveness as the SA. In one-way sensitivity analysis, using 1-year time horizon, when time to EVT is varied, the MSU remained less costly (by $2808) with higher effectiveness (by 0.01 QALYS gained) than the SA. MSU was cost-effective in 49% of probabilistic sensitivity analysis iterations using threshold of $100,000/QALY.</p> <strong>Conclusion</strong></p> MSUs were the most cost-effective transport option for suspected stroke patients at 90-days and 1-year post stroke. Despite the variation in time taken to get to a CSC for EVT, due to geographic location and traffic, our results show MSU to be cost-effective.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/msuispor-2022-pdf.pdf?sfvrsn=d062c4ef_0","title":"MSU_ISPOR 2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117773","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"},{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"},{"id":"bde7079b-7db2-4006-9dbf-54d654e04fc7","parentId":"00000000-0000-0000-0000-000000000000","title":"Surgery","urlName":"Surgery"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of Coronavirus Disease (COVID-19) Pandemic on Non-COVID Healthcare Utilization in Saudi Arabia","id":"6f13eff5-9240-4db2-b6dd-d5dd774037b4","sessionCode":"HSD19","topDisplay":"Alameddine R<sup>1</sup>, Bassil Y<sup>1</sup>, Barhoun J<sup>1</sup>, Asmar K<sup>1</sup>, <b><u>Maskineh C</u></b><sup>1</sup>, Al-Omar H<sup>2</sup><br><sup>1</sup>CCHO FZLLC, Dubai, DU, United Arab Emirates, <sup>2</sup>College of Pharmacy, King Saud University, Riyadh, Saudi Arabia","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b></p> Globally, the COVID-19 pandemic disrupted healthcare systems and their functions including financing and services provision. According to the world health organization (WHO), the preventive and curative services of non-communicable diseases (NCDs) were particularly affected. The United Kingdom (UK) experienced 70% reduction in non-COVID care utilization while the United States (US) witnessed 38% reduction in myocardial infarction treatment. The aim of this study is to estimate the impact of the COVID-19 pandemic on non-COVID healthcare utilization in Saudi Arabia among patients with NCDs.</p> </p> <p><b>METHODS: </b></p> A retrospective analysis of private insurance dataset over three years period was performed for three NCDs: hypertension, diabetes mellitus and breast cancer. Cleaned data from 2018 and 2019 were averaged and considered as pre-COVID, and compared to data from 2020, the COVID period. Services utilization were presented as percentage difference in total number of monthly claims, monthly claims per 1000 claimants and cost of claims. Data was further disaggregated by disease area and service type.</p> </p> <p><b>RESULTS: </b></p> A total of 207,136 claimants were included in the analysis (84% male, 16% females) with a median age of 49 [41-56]. Total monthly number of outpatient claims and total monthly cost of claims were higher during the COVID period compared to pre-COVID except during lockdown period. Inpatient claims dropped during lockdown and in September and October, with a decrease in number of surgeries, admissions and intensive care unit (ICU) admissions starting mid-2020. The number of claims per 1000 claimants was consistently higher during 2020. This trend was noted across outpatient claims, and claims disaggregated by service type (pharmacy, laboratory and radiology services) and disease area.</p> </p> CONCLUSION:</p> The lockdown in Saudi Arabia resulted in less claimants seeking care, however the utilization of healthcare as reflected by number and cost of claims per claimants remained higher during COVID compared to pre-COVID period.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hsd19christianemaskinehhandout-pdf.pdf?sfvrsn=61b955d9_0","title":"HSD19_christianemaskineh_Handout.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116797","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"7755f76a-7fea-42fb-aaab-2d5f305aa95f","parentId":"00000000-0000-0000-0000-000000000000","title":"Diabetes/Endocrine/Metabolic Disorders","urlName":"Diabetes-Endocrine-Metabolic-Disorders"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Economic Burden of Gastroesophageal Reflux Disease, Barrett's Esophagus, and Esophageal Neoplasia in the United States","id":"ed6f6253-fa4b-4264-bd64-d5fa9f640cca","sessionCode":"EE61","topDisplay":"Sharma P<sup>1</sup>, Falk GW<sup>2</sup>, <b><u>Bhor M</u></b><sup>3</sup>, Ozbay AB<sup>3</sup>, Latremouille-Viau D<sup>4</sup>, Guérin A<sup>4</sup>, Shi S<sup>4</sup>, Elvekrog MM<sup>3</sup>, Limburg P<sup>5</sup><br><sup>1</sup>University of Kansas School of Medicine, Kansas City, MO, USA, <sup>2</sup>University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, <sup>3</sup>Exact Sciences, Madison, WI, USA, <sup>4</sup>Analysis Group, Inc., Montreal, QC, Canada, <sup>5</sup>Mayo Clinic, Rochester, MN, USA","locationCode":"","description":"\r\n\t<div><em>Objectives: </em>Gastroesophageal reflux disease (GERD) is a risk factor for Barrett’s esophagus (BE) and esophageal neoplasia (EN). The objective was to evaluate healthcare resource utilization (HRU) and costs associated with GERD, BE, and EN in the US.</p> <em>Methods:</em> Using diagnosis codes in medical claims, adult patients with GERD, non-dysplastic BE (NDBE), and EN, including indefinite for dysplasia (IND), low-grade dysplasia (LGD), high-grade dysplasia (HGD), or esophageal adenocarcinoma (EAC), were identified from the IBM Truven Health MarketScan databases (Q1/2015-Q4/2019) and categorized into the corresponding mutually exclusive cohorts based on the most advanced stage from GERD to EAC. Disease-related HRU and costs (2020 USD) were described for each cohort.</p> <em>Results: </em>A total of 3,310,385 patients were categorized into the GERD, 172,481 into NDBE, 11,516 into IND, 4,332 into LGD, 1,549 into HGD, and 11,676 into the EAC cohort. By cohort, mean age (year) and proportion of female were: 51.02 and 59.58% (GERD), 57.05 and 43.90% (NDBE), 58.07 and 41.21% (IND), 60.12 and 33.10% (LGD), 61.29 and 23.18% (HGD), and 62.79 and 25.15% (EAC). Disease-related annual mean number inpatient admissions, office visits, and emergency room visits by cohort were: 0.09, 1.45, and 0.19 for GERD; 0.08, 1.55, and 0.10 for NDBE; 0.10, 1.92, and 0.13 for IND; 0.09, 2.05, and 0.10 for LGD; 0.12, 2.16, and 0.14 for HGD; and 1.43, 6.27, and 0.87 for EAC. Disease-related annual mean total healthcare costs by cohort were: $6,955 for GERD, $8,755 for NDBE, $9,675 for IND, $12,241 for LGD, $24,239 for HGD, and $146,319 for EAC.</p> <em>Conclusions:</em> Patients with GERD, BE, and EN had important HRU and costs, including inpatient admissions and office visits. As patients progressed from GERD to BE to EAC, there were substantially higher disease-related resource utilization and associated costs.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022---economic-burden-poster-ee61-04-19-2022final-pdf.pdf?sfvrsn=d6abe70f_0","title":"ISPOR 2022 - Economic Burden Poster EE61 04-19-2022_Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115986","diseases":[{"id":"fa5c47a6-1e67-420d-baf4-019c13fc2b50","parentId":"00000000-0000-0000-0000-000000000000","title":"Gastrointestinal Disorders","urlName":"Gastrointestinal-Disorders"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of the COVID-19 Pandemic on Real-World Antipsychotic Treatment Patterns in Patients with Schizophrenia","id":"a301509e-d9f8-46e3-b6e0-d6c13e5e5515","sessionCode":"HSD26","topDisplay":"<b><u>Liu Z</u></b>, Patel CA, Campbell A, Fu A, Benson C<br>Janssen Scientific Affairs, LLC, Titusville, NJ, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>To evaluate the impact of COVID-19 pandemic on oral Antipsychotic (OA) and long-acting injectable (LAI) Antipsychotic (AP) use in schizophrenia.</p> <strong>Methods: </strong>Adults with schizophrenia and ≥6 months baseline continuous enrollment in IBM MarketScan<sup>®</sup> Medicaid Multi-State claims were identified. Patients were characterized as new users of AP, new OA (regardless of prior LAI) or new LAI (regardless of prior OA) users, or active users of any AP, during three observation periods (OP): A: 03/13/2018-12/31/2018 (historic control); B: 03/13/2019-12/31/2019 (historic control); C) 03/13/2020-12/31/2020 (pandemic period). New users had their first claim during one of the OP; active users had treatment overlapping an OP start date and ≥6-months follow-up. Ratios of new LAI:OA users were calculated for each OP and subperiod (first 90 days, second 90 days, remaining days of OP). Treatment patterns during follow-up for active users in each OP were reported.</p> <strong>Results: </strong>There were 7,519 new users of AP, 11,550 OA or LAI new users, and 35,224 active AP users across all OP. No obvious trends in LAI:OA ratios were observed in new users of AP (0.21, 0.25, 0.21) or new OA or LAI users (0.45, 0.49, 0.41) across OP A, B, and C, respectively. A slight increase in LAI:OA ratio was observed during the latter part of the pandemic period in new users of any AP (0.20, 0.20, 0.23) and new OA or LAI users (0.40, 0.39, 0.44), for the first 90 days, second 90 days, and remaining days of OP C, respectively. Follow-up treatment patterns in active users were similar across OP.</p> <strong>Conclusion: </strong>This analysis provided insights on choice of antipsychotics during the pandemic. Given the various effects of the pandemic over time and geographically, further research may identify unmet needs for optimized schizophrenia treatments, including LAIs, that may provide unique benefits in emergency situations that disrupt healthcare.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116059","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Data Visualization: A Tool to Enhance the Interpretability of Complex and Dense Data Sources","id":"6f1684d3-900b-43e6-ba20-d6c5c0b1b9d4","sessionCode":"SA11","topDisplay":"<b><u>Nguyen V</u></b><sup>1</sup>, Huelin R<sup>2</sup>, Yoon S<sup>2</sup><br><sup>1</sup>Evidera, Ivry-sur-Seine Cedex, France, <sup>2</sup>Evidera, Waltham, MA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Systematic literature reviews (SLRs) summarize all available evidence using rigorous methodologies to inform regulatory and HTA decisions, guideline development and clinical practice. With the exponential growth of medical literature, the volume of data included in SLRs have increased tremendously. Further, advanced analysis methods such as network meta-analysis are heavily technical, possibly involving multiple networks, which may hinder interpretation. The density and complexity of static information in SLRs causes challenges in the uptake of data from SLRs. Failure to optimally use high-quality research evidence results in inefficiencies and potential inaccuracies in interpretation. This research aims to develop data visualizations to improve readability of SLRs.</p> <strong><p><b>METHODS</strong>: </b> We carried out a targeted literature review on gastric cancer and gastroesophageal junction cancer in Medline, CDSR, EconLit, and grey literature, identifying 1,544 unique references to inform our initiative. Of those, 47 were ultimately included. Based on these data we developed and tested data visualizations suitable for use with data extractions from SLRs.</p> <strong><p><b>RESULTS</strong>: </b> Data visualizations have the potential to enhance communication of complex data and key findings of SLRs to stakeholders. Our dynamic data visualization tool allows non-technical users to interact with the data outside the static structure of SLR reports. Users are able to select preset data cuts to visually explore the heterogeneity across included studies and customize the graphical presentations of the key findings. The tool is fully bespoke to maximize interpretability.</p> <strong><p><b>CONCLUSIONS</strong>: </b> The current reporting paradigm for SLRs has hindered the dynamic, efficient consumption of evidence due to the increasing volumes and complexity of data. Visualizations will help policy makers and other stakeholders to understand and effectively communicate the key value messages from SLRs that can have important impacts on clinical practice.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116675","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Prevalence of Hematuria and Its Association with Urinary Tract Cancer: A Case-Control Study Using Real-World Data from UK Primary Care","id":"522d0cd2-c205-4f20-9613-d815cdef3a1b","sessionCode":"EPH5","topDisplay":"<b><u>Spanopoulos D</u></b><sup>1</sup>, Pramanick S<sup>2</sup>, Clark A<sup>1</sup>, Carroll R<sup>3</sup><br><sup>1</sup>Bristol Myers Squibb, London, UK, <sup>2</sup>Mu Sigma, Bangalore, India, <sup>3</sup>Bristol Myers Squibb, London, BKM, UK","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Hematuria is a common symptom of urinary tract cancer (UTC). Having an easily identifiable symptom such as hematuria in the case of UTC may result in earlier diagnosis. This study aims to examine the association of hematuria with UTC and explore potential gender differences in its prevalence among bladder cancer patients in UK primary care. <strong><p><b>METHODS: </b></strong> This is a retrospective case-control study using the Clinical Practice Data Link between January 2000 and December 2020. Cases of patients diagnosed with UTC were matched in a 1:4 ratio to controls (patients without UTC diagnosis) by year of birth, gender, and general practitioner practice. Index date for cases was date of UTC diagnosis and for controls index was imputed as the date of diagnosis for their matched case. The association between haematuria and UTC was estimated using conditional logistic regression (CLR) models.<strong> <p><b>RESULTS: </b> </strong>A total of 9147 cases and 36,588 controls were included in the analysis. The mean age in both groups was 70.7 years and 73.3% of patients in each group were males. In the year prior to index date hematuria was present in 49.3% (4511/9147) of cases and 1.1% (400/36,588) of controls. Overall, the odds of hematuria presence were higher in cases vs. the controls in the unadjusted CLR model (Odds Ratio: 158; 95% CIs: 130.76,190.90, <em>P</em> <0.0001). This effect did not diminish in the adjusted model. The presence of hematuria was higher in the male cases (51.6%: 3458/6708) vs. the female cases (43.2%: 1053/2439) <strong>CONCLUSION: </strong>The findings of this study add to the well-established evidence base demonstrating hematuria is a strong prognostic factor of UTC. The lower observed prevalence of hematuria in females might be indicative of under detection of an important symptom of UTC in UK primary care.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115929","diseases":[{"id":"7f059074-623e-4c96-8812-8affdc603f10","parentId":"00000000-0000-0000-0000-000000000000","title":"Urinary/Kidney Disorders","urlName":"Urinary-Kidney-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"2015 American Thyroid Association Guidelines and Outcomes for Patients with Thyroid Cancer","id":"6aca7649-ca63-4de8-9326-d86e662cad53","sessionCode":"HSD41","topDisplay":"<b><u>Hao Q(</u></b>, Segel JE, Hollenbeak CS<br>The Pennsylvania State University, University Park, PA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>In January 2016, the American Thyroid Association guidelines recommended hemithyroidectomy as initial treatment for smaller (1-4cm) primary thyroid carcinomas, particularly for papillary (PTC) and follicular thyroid cancer (FTC). This study evaluated the association between the guideline release and initial surgical procedures for patients with PTC/FTC tumors.</p> <p><b>METHODS: </b>Patients with PTC/FTC tumors 1-4cm who underwent hemithyroidectomy or total-thyroidectomy were identified from the 2009-2018 National Cancer Database. To avoid the bias from the evidence regarding hemithyroidectomy benefits before the guideline release, we used 2009-2011 as baseline and estimated hemithyroidectomy utilization in the following years, 2016-2018 were considered as post-guideline. A linear probability model was used to assess trends in hemithyroidectomy over time, adjusting for patient, disease, and hospital characteristics. We further conducted a stratified analysis by adding the interaction between year and hospital type, which included community cancer programs (CCP), comprehensive community cancer programs (CCCP), academic/research programs (ARP), and integrated network cancer programs (INCP).</p> <p><b>RESULTS: </b>The final study cohort included 69,455 patients, of whom 11.34% received hemithyroidectomy and 88.66% received total thyroidectomy. Hemithyroidectomy utilization did not change significantly from 2012-2015 relative to the 2009-2011 baseline. Following the guideline release, however, Hemithyroidectomy utilization increased significantly in 2016 (1.2%, p=0.004), 2017 (3.5%, p<0.0001), and 2018 (7.2%, p<0.0001). The stratified analysis showed significant differences in timing of the shift to hemithyroidectomy by hospital type. Hemithyroidectomy utilization significantly increased beginning in 2014 for ARP (p<0.0001) and INCP (p<0.0001), in 2015 for CCCP (p<0.0001), and in 2016 for CCP (p<0.0001).</p> <p><b>CONCLUSIONS: </b>Although hemithyroidectomy utilization among patients with PTC and FTC tumors 1-4cm significantly increased following the 2015 ATA guideline, the guideline does not appear to be the catalyst for most hospitals. Research focused cancer centers began increasing hemithyroidectomy two years before the guidelines were released, and only CCP hospitals began to increase hemithyroidectomy utilization following the guideline release.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/posterisopr2022-pdf.pdf?sfvrsn=6495d076_0","title":"Poster_ISOPR_2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115450","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Evaluating the Impact of COVID-19 on the Mental Health of Doctors in Sargodha Pakistan: A Quantitative Approach","id":"a806f096-d4b4-4d68-bb5f-d96d43bb48a5","sessionCode":"HSD21","topDisplay":"Waseem A<sup>1</sup>, <b><u>Azhar S</u></b><sup>2</sup>, Sarfaraz A<sup>3</sup>, Noorka HR<sup>3</sup>, Ahmed J<sup>4</sup>, Saeed Z<sup>2</sup>, Khan LUR<sup>2</sup><br><sup>1</sup>University of Sargodha, Sargodha, Pakistan, <sup>2</sup>University of Sargodha, Sargodha, PB, Pakistan, <sup>3</sup>Rai Medical College, Sargodha, Sargodha, Pakistan, <sup>4</sup>University of Sargodha, Quetta, Pakistan","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>The arrival of COVID-19 exaggerated the psychological and mental health status of doctors. Objective of the study is to evaluate the depression, anxiety, and stress during the COVID-19 pandemic on doctors in Sargodha, Pakistan.</p> <p><b>METHODS: </b>A self-administered questionnaire consisting of demographic details and a DASS-21 survey questionnaire were distributed to DHQ hospital Sargodha during working hours. The severity level and score of depression, anxiety, and stress among doctors have been evaluated. The chi-square test was performed to check the association of DASS-21 with dependent variables by taking p-value <0.05 using SPSS version 21. </p> <p><b>RESULTS</p>: </b>The data of 213/280 doctors were added in the final analysis yielding a good response rate. A considerable number of doctors reported depression (57.75%), anxiety (67.61%), and stress (37.59%). The Chi-square test revealed that significant results were seen in demographics. All the obtained DAS scores on subscales were dichotomized as extremely severe, severe, and moderately depressed while mild and normal were considered as not stressed. The same pattern was followed in anxiety and stress subscales. The majority of the doctors 123 (57.75%) were depressed, 144 (67.61%) were anxious and 80 (37.59%) were stressed.</p> <p><b>CONCLUSIONS</p>: </b>It was concluded that male doctors, house Officer, doctors performing duties in wards, and doctors having moderate to low knowledge of COVID-19 were moderately depressive while males, residents, consultants, emergency area doctors, and doctors working more than 20 hours face severe anxiety. The positive outcome of this study is no doctor feel stress during the duty hours in the COVID-19 pandemic.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116428","diseases":[{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of Huntington's Disease on Driving: A Review of Driving Simulator Measures and Association with Clinical Outcomes Assessments","id":"bbbbc297-d727-40f6-ba82-dc6addd860a2","sessionCode":"CO17","topDisplay":"Hawe E<sup>1</sup>, Castro CV<sup>2</sup>, Johannensen J<sup>3</sup>, Belisario JM<sup>1</sup>, Mordin M<sup>2</sup>, Sawant R<sup>3</sup>, <b><u>Petrillo Billet J</u></b><sup>3</sup><br><sup>1</sup>RTI Health Solutions, Manchester, UK, <sup>2</sup>RTI Health Solutions, Research Triangle Park, NC, USA, <sup>3</sup>Sage Therapeutics, Inc., Cambridge, MA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Huntington’s disease (HD) is a genetic, neurodegenerative disease characterized by motor and behavioral symptoms and decline in cognitive abilities relevant to everyday function. Although scales of gross functional status are available, demonstrating the functional benefits of an intervention in HD remains challenging due to lack of standardized and sensitive measures of functional capacity. In recognition of this gap, a critical review was undertaken to summarize literature addressing the impact of HD on driving (as measured by simulator measures) and the relationship between clinical outcomes assessments (COAs) and driving simulator measures in an HD population.</p> <strong>Methods: </strong>A targeted literature review identified publications, including driving simulator and cognitive function assessments in HD. Simulated driving outcomes were grouped into categories: accidents; attention/reaction; distance control; general errors; infractions; lane position; speed. Standardized mean differences (Hedge’s g method) were generated to evaluate differences in measures between HD and community control samples. Relationships between driving measures and COAs were explored using Pearson correlation.</p> <strong>Results</strong>: Four publications were identified. Driving outcomes worse in HD than controls included higher frequency of accidents, tickets, errors, and some reaction time measures. Pooled estimates of effect size were not calculated as most measures were only in a single study and studies reported on multiple measures. The strength of correlations between COAs (cognitive tests, UHDRS) and driving measures ranged from low to high, and varied across driving measure categories: attention/reaction time (0.48 to 0.85), lane position (0.04 to 0.64), driving speed (-0.35 to 0.52) and across COA measures. The Trail Making Test, commonly used in clinical evaluation of fitness to drive, was moderately correlated with speed (0.43) and lane position (0.49).</p> <strong>Conclusions</strong>: Many measures are used to assess the impact of HD on driving performance. Simulated driving performance shows promise as a potential functional outcome measure for therapeutic development in HD.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/6123ispormordinhd2poster22apr2022rebrand-pdf.pdf?sfvrsn=1dad983c_0","title":"6123_ISPOR_Mordin_HD2_Poster_22Apr2022_REBRAND.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116529","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Effectiveness of Six PD-1/PD-L1 Inhibitors in Treatment of Patients with Advanced Squamous Non-Small Cell Lung Cancer: An Indirect Comparison and Partitioned Survival Model","id":"beab07d3-cc1e-4829-9934-dc745a92d6b1","sessionCode":"CO126","topDisplay":"Zhao M<sup>1</sup>, Shao T<sup>2</sup>, <b><u>Tang W</u></b><sup>2</sup><br><sup>1</sup>China Pharmaceutical University, Nanjing, China, <sup>2</sup>China Pharmaceutical University, Nanjing, 32, China","locationCode":"","description":"\r\n\t<div><strong>Background:</strong> Since 2019, six PD-1/PD-L1 inhibitors (sugemalimab, sintilimab, pembrolizumab, camrelizumab, atezolizumab and tislelizumab ) are already in or about to be launched in the Chinese market, but there are no head-to-head RCT studies reporting the comparative efficacy nor the long-term effectiveness. Therefore, this study aims to indirectly compare these six drugs and project to the final outcome in order to provide evidence for clinical decision and Chinese national reimbursement drug listing.</p> <strong>Methods:</strong> We collected phase III clinical trials targeted on stage IIIB–IV patients for first-line immunotherapy of sq-NSCLC by systematically searching databases and conference abstracts. Chemotherapies were limited to paclitaxel/gemcitabine plus platinum. KEYNOTE-407 (pembrolizumab plus chemotherapy versus chemotherapy) was chosen as the anchor for indirect comparison. We used non-proportional hazard ratio to adjust for PFS rate cycle by cycle among drug groups, and proportional hazard ratio to adjust for OS rate. Life-year estimates in PFS and OS were calculated from Kaplan-Meier survival curve and extrapolated survival curve based on partitional survival model. We also performed sensitivity analysis using the range of parameters distribution as well as different comparison methods to test the robustness of the results.</p> <strong>Results:</strong> A total of 6 clinical trials were included. When followed up till 24 months, sugemalimab achieved the highest PFS benefit (1.061 LYs), with camrelizumab (1.03 LYs), sintilimab (0.9264 LYs), pembrolizumab (0.9255 LYs), tislelizumab (0.788 LYs) and atezolizumab (0.734 LYs) ranking in order. When extrapolated to 120 months, sugemalimab achieved the highest OS benefit (3.799 LYs), with camrelizumab (3.379 LYs), sintilimab (3.287 LYs), pembrolizumab (2.644 LYs) and atezolizumab (2.107 LYs) ranking in order. When simply comparing HR, sugemalimab ranked first in PFS (38%) and OS (42%). The results were robust under all conditions.</p> <strong>Conclusions:</strong> Sugemalimab is significantly superior both in PFS and OS benefits for advanced sq-NSCLC patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/paper115100handout54230-pdf.pdf?sfvrsn=40fe4b69_0","title":"Paper_115100_handout_5423_0.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115100","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"High Willingness to Deprescribe Among People Living with Dementia and Mild Cognitive Impairment","id":"c42a9a62-65fa-4eac-a7b6-de6899d281b4","sessionCode":"HSD18","topDisplay":"<b><u>Maiyani M</u></b><sup>1</sup>, Reeve E<sup>2</sup>, Bayliss E<sup>1</sup>, Shetterly S<sup>1</sup>, Gleason K<sup>1</sup>, Boyd C<sup>3</sup><br><sup>1</sup>Kaiser Permanente, Aurora, CO, USA, <sup>2</sup>University of south Australia, Adelaide, SA, Australia, <sup>3</sup>Johns Hopkins University, Baltimore, MD, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives:</strong> There is limited knowledge about how people living with dementia feel about their medications and possible deprescribing. We used the revised Patients’ Attitude Towards Deprescribing questionnaire for older people living with cognitive impairment (rPATDcog) to capture the beliefs and attitudes about deprescribing among persons living with dementia and cognitive impairment. This study aimed to explore the association between patients’ characteristics and their willingness to deprescribe. </p> </p> <strong>Methods:</strong> The Optimize study is a pragmatic, cluster-randomized trial educating patients and clinicians about deprescribing. Eligible participants were 65+, diagnosed with dementia, or mild cognitive impairment, and prescribed at least 5 chronic medications. Persons in intervention clinics received the rPATDcog survey prior to a scheduled primary care visit. </p> </p> <strong>Results:</strong> The survey was mailed to 1,431 patients and 553 (39%) completed surveys were returned. Participants who responded to the survey were older (80.1 vs 79.8) and more likely to be non-hispanic white than non-responders (p<0.05). 56% (310/553) of surveys were known to be answered by patients and 10% by caregivers (55/553). 78% (431/553) of participants were willing to stop one or more of their medications if their doctor said it was possible. 79% of participants were willing to deprescribe and results were similar by age, race, gender, median family income and neighborhood deprivation index (all p>0.05). 75% (413/553) of participants said they were satisfied with their current medications; willingness to deprescribe was slightly lower in this group compared to persons less satisfied with their regimens (76.2% vs 84.9% chi-square p=0.04).</p> </p> <strong>Conclusions:</strong> A consistently high proportion of patients living with dementia were willing to deprescribe if their doctor said it was possible. These findings can be used to educate clinicians and encourage patients to discuss deprescribing with their clinicians which may lead to an increase in deprescribing discussions.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/maheshispordigitalposterfinal-pdf.pdf?sfvrsn=8072e776_0","title":"Mahesh_ISPOR_Digital_Poster_Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115392","diseases":[{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Does Clinical Evidence of Heterogeneity Influence Treatment Selection? a Case Study of Abiraterone Acetate for Metastatic Castration-Sensitive Prostate Cancer","id":"1539d33e-ac5a-4185-b7e9-dead51449207","sessionCode":"HSD7","topDisplay":"<b><u>Jiao B</u></b>, Nyame Y, Carlson JJ, Garrison LP, Basu A<br>University of Washington, Seattle, WA, USA","locationCode":"","description":"\r\n\t<div><strong>Objective</strong></p> Two pivotal clinical trials, both published in June 2017, have demonstrated that abiraterone acetate (AA) combined with androgen deprivation therapy (ADT) significantly extends the survival of metastatic castration-sensitive prostate cancer (mCSPC) patients compared to ADT alone. Yet, the benefits may be pronounced for younger compared with older patients. We aimed to assess whether the publication of the trials’ results was associated with differential AA utilization between age groups.</p> <strong>Methods </strong></p> We utilized electronic medical records and claims data from the TriNetX platform, collected from healthcare organizations across the United States. Our analysis included newly diagnosed mCSPC patients observed from June 2014 to June 2019. We designed a difference-in-differences (DID) event study to assess the differential uptake rate of AA every six months before and after publication. The dependent variable was a binary indicator of AA initiation. The primary independent variables included time fixed effects (the first pre-publication period, December 2016 to May 2017, was set as reference), an indicator of < 70 years old, and interactions between time fixed effects and age indicator. We employed a linear generalized estimating equation with an exchangeable correlation, adjusting for demographics and clinical conditions.</p> <strong>Results</strong></p> Our sample included 6,896 newly diagnosed mCSPC patients with a baseline mean age of 71 years. The pre-publication trends of AA use were similar between the groups. Over the two years after publication, the increase in uptake rate was significantly faster among the younger than older, with a DID estimate of 5% (3% – 8%).</p> <strong>Conclusions</strong></p> Despite the absence of clinical guideline recommendations for differential use of AA between age groups, our study suggests that self-selection might exist due to the evidence of heterogeneity. This finding also warrants attention that the uncertainties of trials’ subgroup analyses might lead to health loss among the older.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/posterjiaoispor-pdf.pdf?sfvrsn=9d1cb49f_0","title":"Poster_Jiao_ispor.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116665","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"e32f673e-b410-4126-9261-86abf08a0554","parentId":"00000000-0000-0000-0000-000000000000","title":"Personalized and Precision Medicine","urlName":"personalized-and-precision-medicine"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Value of Value Attributing and Why More Attention Needs to be Attributed to New Elements","id":"f22b95fb-e7a1-441d-b064-def6551e315a","sessionCode":"HTA12","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>New therapy pricing is a perennial policy concern. Valuations must balance payer affordability, patient access, fair manufacturer recompence, and implications on future innovation. The ISPOR Special Taskforce has identified and defined a series of value attributes for medical technologies. This study aimed to augment the elements of value and model the attributes in a novel oncology motivating example.</p> <p><b>METHODS: </b>A value-based price (VBP) model was developed in Microsoft Excel to evaluate a motivating example of a hypothetical novel high-value oncology therapy compared to standard of care (SOC). Three scenarios were evaluated by including the following types of elements of value: 1) conventional attributes (Adverse Events, Health Care Utilization, Response Rate, Cost of Standard of Care Therapy, Administration Costs); 2) more novel but previously identified values (Value of Hope, Quality of Life); and 3) novel and previously unidentified elements (Class Tide Effect (i.e.value of innovation), Caregiver Burden, Burden of Illness, Provider Capacity, Indirect Patient Burden). The final value-based price for each scenario was reported along with the key attributes contributing the greatest value.</p> <p><b>RESULTS: </b>For Scenario 1, the final VBP ranged from $288,000-$310,000 in the base case scenarios. The largest value elements were Response Rate and Cost of SOC Therapy. For Scenario 2, the VBP ranged from $366,000-$410,000, driven primarily by Quality of Life attribute. For Scenario 3, the final VBP ranged from $738,000-$743,000. The largest attributes were Class Tide Effect and Burden of Illness.</p> <p><b>CONCLUSIONS: </b>We have described a series of elements that deserve consideration in value-based pricing and economics assessments of health care technologies. Our discussion of some of the more novel elements of value broadens the view of what constitutes value in health care. The study augments the framework for estimating the value and price of assets to inform Pricing and Market Access strategy.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116491","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Development of Frailty Index Using ICD-10 Codes to Predict Mortality and Rehospitalization of Older Adults: An Update of the Multimorbidity Frailty Index","id":"60e23a21-7036-4fac-a752-df3bb25f8ab2","sessionCode":"CO12","topDisplay":"<b><u>LAI HY</u></b><sup>1</sup>, Huang ST<sup>1</sup>, Chen LK<sup>2</sup>, Hsiao FYS<sup>1</sup><br><sup>1</sup>Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan, <sup>2</sup>Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan","locationCode":"","description":"\r\n\t<div><b>Objectives: </b>Several frailty indices have been constructed to identify frail older people at increased risk of mortality and admission. Previously, we have developed a claims-based multimorbidity frailty index (mFI) using Taiwan’s National Health Insurance Research Database (NHIRD). As the ICD-10 coding system was adopted to replace the previous ICD-9-CM system in Taiwan in 2016, it is necessary to renew the mFI using ICD-10 codes and assess the types of deficits and their association with clinical outcomes. </p> <strong>Methods: </strong>Subjects aged 65 to 100 years with full National Health Insurance coverage in 2017 were included. We constructed the renewed mFI using ICD-10 codes (mFI-v10) by the cumulative deficit approach and categorized the subjects according to the mFI-v10 quartiles: fit,mild frailty,moderate frailty,and severe frailty. Multivariate Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of mFI-v10 on outcomes of interest (1-year mortality,unplanned hospitalization,and intensive care unit (ICU) admission),adjusted by sex and age.</p> <strong>Results:</strong>The mFI-v10 incorporated 38 deficits with mean mFI-v10 score of 0.051 (standard deviation = 0.048) among 144,567 subjects.Compared with the fit group, those with severe frailty were associated with a 4-fold (adjusted HR 3.86, 95% CI 3.54-4.20) higher risk for death at one year. Subjects with moderate frailty or mild frailty were associated with a 2.4-fold (adjusted HR 2.35, 95% CI 2.18–2.55) or 1.6-fold (adjusted HR 1.57, 95% CI 1.47–1.69) higher risk for death at one year than the fit group.Similar risk trends can also be observed in unplanned hospitalization and ICU (intensive care unit) admission among the study population.</p> <strong>Conclusion:</strong>The renewed multimorbidity frailty index constructed from ICD-10 codes is associated with an increased risk of 1-year of all-cause mortality, unplanned hospitalization, and ICU admission. It can provide updated information contributing to risk stratification using frailty index in the ICD-10 era.</p> <strong> </strong></p> <strong> </strong></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/development-of-frailty-index-using-icd-10-codes-to-predict-mortality-and-rehospitalization-pdf.pdf?sfvrsn=f93b456a_0","title":"Development of Frailty Index Using ICD-10 Codes to Predict Mortality and Rehospitalization.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115516","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Dupilumab Improves Quality of Life in Caregivers of Children with Uncontrolled Moderate-to-Severe Asthma: Liberty Asthma Voyage Study","id":"3844c88b-e829-4563-9478-dfcbba2abcaf","sessionCode":"CO159","topDisplay":"<b><u>Fiocchi AG</u></b><sup>1</sup>, Phipatanakul W<sup>2</sup>, Durrani S<sup>3</sup>, Cole J<sup>4</sup>, Msihid J<sup>5</sup>, Lederer DJ<sup>6</sup>, Hardin M<sup>7</sup>, Zhang Y<sup>6</sup>, Khan AH<sup>5</sup><br><sup>1</sup>Bambino Gesù Children’s Hospital IRCCS, Rome, RM, Italy, <sup>2</sup>Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA, <sup>3</sup>Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA, <sup>4</sup>OK Clinical Research, Edmond, OK, USA, <sup>5</sup>Sanofi, Chilly-Mazarin, France, <sup>6</sup>Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA, <sup>7</sup>Sanofi, Cambridge, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Children with uncontrolled treatment-refractory asthma have poor quality of life (QoL), which also affects their caregivers. Dupilumab blocks interleukin (IL)-4/IL-13 signaling, key and central drivers of type 2 inflammation. In VOYAGE, a 52-week (wk), randomized, double-blind, placebo-controlled phase–3 study (NCT02948959), add-on dupilumab demonstrated efficacy/safety in children aged 6–11 years with uncontrolled moderate-to-severe type 2 asthma. This analysis assessed QoL in caregivers of pediatric participants in VOYAGE.</p> <p><b>METHODS: </b>Caregivers of children aged 7–11 years, who received add-on dupilumab or matched placebo by bodyweight, completed the pediatric asthma caregiver QoL questionnaire (PACQLQ) over the study-period. PACQLQ global scores (range 1–7; higher scores indicate better QoL) were analyzed for caregivers of children with type 2 asthma (baseline blood eosinophils ≥150cells/µL or FeNO ≥20ppb; n=318) or with baseline eosinophils ≥300cells/µL (n=239) with post hoc analysis for caregivers of children with comorbid allergic rhinitis (AR) in both groups.</p> <p><b>RESULTS: </b>At baseline, 25% of caregivers reported their work was impacted a lot by the child’s asthma. For caregivers of dupilumab- vs placebo-treated children with type 2 asthma, global PACQLQ scores significantly improved by Wk36 and onwards (LS mean difference [LSMD] [95% CI] in change from baseline: 0.40 [0.16;0.64] <em>P</em>=0.0013) and by Wk12 and onwards in caregivers of children with baseline eosinophils ≥300cells/µL (LSMD [95% CI]: 0.34 [0.01;0.67], <em>P</em>=0.0445). Comorbid AR was observed in 77% and 81% of children with type 2 asthma and baseline eosinophils ≥300cells/µL, respectively. For caregivers of these children PACQLQ global score significantly improved as early as Wk12 (type 2-LSMD [95% CI]: 0.41 [0.11;0.72] <em>P</em>=0.0084; eosinophils ≥300cells/µL-LSMD [95% CI]: 0.46 [0.10;0.82] P=0.0127) and beyond for caregivers of dupilumab- vs placebo-treated children.</p> <p><b>CONCLUSIONS: </b>Dupilumab treatment of children aged 7-11 years with moderate-to-severe type 2 asthma, including patients with comorbid AR, may improve QoL in the caregivers of these children.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116891","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost Utility and Budget Impact Analysis of 5-Fluorouracil and Capecitabine Based Regimens for Management of Colorectal Cancer at Kenyatta National Hospital, Kenya","id":"1d982b3b-e842-45c1-8629-dffea844c5e8","sessionCode":"EE68","topDisplay":"<b><u>Koech NJ</u></b><sup>1</sup>, Okalebo F<sup>1</sup>, Owiti E<sup>2</sup>, Wata D<sup>3</sup><br><sup>1</sup>University of Nairobi, Nairobi, Kenya, <sup>2</sup>African Development Bank, Abidjan, Côte d'Ivoire, <sup>3</sup>Kenyatta National Hospital, Nairobi, Kenya","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> The main objective of the study was to compare the cost effectiveness of 5-fluorouracil and capecitabine based regimens for management of colorectal cancer in KNH. In addition, a budget impact analysis of the adoption of capecitabine based regimen was conducted. <strong><p><b>METHODS: </b></strong> A retrospective cohort study was conducted in the oncology wards to identify the key resources used in managing colorectal cancer and its complications. Key informant interview was carried out amongst the billing and procurement officers to collect information on cost of procuring drugs and other resources used for management of colorectal and its complications. Cost utility analysis was conducted using the markov decision model.The study was conducted from a provider perspective with a time horizon of 5 years. Effectiveness data was derived from literature. A budget impact analysis was conducted to assess the cost impact of the adoption of capecitabine based regimen on the budget at Kenyatta National Hospital. The quantitative data on costs was tabulated and summarized in MS Excel spreadsheet. The R version 3.6.0, “<em>heemod</em>” package was used for costing, probabilistic and sensitivity analysis. <strong><p><b>RESULTS: </b></strong> Fluorouracil- based regimen was the most expensive. Capecitabine-based was found to be the most cost effective regimen with an incremental cost effectiveness ratio (ICER) of Ksh.-38632.74 per quality adjusted life years (QALY) gained. The ICER was negative for Capecitabine-based due to the lower cost and more QALY gained. The results show that the use of Capecitabine-based for managing colorectal cancer is cost saving each year. The impact of adopting Capecitabine-based on the KNH annual budget and medicines budget over 5 years ranged between 2.27% to 2.90%. <strong><p><b>CONCLUSIONS: </b></strong> Capecitabine-based is the most cost effective regimen as compared to 5FU from the provider perspective and should be considered as a drug of choice in the management of colorectal cancer in Kenya</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117556","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Choosing Wisely? Use of Intensity Modulated Radiation Therapy Following Lumpectomy in Early-Stage Breast Cancer: A Seer-Medicare Analysis","id":"0f9e3c76-25e6-40db-9b6c-e205a28868db","sessionCode":"HSD3","topDisplay":"<b><u>Vyas A</u></b><sup>1</sup>, Puggioni G<sup>2</sup>, Kogut SJ<sup>1</sup><br><sup>1</sup>University of Rhode Island College of Pharmacy, Kingston, RI, USA, <sup>2</sup>University of Rhode Island, Kingston, RI, USA","locationCode":"","description":"\r\n\t<div><u>Background</u>: The American Society for Radiation Oncology’s (ASTRO) Choosing Wisely (CW) initiative recommends against the routine use of intensity-modulated radiotherapy (IMRT) for whole breast radiotherapy in patients with breast cancer (BC). The impact of CW on use of IMRT in older patients with BC following breast-conserving surgery was evaluated. Also, factors that may predict IMRT use were assessed.</p> <u>Methods</u>: A retrospective observational cohort study using the Surveillance, Epidemiology, End Results-Medicare database was conducted with women age <u>></u>66 years diagnosed with stage I-II incident BC during 2007-2015 who underwent lumpectomy and radiation therapy (N=34,507). The proportion of patients with receipt of an IMRT within six months following lumpectomy were identified for pre- and post-CW periods. An interrupted time-series (ITS) analysis and segmented regression were performed to examine if CW reduced the use of IMRT and to estimate the magnitude of change. A multivariable logistic regression was conducted for the post-CW group to identify significant predictors of IMRT use.</p> <u>Results</u>: During 2007-2015, 18.1% women received IMRT prior to the launch of CW in September 2013 compared to 11.0% post-CW. ITS analysis revealed that there was a significant 0.01 per quarter increase in the IMRT use per 100 patients pre-CW (p<0.0001). However, there was a 3.83 per 100 patients per quarter decline immediately following the implementation of CW. This trend continued and there was a significant 0.59 per 100 patients per quarter decrease in the use of IMRT resulting from CW (p<0.0001). During the post-CW timeframe, being Black, residence in South or North Central US, presence of comorbidities, left tumor laterality, and the receipt of radiotherapy in the free-standing facility were significant predictors of IMRT use.</p> <u>Conclusion</u>: Value-based care in patients with BC improved following the ASTRO’s CW initiative. Our findings also highlight opportunities to reduce unnecessary IMRT use in BC care.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022-posterbreastcncrimrt-pdf.pdf?sfvrsn=50ff5e4e_0","title":"ISPOR 2022 poster_Breast_Cncr_IMRT.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117195","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Treatment Patterns Among Patients with Pulmonary Arterial Hypertension in Brazil: A 10-Year Real-World Analysis","id":"5665d528-f2ac-48ce-befb-e29afcb1ee0c","sessionCode":"RWD8","topDisplay":"Fiuza P<sup>1</sup>, <b><u>Pinto C</u></b><sup>1</sup>, Lemos ACM<sup>2</sup>, Neves MCLC<sup>2</sup>, Martins Netto E<sup>2</sup><br><sup>1</sup>College of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil, <sup>2</sup>Federal University of Bahia, Salvador, Brazil","locationCode":"","description":"\r\n\t<div></p> <p><b>OBJECTIVES: </b> In Brazil, despite the existence of policies to access free treatment for pulmonary arterial hypertension (PAH), few studies have analyzed the disease treatment patterns in the Brazilian public health system (SUS). This study aimed to evaluate treatment patterns and survival outcomes in patients with PAH monitored at a Public Reference Outpatient Clinic in Bahia, Brazil.</p> <p><b>METHODS: </b> Retrospective observational study involving patients with PAH group 1 (WHO classification) diagnosed between January 2010 and December 2019. Diagnosis was confirmed by right heart catheterisation. Sociodemographic and clinical data were collected from medical and pharmaceutical care charts. The treatment pattern was identified as monotherapy when using only one class of medication for PAH, or combination therapy when using two or more therapeutic classes simultaneously. Mortality was ascertained by active follow-up or through the Brazilian Ministry of Health’s Mortality Information System.</p> <p><b>RESULTS: </b> 373 patients were included (49.2 ± 17.8 years, 67.3% female), of whom 63.5% received monotherapy, with sildenafil (95.0%) being the most common. Only 36.5% patients received combination therapy, of which sildenafil-bosentan combination (92.7%) was the most frequently. The shortest distance covered in 6-minute walk test (p=0.02) and use of a greater number of medications for comorbidities treatment (p=0.01) were associated with the combination therapy use. Overall, the treatment discontinuation rate was 13.1% and was higher in monotherapy than combination therapy (16.9% vs. 6.6%). During the mean follow-up of 2.7 years, survival rates at 1-, 2-, 3- and 5-years were 89.5%, 82.3%, 79.1% and 76.3%, respectively.</p> CONCLUSION: Combination therapy is frequently underused for the treatment of PAH in the reference center in Bahia, Brazil. These findings suggest important gaps between the guideline recommendations and clinical practice, pointing to the need to review the current policies of treatment for this disease in the SUS.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117943","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"The Relationship between ICER's Evidence Rating Matrix and Incremental Quality-Adjusted Life Years","id":"2ff39220-0fe7-4d5a-84b9-e338b37adfc2","sessionCode":"HTA8","topDisplay":"<b><u>Fluetsch N</u></b><sup>1</sup>, Agboola FO<sup>2</sup>, Pearson SD<sup>2</sup>, Campbell J<sup>3</sup><br><sup>1</sup>Institute for Clinical and Economic Review, Medfield, MA, USA, <sup>2</sup>Institute for Clinical and Economic Review, Boston, MA, USA, <sup>3</sup>Institute for Clinical and Economic Review, Hingham, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> The Institute for Clinical and Economic Review’s (ICER’s) Evidence Rating Matrix is a comparative clinical effectiveness decision tool that distills an intervention’s net health benefit and its uncertainty into ordered categorical grades. ICER assessments also estimate incremental lifetime quality-adjusted life years (QALYs) through cost-effectiveness modeling. This analysis aims to explore the relationship between ICER’s Evidence Rating Matrix and incremental QALYs. </p> <p><b>METHODS: </b> We used ICER’s Evidence Compendium and corresponding reports to compile a list of pairwise treatment comparisons, their respective Evidence Ratings, and incremental QALY findings. We limited the analysis to consistent pairwise comparisons that used a lifetime time horizon and were published between January 2017 and September 2021. For each pairwise comparison, we collapsed Evidence Ratings into three categories based on estimated net-health benefit: Superior (including A, B, B+), Comparable or Better (including C+, C++), and Uncertain (including P/I, I). Descriptive outcomes by collapsed category included mean incremental QALYs and the proportion with incremental QALYs ≥ 0.5. </p> <p><b>RESULTS: </b> Eighty-three pairwise comparisons were included. Mean incremental QALYs associated with each collapsed rating category were: Superior 2.50 (N = 65), Comparable or Better 0.95 (N = 7), and Uncertain 0.40 (N = 11). The proportion of comparisons with ≥0.5 incremental QALYs by collapsed rating category were: Superior 84.6%, Comparable or Better 71.4%, and Uncertain 18.2%. </p> <p><b>CONCLUSIONS: </b> We observed that better comparative clinical effectiveness ratings were associated with larger health gains when estimated using lifetime cost-effectiveness models. Although unique, ICER’s Evidence Ratings and incremental QALYs contain overlap within their goals. This overlap is supported by the findings from this descriptive study and may be useful in maintaining consistency across assessments.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/hta8nfluetschposter-pdf.pdf?sfvrsn=6c091cb8_0","title":"HTA8_NFluetsch_Poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116331","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of COVID-19 Vaccination in Reducing Average Length of Stay in Hospitals Among COVID-19 Patients in the US - a Retrospective Study from De-Identified Administrative Claims Database","id":"44f14d0b-2d1e-49e0-b334-e48039f87a08","sessionCode":"RWD16","topDisplay":"Pandey N<sup>1</sup>, Verma V<sup>2</sup>, Chopra A<sup>3</sup>, Kukreja I<sup>4</sup>, Gaur A<sup>4</sup>, Sulzicki M<sup>5</sup>, Roy A<sup>4</sup>, Brooks L<sup>6</sup>, Gupta A<sup>7</sup>, <b><u>Pandey S</u></b><sup>8</sup>, Field S<sup>9</sup>, Krebs B<sup>10</sup><br><sup>1</sup>Optum, Gurgaon, India, <sup>2</sup>Optum Global Solutions, India, Gurgaon, HR, India, <sup>3</sup>Optum Global Solutions, India, Gurugram, HR, India, <sup>4</sup>Optum Global Solutions, India, New Delhi, DL, India, <sup>5</sup>Optum, Trumbull, CT, USA, <sup>6</sup>Optum, Basking Ridge, NJ, USA, <sup>7</sup>Optum, Eden Prairie, MN, USA, <sup>8</sup>Optum Global Solutions, India, noida, gautam buddha nagar, UP, India, <sup>9</sup>Optum, Dallas, TX, USA, <sup>10</sup>Optum, Tucson, AZ, USA","locationCode":"","description":"\r\n\t<div><strong>Introduction – </strong>Vaccine hesitancy remains one of the key concerns for countries across the globe while managing COVID-19 pandemic. At the same time, multiple COVID-19 waves are putting tremendous stress on the hospitals and is also causing burn out in healthcare workers. Reduction in the average length of stay in hospital has benefits at multiple levels: reduced healthcare cost, less burden on hospitals and hospital staff, and reduced avoidable deaths. This study aims to understand the impact of COVID-19 vaccination on the average length of stay. Thus, it many provide additional evidence to support vaccination and address the concern of vaccine hesitancy. <strong>Objective – </strong>To study the impact of COVID-19 vaccination in reducing average length of stay among COVID-19 patients in the US. <strong>Method</strong> – In this retrospective study, de-identified administrative claims database was used to identify all the patients above 18 years who underwent treatment for COVID-19 in the US between November 2020 to March 2021. The occurrence of ICD-10 code in the claims database was defined as the index event. These patients were then checked for hospitalization for the treatment of COVID-19. The average length of stay was compared between unvaccinated patients, and fully vaccinated patients (who had COVID-19 after 14 days of the second dose of COVID-19 vaccine). <strong>Results </strong>– Out of 735,754 COVID-19 patients, 708,586 (96%) were unvaccinated while 1,121 (0.2%) were fully vaccinated patients. Among the unvaccinated the average length of stay was 8.9 days, whereas for fully vaccinated patients, it was 4.7 days. Further statistical test will be applied to analyze the level of significance. <strong>Conclusion </strong>– There was a 50% reduction in the average length of stay in patients who had taken two doses of COVID-19 vaccine. Therefore, COVID-19 vaccines are effective in reducing the burden on hospitals for treating COVID-19 patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/impact-of-covid-19-vaccination-in-reducing-los-among-covid-19-patients-in-the-us-pdf.pdf?sfvrsn=f9520c44_0","title":"Impact of COVID-19 vaccination in reducing LOS among COVID-19 patients in the US.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116815","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"},{"id":"5b196821-963c-48d3-9e67-cc2da312735d","parentId":"00000000-0000-0000-0000-000000000000","title":"Vaccines","urlName":"Vaccines"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"CGRP-Inhibitor Utilization and Adherence in an Employer-Insured Migraine Population","id":"57b3e316-a8aa-4cbb-a23a-e5e19204d1fe","sessionCode":"RWD30","topDisplay":"<b><u>Patel R</u></b><sup>1</sup>, Crawford A<sup>2</sup>, Goldfarb N<sup>3</sup><br><sup>1</sup>Thomas Jefferson University, Champaign, IL, USA, <sup>2</sup>Thomas Jefferson University, Philadelphia, PA, USA, <sup>3</sup>Greater Philadelphia Business Coalition on Health, Philadelphia, PA, USA","locationCode":"","description":"\r\n\t<div>Objective: Determine characteristics, service utilization, and adherence for people with migraine being prescribed CGRP- inhibitors in an employer-insured population.</p> Methods: A retrospective observational cohort analysis was conducted on beneficiaries 18-64 using a multi-employer medical and pharmacy claims database provided by Gallagher (benefits consulting organization). The migraine population was identified using ICD codes (“confirmed” migraine) as well as previously-published criteria for those with multiple visits for “headache” and/or pharmacy claims for migraine-specific drugs (“suspected” migraine). Logistic regression assessed likelihood of being prescribed a CGRP-inhibitor based on clinical and demographical characteristics. Adherence (proportion of days covered, PDC) was analyzed for the population prescribed Aimovig, the most commonly prescribed CGRP-inhibitor during the 12-month study period commencing July 2019 (35.9% of all CGRP-inhibitor claims).</p> Results: Most (82.2%) migraineurs were female. Out of 31,161 migraineurs, 2,328 (7.47%) were prescribed a CGRP-inhibitor, with a higher percentage of females amongst the migraine group (7.90%) being prescribed CGRP-inhibitors in comparison to males (5.49%). The 40-49 age group had the highest proportion of members prescribed CGRP-inhibitors (11.58%). Patients with comorbidities such as anxiety and depression were more likely to be prescribed CGRP-inhibitors in both the confirmed and suspected migraine groups. After correcting for start and end dates, 84.91% of patients were deemed adherent on Aimovig, which was defined as >80% (PDC). The average length on therapy for these patients was slightly over 6 months (188 days), with no statistically significant difference between the confirmed and suspected migraine groups. No significant differences in adherence were noted by age group or gender.</p> Conclusion: This is one of the first studies examining CGRP-inhibitor utilization in a commercially insured population. Adherence was relatively high. Longer term studies are needed to examine CGRP-inhibitor impact on health and cost outcomes.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/gallagheradherenceposterispor042222pdf-pdf.pdf?sfvrsn=bc1a18e0_0","title":"Gallagher_adherence_Poster_ISPOR_042222_pdf.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116405","diseases":[{"id":"a31c0c98-2e41-4ccd-bfe9-74bb0e44a573","parentId":"00000000-0000-0000-0000-000000000000","title":"Mental Health","urlName":"Mental-Health"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Real-World Use of Biologics and Prescription Topical Medications in a Pediatric Psoriasis Population","id":"6efa1a8a-f16f-4d84-bc30-e7c565fb2f58","sessionCode":"RWD3","topDisplay":"<b><u>Swenson A</u></b><sup>1</sup>, Kumparatana P<sup>2</sup>, Friedler H<sup>1</sup>, Starzyk K<sup>1</sup>, Paulus J<sup>3</sup><br><sup>1</sup>OM1, Boston, MA, USA, <sup>2</sup>OM1, Boson, MA, USA, <sup>3</sup>OM1, Dedham, MA, USA","locationCode":"","description":"\r\n\t<div><b>Objectives:</b><span style=\"font-weight: 400;\"> A third of psoriasis (PsO) cases report onset during childhood, but few treatments are FDA-approved specifically for use in pediatric patients. The purpose of this analysis was to describe prescription topical and biologic treatment and percent body surface area (%BSA) in a real-world pediatric PsO population.</span></p> <b>Methods:</b><span style=\"font-weight: 400;\"> Data were derived from the OM1 PsO Registry (OM1, Boston, MA), a multisource real-world registry with linked dermatology EMR data and healthcare claims on US patients with PsO (2013</span> <span style=\"font-weight: 400;\">-2021). All patients aged 4 to <18 years of age at the first observed PsO diagnosis code were included. Follow-up was censored at 18 years. Maximum %BSA and medication use during follow-up were reported. Biologics approved for adult or pediatric PsO in the US were analyzed. Prescription topicals evaluated included corticosteroids, vitamin D analogs, and calcineurin inhibitors. </span></p> <b>Results:</b><span style=\"font-weight: 400;\"> Of </span><span style=\"font-weight: 400;\">3,484 pediatric PsO patients identified, 60% were female and mean age at diagnosis was 13 years (SD: 4). Average duration of follow-u</span><span style=\"font-weight: 400;\">p </span><span style=\"font-weight: 400;\">was 30 months (SD: 24). </span><span style=\"font-weight: 400;\">64% of patients were treated with only prescription topicals, 2% were treated with only biologics, and 17% were treated with both. 17% of patients had no record of either treatment. Comorbid inflammatory arthritic/bowel diseases were present in 13% of biologic-treated and 2% of non-biologic-treated patients. Mean maximum %BSA was statistically significantly different based on medication use [10% (SD: 15) in only prescription topicals, 28% (SD: 30) in only biologics, 22% (SD: 24) in both, and 13% (SD:19) in those with no observed prescription treatments, p<0.0001]. </span></p> <b>Conclusion:</b><span style=\"font-weight: 400;\"> Nearly 1 in 5 dermatologist-managed pediatric PsO patients were prescribed biologics before age 18; this population is associated with significantly higher disease burden. Further research is needed to describe the comparative effectiveness of on- and off-label treatments and optimal treatment pathways.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116735","diseases":[{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Cost-Effectiveness Analysis for High Versus Low Dose Caffeine for the Treatment of Apnea in Neonatal Intensive Care Unit","id":"ff74fbe7-f48e-4099-9e22-e908df71a5c7","sessionCode":"EE18","topDisplay":"Alhersh E<sup>1</sup>, Rainkie D<sup>2</sup>, Abushanab D<sup>3</sup>, <b><u>Al-Badriyeh D</u></b><sup>4</sup><br><sup>1</sup>Qatar University, doha, Qatar, <sup>2</sup>Qatar University, Doha, Qatar, <sup>3</sup>Hamad Medical Corporation, Doha, Qatar, <sup>4</sup>College of Pharmacy, Qatar University Health, Qatar University, Doha, Qatar","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong></p> Caffeine is a first-line option for the neonatal intensive care management of apnea of prematurity (AOP) in preterm infants. This is the first study in the literature to evaluate the cost effectiveness of the off-label high dose (HD) of caffeine versus the approved standard lower dose (LD) of caffeine for the treatment of AOP in neonates.</p> <strong>Methods: </strong></p> From the hospital perspective of the Hamad Medical Corporation (HMC) in Qatar, this was a cost-effectiveness analysis based on a conventional decision-analytic model that follows the use and potential consequences of HD maintenance caffeine of 20 mg/kg/dose versus a LD maintenance caffeine of 10 mg/kg/dose in a simulated cohort of AOP neonates, until discharge. The model clinical inputs were primarily published meta-analyses based, while the model cost inputs were locally extracted in HMC. The effectiveness endpoint (success of caffeine) was the neonatal survival with no apnea, with successful extubation removal within 72 hours. This can be with or without adverse events. In contrast, failure was the discontinuation of caffeine due to severe tachycardia adverse drug reaction, all-cause death, or extubation failure due to apnea persistence. At the base case of the model, the analysis was run based on a multivariate uncertainty analysis of the model probability inputs, using the Monte Carlo simulation.</p> <strong>Results: </strong></p> With 0.236 (95% CI, 0.230-0.231) enhancement in success rate, at QAR 14,084 (95% CI, 13,916-14,251) added patient cost, the cost-effectiveness ratio of HD caffeine was QAR 61,500 (95% CI, 55,480-67,520) over LD caffeine per additional case of success. One-way and multivariate sensitivity analyses confirmed the robustness of the study outcome and increased the generalizability of the results.</p> <strong>Conclusion: </strong></p> For AOP, based on the Qatar willingness-to-pay threshold, HD caffeine seems to be cost-effective over LD caffeine. This supports the recently increasing trend of HD caffeine use in HMC.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ee18-pdf.pdf?sfvrsn=8d918308_0","title":"EE18.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115462","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Assessment of Drug-Drug Interactions and Their Associated Risk Factors Among Rheumatoid Arthritis Patients: A Cross-Sectional Study","id":"5e92d3eb-28ae-4d3c-97e2-e9e2a8ed339e","sessionCode":"HSD22","topDisplay":"<b><u>Sah S</u></b><sup>1</sup>, R S<sup>2</sup>, Ramesh M<sup>3</sup><br><sup>1</sup>JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, KA, India, <sup>2</sup>JSS Hospital & JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, India, <sup>3</sup>JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, India","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE: </strong>Rheumatoid arthritis (RA) is a chronic inflammatory disorder that has high disease activity and requires three or more medicines based on approved treatment algorithm to relieve symptoms and prevent joint damage. This increases the risk of drug-drug interactions (pDDIs) among rheumatoid arthritis patients. Therefore, we aimed to assess pDDIs and provide their data on the prevalence, severity and associated risk factors of pDDIs among RA patients.</p> <strong><p><b>METHODS: </b> </strong>A cross-sectional study was conducted at the department of rheumatology in a tertiary care teaching hospital in Sothern India. Patients aged ≥ 16 years, diagnosed with RA, and admitted to hospital or visited outpatient department were included in this study. A clinical pharmacist has been evaluated patients' treatment charts on daily basis to assess pDDIs using IBM Micromedex® drug interaction checker. Based on Micromedex®, pDDIs were classified into contraindicated, major, moderate, and minor. Logistic regression analysis was used to identify the risk factors associated with pDDIs (major and moderate).</p> <strong><p><b>RESULTS: </b> </strong>A total of 528 RA patients’ [Inpatients (n=320, 60.6%) and Outpatients (n=208, 39.3%)] prescriptions were reviewed to assess the pDDIs. Of them, 457/528 (86.5%) patients were presented with ≥1 pDDIs. Overall, 1486 pDDIs were identified, with an average frequency of 3.25 pDDIs per patient. Of 1486 pDDIs, (n=119, 8.0%) contraindicated, (n=551, 37.1%) major, (n=623, 41.8%) moderate and (n=193, 12.9%) minor. Most commonly involved drug pair of pDDIs was prednisolone and aceclofenac (12.93%)-increased likelihood of gastrointestinal ulcer or bleeding. Among identified pDDIs, 5.2% of pDDIs were actual, which caused adverse events among study patients. Patients having ≥3 comorbidities (OR 7.26, p<0.0001) was most common risk factor to develop pDDIs (major and/or moderate)<span>. </span></p> <strong>CONCLUSION: </strong>The prevalence of pDDIs was high among RA patients. Pharmacists and prescribers need to pay attention to assessing pDDIs in high-risk patients to reduce pDDIs and related adverse events.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"14023d0b-776e-43fa-8552-0cd263b29305","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Service Delivery & Process of Care","urlName":"health-service-delivery-process-of-care"}],"categoryIds":["14023d0b-776e-43fa-8552-0cd263b29305"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ddis-in-ra-hsd22-pdf.pdf?sfvrsn=36665ac0_0","title":"DDIs in RA-HSD22.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115991","diseases":[{"id":"f2cabca2-ce06-433e-903c-56285673ffc3","parentId":"00000000-0000-0000-0000-000000000000","title":"Musculoskeletal Disorders","urlName":"Musculoskeletal-Disorders"},{"id":"747104b6-9723-4895-a3d6-28d8c37172e3","parentId":"00000000-0000-0000-0000-000000000000","title":"Systemic Disorders/Conditions","urlName":"Systemic-Disorders-Conditions"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness Analysis of the Colorectal Cancer Screening Program Using Electronic Colonoscopy in Luohu, China","id":"5ab4b116-995b-47d4-97dc-ebf15cded311","sessionCode":"EE95","topDisplay":"<b><u>Ren Y</u></b><sup>1</sup>, Zhao M<sup>1</sup>, Zhou D<sup>1</sup>, Xing Q<sup>1</sup>, Gong F<sup>2</sup>, Tang W<sup>3</sup><br><sup>1</sup>China Pharmaceutical University, Nanjing, China, <sup>2</sup>Shenzhen Luohu Hospital Group LuohuPeople's Hospital, Shenzhen, China, <sup>3</sup>China Pharmaceutical University, Nanjing, 32, China","locationCode":"","description":"\r\n\t<div><strong><span>Objectives:</span></strong><span> This study aimed to evaluate the cost-effectiveness of the colon cancer screening program both implemented in Luohu District, Shenzhen of China among 2018-2021, and when scaled up to the national level.</span></p> <strong><span>Methods:</span></strong><span> The cost-effectiveness of three screening protocols, including electronic colonoscopy (e-CSPY) every 10 years, e-CSPY every 5 years, and e-CSPY every 3 years, were compared with no screening, respectively, from the perspective of the Chinese health care system. A 12-state Markov model was developed to simulate a cohort of 100,000 individuals aging from 40 to 75 in Luohu undergoing from the screening to death. Clinical outcomes included the quality-adjusted life-year (QALY), number of cancers avoided, and number of deaths prevented, were calculated. We used incremental cost-effectiveness ratio (ICER) for each of the above outcomes for decision-making. Additionally, scenarios related to the national population, starting age (50) and different cancer treatment effectiveness were analyzed upon the base-case analysis. </span></p> <strong><span>Results:</span></strong><span> The colon cancer screening program was generally cost-effective, and both 10-year and 5-year strategy had dominance over the non-screening strategy, saving 255.78 USD and 95.06 USD per capita and increasing QALYs by 0.472 and 0.605, respectively. And the ICER of the triennial screening strategy was 364.36 USD/QALY compared to no screening. Receiving screening at earlier age further decreased the ICER by 151.94–351.38 USD/QALY. Screening was also more cost-effective when the prevalence of high-risk adenomas was higher (8.07%), or treatment were not completely successful. Additionally, screening reduced cancer cases by 1,939–6,219 and deaths by 974–3,118 in all situations.</span></p> <strong>Conclusion: </strong>Colon cancer screening using e-CSPY is cost-effective both in Luohu district and when scaled up to mainland China. The higher frequency of screening and earlier starting age are in favor of increased health benefits. Moreover, the earlier the starting age, the more cost-effectiveness the screening would bring.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/14057yinan-renhandout-pdf.pdf?sfvrsn=b191e8d3_0","title":"14057_Yinan Ren_Handout.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116177","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"The Economic Value of HPV Multi-Genotype Detection Technology","id":"6eb71c76-eb0d-407d-bdc7-ec889ff7c6dd","sessionCode":"EE75","topDisplay":"Zhou P<sup>1</sup>, Jie J<sup>2</sup>, Rong C<sup>1</sup>, <b><u>Ming J</u></b><sup>1</sup><br><sup>1</sup>Fudan University, Shanghai, China, <sup>2</sup>Eye & ENT Hospital of Fudan University, Shanghai, China","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong> Based on the perspectives of health service providers and medical insurance, the economic value evidence of multi-genotype HPV detection technology in cervical cancer screening strategies was analyzed and produced, and suggestions were provided for relevant decision-making of health administrative departments and hospitals.</p> <strong><p><b>METHODS: </b></strong> The Markov cervical cancer natural outcome model was constructed by TreeAge Pro 2020, which simulated the natural process of 100,000 initial population from healthy state to cervical cancer incidence, and subdivided HPV high/medium/low risk genotypes. Cost-effectiveness analysis of HPV multi-genotype screening and HPV partial genotype (16/18 high-risk typing) screening, and the effects of sensitivity and specificity of thinprep cytologic test (TCT), colposcopy, and histopathological diagnosis cost on the economic evaluation of screening were analyzed. Besides, two strategic screening pathways are compared, we adjust the primary population state composition to observe the further results of the two strategies.</p> <strong><p><b>RESULTS: </b></strong> Taking the prevention of cervical cancer as the effect index, the effect of HPV multi-genotype is almost the same as that of partial genotypes, and the cost and the number of colposcopy examinations can be significantly reduced. As the sensitivity of TCT increases, the specificity decreases and the cost of colposcopy increases, the cost-effectiveness advantage of HPV multi-genotype over partial genotypes will increase. And with the increase in the cost of histopathological diagnosis, HPV multi-genotype has a cost-effective advantage over partial genotypes, but the advantage effect has not changed significantly. As the primary proportion of HPV51/35/39/68/56/59/66 increases, the reduction of cost and the over-screening of colposcopy are more obvious by multi-genotype screening.</p> <strong><p><b>CONCLUSIONS: </b></strong> HPV polygenic detection technology can reduce the over-utilization of medical resources to a certain extent and further improve the cost-effectiveness of screening. It has economic value in cervical cancer screening strategies.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/abstract-id117531-pdf.pdf?sfvrsn=e25dab2e_0","title":"Abstract ID117531.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117531","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Factors Affecting Total Hospitalization Cost and Cost Effectiveness Analysis of Corticosteroid Management in Patients with Acute Respiratory Distress Syndrome","id":"3697998b-dac5-45eb-9507-ec9e531e11f6","sessionCode":"EE66","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong>Background</strong></p> There is currently a dearth of information in India on the factors that affects total hospitalization cost and cost effectiveness of corticosteroid management in patients with acute respiratory distress syndrome (ARDS).</p> <strong>Methodology</strong></p> A retrospective observational study was conducted in a south Indian tertiary care hospital among patients diagnosed with ARDS for a period 5 years. The total hospitalization cost (in INR [₹]) was used as cost; while, ICU free days (IFD), oxygen free days (OFD), and ventilator free days (VFD) considered as outcomes to perform the cost-effective analysis. Additionally, factors affecting total hospitalization cost also analysed through univariate and multivariate linear regression.</p> <strong>Results</strong></p> A total of 578 patients were included in the study. The factors such as gender, sepsis, septic shock, use and course of antibiotics, ICU, oxygenation and ventilation days have all been identified as significant independent predictors of higher hospitalization cost in ARDS patients. A total of 305 patients were included in the cost effective analysis, with 151 received corticosteroid and 154 did not. Among the steroid group, 69 received intravenous (IV) steroid [IV steroid with or without nebulization/oral], and 82 received other steroid [nebulization/oral without IV]. Steroid treatment is more cost effective than non-steroid treatment, with an incremental cost of 305 per VFD and 1645 for IFD. Additionally steroid treatment had better OFD (12.8vs10.3) with lower cost (₹7815 vs ₹7883). Subgroup analysis indicated that, other steroid was cost effective with a lower cost and better outcomes in terms of VFD (11.8vs9.6; 8681 vs 10001), IFD (6.7vs5.3; 15393 vs 18114) and OFD (13.8vs11.7; 7473 vs 8206). </p> <strong>Conclusion</strong></p> According to this retrospective cost effectiveness analysis based on direct medical costs, corticosteroid management had a beneficial effect on ARDS patients. Furthermore, these findings should be supported by prospective studies that include the indirect medical cost and indirect cost components.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115710","diseases":[{"id":"df83ec61-b03e-44bf-8758-29b1920e7ac8","parentId":"00000000-0000-0000-0000-000000000000","title":"Respiratory-Related Disorders","urlName":"Respiratory-Related-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Real-World Effectiveness of Ubrogepant Among Participants with Prior Treatment Failure: Subgroup Analysis from the Universe Study","id":"dc05d1a4-d1a0-43b8-87c1-ed53eb5a602d","sessionCode":"PCR3","topDisplay":"Shewale A<sup>1</sup>, Poh W<sup>2</sup>, Reed M<sup>3</sup>, Liu J<sup>4</sup>, Cadiou F<sup>2</sup>, Burslem K<sup>1</sup>, Lipton R<sup>5</sup>, <b><u>Gandhi P</u></b><sup>6</sup><br><sup>1</sup>AbbVie, North Chicago, IL, USA, <sup>2</sup>Healint Pte Ltd, Singapore, Singapore, <sup>3</sup>Vedanta Research, Chapel Hill, NC, USA, <sup>4</sup>Genesis Research, Hoboken, NJ, USA, <sup>5</sup>Albert Einstein College of Medicine, Bronx, NY, USA, <sup>6</sup>AbbVie, New Hope, PA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>The safety and efficacy of ubrogepant have been demonstrated in phase 3 ACHIEVE trials; however, effectiveness of ubrogepant in the real-world setting has yet to be fully characterized. This study aims to examine real-world effectiveness of ubrogepant for the acute treatment of migraine in patients who switched to ubrogepant due to the lack of efficacy of their prior acute treatment.</p> <p><b>METHODS: </b>The UNIVERSE (Ubrogepant users’ experience: Patients on ubrogepant, characteristics and outcomes) study is an observational cross-sectional study of US adult users of the Migraine Buddy application who self-reported using ubrogepant for ≥4 prior migraine headaches, including ≥1 dose in the preceding 14 days. Eligible participants completed a 29-question survey assessing patient characteristics, treatment patterns, outcomes, and satisfaction with ubrogepant.</p> <p><b>RESULTS: </b>Of 302 respondents, 87.4% (n=264) switched to ubrogepant due to their prior treatment’s lack of efficacy. For this subgroup, mean age was 42 years, 89% were female, 35.6% had chronic migraine, and 55.9% previously tried ≥3 triptans. Most reported being satisfied with ubrogepant for achieving pain relief at 2-hours (76.1%), 4-hours (83.3%), and 24-hours (78.4%) post-dose. A large proportion reported satisfaction with the ability to think clearly (85.2%) and with their return to normal function (84.8%) after ubrogepant treatment. Most (91.7%) reported they were likely to continue ubrogepant use. Analysis of prior and concurrent acute medication revealed reduced use of opioids (-28%), barbiturates (-25%), ergots (-15%), triptans (-55%), nonsteroidal anti-inflammatory drugs (-38%), and other acute medication classes (-37%).</p> <p><b>CONCLUSIONS: </b>Among patients who self-reported lack of efficacy as the reason for prior treatment failure, ubrogepant use was associated with high satisfaction for achieving pain relief, ability to think clearly, and return to normal function. Most indicated they were likely to continue its use. Ubrogepant was associated with reductions in opioid and barbiturate use, suggesting additional clinical benefits for users.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/universe-tx-failures-ispor22v2-pdf.pdf?sfvrsn=e29b2dbe_0","title":"UNIVERSE Tx Failures (ISPOR22)_v2.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116958","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Revolutionizing Drug Discovery and Preclinical Research Via Artificial Intelligence: A Targeted Literature Review","id":"e620520e-c096-473f-81a9-ed5c4463710d","sessionCode":"MSR8","topDisplay":"Abdelghani I<sup>1</sup>, Jdidi H<sup>1</sup>, Boukhris Y<sup>1</sup>, Louhichi KE<sup>1</sup>, Roch B<sup>2</sup>, <b><u>Francois C</u></b><sup>3</sup>, Toumi M<sup>4</sup>, Bakhutashvili A<sup>5</sup><br><sup>1</sup>Creativ-Ceutical, Tunis, Tunisia, <sup>2</sup>Creativ-Ceuticals, Paris, France, <sup>3</sup>Aix-Marseille University, Paris, France, <sup>4</sup>Aix-Marseille University, Marseille, France, <sup>5</sup>MARCO POLO, Luxembourg, Luxembourg","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b> </strong>Artificial intelligence (AI) and experimental technologies are increasingly combined in drug discovery and preclinical research. The objective is to provide an overview of opportunities and challenges of currently used computed technologies.</p> <strong><p><b>METHODS: </b> </strong>A targeted literature review was conducted on OVID. The selection focused on the two last years, reflecting the tremendous development of AI in non-clinical research.</p> <strong><p><b>RESULTS: </b> </strong>613 studies were identified, mostly from US and China, and were predominantly related to drug discovery. Tool bases were high-throughput docking, quantitative and visualized structure-activity relationship (QSAR/ VISAR), drug-target interaction and absorption, distribution, metabolism, excretion, and toxicity (ADME/T) processes.</p> Machine learning and neural networks, through mathematical modelling and feature extraction, have improved, sped up and drastically rearranged non-clinical research processes resulting in candidates with optimal efficacy and tolerability by predicting molecules properties in-silico from their directed structure and studying disease models. The performance of AI models is affected by the scarcity and high cost of reliable, high-quality databases. These latter will define the quality of descriptors required for reaching a performant and reproducible digital molecular triage.</p> Current AI systems are vulnerable to several issues, including non-reproducibility of results and the risk of over/under-fitting, which impact the accuracy of results.</p> <strong><p><b>CONCLUSIONS: </b> </strong>Emerging AI techniques have renewed the drug discovery journey and decreased the costs by reducing the risk of a drug candidate failing in preclinical research. Nevertheless, original AI approaches must be optimized to address unmet need, such as application to complex living systems. Further AI implementations are required beyond drug discovery while complying to dogmas and ethics of regulatory and potentially Health Technology Assessment (HTA) agencies.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/msr8ispor-poster-ddpc20220505-final-versionchecked-pdf.pdf?sfvrsn=bad4f730_0","title":"MSR8_ISPOR poster DDPC_20220505_ Final version_checked.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117561","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Economic Implications of Clinical Trials Enrollment in a Medicare Population","id":"9b993c13-32ae-4b75-bef7-ee76c1e61b81","sessionCode":"EE40","topDisplay":"<b><u>Fox J</u></b><br>Illumina, San Diego, CA, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: We investigated the impact of clinical trial participation on Medicare costs in a large community-based practice.</p> <strong>Study Design: </strong>Retrospective matched cohort</p> <strong>Methods</strong>: We created matched comparator groups for OCM episodes initiated between 2016-2018 based on cancer type, metastatic status, comorbidity number, performance status, and age using linked EMR and Medicare OCM claims data. The significance of differences in total cost between trial and non-trial episodes was assessed using the Mann–Whitney U test. We assessed impact on active treatment in the last 14 days of life (TxEOL), hospice use, and hospitalizations.</p> <strong>Results</strong>: During the study period, 8,053 completed OCM episodes met study criteria; 459 episodes included clinical trials. On average, episodes during which patients were on trial cost $5,973 less than matched non-trial episodes, independent of early versus late-phase trial. Most savings resulted from decreased drug costs. There were no differences in rates of TxEOL (15% vs. 14% p=1.0), rates of hospitalizations (31% vs. 30% p=0.54), or hospice use (52% vs. 62% p=0.08). Median difference from comparator group average cost was significantly lower for clinical trial episodes (-18% vs. -6%, p<0.01).</p> <strong>Conclusion</strong>: In the community setting, total costs paid by Medicare for patients participating in clinical trials during OCM episodes were lower than costs for similar patients receiving routine care. Clinical trial participation did not adversely impact end-of-life care or likelihood of hospitalization. These findings suggest that patient participation in community-based clinical trials does not increase total cost of care nor enhance financial exposure to payers.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117288","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Mortality Impact Following the EU Approval of Numerous Novel Non-Small Cell Lung Cancer (NSCLC) Therapies between 2010-2020","id":"1d38b873-cb52-4756-bd04-eea65bc2314a","sessionCode":"CO27","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><strong>BACKGROUND: </strong>NSCLC is the most common cancer of lungs. The common gene mutations of NSCLC are TP 53, KRAS, EGFR & ALK in which TP 53 & KRAS mutations accounting for nearly 70% of lung cancers. Lung cancer is the most common cause of cancer death in European countries over the years. The 5-year overall survival rate for NSCLC is very poor, ranging from 68% in patients' stage IB disease to 0-10% with stage IV disease.</p> <strong><p><b>OBJECTIVES: </b> </strong>The overall objective was to outline the impact of various novel therapies on the mortality of NSCLC in select, highly developed European countries from 2010-2020</p> <strong><p><b>METHODS: </b> </strong>Secondary research was limited to the English publications from the EU5 (France, Germany, Italy, Spain, UK) over the last 10 years.</p> <strong><p><b>RESULTS: </b> </strong>Age-standardized mortality rate (ASMR) trends in France, Germany and Italy were 21.54, 20.06, 19.76 in <strong>2010</strong>; 21.59, 19.63, 15.3 in <strong>2020</strong>, respectively. Mortality trends in Spain & UK were 20.31, 20.95 in <strong>2010</strong>; 17.76, 17.68 in <strong>2020</strong>, respectively. Approximately 265 novel therapies targeting various pathways including EGFR, ALK, ROS 1 mutations as well as the PD L1 non-oncogene with different combinations gained EMA approval from the plethora of pipeline therapies in EU5 over the last 10 years. Despite treatment advances, there remains an unmet need for drugs targeting the most common mutations TP 53 & KRAS.</p> <strong><p><b>CONCLUSIONS: </b> </strong>Lung cancer is the leading cause of cancer-related mortality in EU5. As a result of the advent of target-specific therapies, the mortality rates in EU5 have been gradually decreasing over time. With the approval of over 200 therapies in the last decade, one might expect a drastic improvement in mortality, but the true impact was modest and survival rates remain poor. This raises the question of whether these trends are due to limited efficacy or restrictive patient access.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117772","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness of Initiating Antihypertensive Therapy with Single-Pill Combinations Versus Monotherapy in US Adults","id":"231a75a4-65c3-489b-bae8-eed82820b616","sessionCode":"EE310","topDisplay":"<b><u>Bryan A</u></b><sup>1</sup>, Mobley C<sup>1</sup>, Moran AE<sup>1</sup>, Derington C<sup>2</sup>, Zhang Y<sup>1</sup>, Rodgers A<sup>3</sup>, Shea S<sup>1</sup>, Bellows BK<sup>1</sup><br><sup>1</sup>Columbia University Medical Center, New York, NY, USA, <sup>2</sup>University of Utah, Salt Lake City, UT, USA, <sup>3</sup>University of New South Wales, Sydney, NSW, Australia","locationCode":"","description":"\r\n\t<div><span data-contrast=\"auto\"><p><b>OBJECTIVES: </b> To compare the cost-effectiveness </span><span data-contrast=\"none\">of initiating antihypertensive therapy using a dual-therapy, single-pill combination (SPC) product versus monotherapy in US adults newly diagnosed with hypertension. </span><span data-contrast=\"auto\"><p><b>METHODS: </b> A discrete event simulation version of the Cardiovascular Disease (CVD) Policy Model was used to simulate BP-related healthcare processes. The model projected BP changes, medication-related adverse events, CVD events, and survival over 10 years. A nationally representative population of 10,000 US adults from the National Health and Nutrition Examination Survey was simulated. We included participants aged ≥20 years with untreated and u</span><span data-contrast=\"auto\">ncontrolled BP, guideline-eligible for antihypertensive treatment</span><span data-contrast=\"none\">, and with no CVD history. We compared initiating treatment with an SPC containing two half-standard doses vs. one half-standard dose monotherapy. All costs are in 2021 USD. Future costs and quality-adjusted life years (QALYs) were discounted 3% annually. One-way sensitivity analyses were used to examine parameter uncertainty. Uncertainty intervals (UIs) were derived from 100 probabilistic iterations of the model</span><span data-contrast=\"auto\">. </span><span data-contrast=\"auto\"><p><b>RESULTS: </b> At baseline, the population had a mean age of 54.8 years, 41.1% were female, and mean BP was 144.9/81.8 mmHg. At 10 years, mean systolic BP was 6.9 (95%UI 6.2 to 7.5) mmHg lower when initiating SPC vs. monotherapy. Relative to initiating monotherapy, SPC increased mean antihypertensive medication costs by $506 (95%UI $428 to $564), reduced CVD event risk by 2.2% (95%UI 1.2% to 3.1%), and decreased CVD costs by $947 (95%UI $441 to $1,380). Overall, initiating SPC was estimated to cost $490 (95%UI -$1,242 to $263) less and yield 0.02 (95%UI -0.01 to 0.04) more QALYs relative to monotherapy. The model was sensitive to pill-taking adherence and probability of intensifying therapy when BP is uncontrolled. </span><span data-contrast=\"auto\"><p><b>CONCLUSIONS: </b> In US adults newly diagnosed with hypertension and without CVD comorbidities, initiating treatment with SPCs may improve BP outcomes, reduce costs, and improve QALYs compared with monotherapy.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/bryanspc-ce-pdf.pdf?sfvrsn=1ebf2330_0","title":"Bryan_SPC CE.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117111","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Comprehensive Whole Disease Model: Targeted Literature Review and Feasibility Assessment in Schizophrenia","id":"2d5bdd10-6e5a-418c-b841-eefd3b6dd207","sessionCode":"EPH17","topDisplay":"<b><u>Migliaccio-Walle K</u></b><sup>1</sup>, Bloudek L<sup>2</sup>, Nguyen V<sup>2</sup>, Dhanda R<sup>3</sup>, Yonan C<sup>3</sup>, Sullivan SD<sup>2</sup><br><sup>1</sup>Curta Inc., Hollis, NH, USA, <sup>2</sup>Curta Inc., Seattle, WA, USA, <sup>3</sup>Neurocrine Biosciences, Inc., San Diego, CA, USA","locationCode":"","description":"\r\n\t<div><strong>BACKGROUND:</strong> Schizophrenia is a complex neuropsychiatric condition associated with heterogeneous clinical presentations. In the US, 3.2 million individuals and numerous diverse stakeholders are impacted by schizophrenia, with costs upward of $281.6 billion in 2020.</p> <p><b>OBJECTIVES: </b> To assess the feasibility of developing a comprehensive, whole disease model (WDM) of chronic schizophrenia from the perspectives of multiple stakeholders in the US.</p> <p><b>METHODS: </b> A targeted literature review (TLR) was conducted using PubMed and manually searching citation lists in retrieved articles. Evidence on epidemiology, symptoms and progression of schizophrenia, burden of disease, comorbid conditions, sequelae (e.g., clinical, patient- and caregiver-reported, and economic outcomes), and treatment were identified and supplemented with published literature reviews and meta-analyses. Published models of schizophrenia and related health technology assessments (HTA) were used to inform the feasibility assessment and model conceptualization. Available data (and data gaps) from the TLR were qualitatively evaluated to identify critical factors and feasibility for a WDM allowing multiple perspectives (patient, caregiver, provider, policymaker, payer, society).</p> <p><b>RESULTS: </b> Key factors identified for a WDM included: etiology/risk factors (8 articles), incidence/prevalence (9), onset/diagnosis (7), comorbid conditions (4), intervention/management (5), mortality (4), and quality of life (3); together with caregiver (5), societal (6), judicial system (1), and economic (18, including HTAs) burdens. Data limitations were identified around societal burden and natural history. Comorbidity impact, interventions, and mortality data were adequate. Identified opportunities include a need to quantify interrelations of social factors that impact patients with schizophrenia and other stakeholders. Overall, evidence was found to be adequate to develop a WDM from the patient, caregiver and payer perspectives. Available evidence was deemed inadequate to support a provider perspective.</p> <p><b>CONCLUSIONS: </b> Creation of a comprehensive WDM framework that underpins schizophrenia and its broad impacts on US stakeholders is feasible with sufficient data to evaluate the impact of interventions from several stakeholder perspectives.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116963","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Challenges and Recommendations for the Deployment of Information and Communication Technology Solutions for Informal Caregivers: Scoping Review","id":"0e15a777-feb1-47f9-848d-efab8eb0759f","sessionCode":"HTA1","topDisplay":"<b><u>Hassan A</u></b><br>INRCA, Ancona, Italy","locationCode":"","description":"\r\n\t<div><strong><span class=\"abstract-sub-heading\">Objective: </span></strong>The aim of this study was to review literature to explore the challenges of the deployment of ICT-based support solutions for informal caregivers and provide relevant recommendations on how to overcome these challenges.</p> <span class=\"abstract-sub-heading\"><strong>Methods:</strong> </span>A scoping review methodology was used following the Arksey and O’Malley methodological framework to map the relevant literature. A search was conducted using PubMed, IEEE library, and Scopus. Publication screening and scrutiny were conducted following inclusion criteria based on inductive thematic analysis to gain insight into patterns of challenges rising from deploying ICT-based support solutions for informal caregivers.</p> <strong><span class=\"abstract-sub-heading\">Results: </span></strong>The analysis identified 18 common challenges using a coding scheme grouping them under four thematic categories: technology-related, organizational, socioeconomic, and ethical challenges. These range from specific challenges related to the technological component of the ICT-based service such as design and usability of technology, to organizational challenges such as fragmentation of support solutions to socioeconomic challenges such as funding of technology and sustainability of solutions to ethical challenges around autonomy and privacy of data. For each identified challenge, recommendations were created on how to overcome it. The recommendations from this study can provide guidance for the deployment of ICT-based support solutions for informal caregivers.</p> <span class=\"abstract-sub-heading\"><strong>Conclusions:</strong> </span>Despite a growing interest in the potential offered by ICT solutions for informal caregiving, diverse and overlapping challenges to their deployment still remain. Designers for ICTs for informal caregivers should follow participatory design and involve older informal caregivers in the design process as much as possible. A collaboration between designers and academic researchers is also needed to ensure ICT solutions are designed with the current empirical evidence in mind. Taking actions to build the digital skills of informal caregivers early in the caregiving process is crucial for optimal use of available ICT solutions.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115255","diseases":[{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Epilepsy-Related Healthcare Resource Use and Costs in Commercially Insured Patients Before and After Initiating Brivaracetam: A Retrospective Claims Database Analysis","id":"8d43a4d8-6aee-43c9-b581-efd77605e8fc","sessionCode":"EE86","topDisplay":"<b><u>Beaty S</u></b><sup>1</sup>, Estrin A<sup>2</sup>, Lee E<sup>3</sup>, Guntrum K<sup>3</sup>, Loewendorf A<sup>3</sup>, Skornicki M<sup>2</sup><br><sup>1</sup>UCB Pharma, Tucker, GA, USA, <sup>2</sup>Aetion Inc., New York, NY, USA, <sup>3</sup>UCB Pharma, Smyrna, GA, USA","locationCode":"","description":"\r\n\t<div><strong>Objective: </strong>Understand healthcare resource use (HCU) and costs for commercially insured patients with epilepsy in United States treated with brivaracetam (BRV) in the 12 months pre- and post-treatment initiation.</p> <strong>Methods:</strong> Retrospective cohort analysis using IBM MarketScan Commercial Claims and Encounters Database. Patients ≥18 years with baseline epilepsy/seizure diagnosis and continuous medical and pharmacy benefit for 12 months pre- and post-BRV initiation between March 1, 2016 and September 30, 2018 were included. Patients with BRV use during baseline period (12 months pre-BRV initiation) were excluded.</p> <strong>Results:</strong> 479 commercially insured BRV patients were identified (mean age 37.5 years; 60.1% female). Most common seizure type was focal (36.5%). During baseline period, 67.4% of patients received ≥2 antiseizure medications. From 6 months to 1 month pre-BRV initiation, the number of patients with epilepsy-related inpatient or outpatient HCU increased (16 to 32 and 158 to 363, respectively), suggesting uncontrolled epilepsy. Mean total epilepsy-related costs increased 45% during 12-month follow-up period versus 12-month baseline period ($40,212 versus $27,671, respectively), which was mainly driven by pharmacy cost. Within 1 month post-BRV initiation, mean total epilepsy-related medical costs decreased ($2,030 versus $3,122 in the month pre‑BRV initiation), but increased 15% during 12-month follow-up period versus 12-month baseline period ($21,269 versus $18,472, respectively). Mean monthly epilepsy-related medical costs were lower during 12-month follow-up period versus 6 months pre-BRV initiation ($1,772 versus $2,078, respectively). Within 1 month post-BRV initiation, the number of patients with epilepsy-related inpatient or outpatient HCU declined by 50.0% (32 to 16) and 37.5% (363 to 227), respectively, versus the month pre-BRV initiation. This study was not designed to detect statistically significant differences pre- and post-BRV initiation.</p> <strong>Conclusions:</strong> In a seizure/epilepsy patient population newly starting BRV, annual epilepsy-related costs increased but epilepsy-related HCU and medical costs were reduced in the period immediately post-BRV initiation.</p> <strong>Funding:</strong> UCB Pharma-funded.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ee86silkybeatypdf-pdf.pdf?sfvrsn=382661c3_0","title":"EE86_SilkyBeaty_PDF.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115090","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"A Review of Economic Evaluation on Vaccination and Non-Pharmaceutical Interventions for COVID-19 Prevention and Control","id":"c8689bb2-e737-45b4-8e70-f098497a31a1","sessionCode":"SA6","topDisplay":"<b><u>Zhao J</u></b>, Fu Y, Han P, Yang L<br>Peking University, Beijing, 11, China","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To understand the research progress of prevention and control effects and economic benefits of vaccination, other non-pharmaceutical interventions (NPIs) at home and abroad, and to provide theoretical and methodological references for carrying out economic evaluation using Chinese real word data.</p> <p><b>METHODS: </b>This study searched Chinese and English literature from January, 2020 to December, 2021 in PubMed, Embase, Ovid Medline, Web of Science, Elsevier, CNKI databases. Health economic evaluations considering both costs and outcomes were included.</p> <p><b>RESULTS: </b>A total of 54 English literatures and 1 Chinese literature on economic evaluation of prevention and control were included. Economic evaluations of prevention and control measures mainly focused on vaccination alone or vaccination combined with other NPIs, and different assumptions and scenario analyses were conducted according to age, vaccine coverage rate, and vaccine efficiency. Most studies conducted cost-effectiveness analysis from the perspective of societal or healthcare system using Markov or SEIR-based Markov models. Overall, the implementation of NPIs could effectively prevent local outbreaks and avoid large-scale epidemics when vaccination coverage was relatively insufficient. Moreover, the combined use of various measures could reduce the risk of epidemic spreading, disease burden, and delayed the peak of the epidemic more effectively.</p> <p><b>CONCLUSIONS: </b>In general, domestic and international economic evaluation of vaccination and other NPIs have provided ideas and predicting results, while there still lacks economic evaluations of Chinese real-world evidence-based vaccination strategies combined with other NPIs, as well as evidence of cost-effective booster vaccination strategies under the long-term epidemic trends in China. Therefore, the economic evaluation of reasonable combinations of vaccination and NPIs as well as the strategies of booster vaccination based on real-world epidemic trends in China is of great practical importance for the rational pricing of vaccines, the rational layout of prevention and control measures for China under long-term epidemic trends.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117167","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Real-World Patient Characteristics, Efficacy and Safety of Psychiatric Intramuscular Ketamine Treatment: A Retrospective Cohort Study of 452 Outpatients","id":"30738fd3-1d20-4df7-b9ff-f10fe0a6498e","sessionCode":"CO24","topDisplay":"<b><u>Ahuja S</u></b><sup>1</sup>, Brendle M<sup>2</sup>, Smart L<sup>3</sup>, Moore C<sup>3</sup>, Thielking P<sup>3</sup>, Robison R<sup>3</sup><br><sup>1</sup>Novamind, Calgary, AB, Canada, <sup>2</sup>University of Utah, Salt Lake City, UT, USA, <sup>3</sup>Novamind, Draper, UT, USA","locationCode":"","description":"\r\n\t<div><strong>Background: </strong>Ketamine has emerged as a promising pharmacotherapy for depression and other mental illnesses, and the intramuscular (IM) administration of ketamine is now offered at many North American outpatient psychiatric clinics. However, a characterization of the outpatient population receiving IM ketamine treatment, and an evaluation of the real-world efficacy and safety of long-term IM ketamine treatment, has not been reported.</p> <strong>Objectives: </strong>To evaluate the clinical characteristics, treatment patterns, clinical outcomes, and adverse events of patients receiving IM ketamine treatment.</p> <strong>Methods: </strong>Patient data from a private outpatient psychiatric clinic’s EHR were collected and analyzed retrospectively. Adults who received ketamine treatment only by IM administration from January 2018 – June 2021 were included.</p> <strong>Results: </strong>Patients receiving IM ketamine treatment had a mean of 2.8 (SD 1.4) psychiatric diagnoses, and major depressive disorder was the most common diagnosis (420 (93%) patients). Thirty-seven percent (42/114) of patients reported a history of a previous suicide attempt, and patients had an average of 3.1 (SD 2.9) psychiatric medication prescriptions at baseline. Patients received between 1 and 48 IM ketamine treatments. Average depression and anxiety symptoms significantly improved (<em>p</em> < .001) from baseline (PHQ-9: mean=16.3, SD=6.7; GAD-7: mean=12.8, SD=5.7) to patients’ last treatment (PHQ-9: mean=10.8, SD=5.9; GAD-7: mean=8.4, SD=5.5), and suicidal ideation scores also significantly improved (<em>p</em> < .001). With maintenance ketamine treatments, median improvements in depression and anxiety of at least 21% and 19% were maintained for over 13 months. An adverse event occurred during 59 of 2,532 treatments (2.3%).</p> <strong>Conclusion:</strong> IM ketamine is being utilized to treat psychiatric outpatients with a moderate-to-severe mental health history and multiple mental illnesses not limited to depression. IM ketamine treatment shows a strong real-world safety profile, and mental health symptoms significantly improve throughout treatment. Further prospective studies are recommended to confirm the long-term efficacy and safety of IM ketamine.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/isporimketamineahujafinal-pdf.pdf?sfvrsn=15f16cbf_0","title":"ISPOR_IM_Ketamine_Ahuja_Final.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117291","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Societal Costs of Metachromatic Leukodystrophy (MLD) in the Netherlands","id":"8a2b4be8-27f9-4aba-be68-f1a781018e6e","sessionCode":"EE45","topDisplay":"<b><u>Bean K</u></b><sup>1</sup>, Olaye A<sup>2</sup>, Velikanova R<sup>3</sup>, Miller B<sup>4</sup>, Howle K<sup>5</sup>, Wilds A<sup>5</sup>, Walz M<sup>5</sup>, Pang F<sup>6</sup><br><sup>1</sup>Orchard Therapeutics Ltd, London, UK, <sup>2</sup>Orchard Therapeutics, London, UK, <sup>3</sup>iDNA, Groningen, GR, Netherlands, <sup>4</sup>Precision HEOR, Grafton, MA, USA, <sup>5</sup>Magnolia Innovation, Hoboken, NJ, USA, <sup>6</sup>Orchard Therapeutics Ltd, London, Great Britain","locationCode":"","description":"\r\n\t<div>MLD is an ultra-rare neurodegenerative disease leading to motor and cognitive decline and premature death. Prior to the approval of atidarsagene autotemcel (arsa-cel), patients with early-onset MLD had no disease modifying treatment options and very poor survival outcomes, often reaching a decerebrated state before adolescence. Arsa-cel is a one-time ex-vivo gene therapy, potentially enabling affected children to retain their motor and cognitive function into adulthood and contribute to society. Due to the debilitating nature of early-onset MLD, parents are often forced to give up work to care for their affected children. The aim of this study was to determine the lost family income due to caring for early-onset MLD patients, and potential productivity gains associated with arsa-cel treatment from a Dutch perspective.</p> Data from a cross-national MLD caregiver survey were used to inform changes in employment status and lost family income was calculated using average annual salaries and number of working days in the Netherlands in 2020. Future productivity gains were calculated using the Human Capital Approach. Due to lack of employment data in MLD patients, published data from cerebral palsy and Down’s syndrome were utilised as a proxy for impact of motor and cognitive dysfunction on employment, alongside expected earnings based on the Dutch education levels of achievement. A 3.5% discount rate was used to adjust productivity gains and lost family income.</p> In untreated patients over a 30-year timeframe, the estimated family income lost as a result of caring for a MLD patient was €214,416. In an arsa-cel treated patient, the productivity gains accrued over a working life were estimated at €317,484. </p> There are significant productivity gains for patients treated with arsa-cel compared to untreated patients who do not have opportunities to enter the workforce; significant family income is lost through non-treatment particularly in the later stages of MLD.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116843","diseases":[{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Impact of Informal Caregiving in Alzheimer’s Disease Dementia: A Health Utility Study in the UK","id":"a76a1c45-4693-40bd-ae2d-f3ded3600807","sessionCode":"PCR24","topDisplay":"<b><u>Belger M</u></b><sup>1</sup>, Dell’Agnello G<sup>2</sup>, Enstone A<sup>3</sup>, Wyn R<sup>3</sup>, Tockhorn-Heidenreich A<sup>2</sup><br><sup>1</sup>Eli Lilly and Company, Bracknell, SRY, UK, <sup>2</sup>Eli Lilly and Company, Indianapolis, IN, USA, <sup>3</sup>Adelphi Values Ltd, Bollington, UK","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Alzheimer’s disease (AD) dementia is a debilitating, progressive condition that often places caregiving responsibility on informal (unpaid) caregivers, causing a substantial burden to caregivers and society. Caregiver utility comprises an important part of this burden and should be considered when assessing interventions for AD dementia. This study aimed to quantify utility through directly eliciting utility values from the general public in the UK.</p> <p><b>METHODS: </b>Six health state vignettes were developed using published literature, online patient forums, and interviews with experts (N=5) including clinicians, caregivers, and caregiver advocates. Vignettes varied based on disease severity, caregiver-patient relationship and living situation. Health states were validated through further expert interviews (N=3) with clinicians and a caregiver. A pilot study was conducted with the general public (N=10) before finalization of the health states.</p> Utility values (0 to 1) were elicited through time trade-off (TTO) interviews with members of the general public.</p> <p><b>RESULTS: </b>Face-to-face interviews were included with 109 respondents for the analysis. Mean TTO scores were elicited for the caregiver living with a patient with AD with mild (0.79; 95% CI: 0.74 to 0.84), moderate (0.65; 95% CI: 0.60 to 0.71) or severe dementia (0.49; 95% CI: 0.44 to 0.55) and for caregivers living separately from a patient with AD with mild (0.74; 95% CI: 0.70 to 0.79) or moderate dementia (0.71; 95% CI: 0.66 to 0.76). The utility of a caregiver of a person with AD with severe dementia being cared for in a nursing home (0.64, 95% CI: 0.58 to 0.71) was comparable to the utility of a caregiver living with a patient with AD with moderate dementia (0.65, 95% CI: 0.60 to 0.71).</p> <p><b>CONCLUSIONS: </b>This study quantifies the substantial burden of AD dementia caregiving across the AD dementia continuum. Overall, caregiver utility decreased with increasing severity of AD dementia.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/pcr24-belger-et-al-pdf.pdf?sfvrsn=d26377e5_0","title":"PCR24 Belger et al.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116952","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Materiovigilance in Intensive Care Units: An Active Surveillance","id":"503a3d27-dff5-4f55-85c5-f4402b4baff8","sessionCode":"MT5","topDisplay":"<p><span class=\"error\">ABSTRACT WITHDRAWN</span></p>","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>To determine the rate, patterns & predictors of medical devices associated adverse events (MDAEs).</p> </p> <p><b>METHODS: </b>An active surveillance is being carried in intensive care units (ICUs) of a tertiary care teaching hospital located in southern India. The patients are being monitored for MDAEs and the same are being reported on daily basis through patient’s case sheet reviews and, patient and healthcare professional interviews. The reported MDAEs are being assessed for causality and severity based on guidance document version 1.2 issued by Materiovigilance programme of India (MvPI). The predictors are being calculated at 95% confidence interval.</p> <p><b>RESULTS: </b>In the interim data analysis, a total of 107 MDAEs were reported amongst 74 patients [49 (66.2%) were males & 25 (33.7%) were females]. Majority of events were caused by urethral-catheters [30 (28%)], that are classified as low-risk (category A) devices followed by ventilators [16 (15%)] which are moderately high-risk (category C) devices. The elderly patient population experienced majority of MDAEs [68(63%)]. The causality assessment for 76 (71%) MDAEs was probable & 31 (29%) were possible. Majority of events were not severe & 6 (5%) were serious which resulted in prolonged hospitalization. Majority of the devices were single use devices 69 (64.5%) and most of the devices were destroyed 69 (64.5%) while 38 (35.5%) were retained within healthcare facility. With the interim data, the predictors identified were old age and duration of the device used.</p> <p><b>CONCLUSIONS: </b>In an already patient overburdened healthcare system, the active surveillance of MDAEs is a challenge. Clinical pharmacists can play an active role in Materiovigilance reporting by reducing economic burden incurred by MDAEs via extending hospital stay of patients.</div>\r\n\r\n","withdrawn":true,"categories":[{"id":"dda9555e-19ab-4405-936c-34532e5825c6","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Technologies","urlName":"medical-technologies"}],"categoryIds":["dda9555e-19ab-4405-936c-34532e5825c6"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116895","diseases":[{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Variation in COVID-19 Treatment Cost due to Social Factors in the US – Estimation Using Integration of CDC/ATSDR’s Social Vulnerability Index (SVI) and Healthcare Claims Data","id":"ed27e052-2ad1-453f-9885-f44f756a9b74","sessionCode":"RWD2","topDisplay":"Roy A<sup>1</sup>, Gaur A<sup>2</sup>, Gupta A<sup>3</sup>, Upadhyay N<sup>4</sup>, Kukreja I<sup>5</sup>, Chopra A<sup>6</sup>, Brooks L<sup>7</sup>, Sulzicki M<sup>8</sup>, <b><u>Verma V</u></b><sup>9</sup>, Pandey S<sup>10</sup>, Field S<sup>11</sup>, Krebs B<sup>12</sup>, Nayyar A<sup>2</sup><br><sup>1</sup>Optum, Gurgaon, HR, India, <sup>2</sup>Optum, Gurugram, HR, India, <sup>3</sup>Optum, Eden Prairie, MN, USA, <sup>4</sup>Optum Global Solutions, UHG, New Delhi, India, <sup>5</sup>Optum Global Solutions, India, New Delhi, DL, India, <sup>6</sup>Optum Global Solutions, India, Gurugram, HR, India, <sup>7</sup>Optum, Basking Ridge, NJ, USA, <sup>8</sup>Optum, Trumbull, CT, USA, <sup>9</sup>Optum Global Solutions, India, Gurgaon, HR, India, <sup>10</sup>Optum Global Solutions, India, noida, gautam buddha nagar, UP, India, <sup>11</sup>Optum, Dallas, TX, USA, <sup>12</sup>Optum, Tucson, AZ, USA","locationCode":"","description":"\r\n\t<div><strong>Objective</strong>: This study explored the variation in COVID-19 treatment cost by Social Vulnerability Index (SVI) of patients in the US.</p> <strong>Method</strong>: This study included patients diagnosed with COVID-19 infection between 1<sup>st</sup> March 2020 to 30<sup>th</sup> June 2021 with ICD-10-CM diagnosis recorded in the large de-identified database of the US health insurance claims representing ~15% population. Only the patients having continuous eligibility of 1-month post (follow-up period) the first diagnosis of COVID-19 (index date) were included in study. Zip code (if available) closest to COVID-19 diagnosis index of those patient were joined with The Minority Health SVI (mhSVI) file to map patient’s SVI score ranged from 0 to 1. We have estimated medical cost post-index across the four patient groups, categorized based on SVI score (Group 1: 0-0.25; Group 2: 0.251-50; Group 3: 0.501-.75; Group 4: 0.751-1) and have applied the statistical test to analyze the level of significance in cost variation across the four SVI groups. Results will be stratified further by place of service – Inpatient, Emergency, Outpatient.</p> <strong>Results</strong>: Among 306,652 patients diagnosed with COVID-19, we were able to map SVI score for 98% of patients. We have observed four times more medical cost for patients who have SVI score >0.75 than <0.25. Estimated mean medical cost of group 1 (Least socially vulnerable) to group 4 (Highly socially vulnerable) were as follows: $1,108 (SD $7,407), $1,777 (SD $10,886), $2,605 (SD $13,562), $4,374 (SD $20,935).</p> <strong>Conclusion</strong>: Significant variation in COVID-19 treatment cost might be corelated with patient’s severe COVID-19 presentation, higher exposure to risk factors, and other co-morbid condition in socially vulnerable population. This study helps to guide healthcare resource planning and allocation for emergency preparedness in the socially vulnerable communities.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/disparity-in-covid-19-treatment-cost-due-to-social-factors-in-the-us-pdf.pdf?sfvrsn=423694d9_0","title":"Disparity in COVID-19 Treatment Cost due to Social Factors in the US.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116852","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Effectiveness and Safety of Remdesivir for COVID-19: A Quantitative Meta-Analysis","id":"93619024-496e-496e-8c49-f4a17e823382","sessionCode":"SA5","topDisplay":"<b><u>Mohamed AF</u></b><sup>1</sup>, Duong P<sup>2</sup>, Shah T<sup>2</sup>, Zhang M<sup>2</sup>, Mekary RA<sup>3</sup><br><sup>1</sup>MCPHS university, Roxbury, MA, USA, <sup>2</sup>MCPHS University, Boston, MA, USA, <sup>3</sup>MCPHS Univeristy, Boston, MA, USA","locationCode":"","description":"\r\n\t<div><strong><p><b>OBJECTIVES: </b></strong></p> To evaluate the effectiveness (mortality, clinical improvement, discharge status, length of stay, and safety outcome (overall adverse effects) of remdesivir as a treatment for Covid-19 in adults.</p> <strong><p><b>METHODS: </b></strong></p> A literature search was performed on PubMed, Embase, Cochrane library, and clinicaltrials.gov from December 2019 to June 2021. Studies comparing remdesivir to placebo, active comparator, or standard of care (SOC) for the treatment of Covid-19 in adults were included. The random-effects model was utilized to calculate the pooled risk ratio and 95% confidence intervals (CI) for randomized controlled trials (RCTs) and observational studies (OBS) separately.</p> <strong><p><b>RESULTS: </b></strong></p> Seven studies were included, four RCTs, and three OBS. The overall pooled estimates suggested that remdesivir reduced the 15 and 28-day mortality in RCTs (RR 0.63, 95% CI 0.40, 0.97 at day 15 and RR 0.93, 95% CI 0.80, 1.07 at days 28) and OBS (RR 0.31, 95% CI 0.15, 0.62 at day 15 and RR 0.60, 95% CI 0.43, 0.83 at day 28). Compared to the control arm in the RCTs, more patients on remdesivir showed a statistically significant clinical improvement (RR 1.09, 95% CI 1.02,1.16) and had a higher rate of discharge at day 28 (RR 1.08, 95% CI 1.01, 1.15). No difference was found in mean length of stay (-1.7 days, 95% CI -3.93, 0.53) for RCTs and (-2.5 days, -4.55, 0.45) for OBS. While the overall adverse effects were not statistically significant in RCTs (RR 1.02, 95% CI 0.87, 1.20), these reached statistical significance in OBS (RR 0.50, 0.34, 0.74) favoring remdesivir compared to the control group.</p> <strong><p><b>CONCLUSIONS: </b></strong></p> In the current meta-analyses, evidence showed effectiveness and safety in remdesivir in terms of mortality, clinical improvement, and discharge rate compared to the control group at day 28. Length of hospital stay in the remdesivir group was not different from the control group.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/aneeshaispor-poster-pdf.pdf?sfvrsn=587e21bb_0","title":"Aneesha_ISPOR poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116757","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Impact of Prophylactic Therapy on Health Related Quality of Life (HRQOL) of Children with Hemophilia a without Inhibitors: A Systematic Review and Meta-Regression Analysis","id":"51d90764-207f-4da1-9100-f5026ec270fb","sessionCode":"PCR4","topDisplay":"Azeredo da Silva A<sup>1</sup>, Zanotto B<sup>2</sup>, Sato-kuwabara Y<sup>3</sup>, <b><u>Mata V</u></b><sup>4</sup><br><sup>1</sup>HTAnalyze Consulting, Porto Alegre, Brazil, <sup>2</sup>National Health Technology Assessment Institute, Porto Alegre, RS, Brazil, <sup>3</sup>F.Hoffmann-La Roche, Rio de Janeiro, Brazil, <sup>4</sup>F.Hoffmann-La Roche, SAO PAULO, SP, Brazil","locationCode":"","description":"\r\n\t<div><strong>Background:</strong> Hemophilia A can seriously affect the HRQoL of children and adolescents. The aim of this systematic review was to identify studies that have reported HRQoL of this patient population and to assess its relation to effective prophylactic treatment. <strong>Methods:</strong> Randomized or observational clinical studies published in English, Portuguese, or Spanish that recruited a minimum of 30 patients aged < 18 years with non-inhibitor hemophilia A and reported on the results of HRQoL assessment were included. We excluded reports with no primary data reporting. We searched MEDLINE, EMBASE, CENTRAL and LILACS databases from 2010 to 2021. Risk of bias was assessed with the Newcastle-Ottawa Scale. Results are presented as a meta-regression of the proportion of patients under prophylactic treatment on the outcome variable HRQoL as measured with the Haemo-QoL questionnaire (higher scores indicating worse HRQOL). Funded by Roche Pharmaceutical. PROSPERO registration CRD42021235453. <strong>Results:</strong> The initial search yielded 2220 records. After title and abstract screening, 98 studies were retrieved for full text reading, of which 14 studies (778 patients from 12 countries) met the inclusion criteria for the meta-regression analysis. The proportion of patients on prophylactic treatment ranged from 0% to 100% of patients on a prophylactic regimen with regular administration of FVIII (11 studies), turoctocog alfa (two studies), or emicizumab (one study). There was a significant negative association between higher Haemo-QoL scores (worse HRQOL) and the proportion of patients receiving continuous prophylactic treatment (mixed-effects model, Tau<sup>2</sup>=42.7323 (SE=23.9699), I<sup>2</sup>=94.67%, H<sup>2</sup>=18.76%, R<sup>2</sup>=79.34%, y=55.4442-37.4145*x). Three out of the six studies with the highest HRQoL scores (mean total Haemo-QoL score < 30) were treated with extended half-life hemostatic agents. <strong>Discussion:</strong> Most of the observed overall heterogeneity was explained by the range of prophylactic treatment reported in diverse settings. A higher proportion of children with hemophilia A on prophylactic treatment is associated with better HRQOL.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116619","diseases":[{"id":"ac8e5c06-82a1-4ece-9b58-c1a36a72a607","parentId":"00000000-0000-0000-0000-000000000000","title":"Pediatrics","urlName":"Pediatrics"},{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness Analysis of Nivolumab Plus Chemotherapy Vs Chemotherapy in Patients with Advanced Gastric Cancer in Japan","id":"460e3ac8-c29e-4efc-b68a-f54c51d07d80","sessionCode":"HTA7","topDisplay":"<b><u>Morimoto K</u></b><sup>1</sup>, Moriwaki K<sup>2</sup>, Shimozuma K<sup>3</sup>, Nakayama T<sup>4</sup><br><sup>1</sup>Kyoto University, Kyoto, Japan, <sup>2</sup>Ritsumeikan University, Kyoto, 26, Japan, <sup>3</sup>Ritsumeikan University, Kusatsu, Japan, <sup>4</sup>Kyoto Univercity, Kyoto, Japan","locationCode":"","description":"\r\n\t<div><span><p><b>OBJECTIVES: </b> This study aimed to evaluate the cost-effectiveness of combination therapy of nivolumab plus chemotherapy (FOLFOX or XELOX) (Niv+Chemo) comparing with chemotherapy alone for patients with advanced gastric cancer (AGC) in Japan from the perspective of Japanese payer.</span></p> <span> </span></p> <span><strong>METHOD:</strong> A partitioned survival model was developed to predict cost and quality-adjusted life years (QALYs) in a Niv+Chemo arm and a chemotherapy arm. Data on overall and progression-free survival was derived from the CheckMate649 trial. Cost estimates were based on Japanese payer perspective, by using real world data, JMDC claims database. Utilities were derived from previously published study. The incremental cost-effectiveness ratio (ICER) of Niv+Chemo therapy compared with chemotherapy was estimated. A subgroup analysis on the PD-L1 with a combined positive score (CPS) of five or more and one or more was conducted. In addition, deterministic sensitivity analysis was performed to assess the uncertainty in parameter setting. </span></p> <span> </span></p> <span><p><b>RESULTS: </b> Compared with chemotherapy alone, NIV+Chemo incurred an additional cost of USD139,210 and conferred an additional 0.30 QALY, which results in an ICER of USD458,114/QALY gained. The results of a subgroup analysis showed that the ICER AGC patients for PD-L1 CPS of five or more was USD359,134 and the ICER AGC patients for PD-L1 CPS of one or more was USD424,698. Sensitivity analyses showed a relatively robust result that the ICERs remined higher than a Japanese price adjustment threshold of USD75,000/QALY over the full range of model parameters. The results of scenario analysis showed that the ICERs for a 25% or 50% reduction in the price of nivolumab were estimated to be USD361,410/QALY and USD264,707/QALY, respectively. </span></p> <span> </span></p> <span><strong>CONCLUSION:</strong> The combination therapy of nivolumab plus chemotherapy as first-line therapy would not be cost-effective under a willingness-to-pay threshold of USD75,000/QALY. </span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor2022-poster-kosukemorimoto-pdf.pdf?sfvrsn=6439ff13_0","title":"ISPOR2022 poster KosukeMORIMOTO.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115590","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Total Cost of Care and Out-of-Pocket Spending for Medicare Fee-for-Service Beneficiaries with Advanced Melanoma, Advanced Renal Cell Carcinoma, or Advanced Non-Small Cell Lung Cancer","id":"00c237b0-abb6-4b77-9fec-f5b12ea61362","sessionCode":"EE89","topDisplay":"Schwartz T<sup>1</sup>, Morley M<sup>1</sup>, Lane D<sup>2</sup>, <b><u>Palaia J</u></b><sup>2</sup>, Macher D<sup>1</sup>, Petrilla A<sup>3</sup><br><sup>1</sup>Avalere Health, Washington, DC, USA, <sup>2</sup>Bristol-Myers Squibb, Lawrenceville, NJ, USA, <sup>3</sup>Avalere Health, Alexandria, VA, USA","locationCode":"","description":"\r\n\t<div><strong>OBJECTIVE</strong>: This retrospective study measured direct cost of care and patient out-of-pocket (OOP) spending for Medicare Fee-For-Service (FFS) beneficiaries with advanced melanoma (advMelanoma), advanced renal cell carcinoma (aRCC), or advanced non-small cell lung cancer (aNSCLC). <strong><p><b>METHODS</strong>: </b> The 100% sample of Medicare FFS enrollment/claims data was used to identify adult patients with ≥1 inpatient or ≥2 outpatient medical claims with diagnosis of melanoma (ICD-10-CM C43.X), RCC (C64.1, C64.2, C64.9), or lung cancer (C34.XX) and ≥2 claims with diagnosis of metastasis/secondary neoplasm (C77.x-C79.x) between July 1, 2017 and June 31, 2019. Date of first metastasis was considered the index date. Cohorts were defined by primary tumor type. Total all-cause direct cost of care (based on Medicare payments for all adjudicated claims for Parts A/B/D medical and pharmacy services) and patient OOP spending were measured over a 24-month period. <strong><p><b>RESULTS</strong>: </b> The study population included 3,429, 2,551, and 8,450 patients with advMelanoma, aRCC, and aNSCLC, respectively. Mean Parts A/B/D Medicare payments per patient over 24-months (and per-patient per-month [PPPM]) were $118,235 ($4,927) for patients with advMelanoma, $139,408 ($5,809) for patients with aRCC, and $145,775 ($6,074) for patients with aNSCLC. Mean OOP costs per patient over 24-months (PPPM) were $22,995 ($958), $21,261 ($886), and $27,636 ($1,152), respectively. This study does not include the cost of lost productivity or premature death from cancer.</p> <strong>CONCLUSION</strong>: In this retrospective study of 14,430 Medicare beneficiaries diagnosed with 1 of 3 advanced solid tumors who survived at least 24 months, there is considerable cost to the Medicare program and patients associated with the treatment of melanoma, RCC, and NSCLC. This study highlights the need for innovative strategies to help address patient burden while acknowledging the advances made in cancer detection and treatment, which have contributed to increased survival in this patient population.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115499","diseases":[{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Using Artificial Intelligence Methods for Systematic Review in Health Sciences: A Systematic Review","id":"c8550844-3123-4ff5-8c67-f6406fd0c529","sessionCode":"MSR1","topDisplay":"<b><u>Blaizot A</u></b><sup>1</sup>, Veettil SK<sup>1</sup>, Saidoung P<sup>2</sup>, Moreno-Garcia CF<sup>3</sup>, Wiratunga N<sup>4</sup>, Aceves-Martins M<sup>4</sup>, Lai NM<sup>5</sup>, Chaiyakunapruk N<sup>1</sup><br><sup>1</sup>University of Utah, Salt Lake City, UT, USA, <sup>2</sup>Chiang Mai University, Chiang Mai, Thailand, <sup>3</sup>Robert Gordon University, Aberdeen, UK, <sup>4</sup>University of Aberdeen, Aberdeen, UK, <sup>5</sup>Taylor’s University Malaysia, Subang Jaya, Malaysia","locationCode":"","description":"\r\n\t<div><span><strong><p><b>OBJECTIVES: </b></strong> The exponential increase in published articles makes a thorough and expedient review of literature increasingly challenging. Artificial Intelligent (AI) platforms have been developed to attempt to address this problem, with them progressively being incorporated into practice. This review delineated the common automated tools and platforms that employ AI approaches and evaluated the reported benefits and challenges in using such methods. </span></p> <span><strong><p><b>METHODS: </b></strong> A search was conducted in 4 databases (Medline, Embase, Cochrane database of systematic reviews, and Epistemonikos) up to April 2021 for systematic reviews and other related reviews implementing AI methods. To be included, an AI-assisted review must use any form of AI method, including machine learning, deep learning, neural network, or any other applications that are used to enable the full or semi-autonomous performance of one or more stages in the development of evidence synthesis. </span></p> <span><strong><p><b>RESULTS: </b></strong> From a total of 4911 records identified, 87 articles underwent full-text screening, and 12 reviews were included. These reviews used nine different tools to implement 15 different AI methods. Eleven methods were used in the screening stages of the review (73%). The rest were divided: two in data extraction (13%) and two in risk of bias assessment (13%). The ambiguous benefits of the data extractions, combined with the reported advantages from 10 reviews, indicate that AI platforms have taken hold with varying success in evidence synthesis. The results are qualified by the reliance on the self-reporting of the review authors. </span></p> <strong><p><b>CONCLUSIONS: </b></strong> Extensive human validation still appears required at this stage in the implementation of AI/ML methods, though further evaluation is required to define the overall contribution of such platforms in enhancing efficiency and quality in evidence synthesis.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"9a8a8cd2-8374-445e-898f-1c074569c9bd","parentId":"00000000-0000-0000-0000-000000000000","title":"Methodological & Statistical Research","urlName":"methodological-statistical-research"}],"categoryIds":["9a8a8cd2-8374-445e-898f-1c074569c9bd"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116771","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Passport for Travel: Proposed Framework for Transportability of Oncology Real World Evidence","id":"27dcc7a2-ffde-4f71-9e0e-f6c3015f062f","sessionCode":"HTA3","topDisplay":"<b><u>Beal B</u></b><sup>1</sup>, Altomare I<sup>1</sup>, Ray J<sup>2</sup>, Bargo D<sup>1</sup>, Adamson B<sup>1</sup><br><sup>1</sup>Flatiron Health, New York, NY, USA, <sup>2</sup>F. Hoffmann-La Roche, Basel, Switzerland","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES<span style=\"font-weight: 400;\">: </b>There is an increased demand for oncology RWD to support decision-making by health-technology assessment (HTA) bodies, particularly when there is a lack of long-term comparative data. The extent to which insights generated from US RWD should be used to address uncertainty in ex-US markets is commonly questioned. This study aimed to identify challenges in assessing the transportability of evidence derived from real-world US electronic health records (EHR) and proposes a framework for mitigating risks to HTA decision-makers.</span></p> <p><b>METHODS<span style=\"font-weight: 400;\">: </b>We focused on treatment patterns and outcomes published from German markets between 2015 and 2020 to those in the Flatiron Health US EHR-derived databases with a goal of enumerating challenges in replicating results between countries. We identified studies in four disease states (multiple myeloma, non-small cell lung cancer, breast cancer, and bladder cancer) published using German real-world databases. We categorized observable and non-observable data elements which could lead to dissimilarities between the insights from the German and US data studies.</span></p> <p><b>RESULTS<span style=\"font-weight: 400;\">: </b>We structured our findings into two ranks - a set of three core themes and four to five factors within those themes affecting the representativeness, and hence transportability, of real-world data. The identified themes were patient-characteristic differences, setting-of-care differences, and treatment pattern differences. Accounting for these in the pre-specification process allowed for a clearer understanding of whether inferences generated from the Flatiron Health EHR-derived data source may be transportable to other countries of interest for the purposes of HTA.</span></p> <p><b>CONCLUSIONS<span style=\"font-weight: 400;\">: </b>Differences in a given target population may impact the transportability of causal inferences generated from RWD. Some differences may be adjusted for while other, potentially unknowable differences, may not. Clearly characterizing these differences in a consistent framework promotes a more systematic approach during the pre-specification process, allowing for increased representativeness in the sample population and more transparency during a given HTA submission.</span></div>\r\n\r\n","withdrawn":false,"categories":[{"id":"6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Technology Assessment","urlName":"health-technology-assessment"}],"categoryIds":["6f5ef72f-8f2d-4f1e-8746-b96cc7c07b73"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-2022-transportability-pdf.pdf?sfvrsn=9d1d93d_0","title":"ISPOR 2022_ Transportability.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115783","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Changes in the Practising Midwives Density per 100 Hospital Beds in European Healthcare Systems","id":"95adb99d-4f17-4749-8e70-f7353c3327da","sessionCode":"HPR8","topDisplay":"<b><u>Elmer D</u></b><sup>1</sup>, Endrei D<sup>2</sup>, Csákvári T<sup>2</sup>, Németh N<sup>2</sup>, Kajos L<sup>3</sup>, Boncz I<sup>2</sup><br><sup>1</sup>University of Pécs, Pécs, PE, Hungary, <sup>2</sup>University of Pécs, Pécs, Hungary, <sup>3</sup>University of Pécs, Pécs, BA, Hungary","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong>: Our aim was to examine the numbers of practising midwives per 100 hospital beds in European OECD countries.</p> </p> <strong>Methods</strong>: Indicators analysed regarding numbers of practising midwives and total hospital beds were derived from the ’OECD Health Statistics 2021’ online database, for the period 2000-2018. 24 European OECD countries were grouped and compared according to type of healthcare system (Bismarckian-type, solidarity-based health insurance system versus Beveridge-type national health system). The comparison was focused especially on years 2000, 2010 and 2018. Data were calculated for 100 hospital beds.</p> </p> <strong>Results</strong>: In 2000, the average number of practising midwives was 3.7 per 100 hospital beds in countries having a Bismarckian-like, and 8.8 per 100 hospital beds in countries with a Beveridge-like system. The difference was not significant (p=0.153). In 2018, the average number of practising midwives was 5.9 per 100 hospital beds in countries with a Bismarckian-like and 16.6 per 100 hospital beds in countries with a Beveridge-like system. The difference was not significant (p=0.055). Between 2000-2018, the average number of practising midwives per 100 hospital beds increased from 3.7 to 5.9 (+62 %) in countries having a Bismarckian-like system while in countries with a Beveridge-like healthcare system the increase was from 8.8 to 16.6 (+89 %). During the same period, the average number of practising midwives per 100 hospital beds in all OECD countries increased from 5.6 to 9.7 (+72 %). As for the countries, the highest number of practising midwives was found by Sweden also in 2000 (19.1) and 2018 (35.8). The lowest number was reported by the Netherlands (2.1) in 2000 and by Slovenia (2.6) in 2018. </p> </p> <strong>Conclusions</strong>: Between 2000 and 2018, Beveridge-like systems showed a higher increase in the number of practising midwives per 100 hospital beds compared to countries using the Bismarckian model. The difference was not significant.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/elmerdprinthpr820220422final-pdf.pdf?sfvrsn=ea2947a5_0","title":"ElmerD_PRINT_HPR8_20220422_FINAL.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117427","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Trends in FDA Approval of New Nervous System Drug 1980-2021","id":"5122d670-0c56-4ffb-b955-f7c7bc735769","sessionCode":"HPR10","topDisplay":"<b><u>Bukhari K</u></b><sup>1</sup>, Alanazi A<sup>1</sup>, Seoane-Vazquez E<sup>2</sup><br><sup>1</sup>Chapman University, Irvine, CA, USA, <sup>2</sup>Chapman University School of Pharmacy, Irvine, CA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Nervous system (NS) drugs, including stimulants and antidepressants, are among the most commonly used drugs in the US. This study assessed the characteristics and trends in the approval of new nervous system drugs in the US in 1980-2021.</p> <p><b>METHODS: </b> We collected regulatory information for new molecular entities (NME) and new biologic license applications (BLA) authorized in 1980-2021 from the FDA website. Information collected included non-proprietary name, submission and approval date, priority review, orphan designation, generic approvals, and market status. Descriptive statistics and chi-squared tests were performed in the analysis.</p> <p><b>RESULTS: </b> The FDA approved 153 new NS drugs (11.7% of all new drugs), including 148 NME and 5 BLA. The number of BLA was significantly lower for NS than other therapeutic classes (p<0.0001). The number of approvals was 22 (14.3%) in the 1980s, 38 (14.7%) in the 1990s, 35 (15.4%) in the 2000s, 37 (25.9%) in the 2010s, and 11 (10.3%) in 2020-2021. The FDA granted orphan designation to 23 (15.0%) NS drugs and to 340 (33.5%) from other drugs (p<0.001), and priority review designation to 45 (29.4%) NS drugs and 665 (65.5%) from other therapeutic classes (p<0.001). Generic competition occurred for 96 (62.7%) of NS drugs and 513 (31.6%) of other drugs (p<0.005). A total of 10 (6.5%) NS and 178 (17.5%) other drugs were discontinued from the market as of December 31, 2021 (p<0.001), including 3 (2.0%) NS and 30 (2.7%) drugs from other classes (NS) discontinuations for safety reasons.</p> <p><b>CONCLUSIONS: </b> New NS approvals included a lower percentage of biologics and orphan drugs than other therapeutic classes. The FDA granted priority review to less than one-third of NS drugs, indicating that most new NS drugs did not represent an improvement over the therapies already available in the market.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117842","diseases":[{"id":"e7063f12-1b6c-43a7-bc6e-23a7adf361a4","parentId":"00000000-0000-0000-0000-000000000000","title":"Neurological Disorders","urlName":"Neurological-Disorders"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Overall Mortality Among Patients with Hemophilia: A Systematic Review and Meta-Analysis","id":"8a05e842-25ef-4d69-b17e-f9770654f52c","sessionCode":"EPH9","topDisplay":"<b><u>Sultan I</u></b><sup>1</sup>, Syed SS<sup>1</sup>, Fathima A<sup>1</sup>, Farag H<sup>1</sup>, Yunusa I<sup>2</sup>, Doucette J<sup>1</sup>, Rittenhouse B<sup>3</sup>, Eguale T<sup>1</sup><br><sup>1</sup>MCPHS University, Boston, MA, USA, <sup>2</sup>University of South Carolina, Columbia, SC, USA, <sup>3</sup>MCPHS University, Winchester, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Mortality estimates in Patients with Hemophilia (PwH) have changed over the past 40 years. Advances in its therapeutic management have significantly improved both, the life expectancy as well as the quality of life for these patients. The aim of the current study was to assess overall mortality among PwH. </p> <p><b>METHODS: </b> Using search terms related to Mortality and Hemophilia, we conducted a search in Pubmed, Embase and Cochrane databases up to 31 st March 2021. Studies reporting mortality in as Standardized mortality ratio (SMR) or Hazard ratio (HR) were included in the analysis. Subgroup analysis based on mid-year of data study period and region of published studies was conducted.</p> <p><b>RESULTS: </b> A total of 3186 studies were identified and screened. Ten studies were used to estimate the overall mortality, the pooled SMR was 1.74 (95% CI 1.35-2.25), indicating 74% increased mortality in PwH compared to the general population. Subgroup analysis revealed a decreased SMR in years after 2000 (1.24; 95%CI: 1.05-1.45) compared to the years before (2.07; 95%CI: 1.51-2.85). European PwH had 64% increase in mortality (1.64; 95% CI: 1.30-2.07), mortality of Non-European PwH was 2.02 (95% CI: 0.98-4.16). For severe PwH, more than three-fold increase in SMR (3.27; 95%CI: 1.88-5.70) was estimated. The median overall life expectancy was higher after 2000 (74.1 years) compared to before 2000 (67 years) and showed a similar trend for severity-based life expectancy.</p> <p><b>CONCLUSIONS: </b> Mortality among PwH has decreased over the past decades, however it still continuous to be higher than the general population.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"b38de85b-d227-4038-a2c1-1024cdf2574b","parentId":"00000000-0000-0000-0000-000000000000","title":"Epidemiology & Public Health","urlName":"epidemiology-public-health"}],"categoryIds":["b38de85b-d227-4038-a2c1-1024cdf2574b"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117624","diseases":[{"id":"ba7a1cc5-9a61-4430-a2cb-4e6b48868596","parentId":"00000000-0000-0000-0000-000000000000","title":"Rare and Orphan Diseases","urlName":"rare-and-orphan-diseases"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Health-Related Quality of Life Reported By Patients of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)","id":"2e830243-8814-4781-8147-fb24f0d463b8","sessionCode":"CO8","topDisplay":"<b><u>Araja D</u></b>, Berkis U, Murovska M<br>Riga Stradins University, Riga, Latvia","locationCode":"","description":"\r\n\t<div><strong>Objectives</strong><strong>:</strong> Pandemic circumstances induce the increased prevalence of chronic diseases due to the limitations in accessibility of outpatient treatment and the frequently detected long-term consequences of COVID-19 infection. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), as one of the proven consequences of COVID-19, is a disease characterised by chronic fatigue not alleviated by rest, and multi-system disorder leading to deterioration in quality of life. The aim of this research is to evaluate the Health-Related Quality of Life (HRQL) of the patients suffered by ME/CFS.</p> <strong>Methods:</strong> Patient-reported outcomes (PROs) were collected through the survey performed in Latvia (project No lzp-2019/1-0380). Diagnostics of ME/CFS is complicated and occasionally imprecise, therefore 74 patients with symptomatically similar diagnoses were involved in the survey (ICD-10 code G93.3, R53 and B94.8). Patients were asked to rate their HRQL on a scale from 1 to 100 (100—the best possible HRQL, and 1—the worst) for the year prior to onset of illness, and for the current state. The detailed current level of HRQL was assessed by EuroQol-5D-5L measure (1—the best possible option, and 5—the worst). Descriptive and analytical statistical methods were utilised for analysis of obtained data.</p> <strong>Results: </strong>PROs demonstrated the mean HRQL—74.6 (SD 24.0, 95% CI 69.0–80.2) for the year prior to illness and 57.3 (SD 16.3, 95% CI 53.5–61.1) for the current state. The initial relatively low HRQL slightly corelates with the overall HRQL of Latvian population, as Eurostat data discover that only 47.1% of Latvians report good or very good health state (EU average measure is 68.6%). The data of EuroQol-5D-5L of ME/CFS patients were in diapason from 2.9 (self-care) to 3.3 (anxiety/depression).</p> <strong>Conclusion:</strong> The results indicate the relatively poor HRQL in ME/CFS, and due to disease progress, coverage predictably will affect a significant ratio of people of working age.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"87546aa9-e592-49a6-ba7f-a9e9daa90133","parentId":"00000000-0000-0000-0000-000000000000","title":"Clinical Outcomes","urlName":"clinical-outcomes"}],"categoryIds":["87546aa9-e592-49a6-ba7f-a9e9daa90133"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispordianaarajac08-pdf.pdf?sfvrsn=4a520479_0","title":"ISPOR_Diana_Araja_C08.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117834","diseases":[{"id":"51dd65bf-b41e-4681-b7ab-844cd26e5fe6","parentId":"00000000-0000-0000-0000-000000000000","title":"Infectious Disease (non-vaccine)","urlName":"Infectious-Disease--non-vaccine-"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Statin Adherence and Its Predictors: A Systematic Literature Review","id":"dadd0ddb-331e-481f-abcd-fb474375b1a3","sessionCode":"PCR36","topDisplay":"<b><u>Vohra Y</u></b><sup>1</sup>, Pinto L<sup>2</sup>, Brown CM<sup>1</sup><br><sup>1</sup>The University of Texas at Austin College of Pharmacy, Texas Center for Health Outcomes Research and Education (TxCORE), Austin, TX, USA, <sup>2</sup>Travere Therapeutics, San Diego, CA, USA","locationCode":"","description":"\r\n\t<div>Objective: The American College of Cardiology (ACC) and the American Heart Association (AHA) recommend adherence monitoring within 4 to 12 weeks following statin initiation. The objective of the study was to understand adherence of statins and their key predictors which could be used in adherence monitoring.</p> Methods: A systematic literature review using PRISMA guidelines was conducted in June 2020. Key search terms (cardiovascular disease, atherosclerosis, adherence, statins) were used in multiple combinations in PubMED and MEDLINE to identify studies. Studies conducted among humans, during the period 2012-20, within the US and using retrospective observational methods were included. Studies without adherence as the primary outcome, economic models, randomized control trials and reviews were excluded. Screening, data extraction and qualitative analysis were conducted by two independent researchers.</p> Results: 241 initial studies were identified, title and abstracts of 80 studies were reviewed and 28 studies were included in the final review. Twenty studies reported proportion of days covered (PDC) as a dichotomous outcome; the percentage of patients with PDC ≥80% ranged from 29.2% to 74.2%. Eleven studies reported a continuous outcome of PDC, with mean values ranging from 0.57 to 0.86. Four studies reported medication possession ratio (MPR) as a dichotomous outcome; the percentage of patients with MPR <u>></u> 80% ranged from 45.3% to 75%. Common positive predictors of adherence were care coordination issues with healthcare providers (N=7), followed by medication-related issues (N=4), and presence of chronic disease (N=3). Negative predictors of adherence were high co-morbidity burden (N=3), and prescription of high intensity statin (N=2).</p> Conclusion: A majority of studies reported higher adherence levels in more than 50% of patients. Care-coordination issues with health care providers was most commonly identified as an important predictor of medication adherence among patients.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/statin-adherence-systematic-reviewvohra04232022-pdf.pdf?sfvrsn=af2ecbef_0","title":"Statin Adherence Systematic Review_Vohra_04232022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115587","diseases":[{"id":"5721cfed-79ad-4127-b7b8-65e53157cf3a","parentId":"00000000-0000-0000-0000-000000000000","title":"Cardiovascular Disorders","urlName":"Cardiovascular-Disorders"},{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"97c2e725-3c74-4625-997f-a72378c5a557","parentId":"00000000-0000-0000-0000-000000000000","title":"Generics","urlName":"Generics"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"An Innovative Algorithm of Identifying Line of Therapy in Colorectal Cancer","id":"20c5a853-53e5-4c70-9cc1-fc2b8255f536","sessionCode":"RWD28","topDisplay":"<b><u>Wang X</u></b><sup>1</sup>, Xia R<sup>2</sup>, Peng C<sup>2</sup>, Wang W<sup>3</sup>, Zhu T<sup>3</sup>, Yang M<sup>4</sup><br><sup>1</sup>Happy Life Technology, Plymouth meeting, PA, USA, <sup>2</sup>Happy Life Technology, Shanghai, China, <sup>3</sup>Happy Life Technology, Beijing, China, <sup>4</sup>Happy Life Technology, Short Hills, NJ, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b> Accurately determining line of therapy (LOT) is important for characterizing patients’ treatment history in the real-world setting. This study aims to describe an innovative algorithm of identifying LOT in metastatic colorectal cancer (mCRC) patients using the real-world data in China.</p> <p><b>METHODS: </b> We developed an innovative algorithm to determine LOT in mCRC patients by using both the structured prescription information (including systemic anticancer therapy (SACT) drug name, start and end dates) and unstructured medical notes (including tumor progression etc.) from authorized electronic medical records in China. We have filed patent application for this innovative algorithm. The first SACT given after the first metastatic diagnosis was considered as the initiation of the 1st line (1L). For those without metastatic diagnosis, who underwent 1 radical surgery, the date of first SACT administered after 6 months from the surgery was considered as the start date of the 1L. Successive SACTs administered within 9 days were considered as the same regimen. Tumor progression identified from medical notes by natural language processing (NLP) or switching to subsequent regimen (a gap of >25 days) whichever occurs first were used to identify line advancement. The accuracy of this algorithm was further validated by manual chart review of 50 patients randomly selected from the study population.</p> <p><b>RESULTS: </b> An accuracy rate of 95.2% was achieved by comparing our results to the results of manual chart review of 50 randomly selected patients.</p> <p><b>CONCLUSIONS: </b> In additional to prescription information, our algorithm also used tumor progression to improve the precision of identifying LOT, which resulted in better efficiency and reduced costs compared to manual review. However, our algorithm is developed for colorectal cancer and the accuracy is contingent on the data quality. LOT algorithm in other tumors needs further investigation.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8fc65ff1-67e1-4c44-abef-e07243624552","parentId":"00000000-0000-0000-0000-000000000000","title":"Real World Data & Information Systems","urlName":"real-world-data-information-systems"}],"categoryIds":["8fc65ff1-67e1-4c44-abef-e07243624552"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116642","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Cataloging Health-Related Quality of Life Estimates for Duchenne Muscular Dystrophy and Related Conditions","id":"3bbfcc4f-8304-4921-a6e3-fc3ec46e0a1b","sessionCode":"PCR23","topDisplay":"<b><u>Do L</u></b><sup>1</sup>, Sedita L<sup>2</sup>, Klimchak AC<sup>2</sup>, Salazar R<sup>2</sup>, Kim D<sup>1</sup><br><sup>1</sup>Tufts Medical Center, Boston, MA, USA, <sup>2</sup>Sarepta Therapeutics, Cambridge, MA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>Duchenne muscular dystrophy (DMD) is a rare genetic disorder characterized by progressive muscle weakness. By the early non-ambulatory phase, patients’ inability to walk substantially impacts their health-related quality of life (HRQOL). Estimating HRQOL for young patients with DMD is challenging, highlighting the need for proxy measures. This paper aims to catalogue and compare utilities for DMD and related conditions.</p> <p><b>METHODS: </b>We first obtained a utility estimate for US patients in the early non-ambulatory DMD phase from existing literature (0.21). After applying ± 0.03 as the minimal clinically important difference (0.18-0.24), we extracted health states with similar utilities from the Tufts Cost-Effectiveness Analysis Registry (various utility instruments, tariffs, and raters [proxy or self]). Second, we identified health states from the Registry using pre-defined keywords (e.g., wheelchair, muscle weakness, frequent falls). A clinical expert rated each health state on a scale of 0 to 10 based on its clinical similarity to the early non-ambulatory phase, and then we extracted utilities for health states with scores ≥ 8.</p> <p><b>RESULTS: </b>The first search identified 223 utilities. Most common health states included severe strokes (9%, N=20, utility <em>μ</em>=0.201), chronic liver diseases (8.1%, N=18, <em>μ</em>=0.204), terminal cancers (6.3%, N=14, <em>μ</em>=0.21), severe rheumatoid arthritis (3.1%, N=7, <em>μ</em>=0.222), and heart failure (3.7%, N=6, <em>μ</em>=0.203). Nearly all remaining health states represented the moderate to severe stages of various other diseases. The second search identified 46 utilities for health states that are highly similar to the clinical conditions of the early non-ambulatory phase. Among this sample, the mean utility was 0.32, 52% higher than the obtained estimate from existing literature.</p> <p><b>CONCLUSIONS: </b>When available estimates are limited, using utilities of clinically similar conditions could be a strategy for overcoming the information gap. However, it requires careful evaluation of the types of utility instruments, tariffs, and raters (proxy or self).</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"d72a145a-f216-45d6-a2d2-af65d912c83d","parentId":"00000000-0000-0000-0000-000000000000","title":"Patient-Centered Research","urlName":"patient-centered-research"}],"categoryIds":["d72a145a-f216-45d6-a2d2-af65d912c83d"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/116659","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"The Relative Value of Anti-Obesity Medications Compared to Similar Therapies","id":"047225c5-4dde-4490-a05a-fcc4d5b4db00","sessionCode":"EE72","topDisplay":"<b><u>Kim N</u></b><sup>1</sup>, Estrada J<sup>2</sup>, Chow I<sup>2</sup>, Ruseva A<sup>3</sup>, Ramasamy A<sup>4</sup>, Burudpakdee C<sup>4</sup>, Blanchette CM<sup>4</sup><br><sup>1</sup>Novo Nordisk Inc, Edgewater, NJ, USA, <sup>2</sup>IQVIA, San Francisco, CA, USA, <sup>3</sup>Novo Nordisk Inc, Philadelphia , PA, USA, <sup>4</sup>Novo Nordisk Inc, Plainsboro, NJ, USA","locationCode":"","description":"\r\n\t<div><strong>Objectives: </strong>Access/coverage for anti-obesity medications (AOMs) is limited compared to treatments for other chronic diseases, despite high disease burden. We aimed to assess the relative value of AOMs through analysis and comparison of cost-benefit and/or clinical benefit for covered medications across selected therapeutic areas.</p> <strong>Methods:</strong> Comparators included a single pharmacotherapy per therapeutic area (smoking cessation, varenicline; daytime sleepiness, modafinil; migraine, erenumab; and fibromyalgia, pregabalin) selected based on similarity to AOMs across multiple characteristics (e.g., U.S. prevalence, coverage, cost evolution, type of indication). A targeted literature review (TLR) was performed to identify sources with clinical and financial outcomes for selected therapeutic areas. Parameters extracted and evaluated included direct and indirect medical costs, cost drivers, and associated comorbidities.</p> <strong>Results: </strong>The TLR identified 2,956 papers. Results were screened for relevant data for extraction and analysis resulting in 89 publications. Smoking and obesity represented the highest economic burden with $300 and $260 billion in yearly direct and indirect medical costs, respectively. Weight loss resulted in a reduction of $2,586 in direct medical costs per patient per year (PPPY), which is higher than cost reductions of $930 PPPY for varenicline, $1,045 PPPY for modafinil, $468 PPPY for erenumab; pregabalin utilization showed an increase of $924 PPPY. Main drivers of cost savings were reductions in outpatient, inpatient, and emergency room costs. Obesity was associated with significantly more comorbidities (17, p<0.05) than comparators (migraine=9, smoking=8, daytime sleepiness=5, fibromyalgia=2). Smoking and obesity were associated with the costliest comorbidities of cardiovascular disease, stroke, and cancer.</p> <strong>Conclusions:</strong> AOMs provide high relative value compared to selected analogues. Obesity was associated with the costliest comorbidities and weight loss had the largest medical cost savings. Despite this, AOMs are not currently covered by most health plans. AOM coverage and utilization may reduce the economic burden associated with obesity.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ee72kimposter-pdf.pdf?sfvrsn=62ef66a3_0","title":"EE72_Kim_poster.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115107","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"}],"viewingMethods":[{"id":"00b08e58-0c84-48d1-a452-424640596c49","title":"In-person & Virtual","urlName":"in-person-virtual"}],"shouldShowPdfs":true},{"title":"Relationship/Association between Clinical Potential of Orphan Drugs and Registration Status Assigned By the European Medicines Agency: Selected Aspects","id":"df8a0fad-ec7f-46dc-97c5-fcc702320383","sessionCode":"HPR14","topDisplay":"Jakubowski S, <b><u>Kawalec P</u></b>, Malinowski K<br>Jagiellonian University Medical College Institute of Public Health, Kraków, Poland","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>While there have been some attempts to investigate potential factors influencing the registration status of orphan drugs, clinical data for these drugs (such as evidence on effectiveness, safety and cost-effectiveness) are limited. We aimed to assess the association between available clinical data for orphan drugs and the registration status assigned by the European Medicines Agency (EMA).</p> <p><b>METHODS: </b> The analysis included medicines with an orphan designation for June 1, 2020, in the EMA registry. Clinical data were collected from the EPAR reports for each drug, containing such information as clinical trial characteristics or drug safety and efficacy. Data were categorized, and statistical analysis was performed.</p> <p><b>RESULTS: </b>We identified 968 studies reporting the results of 1342 clinical evaluations of 105 orphan drugs in a total number of almost 130 000 patients. There were 447 open-label studies (46%), 151 randomized controlled trials (16%), 37 retrospective studies (4%), and 178 dose-response studies (18%). Single or double blinding was used in 209 studies (22%), while placebo in 180 trials (19%). At least one control group was included in 294 studies (30%). In multiple logistic regression, each additional dose-response trial was associated with a 33-fold increase in the odds for authorisation with additional monitoring (OR=33.1, 95%CI: 1.90-833.99; p=0.02). Each additional study with a safety endpoint assessed within 2 months was associated with a 63% reduction in the odds for exceptional circumstances status (OR=0.37, 95%CI: 0.10-0.93; p=0.03). Each additional percent point for a study with a study duration longer than 2 years was associated with a 98% reduction in the odds for accelerated assessment (OR=0.02, 95%CI: 0.00-0.50; p=0.01).</p> <p><b>CONCLUSIONS: </b>Our innovative quantitative analysis of the EMA authorization decision-making process revealed that the characteristics of a clinical trial and the quality of collected evidence can be significantly associated with the odds for a specific authorization status.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"8941efe7-b0c8-4b8d-a768-64303f53d436","parentId":"00000000-0000-0000-0000-000000000000","title":"Health Policy & Regulatory","urlName":"health-policy-regulatory"}],"categoryIds":["8941efe7-b0c8-4b8d-a768-64303f53d436"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/posterispor11-04-pdf.pdf?sfvrsn=8cadac54_0","title":"Poster_ISPOR_11.04.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117164","diseases":[{"id":"e8a428f2-769e-4a1a-9cd7-c8bf0bdf664d","parentId":"00000000-0000-0000-0000-000000000000","title":"No Additional Disease & Conditions/Specialized Treatment Areas","urlName":"no-additional-disease-conditions-specialized-treatment-areas"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Comparison of Network Meta-Analysis Methodologies Used to Assess First-Line Treatments in Renal Cell Carcinoma: A Systematic Review","id":"0d3d2fd5-0159-4973-a6ff-fcddd0d11bb0","sessionCode":"SA8","topDisplay":"<strong><span style=\"text-decoration: underline;\">Marciniak A</span></strong><sup>1</sup>, Obrzut G<sup>2</sup>, Dlotko E<sup>2</sup>, Fu S<sup>3</sup>, Mollon P<sup>1</sup>, Wallace JF<sup>4</sup><br />\n<sup>1</sup>Ipsen, Boulogne-Billancourt, France, <sup>2</sup>Certara, Krakow, Poland, <sup>3</sup>Certara, Loerrach, BW, Germany, <sup>4</sup>Exelixis, Inc., Alameda, CA, USA","locationCode":"","description":"<div><strong>OBJECTIVE</strong></div>\nThe combination of cabozantinib plus nivolumab (CaboNivo) is approved for the first-line (1L) treatment of adults with advanced renal cell carcinoma (aRCC). We conducted a systematic literature review to assess the methodological quality of network meta-analyses (NMAs) including 1L CaboNivo in patients with aRCC. Outcomes for CaboNivo versus alternative combinations were also assessed. <strong></strong>\n<p><strong><strong>METHODS</strong>: </strong></p>\nSystematic searches were run (April 27 [updated August 23], 2021) in MEDLINE® and Embase to identify NMAs featuring 1L CaboNivo in aRCC populations. Publication titles/abstracts were screened for relevance. The analysis methods used in eligible NMAs were characterized. <strong></strong>\n<p><strong><strong>RESULTS: </strong></strong></p>\nTwenty-eight NMAs involving aRCC populations were identified, of which four NMAs (6 publications) compared 1L CaboNivo versus various alternatives. All NMAs included comparisons of 1L CaboNivo versus axitinib/pembrolizumab and sunitinib, three versus lenvatinib/pembrolizumab, atezolizumab/bevacizumab, ipilimumab/nivolumab, and avelumab/axitinib, and one versus single-agent tyrosine kinase inhibitors, including cabozantinib. All four NMAs analyzed efficacy outcomes (overall survival [OS], progression-free survival [PFS], objective response rate [ORR]). Safety endpoints varied among NMAs. Three NMAs performed analyses for prognostic risk and programmed death ligand-1 expression subgroups. All NMAs were based on hazard ratio comparisons (3 used Frequentist methods; 1 used Bayesian analyses). All four NMAs assumed proportional hazards (PH), despite frequent violation of the assumption for at least one CaboNivo comparator. CaboNivo was consistently ranked first for OS, and second or third for PFS versus alternative combination therapies, but its rank order varied for the ORR, safety and subgroup analyses. <strong></strong>\n<p><strong><strong>CONCLUSIONS: </strong> </strong>The validity of published NMA results comparing 1L CaboNivo versus alternative combination therapies for aRCC are limited by their reliance on the PH assumption. A more robust NMA that uses survival models with parameters for shape and scale, using the full Kaplan–Meier curves, is warranted to offer more reliable comparative outcome estimates, including long-term estimates, for 1L combination aRCC therapies.</p>","withdrawn":false,"categories":[{"id":"d6301e91-40d4-4f22-8c55-9247675547c3","parentId":"00000000-0000-0000-0000-000000000000","title":"Study Approaches","urlName":"study-approaches"}],"categoryIds":["d6301e91-40d4-4f22-8c55-9247675547c3"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117033","diseases":[{"id":"8e45721c-577e-4445-ba28-7da762aa0e0f","parentId":"00000000-0000-0000-0000-000000000000","title":"Drugs","urlName":"Drugs"},{"id":"4c3286be-524e-4892-8f01-1b369a24d82e","parentId":"00000000-0000-0000-0000-000000000000","title":"Oncology","urlName":"Oncology"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Driving Value through Innovation","id":"a217fe9b-cc11-4123-bc01-feb975f111bd","sessionCode":"EE91","topDisplay":"<b><u>Iyer V</u></b><br>Bruin Biometrics LLC, Los Angeles, CA, USA","locationCode":"","description":"\r\n\t<div><p><b>OBJECTIVES: </b>NICE CG179 Pressure Ulcers: Prevention and Management (NICE GC179 2014) details individual steps required to screen and prevent pressure ulcers (PU) in patients in the UK, it then identifies the interventions required to manage patients with PUs. However, despite this ~1700-2000 patients develop a PU each year in the UK at a cost of ~£3.5m per day. Healthcare practitioners (HCP) rely on visual and tactile skin assessment which has been reported to be subjective and dependent on the HCP experience level; it is even more challenging in patients with darker skin tone leading to higher PU incidence levels in this cohort of patients.</p> This abstract represents the results of an economic model – the aim of which is to assess the cost-effectiveness of an innovative skin assessment technology* when used as an adjunct to clinical guidelines (standard of care [SoC] plus technology) compared with the current SoC alone (adapted from NICE CG179, 2014).</p> <p><b>METHODS: </b>A decision tree model was developed based on the sensitivity and specificity of the two assessment methods in detecting early signs of pressure damage, and the effect of early detection on PU incidence.</p> The model is based on a 450 bed acute care facility and includes probabilistic sensitivity analysis. Patient and cost parameters are based on peer reviewed publications:</p> <ul> <li>41% patients identified at risk of PU</li> <li>Average bed occupancy 83%</li> <li>Mean facility length of stay 4.5 days</li> <li>9 beds per device</li> </ul> <p><b>RESULTS</p>: </b><ul> <li>43 PU prevented (reduction of 8.6%)</li> <li>£354,115 cost saving equates to £28.51 per patient</li> <li>Probability Intervention is cost-effective (threshold of £30k per QALY) 96.29%</li> <li>Probability Intervention improves QALYs 98.54%</li> <li>Probability intervention is cost saving 95.08%</li> </ul> <p><b>CONCLUSIONS: </b>The modelling analysis demonstrates that the innovative technology is a dominant option which has the potential to improve patient outcomes and reduce costs to the healthcare system.</p> </p> *SEM Scanner</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[{"url":"https://www.ispor.org/docs/default-source/intl2022/ispor-posterdriving-value-through-innovationvfsubmission-version21apr2022-pdf.pdf?sfvrsn=dc14ca61_0","title":"ISPOR Poster_Driving Value Through Innovation_VF_Submission Version_21Apr2022.pdf"}],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/117470","diseases":[{"id":"9f4dd7f6-8042-4f9a-bc9c-675cf1739ab4","parentId":"00000000-0000-0000-0000-000000000000","title":"Medical Devices","urlName":"Medical-Devices"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true},{"title":"Cost-Effectiveness Analysis of the Oncotype DX Breast Recurrence Score® Test for HR+/HER2- Early-Stage Breast Cancer in the US","id":"cf95460b-8386-45fe-8099-ff12b96342e5","sessionCode":"EE92","topDisplay":"<b><u>Berdunov V</u></b><sup>1</sup>, Cuyun Carter G<sup>2</sup>, Laws E<sup>1</sup>, Luo R<sup>2</sup>, Russell C<sup>2</sup>, Campbell S<sup>2</sup>, Force J<sup>3</sup>, Abdou YG<sup>4</sup><br><sup>1</sup>PHMR Ltd, London, UK, <sup>2</sup>Exact Sciences, Madison, WI, USA, <sup>3</sup>Duke University School of Medicine, Durham, NC, USA, <sup>4</sup>UNC School of Medicine, Chapel Hill, NC, USA","locationCode":"","description":"\r\n\t<div><span><p><b>OBJECTIVES: </b> </span></p> The Oncotype DX Breast Recurrence Score® (RS) test is a multigene assay providing information to personalize treatment plans for patients with HR+/HER2- early-stage breast cancer. As demonstrated in the TAILORx and RxPONDER prospective randomized clinical trials, the Oncotype DX test can identify patients who are unlikely to benefit from adjuvant chemotherapy. The cost-effectiveness of decisions based on the Oncotype DX test compared to clinic-pathologic risk assessment alone was assessed from a US Medicare perspective.</p> <p><b>METHODS: </b></p> A decision-analytic model was developed to simulate the lifetime costs and health outcomes, such as quality-adjusted life-years (QALYs) of treatment decisions in node-negative (N0) or node-positive (N+) HR+/HER2- early breast cancer patients. A decision tree model stratified patients according to RS results for adjuvant treatment assignment per guidelines. The estimated probabilities of chemotherapy assignment with/without having received the Oncotype DX test were obtained from US breast cancer specialists. A Markov model was developed to derive estimated lifetime costs and outcomes of distant recurrence and potential adverse events of chemotherapy using values from published literature. Costs were based on Medicare fee schedules in 2020 US dollars.</p> <p><b>RESULTS: </b></p> Compared to clinic-pathologic risk assessment alone, the decisions based on the Oncotype DX test resulted in lower total lifetime costs, -$8,534 for N0 and -$1,194 for N+, while providing additional QALYs of 0.29 and 0.12 for N0 and N+, respectively. The cost savings were driven by reduced adjuvant chemotherapy use and costs of treating distant recurrence. Increased QALYs were the result of avoiding distant recurrence and long-term consequences of chemotherapy.</p> <p><b>CONCLUSIONS: </b></p> This cost-effectiveness analysis demonstrated that individualized treatment decisions based on the Oncotype DX test dominated clinic-pathologic assessment alone, resulting in substantial cost savings from a Medicare perspective while improving outcomes among patients with HR+/HER2- early-stage breast cancer.</div>\r\n\r\n","withdrawn":false,"categories":[{"id":"63ee603c-f5ab-4644-b76c-0d8299764d84","parentId":"00000000-0000-0000-0000-000000000000","title":"Economic Evaluation","urlName":"economic-evaluation"}],"categoryIds":["63ee603c-f5ab-4644-b76c-0d8299764d84"],"relatedPdfs":[],"detailUrl":"https://www.ispor.org/heor-resources/presentations-database/presentation/intl2022-3459/115204","diseases":[{"id":"e32f673e-b410-4126-9261-86abf08a0554","parentId":"00000000-0000-0000-0000-000000000000","title":"Personalized and Precision Medicine","urlName":"personalized-and-precision-medicine"}],"viewingMethods":[{"id":"536e96bf-242f-4077-a6a1-bcc1b601d9a5","title":"Virtual","urlName":"virtual"}],"shouldShowPdfs":true}]; </script> <script> window.mgConfexProgramConfig = window.mgConfexProgramConfig || {}; window.mgConfexProgramConfig.programType = "posters"; window.mgConfexProgramConfig.usePosterLinks = true; </script> <div> <div id="confex-sessions-v2"></div> </div> <script src='/ResourcePackages/ISPOR/modules/confex-sessions-v2/dist/assets/index.js?v=2023-09-07-10:08' type='module'></script> </div> </div> </div> </div> </div> </div> <div > <div class="sfContentBlock sf-Long-text" ></div> </div> </main> <!--stopindex--> <footer class="section__footer py-8"> <div id="footer__links" class="container"> <div class="row"> <div class="col-md-5"> <div > <div class="sfContentBlock sf-Long-text" ><h5>Quick Links</h5><hr /></div> </div> <div> <ul class="footer-nav"> <li class=""> <a href="/about" target="_self">About</a> </li> 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