The 2006 European National Health and Wellness Survey (NHWS) showed that a large proportion of asthmatics had uncontrolled asthma. The current analysis estimated the prevalence of asthma and asthma control (Asthma Control Test TM (ACT); QualityMetric Inc., Lincoln, RI, USA) in five European countries using the 2008 NHWS. Health-related quality of life (HRQoL), using the Short Form-12 (SF-12) health survey, and work productivity/activity impairment were assessed. Of 3,619 respondents aged o18 yrs, the prevalence of self-reported physician diagnosis of asthma was 6.1% (15 million people); 56.6% of treated asthmatics were not well-controlled (NWC; ACT score f19). Individual components of the ACT showed that, compared with at least wellcontrolled patients (ALWC; ACT score o20), NWC patients had activity limitations at least some of the time (40.8% versus 1.5%, p,0.001), were breathless o3 times per week (72.5% versus 5.4%, p,0.001), suffered sleep difficulties due to asthma at least once per week (60.3% versus 4.6%, p,0.001) and required rescue medication o2-3 times per week (77.4% versus 15.9%, p,0.001). NWC patients had also received more healthcare contact in the past 6 months, including hospitalisation (17.4% versus 9.9%, p,0.001). The SF-12 physical and mental summary scores were 7.46 and 4.73 points higher, respectively, for ALWC patients compared with NWC patients (p,0.001). ALWC patients reported less absenteeism (5.5% versus 12.2%) and work impairment (15.4% versus 30.0%) than NWC patients (both p,0.001).The proportion of asthmatics with NWC asthma has not improved since 2006. ALWC asthma is associated with a significant positive impact on healthcare resource use, HRQoL and work productivity.

Background: Although insulin therapy is well-accepted by symptomatic diabetic patients, it is still often delayed in less severe patients, in whom injectable insulin remains under-used. A better understanding of patients' perception of insulin would eventually help physicians to adopt the most appropriate dialogue when having to motivate patients to initiate or to intensify insulin injection.

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A139 outputs include total costs (Singapore dollars (SGD); 1 SGD=0.82 USD), IFIs avoided, life-years saved, and incremental cost-effectiveness of posaconazole versus fluconazole/ itraconazole. A probabilistic sensitivity analysis (PSA) was conducted, where probabilities of IFI, IFI-related death, and 100-day other cause mortality were assigned beta distributions from trial data. RESULTS: Total costs of prophylaxis with fluconazole/ itraconazole and posaconazole were SGD 4,475 and SGD 4,999, respectively. Corresponding health outcomes were 0.11 and 0.05 IFIs and 2.44 and 2.51 life-years. Incremental cost-effectiveness ratios for posaconazole were SGD 8,150 per IFI avoided and SGD 7,526 per life-year saved. Posaconazole was cost-effective compared to fluconazole/ itraconazole in 94% of PSA simulations at a threshold of SGD 80,000 (commonly cited threshold in Singapore). CONCLUSIONS: Use of posaconazole in place of fluconazole/ itraconazole for prevention of IFIs in a high-risk neutropenic population is costeffective at a willingness-to-pay threshold of SGD 80,000 per life-year saved in Singapore.

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