There is no evidence to support either intervention in preventing falls on a rehabilitation ward, but within this low-powered study, there was a strong trend towards vinyl being superior.

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OBJECTIVES: Epilepsy is common chronic disorder characterized by recurrent unprovoked seizures with incidence rate of 20 to 70 per 100 000 population per year. Approximately 150,000 children sustain a first-time unprovoked seizure every year, and of those, 30,000 develop epilepsy. To evaluate the economic burden of pediatric epileptic patients and cost of their epilepsy management from the patients' perspective. METHODS: This study adopted a prospective cross sectional design by interviewing the patient's parents from neurology clinic of Hospital Pulau Pinang, Malaysia. A retrospective data (for the past 12 months) was collected from patient's medical record for the laboratory test, investigations and treatment received. The collected data included information about the patient's resources utilization, lost productivity, and out of pocket expenditure. RESULTS: Majority of respondent was male which comprise of 64.2% whereby female was 35.8%. Mean (±SD) total annual cost from patient perspective was RM 1303.05 ± 2288.66 (USD 366.69±644.06) per patient. The highest item cost which contributes to the total annual cost was the loss of productivity which is RM 528.26 ± 786.22 (USD 148.66±221.25) followed by cost of caretaker RM 690. 32 ± 1929.41 (USD 194.26±542.96) and meal/snack cost during clinic visit RM 44.97±56.87 (USD 12.66±16). The lowest contributor for annual cost from patient perspective was transportation cost with a mean of RM 39.51 ± 31.73 (USD 11.22±8.93). CONCLUSIONS: In conclusion, from patients' perspectives loss of productivity is the major contributor in economic burden to epilepsy management in pediatric. Type of seizure associated with neurological deficit and the response to the medication which affects the number of clinic visit, number of hospitalization and length of hospital admission influence lifetime cost of epilepsy bear by the patient depending on employment and monthly incomes as well as who is the caretaker and who bring the child to clinic visit and accompanied the child during hospital admission. PND28 aNalysis Of meDical cOsts Of rrms relaPsesNakamura Y. Milliman, Tokyo, Japan OBJECTIVES: No recent study on the medical costs of multiple-sclerosis (MS) has employed real world data to analyze relapsing-remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS). This paper analyzes the medical costs of RRMS to identify the causes of the high medical costs of MS. METHODS: We selected subjects from among active employees and their families who were covered by private health insurance from MedStat Commercial Data from 2005 to 2012. We developed logic to identify MS patients, MS relapses and RRMS patients and PPMS patients with claims data. The PPPM of RRMS patients was analyzed in cases where relapsing intervals were greater than the average interval length. RESULTS: The PPPM of RRMS patients was $4,964 PPPM. The frequency of RRMS relapses was 3.2 times during 5 years. The PPPM of RRMS patients was reduced by $958 PPPM when relapsing intervals were increased by 1...

males, 10% and 7% were children and females respectively. Majority of the males (79%) were between the ages of 15-35 years of age. On an average the direct cost incurred to treat the injured cases (103) was PKR13,000 excluding subsidy of at least PKR53,000. The total cost was PKR66,000 (USD805) and this cost shall be considered as minimum cost. CONCLUSIONS: Motorcycle accidents are incurring huge economic burden on society. The morbidity and mortality can be reduced by legislative action concerning helmet use, licensing and rigid enforcement of traffic laws. Rehabilitation services for the victims to get fully recovered may also be provided to reduce the future economic loss. OBJECTIVES:Orthopedic surgery has been associated with significant risk of develop deep vein thrombosis (DVT). The objective of this study was to estimate the cost-effectiveness of thromboprophylaxis therapies for prevention of DVT associated in patients undergoing hip surgery from an institutional perspective (Mexican Social Security Institute, IMSS). METHODS: Economic and health consequences of thromboprophylaxis were assessed through a six-state Markov model (one-year time horizon, one-week cycles). Effectiveness measure was reduction in DVT (per 1000 patients). Effectiveness was estimated by local meta-analysis. Doses of alternatives compared were: warfarin (basecase, 5mg 30d); dalteparin (not listed in Mexican formulary, 5000 IU/day 30d); acenocoumarol (4 mg/day 30d); enoxaparin (40 mg/day 30d); nadroparin (5700 IU/day 30d) and unfractionated heparin (UFH) plus warfarin (10000 IU/day 10dϩwarfarin 5 mg/day 20d). No prophylaxis was assessed too. Resource use and unit costs were extracted from IMSS databases (dalteparin cost was provided by the manufacturer). Costs included outpatient and inpatient services, medication costs, imaging and laboratory tests. Univariate sensitivity analysis was performed. Acceptability curves were constructed. RESULTS: DVT cases per alternative were: warfarin 61 (CI 95% 60 -62); dalteparin 33 (32-34); acenocoumarol 80 (78 -82); enoxaparin 57 (56 -58); nadroparin 67 (66 -68); OBJECTIVES: Cost-effectiveness of denosumab versus oral bisphosphonates in PMO from a US third party payer perspective was evaluated. METHODS: A lifetime cohort Markov model was developed with seven health states: well, hip fracture, vertebral fracture, other osteoporotic fracture, post hip fracture, post vertebral fracture, and dead. During each cycle, a patient could fracture, remain healthy, remain in a post fracture state or die. Relative fracture risk reduction, background fracture risks, mortality rates, utilities, medical and drug costs were derived using published sources. Expected costs and quality-adjusted life years (QALYs) were estimated for denosumab, risedronate, ibandronate, and generic alendronate in the overall PMO population and high risk subgroups: 1) 2 of the 3 risks i.e., Ͼ70years-old, bone mineral density T-scoreՅ-3.0 and prevalent vertebral fracture, and 2) Ն75 years-old. Costs and QALYs were discounted at 3% annuall...

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NCT00953173.

relationship between RMU and migraine symptom end points was also assessed. RESULTS: This post hoc analysis included 794 patients randomized (1:1) to receive double-blind treatment with MAP0004 or placebo. The primary results of the study were previously published. Patients were well matched for demographic and baseline characteristics. Patients receiving MAP0004 experienced statistically significant migraine symptom reduction compared with patients receiving placebo. RMU in the double-blind period was consistently lower with MAP0004 than with placebo at 2 hours (4% vs. 8%, Pϭ0.0261), 4 hours (19% vs 37%, PϽ0.0001), 24 hours (36% vs. 54%, PϽ0.0001), and 48 hours (42% vs. 59%, PϽ0.0001) after study-drug administration. RMU was also significantly lower with MAP0004 than with placebo across demographic and baseline characteristics. Among patients who reported pain relief at 2 hours, MAP0004-treated patients had significantly lower RMU at 4, 24, and 48 hours than placebo-treated patients. The overall adverse event rate was comparable to that of placebo. CONCLUSIONS: In this study, RMU was significantly lower with MAP0004 than with placebo overall and across demographic and baseline characteristics. OBJECTIVES:To profile real world treatment patterns of patients with tuberous sclerosis complex (TSC) which is a genetic disease that can affect multiple organ systems in the body. METHODS: We conducted a retrospective cohort study with a large national healthcare claims database that consists of 39 million commercially insured Americans between 2000 and 2009. Patients with a TSC claim and continuous enrollment 12 months before and 12 months after their first TSC diagnosis were included in the study (these selection criteria lead to the exclusion of those at age less than one). Resource utilization rates (measured as number of claims per patient) were examined for different provider types and places of services, and compared between the year before and after the first TSC diagnosis. Two-tail paired sample dependent t test and Chi-square test were used for pre-post comparisons as well as cross-region comparison. RESULTS: The included patients (Nϭ1249) had a mean age of 33.9 years at their first TSC diagnosis, and 57.5% were female. Resource utilization rates with significant pre-post differences were inpatient admissions (0.16 vs. 0.08, pϽ0.01), emergency care (1.14 vs. 0.78, pϽ0.05), hospital outpatient care (12.68 vs. 6.66, pϽ0.05), neurologist care (0.60 vs. 0.32, pϽ0.05), neurological surgeon care (0.06 vs. 0.02, pϽ0.05), oncologist care (0.32 vs. 0.12, pϽ0.05), and the use of anti-epilepsy medications (2.45 vs. 2.10, pϽ0.05). The most common places of care were physician offices (21.44), hospital outpatient departments (12.68) and specialty care facilities (8.37); the most common provider specialties were primary care providers (6.07), neurologists (0.60), oncologists (0.32), surgeons (0.29); and the most common class of medications were anti-epilepsy medications (2.45). Significant cross-region variations in TSC medic...