Objectives: Early initiation of antifungal treatment for invasive candidiasis is associated with significant reduction of morality. The process of blood culture is timeconsuming and sensitivity is low for the deep-seated infection. Blood culture-guided treatment is mostly delayed. 1,3-beta-D-glucan (BDG) is one of the components in fungal cell wall and BDG assay is recommended for diagnosis of invasive candidiasis. The objective of this study was to evaluate the potential cost-effectiveness of active BDG surveillance for invasive candidiasis in patients admitted to ICU from the perspective of Hong Kong healthcare provider. MethOds: A Markov model was designed to simulate outcomes of active BDG surveillance with preemptive antifungal therapy (surveillance group) and no surveillance (standard care group). Candidiasis-associated outcome measures were mortality rate, quality-adjusted life year (QALY) loss, and direct medical cost. Sensitivity analyses evaluated robustness of model results. Results: In base-case analysis, the surveillance group was more costly (USD1,387 versus USD664) (USD1= HKD7.8) with lower candidiasis-associated mortality rate (0.653 versus 1.426 per 100 ICU admissions) and QALY loss (0.116 versus 0.254) than standard care group. The incremental cost per QALY saved by surveillance group versus standard care group was 5,239 USD/QALY. One-way sensitivity analyses found base-case results to be robust to variation of all model inputs.In probabilistic sensitivity analysis, the probability of surveillance group to be costeffective was 100% at willingness-to-pay (WTP) threshold of ≥ 27,800 USD/QALY (gross domestic product per capita in Hong Kong 2015= USD40,596). cOnclusiOns: Active BDG surveillance in ICU setting appears to be a highly cost-effective strategy to reduce candidiasis-associated mortality rate and save QALY in Hong Kong.

A471 the literature was undertaken to identify published resources relating to the unique characteristics of adoptive immunotherapies and the challenges that these technologies may pose for health economic evaluations. Results: The key challenge identified is the high manufacture cost as the therapy is tailored to each patient and, therefore, mass production is not possible. Therefore, to be reimbursed within the UK these therapies would have to produce large QALY gains under the current NICE threshold. These therapies do have the potential to generate significant benefits if they prove to be curative. However, this leads to a second challenge as they are often evaluated in small-scale, single-arm clinical trials. Therefore, to estimate long-term benefits, extrapolation would be required leading to potential uncertainty, which will impact on decisions relating to HTAs. If large QALY gains cannot be established with confidence then it may be necessary to explore alternative payment methods (e.g. lifetime leasing). ConClusions: Adoptive immunotherapies have the potential to generate significant benefits to patients but the high costs of production and uncertainty over long-term outcomes may prove challenging for future HTAs.

A401representing 5 jurisdictions: England (NICE), Scotland (SMC), France (HAS), Germany (IQWiG) and the Netherlands (ZIN). A standardized data-extraction form was used to extract information on RWD inclusion for both REAs and CEAs. A panel of senior HTA assessors representing the 5 agencies was consulted to check the robustness of data extracted and interpretation. Results: Fifty-two reports were retrieved. All 52 reports contained REAs; CEAs were present in 25. RWD was included in 28 of 52 REAs (54%); mainly to estimate melanoma prevalence. RWD was included in 22 of 25 (88%) of CEAs; mainly to extrapolate long-term effectiveness and/or identify drug-related costs drugs. Differences emerged between agencies regarding RWD use in REAs; ZIN and IQWiG cited RWD for evidence on prevalence whereas NICE, SMC and HAS additionally cited RWD use for drug effectiveness. No visible trend for RWD use in REAs and CEAs over time was observed. ConClusions: In general, RWD inclusion was higher in CEAs than REAs. It was mostly used to estimate melanoma prevalence in REAs or to predict long-term effectiveness in CEAs. Differences emerged between agencies' use of RWD. However, no visible trends for RWD use over time were observed. Future research should explore the use of RWD in HTA of drugs in other disease indications and in conditional reimbursement schemes.

costs at one year from ID were € 5'480, 39% RA-related (€ 682 for drugs and 1'444 for hospitalisations), € 1'345 for ambulatory care, € 1'016 for other drugs and € 994 for other hospitalisations. ConClusions: Treatment patterns of RA patients in Italy are heterogeneous, with a variety of strategy options reported. More than half of healthcare costs in RA patients are not disease-related, suggesting that management of comorbidities is a cost-driver.