Pharmacotherapeutic decisions are increasingly constrained in all clinical settings by the costs of drug treatment and medical care. Some biotech therapies (e.g., Avastin, Cerzyme, Herceptin, Gleevec, Erbitux) can cost from $10,000 to more than $100,000 per treatment episode. In 1996 the average drug treatment cost for advanced colon cancer was $500, and the average patient survival was 11 months. In 2006 the average drug treatment cost for such patients was $250,000, and the average patient survival was 24 months.(1) It is apparent that we are quickly arriving at a situation in which the determinants of medical decision making are not simply the clinical risks and benefits of treatment options but also how these are balanced against the economic costs of therapy.

A273 from remission, progression to long-term adverse outcomes (cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, end-stage liver disease) and commonly observed side effects (anemia, neutropenia and rash) along with a gradient of their severity. Model inputs were determined from a review of the published literature and phase II or III clinical trials. Clinical trials estimates were converted to risk ratios to facilitate comparison. Costs were inflated to 2013 US dollars. Costs and quality adjusted life years were discounted at standard rate of 5%. Sensitivity analyses were performed to assess model sensitivity and address uncertainty. Results: Relative to treatment with PR only, response-guided triple therapy with BOC+PR was the most cost effective therapy (ICER $28,723/QALY) followed by responseguided triple therapy with TVR+PR (ICER $64,569/QALY). PR treatments with SIM or SOF were dominated by BOC+PR. The model was sensitive to variations in costs of initial drug therapy and likelihood of attaining SVR. ConClusions: Addition of protease inhibitors to PR therapy improves health outcomes. Response-guided regimen BOC+PR was found to be cost-effective for treating newly diagnosed genotype 1 HCV patients. Shortening of PR therapy guided by a rapid virologic response may help reduce overall costs. Robust sensitivity analyses can help in overcoming the challenge of sparse data availability.

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A59 the multiplier effect. This novel approach highlighted the unique characteristics of Alzheimer's disease with particular focus on the additional costs and societal impact stemming from caring for a patient with Alzheimer's. Future cost effectiveness studies need to consider these additional impacts when quantifying their results and potential benefit to the health care system. Approaches to modelling long term disease impact must therefore be expanded to consider the wide reaching societal impact of Alzheimer's disease to the direct health care costs.

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);

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