Background: Despite international initiatives on collaboration within the field of rare diseases, patient access to orphan medicinal products (OMPs) and healthcare services differ greatly between countries. This study aimed to create a comprehensive and in-depth overview of rare diseases policies and reimbursement of OMPs in a selection of 12 countries in the Western Eurasian region: Armenia,

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Region to legislate on the matter, supporting the prescription of the biosimilar to the naive patient. The aim of this study was to evaluate the impact of cost-containment policies about biosimilars in Campania between 2009 and 2013. Methods: IMS Health regional database was used to carry out this descriptive retrospective drugutilization for the years 2009 through 2013. Information was retrieved about different distribution channels (retail, direct distribution, hospital). Consumptions are expressed in Counting Units (CU) and trends have been calculated using Compound Average Grow Rate (CAGR). Results: In 2013, a total consumption of 930.859 CU of biosimilar drugs was registered in Italy (CAGR 13/09 68,8%). The penetration rate of biosimilar was 23,9% with regard to expenditure and 25,3% with regard to consumption. Analyzing the consumption of biosimilars by therapeutic category in Italy, the consumption of erythropoietin and filgrastim has an index of annual growth respectively equal to 153.4% and 174.7%. In Campania, the penetration rate of all biosimilars was 31.4% of total expenditure and 35.9% of consumption. Analyzing the trend in consumption for single therapeutic category, it can be seen that penetration is due to erythropoietin (297.5% CAGR); with regard to filgrastim, however, the average annual growth rate is around 54%. ConClusions: The results suggest that Campania Region records an index of market penetration of biosimilars higher than the national. This trend could be attributable to the cost-containment policies implemented in the region.

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inhibitors in Norway. Pharmacoeconomic analyses also show that large financial resources would be saved if the structure of the utilized ACE inhibitors in Serbia were more similar to the one in Norway. OBJECTIVES:Around 800,000 patients are diagnosed for atrial fibrillation (AF) in France with an increased risk of strokes. For many of them, prevention with anticoagulant is managed in primary care. Prevention should be driven by individual risk for stroke estimated with a score (CHADS2) ranging from 0 (lower risk) to 6 (higher risk). This study was to describe AF patients' management by general practitioners (GP). METHODS: This cross-sectional study analyzed a medical files and prescriptions database of a representative sample of 1,200 GPs. Data from all patients present in the database from July-2010 to June-2011, with a diagnosis of AF and aged 18 and above were extracted. Based on age (Ͼ75), comorbidities (HTA/ Diabetes) and history of stroke/TIA/CHF, CHADS2 was calculated for all patients. Under-treatment status was defined according European guidelines which recommend prevention with aspirin or vitamin-K antagonists (VKA) for CHADS2ϭ1 and VKA for CHADS2Ն2. RESULTS: A total of 15,623 AF patients were identified. Mean age was 74.6(Ϯ11.1) years old, 59.5% were men and mean CHADS2 was 1.5(Ϯ1.1). 12,985 patients (83.1%) were found eligible for stroke prevention (i.e.CHADS2Ն1). Among them, 23.4% received no prevention at all, 11.4% were under-treated (i.e. aspirin instead of VKA) and 4.7% received non-recommended treatment (i.e. clopidogrel). Within patients with CHADS2ϭ1 (nϭ5,026), 26.7% had no treatment, 48.9%, 20.5% and 3.9% were treated with VKA, aspirin and clopidogrel, respectively. Within those with CHADSՆ2 (nϭ7,959), only 54.9% received VKA when 21.3% had no treatment and 18.6% and 5.1% were prescribed aspirin and clopidogrel, respectively. CONCLUSIONS: In this large study in French primary care, four out of five (83.1%) of patients diagnosed with AF should benefit from stroke prevention. Overall, around 45% of thromboembolic high-risk patients (i.e.CHADS2Ͼ2) were not treated or inadequately treated. Future analyses should be performed to investigate the gap between clinical practice and guidelines.