ObjectivesTo compare outcomes with single tablet regimens (STR) versus multi-tablet regimens (MTR) for human immunodeficiency virus (HIV) treatment using published data.DesignSystematic review and random-effects meta-analysis of literature on approved and investigational HIV regimens.MethodsThe research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Single or un-blinded studies reporting a direct comparison between STR and MTR were eligible for the meta-analysis. Double-blinded studies were excluded due to lack of difference in pill burden between cohorts. The key outcomes of interest included: adherence rates/proportion meeting target, efficacy, safety/tolerability, non-clinical and economic outcomes.ResultsAfter screening 63 full-text articles and posters, 14 studies were eligible for the meta-analysis. The analysis showed that patients taking STR had improved outcomes over those taking MTR. Patients were significantly more adherent regardless of daily dosing frequency (odds ratio [OR]: 1.96, p < 0.001) and were more likely to achieve virological suppression (relative risk [RR]: 1.05, p = 0.002). There was a trend toward a lower discontinuation risk in the STR cohort, together with reported higher therapy satisfaction, better symptom control, improved health status, reduced healthcare resource utilization and demonstrated cost-effectiveness compared to MTR. There were no differences in CD4 cell count increase (at 48 weeks) or safety outcomes.ConclusionsThe findings of this study confirm previously reported preliminary findings of the advantages of STR over MTR for HIV treatment in adherence, therapy continuation, viral suppression, tolerability, quality of life improvement, cost-effectiveness and healthcare resource utilization.Electronic supplementary materialThe online version of this article (10.1186/s12981-018-0204-0) contains supplementary material, which is available to authorized users.

A229Objectives: In Mexico, iron deficiency anemia (IDA) is frequent and varies according to age: children between 0 and 5 years: 23.7%, women between 15 and 44.99 years: 15.6%, pregnant women 20.6%. Intravenous iron (IV) is a treatment option for IDA when patients are intolerant to oral iron or there is a need to replenish iron stores. The objective of this study was to estimate the relative direct health care costs of ferric carboxymaltose (FCM), IV iron dextran (ID), and red-blood cells (RBC) transfusions for patients with IDA in Mexican private hospitals. The assessment has been made from the third party payer perspective represented by health insurances across multiple therapeutic areas (TA) (gastroenterology, gynecology, and surgery). MethOds: A cost-minimization analysis assuming similar efficacy and safety of the alternatives was conducted since the evidence of IV ID is limited in the selected TAs limiting our ability for indirect comparisons. Mean IV iron dose needed to correct IDA is estimated to be 1000 mg per patient and IV infusion time required is based on the Mexican SmPc for both products (FCM 15 minutes versus ID 6 hours). Mean cost of infusions was calculated based on daily hospitalization costs according to national tariffs (according to 5 private health care institutions). Cost savings due to IV iron-induced reduction of RBC transfusion before hip and knee surgery are based on published evidence (Kotze et al). Results: In all the TAs, the use of FCM compared to ID regarding infusion efficiency derived from reduced hospitalization time and IV iron-induced reduction of RBC transfusions resulted in substantial cost savings. Independently of the TA, mean costs savings per patient were $6980 Mexican pesos. cOnclusiOns: This study showed that the utilization of FCM could reduce costs to the health insurances at private hospitals due to improved administration efficiency and reduction in RBC transfusions. PSY34CoSt-MiniMization analYSiS of anti-tnf BiologiCS in the treatMent of rheuMatoid arthritiS,

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shortcut though impairs the analysis in many different ways, limiting our full understanding of the phenomenon being modelled and ultimately our ability to accurately assess 'value for money' beyond the simple 'average'. This paper explores the value of access to individual patient data for cost-effectiveness modelling, structuring the discussion of the topic around three interrelated questions. First, what benefits can access to IPD bring to cost-effectiveness modelling? Second, what are the challenges for the simultaneous statistically synthesis of AD plus IPD to derive input parameters for a cost-effectiveness model? Third, what is the value of access to IPD compared to AD for cost-effectiveness modelling? Using two different case studies, the above questions will be addressed and discussed in the context of the debate around CEA of individualised treatment decisions. OBJECTIVES:When comparing combined therapy with peginterferon alpha-2a or alpha-2b and ribavirin to treat chronic hepatitis C (CHC), the results of clinical trials, observational studies, and meta-analyses have been inconsistent. Their effectiveness and tolerability were investigated using the nationwide database of chronic hepatitis patients who received interferon therapy in Japan. METHODS:The proportion with a sustained virologic response (SVR) and the dropout rate due to adverse events (AEs) were compared between alpha-2a and alpha-2b. All patients also received ribavirin. Multivariate logistic regression was conducted with adjustment for age, sex, platelet counts, ALT, viral load, genotype, and whether the patient was treatment-naïve, which are associated with effectiveness and tolerability. RESULTS: By December 2011, the database included 7820 patients. CHC patients treated with either alpha-2a (nϭ1737) or alpha-2b (nϭ4495) were analyzed. The mean (SD) age was 58.1 (10.4) years, and 3131 (50.2%) were female. In total, 2503 (41.0%) patients had a platelet count Ͻ150x103, 2503 (40.5%) had ALT Ͼ 60 IU/L, and 5765 (93.2%) had a high viral load. The numbers with genotype 1, 2, and 3 were 4291 (69.2%), 1838 (29.6%), and 76 (1.2%), respectively. Overall, 4434 (71.2%) patients were treatment-naïve. SVR was achieved in 53.5% (95% CI: 51.1-55.9%) with alpha-2a and 61.6% (95% CI: 60.2-63.1%) with alpha-2b (pϽ0.001). The dropout rate due to any AEs was 10.3% (95%CI: 8.9-11.8%) and 9.3% (95%CI: 8.5-10.2%) for alpha-2a and alpha-2b, respectively (pϭ0.226). After adjustment for possible confounders, no differences in effectiveness or tolerability were observed between the therapies, and the odds ratio of alpha-2a for SVR was 0.97 (95% CI: 0.86-1.10), and its odds ratio for dropout due to any AEs was 0.96 (95% CI: 0.79-1.17). There was no significant interaction of genotype and therapy. CONCLUSIONS: Alpha-2a and alpha-2b in combination with ribavirin showed comparable effectiveness and tolerability in clinical settings.

as defined by the PDC (proportion of days covered) ratio. Considering the third agent consumption of the adherent patient population, amongst PI's persistence of DRV was the highest. Assuming 60-day gaps, the 1-year and 5-year persistence was 87% and 51%, respectively, and the median was 1851 days. ConClusions: Due to the development of ARV therapies and understanding their mechanism of action and keeping in mind the perspective of patients, we conclude that the tolerability and simplification of treatment administration could be major aspects of treatment success in real-world settings.

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OBJECTIVES: Few studies have evaluated the impact of GERD-symptoms on work productivity and no French data are available. The aim of this study was to evaluate the impact of GERD typical symptoms on work productivity and daily activities in patients with nocturnal compared to diurnal symptoms. METHODS: A prospective, multicenter, observational study was carried out in French primary care setting. Each physician had to include the first two consecutive adult patients on full-time job who had experienced GERD typical symptoms at least once during the 7 days/nights preceding the inclusion visit: 1 with exclusively diurnal symptoms and 1 with nocturnal symptoms. Data collected by physicians were: patients' characteristics, symptomatology and treatments. Work productivity loss was assessed using the validated self-administered Work Productivity and Activity Impairment questionnaire specific to GERD (WPAI-GERD). Predictors of work productivity loss were identified by multivariate regression models and its cost estimated. RESULTS: A total of 407 physicians included 716 eligible patients: 50.8% with nocturnal and 49.2% with exclusive diurnal symptoms (EDS). The mean age was 46.3 years (SD 8.7), 62.8% were men, and 58.3% of patients diagnosed before inclusion were treated for GERD. Work productivity and daily activities decreased by 31.4% and 32.6%, respectively. Decrease rates were higher in EDS-patients (pϽ0.001 each). Work productivity impairment was mostly due to impairment while working (presenteeism) rather than absenteeism. The symptoms intensity and composite intensity index, reflecting disease severity, were identified as the main predictors of decreased work productivity. The mean cost of work productivity loss per patient was estimated as €313/ week, also higher in EDS-patients (pϽ0.001). CONCLUSIONS: GERD incurs high work productivity loss which yields a substantial burden. Improving patients' outcomes, especially in those with moderate or severe disease, with most effective tailored treatments and care management could be expected to reduce work productivity loss and associated costs.