The prevalence of differentiated thyroid cancer (DTC) locally advanced or metastatic refractory to radioactive iodine (RAI) has been increasing in the past decade. The treatments related to this condition are limited and are associated with substantial direct medical costs, low quality of life and survival. The aim of this study was to estimate the cost and effectiveness of sorafenib administrated in radioiodine-refractory DTC patients in Colombia. MethOds: We adapted a Markov Model to simulate the process of radioiodine-refractory DTC patients treated with sorafenib. Clinical data were obtained from a systematic review. Costs were estimated from a standard costing based on expert panel. The primary outcomes were costs and QALYS. We performed one-way sensitivity analysis as well as probabilistic sensitivity analysis based on Monte Carlo simulation of 1000 iterations to explore the uncertainty of the parameters used in the model. Results: The estimated direct medical cost of DTC-RAI was COP $ 575,512 in ambulatory patients. The standard cost of the disease progression was COP $ 2,481,336 in outpatient and COP $ 10,812,295 in inpatient. The progression free survival was 1.30 months for sorafenib and 0.45 for Best Supportive Care (BSC). The monthly costs of treatments were COP $ 20,510,821 and COP $ 9,138,752 for BSC and Sorafenib, respectively. Treatment with sorafenib resulted in additional gains in terms of effectiveness compared to the BSC option. (0.67 QALYs more than treatment with BSC which reported gains of 1.74 QALYs). Moreover, sorafenib results in cost savings for early progression in COP $ 11,299,586 compared to BSC. cOnclusiOns: Sorafenib is a treatment that delays disease progression. Also, given its cost savings results, is a potentially cost effective treatment option in patients with DTC-RAI in Colombia.
PCN35 Estudio dE Costo-EfECtividad E imPaCto PrEsuPuEstal dE dENosumab vs.
s133hospital admissions (0.98; 0.96-0.99). No difference was observed among admissions for ACSCs. ConClusions: These findings suggest MH healthcare is associated with improvements in healthcare utilization rates. Additional healthcare utilization outcomes should be evaluated and further longitudinal analyses, including adjustments for other potential confounders, should be conducted as more MHs are implemented and additional years' data become available.
Objectives: Acute respiratory infections (ARI) are a great leading morbidity and mortality cause worldwide. The aim of this study was to describe ARI mortality inequalities in children under five years in Colombian municipalities. MethOds: Vital statistics from National Administrative Department of Statistics (DANE, in Spanish) were used to estimate ARI mortality rates per 100.000 children under five years (ARIMR< 5) in the Colombian municipalities with mortality registers during 2000, 2005, 2010 and 2013. ARIMR< 5 were compared between groups determined by unsatisfied basics needs (UBN) quintiles as a proxy of poverty (Q1, Q2, Q3, Q4 and Q5, being the last the poorest). Concentration curves were also used to show socioeconomic inequalities in ARIMR< 5. Results: Between 2000 and 2013 Colombia registered 18,012 deaths in children under five years old caused by ARI, 55.7% of cases were boys. The ARIMR< 5 for Colombian boys in 2000 and 2013 was 49.9 and 19.6 per 100.000, respectively. For girls, the rates were 45.2 and 17 per 100.000. At municipal level, ARI mortality rates in boys were higher in poorest municipal quintiles (Q4 and Q5) than Q1 (lowest poverty) for 2005, 2010 and 2013. ARI mortality rates in girls showed the same pattern than in boys. In 2000, an inverse relationship between poverty and ARI mortality in both, girls and boys. In boys, ARIMR< 5 was 1.6, 2.2 and 2.3 times greater in quintiles with high poverty (Q4 and Q5) versus Q1 (low poverty) for, 2005, 2010 and 2013, respectively. In girls, the differences were 1.7, 2.1 and 2.8. Concentration curves showed that 52% of the total IRA boys deaths were accumulated in the 15% of poorest population. In girls, the same proportion was accumulated in 22% of poorest population. cOnclusiOns: The current inequalities of the IRA mortality in Colombian municipalities continue to be a huge challenge for Colombian stakeholders.
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