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A 3 4 7 -A 7 6 6 of the present study is to investigate the extent of CHE of households with women with breast cancer in Greece and their private expenditure due to the cost of the disease. Methods: A cross-sectional study was conducted among 390 breast cancer patients, diagnosed between January 2011 and August 2014, based on a structured questionnaire. Patients were approached through the respective patient organizations. Results: The average private expenditure for surgery was estimated at 2,160€ , for chemotherapy at 789.4€ , for treatment with biologic agents at 264.6€ , for radiation therapy at 706.8€ and the annual cost of follow up at 571.9€ . The total mean private expenditure from diagnosis to end of treatment was estimated at 4,706€ , which incurred in an average period of 10.5 months. It was found that 47.3% of households that had a breast cancer patient spent more than 20% of their total family income on treatments, 28.2% spent more than 50%, 12.2% spent more than 100%, 8.5% spent more than 150%, while 5.9% spent more than 200%. 73.3% of the patients stated that this cost was mostly covered by their family income, 35.8% from family's savings, 19% from parents' contributions while 10% had to borrow money or to liquidate private assets. ConClusions: The study suggests that a significant share of households with breast cancer patients undergo CHE in order to cover the cost of the disease or to receive the care they desire. The organization of the national health system in a way that protects households from CHE and provides patients with access to needed services is essential. The reduction of out-of-pocket spending through the development of social insurance would protect households from CHE.objeCtives: Catastrophic health expenditure (CHE) occurs when over 20% of the total family income is spent on healthcare services as out-of-pocket payments. Aim

Purpose: To estimate the net cost effect associated with the real-world practice of repeated use of designated single-use medical devices (SUDs) versus their proper single use in cataract surgery in Greece. Design: A cost-benefit analysis model was constructed in the form of a decision tree. Methods: A digital expert panel was assembled in order to estimate the probabilities of intraoperative and postoperative complications associated with single and repeated use of SUDs. Unit costs for the management of each complication were obtained from the official Greek bulletins. A Monte Carlo-type sensitivity analysis was performed to assess the robustness of the results. Results: Based on the probabilities of complications attained from the expert panel, repeated use of SUDs is associated with a higher chance of complications compared to single use, which results in higher cost of complication management. Under the healthcare sector perspective, the total expected cost per cataract surgery is 1,403.98€ (1,244.20€ the initial cost of cataract surgery plus 159.78€ the cost of adverse events) in the case of single use, while for repeated use the total cost is 1,486.29€ (1,146.86€ + 339.43€, respectively) and, thus, repeated use of SUDs in cataract surgery results in 82.31€ higher expected cost per patient compared to their single use. Moreover, the societal perspective analysis indicated even higher additional costs in the case of SUD reuse (108.24€). Conclusion: Repeated use of SUDs in cataract surgery is not appropriate, it jeopardizes patient safety and carries a legal liability for the reuser. The present study, which is the first to attach a monetary value to the common yet questionable practice of SUD reuse, shows that it is not cost beneficial. Therefore, it is expected that the results will have implications in policy formulations to improve the delivery of cataract healthcare.

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