loss of efficacy is evaluated. As outcome measure, improvement of functional status (BASFI) is recorded, converted to quality of life, and compared to mean natural progression. Incremental quality-adjusted life years (QALYs) are calculated. Results: Direct costs excluding value-added tax and mandatory rebates are € 77,194.65 for Inflectra® vs. € 96,407.67 for Remicade®. Indirect costs are € 439,314.28 vs. € 440,972.54. Total costs excluding value-added tax and mandatory rebates are € 516,508.93 for Inflectra® vs. € 537,380.21 for Remicade®. Patients gain 4.86 QALYs with Inflectra® and 4.61 QALYs with Remicade®.The incremental cost-utility ratio is negative for the biosimilar, i.e. patients gain more QALYs at lower total costs. Sensitivity analysis shows the results' robustness when altering mortality rates, disease progression, time on treatment with nonsteroidal anti-inflammatory drugs and overall time on treatment. ConClusions: Treatment of AS with biosimilar Inflectra® is cost-effective compared with Remicade® treatment. Inflectra® lowers total costs from a societal perspective. To capture the whole range of the treatments' economic effects, estimation of cost-effectiveness relies on simulation with a lifetime horizon. PMS57 Patient Burden of rheuMatoid arthritiS: reSultS of a GloBal SySteMatic literature review on diSaBility, work diSruPtion, and functional caPaBility in the real world
formula. Prescription drug cost and activity trends were analysed at a drug-class (BNF chapter) and regional level. Regions were defined by sustainability and transformation plan (STP) area. Risk-adjustment helped determine what cost we would 'expect' based on each STP's risk profile compared to the English average. Costs were projected over a five-year period under various scenarios, using expected changes in population size and structure published by the NHS. Results: The reduction in expenditure is driven by a combination of lower average costs (3.83% decrease) and lower levels of activity (0.92% decrease). These decreases in total cost are slightly offset by the 1.19% increase in the English population size. The research highlights particular BNF chapters and STP regions that are driving these trends as well as how STP regions' experience compares to the English average on a risk-adjusted basis. The projection model shows that prescription drug costs can be expected to decrease by 3.6% p.a. over the next five years if historical trends persist. Conclusions: The insights provided by this research can help stakeholders with experience analysis and planning by identifying cost and activity drivers on a population risk-adjusted basis as well as having a view of how demand may develop over the projection period.
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