Psy20 Economic Evaluation of Sequential Analgesic Treatment in the Management of Moderate Ankle Sprain in Mexican Adults

Abstract

line characteristics: Age, Sex, and BMI. We used existing literature and public datasets to estimate the parameters of the model. For the BMI trajectory, we utilized existing literature on pooled databases of the individuals' BMI over time. For the probability of death, we constructed life tables by estimating the 5-year probability of death using a logistic regression model using data from the National Health Institute Survey linked with National Death Index (NHIS-NDI) between 1997 and 2005. For costs and QALYs, we use Medical Expenditure Panel Survey Panels 6-10 to estimate hedonic linear regressions in each period. Costs and QALYs were discounted at 3%. RESULTS: In the base case-for a 45 year-old female-the expected age of death for baseline BMI of 25, 35, or 45 was 83, 80, and 77, respectively. The projected difference in discounted lifetime healthcare costs between this nonobese (BMI ϭ 25) person and someone BMI ϭ 45 is about $26,000. If the loss in QALYs were valued at $100,000/QALY, the net economic value loss is projected at $271,000. CONCLUSIONS: Obesity is associated with higher medical costs, lower quality of life, and reduced life expectancy. The societal cost of delivering effective weight loss interventions to obese Americans should be considered in the context of these lifetime outcomes.OBJECTIVES: ITP is characterized by reduced platelet counts and increased risk of bleeding. Romiplostim, a first-in-class thrombopoietin mimetic, safely increases and sustains platelet counts in most adult patients with chronic ITP for as long as needed, while reducing the need for concurrent and emergency medications. We evaluated treatment costs per overall platelet response with romiplostim ϩ concurrent treatment vs. placebo ϩ concurrent treatment in chronic adult ITP, from a Public Mexican Healthcare perspective. METHODS: Overall response, defined as Ն 4 weekly platelet responses (Ն50x10 9 /L ) from weeks 2 to 25, was derived from two randomized parallel trials with splenectomised and non-splenectomised patients over period of 24 weeks. All patients were allowed to enter on concurrent ITP medication (danazol, corticosteroids, azathioprine) and receive rescue medication (eg, intravenous immunoglobulin). Treatment costs included intervention, rescue medication and management of bleeding-related events during one year period. Unitary costs were obtained from the 2010 Official Price List of the Public Healthcare System in Mexico ($MXP). Mean treatment cost per response was calculated for splenectomized and non-splenectomized patients. RESULTS: Cost per response was lower for romiplostim compared to placebo. Overall response rates were 79% for romiplostim and 0% for placebo in splenectomized patients and 88% for romiplostim vs. 14% for placebo in non-splenectomized patients. Mean treatment costs were MXP$574,580 for romiplostim and MXP$301,218 for placebo in splenectomized patients and MXP$402,083 for romiplostim and MXP$180,692 for placebo in non-splenectomized patients. Cost per response were MXP$727,317 for romipl...