VALUE IN HEALTH 16 (2013) A1-A298 A189 analyzed for 365 days after and before the accrual period. RESULTS: On a total of 2,962,498 subjects observed, 594 patients were hospitalized for melanoma (53.4% males) during 2009 (prevalence rate: 20.0 per 100,000). Among them, 43% had at least one chronic comorbidity, hypertension is the most common (14.6%) followed by combination of dyslipidemia and hypertension (3.0%). Therapy for melanoma is made both in and outside the hospital. Interferon alfa-2b was the most prescribed treatment outside the hospital with an average cost of €110, followed by Temozolomide (€40.7) and Erythropoietin (€39.6). During one-year of follow-up, 13% of patients was hospitalized for chemotherapy with an average cost of €7398. This amount covers also drug treatment cost during hospitalization. The average yearly cost/patient for population with melanoma was €4777 (hospitalizations: 70.8%, drugs: 14.4%, diagnostic examinations: 14.8%), with an higher cost for the subgroup of patient already in treatment the previous year before the accrual period (€6156 vs €4361). If we consider the subgroup of patient with metastatic melanoma (N=176), the overall cost rises at €15,984, most of it (60%) due to drug costs for specific therapy of melanoma and chemotherapy. Surprisingly methotrexate and cyclophosphamide appear in the top five list of prescribed drugs. CONCLUSIONS: This study shows high cost of patients with melanoma and how real world practice therapy, especially for metastatic melanoma, seems to be far from the guidelines recommendation. This suggests to create a regional network to correctly redirect therapeutic choices. PHS24 COST-OF-ILLNESS STUDIES IN DIABETES MELLITUS: A SYSTEMATIC REVIEW Ng CS 1 , Lee JYC 1 , Toh MPHS 2 , Ko Y 1 1 National University of Singapore, Singapore, Singapore, 2 National Healthcare Group, Singapore, Singapore, Singapore OBJECTIVES: Diabetes mellitus (DM) is recognised as a major health problem. Its chronic nature and complications make it a costly disease. The aim of this study is two-fold: (1) to describe the methods used in the identified cost-of-illness (COI) studies of DM and (2) to summarise their study findings regarding the economic impact of DM. METHODS: This is a systematic review of MEDLINE and Scopus journal articles reporting the cost of type-1 and/or type-2 DM that were published in English from 2007 to 2011. Costs reported in the included studies were converted to US dollars for comparison purposes. RESULTS: The systematic search yielded 30 articles that met the predetermined criteria. The studies varied considerably in their study design, perspective and included cost categories. Estimates for the total annual costs of DM ranged from US$141.6 million to US$174 billion; direct costs ranged from US$150 to US$14,060 per patient per year (pppy) whereas indirect costs ranged from US$39.6 to US$7,164 pppy. Inpatient cost was the major contributor to direct cost in half of the studies that included inpatient costs, physician services and medications. In addition, patients with DM consumed significantly more health care resources and incurred higher health care costs than patients without DM. CONCLUSIONS: There is a considerable economic burden associated with DM, not only on the health care system, but also on the individual and society as a whole. Future research should focus on improving methods of estimating costs, enhancing the interpretation of study findings and facilitating comparisons between studies. PHS25 DIRECT HEALTH CARE COSTS IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION IN THE NATIONAL INSTITUTE OF CARDIOLOGY "IGNACIO CHÁVEZ" (NIC), MEXICO CITY Rely K 1 , Pulido Zamudio T 2 , Escamilla C 3 , Ramírez-Neria P 2 , Vazquez A 4 , Cañedo A 5 1 CEAHealthTech, Mexico City, D.F., Mexico, 2 Instituto Nacional de Cardiología - Ignacio Chávez, Mexico City, Mexico, 3 INSP, Mexico City, Mexico, 4 Actelion Pharmaceuticals Mexico, Mexico City, Mexico, 5 Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico OBJECTIVES: To evaluate the cost of Pulmonary Arterial Hypertension (PAH) to health services in Mexico based on epidemiological trends, to project this estimate to 2012. METHODS: Retrospective medical chart review using data from the NIC. Clinical and resource utilization data for all patients admitted to the NIC with PAH between January 1, 2009 and 2011 were collected and the mean treatment costs per person were calculated by assigning appropriate unit cost data to all resource use. A prevalence based approach was used to estimate the economic burden of PAH. Contemporary data were obtained from epidemiological studies, government datasets, and other sources to estimate prevalence. National costs (US dollar 2012) of treatment for PAH were estimated by extrapolation of mean cost estimate per person to national incidence data for PAH. Because of uncertainties surrounding some of our estimates such as prevalence, one way sensitivity analyses were undertaken. RESULTS: A total of 113 PAH patients were identified and their demographic and clinical characteristics, patterns of care were examined. The mean age was 38 years, and 83% were female. The average per patient annual cost was $ 10,869 without specific treatment (min $ 137; max $155,928). The annual cost for the treatment of a single PAH patient per year with specific therapy (Bosentan) was calculated in $31.433. Aggregate national health care expenditures for treatment of PAH were USD 46.6 million In multivariate analysis, length of hospital stay, stay in ICU, were all significant independent predictors of treatment CONCLUSIONS: Treatment costs of PAH in Mexico are substantial and primarily driven by the intensity of hospital treatment. With the expected increase in the incidence of PAH in Mexico over the coming decades, these results emphasize the need for effective preventive and acute medical care. PHS26 DIRECT MEDICAL COST AND QUALITY OF LIFE OF DIASTOLIC HEART FAILURE IN HONG KONG Lee VW, Yan B, Chan CY, Leung AW, Yu CM, Lam YY The Chinese University of Hong Kong, Shatin, Hong Kong OBJECTIVES: The current study aimed to examine direct medical cost and humanistic outcome of diastolic heart failure (DHF) management in Hong Kong. Whether the presence of comorbidities, including hypertension, diabetes and renal impairment, affect the cost and humanistic outcome was also evaluated. METHODS: Retrospective, non-randomized study design was adopted. Subjects were recruited from the Heart Failure Registry of the Prince of Wales Hospital in Hong Kong between 2006 and 2008 and completion of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) at 3 designated time pints to be eligible. Patients with significant valvular disorder were excluded. One year medical records since admission were reviewed. Heart failure related admissions, clinic visits, cardiovascular drugs, laboratory and diagnostic tests were recorded. The costs and MLHFQ scores in patients with or without hypertension, diabetes, and renal impairment were compared. Non-parametric Wilcoxon Signed Rank and Mann-Whitney tests were used. A p-value < 0.05 was considered statistically significant. RESULTS: A total of 73 DHF patients were included. The mean 1-year direct medical cost was USD 20,098 (1 USD = 7.75 HKD), with in-patient care cost contributing to the largest proportion (72.2%) of the total cost. Patients with diabetes or renal impairment were associated with a higher cost of DHF management. Significant difference was found in the renal impairment group (median cost: USD 24,763 versus USD 12,789 in no impairment group, p=0.023). The mean MLHFQ scores of the subjects improved significantly from baseline 30.81±13.89 to 12 months 15.84 ±11.32 (p<0.0005). CONCLUSIONS: The cost of management of DHF was shown to be enormous and further increased in the presence of comorbidities. With the aging population in Hong Kong, the incidence of DHF is expected to increase progressively. Further studies are demanded to guide more optimal medical resource allocation for DHF management. PHS27 AN INCIDENCE MODEL OF THE COST OF ADVANCED PROSTATE CANCER IN SPAIN Hart WM 1 , Nazir J 2 1 EcoStat Consulting UK Ltd, Sidestrand, UK, 2 Astellas Pharma Europe Ltd., Chertsey, UK OBJECTIVES: Prostate cancer is the second leading cancer diagnosed among men. In Spain the incidence of prostate cancer was 100.4 cases per 100,000 males. Advanced prostate cancer is cancer that has spread outside of the prostate capsule and may involve other parts of the body, most commonly to the lymph nodes and bones . The aim of this study was to estimate the lifetime costs of a cohort of advanced prostate cancer patients diagnosed in Spain in 2012. METHODS: An economic model was developed in EXCEL incorporating Spanish incidence, mortality and cost data supplemented with data from the international literature. Progression from Stage III to Stage IV was permitted. Costs were discounted. Lifetime costs were presented on an individual basis and for the entire cohort of newly diagnosed Stage III and Stage IV prostate cancer patients. RESULTS: Lifetime costs for advanced prostate cancer were approximately 23,032 € per patient. Using the projected incident cases for 2012, the total cost for the incident cohort of patients in 2012 would amount to 172 million euros. These results were more sensitive to changes in the ongoing costs (post initial 12 months) of Stage III prostate cancer, the rate of progression from Stage III to Stage IV and the discount rate applied to costs. CONCLUSIONS: This study provides an estimate of the lifetime costs of advanced prostate cancer in Spain and a framework for further research. Until improved long-term prospective or observational data do become available the current results indicate that the burden of advanced prostate cancer is substantial and will increase due to an increasing number of new cases and reductions in mortality. Any treatments that could potentially reduce the economic burden of the disease should be of interest to health care decision makers given the context of limited resources in Europe. PHS28 EVALUATION OF HEALTH CARE COST OF DIABETES WITH CO-MORBIDITIES IN SOUTH INDIA- A COST OF ILLNESS STUDY Mateti UV 1 , Akari S 2 , Buchireddy K 3 , Anantha NN 1 1 Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India, 2 St.Peter's Institute of Pharmaceutical Sciences, Warangal, India, 3 Rohini Super Specialty Hospital, Warangal, India OBJECTIVES: To evaluate the health care cost of diabetes with co-morbidities by using cost of illness analysis. METHODS: A prospective observational study was conducted for a period of six months at Rohini super specialty hospital, AP, India. The patients were identified during ward rounds and by regular case record reviews during study period. The enrolled patients were followed from the day of admission till the day of discharge and the relevant study data including total direct costs which include direct medical costs, cost of laboratory investigations, cost of consultation, cost of hospitalization, direct nonmedical cost includes the transportation cost to hospital and indirect costs which include days lost from work or productivity, was documented in case record form. RESULTS: A total of 150 patients were enrolled during the study period. The average cost per diabetic patient without complications was Rs. 1623 this includes the average total direct medical cost was Rs.1483 (91.37%), the average direct non medical cost was Rs. 20 (1.23%) and the average total indirect cost was Rs. 120 (7.4%) compared to for those with diabetes complications, Rs. 7706 for macrovascular complications, Rs. 4907 for microvascular complications and Rs. 2810 others infections. The cost for the treat diabetes with co morbidities was found to be Rs. 17046, the average total direct medical cost was Rs. 15738 (92.41%), the average direct non medical cost was Rs. 204 (1.12%) and the average total indirect cost was Rs. 1104 (6.47%). CONCLUSIONS: Our study results