A11 Abstracts sentative sample of Medicare beneficiaries. METHODS: This study used data from the 2003 Medicare Current Beneficiary Survey (MCBS), a continuous national sample of approximately 12,000 persons. Study patients were 65+ years old, eligible for Medicare Parts A and B, and community residents. The COPD cohort comprised patients with 1+ medical claim(s) with a COPD diagnosis (ICD-9-CM codes: 491.xx, 492.x, 496). The comparison cohort included non-COPD patients, with at least one medical claim, matched 1:1 based on age, sex, race, and edu- cation level. The study measures included self-rated general health status, self-reported medical conditions, impairment in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). RESULTS: A total of 1219 patients were identified for the COPD cohort, all of whom were matched to comparison cohort patients (mean age ± SD: 76 ± 7; 50% female). COPD patients reported poorer general health (43% reported “fair” or “poor” health versus 22% among controls; P < 0.001) and more chronic medical conditions (mean of 4.2 versus 3.2 for controls; P < 0.001). COPD patients were also sig- nificantly (P < 0.001) more likely to report difficulties in per- forming one or more ADLs (46% versus 28%) or IADLs (42% versus 26%). For the COPD cohort, the most common ADL lim- itations were difficulty walking (42%) and transferring from a bed or chair (20%), while the most common IADL limitations were difficulty doing heavy housework (42%) and shopping (17%). CONCLUSION: In this community-residing Medicare population, COPD patients reported poorer health and had greater impairment in functioning than those without COPD. These results have implications for improving COPD manage- ment in the Medicare population. RS4 IMPACT OF EARLY INITIATION OF INHALED CORTICOSTEROIDS ON RESOURCE UTILIZATION AND COSTS IN PATIENTS WITH COPD: A PROPENSITY SCORE MATCHING APPROACH Akaza wa M , Stearns S, Biddle AK University of North Carolina at Chapel Hill, Chapel Hill, NC, USA OBJECTIVES: Economic benefits of early initiation of inhaled corticosteroids (ICS) treatment in patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD) were assessed using a large managed care claims database. METHODS: Early initiation was defined as beginning ICS within three months of initiation of regular bronchodilators and was compared with patients who initiated ICS therapy thereafter. To avoid biases due to the treatment selection, a propensity-score-matching tech- nique was used. Exacerbation risks and other resource utiliza- tion per person-year were compared between the two groups. A two-part model with multivariate logistic and generalized linear model (GLM) regression was used to estimate differences in medical, pharmacy, and total service costs. RESULTS: A total of 7712 matched COPD patients with comparable background characteristics were identified. Early initiation of ICS was asso- ciated with lower exacerbation risks and resource utilization. Patients who started ICS within three months had more ICS pre- scriptions (3.7 vs. 2.4 prescriptions per year) and higher phar- macy costs ($4077 vs. $3868: mean difference +$209, p < 0.05). However, because of lower medical services use, early initiation of ICS could save medical costs ($13,837 vs. $14,925: mean dif- ference -$1.089; p < 0.05) and total costs ($17,994 vs. $18,883: mean difference -$889; p < 0.05). The same trends were observed for services directly attributable to COPD conditions. CONCLUSION: Initiating ICS earlier than the current clinical guideline recommendation may be beneficial to avoid exacerba- tions and reduce treatment costs. PODIUM SESSION III: CANCER CN1 A COST—EFFECTIVENESS ANALYSIS MODEL FOR THE SECOND LINE TREATMENT OF GASTROINTESTINAL STROMAL TUMOURS (GIST) IN MEXICO Contr eras-Hernandez I 1 , Mould-Quevedo J 2 , Salinas-Escudero G 3 , Silva A 4 ,Tapia-Valencia J 2 , Davila-Loaiza G 2 , Garduño-Espinosa J 1 1 Social Security Mexican Institute, Mexico City, Mexico, 2 Pfizer Mexico, Mexico City, Mexico, 3 Social Security Mexican Institute, Mexico City, Federal District, Mexico, 4 Social Security Mexican Institute, Mexico City, Mexico, Federal District, Mexico OBJECTIVES: Gastrointestinal Stromal Tumours (GIST) are rare cancers that generate high expenditures in the Mexican Health System. The purpose of the study was to model the eco- nomic and health consequences of second-line treatments (pre- vious imatinib 400 mg/day failure) in adult patients with GIST in advanced stages within the Social Security Mexican Institute. METHODS: A cost–effectiveness analysis was developed using a Markov modeling approach. The model simulates costs and effectiveness outcomes in a five-year period. The model aimed to compare sunitinib 50 mg/day, imatinib 800 mg/day and local best supportive care (BSC) as second-line treatments. Transition probabilities of the Markov model were obtained according to clinical trials previously published in the literature. Effectiveness measures were the number of progression-free-months (PFM) and life-years gained (LYG). The analysis was conducted from the health care payer’s perspective (only direct medical costs were used). Resource use and costs data was obtained from hospital records at Hospital de Oncología CMN “Siglo XXI” in Mexico City (n = 12). Both costs and health outcomes were discounted using a 3% annual rate. Probabilistic sensitivity analysis was per- formed and acceptability curves were constructed. RESULTS: Second line treatment with imatinib showed the highest expected costs (US$37,197.8 ± 1368.8) followed by sunitinib (US$16,641.0 ± 368.6) and BSC (US$1900.7 ± 404.2). On the other hand, the best clinical outcomes were obtained by suni- tinib in both PFM and LYG (5.64 months, 1.4 years) followed by imatinib (5.28 months, 1.3 years) and BSC (2.52 months, 1.1 years). Imatinib option resulted dominated by sunitinib and the ICER between sunitinib and BSC was of US$49,134.3 per LYG. Results were robust to Monte Carlo second order sensitivity analysis and acceptability curves showed the same results. CON- CLUSION: In Mexico, sunitinib second-line treatment was the most cost—effective alternative compared to imatinib. These results should be taken into account by Mexican decision makers in the management of patients with GIST. CN2 PHARMACOECONOMIC ANALYSIS OF CAPECITABINE IN ADJUVANT TREATMENT OF STAGE III COLON CANCER IN TAIWAN Hsu TC 1 , Chen HH 2 , Chen LT 3 , Changchien CR 4 , Liu MC 5 , Wang HM 6 ,Yang L 7 1 Taipei Medical University,Taipei,Taiwan, 2 Chang Guang Memorial Hospital, Kaohsiung Branch, Kaohsiung,Taiwan, 3 National Health Research Institutes,Taipei,Taiwan, 4 Chang Guang Memorial Hospital, Linkou Branch, Linkou,Taiwan, 5 Koo Foundation Sun Yat-Sen Cancer Center,Taipei,Taiwan, 6 Taichung Veterans General Hospital,Taichung, Taiwan, 7 Roche Products Ltd,Taipei,Taiwan OBJECTIVES: Colorectal cancer is the second most commonly diagnosed cancer and the third cause of cancer-related mortality in Taiwan. Capecitabine, an oral fluoropyrimidine, is an effec- tive alternative to intravenous fluorouracil plus leucovorin (5- FU/LV) in adjuvant treatment of stage III colon cancer. The