Chilean Pesos Research Articles

Effects of an Eventual Upcoming Withdrawal of Pension Funds

The three withdrawals from pension funds injected almost US$ 50.000 billion into the market bringing with them inflationary pressures in the short and medium term, a decision that was harmful to people and companies. On the economic side, more than half of domestic inflation is due to the three withdrawals, decreasing the value of people´s money and increase the interest rates. On the pension side, eleven million people managed to withdraw their money and almost four million people were left without their funds. For women a drop of 33% in the amount of the future pension and for men a 24% on average. And on the financial side, a destruction of the capital market causing a significant drop in assets prices and companies to stop investing in big projects in Chile. During 2023, a new project was carried out on a new withdrawal of pension funds but it the form of a self-loan, a benefit that would have between one million and ten million Chilean pesos saved in their accounts to withdraw up to one million Chilean pesos. The purpose of this work is to see the effects of a possible fourth withdrawal from pension funds. And we conclude that an upcoming retirement has three consequences. In the economic sense, it would bring with another increase in the monetary base, which in turn translates into an increase in inflation. In the sense of pensions, more than three million people would again run out of funds and would cause a potential additional 16% drop in the amounts of future pension affecting the current saving of contributors. Finally, in the financial sense, the capital markets would be destroyed, causing a significant drop in assets prices and companies to stop investing in big projects in Chile.

Budget impact analysis of durvalumab consolidation therapy vs no consolidation therapy after chemoradiotherapy in stage III non-small cell lung cancer in the context of the Chilean health care system.

Durvalumab, used as consolidation immunotherapy, has shown to improve survival in patients with stage III non-small cell lung cancer who respond to chemoradiotherapy, based on the most recent follow-up of PACIFIC. The Chilean healthcare system provides access to certain immunotherapies for this condition. The present study sought to estimate the budget impact of durvalumab versus standard of care in the context of the Chilean healthcare system. A partitioned survival model was adapted to compare two strategies: durvalumab as consolidation therapy and standard of care for treating stage III NSCLC. The number of patients eligible for treatment was estimated using published incidence data and modeled for a 5-year time horizon. Model inputs were based on published literature, and the duration of treatment was estimated using survival curves obtained from PACIFIC. Costs were estimated in Chilean pesos (CLP) and converted to USD dollars using an exchange rate of USD 1 = CLP 827. Scenario analyses were performed to assess different subsequent therapy splits, variations in the target population and dosage of durvalumab. Durvalumab uptake projected total costs ranging from USD 1.27 in Year 1 to 8.5 million in Year 5 from the public perspective. From the private perspective, the budget impact for the first year is USD 1.3 million to USD 3 million for 2028. This difference relies mostly on the lower number of patients treated. Both perspectives anticipated cost savings over the time horizon through reduced monitoring, adverse events, and end-of-life expenses. This study demonstrates that the inclusion of Durvalumab for NSCLC in Chile represents an investment in the Chilean health system. The incremental costs align with clinical benefits and potential savings in healthcare resource utilization. However, a comprehensive cost-effectiveness analysis is needed to evaluate its economic value thoroughly.

The expected cost of cancer in Chile

Cancer is a public health priority in Chile. To estimate the expected annual cost of cancer in Chile, due to direct costs of health services, working allowances and indirect costs for productivity losses. We undertook an ascendent costing methodology to calculate direct costs. We built diagnostic, treatment and follow-up cost baskets for each cancer type. Further, we estimated the expenditure due to sick leave subsidies. Both estimates were performed either for the public or private sector. Costs related to productivity loss were estimated using the human capital approach, incorporating disease related absenteeism premature deaths. The time frame for all estimates was one year. The annual expected costs attributed to cancer was $1,557 billion of Chilean pesos. The health services expected annual costs were $1,436 billion, 67% of which are spent on five cancer groups (digestive, hematologic, respiratory, breast and urinary tract). The expected costs of sick leave subsidies and productivity loss were $48 and $71 billion, respectively. Cancer generates costs to the health system, which obliges health planners to allocate a significant proportion of the health budget to this disease. The expected costs estimated in this study are equivalent to 8.9% of all health expenditures and 0.69% of the Gross Domestic Product. This study provides an updated reference for future research, such as those aimed at evaluating the current health policies in cancer.

Impact of COVID-19 outbreak in knee arthroplasty in Chile: a cross-sectional, national registry-based analysis.

The need for beds and health personnel to treat coronavirus (COVID- 19) patients has led to the suspension of many elective sur-geries in Chile, including knee arthroplasties. This study aims to determine the incidence of knee arthroplasty in 2020, reflecting the effect of the COVID- 19 pandemic, and estimate the cost and time it would take to recover the waiting list prior to March 2020. A cross- sectional study was designed. We analyzed databases from The Department of Statistics and Health Information databases from Chile for 2019 and 2020, identifying patients with surgical discharges associated with knee arthroplasty codes. We estimated the time it would take to recover the surgeries unperformed in 2020 by simulating a monthly workload increase from the 2019 baseline. The costs of knee arthroplasty paid by the National Health Fund to institutions were estimated by diagnosis-related groups. We found that the incidence rate of knee arthroplasty in 2020 decreased by 64% compared with 2019. The impact was higher in the public system (68%) and the National Health Found (63%). A simulated increase in knee arthroplasty productivity by 30% would allow recovering the postponed knee arthroplasty surgeries in 27 months, at a monthly cost to the public system of 318 million Chilean pesos (378 thousand US dollars). The incidence rate of knee arthroplasty during 2020 decreased by 64%, revealing the extensive waiting line for people with knee osteoarthritis. An increase between 20- 40% in productivity compared with 2019 would allow recovering the unperformed surgeries in 20 to 41 months, at a monthly cost to the public network between 210 and 425 million Chilean pesos (250 to 506 thousand US dollars).

Espacio y territorio como categorías para la comprensión del tiempo presente: Emergencia teórica y renovación conceptual a propósito del octubre chileno – 2019

The mobilization cycle that began in October 2019 represented a crucial moment in the Chilean democratic trajectory. What began as a protest for the rise of 30 Chilean pesos in the Santiago Metro, quickly took on national demand as the horizon exceeded that specific bid, and became a systemic and structural criticism of the democratic institutions and the constitutional, economic, social and cultural structure inherited from the dictatorship. This social awakening in October not only implied transformations associated to material life. Also the conceptual and theoretical tools that were used to understand social phenomena from spaces of intellectual exercise, such as universities were modified. One of these categories is precisely space and territory, which from the nineties with supported and growing socio-environmental movements, was installed in the repertoire of popular demands. A dimension that was also strongly glimpsed in the October protests: the defence of territories as spaces for life. Based on this, a two-dimensional journey is proposed, first a theoretical conceptual debate and on the other hand a historical approach dealing with the emergence of the concept in recent Chilean history, with the interest of understanding a socio-territorial and historical dimension of what happened in October 2019.

The Cost of Reducing Municipal Unsorted Solid Waste: Evidence from Municipalities in Chile

The management of municipal solid waste sector is crucial for a sustainable circular economy. Waste utilities are expected to provide high quality solid waste services at an affordable price. The efficient management of solid waste requires its assessment from an economic and environmental perspective, i.e., eco-efficiency assessment. Although the reduction of unsorted waste incurs an economic cost, its positive externalities are huge for the well-being of society, the environment, and people. Our study quantifies the marginal cost of reducing any unsorted waste using stochastic frontier analysis techniques which allow us to estimate the eco-efficiency of the waste sector. Our empirical approach focuses on the municipal solid waste collection and recycling services provided by several waste utilities in Chile. The results indicate that substantial eco-inefficiency in the sector exists, since the average eco-efficiency score is roughly 0.5 which means that the municipalities could approximately halve their operational costs and unsorted waste to produce the same level of output. The average marginal cost of reducing unsorted waste is 32.28 Chilean pesos per ton, although notable differences are revealed among the waste utilities evaluated. The results provided by this study are of great interest to stakeholders to promote sustainable management solutions and resource efficient solid waste services.

Evolution of health social security expenditure in Chile: A review of financial aggregates from 2000 to 2018

In Chile, there is controversy regarding the magnitude of financing for the health system. Some experts state that more resources are needed, while others refer to the problems that may arise in managing a growing pool of resources. This article aims to offer evidence to encourage critical discussion through a time series analysis of the leading financial aggregates in constant 2018 Chilean pesos of the Chilean social security in the period from 2000 to 2018. We did an observational, descriptive, longitudinal, and time series trend analysis study. Financial aggregates are organized according to social security definitions and by financial administratorsthe public National Health Fund and the private health insurers. Social security health spending has increased almost four-fold in the study period. After enacting the Explicit Guarantees in Health, the National Health Fund expanded more than the private health insurance system due to government allocations to the National Health Fund. In contrast, individual contributions decreased steadily every year during the study period. Per capita expenditure was higher in the private health insurance system. However, the per capita expenditure of the private insurance system over the public health fund has gradually decreased over time. Firstly, Chile increased its health spending at a rate higher than observed in other Organization for Economic Co-operation and Development countries. Secondly, it transitioned from financing health mainly through workers contributions to growing prominence of the governments overall contribution. In the wake of the announced health reform, the discussion of health funding will include employers role in health financing.

Cost-effectiveness of ceftazidime/avibactam versus colistin + meropenem for treatment of carbapenemic-resistant enterobacteria infections in Chile

Ceftazidime-avibactam (C/A), has shown reduction in mortality rates and risk of nephrotoxicity, compared to colistin, conventional therapy. To estimate the cost-effectiveness of C/A versus colistin + meropenem in the treatment of infections due to carbapenem-resistant Enterobacteriaceae (CRE) in Chile. An economic decision tree type model was adapted. The perspective of the public payer was used with a time horizon of 30 days and extrapolation to life expectancy. The clinical information was derived from an observational study. Medication and care costs correspond to local reports. The results are expressed as incremental cost-effectiveness ratio (ICER) per life year gained (LYG) and per quality adjusted life year (QALY) in Chilean pesos and US dollars (US$ 1.00 = $792.2218). 8.65 and 6.48 LYGs and 6.44 and 4.27 QALYs were obtained, for C/A and colistin + meropenem, respectively. The estimated ICER for C/A was $940,488 (US$1,187.2) per AVG and $938,715 (US$1,184.9) per QALY. Given the lack of publications or evidence, the model is based on an observational study. C/A would reduce the death rate and increase LYGs and QALYs, resulting in a cost-effective alternative vs. colistin + meropenem for CRE.

Linear programming based decision support system for grapes transport planning in CAPEL

AbstractThis research is about developing a decision support system (DSS) for the distribution of grapes and grape must in a Chilean cooperative, Cooperativa Agrícola Pisquera Elqui Limitada (CAPEL). CAPEL is dedicated to producing and distributing several beverages such as sparkling wines, beers, energy drinks, rum, and pisco. This work aims to support the grinding‐related transport stage through a linear programming based DSS, in order to find the optimal use of the transport demand in a network based on source and destination plants during the harvest season. To achieve this aim, an operational research (OR) model that feeds the DSS is developed, whose objective function seeks to minimize the total transport cost. The decision variables define the grape cargo to be transported from a source plant to a destination plant. The OR model uses constraints such as transportation demand, grinding capacity, maximum storage, and available grape in plants. The model succeeded in reducing the total transport costs by 14% for the 2017 season of the pisco‐making process, meaning approximately savings of 59 million Chilean pesos.

Implied monetary policy extracted from interest rate swaps in Chile

This article describes a methodology that uses interest rate swaps in Chilean Pesos to extract monetary policy paths, as well as their probability, with nodes on future Central Bank meetings. It is concluded that implied policy paths contain term premiums that correlate with the policy cycle. Accordingly, implied paths have consistently overestimated the future path of future interest rates, pricing hikes more often than cuts and underestimating the likelihood of rates becoming more expansionary. Moreover, the level of implied rates has been governed by the front end of the curve, instead of expectations of the economic cycle. The result is that extracting implied rates from the swap curve is an ineffective tool for forecasting, and that the swap curve has not been able to anticipate changes in policy. These findings provide insights on the asymmetrical risk profile of future monetary policy and may contribute to the design of hedging strategies

Cost-effectiveness of adding fluoride varnish to a preventive protocol for early childhood caries in rural children with no access to fluoridated drinking water

ObjectivesEvidence of the cost-effectiveness of fluoride varnish in the prevention of caries is not yet fully conclusive. The aim of this study was to assess the incremental cost-effectiveness ratio (ICER) of the community-wide application of fluoride varnish in the prevention of early childhood caries (ECC) in non-fluoridated areas. Materials and methodsA cost-effectiveness analysis was carried out based on a clinical decision tree from the payer’s perspective. The effectiveness and cost of the varnish were determined from a two-year follow-up triple-blind randomized control trial in 275 two- to three-year-old children. Costs and benefits were discounted at 3% per year. Only direct costs were evaluated, expressed in Chilean pesos (CLP) valued in July, 2019 (exchange rate USD = CLP686.06). A univariate deterministic sensitivity analysis was carried out. ResultsIncidence of ECC was 45 % for the varnish group and 55.6 % for the placebo group with a two-year follow-up. The weighted cost to intervene and treat the consequences of ECC was CLP 67,757 (USD98.76) for the fluoride varnish and CLP 67,739 (USD98.74) for the control group. The ICER was CLP 173 (USD0.25) for each extra healthy child in favor of fluoride varnish. The sensitivity analysis showed that the increase in caries was the variable which most influenced the ICER. ConclusionsThe protocol that included fluoride varnish is more effective and less costly in the prevention of ECC in non-fluoridated areas, compared with a placebo. Clinical significanceFindings support the application of fluoride varnish as a cost-effective community strategy to prevent ECC in non-fluoridated areas.

PRS24 COST-EFFECTIVENESS OF MEPOLIZUMAB ADD-ON IN THE TREATMENT OF SEVERE EOSINOPHILIC ASTHMA IN CHILE

The aim of this study was to evaluate the cost-effectiveness of mepolizumab as an add-on alternative compared to the best available therapy (BAT). It includes a combined therapy of inhaled corticosteroid and a long acting beta agonist, plus short acting beta agonist and oral corticosteroid SOS. This analysis takes place at the public Chilean health system for the treatment of severe eosinophilic asthma. A Markov model was adapted to represent the day-to-day of patients with severe asthma over a lifetime horizon. The expected direct cost measured as Chilean Pesos ($1USD= CLP$640) and utilities for the health states and exacerbation were obtained from the literature. Comparative effectiveness of mepolizumab related to exacerbation rates were estimated from clinical trials. Deterministic and Probabilistic sensitive analysis were performed to account for second order uncertainty of the model. Also, a risk subgroup analysis was conducted to evaluate the cost-effectiveness of mepolizumab across different risk population. Mepolizumab was the most effective alternative, generating 1,014 QALYs more than BAT. The incremental cost-effectiveness ratio (ICER) of mepolizumab compared to BAT was $110.273 USD per QALY gained, which is above the reference threshold for Chile ($15.618 USD). From the subgroup analysis, it was observed that the cost-effectiveness of mepolizumab increases in specific subgroups, achieving an ICER of $46.640 USD in patients with eosinophils count of 300 and more cell/mcL and an exacerbation history of at least 4 exacerbations in the past year. In the light of the Chilean threshold, mepolizumab cannot be considered a cost-effective strategy. However, price discount in specific subgroups improves its cost-effectiveness profile significantly. It was estimated an ICER of $24.116 USD in the best performance subgroup with a 50% price discount.

PND27 COST-UTILITY OF MECHANICAL THROMBECTOMY AFTER THROMBOLYSIS IN ISCHEMIC-STROKE IN THE CHILEAN PUBLIC SECTOR.

Ischemic-Stroke (IS) is a prevalent disease in Chile, responsible for long-term disability and premature deaths. Available treatments for IS due to Large Vessel Occlusion (LVO) are Thrombolysis (IV-tPA) and Mechanical Thrombectomy (MT). However, MT is not funded by any local-coverage regimen. A Cost-Utility Analysis (CUA) was conducted to estimate the economic-value of adding MT to the current IV-tPA treatment in Chile. A University of York Health Economics Consortium Model was validated and adapted to the Chilean setting. The CUA was carried-out for a lifetime horizon and from two perspectives: public payor and societal. A scoping review was conducted to validate key variables according to CHEERS criteria. Variables of a Mixed Model were validated and adapted: Short-term Decision tree for the acute post-phase -from the onset of symptoms until 90 days-; And Markov from 91 days to the first year, and then annual cycles. The Model consists of seven Health States defined by the mRS scale (including death). Sources of local costs were Related-Diagnosis Groups (DRGs) of a sample of high-complexity public providers and bundled-payment tariffs. For each Health State, a local cost (Chilean pesos), a utility (QALY), and probabilities of transition/distribution were identified. The discount rate was 3%. Over a lifetime period, MT after IV-tPA is estimated to be cost-effective leading to a gain of +2.63 QALYs and +1.19 life years (LY), with an Net Monetary Benefit (NMB) of $37,289,874 and an ICER of $3,807,413/QALY. After adding Physical Therapy costs, MT after IV-tPA remains cost-effective (+2.54 QALYs, +1,13 LY, NMB is $35,670,319, and ICER is $3,960,624/QALY). With the incorporation of long-term costs in care-dependent groups, ICER drops ($951,911/QALY), and NMB improves ($43,318,072). Sensitivity analyses confirm the robustness of these results (1,000 iterations). The addition of MT after IV-tPA for treating IS due to LVO showed to be cost-effective in Chile.

Mediation in public healthcare: opportunities for improvement

Mediation in healthcare is a non-adversarial process to resolve a dispute risen between patients and health providers during medical attention Aim: To characterize the mediation process taking place in the public health system in Chile, from its start until 2017. Cross-sectional descriptive study. Under the Transparency Law, information about mediation processes between 2005 and 2017 was requested to the State Defense Council (CDE in its Spanish acronym). This data was complemented with the information available on the website of this agency. Ninety four percent of the complaints filed at the CDE were deemed eligible for mediation. Only 19% of the concluded cases led to an agreement between the disputing parties. The agreements reached were mostly monetary compensation, medical assistance, and apologies/explanation of the facts. The average amount of compensation reached $14,862,088 (Chilean pesos). The most commonly claimed damage resulting from medical care was partial disability. The medical specialties more often claimed were Obstetrics and Gynecology, General Surgery, and Internal Medicine. The analysis of conducted mediations is a source of feedback for healthcare staff and health institutions. It would greatly contribute to prevent possible damage and medical conflicts, specially within the specialties with the most complaints. Improvements to the existing legislation are required to ensure free access for all the population.

Online Marketing by Private English Tutors in Chile: A Content Analysis of a Tutor Listing Website

To provide business advice for Chilean pre-service and in-service English teachers who are aspiring to become a private English tutor, this study seeks to investigate the price charged for English private tutoring services and assesses the impact of tutors’ years of experience on the lesson’s price charged per hour by private tutors. A random sample of over one-twenty individual English tutor profiles advertising on a Chilean tutor listing website was considered. The results of the quantitative analysis indicate that the majority of Chileans private English tutors charged between 11000 and 15000 Chilean pesos for English for General Purposes per hour. Other major findings include a weak negative correlation between the tutors’ years of experience and tuition fees charged by them. Implications of the results and future research directions are also presented. https://doi.org/10.26803/ijlter.18.12.4

The cost-utility of school-based first permanent molar sealants programs: a Markov model

BackgroundEvidence of the cost-effectiveness of school-based first permanent molar sealants programs is not yet fully conclusive. The aim of this study was to determine the incremental cost-utility ratio (ICUR) of school-based prevention programs for the application of sealants in molars of schoolchildren compared with non-intervention.MethodsA cost-utility analysis based on a Markov model was carried out using probability distribution. The utility was measured in quality-adjusted tooth years (QATY). The assessment was carried out from the public payer’s perspective with a six-year time horizon. Costs and benefits were discounted at 3% per year. Only direct costs were evaluated, expressed in Chilean pesos (CLP) at 7th May at 2019 values (exchange rate USD = CLP 681.09). Univariate deterministic sensitivity analysis and probabilistic analysis were carried out.ResultsAfter a six-year follow up, the cost of sealing all first permanent molars was found to be higher than non-intervention, with a mean cost difference of USD 1.28 (CLP 875) per molar treated. The “seal all” strategy was more effective than non-intervention, generating 0.2 quality-adjusted tooth years more than non-intervention. The ICUR of the “seal all” strategy compared to non-intervention was USD 6.48 (CLP 4,412) per quality-adjusted tooth years. The sensitivity analysis showed that the increase in caries was the variable which most influenced the ICUR.ConclusionsA school-based sealant program is a cost-effective measure in populations with a high prevalence of caries.

PCN78 COST EFFECTIVENESS OF MIDOSTAURIN IN ADDITION TO STANDARD CARE VERSUS STANDARD CARE ALONE IN FIRST LINE TREATMENT OF ACUTE MYELOD LEUKEMIA WITH FLT3 MUTATION FROM THE PERSPECTIVE OF CHILEAN HEALTH SYSTEM

The aim of this analysis was to estimate the cost-effectiveness of Midostaurin in addition to standard care as first line treatment for acute myeloid leukemia in patients with FLT3 mutation from the perspective of Chilean health system. A partitioned cohort model was adapted in order to represent the natural evolution of the disease. Estimation of resource usage and costs was performed from the perspective of public payer. Expected costs were measured in Chilean pesos (1 USD = 650 CLP) and benefits in quality adjusted life years (QALYs). Other outcomes represented were rate of response and life years. Health related quality of life was estimated from published literature. A lifetime time horizon was used and a 3% discount rate was considered for costs and outcomes. A probabilistic sensitivity analysis was performed to account for uncertainty. The total expected costs of treating acute myeloid leukemia with Midostaurin plus standard therapy are higher than standard therapy alone (USD148,128 and USD76,909 respectively). Similarly, the expected incremental health benefit is higher in Midostaurin group (1.57 incremental QALYs). The base case scenario (current market prices for all treatments) shows an average ICER of Midostaurin in addition to standard care versus standard therapy of USD 45,470/QALY. The ICER is reduced to USD 38,904 when the base price of Midostaurin is reduced a 25%. Both ICERs are between the cost effectiveness threshold range suggested by WHO of 1 to 3 GDPs per capita. Deterministic sensitivity analysis shows a high impact of price, hazard ratio, rate of stem cell therapy and maintenance therapy duration as drivers of change of incremental cost-effectiveness ratio. Estimates of cost effectiveness ratio of Midostaurin can be considered as cost effective for Chilean health system. The assessed intervention delivers high gains in life years and quality adjusted life years in comparison with standard care.

PCN83 BUDGET IMPACT ANALYSIS OF OSIMERTINIB VERSUS PEMETREXED FOR THE SECOND-LINE TREATMENT OF ADVANCED LUNG CANCER WITH T790M POSITIVE FROM PUBLIC HEALTH PERSPECTIVE IN CHILE

Assess the budget impact of Osimertinib (Osim) versus Pemetrexed (PEM) for the second-line treatment of advanced lung cancer with T790m (aLC-T790m) mutated from the perspective of the Chilean public healthcare system A cohort of patient with aLC-T790m using a constructed data with prevalence and incidence for lung cancer distributed by sex and proportions for non-small cell lung cancer, EGFR mutated, eligible patient for systemic treatment, which was provided for international literature, clinical experts and real-world data from Chile, in accordance with ISPOR principle good practice. Expected costs were measured in Chilean pesos (1 USD = 680 CLP$). The analysis was made from the perspective of Chilean public health assuming a 100% reimbursement. We considered pharmacological, drug administration, follow-up cost and adverse event. Annual costs were estimated considering a time horizon of five years. The budget impact was presented for the price sent by the company. When considering current full monthly price of US$8,647.87 monthly an additional of US$1,779,692 relative to PEM are needed in the first year, and US$5,526,411 for the second year. Moreover, Osim presented monetary savings in all the years studied for the items, drug administration and adverse event. Despite for the highest cost for Osim, items like cost for drug administration and adverse event, were significantly favorable for innovator drug. To summary, Osim is more expensive than PEM and shows an increasing cost with the time. Nevertheless, the patients treated with Osim lives more time than PEM generating highest cost in the time

PCN79 COST EFFECTIVENESS OF OSIMERTINIB VERSUS CHEMOTHERAPY IN SECOND LINE TREATMENT OF NON SMALL CELL LUNG CANCER WITH EPIDERMAL GROWTH FACTOR AND 790M MUTATION IN CHILEAN HEALTH SYSTEM

The aim of this analysis is to estimate the cost effectiveness of Osimertinib versus standard chemotherapy for patients with non-small cell lung cancer (NSCLC) with epidermal growth factor and 790m mutation who have failed to first line tirosin-kinase inhibitor treatment. A partitioned cohort model with 3 health states (Pre progression, progression and death) was adapted in order to represent the natural evolution of the disease. Estimates of resource usage and costs were performed from the perspective of public payer. Expected costs were measured in Chilean pesos (1 USD = 650 CLP) and benefits in quality adjusted life years (QALYs). Health related quality of life was estimated from AURA-3 trial study. A lifetime time horizon was used, and a 3% discount rate was considered for costs and outcomes. A probabilistic sensitivity analyses was performed to account for uncertainty. The total expected costs of treating NSCLC with Osimertinib are higher than standard chemotherapy (USD122,500 and USD13,000 respectively). Similarly, the expected incremental health benefit is higher in Osimertinib group (1.07 incremental QALYs). The base case scenario (current market prices for all treatments) shows an average ICER of Osimertinib versus standard chemotherapy of USD 101,777/QALY. The ICER is reduced to USD 78,206/QALY when the base price of Osimertinib is reduced a 25%. Both ICERs are above the cost effectiveness threshold range suggested by WHO of 1 to 3 GDPs per capita (USD15,000 to USD45,000). Deterministic sensitivity analysis shows a high impact of the price of treatment as a driver for incremental cost-effectiveness ratio. Osimertinib delivers high gains in life years and quality adjusted life years in comparison with standard chemotherapy. Higher costs driven by the price of the intervention under analysis should be a matter of negotiation in order to provide financial coverage to Chilean population.

PSY100 - COST-EFFECTIVENESS ANALYSIS OF SECOND LINE TREATMENT FOR PATIENTS WITH ULCERATIVE COLITIS

To evaluate the incremental cost-effectiveness ratio (ICER) of infliximab versus adalimumab and golimumab for second line treatment in adult patients diagnosed with moderate to severe ulcerative colitis with inadequate response or refractory to treatment with immunomodulators, in the Chilean context. A cost-effectiveness analysis based on a Markov model and a literature review of mathematical models for the pathology was conducted to inform the model structure.The Markov model comprised five health states:1.moderate to severe ulcerative colitis; 2.mild ulcerative colitis; 3.post-surgery; 4.specific death and 5.other causes of death. The effectiveness was expressed in quality adjusted life years (QALY), while the costs were expressed in Chilean pesos (CLP) 2017. A public health payer perspective and an undifferentiated discount rate for costs and effects of 3% were adopted. A cohort from age 18 to Chilean life expectancy 80 years old, was modelled. A probabilistic sensitivity analysis was performed for utility values, costs, transition probabilities and discount rates within a range of 0 and 6%. The base case ICER for infliximab versus adalimumab was $59.751.286 CLP (USD 94.904) per quality adjusted life year (QALY) gained. Golimumab presented extended dominance. Only two parameters presented significant uncertainty:discount rate and cost of adalimumab, however it does not change the results. Infliximab delivers more QALYs than adalimumab and golimumab, but it is not a cost-effective option. The ICER is above the cost-effectiveness threshold of 1 gross domestic product (GDP) per capita for 2017 in Chile. More long-term effectiveness studies are need it in order to decrease uncertainty of the Markov model results.