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Mohamed Hamouda,1 Mohamed Farghaly,2 Sara Al Dallal2,3 1Value Access & HEOR, GSK, Dubai, United Arab Emirates; 2Health Insurance Section, Dubai Health Authority, Dubai, United Arab Emirates; 3Emirates Health Economics Society, Dubai, United Arab EmiratesCorrespondence: Mohamed Hamouda, Value Access & HEOR, GSK, ARENCO Tower, 19th Floor, Dubai Media City, PO Box 50199, Dubai, United Arab Emirates, Tel +971543604604, Email mohamed.a.hamouda@gsk.comPurpose: Asthma is a common, chronic respiratory disorder associated with substantial societal and economic burden globally, despite the availability of different treatment modalities. GSK has developed a once-daily single-inhaler triple therapy (SITT), comprised of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI); a combination of inhaled corticosteroid, long-acting muscarinic antagonist, and long-acting β2-agonist for patients with uncontrolled asthma. A budget impact analysis was conducted to determine the financial impact of introducing FF/UMEC/VI SITT from the perspective of the Dubai Academic Healthcare Corporation (DAHC).Methods: A budget impact model was constructed using an epidemiology-based approach and used to estimate the expected 5-year budget impact of including FF/UMEC/VI for the treatment of eligible patients within the DAHC in the United Arab Emirates (UAE). The model included both pharmacy and efficacy-related costs. The perspective of the DAHC healthcare payer was adopted, thus only direct payer costs were included in the analysis. A one-way sensitivity analysis was conducted to test the robustness of the model structure, assumptions, and input parameters.Results: The total budget impact was estimated to save 1 million United States Dollars (USD) over 5 years, with budget impacts of 0.08 million USD in Year 1; 0.14 million USD in Year 2; 0.22 million USD in Year 3; 0.28 million USD in Year 4; and 0.33 million USD in Year 5. The overall budget impact per patient was estimated to save 12.2 USD over 5 years. In one-way sensitivity analyses, the budget impact was most sensitive to changes in the market uptake of FF/UMEC/VI.Conclusion: Healthcare payers may consider FF/UMEC/VI in the management of uncontrolled asthma which would save costs and reduce healthcare resource use in the UAE.Keywords: asthma, asthma maintenance therapy, budget impact analysis, triple therapy, United Arab Emirates

Mahmoud Farghaly,1 Abdallah Kamal,1,2 Maged El-Setouhy,3,4 Jon Mark Hirshon,5,6 Mohamed El-Shinawi1,7 1Department of General Surgery, Ain Shams University, Cairo, Egypt; 2Department of Radiology, Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA; 3Department of Community, Environmental and Occupational Medicine, Ain Shams University, Cairo, Egypt; 4Department of Family and Community Medicine, Jazan University, Jazan, Saudi Arabia; 5Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; 6Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA; 7Department of Medical Education, Galala University, Cairo, EgyptCorrespondence: Mahmoud FarghalyDepartment of General Surgery, Ain Shams University, Cairo, EgyptTel +20 1001775378Email Mahmoudfarghali@med.asu.edu.egStudy Design: Retrograde cross-sectional study.Objective: To assess patient satisfaction and outcomes in polytraumatized patients in EL-Demerdash hospital.Background: This is the first study that assessed patient satisfaction with a tertiary hospital in Egypt. Ain Shams University Surgery Hospital, which is one of the largest hospitals in Egypt and serves millions of patients each year, was the site of the study.Methods: A version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used to query 361 patients from November 2015 until July 2018 Survey questions were divided into the following categories: communication with doctors, responsiveness of hospital staff, cleanliness of the hospital environment, quietness of the hospital environment, pain management, communication about medicines, discharge information, overall rating of the hospital, and willingness to recommend the hospital.Results: A total of 361 patients were interviewed. The results showed both positive and negative levels of satisfaction. The positive results included no delay in admission, friendly staff including nurses and doctors, better patient outcomes regarding pain management and adverse side effects, and the overall rating of the hospital was good, which reflected patient satisfaction. The negative findings were lack of proper communication between the medical staff and patients. Patients indicated they did not get a satisfactory explanation of their prescribed drug doses and drug adverse effects. In addition, they did not get enough instruction on what to do after being released from the hospital.Conclusion: The medical staff at Ain Shams University Surgery Hospital should focus more on the patient’s own preferences and communicate better with patients. We recommended that the hospital organize regular communication skills courses for medical students, physicians, and nurses. Patients should understand the discharge report and indications and side effects of the medications before leaving the hospital.Keywords: HCAHPS, quality, patients’ satisfaction, community

Viktor V Chirikov,1 Chris Walker,2 Jennifer M Stephens,1 Patricia Schepman,3 Richard Chambers,4 Mahmoud Bakir,5 Gregory W Poorman,1 Seema Haider,6 Mohammed Farghaly7 1OPEN Health, Bethesda, MD, USA; 2Global Medical Affairs, Viatris, Tadworth, UK; 3Global Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA; 4Biostatistics, Pfizer Inc, Collegeville, PA, USA; 5Upjohn Export B.V., Jeddah, Saudi Arabia; 6Pfizer Inc., Groton, CT, USA; 7Dubai Medical College, Dubai, United Arab EmiratesCorrespondence: Jennifer M StephensOPEN Health, Bethesda, MD, USATel +1 703 625 5943Email jstephens@pharmerit.comObjective: Data on osteoarthritis patients from the PRECISION trial were used to evaluate the cost-effectiveness of celecoxib (100 mg twice daily) versus ibuprofen (600– 800 mg three times daily) and naproxen (375– 500 mg twice daily). The perspective was that of the United Arab Emirates (UAE) healthcare system.Methods: Discrete-state Markov model with monthly cycles, 30-month horizon, and 3% discount rate was constructed to assess incremental costs per quality adjusted life year (QALYs) gained from reduced incidence of three safety domains examined in PRECISION: renal, serious gastrointestinal (GI), and major adverse cardiovascular events (MACE). Costs for managing these toxicities were derived from Dubai Administrative Billing Claims (2018). Median monthly drug costs were derived from UAE Ministry of Health and Prevention’s published prices ($26.98 celecoxib; $20.25 ibuprofen; $20.50 naproxen). Health utility and excess mortality associated with toxicities were sourced from the literature. The willingness-to-pay thresholds used were 1 and 3 GDP per capita ($40,000–$120,000).Results: The total average cost per patient was $812.88 for celecoxib, $775.26 for ibuprofen, and $731.17 for naproxen while cost components attributed to toxicities were lowest with celecoxib ($360.26, $438.31, and $388.60, respectively). Patients on celecoxib had more QALYs (1.339), compared with ibuprofen (1.335) and naproxen (1.337), resulting in an incremental cost-effectiveness ratio of $11,502/QALY gained for celecoxib versus ibuprofen and $39,779 for celecoxib versus naproxen. Probabilistic sensitivity analyses demonstrated celecoxib to be 81% cost-effective versus ibuprofen and 50% versus naproxen at $40,000/QALY. The most influential model parameters were MACE relative safety and drug costs.Conclusion: From UAE third payer perspective, celecoxib is a long-term cost-effective treatment for osteoarthritis patients when compared with ibuprofen, and equally likely as naproxen to be cost-effective. With the expected increasing burden of chronic diseases in the Gulf region, study findings can inform decisions regarding the cost-effective pain management of osteoarthritis in UAE.Clinicaltrials.gov Registration Number: NCT00346216.Keywords: Markov, NSAIDs, comparative effectiveness, safety, Gulf region, AfME, MENA

Suspensions of calcium carbonate are of a major concern in various fields, such as coating, painting and ceramics and their rheological properties are very important. The effect of polyacrylic acid (PAA) of different molecular mass as a surface modifier on the surface and rheological properties of the aqueous suspension of calcium carbonate was investigated. The effect of the volume fraction of particles and polymer concentration on the viscosity at lower shear rate was discussed. The flow behavior of the concentrated suspension in the presence of PAA can be explained by the difference of the repulsive force among particles, induced by the adsorbed polymer. The results showed that the dispersibility is more pronounced by the steric hindrance behavior rather than the electrostatic behavior. [ABSTRACT FROM AUTHOR]

In this work, the interactions of 7Li nuclei with emulsion at 3 A GeV/c were studied. Multiplicity of the charged secondary particles as well as the charge of the outgoing projectile fragments were measured, while correlations among them are discussed. The values of the total charge of the noninteracting projectile nucleons and the average number of interacting projectile nucleons are estimated. The dependence of the secondary particles on the number of heavily-ionized tracks is analyzed. The results show that interactions of 7Li nuclei with emulsion nuclei exhibit a number of regularities, which had been noted in experiments with lighter nuclei. The absorption of relativistic particles, while increasing the degree of target destruction, is observed. The average multiplicities of the secondary charged particles depend on the impact parameter, as their values increase, while decreasing the impact parameter. The number of secondary charged particles in the heavy-ion interactions depends on the degree of disintegration of the target nuclei. This dependence is not observed in the case of the interaction of hadron with emulsion. The experimental data of the interaction of 7Li are systematically compared with the other interactions at different energies. The results agree with the corresponding results at nearly the same energy. [ABSTRACT FROM AUTHOR]