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Introduction: The burden of septic shock management is ascertained. This study aimed to explore the burden of septic shock management in the Intensive Care Unit (ICU) in a tertiary hospital and to evaluate the effect of intravenous ascorbic acid in this population. Methodology: A retrospective observational study was conducted between 2018 and 2020 on the cost of surviving and non-surviving sepsis patients from a paymaster perspective. Medical records were abstracted to identify events and resources consumed in ICU retrospectively. The cost accrued was received from the price listed by the Attorney General's Chambers of Malaysia for foreigner and private pathology lab. The price list of types and quantities of healthcare components utilized during the patient's stay were taken into consideration. Results: An average cost of treatment in ICU for sepsis patients was RM14,833.50 (CI: RM10,560.94, 95%CI). From the 35 sepsis shock patients, 71.43% passed on and 28.57% survived and were discharged from ICU. The mean hospital costs incurred per surviving patient was RM 5,813.07 and the average stay in ICU was 6.90 days. The mean hospital cost incurred per death in ICU was RM18,441.67 with an average stay of 23 days. Only the number of total ICU stay has a strong relationship (r:-0.99) with the management cost. The proportion of the cost of intravenous ascorbic acid was 2.84% (CI: 0.65%,95%CI) from the total management cost. The majority of the expenses accrued was from laboratory tests which was 52.98% (CI:1.03,95%CI). Conclusions: This study provided insight with the efficacy of intravenous ascorbic acid and the burden of sepsis shock management in ICU. Disclaimer: Abstract text might vary slightly from what is displayed in the e-poster.

Asrul Akmal Shafie,1 Chin Hui Ng2 1Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Penang, Malaysia; 2Pharmacy Department, Hospital Raja Permaisuri Bainun, Ipoh 30450, Perak, MalaysiaCorrespondence: Asrul Akmal ShafieDiscipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, 11800 Universiti Sains Malaysia, Penang, MalaysiaEmail aakmal@usm.myObjective: To compare the cost-effectiveness of long-acting insulin analogue (LAIA) (insulin Detemir and insulin Glargine) versus NPH insulin in the basal insulin regime for naïve insulin T2DM Malaysian patients.Methods: The UKPDS-Outcome Model version 2.0 (UKPDS-OM2) was used to evaluate the cost and consequence of diabetes-related complication. The effectiveness of the insulin was derived from the literature review, and the patients’ epidemiology characteristics were retrieved from the Malaysian Diabetes Registry. A discount rate of 3% was applied to both costs and health effects. Another simple mathematical model was used to compare the benefit of reducing the hypoglycemia events between LAIA and NPH insulin. The outputs of the models were combined to obtain the final result. One-way sensitivity analyses were performed to assess the uncertainties.Results: The net cost difference (without accounting for hypoglycemia) was RM4868 for insulin Glargine and RM6026 for insulin Detemir. The saving from preventing severe hypoglycemia was RM4377 for insulin Glargine and RM12,753 for insulin Detemir. The total additional QALY gained from insulin Glargine was 0.1317 and from insulin Detemir was 0.8376. The sensitivity analysis shows the discount rate, and drug acquisition cost may affect the incremental cost-effectiveness ratio (ICER) value.Conclusion: Both insulin Detemir and Glargine are cost-effective compared to NPH insulin for T2DM patients, especially when the benefit of reducing the hypoglycemia event rate is taken into account.Keywords: type 2 diabetes mellitus, insulin Glargine, insulin Detemir, cost-effectiveness analysis