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Pedro Santos-Moreno,1 Nelson J Alvis-Zakzuk,2 Edwin Castillo,1 Laura Villarreal,1 Carlos Pineda,3 Hugo Sandoval,4 Omaira Valencia1,5 1Center of Rheumatoid Arthritis, BIOMAB, Bogota, Colombia; 2Universidad de la Costa-CUC, Departamento de Ciencias Económicas, Barranquilla, Colombia; 3Sociomedical Research Unit, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico; 4Sociomedical Research Unit, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México; 5Fundación Santa Fé de Bogotá, Bogotá, ColombiaCorrespondence: Omaira ValenciaFundación Santa Fé de Bogotá, Carrera 7B # 123-90, Bogotá, ColombiaEmail o.valencia10@uniandes.edu.coBackground: Seronegative rheumatoid arthritis (SRA) is a condition that is not well understood and difficult to confirm by a conventional diagnostic process. We aimed to quantify the potential cost-savings of an alternative diagnostic process (ADP) imaging-based, for patients with presumptive SRA from everyday clinical practice.Methods: We performed a retrospective analysis for patients with presumptive SRA who tested negative for both rheumatoid factor and anti-cyclic citrullinated peptide antibodies, through an ADP imaging-based, that is a standard clinical practice in our center. After we confirmed the diagnosis of SRA or reclassified patients in terms of another proper diagnosis, we estimate direct costs in two scenarios: a conventional and ADP. We compared the cost of RA treatment during the first year against the cost of the most misdiagnosed treatment (osteoarthritis) found after applying the ADP to determine potential cost-savings.Results: We included 440 patients with a presumptive diagnosis of SRA. According to the imaging-based ADP, SRA was confirmed in 106/440 (24.1%), unspecified RA in 9/440 (2.0%), and osteoarthritis in 325/440 (73.9%) of those patients. Although the costs of conventional diagnosis per patient is lower than those of ADP ($59,20 USD vs $269,57 USD), we found a potential drug cost-savings of $1,570,775.20 US Dollars after 1 year of correct treatment.Conclusion: An alternative diagnosis process, including X-rays, US and MRI imaging, and clinical and blood-test assessment, not only increased diagnostic certainty in patients referred for evaluation of presumptive SRA but also suggested a potential cost-savings in pharmacological treatments avoided in misdiagnosed patients.Keywords: cost-savings, seronegative rheumatoid arthritis, diagnosis, imaging

Background Care models can affect the clinical outcome of patients with rheumatic and musculoskeletal diseases. Objective We aimed to compare how an innovative model of a rheumatoid arthritis disease-management program can improve the clinical outcomes of patients compared to a conventional assessment approach. Methods We performed a retrospective analysis of real-world data from clinical records of a cohort of 5078 patients diagnosed with rheumatoid arthritis who were followed up at the Center of Excellence in Rheumatoid Arthritis vs the clinical outcomes reported in the Colombian National Registry of Rheumatoid Arthritis. Results We found significant differences in the diagnosis and follow-up between the specialized Center program and the usual care reported by the Colombian National Registry (p

Background: The prevalence of acute malnutrition in Columbia was 1.6% in 2015, which was significantly higher than that found in 2010 (0.9%). Further, the distribution by age shows a higher prevalence of malnutrition in children under 2 years of age. Low rates (36.1%) of exclusive breastfeeding (BF) were found in these children, and adequate BF rates (45.5%) were found for children between 6 and 23 months. These percentages were low compared to the world average of 46%. The objective was to evaluate breastfeeding practices, relactation and feeding processes related to the recovery of children between 0 and 24 months of age with a diagnosis of moderate or severe acute malnutrition (SAM) treated at prioritized health service provider institutions and in the Nutritional Recovery Centers of the Instituto Colombiano de Bienestar Familiar (ICBF).Methods: This research was a mixed-type observational descriptive design in the community with a quantitative and qualitative component in three phases. The first phase characterized the practices of breastfeeding and relactation among mothers seeking help for their infants through the Nutritional Recovery Centers of the Instituto Colombiano de Bienestar Familiar ICBF and health service provider institutions during the study period. In the second phase, a technical strengthening intervention will be carried out aimed at health professionals, and in the third phase, the care processes will be reviewed before and after the intervention. In addition, anthropometric variables and practices of breastfeeding on admission and discharge from care facilities were reviewed to identify potential factors related to the nutritional recovery process.Discussion: This research aims to provide a characterization of breastfeeding and relactation in the population treated for infants with severe acute malnutrition in the CRN and IPS, improve health professionals’ care processes for children with SAM, contribute to the achievement of relactation in mothers of children with moderate and severe acute malnutrition that graduate from the IPS and CRN and identify the potential factors related to the nutritional recovery of these children.Trial registration: Not aplicable

Aspects of the biology of the crested oropendolas Psarocolius decumanus and the clay-coloured Thrush Turdus grayi at the Cotove Agrarian Station at the National University of Colombia were studied. The Station is located in the municipality of Santa Fe de Antioquia, geographic area of tropical dry forest. The Agrarian Station is operated with a silvopastoral system, which integrates the use of trees and pastures in livestock production, thus conserving habitats for wildlife species. Six field samplings were carried out between December 2009 and October 2010, every two months, in both dry and rainy periods. Records of the presence of the both species in the different habitats available were made. It became evident the role that forest fragments and silvopastoral systems accomplishes in favor of the conservation of the diversity of birds, and in particular of the crested oropendolas and the clay-coloured Thrush. Psarocolius decumanus and Turdus grayi used the Agrarian Station as a foraging site, predominate in forest edges. Both species are very susceptible to the loss and fragmentation of the natural forest and to the transformation of these ecosystems into lands dedicated to agriculture and livestock, mainly the crested oropendolas that did not register reproductive activity during the study. The other hand, for the clay-coloured Thrush Turdus grayi , reproductive activity in the months of April and June 2010 was observed.

Objective: To describe sustainability of low disease activity levels in patients with rheumatoid arthritis (RA) who were followed-up in a specialized center based on a healthcare model maintaining adherence to appointments and treatment.Material and methods: As part of a comprehensive RA healthcare model, services related to care like rheumatology, physiatry, physiotherapy, occupational therapy, nutrition, and psychology can be found in the specialized center. Patients with RA are followed-up at least six times a year to ensure retention in care model and adherence to the treatment. Using this approach, a cohort of RA patients were followed-up during 2018. Demographical and clinical data were extracted retrospectively from the electronic health records. The association between clinical and demographic variables was studied by means of the Chi-square test and analyzed using the McNemar test for changes in disease activity levels. Results: 2,239 RA patients were followed-up, 82.76% were women. The average disease duration was eight years (IQR: 3-18 years). During the follow-up year, 91.62% of patients with conventional therapy had at least six rheumatology appointments, while for those who received biological therapy 81.51%. For the ones treated with biological therapy, there were no significant changes for each level of disease activity during study period; nevertheless, in patients who received conventional therapy there was a significant increase of patients in remission (p-value = 0.004).Conclusions: The results evidence that the model used guarantees high levels of adherence for medical appointments and keeps remission levels for RA under control.

Pedro Santos-Moreno,1 Fernando Gómez-De la Rosa,2 Devian Parra-Padilla,2,3 Nelson J Alvis-Zakzuk,2,4 Nelson R Alvis-Zakzuk,2 María Carrasquilla-Sotomayor,2 Omaira Valencia,1 Nelson Alvis-Guzmán2,5 1Biomab IPS – Center for Rheumatoid Arthritis, Bogotá, Colombia; 2Department of Health Technology Assessment, ALZAK Foundation, Cartagena, Colombia; 3Health Economics Research Group, Universidad de Cartagena, Cartagena, Colombia; 4Department of Health Sciences, Universidad de la Costa-CUC, Barranquilla, Colombia; 5Department of Economic Sciences, Universidad de Cartagena, Cartagena, ColombiaCorrespondence: Nelson J Alvis-ZakzukDepartment of Health Sciences Universidad de la Costa-CUC, Calle 58 # 55 - 66, Barranquilla, ColombiaTel +57 3002209164Email nalvis1@cuc.edu.coObjective: To estimate the frequency of health care resource utilization and direct medical costs associated with Psoriatic Arthritis (PsA) in a rheumatic care center in Colombia.Methods: A retrospective prevalence-based cost of illness study under the Colombian health care system perspective was conducted. We analyzed the frequency of health care resource utilization and estimated direct medical costs using anonymized medical records of adult patients (≥ 18 years) diagnosed with PsA at a rheumatology care center in Bogotá, Colombia. Patients were required to have at least one medical visit linked to a PsA diagnosis (ICD-10 L40.5) between October 2018 and October 2019 and a previous diagnose by the CASPAR criteria. Data on hospitalization episodes was not available. Direct medical costs were estimated in Colombian pesos (COP) and reported in US dollars (USD) using an exchange rate of 1USD = 3263.4 COP. A multivariate generalized linear model was used for identifying potential cost predictors.Results: A sample of 83 patients was obtained. Of these, 54.2% were women and had a mean (SD) age of 58.7 (12) years at baseline. On average, they had 2.2 and 3.8 medical visits to the dermatologist and rheumatologist in the study period. The total direct medical cost was estimated at 410,985 US Dollars. Medical visits, therapies, laboratory and imaging represented 3.2% of total expenses and medications the remaining 96.8%. Patients receiving conventional DMARDs (cDMARDs) had an associated mean cost of 1020.1 USD (CI 701.4– 1338.8) in a year. Among patients treated with cDMARDs and biological DMARDs (bDMARDs) the mean cost increase to 8113.9 USD (SD 5182.0– 95% CI 6575.1– 9652.8).Conclusion: A patient under biological therapy can increase their annual cost by 7.9 times the cost of a patient in conventional therapy. This provided updated knowledge on the direct medical costs, from the provision of a rheumatic care center service, to support epidemiologic or pharmacovigilance models.Keywords: psoriatic arthritis, direct medical costs, treatment

Purpose Incidence and prevalence are important factors in policy making and planning in health care systems. The aim of this study was to compare two different estimates of the incidence and prevalence of cancer in Colombia—real-world data from the health care system and estimates from cancer registries. Materials and Methods Data from all providers were aggregated by the High-Cost Diseases Office (Cuenta de Alto Costo [CAC]). The real-world, age-standardized observed incidence (OI) and observed prevalence (OP) rates were calculated using the number of patients with a diagnosis of cancer who were cared for in the national health system between 2014 and 2015. The registry estimated incidence (EI) and estimated prevalence (EP) were extracted from GLOBOCAN population fact sheets for 2012, which use data from four Colombian city-based registries and extrapolate survival using the average for Asian countries, together with registries from Uganda and Zimbabwe. Results A total of 130,441 patients were analyzed. The OI of cancer in Colombia was 69.2 and the OP was 479 (per 100,000 people) in early 2015, whereas the EI was 175.2 and the 5-year EP was 501.2 (per 100,000 people), showing a higher estimate from GLOBOCAN data for 2012 than was observed in early 2015 by the CAC. Some differences were higher in specific cancers. Conclusion Because of differences in methodology, the EI and the EP are not comparable to the OI and the OP. Policymakers need robust and current information to prioritize disease prevention and control programs. In Colombia, the OI and the OP—calculated by the CAC with data from the whole country—offer an opportunity for a more precise real-world estimation of patients with cancer in Colombia.

Background: The diagnosis of rheumatoid arthritis (RA) using EULAR criteria through conventional assessments remains controversial, especially for those with seronegative results, many of patients without other diagnostic aids as imaging, could be wrong diagnosed followed by expensive treatments (1-3). Objectives: To evidence through real-world data how the use of imaging within a screening process of diagnosis of RA can saving future costs for unnecessary treatments in patients with misdiagnosis of RA. Methods: A retrospective real-world data (RWD) analysis was developed from medical records of patients with presumptive RA diagnosis reportedly seronegative for both rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (ACPA), and who met ACR/EULAR 2010 classification criteria, in the period between July 2016 and June of 2017; patients were assessed by imagenology (X-ray, ultrasound (US) or magnetic resonance imaging (MRI) according to the screening diagnosis protocol in a center of integral attention for rheumatoid arthritis (CIA-RA) in order to confirm diagnosis of RA, or classify patients in an alternative proper diagnosis. Direct costs of diagnosis was estimated in two scenarios: the conventional diagnosis and the screening process of diagnosis in the CIA-RA. To quantify the cost-savings for this process we also estimated the cost of treatment for the first year after diagnosis for patients with RA and patients with the most common diagnosis found after screening. Results: 440 patients were referred to our center with presumptive diagnosis of RA in the period, who were assessed for ACPA and RF obtaining a seronegative result for both. After screening process just 115 patients were classified as RA, 99 as SRA and 16 as Nonspecific RA; 12.2% were identified by X-Ray, 67.7% were identified by US and 20% by MRI. The most frequently misdiagnosis found was Osteoarthritis in the 72.5% of patients assessed by the screening process. In that way, the conventional diagnosis cost $54.4, while the CIA-RA screening diagnosis cost was $247.1 per patient, however there was found a potential cost-saving from using the CIA-RA screening process of diagnosis of $1,440,494 per year due to the pharmacological cost saving of 325 patients who requires treatment for OA and not for RA. Conclusion: According with our findings the use of imaging within a diagnostic screening process combining conventional criteria is a useful tool to discard false positive diagnosis of RA. Despite the fact that at first sight, the cost of screening process of diagnosis is more expensive than conventional diagnosis, after one year of treatment it can be assumed potential cost-savings using the proposed approach. References [1] Hu H, Luan L, Yang K, Li S-C. Burden of rheumatoid arthritis from a societal perspective: A prevalence-based study on cost of illness for patients with rheumatoid arthritis in China. Int J Rheum Dis [Internet]. 2017 Feb 17 [cited 2017 Mar 1]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/28211251 [2] Cross M, Smith E, Hoy D, Carmona L, Wolfe F, Vos T, et al. The global burden of rheumatoid arthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6). [3] Ostergaard M, Pedersen SJ, Dohn UM. Imaging in rheumatoid arthritis - status and recent advances for magnetic resonance imaging, ultrasonography, computed tomography and conventional radiography. Best Pract Res Clin Rheumatol [Internet]. 2008;22(6):1019–44. Available from: http://dx.doi.org/10.1016/j.berh.2008.09.014 Disclosure of Interests: Omaira Valencia: None declared, Pedro Santos-Moreno Grant/research support from: Dr Santos has received research grants from Janssen, Abbvie and UCB, Speakers bureau: Dr Santos has received speaker fees from Sanofi, Lilly, Bristol, Pfizer, Abbvie, Janssen and UCB, Edwin Castillo: None declared, Nelson Alvis : None declared

Background:Several medicines are prescribed for chronic disease management of rheumatoid arthritis (RA) including biologics; however, adherence to long-term therapy remains poor because many causes; the latter results in worsening clinical results.Objectives:To analyze the relationship between adherence to treatment and the achievement of remission or low disease activity in patients with RA treated with three anti-TNF molecules of subcutaneous use.Methods:In patients treated with 3 subcutaneous anti-TNFs, with at least one year of follow-up previously, adherence was measured with Compliance Questionnaire for Rheumatology (CQR19) applied by psychologist; the CQR19 is a 19 item, self-administered questionnaire that was developed with the aim of correctly identify rheumatology patients that were classified as “low” adherers (taking Results:112 patients diagnosed with RA were included, 34.8% (39/112) treated with adalimumab, 38.4% (43/112) etanercept and 26.8% (30/112) golimumab; The results of CQR19 at BL, M6 and M12 were greater than 80%, with no statistically significant differences between the three molecules. The MPR was higher than 80% in the three periods, being very similar between the three molecules, but in M12 period the difference in MPR between adalimumab 86% and golimumab 92.1% was statistically significant (p CQR19MPRBLM6M12BLM6M12ADALIMUMAB89,789,390,198,590,586,1ETANERCEPT87,489,789,797,989,690,9GOLIMUMAB88,287,691,597,196,192,1No statistical differences in adherence between biologics were found depending on sex, type of concomitant conventional treatment for RA or presence of comorbidities.RELATION BETWEEN Rem/LDA AND COMPLIANCE WITH APPOINTMENTSRemLDAMDAHDAADALIMUMAB63%60%53%29%PETANERCEPT66%62%73%--GOLIMUMAB68%73%55%-PConclusion:There seems to be a higher MPR with the monthly golimumab compared to the biweekly adalimumab and weekly etanercept; however, it does not necessarily imply greater effectiveness. Longer term studies are needed to confirm if there is better adherence and clinical results with monthly anti-TNFs than to other dosing regimens. Patients with remission and low disease activity had greater assistance to scheduled consultations with the interdisciplinary group, regardless of the type of molecule used. This study confirms the relation between adherence to medications and care model with clinical results.Disclosure of Interests:Paola Osorio: None declared, Laura Villarreal: None declared, Michael Cabrera: None declared, Omaira Valencia: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.

Background:Tofacitinib is the first oral Janus Kinasa inhibitor approved for the treatment of rheumatoid arthritis (RA); and although it is approved both after conventional treatment and after biological therapy, it is not well known its real-life effectiveness in both cases and if it is preferable to use it after cDMARDs or biologics.Objectives:We compare the effectiveness and safety of Tofacitinib in patients with RA analyzing if better and safer Tofacitinib after cDMARDs or biologics.Methods:A retrospective analysis of a real-world cohort of patients with RA, who were treated with Tofacitinib in last 3 years, as first line of treatment (T1) after failure with cDMARDS and second line of treatment after biologic drug failure (T2). The therapy was considered effective with the change from moderate-high disease activity to low disease activity or remission measured by DAS28, in those who met criteria of high adherence, without change or addition of other conventional DMARDs, without new dose or increase of dose of oral glucocorticoids. A logistic model of regression was performed to evaluate de differences between T1 and T2, using as covariates sex, age, comorbidities, time of disease evolution, adverse events and other causes of discontinuation. Medication survival time and the main causes of suspension were measured. Mixed model regression and least-squared means were used to estimate the baseline changes and a Kaplan-Meyer survival analysis to estimate time to remission and drug survival.Results:105 patients with RA were included (median age: 56.1 ± 11.7 years; 80.9% female, median disease duration 11.48 ± 10.1 years); 43% (45/105) of patients with positive rheumatoid factor and 73% (77/105) positive anti-citrulline antibodies. Regarding treatment 51% (54/105) used Tofacitinib as 1T, after failure to cDMARDs; on the other hand, Tofacitinib was used as 2T, after failure to biologics in 49% (51/105) of patients. DAS28 levels were reduced at 8, 16 and 24 weeks with statistical difference (p value 0.004, Conclusion:In patients with RA, the use of Tofacitinib as the first line of treatment (after failure to cDMARDs) is better in effectiveness and safer in comparison with its use as a second line of treatment (after biologics), with significant differences in the rates of therapeutic failure and occurrence of adverse events/reactions. On the other hand, concomitant corticoids use, positive RF, extended release tablet of Tofacitinib seem to increase the effectiveness of Tofacitinib in terms of DAS28 and HAQ-DI.Disclosure of Interests:Omaira Valencia: None declared, Michael Cabrera: None declared, Fernando Rodriguez: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.

Background It is difficult to make a differential diagnosis between seronegative RA and other inflammatory arthropathies. Many patients could be wrong diagnosed followed of expensives treatments. Objectives To assess the usefulness of X-rays of hands and feet (X-rays), Ultrasound (US) and Magnetic Resonance Imaging (MRI) to discard false positive diagnosis of seronegative RA from real-world evidence. Methods An analysis from medical records of patients with presumptive seronegative RA diagnosis reportedly seronegative for both rheumatoid factor and anti-cyclic citrullinated peptide antibodies and clinical criteria of RA, in the period between July 2016 and ; June of 2017 who were assesed by imagenology (X-rays, US or MRI) in a centre of rheumatoid arthritis to confirm diagnosis or discard it. Laboratory, and imagenology data was retrospectively analysed and multivariate analysis was performed to determinate the usefulness of imagenology. Results 360 patients were received in the centre with presumptive diagnosis of RA in the period, mean of age was 58 years, 80,9% females and 19,1% males. X-rays shows only 3,59% of patients with erosions, 38,6% were positive for Ostheoarthritis (OA), and 58,6% of patients without erosions. From patients without erosions, 36% were confirmed for RA and 13,4% for OA by US; on the other hand 37% was confirmed for RA and 20% for OA by MRI. A total of 94 patients (26,1%) had a final diagnosis of seronegative RA, while (261) patients 72,5% were confirmed for Osteoarthrosis,5 1,4% were classified in other arthropaties. Conclusions According with our findings the screening by imagenology is a useful tool with low cost to make a differential diagnosis of seronegative RA and other arthropaties. In order to improves outcomes through well-defined treatments and to save high cost treatments for pathologies with more precise diagnoses. Disclosure of Interest None declared

Este trabajo presenta la caracterización palinológica de diez (10) muestras de miel de la abeja Apis mellifera de diferentes cosechas de miel del año 2011, tomadas del apiario asociado al Laboratorio de Investigaciones Melitológicas y Apícolas (LIMA) de la Universidad Nacional de Colombia, sede Medellín. Las muestras fueron sometidas a tratamiento de acetolisis y montadas en gelatina glicerinada, de acuerdo con procedimientos estándar. El análisis cualitativo y cuantitativo del espectro polínico permitió identificar el 16% del total de los taxa a nivel de especie, 37% fue asociado a un género, 42% a familia y 5% a subfamilia. Los tipos polínicos encontrados en mayor abundancia fueron Eucalyptus spp. (28,7%), Myrtaceae (16%), Lamiaceae/Fraxinus spp (16%), Mimosa spp. (10%), Arecaceae (6,3%), Bignoniaceae (6,3%) y Cecropia spp (4,2%). Las mieles del apiario LIMA se consideran multiflorales.

Background: AIDS is associated with a number of malignancies, which in turn carry a high burden of mortality and morbidity in affected patients. This article was developed as an initiative of the High-Cost Diseases Office (CAC in Spanish) to provide the Colombian health system with evidence on the incidence of Cancer in patients diagnosed with AIDS in the country. Methods: The CAC compiled the National Cancer and Human Immunodeficiency Virus (HIV) administrative registries, which identify unique patients diagnosed with both Cancer and AIDS from 1983 to 2015. For the 736 cases found, we considered only those diagnosed with Cancer five years before a diagnosis of AIDS and all cases after the diagnosis. A final sample of 238 individuals, with age ranging from 17 to 84 years, diagnosed with AIDS between 1998 and 2015, was analyzed using Stata Software to compute Standardized Incidence Ratio (SIR) of cancers. Results: Results show that patients with AIDS display an elevated risk of developing the following specific types of cancer: Kaposi’s sarcoma’s (male SIR 301.12; female SIR 252.67) Invasive cervical cancer (female SIR 5.09); Non- Hodgkin Lymphoma (male SIR 20.65; female SIR 9.10). The following non-AIDS-defining cancers were also more common in patients with the disease: in men, anal cancer (SIR 51.52), eye and related malignancies (SIR 27.24), and Hodgkin’s Lymphoma (SIR 20.96); in women: anal (SIR 24.82); vaginal and vulvar (SIR 10.36); and in situ cervical cancer (SIR 5.83). Conclusion: There is an increased incidence of specific types of cancers in a population of patients diagnosed with AIDS in Colombia, in accordance with data from other regions of the world. The National Cancer and AIDS registries provide local information, which can be used for health care policy planning.

e18288 Background: Gastric (GC) and colorectal cancer (CRC) are major health problems worldwide due to their high incidence and lethality associated with late presentation. The aim of this study was to develop a set of clinical, quality and administrative measures, for gastric and colorectal cancer based on evidence to assist health care insurers, providers and policy makers in controlling these diseases in Colombia. Methods: A systematic evidence-based literature search was performed to identify the initial list of indicators, which were then selected and developed using an adaptation of the RAND/UCLA appropriateness method by a panel of multidisciplinary expert panels with expertise in CRC and GC care, quality and public health. The following institutions participated in the study: The Ministry of Health and its High Cost Disease Office, medical professional societies, National Health Institute, Institute of evaluation of technologies in health, health care insurers and providers. A total of 1589 cases of GC and 2025 of CRC from the national administrative cancer registry, representing all new cases of these diseases in the country in 2015, were used to define the viability of the proposed measures, which the involved parties developed taking in consideration the whole disease spectrum from diagnosis to treatment. Results: After reviewing relevant articles and holding an in-person expert discussion the panel generated an initial proposed set of 45 disease-management indicators. A total of 15 disease-management measures for CRC and 16 for GC were developed and approved by the expert panel after two rounds of discussion and voting; these are related to opportunities to improve time between diagnoses to treatment and also include measures assessing clinical outcomes and administrative processes. Conclusions: We developed disease-management indicators for GC and CRC in a consensus with healthcare system stakeholders that are feasible and applicable in Colombia. In time, through continuous efforts towards improving the quality of care provided, these will allow all parties to monitor and decrease the burden of GC and CRC in the country and may serve as a model to other low and middle income countries.