Optimization of drug supply for patients with malignant neoplasms in a region of the Russian Federation
https://doi.org/10.17749/2070-4909.2019.12.4.300-308
Abstract
The aim was to assess the possibility of optimizing the costs of drugs for cancer patients in a subject of the Russian Federation considering the expiration of patent protection period.
Materials and methods. The possibility of optimizing the costs of antitumor drugs was studied using a model of a hypothetical region with a population of 2 million. A gradual replacement of the reference drugs with expiring patent protection by generics or biosimilars over 5 years was simulated. Two replacement scenarios were analyzed: 1) maintaining the drug consumption at a stable level; 2) increasing the drug consumption to the level identified in a previous retrospective analysis of the pharmaceutical market. The baseline scenario implied that the drug purchases remained unchanged (in physical and monetary terms) at the level of 2018. We calculated the difference between the drug costs in the baseline scenario and the costs of the same drugs replaced with generics or biosimilars for a 5 year period.
Results. By gradually replacing the reference drugs with generics or biosimilars in a region with a population of 2 million and keeping the costs of drugs for solid tumors at the 352.2 million rubles for 5 years (baseline scenario), 69.4 million rubles can be saved. That amount represents 19.7% of the base level if the drug consumption remains at the 2018 level. With an increase in the INN consumption after the release of generics/ biosimilars, no saving is expected; on the contrary, expenses will increase by 14.1% to 400 million rubles, although, an 8.45-fold increase in consumption is projected.
Conclusion. With the appearance of generics / biosimilars for the treatment of solid malignant tumors, the possibility of fund saving depends on the increase in drug consumption.
About the Authors
A. V. NikitinaRussian Federation
Anna V. Nikitina – Chief Specialist at the Department of Methodological Support for Comprehensive HTA
10-5 Khokhlovskii pereulok, Moscow 109028
F. V. Gorkavenko
Russian Federation
Filip V. Gorkavenko – Lead Specialist, Department of Methodological Support for Comprehensive HTA
Researcher ID: A-8805-2017
10-5 Khokhlovskii pereulok, Moscow 109028
Y. S. Saybel
Russian Federation
Yegor S. Saybel – PhD, Lead Specialist, Department of Methodological Support for Comprehensive HTA
10-5 Khokhlovskii pereulok, Moscow 109028
M. V. Avxentyeva
Russian Federation
Maria V. Avxentyeva – MD, PhD, Advisor to the Director-General, Center of Healthcare Quality Assessment and Control, Ministry of Health of the Russian Federation. Leading Research Fellow at the Center of Health Care Finance, Financial Research Institute at the Ministry of Finances of the Russian Federation, Professor at the High School of Health Administration, Sechenov First Moscow State Medical University (Sechenov University)
10-5 Khokhlovskii pereulok, Moscow 109028
3-2 Nastasyinsky pereulok, Moscow 127006
82 Vernadskogo prospect, Moscow 119571
M. S. Sura
Russian Federation
Mariya V. Sura – MD, PhD, Head of the Scientific and Research Department, Center of Healthcare Quality Assessment and Control, Ministry of Health of the Russian Federation, Leading Researcher at the Center for HTA, Institute for Applied Economic Research, Russian Presidential Academy of National Economy and Public Administration (RANEPA); Senior Staff Member at the Center for Healthcare Finance Studies, Financial Institute of the Russian Federation, Ministry of Finance
10-5 Khokhlovskii pereulok, Moscow 109028
82 Vernadskogo prospect, Moscow 119571
D. V. Fedyaev
Russian Federation
Denis V. Fedyaev – Deputy Head of the Department for Methodological Support of Methods of Payment for Medical Care, «Center for Expertise and Quality Control of Medical Care», Ministry of Health of the Russian Federation, Research Fellow at the Laboratory for HTA at the Institute of Applied Economic Research of the Russian Academy of Science, Research Associate at the Center for Healthcare Finance Studies
10-5 Khokhlovskii pereulok, Moscow 109028
3-2 Nastasyinsky pereulok, Moscow 127006
82 Vernadskogo prospect, Moscow 119571
References
1. Estimated number of prevalent cases (1-year) as a proportion in 2018, all cancers, both sexes, all ages. [Electronic resource] URL: http://gco.iarc.fr/today/online-analysis-map?v=2018&mode=population&mode_population=continents&population=900&populations=900&key=asr&sex=0&cancer=39&type=2&statistic=1&prevalence=1&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&nb_items=5&group_cancer=1&include_nmsc=1&include_nmsc_other=1&projection=naturalearth&color_palette=default&map_scale=quantile&map_nb_colors=5&continent=0&rotate=%255B10%252C0%255D. Accessed: 04.11.19.
2. Omelyanovskiy V.V. Early assessment of healthcare technologies as a tool for examination and impact on the development of new medical products. Meditsinskie tekhnologii. Otsenka i vybor. 2014; 2 (16): 23-29. (in Russ).
3. Early health technologies assessment – new approach to improving the efficiency of the medical technology development process. FARMAKOEKONOMIKA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2016; 9 (3):53-59. (In Russ.) https://doi.org/10.17749/2070-4909.2016.9.3.053-059.
4. More health for the money [Elektronnyi resurs] URL: http://www.who.int/whr/2010/10_chap04_en.pdf?ua=1. Accessed: 04.11.19.
5. Musa B.M., John D., Habib A.G., & Kuznik A. Cost-optimization in the treatment of multidrug resistant tuberculosis in Nigeria. Tropical Medicine & International Health. 2016; 21 (2): 176-182.
6. The program “Development of the pharmaceutical and medical industry of the Russian Federation for the period up to 2020 and the future perspective” [Electronic resource] URL: http://minpromtorg.gov.ru/common/upload/files/docs/MinProm_02.06.14.pdf : 01.08.2019.
7. Ulumbekova G.E., Kalashnikova A.V. Approaches to the formation of the concept of national drug policy. Part 1. Analysis of the drug market in the Russian Federation. Vestnik VShOUZ. 2018; 4: 53-75. [Electronic resource] URL: https://www.vshouz.ru/journal/2018-god/analiz-rynkalekarstvennykh-preparatov-v-rf/. Accessed: 04.11.19. (In Russ.).
8. Instructions on the grouping of cases, including the rules for accounting for additional classification criteria, and approaches to paying for medical care on an outpatient basis according to the per capita funding standard (FOMS letter No. 938 / 26-2 / i dated January 25, 2018). [Electronic resource] URL: http://www.ffoms.ru/documents/the-orders-oms/. Accessed: 04.11.19. (In Russ.).
9. Avksentyeva M.V., Omelyanovskiy V.V., Petrovskii A.V. et al. New approaches to the formation of clinical and statistical groups combining hospitalizations for the treatment of malignant neoplasms. Meditsinskie tekhnologii. Otsenka i vybor. 2018; 2 (32): 8-22. (In Russ.).
10. Website IAS «Zakupki» [Electronic resource] URL: http://gzakupki.com. Accessed: 04.11.19. (In Russ.).
11. The state register of medicines [Electronic resource] URL: http://grls.rosminzdrav.ru/Default.aspx. Accessed: 04.11.19. (In Russ.).
12. Gorkavenko F.V., Nikitina A.V., Saibel’ E.S., Avksent’eva M.V., Sura M.V., Fedyaev D.V. Dynamics of prices and consumption of anticancer drugs in Russia after their generics and biosimilars became available. FARMAKOEKONOMIKA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2019; 12 (2): 115-124. (In Russ.) https://doi.org/10.17749/2070-4909.2019.12.2.115-124.
13. Cameron A., Mantel-Teeuwisse A.K., Leufkens H.G.M. et al. Switching from originator brand medicines to generic equivalents in selected developing countries: how much could be saved? Value in health. 2012; 15 (5): 664-673.
14. Sun J., Ren L., Wirtz V. How much could be saved in Chinese hospitals in procurement of anti-hypertensives and anti-diabetics? Journal of medical economics. 2016; 19 (9): 881-888.
15. Lopes G.L. Cost comparison and economic implications of commonly used originator and generic chemotherapy drugs in India. Annals of oncology. 2013; 24 (5): v13-v16.
16. Padula W.V., Larson R.A., Dusetzina S.B. et al. Cost-effectiveness of tyrosine kinase inhibitor treatment strategies for chronic myeloid leukemia in chronic phase after generic entry of imatinib in the United States. Journal of the National Cancer Institute. 2016; 108 (7). https://doi.org/10.1093/jnci/djw003. Print 2016 Jul.
Review
For citations:
Nikitina A.V., Gorkavenko F.V., Saybel Y.S., Avxentyeva M.V., Sura M.S., Fedyaev D.V. Optimization of drug supply for patients with malignant neoplasms in a region of the Russian Federation. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2019;12(4):300-308. (In Russ.) https://doi.org/10.17749/2070-4909.2019.12.4.300-308

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