PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology

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Vol 9, No 2 (2016)
View or download the full issue PDF (Russian)

Original Article

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The aim of the current study is pharmacoeconomic evaluation of using combined drug Vesomni (controlled release tablets tamsulosin 0.4 mg + solifenacin 6 mg) for treatment of patients with storage symptoms associated with benign prostatic hyperplasia, who do not respond to first line tamsulosin therapy.

Materials and methods. We consider three therapy options: 1) combined drug Vesomni; 2) combination of tamsulosin (modified release capsules 0.4 mg) and solifenacin (5 mg); 3) combination of tamsulosin (controlled release tablets 0.4 mg) and solifenacin (5 mg). These options are evaluated with cost minimization and budget impact analysis.

Results. We found that approx. 250,000 patients in Russia need combined tamsulosin and solifenacin therapy, including 35,400 patients eligible for government reimbursement. Using combined drug is cost saving alternative that annually requires 22,000 rubles per patient, which is 2,000 rubles less than second best option. The overall healthcare annual expenses of using combined drug are 5,7 billion rubles (500 million rubles less than for second best option), and government reimbursement costs are 606 million rubles (74 million less than for second best option).

Conclusion. Using combined drug Vesomni for treatment of patients with storage symptoms associated with benign prostatic hyperplasia is cost saving alternative compared to combination of monotheraphy regimens.

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Purpose — to study rationality of financial expenses on the treatment of patients with the severe pneumonia.

Materials and methods. It was selected 30 medical histories of patients with severe community-acquires pneumonia passing hospitalization in pulmonology department and department of intensive care in 2004, 2011 and 2014. The frequency analysis was applied to studying the structure of the carried-out drug treatment and identification of frequency of the separate medicinal preparations. We have data about the cost of drug which were received from the database of «1C: Drugstore» of regional clinical hospital.

Results. Expenses on the treatment of severe community-acquires pneumonia according to 2014 year are rational, 92.23% of expenses are vitally necessary drug entering into modern clinical references. According to the ABC/VEN analysis during the period from 2004 till 2014 we found positive dynamics of increase of expenditure of money at category V. The appreciable attention should be paid to the treatment of accompanying pathology in the therapy of severe communityacquires pneumonia which can make heavier a current of basic disease and become the reason of complications, often fatal. Costs of the medicinal preparations for treatment of the accompanying pathology in 2014 year was made 6.27% that it is necessary to consider at advance planning of provision of medicines in pulmonology department.

Conclusion. The results received by us testify about rational use of financial costs on treatment of patients with severe community-acquires pneumonia.

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Non-alcoholic fatty liver disease (NAFLD) is an important medical and social problem. Essentially, it can be attributed to the problems of interdisciplinary, since it involves issues related to insulin resistance, metabolic syndrome, dyslipidemia. Due to erased clinical manifestation of nonalcoholic fatty liver disease often is diagnosed at late stages of the disease — fibrosis and cirrhosis. The lack of epidemiological data in Russia has identified the need for a larger study to research the prevalence of NAFLD in the Russian Federation. DIREG 2 was the most extensive epidemiological study on the subject, which is coordinated by the leading experts in partnership with Sanofi Russia.

Objective: to estimate the prevalence of NAFLD within the general practitioner’s and gastroenterologist’s patient flow. It is important to know current prevalence of NAFLD in Novosibirsk (Siberian Federal district) and to compare with DIREG 2 results.

Materials and methods. Epidemiologic, observational, multicenter study assessing the prevalence of NAFLD among patients outpatient practice. A total of 50145 patients (3220 in Novosibirsk) including those suspected of having NAFLD criteria were enrolled in the Program. The investigators were qualified doctors (GPs \ therapist’s \ gastroenterologists), providing outpatient care for the population. The epidemiological data were obtained, recorded during two routine patient visits to investigating centers.

Study results. Percentage of patients with revealed NAFLD within the patient flow primary or consistently coming to selected doctors for any reason including those suspected of having NAFLD was 37.3% in Russia vs 56.9% in Novosibirsk (Siberian Federal district).

Conclusion. Prevalence of NAFLD among patient flow of doctors in Russia is quite high. It has been revealed a high prevalence of NANCFLD within the patient flow primary or consistently coming to selected by doctors for any reason.

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Objectives. To assess the incremental budget impact (BI) of using of utilizing perampanel to treat partial-onset seizures (POS) and primary generalized tonic-clonic seizures (PGTCS) in patients who are 12 years of age and older in Russia.

Methods. The budget impact was estimated by comparing two different scenarios: Cost of POS & PGTCS without Perampanel and Cost of POS & PGTCS with Perampanel (Perampanel Adoption). In the latter scenario, market share of perampanel was assumed to increase every year for up to five years. The model was developed from a payer perspective with a time horizon of five years. Direct costs included drugs and medical resources (hospitalization, emergency care costs, visits to physician). BI was calculated as the difference in costs between Perampanel Adoption scenario and the cost without Perampanel.

Results. In Russia, approximately 125,499 patients who are at least 12 years old are treated for refractory POS & PGTCS each year. The market share of perampanel in the perampanel adoption scenario from year 1 to year 5 was 0.1%, 0.5%, 1.0%, 2.0% and 3.0%, respectively. During the same period, the adoption of perampanel is projected to increase drug costs (in millions) by RUB15.2 (1.2%), RUB76.1 (6.2%), RUB152.4 (12.3%), RUB305.4 (24.7%), and RUB459.0 (37.0%), respectively. A significant portion of the 5-year cumulative increase in drug costs (RUB 1,008 million) will be offset by a decrease in non-drug medical resources (-RUB152.7 million). The cumulative budget impact from perampanel adoption for the first five years is projected to be RUB855 million (0.7%), with an additional 231 patients gaining seizure freedom over a period of 5 years from the adoption of perampanel.

Conclusion. Perampanel should be considered as an alternative alongside current antiepileptic drugs in patients with symptoms refractory to prior antiepileptic treatments.

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Targeted drugs are recommended for treatment of metastatic colorectal cancer. Second and further lines therapy options include anti-EGFR therapy, eligible for patients with wild-type KRAS (cetuximab and panitumumab), and relatively new drug — regorafenib, which could be used for all patients.

The aim of this study is to compare costs associated with these options in Russia.

Materials and methods. We calculated cost of medication for treating one patient during one month with cetuximab, panitumumab and regorafenib. We also employed cost-effectiveness analysis, but its results should be treated with caution due to non-comparable patients in regorafenib and anti-EGRF drugs studies.

Results. We found that monthly per patient medication costs of using regorafenib are 255,000 rubles, which is 104,000 rubles less when using cetuximab or 184,000 rubles less when using panitumumab. Cost-effectiveness ratio for regorafenib was estimated at 111,500 rubles per month and is the lowest among the alternatives: 136,000 rubles per month for cetuximab and 310,000 rubles per month for panitumumab.

Conclusions. Regorafenib is cost-saving alternative for treatment of metastatic colorectal cancer in second and further lines therapy compared to cetuximab and panitumumab in Russia.

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Objective. To determine the priority used to vital drugs in сhronic obstructive pulmonary disease (COPD) patients in hospitals of the Kirov region.

Materials and Methods. We analyzed 143 medical records of the patient, the analysis of cost of illness, ABC\ VEN — analysis.

Results. The results of АВС analysis show that the percentage correlation of medicines of different groups generally corresponds to the recommended norm. The results of VEN analysis prove that the number of vital drugs is decreased while the number of second line drugs is increased.

Conclusion. Most of the financial costs were for the treatment of exacerbations of COPD, the appropriate Federal clinical guidelines, simultaneously, there is an active assignment of the second line drugs. Reducing their use and rational therapy of acute conditions will enable competently reallocate financial resources in favour of vital drugs to increase the effectiveness of treatment and reduce the cost of inpatient care.

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The purpose of this study was to conduct the analysis of the structure and the rationality of cost in particular of providing preferential medicines patients with сhronic obstructive pulmonary disease (COPD) in Krasnoyarsk region.

Materials and methods. The database of Ministry of Health of Krasnoyarsk region and Territorial fund of obligatory medical insurance of Krasnoyarsk region on the released preferential preparations to patients with the code J44 on the territory of Krasnoyarsk region for 2014 was used. For the diagnosis of rationality costs method of pharmaco-economic analysis — АВС/VEN analysis — was applied.

Results. Most of the costs amounted to vital medicines (99.8%) of which the maximum share of costs associated with bronchodilators (73.9%) and a combination of DDBA and inhalation GCS (18.5%). In this research the most finances was spent on Tiotropium bromide (51%), Fenoterolum/Ipratropium bromide (18.7%) and Salmeterol/ Fluticasonum (11%). The nomenclature of International unlicensed name of the drugs which are released according to preferential prescriptions for 98.9% is bound to pathogenetic therapy of COPD and doesn't contradict to the modern recommendations on a pharmacotherapy of this pathology. Most of patients were provided with the following drugs of International unlicensed name: the combined preparation of Fenoterolum/ Ipratropium bromide (72.2%), a lond-acting cholinoblocker Tiotropium bromide (38.9%) and mucolytic preparation N- Acetylcysteinum (38.7%). To the category N is referred only 3 drugs of International unlicensed name the necessary of which is in doubt.

Conclusion. The ABC/ VEN analysis showed rational use of financial means on pharmacotherapy patients with COPD in Krasnoyarsk region. The list of drugs of International unlicensed name is consistent with the current recommendations for management of such patients.

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Objective. The study of gender features of attitudes visitors of pharmacies to medicines.

Materials and Methods. Conducted sociological survey thru the original questionnaires in 2015 among pharmacy customers. The survey included 380 respondents (190 men and 190 women) living in the cities of Central Russia. During the interview, respondents were asked, among other things evaluate the 13 influencing their choice when buying of consumer qualities of medicines. For statistical analysis used the methods of variation statistics, ranking, grouping, correlation analysis.

Results. We have identified the priority qualities of medicines which are essential for consumers, in particular: efficiency, minor side effects, low cost, clear information on the package, convenient medicinal form of production. We have not detected significant gender differences in the assessment of consumer qualities of medicines that led to the conclusion of equivalence of consumer attitudes of men and women to them.

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The use of narcotic drugs in healthcare system nowadays is characterized by lawful aspects prevalence over medical, bioethics, economic and social aspects. The paper highlights the management imbalance in the system of record and control of narcotic drugs and suggests using in its decision real management tools: functional and process approaches as well as balance score card. The operation definition will allow to identify the ineffective phases, functional overlaps and basic losses in the process of narcotic drugs turnover while balance score card implementation will help to reveal the anticipatory indexes of efficient use of such medication.

ISSN 2070-4909 (Print)
ISSN 2070-4933 (Online)