FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology

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Vol 9, No 4 (2016)
View or download the full issue PDF (Russian)

Original Article

3-8 286

Objective. Pharmacoeconomic analysis of the use of combinations of antihypertensive drugs were olmesartan/lercanidipine and zofenopril/lercanidipine in patients with essential hypertension II-III stage.

Materials and methods. The authors performed prospective randomized uncontrolled study. Were examined in 27 people essential hypertension with II-III stage age from 40 to 71 years before and after the use of combinations of drugs olmesartan/lercanidipine and zofenopril/lercanidipine. An ABC/VEN-analysis, сost-effectiveness analysis, comparative assessment of the incidence of side effects of the studied drugs were performed.

Results. Anti-hypertensive effect of the studied combinations of drugs were not significantly different and equally effectively reduced blood pressure. But the cost of blood pressure reduction at 1 mm Hg was the smallest in the group zofenopril/lercanidipine.

Conclusion. The results of pharmacoeconomic analysis to be more cost-effective combination for the treatment of patients with essential hypertension II-III stage is the combination of zofenopril/lercanidipine.

9-13 360

Background and Objective. Currently in clinical practice are widely used local anesthetics, including racemic bupivacaine, levo isomer of its levobupivacaine and structurally similar to bupivacaine levo isomer ropivacaine. The aim of this work was to assess the cost of anesthesia
levobupivacaine, bupivacaine and ropivacaine.

Material and methods. In accordance with the results of comparative clinical trials and expert
evaluation analysis was conducted in two ways: under the assumption of equal clinical effectiveness of levobupivacaine and bupivacaine and a higher efficiency of levobupivacaine compared with ropivacaine (assumed in various clinical situations with an equal volume of solution used ropivacaine in concentrations of 0.5% may be replaced without reducing clinical efficacy of levobupivacaine in a concentration of 0.5%, ropivacaine in a concentration of 0.75% – levobupivacaine in a concentration of 0.5 and 0.75% (in equal proportions); ropivacaine at a
concentration of 1% – levobupivacaine at a concentration of 0.75%. The ropivacaine dose equivalent to 1 mg of levobupivacaine, made when calculating the average of 1.20 mg), and under the assumption of equal clinical effectiveness compare local anesthetics. The analysis was carried out for medicines containing 10 ml of solution per ampoule on the basis of registered prices of bupivacaine and ropivacaine. The cost of levobupivacaine was calculated based on expected rates of registration in the case of inclusion in the Essential Drugs List (0,5% R-R amp. 10 ml №10 – 947,74 RUB; 0.75% of p-p amp. 10 ml №10 – 1421,60 RUB).

Results. Subject to the adopted scenario 1 assumptions levobupivacaine allows you to reduce costs 29.6-56.9 per cent compared with bupivacaine and ropivacaine. Taking into account the
consumption of local anesthetics in 2016 (according to IMS Health), the replacement of bupivacaine and ropivacaine by levobupivacaine will allow you to reduce costs on average by 38.0%. Projected savings when replacing bupivacaine and ropivacaine in concentrations of 0.5-1.0% in ampoules of 10 ml will be 69,305 million RUB/year, taking into account the accepted assumptions. Under the assumption of equal effectiveness bupivacaine, ropivacaine and levobupivacaine (scenario 2), the replacement of bupivacaine and ropivacaine on levobupivacaine will reduce costs by an average of 29.6%. Given the amount of consumption savings will be 34,012 million RUB/year.

Conclusion. Replacement of bupivacaine and ropivacaine in concentrations of 0.5-1.0% in vials of 10 ml levobupivacaine at a concentration of 0.5-0.75% will allow taking into account assumptions significantly reduce budget costs without reducing the effectiveness of treatment. Reducing the burden on the budget could be achieved under the assumption of equal efficacy of drugs and replacement of bupivacaine and ropivacaine by levobupivacaine in the same concentration.

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Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized as an important problem that can lead to cirrhosis and hepatic failure. It may be the most prevalent liver disease. However, knowledge of the epidemiology is limited. These findings encourage to conduct a larger sample size study to evaluate the real prevalence of NAFLD in the Russian population. It is important to know current prevalence of NAFLD. DIREG 2 study was performed under umbrella of leading Russian professional societies in partnership with Sanofi Russia.

Objective: to estimate the prevalence of NAFLD within the general practitioners and gastroenterologist’s patient flow. It is important to know current prevalence of NAFLD in Republic of Bashkortostan and to compare with DIREG 2 results.

Materials and methods. Epidemiologic, observational, multicenter study assessing the prevalence of NAFLD among patient’s outpatient practice. A total of 50145 patients (3232 in Republic of Bashkortostan) 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.

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 40,8% in Republic of Bashkortostan.

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.

24-30 167

Private health spending in modern developed countries varies considerably depending on the national policy objectives, selected regulatory instruments as well as general socio-economic conditions.

The objective of this paper is to analyze key determinants of private health spending.

Materials and Methods. To achieve this objective we analyze academic works dealing with theoretical and empirical studies of private health spending.

Results. From the analysis the effects of private health spending determining national health financing policy, significant discretionary (breadth and depth of social healthcare system, public health expenditure, regulatory measures on cost sharing, paid medical services, voluntary health insurance) and non-discretionary factors (relative health services price, income and its distribution, age structure, level of education, political preferences) were highlighted.

Conclusion. In developed countries priorities of health private spending regulatory policy now are ensuring accessibility of essential health care and preventing consumer’s moral hazard. The most significant discretionary factor influencing the share and amount of private health spending is the management of state guarantees of free medical care; the most significant non-discretionary factor is the income and its distribution.

31-37 170

The article describes questions of medical care regulation and possibility using the mechanisms of concretization for formation of State Guarantees fоr free Medical care for Russian Citizen. The proposed approaches are aimed at the formation of a new system of documentary maintenance of the health system. Inclusion in regulations of mechanisms of concretization allow to control volume, financial resources, quality and availability of medical care.

38-45 139

The article describes questions about State Guarantees fоr free Medical care for Russian Citizen, how they are reflected in existing Programs and changing in the annual revision. Proposed the basic directions of concretization and specified criteria for certain types of medical care. Estimate the positive and negative sides of the proposed reforms.

Foreign Experience

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This publication presents a comparison of recommendations of screening programs and prevention activities in the United States, Canada, the Netherlands and Germany for adult non-pregnant population excluding infectious diseases. Sources of funding for such programs and information about their implementation are descripted. According to the search results of the relevant information in open sources, a list of recommended screening programs, as well as the amount of available information describing these programs in foreign countries varies.


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