FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology

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Vol 7, No 2 (2014)
View or download the full issue PDF (Russian)

Original Article 

3-5 719

in the present paper we have studied a group of pharmaceutical drugs used in the treatment of a widely spread today medical condition – allergic rhinitis. We have developed a conceptual approach to the analysis of the local market, which allowed us to elicit the main trends and peculiarities of the pharmaceutical market of nasal glucocorticosteroids of Lipetsk. As a result of research we identified the leaders of sales on the market nasal glucocorticosteroid, Lipetsk: drugs Nasobek market share – 31.1%, Nasonex with a market share of 26.4%, Awami and Flixonase – 20.4% and 14.8%, respectively.

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Abstract: we have performed the first-ever comparative pharmacoeconomic analysis in a Russian context of bendamustine in the first line of therapy of a multiple myeloma for for patients more senior 65 years old with clinical manifestations of a polineuropathy, which autological transplantation of stem cells isn’t shown. Research was conducted from a position of the state health system by means of mathematical modeling. Markov modeling and the sensitivity analysis were used. For primary patients who aren’t candidates for transplantation the following regimes of treatment were compared of: bendamustine + prednisone; melphalan + prednisone; bortezomibe + dexamethasone. The results show that the use of bendamustine in the first line of therapy of a multiple myeloma for elderly patients with the phenomena of a polyneuropathy is economically expedient from the point of view of a ratio of cost and efficiency.

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the analysis of the effectiveness of thromboprophylaxis among pregnant women with mesenchymal dysplasia was carried out. It was concluded that it reduces the risk of thrombohemorrhagic complications and accordingly the economic costs of medical care.

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the economic analysis of influence of various immunocorrective remedies on the frequency of respiratory infections at children of younger school age was made. It was revealed that carrying out the preventive immunocorrection including lysates of bacteria or gljukozaminilmuramildipeptid in combination with a vitamin and mineral complex, leads to statistically significant decrease in frequency of respiratory infections and considerable decrease direct and indirect cost on treatment of respiratory infectious diseases. Preventive use Echinacea purpurea, azoksimer bromide or interferon alpha 2b in combination with a vitamin and mineral complex statistically significantly reduces the frequency of respiratory infections and slightly cuts direct and indirect costs on their treatment.

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Background: no multicenter studies to assess the prevalence of Magnesium (Mg) deficiency in the general population, particularly among pregnant women have been previously conducted in Russia. Objectives: to evaluate Mg deficiency incidence and management in a pregnant population monitored in Russian polyclinics. Materials and Methods: pregnant women (at any trimester) aged over 18 years were included. Mg deficiencies due to any other concomitant condition were exclusion criteria. Data coming from medical records were collected at Visit 1 and visit 2 (1 month +/- 1 week): complete medical history; diagnosis of Mg deficiency confirmed by serum Mg level (<0.7 mmol/l) routine laboratory tests performed in the course of current practice (blood count, Mg plasma determination and urinalysis) and evaluation of total score (superior 30) using a structured 28 questions self-administrated Magnesium Deficiency Questionnaire (MDQ). Spontaneous reports of adverse reactions were collected. The statistical tests were applied according to type of variable distribution (the Shapiro-Wilkestest) and the estimation of equality of variances (Levene's test of Homogeneity of Variance). If two terms were true the Student’s t-test was used, alternatively the Wilcoxon-Mann-Whitney-Test was used. Paired samples t-test or Wilcoxon test were run for the comparison of changes in study continuous variables. Chi-square (χ2) and Fischer's exact tests were used for comparisons of categorical data. Results: 1130 pregnant women, mean age 28.95±5 years were included. Estimated combining prevalence of Mg deficiency according to the blood plasma levels (<0.7 mmol) and MDQ was 81,2%. It was observed that physicians commonly prescribe different organic Mg salts to pregnant women with Mg deficiency as a routine practice. Thus, Mg was prescribed to 1110 pregnant women: 84.1% received Mg Citrate (933/1110) and 21.3% (177/1110) Mg lactate. At the 1 visit the Mg deficiency according to MDQ score analysis was observed in 80.3% (870/1083) and at the end of the program only 5.75% (62/1083; р<0,001) presented Mg deficiency. An improvement of Mg deficiency signs evaluated using a MDQ was observed. Thus, the mean MDQ score significantly decreased by 22.6±11.9 points (Baseline: 15.8±7.9; Final visit 38.3±13.4 points; р<0,001). During the observational registry period one ADR was reported as an allergic dermatitis in a woman receiving Mg Citrate. Conclusions: the study identified a high prevalence of Mg deficiency in pregnant women population. The prevalence of Mg deficiency was 81.2%. It was observed that organic Mg salts are commonly prescribed by physicians to pregnant women with established Mg deficiency and statistically significant improvement in Mg deficiency signs in pregnant women receiving organic Mg salts was observed. To confirm these findings in other populations leaving across the Russian Federation, it is necessary to conduct an additional study with increased sample size, especially considering the age distribution of the population (women of childbearing age) and the life style.

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the lack of proper information on the epidemiological characteristics of epilepsy results in significant shortcomings in available health care. This pharmacoepidemiological study was undertaken to improve the situation. Objective: to assess the prevalence profile and management of patients with epilepsy in Minsk based on out-patient visit data obtained in health centres subordinate to the Ministry of Health of the Republic of Belarus. Materials and methods: the epidemiological study was conducted in accordance with the ILAE ‘Guidelines for epidemiologic studies on epilepsy’. Results: epilepsy incidence and prevalence were evaluated across Minsk gender- and age-based population groups. Aetiological and social aspects of epilepsy were reviewed. Out-patient visit data collected for the period from 2008 to 2012 revealed 705 patients with epilepsy. The overall epilepsy prevalence rate of the district varied from 165.2 per 100,000 population in 2008 to 275.5 per 100,000 population in 2012, while the incidence rate ranged from 36.9 per 100,000 population (in 2008) to 25.0 per 100,000 population (in 2012). The most frequently administered anti-epileptics included carbamazepine (52.9 % of patients) and valproates (31.0 % of subjects). The most commonly administered second-generation anti-epileptics were topiramate (7.1 % of patients) and lamotrigine (2.9 % of subjects). No anti-epileptics were used by 9.5 % of study subjects. Conclusions: the prevalence of epilepsy corresponds to the European Union prevalence rate. Proposals have been made concerning optimization of health care for patients with epilepsy. There is a need for large-scale pharmacoepidemiological and pharmacoeconomic studies.

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stable angina is a socially significant disease that requires significant financial costs to the health system and patients. In recent years the increased heart rate has been considered as a significant risk factor for poor prognosis in stable angina. The aim of the research: assessment of the economic viability of the inclusion of ivabradine in the scheme of treatment of stable angina in terms of health care system of the Republic of Belarus. Material and methods. Markov’s model of ivabradine use in patients with stable angina pectoris has been constructed on the basis of a systematic review of the literature, national surveillance data, local health services market and cardiovascular drugs market estimation. “Cost-effectiveness” and “cost-utility” analyses have been used. The target population of patients suffering from angina pectoris and in need of ivabradine prescription has been estimated with data from clinical studies and national epidemiological data. The potential effectiveness of ivabradine in the Belarusian patient population has been evaluated. Results. The size of the target patient population with stable angina for the ivabradine prescription was 17559 people. The use of ivabradine within 18 months in the target population patient with increased heart rate would allow potentially prevent 366 cases of nonfatal myocardial infarction and unstable angina, 143 cases of cardiovascular death, 391 case of revascularization. According to the results of the analysis the prescription of ivabradine in optimum dose with a minimum cost per 1 mg is the optimum pharmacoeconomic acceptability in patients with stable angina and high heart rate (70 beats per minute).

Drug Utilization 

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analysis of drug products assortment acquirable by healthcare organizations for medical treatment in hospital settings was conducted. Numerous violations of active law were detected and creation of drug assistance medical care standards was suggested as a financial spending optimization tool based on acquisition of drug products with proven clinical efficiency and minimal treatment cycle cost.


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selection of the best model of health care to ensure more efficient use of resources to improve the quality and accessibility of health careis essentialin any country. The Russian Federation is not an exception. Currently the country has a mixed budgetary-insurance health care model, the transition to which startsin 1991, when the Law #1499-I "On Medical Insurance of the citizens of the Russian Federation"was approved.With the introduction of the Law "On Compulsory Medical Insurance in the Russian Federation"#326-FZ of November 29, 2010 the course was taken to develop the insurance model of health care system, however it had still not been implemented, and the insurance principle is not earned.

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