The clinico-economic analysis of pharmacotherapy in patients with non-alcoholic steatohepatitis

Abstract

Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH) have become the most common liver diseases in the world. Aim. To conduct the clinico-economic analysis of pharmacotherapy in patients with NASH, who underwent treatment in one of the healthcare institutions of Kharkiv in 2013. Materials and methods. The study materials were case histories of patients and such regulatory documents of the Ministry of Health of Ukraine as the State Formulary (SF) of Medicines of Ukraine (2013), methodological recommendations on the diagnosis and pharmacotherapy of the digestive system diseases (2007), the Unified Clinical Protocol (UCP) “Non-alcoholic steatohepatitis” (Order No. 826 dated November 6, 2014). The pharmacoeconomic methods used were ABC, VEN and frequency analyses. Results. The results of the study demonstrated that the pharmacotherapy of patients with NASH complied with the main requirements specified in the Ukrainian Methodological Recommendations (2007), but did not meet the requirements of the NASH UCP by the approaches of the pathogenetic therapy prescribed. The results of “formal” VEN analysis showed that most drugs prescribed (76 %) were classified as group V – vital drugs since they were present in the SF of Ukraine. A predominant portion (83.2 %) of costs associated with the pharmacotherapy in patients with NASH was spent on these drugs. However, 16.8 % of the costs spent on 24 % of drugs, which are absent in the SF, indicates the need for further correction of the NASH pharmacotherapy in the healthcare institution under study. Conclusions. The pharmacotherapy of patients with NASH in the healthcare institution of Kharkiv is rational from clinical and economic point of view, but requires further correction in accordance with the SF and the new UCP for NASH.