Pub Date : 2021-01-01DOI: 10.17116/medtech20214302151
D. Tolkacheva, V. Mladov, V. Sokolova
{"title":"Efficacy of biologics and targeted synthetic drugs approved in Russia to treat adults with active psoriatic arthritis: a systematic review and network meta-analysis","authors":"D. Tolkacheva, V. Mladov, V. Sokolova","doi":"10.17116/medtech20214302151","DOIUrl":"https://doi.org/10.17116/medtech20214302151","url":null,"abstract":"","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"30 23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78032671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.17116/medtech20214303164
V. Madyanova, S. A. Orlov, D.A. Lisovskiy
{"title":"Assessing the consumption of specialized medical care by people over working age in the Moscow region","authors":"V. Madyanova, S. A. Orlov, D.A. Lisovskiy","doi":"10.17116/medtech20214303164","DOIUrl":"https://doi.org/10.17116/medtech20214303164","url":null,"abstract":"","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82562442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.17116/medtech2021430419
{"title":"Healthcare for patients with inflammatory bowel disease in Russian Federation in 2015—2021: information from the Healthcare Expert Advisory Board of the Social Policy Committee of the Federation Council","authors":"","doi":"10.17116/medtech2021430419","DOIUrl":"https://doi.org/10.17116/medtech2021430419","url":null,"abstract":"","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90265097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.17116/medtech2020410319
A. Solodovnikov, E.Yu. Sorokina, T. A. Goldina
{"title":"Real-world data: from planning to analysis","authors":"A. Solodovnikov, E.Yu. Sorokina, T. A. Goldina","doi":"10.17116/medtech2020410319","DOIUrl":"https://doi.org/10.17116/medtech2020410319","url":null,"abstract":"","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83345364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.31556/2219-0678.2020.39.1.055-060
I. Zheleznyakova, A. Fyodorov
Existing approaches to the implementation of cost-sharing agreements in the Russian Federation are described. Such agreements are used in practice to limit budget expenditures while improving access to modern drug therapy for patients. Presently, innovative models of drug provision are not directly mentioned in federal legislation and are not covered by special legal regulation; therefore, they are regulated by the general rules of the applicable law. The authors propose approaches to determining the juridical nature of cost-sharing agreements, analyze the organizational schemes used in practice and assess their compliance with different legislative fields: civil law, legislation on the protection of competition, law on the contract system in the procurement of goods and services for state and municipal needs, and the law on obligatory medical insurance. The results of the analysis can be used in the implementation of cost-sharing agreements in the daily activities of medical organizations and public health authorities of the Russian Federation.
{"title":"Approaches to Increasing Access to Innovative Drugs Based on Cost-sharing Agreements","authors":"I. Zheleznyakova, A. Fyodorov","doi":"10.31556/2219-0678.2020.39.1.055-060","DOIUrl":"https://doi.org/10.31556/2219-0678.2020.39.1.055-060","url":null,"abstract":"Existing approaches to the implementation of cost-sharing agreements in the Russian Federation are described. Such agreements are used in practice to \u0000limit budget expenditures while improving access to modern drug therapy for patients. Presently, innovative models of drug provision are not directly \u0000mentioned in federal legislation and are not covered by special legal regulation; therefore, they are regulated by the general rules of the applicable law. \u0000The authors propose approaches to determining the juridical nature of cost-sharing agreements, analyze the organizational schemes used in practice \u0000and assess their compliance with different legislative fields: civil law, legislation on the protection of competition, law on the contract system in the \u0000procurement of goods and services for state and municipal needs, and the law on obligatory medical insurance. The results of the analysis can be used \u0000in the implementation of cost-sharing agreements in the daily activities of medical organizations and public health authorities of the Russian Federation.","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77965675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.31556/2219-0678.2020.39.1.043-047
I. Zheleznyakova, M. Avxentyeva, A. V. Bereznikov, N. A. Kamenskaya, A. Fyodorov, A. Petrovsky
Проблемные вопросы, связанные с обеспечением качества и безопасности медицинской деятельности, особенно важны при оказании медицинской помощи по профилю «онкология» в виду установленных в Программе государственных гарантий1 приоритетов, связанных со сроками и объемами оказания такой помощи. В целях проработки наиболее актуальных вопросов 24 января 2020 года в Москве состоялся научнопрак тический семинар «Управление качеством и безопасностью медицинской деятельности в онкологии», предназначенный преимущественно для руководителей медицинских организаций, оказывающих медицинскую помощь по профилю «онкология». В семинаре приняли участие представители страховых медицинских организаций и территориальных фондов обязательного медицинского страхования, медицинские юристы, а также сотрудники ФГБУ «Центр экспертизы и контроля качества медицинской помощи» Минздрава России. На вопросы отвечают участники панельной дискуссии «Практические вопросы обеспечения качества и безопасности медицинской помощи в онкологии»: Инна Александровна Железнякова – заместитель генерального директора ФГБУ «ЦЭККМП» Минздрава России, Мария Владимировна Авксентьева – советник генерального директора ФГБУ «ЦЭККМП» Минздрава России, Алексей Васильевич Березников – руководитель дирекции медицинской экспертизы и защиты прав застрахованных ООО «АльфаСтрахование – ОМС», Наталья Андреевна Каменская – доцент кафедры медицинского права ФГАОУ ВО Первый МГМУ им. И.М. Сеченова (Сеченовский университет) Минздрава России,
{"title":"Practical Problems in Organization and Payment for Medical Care for Patients with Oncological Diseases Within the Frame of Providing Quality and Safety of Medical Care: Expert Opinion","authors":"I. Zheleznyakova, M. Avxentyeva, A. V. Bereznikov, N. A. Kamenskaya, A. Fyodorov, A. Petrovsky","doi":"10.31556/2219-0678.2020.39.1.043-047","DOIUrl":"https://doi.org/10.31556/2219-0678.2020.39.1.043-047","url":null,"abstract":"Проблемные вопросы, связанные с обеспечением качества и безопасности медицинской деятельности, особенно важны при оказании медицинской помощи по профилю «онкология» в виду установленных в Программе государственных гарантий1 приоритетов, связанных со сроками и объемами оказания такой помощи. В целях проработки наиболее актуальных вопросов 24 января 2020 года в Москве состоялся научнопрак тический семинар «Управление качеством и безопасностью медицинской деятельности в онкологии», предназначенный преимущественно для руководителей медицинских организаций, оказывающих медицинскую помощь по профилю «онкология». В семинаре приняли участие представители страховых медицинских организаций и территориальных фондов обязательного медицинского страхования, медицинские юристы, а также сотрудники ФГБУ «Центр экспертизы и контроля качества медицинской помощи» Минздрава России. На вопросы отвечают участники панельной дискуссии «Практические вопросы обеспечения качества и безопасности медицинской помощи в онкологии»: Инна Александровна Железнякова – заместитель генерального директора ФГБУ «ЦЭККМП» Минздрава России, Мария Владимировна Авксентьева – советник генерального директора ФГБУ «ЦЭККМП» Минздрава России, Алексей Васильевич Березников – руководитель дирекции медицинской экспертизы и защиты прав застрахованных ООО «АльфаСтрахование – ОМС», Наталья Андреевна Каменская – доцент кафедры медицинского права ФГАОУ ВО Первый МГМУ им. И.М. Сеченова (Сеченовский университет) Минздрава России,","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75019757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.31556/2219-0678.2020.39.1.061-069
S. Nedogoda, A. Salasyuk, I. Barykina, V. O. Smirnova, M. Frolov
Objective: to assess the cost of the severe bronchial asthma (BA) treatment with various biological agents at inpatient and day care setting from the compulsory medical insurance (CMI) system perspective. Methods. The authors constructed the MS Excel® analytical decision-making model and calculated the CMI system’s costs of severe BA treatment with various biological drugs at inpatient and day care setting. The costs of treatment with benralizumab, dupilumab, omalizumab, reslizumab and mepolizumab were compared. The cost difference between benralizumab and other drugs was identified taking into account the frequency of the drugs’ administration. The first administration was assumed to be inpatient, followed by the administrations in day care ward. Results. The use of benralizumab reduces the expenses of the CMI system by 0.8 million rubles per patient (–39%) compared with omalizumab, mepolizumab, resizumab and by 2.9 million rubles per patient (–69%) versus dupilumab due to the lowest frequency of administration, therefore less hospitalizations for therapy. With a 5-year modeling horizon, benralizumab therapy allows to reduce the CMI system expenses by 4.5 million rubles (–48%) compared with omalizumab, mepolizumab, reslizumab and by 13.9 million rubles (–74%) compared with dupilumab. The use of benralizumab will release 5–7 cases per patient per year compared to omalizumab, resizumab and mepolizumab and 18–20 cases per patient per year compared to dupilumab. Conclusion. Benralizumab therapy in patients with severe BA in inpatient and day care settings will lead to the optimization of CMI expenditures and more rational use of budgets allocated to hospitals.
{"title":"Сost of the Biologacal Therapy for Severe Brochcial Asthma Treatment at Inpatient and Day Care Setting","authors":"S. Nedogoda, A. Salasyuk, I. Barykina, V. O. Smirnova, M. Frolov","doi":"10.31556/2219-0678.2020.39.1.061-069","DOIUrl":"https://doi.org/10.31556/2219-0678.2020.39.1.061-069","url":null,"abstract":"Objective: to assess the cost of the severe bronchial asthma (BA) treatment with various biological agents at inpatient and day care setting from the compulsory medical insurance (CMI) system perspective.\u0000\u0000Methods. The authors constructed the MS Excel® analytical decision-making model and calculated the CMI system’s costs of severe BA treatment with various biological drugs at inpatient and day care setting. The costs of treatment with benralizumab, dupilumab, omalizumab, reslizumab and mepolizumab were compared. The cost difference between benralizumab and other drugs was identified taking into account the frequency of the drugs’ administration. The first administration was assumed to be inpatient, followed by the administrations in day care ward.\u0000\u0000Results. The use of benralizumab reduces the expenses of the CMI system by 0.8 million rubles per patient (–39%) compared with omalizumab, mepolizumab, resizumab and by 2.9 million rubles per patient (–69%) versus dupilumab due to the lowest frequency of administration, therefore less hospitalizations for therapy. With a 5-year modeling horizon, benralizumab therapy allows to reduce the CMI system expenses by 4.5 million rubles (–48%) compared with omalizumab, mepolizumab, reslizumab and by 13.9 million rubles (–74%) compared with dupilumab. The use of benralizumab will release 5–7 cases per patient per year compared to omalizumab, resizumab and mepolizumab and 18–20 cases per patient per year compared to dupilumab.\u0000\u0000Conclusion. Benralizumab therapy in patients with severe BA in inpatient and day care settings will lead to the optimization of CMI expenditures and more rational use of budgets allocated to hospitals.","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"2014 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73295248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.31556/2219-0678.2020.39.1.019-029
M. L. Lazareva, I. Zheleznyakova, M. Avxentyeva, D. Fedyaev, A. V. Zuev, Y. Ledovskikh, E. Semakova, V. Omelyanovskiy
Since 2013 a diagnosis-related groups (DRG) model has been introduced for the payment of medical care provided in inpatient settings and the day hospitals in Russia at the federal level. The DRG model is improved annually by the increasing of DRG number and specifying the classification criteria for attributing treatment cases to a particular group. In this article, we describe the main changes in the DRG model in 2020 compared with the last year. Main changes include the creation of new classification criteria for the formation of DRG, new DRG in the oncology profile, the changes in the DRG for epilepsy and chronic viral hepatitis C treatment, as well as for the use of genetically engineered biological drugs and selective immunosuppressants. The article also describes the innovations regarding the general approaches to paying for health care with respect to DRG: the rules for applying regional correction factors and for simultaneous payment for two DRG within one treatment case.
{"title":"Main Changes in the Model of Diagnosis-Related Groups in Russia in 2020","authors":"M. L. Lazareva, I. Zheleznyakova, M. Avxentyeva, D. Fedyaev, A. V. Zuev, Y. Ledovskikh, E. Semakova, V. Omelyanovskiy","doi":"10.31556/2219-0678.2020.39.1.019-029","DOIUrl":"https://doi.org/10.31556/2219-0678.2020.39.1.019-029","url":null,"abstract":"Since 2013 a diagnosis-related groups (DRG) model has been introduced for the payment of medical care provided in inpatient settings and the day hospitals in Russia at the federal level. The DRG model is improved annually by the increasing of DRG number and specifying the classification criteria for attributing treatment cases to a particular group. In this article, we describe the main changes in the DRG model in 2020 compared with the last year. Main changes include the creation of new classification criteria for the formation of DRG, new DRG in the oncology profile, the changes in the DRG for epilepsy and chronic viral hepatitis C treatment, as well as for the use of genetically engineered biological drugs and selective immunosuppressants. The article also describes the innovations regarding the general approaches to paying for health care with respect to DRG: the rules for applying regional correction factors and for simultaneous payment for two DRG within one treatment case.","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82696233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.31556/2219-0678.2020.39.1.080-089
Tatyana Sergeevna Teptsova, V. K. Fedyaeva, A. V. Nikitina
The only source of financing for immunoglobulin replacement therapy needed by patients with primary immunodeficiencies (PID) in Russian Federation is the compulsory health insurance system: payment is based on diagnosis-related groups (DRG), including the DRG for immunoglobulin treatment at day care and inpatient setting. PID are not included either into regional program for rare diseases, or into federal program of 12 high-cost diseases. This leads to limited coverage of patients with effective drug treatment. Furthermore, currently in Russian Federation there is no neonatal screening for PID, which could facilitate early detection of the disease and timely start of treatment. Goal of the study: to conduct the analysis of cost and effectiveness of different scenarios of drug provision for the patients with PID, which differ in coverage of patients with therapy and by presence/absence of neonatal screening. Materials and methods. The model compared three scenarios of drug provision for patients with PID: a) current practice, when in accordance with available data not all patients get necessary immunoglobulin replacement therapy, b) new scenario 1 – financing of drugs for all registered patients with PID when large-scale neonatal screening for PID is absent; c) new scenario 2 – financing of drugs for all registered patients with PID when large-scale neonatal screening is implemented. In each scenario direct medical costs and number of prevented deaths was calculated. Comparison of scenarios was planned to be made by calculation of additional costs per prevented death due to PID, or by assessment of difference of costs and effectiveness (number of prevented deaths) with identification of a dominant scenario. Results. Both new scenarios including financing of drugs for all registered patients with PID lead to the prevention of significant number of deaths and also to cost savings if compared with current practice. Total costs for current, 1st new and 2nd new scenario for 15 year was^ 2 285,54, 616,49 and 1 318,61 billions of rubles respectively. Also when comparing 1st and 2nd new scenarios with current practice we expect prevention of 243 and 2076 deaths respectively. Conclusion. Most effective approach is the introduction of large-scale neonatal screening for PID combined with the new source of financing: this scenario saves less money, but helps to prevent highest number of deaths compared with current practice. This scenario can prevent deaths of patients who would not have been diagnosed with PID in the absence of screening, and also helps to save healthcare system budget by centralization of government procurement of drugs.
{"title":"Different Scenarios of Providing Drugs for Patients with Primary Immunodeficiency in Russia: Analysis of Costs and Effectiveness","authors":"Tatyana Sergeevna Teptsova, V. K. Fedyaeva, A. V. Nikitina","doi":"10.31556/2219-0678.2020.39.1.080-089","DOIUrl":"https://doi.org/10.31556/2219-0678.2020.39.1.080-089","url":null,"abstract":"The only source of financing for immunoglobulin replacement therapy needed by patients with primary immunodeficiencies (PID) in Russian Federation is the compulsory health insurance system: payment is based on diagnosis-related groups (DRG), including the DRG for immunoglobulin treatment at day care and inpatient setting. PID are not included either into regional program for rare diseases, or into federal program of 12 high-cost diseases. This leads to limited coverage of patients with effective drug treatment. Furthermore, currently in Russian Federation there is no neonatal screening for PID, which could facilitate early detection of the disease and timely start of treatment.\u0000\u0000Goal of the study: to conduct the analysis of cost and effectiveness of different scenarios of drug provision for the patients with PID, which differ in coverage of patients with therapy and by presence/absence of neonatal screening.\u0000\u0000Materials and methods. The model compared three scenarios of drug provision for patients with PID: a) current practice, when in accordance with available data not all patients get necessary immunoglobulin replacement therapy, b) new scenario 1 – financing of drugs for all registered patients with PID when large-scale neonatal screening for PID is absent; c) new scenario 2 – financing of drugs for all registered patients with PID when large-scale neonatal screening is implemented. In each scenario direct medical costs and number of prevented deaths was calculated. Comparison of scenarios was planned to be made by calculation of additional costs per prevented death due to PID, or by assessment of difference of costs and effectiveness (number of prevented deaths) with identification of a dominant scenario.\u0000\u0000Results. Both new scenarios including financing of drugs for all registered patients with PID lead to the prevention of significant number of deaths and also to cost savings if compared with current practice. Total costs for current, 1st new and 2nd new scenario for 15 year was^ 2 285,54, 616,49 and 1 318,61 billions of rubles respectively. Also when comparing 1st and 2nd new scenarios with current practice we expect prevention of 243 and 2076 deaths respectively.\u0000\u0000Conclusion. Most effective approach is the introduction of large-scale neonatal screening for PID combined with the new source of financing: this scenario saves less money, but helps to prevent highest number of deaths compared with current practice. This scenario can prevent deaths of patients who would not have been diagnosed with PID in the absence of screening, and also helps to save healthcare system budget by centralization of government procurement of drugs.","PeriodicalId":18386,"journal":{"name":"Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор)","volume":"177 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83393526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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