Pub Date : 2021-02-06DOI: 10.17749/2070-4909/FARMAKOEKONOMIKA.2020.070
O. Gromova, I. Torshin, V. A. Maksimov, A. Chuchalin, V. Zgoda, А. N. Gromov, O. Tikhonova
Introduction. Hemosiderosis is a pathologic condition that accompanies liver, lung, and other organ diseases. Polypeptide-containing drug Laennec contributes to the elimination of excessive iron deposits in tissues.Aim. The study was aimed to identify peptides contained in the composition of the drug that take part in the regulation of iron homeostasis and correction of hemosiderosis and hyperferritinemia.Materials and Methods. The study of the drug composition was conducted with hybrid mass-spectrometry and modern methods of analysis of Big Data based on the topological approach to recognition.Results. The preparation contains 19 peptides that are potentially important for the regulation of iron homeostasis. These peptides help to treat the disorders of iron metabolism by regulating the levels of the main hormone of iron homeostasis hepcidin by reducing the synthesis of ferritin and by exhibiting anti-inflammatory and immunomodulatory effects.Conclusion. The identified peptides allowed the authors to describe the molecular mechanisms of the iron overload elimination that are known from experimental and clinical studies of the analyzed polypeptide drug.
{"title":"Peptides contained in the composition of Laennec that contribute to the treatment of hyperferritinemia and iron overload disorders","authors":"O. Gromova, I. Torshin, V. A. Maksimov, A. Chuchalin, V. Zgoda, А. N. Gromov, O. Tikhonova","doi":"10.17749/2070-4909/FARMAKOEKONOMIKA.2020.070","DOIUrl":"https://doi.org/10.17749/2070-4909/FARMAKOEKONOMIKA.2020.070","url":null,"abstract":"Introduction. Hemosiderosis is a pathologic condition that accompanies liver, lung, and other organ diseases. Polypeptide-containing drug Laennec contributes to the elimination of excessive iron deposits in tissues.Aim. The study was aimed to identify peptides contained in the composition of the drug that take part in the regulation of iron homeostasis and correction of hemosiderosis and hyperferritinemia.Materials and Methods. The study of the drug composition was conducted with hybrid mass-spectrometry and modern methods of analysis of Big Data based on the topological approach to recognition.Results. The preparation contains 19 peptides that are potentially important for the regulation of iron homeostasis. These peptides help to treat the disorders of iron metabolism by regulating the levels of the main hormone of iron homeostasis hepcidin by reducing the synthesis of ferritin and by exhibiting anti-inflammatory and immunomodulatory effects.Conclusion. The identified peptides allowed the authors to describe the molecular mechanisms of the iron overload elimination that are known from experimental and clinical studies of the analyzed polypeptide drug.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132080892","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 : 2021-01-06DOI: 10.17749/2070-4909/FARMAKOEKONOMIKA.2020.076
M. Frolov, A. Salasyuk, V. A. Rogov
Aim. The study aimed to assess the economic effect of biological therapy with anti-interleukin (IL)-6 drugs: tocilizumab, olokizumab, and levilimab in patients with severe COVID-19 and cytokine storm.Materials and Methods. An assessment of the economic consequences of severe COVID-19 therapy was carried out using the cost of illness analysis in a model developed in Microsoft Excel 2016 (Microsoft, USA). The direct medical costs of providing care for COVID-19 were taken into account (ICU service, the cost of biological therapy, and the use of glucocorticosteroids (GC)). Data from a prospective, historical controlled CHIC study conducted in the Netherlands were used as a source of efficacy. A mathematical model has been developed for extrapolating the CHIC study results to clinical outcomes (transfer to mechanical ventilation, discharge from ICU, lethal outcome) and forecasting the costs of managing severe patients with COVID-19 in real clinical practice in the Russian Federation.Results. The reduction in the cost of therapy when the hypothesis of equal efficacy of tocilizumab, olokizumab, and levilimab is accepted by reducing the cost of drug therapy will be 1,251,698.99 rubles per 72 patients when comparing olokizumab with tocilizumab and 939,718.84 rubles per 72 patients when comparing olokizumab with levilimab.Conclusion. Anti-interleukin (IL)-6 drugs in combination with GC are an effective treatment option for moderate to severe patients with COVID-19 and cytokine storm symptoms. This group of drugs is indicated as the main one for the treatment of this condition.
{"title":"Evaluation of the economic effect of biological therapy in patients with severe COVID-19 and cytokine storm","authors":"M. Frolov, A. Salasyuk, V. A. Rogov","doi":"10.17749/2070-4909/FARMAKOEKONOMIKA.2020.076","DOIUrl":"https://doi.org/10.17749/2070-4909/FARMAKOEKONOMIKA.2020.076","url":null,"abstract":"Aim. The study aimed to assess the economic effect of biological therapy with anti-interleukin (IL)-6 drugs: tocilizumab, olokizumab, and levilimab in patients with severe COVID-19 and cytokine storm.Materials and Methods. An assessment of the economic consequences of severe COVID-19 therapy was carried out using the cost of illness analysis in a model developed in Microsoft Excel 2016 (Microsoft, USA). The direct medical costs of providing care for COVID-19 were taken into account (ICU service, the cost of biological therapy, and the use of glucocorticosteroids (GC)). Data from a prospective, historical controlled CHIC study conducted in the Netherlands were used as a source of efficacy. A mathematical model has been developed for extrapolating the CHIC study results to clinical outcomes (transfer to mechanical ventilation, discharge from ICU, lethal outcome) and forecasting the costs of managing severe patients with COVID-19 in real clinical practice in the Russian Federation.Results. The reduction in the cost of therapy when the hypothesis of equal efficacy of tocilizumab, olokizumab, and levilimab is accepted by reducing the cost of drug therapy will be 1,251,698.99 rubles per 72 patients when comparing olokizumab with tocilizumab and 939,718.84 rubles per 72 patients when comparing olokizumab with levilimab.Conclusion. Anti-interleukin (IL)-6 drugs in combination with GC are an effective treatment option for moderate to severe patients with COVID-19 and cytokine storm symptoms. This group of drugs is indicated as the main one for the treatment of this condition.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122270216","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 : 2020-11-18DOI: 10.17749/2070-4909/farmakoekonomika.2020.052
S. Tishkina, V. E. Matskevich, Y. Ledovskikh, E. Semakova, V. Omelyanovskiy
Aim. To conduct an analytical review of the regulatory legal framework on the resources provision required in medical organizations for the provision of oncological medical care based on clinical guidelines.Materials and methods. Using Russian normative legal and regulative documents on the oncological medical care, the authors studied the normative regulation of the issues of both resources’ provision for medical organizations and resources’ demand assessment, including the need for financial support from various sources of the budgetary system of the Russian Federation. The analysis was carried out in two regulatory areas: financing and organization of the provision of medical care. The authors examined the main legislation acts relating to oncological medical care, including documents of the compulsory medical insurance, the annual decrees of the Government of the Russian Federation on the program of state guarantees of free provision of medical care to citizens for the coming year and the planned period, the decree of the Government of the Russian Federation regulating the provision of medicines and medical products, provisions on the organization of medical care by type of medical care, procedures for the provision of oncological medical care, regulatory documents on clinical guidelines and standards of medical care.Results. The content analysis of the studied materials showed that certain components of the resources’ provision, including the financial provision of oncological medical care, are regulated by various regulatory documents, and there is no methodology for assessing the resources’ demand based on clinical guidelines.Conclusion. New approaches to assessing the resources’ demand for the provision of medical care and the required financial support based on clinical guidelines need to be developed.
{"title":"Regulatory framework of the oncological medical care provision","authors":"S. Tishkina, V. E. Matskevich, Y. Ledovskikh, E. Semakova, V. Omelyanovskiy","doi":"10.17749/2070-4909/farmakoekonomika.2020.052","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2020.052","url":null,"abstract":"Aim. To conduct an analytical review of the regulatory legal framework on the resources provision required in medical organizations for the provision of oncological medical care based on clinical guidelines.Materials and methods. Using Russian normative legal and regulative documents on the oncological medical care, the authors studied the normative regulation of the issues of both resources’ provision for medical organizations and resources’ demand assessment, including the need for financial support from various sources of the budgetary system of the Russian Federation. The analysis was carried out in two regulatory areas: financing and organization of the provision of medical care. The authors examined the main legislation acts relating to oncological medical care, including documents of the compulsory medical insurance, the annual decrees of the Government of the Russian Federation on the program of state guarantees of free provision of medical care to citizens for the coming year and the planned period, the decree of the Government of the Russian Federation regulating the provision of medicines and medical products, provisions on the organization of medical care by type of medical care, procedures for the provision of oncological medical care, regulatory documents on clinical guidelines and standards of medical care.Results. The content analysis of the studied materials showed that certain components of the resources’ provision, including the financial provision of oncological medical care, are regulated by various regulatory documents, and there is no methodology for assessing the resources’ demand based on clinical guidelines.Conclusion. New approaches to assessing the resources’ demand for the provision of medical care and the required financial support based on clinical guidelines need to be developed.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126996040","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 : 2020-11-17DOI: 10.17749/2070-4909/farmakoekonomika.2020.049
O. Gromova, I. Torshin, A. Naumov, V. A. Maksimov
Introduction. The pharmaceutical drugs used in the treatment of osteoarthritis (OA) differ not only in the mechanisms of anti-inflammatory action but also in the effects on the human microbiome.Purpose. Evaluation of the influence of some drugs used in the therapy of OA on the human microbiome by the method of chemoinformation analysis.Materials and methods. Сomparative chemomicrobiome analysis of glucosamine sulfate (GS), diclofenac, acetylsalicylic acid (ASA), and three prebiotics (lactose, lactulose, fructose) as molecules of comparison. For each substance, estimates of the area under the curve (AUC) were obtained for a representative sampling of human microbiota (38 commensal bacteria). The minimum inhibitory concentrations (MIC) were established for more than 120 pathogenic bacteria.Results. On average, according to a representative sampling of microbiota, the profile of the action of GS on the microbiome was almost identical to the profile of the action of lactose (AUC=0.23±0.18). The most effective growth of the microbiome was provided by fructose and lactulose (AUC=0.58±0.21). The effects of diclofenac and ASA on the commensals of microbiome were comparable to the effects of GS (AUC=0.27±0.22). However, the analysis of the obtained MIC values for pathogenic bacteria showed that diclofenac supported the growth of the pathogenic flora (MIC=35±1.4 μg/ml) to a greater extent than GS (MIC=16±1.5 μg/ml) and ASA (MIC=23±2.2 μg/ml).Conclusion. The effects of GS on the microbiome are comparable to the effects of the prebiotic lactose whereas the inhibitory effect of GS and ASA on pathogenic bacteria is more pronounced than that of diclofenac. The inhibition of pathogenic bacteria by the GS helps to reduce inflammation.
{"title":"Chemomicrobiomic analysis of glucosamine sulfate, prebiotics and non-steroidal anti-inflammatory drugs","authors":"O. Gromova, I. Torshin, A. Naumov, V. A. Maksimov","doi":"10.17749/2070-4909/farmakoekonomika.2020.049","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2020.049","url":null,"abstract":"Introduction. The pharmaceutical drugs used in the treatment of osteoarthritis (OA) differ not only in the mechanisms of anti-inflammatory action but also in the effects on the human microbiome.Purpose. Evaluation of the influence of some drugs used in the therapy of OA on the human microbiome by the method of chemoinformation analysis.Materials and methods. Сomparative chemomicrobiome analysis of glucosamine sulfate (GS), diclofenac, acetylsalicylic acid (ASA), and three prebiotics (lactose, lactulose, fructose) as molecules of comparison. For each substance, estimates of the area under the curve (AUC) were obtained for a representative sampling of human microbiota (38 commensal bacteria). The minimum inhibitory concentrations (MIC) were established for more than 120 pathogenic bacteria.Results. On average, according to a representative sampling of microbiota, the profile of the action of GS on the microbiome was almost identical to the profile of the action of lactose (AUC=0.23±0.18). The most effective growth of the microbiome was provided by fructose and lactulose (AUC=0.58±0.21). The effects of diclofenac and ASA on the commensals of microbiome were comparable to the effects of GS (AUC=0.27±0.22). However, the analysis of the obtained MIC values for pathogenic bacteria showed that diclofenac supported the growth of the pathogenic flora (MIC=35±1.4 μg/ml) to a greater extent than GS (MIC=16±1.5 μg/ml) and ASA (MIC=23±2.2 μg/ml).Conclusion. The effects of GS on the microbiome are comparable to the effects of the prebiotic lactose whereas the inhibitory effect of GS and ASA on pathogenic bacteria is more pronounced than that of diclofenac. The inhibition of pathogenic bacteria by the GS helps to reduce inflammation.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121535341","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 : 2020-08-08DOI: 10.17749/2070-4909/farmakoekonomika.2020.020
M. Chernyavskaya, I. Narkevich
Aim. To review scientific publications on clinical effectiveness and potential application of phytoestrogens (PE) in the treatment of climacteric syndrome. Materials and methods. The PRISMA approach was used. The systematic search was performed in three electronic scientific databases: Cochrane library, PubMed/MEDLINE, and eLIBRARY.ru. The publications were also manually searched for in the reference lists of the relevant articles. Results. The filters were used to select 79 publications; 26 of them were included in the final review. The main method of treatment for the manifestations of the climacteric syndrome is menopausal hormonal therapy (MHT). One of the alternative methods for the control of its symptoms is the application of phytoestrogens (PE), primarily, isoflavones, lignans, and coumestans. Active metabolites of PE are expressed under the influence of gut microflora that is different in various groups of women, which can determine the differences in the effectiveness. Taking into account multidirectional character of the studies as well as numerous publications of low quality, it is still impossible to come to the final conclusion on the effectiveness of PE-containing food supplements (FS) when it comes to a decrease in the occurrence rate and expression of such symptoms as hot flushes, night sweats, and cognitive deterioration. The conclusions on the prevention of cardio-vascular diseases are not definite either. Conclusions . The review showed that scientists could not come to the conclusion on the effectiveness and safety of PE-containing FS. Probably, the most prospective means of the control of climacteric syndrome are FS that contain isoflavones of red clover and soy in the maximum effective concentration. Considering free access to such FS on the market, they must meet high safety requirements.
{"title":"Biological effects of phytoestrogens: clinical effectiveness and potential application in the treatment of climacteric syndrome","authors":"M. Chernyavskaya, I. Narkevich","doi":"10.17749/2070-4909/farmakoekonomika.2020.020","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2020.020","url":null,"abstract":"Aim. To review scientific publications on clinical effectiveness and potential application of phytoestrogens (PE) in the treatment of climacteric syndrome. Materials and methods. The PRISMA approach was used. The systematic search was performed in three electronic scientific databases: Cochrane library, PubMed/MEDLINE, and eLIBRARY.ru. The publications were also manually searched for in the reference lists of the relevant articles. Results. The filters were used to select 79 publications; 26 of them were included in the final review. The main method of treatment for the manifestations of the climacteric syndrome is menopausal hormonal therapy (MHT). One of the alternative methods for the control of its symptoms is the application of phytoestrogens (PE), primarily, isoflavones, lignans, and coumestans. Active metabolites of PE are expressed under the influence of gut microflora that is different in various groups of women, which can determine the differences in the effectiveness. Taking into account multidirectional character of the studies as well as numerous publications of low quality, it is still impossible to come to the final conclusion on the effectiveness of PE-containing food supplements (FS) when it comes to a decrease in the occurrence rate and expression of such symptoms as hot flushes, night sweats, and cognitive deterioration. The conclusions on the prevention of cardio-vascular diseases are not definite either. Conclusions . The review showed that scientists could not come to the conclusion on the effectiveness and safety of PE-containing FS. Probably, the most prospective means of the control of climacteric syndrome are FS that contain isoflavones of red clover and soy in the maximum effective concentration. Considering free access to such FS on the market, they must meet high safety requirements.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121714814","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 : 2020-04-24DOI: 10.17749/2070-4909.2020.13.1.64-70
E. Ushkalova, S. Zyryanov, I. Gopienko
Oncological diseases rank high in the structure of population morbidity and mortality. They entail considerable direct and indirect economic costs. In the past decades, the cost of oncotherapy has increased significantly, which is largely conditioned by high prices of antitumor drugs, which on average increased by ten times in the past ten years. At the same time, many innovative medications have only minor advantages over cheaper old medications because they are registered based on the data on the achievement of the surrogate endpoint – extension of progression-free survival. The high cost of oncotherapy is associated with financial toxicity that affects negatively the patients’ quality of life, their adherence to treatment and consequently survival. To reduce the cost of oncotherapy, it is necessary to conduct pharma-economic analysis, the results of which can serve as the basis to negotiate price-cutting with the manufacturers, as well as to use high-quality generics and biosimilars as effective and safe as their originals, and to monitor effectiveness and safety of all antitumor drugs within the pharmacovigilance framework.
{"title":"Economic challenges of oncological diseases’ pharmacotherapy","authors":"E. Ushkalova, S. Zyryanov, I. Gopienko","doi":"10.17749/2070-4909.2020.13.1.64-70","DOIUrl":"https://doi.org/10.17749/2070-4909.2020.13.1.64-70","url":null,"abstract":"Oncological diseases rank high in the structure of population morbidity and mortality. They entail considerable direct and indirect economic costs. In the past decades, the cost of oncotherapy has increased significantly, which is largely conditioned by high prices of antitumor drugs, which on average increased by ten times in the past ten years. At the same time, many innovative medications have only minor advantages over cheaper old medications because they are registered based on the data on the achievement of the surrogate endpoint – extension of progression-free survival. The high cost of oncotherapy is associated with financial toxicity that affects negatively the patients’ quality of life, their adherence to treatment and consequently survival. To reduce the cost of oncotherapy, it is necessary to conduct pharma-economic analysis, the results of which can serve as the basis to negotiate price-cutting with the manufacturers, as well as to use high-quality generics and biosimilars as effective and safe as their originals, and to monitor effectiveness and safety of all antitumor drugs within the pharmacovigilance framework.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"212 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122651226","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 : 2020-04-24DOI: 10.17749/2070-4909.2020.13.1.23-34
I. Torshin, A. Lila, O. A. Limanova, O. Gromova
Introduction. Chondroitin sulfate (CS) and glucosamine sulfate (GS), widely used as chondroprotectors, can maintain the normal functioning of the urinary system but their effect has not been analyzed systematically.Aim: to perform a systematic analysis of the possibilities of using CS and GS in patients with pathology of the kidneys and urinary system.Materials and methods. Predictive analysis of 2,093 publications on the interactions of CS/GS with the functioning of the kidneys and other organs of the urinary system found at the request “(urinary OR bladder OR kidney) AND (glucosamine OR chondroitin)” by methods of the theory of topological data analysis.Results. Disorders of cholesterol and glucosamine metabolism are characteristic of cystitis, glomerular nephritis, urinary tract infections (UTIs), urolithiasis, proteinuria, and formation of diabetic nephropathy. In addition to inhibiting the pro-inflammatory cascade NF-kB, CS/GS contribute to eliminating the deficiency of glycosaminoglycans in the pathology of urothelium, inhibit urolithiasis, inhibit the synthesis of pro-inflammatory nitric oxide NO in macrophages, and modulate O-glycosylation processes.Conclusion. The results of fundamental and clinical studies show that subsidies of CS/GS substances of pharmacological quality per os and CS instillation in the bladder (in particular, in combination with hyaluronic acid) are the means of choice for patients suffering from osteoarthritis and diseases of the urinary system. Highly purified pharmacological CS substances are part of the preparation Chondroguard.
{"title":"Prospects for the use of chondroitin sulfate and glucosamine sulfate with osteoarthritis associated with pathology of the kidneys and urinary system","authors":"I. Torshin, A. Lila, O. A. Limanova, O. Gromova","doi":"10.17749/2070-4909.2020.13.1.23-34","DOIUrl":"https://doi.org/10.17749/2070-4909.2020.13.1.23-34","url":null,"abstract":"Introduction. Chondroitin sulfate (CS) and glucosamine sulfate (GS), widely used as chondroprotectors, can maintain the normal functioning of the urinary system but their effect has not been analyzed systematically.Aim: to perform a systematic analysis of the possibilities of using CS and GS in patients with pathology of the kidneys and urinary system.Materials and methods. Predictive analysis of 2,093 publications on the interactions of CS/GS with the functioning of the kidneys and other organs of the urinary system found at the request “(urinary OR bladder OR kidney) AND (glucosamine OR chondroitin)” by methods of the theory of topological data analysis.Results. Disorders of cholesterol and glucosamine metabolism are characteristic of cystitis, glomerular nephritis, urinary tract infections (UTIs), urolithiasis, proteinuria, and formation of diabetic nephropathy. In addition to inhibiting the pro-inflammatory cascade NF-kB, CS/GS contribute to eliminating the deficiency of glycosaminoglycans in the pathology of urothelium, inhibit urolithiasis, inhibit the synthesis of pro-inflammatory nitric oxide NO in macrophages, and modulate O-glycosylation processes.Conclusion. The results of fundamental and clinical studies show that subsidies of CS/GS substances of pharmacological quality per os and CS instillation in the bladder (in particular, in combination with hyaluronic acid) are the means of choice for patients suffering from osteoarthritis and diseases of the urinary system. Highly purified pharmacological CS substances are part of the preparation Chondroguard.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134276367","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 : 2020-04-23DOI: 10.17749/2070-4909.2020.13.1.43-51
M. Tamm
Aim:to present a mathematical model of the development of COVID-19 in Moscow along with the analysis of some scenarios of epidemic control and possible epidemic consequences.Materials and Methods.The modeling of the epidemics was based on the extended SEIR model proposed lately in the group of Prof. R. Neher and realized as a freely available software program. The authors based the choice of the parameters of modeling on published data on the epidemiological properties of the novel coronavirus SARS-CoV-2 and open access data on the registered cases of COVID-19 in Moscow for 8-27 March 2020.Results.Five potential scenarios of the development of COVID-19 epidemics are studied. The scenarios are differed by the levels of the control measures: Null Scenario corresponded to the lack of protective measures, Scenario A – mild measures of the epidemic control (closing of schools and universities, recommendations for senior citizens to stay inside), Scenario B – medium level of control (closing of all public places, recommendation for the citizens to stay inside), Scenarios C and D – complete lockdown (from the beginning of May 2020 within Scenario C and from the beginning of April 2020 within Scenario D). It was shown that within the Null Scenario, the lethality from the novel coronavirus in Moscow will exceed 100 thousand people, and the number of critically ill patients on the peak of the epidemics will exceed the capacities of the system of healthcare. Scenarios A and B did not provide for a radical decrease in the fatality rate, and the number of critically ill patients at the peak of epidemics will still exceed the capacities of the system of healthcare. Besides, within Scenario B, the epidemics will last for more than a year. Scenarios C and D will allow for the control of epidemics and a significant decrease in the rate of letha lity (by 30 and 400 times, respectively). At the same time, these two scenarios prevent the population from developing herd immunity, which would result in the population susceptibility to repeated epidemics outbreaks.Conclusion. The scenarios intended for the slow development of herd immunity in the conditions of epidemic control would not bring sufficient results: the lethality would remain unacceptably high, the capacities of the system of healthcare would be overloaded, and the time of limiting measures would be unacceptably long. Such measures as complete lockdown would stop the present epidemics. The earlier they are introduced, the more efficient will be the results. To prevent further repeated outbreaks of the epidemics, it is necessary to establish a system of available, quick, and efficient testing in combination with point isolation of the infected patients and their contacts.
{"title":"COVID-19 in Moscow: prognoses and scenarios","authors":"M. Tamm","doi":"10.17749/2070-4909.2020.13.1.43-51","DOIUrl":"https://doi.org/10.17749/2070-4909.2020.13.1.43-51","url":null,"abstract":"Aim:to present a mathematical model of the development of COVID-19 in Moscow along with the analysis of some scenarios of epidemic control and possible epidemic consequences.Materials and Methods.The modeling of the epidemics was based on the extended SEIR model proposed lately in the group of Prof. R. Neher and realized as a freely available software program. The authors based the choice of the parameters of modeling on published data on the epidemiological properties of the novel coronavirus SARS-CoV-2 and open access data on the registered cases of COVID-19 in Moscow for 8-27 March 2020.Results.Five potential scenarios of the development of COVID-19 epidemics are studied. The scenarios are differed by the levels of the control measures: Null Scenario corresponded to the lack of protective measures, Scenario A – mild measures of the epidemic control (closing of schools and universities, recommendations for senior citizens to stay inside), Scenario B – medium level of control (closing of all public places, recommendation for the citizens to stay inside), Scenarios C and D – complete lockdown (from the beginning of May 2020 within Scenario C and from the beginning of April 2020 within Scenario D). It was shown that within the Null Scenario, the lethality from the novel coronavirus in Moscow will exceed 100 thousand people, and the number of critically ill patients on the peak of the epidemics will exceed the capacities of the system of healthcare. Scenarios A and B did not provide for a radical decrease in the fatality rate, and the number of critically ill patients at the peak of epidemics will still exceed the capacities of the system of healthcare. Besides, within Scenario B, the epidemics will last for more than a year. Scenarios C and D will allow for the control of epidemics and a significant decrease in the rate of letha lity (by 30 and 400 times, respectively). At the same time, these two scenarios prevent the population from developing herd immunity, which would result in the population susceptibility to repeated epidemics outbreaks.Conclusion. The scenarios intended for the slow development of herd immunity in the conditions of epidemic control would not bring sufficient results: the lethality would remain unacceptably high, the capacities of the system of healthcare would be overloaded, and the time of limiting measures would be unacceptably long. Such measures as complete lockdown would stop the present epidemics. The earlier they are introduced, the more efficient will be the results. To prevent further repeated outbreaks of the epidemics, it is necessary to establish a system of available, quick, and efficient testing in combination with point isolation of the infected patients and their contacts. ","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129085196","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 : 2020-02-18DOI: 10.17749/2070-4909.2019.12.4.318-326
V. Omelyanovskiy, N. Sisigina, V. K. Fedyaeva, N. Musina
Methods of payment to care providers constitute an essential part of the healthcare financing system; these mechanisms determine the motivation of service providers. Throughout the history of public health care, the payment methods have been gradually improved so to stimulate the providers to best match the societal demands (greater access to health services, cost reduction, and better quality) and prevent “moral hazards”. As a result, the most advanced healthcare systems have stopped paying simply for service volume and rigorously restraining the costs. Instead, the updated system is based on the integrated payments combining the elements of cost control with the stimuli that promote a high quality and better access to healthcare service. At present, the new payment mechanisms aiming at improving the long-term treatment outcomes (life expectancy and quality of life) are available. The care provider payment system existing in Russia, by large, corresponds to the best international practices as far as the hospital care is concerned. However, the payment arrangements in the primary care network still lag behind the international standards. To improve the situation, quality indicators should be included in payments for primary care services.
{"title":"Evolution of healthcare provider payment mechanisms","authors":"V. Omelyanovskiy, N. Sisigina, V. K. Fedyaeva, N. Musina","doi":"10.17749/2070-4909.2019.12.4.318-326","DOIUrl":"https://doi.org/10.17749/2070-4909.2019.12.4.318-326","url":null,"abstract":"Methods of payment to care providers constitute an essential part of the healthcare financing system; these mechanisms determine the motivation of service providers. Throughout the history of public health care, the payment methods have been gradually improved so to stimulate the providers to best match the societal demands (greater access to health services, cost reduction, and better quality) and prevent “moral hazards”. As a result, the most advanced healthcare systems have stopped paying simply for service volume and rigorously restraining the costs. Instead, the updated system is based on the integrated payments combining the elements of cost control with the stimuli that promote a high quality and better access to healthcare service. At present, the new payment mechanisms aiming at improving the long-term treatment outcomes (life expectancy and quality of life) are available. The care provider payment system existing in Russia, by large, corresponds to the best international practices as far as the hospital care is concerned. However, the payment arrangements in the primary care network still lag behind the international standards. To improve the situation, quality indicators should be included in payments for primary care services.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126521365","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 : 2020-02-18DOI: 10.17749/2070-4909.2019.12.4.291-299
A. T. Burbello, A. S. Fedorenko, E. L. Latariya, M. Pokladova, K. Zagorodnikova
Objectives . To study the structure of drug purchases by a general hospital considering the names and costs of the purchased drugs as well as their current consumption by various clinical departments. Materials and Methods . The drug consumption was analyzed using the ABC/VEN and ATC/DDD methods with a simultaneous analysis of case histories. Results . The analysis of drug purchases in 2014-2018 and the obtained results prompted a reassessment of the drug procurement policy and readjustment of the financial resources between various groups of drugs. Conclusion . The simultaneous use of the ABC/VEN and ATС/DDD analyzes and the reevaluation of the list of prescribed medications allowed us to propose the ways to optimize the structure of drug consumption in a typical hospital.
{"title":"Clinical and economic analysis of drug costs in a general hospital in 2014-2018","authors":"A. T. Burbello, A. S. Fedorenko, E. L. Latariya, M. Pokladova, K. Zagorodnikova","doi":"10.17749/2070-4909.2019.12.4.291-299","DOIUrl":"https://doi.org/10.17749/2070-4909.2019.12.4.291-299","url":null,"abstract":"Objectives . To study the structure of drug purchases by a general hospital considering the names and costs of the purchased drugs as well as their current consumption by various clinical departments. Materials and Methods . The drug consumption was analyzed using the ABC/VEN and ATC/DDD methods with a simultaneous analysis of case histories. Results . The analysis of drug purchases in 2014-2018 and the obtained results prompted a reassessment of the drug procurement policy and readjustment of the financial resources between various groups of drugs. Conclusion . The simultaneous use of the ABC/VEN and ATС/DDD analyzes and the reevaluation of the list of prescribed medications allowed us to propose the ways to optimize the structure of drug consumption in a typical hospital.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121412081","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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