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A social-economic burden of rhinosinusitis with nasal polyps with comorbid asthma and influence of dupilumab 鼻窦炎伴鼻息肉并发哮喘的社会经济负担及dupilumab的影响
Pub Date : 2021-12-07 DOI: 10.37489/2588-0519-2021-3-16-30
I. Krysanov, V. Krysanova, V. Ermakova
Rhinosinusitis with nasal polyps (RwNP) is a one of most common comorbidities in asthma and contrariwise and can lead to exacerbation of severe asthma (SA). Dupilumab is a perspective medicine for treatment of both, because it decreases exacerbations and prevents of a necessity of surgeon. Economics aspects of dupilumab treatment in RwNP + SA are not examined yet. Thus aim of this study was evaluation of social-economic burden of RwNP + SA in the Russian Federation and dupilumab influence on it. Materials and methods. Direct medical (cost of medicines, treatment in outpatients department and in hospital, including surgery and rate of exacerbations per year) and non-medical (payment for temporary and stable disability) and indirect costs (GDP loses) in RwNP + SA patients have been evaluated. Medical cure of a patient with RwNP + SA was created according to survey of experts from different regions of Russia. Modelling of expenditures was prepared on all calculated cohort of potential patients with RwNP + SA from “State” position and growing approach. Results. Expenditures for cure of one patient with RwNP were as 234 217,71 RUR/year. Weighted average costs for one patient with RwNP + SA were 1 881 883,39 RUR, and mostly were associated with indirect costs. Dupilumab can decrease expenditures for one patient with RwNP + SA till 1 593 162,87 RUR (on 15,3 %) annually. Potential cohort with RwNP + SA has been estimated above 39 thousand patients. Total economic burden of RwNP + SA in Russia were estimated as 1,7 bln RUR. Dupilumab usage in patients with RwNP + SA fixed in Register can help decrease economic burden on 259 mln RUR annually. Hidden economic burden of comorbidity can reach 73,4 bln RUR (for all calculated / modelled cohort of patients with RwNP + SA), dupilumab saves 11,3 bln RUR annually in this scenario. Conclusion. Comorbid pathology — RwNP+SA has a sufficient social-economic burden in Russia, that could be decreased by modern biologic drugs, in particular, with dupilumab.
鼻窦炎伴鼻息肉(RwNP)是哮喘最常见的合并症之一,相反,可导致严重哮喘(SA)的恶化。Dupilumab是治疗这两种疾病的理想药物,因为它减少了病情恶化,避免了外科手术的必要性。dupilumab治疗RwNP + SA的经济学方面尚未得到研究。因此,本研究的目的是评估俄罗斯联邦RwNP + SA的社会经济负担以及杜匹单抗对其的影响。材料和方法。已经评估了rnp + SA患者的直接医疗费用(药费、门诊部和住院治疗费用,包括手术和每年的恶化率)、非医疗费用(暂时和稳定残疾的支付)和间接费用(国内生产总值损失)。根据对俄罗斯不同地区专家的调查,创建了RwNP + SA患者的医学治疗方法。从“状态”位置和增长方法对所有计算出的RwNP + SA潜在患者队列进行支出建模。结果。1例RwNP患者的治疗费用为234,217,71 RUR/年。1例RwNP + SA患者的加权平均成本为1 881 883 39 RUR,且大多与间接成本相关。Dupilumab可将一名RwNP + SA患者的支出减少至每年1593 162,87 RUR(15.3%)。RwNP + SA的潜在队列估计超过3.9万例。RwNP + SA在俄罗斯的总经济负担估计为17亿卢布。在登记的RwNP + SA患者中使用Dupilumab可以帮助减少每年2.59亿RUR的经济负担。合并症的隐性经济负担可达734亿RUR(对于所有计算/建模的RwNP + SA患者队列),在这种情况下,杜匹单抗每年可节省113亿RUR。结论。合并症病理- RwNP+SA在俄罗斯有足够的社会经济负担,可以通过现代生物药物,特别是杜匹单抗来减轻。
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引用次数: 0
COVID-19: economic aspects of influenza vaccine prevention COVID-19:流感疫苗预防的经济方面
Pub Date : 2021-08-06 DOI: 10.37489/2588-0519-2021-1-16-21
E. Zhidkova, E. Gutor, Y. Tkachenko, I. V. Rogova, I. A. Popova, K. Gurevich
Relevance. A viral pandemic caused by the SARS-CoV-2 coronavirus has led to the development of a new coronavirus disease-2019 (COVID-19). The COVID-19 pandemic has forced the mobilization of all available health system resources. There are separate publications on reducing the risk of developing coronavirus infection in people vaccinated against influenza. Objective: to study the cost-effectiveness of influenza vaccination in the conditions of the» first « wave of COVID-19. Materials and methods. The archival data of 2,452 people from among the sick employees of JSC «Russian Railways» were analyzed. The control group consisted of 2,911 employees who were not infected with COVID-19, comparable by gender, age and territory of residence. Scores on the Charlson comorbidity scale were calculated for all individuals. The pharmacoeconomical cost of the patient’s treatment was predicted using the Markov model. Results. Having a flu shot reduced the likelihood of getting COVID-19 by 1.3 times. In the presence of a diagnosis of coronavirus infection, inpatient treatment for influenza vaccinated patients was required 2 times less often than for unvaccinated patients. Compared to the situation of the absence of vaccinated persons, in the «first wave», the estimated cost savings for the treatment of patients with coronavirus infection amounted to 124 million rubles. When the number of points on the comorbidity scale increased from 1 to 8, the average cost of treatment of patients without previous influenza vaccination increased by 2 times, and in the presence of vaccination, the average cost of treatment increased by 1.7 times. Conclusion. Thus, this study shows that influenza vaccination is cost-effective against COVID-19. The effect is achieved by reducing the likelihood of getting a coronavirus infection in the presence of a flu shot.
的相关性。由SARS-CoV-2冠状病毒引起的病毒大流行导致了一种新的冠状病毒疾病-2019 (COVID-19)的发展。COVID-19大流行迫使调动所有可用的卫生系统资源。关于降低接种流感疫苗的人感染冠状病毒的风险,有单独的出版物。目的:研究2019冠状病毒病“第一波”疫情条件下流感疫苗接种的成本-效果。材料和方法。对俄罗斯铁路公司患病员工中2452人的档案数据进行了分析。对照组由2911名未感染COVID-19的员工组成,性别、年龄和居住地区具有可比性。计算所有个体的Charlson共病量表得分。使用马尔可夫模型预测患者治疗的药物经济成本。结果。注射流感疫苗将感染COVID-19的可能性降低了1.3倍。在诊断为冠状病毒感染的情况下,流感疫苗接种患者需要住院治疗的次数比未接种疫苗的患者少2倍。与没有接种疫苗的人相比,在"第一波"中,估计为治疗冠状病毒感染患者节省了1.24亿卢布的费用。当共病量表点数从1分增加到8分时,未接种流感疫苗的患者的平均治疗费用增加了2倍,接种过流感疫苗的患者的平均治疗费用增加了1.7倍。结论。因此,这项研究表明,接种流感疫苗对COVID-19具有成本效益。这种效果是通过降低在注射流感疫苗的情况下感染冠状病毒的可能性来实现的。
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Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice
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