Pub Date : 2022-10-09DOI: 10.17749/2070-4909/farmakoekonomika.2022.120
E. Novoderezhkina, S. Zyryanov
Real world data (RWD) and real world evidence (RWE) is one of the most rapidly developing areas in the modern health care systems, which is caused by the development of technologies for both collecting and analyzing data, the emergence of new data sources and the formation of needs both by regulatory bodies, health technology assessment (HTA) agencies, and by the clinical and scientific communities. However, at the moment, there is no universal approach to RWD/E generation and application in the context of HTA. Over the past few years, the rate of including RWD/E in the HTA dossier has noticeably increased, but the nature of the existing guidelines and recommendations is rather fragmentary, which might create obstacles in the way of RWD/E study development and submission. The publication is aimed to describe and summarize the main and most rapidly developing spheres of RWD/E applications and analyze the possibilities of using RWD/E in various HTA areas in the world and in the Russian Federation considering the main trends in the further HTA development.
{"title":"The role of real world data and real world evidence in health technology assessment","authors":"E. Novoderezhkina, S. Zyryanov","doi":"10.17749/2070-4909/farmakoekonomika.2022.120","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.120","url":null,"abstract":"Real world data (RWD) and real world evidence (RWE) is one of the most rapidly developing areas in the modern health care systems, which is caused by the development of technologies for both collecting and analyzing data, the emergence of new data sources and the formation of needs both by regulatory bodies, health technology assessment (HTA) agencies, and by the clinical and scientific communities. However, at the moment, there is no universal approach to RWD/E generation and application in the context of HTA. Over the past few years, the rate of including RWD/E in the HTA dossier has noticeably increased, but the nature of the existing guidelines and recommendations is rather fragmentary, which might create obstacles in the way of RWD/E study development and submission. The publication is aimed to describe and summarize the main and most rapidly developing spheres of RWD/E applications and analyze the possibilities of using RWD/E in various HTA areas in the world and in the Russian Federation considering the main trends in the further HTA development.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"2013 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86242730","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 : 2022-10-09DOI: 10.17749/2070-4909/farmakoekonomika.2022.145
I. Torshin, О. Gromova, A. Lila
The relationship between the pathophysiology of osteoarthritis (OA) and metabolic disorders (metabolic syndrome, obesity) is provided not only by mechanical causes (increased body weight pressure on the joints). A complex of molecular mechanisms, which mediates OA effect on the development of obesity, was established. Excessive activity of toll receptors, the NF-κB cascade, and metabolic disorders of endogenous chondroitin sulfates (CS) lead to chronic inflammation and the development of a complex of comorbid pathologies, including OA, atherosclerosis, and obesity. The relationship between insulin resistance and CS metabolism is also mediated by impaired genomic DNA methylation. Exogenous CS and glucosamine sulfate (GS) used in the long-term treatment of OA also contribute to the inhibition of the pathophysiology of obesity. By inhibiting O-glucosamination of intranuclear proteins (i.e., p53), GS can accelerate lipolysis of visceral fat. Anti-inflammatory effects of CS and GS is associated with inhibition of toll receptors and NF-κB, increased levels of antioxidant enzymes, regulation of expression of fibroblast growth factor 21, activation of adenosine monophosphate-activated protein kinase, and inhibition of secretion of chemoattractant protein MCP-1 and pancreatic lipase. Positive effect of CS and its oligosaccharides exposure on the pathophysiology of metabolic disorders is associated not only with a decrease in inflammation and normalization of fat metabolism but also with an improvement in the state of the intestinal microbiota. Experimental and clinical studies confirm the effects of CS and GS on body mass control. CS and GS are effective and safe when used in patients with OA associated with metabolic syndrome and/or obesity.
{"title":"Prospects for the use of chondroitin sulfate and glucosamine sulfate in the treatment of patients with obesity-associated osteoarthritis (metabolic syndrome)","authors":"I. Torshin, О. Gromova, A. Lila","doi":"10.17749/2070-4909/farmakoekonomika.2022.145","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.145","url":null,"abstract":"The relationship between the pathophysiology of osteoarthritis (OA) and metabolic disorders (metabolic syndrome, obesity) is provided not only by mechanical causes (increased body weight pressure on the joints). A complex of molecular mechanisms, which mediates OA effect on the development of obesity, was established. Excessive activity of toll receptors, the NF-κB cascade, and metabolic disorders of endogenous chondroitin sulfates (CS) lead to chronic inflammation and the development of a complex of comorbid pathologies, including OA, atherosclerosis, and obesity. The relationship between insulin resistance and CS metabolism is also mediated by impaired genomic DNA methylation. Exogenous CS and glucosamine sulfate (GS) used in the long-term treatment of OA also contribute to the inhibition of the pathophysiology of obesity. By inhibiting O-glucosamination of intranuclear proteins (i.e., p53), GS can accelerate lipolysis of visceral fat. Anti-inflammatory effects of CS and GS is associated with inhibition of toll receptors and NF-κB, increased levels of antioxidant enzymes, regulation of expression of fibroblast growth factor 21, activation of adenosine monophosphate-activated protein kinase, and inhibition of secretion of chemoattractant protein MCP-1 and pancreatic lipase. Positive effect of CS and its oligosaccharides exposure on the pathophysiology of metabolic disorders is associated not only with a decrease in inflammation and normalization of fat metabolism but also with an improvement in the state of the intestinal microbiota. Experimental and clinical studies confirm the effects of CS and GS on body mass control. CS and GS are effective and safe when used in patients with OA associated with metabolic syndrome and/or obesity.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87451266","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 : 2022-10-09DOI: 10.17749/2070-4909/farmakoekonomika.2022.150
N. Avxentyev, Y. Makarova
Background. Diabetic nephropathy (DN) is a specific kidney lesion in patients with diabetes mellitus, which leads to the development of endstage kidney disease and requires substitutive renal therapy (dialysis or transplantation). Canagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor, which exerts a renoprotective effect. According to the published data, the application of canagliflozin in patients with type 2 diabetes mellitus (DM2) and DN could postpone dialysis therapy for almost 13 years.Objective: to perform a long-term analysis of canagliflozin budget impact in adult patients with DM2 and DN from the point of view of the constituent entities of the Russian Federation.Material and methods. A group of comparison for canagliflozin was placebo (no renoprotective pharmacotherapy). The authors proposed a mathematical model for DN progression in groups of patients who received canagliflozin (100 mg orally, daily, long-term) or placebo. The model was based on the extrapolation of the CREDENCE study data. The model was used for the analysis of the direct costs on the lifetime pharmacotherapy and dialysis per one patient. Epidemiologic data from the federal register on the number of adult patients with DM and DN prevalence among these patients were used to evaluate the size of the target population. Based on the clinical recommendations and the medical care standards for patients with DM and the data on the actual state procurement of SGLT2 inhibitors and glucagon-like peptide-1 receptor agonists in 2021, we evaluated the share of patients with DM2+DN who currently do not receive renoprotective therapy but who must be supplied with canagliflozin according to the standards. Among this population, we determined the patients with the glomerular filtration rate within 30–90 ml/min/1.73 m2, which provides the comparability of the target population with patients included in CREDENCE clinical study.Results. Direct medical costs per one patient receiving canagliflozin therapy were 678 108 rubles, which was 52.8% (759,239 rubles) lower than without renoprotective pharmacotherapy (1,437,347 rubles). As a result, considering the modeling period and current practice, the budget costs for pharmacotherapy of patients with DM2+DN were 99.82 billion rubles, in comparison with the proposed practice, which was 47.09 billion rubles (difference in budget costs is 52.73 billion rubles, or 52.8%). The accumulated costs of the regional health care system were lower in patients receiving canagliflozin in comparison with patients without renoprotective pharmacotherapy 11 years after the beginning of treatment.Conclusion. The expansion of canagliflozin application in the therapy for patients with DM2+DN leads to the budget cost cuts in the long run due to the extension of the dialysis-free period.
{"title":"Long-term analysis of сanagliflozin budget impact in adult patients with type 2 diabetes mellitus and diabetic nephropathy in the Russian Federation","authors":"N. Avxentyev, Y. Makarova","doi":"10.17749/2070-4909/farmakoekonomika.2022.150","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.150","url":null,"abstract":"Background. Diabetic nephropathy (DN) is a specific kidney lesion in patients with diabetes mellitus, which leads to the development of endstage kidney disease and requires substitutive renal therapy (dialysis or transplantation). Canagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor, which exerts a renoprotective effect. According to the published data, the application of canagliflozin in patients with type 2 diabetes mellitus (DM2) and DN could postpone dialysis therapy for almost 13 years.Objective: to perform a long-term analysis of canagliflozin budget impact in adult patients with DM2 and DN from the point of view of the constituent entities of the Russian Federation.Material and methods. A group of comparison for canagliflozin was placebo (no renoprotective pharmacotherapy). The authors proposed a mathematical model for DN progression in groups of patients who received canagliflozin (100 mg orally, daily, long-term) or placebo. The model was based on the extrapolation of the CREDENCE study data. The model was used for the analysis of the direct costs on the lifetime pharmacotherapy and dialysis per one patient. Epidemiologic data from the federal register on the number of adult patients with DM and DN prevalence among these patients were used to evaluate the size of the target population. Based on the clinical recommendations and the medical care standards for patients with DM and the data on the actual state procurement of SGLT2 inhibitors and glucagon-like peptide-1 receptor agonists in 2021, we evaluated the share of patients with DM2+DN who currently do not receive renoprotective therapy but who must be supplied with canagliflozin according to the standards. Among this population, we determined the patients with the glomerular filtration rate within 30–90 ml/min/1.73 m2, which provides the comparability of the target population with patients included in CREDENCE clinical study.Results. Direct medical costs per one patient receiving canagliflozin therapy were 678 108 rubles, which was 52.8% (759,239 rubles) lower than without renoprotective pharmacotherapy (1,437,347 rubles). As a result, considering the modeling period and current practice, the budget costs for pharmacotherapy of patients with DM2+DN were 99.82 billion rubles, in comparison with the proposed practice, which was 47.09 billion rubles (difference in budget costs is 52.73 billion rubles, or 52.8%). The accumulated costs of the regional health care system were lower in patients receiving canagliflozin in comparison with patients without renoprotective pharmacotherapy 11 years after the beginning of treatment.Conclusion. The expansion of canagliflozin application in the therapy for patients with DM2+DN leads to the budget cost cuts in the long run due to the extension of the dialysis-free period.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84458342","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 : 2022-10-09DOI: 10.17749/2070-4909/farmakoekonomika.2022.122
I. Bocharova, A. Rymanov
Objective: to conduct an analysis of the channels, the volume of COVID payments to medical workers and assess the preliminary effectiveness of funding for coronavirus health worker payments.Material and methods. Statistical comparative analysis of data in the field of health care funding was carried out. The assessment of changes in the level of wages of medical workers was performed using the index method and the grouping method. Relative indicators of the structure were used to evaluate the distribution of transfers by region. The study was conducted on the basis of open Rosstat data on the salaries of medical workers.Results. The regional distribution of transfers was regulated in 2020 by the Federal Government. The main channel for financing COVID payments to medical workers was the allocation of transfers and subsidies. More than half of the funding was accounted for by transfers for incentive payments to health care workers for fulfilling particularly important works. The largest share of allocated transfers fell on the Moscow Region (5.6% of the total volume of transfers), Nizhny Novgorod Region (5.1%), and Saint Petersburg (5.0%), the lowest – on the Republic of Kalmykia, the Republic of Khakassia, the Amur Region (0.2% each), the Nenets Autonomous District (0.1%). Transfers for incentive payments for special working conditions and additional workload were paid in 2020 in a total of 670 thousand persons. Transfers for incentive payments for fulfilling particularly important works were paid in a total of 363 thousand medical workers and 53 thousand ambulance drivers. An assessment of the effectiveness of financing COVID payments in the form of transfers and subsidies showed that it was largely due to them that the medical workers’ mean salary increased.Conclusion. The distribution of aggregated amounts of transfers between the constituent entities of the Russian Federation was carried out until November 2020 on the basis of the number of persons insured under Compulsory Health Insurance program in a corresponding region. In the early months of fighting the pandemic, the use of this aggregate was appropriate.
{"title":"Funding for coronavirus health worker payments","authors":"I. Bocharova, A. Rymanov","doi":"10.17749/2070-4909/farmakoekonomika.2022.122","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.122","url":null,"abstract":"Objective: to conduct an analysis of the channels, the volume of COVID payments to medical workers and assess the preliminary effectiveness of funding for coronavirus health worker payments.Material and methods. Statistical comparative analysis of data in the field of health care funding was carried out. The assessment of changes in the level of wages of medical workers was performed using the index method and the grouping method. Relative indicators of the structure were used to evaluate the distribution of transfers by region. The study was conducted on the basis of open Rosstat data on the salaries of medical workers.Results. The regional distribution of transfers was regulated in 2020 by the Federal Government. The main channel for financing COVID payments to medical workers was the allocation of transfers and subsidies. More than half of the funding was accounted for by transfers for incentive payments to health care workers for fulfilling particularly important works. The largest share of allocated transfers fell on the Moscow Region (5.6% of the total volume of transfers), Nizhny Novgorod Region (5.1%), and Saint Petersburg (5.0%), the lowest – on the Republic of Kalmykia, the Republic of Khakassia, the Amur Region (0.2% each), the Nenets Autonomous District (0.1%). Transfers for incentive payments for special working conditions and additional workload were paid in 2020 in a total of 670 thousand persons. Transfers for incentive payments for fulfilling particularly important works were paid in a total of 363 thousand medical workers and 53 thousand ambulance drivers. An assessment of the effectiveness of financing COVID payments in the form of transfers and subsidies showed that it was largely due to them that the medical workers’ mean salary increased.Conclusion. The distribution of aggregated amounts of transfers between the constituent entities of the Russian Federation was carried out until November 2020 on the basis of the number of persons insured under Compulsory Health Insurance program in a corresponding region. In the early months of fighting the pandemic, the use of this aggregate was appropriate.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83198692","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 : 2022-10-09DOI: 10.17749/2070-4909/farmakoekonomika.2022.131
А. V. Kukurika
Objective: to systematize data on cost-effectiveness evaluation of new multidrug and extensively drug-resistant tuberculosis (MDR/XDR-TB) chemotherapy regimens.Material and methods. An analysis of 19 publications devoted to the economic evaluation of the treatment of active MDR/XDR-TB was carried out. The literature search was performed in the electronic databases PubMed/MEDLINE, Google Scholar, eLibrary for the period from January 2015 to February 2022 inclusively.Results. Economic efficiency was studied in high-, middleand low-income countries. All publications contained calculation of treatment costs, and a third of the studies also estimated additional costs. Bedaquiline, delamanid, and pretomanid regimens were included in treatment alone or compared with a background regimen. The most commonly used economic model was the Markov one. To compare primary outcomes, most studies assessed disabilityand quality-adjusted life years. The overall cost of MDR/XDR-TB treatment varied by country income level. In all cases, bedaquiline-based regimens represented a cost-effective alternative to previous treatment, showed high efficacy in MDR/XDR-TB therapy, and were more cost-effective than delamanid regimens.Conclusion. Cost-effective interventions for active MDR/XDR-TB therapy should include the introduction of new chemotherapy regimens, reduced hospital stays and decentralized treatment, which is especially relevant in countries with high tuberculosis burden.
{"title":"Economic aspects of using new chemotherapy regimens for multidrug and extensively drugresistant tuberculosis","authors":"А. V. Kukurika","doi":"10.17749/2070-4909/farmakoekonomika.2022.131","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.131","url":null,"abstract":"Objective: to systematize data on cost-effectiveness evaluation of new multidrug and extensively drug-resistant tuberculosis (MDR/XDR-TB) chemotherapy regimens.Material and methods. An analysis of 19 publications devoted to the economic evaluation of the treatment of active MDR/XDR-TB was carried out. The literature search was performed in the electronic databases PubMed/MEDLINE, Google Scholar, eLibrary for the period from January 2015 to February 2022 inclusively.Results. Economic efficiency was studied in high-, middleand low-income countries. All publications contained calculation of treatment costs, and a third of the studies also estimated additional costs. Bedaquiline, delamanid, and pretomanid regimens were included in treatment alone or compared with a background regimen. The most commonly used economic model was the Markov one. To compare primary outcomes, most studies assessed disabilityand quality-adjusted life years. The overall cost of MDR/XDR-TB treatment varied by country income level. In all cases, bedaquiline-based regimens represented a cost-effective alternative to previous treatment, showed high efficacy in MDR/XDR-TB therapy, and were more cost-effective than delamanid regimens.Conclusion. Cost-effective interventions for active MDR/XDR-TB therapy should include the introduction of new chemotherapy regimens, reduced hospital stays and decentralized treatment, which is especially relevant in countries with high tuberculosis burden.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87883705","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 : 2022-10-09DOI: 10.17749/2070-4909/farmakoekonomika.2022.148
V. Omelyanovskiy, D. Lukyantseva, N. Sisigina
Objevtive: to identify and systematize the main approaches to planning health care provider network used in foreign countries.Material and methods. Preliminary search for countries who had an experience of systematical planning of health care provider network and tools that they used for planning was conducted in regular health system reviews made by the European Observatory on Health Systems and Policies. Identified tools became a subject of general Internet search for the official publications about goals, mechanisms and results of their usage. The findings were analysed to reveal the similarities and differences between national health care provider network planning policies as well as the objective preconditions for the formation of such policies.Results. Three main approaches to health care provider network planning were identified in the analysis: (1) through establishing state-owned health care providers, (2) through granting the right to deliver guaranteed health care or (3) through granting the right to deliver health care of all categories. A close relationship between the choice of prevailing approach to planning and specific planning tools and the national health care model and structure of health services supply was shown. The typical policy of countries most similar to Russia on these parameters (“young” insurance systems, operating under conditions of predominant state supply of medical services) is the protection of key providers on the basis of minimum activity or income guarantees with the gradual development of a competitive health care market based on the rest of the Compulsory Health Insurance program.Conclusion. Current Russian health care provider network planning regulation based on the direct control over the state-owned health care providers does not correspond to the changed health care model and does not allow taking full advantages of the social health insurance. The results of the review can be used to develop new tools for planning health care provider network spanning on non-state providers.
{"title":"Review of international practice of health care provider network planning","authors":"V. Omelyanovskiy, D. Lukyantseva, N. Sisigina","doi":"10.17749/2070-4909/farmakoekonomika.2022.148","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.148","url":null,"abstract":"Objevtive: to identify and systematize the main approaches to planning health care provider network used in foreign countries.Material and methods. Preliminary search for countries who had an experience of systematical planning of health care provider network and tools that they used for planning was conducted in regular health system reviews made by the European Observatory on Health Systems and Policies. Identified tools became a subject of general Internet search for the official publications about goals, mechanisms and results of their usage. The findings were analysed to reveal the similarities and differences between national health care provider network planning policies as well as the objective preconditions for the formation of such policies.Results. Three main approaches to health care provider network planning were identified in the analysis: (1) through establishing state-owned health care providers, (2) through granting the right to deliver guaranteed health care or (3) through granting the right to deliver health care of all categories. A close relationship between the choice of prevailing approach to planning and specific planning tools and the national health care model and structure of health services supply was shown. The typical policy of countries most similar to Russia on these parameters (“young” insurance systems, operating under conditions of predominant state supply of medical services) is the protection of key providers on the basis of minimum activity or income guarantees with the gradual development of a competitive health care market based on the rest of the Compulsory Health Insurance program.Conclusion. Current Russian health care provider network planning regulation based on the direct control over the state-owned health care providers does not correspond to the changed health care model and does not allow taking full advantages of the social health insurance. The results of the review can be used to develop new tools for planning health care provider network spanning on non-state providers.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90043806","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 : 2022-10-09DOI: 10.17749/2070-4909/farmakoekonomika.2022.146
V. Timiryanova, I. Lakman, N. Zagidullin, D. Gareeva
Background. The sudden emergence and rapid spread of the novel coronavirus infection (COVID-19) caused tremendous burden on the health care system including the economic one. In this regard, many questions concerning the prioritization of funding for various restrictive and preventive procedures have arisen; also the introduction of various intervention methods for monitoring and timely treatment of post-COVID consequences became an urgent problem. These challenges actualized the development of pharmacoeconomic methods that improve the quality of decisions making in such extreme conditions.Objective: to systematize available studies on the assessment of the global economic burden of the novel coronavirus infection.Material and methods. A feature of the proposed review design was the highlighting of the observed shortcomings and areas in which scientists make additions to the assessment methods taking into account the chronology of the pandemic determining changes in the information field. Therefore, an analysis was made of 80 studies published in 2020–2022 and dedicated to the assessment and forecast of the global economic burden of COVID-19. The main inclusion criteria for the studies was the estimation of COVID-19 global burden. The search was carried out in PubMed/MEDLINE, Web of Science, Scopus, and eLibrary databases. Using a predefined data collection form, two reviewers independently extracted information characterizing the studies.Results. An analysis of the publications showed a fairly wide variety of studies in the field of the COVID-19 burden, including those determined by the difference in observation objects, analysis methods, factors taken into account, etc. Scientists actively use international (73.8%) and national (90%) databases, and surveys (57.5%). Predominantly, the estimates involve the calculation of quality-adjusted life years lost (QALY) (66.3%), 37.6% of the studies are based on the results of constructing scenario models, 28.8% consume algorithms of epidemiological SIR (susceptible, infected, or recovered) models, and 66.3% provide for cost assessment. As part of the estimated economic burden, the loss of productivity (26.3% of publications), the introduction of vaccination (32.5%), comorbidity (25%), post-COVID complications (17.5%) are considered.Conclusion. A significant interest of the world scientific community in assessing the COVID-19 global burden is observed, determined by the search for the most effective study methods. Further investigations in this area should focus on detailing within the estimated economic burden of losses associated with post-COVID-19 complications, including their various combinations, as well as on the analysis of the correlation and mutual compensation of effects from various types of treatment, with a deeper study of indirect losses. The results of this work will be also useful in conducting similar studies, including for determining their design and applying modern mathematical modeli
背景。新型冠状病毒感染(COVID-19)的突然出现和迅速传播给包括经济在内的医疗卫生系统带来了巨大的负担。在这方面，出现了许多关于为各种限制性和预防性程序提供资金的优先次序的问题;引入各种干预方法来监测和及时治疗新冠肺炎后的后果也成为一个紧迫的问题。这些挑战实现了药物经济学方法的发展，提高了在这种极端条件下决策的质量。目的:对新型冠状病毒感染全球经济负担评估的现有研究进行系统整理。材料和方法。拟议审查设计的一个特点是突出指出观察到的缺点和科学家在考虑到决定信息领域变化的大流行年表的情况下对评估方法作出补充的领域。因此，对2020-2022年发表的80项研究进行了分析，致力于评估和预测COVID-19的全球经济负担。这些研究的主要纳入标准是对COVID-19全球负担的估计。检索在PubMed/MEDLINE、Web of Science、Scopus和library数据库中进行。使用预定义的数据收集表，两位审稿人独立地提取研究特征信息。对出版物的分析显示，在COVID-19负担领域的研究种类繁多，包括由观察对象、分析方法、考虑因素等差异决定的研究。科学家积极使用国际(73.8%)和国内(90%)数据库，以及调查(57.5%)。这些估计主要涉及计算质量调整生命损失年(QALY)(66.3%)， 37.6%的研究基于构建情景模型的结果，28.8%的研究使用流行病学SIR(易感、感染或恢复)模型的算法，66.3%的研究提供成本评估。作为估计经济负担的一部分，考虑到生产力损失(占出版物的26.3%)、疫苗接种的引入(32.5%)、合并症(25%)和covid后并发症(17.5%)。通过寻找最有效的研究方法，世界科学界对评估COVID-19全球负担非常感兴趣。这一领域的进一步调查应侧重于详细说明与covid -19后并发症(包括其各种组合)相关的损失在估计经济负担范围内的情况，以及分析各种治疗效果的相关性和相互补偿，并对间接损失进行更深入的研究。这项工作的结果也将有助于进行类似的研究，包括确定其设计和应用现代数学建模工具。
{"title":"Economic burden of the novel coronavirus infection: a systematic review","authors":"V. Timiryanova, I. Lakman, N. Zagidullin, D. Gareeva","doi":"10.17749/2070-4909/farmakoekonomika.2022.146","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.146","url":null,"abstract":"Background. The sudden emergence and rapid spread of the novel coronavirus infection (COVID-19) caused tremendous burden on the health care system including the economic one. In this regard, many questions concerning the prioritization of funding for various restrictive and preventive procedures have arisen; also the introduction of various intervention methods for monitoring and timely treatment of post-COVID consequences became an urgent problem. These challenges actualized the development of pharmacoeconomic methods that improve the quality of decisions making in such extreme conditions.Objective: to systematize available studies on the assessment of the global economic burden of the novel coronavirus infection.Material and methods. A feature of the proposed review design was the highlighting of the observed shortcomings and areas in which scientists make additions to the assessment methods taking into account the chronology of the pandemic determining changes in the information field. Therefore, an analysis was made of 80 studies published in 2020–2022 and dedicated to the assessment and forecast of the global economic burden of COVID-19. The main inclusion criteria for the studies was the estimation of COVID-19 global burden. The search was carried out in PubMed/MEDLINE, Web of Science, Scopus, and eLibrary databases. Using a predefined data collection form, two reviewers independently extracted information characterizing the studies.Results. An analysis of the publications showed a fairly wide variety of studies in the field of the COVID-19 burden, including those determined by the difference in observation objects, analysis methods, factors taken into account, etc. Scientists actively use international (73.8%) and national (90%) databases, and surveys (57.5%). Predominantly, the estimates involve the calculation of quality-adjusted life years lost (QALY) (66.3%), 37.6% of the studies are based on the results of constructing scenario models, 28.8% consume algorithms of epidemiological SIR (susceptible, infected, or recovered) models, and 66.3% provide for cost assessment. As part of the estimated economic burden, the loss of productivity (26.3% of publications), the introduction of vaccination (32.5%), comorbidity (25%), post-COVID complications (17.5%) are considered.Conclusion. A significant interest of the world scientific community in assessing the COVID-19 global burden is observed, determined by the search for the most effective study methods. Further investigations in this area should focus on detailing within the estimated economic burden of losses associated with post-COVID-19 complications, including their various combinations, as well as on the analysis of the correlation and mutual compensation of effects from various types of treatment, with a deeper study of indirect losses. The results of this work will be also useful in conducting similar studies, including for determining their design and applying modern mathematical modeli","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88198549","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 : 2022-09-19DOI: 10.17749/2070-4909/farmakoekonomika.2022.149
V. V. Strizheletsky, Y. Gomon, Е. А. Spichakova, А. Kolbin, А. А. Kalyapin, S. A. Makarov, А. B. Lomiya А.B., F. Sultanova
Objective: аssessment of orlistat, liraglutide and sibutramine consumption in the Russian Federation as drugs recommended by the Russian clinical guidelines for the pharmacotherapy of obesity.Material and methods. From IQVIA database, the information was selected on retail sales and procurement of the specified drugs at the expense of the federal and regional budgets in the period of 2011–2021. The consumed volumes of each drug were recalculated into the number of defined daily doses (DDDs) for each international nonproprietary name in accordance with the World Health Organization methodology.Results. It was demonstrated that over a 10-year period there was a tendency to reduce the consumption of drugs for the treatment of obesity from 83.03 million DDDs in 2011 to 71.7 million in 2021. Sibutramine consumption dominated throughout the observation period: its share ranged from 76% to 84%. The proportion of people receiving obesity pharmacotherapy in the Russian Federation was about 0.5%. Herewith 58–66% of DDDs sales took place in 3 regions: Moscow, Moscow Region and Saint Petersburg.Conclusion. Low efficacy, high frequency of adverse reactions, frequent weight gain after discontinuation of therapy, as well as low orientation of doctors to the need for pharmacotherapy are probably the main factors determining the low prevalence of using drugs for the treatment of obesity in Russia.
{"title":"Drug therapy for obesity in the Russian Federation: pharmacoepidemiological study","authors":"V. V. Strizheletsky, Y. Gomon, Е. А. Spichakova, А. Kolbin, А. А. Kalyapin, S. A. Makarov, А. B. Lomiya А.B., F. Sultanova","doi":"10.17749/2070-4909/farmakoekonomika.2022.149","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.149","url":null,"abstract":"Objective: аssessment of orlistat, liraglutide and sibutramine consumption in the Russian Federation as drugs recommended by the Russian clinical guidelines for the pharmacotherapy of obesity.Material and methods. From IQVIA database, the information was selected on retail sales and procurement of the specified drugs at the expense of the federal and regional budgets in the period of 2011–2021. The consumed volumes of each drug were recalculated into the number of defined daily doses (DDDs) for each international nonproprietary name in accordance with the World Health Organization methodology.Results. It was demonstrated that over a 10-year period there was a tendency to reduce the consumption of drugs for the treatment of obesity from 83.03 million DDDs in 2011 to 71.7 million in 2021. Sibutramine consumption dominated throughout the observation period: its share ranged from 76% to 84%. The proportion of people receiving obesity pharmacotherapy in the Russian Federation was about 0.5%. Herewith 58–66% of DDDs sales took place in 3 regions: Moscow, Moscow Region and Saint Petersburg.Conclusion. Low efficacy, high frequency of adverse reactions, frequent weight gain after discontinuation of therapy, as well as low orientation of doctors to the need for pharmacotherapy are probably the main factors determining the low prevalence of using drugs for the treatment of obesity in Russia.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90474740","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 : 2022-07-28DOI: 10.17749/2070-4909/farmakoekonomika.2022.142
I. Torshin, O. Gromova
Background. Omega-3 polyunsaturated fatty acids (ω-3 PUFAs) are widely used in modern cardiology. The anti-inflammatory effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is realized, in particular, by modulating the activity of the arachidonic acid (ARA) cascade.Objective: to conduct biophysical analysis of the interactions of various forms of PUFAs (ARA, EPA, DHA, EPA and DHA ethyl esters) with three target proteins-enzymes of the ARA cascade (cyclooxygenase-1 (COX-1), COX-2, 5-lipoxygenase (5-LPOG)).Material and methods. The minimization of the energy of the ligand-receptor complexes at various initial positions of the molecule relative to the receptor pocket and the molecular energy profiles of the protein (the energy of side chain transfer from solvent to protein) were calculated using the ECMMS package.Results. EPA and DHA ethyl esters were characterized by significantly higher absolute values of specific binding energies of target proteins than ARA or simply EPA/DHA. For example, in the case of COX-2, EPA, DHA and EPA ethyl ester had similar ∆∆G values (–3.0...–3.1 kcal/mol), while the COX-2 complex with DHA ethyl ester was somewhat more stable (∆∆G = –3.4 kcal/mol). In the case of the 5-LPOG enzyme, the complex with EPA ethyl ester was the most stable (∆∆G = –1.62 kcal/mol). Higher absolute binding energies indicate a higher affinity of EPA and DHA ethyl esters to enzymes of the ARA cascade.Conclusion. The results suggest that the high affinity of EPA and DHA ethyl esters to the enzymes of the ARA cascade is one of the molecular bases of therapeutic efficacy of ω-3 PUFAs with high degree of standardization.
{"title":"Biophysical modeling indicates a high affinity of ethyl esters of omega-3 polyunsaturated fatty acids to the enzymes of the pro-inflammatory arachidonic acid cascade","authors":"I. Torshin, O. Gromova","doi":"10.17749/2070-4909/farmakoekonomika.2022.142","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.142","url":null,"abstract":"Background. Omega-3 polyunsaturated fatty acids (ω-3 PUFAs) are widely used in modern cardiology. The anti-inflammatory effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is realized, in particular, by modulating the activity of the arachidonic acid (ARA) cascade.Objective: to conduct biophysical analysis of the interactions of various forms of PUFAs (ARA, EPA, DHA, EPA and DHA ethyl esters) with three target proteins-enzymes of the ARA cascade (cyclooxygenase-1 (COX-1), COX-2, 5-lipoxygenase (5-LPOG)).Material and methods. The minimization of the energy of the ligand-receptor complexes at various initial positions of the molecule relative to the receptor pocket and the molecular energy profiles of the protein (the energy of side chain transfer from solvent to protein) were calculated using the ECMMS package.Results. EPA and DHA ethyl esters were characterized by significantly higher absolute values of specific binding energies of target proteins than ARA or simply EPA/DHA. For example, in the case of COX-2, EPA, DHA and EPA ethyl ester had similar ∆∆G values (–3.0...–3.1 kcal/mol), while the COX-2 complex with DHA ethyl ester was somewhat more stable (∆∆G = –3.4 kcal/mol). In the case of the 5-LPOG enzyme, the complex with EPA ethyl ester was the most stable (∆∆G = –1.62 kcal/mol). Higher absolute binding energies indicate a higher affinity of EPA and DHA ethyl esters to enzymes of the ARA cascade.Conclusion. The results suggest that the high affinity of EPA and DHA ethyl esters to the enzymes of the ARA cascade is one of the molecular bases of therapeutic efficacy of ω-3 PUFAs with high degree of standardization.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77272933","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 : 2022-07-28DOI: 10.17749/2070-4909/farmakoekonomika.2022.125
Yu.A. Zuenkova, D. Kicha, L. N. Izyurov
Objective: implementation of value-based approach and development of adherence to treatment in patients with non-melanoma cancer.Material and methods. The observational, single-arm, prospective, long-term single-center study of the quality of life and patients’ experience was performed. It included 42 patients aged from 42 to 82 years. Validated questionnaires were used: Patient-Reported Outcome Measures (PROMs) (as a decision support tool), Patient-Reported Experience Measures (PREMs) (3 months after treatment to assess the patient's experience).Results. Mean concern about appearance was 43.5 points (Rasch psychometric model). Younger patients (r=–0.398, p=0.009) and female patients (r=–0.475, p=0.001) were more concerned about appearance. In 10 cases (24%), the involvement was estimated as 4 points, in 18 cases (43%), it was 3 points, in 14 cases (33%), it was 2 points. Older patients were less involved in the choice of treatment method (r=–0633, p<0.001). The level of satisfaction with communications was more than 50 points. The use of a patient-oriented algorithm of communication has a positive effect on a patient's experience.Conclusion. The heads of oncological care are recommended to evaluate the patient's experience on a regular basis, create conditions for patients to choose treatment methods according to their individual needs, analyze the outcomes obtained by the introduction of validated questionnaires on the appropriate nosological profile and take these results into account in treatment. Further studies of the degree of influence of different factors on a patient’s choice of treatment method are needed, as well as conducting studies among other groups of patients with non-melanoma skin cancer (located in other parts of the body, larger than 2 cm).
{"title":"Experience of implementing a value-based approach in oncodermatology","authors":"Yu.A. Zuenkova, D. Kicha, L. N. Izyurov","doi":"10.17749/2070-4909/farmakoekonomika.2022.125","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.125","url":null,"abstract":"Objective: implementation of value-based approach and development of adherence to treatment in patients with non-melanoma cancer.Material and methods. The observational, single-arm, prospective, long-term single-center study of the quality of life and patients’ experience was performed. It included 42 patients aged from 42 to 82 years. Validated questionnaires were used: Patient-Reported Outcome Measures (PROMs) (as a decision support tool), Patient-Reported Experience Measures (PREMs) (3 months after treatment to assess the patient's experience).Results. Mean concern about appearance was 43.5 points (Rasch psychometric model). Younger patients (r=–0.398, p=0.009) and female patients (r=–0.475, p=0.001) were more concerned about appearance. In 10 cases (24%), the involvement was estimated as 4 points, in 18 cases (43%), it was 3 points, in 14 cases (33%), it was 2 points. Older patients were less involved in the choice of treatment method (r=–0633, p<0.001). The level of satisfaction with communications was more than 50 points. The use of a patient-oriented algorithm of communication has a positive effect on a patient's experience.Conclusion. The heads of oncological care are recommended to evaluate the patient's experience on a regular basis, create conditions for patients to choose treatment methods according to their individual needs, analyze the outcomes obtained by the introduction of validated questionnaires on the appropriate nosological profile and take these results into account in treatment. Further studies of the degree of influence of different factors on a patient’s choice of treatment method are needed, as well as conducting studies among other groups of patients with non-melanoma skin cancer (located in other parts of the body, larger than 2 cm).","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79313676","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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