Pub Date : 2022-04-15DOI: 10.17749/2070-4909/farmakoekonomika.2022.046
O. Zhukova, O. V. Ruina, M. Khazov, T. M. Konyshkina, E. A. Rodin, D. K. Lipatov
Objective: pharmacoepidemiological analysis of medication list used in a multidepartmental hospital.Material and methods. The material for the analysis was the costs of medications for the reporting period of 2017–2018. We used the tools of ABC/VEN analysis and import substitution assessment. The assessment of import substitution in a medical organization was carried out in comparison of 2018 with 2017 by the change in costs for various pharmacotherapeutic groups of medications in two segments (domestic and foreign production) in percentage terms.Results. The results of the analysis revealed, that the antibiotics are the largest volume of the cost structure for various pharmacotherapeutic groups: 18.8% in 2017 and 15.6% in 2018. The analysis of the medication list used in a medical organization, regarding to the production segment, showed that in 2017 22.6% was spent on domestic medications. In 2018, this indicator increased by 15.2% and amounted to 37.8%. The correct, regular distribution of groups V, E, N in groups A, B, C was revealed. More than 80% of group A consists of medications from group V of all monetary costs and the share of medication belonging to group N is less than 3%. In total, the cost of medications of groups V and E is more than 90%.Conclusion. The use of these methods allows to optimize the costs of medications provision for therapeutic and diagnostic processes and to improve pharmaceutical diseases therapy. In 2018, compared to 2017, there is a redistribution of the cost structure for medications towards an increase in the share of Russian-made medications. Given the lower cost of Russian medications compared to imported analogues, this approach will allow in the future to save the money of medical organizations with no deterioration in the quality of treatment.
{"title":"Pharmacoepidemiological analysis of medication consumption in a multidepartmental hospital as an element of medical care quality management and the basis for assessing import substitution","authors":"O. Zhukova, O. V. Ruina, M. Khazov, T. M. Konyshkina, E. A. Rodin, D. K. Lipatov","doi":"10.17749/2070-4909/farmakoekonomika.2022.046","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.046","url":null,"abstract":"Objective: pharmacoepidemiological analysis of medication list used in a multidepartmental hospital.Material and methods. The material for the analysis was the costs of medications for the reporting period of 2017–2018. We used the tools of ABC/VEN analysis and import substitution assessment. The assessment of import substitution in a medical organization was carried out in comparison of 2018 with 2017 by the change in costs for various pharmacotherapeutic groups of medications in two segments (domestic and foreign production) in percentage terms.Results. The results of the analysis revealed, that the antibiotics are the largest volume of the cost structure for various pharmacotherapeutic groups: 18.8% in 2017 and 15.6% in 2018. The analysis of the medication list used in a medical organization, regarding to the production segment, showed that in 2017 22.6% was spent on domestic medications. In 2018, this indicator increased by 15.2% and amounted to 37.8%. The correct, regular distribution of groups V, E, N in groups A, B, C was revealed. More than 80% of group A consists of medications from group V of all monetary costs and the share of medication belonging to group N is less than 3%. In total, the cost of medications of groups V and E is more than 90%.Conclusion. The use of these methods allows to optimize the costs of medications provision for therapeutic and diagnostic processes and to improve pharmaceutical diseases therapy. In 2018, compared to 2017, there is a redistribution of the cost structure for medications towards an increase in the share of Russian-made medications. Given the lower cost of Russian medications compared to imported analogues, this approach will allow in the future to save the money of medical organizations with no deterioration in the quality of treatment. ","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84909286","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 : 2022-04-15DOI: 10.17749/2070-4909/farmakoekonomika.2022.124
R. Yagudina, A. Kulikov, V. Serpik, O. Gromova, I. Torshin
Objective: comparative pharmacoeconomic analysis of iron preparations for intravenous infusion in the treatment of iron deficiency anemia (IDA) within the concept of patient blood management program.Material and methods. A retrospective pharmacoeconomic study was carried out using methods of analysis of efficiency, costs and costeffectiveness. Comparison of preparations of oligoisomaltose iron [III] (Monofer) and carboxymaltose iron [III] (Ferinject®) was carried out.Results. In general, Monofer and Ferinject® are characterized by comparable efficacy in terms of hematological response. Using a dosiological model of an increase in hemoglobin blood levels over time in treatment with the drugs under consideration the frequencies of the hematological response were calculated (Monofer – 79%, Ferinject® – 70%). The cost of treating one patient with an average body weight of 88.3 kg and an initial hemoglobin level of 100 g/l was 13,097 rubles for Monofer and 15,681 rubles for Ferinject®. The values of the cost-effectiveness indicator calculated in accordance with the criterion of the effectiveness of the hematological response amounted to 16,578 rubles (Monofer) and 22,402 rubles (Ferinject®), which allows to consider Monofer as strictly preferred. With the colorectal surgery as an example, it has been shown that the use of this drug in patients blood management can reduce the total cost of treatment (in particular, by reducing the required number of portions of red blood cells).Conclusion. The wider use of iron preparations for intravenous infusion in IDA has reasonable economic advantages. The preparation of oligoisomaltose iron Monofer is strictly preferred in relation to the preparation of carboxymaltose iron.
{"title":"Pharmacoeconomic analysis of using Monofer in patients with iron deficiency anemia as part of the provision of medical care under the state guarantees program in the health care system of the Russian Federation","authors":"R. Yagudina, A. Kulikov, V. Serpik, O. Gromova, I. Torshin","doi":"10.17749/2070-4909/farmakoekonomika.2022.124","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.124","url":null,"abstract":"Objective: comparative pharmacoeconomic analysis of iron preparations for intravenous infusion in the treatment of iron deficiency anemia (IDA) within the concept of patient blood management program.Material and methods. A retrospective pharmacoeconomic study was carried out using methods of analysis of efficiency, costs and costeffectiveness. Comparison of preparations of oligoisomaltose iron [III] (Monofer) and carboxymaltose iron [III] (Ferinject®) was carried out.Results. In general, Monofer and Ferinject® are characterized by comparable efficacy in terms of hematological response. Using a dosiological model of an increase in hemoglobin blood levels over time in treatment with the drugs under consideration the frequencies of the hematological response were calculated (Monofer – 79%, Ferinject® – 70%). The cost of treating one patient with an average body weight of 88.3 kg and an initial hemoglobin level of 100 g/l was 13,097 rubles for Monofer and 15,681 rubles for Ferinject®. The values of the cost-effectiveness indicator calculated in accordance with the criterion of the effectiveness of the hematological response amounted to 16,578 rubles (Monofer) and 22,402 rubles (Ferinject®), which allows to consider Monofer as strictly preferred. With the colorectal surgery as an example, it has been shown that the use of this drug in patients blood management can reduce the total cost of treatment (in particular, by reducing the required number of portions of red blood cells).Conclusion. The wider use of iron preparations for intravenous infusion in IDA has reasonable economic advantages. The preparation of oligoisomaltose iron Monofer is strictly preferred in relation to the preparation of carboxymaltose iron. ","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87905384","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 : 2022-04-15DOI: 10.17749/2070-4909/farmakoekonomika.2022.103
I. Petrukhina, P. A. Lebedev, E. Gladunova, T. K. Ryazanova, A. Garanin, P. R. Blinkova
Objective: to determine the compliance of antihypertensive drugs consumption with the trends of modern pharmacotherapy.Material and methods. The analysis of the consumption level of antihypertensive drugs, their fixed combinations (FC), as well as statins in the retail sector of the pharmaceutical market of the Samara Region in 2015–2020 was carried out. The material of this retrospective study was information about the nomenclature and volume of drug sales in physical and monetary terms for the period under review in one of the retail pharmacies of the Samara Region. The traditional method of pharmacoepidemiological analysis aimed at studying the correctness, completeness and preferences of drug use in real practice is questionnaires for physicians and patients. The main antihypertensive drugs (diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, β-blockers) and their FC were selected for the analysis.Results. Long-term use of medications aimed at reducing high blood pressure and hypercholesterolemia is seen as an effective strategy for reducing cardiovascular complications and mortality in both primary and secondary prevention. The analysis of sales of basic cardiological drugs in the pharmacy network segment of the Samara Region in 5-year dynamics showed that the consumption of hypotensive drugs and statins makes up 4.72% of the total item sales, with prevalence of angiotensin-converting enzyme inhibitors (28.0%) and β-blockers (23.5%), with insufficient consumption of FC (23.7%), extremely low sales of statins (7.58%).Conclusion. The structure of the studied segment of the pharmaceutical market is conservative with insufficient positive dynamics in the consumption of effective modern drugs and their FC.
{"title":"The analysis of the consumption level of antihypertensive drugs and statins in a retail pharmacy of the Samara Region in 2015–2020","authors":"I. Petrukhina, P. A. Lebedev, E. Gladunova, T. K. Ryazanova, A. Garanin, P. R. Blinkova","doi":"10.17749/2070-4909/farmakoekonomika.2022.103","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.103","url":null,"abstract":"Objective: to determine the compliance of antihypertensive drugs consumption with the trends of modern pharmacotherapy.Material and methods. The analysis of the consumption level of antihypertensive drugs, their fixed combinations (FC), as well as statins in the retail sector of the pharmaceutical market of the Samara Region in 2015–2020 was carried out. The material of this retrospective study was information about the nomenclature and volume of drug sales in physical and monetary terms for the period under review in one of the retail pharmacies of the Samara Region. The traditional method of pharmacoepidemiological analysis aimed at studying the correctness, completeness and preferences of drug use in real practice is questionnaires for physicians and patients. The main antihypertensive drugs (diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, β-blockers) and their FC were selected for the analysis.Results. Long-term use of medications aimed at reducing high blood pressure and hypercholesterolemia is seen as an effective strategy for reducing cardiovascular complications and mortality in both primary and secondary prevention. The analysis of sales of basic cardiological drugs in the pharmacy network segment of the Samara Region in 5-year dynamics showed that the consumption of hypotensive drugs and statins makes up 4.72% of the total item sales, with prevalence of angiotensin-converting enzyme inhibitors (28.0%) and β-blockers (23.5%), with insufficient consumption of FC (23.7%), extremely low sales of statins (7.58%).Conclusion. The structure of the studied segment of the pharmaceutical market is conservative with insufficient positive dynamics in the consumption of effective modern drugs and their FC. ","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74498739","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 : 2022-04-15DOI: 10.17749/2070-4909/farmakoekonomika.2022.107
A. Kolbin, Y. Gomon, A. Kasimova, A. Kurylev, A. Bem
Objective: to assess the compliance of the actual practice of conducting clinical and economic research with the requirements applicable in the Russian Federation (RF) when including drugs in the Federal Program of High-Cost Nosologies (HCN).Material and methods. In the CyberLeninka and eLibrary databases, a search was made for clinical and economic studies of medicines included in the HCN list published in the RF in the period from 2011 to June 2021.Results. Information was obtained on 23 published clinical and economic studies of the effectiveness of drugs, which is less than 30% of all drugs included in the HCN program during the specified period. More than half of the studies of chronic disabling diseases had a modeling horizon of 1 year. The sensitivity analysis of the results in over 1/3 of cases considered only the deviation of the price of the strategies under consideration, and in a quarter of cases it was not carried out at all. Only 4 studies evaluated the increase in quality-adjusted life year, although, for chronic disabling diseases, quality of life is one of the key performance indicators.Conclusion. In the RF, less than 30% of the results of pharmacoeconomical studies of drugs included in the HCN Program are published, which does not allow to make adequate evaluation of pharmacoeconomical approaches to its formation. To analyze the effectiveness of the tools used in assessing the economic efficiency of expensive medical technologies, a further retrospective research of the studies conducted in the RF is required.
{"title":"The real practice of clinical and economic research of drugs included in the Federal Program of High-Cost Nosologies","authors":"A. Kolbin, Y. Gomon, A. Kasimova, A. Kurylev, A. Bem","doi":"10.17749/2070-4909/farmakoekonomika.2022.107","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.107","url":null,"abstract":"Objective: to assess the compliance of the actual practice of conducting clinical and economic research with the requirements applicable in the Russian Federation (RF) when including drugs in the Federal Program of High-Cost Nosologies (HCN).Material and methods. In the CyberLeninka and eLibrary databases, a search was made for clinical and economic studies of medicines included in the HCN list published in the RF in the period from 2011 to June 2021.Results. Information was obtained on 23 published clinical and economic studies of the effectiveness of drugs, which is less than 30% of all drugs included in the HCN program during the specified period. More than half of the studies of chronic disabling diseases had a modeling horizon of 1 year. The sensitivity analysis of the results in over 1/3 of cases considered only the deviation of the price of the strategies under consideration, and in a quarter of cases it was not carried out at all. Only 4 studies evaluated the increase in quality-adjusted life year, although, for chronic disabling diseases, quality of life is one of the key performance indicators.Conclusion. In the RF, less than 30% of the results of pharmacoeconomical studies of drugs included in the HCN Program are published, which does not allow to make adequate evaluation of pharmacoeconomical approaches to its formation. To analyze the effectiveness of the tools used in assessing the economic efficiency of expensive medical technologies, a further retrospective research of the studies conducted in the RF is required.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78232136","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 : 2022-04-15DOI: 10.17749/2070-4909/farmakoekonomika.2022.132
D. Blinov, A. Solopova, A. N. Plutnitskiy, D. M. Ampilogova, L. Sandzhieva, D. I. Korabel’nikov, D. Petrenko
During the past decades, the prevalence of cancer diseases of female reproductive system has been constantly growing. The issue is especially acute in reproductive-age women because of earlier oncological pathology onset. Morpho-functional disorders and aggressive methods of anti-tumor therapy significantly affect the patients’ quality of life, psychological well-being, emotional stability, and family relationship, which leads to a limitation of physiological and social possibilities. Rehabilitation programs for oncological patients target to prevent unwanted sequela of the disease, its therapy, and relapses. Pre-rehabilitation plays a special role. It includes psychological and specialized medical care for the patient during the period from the disease verification to the start of therapy. Timely rehabilitation measures reduce the rate of repeated hospitalizations for side effects of chemotherapy, radiotherapy complications, antitumor therapy, and radical surgical interventions. Rehabilitation as a part of standard therapeutic strategy can reduce pharmacoeconomical burden for the health care system. However, further clinical and pharmacoeconomic studies are required for the implementation of rehabilitation at the level of the health care system.
{"title":"Strengthening health care to provide rehabilitation services for women with cancer diseases of the reproductive system","authors":"D. Blinov, A. Solopova, A. N. Plutnitskiy, D. M. Ampilogova, L. Sandzhieva, D. I. Korabel’nikov, D. Petrenko","doi":"10.17749/2070-4909/farmakoekonomika.2022.132","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.132","url":null,"abstract":"During the past decades, the prevalence of cancer diseases of female reproductive system has been constantly growing. The issue is especially acute in reproductive-age women because of earlier oncological pathology onset. Morpho-functional disorders and aggressive methods of anti-tumor therapy significantly affect the patients’ quality of life, psychological well-being, emotional stability, and family relationship, which leads to a limitation of physiological and social possibilities. Rehabilitation programs for oncological patients target to prevent unwanted sequela of the disease, its therapy, and relapses. Pre-rehabilitation plays a special role. It includes psychological and specialized medical care for the patient during the period from the disease verification to the start of therapy. Timely rehabilitation measures reduce the rate of repeated hospitalizations for side effects of chemotherapy, radiotherapy complications, antitumor therapy, and radical surgical interventions. Rehabilitation as a part of standard therapeutic strategy can reduce pharmacoeconomical burden for the health care system. However, further clinical and pharmacoeconomic studies are required for the implementation of rehabilitation at the level of the health care system. ","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85895213","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 : 2022-04-15DOI: 10.17749/2070-4909/farmakoekonomika.2022.136
I. Torshin, T. Minasov, N. Zagorodniy, A. Lila, O. Gromova
Joint endoprosthetics is a treatment of choice for patients with decompensated osteoarthritis (OA), who have exhausted the possibilities of pharmacotherapy and other methods of conservative treatment. Preparation for endoprosthetics and rehabilitation after surgery usually includes measures to improve the muscle condition and local blood circulation in the joint area, and if necessary, pain management. The unique spectrum of anti-inflammatory effect of chondroprotectors based on chondroitin sulfate and glucosamine sulfate includes inhibition of NF-κB cascade, toll-like receptors, pro-inflammatory cytokines, metalloproteinases, and significantly alleviates the course of OA. Reducing the severity of OA is important for preparing for surgery, subsequent rehabilitation, and preventing the revision surgery.
{"title":"Perioperative pharmacotherapy for endoprosthetics: potential of chondroitin sulfate and glucosamine sulfate","authors":"I. Torshin, T. Minasov, N. Zagorodniy, A. Lila, O. Gromova","doi":"10.17749/2070-4909/farmakoekonomika.2022.136","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.136","url":null,"abstract":"Joint endoprosthetics is a treatment of choice for patients with decompensated osteoarthritis (OA), who have exhausted the possibilities of pharmacotherapy and other methods of conservative treatment. Preparation for endoprosthetics and rehabilitation after surgery usually includes measures to improve the muscle condition and local blood circulation in the joint area, and if necessary, pain management. The unique spectrum of anti-inflammatory effect of chondroprotectors based on chondroitin sulfate and glucosamine sulfate includes inhibition of NF-κB cascade, toll-like receptors, pro-inflammatory cytokines, metalloproteinases, and significantly alleviates the course of OA. Reducing the severity of OA is important for preparing for surgery, subsequent rehabilitation, and preventing the revision surgery. ","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84783785","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 : 2022-04-15DOI: 10.17749/2070-4909/farmakoekonomika.2022.128
V. Sokolova, N. Sableva, V. Mladov, D. Tolkacheva
Background. A systematic literature review helps to identify the main treatment options, and evidence synthesis supports decision-making by comparing clinical efficacy of different treatments. Nowadays new drugs and clinical trials emerge rapidly, so previous network meta-analyses might need to be updated.Objective: to update the existing systematic review and network meta-analysis comparing efficacy of targeted drugs in adult patients with moderate-to-severe plaque psoriasis by adding randomized clinical trials (RCTs) on a new interleukin (IL) 23 inhibitor registered in the Russian Federation – risankizumab, and other RCTs published after 2019; to reassess the Psoriasis Area and Severity Index (PASI) 75/90 numbers of patients needed to treat to achieve clinical response to therapy and the costs per responder for 12–16 weeks and 1 year of therapy.Material and methods. We updated our systematic literature search in the PubMed/MEDLINE and Embase databases. Evidence synthesis included RCTs evaluating the efficacy of adalimumab (ADA), infliximab (INF), etanercept (ETN), certolizumab pegol (CZP), ixekizumab (IXE), netakimab (NTK), secukinumab (SEC), risankizumab (RIS), guselkumab (GUS), ustekinumab (UST), tofacitinib (TOFA), and apremilast (APR) after 12 weeks of therapy. The Bayesian meta-analyses with meta-regression models were performed in order to account for high heterogeneity in patient characteristics and significant differences in the placebo response rates. The considered drugs were ranked based on values of surface under the cumulative ranking curve (SUCRA). Additionally, drug class analyses were carried out.Results. Twenty three new RCTs were added to the network. IL-23 inhibitor RIS, recently approved in the Russian Federation, has joined the group of the most efficacious drugs, such as IL-17 inhibitors NTK and IXE, as well as IL-23 inhibitor GUS. In terms of PASI 75, RIS and IXE showed superiority compared to all tumor necrosis factor alpha (TNFα) inhibitors (INF, ADA, ETN), small molecules (TOFA and APR), and IL-12/23 inhibitor UST, while NTK and GUS were characterized by comparable efficacy with INF and outperformed the remaining drugs. There were no statistically significant differences in efficacy between all the TNFα inhibitors. GUS, IXE, INF, NTK, RIS and SEC demonstrated that no more than 2 patients need to be treated to achieve one PASI 75 response, and no more than 3 need to be treated for one PASI 90 response (according to the upper limit of 95% credible interval). Same as in the previously published study, NTK showed the lowest costs per responder for both 12-week and 1-year periods.Conclusion. The addition of head-to-head trials and increased statistical power of the network revealed previously unidentified significant differences between treatment options for moderate-to-severe plaque psoriasis.
{"title":"Efficacy of targeted drugs for the treatment of adults with moderate-to-severe plaque psoriasis in the Russian Federation: a systematic literature review update","authors":"V. Sokolova, N. Sableva, V. Mladov, D. Tolkacheva","doi":"10.17749/2070-4909/farmakoekonomika.2022.128","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.128","url":null,"abstract":"Background. A systematic literature review helps to identify the main treatment options, and evidence synthesis supports decision-making by comparing clinical efficacy of different treatments. Nowadays new drugs and clinical trials emerge rapidly, so previous network meta-analyses might need to be updated.Objective: to update the existing systematic review and network meta-analysis comparing efficacy of targeted drugs in adult patients with moderate-to-severe plaque psoriasis by adding randomized clinical trials (RCTs) on a new interleukin (IL) 23 inhibitor registered in the Russian Federation – risankizumab, and other RCTs published after 2019; to reassess the Psoriasis Area and Severity Index (PASI) 75/90 numbers of patients needed to treat to achieve clinical response to therapy and the costs per responder for 12–16 weeks and 1 year of therapy.Material and methods. We updated our systematic literature search in the PubMed/MEDLINE and Embase databases. Evidence synthesis included RCTs evaluating the efficacy of adalimumab (ADA), infliximab (INF), etanercept (ETN), certolizumab pegol (CZP), ixekizumab (IXE), netakimab (NTK), secukinumab (SEC), risankizumab (RIS), guselkumab (GUS), ustekinumab (UST), tofacitinib (TOFA), and apremilast (APR) after 12 weeks of therapy. The Bayesian meta-analyses with meta-regression models were performed in order to account for high heterogeneity in patient characteristics and significant differences in the placebo response rates. The considered drugs were ranked based on values of surface under the cumulative ranking curve (SUCRA). Additionally, drug class analyses were carried out.Results. Twenty three new RCTs were added to the network. IL-23 inhibitor RIS, recently approved in the Russian Federation, has joined the group of the most efficacious drugs, such as IL-17 inhibitors NTK and IXE, as well as IL-23 inhibitor GUS. In terms of PASI 75, RIS and IXE showed superiority compared to all tumor necrosis factor alpha (TNFα) inhibitors (INF, ADA, ETN), small molecules (TOFA and APR), and IL-12/23 inhibitor UST, while NTK and GUS were characterized by comparable efficacy with INF and outperformed the remaining drugs. There were no statistically significant differences in efficacy between all the TNFα inhibitors. GUS, IXE, INF, NTK, RIS and SEC demonstrated that no more than 2 patients need to be treated to achieve one PASI 75 response, and no more than 3 need to be treated for one PASI 90 response (according to the upper limit of 95% credible interval). Same as in the previously published study, NTK showed the lowest costs per responder for both 12-week and 1-year periods.Conclusion. The addition of head-to-head trials and increased statistical power of the network revealed previously unidentified significant differences between treatment options for moderate-to-severe plaque psoriasis.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75464150","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 : 2022-04-14DOI: 10.17749/2070-4909/farmakoekonomika.2022.102
A. A. Leshkevich, D. S. Yurochkin, Z. М. Golant, I. Narkevich
Objective: analysis of state regulation of prices and costs for the purchase of medicines (drugs) in the United Kingdom (UK), and proposal development to improve the processes of state regulation of manufacturers’ marginal registered prices of medicines included in the list of vital and essential drugs approved in the Russian Federation.Material and methods. Analysis of the structure of state regulation of prices and costs for the procurement of drugs was carried out based on information contained in the regulatory legal documents of the UK Government, health services and technical regulation, and data provided in systematic reviews and articles.Results. A key feature of regulation in the UK is maximizing the efficiency of health care costs based on the principles of digitization, long-term planning and health technology assessment in pricing. Government regulation of costs is focused on the patent-protected drug segment. Providers of such medicines fall under the Voluntary or Statutory Scheme and are required to make payments in the form of a fixed percentage of sales to the Department of Health and Social Care. Certain drug segments are exempt from payments to stimulate innovative development of the pharmaceutical industry and accelerate market access for new therapies. As practice shows, the Voluntary Scheme is more profitable for most companies. Regulation in the segment of reproduced drugs is carried out by free-market mechanisms and the antimonopoly service.Conclusion. The analysis revealed the mechanisms and key features of the methods of state regulation of prices and costs of the health care system for the procurement of drugs, identified best practices that are promising for adaptation to improve the state regulation of prices in the Russian Federation.
{"title":"Study of methods for state regulation of prices and costs of the health care system for medicines in the United Kingdom","authors":"A. A. Leshkevich, D. S. Yurochkin, Z. М. Golant, I. Narkevich","doi":"10.17749/2070-4909/farmakoekonomika.2022.102","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.102","url":null,"abstract":"Objective: analysis of state regulation of prices and costs for the purchase of medicines (drugs) in the United Kingdom (UK), and proposal development to improve the processes of state regulation of manufacturers’ marginal registered prices of medicines included in the list of vital and essential drugs approved in the Russian Federation.Material and methods. Analysis of the structure of state regulation of prices and costs for the procurement of drugs was carried out based on information contained in the regulatory legal documents of the UK Government, health services and technical regulation, and data provided in systematic reviews and articles.Results. A key feature of regulation in the UK is maximizing the efficiency of health care costs based on the principles of digitization, long-term planning and health technology assessment in pricing. Government regulation of costs is focused on the patent-protected drug segment. Providers of such medicines fall under the Voluntary or Statutory Scheme and are required to make payments in the form of a fixed percentage of sales to the Department of Health and Social Care. Certain drug segments are exempt from payments to stimulate innovative development of the pharmaceutical industry and accelerate market access for new therapies. As practice shows, the Voluntary Scheme is more profitable for most companies. Regulation in the segment of reproduced drugs is carried out by free-market mechanisms and the antimonopoly service.Conclusion. The analysis revealed the mechanisms and key features of the methods of state regulation of prices and costs of the health care system for the procurement of drugs, identified best practices that are promising for adaptation to improve the state regulation of prices in the Russian Federation. ","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83380371","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 : 2022-04-14DOI: 10.17749/2070-4909/farmakoekonomika.2022.129
K. A. Perova, D. Shchurov, D. Blinov, N. V. Bashmakova, N. Musina
Objective: to evaluate clinical-economic feasibility and impact of follitropin alfa on the state healthcare budget of the Russian Federation in the population of women with diagnosed infertility and poor ovarian response, who undergo treatment with assisted reproductive technologies (ART).Material and methods. A cost minimization analysis to evaluate clinical-economic feasibility of follitropin alfa in women with infertility and poor ovarian response who underwent ART was performed. The model of the budget impact analysis included the costs required for the ovarian stimulation of patients distributed by various variants of their management. The current practice involved the application only of fixed dose combinations (FDC) of follitropin alfa + lutropin alfa. The expected practice suggested a change in the approach by shifting 25% of patients with poor ovarian response from FDC of follitropin alfa + lutropin alfa to follitropin alfa. A time horizon of modeling was 1 year.Results. The cost minimization analysis demonstrated that the application of drug with international nonproprietary name follitropin alfa is characterized by the cost cut of 12,020 rubles (–21.56%) per patient compared with FDС of follitropin alpha + lutropin alpha. The results of budget impact analysis showed that a shift of 25% of population from FDC of follitropin alfa + lutropin alfa to follitropin alfa could cut direct medical costs by 7.96 million rubles per year (–5.39%).Conclusion. Evaluation of clinical-economic feasibility and budget impact analysis showed that the application of follitropin alfa during ovarian stimulation in women with infertility and poor ovarian response leads to a decrease in budget expenses.
{"title":"Pharmacoeconomic analysis of the application of follitropin alfa in combination with assisted reproductive technologies","authors":"K. A. Perova, D. Shchurov, D. Blinov, N. V. Bashmakova, N. Musina","doi":"10.17749/2070-4909/farmakoekonomika.2022.129","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.129","url":null,"abstract":"Objective: to evaluate clinical-economic feasibility and impact of follitropin alfa on the state healthcare budget of the Russian Federation in the population of women with diagnosed infertility and poor ovarian response, who undergo treatment with assisted reproductive technologies (ART).Material and methods. A cost minimization analysis to evaluate clinical-economic feasibility of follitropin alfa in women with infertility and poor ovarian response who underwent ART was performed. The model of the budget impact analysis included the costs required for the ovarian stimulation of patients distributed by various variants of their management. The current practice involved the application only of fixed dose combinations (FDC) of follitropin alfa + lutropin alfa. The expected practice suggested a change in the approach by shifting 25% of patients with poor ovarian response from FDC of follitropin alfa + lutropin alfa to follitropin alfa. A time horizon of modeling was 1 year.Results. The cost minimization analysis demonstrated that the application of drug with international nonproprietary name follitropin alfa is characterized by the cost cut of 12,020 rubles (–21.56%) per patient compared with FDС of follitropin alpha + lutropin alpha. The results of budget impact analysis showed that a shift of 25% of population from FDC of follitropin alfa + lutropin alfa to follitropin alfa could cut direct medical costs by 7.96 million rubles per year (–5.39%).Conclusion. Evaluation of clinical-economic feasibility and budget impact analysis showed that the application of follitropin alfa during ovarian stimulation in women with infertility and poor ovarian response leads to a decrease in budget expenses. ","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74614256","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 : 2022-04-14DOI: 10.17749/2070-4909/farmakoekonomika.2022.130
T. O. Bessonova, F. Gorkavenko, D. Shchurov, Y. Seryapina, O. R. Chetverikova, V. Omelyanovskiy, S. Krivolapov, N. M. Neminushchiy, A. A. Kalemberg
Objective: to evaluate cost-effectiveness and budget impact of using single and dual chamber implantable cardioverter-defibrillators (ICD) adjunctive to the standard drug therapy (DT) compared to the standard DT alone for the primary and secondary prevention of sudden cardiac death (SCD).Material and methods. Original partitioned survival analysis model was developed to assess the cost-effectiveness of using ICD within the modelling horizon of 8 years. The following model outcomes were used: life years and quality-adjusted life years (QALY). Primary prevention model was focused on patients after myocardial infarction with left ventricular ejection fraction (LVEF) ≤30%, whilst secondary prevention model considered cardiac arrest survivors and/or patients diagnosed with ventricular tachycardia or ventricular fibrillation with LVEF ≤35%. The model summarizes treatment effect and costs for ICD and DT specific to the healthcare system of the Russian Federation (RF). The main scenario accounted for ICD implantation cost in accordance with general reimbursement price asserted in the high technology medical care list part 2 (HТMC 2). Additionally, alternative scenario of ICD reimbursement level was developed to account for general tariff split onto singleand dual-chamber ICD implantation reimbursement tariffs which can be financed through high technology medical care list part 1 (HТMC 1). Budget impact analysis compared the costs of using ICD within the current volume of the annual increase in ICD implantations and a threefold increased volume of ICD implantations.Results. By the end of the modelling period, additional 34% of patients survived in the ICD group compared to the DT group. Incremental cost-effectiveness ratio (ICER) per 1 QALY constituted 2.8 and 2.2 million rubles for primary and secondary prevention, respectively. ICER values are slightly above or lower than the willingness-to-pay threshold of 2.5 million rubles per 1 QALY in the RF in the segment of primary and secondary SCD prevention, respectively. Additional HТMC 1 scenario incorporating lower ICD implantation prices resulted in an average ICER drop by 13% compared to HTMC 2. Overall patient population requiring SCD prevention comprised of 7,161 and 3,341 patients in primary and secondary prevention, respectively. Budget impact analysis showed that threefold rise in the ICD implantations rate will require additional 648 million rubles for primary prevention cohort to provide additional 573 patients with ICD, and 230 million rubles for secondary prevention cohort with additional 267 patients covered with ICD. ICD reimbursement price drop within the HТMC 1 scenario will save 133 million rubles and allow to provide additional 143 patients with ICDs for a given budget.Conclusion. ICD is a cost-effective option of secondary prevention of SCD. Additional analysis of ICD reimbursement price drop drives ICER downwards to a considerable extent which in turn increases the accessibility of ICDs t
{"title":"Cost-effectiveness and budget impact analyses of using implantable cardioverter-defibrillators in the Russian Federation","authors":"T. O. Bessonova, F. Gorkavenko, D. Shchurov, Y. Seryapina, O. R. Chetverikova, V. Omelyanovskiy, S. Krivolapov, N. M. Neminushchiy, A. A. Kalemberg","doi":"10.17749/2070-4909/farmakoekonomika.2022.130","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.130","url":null,"abstract":"Objective: to evaluate cost-effectiveness and budget impact of using single and dual chamber implantable cardioverter-defibrillators (ICD) adjunctive to the standard drug therapy (DT) compared to the standard DT alone for the primary and secondary prevention of sudden cardiac death (SCD).Material and methods. Original partitioned survival analysis model was developed to assess the cost-effectiveness of using ICD within the modelling horizon of 8 years. The following model outcomes were used: life years and quality-adjusted life years (QALY). Primary prevention model was focused on patients after myocardial infarction with left ventricular ejection fraction (LVEF) ≤30%, whilst secondary prevention model considered cardiac arrest survivors and/or patients diagnosed with ventricular tachycardia or ventricular fibrillation with LVEF ≤35%. The model summarizes treatment effect and costs for ICD and DT specific to the healthcare system of the Russian Federation (RF). The main scenario accounted for ICD implantation cost in accordance with general reimbursement price asserted in the high technology medical care list part 2 (HТMC 2). Additionally, alternative scenario of ICD reimbursement level was developed to account for general tariff split onto singleand dual-chamber ICD implantation reimbursement tariffs which can be financed through high technology medical care list part 1 (HТMC 1). Budget impact analysis compared the costs of using ICD within the current volume of the annual increase in ICD implantations and a threefold increased volume of ICD implantations.Results. By the end of the modelling period, additional 34% of patients survived in the ICD group compared to the DT group. Incremental cost-effectiveness ratio (ICER) per 1 QALY constituted 2.8 and 2.2 million rubles for primary and secondary prevention, respectively. ICER values are slightly above or lower than the willingness-to-pay threshold of 2.5 million rubles per 1 QALY in the RF in the segment of primary and secondary SCD prevention, respectively. Additional HТMC 1 scenario incorporating lower ICD implantation prices resulted in an average ICER drop by 13% compared to HTMC 2. Overall patient population requiring SCD prevention comprised of 7,161 and 3,341 patients in primary and secondary prevention, respectively. Budget impact analysis showed that threefold rise in the ICD implantations rate will require additional 648 million rubles for primary prevention cohort to provide additional 573 patients with ICD, and 230 million rubles for secondary prevention cohort with additional 267 patients covered with ICD. ICD reimbursement price drop within the HТMC 1 scenario will save 133 million rubles and allow to provide additional 143 patients with ICDs for a given budget.Conclusion. ICD is a cost-effective option of secondary prevention of SCD. Additional analysis of ICD reimbursement price drop drives ICER downwards to a considerable extent which in turn increases the accessibility of ICDs t","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91386371","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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