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Application of chondroprotective agents to inhibit osteodestructive processes in the subchondral bone in patients with osteoarthritis 应用软骨保护剂抑制骨关节炎患者软骨下骨的骨破坏过程
Q3 Medicine Pub Date : 2022-03-15 DOI: 10.17749/2070-4909/farmakoekonomika.2022.126
О. Gromova, А. M. Lila, I. Torshin, I. А. Reier
Background. Osteoarthritis (OA) is associated with an acute activation of local and systemic inflammation and involves subchondral tissue of the joint.Objective: to conduct a systemic analysis of the publications on the association between OA and metabolic disorders in bones.Material and methods. The authors analyzed 3,296 publications on the studies of OA and metabolic disorders in bones tissue by the method of a topologic theory of recognition selected by the request “osteoarthritis AND (bone resorption OR osteopenia OR osteoporosis)” in the database of biomedical publications PubMed/MEDLINE. The control sampling included 4,000 articles randomly selected out of 97,331 found by the request “osteoarthritis NOT bone NOT resorption NOT osteopenia NOT osteoporosis” (i.e. publications on OA that do not cover issues of bone metabolism).Results. The associations between cartilaginous pathology and bone tissue destruction are mediated by anti-inflammatory cytokines, osteoblast and osteoclast balance impairments, steroid hormone imbalance, and carbohydrate metabolism. Bone metabolism disorders are associated with an intensification of OA-associated pain syndrome. Chondroprotective agents (chondroitin sulfate (CS), glucosamine sulfate (GS), and undenaturated collagen) block the activity of antiinflammatory cytokines (NF-κB and toll-receptors), stimulate the activity of osteoblasts (bone tissue synthesizing cells), and decrease the excessive activity of osteoclasts (cells that degrade bone tissue).Conclusion. Pharmaceutically standardized forms of CS and GS can be used for the normalization of bone metabolism along with safe osteoptotective means (vitamin D, calcium, etc.) in patients with OA.
背景。骨关节炎(OA)与局部和全身炎症的急性激活有关,涉及关节软骨下组织。目的:对骨关节炎与骨骼代谢紊乱之间关系的文献进行系统分析。材料和方法。作者根据PubMed/MEDLINE生物医学出版物数据库中“骨关节炎与(骨吸收或骨质减少或骨质疏松)”的要求选择了一种拓扑识别理论,分析了3296篇关于骨性关节炎和骨组织代谢紊乱研究的出版物。对照样本包括根据“骨关节炎、骨吸收、骨减少、骨质疏松”(即不涉及骨代谢问题的OA出版物)的要求从97,331篇文章中随机抽取的4,000篇。软骨病理和骨组织破坏之间的关联是由抗炎细胞因子、成骨细胞和破骨细胞平衡受损、类固醇激素失衡和碳水化合物代谢介导的。骨代谢紊乱与oa相关疼痛综合征的加重有关。软骨保护剂(硫酸软骨素(CS)、硫酸氨基葡萄糖(GS)和不饱和胶原)可阻断抗炎细胞因子(NF-κB和toll受体)的活性,刺激成骨细胞(骨组织合成细胞)的活性,降低破骨细胞(骨组织降解细胞)的过度活性。在OA患者中,药物标准化的CS和GS可用于骨代谢的正常化以及安全的保骨手段(维生素D,钙等)。
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引用次数: 1
History of controlled trials in medicine: real priorities are little-known. Report 3. Quasi-randomized and randomized trials in humans and animals 医学对照试验的历史:真正的优先事项鲜为人知。报告3。人类和动物的准随机和随机试验
Q3 Medicine Pub Date : 2022-01-16 DOI: 10.17749/2070-4909/farmakoekonomika.2021.091
A. N. Koterov, O. A. Tikhonova, L. Ushenkova, A. Biryukov
The three-report review is aimed to describe the historical development of clinical trials, controlled trials (CT) and randomized controlled trials (RCT), and the inclusion of these approaches in health-related disciplines (Medicine and Epidemiology). Report 3 summarizes historical milestones (ideas and studies) for quasi-randomized CT (‘alternate allocation’; 88 milestones) and RCT (37 milestones). It was found that although the ideas of both designs are a thing of the past (from A. Lesassier Hamilton (1816) and J.B. Van Helmont (1648), respectively), the bulk of the tests were carried out in the 20th century, when both designs existed in parallel. Overall, the alternate allocation was used nearly three times longer than randomization.Analysis of the sources showed that the first RCT in medicine was the work of D. Colebrook, 1925 (Great Britain), and the first close to the modern RCT, including randomization according to the table of random numbers, was J.A. Bell, 1941 (USA). Often referred to as the ‘new era in CT’ and ‘the origine of RCT’, a study of the effects of streptomycin on tuberculosis in 1946–1948, which was also designed by A.B. Hill is only 13th known RCT, only 9th RCT in medicine and only the 2nd with modern randomization. Other facts of insufficient reflection of the priorities and real history of CT/RCT in West and Russian publications were found, including dozens of Western textbooks on epidemiology and evidence-based medicine of recent decades. True priorities are often omitted, and the most frequent references to the history of CT (progressively) are the experience of the prophet Daniel, the experience of the surgeon J. Lind, and the study on the effect of streptomycin on tuberculosis in 1946–1948.Based on a PubMed/MEDLINE search, a summary of alternate allocation CT, and RCT for the period 1960–1990 to 2020 is provided. In the first case, single publications were found, but the fact that design with alternation survives to this day is important. For RCT, since 1990s, an increase in the number of papers (up to tens of thousands per year) has been revealed. The data are given for the total number of RCTs performed by countries, continents and parts of the world for 2020. According to the calculated index of the ratio of the number of RCTs to the specific number of doctors (per 100,000 population) among 45 countries of Eurasia (from France to Tajikistan), Russia ranks 12th.A three-report review based on the originals of nearly all publications from the late 19th century and including the necessary references and citations can serve as a reference guide to the historical development of CT and related topics.
这三篇综述旨在描述临床试验、对照试验(CT)和随机对照试验(RCT)的历史发展,以及这些方法在健康相关学科(医学和流行病学)中的应用。报告3总结了准随机CT的历史里程碑(思想和研究)(“交替分配”;88个里程碑)和随机对照试验(37个里程碑)。人们发现,虽然这两种设计的想法都是过去的事情(分别来自a . Lesassier Hamilton(1816)和J.B. Van Helmont(1648)),但大部分测试是在20世纪进行的,当时两种设计并行存在。总的来说,替代分配的使用时间几乎是随机分配的三倍。对资料来源的分析表明,医学上的第一个随机对照试验是1925年(英国)的D. Colebrook的工作,而第一个接近现代随机对照试验(包括根据随机数表随机化)的是1941年(美国)的J.A. Bell。通常被称为“CT的新时代”和“随机对照试验的起源”,1946-1948年由A.B. Hill设计的一项关于链霉素对结核病的影响的研究仅是已知的第13项随机对照试验,医学上的第9项随机对照试验,也是第2项现代随机化的随机对照试验。在西方和俄罗斯的出版物中,包括近几十年西方流行病学和循证医学教科书中,还发现了其他未能充分反映CT/RCT优先级和真实历史的事实。真正的优先级往往被忽略,而最常提到的CT史(逐步)是先知丹尼尔的经验,外科医生J.林德的经验,以及1946-1948年关于链霉素对结核病的影响的研究。基于PubMed/MEDLINE检索,提供了1960-1990至2020年期间交替分配CT和RCT的摘要。在第一种情况下,发现了单一的出版物,但具有交替的设计存在到今天的事实很重要。对于随机对照试验,自20世纪90年代以来,论文数量有所增加(每年多达数万篇)。这些数据是2020年世界各国、各大洲和部分地区进行的随机对照试验的总数。根据欧亚大陆45个国家(从法国到塔吉克斯坦)的随机对照试验数量与医生具体人数(每10万人)之比的计算指数,俄罗斯排名第12位。一份基于19世纪末几乎所有出版物原件的三份报告综述,包括必要的参考文献和引文,可以作为CT和相关主题历史发展的参考指南。
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引用次数: 1
Analysis of the consumption volumes of antithrombotic drugs used for pharmacotherapy of atrial fibrillation in Saratov Region 萨拉托夫地区房颤药物治疗用抗栓药物用量分析
Q3 Medicine Pub Date : 2022-01-15 DOI: 10.17749/2070-4909/farmakoekonomika.2021.090
А. Sokolov, О. V. Reshet’ko
Objective: To study the evolution of consumption of antithrombotic drugs used for the treatment of atrial fibrillation (AF) at the outpatient stage in the Saratov Region using the ATC/DDD (Anatomical Therapeutic Chemical Classification / Defined Daily Doses) and drug utilization 90% (DU90%) analysis.Material and methods. We analyzed the outpatient stage of treatment using the data reflected in 511 case histories of AF patients hospitalized in specialized cardiology departments of the Saratov Region in 2011–2018. The study of the consumption volumes of antithrombotic drugs was carried out using the ATC/DDD- and DU90%-analysis methodology. The consumption of drugs with proven efficacy in AF was expressed as the number of daily doses (NDDD) per 1000 AF patients per day.Results. In 2011, the number of prescribed DDD of oral anticoagulants (OACs) was 5.29 NDDD per 1000 AF patients per day, and all of them were represented by warfarin; in 2018, this indicator increased up to 277.51 NDDD per 1000 AF patients per day, of which direct OACs amounted to 237.06. The consumption of antiplatelet agents remained at a high level, and in 2018, was 582.53 NDDD per 1000 AF patients per day. Acetylsalicylic acid was included in the group of drugs accounting for 90% of all antithrombotic drugs at the outpatient stage – 99.02% in 2011, 93.08% in 2012, 58.55% in 2016, 60.27% in 2017, and 46.66% in 2018.Conclusion. The consumption volumes of OACs used at the outpatient stage of treatment of AF in the Saratov Region increased significantly in the period from 2011 to 2018, mainly due to direct OACs. At the same time, the consumption volumes of antiplatelet agents remained at a high level.
目的:采用ATC/DDD(解剖治疗化学分类/限定日剂量)和药物利用90% (DU90%)分析,研究萨拉托夫地区门诊治疗房颤(AF)抗栓药物的消费演变。材料和方法。我们利用2011-2018年萨拉托夫地区心脏病专科住院的511例房颤患者的病史数据分析了门诊阶段的治疗。采用ATC/DDD-和du90% -分析方法对抗血栓药物的消费量进行研究。证明对房颤有效的药物的消耗量表示为每1000名房颤患者每天的每日剂量(NDDD)。2011年口服抗凝剂(oac)处方DDD为5.29 NDDD / 1000 AF患者/天,均以华法林为代表;2018年,这一指标增加到277.51 NDDD / 1000 AF患者,其中直接oac为237.06。抗血小板药物的消费量保持在较高水平,2018年为582.53 NDDD / 1000 AF患者/天。2011年、2012年、2016年、2017年和2018年分别为99.02%、93.08%、58.55%、60.27%和46.66%,乙酰水杨酸被纳入门诊阶段抗栓药物占全部抗栓药物90%的药物组。2011年至2018年期间,萨拉托夫地区房颤门诊阶段使用的oac消费量显著增加,主要是由于直接oac。与此同时,抗血小板药物的消费量仍处于较高水平。
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引用次数: 0
Peptides of Laennec® preparation that contribute to the elimination of endotheliopathy Laennec®制剂中有助于消除内皮病变的肽
Q3 Medicine Pub Date : 2022-01-15 DOI: 10.17749/2070-4909/farmakoekonomika.2021.114
I. Torshin, О. Gromova, V. Zgoda, А. Chuchalin, V. A. Maksimov, О. V. Tikhonova
Objective: identification of peptides in the composition of Laennec®, which can inhibit the development of endotheliopathy (endothelial dysfunction).Material and methods. Hybrid mass spectrometry followed by data analysis based on topological recognition theory was performed. The analysis of the peptide composition of Laennec® included four stages: purification of the drug, chromatographic separation of peptides, determination of the multidimensional mass spectrum of the peptide fraction, and de novo sequencing of the isolated peptides.Results. The preparation contains peptides-inhibitors of specific target proteins (PRKCZ, PKB, PKD1, MAPK14, IKKB, PDPK1) involved in the activation of the pro-inflammatory transcription factor NF-κB. Inhibition of CDK5 and SHC1 kinases helps to reduce endothelial cell apoptosis. The peptides of the drug also block enzymes involved in the synthesis and maturation of the tumor necrosis factor alpha (MAPKAPK2/3, ADAM17).Conclusion. In the composition of Laennec®, peptides have been found that contribute to a complex pathogenetic action against endotheliopathy. Endothelial regeneration is especially important in the rehabilitation of patients who have recovered from COVID-19.
目的:鉴定Laennec®成分中抑制内皮病变(内皮功能障碍)发展的肽。材料和方法。采用混合质谱法,并基于拓扑识别理论进行数据分析。Laennec®多肽成分分析包括四个阶段:药物纯化、多肽的色谱分离、多肽部分的多维质谱测定和分离肽的从头测序。该制剂含有参与促炎转录因子NF-κB激活的特异性靶蛋白(PRKCZ、PKB、PKD1、MAPK14、IKKB、PDPK1)的肽抑制剂。抑制CDK5和SHC1激酶有助于减少内皮细胞凋亡。该药的多肽还能阻断参与肿瘤坏死因子α合成和成熟的酶(MAPKAPK2/3, ADAM17)。在Laennec®的成分中,已发现肽有助于对抗内皮病变的复杂发病作用。内皮再生在COVID-19康复患者的康复中尤为重要。
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引用次数: 0
Hepatoprotective effects of chondroitin sulfate and glucosamine sulfate 硫酸软骨素和硫酸氨基葡萄糖的肝保护作用
Q3 Medicine Pub Date : 2022-01-15 DOI: 10.17749/2070-4909/farmakoekonomika.2021.112
I. Torshin, A. M. Lila, O. Gromova
Background. Long-term use of chondroprotective agents – chondroitin sulfate (CS) and glucosamine sulfate (GS) in the treatment of osteoarthritis puts forward increased requirements for the safety of drugs, primarily in terms of effects on the liver and kidneys.Objective: systematization of data on the effect of chondroprotectors on liver structure and functions.Material and methods. Using the methods of the theory of topological text analysis, an intellectual analysis of 2319 publications on fundamental and clinical studies of the relationship of CS and GS with liver function was carried out. The search was performed by a key query “(chondroitine OR glucosamine) AND (liver OR hepatic OR hepatocy*)” in the PubMed/MEDLINE database.Results. The systematic analysis indicated a pronounced hepatoprotective effect of CS and GS pharmaceutical substances with a high degree of purification from inorganic and organic impurities. By regulating inflammation processes, lymphocyte function, fat and carbohydrate metabolism in the liver, standardized forms of CS and GS have a beneficial effect on fat metabolism, reduce chronic inflammation in the liver, exhibit antitumor and pronounced hepatoprotective effects on various models of liver intoxication.Conclusion. The results of this analysis allow us to assert the high safety of drugs based on pharmaceutical standardized forms of CS and GS in terms of liver function.
背景。长期使用软骨保护剂硫酸软骨素(CS)和硫酸氨基葡萄糖(GS)治疗骨关节炎,对药物的安全性提出了更高的要求,主要是在对肝脏和肾脏的影响方面。目的:整理软骨保护剂对肝脏结构和功能影响的资料。材料和方法。采用拓扑文本分析理论的方法,对2319篇有关CS、GS与肝功能关系的基础和临床研究文献进行智力分析。在PubMed/MEDLINE数据库中通过关键查询“(chondroitine OR glucosamine) AND (liver OR liver OR hepatocy*)”进行搜索。系统分析表明,CS和GS原料药具有明显的保肝作用,且从无机和有机杂质中纯化程度高。通过调节肝脏的炎症过程、淋巴细胞功能、脂肪和碳水化合物代谢,标准化的CS和GS对多种肝中毒模型具有有益的脂肪代谢、减轻肝脏慢性炎症、抗肿瘤和明显的肝保护作用。这项分析的结果使我们能够根据CS和GS在肝功能方面的药物标准化形式断言药物的高度安全性。
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引用次数: 6
Features of intellectual property protection mechanisms on the example of orphan drugs circulation 以孤儿药流通为例的知识产权保护机制特征
Q3 Medicine Pub Date : 2022-01-15 DOI: 10.17749/2070-4909/farmakoekonomika.2021.092
D. S. Yurochkin, К. V. Nasonova, Z. М. Golant, I. Narkevich, V. Trukhin
Objective: to study features of intellectual property protection mechanisms on the example of drugs for the treatment of rare (orphan) diseases.Material and methods. Analysis of pharmaceutical market data was performed with the DSM Group analytical database. The approach proposed by the Russian Federal Industrial Property Service was used for creating patent landscape. The method supposes conducting a patent search and analysis of the documents found for date of filing, office (country) of filing, applicant, as well as analysis of the patent activity (dynamics) for the subject, in this case, for orphan drugs having a defined structure.Results. We proposed the complex conclusions to increase national drug safety. Intellectual property limitations for importing countries such as data exclusivity, do not allow to reproduce clinical trials, which leads to non-disclosure of medical data to all parties – medical society and patients, all other market participants, including local pharmaceutical producers. Current intellectual property restrictions conceal crucial data from medical and patient society and other market players and affect accuracy of diagnosis and treatment. Along with outstanding cost of new therapies it causes enormous budget burden for the healthcare system and prevents the introduction of objective criteria in the appointment and use of medicines. Prior to the approval and submission of the registration certificate by the regulatory authority, it is necessary to establish reasonable marginal prices, to form a sufficient set and volume of clinical guidelines and to determine in advance the sources of financing and mechanisms of integration into the national system of drug provision.Conclusion. The introduction of drugs for the treatment of rare diseases into circulation leads to a sharp increase in the burden on the budgets of the healthcare system at all levels. Current restrictions and obligations in the field of intellectual property rights protection, the degree of disclosure of medical data in the process of registration and admission to the market require significant changes to the traditional system of drug provision and the system of placing state orders, as well as the introduction of new regulatory mechanisms (for example, compulsory licensing or producing individual dosage forms in pharmacy organizations), contributing to the development of the local pharmaceutical industry and providing the national health system with the necessary volume of drugs with a sufficient level of quality and safety.
目的:研究以罕见病(孤儿)药为例的知识产权保护机制特点。材料和方法。医药市场数据分析采用DSM集团分析数据库。俄罗斯联邦工业产权局提出的方法被用于创造专利景观。该方法假设对所找到的文件进行专利检索和分析,包括申请日期、申请局(国家)、申请人,以及对主题的专利活动(动态)进行分析,在本例中,针对具有明确结构的孤儿药。结果。我们提出了复杂的结论,以提高国家药品安全。对进口国的知识产权限制,如数据独占性,不允许复制临床试验,这导致医疗数据不向所有各方——医疗协会和患者、所有其他市场参与者,包括当地药品生产商——披露。目前的知识产权限制对医疗和患者协会以及其他市场参与者隐瞒了关键数据,影响了诊断和治疗的准确性。随着新疗法的突出成本,它给医疗保健系统造成了巨大的预算负担,并阻碍了在预约和使用药物时引入客观标准。在监管机构批准和提交注册证书之前,有必要确定合理的边际价格,形成足够数量的临床指南,并提前确定资金来源和纳入国家药物供应系统的机制。将治疗罕见病的药物引入流通,导致各级卫生保健系统预算负担急剧增加。目前在知识产权保护、注册和进入市场过程中医疗数据的披露程度等领域的限制和义务要求对传统的药品供应制度和国家下订单制度进行重大改革,并引入新的监管机制(例如,在药房组织强制许可或生产个别剂型)。促进当地制药业的发展,并为国家卫生系统提供必要数量的具有足够质量和安全水平的药品。
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引用次数: 0
Economic burden of chronic viral hepatitis C 慢性病毒性丙型肝炎的经济负担
Q3 Medicine Pub Date : 2022-01-15 DOI: 10.17749/2070-4909/farmakoekonomika.2021.087
R. A. Yakhina, I. Lakman, D. Valishin, R. Bakhitova
Background. The spread of chronic viral hepatitis C (CVHC) among the population entails significant costs for society, both direct, associated with the treatment of such patients, and indirect, associated with the shortfall in fiscal payments to the budget, due to the disability of this category of patients. Therefore, an important task remains to assess the global economic burden of the disease, taking into account the pathological conditions of the human body associated with it.Objective: to systematize studies of published sources devoted to assessing the global economic burden of chronic viral hepatitis C.Material and methods. A feature of the proposed review design is paying attention not only to the objects of assessment under study, but also to the instrumental (including mathematical) means of scenario assessment of the global burden. The study analyzed 29 sources published between 2014 and 2020 and dedicated to assessing and forecasting the global economic burden of CVHC both in individual countries and continents as a whole, and in individual regions of countries. The main criterion for the selection of studies was the availability of an estimate of the global burden of CVHC, taking into account the use of direct antiviral drugs for the treatment of hepatitis C. The search was conducted in PubMed/MEDLINE and eLibrary databases, and in the ResearchGate network.Results. Of the 29 analyzed sources, 40% of the works consider the burden for CVHC only of certain genotypes; in the overwhelming number of articles (80%), when assessing the burden, the distribution of patients by the degree of liver fibrosis is taken into account. In 50% of the studies reviewed, quality of life adjustment tools (QALY or DALY) were used to estimate the global economic burden. A third of the publications took into account both the direct costs of treating CVHC and indirect costs, including those associated with a shortfall in the contribution to the gross national product due to temporary or permanent disability of this category of patients.Conclusion. The analysis showed that interest in assessing the global burden of CVHC began to appear in recent years, when expensive directacting antivirals for the treatment appeared. This is explained by the emergence of a question about the cost of implementing a scenario in which by a certain year it will be possible to completely exclude the spread of the disease. The results of this work may be useful in conducting such studies, including the determining of their design and the use of modern mathematical modeling tools.
背景。慢性病毒性丙型肝炎(CVHC)在人群中的传播给社会带来了巨大的成本,既有与这类患者的治疗有关的直接成本,也有因这类患者残疾而导致财政预算支出不足的间接成本。因此,一项重要的任务仍然是评估该疾病的全球经济负担,同时考虑到与之相关的人体病理状况。目的:对已发表的关于评估慢性病毒性丙型肝炎全球经济负担的研究资料进行系统化整理。拟议的审查设计的一个特点是不仅注意所研究的评估对象,而且注意全球负担情景评估的工具(包括数学)手段。该研究分析了2014年至2020年间发表的29个来源,致力于评估和预测CVHC在个别国家和整个大陆以及国家个别地区的全球经济负担。选择研究的主要标准是考虑到直接使用抗病毒药物治疗丙型肝炎的情况下,CVHC全球负担估计的可用性。检索在PubMed/MEDLINE和eLibrary数据库以及ResearchGate网络中进行。在分析的29个来源中,40%的工作只考虑某些基因型的CVHC负担;在绝大多数(80%)的文章中,在评估负担时,考虑了按肝纤维化程度划分的患者分布。在所回顾的50%的研究中,生活质量调整工具(QALY或DALY)被用于估计全球经济负担。三分之一的出版物既考虑了治疗CVHC的直接成本,也考虑了间接成本,包括由于这类患者的暂时或永久性残疾而导致的国民生产总值贡献不足的相关成本。分析表明,评估CVHC全球负担的兴趣是近年来开始出现的,当时出现了用于治疗的昂贵的定向抗病毒药物。这是由于出现了一个问题,即实施到某一年有可能完全排除该疾病传播的设想所需的费用。这项工作的结果可能有助于开展此类研究,包括确定其设计和使用现代数学建模工具。
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引用次数: 0
Experience of using telemedicine technologies in healthcare systems of foreign countries and the Russian Federation: systematic review 外国和俄罗斯联邦卫生保健系统使用远程医疗技术的经验:系统审查
Q3 Medicine Pub Date : 2022-01-15 DOI: 10.17749/2070-4909/farmakoekonomika.2021.109
O. Volkova, S. S. Budarin, E. V. Smirnova, Yulia V. Elbek
Background. Today, the development and widespread use of digital technologies in medicine is considered as one of the most promising mechanisms for optimizing costs and improving the efficiency of healthcare and the quality of life of the aging society.Objective: to study the experience of using telemedicine technologies for providing medical care in the health systems of different countries, including the Russian Federation.Material and methods. To obtain the necessary information, an overview of the most relevant studies published in Medscape, PubMed/ MEDLINE, ScienceDirect, Scopus, eLibrary, CyberLeninka databases, World Health Organization repository and open sources from Google and Yandex search, as well as relevant regulatory documents was carried out.Results. The experience of using telemedicine technologies for medical care in healthcare systems of different countries, including Russia, presented in the article, demonstrates both the advantages of these technologies, and the limitations for their use in healthcare.Conclusion. Despite all the undisputed advantages of telemedicine technologies, their development should not become an end in itself. The expediency of their use in each specific case of providing medical care and exclusively as another, additional tool to improve the quality and accessibility of medical care should be considered.
背景。如今,数字技术在医学领域的发展和广泛应用被认为是优化成本、提高医疗保健效率和老龄化社会生活质量的最有前途的机制之一。目的:研究包括俄罗斯联邦在内的不同国家卫生系统使用远程医疗技术提供医疗服务的经验。材料和方法。为了获得必要的信息,我们对Medscape、PubMed/ MEDLINE、ScienceDirect、Scopus、eLibrary、CyberLeninka数据库、World Health Organization repository以及Google和Yandex搜索的开放资源中发表的最相关的研究以及相关的监管文件进行了综述。本文介绍了在包括俄罗斯在内的不同国家的医疗保健系统中使用远程医疗技术进行医疗保健的经验,既展示了这些技术的优点,也展示了它们在医疗保健中使用的局限性。尽管远程医疗技术具有无可争议的优势,但其发展本身不应成为目的。应考虑在提供医疗保健的每一具体情况下使用它们的便利性,并专门作为提高医疗保健质量和可及性的另一种额外工具。
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引用次数: 1
Development of the system of state financing of Compulsory Health Insurance 发展国家资助的强制性健康保险制度
Q3 Medicine Pub Date : 2022-01-15 DOI: 10.17749/2070-4909/farmakoekonomika.2021.097
А. V. Larionov, S. Russkikh, S. V. Maslennikov
Objective: to study the potential for the development of financing the Compulsory Health Insurance (CHI) system in Russia.Material and methods. Оur research estimates the amount of funds available in the CHI system based on fractal analysis and ARIMA modeling. The proposed approach makes it possible to determine the critical amount of funds in the CHI system. Once the limit is reached, the chance of violating the economic security requirements will increase. Results. Аn increase in the volume of available funds in the CHI sector is expected in the mid-term perspective on the verge of quarter 1, 2023. The amount of funds required to pay for medical care for the respective period of time will increase by 0.77% quarterly.Conclusion. Gaining additional funds might be possible by optimizing the internal networks for generating cash flows in the CHI system, as well as applying additional ways of financing medical care (particularly Voluntary Health Insurance policies). It would be practical to redistribute the functions of financing health care between the Federal Fund for CHI and its territorial branches. It is essential to review the role of health insurance companies in monitoring the health care quality by improving the communication with citizens.
目的:研究俄罗斯强制医疗保险制度融资发展的潜力。材料和方法。Оur research基于分形分析和ARIMA模型估算了CHI系统中可用的资金数量。所提出的方法使确定CHI系统中的临界资金数额成为可能。一旦达到这个限度,违反经济安全要求的可能性就会增加。结果。Аn从中期角度来看,预计在2023年第1季度的边缘,CHI行业的可用资金量将增加。在相应的时间段内,支付医疗费用所需的资金将以每季度0.77%的速度增长。通过优化内部网络以产生CHI系统的现金流,以及采用额外的医疗保健融资方式(特别是自愿健康保险政策),可能会获得额外的资金。切实可行的做法是将保健筹资职能重新分配给卫生保健联邦基金及其地区分支机构。必须通过改善与公民的沟通,审查健康保险公司在监测保健质量方面的作用。
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引用次数: 3
Peculiarities of administration of medications to patients with circulatory system diseases within the framework of the federal program of preferential provision of medicines 在优先提供药物的联邦计划框架内,对循环系统疾病患者的药物管理的特点
Q3 Medicine Pub Date : 2021-10-08 DOI: 10.17749/2070-4909/farmakoekonomika.2021.065
I. Petrukhina, R. Yagudina, N. V. Veyner, T. K. Ryazanova, E. Gladunova, V. Kurkin, P. R. Blinkova, E. N. Zaitseva
Objective: to analyse of medicines prescriptions for federal beneficiaries with circulatory system diseases and to identify the main trends in the implementation of the federal program for the provision of necessary medicines in the Samara Region in 2014–2017.Material and methods. The authors reviewed the nomenclature of medicines used to treat circulatory system diseases (CSDs) and distributed to the population of the Samara Region as part of the federal program for the provision of necessary medicines for the period from 2014 to 2017. The methods of comparative, retrospective, logical, graphical and content analysis, the method of data grouping according to Anatomical Therapeutic Chemical classification and methods of descriptive statistics were used.Results. In 2014–2017 the share of financial costs for the purchase of medicines in the total budget of the federal program for the provision of necessary medicines in the Samara Region did not exceed 6%. Still, in physical terms (in terms of the number of packages) the share of medicines of this pharmacotherapeutic group in the federal program for the provision of necessary medicines averaged about 25%. Nomenclature of medicines of the analyzed group prescribed to federal beneficiaries in 2014–2017 ranged from 90 to 107 nomenclature items. The number of international nonproprietary names (INN) decreased from 51 in 2014 to 36 in 2017. During the period under review, there was a decrease in the acquisition cost of medicines for the treatment of circulatory system diseases and the weighted average cost of one package (by 63% and 53%, respectively).Conclusion. Perindopril-containing medicines occupied the maximum consumption volumes in monetary terms. There was a decrease in the average cost of one package in 2017, which may be associated with the replacement of original medicines with generics and a concomitant reduction in the number of INN within the subgroup.
目的:分析患有循环系统疾病的联邦受益人的药物处方,并确定2014-2017年萨马拉州提供必要药物的联邦方案实施的主要趋势。材料和方法。作者审查了用于治疗循环系统疾病(CSDs)的药物的名称,并将其作为2014年至2017年期间提供必要药物的联邦计划的一部分分发给萨马拉地区的人口。采用比较分析法、回顾性分析法、逻辑分析法、图解分析法和内容分析法,采用解剖治疗化学分类法和描述性统计方法进行数据分组。2014-2017年,在萨马拉地区提供必要药物的联邦方案总预算中,购买药品的财务费用所占比例不超过6%。尽管如此,在物理方面(在包装数量方面),该药物治疗组的药物在提供必要药物的联邦计划中的份额平均约为25%。2014-2017年为联邦受益人规定的分析组药物命名项目从90到107个不等。国际非专有名称(INN)数量从2014年的51个减少到2017年的36个。在本报告所述期间,用于治疗循环系统疾病的药物的购置成本和每包加权平均成本分别下降了63%和53%。以货币计算,含培哚普利药物的消费量最大。2017年,每包药品的平均成本有所下降,这可能与用仿制药替代原研药以及该亚组内INN数量的减少有关。
{"title":"Peculiarities of administration of medications to patients with circulatory system diseases within the framework of the federal program of preferential provision of medicines","authors":"I. Petrukhina, R. Yagudina, N. V. Veyner, T. K. Ryazanova, E. Gladunova, V. Kurkin, P. R. Blinkova, E. N. Zaitseva","doi":"10.17749/2070-4909/farmakoekonomika.2021.065","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2021.065","url":null,"abstract":"Objective: to analyse of medicines prescriptions for federal beneficiaries with circulatory system diseases and to identify the main trends in the implementation of the federal program for the provision of necessary medicines in the Samara Region in 2014–2017.Material and methods. The authors reviewed the nomenclature of medicines used to treat circulatory system diseases (CSDs) and distributed to the population of the Samara Region as part of the federal program for the provision of necessary medicines for the period from 2014 to 2017. The methods of comparative, retrospective, logical, graphical and content analysis, the method of data grouping according to Anatomical Therapeutic Chemical classification and methods of descriptive statistics were used.Results. In 2014–2017 the share of financial costs for the purchase of medicines in the total budget of the federal program for the provision of necessary medicines in the Samara Region did not exceed 6%. Still, in physical terms (in terms of the number of packages) the share of medicines of this pharmacotherapeutic group in the federal program for the provision of necessary medicines averaged about 25%. Nomenclature of medicines of the analyzed group prescribed to federal beneficiaries in 2014–2017 ranged from 90 to 107 nomenclature items. The number of international nonproprietary names (INN) decreased from 51 in 2014 to 36 in 2017. During the period under review, there was a decrease in the acquisition cost of medicines for the treatment of circulatory system diseases and the weighted average cost of one package (by 63% and 53%, respectively).Conclusion. Perindopril-containing medicines occupied the maximum consumption volumes in monetary terms. There was a decrease in the average cost of one package in 2017, which may be associated with the replacement of original medicines with generics and a concomitant reduction in the number of INN within the subgroup.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88403241","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}
引用次数: 0
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Farmakoekonomika
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