非酒精性脂肪性肝炎患者药物治疗的临床经济分析

O. Tkachova, M. Allaberdiev
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摘要

非酒精性脂肪性肝病和非酒精性脂肪性肝炎(NASH)已成为世界上最常见的肝脏疾病。的目标。对2013年在哈尔科夫一家医疗机构接受治疗的NASH患者进行药物治疗的临床经济分析。材料和方法。研究材料是患者的病例史和乌克兰卫生部的监管文件,如乌克兰国家药品处方集(SF)(2013年)、消化系统疾病诊断和药物治疗的方法学建议(2007年)、统一临床方案(UCP)“非酒精性脂肪性肝炎”(2014年11月6日第826号命令)。采用ABC法、VEN法和频次分析法进行药物经济学分析。结果。研究结果表明,NASH患者的药物治疗符合乌克兰方法学建议(2007)中规定的主要要求,但在规定的病理治疗方法上不符合NASH UCP的要求。“正式”VEN分析的结果显示,大多数处方药物(76%)被归类为V组-乌克兰SF中存在的重要药物。NASH患者药物治疗相关费用的主要部分(83.2%)花在这些药物上。然而,16.8%的费用花费在24%的药物上,而这些药物在SF中是不存在的,这表明需要进一步纠正所研究的医疗机构的NASH药物治疗。结论。从临床和经济角度来看,哈尔科夫医疗机构对NASH患者的药物治疗是合理的,但需要根据SF和新的NASH UCP进一步纠正。
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The clinico-economic analysis of pharmacotherapy in patients with non-alcoholic steatohepatitis
Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH) have become the most common liver diseases in the world. Aim. To conduct the clinico-economic analysis of pharmacotherapy in patients with NASH, who underwent treatment in one of the healthcare institutions of Kharkiv in 2013. Materials and methods. The study materials were case histories of patients and such regulatory documents of the Ministry of Health of Ukraine as the State Formulary (SF) of Medicines of Ukraine (2013), methodological recommendations on the diagnosis and pharmacotherapy of the digestive system diseases (2007), the Unified Clinical Protocol (UCP) “Non-alcoholic steatohepatitis” (Order No. 826 dated November 6, 2014). The pharmacoeconomic methods used were ABC, VEN and frequency analyses. Results. The results of the study demonstrated that the pharmacotherapy of patients with NASH complied with the main requirements specified in the Ukrainian Methodological Recommendations (2007), but did not meet the requirements of the NASH UCP by the approaches of the pathogenetic therapy prescribed. The results of “formal” VEN analysis showed that most drugs prescribed (76 %) were classified as group V – vital drugs since they were present in the SF of Ukraine. A predominant portion (83.2 %) of costs associated with the pharmacotherapy in patients with NASH was spent on these drugs. However, 16.8 % of the costs spent on 24 % of drugs, which are absent in the SF, indicates the need for further correction of the NASH pharmacotherapy in the healthcare institution under study. Conclusions. The pharmacotherapy of patients with NASH in the healthcare institution of Kharkiv is rational from clinical and economic point of view, but requires further correction in accordance with the SF and the new UCP for NASH.
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