Медико-экономический анализ последствий расширения программы лекарственного обеспечения больных хронической обструктивной болезнью легких в Российской Федерации

Abstract

Purpose of the study. Healthcare budget impact analysis in the Russian Federation of providing adult patients with chronic obstructive pulmonary disease (COPD) with basic therapy for outpatient treatment. Material and methods. The hypothesis of reducing costs for the treatment of exacerbations of COPD was tested while providing all patients with basic therapy on an outpatient basis. The model calculates the direct medical costs of drug provision and treatment of exacerbations in patients with COPD in the current situation and when all patients with COPD are covered with basic therapy as part of a program of preferential drug provision. The simulation period is 1 year. The analysis does not take into account social losses associated with disability, payment of disability certificates, reduced labor productivity and mortality. Results. The cost of providing all patients with COPD with the recommended basic drug therapy on an outpatient basis is substantially offset by a decrease in the cost of treating exacerbations: drug costs should increase by 14.1 billion rubles compared with the current situation, while the cost of providing medical care to patients with exacerbations is reduced by 9.7 billion rubles. As a result, the difference in direct medical costs, or the necessary additional investments, is 4.4 billion rubles. The price of drugs used for basic therapy has the greatest impact on the size of the required additional investments. Conclusion. Providing all patients with COPD with the recommended basic drug therapy on an outpatient basis, we can expect a decrease in the number of moderate exacerbations per year by 14.7% and severe exacerbations by 31.2%. Taking into account not only medical, but also socio-economic costs can not only offset additional investments, but also demonstrate significant savings. When implementing a pilot project of preferential drug provision for patients with COPD in a specific region of the Russian Federation, it is possible to reduce the cost of purchasing medicines when forming a municipal order.