Фармакоекономічний аналіз інфузійної терапії N-хлортаурином в лікуванні пацієнтів з перитонітом

Abstract

Peritonitis is the main cause of death in patients with acute surgical diseases of the abdominal cavity. The average mortality rate from disseminated forms is currently 30%. In complications of multiple organ failure and infectious-toxic shock, as well as in postoperative peritonitis in elderly patients, the lethality rate can reach 40%–70%. Thus, this disease is one of the most pressing medical, biological and economic problems of our time. The purpose of the study was to perform pharmacoeconomic analysis of peritonitis treatment by medical technology using N-chlorotaurine in comparison with infusion detoxifying solutions. Materials and methods. The source of data on the effectiveness of N-chlorotaurine is the results of the clinical effectiveness of the use of N-chlorotaurine in patients with peritonitis. As part of the study, there was a pharmacoeconomic evaluation of the use of the infusion solution of N-chlorotaurine (52 patients) in comparison with the use of Ringer's solutions (50 patients) and Rheopolyglucin solution (45 patients). Results and discussion. Costs were calculated based on Peritonitis Treatment Guidelines. The cost of a course of infusion therapy using N-chlorotaurine, Ringer's solution, and Rheopolyglucin was added to the standard therapy specified in this regulatory document. The daily composition of complex infusion therapy included 1000 ml of sodium hypochlorite solution or 1000 ml of glucose solution, as well as a daily dose of comparative infusion detoxifiers, namely, Ringer's solution and Rheopolyglucin, in the proven volume of total infusion therapy up to 4000 ml. Thus, treatment efficacy in patients treated with the drug was 94.2%, which is statistically significantly higher than the corresponding indicator in the control group – 52.0%, and confirms the hypothesis about the predominant efficiency of therapy in the main group of subjects compared to the control group. Taking into account the treatment regimens used in the study and the cost of drugs, we calculated the cost of each at the inpatient phase, taking into account the equivalent course dose and taking into account the data on the equivalent course dose. So, the amount of costs is 93,834 UAH for N-chlorotaurine, 110,650 UAH for Ringer, and 98,252 UAH for Rheopolyglucin. The economic component of the calculations showed that according to the "cost-effectiveness" methodology, the results of the efficiency and cost and effectiveness analyses performed earlier showed the advantages of using N-chlorotaurine in patients with acute peritonitis in the complex treatment. Conclusion. The above data indicate the relevance of the development and clinical and economic substantiation of the use of a fixed combination of a low-concentration solution of sodium hypochlorite with N-chlorotaurine in the treatment of peritonitis with endogenous intoxication syndrome