Comparative clinical and economic analysis of the use of symptomatic slow-acting drugs containing glucosamine sulfate in patients with Stage II gonarthrosis during outpatient care

Abstract

Objective : to carry out a comparative clinical and economic analysis of treatment regimens for primary gonarthrosis (GA) Stage II with a combination of dosage forms of Sustaguard ® Artro (ampoules) + Sustaguard ® Artro (powder for oral solution) and Dona ® (ampoules) + Dona ® (powder for oral solution) in outpatient practice. Patients and methods . A retrospective comparative study was conducted using data from medical records of outpatients with GA radiographically classified as Kellgren–Lawrence Stage II. The investigators made cost-effectiveness and budget impact analyses and missed opportunity calculation for pharmacoeconomic examination, by taking into account direct costs and treatment effectiveness on the basis of assessment of the dynamics of pain syndrome, joint functional ability by the Lequesne index, visual analogue scale, WOMAC index, knee joint ultrasound data, and quality of life according to the EuroQol-5D questionnaire. The materials from the medical records of 60 patients with stage II GA were systematized according to the inclusion/exclusion criteria. All the patients were divided into two groups: 1) 30 patients received therapy with intramuscular (IM) Sustaguard ® Artro 3 ml thrice weekly; the treatment cycle was 12 injections for 28 days + 1.5-g Sustaguard ® Artro powder in a package, dissolved in 200 ml of water, once daily; the treatment cycle was 40 days; the full therapy cycle was 68 days; 2) 30 patients had therapy with IM Dona ® 3 ml thrice weekly; the treatment cycle was 12 injections for 28 days + 1.5-g Dona ® powder, dissolved in 200 ml of water, once daily; the treatment cycle was 40 days; the full therapy cycle was 68 days. The patients of both groups had a cycle of therapy with a nonsteroidal anti-inflammatory drug (nimesulide) at a dose of 100 mg twice daily for 15 days. Results and discussion . Sustaguard ® Artro treatment for Stage II GA was shown to be more economically feasible in terms of the cost-effectiveness ratio compared to Dona ® therapy for 68 days, with the long-term results of treatment being maintained for 2 months after the start of therapy. The effective technology of Sustaguard ® Artro therapy makes it possible to save significant budgetary funds (as many as 1.2 million rubles) and to additionally treat 50 patients. Conclusion . The clinical and economic study has established that the use of Sustaguard ® Artro as a treatment for primary GA Stage II is more economically feasible in terms of cost-effectiveness ratio.