PGI18 - PHARMACOECONOMIC ASSESSMENT OF QUADROTHERAPY WITH ORIGINAL BISMUTH SUBCITRATE DRUG VERSUS QUADROTHERAPY WITH GENERIC DRUG IN PATIENTS WITH PEPTIC ULCER ASSOCIATED WITH HELICOBACTER PYLORI IN UKRAINE

Abstract

Quadrotherapy including drugs of colloidal bismuth (bismuth preparation, a proton pump and two antibiotics) is replacement for standard triple antihelicobacter therapy (AHT) and contributes to a significant decrease in H. pylori resistance to antibiotics. Adding bismuth subcitrate preparation increases considerably AHT cost, which in turn reduces the economic availability of treatment to the patient. This is especially important for Ukrainian patients since they are main payers. Given this, the use of generic cheaper bismuth subcitrate drug has an actual task. The aim - pharmacoeconomic grounding the benefits of using of quadrotherapy with bismuth subcitrate generic drug (QTGB) versus quadrotherapy with bismuth subcitrate original drug (QTOB). Cost-effectiveness analysis of the two schemes QTOB and QTGB according to clinical research: G. D. Fadyeyenko, E. V. Kolesnikov. Place bismuth subcitrate in the treatment of patients with peptic ulcer disease, associated with Helicobacter pylori (Modern gastroenterology, 2015, №1 (81), p.37-43), was carried out. Onevariate sensitivity analysis of the results to changes in price of drugs was carried out. On 21.11.14 the currency ratio of UAH to € was 20.04:1. Quadrotherapy with generic drug of bismuth subcitrate has a lower cost of treatment 19.84 € vs. 29.06 € and is less effective among the investigated schemes (90% of patients with H. pylori eradication vs. 96.7%, p <0,05) and more cost effective (CER = 22.04 € per 1 patient with H. pylori eradication vs. 30.05 €). The costs of an additional unit of effectiveness in the transition to a more effective QTOB are 119.55 €. In the context of the Ukrainian pharmaceutical market realities QTGB in patients with peptic ulser, associated with H. pylori, is more cost effective compared to QTOB, but less clinically effective. The sensitivity analysis showed, that the 36.3% decrease in the price of the original drug of bismuth subcitrate quadrotherapy with it would be dominant.