Pharmacoeconomic analysis of various treatment regimens of Congo-Crimean hemorrhagic fever

Abstract

Background: Kazakhstan has gained experience in the treatment of Congo-Crimean hemorrhagic fever (CCHF) with ribavirin and immunized plasma. In recent years, the effectiveness of therapy in various diseases has been evaluated not only by clinical and laboratory parameters, but also by pharmacoeconomic indicators. In this regard, the purpose of the study is to conduct the pharmacoeconomic analysis of the effectiveness of CCHF therapy with ribavirin and plasma of CCHF convalescents. Methods and materials: The study included 94 patients with CCHF who underwent inpatient treatment in hospitals in endemic areas of southern Kazakhstan in 2001–2019. Patients of the 1st group (n = 32) received only pathogenetic therapy according to the clinical diagnostic and treatment protocol used in Kazakhstan. Group II patients (n = 32) were additionally treated with ribavirin according to the scheme recommended by WHO. Patients of group III (n = 30) received combination therapy with ribavirin and immunized plasma of CCHF convalescents. For a comparative pharmacoeconomic evaluation of treatment regimens, the total cost of the disease (COI) and the cost-effectiveness indicator (CEA) were calculated. Results: Mortality in the 1st group of patients was 15.6%, in the 2nd – 9.4%, in the 3rd – 3.3%. The higher average amount of money spent on medications per patient in the 3rd group, compared with the 1st and 2nd, did not lead to a statistically significant difference in the total cost of the disease (COI). The analysis according to the CEA criterion showed that the lowest costs per unit of effectiveness of treatment was in the 3rd group. CEA in 3rd group was 2.5 times less than in the 1st and 1.5 times less than in the 2nd. CEA in the 2nd group was 1.6 times less than in the 1st. Conclusion: The usage of combination of ribavirin and immunized plasma in the treatment of CCHF lead to a more rapid decreasing of clinical and laboratory manifestations of the disease, reduces the risk of death, This treatment regimen is most beneficial according to CEA pharmacoeconomic parameter.