Abstract
Introduction. Exudative tumor pleurisy affects up to 100 000 people a year in Russia, up to 400 000 people a year in Europe. Inpatient treatment of such patients is associated with certain costs, and there are also queues for treatment in oncology hospitals. An outpatient pleurodesis can reduce these problems. The objective was to compare pharmacoeconomic parameters for inpatient pleurodesis and outpatient pleurodesis to determine the most cost-effective treatment option. Methods and materials. 179 patients in the clinic of the Federal State Budgetary Institution Scientific Research Center for Oncology named after N. N. Petrov of the Russian Ministry of Health underwent pleurodesis using various methods (talc, bleocin, combined). The effectiveness of the methods and the direct medical costs of treatment were evaluated. The effectiveness of a stationary thoracoscopic pleurodesis was evaluated according to foreign literature, and the direct medical costs of treatment were calculated. Based on the obtained results, the pharmacoeconomic indicators of CER and ICER were calculated. Results. Direct medical costs for stationary thoracoscopic pleurodesis amounted to 35056.4 rubles with an efficiency of 89 %. Direct medical costs for outpatient pleurodesis were: for talc pleurodesis – 8051.7 rubles, for bleocin and combined pleurodesis – 11799.2 rubles. CER amounted to: for a thoracoscopic pleurodesis in the hospital – 393.9, for talc pleurodesis – 115.35, for bleocin pleurodesis – 188.7, for combined pleurodesis – 155.8. ICER in relation to stationary pleurodesis was 1406.4 for talc pleurodesis, 877.6 for bleocin pleurodesis, 1748.6 for combined pleurodesis. Conclusion . CER was almost 3 times lower with outpatient pleurodesis, which makes it the most cost-effective option for the treatment of tumor exudative pleurisy. ICER was maximal in combined pleurodesis, which makes it preferred among outpatient pleurodesis options. Based on the obtained data, it can be argued that the use of ambulatory pleurodesis as an initial stage of care for patients with tumor exudative pleurisy is economically justified.
Highlights
С учетом того, что эффективность торакоскопического плевродеза выше, чем таковая у амбулаторного, был рассчитан ICER, отдельно для каждого из вариантов амбулаторного плевродеза по отношению к стационарному
P., Penz Erika D., Manns Braden J. et al Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion // Respirology. – 2017. – Vol 22. – С. 764–770
(Med.), thoracic surgeon, City Hospital No 26 (Saint Petersburg, Russia), ORCID: 0000-0001-7392-6654
Summary
Материалом для исследования явились медицинские карты 179 пациентов, которые находились на амбулаторном обследовании и лечении по поводу рецидивирующего экссудативного опухолевого плеврита неустановленной первичной локализации в период с 2013 по 2017 г. Всем пациентам выполняли тот или иной вид амбулаторного плевродеза – тальковый, блеоциновый, комбинированный (тальк, блеоцин). В качестве критерия эффективности было избрано отсутствие рецидива клиники дыхательной недостаточности у пациентов за весь период наблюдения. В ходе исследования были подсчитаны прямые затраты на выполнение торакоскопического плевродеза в стационаре и амбулаторного плевродеза (тальковый, блеоциновый, комбинированный). Основным источником информации о ценах на Иванов О.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
