Pharmacoeconomic Studies Research Articles

Economic Evaluation of Once-Weekly Insulin Icodec from Italian NHS Perspective.

Icodec, once-weekly basal insulin, aims to simplify therapy management by reducing injection frequency for diabetic patients. The efficacy and safety of icodec were evaluated in the ONWARDS clinical development program. This study evaluates icodec economic and quality of life impact from the Italian National Healthcare System (NHS) perspective. A pharmacoeconomic study was developed to assess the once-weekly insulin icodec value, highlighting its potential to decrease needle use while improving adherence and quality of life. In the base case, a differential cost and cost-utility analysis over one year compared to once-daily insulin degludec were developed. Based on the comparison with degludec, a scenario analysis was planned between icodec and the mix of basal insulins available on the market. Economic evaluations included drug and administration costs, needles, and impact on adherence. The cost-utility analysis measured the utility associated with the weekly injection compared to the daily ones, resulting in an incremental cost-effectiveness ratio (ICER), measured as Δ€/ΔQALY (Quality Adjusted Life Years). To assess the robustness of the results, a deterministic one-way sensitivity analysis and a probabilistic sensitivity analysis were carried out. At an annual cost 25% higher than degludec, considering the economic benefits generated by the needle use reduction (-€51.10) and adherence improvement (-€54.85), once-weekly icodec grants no incremental cost and even potential savings per patient. Furthermore, icodec reported a utility advantage (0.023). It achieved a dominant incremental cost-effectiveness ratio (ICER) compared to degludec. The comparison with the mix of basal insulins also reported a cost-effectiveness profile. Sensitivity tests conducted confirmed the robustness of the findings, highlighting the key drivers of the analysis. Icodec represents a new therapeutic option to simplify basal insulin treatment. It also improves the patient's management and his quality of life, without increasing the economic burden for the Italian NHS, while guaranteeing an excellent cost-effectiveness profile.

On cytisine’s safety, efficacy and cost-effectiveness in smoking cessation: A brief summary of clinical and pharmacoeconomic study results

On cytisine’s safety, efficacy and cost-effectiveness in smoking cessation: A brief summary of clinical and pharmacoeconomic study results

Pharmacoeconomic Aspects of Diabetes Mellitus: Outcomes and Analysis of Health Benefits Approach.

Pharmacoeconomics is an important tool for investigating and restructuring healthcare policies. In India, recent statistical studies have shown that the number of diabetic patients is rapidly increasing in the rural, middle and upper-class settings. The aim of this review is to call attention towards the need to carry out pharmacoeconomic studies for diabetes mellitus and highlight the outcome of these studies on healthcare. A well-structured literature search from PubMed, Embase, Springer, ScienceDirect, and Cochrane was done. Studies that evaluated the cost-effectiveness of various anti-diabetic agents for type 2 diabetes were eligible for inclusion in the analysis and review. Two independent reviewers sequentially assessed the titles, abstracts, and full articles to select studies that met the predetermined inclusion and exclusion criteria for data abstraction. Any discrepancies between the reviewers were resolved through consensus. By employing search terms such as pharmacoeconomics, diabetes mellitus, cost-effective analysis, cost minimization analysis, cost-utility analysis, and cost-benefit analysis, a total of 194 papers were gathered. Out of these, 110 papers were selected as they aligned with the defined search criteria and underwent the removal of duplicate entries. This review outlined four basic pharmacoeconomic studies carried out on diabetes mellitus. It gave a direction that early detection, patient counseling, personalized medication, appropriate screening intervals, and early start of pharmacotherapy proved to be a cost-effective as well as health benefits approach.

Assessing the cost-effectiveness of replacing antimetabolites with mTOR inhibitors in heart transplant immunosuppression in China: a network meta-analysis-based economic evaluation.

Although several pharmacoeconomic studies have assessed the cost-effectiveness of maintenance immunosuppressive regimens for heart transplant recipients, economic comparisons between various combination drug therapies remain sparse. This study used an economic evaluation based on network meta-analysis to assess the cost-effectiveness of four immunosuppressive regimens for adult heart transplant recipients in China. We conducted a systematic search for clinical trials in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database. A validated Markov model was adapted to reflect the Chinese medical landscape. Four maintenance immunosuppression regimens were considered: tacrolimus/mycophenolate mofetil (TAC/MMF), cyclosporine/mycophenolate mofetil (CSA/MMF), everolimus/cyclosporine (EVL/CSA), and sirolimus/tacrolimus (SRL/TAC). The probabilities of health events were derived from a comprehensive literature review. Direct medical costs, adjusted for 2022 values, were from public documents and websites, while utilities for quality-adjusted life-years (QALYs) were taken from previous studies. Primary outcomes were mean lifetime cost, QALYs, and cost-effectiveness, with a willingness-to-pay (WTP) threshold set at three times China's GDP per capita in 2022. Sensitivity analyses were conducted to test the robustness of the results. The base case analysis identified TAC/MMF as the most cost-effective regimen, producing a mean of 6.31 QALYs per patient at a cost of Chinese Yuan (CNY) 534,182.89. Sensitivity analyses consistently reinforced TAC/MMF as the most cost-effective and robust choice. TAC/MMF is the most cost-effective maintenance immunosuppressive regimen for heart transplant recipients within the Chinese health system. The study findings are reinforced by sensitivity analyses, affirming their robustness amid various uncertainties.

Cost Variation Analysis Of Oral Antihypertensive Drugs Currently Available In Indian Pharmaceutical Market- A Pharmacoeconomic Study

Cost Variation Analysis Of Oral Antihypertensive Drugs Currently Available In Indian Pharmaceutical Market- A Pharmacoeconomic Study

Pharmacoeconomic and clinical impact of pharmaceutical service in the intensive care unit: a systematic review

Clinical pharmacy is a fast-growing discipline in Europe, ensuring optimisation and a guarantee of safety in therapeutic management. Within a hospital the intensive care unit (ICU) typically admits the most...

Pharmacoeconomic Study of Homeopathic Medicines: A Critical Appraisal of Methods and Conclusions Shows Serious Cause for Concern.

Pharmacoeconomic Study of Homeopathic Medicines: A Critical Appraisal of Methods and Conclusions Shows Serious Cause for Concern.

Chemoradiotherapy plus immunotherapy for locoregionally advanced nasopharyngeal carcinoma: A cost-effectiveness analysis.

Research focused on the addition of immune checkpoint inhibitors (ICIs) to radiotherapeutic regimens in patients with cancer has become increasingly common, revealing promising improvements in efficacy outcomes. In patients with locoregionally advanced nasopharyngeal carcinoma (NPC), combining immunotherapy with chemoradiotherapy can facilitate the significant prolongation of survival, emphasizing the need for pharmacoeconomic studies focused on the clinical uptake of these innovative treatment regimens. A three-state Markov model was developed based on clinical data from the randomized phase 3 CONTINUUM trial and used to compare the cost-effectiveness of chemoradiotherapy plus sintilimab (sintilimab group) to chemoradiotherapy alone (standard group), analyzing outcomes including incremental cost-effectiveness ratio (ICER), incremental net monetary benefit (INMB), and incremental net-health benefit (INHB) values at a willingness-to-pay (WTP) threshold corresponding to three times the Chinese GDP per capita ($37 035 per quality-adjusted life year [QALY]). The total costs for patients in the sintilimab and standard groups (QALYs [LYs]) were $92 116 (6.68 [10.03]) and $53 255 (3.75 [5.55]), respectively, for an ICER of $13 230/QALY ($8672/LY), an INMB of $70 021 with INHB of 1.89 QALYs. Using the selected WTP threshold. On the standard WTP threshold, the prevalence of sintilimab group as the primary treatment was 90.55% in China. The establishment of the model is stable. Adding sintilimab to chemoradiotherapeutic regimens represents an innovative and cost-effective means for patients with locoregionally advanced NPC management in China.

Pharmacy practice and policy research in Türkiye: a systematic review of literature.

In recent decades, there has been an interest in clinical pharmacy practice in Türkiye with emerging studies in this area. Despite the recent emergence of diverse pharmacy practice studies in Türkiye, a comprehensive assessment of overall typology of studies and impact has not been conducted thus far. This systematic review aims to document and assess pharmaceutical policy and practice literature published within the last 5 years in Türkiye. The other aim is to summarise the expected impact of published studies on policy and practice research. The systematic review was conducted according to the guidelines described in the PRISMA Statement. A comprehensive search approach, incorporating Medical Subject Headings (MeSH) queries and free-text terms was employed to locate pertinent literature related to pharmacy practice and policy in Türkiye. The search covered the period from January 1, 2019, to January 1, 2024, and involved electronic databases including PubMed, Medline Ovid, Scopus, ScienceDirect, Springer Link, PlosOne, and BMC. In the final grouping, 73 articles met the inclusion criteria and were selected for this review. Among the quantitative studies, majority studies were cross-sectional survey studies. Through the rigorous thematic content analysis seven research domains were developed from the selected literature: drug utilisation and rational drug use, the emerging role of pharmacist, access to medicines and generic medicines, community pharmacy practice, pharmacovigilance/adverse drug reactions, and pharmacoeconomic studies. The pharmacist role is evolving; however, several challenges remain in fully realising the potential of pharmacists. These include regulatory barriers, limited public awareness of pharmacists' expanded roles, workforce capacity issues, and the need for ongoing professional development and training. Research studies are needed in the areas of generic prescribing, medicine adherence, intervention studies in community and hospital pharmacy practice, and on pharmacoeconomics and pharmacovigilance.

Excessive prescription duration is a major contributor of inappropriate antibiotic use in primary care

ObjectivesIn France, 75% of systemic antibiotics are prescribed by general practitioners (GPs) in primary care. We aimed to estimate the burden of inappropriate use related to excessive prescription duration. Patients and methodsIn 2021, we performed a cross-sectional and pharmaco-economic study of a network of six GPs. The references for optimal durations were those of the French national guidelines for antibiotic prescription. ResultsOut of 196 antibiotic prescriptions, 33.7 % were of excessive duration, with a mean excess of 0.9 [0.86–0.94] to 1.6 [1.45–1.72] days per prescription. Ear, nose, and throat, respiratory tract, and skin and skin structure infections were the main infections associated with excessive prescription. The pharmaco-economic analysis showed that the cost of excessive prescription duration would range from an estimated 151 to 262 million € in France in 2021. ConclusionAddressing excessive antibiotic prescription duration by GPs may represent a powerful and cost-saving tool in antimicrobial stewardship programs.

Clinical Pharmacist-Led Interventions for Improving Breast Cancer Management-A Scoping Review.

Breast cancer is the leading cause of cancer-related death in women worldwide and the fifth most common cause of cancer death overall. Most women with breast cancer have a good prognosis if the cancer is detected at an early stage and the patients have access to the appropriate treatment and disease management. This study aims to evaluate the impact of pharmacist-led interventions on breast cancer management and health outcomes. A literature review was carried out through the scientific databases PubMed, Scopus, and Web of Science using predefined keywords. Only full-text original articles written in English that investigated the role of the pharmacist in the management of breast cancer were included in the final analysis. No publication date limits were set. A total of 1625 articles were retrieved from the electronic databases, of which 14 met the inclusion criteria. The current scoping review consists of different study types, including randomized controlled trials, cross-sectional studies, pre-post studies, retrospective cohort studies, quality improvement projects, case-control studies, and one pharmacoeconomic study. Pharmacists commonly provided the following interventions: consultations regarding chemotherapy treatment, risk assessment and patient education, adverse drug reactions and drug-drug interactions detection, and adherence assessment. This scoping review highlights the beneficial effects of the involvement of pharmacists in breast cancer management, such as better quality of life, reduced drug interaction risk, greater adherence rates, and improved patient knowledge. This confirms the importance of including the pharmacist in the oncology team caring for patients with breast cancer.

Evaluating the Efficacy of Omalizumab in Severe Cedar Seasonal Allergic Rhinitis in Japan.

Traditional treatments for cedar seasonal allergic rhinitis include second-generation antihistamines, nasal corticosteroids, and sublingual immunotherapy (SLIT). Omalizumab (Xolair®), an anti-immunoglobulin E (IgE) monoclonal antibody, is an additional option for severe cases unresponsive to existing therapies. Numerous studies have demonstrated the therapeutic effectiveness of omalizumab for cedar seasonal allergic rhinitis; however, most reported results after only up to four weeks of follow-up. Therefore, this study evaluates the clinical efficacy of omalizumab throughout one whole cedar pollen season. Subjects and methods: This study included patients from our department and the Otorhinolaryngology Department of Minami Osaka Hospital between 2021 and 2023 who were ≥ 12 years old and had serum total IgE levels of 30-1,500 IU/mL, a baseline weight of 30-150 kg, and persistent severe nasal symptoms despite conventional treatments. Patients taking oral steroids at the time of enrollment or had fewer than two omalizumab doses were excluded. Forty-six patients (26 males, 20 females; mean age, 19.1 ± 11.2 years) met these criteria and received subcutaneous omalizumab every 2 or 4 weeks based on their IgE levels and weight. Symptoms were assessed at baseline and 4, 8, and 12 weeks post-administration using the Total Nasal Symptom Score (TNSS) and the Japanese Standard Quality of Life Questionnaire (JRQLQ No. 1) for allergic rhinitis. Results: Thirty-six patients were followed up for 8 weeks and 13 for 12 weeks. TNSS significantly improved from 6.6 to 4.5 at 4 weeks, 4.2 at 8 weeks, and 4.1 at 12 weeks (p<0.05). Nasal discharge, sneezing, nasal obstruction, itchy eyes, and tearfulness showed significant improvements (p<0.05). Quality of life scores improved in daily activities, sleep, and physical health from week 4 to week 12. Discussion: Consistent with previous findings, omalizumab significantly improved nasal and ocular symptoms and quality of life in patients with severe cedar seasonal allergic rhinitis. Despite many patients discontinuing the drug after eight weeks due to high costs, the drug's effectiveness in preventing symptom recurrence suggests potential long-term benefits. Combining omalizumab with SLIT showed no significant differences in outcomes; however, further pharmacoeconomic studies are warranted to evaluate cost-effectiveness. Conclusion: Omalizumab proved to be an effective treatment for severe cedar seasonal allergic rhinitis, providing significant symptom relief and quality of life improvements. Further studies should investigate its long-term efficacy and safety, including potential adverse effects and the development of anti-omalizumab antibodies.

Additional Hepatic Arterial Infusion Chemotherapy to Sorafenib Was Cost-Effective for Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombosis.

The combination of sorafenib and hepatic arterial infusion chemotherapy (SoHAIC) has shown to enhance overall survival rates in patients with advanced hepatocellular carcinoma and major portal vein tumor thrombosis (HCC-Vp3-4) compared to sorafenib alone. Our objective was to evaluate the cost-effectiveness of SoHAIC versus sorafenib for the treatment of HCC-Vp3-4, taking into account the viewpoint of Chinese healthcare payers. This pharmacoeconomic study employed a Markov model to assess the cost-effectiveness of treating HCC-Vp3-4 with SoHAIC in comparison to sorafenib. The patient characteristics were drawn from individuals from the trial conducted between June 2017 and November 2019, with cost and health value data sourced from published literature. The primary outcome measure in this research was the incremental cost-effectiveness ratio (ICER), which indicates the additional cost per quality-adjusted life year (QALY). The willingness-to-pay (WTP) threshold per QALY was set at $30,492.00. Furthermore, 1-way sensitivity and probabilistic sensitivity analyses were carried out to validate the consistency of the results. In the baseline scenario, sorafenib resulted in 0.42 QALY at a cost of $10,507.89, while SoHAIC generated 1.66 QALY at a cost of $32,971.56. When comparing SoHAIC to sorafenib, the ICER was $18,237.20 per QALY, which was below the WTP threshold per QALY. Furthermore, the 1-way sensitivity analysis demonstrated that the ICER remained within the WTP threshold despite fluctuations in variables. In the probabilistic sensitivity analysis, SoHAIC had a 98.8% probability of being cost-effective at the WTP threshold, considering a wide range of parameters. In this cost-effectiveness evaluation, SoHAIC demonstrated cost-effectiveness over sorafenib for HCC with major portal vein tumor thrombosis, as observed from the perspective of a Chinese payer.

Clinical and economic studies of pharmacotherapy for multiple myeloma: literature review data

Among hematological diseases, Multiple myeloma (MM) is the second most common malignancy in adults worldwide. In the vast majority of cases, MM remains incurable, despite improvements in progression-free survival and overall survival due to advances in pharmacotherapy, as well as the emergence of innovative drugs in recent years. Unfortunately, this does not prevent patients from relapse and, ultimately, multidrug resistance and poor prognosis. In conditions of limited funding, one of the determining factors for the success of therapy is the cost of treatment. There is a need to conduct a clinical and economic analysis of the use of targeted drugs to determine the most economically feasible treatment option. The purpose of the review is to provide an overview of current and experimental treatments for relapsed/refractory MM (RRMM), with an emphasis on their pharmacoeconomic availability to assist clinicians in their decision-making process. Let's look at the latest data that will help improve approaches to the treatment of this still incurable disease and analyze pharmacoeconomic studies of modern expensive treatment regimens for RRMM in various countries.

Pharmacoeconomic study of anti-influenza virus drugs in Japan based on a network meta-analysis.

An analysis was conducted in Japan to determine the most cost-effective neuraminidase inhibitor for the treatment of influenza virus infections from the healthcare payer's standpoint. This study reanalysed the findings of a previous study that had some limitations (no probabilistic sensitivity analysis and quality of life scores measured by the EQ-5D-3L instead of the EQ-5D-5L) and used a decision tree model with only three health conditions. This study incorporated new data from a network meta-analysis study into the first examination. The second examination involved constructing a new decision tree model encompassing seven health conditions and identifying costs, which consisted of medical costs and drug prices based on the 2020 version of the Japanese medical fee index. Effectiveness outcomes were measured using EQ-5D-5L questionnaires for adult patients with a history of influenza virus infections within a 14-day time horizon. Deterministic and probabilistic sensitivity analyses were performed to examine the uncertainty. In the first examination, the base-case cost-effectiveness analysis confirmed that oseltamivir outperformed laninamivir, zanamivir and peramivir, making it the most cost-effective neuraminidase inhibitor. The second examination revealed that oseltamivir dominated the other agents. Both deterministic and probabilistic sensitivity analyses showed robust results that validated oseltamivir as the most cost effective among the four neuraminidase inhibitors. This study thus reaffirms oseltamivir's position as the most cost-effective neuraminidase inhibitor for the treatment of influenza virus infections in Japan from the perspective of healthcare payment. These findings can help decision makers and healthcare providers in Japan.

Pharmacoeconomic Evaluation of Homeopathy: Assessing Efficacy, Economics, and Policy Perspectives

Background: In contemporary healthcare, evidence-based practices are fundamental for ensuring optimal patient outcomes and resource allocation. Essential steps for conducting pharmacoeconomic studies in homeopathy involve study design, intervention identification, comparator selection, outcome measures definition, data collection, cost analysis, effectiveness analysis, cost-effectiveness analysis, cost-benefit analysis, sensitivity analysis, reporting, and peer review. While conventional medicine undergoes rigorous pharmacoeconomic evaluations, the field of homeopathy often lacks such scrutiny. However, the importance of pharmacoeconomic studies in homeopathy is increasingly recognized, given its growing integration into modern healthcare systems. Methods: A systematic search of electronic databases (PubMed, Scopus, Web of Science) was performed to identify relevant literature using keywords such as "homeopathy," "pharmacoeconomics," and "efficacy." Articles meeting inclusion criteria were assessed for quality using established frameworks like the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Data synthesis was conducted thematically, focusing on study objectives, methodologies, findings, and conclusions. Results: Ten pharmacoeconomic studies within homeopathy were identified, demonstrating varying degrees of compliance with reporting guidelines. While most studies reported costs comprehensively, some lacked methodological transparency, particularly in analytic methods. Heterogeneity was observed in study designs and outcome measures, reflecting the complexity of economic evaluation in homeopathy. Quality of evidence varied, with some studies exhibiting robust methodologies while others had limitations. Conclusion: Based on the review, recommendations include promoting homeopathic clinics, providing policy support, adopting collaborative healthcare models, and leveraging India's homeopathic resources. Pharmacoeconomic studies in homeopathy are crucial for evaluating its economic implications compared to conventional medicine. While certain studies demonstrated methodological rigor, opportunities exist for enhancing consistency, transparency, and quality in economic evaluations. Addressing these challenges is essential for informing decision-making regarding the economic aspects of homeopathic interventions

Methodological features of the implementation of pharmacoeconomic models in veterinary medicine

The relevance of introducing pharmacoeconomic studies into veterinary medicine is undeniable, since they allow us to assess the cost and effectiveness of various medications and manipulations associated with their use, which helps veterinary specialists choose the most optimal treatment methods and prevent inappropriate or unnecessarily expensive con-sumption of medical resources. Such an economic assessment makes it possible to reduce the costs of veterinary care and ensure the availability of high-quality medical care for all categories of animals.The main problem of using existing pharmacoeconomic methods in veterinary medicine is the actual absence or impossibility of relevant assessment of certain characteristics (for example, indicators of the “benefit” of treatment for compaion animals; the integral indicator QALY - “years of quality life saved,” etc.), which allows us to consider analysis and generalization of methodological features of the implementation of pharmacoeconomic models in veterinary medicine is an urgent task.To achieve this goal, the scientific literature was analyzed (including bibliographic peer-reviewed databases such as Scopus, WoS, Pubmed, elibrary) with a further selection of relevant and current sources (published over the last 10 years) with their subsequent stratification according to the principle of applicability of the described methodological approaches for veterinary medicine, which were generalized and systematized.As a result of the analysis, it was determined that in veterinary medicine it is permissible to use analytical, statistical and simulation mathematical models.Pharmacoeconomic studies play an important role in assessing the relationship between treatment costs and outcomes. This allows you to evaluate the effectiveness of using a particular drug, conduct a comparative analysis of various treatment methods and make informed decisions about choosing the most suitable drug. In this way, pharmacoeconomic studies help improve the quality of veterinary treatment and ensure maximum benefit to the owner.

Optimization of pharmaceutical care for children with diseases of the upper respiratory tract in outpatient polyclinic institutions

Introduction. The analysis of scientific and information materials has shown that the theoretical foundations and conceptual provisions of pharmaceutical management and pharmacoeconomic research have been developed in the works of domestic scientists. At the same time, research on optimization of pharmaceutical care for children in outpatient facilities is currently only fragmentary, and there is no systematic approach to solving this problem.&#x0D; The aim of the study. On the basis of a systemic approach, form a system of research on the optimization of pharmaceutical care for children with ENT diseases in outpatient polyclinic institutions.&#x0D; Materials and methods. The methodological basis is the approaches of modern management in the field of strategic management, pharmacoeconomics, approaches to the assessment of drug consumption, legislative and regulatory documents. The objects of the study were family outpatient clinics and children's outpatient polyclinic institutions in the city of Kyiv and the Kyiv region. The initial information was 390 outpatient charts of patients with ENT diseases aged 3 to 17 years for the period of 2022; 125 expert questionnaires of otolaryngologists; 50 questionnaires of a sociological survey of parents of patients with ENT diseases. The research used methods of logical, structural analysis, SWOT analysis, sociological methods (expert opinions, interactive survey, questionnaire).&#x0D; Results. A methodical approach to conducting pharmacoeconomic studies of pharmaceutical care for children in outpatient clinics has been developed. For the first time, an original method of multi-aspect matrix analysis was proposed, which makes it possible to evaluate and multi-factorially position the medicinal products of the researched assortment in order to justify its inclusion in the assortment list for the treatment of a certain nosology in ambulatory polyclinic conditions.&#x0D; Conclusions. The practical significance of the research results lies in the creation of a system of approaches to optimizing pharmaceutical care for children in outpatient settings at the territorial level.

Pharmacoeconomic analysis fenofibrate + rosuvastatin of fixed combination compare to loose-pill combination in patients with atherogenic dyslipidemia

This article presents the results of a pharmacoeconomic analysis of the use of a combination of rosuvastatin + fenofibrate in a single film-coated tablet (“Suprozafen”) and fenofibrate + rosuvastatin in the loose-pill combination of various trade names in the treatment of patients with atherogenic dyslip- idemia. In the pharmacoeconomic evaluation cost-effectiveness analysis and budget impact analysis were used. From the point of view of clinical efficacy, it was found that the fixed combination has an advantage compared to loose-pill combination, expressed in a decrease in the incidence of serious cardiovas- cular events when prescribing a fixed combination of drugs by 8.64%. The results of cost analysis calculations showed that annual cost of of treatment with the fixed combination drug Suprozafen is 11,184 rubles, while treatment with loose-pill combination of rosuvastatin and fenofibrate will be accompa- nied by costs of 10,775 rubles. Thus, the cost of a fixed combination is only 409 rubles. (per year per patient) or 3.7% more higher than when prescrib- ing rosuvastatin and fenofibrate separately, that reflects the comparability of this expenditures. Cost savings for the treatment of serious cardiovascular events when using the fixed combination drug (Suprozafen), which arose due to higher adherence to treatment and a decrease in the risk of these events, is 11,188.9 rubles. per patient per year. Taking into account the results of the cost analysis, the savings in the healthcare system budget for a time hori- zon of one year per 100 patients using a fixed combination of rosuvastatin + fenofibrate is 1,078,001 rubles. The results of the pharmacoeconomic study confirm and allow us to accept the hypothesis that the fixed combination of the drug rosuvastatin and fenofibrate (drug Suprozafen) has a pharmacoeco- nomic advantage compared to the appointment of loose-pill combination. At an almost comparable cost of treatment, the fixed combination, due to higher patient adherence, allows achieving better disease control, reducing the risk of developing serious cardiovascular events and the associated economic burden.

“The end of the era of antibiotics” — myth or reality: what the past COVID-19 pandemic has shown

BACKGROUND: During the coronavirus disease 2019 pandemic, the sale of antimicrobials (AMPs) in the pharmacy network and their purchases by healthcare facilities of the Russian Federation have significantly increased. Microbiological monitoring conducted at the City Clinical Hospital No. 67 named after L.A. Vorokhobov of the Moscow Health Department in 2020–2021 revealed an urgent problem: gram-negative bacteria, which are dominated by multidrug-resistant (MDR) strains, are now mainly isolated from patients with healthcare-associated infections (HAIs). Pharmacoeconomic studies have shown that the cost of one course of targeted antibiotic therapy for HAIs can increase by 6–12 times compared with a similar course of therapy in the absence of nosocomial MDR and extensively drug-resistant (XDR) pathogens.&#x0D; AIM: To increase the effectiveness of preventive measures aimed at preventing the spread of hospital-acquired pathogen strains in the intensive care unit (ICU) using effective bacteriophages against MDR strains of Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii, which were selected in accordance with an individualized algorithm.&#x0D; MATERIALS AND METHODS: The study included two groups, totaling 20 patients, who were on prolonged mechanical ventilation in the ICU of City Clinical Hospital No. 67 named after L.A. Vorokhobov of the Moscow Health Department in 2022. The second group received 20 mL of bacteriophages via an intragastric tube for five consecutive days. The concept of a personalized approach to phage therapy for various forms of HAIs caused by nosocomial MDR pathogens in patients of a multidisciplinary hospital has been proposed and tested.&#x0D; RESULTS: With this medical technology, the effectiveness of phage therapy for various nosological forms of HAIs caused by nosocomial MDR and XDR strains increased by 30%, and the effectiveness of the initial antibiotic therapy regimen was ≥70%. The economic effect of the combination of antibiotic therapy and phage therapy (booster therapy) amounted to more than 3 million rubles compared with the use of AMP alone for treating patients with HAIs caused by nosocomial MDR/XDR strains.&#x0D; CONCLUSIONS: Booster therapy as a variant of IIB therapy reduces the cost of treatment of AMPs of various forms of HAIs by ≥2.5 times compared with AMPs alone.