Results Of Pharmacoeconomic Analysis Research Articles

Analysis of the vitamin’s list with pharmacoeconomic rates for the treatment of long covid conditions during the pandemic COVID-19 in Ukraine

To ensure adequate vital activity, especially during the COVID-19 pandemic, the human body needs, in particular vitamins, minerals (macro and micronutrients).
 The purpose of the study is the range, qualitative and quantitative composition of vitamin complexes (VC) in the pharmaceutical market of Ukraine; to develop a method of pharmacoeconomic analysis to determine the cost of treatment of VC.
 Materials of research – data DRLZ, «Compendium», prices for VC (www.tabletki.ua). Research methods: webometric, comparative, content, «cost minimization» analysis; systematization, generalization.
 20 VCs were analyzed, of which 15 – group A11A (75%) and 5 – A11B (25%). The highest content of vitamins in: Elevit Pronatal, Vitrum Energy, etc. All groups of vitamins contain: Vitrum Centuri, Vitrum Energy. The least vitamins in – Metovitan, Optics. Vitrum Centuri and Vitrum Energy contain most of the trace elements. Metovitan, Optics, Quadevit contain the least amount of trace elements. In addition to trace elements, the composition of VC includes: amino acids (cysteine, methionine), papain, fish oil, etc.
 It is established that the recommended doses of vitamins A, C, B1, B2, B5, B6, B12 in Ukraine are higher than recommended by the WHO; D, B9, H – the recommended doses in Ukraine are lower than recommended by the WHO; recommended doses of all trace elements in Ukraine are higher than the WHO. 20 VCs are registered in Ukraine, of which 15 are group A11A and 5 are A11B. 90% of VC contain vitamins A, E, C, B1, B2, B9, B12, PP. Vitamin B6 – in 85% of VC; vitamin D3 is in the composition of 62% of VC; vitamin B5 – 58%; vitamins H and K – in the composition of almost 15% of VC. It was found that 54% of VCs contain calcium; 61.5% of VC contain iron and copper; 31% of VC contain phosphorus and manganese; up to 23% of VCs contain molybdenum, boron, nickel, vanadium, tin, etc. It is established that Zinc is a part of 62% of VCs registered in Ukraine. The results of pharmacoeconomic analysis by the method of «minimization of cost» showed that the affordability of domestic multivitamin and vitamin-mineral complexes are 1.5–4.7 times more economically affordable for treatment compared to imported, with a qualitative composition are similar. Quantitative content of vitamins and minerals in domestic VC meets the national requirements of daily intake.

CONDUCTING COMPARATIVE CLINICAL-PHARMACOLOGICAL EVALUATION PHARMACOTHERAPY PREPARATIONS OF BOTULINUM TOXIN A IN CHILDREN WITH CEREBRAL PALSY SYNDROME WITH MARKED SPASTICITY

The original methodology for retrospective clinical studies on the criteria of “efficiency/safety” and pharmacoeconomics on the criteria of “cost/effectiveness”is proposed. The results of a retrospective study of medical records in 169 patients with cerebral palsy, which showed that the use of drugs botulinum toxin type A is an important integral component in the long-term treatment of children with spastic forms of cerebral palsy. Presents the results of pharmacoeconomic analysis of the treatment of the syndrome of spasticity in cerebral palsy when used in the complex treatment of Dysport, Botox and Xeomin.

Economic Evaluation And Cost-Effectiveness Threshold In Practice Of Decision-Making On Orphan Drug Reimbursement In Poland

Use of economic evaluations and cost-effectiveness thresholds for orphan drugs raise concerns and discussions worldwide. Orphan drugs undergo a full pharmacoeconomic evaluation and assessment in Poland. The goal of this study was to find out how important the reimbursement criterion of cost-effectiveness threshold (3xGDP per capita for QALY/LYG gained) is in case of orphan drugs in Poland. Documents published by the Agency for Health Technology Assessment and Tariff System (AHTAPol) and Minister of Health (MoH), pertaining to all orphan drugs considered for reimbursement between 2015 and 2016, were analysed. Inferences from published sources were used when ICUR values (cost-effectiveness indicators) were not disclosed due to confidentiality. ICUR value was calculated in 30 cases out of 32 orphan drug reimbursement applications. Positive recommendations of AHTAPol’s President (RAP) were issued for 30% of cost-ineffective cases. Negative RAP were issued for 13% of cost-effective cases. Positive MoH’s reimbursement decisions were issued for 33% of cost-ineffective cases, while 17% of cost-effective cases did not receive positive MoH reimbursement decisions. Risk sharing schemes (RSS) were proposed in 22 applications, of which 13 cases assessed by AHTAPol’s President were found as insufficient. For 10 applications, RSS were not proposed (for 7 of them AHTAPol’s President suggested necessity of RSS). The main reasons for negative RAP in cost-effective cases included lack of evidence of clinical effectiveness and uncertainty of estimations. The main reasons for positive RAP in cost-ineffective cases included limited therapeutic options, the only therapy available and proven clinical-effectiveness. Despite existence of formal cost-effectiveness threshold and no special formal approach to reimbursement of orphan drugs, results of pharmacoeconomic analysis do not determine final reimbursement decisions in Poland. Cost-effectiveness cannot be considered as a crucial criterion in decision-making on orphan drug reimbursement in Poland.

CLINICAL AND ECONOMIC EVALUATION OF CHRONIC DISEASE TREATMENT: A DISCREPANCY BETWEEN THE TRADITIONAL PHARMACOECONOMIC AND SOCIO-ECONOMIC ANALYSES

The article presents the results of traditional pharmaco-economic analysis (the “cost-effectiveness” method) and socio-economic analysis of pharmaco-therapeutic regimens in a chronic disease. The specific aim was to compare the methods of pharmaco-economic and socioeconomic analyses when applied to the treatment of children with chronic asthma exacerbations. Materials and methods . The data on basic therapy of asthma exacerbations in children hospitalized in 2014-2015 were used (total 608 cases). Results . The combination of an inhaled glucocorticosteroid and long-acting β2-agonists proved to be the most optimal therapy as far as pharmaco-economics is concerned. The ways to calculate the coefficient of incremental costs of therapeutic regimens are shown. The discrepancy between the results of pharmacoeconomic analysis, on the one hand, and the data on socio-economic losses, on the other hand, was documented. The addition of montelukast (a leukotriene receptor antagonist) in the treatment regimen leads to an increase in medical costs from 873.00 rubles to 1515.39 rubles, and to a decrease in the average number of hospitalizations per year. In this case, the number of days of absence from work for a parent also decreases, which contributes to a higher GDP. As exemplified in this model group of 1000 patients, an increase in the direct medical costs by 734 thousand rubles leads to a decrease in the socio-economic losses (saving 34 million rubles.) Сonclusion . The traditional pharmacoeconomic analysis is the ideal instrument to compare between the original and generic drugs, and to evaluate the treatment of acute diseases. With respect to chronic diseases, this pharmaco-economic analysis should be used with caution. Without taking into account the effectiveness of the analyzed pharmacotherapy in treating possible exacerbations, or the transition to a more severe / mild form of the disease, the clinical component of the pharmaco-economic analysis may be missed. And if so, only the economic component of the selected therapy will play the major role in the final assessment. In this case, the results of the entire pharmaco-economic analysis may become less significant as they will reflect the least expensive treatment only, leaving behind the clinical aspects, e. g. the number of positive outcomes.

PP108 Health Technology Assessment Educational Programs In The Russian Federation

INTRODUCTION:Health Technology Assessment (HTA) processes are extensively used during making decisions on the inclusion of medicinal products in Essential medicines lists. There is a high interest in HTA among specialists in the healthcare sphere and decision makers in Russia. According to a survey of chief physicians 62 percent of them would like to attend HTA educational programs. One of the steps necessary to disseminate HTA in Russia is the exploration of experience and best practices.METHODS:Information retrieval using websites of medical institutions in Russia were observed.RESULTS:As a result, it was found that educational program “Modern requirements for conducting health technology assessment” for decision makers in the area of health care is held in Department of organization of medicinal provision and pharmacoeconomics of the I.M. Sechenov First Moscow State Medical University. During this course basic methods of pharmacoeconomic analysis and their practical application, modern schemes of treatment and peculiarities of the conduct of pharmacoeconomic studies in different diseases, issues of HTA at different levels of the health system are covered. More than 1,900 specialists from 12 subjects of Russia (Samara, Nizhny Novgorod, Rostov, Orenburg, Bryansk, Astrakhan regions, Khanty-Mansi Autonomous Okrug, Altai, Krasnoyarsk, Stavropol and Perm territories, the Republic of Tatarstan) attended seminars including heads of regional health authorities, chief specialists of the ministries, chief physicians of hospitals, and heads of pharmacies.CONCLUSIONS:During the educational process the results of pharmacoeconomic analysis and their interpretation at the regional level, legislative changes in the sphere of health technologies circulation, the data requirements for inclusion of a medicinal product in the state lists, the rules of state procurement, and the interchangeability of medicines are highlighted. During educational process the results of pharmacoeconomic analysis and their interpretation at the regional level, legislative changes in the sphere of health technologies circulation, the data requirements for inclusion of a medicinal product in the state Lists, the rules of state procurement, and the interchangeability of medicines are highlighted.

Clopidogrel versus aspirin for the secondary prevention of ischemic stroke and mortality in patients with cardiovascular disease: pharmacoeconomic aspect

Aspirin, dipyridamole and clopidogrel are three widely used antithrombotic drugs for the purpose of the secondary prevention of stroke. Based on the results of many clinical studies it has been shown that aspirin and clopidogrel are effective, but both have potentially serious side effects, however, clopidogrel is more expensive than aspirin. The article presents the results of the evaluation of cost-effectiveness of using antiplatelet agents of clopidogrel compared to aspirin in patients with atherosclerosis with ischemic stroke (IS), myocardial infarction (MI) and peripheral artery disease for prevention of acute ischemic stroke and cardiovascular mortality according to the results of CAPRIE randomized clinical research. For pharmacoeconomic analysis such methods as mathematical modeling and decision tree analysis «cost – effectiveness» have been used. The results of CAPRIE randomized clinical trial have shown that the long-term use of clopidogrel in patients with atherosclerotic vascular disease is more effective than aspirin in reducing the combined risk of IS, MI, or cardiovascular death. The common safety profile of clopidogrel is the same as for aspirin. The results of pharmacoeconomic analysis indicate that the use of clopidogrel as an antiplatelet agent in patients with cardiovascular disease for prevention of stroke compared to acetylsalicylic acid is more expensive for the payer, but provides additional effectiveness – two surviving lives when treating 1 000 patients.

Tiotropium Bromide Inhalation Powder

The anticholinergic agent tiotropium bromide (Spiriva®) is a long-acting bronchodilator that is indicated for the treatment of chronic obstructive pulmonary disease (COPD). This article reviews the clinical efficacy and tolerability of tiotropium bromide inhalation powder, administered using the HandiHaler® device, in patients with COPD, as well as reviewing its pharmacological properties and the results of pharmacoeconomic analyses. Shorter-term placebo-controlled trials in patients with COPD demonstrated significantly higher trough forced expiratory volume in 1 second (FEV(1)) responses with tiotropium bromide than with placebo, confirming it has a duration of action of ≥24 hours and is suitable for once-daily administration. Lung function improved to a greater extent with tiotropium bromide than with ipratropium bromide or, in most instances, salmeterol. Indacaterol was shown to be noninferior to tiotropium bromide in terms of the trough FEV(1) response. The large, 4-year UPLIFT® trial did not show a significant reduction in the annual rate of decline in FEV(1) with tiotropium bromide versus placebo in patients with COPD, although subgroup analyses demonstrated a significantly lower rate of decline with tiotropium bromide than with placebo in some patient groups (e.g. patients with moderate COPD, patients aged ≥50 years, patients not receiving maintenance therapy at baseline). Tiotropium bromide prevented exacerbations in patients with COPD, with a significantly lower exacerbation rate and a significantly longer time to first exacerbation seen with tiotropium bromide than with placebo or salmeterol. Exacerbation rates did not significantly differ between patients receiving tiotropium bromide and those receiving salmeterol/fluticasone propionate. Tiotropium bromide also had beneficial effects on health-related quality of life (HR-QOL) and other endpoints, such as dyspnoea and rescue medication use. Combination therapy with tiotropium bromide plus formoterol with or without budesonide improved lung function to a significantly greater extent than tiotropium bromide alone in patients with COPD. In addition, exacerbation rates were lower and HR-QOL was improved with tiotropium bromide plus budesonide/formoterol versus tiotropium bromide alone. Although the addition of salmeterol/fluticasone propionate to tiotropium bromide did not reduce the COPD exacerbation rate, it did improve lung function and HR-QOL. Tiotropium bromide inhalation powder is generally well tolerated in patients with COPD, with anticholinergic adverse events (e.g. dry mouth, constipation, gastrointestinal obstruction, dysuria) among the most commonly reported adverse events. The UPLIFT® trial showed no significant difference between tiotropium bromide and placebo recipients in the risk of stroke, and the risk of serious cardiac adverse events (including congestive heart failure and myocardial infarction) was significantly lower with tiotropium bromide than with placebo. The absence of a detrimental effect on cardiovascular outcomes was supported by the results of a meta-analysis and pooled analyses. In addition, on-treatment mortality was lower with tiotropium bromide than with placebo in the UPLIFT® trial. Pooled analyses showed significantly lower cardiovascular mortality with tiotropium bromide than with placebo, with a meta-analysis demonstrating no significant difference between patients receiving tiotropium bromide and controls in cardiovascular mortality. Results of modelled pharmacoeconomic analyses conducted from a healthcare payer perspective in several developed countries suggest that tiotropium bromide is a cost-effective option in patients with COPD. In conclusion, tiotropium bromide inhalation powder is a useful option for the maintenance treatment of patients with COPD.

Russian registry of patients receiving rituximab: results of pharmacoeconomic analysis

Система комплексной поддержки и сопровождения научного журнала Elpub позволяет запустить двуязычный сайт журнала со встроенной системой электронной редакции в соответствии с лучшими издательскими практиками, а так же предусматривает техническую и методическую поддержку со стороны специалистов НЭИКОН.

Clinical and economic substantiation of technologies of regulation of energy metabolism from the viewpoint of systemic pharmacodynamics

The data of experimental and clinical evaluation and the results of pharmacoeconomic analysis of the effects of regulators of energy metabolism attest to their multiple pharmacodynamics during correction of pathological processes in systems differing by their structure, function, and metabolism. Polyorgan energy protection of regulators of energy metabolism improves organism’s resistance, accelerates sanogenesis, and reduces the costs per unit of clinically significant effect. Here we discuss the creation of pharmacotherapeutic technologies based on principles of bioenergetic pharmacology.

PHP5: POLISH GUIDELINES FOR CONDUCTING PHARMACOECONOMIC EVALUATIONS IN COMPARISON TO INTERNATIONAL HEALTH ECONOMIC GUIDELINES

OBJECTIVES: Poland is the next European country, which is in the process of drafting country-specific guidelines for economic evaluation of pharmaceuticals. The aim of the study was to compare Polish pharmacoeconomic guidelines with international health economic guidelines, highlighting areas of agreement and dissent. METHODS: Existing documents from 18 countries were reviewed, analyzed and a comparison was undertaken. The following topics were considered: objective, use of pharmacoeconomic analyses, responsibility in their conduct and target audience, methodology and ethical code of practice while conducting and publishing results of pharmacoeconomic analysis. The explanation of differences was taken. RESULTS: For a number of issues recommendations are consistent between Poland and other countries. For the purpose of the Polish pharmacoeconomic research guidelines, the Canadian, Australian, Dutch and Belgian guidelines have, in some parts, been specially adopted to the Polish situation. In some parts it was possible to combine certain aspects; in the other, due to the unique local circumstances, there was a need to develop the methodological guidelines on a pure national level. For example there is a lack of consensus concerning costing and utility measurement. CONCLUSIONS: The guidelines for conducting pharmacoeconomic evaluations are linked to existing health care system and approaches to the pricing and reimbursement of pharmaceuticals. This is the purpose of differences between international health economic guidelines. To reach an optimal degree of the use of pharmacoeconomic studies in decision-making process it is essential to take into account local situation and create country-specific guidelines.