PharmacoEconomics - Modern pharmacoeconomics and pharmacoepidemiology (E-Journal) / ФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология
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Сравнительный фармакоэкономический анализ применения энзалутамида, абиратерона и кабазитаксела при лечении кастрационно-резистентного рака предстательной железы, прогрессирующего на фоне применения доцетаксела
Get PDFRecently, an increase in the incidence of severe forms of prostate cancer, in particular castration-resistant prostate cancer (CRPC) has been noticed. Treatment of CRPC patients is associated with increasing expenses and thus impacts the healthcare budgets at various levels. The aim was to study the pharmacoeconomic aspects of using enzalutamide, cabazitaxel and abiraterone for the second-line therapy of CRPC (after treatment with docetaxel) in the Russian Federation. Materials and Methods. A cost effectiveness analysis of patient management was conducted for each of the three drugs. The direct costs included the costs of visiting the doctor, the diagnostic tests and procedures, the best supportive therapy with other drugs in accordance with the standards, the treatment of adverse events, the end-of-life palliative therapy in hospital, and the costs of prescribing one of the three drugs in question. Results. The expenses for diagnosing, maintaining the treatment regimen, consulting, monitoring and nurse caring in patients with CRPC were 15-20% lower with enzalutamide compared to abiraterone and two-fold lower than that with cabazitaxel. The general assessment of direct costs without the cost of the above drugs showed that the use of enzalutamide was 10% less expensive than abiraterone and 35% less expensive than cabazitaxel. The pharmacoeconomic advantages of enzalutamide over the two other agents are supported by the «decision tree» model and by the cost/effectiveness ratio. Conclusion. The use of enzalutamide is associated with lower direct costs of care, treatment, diagnostic and supportive procedures as compared with abiraterone and cabazitaxel.
МЕТОДЫ РАСЧЕТА QALY КАК ИНТЕГРАЛЬНОГО ПОКАЗАТЕЛЯ ЭФФЕКТИВНОСТИ В ПРОЦЕССЕ КОМПЛЕКСНОЙ ОЦЕНКИ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ
Get PDFThis report addresses the ways of calculating QALY (Quality-adjusted life-year). OutsideRussia, a standardized methodology to calculate QALY is in use; such an approach makes it possible to apply this universal criterion of effectiveness to the evaluation of new health technologies. Its versatility enables better decision-making on financing the medical treatment within a limited budget. With this algorithm, the financial resources are allocated in such a way as to maximize the levels of QALY. InRussiato date, the use of QALY as a measure of drug effectiveness is not yet possible because of the lack of standardized calculating methods, as well as the absence of uniform tariffs for assessing the medical status of the patient in terms of health utility. Here, we present a number of methods for estimating the health utility, which are used to calculate the QALY, and describe advantages and disadvantages of these methods. В статье описаны основные подходы к вычислению QALY. В зарубежных странах разработана и используется стандартизованная методика расчета QALY, позволяющая применять данный показатель как универсальный критерий эффективности при проведении оценки технологий здравоохранения. Его универсальность позволяет принимать решения о финансировании медицинских технологий для лечения различных заболеваний в рамках ограниченного бюджета. При этом финансовые ресурсы распределяются таким образом, чтобы максимизировать прирост QALY. В России на сегодняшний день использование QALY как критерия эффективности при проведении комплексной оценки лекарственных препаратов не представляется возможным ввиду отсутствия стандартизованной методики расчета, а также отсутствия единых тарифов для перевода профилей состояний здоровья в полезность. Приведены основные методы расчета полезностей состояний здоровья, необходимых для вычисления QALY, описаны основные достоинства и недостатки существующих методов.
Oбзор существующих зарубежных подходов к определению и оценке инновационности лекарственных препаратов
Get PDFA set of criteria for assessing the innovative potential of drugs (therapeutic value) have been developed and are widely used elsewhere. These approaches allow the state (the payer) to assess the clinical significance of a new medical product and make an educated decision on the reimbursement, cost and priority at the stage of registration. In the Russian Federation though, such criteria and methods are not sufficiently developed. This review describes the principle approaches to assessing the drug innovative potential in countries outside Russia. В зарубежных странах разработаны и широко используются критерии оценки степени инновационности лекарственных препаратов (ЛП) (терапевтической ценности), которые позволяют государству, как плательщику, оценить клиническую значимость нового ЛП и принять обоснованное решение о его возмещении, определении его стоимости и приоритетности на стадии регистрации. В настоящее время в РФ не разработаны в достаточной степени критерии и методология проведения данной оценки. В статье описаны основные методологические подходы к оценке инновационности ЛП в зарубежных странах.
Клинико-экономическое исследование применения брентуксимаба ведотина у взрослых пациентов с рецидивирующей или рефрактерной лимфомой Ходжкина
Get PDFПациенты с неврологическими расстройствами: обоснование необходимости фармакоэкономической оценки оптимизации затрат на ведение с использованием нейроспецифических белков в качестве маркеров повышения проницаемости гематоэнцефалического барьера
No full textЭффективность и безопасность пероральных антикоагулянтов при венозных тромбоэмболических осложнениях: непрямые сравнения
Get PDFObjective. The aim was to perform an indirect comparisons of the effectiveness and safety of new oral anticoagulants (NOACs) in the management of venous thromboembolism (VTE).Material and methods. In the absence of a head-to-head comparisons, indirect comparison was done using the method proposed by Butcher et al.Results. The indirect comparison included 5 RCTs. Apixaban, rivaroxaban and dabigatran were equally effective in preventing recurrent symptomatic VTE, deep vein thrombosis and pulmonary embolism. Dabigatran increased major bleeding risk compared to apixaban RR=2.36; 95% CI 1.15-4.82 and the risk major or clinical relevant non-major (CRNM) bleedings RR=1.43; 95% CI 1.06-1.93. Dabigatran and apixaban were associated with the significant lower risk of major and CRNM bleeding compared with rivaroxaban RR=1.49; 95% CI 1.17-1.91 and RR=2.13; 95% CI 1.66-2.74.Conclusions. There were no statistically significant differences between apixaban, dabigatran and rivaroxaban in effectiveness. Apixaban treatment associated with the most favorable safety profile of the NOACs
Фармакоэкономический анализ лекарственных средств, применяемых в лечении ревматоидного артрита при неэффективности базовых противовоспалительных средств
Get PDFObjective. To perform health economic evaluation of several antirheumatic drugs in patients with rheumatoid arthritis (RA) progressed after DMARDs.Materials and methods. Three consequent line of rheumatoid arthritis therapy in patients progressed after methotrexate were modeled in Russian economic conditions. Markov modelling and CEA accounting for direct medical costs were used. The effectiveness criteria of RA treatment were: patient-years in remission and patient-years in low disease activity. We compared 12 different treatment regimens of second, third and fourth therapy line in patients progressed after methotrexate.Results. The health economic analysis of different RA treatment regimen after progression on methotrexate showed that evaluated regimens do not differs in terms of effectiveness and safety. At the mean time the model account for the patients compliance and showed that the maximum number of patient-years in remission can be reached with etanercept and tofacitinib treatment. Moreover, above mentioned combination in comparison to adalimumab and infliximab showed the positive budget impact.Conclusion. The choice of etanercept and tofacitinib in case of similar economics should be done accounting for individual patient features
Гендерные особенности в отношениях населения к лекарственным средствам
Get PDFObjective. The study of gender features of attitudes visitors of pharmacies to medicines.Materials and Methods. Conducted sociological survey thru the original questionnaires in 2015 among pharmacy customers. The survey included 380 respondents (190 men and 190 women) living in the cities of Central Russia. During the interview, respondents were asked, among other things evaluate the 13 influencing their choice when buying of consumer qualities of medicines. For statistical analysis used the methods of variation statistics, ranking, grouping, correlation analysis.Results. We have identified the priority qualities of medicines which are essential for consumers, in particular: efficiency, minor side effects, low cost, clear information on the package, convenient medicinal form of production. We have not detected significant gender differences in the assessment of consumer qualities of medicines that led to the conclusion of equivalence of consumer attitudes of men and women to them
Анализ международного опыта планирования объемов и оплаты стационарной медицинской помощи
Get PDFObjective. To examine approaches to organization and planning as well as expenditures of inpatient care in countries outside of Russia.Methods. A narrative review of published articles and legal documents was conducted. The review focused on health systems organization, planning volumes and costs associated with inpatient care in nine foreign countries (Germany, France, Denmark, Norway, Austria, Great Britain, Canada, Belarus and Kazakhstan) was conducted.Results. In all countries, there is a growth in health care costs both in monetary terms and as a percentage of GDP. The primary policy responses to expenditure growth have focused on outpatient pharmaceuticals, evaluation of medical technologies and reducing volumes of provided hospital care by providing assistance in day hospitals, outpatient or with home-visiting teams. In most countries, responsibility for the organization and planning of inpatient care rests with regional authorities. In all of countries, quality measures are regularly taken as a means to optimize or reduce numbers of beds, reduce hospital length of stay or increase turnover as a means to reduce transaction costs and costs of infrastructure maintenance. The main method of payment for acute care services is based on per case of treatment for a relevant group of diseases (diagnosis related group (DRG)). Planning of medical care in many of these countries is based on financial capacity and performance of previous years. Approaches to planning are typically part of political decision-making, developed at regional or municipal level, leading to variable approaches in health systems characterized by a federation of health regions