Pharmacoeconomics: theory and practice
№1, 2024, Vol.12

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Modern challenges and threats, as well as unprecedented sanctions pressure on the Russian Federation, have contributed to the intensification of research both on the development of innovative medical technologies and on expanding the range of use of existing ones. At the same time, on the one hand, there is an increase in incoming proposals for the use of various medical technologies in military healthcare, and on the other hand, the need to ensure accessibility and improve the quality of medical care for military personnel and other cate- gories of assigned contingents is rapidly increasing. At the same time, in con- ditions of limited resources, the level of requirements for justifying the need to introduce one or another medical technology into the activities of military medical organizations and other medical units of the Armed Forces of the Rus- sian Federation naturally increases. All this predetermines the relevance of the development of a departmental system for assessing medical technologies for effective information support for making rational management decisions. The study examined the main directions of development of the medical tech- nology assessment system in military healthcare. In particular, goals and objectives are defined, the main aspects and possible forms of organizing a departmental system for assessing medical technologies are substantiated. The main elements of the basic model for assessing medical technologies in military healthcare are identified. In addition, the characteristics of the in- formation system for assessing medical technologies in military healthcare are given, its main components are given, as well as the expected effects of implementation. The implementation of the departmental concept for assessing medical tech- nologies in the main directions of development presented in the article on the basis of a specialized information system will not only help increase the availability of effective and safe medical technologies, but also the rational use of funds and other military healthcare resources. In addition, taking into ac- count the results of departmental assessment of medical technologies at the state level will serve as the basis for the formation of priority directions for the strategic development of the domestic medical and pharmaceutical industry in the interests of national defense and state security.

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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.

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When considering the problems of digital transformation of various spheres of life support for the country and maintaining the defense capability of the state, it seems advisable to focus on the most effective digital technologies. Among them, in the context of an increasing risk of cyber threats, blockchain technology, which has a promisingly increasing potential for information security and demonstrates dynamic development in many areas of socio-economic life, primarily attracts at- tention. The article discusses the historical aspects of the development of blockchain tech- nology, presents the results of a study of its main characteristics, international and domestic experience of application, and also presents prospects for implementa- tion in the management of medical property resources. It has been determined that in the context of using distributed database technology in the field of military healthcare, the preferred solution is to use a closed type of blockchain, characterized by a high degree of digital security and scalability. Based on the results obtained during the study, the main advantages and limita- tions of implementing distributed database technology within military healthcare were highlighted. It has been determined that in order to increase the efficiency of the medical ser- vice, it is promising to build a single digital loop for managing medical property resources on the basis of blockchain technology in accordance with the territorial medical support system. It is concluded that digital transformation through the integration of blockchain technology into the practical activities of a medical service can be an effective tool for optimizing the processes of managing medical property resources. However, further comprehensive study of this issue is required, as well as justification and development of possible modifications of existing digital solutions, taking into ac- count the needs of military healthcare and the need to rationalize the provision of medical equipment to assigned contingents.