Arinina E E

Arinina E.E., Kulikov A.Y., Novikov I.V., Tolkushin A.G. 1739

Study objective: To perform a comparative pharmacoeconomic analysis of the therapy combinations: sitagliptin with metformin, and sulfonylureas with metformin in patients with type 2 diabetes on metformin monotherapy whose target glycemic goal is not reached with diet and exercise.

Materials and methods: A time horizon of 10 years was used to conduct the comparative pharmacoeconomic analysis. The following were used as reference data for the calculations: drug prices, as registered in the VED [Vital Essential Drugs]; earlier publications on the cost of complications; and data on treatment outcomes and hypoglycaemia rates in comparator groups from the JADE modelling study, based upon the data from clinical study 024 for the Russian patient population.

Results: Total medical expenditures for one patient came to 449,927 rubles in the sitabliptin+metformin group, and 415,385 rubles in the sulfonylurea+metformin group – a difference of 7.7%. Within this, the share of costs for the actual drugs was 53% and 11%, respectively, indicating a greater burden due to longterm consequences (hypoglycaemia, complications from type 2 diabetes, transitioning to insulin) for the sulfonylurea group. When converted to 10,000 patients, the cost of the drugs in the sitagliptin group was 2,149 million rubles higher, and the expenditures for complications, including hypoglycaemia and insulin therapy, were 1,559 million rubles lower. Thus, in the sitagliptin group – unlike the sulfonylurea group – 410,000 cases of hypoglycaemia were prevented, as well as 40 cases of macro- and microvascular complications. Conclusion: the results suggest that the combination use of sitagliptin + metformin is pharmacoeconomically justified when compared to sulfonylurea + metformin to treat type 2 diabetes patients.

Arinina E.E., Makarova E.I., Tolordava G.A. 1207

For many years antiplatelet therapy is the basis for the prevention of cardiovascular diseases. Acetylsalicylic acid is the “gold standard” among all antiplatelet drugs. However, ASA administration has an adverse effect in the form of development of NSAID-induced gastropathy To reduce this effect various forms of production of medicines ASA are used. In this study the pharmacoeconomic assessment of drugs Thrombo ASS, Cardiomagnyl and Aspirin Cardio in patients with previous cardiovascular diseases was conducted. According to the results of conducted cost-minimization analysis determined that the treatment scheme with the use of Thrombo ASS is characterized by the lowest cost compared with Cardiomagnyl and Aspirin Cardio. The results of the budget impact analysis suggest that therapy drugs Thrombo ASS leads to budget savings up to 33 million rubles calculated for all patients with cardiovascular diseases in Moscow compared with alternatives.

Arinina E.E., Kulikov A.Y., Tolordava G.A. 993

Blockade of renin-angiotensin system (RAS) remains one of the most main strategies in treatment of arterial hypertension (AH), and drugs blocking this system, mainly angiotensin-converting-enzyme inhibitor (ACEI) and blockers of receptors to angiotensin II, are the main classes of antihypertensive drugs. The presence of different clinical effectiveness of drugs in these groups, as well as different frequencies of occurrence of undesirable cardiovascular events, side effects and formed the basis of pharmacoeconomic (PE) studies. According to the conducted cost-effectiveness analysis, the treatment regimen using Monopril is characterized by lowest cost and the lowest coefficient of cost-effectiveness ratio in the treatment of patients with AH. The results of the budget impact analysis suggest that therapy with Monopril leads to budget savings. The results of the sensitivity analysis demonstrated the adequacy of the performed pharmacoeconomic analysis and the stability of the obtained data – during the change of the cost factors in the range of ± 97% the therapy with the drug Monopril maintained its advantage expressed by the results of the cost-effectiveness analysis. Сost-effectiveness analysis and budget impact analysis were used in this study. The indirect comparison of two antihypertensive drugs was performed: ACEI (fosinopril, ramipril, lisinopril, perindopril) and ARB II (valsartan, losartan, telmisartan, candesartan). Both groups of drugs are not only one of the main classes of antihypertensive drugs, which can be prescribed to all patients with AH, but also have priority indications, such as diabetes mellitus, metabolic syndrome etc. Results of costs analysis show that fosinopril treatment scheme is characterized with total costs - 22 751 rub., with the lowest cost-effectiveness ratio – 285, during the treatment of AH and budget economy from 5 048 rub. to 46 805 rub. per 1 person per year compared with–ramipril, lisinopril, perindopril, valsartan, losartan, telmisartan, candesartan.

Arinina E.E., Serpik V.G. 590

This article provides a comparative pharmacoeconomic evaluation of ambrisentan and bosentan used in the treatment of patients with functional class II or III pulmonary arterial hypertension (PAH) in Russia. The evaluation included methods of cost analysis, cost -minimization analysis, cost-utility analysis and budget impact analysis. The cost analysis revealed that the Volibris (ambrisentan) and Tracleer (bosentan) – associated costs, based on the per-patient per year treatment cost for one patient with PAH regardless of its functional class, were 1 585 649 rubles and 2 488 878 rubles, respectively. The results of cost-minimization analysis, based on the assumption of equal effectiveness of compared drugs, have shown that the per-patient per year treatment costs for Volibris (ambrisentan) allow cost savings of 909 789 rubles as compared to Tracleer (bosentan). The values of a cost-utility analysis for Volibris (ambrisentan) appeared to be lower than those for Tracleer (bosentan). For the former, depending on the functional class of the disease and drug dosage, the values of a cost-utility analysis varied from 2 321 771 rubles to 3 535 685 rubles per QALY, whereas for Tracleer (bosentan) the corresponding values were 4 335 477 rubles and 5 718 143 rubles per QALY in patients with functional class II PAH and functional class III PAH, respectively. The budget impact analysis, based on the estimated number of patients with PAH in RF of 3292 subjects, has shown that the total annual costs for Tracleer (bosentan) would be 8,193 billion rubles versus 5,219 billion rubles had the same patients been treated with Volibris (ambrisentan). Therefore, the possible cost savings with Volibris (ambrisentan) would be 2,973 billion rubles had it been used instead of Tracleer (bosentan), thus indicating that from the pharmacoeconomic perspective treatment with Volibris (ambrisentan) is a dominant choice.

Arinina E.E., Rashid M.A. 279

According to the first Global Report of the WHO, diabetes mellitus is an important public health problem, one of four priority noncommunicable diseases (NCDs) targeted for action by world leaders. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades. In the estimation of the WHO, 422 million adults were living with diabetes in 2014, compared to 108 million in 1980. The global prevalence (age-standardized) of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population.

Arinina E.E., Kulikov A.Y., Novikov I.V., Tolkushin A.G. 1739

Study objective: To perform a comparative pharmacoeconomic analysis of the therapy combinations: sitagliptin with metformin, and sulfonylureas with metformin in patients with type 2 diabetes on metformin monotherapy whose target glycemic goal is not reached with diet and exercise.

Materials and methods: A time horizon of 10 years was used to conduct the comparative pharmacoeconomic analysis. The following were used as reference data for the calculations: drug prices, as registered in the VED [Vital Essential Drugs]; earlier publications on the cost of complications; and data on treatment outcomes and hypoglycaemia rates in comparator groups from the JADE modelling study, based upon the data from clinical study 024 for the Russian patient population.

Results: Total medical expenditures for one patient came to 449,927 rubles in the sitabliptin+metformin group, and 415,385 rubles in the sulfonylurea+metformin group – a difference of 7.7%. Within this, the share of costs for the actual drugs was 53% and 11%, respectively, indicating a greater burden due to longterm consequences (hypoglycaemia, complications from type 2 diabetes, transitioning to insulin) for the sulfonylurea group. When converted to 10,000 patients, the cost of the drugs in the sitagliptin group was 2,149 million rubles higher, and the expenditures for complications, including hypoglycaemia and insulin therapy, were 1,559 million rubles lower. Thus, in the sitagliptin group – unlike the sulfonylurea group – 410,000 cases of hypoglycaemia were prevented, as well as 40 cases of macro- and microvascular complications. Conclusion: the results suggest that the combination use of sitagliptin + metformin is pharmacoeconomically justified when compared to sulfonylurea + metformin to treat type 2 diabetes patients.

Arinina E.E., Makarova E.I., Tolordava G.A. 1207

For many years antiplatelet therapy is the basis for the prevention of cardiovascular diseases. Acetylsalicylic acid is the “gold standard” among all antiplatelet drugs. However, ASA administration has an adverse effect in the form of development of NSAID-induced gastropathy To reduce this effect various forms of production of medicines ASA are used. In this study the pharmacoeconomic assessment of drugs Thrombo ASS, Cardiomagnyl and Aspirin Cardio in patients with previous cardiovascular diseases was conducted. According to the results of conducted cost-minimization analysis determined that the treatment scheme with the use of Thrombo ASS is characterized by the lowest cost compared with Cardiomagnyl and Aspirin Cardio. The results of the budget impact analysis suggest that therapy drugs Thrombo ASS leads to budget savings up to 33 million rubles calculated for all patients with cardiovascular diseases in Moscow compared with alternatives.

Arinina E.E., Kulikov A.Y., Tolordava G.A. 993

Blockade of renin-angiotensin system (RAS) remains one of the most main strategies in treatment of arterial hypertension (AH), and drugs blocking this system, mainly angiotensin-converting-enzyme inhibitor (ACEI) and blockers of receptors to angiotensin II, are the main classes of antihypertensive drugs. The presence of different clinical effectiveness of drugs in these groups, as well as different frequencies of occurrence of undesirable cardiovascular events, side effects and formed the basis of pharmacoeconomic (PE) studies. According to the conducted cost-effectiveness analysis, the treatment regimen using Monopril is characterized by lowest cost and the lowest coefficient of cost-effectiveness ratio in the treatment of patients with AH. The results of the budget impact analysis suggest that therapy with Monopril leads to budget savings. The results of the sensitivity analysis demonstrated the adequacy of the performed pharmacoeconomic analysis and the stability of the obtained data – during the change of the cost factors in the range of ± 97% the therapy with the drug Monopril maintained its advantage expressed by the results of the cost-effectiveness analysis. Сost-effectiveness analysis and budget impact analysis were used in this study. The indirect comparison of two antihypertensive drugs was performed: ACEI (fosinopril, ramipril, lisinopril, perindopril) and ARB II (valsartan, losartan, telmisartan, candesartan). Both groups of drugs are not only one of the main classes of antihypertensive drugs, which can be prescribed to all patients with AH, but also have priority indications, such as diabetes mellitus, metabolic syndrome etc. Results of costs analysis show that fosinopril treatment scheme is characterized with total costs - 22 751 rub., with the lowest cost-effectiveness ratio – 285, during the treatment of AH and budget economy from 5 048 rub. to 46 805 rub. per 1 person per year compared with–ramipril, lisinopril, perindopril, valsartan, losartan, telmisartan, candesartan.

Arinina E.E., Serpik V.G. 590

This article provides a comparative pharmacoeconomic evaluation of ambrisentan and bosentan used in the treatment of patients with functional class II or III pulmonary arterial hypertension (PAH) in Russia. The evaluation included methods of cost analysis, cost -minimization analysis, cost-utility analysis and budget impact analysis. The cost analysis revealed that the Volibris (ambrisentan) and Tracleer (bosentan) – associated costs, based on the per-patient per year treatment cost for one patient with PAH regardless of its functional class, were 1 585 649 rubles and 2 488 878 rubles, respectively. The results of cost-minimization analysis, based on the assumption of equal effectiveness of compared drugs, have shown that the per-patient per year treatment costs for Volibris (ambrisentan) allow cost savings of 909 789 rubles as compared to Tracleer (bosentan). The values of a cost-utility analysis for Volibris (ambrisentan) appeared to be lower than those for Tracleer (bosentan). For the former, depending on the functional class of the disease and drug dosage, the values of a cost-utility analysis varied from 2 321 771 rubles to 3 535 685 rubles per QALY, whereas for Tracleer (bosentan) the corresponding values were 4 335 477 rubles and 5 718 143 rubles per QALY in patients with functional class II PAH and functional class III PAH, respectively. The budget impact analysis, based on the estimated number of patients with PAH in RF of 3292 subjects, has shown that the total annual costs for Tracleer (bosentan) would be 8,193 billion rubles versus 5,219 billion rubles had the same patients been treated with Volibris (ambrisentan). Therefore, the possible cost savings with Volibris (ambrisentan) would be 2,973 billion rubles had it been used instead of Tracleer (bosentan), thus indicating that from the pharmacoeconomic perspective treatment with Volibris (ambrisentan) is a dominant choice.

Arinina E.E., Rashid M.A. 279

According to the first Global Report of the WHO, diabetes mellitus is an important public health problem, one of four priority noncommunicable diseases (NCDs) targeted for action by world leaders. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades. In the estimation of the WHO, 422 million adults were living with diabetes in 2014, compared to 108 million in 1980. The global prevalence (age-standardized) of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population.