Tolkushin A G

Arinina E.E., Kulikov A.Y., Novikov I.V., Tolkushin A.G. 2630

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.

Davydovskaya M.V., Ermolaeva T.N., Kokushkin K.A., Tolkushin A.G., Yagudina R.I. 400

1 Clinical Trials and Healthcare Technology Assessment Centre of Moscow Department of Healthcare, Moscow, Russia 2 First Moscow State Medical University I.M. Sechenov (Sechenov University), Moscow, Russia

Andreev D.A., Davydovskaya M.V., Ermolaeva T.N., Kokushkin K.A., Tolkushin A.G. 44

OBJECTIVE: To compare and identify differences in the economic burden of multiple sclerosis amount and structure in European countries and in Russia. MATERIALS AND METHODS: The results of the cross-sectional observational retrospective study of the socio-economic burden of multiple sclerosis “New insights into the burden and costs of multiple sclerosis in Europe” were taken as an input data for the current article. The study was held in 16 European countries: Austria, Belgium, Hungary, Great Britain, Germany, Denmark, Spain, Italy, Netherlands, Poland, Portugal, Russia, France, Czech Republic, Switzerland, Sweden. The study reported data was divided by the following groups: direct costs (healthcare costs: inpatient care, day admission, consultations, tests, medication, disease-modifying treatments (DMTs), services and informal care costs) and indirect (short-term absence, long-term absence, invalidity, early retirement). We conducted an in-depth comparative cost structure analysis in the countries examined. As the costs were presented in terms of severity according to the EDSS scale, the average weighted cost was calculated considering the proportion of patients with different severity. We analyzed costs per patient, including direct medical costs, costs of DMTs, as well as indirect costs, and besides that the total cost for each country (total damage) based on the prevalence of multiple sclerosis was calculated. To describe the cost structure, the following ratios were developed: DMTs share of total cost, total cost to GDP per capita. With the help of the range ranking minimum, maximum, average, median, and also standard (mean square) deviation values were determined. RESULTS: The total average cost per patient with multiple sclerosis per year for any European country examined was about 2 million rubles. ± 882 thousand rubles, for Russia - 671 thousand rubles. (minimum value). The average direct costs per patient reaches 949 ± 370 thousand rubles in general, in Russia it is 464 thousand rubles (the minimum value). The DMTs costs in the structure of total costs were highest in Russia (57.16%) with an average value of 30.97% ± 14.36%. The lowest DMTs costs were in the UK (11.49%), Netherlands (10.07%) and Sweden (10.04%). The total multiple sclerosis burden for the country with an allowance for the prevalence of the disease, ranged from 393 billion rubles in Germany to 8.8 billion rubles in Hungary (in Russia - 78.8 billion rubles). The average of total costs to GDP per capita ratio for all countries was 84.64% ± 23.06%, for Russia - 41.05% (minimum value). CONCLUSION: In Russia, the economic burden of multiple sclerosis (including direct and indirect costs) is relatively small in comparison with European countries; while the share of DMTs costs in Russia is the highest among the countries surveyed.

Arinina E.E., Kulikov A.Y., Novikov I.V., Tolkushin A.G. 2630

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.

Davydovskaya M.V., Ermolaeva T.N., Kokushkin K.A., Tolkushin A.G., Yagudina R.I. 400

1 Clinical Trials and Healthcare Technology Assessment Centre of Moscow Department of Healthcare, Moscow, Russia 2 First Moscow State Medical University I.M. Sechenov (Sechenov University), Moscow, Russia

Andreev D.A., Davydovskaya M.V., Ermolaeva T.N., Kokushkin K.A., Tolkushin A.G. 44

OBJECTIVE: To compare and identify differences in the economic burden of multiple sclerosis amount and structure in European countries and in Russia. MATERIALS AND METHODS: The results of the cross-sectional observational retrospective study of the socio-economic burden of multiple sclerosis “New insights into the burden and costs of multiple sclerosis in Europe” were taken as an input data for the current article. The study was held in 16 European countries: Austria, Belgium, Hungary, Great Britain, Germany, Denmark, Spain, Italy, Netherlands, Poland, Portugal, Russia, France, Czech Republic, Switzerland, Sweden. The study reported data was divided by the following groups: direct costs (healthcare costs: inpatient care, day admission, consultations, tests, medication, disease-modifying treatments (DMTs), services and informal care costs) and indirect (short-term absence, long-term absence, invalidity, early retirement). We conducted an in-depth comparative cost structure analysis in the countries examined. As the costs were presented in terms of severity according to the EDSS scale, the average weighted cost was calculated considering the proportion of patients with different severity. We analyzed costs per patient, including direct medical costs, costs of DMTs, as well as indirect costs, and besides that the total cost for each country (total damage) based on the prevalence of multiple sclerosis was calculated. To describe the cost structure, the following ratios were developed: DMTs share of total cost, total cost to GDP per capita. With the help of the range ranking minimum, maximum, average, median, and also standard (mean square) deviation values were determined. RESULTS: The total average cost per patient with multiple sclerosis per year for any European country examined was about 2 million rubles. ± 882 thousand rubles, for Russia - 671 thousand rubles. (minimum value). The average direct costs per patient reaches 949 ± 370 thousand rubles in general, in Russia it is 464 thousand rubles (the minimum value). The DMTs costs in the structure of total costs were highest in Russia (57.16%) with an average value of 30.97% ± 14.36%. The lowest DMTs costs were in the UK (11.49%), Netherlands (10.07%) and Sweden (10.04%). The total multiple sclerosis burden for the country with an allowance for the prevalence of the disease, ranged from 393 billion rubles in Germany to 8.8 billion rubles in Hungary (in Russia - 78.8 billion rubles). The average of total costs to GDP per capita ratio for all countries was 84.64% ± 23.06%, for Russia - 41.05% (minimum value). CONCLUSION: In Russia, the economic burden of multiple sclerosis (including direct and indirect costs) is relatively small in comparison with European countries; while the share of DMTs costs in Russia is the highest among the countries surveyed.