Kulikov Andrey Yurievich

professor of Department of organization of medical provision and pharmacoeconomics, I.M. Sechenov First Moscow State Medical University Moscow,Russia
Babiy V.V., Kulikov A.Y. 182

The objectives of this study were to determine the most advantageous antiviral therapy option for chronic hepatitis C (CHC) (peginterferon alfa + ribavirin (PegIFN + RBV) 48 weeks (F0–F4), peginterferon alfa + simeprevir + ribavirin (PegIFN + SMV + RBV) 24 weeks (F0–F4), peginterferon alfa + sofosbuvir + ribavirin (PegIFN + SOF + RBV) 12 weeks (F0–F4), dasabuvir + ombitasvir/paritaprevir/ritonavir (Dasabuvir + Ombitasvir/ paritaprevir/ritonavir) 12 weeks (F0–F3) and dasabuvir + ombitasvir/ paritaprevir/ritonavir + ribavirin (Dasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV) 12 weeks (F4)) among treatment-naive and treatment-experienced patients (HCV genotype 1) based on the comparison of cost-effectiveness ratios and economic outcomes (“budget impact” analysis) from implementing the treatment strategy PegIFN-α + SOF + RBV instead of PegIFN-α + RBV, PegIFN-α + SIM + RBV and Dasabuvir + Ombitasvir/paritaprevir/ritonavir. Model-based pharmacoeconomic analysis has been conducted. The costeffectiveness analysis showed that independently of the former treatment experience of CHC (genotype 1) patients the combination PegIFN-α + SOF + RBV was a predominant regimen as compared to PegIFN-α + RBV and PegIFN-α + SMV + RBV. In the groups of patients without cirrhosis and with cirrhosis the highest QALY value was noted for Dasabuvir + Ombitasvir/ paritaprevir/ritonavir and Dasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV combinations, respectively. Also a smaller cost-effectiveness ratio (CER) relative to the two above regimens was noted for PegIFN-α + SOF + RBV. In the group of treatment-naive patients without cirrhosis incremental costeffectiveness ratio (ICER) of Dasabuvir + Ombitasvir/paritaprevir/ritonavir vs PegIFN-α + SOF + RBV was higher than willingness-to-pay threshold (WPT), whereas in the group of patients with cirrhosis ICERDasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV vs PegIFN-α + SOF + RBV was lower than WPT. Using “budget impact” analysis it was shown that switching to PegIFN-α + SOF + RBV from PegIFN-α + RBV regimen will involve extra direct costs for antiviral treatment (AVT), but will lead to a reduction in medical aid costs to the patients not reaching SVR, patients with CHC complications and, as a consequence, will lead to a reduction in cumulative medical costs. Moreover, transition from PegIFN-α + SMV + RBV, Dasabuvir + Ombitasvir/paritaprevir/ ritonavir and Dasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV to PegIFN-α + SOF + RBV will lead to a reduction in both AVT costs and cumulative medical costs.

Glushchenko A.A., Kulikov A.Y., Yagudina R.I. 182

This paper is devoted to assessment of economic burden of excessive alcohol consumption in Russian Federation. In the course of analysis, we gathered data about direct costs of treatment of conditions, directly or indirectly caused by excessive alcohol consumption, and indirect costs. A total burden of excessive alcohol consumption is more than 547 billion rubles, which makes up to 0,68% of Russia’s GDP for the year 2015. Since 2010 the burden has decreased by nearly 100 billion rubles, and the decrease of burden in relative values from 1,98% to 0,68% of GDP, which gives the evidence of the effectiveness of the government policy in the sphere of alcohol consumption control.

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Babiy V.V., Kulikov A.Y. 182

The objectives of this study were to determine the most advantageous antiviral therapy option for chronic hepatitis C (CHC) (peginterferon alfa + ribavirin (PegIFN + RBV) 48 weeks (F0–F4), peginterferon alfa + simeprevir + ribavirin (PegIFN + SMV + RBV) 24 weeks (F0–F4), peginterferon alfa + sofosbuvir + ribavirin (PegIFN + SOF + RBV) 12 weeks (F0–F4), dasabuvir + ombitasvir/paritaprevir/ritonavir (Dasabuvir + Ombitasvir/ paritaprevir/ritonavir) 12 weeks (F0–F3) and dasabuvir + ombitasvir/ paritaprevir/ritonavir + ribavirin (Dasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV) 12 weeks (F4)) among treatment-naive and treatment-experienced patients (HCV genotype 1) based on the comparison of cost-effectiveness ratios and economic outcomes (“budget impact” analysis) from implementing the treatment strategy PegIFN-α + SOF + RBV instead of PegIFN-α + RBV, PegIFN-α + SIM + RBV and Dasabuvir + Ombitasvir/paritaprevir/ritonavir. Model-based pharmacoeconomic analysis has been conducted. The costeffectiveness analysis showed that independently of the former treatment experience of CHC (genotype 1) patients the combination PegIFN-α + SOF + RBV was a predominant regimen as compared to PegIFN-α + RBV and PegIFN-α + SMV + RBV. In the groups of patients without cirrhosis and with cirrhosis the highest QALY value was noted for Dasabuvir + Ombitasvir/ paritaprevir/ritonavir and Dasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV combinations, respectively. Also a smaller cost-effectiveness ratio (CER) relative to the two above regimens was noted for PegIFN-α + SOF + RBV. In the group of treatment-naive patients without cirrhosis incremental costeffectiveness ratio (ICER) of Dasabuvir + Ombitasvir/paritaprevir/ritonavir vs PegIFN-α + SOF + RBV was higher than willingness-to-pay threshold (WPT), whereas in the group of patients with cirrhosis ICERDasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV vs PegIFN-α + SOF + RBV was lower than WPT. Using “budget impact” analysis it was shown that switching to PegIFN-α + SOF + RBV from PegIFN-α + RBV regimen will involve extra direct costs for antiviral treatment (AVT), but will lead to a reduction in medical aid costs to the patients not reaching SVR, patients with CHC complications and, as a consequence, will lead to a reduction in cumulative medical costs. Moreover, transition from PegIFN-α + SMV + RBV, Dasabuvir + Ombitasvir/paritaprevir/ ritonavir and Dasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV to PegIFN-α + SOF + RBV will lead to a reduction in both AVT costs and cumulative medical costs.

Glushchenko A.A., Kulikov A.Y., Yagudina R.I. 182

This paper is devoted to assessment of economic burden of excessive alcohol consumption in Russian Federation. In the course of analysis, we gathered data about direct costs of treatment of conditions, directly or indirectly caused by excessive alcohol consumption, and indirect costs. A total burden of excessive alcohol consumption is more than 547 billion rubles, which makes up to 0,68% of Russia’s GDP for the year 2015. Since 2010 the burden has decreased by nearly 100 billion rubles, and the decrease of burden in relative values from 1,98% to 0,68% of GDP, which gives the evidence of the effectiveness of the government policy in the sphere of alcohol consumption control.

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Professor of the Department of organization of drug supply and pharmacoeconomics, leading researcher pharmacoeconomic studies of the Laboratory Research Institute of Pharmacy, First MGMU them. IM Sechenov. Moscow, Russia