Pharmacoeconomics: theory and practice
№4, 2022, Vol.10
The article presents an analysis of development trends, as well as the dynamics of dominance and competition among drug manufacturers, distributors, and pharmacy chains in the Russian pharmaceutical market. The authors analyzed the mergers and acquisitions that took place in the pharmaceutical market, as well as data on the shares of leading companies in each market segment from 2004 to 2021 to identify dominance and determine the level of differentiation in the dominant groups. The Linda and Herfindahl-Hirschman indices, as well as the SV matrix (strength/variety) and concentration coefficients were used as analysis tools. In the market of drug manufacturers, both domestic and foreign companies have significant obstacles to consolidating and increasing their share. In this regard, the dominance of manufacturers in the market was not found. The distributor market, which had been in a state of “natural oligopoly” for a long time (B4 quadrant), turned into a “red ocean” state (RO quadrant) due to the loss of aggregate market share by the dominant group. The pharmacy chain market, on the contrary, has consolidated, and in the last four years a dominant group has appeared on it, and now the market is moving from the “red ocean” state (RO quadrant) to the “natural oligopoly” (B4 quadrant). Major players such as the multi-gamma alpha company ASNA, the IRIS partnership, and the interconnected networks resulting from mergers and acquisitions began to stand out. The results of the analysis indicate an increase in the importance of pharmacy chains against the background of a deterioration in the positions of distributors, and also reflect the development trends of the pharmaceutical market.
Diabetic retinopathy (DR) is a specific neuromicrovascular complication of diabetes mellitus. Diabetic macular edema (DME) is a retinal thickening associated with fluid accumulation in the intercellular space of the neuroep- ithelium due to hematoretinal barrier failure and mismatch between fluid transudation and reabsorption ability of the pigment epithelium cells. Treat- ment of DR and DME appears to be costly, but there are no data on the economic burden of the disease in the Russian Federation. The analysis of direct (the cost of medications, laboratory and instrumental methods of research, the cost of medical products, etc.), indirect (the patient’s lost income in connection with temporary disability, disability payments) and indirect (loss of gross domestic product, etc.) expenses for DR and DMD was carried out. When calculated for the total population of patients with DR and DMD, the total costs amounted to 466,777,104,440 rubles. Of these, RUB 24,059,855,774 were costs for patients with DR, RUB 11,428,438,452 were costs for patients with DMO, RUB 260,078,000,343 were costs for patients with clinically significant DMO, and RUB 171,210,809,871 were costs for patients with clinically significant DMO in both eyes. Direct medical costs accounted for most of the total economic burden (62.44%).
To determine the feasibility of using cluster analysis to manage treatment costs of systemic autoimmune rheumatic diseases (SARDs). MATERIALS AND METHODS. The object of the study was the case histories of patients hospitalized in 2020. A total of 954 case histories of patients with SARDs were analyzed, among them systemic scleroderma – 411 patients (43.1%), systemic lupus erythematosus – 263 (27.5%), rheumatoid arthritis seropositive and seronegative – 103 (10.8%), systemic vasculitis associated with anti-neutrophil cytoplasmic antibodies – 98 (10.3%), idiopathic inflam- matory myopathies (polymyositis, dermatomyositis) – 57 (6%), Sjögren’s disease – 22 (2.3%). Hierarchical cluster analysis by weighted pairwise mean using Euclidean distance and Chebyshev distance, and non-hierarchical clus- tering by k-means were performed for the sample of case histories in the STA- TISTICA 13.3. Multiple regression model with a dependent factor of treatment costs was built in MS Excel. RESULTS. Hierarchical clustering resulted in 2 dendrograms, which yielded the same number of clusters – 4. The cluster analysis identified 4 clusters with significant differences (p<0.05) in treatment costs with formative indicators: gender, age of patients, duration of disease, number of bed-days, number of hospitalizations, disease activity level, number of comorbidities and compli- cations, previous use of biologic agents, total number of medications pre- scribed, use of Acellbia, Benlista, other biologic agents, and immunoglobulins during hospitalization. General multiple regression model for all patients with SARDs and separate multiple regression models for each cluster were con- structed using statistically significant factors. CONCLUSIONS. Factors affecting the treatment costs for patients with SARDs include the number of days of hospitalization, the degree of disease activity, the number of medications prescribed, and the use of biologic agents and immunoglobulins during hospitalization.
Analysis of the quality of life of patients with prostate cancer on hormone therapy using information technology
Malignant neoplasms of the prostate gland are the second most common malignant disease in the male population after lung cancer. Prostate cancer is the type of diseases, which can only be controlled, but not completely cured. The purpose of this article is to study the quality of life of patients with prostate cancer on hormonal therapy with the drug buserelin, which depends on the frequency of injection and combination with the drug bicalutamide. Methods: the results of analyses 70 questionnaires of patients with prostate cancer, diagnosed with locally advanced prostate cancer, aged 68 to 75 years. There were analyzed using data processing programs: Statistica 10.0. and MS Excel. Results: according to the data obtained, the treatment regimen consisting of buserelin and bicalutamide received the highest score for general health and emotional state. Most often, patients suffer from symptoms: «fatigue», «shortness of breath», «insomnia», which increase as the duration of the injection therapy of Buserelin increases. Conclusion: the results of the study showed the need to develop organizational technologies for optimizing drug supply for oncourological patients by introducing mechanisms for recording data on the quality of life on various types of therapy in medical records.