Egorova S N
Twelve traditional therapeutic schemes of infusion-detoxification therapy of budget narcological hospitals of the Republic of Tatarstan and also an innovative scheme with greater efficiency were evaluated and compared from the viewpoint of pharmacoeconomics in this research. Analysis of effectiveness showed that innovation scheme, one bed in resuscitation of narcological hospital can serve the needs of 93 patients per year, i.e. bedspace will be in use more intensively. During treatment according to traditional schemes the indicator of the “function hospital bed” was equal to 56 and 70 patients a year. The analysis of the cost showed that the maximum annual budget of traditional therapy is represented on the scheme №3 (1 050 560 RUB), and the minimum one is on the scheme №9 (893 200 RUB). The budget of innovative scheme was 1 452 906 RUB. The innovative scheme of infusion-detoxification therapy according to the analysis was more effective, but the therapy was more expensive. During the research of the cost of the structure with innovative treatment scheme it was found out that the greatest part of the cost (38%) is the cost of pharmacotherapy. The analysis of “cost minimization” allowed choosing among the traditional schemes of infusion-detoxification therapy the most optimal variant. According to “budget impact” analysis the transfer of 50% of patients to the innovative therapies, would require a budget increase to 2,2%, and for transfering 100% of patients on the new scheme of the IDT the budget increase must be 6% relative to 100% applications of traditional schemes in regional narcological hospital.
Patients with cardiovascular diseases need systematic monitoring of the main parameters of the cardiovascular system on an outpatient basis using special medical devices. The aim of the study is to conduct an assortment analysis of medical devices intended for use at home by patients with cardiovascular diseases. Materials and methods: The objects of the study were clinical recommendations for the treatment of diseases of the cardiovascular system (12); State Register of Medical Devices of the Russian Federation; Internet sites of pharmacy chains of the Republic of Tatarstan (5), sites of Internet pharmacies (1); data of the reference service “003” State Unitary Enterprise “Medical equipment and pharmacy of Tatarstan”. The work uses the methods of content analysis, logical, structural, graphic analysis. Price segmentation was carried out using the Sturgess grouping method. Results. An analysis of clinical guidelines for the prevention and treatment of diseases of the cardiovascular system was carried out to identify the main control parameters required on an outpatient basis. The groups of medical devices used by patients on their own have been determined: tonometers, pulse oximeters and diagnostic tests. The analysis of the State Register of Medical Products and Pharmacy Assortment of the Republic of Tatarstan was carried out in order to identify the availability of medical products to the population. Price segmentation of the studied groups of medical devices was carried out in order to determine consumer opportunities; the indicators of the completeness of the assortment were calculated. A wide range of tonometer models is presented in pharmacies of the Republic of Tatarstan. More than 60% of mechanical and automatic blood pressure monitors are in the low segment; the indicator of the completeness of the assortment Kp = 0.83, which allows satisfying the needs of patients. 50% of the assortment group “pulse oximeters” sold from pharmacies belongs to the low price segment; assortment completeness indicator Kp = 0.29. Diagnostic tests implemented in the Republic of Tatarstan are represented by express tests for the determination of ketones in blood and urine; assortment completeness indicator Kp = 0.31. The price segmentation of test systems is largely determined by the need to use additional instruments (analyzers). 75% of the total number of express tests presented on the pharmaceutical market of the Republic of Tatarstan belong to the middle price segment. Conclusions. As of March 2021, 950 medical devices used in the diagnosis and treatment of cardiovascular diseases were registered on the domestic market. At the same time, 22.6% can be used at home and are sold to the population by pharmacy organizations. For self-monitoring of indicators of the cardiovascular system on an outpatient basis, tonometers, test systems and heart rate monitors are used. Their share of the total number of registered medical devices used in the diagnosis and treatment of cardiovascular diseases is 17%. The price segmentation of the studied groups of medical devices indicates the availability of their purchase by customers with high and medium paying capacity. The prospects for expanding the range of medical products for independent use by patients with cardiovascular diseases in the regional pharmaceutical market have been identified.
About 30% of the population of the planet Earth suffers from allergic diseases (AD). Allergic conditions involve multiple body organs and systems and their presentation may vary. This variable presentation makes it difficult for a pharmacist to choose and offer a patient the most effective and safe medication while also explaining the patient why the offered over the counter medication (OTC medication) is the most appropriate for them. A pharmacist may greatly benefit from knowing what OTC medicines are preferred by physicians - allergists when treating certain types of allergic diseases (AD). The goal of the study: analysis of physician’s preferences when treating certain types of AD using different pharmacologic groups of OTC allergy medications and comparison of the obtained data with clinical recommendations (CR) with a goal of using the results for clinical consultations of the patients at the pharmacy. METHODS: a group expert opinion method using a questionnaire was used to collect expert opinions of 16 physicians-allergists. This questionnaire contained comparison OTC allergy medications that are used for treatment of certain AD. A Method of Main Components (MMC) model was used for creating of matrix «Effectiveness of OTC allergy medications». RESULTS: the study found that the main sources of knowledge about allergy medications for physicians-allergists are clinical recommendations and standards of treatment (56,25%), and the effectiveness serves as the most important factor when choosing between allergy medications (4.96 points out of 6). Graphically represented MMC model revealed 2 main trends concerning symptoms of AD: 1) symptoms of allergic rhinitis (AR) and allergic conjunctivitis (AC) and 2) skin symptoms of allergic dermatitis (Al D). MMC model allowed for interpretation of data allowing comparison of OTC allergy medications effectiveness in relieving of AD symptoms. This made possible grouping of OTC allergy medications into clusters: 1) the most effective in relieving systemic and local symptoms of AR and AC, 2) the most effective in relieving systemic and local symptoms of Al D, and 3) oral OTC allergy medications equally effective in relieving of both symptoms of AR/AC and Al D. CONCLUSION: study results allowed to reveal OTC allergy medications preferences of physicians-allergists for relieving symptoms of certain allergic conditions. A database of OTC allergy medications was created to facilitate pharmacy consulting for a responsive self-treatment of allergy with consideration of an individual patient’s symptoms. Theoretical knowledge about different groups of OTC allergy medications, their properties and characteristics, combined with new insights about their effectiveness and safety based on practical knowledge of physicians-allergists, will allow a pharmacist to provide consulting better suited to individual patient’s needs.
Twelve traditional therapeutic schemes of infusion-detoxification therapy of budget narcological hospitals of the Republic of Tatarstan and also an innovative scheme with greater efficiency were evaluated and compared from the viewpoint of pharmacoeconomics in this research. Analysis of effectiveness showed that innovation scheme, one bed in resuscitation of narcological hospital can serve the needs of 93 patients per year, i.e. bedspace will be in use more intensively. During treatment according to traditional schemes the indicator of the “function hospital bed” was equal to 56 and 70 patients a year. The analysis of the cost showed that the maximum annual budget of traditional therapy is represented on the scheme №3 (1 050 560 RUB), and the minimum one is on the scheme №9 (893 200 RUB). The budget of innovative scheme was 1 452 906 RUB. The innovative scheme of infusion-detoxification therapy according to the analysis was more effective, but the therapy was more expensive. During the research of the cost of the structure with innovative treatment scheme it was found out that the greatest part of the cost (38%) is the cost of pharmacotherapy. The analysis of “cost minimization” allowed choosing among the traditional schemes of infusion-detoxification therapy the most optimal variant. According to “budget impact” analysis the transfer of 50% of patients to the innovative therapies, would require a budget increase to 2,2%, and for transfering 100% of patients on the new scheme of the IDT the budget increase must be 6% relative to 100% applications of traditional schemes in regional narcological hospital.
Patients with cardiovascular diseases need systematic monitoring of the main parameters of the cardiovascular system on an outpatient basis using special medical devices. The aim of the study is to conduct an assortment analysis of medical devices intended for use at home by patients with cardiovascular diseases. Materials and methods: The objects of the study were clinical recommendations for the treatment of diseases of the cardiovascular system (12); State Register of Medical Devices of the Russian Federation; Internet sites of pharmacy chains of the Republic of Tatarstan (5), sites of Internet pharmacies (1); data of the reference service “003” State Unitary Enterprise “Medical equipment and pharmacy of Tatarstan”. The work uses the methods of content analysis, logical, structural, graphic analysis. Price segmentation was carried out using the Sturgess grouping method. Results. An analysis of clinical guidelines for the prevention and treatment of diseases of the cardiovascular system was carried out to identify the main control parameters required on an outpatient basis. The groups of medical devices used by patients on their own have been determined: tonometers, pulse oximeters and diagnostic tests. The analysis of the State Register of Medical Products and Pharmacy Assortment of the Republic of Tatarstan was carried out in order to identify the availability of medical products to the population. Price segmentation of the studied groups of medical devices was carried out in order to determine consumer opportunities; the indicators of the completeness of the assortment were calculated. A wide range of tonometer models is presented in pharmacies of the Republic of Tatarstan. More than 60% of mechanical and automatic blood pressure monitors are in the low segment; the indicator of the completeness of the assortment Kp = 0.83, which allows satisfying the needs of patients. 50% of the assortment group “pulse oximeters” sold from pharmacies belongs to the low price segment; assortment completeness indicator Kp = 0.29. Diagnostic tests implemented in the Republic of Tatarstan are represented by express tests for the determination of ketones in blood and urine; assortment completeness indicator Kp = 0.31. The price segmentation of test systems is largely determined by the need to use additional instruments (analyzers). 75% of the total number of express tests presented on the pharmaceutical market of the Republic of Tatarstan belong to the middle price segment. Conclusions. As of March 2021, 950 medical devices used in the diagnosis and treatment of cardiovascular diseases were registered on the domestic market. At the same time, 22.6% can be used at home and are sold to the population by pharmacy organizations. For self-monitoring of indicators of the cardiovascular system on an outpatient basis, tonometers, test systems and heart rate monitors are used. Their share of the total number of registered medical devices used in the diagnosis and treatment of cardiovascular diseases is 17%. The price segmentation of the studied groups of medical devices indicates the availability of their purchase by customers with high and medium paying capacity. The prospects for expanding the range of medical products for independent use by patients with cardiovascular diseases in the regional pharmaceutical market have been identified.
About 30% of the population of the planet Earth suffers from allergic diseases (AD). Allergic conditions involve multiple body organs and systems and their presentation may vary. This variable presentation makes it difficult for a pharmacist to choose and offer a patient the most effective and safe medication while also explaining the patient why the offered over the counter medication (OTC medication) is the most appropriate for them. A pharmacist may greatly benefit from knowing what OTC medicines are preferred by physicians - allergists when treating certain types of allergic diseases (AD). The goal of the study: analysis of physician’s preferences when treating certain types of AD using different pharmacologic groups of OTC allergy medications and comparison of the obtained data with clinical recommendations (CR) with a goal of using the results for clinical consultations of the patients at the pharmacy. METHODS: a group expert opinion method using a questionnaire was used to collect expert opinions of 16 physicians-allergists. This questionnaire contained comparison OTC allergy medications that are used for treatment of certain AD. A Method of Main Components (MMC) model was used for creating of matrix «Effectiveness of OTC allergy medications». RESULTS: the study found that the main sources of knowledge about allergy medications for physicians-allergists are clinical recommendations and standards of treatment (56,25%), and the effectiveness serves as the most important factor when choosing between allergy medications (4.96 points out of 6). Graphically represented MMC model revealed 2 main trends concerning symptoms of AD: 1) symptoms of allergic rhinitis (AR) and allergic conjunctivitis (AC) and 2) skin symptoms of allergic dermatitis (Al D). MMC model allowed for interpretation of data allowing comparison of OTC allergy medications effectiveness in relieving of AD symptoms. This made possible grouping of OTC allergy medications into clusters: 1) the most effective in relieving systemic and local symptoms of AR and AC, 2) the most effective in relieving systemic and local symptoms of Al D, and 3) oral OTC allergy medications equally effective in relieving of both symptoms of AR/AC and Al D. CONCLUSION: study results allowed to reveal OTC allergy medications preferences of physicians-allergists for relieving symptoms of certain allergic conditions. A database of OTC allergy medications was created to facilitate pharmacy consulting for a responsive self-treatment of allergy with consideration of an individual patient’s symptoms. Theoretical knowledge about different groups of OTC allergy medications, their properties and characteristics, combined with new insights about their effectiveness and safety based on practical knowledge of physicians-allergists, will allow a pharmacist to provide consulting better suited to individual patient’s needs.
