Pharmacoeconomics: theory and practice
№4, 2024, Vol.12

The article presents the results of an analysis of the direct costs of treating tuberculosis patients with various types of drug resistance combined with HIV infection in the Republic of Karelia, as well as calculations of the clinical and economic effectiveness of treatment of combined infection. It was found that the cost of treating one patient with tuberculosis combined with HIV infection varied depending on the type of drug resistance: from 316,828 rubles with preserved drug sensitivity to 1,210,470 rubles with very wide drug resistance. A significant part of the costs fell on inpatient treatment, which cost from 234,277 to 273,619 rubles, while the average duration of hospitalization was 2-3 times higher than the average European standards. Indicators of clinical and economic efficiency, reflecting the cost of therapy, taking into account the effectiveness of treatment of patients with tuberculosis combined with HIV infection, increase three times, compared with direct costs, for multidrug-resistant and extremely drug-resistant tuberculosis (1,916,584 rubles and 3,631,411 rubles) due to the low effectiveness of treatment.

Pharmacoeconomic analysis aims to assess the cost and effectiveness of medical interventions, including medicines, diagnostic procedures, treatments, to ensure rational allocation of resources. The article analyses publications in this field over a five-year period in the Russian Federation. STUDY OBJECTIVE: search and analysis of pharmacoeconomic studies published in the Russian Federation over a five-year period. METHODS: an information search was conducted using the keywords «pharmacoeconomics», «pharmacoeconomic analysis», «clinical-economic analysis», «pharmacoeconomic modelling», «pharmacoeconomic research», «pharmacoeconomic aspects», «clinical epidemiology», «pharmacoepidemiology», «disease burden», «effectiveness analysis», «cost analysis», «budget impact analysis», «cost-effectiveness analysis», «cost–utility analysis», «modelling», « methodology of pharmacoeconomic analysis», «costs», «direct costs», «indirect costs», «cost burden», «cost-effectiveness», «evaluation of pharmacoeconomic indicators», «cost of treatment», «methodology», «evaluation of health care technologies» in eLIBRARY and CyberLeninca databases.

AIM. To estimate treatment costs depending on the sensitivity of the bacterial flora to perioperative antibiotics (PA) in patients undergoing pancreaticoduo- denectomy (PDR). MATERIALS AND METHODS. This retrospective study included patients who underwent PDR at the Moscow Clinical Research Center named after A. S. Loginov. 108 patients met the inclusion criteria; they were divided into two groups: patients with bile flora resistant to PA and patients with bile flora sen- sitive to PA. Subsequently, the course of the postoperative period was assessed: the incidence of complications in the study groups, including SSI, du- ration of hospitalization, assessment of the costs of diagnosis and treatment, as well as drug provision. The source for calculating the costs of diagnosis and treatment was the official Price List of the at the A. S. Loginov Moscow Clinical Research Center in 2024. Cost estimates for medicines were made according to the state register of maximum selling prices of manufacturers included in the list of vital and essential medicines. Statistical data analysis was carried out using the statistical package R 3.4.2 (USA). The study used methods of descriptive statistics, the Mann-Whitney U test to compare two independent samples, the chi-square test and Fisher’s exact test to analyze contingency tables. CONCLUSION. In cases of a personalized approach to the selection of an antibacterial drug for perioperative use during PDR, the risk of SSI can be significantly reduced and the costs of a completed case of medical care can be reduced.

THE AIM is to develop an approach to rationalize the choice of drugs used in the treatment of malignant neoplasms of the prostate gland. MATERIALS AND METHODS. The materials were: State Register of Medicines of the Russian Federation; standards of medical care and clinical recommendations for the treatment of malignant neoplasms of the prostate gland; data from the software for the preferential supply «L`gota-2014» of the pharmacy chain of the State Autonomous Institution «Regional Pharmacy Warehouse»; data on the quality of life of patients with malignant neoplasms of the prostate gland on hormonal therapy (70 questionnaires) and expert assessment of the effectiveness and safety of drugs used in the treatment of malignant neoplasms of the prostate gland (9 questionnaires). During the research, the following methods were used: documentary and sociological research, structural-logical, situational, ABC-analysis and the method of expert assessment of the effectiveness and safety of anticancer drugs. RESULTS. The justification and development of an approach to rationalizing the choice of drugs used in the treatment of malignant neoplasms of the prostate gland was carried out on the basis of a study of: the range of drugs used in the treatment of malignant neoplasms of the prostate gland, registered and recommended for use in the Russian Federation for patients with malignant neoplasms of the prostate gland; a list of drugs purchased within the framework of the regional benefit and the system for providing the necessary drugs used in the treatment of malignant neoplasms of the prostate gland, including an ABC analysis of the purchase of drugs used in the treatment of malignant neoplasms of the prostate gland at the outpatient level of medical care; results of assessing the quality of life of patients with malignant neoplasms of the prostate gland and expert assessment of the effectiveness and safety of drugs recommended for use for the treatment of malignant neoplasms of the prostate gland. The conducted studies made it possible to formulate criteria for inclusion of the studied drugs used in the treatment of diarrhea in: rational lists of drugs for drug provision of the population within the framework of state guarantee programs for the provision of free medical care to citizens for regional procurement at the inpatient and outpatient levels; a rational list of drugs for organizing drug supply to the population at the expense of citizens’ personal funds for pharmacy organizations. CONCLUSION. The developed rational lists of drugs used in the treatment of malignant neoplasms of the prostate gland have been introduced into practical activities related to the organization of drug provision for urological cancer patients at the regional level.