Pharmacoeconomics: theory and practice
№2, 2025, Vol.13

The emergence of modern lipid-lowering drugs (alirocumab, inclisiran, evolocumab) for the treatment of patients with hypercholesterolemia poses the problem of justifying the choice of optimal therapeutic approaches not only from a clinical but also from an organizational and economic point of view. METHODS: For this purpose, an assessment of the features of budget planning was carried out when providing patients with these drugs based on a budget impact analysis. RESULTS: The conducted cost analysis showed that the lowest annual cost of treating one patient is for inclisiran - 320,100 rubles in the first year and 213,400 rubles in subsequent years, the annual cost of both alirocumab and evolocumab was higher and amounted to 380,380 rubles and 352,021 rubles, respectively. Cost savings for inclisiran over two years were 29.87% and 24.22% compared to alirocumab and evolocumab, respectively, and will tend to increase over time due to the reduction in the number of injections in the second and subsequent years. For the funds required to treat 10 patients with alirocumab and evolocumab for two years, 14 and 13 people, respectively, can be treated with inclisiran. Cold chain conditions for transportation and storage are not required for inclisiran, but are required for alirocumab and evolocumab, accounting for a small proportion of the costs of the drugs in question, but may require additional organizational measures and time resources. CONCLUSION: The conducted assessment of the features of budget planning when providing patients with lipid metabolism disorders demonstrated that with comparable clinical efficacy of alirocumab, inclisiran and evolocumab, the choice of inclisiran compared to alternatives is accompanied not only by significant cost savings, but also avoids the risks of violating the conditions of compliance with the “cold chain” during transportation and storage of the drug. The minimum frequency and frequency of administration of inclisiran ensures better patient compliance with therapy compared to alirocumab and evolocumab, which in real clinical practice can contribute to achieving better control over hypercholesterolemia, which in turn is an important indicator of the effectiveness of dispensary monitoring of patients with coronary heart disease, as well as those who have suffered cardiovascular events. This indicator is monitored within the framework of the Federal Project “Fight against Cardiovascular Diseases”, the main goal of which is to reduce cardiovascular mortality in Russia.

Starting in 2020, the insurance market in Russia has faced a number of challenges, which are significantly reflected in the development strategies of insurance companies and the sets of products they offer. As a result of several successive crises, such as the COVID-19 pandemic and the post-2022 crisis, insurers’ approach to Voluntary Medical Insurance (VMI) and Drug Insurance (DI) programs has changed significantly. The purpose of the study is to measure the flexibility of VMI and DI products in the Russian Federation and assess their content content. The article presents the results of a study of VMI and programs offered by the largest Russian insurance companies, which together receive almost 80% of all insurance premiums. The content analysis of the programs offered by insurers allowed us to assess not only the prevalence of the studied segments among insurers, but also the fullness and diversity of insurance programs. A system for evaluating VMI, DI, Telemedicine products, as well as new products such as assay insurance is proposed. Indexes have been formed that make it possible to conduct a comparative analysis of insurance programs and provide a situational assessment of the state of these segments in the Russian Federation (RF) in 2025. The results of the study provide insurance companies with a comparative description of insurance products, which can optimize the set of programs, expand the product line, update the services offered and improve customer interaction. Using the research data, clients can choose the company and program that best meets their requirements and needs. In addition, these studies can be used to modernize and update government regulatory and incentive programs for the development of insurance business in Russia in the VMI and DI segments, as well as to further improve scientifically sound methodological solutions in the field under study.

INTRODUCTION. Type 1 diabetes mellitus requires lifelong insulin therapy, which leads to significant healthcare system costs. The emergence of new technologies for diabetes control determines the need to evaluate their cost-effectiveness. AIM. To study the historical aspects and modern trends in economic evaluation of insulin therapy in type 1 diabetes mellitus. MATERIALS AND METHODS. A search for publications was conducted in the databases of medical and biological publications of the US National Library of Medicine, “eLIBRARY,” and “CYBERLENINCA” using keywords related to type 1 diabetes mellitus and various aspects of economic evaluation. RESULTS AND DISCUSSION. Analysis has shown that economic evaluation methods for diabetes developed in parallel with treatment technologies: from simple cost calculations for educational programs in the 1980s to the creation of complex models such as the CORE Diabetes Model and Sheffield Type 1 Diabetes Policy Model. The main research directions were identified: evaluation of early diagnosis of complications, comparison of multiple daily insulin injection regimens and continuous subcutaneous insulin infusion, economic assessment of continuous glucose monitoring, and analysis of insulin analogs usage. The key role of longterm modeling for predicting the impact of various therapy methods on the development of complications and patients’ quality of life has been established. CONCLUSIONS. Promising research directions include assessment of telemedicine monitoring costs, adaptation of models for the Russian healthcare system, and studying the impact of glycemic variability on the cost-effectiveness of treatment.