Pharmacoeconomics: theory and practice
№1, 2018, Vol.6
Abstract: We provided a pharmacoeconomic evaluation of the treatment of gastric cancer in the second line of therapy with ramucirumab, using the relative value analysis method. Ramucirumab is the only anti-angiogenic drug registered for the treatment of advanced gastric cancer. In comparison with the standard regimens of the second line of chemotherapy for gastric cancer, the use of the ramucirumab has a statistically significant advantage, increasing the median overall survival by 30%. Ramucirumab (Cyramza) cost of treating per one patient is 1 761 564 RUB. From the perspective of relative value analysis the cost of an additional unit of effectiveness of ramucirumab is comparable or even lower than the same criteria of other antitumor drugs of monoclonal antibodies already included in the national EDL. Consequently, ramucirumab can be characterized as an acceptable technology. The budget impact analysis showed that providing patients with advanced gastric cancer with the ramucirumab is characterized by a lower burden on the drug support budget for oncological patients than bevacizumab, trastuzumab and cetuximab in the therapy of the oncology nosologies, at the their approval date. According to the results of the budget impact analysis on the drug supply of ramucirumab, 200 patients will additionally require 329.19 million rubles, which is only 0.64% of the budget for the treatment of cancer in 2016. Key words: gastric cancer, pharmacoeconomics, cost-effectiveness analysis, budget impact analysis, relative value analysis, bevacizumab, cetuximab, ramucirumab, trastuzumab.
Bronchial asthma (BA) is an urgent public health problem. Treatment of asthma is based on the level of disease control. The change in the structure of basic therapy and the replacement of inhalers are the main causes of exacerbations of asthma and an increase in material costs. «Symbicort Maintenance And Reliever Therapy» (SMART) promote effective control of asthma: providing monitoring and decrease future risk of exacerbation. Improving control of asthma will reduce the steroid load, to reduce the number of hospitalizations and the number of ambulance calls. Key words: bronchial asthma, preferential provision of medicines, combined basic therapy, efficiency
Complicated intra-abdominal infection at multidisciplinary hospital: economics of real practice of antimicrobial treatment
Aim: To assess economic efficiency of complicated intra-abdomibal infections treatment in real practice compared to alternative scenario (treatment with carbapenem Ertapanem) taking in to account E. coli resistance. Methods: Cost-effectiveness analysis were performed. Mathematic modelling was done to assess prognosis of bacterial resistance. Results: Cost of 1 case of complicated intra-abdomibal infections in real practice is 83048,08 rub compared to 91706,06 rub according to alternative strategy. Cost-effectiveness analysis revealed that real practice of treatment intra-abdomibal infections dominated alternative scenario: less effectiveness lead to lower cost. Additional effectiveness (1,95%) demand additionally 443316,97 rub. Taking into account dynamic of E. Coli resistance ICER during 2011-2015 period decreased up to 40%. Conclusion: Antimicrobial resistance of bacterial agents is important criteria which should be used to estimate economic effectiveness of any medical strategy. Key words: complicated intra-abdominal infection, bacterial resistance, pharmacoeconomic analysis
Methodology of calculation of QALY in pharmacoeconomic modelling: using questionnaires of study of patient’s quality of life
This article presents a methodology for calculating QALY using questionnaires to study the quality of life of a patient. The review and classification of the most frequently used questionnaires of quality of life measurement validated to QALY are presented, their main features, advantages and disadvantages are highlighted. The main elements of universal questionnaires, as well as the stages of obtaining the utility index, are described in detail. In addition, alternative methods to obtaining health state utility values for generic questionnaires have been explored, using forecasting (mapping) based on data on other indicators of the patient’s health status.