Pharmacoeconomics: theory and practice
№4, 2019, Vol.7
Pharmacoeconomic evaluation of baricitinib in the treatment of adult patient with moderate to severe rheumatoid arthritis with intolerance or lack of an adequate response to treatment with one or more basic antirheumatic drugs in the Russian Federation
Pharmacoeconomic assessment is an obligate element for including a drug in the reimbursement lists – EDL and state federal reimbursement drug list, which in turn represents an important step in ensuring the availability of drug therapy. In this regard, the registration of a new drug of the group of janus kinase inhibitors, baricitinib in Russia, used in the treatment of rheumatoid arthritis in patients with moderate and severe degree of intolerance or lack of adequate treatment for one or more basic antirheumatic drugs, actualized the task of its pharmacoeconomic assessment. The pharmacoeconomic analysis of baricitinib by the cost-effectiveness methods compared with adalimumab and the “budget impact” compared with the entire group of genetically engineered biological products showed that, from the point of view of the cost-effectiveness evaluation, baricitinib is characterized as a dominant alternative, and with the position of the “budget impact” evaluation, the use of baricitinib is accompanied by budget savings. In accordance with the current rules of pharmacoeconomic assessment, the drug baricitinib gains + 9 points and, by decision of the Commission of Ministry of Health, was included in the lists of EDL and state federal reimbursement drug list, approved by Order of the Government of the Russian Federation 2406-R of October 12, 2019.
Wide range of available platforms for phacoemulsification of cataracts and limited financing of the health care system make crucial of optimal decisions in choosing specific models of platforms. In this regard, for the first time in Russia and in the world, an assessment of healthcare technology (HTA) of 6 platforms for cataract phacoemulsification was carried out - Centurion, Infiniti, Stellaris, Stellaris PC, Whitestar Signature, Visalis 500. Our study revealed the limitations of the existing evidence base for comparative purposes evaluations of various phacoemulsification platforms from a health system perspective. Due to this we made an assumption of the use expert assessment of the analized platforms in terms of ultrasound time and the volume of aspirated liquid allowed us to provide HTA, the results of which on the one hand confirm the applicability of the HTA methodology itself for the analysis of the type of medical device under consideration, and with available cost data demonstrated «cost-effectiveness ”of the Centurion platform and its advantage in terms of budget impact analysis among other platforms of the latest generation. The full use of HTA for cataract phacoemulsification platforms requires the creation of an evidence base, taking into account perspective of organizational decision-making process.
In recent years, due to the widespread use of pharmacoeconomic modeling for economic and decision analysis, the variety of pharmacoeconomic models has significantly increased, which from the point of view of methodology actualizes the problem of their systematization. The first step in solving this problem is to identify the key principles of a possible classification, for which, in turn, it is necessary to highlight and describe the interaction of the attributes of pharmacoeconomic models. In this article, the authors highlighted, grouped, and described 26 attributes of pharmacoeconomic models.