Pharmacoeconomics: theory and practice
№1, 2021, Vol.9
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.
Purpose. The aim of the study was to assess the problems of providing patients with HIV in the Russian Federation with antiviral drugs of the ATС group – J05AF (nucleosides and nucleotides - reverse transcriptase inhibitors) included in the list of strategically important drugs, and the prospects for its improvement. Materials and methods. The scientific research was carried out sequentially and included four interrelated stages. The objective of the first stage was to analyze the auctions for public procurement of antiretroviral drugs of the ATС- J05AF group for 6 INNs included in the list of strategically important drugs. The task of the second stage of the work was a comparative analysis of the dynamics of the range of antiretroviral drugs and substances for their production, registered in the Russian Federation, of the ATС group - J05AF by 6 INN. At the third stage, an analysis was made of the availability of interchangeable drugs for each INN. The objective of the fourth stage was to analyze the registered prices for domestic and foreign medicines for each INN. Results. It was found that by 2020 the share of domestic drugs was 63% of the planned 90%. In the Russian Federation, only 4 manufacturers in a limited range produce drugs for the treatment of HIV-infected patients. For individual INNs, domestic substances are completely absent, or are produced in insufficient quantities, which forces manufacturers to purchase pharmaceutical substances from the same enterprises, mainly in China and India. In the State Register of Medicines by 2020, for various INNs, interchangeable medicines appeared, the price of which does not differ statistically significantly, nevertheless, 91% of auctions in 2018 were held with a single supplier. Such a result of the auctions is difficult to explain, since the price of interchangeable drugs in the ATС - J05AF group does not differ statistically significantly between domestic and foreign manufacturers. Conclusion: In order to increase the level of import substitution of strategically important antiretroviral drugs, it is necessary, first of all, to solve the problem of providing Russian manufacturers with domestic pharmaceutical substances.
The presence in Russia of legally approved rules for the pharmacoeconomic assessment of drugs when considering their inclusion in the lists of vital and essential drugs (reimbursement), as well as in the list of medical nutrition for children with disabilities, has features of pharmacoeconomic analysis of parenteral and enteral nutrition. Since parenteral and enteral nutrition can have different legal status - a drug (MP), biologically active additive (BAA) and even medical products, the rules for pharmacoeconomic assessment at the federal level will be different for them.