19 research outputs found
Π€Π°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Π΄ΡΡΠ³ΠΈΠΌΠΈ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠ°ΠΌΠΈ PD-1 Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ ΠΏΠΎΡΠ»Π΅ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΡΡΡΠ΅ΠΉ Ρ ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ
Aim: to evaluate the pharmacoeconomic efficacy of the application of the atesolizumab (PD-L1 inhibitor) preparation compared with other control point inhibitors (PD-1 inhibitors) in patients with advanced non-small cell lung cancer (NSCLC) after chemothe rapy.Materials and methods. Study design included a retrospective analysis of literature data and modeling. Based on the calculations conducted in a Microsoft Excel model, we analyzed the effect of minimizing costs on using comparable drugs with comparable efficacy; we evaluated how the provision of all patients with NSCLC will impact the health system budget taking into consideration the fact that all these patients are currently provided with PD-1 inhibitors in the second and third lines and with the atezolizumab preparation. For calculations, we used the prices stated in the state register of maximum selling prices; the weighted average maximum wholesale premium was calculated according to the Federal Antimonopoly Service (FAS). Results. In the analysis of cost minimization, atesolizumab proved itself to be highly clinically and economically effective. It allowed reducing the costs by 28.6% over 3 years compared with the use of nivolumab, and by 31.3% compared with the use of pembrolizumab in the second- and third-line NSCLC treatment regimen. Analysis of the impact on the budget showed that if all 848 patients currently receiving PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens had been initially provided with atesolizumab, this would have reduced the pressure on budget by 21.90% or 664.25 million rubles for 3 years.Conclusion. The use of the atesolizumab preparation is pharmacoeconomically reasonable and appropriate in comparison with the use of nivolumab and pembrolizumab. It will allow reducing the cost of PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens.Β Π¦Π΅Π»Ρ β ΠΎΡΠ΅Π½ΠΈΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± (ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡ PD-L1) Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Π΄ΡΡΠ³ΠΈΠΌΠΈ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠ°ΠΌΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΡΡ
ΡΠΎΡΠ΅ΠΊ (ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ PD-1) Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ (ΠΠΠ Π) ΠΏΠΎΡΠ»Π΅ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΡΡΡΠ΅ΠΉ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠΈΠ·Π°ΠΉΠ½ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΈ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ°ΡΡΠ΅ΡΠΎΠ², ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΡ
Π² ΠΌΠΎΠ΄Π΅Π»ΠΈ, ΠΏΠΎΡΡΡΠΎΠ΅Π½Π½ΠΎΠΉ Π½Π° Π±Π°Π·Π΅ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ½ΠΎΠ³ΠΎ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ Microsoft Excel, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π·Π°ΡΡΠ°Ρ Π½Π° ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΡΠ°Π²Π½ΠΈΠ²Π°Π΅ΠΌΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², ΠΎΠ±Π»Π°Π΄Π°ΡΡΠΈΡ
ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ, ΠΎΡΠ΅Π½Π΅Π½ΠΎ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ ΡΠΈΡΡΠ΅ΠΌΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΏΡΠΈ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΠΈ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ Π, Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅ΠΌΡΡ
ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠ°ΠΌΠΈ PD-1 Π²ΠΎ Π²ΡΠΎΡΠΎΠΉ ΠΈ ΡΡΠ΅ΡΡΠ΅ΠΉ Π»ΠΈΠ½ΠΈΠΈ, ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±. ΠΠ»Ρ ΡΠ°ΡΡΠ΅ΡΠΎΠ² ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΡΠ΅Π½Ρ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΌΡ ΡΠ΅Π΅ΡΡΡΡ ΠΏΡΠ΅Π΄Π΅Π»ΡΠ½ΡΡ
ΠΎΡΠΏΡΡΠΊΠ½ΡΡ
ΡΠ΅Π½, ΡΡΠ΅Π΄Π½Π΅Π²Π·Π²Π΅ΡΠ΅Π½Π½Π°Ρ ΠΏΡΠ΅Π΄Π΅Π»ΡΠ½Π°Ρ ΠΎΠΏΡΠΎΠ²Π°Ρ Π½Π°Π΄Π±Π°Π²ΠΊΠ° β ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ Π€Π΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠΉ Π°Π½ΡΠΈΠΌΠΎΠ½ΠΎΠΏΠΎΠ»ΡΠ½ΠΎΠΉ ΡΠ»ΡΠΆΠ±Ρ (Π€ΠΠ‘).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π°Π½Π°Π»ΠΈΠ·Π΅ ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π·Π°ΡΡΠ°Ρ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π±ΠΎΠ»ΡΡΡΡ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ β Π΅Π³ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ½ΠΈΠ·ΠΈΡΡ Π·Π°ΡΡΠ°ΡΡ Π½Π° 28,6% Π·Π° 3 Π³ΠΎΠ΄Π° Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π½ΠΈΠ²ΠΎΠ»ΡΠΌΠ°Π±Π°, ΠΈ Π½Π° 31,3% Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ΅ΠΌΠ±ΡΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° Π²ΠΎ Π²ΡΠΎΡΠΎΠΉ ΠΈ ΡΡΠ΅ΡΡΠ΅ΠΉ Π»ΠΈΠ½ΠΈΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠΠ Π. ΠΠ½Π°Π»ΠΈΠ· Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ ΠΏΠΎΠΊΠ°Π·Π°Π», ΡΡΠΎ Π΅ΡΠ»ΠΈ Π±Ρ Π²ΡΠ΅ 848 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΏΠΎΠ»ΡΡΠ°ΡΡΠΈΠ΅ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ PD-1/PD-L1 Π²ΠΎ Π²ΡΠΎΡΠΎΠΉ ΠΈ ΡΡΠ΅ΡΡΠ΅ΠΉ Π»ΠΈΠ½ΠΈΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠΠ Π, ΠΈΠ·Π½Π°ΡΠ°Π»ΡΠ½ΠΎ Π±ΡΠ»ΠΈ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½Ρ Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±ΠΎΠΌ, ΡΡΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ Π±Ρ ΡΠ½ΠΈΠ·ΠΈΡΡ Π½Π°Π³ΡΡΠ·ΠΊΡ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ Π·Π° 3 Π³ΠΎΠ΄Π° Π½Π° 21,90%, ΠΈΠ»ΠΈ Π½Π° 664,25 ΠΌΠ»Π½ ΡΡΠ±.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΡΠΌ ΠΈ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠΌ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π½ΠΈΠ²ΠΎΠ»ΡΠΌΠ°Π±Π° ΠΈ ΠΏΠ΅ΠΌΠ±ΡΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° ΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΡΠ½ΠΈΠ·ΠΈΡΡ ΡΠ°ΡΡ
ΠΎΠ΄Ρ Π½Π° ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ PD-1/PD-L1 Π²ΠΎ Π²ΡΠΎΡΠΎΠΉ ΠΈ ΡΡΠ΅ΡΡΠ΅ΠΉ Π»ΠΈΠ½ΠΈΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠΠ Π
Π‘ΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π³Π΅Π½Π½ΠΎΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΡΡ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΏΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ Π½Π΅ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠΉ ΡΡΠ΅Π΄Π½Π΅ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΡΠΎΠ½Ρ ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ
Objective β to conduct a pharmacoeconomic analysis of using omalizumab, mepolizumab and reslizumab in the treatment of patients with uncontrolled moderate and severe atopic asthma in the healthcare setting of the Russian Federation.Materials and Methods. A pharmacoeconomic model based on clinical data was created. The cost-effectiveness ratios for omalizumab, mepolizumab and reslizumab were calculated and compared. Budget impact analysis for the partial replacement of omalizumab with mepolizumab and/or reslizumab has been performed.Results. The use of omalizumab costs 13.3% less than that of reslizumab and 1.6% more than that of mepolizumab. The cost-effectiveness ratio for omalizumab is significantly lower vs the competitors. To prevent asthma exacerbations by omalizumab requires 463 805 rubles, which is 24.80% less than for reslizumab and by 382,640 or 20.89% less than for mepolizumab. The results are robust and resistant to 10% fluctuations in prices for the compared products. According to the budget impact analysis, by introducing reslizumab instead of omalizumab for a 3-year therapy in 210 patients with asthma and blood eosinophilia β₯400 cells/Β΅l, will increase the burden on the budget by 13.25% or by 83.2 million rubles. In a group of 594 patients with eosinophilia β₯150 cells/Β΅l, using mepolizumab instead of omalizumab will increase the budget burden by 1.58% or by 24.0 million rubles. In the total group of 759 patients receiving genetically-engineered products, switching to mepolizumab and reslizumab will increase the budget spending by 3.3% or 67.2 million rubles for 3 years.Conclusion. The analysis shows that using omalizumab in patients with severe asthma that is uncontrolled by medium and high doses of inhaled corticosteroids, has the lowest burden on the budget of the healthcare system and is more effective compared to mepolizumab and reslizumab.Π¦Π΅Π»Ρ β ΠΏΡΠΎΠ²Π΅ΡΡΠΈ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π±, ΠΌΠ΅ΠΏΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± ΠΈ ΡΠ΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π± ΠΏΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Π½Π΅ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠΉ ΡΡΠ΅Π΄Π½Π΅ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΠΎΡΡΠΈΠΉΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΎΠΏΡΠ±Π»ΠΈΠΊΠΎΠ²Π°Π½Π½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΡΡΠΎΠ΅Π½Π° ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Β«Π·Π°ΡΡΠ°ΡΡ-ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΒ» Π΄Π»Ρ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π±, ΠΌΠ΅ΠΏΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± ΠΈ ΡΠ΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π±, Π° ΡΠ°ΠΊΠΆΠ΅ Π°Π½Π°Π»ΠΈΠ· Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ ΠΏΡΠΈ ΡΠ°ΡΡΠΈΡΠ½ΠΎΠΉ Π·Π°ΠΌΠ΅Π½Π΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π± Π½Π° ΠΌΠ΅ΠΏΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± ΠΈ/ΠΈΠ»ΠΈ ΡΠ΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π±.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π± ΡΡΠ΅Π±ΡΠ΅Ρ Π½Π° 13,3% ΠΌΠ΅Π½ΡΡΠ΅ Π·Π°ΡΡΠ°Ρ, ΡΠ΅ΠΌ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠ΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π±Π°, ΠΈ Π½Π° 1,6% Π±ΠΎΠ»ΡΡΠ΅, ΡΠ΅ΠΌ ΠΌΠ΅ΠΏΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π°. Π‘ΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ Π·Π°ΡΡΠ°Ρ ΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π± ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ Π½ΠΈΠΆΠ΅, ΡΠ΅ΠΌ ΠΏΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ. ΠΠ»Ρ ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠ΅Π½ΠΈΡ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΡ ΠΏΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠΈ ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π±Π° ΠΏΠΎΡΡΠ΅Π±ΡΠ΅ΡΡΡ ΠΏΠΎΡΡΠ°ΡΠΈΡΡ Π½Π° 463 805 ΡΡΠ±., ΠΈΠ»ΠΈ Π½Π° 24,80% ΠΌΠ΅Π½ΡΡΠ΅, ΡΠ΅ΠΌ ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π±Π°, ΠΈ Π½Π° 382 640 ΡΡΠ±., ΠΈΠ»ΠΈ Π½Π° 20,89% Π½ΠΈΠΆΠ΅, ΡΠ΅ΠΌ ΠΌΠ΅ΠΏΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π°. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΡΡΠΎΠΉΡΠΈΠ²Ρ ΠΊ ΠΊΠΎΠ»Π΅Π±Π°Π½ΠΈΡΠΌ ΡΠ΅Π½ Π½Π° ΡΡΠ°Π²Π½ΠΈΠ²Π°Π΅ΠΌΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ Π½Π° 10%. Π‘ΠΎΠ³Π»Π°ΡΠ½ΠΎ Π°Π½Π°Π»ΠΈΠ·Ρ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ, Π·Π° 3 Π³ΠΎΠ΄Π° Π² Π³ΡΡΠΏΠΏΠ΅ 210 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΈΠ΅ΠΉ β₯400 ΠΊΠ»Π΅ΡΠΎΠΊ/ΠΌΠΊΠ» ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠ΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° Π²ΠΌΠ΅ΡΡΠΎ ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π±Π° ΡΠ²Π΅Π»ΠΈΡΠΈΡ Π½Π°Π³ΡΡΠ·ΠΊΡ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ Π½Π° 13,25%, ΠΈΠ»ΠΈ Π½Π° 83,2 ΠΌΠ»Π½ ΡΡΠ±. Π Π³ΡΡΠΏΠΏΠ΅ 594 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΈΠ΅ΠΉ β₯150 ΠΊΠ»Π΅ΡΠΎΠΊ/ΠΌΠΊΠ» ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΌΠ΅ΠΏΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° Π²ΠΌΠ΅ΡΡΠΎ ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π±Π° ΠΏΡΠΈΠ²Π΅Π΄Π΅Ρ ΠΊ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ Π½Π°Π³ΡΡΠ·ΠΊΠΈ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ Π½Π° 1,58%, ΠΈΠ»ΠΈ Π½Π° 24,0 ΠΌΠ»Π½ ΡΡΠ±. Π ΠΎΠ±ΡΠ΅ΠΉ Π³ΡΡΠΏΠΏΠ΅ 759 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ, ΠΏΠΎΠ»ΡΡΠ°ΡΡΠΈΡ
Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΡΠ΅ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ (ΠΠΠΠ), ΠΏΠ΅ΡΠ΅ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΈΠΌΠ΅ΡΡΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ, Π½Π° ΠΌΠ΅ΠΏΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± ΠΈ ΡΠ΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π±, ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ Π½Π°Π³ΡΡΠ·ΠΊΠΈ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ Π½Π° 3,3%, ΠΈΠ»ΠΈ Π½Π° 67,2 ΠΌΠ»Π½ ΡΡΠ±. Π·Π° 3 Π³ΠΎΠ΄Π°.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ, ΡΡΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΎΠΌΠ°Π»ΠΈΠ·ΡΠΌΠ°Π±Π° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ, Π½Π΅ ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠΉ Π½Π° ΡΡΠ΅Π΄Π½ΠΈΡ
ΠΈ Π²ΡΡΠΎΠΊΠΈΡ
Π΄ΠΎΠ·Π°Ρ
ΠΈΠ½Π³Π°Π»ΡΡΠΈΠΎΠ½Π½ΡΡ
ΠΊΠΎΡΡΠΈΠΊΠΎΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ², ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π½Π°ΠΈΠΌΠ΅Π½ΡΡΡΡ Π½Π°Π³ΡΡΠ·ΠΊΡ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ ΡΠΈΡΡΠ΅ΠΌΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΌΠ΅ΠΏΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° ΠΈ ΡΠ΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π±Π°
Prototype ATLAS IBL Modules using the FE-I4A Front-End Readout Chip
The ATLAS Collaboration will upgrade its semiconductor pixel tracking
detector with a new Insertable B-layer (IBL) between the existing pixel
detector and the vacuum pipe of the Large Hadron Collider. The extreme
operating conditions at this location have necessitated the development of new
radiation hard pixel sensor technologies and a new front-end readout chip,
called the FE-I4. Planar pixel sensors and 3D pixel sensors have been
investigated to equip this new pixel layer, and prototype modules using the
FE-I4A have been fabricated and characterized using 120 GeV pions at the CERN
SPS and 4 GeV positrons at DESY, before and after module irradiation. Beam test
results are presented, including charge collection efficiency, tracking
efficiency and charge sharing.Comment: 45 pages, 30 figures, submitted to JINS
Π ΠΠΠΠ’ΠΠ ΠΠ«Π Π ΠΠΠ‘ΠΠΠ ΠΠΠΠ’ΠΠ ΠΠ«Π ΠΠ‘ΠΠ«Π’ΠΠΠΠ― Π ΠΠ‘Π‘ΠΠΠΠΠΠΠΠΠ― ΠΠ ΠΠ«Π‘Π’Π Π«Π₯ ΠΠ ΠΠ’ΠΠ§ΠΠ‘ΠΠΠ₯ Π‘ΠΠΠ ΠΠΠ₯ ΠΠ«Π‘ΠΠΠΠΠΠΠ’ΠΠΠΠ ΠΠΠΠΠΠΠΠΠΠΠ©ΠΠΠΠΠΠ Π£Π ΠΠ-Π¦ΠΠ ΠΠΠΠΠΠΠΠΠ ΠΠΠ ΠΠΠΠΠ’Π ΠΠΠΠΠΠ Π’ΠΠΠΠΠΠ
UZrCN fuel is a high-density, high-temperature fuel that has potential for application in different type reactors. In the past, reactor tests using UZrCN HEU (96% U-235) fuel have been performed to low burnup. However, reactor-testing data are still needed at high burnup to confirm the optimal performance of this-type fuel. The SM-3 research reactor, which is a high-flux reactor located at the State Scientific Center β Research Institute of Atomic Reactors, Dimitrovgrad, Russia, will be used to test a UZrCN LEU (19.73% U-235) fuel to ~40% of burnup. The fuel will then be examined to determine its performance during irradiation.On the βGiacintβ and βKristalβ critical facilities located at the Joint Institute for Power and Nuclear Research β SOSNY of the National Academy of Sciences of Belarus, Minsk, Belarus, criticality experiments on multiplying systems modeling physical features of cores with UZrCN LEU (19.75% U-235) fuel have been prepared for use in works on fast reactors with gaseous and liquid-metal coolants. Critical assemblies represent uniform hexagonal lattices of fuel assemblies, each of which consists of 7 fuel rods and has no clad. The active fuel length is 500 mm. Clad material is stainless steel or Nb. Three types of fuel assemblies with different matrix material (air, aluminum and lead) are investigated. These are side radial, top and bottom reflectors β beryllium (internal layer) and stainless steel (external layer).This article desribes the design of the experiment that will be performed in the SM-3 reactor and discusses the results of different calculations that have been performed to show that the experiment design will meet all objectives. The description of construction and composition of critical assemblies with UZrCN fuel and the calculation results are also presented.Β Π’ΠΎΠΏΠ»ΠΈΠ²ΠΎ UZrCN ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅Ρ ΡΠΎΠ±ΠΎΠΉ Π²ΡΡΠΎΠΊΠΎΠΏΠ»ΠΎΡΠ½ΠΎΠ΅ Π²ΡΡΠΎΠΊΠΎΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ½ΠΎΠ΅ ΡΠΎΠΏΠ»ΠΈΠ²ΠΎ, ΠΊΠΎΡΠΎΡΠΎΠ΅ ΠΌΠΎΠΆΠ΅Ρ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡΡΡ Π² ΡΠ΅Π°ΠΊΡΠΎΡΠ°Ρ
ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠΈΠΏΠΎΠ². Π ΠΏΡΠΎΡΠ»ΠΎΠΌ ΡΠ΅Π°ΠΊΡΠΎΡΠ½ΡΠ΅ ΠΈΡΠΏΡΡΠ°Π½ΠΈΡ ΠΠΠ£ (96% U-235) UzrCN-ΡΠΎΠΏΠ»ΠΈΠ²Π° Π±ΡΠ»ΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½Ρ ΡΠΎΠ»ΡΠΊΠΎ Ρ Π½ΠΈΠ·ΠΊΠΈΠΌ Π²ΡΠ³ΠΎΡΠ°Π½ΠΈΠ΅ΠΌ. ΠΠΌΠ΅ΡΡΠ΅ Ρ ΡΠ΅ΠΌ Π΄Π°Π½Π½ΡΠ΅ ΡΠ΅Π°ΠΊΡΠΎΡΠ½ΡΡ
ΠΈΡΠΏΡΡΠ°Π½ΠΈΠΉ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΡ ΠΏΡΠΈ Π²ΡΡΠΎΠΊΠΎΠΌ Π²ΡΠ³ΠΎΡΠ°Π½ΠΈΠΈ Π΄Π»Ρ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ΠΈΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΡΡΠΎΠ³ΠΎ ΡΠΈΠΏΠ° ΡΠΎΠΏΠ»ΠΈΠ²Π°. ΠΡΡΠΎΠΊΠΎΠΏΠΎΡΠΎΡΠ½ΡΠΉ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΡΠΊΠΈΠΉ ΡΠ΅Π°ΠΊΡΠΎΡ Π‘Π-3, ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Π½ΡΠΉ Π² ΠΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΌ Π½Π°ΡΡΠ½ΠΎΠΌ ΡΠ΅Π½ΡΡΠ΅ β ΠΠ°ΡΡΠ½ΠΎ-ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΡΠΊΠΈΠΉ ΠΈΠ½ΡΡΠΈΡΡΡ Π°ΡΠΎΠΌΠ½ΡΡ
ΡΠ΅Π°ΠΊΡΠΎΡΠΎΠ² (Π³. ΠΠΈΠΌΠΈΡΡΠΎΠ²Π³ΡΠ°Π΄, Π ΠΎΡΡΠΈΡ), Π±ΡΠ΄Π΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡΡΡ Π΄Π»Ρ ΠΈΡΠΏΡΡΠ°Π½ΠΈΡ ΠΠΠ£ (19,73% U-235) UzrCN-ΡΠΎΠΏΠ»ΠΈΠ²Π° Π΄ΠΎ ~40 % Π²ΡΠ³ΠΎΡΠ°Π½ΠΈΡ. ΠΠ°ΡΠ΅ΠΌ ΡΠΎΠΏΠ»ΠΈΠ²ΠΎ Π±ΡΠ΄Π΅Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΡΡΡ Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π΅Π³ΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΠΏΠΎΡΠ»Π΅ ΠΎΠ±Π»ΡΡΠ΅Π½ΠΈΡ.ΠΠ° ΠΊΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ΅Π½Π΄Π°Ρ
Β«ΠΠΈΠ°ΡΠΈΠ½ΡΒ» ΠΈ Β«ΠΡΠΈΡΡΠ°Π»Β» Π² ΠΠ±ΡΠ΅Π΄ΠΈΠ½Π΅Π½Π½ΠΎΠΌ ΠΈΠ½ΡΡΠΈΡΡΡΠ΅ ΡΠ½Π΅ΡΠ³Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΡΠ΄Π΅ΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ β Π‘ΠΎΡΠ½Ρ ΠΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π°ΠΊΠ°Π΄Π΅ΠΌΠΈΠΈ Π½Π°ΡΠΊ ΠΠ΅Π»Π°ΡΡΡΠΈ (Π³. ΠΠΈΠ½ΡΠΊ, ΠΠ΅Π»Π°ΡΡΡΡ) ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠ° ΠΊ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°ΠΌ ΠΏΠΎ ΠΊΡΠΈΡΠΈΡΠ½ΠΎΡΡΠΈ Π½Π° ΡΠ°Π·ΠΌΠ½ΠΎΠΆΠ°ΡΡΠΈΡ
ΡΠΈΡΡΠ΅ΠΌΠ°Ρ
, ΠΌΠΎΠ΄Π΅Π»ΠΈΡΡΡΡΠΈΡ
ΡΠΈΠ·ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π°ΠΊΡΠΈΠ²Π½ΡΡ
Π·ΠΎΠ½ Ρ ΠΠΠ£ (19,75% U-235) UzrCN-ΡΠΎΠΏΠ»ΠΈΠ²ΠΎΠΌ Π΄Π»Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π² ΡΠ°Π±ΠΎΡΠ°Ρ
ΠΏΠΎ Π½ΠΎΠ²ΠΎΠΌΡ ΠΏΠΎΠΊΠΎΠ»Π΅Π½ΠΈΡ Π±ΡΡΡΡΡΡ
ΡΠ΅Π°ΠΊΡΠΎΡΠΎΠ² Ρ Π³Π°Π·ΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠΌΠΈ ΠΈ ΠΆΠΈΠ΄ΠΊΠΎΠΌΠ΅ΡΠ°Π»Π»ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΡΠ΅ΠΏΠ»ΠΎΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠΌΠΈ. ΠΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ±ΠΎΡΠΊΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΡΡ ΡΠΎΠ±ΠΎΠΉ ΠΎΠ΄Π½ΠΎΡΠΎΠ΄Π½ΡΠ΅ Π³Π΅ΠΊΡΠ°Π³ΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΡΠ΅ΡΠ΅ΡΠΊΠΈ ΡΠΎΠΏΠ»ΠΈΠ²Π½ΡΡ
ΡΠ±ΠΎΡΠΎΠΊ, ΠΊΠ°ΠΆΠ΄Π°Ρ ΠΈΠ· ΠΊΠΎΡΠΎΡΡΡ
ΡΠΎΡΡΠΎΠΈΡ ΠΈΠ· ΡΠ΅ΠΌΠΈ ΡΠΎΠΏΠ»ΠΈΠ²Π½ΡΡ
ΡΡΠ΅ΡΠΆΠ½Π΅ΠΉ ΠΈ Π½Π΅ ΠΈΠΌΠ΅Π΅Ρ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ. ΠΠ»ΠΈΠ½Π° Π°ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΡΠ°ΡΡΠΈ ΡΠΎΠΏΠ»ΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΡΠ΅ΡΠΆΠ½Ρ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ 500 ΠΌΠΌ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ β Π½Π΅ΡΠΆΠ°Π²Π΅ΡΡΠ°Ρ ΡΡΠ°Π»Ρ ΠΈΠ»ΠΈ Π½ΠΈΠΎΠ±ΠΈΠΉ. ΠΡΠ΄ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ ΡΡΠΈ ΡΠΈΠΏΠ° ΡΠΎΠΏΠ»ΠΈΠ²Π½ΡΡ
ΡΠ±ΠΎΡΠΎΠΊ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»ΠΎΠΌ ΠΌΠ°ΡΡΠΈΡΡ Π² Π½ΠΈΡ
(Π²ΠΎΠ·Π΄ΡΡ
, Π°Π»ΡΠΌΠΈΠ½ΠΈΠΉ ΠΈ ΡΠ²ΠΈΠ½Π΅Ρ). ΠΠΎΠΊΠΎΠ²ΠΎΠΉ ΡΠ°Π΄ΠΈΠ°Π»ΡΠ½ΡΠΉ, Π²Π΅ΡΡ
Π½ΠΈΠ΅ ΠΈ Π½ΠΈΠΆΠ½ΠΈΠ΅ ΠΎΡΡΠ°ΠΆΠ°ΡΠ΅Π»ΠΈ β Π±Π΅ΡΠΈΠ»Π»ΠΈΠΉ (Π²Π½ΡΡΡΠ΅Π½Π½ΠΈΠΉ ΡΠ»ΠΎΠΉ) ΠΈ Π½Π΅ΡΠΆΠ°Π²Π΅ΡΡΠ°Ρ ΡΡΠ°Π»Ρ (Π²Π½Π΅ΡΠ½ΠΈΠΉ ΡΠ»ΠΎΠΉ).Π Π½Π°ΡΡΠΎΡΡΠ΅ΠΉ ΡΡΠ°ΡΡΠ΅ ΠΎΠΏΠΈΡΡΠ²Π°ΡΡΡΡ ΠΏΡΠΎΠ΅ΠΊΡΠ½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°, ΠΊΠΎΡΠΎΡΡΠΉ Π±ΡΠ΄Π΅Ρ ΠΎΡΡΡΠ΅ΡΡΠ²Π»Π΅Π½ Π½Π° ΡΠ΅Π°ΠΊΡΠΎΡΠ΅ Π‘Π-3, ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π°ΡΡΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΠ°ΡΡΠ΅ΡΠΎΠ², ΠΏΡΠΈΠ·Π²Π°Π½Π½ΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΡ, ΡΡΠΎ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½Ρ Π±ΡΠ΄Π΅Ρ ΠΎΡΠ²Π΅ΡΠ°ΡΡ Π²ΡΠ΅ΠΌ ΠΏΠΎΡΡΠ°Π²Π»Π΅Π½Π½ΡΠΌ ΡΠ΅Π»ΡΠΌ. Π’Π°ΠΊΠΆΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΠΎΠΏΠΈΡΠ°Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ ΠΈ ΡΠΎΡΡΠ°Π²Π° ΠΊΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ±ΠΎΡΠΎΠΊ Ρ ΡΠΎΠΏΠ»ΠΈΠ²ΠΎΠΌ UZrCN ΠΈ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΡ
ΡΠ°ΡΡΠ΅ΡΠΎΠ².
The Nuclear-Weapons Complex and Denuclearization of North Korea
The result of the implementation of the DPRKβs nuclear weapons program was the creation and successful testingΒ ofΒ aΒ thermonuclearΒ explosive device. Over a fifty-year period, the nuclear industry was established in the country, including all the necessary enterprises, from uranium ore mining, enrichment, the production of uranium metal and uranium hexafluoride, and the production of special materials such as ultra-pure graphite, lithium-6 and lithium deuteride. The nuclear complex in Yongbyon played a central role in the implementation of the program, a reactor was built for the production of weapons-grade plutoniumΒ and tritium,Β production of fuel for this reactor was created, chemical reprocessing of irradiated nuclear fuel with separation of plutoniumΒ was created, and uranium enrichment production plant was put in operation.The task of the complete controlled and irreversible denuclearization of the DPRK, put on the agenda, will require complete informationΒ about the North Korean nuclear weaponsΒ programΒ andΒ theΒ nuclear weapons complex thatΒ was developed. However, the presented review shows that information about the state of the nuclear programs of the DPRK, due to the extreme closeness of the country, is very scarce and contradictory. InΒ thisΒ regard, theΒ implementation of denuclearization will require extraordinary effort, time, and a step-by-step approach
Π€Π°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Π΄ΡΡΠ³ΠΈΠΌΠΈ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠ°ΠΌΠΈ PD-1 Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ ΠΏΠΎΡΠ»Π΅ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΡΡΡΠ΅ΠΉ Ρ ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ
Aim: to evaluate the pharmacoeconomic efficacy of the application of the atesolizumab (PD-L1 inhibitor) preparation compared with other control point inhibitors (PD-1 inhibitors) in patients with advanced non-small cell lung cancer (NSCLC) after chemothe rapy.Materials and methods. Study design included a retrospective analysis of literature data and modeling. Based on the calculations conducted in a Microsoft Excel model, we analyzed the effect of minimizing costs on using comparable drugs with comparable efficacy; we evaluated how the provision of all patients with NSCLC will impact the health system budget taking into consideration the fact that all these patients are currently provided with PD-1 inhibitors in the second and third lines and with the atezolizumab preparation. For calculations, we used the prices stated in the state register of maximum selling prices; the weighted average maximum wholesale premium was calculated according to the Federal Antimonopoly Service (FAS). Results. In the analysis of cost minimization, atesolizumab proved itself to be highly clinically and economically effective. It allowed reducing the costs by 28.6% over 3 years compared with the use of nivolumab, and by 31.3% compared with the use of pembrolizumab in the second- and third-line NSCLC treatment regimen. Analysis of the impact on the budget showed that if all 848 patients currently receiving PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens had been initially provided with atesolizumab, this would have reduced the pressure on budget by 21.90% or 664.25 million rubles for 3 years.Conclusion. The use of the atesolizumab preparation is pharmacoeconomically reasonable and appropriate in comparison with the use of nivolumab and pembrolizumab. It will allow reducing the cost of PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens.Π¦Π΅Π»Ρ - ΠΎΡΠ΅Π½ΠΈΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± (ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡ PD-L1) Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Π΄ΡΡΠ³ΠΈΠΌΠΈ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠ°ΠΌΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΡΡ
ΡΠΎΡΠ΅ΠΊ (ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ PD-1) Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ (ΠΠΠ Π) ΠΏΠΎΡΠ»Π΅ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΡΡΡΠ΅ΠΉ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠΈΠ·Π°ΠΉΠ½ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ - ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΈ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ°ΡΡΠ΅ΡΠΎΠ², ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΡ
Π² ΠΌΠΎΠ΄Π΅Π»ΠΈ, ΠΏΠΎΡΡΡΠΎΠ΅Π½Π½ΠΎΠΉ Π½Π° Π±Π°Π·Π΅ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ½ΠΎΠ³ΠΎ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ Microsoft Excel, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π·Π°ΡΡΠ°Ρ Π½Π° ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΡΠ°Π²Π½ΠΈΠ²Π°Π΅ΠΌΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², ΠΎΠ±Π»Π°Π΄Π°ΡΡΠΈΡ
ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ, ΠΎΡΠ΅Π½Π΅Π½ΠΎ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ ΡΠΈΡΡΠ΅ΠΌΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΏΡΠΈ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΠΈ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ Π, Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅ΠΌΡΡ
ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠ°ΠΌΠΈ PD-1 Π²ΠΎ Π²ΡΠΎΡΠΎΠΉ ΠΈ ΡΡΠ΅ΡΡΠ΅ΠΉ Π»ΠΈΠ½ΠΈΠΈ, ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±. ΠΠ»Ρ ΡΠ°ΡΡΠ΅ΡΠΎΠ² ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΡΠ΅Π½Ρ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΌΡ ΡΠ΅Π΅ΡΡΡΡ ΠΏΡΠ΅Π΄Π΅Π»ΡΠ½ΡΡ
ΠΎΡΠΏΡΡΠΊΠ½ΡΡ
ΡΠ΅Π½, ΡΡΠ΅Π΄Π½Π΅Π²Π·Π²Π΅ΡΠ΅Π½Π½Π°Ρ ΠΏΡΠ΅Π΄Π΅Π»ΡΠ½Π°Ρ ΠΎΠΏΡΠΎΠ²Π°Ρ Π½Π°Π΄Π±Π°Π²ΠΊΠ° - ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ Π€Π΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠΉ Π°Π½ΡΠΈΠΌΠΎΠ½ΠΎΠΏΠΎΠ»ΡΠ½ΠΎΠΉ ΡΠ»ΡΠΆΠ±Ρ (Π€ΠΠ‘).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π°Π½Π°Π»ΠΈΠ·Π΅ ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π·Π°ΡΡΠ°Ρ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π±ΠΎΠ»ΡΡΡΡ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ - Π΅Π³ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ½ΠΈΠ·ΠΈΡΡ Π·Π°ΡΡΠ°ΡΡ Π½Π° 28,6% Π·Π° 3 Π³ΠΎΠ΄Π° Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π½ΠΈΠ²ΠΎΠ»ΡΠΌΠ°Π±Π°, ΠΈ Π½Π° 31,3% Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ΅ΠΌΠ±ΡΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° Π²ΠΎ Π²ΡΠΎΡΠΎΠΉ ΠΈ ΡΡΠ΅ΡΡΠ΅ΠΉ Π»ΠΈΠ½ΠΈΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠΠ Π. ΠΠ½Π°Π»ΠΈΠ· Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ ΠΏΠΎΠΊΠ°Π·Π°Π», ΡΡΠΎ Π΅ΡΠ»ΠΈ Π±Ρ Π²ΡΠ΅ 848 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΏΠΎΠ»ΡΡΠ°ΡΡΠΈΠ΅ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ PD-1/PD-L1 Π²ΠΎ Π²ΡΠΎΡΠΎΠΉ ΠΈ ΡΡΠ΅ΡΡΠ΅ΠΉ Π»ΠΈΠ½ΠΈΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠΠ Π, ΠΈΠ·Π½Π°ΡΠ°Π»ΡΠ½ΠΎ Π±ΡΠ»ΠΈ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½Ρ Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±ΠΎΠΌ, ΡΡΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ Π±Ρ ΡΠ½ΠΈΠ·ΠΈΡΡ Π½Π°Π³ΡΡΠ·ΠΊΡ Π½Π° Π±ΡΠ΄ΠΆΠ΅Ρ Π·Π° 3 Π³ΠΎΠ΄Π° Π½Π° 21,90%, ΠΈΠ»ΠΈ Π½Π° 664,25 ΠΌΠ»Π½ ΡΡΠ±.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π°ΡΠ΅Π·ΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π± ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΡΠΌ ΠΈ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠΌ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π½ΠΈΠ²ΠΎΠ»ΡΠΌΠ°Π±Π° ΠΈ ΠΏΠ΅ΠΌΠ±ΡΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° ΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΡΠ½ΠΈΠ·ΠΈΡΡ ΡΠ°ΡΡ
ΠΎΠ΄Ρ Π½Π° ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ PD-1/PD-L1 Π²ΠΎ Π²ΡΠΎΡΠΎΠΉ ΠΈ ΡΡΠ΅ΡΡΠ΅ΠΉ Π»ΠΈΠ½ΠΈΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠΠ Π
Pharmacoeconomic efficacy of atesolizumab compared with other PD-1 inhibitors in patients with advanced non-small cell lung cancer after chemotherapy
Aim: to evaluate the pharmacoeconomic efficacy of the application of the atesolizumab (PD-L1 inhibitor) preparation compared with other control point inhibitors (PD-1 inhibitors) in patients with advanced non-small cell lung cancer (NSCLC) after chemothe rapy.Materials and methods. Study design included a retrospective analysis of literature data and modeling. Based on the calculations conducted in a Microsoft Excel model, we analyzed the effect of minimizing costs on using comparable drugs with comparable efficacy; we evaluated how the provision of all patients with NSCLC will impact the health system budget taking into consideration the fact that all these patients are currently provided with PD-1 inhibitors in the second and third lines and with the atezolizumab preparation. For calculations, we used the prices stated in the state register of maximum selling prices; the weighted average maximum wholesale premium was calculated according to the Federal Antimonopoly Service (FAS). Results. In the analysis of cost minimization, atesolizumab proved itself to be highly clinically and economically effective. It allowed reducing the costs by 28.6% over 3 years compared with the use of nivolumab, and by 31.3% compared with the use of pembrolizumab in the second- and third-line NSCLC treatment regimen. Analysis of the impact on the budget showed that if all 848 patients currently receiving PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens had been initially provided with atesolizumab, this would have reduced the pressure on budget by 21.90% or 664.25 million rubles for 3 years.Conclusion. The use of the atesolizumab preparation is pharmacoeconomically reasonable and appropriate in comparison with the use of nivolumab and pembrolizumab. It will allow reducing the cost of PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens
Utilization of 1-chloromethylsilatrane by Rhodotorula mucilaginosa
The imperfect yeast, Rhodotorula mucilaginosa utilized nitrogen of 1-chloromethylsilatrane (CMS) as a sole nitrogen source when grown on glucose, glycerol, methanol, ethanol and succinate. Under such conditions and at concentrations from 0.45 to 4.5 mM, CMS was a growth-limiting factor. Atomic absorption spectrometry revealed the accumulation of silicon compounds in the cultural liquid which were chloroform-insoluble in contrast to CMS. The following pathway of the partial decomposition of CMS is propoposed: CMS β chloromethylsilanethryol β bis(chloromethyldisiloxane) tetraol. Β© 1987
Pharmacoeconomic analysis of using biological agents for uncontrolled moderate-to-severe atopic asthma in the Russian Federation
Objective β to conduct a pharmacoeconomic analysis of using omalizumab, mepolizumab and reslizumab in the treatment of patients with uncontrolled moderate and severe atopic asthma in the healthcare setting of the Russian Federation.Materials and Methods. A pharmacoeconomic model based on clinical data was created. The cost-effectiveness ratios for omalizumab, mepolizumab and reslizumab were calculated and compared. Budget impact analysis for the partial replacement of omalizumab with mepolizumab and/or reslizumab has been performed.Results. The use of omalizumab costs 13.3% less than that of reslizumab and 1.6% more than that of mepolizumab. The cost-effectiveness ratio for omalizumab is significantly lower vs the competitors. To prevent asthma exacerbations by omalizumab requires 463 805 rubles, which is 24.80% less than for reslizumab and by 382,640 or 20.89% less than for mepolizumab. The results are robust and resistant to 10% fluctuations in prices for the compared products. According to the budget impact analysis, by introducing reslizumab instead of omalizumab for a 3-year therapy in 210 patients with asthma and blood eosinophilia β₯400 cells/Β΅l, will increase the burden on the budget by 13.25% or by 83.2 million rubles. In a group of 594 patients with eosinophilia β₯150 cells/Β΅l, using mepolizumab instead of omalizumab will increase the budget burden by 1.58% or by 24.0 million rubles. In the total group of 759 patients receiving genetically-engineered products, switching to mepolizumab and reslizumab will increase the budget spending by 3.3% or 67.2 million rubles for 3 years.Conclusion. The analysis shows that using omalizumab in patients with severe asthma that is uncontrolled by medium and high doses of inhaled corticosteroids, has the lowest burden on the budget of the healthcare system and is more effective compared to mepolizumab and reslizumab