Pharmacoeconomics analysis of pegylated liposomal doxorubicin (Caelyx®) in the treatment of patients with metastatic breast cancer at high risk of cardiac events

Goal: to conduct the pharmacoeconomic analysis of use of pegylated liposomal doxorubicin (PLD) versus doxorubicin in patients with metastatic breast cancer at a high risk of cardiac events with prior adjuvant anthracycline therapy. Materials and methods: Markov model was developed to estimate such outcomes as overall survival, fatal and non-fatal cardiac events in patients treated with PLD compared to doxorubicin. Treatment efficiency data were derived from clinical trials. The analysis was performed from the point of view of Russian health care system - only direct medical cost such as cost of primary therapy, visit to the doctor and treatment of cardiac events were considered. Results: The analysis demonstrated that use of PLD in treatment of metastatic breast cancer compared to doxorubicin was shown to be cost-effective option for patients at high risk of cardiac events in frame of Russian health care system. Resulting incremental cost-effectiveness ratio (ICER) was 549 831 RUB turned out to be significantly lower than willingness-to-pay threshold equal to 1 648 924 RUB in 2015. Sensitivity analyses showed that results were non sensitive to price for medicines (+/-20%), cost of visit to the doctor (+/-20%), but sensitive to time horizon

Analysis the cost of chronic obstructive pulmonary disease in Russian Federation

Objective: to evaluate the economic burden of chronic obstructive pulmonary disease (COPD) in Russian Federation. Methods: This paper analyzes the existing evidence base for assessing the value of COPD. The estimation of the economic burden of COPD in Russia using clinical-economic analysis — the «cost of illness» (COI). The study took into account only the direct costs of the state, there were two variants of calculations using statistics in 2007 (according to some indicators more recent data are not available) and extrapolated data based on the incidence in 2012. Results: The economic burden of COPD in Russian Federation (direct costs excluding the costs of drug therapy) for the first version (2007 statistics) calculations was 54.6 billion rubles for the second option (statistics extrapolated to 2012) calculations — 61.6 billion rubles. Structure of direct expenses of the state for the treatment of COPD in Russia was as follows — 77% of hospitalization costs, 21% — the costs of outpatient care, 2% of the cost — emergency medical care. The largest share of costs associated with COPD exacerbation. Conclusion: At the present stage of COPD is an important cause of morbidity and mortality worldwide, resulting in significant economic and social damage, the level of which increases. Prevalence, morbidity and mortality due to this disease varies greatly in different countries and subpopulations within a country and usually depend on the prevalence of smoking. Correct interpretation of the concept of COPD, use of common diagnostic criteria, standardization conducted epidemiological and economic studies are essential estimate of the true damage this disease

Pharmacoeconomic study of the effectiveness of cytogenetic studies in patients with MM before prescribing first-line therapy

Purpose of the study. Conducting an assessment of the economic consequences (clinical and economic analysis) when conducting cytogenetic studies before prescribing various first-line treatment regimens for multiple myeloma (MM). Materialsand methods. The pharmacoeconomic study was carried out using the method of cost analysis, “cost-effectiveness” within the framework of the State Guarantee Program (SGP). Results. A review of the literature demonstrated that a limited number of data are currently available on the clinical effectiveness of the analyzed regimens in the first line, both in patients with normal and high cytogenetic risk. The cost-effectiveness analysis showed that among the three studied 1st-line treatment regimens (VMP, Rd, VRd), in terms of PFS (progression-free survival), the coefficient was minimal for the VMP regimen in patients with high cytogenetic risk. Conclusion. The study showed that the choice and prescription of first-line therapy, depending on the results of a cytogenetic study, is a clinically effective and cost-effective approach to organizing medical care for adult patients with multiple myeloma in the Russian Federation. This could be used in the future to formulate

A pharmacoeconomic analysis of sertindole in the treatment of schizophrenia

We conduct a comparative cost-effectiveness and budget impact analysis of atypical antipsychotics for the treatment of schizophrenia - sertindole versus quetiapine, paliperidone. The primary outcome of interest was rehospitalization rates. The cost of the annual treatment of patients with schizophrenia in the outpatient setting was calculated, costs of hospital readmission and total costs

Pharmacoepidemiological analysis of the effect of lipid-lowering therapy on cardiovascular mortality in the regions of the Russian Federation

Objectives. Cardiovascular diseases (CVD) are one of the leading causes of death worldwide, including Russia. According to the data obtained from the ESSE-RF study, the most common risk factor for the development of CVD is high level of cholesterol. At the same time, among drugs that lower cholesterol levels, statins are the most studied. The main aim of the study was to conduct a retrospective pharmacoepidemiological study to assess the effect of hypolipidemic therapy on overall and cardiovascular mortality in the regions of the Russian Federation. Methods. At the first stage, the indicators of population, cardiovascular and overall mortality in 2012–2018 were analyzed for 84 subjects of the Russian Federation. The time period of the analysis is determined by the timing of the implementation of the Federal project "Combating Cardiovascular Diseases". Next, we analyzed the frequency of prescribing lipid-lowering therapy in high doses in 84 regions of the Russian Federation in 2014– 2018, according to IMS Health for 2 market segments (preferential and hospital). The number of patients receiving high-dose statins (HDS) (atorvastatin 40 and 80 mg, rosuvastatin 20 and 40 mg) was calculated based on sales volumes in natural terms. Results. Based on the analysis of cardiovascular mortality, all 84 regions of the Russian Federation were divided into 3 groups: high, medium and moderate mortality. In the high-mortality group, HDS consumption per patient averaged 4.45 patients per 100,000 population, in the moderate-mortality group, 19.39 patients, and in the moderate-mortality group, 21.51 patients. Conclusions. The results of the study showed that there is a relationship between the frequency of HDS use and cardiovascular mortality in the regions of the Russian Federation. These results may indicate the effectiveness of lipid-lowering therapy in real practice

Comparative pharmacoeconomic analysis schemes dosage of hormonal stimulation during in vitro fertilization

Purpose: Definition the scheme of hormonal stimulation, which is the most pharmacoeconomical founded. Methods: Pharmacoeconomic analysis was performed using the cost minimization analysis on the assumption of equal effectiveness compared schemes of hormonal stimulation, which was confirmed in the review of clinical trials and meta-analysis. To estimate the cost of drugs for ovulation induction we used registered VED rates and recommended in the instructions for medical use and the standard of care for infertility using assisted reproductive technologies dosing regimens. Results: The cost of the courses of drugs (1) corifollitropin a + ganirelix (32.9%), corifolhtropin a + ganirelix + follitropin (3 (67.1%) and (2) follitropin a + cetrorelix was 38 108.5 rub. and 47 102 rub., respectively. Cost saving of the budget by using the first scheme was 8 993.5 rub. for one course of in vitro fertilization. Conclusions: The scheme of hormonal stimulation using corifollitropin a is more pharmacoeconomical reasonable

A social-economic burden of rhinosinusitis with nasal polyps with comorbid asthma and influence of dupilumab

Rhinosinusitis with nasal polyps (RwNP) is a one of most common comorbidities in asthma and contrariwise and can lead to exacerbation of severe asthma (SA). Dupilumab is a perspective medicine for treatment of both, because it decreases exacerbations and prevents of a necessity of surgeon. Economics aspects of dupilumab treatment in RwNP + SA are not examined yet. Thus aim of this study was evaluation of social-economic burden of RwNP + SA in the Russian Federation and dupilumab influence on it. Materials and methods. Direct medical (cost of medicines, treatment in outpatients department and in hospital, including surgery and rate of exacerbations per year) and non-medical (payment for temporary and stable disability) and indirect costs (GDP loses) in RwNP + SA patients have been evaluated. Medical cure of a patient with RwNP + SA was created according to survey of experts from different regions of Russia. Modelling of expenditures was prepared on all calculated cohort of potential patients with RwNP + SA from “State” position and growing approach. Results. Expenditures for cure of one patient with RwNP were as 234 217,71 RUR/year. Weighted average costs for one patient with RwNP + SA were 1 881 883,39 RUR, and mostly were associated with indirect costs. Dupilumab can decrease expenditures for one patient with RwNP + SA till 1 593 162,87 RUR (on 15,3 %) annually. Potential cohort with RwNP + SA has been estimated above 39 thousand patients. Total economic burden of RwNP + SA in Russia were estimated as 1,7 bln RUR. Dupilumab usage in patients with RwNP + SA fixed in Register can help decrease economic burden on 259 mln RUR annually. Hidden economic burden of comorbidity can reach 73,4 bln RUR (for all calculated / modelled cohort of patients with RwNP + SA), dupilumab saves 11,3 bln RUR annually in this scenario. Conclusion. Comorbid pathology — RwNP+SA has a sufficient social-economic burden in Russia, that could be decreased by modern biologic drugs, in particular, with dupilumab

Influence of dupilumab on the economic burden of severe asthma and atopic dermatitis

The prevalence of comorbidity — asthma and atopic dermatitis — is not understood well yet. More severe processes decreasing quality of life and increasing a social-economic burden of disease are occurred in such kind comorbidity.Aim: an evaluation of economic burden of non-control severe asthma in combination with severe atopic dermatitis in the local conditions.Materials and methods. Analysis has been performed for adult patients; the bottom-up approach of costs evaluation was used. Direct medical and non-medical as well as indirect costs were calculated for two models: Model 1 — current practice of the treatment, Model 2 — treatment with Dupilumab. Results. Model 1 — Weighted average expenditures for one patient were 3,1 mln RUR, indirect costs were dominated (76 % from the total), severe atopic dermatitis had 15 % of total. Model 2 (with Dupilumab) — Dupilumab has decreased the total weighted average cost on 903 905 RUR. The total economic burden of comorbidity was 17,6 bln RUR in the current treatment option, and 12,4 bln RUR in Dupilumab hand (different is 5,2 bln RUR, or burden decrease is expected on 29,2 %).Conclusion. The wider introduction of Dupilumab into clinical practice, which allows achieving control in the treatment of severe asthma and severe atopic dermatitis, should reduce treatment costs and reduce the socio-economic burden of these diseases as a result