ПРОБЛЕМА ОЖИРЕНИЯ И ИЗБЫТОЧНОЙ МАССЫ ТЕЛА В РОССИЙСКОЙ ФЕДЕРАЦИИ И ЕЕ ФАРМАКОЭКОНОМИЧЕСКАЯ ОЦЕНКА

Background: Due to high prevalence of obesity that has turned into enormous economic and social burden, studies aimed at assessment of damages caused by this medico-social problem are seen as very important in the last years. Aim: To assess economic burden of obesity in the Russian Federation taking as an example three main socially significant medical conditions: acute cerebrovascular accident (stroke), acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM).Materials and methods: We analyzed available evidence on assessment of costs of management and treatment of obese patients and its relation to the disorders selected. To measure costs of obesity for the state budget, we used clinical and economic analysis “cost of illness” with consideration of risks of stroke, AMI and T2DM in the population. Taking into account specific features of cost assessment and based on publically available data, we developed separate models to calculate cost of illness for each selected disease type.Results: Obesity-related expenses incurred by the state for treatment and management of patients amounted to 10.2 billion rubles for stroke, 7.6 billion rubles for AMI and 346.3 billion rubles for T2DM.Conclusion: Оbesity is a serious problem causing significant economic and social losses that are increasing.Актуальность. В связи с высокой распространенностью ожирения, ставшего тяжелым экономическим  и социальным бременем, в последние годы большую актуальность приобрели  исследования, направленные   на  оценку ущерба, обусловленного этой медико-социальной проблемой.Цель – провести  оценку экономического  бремени ожирения в Российской Федерации на примере трех основных социально значимых нозологий: острого нарушения мозгового кровообращения (ОНМК), острого инфаркта миокарда (ОИМ) и сахарного диабета 2-го типа (СД 2 типа).Материал и методы.  Проведен  анализ  существующей доказательной базы по оценке затрат на ведение  и лечение пациентов с ожирением, его связи с выбранными нозологиями. Для оценки  влияния  ожирения   на  государственный бюджет использовался клинико-экономический анализ «стоимость болезни» (COI – cost of illness) с учетом популяционного  риска развития ОНМК,  ОИМ и СД 2 типа.  Принимая  во внимание  особенности  оценки  затрат  и основываясь  на  имеющихся в свободном  доступе данных,   для   каждой   выбранной   нозологии была разработана своя модель расчета стоимости заболевания.Результаты.  Затраты государства  на лечение и ведение  пациентов, связанные  с ожирением, составили около  10,2 млрд рублей  для ОНМК  7,6 млрд рублей – для ОИМ, 346,3 млрд рублей – для СД 2 типа.Заключение. Ожирение – серьезная проблема, приводящая к существенному экономическому и социальному  ущербу, уровень  которого  возрастает

Patterns of antimicrobial dispensing in community pharmacies in Russia during the COVID-19 pandemic

Objective. To evaluate the existing patterns of antimicrobials dispensing in community pharmacies during the COVID-19 pandemic. Materials and Methods. In a cross-sectional study conducted from October 2020 to January 2021 it was obtained the data on the major antimicrobials dispensing in community pharmacies in Moscow and four regions of Russian Federation: date of release, customer’s age and gender, drug name and formulation, the reason for the release (symptoms, preliminary or confirmed diagnosis), prescription-based supply or not/emergency releasing. Results. The study included 71 pharmacies, including 41 private and 30 public organizations. During the mentioned period of time 5514 antimicrobials were supplied to 5270 customers. Antibiotics and antiviral drugs for systemic use accounted the largest share in the structure of purchased antimicrobials (60.5% and 26.3% of all sales, respectively). The frequency of non-prescription-based supplies was 28.5%. The greatest demand among antibiotics was registered for macrolides (14.9%), combinations of penicillins with beta-lactamase inhibitors (12.3%) and fluoroquinolones (11.4%). Upper respiratory tract infections were the most frequent reason for antimicrobials releasing – 36,9%. COVID-19 was the reason for 8.4% of antimicrobials sales. Azithromycin and umifenovir were the most frequently used drugs for SARS-CoV-2. Conclusions. Antibiotics for systemic use have still remained the commonly used ones, whereas upper respiratory tract infections are the main indication for their purchase. Nearly a third of antimicrobials, including systemic antibiotics, were dispensed in private pharmacies without prescription. COVID-19 is uncommon cause of outpatient antimicrobial sales, but a common reason for systemic antibiotic prescribing