Анализ доступности лекарственных препаратов для детей, нуждающихся в паллиативной медицинской помощи

Objective: to analyze the availability and affordability of pharmaceuticals for children in need of palliative care.Materials and methods. The price, affordability and physical availability of pharmaceuticals for children in need of palliative care were analyzed in accordance with the Health Action International guidelines of the World Health Organization. Linear distribution index (LDI) was calculated to produce the best estimates of availability. Research data was sourced from AlphaRM (as of April 26, 2021) and International Medicine Reference Piece Data. The data array was based on the fiscal data provided by pharmacies. The research was carried out on the total population of pharmacies in the Russian Federation (69,050 pharmacies) and in St. Petersburg (1986 pharmacies).Results. Pharmaceutical price and affordability estimates show that low-priced generics, which cover over 75% of the whole range, have the most optimal median value of the median price ratio (MPR<1) on top of low affordability ratios (AR<1). Ibuprofen, paracetamol, gabapentin, diazepam, morphine, midazolam, and carbamazepine were found to be the least affordable medications, price-wise (MPR>1). Midazolam (AR=2.494), morphine (AR=2.324), and celecoxib (AR=1.373) had low affordability. Notably, prescription-based pharmaceuticals such as diazepam, midazolam, tramadol, morphine, and fentanyl had the lowest physical availability scores (LDI<3%) in the Russian market compared to the relatively high scores of over-the-counter drugs (LDI>60%).Conclusions. The results call for better organizational action in the pharmaceutical industry to provide due drug regimens to children in need of palliative care.Цель: оценка ценовой, экономической и физической доступности лекарственных препаратов (ЛП) для детей, нуждающихся в паллиативной медицинской помощи.Материал и методы. Анализ базировался на методике Всемирной организации здравоохранения Health Action International. С целью максимально корректной оценки физической доступности рассчитывали линейный индекс дистрибуции (ЛИД). Информационную базу исследования составили данные аналитического агентства AlphaRM (по состоянию на 26.04.2021), а также International Medicine Reference Piece Data. Массив данных сформирован на основе фискальных данных аптечных организаций (АО). Исследование проводилось на генеральной совокупности АО Российской Федерации (69 050 АО), а также генеральной совокупности АО Санкт- Петербурга (1986 АО).Результаты. Оценка параметров ценовой и экономической доступности ЛП демонстрирует, что оптимальным значением медианы коэффициента медианной цены (КМЦ<1) на фоне низких величин коэффициента экономической доступности (КЭД<1) характеризуется сегмент воспроизведенных ЛП с минимальной ценой, охватывающий более 75% ассортимента. Выявлено, что на макроуровне наименьшей ценовой доступностью (КМЦ>1) обладают препараты ибупрофена, парацетамола, габапентина, диазепама, морфина, мидазолама и карбамазепина. При этом минимальная экономическая доступность отмечена у позиций мидазолама (КЭД=2,494), морфина (КЭД=2,324), целекоксиба (КЭД=1,373). Показано, что наименьшей физической доступностью (ЛИД<3%) в рамках розничного сегмента российского фармацевтического рынка характеризуются ЛП контролируемой группы (диазепам, мидазолам, трамадол, морфин, фентанил) на фоне сравнительно высоких значений данного показателя (ЛИД>60%) у позиций безрецептурной категории.Заключение. Полученные результаты диктуют необходимость совершенствования организационно-фармацевтических механизмов лекарственного обеспечения детей, нуждающихся в паллиативной медицинской помощи

Оценка структуры потребления лекарственных препаратов в условиях стационарного лечения детей, больных ОРВИ

The purpose of the study was to analyze the structure of drug consumption in the conditions of inpatient treatment of children with acute respiratory viral infections to optimize treatment standards and reduce material costs. The paper presents the results of a retrospective study of the consumption of drugs in the inpatient treatment of children with acute respiratory viral infections. It is shown that the most vulnerable group for the occurrence and development of acute respiratory viral infections is represented by children aged 1 year to 7 years (60.0% of the total population). Evaluation of drug consumption suggests that the frequency of prescriptions is dominated by J01 category «Antibacterial drugs for systemic use» and R01 «Nasal preparations» (18.58% and 16.56%, respectively). At the same time, the group L03 «Immunostimulants» makes a significant contribution to the consumption structure according to the frequency of appointments, covering 9.31%.Цель исследования — проанализировать структуру потребления лекарственных препаратов в условиях стационарного лечения детей, больных ОРВИ, для оптимизации стандартов терапии и снижения материальных затрат. В работе представлены результаты ретроспективного исследования потребления лекарственных препаратов в условиях стационарного лечения детей с ОРВИ. Показано, что наиболее уязвимая группа для возникновения и развития ОРВИ представлена детьми в возрасте от 1 года до 7 лет (60,0% генеральной совокупности). Оценка потребления лекарственных препаратов позволяет утверждать, что по частоте назначений преобладают препараты категории J01 «Антибактериальные препараты для системного использования» и R01 «Назальные препараты» (18,58% и 16,56% соответственно). При этом весомый вклад в структуру потребления по частоте назначений вносит группа L03 «Иммуностимуляторы», охватывая 9,31%

Маркетинговая оценка потенциала российского фармацевтического рынка в рамках этиотропной терапии детей, больных кампилобактериозом

The paper analyzes approaches to etiotropic therapy and structural assessment of the range of drugs for the treatment of campylobacteriosis in children. The methods of content analysis, grouping, data aggregation, comparative and marketing analysis were used. The information base of the study was the State Register of Medicines, federal clinical guidelines for the provision of medical care to children with campylobacteriosis, European and American clinical guidelines, as well as instructions for the medical use of drugs.Comparative analysis showed that Russian clinical guidelines contain 15 international non-proprietary names used for the etiotropic therapy of campylobacteriosis. The analysis carried out by drug producing countries shows that the leading positions in the supply structure are occupied by Russian producers (68.26%). Structuring by dosage forms makes it possible to single out tablet positions (47.46%). At the same time, 36.47% of the range of drugs are approved for use from the age of 12, which limits the implementation of modern approaches to the rational etiotropic therapy of campylobacteriosis in pediatrics. Structural analysis of the range of pharmaceutical substances identifies a significant contribution to the structure of imports of Chinese producers (46.30%), which, in turn, justifies the prospects for import substitution. Solving the problem of improving the quality of medical care for children with campylobacteriosis determines the prospects for further research based on the principles of evidence-based medicine using the tools of mathematical-statistical and pharmacoeconomic analyses.В работе проведены анализ подходов к этиотропной терапии и структурная оценка ассортимента лекарственных средств для лечения кампилобактериоза у детей. Использованы методы контент-анализа, группировки, агрегирования данных, сравнительного и маркетингового анализа. Информационную базу исследования составили Государственный реестр лекарственных средств, федеральные клинические рекомендации по оказанию медицинской помощи детям с кампилобактериозом, европейские и американские клинические рекомендации, а также инструкции по медицинскому применению лекарственных препаратов.Результаты. Сравнительный анализ показал, что в российских клинических рекомендациях представлено 15 международных непатентованных наименований, применяемых для этиотропной терапии кампилобактериоза. Проведенный анализ по странам-производителям лекарственных препаратов демонстрирует, что лидирующие позиции в структуре предложения занимают российские продуценты (68,26%). Структуризация по лекарственным формам позволяет выделить таблетированные позиции (47,46%). При этом 36,47% ассортимента лекарственных препаратов разрешены к применению с 12 лет, что лимитирует реализацию современных подходов к рациональной этиотропной терапии кампилобактериоза в педиатрии. Структурный анализ ассортимента фармацевтических субстанций идентифицирует существенный вклад в структуру импорта китайских продуцентов (46,30%), что, в свою очередь, обосновывает перспективы импортозамещения. Решение задачи по повышению качества оказания медицинской помощи детям с кампилобактериозом определяет перспективы дальнейших исследований, базирующихся на принципах доказательной медицины с применением инструментов математико-статистического и фармакоэкономического анализов

MULTIPLE VIEW MARKETING ANALYSIS OF THE RUSSIAN PLANT-BASED DRUGS MARKET

The received results show that the greatest (79%) share of plant-based drugs is presented by the domestic manufacturers. The greatest contribution (more than 13%) in structure of import supply is made by the European manufacturing enterprises. Germany (6.86%) is leading among them. The presentation of botanical drugs (31.54%) is the most frequent. One can’t help paying attention to the fraction of substances (7.67%) and semi-finished products (10.17%) in structure of import supply. The latter the indicates the dependence of domestic manufacturers on supply of raw materials from abroad. It is important to notice the share (19.87%) of medicines for digestive tract diseases and metabolic disorders treatment

PHARMACEUTICAL DEVELOPMENT OF DRUGS FOR PEDIATRIC PRACTICE: FUNDAMENTAL BASES AND SPECIFIC FEATURES

The principles of the rational pharmacotherapy in pediatric practice are generalized. It should take into account characteristics of pharmacokinetic and pharmacodynamic of drugs influences on the children organism. It is established, that solution of problem for development of high-potent and harmless pharmaceutical forms for children is impossible without including medical, pharmaceutical and regulatory aspects

COMPARATIVE ANALYSIS OF LEBANON DEVELOPMENT. PROSPECTS FOR COOPERATION WITH THE RUSSIAN FEDERATION

The objective of the research was to conduct a comparative analysis of the development of Lebanon based on a number of demographic, economic and social indicators characterizing the health care of Lebanon, and to determine the prospects for the cooperation with the Russian Federation (RF) in the pharmacy field.Materials and methods. The studies were conducted from 2009 to 2016. The objects were the statistical data accumulated on the basis of the data from national institutions and international organizations. These data were published annually in the reports of the Department of Economic and Social Affairs, the United Nations Population Division for 11 countries in the Middle East: Bahrain, Jordan, Yemen, Kuwait, Lebanon, United Arab Emirates, Oman, Saudi Arabia (Asian countries); Egypt, Sudan, Tunisia (North African countries). The research methods were: a comparative analysis, analytical grouping of data, ranking.Results. A comparative analysis of demographic, economic and social indicators revealed that low mortality rates and high life expectancy in Lebanon were achieved both due to a satisfactory level of health care financing (Rank 5) and due to the adoption of adequate decisions in organizing and managing the Lebanese health care system. The positive trends that were inherent in the Lebanese health care system in previous decades continued to operate within the framework of earlier inertia, while migration flows intensified. However, there has been a slowdown in the decline in infant mortality in the dynamics of growth rates, which is a signal of the emergence of negative processes in the social sphere of the country.Conclusion. The current situation in the Lebanese health care system, associated with limited financial resources, poses new challenges in the search for managerial decisions in the field of organizational management. The import of drugs from the Russian Federation will provide a significant reduction in the financial costs of providing the population of Lebanon and migrants with medicines which will increase the monetary costs of providing medical care

Assessment of consumption of medicines of drugs in conditions of stationary treatment children with acute respiratory viral infections

The purpose of the study was to analyze the structure of drug consumption in the conditions of inpatient treatment of children with acute respiratory viral infections to optimize treatment standards and reduce material costs. The paper presents the results of a retrospective study of the consumption of drugs in the inpatient treatment of children with acute respiratory viral infections. It is shown that the most vulnerable group for the occurrence and development of acute respiratory viral infections is represented by children aged 1 year to 7 years (60.0% of the total population). Evaluation of drug consumption suggests that the frequency of prescriptions is dominated by J01 category «Antibacterial drugs for systemic use» and R01 «Nasal preparations» (18.58% and 16.56%, respectively). At the same time, the group L03 «Immunostimulants» makes a significant contribution to the consumption structure according to the frequency of appointments, covering 9.31%

An observational study to assess the outcomes of treatment of patients with stable angina after planned percutaneous coronary intervention: baseline patient characteristics

Aim. To describe the characteristics of patients who were invited in observational, prospective study on a value-based approach to assess the outcomes of treatment of patients with stable coronary artery disease (CAD) by percutaneous coronary intervention (PCI).Material and methods. We analyzed the baseline characteristics of patients with stable CAD enrolled in a planned PCI with stenting at Almazov National Medical Research Center in 2017. Statistical processing of the results was carried out using Statistica 6.0 (Statsoft Russia) and Microsoft Excel 2017. All registered patients were included in the statistical analysis. Based on the initial clinical characteristics of the patients included in the study, descriptive statistical parameters were calculated. For continuous variables, the mean value and standard deviation were calculated, for the categorical variables — the frequency of characteristic occurrence.Results. From January 1, 2017 to December 31, 2017, were performed 1740 PCI operations with stenting in 1458 patients aged 63,8±9,6 years (men — 1008 (69,1%)). At the time of admission to the hospital, the body mass index was 29,4±5,2 kg/m2, BP=132,3±15,1/79,6±8,5 mm Hg; HR=69,4±8,3 beats per minute. PCI of one coronary artery was performed in 75,6%, multivascular — in 16,6%, in chronic occlusions — in 4,6% and in bifurcation lesions — in 3,2% of patients, respectively. Type 4a myocardial infarction as a complication of PCI was registered in 2,9% of patients. The average duration of inpatient treatment was 5,5±3,4 days.Conclusion. Patients with stable CAD who underwent PCI are a representative sample which allows the assessment of treatment outcomes, an objective assessment of the intervention and the calculation of pharmacoeconomic parameters. An observational study will help identifying the factors affecting the efficiency of surgery and getting knowledge of patients’ opinions about this method