Репозиторий Университета

© Bionika Media Ltd. Objective. To determine a drug that is predominant in terms of pharmacoeconomic analysis for the treatment of infertility in patients with an insufficient ovarian response. Material and methods. An information search for publications on the appropriate topic of this study was conducted in the PubMed, Medlink, and Cochrane Library databases. A total of 134 articles and abstracts were found. Two publications on an open prospective randomized controlled trial by Ferraretti et al. (2004) and an open randomized trial by Carone et al. (2012) were selected for further analysis. These articles are unique in the contents and design of the study. Results. It was established that there was presently a limited number of studies available on the treatment of infertility in women with a suboptimal ovarian response, which had been conducted on a large sample of patients. An economic evaluation of the effectiveness of infertility treatment was made in patients with an insufficient ovarian response on the basis of effectiveness analysis, cost analysis, cost-effectiveness analysis, budget impact analysis, and sensitivity analysis. The compared alternatives were follitropin-alpha + lutropinñ alpha/ recombinant follicle-stimulating hormone (rFSH) + recombinant luteinizing hormone (rLH), follitropin-alpha/ rFSH, and menotropin/human menopausal gonadotropin (hMG). Conclusion. The results of pharmacoeconomic analysis have shown that follitropin-alpha + lutropin-alpha dominates in terms of cost-effectiveness analysis and leads to cost savings in the treatment of infertility in patients with a suboptimal ovarian response.

© 2018 ABV-Press Publishing House. All rights reserved. Modern anticancer therapy due to its intensity and molecular biology orientation allows achieving higher efficiency and theoretically reducing the incidence of complications. However, the increase in efficacy in the modern oncology really exists, but reducing complication frequency, unfortunately, is far from being solved. In many respects the problems of diagnosis, treatment and complications monitoring are associated with the impact on the complex physiological processes occurring in oncological patient. Timely implementation of modern and adequate programs for the prevention and treatment of these complications defines the concept of "supportive therapy", which provides at least half the effectiveness of antitumor treatment. To date, according to most studies, the most frequent complications of antitumor therapy are hematologic, in particular - anemia. In clinical practice, blood transfusions, recombinant human erythropoietins, hemopoiesis stimulating cofactors are used to correct this type of complications. The need for anemia treatment is determined by its negative impact on quality of life, as well as a negative prognostic impact on the life expectancy of cancer patients, because hypoxia of tumor tissue can be associated with resistance to chemo- and radiation therapy, the stimulation of genetic mutations and neoangiogenesis, which make it difficult to control of tumor growth. In numerous studies using multivariate analysis confirmed the association of low hemoglobin levels and/or tumor tissue hypoxia with worsening prognosis and overall survival in many types of tumors. The modern anemia treatment should not be determined only by increased in hemoglobin level, but should be considered as an active prophylaxis for its reducing. Recombinant forms of human erythropoietin and intravenous forms of iron preparations should be the most popular correction methods in everyday practice. The high cost of complex anemia therapy and the social significance of oncological diseases necessitate a pharmaco-economic analysis of registered in Russia erythropoietin preparations and the optimization of existing anemia treatment regimens in cancer patients in order to reduce the expenditures of the health budget. At present, an active import substitution program is underway in the Russian Federation to support the development of the Russian pharmaceutical industry and provide the population with more affordable medicines while maintaining its quality and efficiency. The need to address these issues, and the effective use of the domestic biological analogue epoetin alfa, served as an excuse for performing a comparative clinical and economic analysis. They were selected drugs that differ in pharmacokinetic properties: Eralfon® - analogue of epoetin alfa and Aranesp® - darbepoetin alfa. The treatment model of adults oncological patients with anemia receiving chemotherapy was created, which takes into account various therapies using erythropoietin preparations. The total therapy cost for an oncological patient with anemia is less when using short-acting erythropoietin - epoetin alfa - 131 609 rubles in comparison with the long-acting erythropoietin - darbepoetin alfa - 245 159.2 rubles, the difference was 113 550.2 rubles (-46 %) in favor of the epoetin alfa. According to pharmaco-economic analysis, the treatment of anemia with a Russian-produced drug epoetin alfa (Eralfon®) is preferred in comparison to darbepoetin alfa (Aranesp) in adult cancer patients with nonmyeloid malignancies in the Russian Federation, as it allows increasing the number of treated patients at a cost reduction.

© 2018, Media Sphera Publishing Group. All rights reserved. Objective. A pharmacoeconomic analysis of direct costs on treatment with high dose intravenous immunoglobulins (IVIG) and plasmapheresis (PP) in children. Material and methods. Literature data on the pathogenesis of Guillain—Barre syndrome (GBS) were analyzed. The results of pharmacoeconomic analysis of direct costs on treatment of GBS using IVIG and PP are presented. Risks for complications during treatment with IVIG and PP are calculated. Results and conclusion. The pharmacoeconomic analysis demonstrates comparable costs of treatment with IVIG or PP in the Russian Federation. Nevertheless, a less number of complications, convenience in use and the good safety and tolerability profile make it more preferable to this group of patients. In a clinical case of a 7-year child described in the article, treatment with 10% IVIG — privigen in dose 2 g/kg during 5 days started in the 3rd week of disease showed a marked positive effect.