Pharmacoeconomic analysis of neuroprotectors used in the treatment of ischemic stroke

Authors:
R.I. Yagudin ¹ , A.Yu. Kulikov ¹ , V.A. Krylov ¹ , E.Yu. Soloviev ² , A.I. Fedin ²

¹ FGBU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
² FSBI in Russian National Research Medical University named after N.I. Pirogov ", Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2019, T. 119, No. 7

Summary:
Purpose of the study. Conduct a pharmacoeconomic analysis of the most frequently prescribed drugs of a group of neuroprotectors for the treatment of patients with an ischemic stroke (AI) of a mild and early recovery period in the Russian Federation. Material and methods. Three medical technologies were compared: ethylmethylhydroxypirinate (drug - LP - Mexidol), Inosin + nicotinamide + riboflavin + amber acid (LP cytoflavin) and disordered hemoderivat of blood calves (LP Actovegin). Based on the results of an indirect comparison, a pharmacoeconomic analysis was carried out through the following methods: analysis of cost minimization, analysis of “influence on the budget” and sensitivity analysis. Results. Analysis of effectiveness showed that the LP studied have equal efficiency: the difference of the average LP Aktovegin is 0.2 (di min 0.18; max 0.22), Mexol Mexidol LP (confidence interval - di - min 0.25; Max; 0.65), LP cytoflavin - 0.61 (di min 0.23; max 0.99). Analysis of the minimization of costs showed that the cost of a course of the treatment of one patient of the LP Mexol is accompanied by the lowest costs, while saving is observed when assessing both the total costs and individual components: a solution for injection and tablet forms. The savings in comparison with the LP Cytoflavin and LP Aktovegin is 231 rubles. and 12,872 rubles. respectively. It is possible to additionally treat 5 patients with AI Mexidol on saved only from one course. Moreover, the oral therapy of the Mexol Mexidol LP is more economical by 164 rubles. and 3481 rub. Therapies with similar dosage forms of the Cytoflavin and Actoveginal Public Use, which is an advantage for the population in treatment at the outpatient stage. An analysis of the impact on the budget showed that the total costs of the current distribution of patients according to treatment schemes are 1.99 billion rubles. With an increase in the share of patients receiving Mexidol LP, 10% of the total costs will amount to 1.75 billion rubles, which is 240 million rubles. Less current. On saved products, 85 thousand patients with AI can be additionally treated. A two -factor analysis of sensitivity showed that the result of the analysis of minimization of costs and the impact on the budget remains stable when the number of patients and the cost of 1 mg of Mexidol LP per amount from -10% to +10% changes. Conclusion. In the course of the indirect comparison, it was found that the LP Mexidol, the LP Cytoflavin and LP Actovegin are equal in terms of effectiveness. However, the Mexidol LP has an advantage from the point of view of analyzing the minimization of costs: there are enough funds saved from one course to treat 5 patients with II Mexidol. When considering the consequences of increasing the share of patients receiving Mexol's LP, data were also obtained indicating the savings of funds, which allows us to consider the therapy of the LP Mexoli -preserving budget -storage in the treatment of Easy degree in the Russian Federation. Key words: pharmacoeconomics, indirect comparison, analysis of cost minimization, analysis of “influence on the budget”, neuroprotectors, ischemic stroke.