[Pharmacoeconomic study of using solifenacin for the treatment of urge urinary incontinence in patients with overactive bladder syndrome].

Overactive bladder syndrome (OAB), accompanied by incontinence, is a relatively common disease. Currently, in the Russian Federation, unfortunately, management of patients with OAB includes the recommendations for symptomatic use of incontinence pads without pharmacotherapy. Along with this, the market is represented by a number of drugs that can reduce the occurrence of adverse symptoms associated with OAB syndrome. This study presents the pharmacoeconomic analysis of use of solifenacin for the treatment of patients with the OAB syndrome in Russia. Based on previous clinical studies, formal mathematical model for the development of OAB have been suggested, taking into account the concomitant symptoms (urinary incontinence), and complications (urinary tract infections, skin infections, depression and fractures). The model considers the direct medical and non-medical costs, as well as indirect social costs, arising from the traditional management of patients with OAB syndrome (no medication) and the use of solifenacin. As a result, it was found that the use of solifenacin is economically feasible option for the management of patients with OAB within 1 year, the difference in costs between these strategies per patient is 2,385 rubles. The use of solifenacin ceases to be a resource-saving if the cost of incontinence pads will reduced by more than half of the basic price included in the calculations, or if the effectiveness of solifenacin would be 15% lower than the value used in the basic model.

[Comparative pharmacoeconomic analysis of prostanoids for peripheral arterial occlusive].

Peripheral arteries occlusive disease (PAOD) is a prevalent illness that needs improved pharmacological management, especially for patients not eligible for surgical revascularization. Prostanoids (alprostadil or iloprost) were shown to be effective in PAOD and critical limb ischemia (CLI) but are rather costly. The results of our pharmacoeconomic study (cost estimation based on randomized control trial results) showed that iloprost does not increase cost of treatment when only direct medical costs are taken into account. If indirect costs are included into the analysis iloprost saves up to 27 thousand rubles per patient. Clinical efficacy is still high. Thus iloprost is a better alternative than alprostadil for CLI.

[Pharmacoeconomics aspects of therapy for obliterating diseases of lower-limb peripheral arteries].

The study was aimed at assessing feasibility of treatment of patients suffering from critical ischaemia of lower extremities with iloprost as compared to the basic therapy by means of pharmacoeconomic analysis. The findings of clinical studies and meta-analyses demonstrated that therapy with iloprost results in a pronounced clinical effect as compared with the basic therapy: significantly (p<0.005) decreasing the number of amputations above the knee joint (23% versus 39%) and more frequently decreasing the size of trophic ulcers (in 49% of cases versus 26%). This provides maintenance of the ability to work in part of patients and a decrease in the frequency of hospitalization, which in its turn results in decreased costs of treatment and indirect expenses.. The results of the carried out study show that with due regard for only direct costs economy from treatment with iloprost would amount to 1,544,556 Roubles per 100 patients. With additionally taking into account of indirect costs economy from using iloprost as compared with basic therapy increases to 25,689,11 Roubles per 100 patients.

[A screening algorithm for patients with adrenal incidentalomas].

Integrated clinical and economic analysis of the efficiency of screening was made in patients with adrenal incidentalomas under the established practical conditions; the average cost of screening of a patient with adrenal incidentalomas and the cost of one detected case were determined under these conditions. Based on the clinical and economic analysis, the authors have elaborated and scientifically substantiated an algorithm for screening of patients with adrenal incidentalomas, the use of which will permit, with high clinical efficacy, a significant reduction in the cost of screening.

[Economic assessment of efficacy of vasaprostan treatment of critical lower limbs ischemia]. / Ekonomicheskaia otsenka éffektivnosti primeneniia vazaprostana pri kriticheskoi ishemii nizhnikh konechnostei.

AIM: To estimate cost-effect efficacy of vasaprostan treatment of inpatients with arterial chronic obliteration (ACO) with critical ischemia of the lower limbs (Fonten stage III-IV). MATERIAL AND METHODS: Case histories of 105 ACO patients with critical ischemia of the lower limbs (mean age 65 +/- 11.8 years) were analysed to compare efficacy and cost of the "typical practice" of hospital treatment of such patients with prognostic cost of basaprostan treatment using drug-cost modeling. RESULTS: The cost-effect analysis comparing efficacy of "typical practice" and vasaprostan treatment showed that in "typical practice" amputations of the limb are inevitable in 41% while vasaprostan treatment reduces the percentage of the operations to 8.6-12% (according to the literature); overall cost of the "typical" treatment for 105 patients reached 3,909,222 roubles while relevant prognostic cost of vasaprostan treatment made up 4,407,162-4,570,653 roubles. Thus, vasaprostan treatment is characterized by less expense per 1 case of the limb amputation prevention vs "typical practice". CONCLUSION: The models used demonstrated that vasaprostan treatment is more cost-effective than "typical practice".