[Economics of nephroprotection in arterial hypertension and type 2 diabetes mellitus].

Based on results of large-scale controlled trials of irbesartan (I), valsartan (V) and amlodipine (A) (PRIME and MARVAL) we carried out the Markov s modeling of their pharmacoeconomic parameters in arterial hypertension (AH) combined with diabetes mellitus type 2 (DM 2) and microalbuminuria (MAU) projected for 8-years perspective. Cost and efficacy was evaluated taking into account years of life gained and outcomes of concomitant diseases and complications. Indexes of cost/efficacy (C/E) were calculated for each drug. Among investigated drugs I appeared to be the most economic at the account of retardation of development of terminal nephropathy and cardiovascular diseases. The use of I compared with V could save 565300 rub/100 patients/year. C/E of I was 26.5 and 37.4% lower that those of V and A, respectively. Costs of year of life saved was 12716, 16432, and 18325 for I, V, and A, respectively. Comparative pharmacoeconomic modeling of 8-year economic perspectives of I, V and A demonstrated financial benefits of I.

[Cost-effect estimation of dopamine agonist (mirapex) application in patients with Parkinson's disease]. / Farmakoékonomicheskiaia tsenka primeneniia agonista dofaminovykh retseptorov (mirapeksa) u patsientov s bolezn'iu Parkinsona.

Parkinson's disease is a neurodegenerative disorder with a growing social significance. Currently, dopamine agonists are considered as first-line medication used before levodopa treatment. High cost of dopamine agonists makes it necessary to estimate their cost efficacy by means of pharmacoeconomical studies. We studied efficacy of mirapex evaluated by UPDRS and PDQ-39 scores before and after 1-year treatment in 44 patients with Parkinson's disease: 18 patients non-pretreated with levodopa and 26 patients pretreated with levodopa. Treatment cost was estimated separately for two patients groups with subsequent cost-effectiveness analysis. Early use of mirapex as a dopamine agonist for patients non-treated with levodopa seems to be beneficial from clinical well as from pharmacieconomical points of view.

[Results of pharmacoepidemiological study of arterial hypertension in Russia (PIFAGOR)]. / Rezul'taty farmakoépidemiologicheskogo issledovaniia arterial'noi gipertonii v Rossii (PIFAGOR).

AIM: To assess physicians preferences concerning the use of various groups of antihypertensive drugs in Russia. METHODS: Special questionnaires containing 8 questions related to preferential adherence to representatives of various groups of antihypertensive drugs were distributed among practicing physicians who routinely treated patients with hypertension. RESULTS: Of questionnaires returned between January and July of 2002 from 34 towns 530 were considered valid for analysis. Half of responses (50.4%) were from hospital physicians, 40.5% - from physicians of policlinics (outpatient clinics), 9.1% - from physicians working in other health care facilities. Most of respondents were internists (60.8%) and cardiologists (32.7%). Preferences concerning prescription of antihypertensive drugs were distributed in the following way: angiotensin converting enzyme inhibitors - 32% (50% captopril and enalapril); beta-adrenoblockers - 27% (77% atenolol, metoprolol and propranolol); diuretics (hydrochlorothiazide and indapamide) - 22%; calcium antagonists - 15% (81% verapamil, nifedipine, diltiazem, 64% - long acting preparations); angiotensin receptor blockers - 1.7%; centrally acting drugs - 1.5%; alpha-adrenoblockers - 0.8%. CONCLUSION: Tendencies in real life treatment of patients with hypertension in Russia should be considered positive. Basic antihypertensive therapy included agents (mostly long-acting) from 4 main classes and the use of outdated drugs such as clonidine and reserpine was low.