[Pharmacoeconomic analysis of anti-angiogenic drugs for diabetic macular edema]. / Farmakoekonomicheskii analiz primeneniya antiangiogennykh preparatov pri diabeticheskom makulyarnom oteke.

Diabetic macular edema (DME) is a degenerative disease of the macular area in diabetes mellitus and can lead to vision loss, disability, and significantly reduced quality of life. Faricimab is the only bispecific antibody for DME therapy that targets two pathogenic pathways (Ang-2 and VEGF-A). PURPOSE: This study comparatively evaluates the clinical and economic feasibility of faricimab and other angiogenesis inhibitors in patients with DME. MATERIAL AND METHODS: This article analyzed literature on the efficacy and safety of intravitreal injections (IVI) of ranibizumab 0.5 mg, aflibercept 2 mg, and faricimab 6 mg. A model of medical care was developed for patients with DME receiving anti-angiogenic therapy. Pharmacoeconomic analysis was performed using cost minimization and budget impact analysis (BIA) methods. Modeling time horizon was 2 years. The research was performed from the perspective of the healthcare system of the Russian Federation. RESULTS: The efficacy and safety of faricimab in a personalized regimen (up to one IVI in 16 weeks) are comparable to those of aflibercept and ranibizumab, administered in various regimens. The use of faricimab is associated with the lowest number of IVIs. Over 2 years, the maximum costs of drug therapy were associated with the use of ranibizumab (about 914 thousand rubles), while the minimum costs were associated with the use of faricimab (614 thousand rubles). The reduction in inpatient care costs with faricimab therapy was 36% compared to aflibercept (216 and 201 thousand rubles in inpatient and day hospitals, respectively) and 82% compared to ranibizumab (486 and 451 thousand rubles in inpatient and day hospitals, respectively). BIA demonstrated that the use of faricimab will reduce the economic burden on the healthcare system by 11.3 billion rubles (9.8%) over 2 years. CONCLUSION: The use of faricimab is a cost-effective approach to treatment of adult patients with DME in Russia.

[Pharmacoeconomic aspects of using cladribine (in tablets) for treatment of adult patients with remitting multiple sclerosis]. / Farmakoekonomicheskie aspekty primeneniya kladribina dlya lecheniya vzroslykh patsientov s vysokoaktivnym remittiruyushchim rasseyannym sklerozom.

OBJECTIVE: To conduct a pharmacoeconomic analysis of using cladribine (in tablets) as a second-line treatment option for adult patients with highly active remitting multiple sclerosis in Russia. MATERIAL AND METHODS: Current treatment practice of highly active multiple sclerosis (natalizumab, fingolimod, alemtuzumab, ocrelizumab) was considered as a comparator for cladribine (in tablets). Clinical and economic study was conducted using the «cost minimization¼ method. For budget impact analysis cost of using cladribine (in tablets) was compared to the cost of using current treatment practice. RESULTS: Cladribine in tablets is a cost-saving alternative for treatment of patients with highly active multiple sclerosis compared to the current treatment practice. Within a 4-year period direct medical costs reduction is 2 million RUB (50.1%) per person. CONCLUSION: In case of switching the patients, who are currently provided with other disease modifying drugs, to cladribine, in 4 years health budget will save up to 6284 million RUB (50.1%).

[The study of starter cultures compositions influence on the cholesterol level in fermented meat products].

The article considers the possibility of using starter cultures compositions to reduce cholesterol in meat fermented products. An analysis of own researches and other scientific data allowed to conclude that the ability to reduce cholesterol by starting cultures in vitro is the strain-specific property. In view of the technological properties and the ability to reduce cholesterol in vitro, six compositions of starter cultures from the MGUPP collection were suggested. The compositions consisted of microorganisms belonging to the three genuses: Lactobacillus, Pediococcus and Staphylococcus. The absence of antagonism between the strains within each composition was determined by perpendicular strokes. Strains of each composition were co-cultured in a medium containing cholesterol. The residual cholesterol amount in the medium was determined after 24 hours by the Zlatkis- Zakmethod. This method is based on the cholesterol reaction with FeCl3 in the presence of concentrated sulfuric acid and glacial acetic acid to form a yellow colored complex. It was found that the compositions showed stronger activity for cholesterol reduction than each strain separately. Synergistic effect of cholesterol reduction was detected in starter cultures strains included into compositions. Reduction of cholesterol observed at 25.0-45.7%of its initial concentration in the medium. In those compositions, which included strains with a high capacity to reduce cholesterol, total cholesterol degradation ability was also higher. It was found that starter cultures reduced cholesterol not only in vitro, but also in the process of meat raw material fermentation in production of dry-smoked sausage. Composition a (Lactobacillus sakei 105, Pediococcus pentosaceus 31, Staphylococcus xylosus 45 at a ratio of 1:1:1) was chosen for the manufacture of drysmoked sausage. Bacterial composition was introduced into the meat raw materials on the mince preparation step in an amount of 109 CFU/g mince. Cholesterol maintenance in minced meat and ready-made dry-smoked sausages was determined by HPLC. In minced meat it was 840±10 mg/kg. In the ready sausages the greatest amount of cholesterol was detected in the control sample and was 971±15 mg/kg. Increasing cholesterol levels apparently due to loss of product weight by drying. Cholesterol level decreased by 21.4% in the test sample with the addition of bacterial composition (763±12 mg/kg).