The Congress, "Rational pharmacotherapy"
(Saint - Petersburg, 12 - September 14, 2011)
"Actual issues of pharmacoeconomics"
In the school RSPOR was attended by 28 people. One of the main topics was to consider the report of the formulary committee, "Public Health in Russia 2010". The report was voiced by the Vice-President of the formulary committee prof. Vorobyev Pavel - President RSPOR. This is the second report of the Committee, the previous (2008) was devoted mainly to issues of drug supply in the country. Report is available on the website RSPOR www.rspor.ru.
This multifaceted empirical research of more than 160 pages of the country considers health from very different of positions, and taking into account the current state of infrastructure, human resources, health technology assessment, development of civil society, corrupt processes, new legislative initiatives.
An interesting report was made by head of the Laboratory of pharmacoeconomics in Institute of Pulmonology State Medical University im.I.P.Pavlova MD Ilkovich YM She spoke about the pharmacoeconomic aspects of the treatment of bronchial asthma. Despite the existence in the country for many years, recommendations for treatment of asthma (GOLD) they are not satisfied neither patients neither doctors. Some possible ways to improve patient compliance and was told.
In his report to the director on work with state and social structures of LLC "Novo Nordisk" Bykov A noted that Russia, along with India, China, USA and Japan, among the top five countries with the highest incidence of diabetes. Insulin consumption in Russia is one of the lowest in the world. State costs for 1 patient with diabetes in Russia ~ $ 175, in Europe up to about $ 5000 in the United States up to 13 000 $. The necessity of introducing in Russia the full medicinal insurance unquestioned leadership of the country, supported by the leadership of relevant agencies and leading Russian experts, but however, there is no clarity on the issue of funding. At whose expense will be implemented by the project? As the new system will be combined with the developed or already in place existing CHI, ASD and others?
The report of Professor Saint-Petersburg Chemical - Pharmaceutical Academy Rudakova A. stated that the average life expectancy in Russia is 68 years old, and advanced countries - about 80. Spending on health in Russia, 5.4% of GDP, but, for example, in Germany the figure is 11.4% of GDP. QALY in Russia, on the recommendation of WHO should "cost" about 315 thousand rubles / QALY, the United States about 46 700 $ / QALY.
Very interesting was the report "Problems of rational planning in the pharmaceutical supply Phthisiatry" researcher laboratory quality management of care of the St. Petersburg Institute of Phthisiopulmonology Ayzikov DL He noted the need to assess of the effectiveness of existing TBmedicines resources, with limited financing. Assessment of pharmaceutical supply on the example of 6 subjects of the Russian Federation within the Urals Federal District.
Anti-tuberculosis institutions UFD plan in 2011 to provide TB drugs for a total of 82 326 people. The main group of patients who will be assigned to drug exposure - 64 258 - is the person receiving chemoprophylaxis, an anti recurrent courses, presumptive treatment - in other words, people with tuberculosis are not sick! The remaining 18 068 patients scheduled for treatment with other chemotherapy regimen. Among those who planned to designation in 2011 of TB treatment - 79% are patients of 0, III, IV, VI of Control (chemoprophylaxis, an anti recurrent courses, presumptive treatment), patients receive all the other modes of HT is 21%. The report noted that the costs of "test-therapy" comparable to the cost of the planned number of patients treated by the former regime of chemotherapy. For example, in the Kurgan region the group receiving the test therapy was 151 adults and 59 children. Diagnosis of active TB was confirmed in 37 adults and 4 children. The more often a subject uses a test-treatment, the higher the frequency of inefficient use of anti-TB drugs. Given the frequency without result of the test treatment is expected to inefficient use of 7.5 million rubles (70% of the cost of acquisition of anti-TB drugs for treatment of the test).
The report "Decision-making in health care and medical technology assessment: The European Experience," which was presented O. Borisenko, now - the chief economist of Health Synergus AB (Sweden) spoke about the differences between the approaches in the assessment of medicines and medical equipment, namely, : The use of "standard" criteria for diagnostic equipment can be difficult (QALY to assess the benefits of the PSA-test - requires control of all parameters, except for the test), excellent pricing (rapid erosion of the technology, a rapid decrease in prices), meaning "learning effect" - rates significantly improve with the accumulation of individual experience of the equipment (performance evaluation in different time intervals) and other emerging new technical capabilities that extend the range of research methods of drugs, as in many countries, the establishment of registers (Swedish registers in rheumatology) is a condition of admission drug on the market, to monitor its effectiveness.
How it is rarely - the speakers were not limited in time and participating schools were able to ask questions and are interested to discuss certain aspects of the reports.