PHARMACOECONOMIC ASPECTS OF BRONCHIAL ASTHMA TREATMENT
Relevance. The prevalence of bronchial asthma (BA) in the world reaches 300 million patients, accounting for 6.9% among adults. In clinical guidelines, the main criterion for the effectiveness of BA pharmacotherapy is symptom control with a decrease in the frequency of exacerbation of the disease. The search for clinically significant BA phenotypes is a promising tool for optimizing the pharmacotherapy of the disease in order to increase its effectiveness and reduce treatment costs. It seems promising to study the modes of pharmacotherapy of bronchial asthma taking into account phenotypic heterogeneity in order to calculate pharmacoeconomic indicators to increase the effectiveness of treatment. Purpose. On the basis of a comprehensive pharmacoeconomic study, substantiate drug provision for patients suffering from bronchial asthma, taking into account the phenotype of the disease. Materials and methods. The object of the study was 570 patients hospitalized in the pulmonary department of the ChUZ "Clinical Hospital" Russian Railways Medicine ", Voronezh". During the collection of material, 570 records of patients hospitalized with BA exacerbation were filled in. When analyzing the costs of therapy, ABC-VEN-analysis, frequency analysis, the method of “cost minimization” were used. Statistical processing of the results was carried out using Microsoft Excel (2010). The chi-square test and Fisher's exact test were used to assess the statistical significance of the differences. Differences were assessed as significant at p <0.05. Results. In patients with bronchial asthma, a pharmacoeconomic assessment of therapy for exacerbation of the disease was carried out. Differences in the cost of one bed-day in patient groups were determined by a combination of drugs that included basic treatment (ICS / LABA) and additional therapy (mucolytics, short-acting beta-agonists, systemic glucocorticosteroids), the intake of which depended on the clinical course of the disease. The costs of BA pharmacotherapy depended on the disease phenotype (allergic BA, non-allergic BA, “late onset” BA, BA in obese patients). The study found that the cost of treatment increased by 17-20% in patients with a mixed BA phenotype. The results of the study showed that the formation of drug supply for BA patients should take into account the list of medical prescriptions, and the cost of the pharmacotherapy performed depends on the phenotype of the disease. Conclusion. The obtained data make it possible to formulate the formulary of the pulmonary department in patients with asthma. This is necessary for planning budgetary funds for financing the therapy of BA exacerbation at the stage of hospital treatment. The continuation of the study is the development of a program for calculating the individual cost of pharmacotherapy depending on the severity of the disease, the duration of inpatient treatment, and the nature of concomitant pathology.