Results of clinical and economic analysis of pharmacotherapy of patients epilepts

Keywords: epilepsy, clinical and economic analysis, drugs, costs, pharmacotherapy

Abstract

Epilepsy is one of the most common serious diseases of the central nervous system in the world. The effective system of pharmaceutical care for epileptic patients requires the involvement of appreciable budgetary financial resources. In order to determine the actual state of pharmaceutical care to the population, clinical and economic studies are used, the results of which allow to optimize the cost of pharmacotherapy and ensure the implementation of the constitutional rights of Ukrainian citizens to available medical and pharmaceutical care.

The aim of the study was to conduct a clinical and economic analysis of pharmacotherapy of epilepsy.

The object of the study was the data of 118 medical records of patients diagnosed with epilepsy, who were treating at specialized healthcare facilities. Evaluation of the degree of pharmacotherapy rationality in epileptic patients was taken using frequency, VEN, ABC analysis.

The results of the investigation of patients’ medical records showed that 87 trade names of medications (76 international non-proprietary names of medications) were prescribed for epileptic patients. The total number of prescriptions is 918. The average number of prescriptions per patient is 7, which indicates polypragmasy. It was found that the leader in the number of appointments were carbamazepine – 11.11% of the total number of prescriptions and valproic acid – 3.49%. It is proved that in the structure of prescriptions for epileptic patients the part of medication with index V was 7.89%, which indicates a low degree of prescriptions compliance with healthcare standards. According to the results of the integrated ABC and VEN analysis, it was proved that among the groups A/V, A/E, A/N, the group A/V has the largest amount of expenditures – 36.38% of total cost. In general, group N accounts for 41.97% of total costs, which may indicate the irrational use of drugs in the provision of pharmaceutical care to epileptic patients.

The results of clinical and economic analysis of medical records of epileptic patients allowed to identify features in the organization of pharmaceutical care, as well as to substantiate the main directions of improving pharmacotherapy of epileptic patients with limited budget funding for healthcare.

References

World Health Organization. Sixty-eighth world health assembly. Resolutions and decisions annexes. Geneva. 2015. – URL: https://apps.who.int/gb/ebwha/pdf_files/WHA68-REC1/A68_R1_REC1-en.pdf

WHO Еpilepsy. 2019. – URL: https://www.who.int/ru/news-room/fact-sheets/detail/epilepsy

WHO Еpilepsy. 2019. A public health imperative. – URL: http://www.who.int/mental_health/neurology/epilepsy/report_2019/en_171.pdf

Volkova A. V., Korzh Yu. V., Oleinikova N. V. ta in. Doslidzhennia pokaznykiv zakhvoriuvanosti naselennia na epilepsiiu v Ukraini na derzhavnomu ta rehionalnomu rivniakh // Sotsialna farmatsiia v okhoroni zdorovia. – 2019. – T. 5, № 4. – S. 14–22. https://doi.org/10.24959/sphhcj.19.173

Zakhvoriuvanist ta poshyrenist rozladiv psykhiky ta povedinky. Derzhavnyi zaklad «Tsentr medychnoi statystyky MOZ Ukrainy» [Elektronnyi resurs]. – Rezhym dostupu: http://medstat. gov.ua/ukr/statdan.html

Faught E., Li X., Choi J. et al. Real-world analysis of hospitalizations in patients with epilepsy and treated with perampanel // Epilepsia Open. – 2021. – V. 6, N 4. – P. 645–652. https://doi.org/10.1002/epi4.125157

Mehta D., Davis M., Epstein A. J. et al. Comparative Economic Outcomes in Patients with Focal Seizure Initiating First-Line Eslicarbazepine Acetate Monotherapy versus Generic Antiseizure Drugs // Clinicoecon. Outcomes. Res. – 2021. – V. 13. – P. 251–261. https://doi.org/10.2147/CEOR.S3030798

Kotvitska A. A., Prokopenko O. S. Kliniko-ekonomichne obgruntuvannia suchasnykh napriamkiv udoskonalennia farmatsevtychnoi dopomohy khvorym na khvorobu Parkinsona. – Kharkiv: NfaU, 2020. – 30 s.

Nemchenko A. S., Nazarkina V. N., Kurylenko Y. The study of the state of pharmaceutical provision for patients with cardiovascular diseases using ABC-and VEN-analyses // Visnyk farmatsii. – 2018. – № 3 (95). – S. 44–48. https://doi.org/10.24959/nphj.18.2218

Iakovlieva L. V., Bahlai T. O. Kliniko-ekonomichnyi analiz farmakoterapii khvorykh z toksychnymy urazhenniamy pechinky v ZOZ m. Kharkova // Ukr. biofarmats. zhurn. – 2020. – N 2 (63). – S. 36–43. https://doi.org/10.24959/ubphj.20.266

Matushchak M. R. et al. Rezultaty analizu likarskykh pryznachen ta struktury spozhyvannia preparativ khvorymy na limfohranulematoz v Ukraini // Sotsialna farmatsiia v okhoroni zdorovia. – 2021. – Т. 7, № 1. – S. 24–35. https://doi.org/10.24959/sphhcj.21.213

MOZ Ukrainy. Nakaz № 276 vid 17. 04. 2014 r. «Unifikovanyi klinichnyi protokol pervynnoi, ekstrenoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy epilepsii u doroslykh». – URL: http://mtd.dec.gov.ua/images/dodatki/2014_276_Epilepsii/2014_276_YKPMD_epi-lepsiya_dorosli.pdf

KMU. Postanova vid 23. 12. 2021 r. № 1431. «Pro vnesennia zmin do Natsionalnoho pereliku osnovnykh likarskykh zasobiv». – URL: https://zakon.rada.gov.ua/laws/show/1081-2017-%D0%BF#n8

MOZ Ukrainy. Nakaz vid 06. 05. 2020 r. № 1075 «Pro zatverdzhennia dvanadtsiatoho vypusku Derzhavnoho formuliara likarskykh zasobiv ta zabezpechennia yoho dostupnosti». – URL: https://moz.gov.ua/article/ministry-mandates/nakaz-moz-ukraini-vid-06052020--1075-pro-zatverdzhennja-dvanadcjatogo-vipusku-derzhavnogo-formuljara-likarskih-zasobiv-ta-zabezpechennja-jogo-dostupnosti

Fediak I. O., Kupnovytska I. H., Hrynyk N. R. Kliniko-ekonomichna otsinka farmakoterapii khvorykh na tuberkuloz u viddilenniakh intensyvnoi terapii protytuberkuloznykh dyspanseriv // Sotsialna farmatsiia v okhoroni zdorovia. – 2018. – T. 4, № 2. – S. 19–28. https://doi.org/10.24959/sphhcj.18.114

Nemchenko A. S., Balynska M. V. Rezultaty kliniko-ekonomichnoho analizu spozhyvannia likarskykh preparativ khvorymy dytiachoho viku na virusnu diareiu // Upravlinnia, ekonomika ta zabezpechennia yakosti v farmatsii. – 2016. – № 3. – S. 60–67.

Perucca E. The pharmacological treatment of epilepsy: recent advances and future perspectives // Acta Epileptologica. – 2021. – N 3. https://doi.org/10.1186/s42494-021-00055-z

Tharavichitkun J., Yadee T., Angkaow P., Suansanae T. Evaluating Therapeutic Equivalence of Generic and Original Levetiracetam in Patients with Epilepsy: A Retrospective Study // Neurol. Int. – 2022. – V. 14, N 1. – P. 271–283. https://doi.org/10.3390/neurolint14010022

Published
2022-06-29
How to Cite
Olieinikova, N. V., Korzh, I. V., Surikova, I. O., & Afanasenko, O. V. (2022). Results of clinical and economic analysis of pharmacotherapy of patients epilepts. Farmatsevtychnyi Zhurnal, (3), 33-43. https://doi.org/10.32352/0367-3057.3.22.04
Section
Pharmacoeconomics