Pharmacoeconomic research of pharmacotherapy schemes of community-acquired pneumonia with the inclusion of antiviral drugs
In the early 21st century, pneumonia remains an important medical and social problem. In Ukraine, within the structure of acute and chronic bronchopulmonary pathologies, community-acquired pneumonia (CAP) is at the forefront. According to contemporary views, the main and most common cause of CAP is bacterial pathogens. Meanwhile, the outcomes of numerous microbiological studies carried out in recent years strongly suggest that viruses definitely rank second in the etiology of CAP. Today, as the complex therapy of respiratory tract diseases proved to be successful, antiviral therapy is used, allowing to reduce the severity of the disease and to minimize the risk of complications.
Goal – pharmacoeconomic analysis of additional antiviral pharmacotherapy of CAP with the use of vitaglutam based on mathematical modeling.
The efficacy analysis of pharmacotherapy with the inclusion of vitaglutam was based on the retrospective data of 114 patients with viral-bacterial moderate-flow CAP. Patients were randomly assigned to two subgroups depending on the technology of empirical antimicrobial chemotherapy. In the 1st main subgroup (48 patients), antibiotic therapy was combined with the vitaglutam antiviral drug, whereas in the 2nd control group (66 patients) only antibacterial therapy was used. For each homogeneous group of patients, the application of a pharmacoeconomic model based on a «cost of disease» analysis was proposed, which is a basic method of pharmacoeconomic assessment and takes into account the efficiency of the conducted pharmacotherapy, expressed in the achievement of recovery using various technologies of pharmacotherapy in the presence and absence of a viral infection.
Analysis of the results of clinical, and laboratory, and radiological studies showed that pharmacotherapy contributed to the positive results for both options. Meanwhile, time to achieve positive results in both groups of patients was significantly different. Pharmacoeconomic modeling, conducted for a group of 1000 simulated patients with CAP, revealed that in 27% of cases the strategy of non-inclusion of vitaglutam in pharmacotherapy scheme for patients with CAP will be dominant. However, for 73% of the simulated results, a maximum cost ratio of 16.97 was established, with an average value being 3.55. Thus, on average, the use of vitaglutam as additional antiviral pharmacotherapy is reasonable if the cost of additional antiviral pharmacotherapy is less than 3.5 times the cost per day of baseline therapy. Studies conducted in recent years have convincingly demonstrated the rationality of antiviral drugs inclusion in the pharmacotherapy scheme for patients with CAP.
2. Feshchenko Yu. I., Holubovsʹka O. A., Honcharov K. A. ta in. Nehospitalʹna pnevmoniya u doroslykh osib: etiolohiya, patohenez, klasyfikatsiya, diahnostyka, antybakterialʹna terapiya (proekt klinichnykh nastanov) // Ukr. pulʹmonol. Zhur. – 2012. – № 4. – S. 5–17.
3. Musher D. M., Thorner A. R. Community-acquired pneumonia // New Engl. J. Med. – 2014. – № 371. – C. 1619–1628. https://doi.org/10.1056/NEJMra1312885
4. Wunderink R. G., Waterer G. W. Clinical practice. Community-acquired pneumonia // N Engl. J. Med. – 2014. – N 370. – P. 543. https://doi.org/10.1056/NEJMcp1214869
5. Dzyublyk, O. Ya. Spektr virusnykh zbudnykiv u khvorykh na nehospitalʹnu pnevmoniyu // Ukr. pulʹmonol. Zhurn. – 2010. – № 1. – S. 27–30.
6. Dzyublyk O. Yа. Nehospitalʹni infektsiyi nyzhnikh dykhalʹnykh shlyakhiv. – Vinnytsya: «Merkkʹyuri-Podillya». – 2016.– 255 s.
7. Dzyublyk Ya. O., Slyesarenko O. P. Optymizatsiya antymikrobnoyi khimioterapiyi u khvorykh na nehospitalʹnu pnevmoniyu virusno-bakterialʹnoyi etiolohiyi // Ukr. pulʹmonol. Zhurn. – 2013. – № 4. – S. 19–24.
8. Solovіov S. O., Dzyublyk I. V., Zalisʹka O. M., Sakhno H. O. Analitychne obgruntuvannya vklyuchennya protyvirusnoho preparatu v skhemu likuvannya patsiyentiv z pidozroyu na hostre virusne zakhvoryuvannya // Annaly Mechnykovsʹkoho instytutu. – 2016. – № 4. – S. 18–26.
9. Pinyazhko O. B., Zalisʹka O. M. Teoretychni osnovy i napryamy vykorystannya mulʹtykryterialʹnoho analizu rishenʹ u farmatsevtychniy haluzi Ukrayiny vidpovidno do yevropeysʹkoho vektora reformuvannya // Farmats. Chasopys. 2015. – № 2. – С. 119–123. https://doi.org/10.11603/2312-0967.2015.2.4760
10. Zalisʹka O. M., Parnovsʹky B. L. Farmakoekonomika i ratsionalʹne vykorystannya likiv. Navch. posib. dlya provizoriv-interniv ta provizoriv-slukhachiv zakl. (f-tiv) pislyadyplom. osvity. – Lʹviv: Afisha, 2014. – 250 s.
11. Pinyazhko O. B., Zalisʹka O. M. Metodychni pidkhody do provedennya otsinky tekhnolohiy okhorony zdorovʺya v Ukrayini na osnovi yevropeysʹkoyi modeli // Sotsialʹna farmatsiya v okhoroni zdorovʺya. – 2015. – Т. 1, № 2. – S. 44–54.
This work is licensed under a Creative Commons Attribution 4.0 International License.