The clinico-economic analysis of pharmacotherapy in patients with non-alcoholic steatohepatitis
DOI:
https://doi.org/10.24959/cphj.17.1416Keywords:
non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, medical regulatory documents, clinicoeconomic analysisAbstract
Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH) have become the most common liver diseases in the world.
Aim. To conduct the clinico-economic analysis of pharmacotherapy in patients with NASH, who underwent treatment in one of the healthcare institutions of Kharkiv in 2013.
Materials and methods. The study materials were case histories of patients and such regulatory documents of the Ministry of Health of Ukraine as the State Formulary (SF) of Medicines of Ukraine (2013), methodological recommendations on the diagnosis and pharmacotherapy of the digestive system diseases (2007), the Unified Clinical Protocol (UCP) “Non-alcoholic steatohepatitis” (Order No. 826 dated November 6, 2014). The pharmacoeconomic methods used were ABC, VEN and frequency analyses.
Results. The results of the study demonstrated that the pharmacotherapy of patients with NASH complied with the main requirements specified in the Ukrainian Methodological Recommendations (2007), but did not meet the requirements of the NASH UCP by the approaches of the pathogenetic therapy prescribed. The results of “formal” VEN analysis showed that most drugs prescribed (76 %) were classified as group V – vital drugs since they were present in the SF of Ukraine. A predominant portion (83.2 %) of costs associated with the pharmacotherapy in patients with NASH was spent on these drugs. However, 16.8 % of the costs spent on 24 % of drugs, which are absent in the SF, indicates the need for further correction of the NASH pharmacotherapy in the healthcare institution under study.
Conclusions. The pharmacotherapy of patients with NASH in the healthcare institution of Kharkiv is rational from clinical and economic point of view, but requires further correction in accordance with the SF and the new UCP for NASH.
References
Non-alcoholic Fatty Liver Disease: Diagnosis and Management / T. Wilkins, A. Tadkod, I. Hepburn et al. // Am. Fam. Physician.– 2013. – Vol. 1, No. 88 (1). – Р. 35–42.
Non-alcoholic Steatohepatitis. A Case for Personalised Treatment Based on Pathogenic Targets / Z. M. Younossi, M. J. Reyes, A. Mishra et al. // Aliment Pharmacol. Ther. – 2014. – Vol. 39, No. 1. – Р. 3–14.
Драпкина, О. М. Патогенез, лечение и эпидемиология НАЖБП – что нового? Эпидемиология НАЖБП в России / О. М. Драпкина, В. И. Смирин, В. Т. Ивашкин // РМЖ. – 2011. – № 28. – С. 1717–1721.
Павлов, Ч. Неалкогольный стеатогепатит: клинические особенности и принципы лечения / Ч. Павлов, И. Бакулин // Врач. – 2007. – № 10. – С. 24–28.
Characteristics of patients with nonalcoholic steatohepatitis who develop hepatocellular carcinoma / K. Yasui, E. Hashimoto, Y. Komorizono et al. // Clin. Gastroenterol. Hepatol. – 2011. – Vol. 9. – P. 428–433. doi: 10.1016/j.cgh.2011.01.023.
Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study / C. Williams, J. Stenger, M. Asike et al. // Gastroenterol. – 2011. – Vol. 143. – P. 124–131. doi: 10.1053/j.gastro.2010.09.038.
Franceschi, S. Epidemiology and prevention of hepatocellular carcinoma / S. Franceschi, S. A. Raza // Cancer Lett. – 2009. – Vol. 286. – Р. 5–8. doi: 10.1016/j.canlet.2008.10.046.
Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: systematic review and economic evaluation / C. Crossan, E. A. Tsochatzis, L. Longworth et al. // NIHR J. Library. – 2015. – Vol. 19 (9). – Р. 1–409. doi: 10.3310/hta19090.
Cost-utility analysis of nonalcoholic steatohepatitis screening / E. Zhang, C. Wartelle-Bladou, L. Lepanto et al. // European Society of Radiol. – 2015. – No. 5. – Р. 1–13.
Estimation of diagnosis and treatment costs of non-alcoholic fatty liver disease: a two-year observation / M. E. Ghamar Chehreh, M. Vahedi, M. A. Pourhoseingholi et al. // Hepat. Mon. – 2013. – Vol. 8, No. 13 (5). – Р. 12–19. doi: 10.5812/hepatmon.7382.
Бабак, О. Я. Гастроэнтеролог. Рациональная диагностика и фармакотерапия заболеваний органов пищеварения:метод. рек. / О. Я. Бабак, Н. В. Харченко. – К.: Доктор-Медиа, 2007. – 134 с.
Lifestyle intervention in individuals with normal versus impaired glucose tolerance / S. Schafer, K. Kantartzis, J. Machann, C. Venter et al. // Eur. J. Clin. Invest. – 2007. – Vol. 37. – P. 535–543. doi: 10.1111/j.1365–2362.2007.01820.x.
Державний формуляр лікарських засобів. Вип. V. – К.: ДП «Державний експертний центр МОЗ України», 2013. – 1308 с.
Уніфікований клінічний протокол первинної, вторинної медичної допомоги «Неалкогольний стеатогепатит»:наказ МОЗ України від 6.11.2014 р. № 826) [Електронний ресурс]. – Режим доступу: http://moz.gov.ua/docfiles/dn_20141106_0826_dod_ukp_nsg.pdf
Оцінка клінічної та економічної доцільності використання лікарських засобів у лікувально-профілактичному закладі: метод. рек. / А. М. Морозов, Л. В. Яковлєва, Н. В. Бездітко та ін. – Х.: Стиль-Издат, 2013. – 36 с.
Програмний комплекс «Аптека» компанії «Моріон» [Електронний ресурс]. – Режим доступу до сайту: http://pharmbase.com.ua/poisk/
Downloads
Published
Issue
Section
License
Copyright (c) 2017 National University of Pharmacy
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
