Качественная клиническая практика (May 2018)
Pharmacoeconomic analysis of naftidrofuryl for treatment of ischemic stroke
Abstract
Strokes are one of the most important causes of death and disability both worldwide and in Russian Federation (RF). This disease requires intensive, prolonged treatment and rehabilitation and thus is associated with considerable temporary disability, as well as significant rate of permanent complete disability. Available information indicates that vasodilators affecting peripheral arteries can play a favorable role in treating ischemic strokes, which are the most widespread form of this pathology. However, this type of pharmaceutical is currently not represented in RF standards pertaining to treatment of ischemic strokes. Thus it is expedient to assess the pharmacoeconomics of introducing naftidrofuryl, a member of aforementioned group, into RF treatment and rehabilitation standards for ischemic stroke Aim. To perform the pharmacoeconomic analysis of including naftidrofuryl into the RF standards for treatment and rehabilitation of patients suffering from ischemic stroke by means of performing Cost Minimization Analysis (CMA) and Budget Impact Analysis (BIA). Methodology. The analysis was performed by constructing decision trees for two simulated cohorts. One cohort received only standard treatment and rehabilitation while the other was also receiving naftidrofuryl in addition to standard treatment and rehabilitation. Both direct and indirect costs were accounted. The source of data on the clinical effectiveness was taken from randomized controlled trials and meta-analyzes, which examined the efficacy, safety and tolerability of naftidrofuryl. Analysis of data sources has found that, while there is not enough information to ascertain naftidrofuryl effect on hard clinical endpoints, naftidrofuryl demonstrates an ability to reduce time required to obtain clinical results, thus reducing treatment time and hospital stay. Existing standards were used to calculate expenditures associated with diagnosing, treating, and rehabilitating stroke patients in each simulated group. CMA, BIA and sensitivity analysis were performed. Result. The CMA index for naftidrofuryl was found to be minus 250,630 millions, indicating significant cost reduction. BIA indicated budget savings of 7,59% in the naftidrofuryl group, which amounts to 59,471 mln rubles per 100,000 of population. Sensitivity analysis confirmed these results, indicating stability both in case of price increase and in case of negative alteration of assumptions underlying the model. Conclusion. Including naftidrofuryl in RF national standards for treatment and rehabilitation of patients with ischemic strokes would allow reducing healthcare organization spending as well as overall budgetary burden.
