Organizational and pharmacoeconomic aspects of medical provision of servicemen with H.Pylori-associated peptic ulcer
Abstract
The purpose – evaluation of clinical and pharmacoeconomic efficacy of bismuth and triple antihelicobacter therapy (AHBT) in peptic duodenum ulcer (PDU) with the use of domestic drugs and the impact on the budget of the Armed Forces of Ukraine (AFU) of pharmacoeconomically appropriate treatment regimens for PDU.
Materials and methods. The bibliographic method was used to study the state of providing servicemen with modern approaches for the treatment of peptic ulcer of the duodenum, the place and role of pharmacoeconomic analysis (FEA) in the system of medical service of the AFU; mathematical and statistical - to study the dynamics of morbidity of servicemen; methods of "cost", "cost-effectiveness" and "cost-effectiveness" - to select the most optimal schemes of AHBT for clinical and pharmacoeconomic indicators; descriptive modeling - to determine the total cost of providing treatment for PDU in the military medical service. Clinical trials included the examination of 40 patients with HP-associated PDU, whose diagnosis was confirmed by clinical and endoscopic studies. All examined patients underwent general clinical examinations, ultrasonographic examination of the abdominal cavity, indication of HR before treatment and 4 weeks after the end of AHBT. For expert assessment of pharmacoeconomic efficacy, a study of QOL indicators was conducted using the SF-36 Health Status Survey.
Results. An algorithm for medical supply of servicemen (MSS) in peptic ulcer of the duodenum, taking into account the indicators of FEA, is proposed. The clinical and pharmacoeconomic advantages of the use of bismuth-containing AHBT with the use of domestic esomeprazole and colloidal bismuth subcitrate are shown, which is justified by the best cost (20%), higher antihelicobacter activity (30%) and the predominance of cost-effectiveness based on omeprazole.
Conclusions. The management system of MSS should take into account the pharmacoeconomic parameters of modern treatment systems. The formation of a drugs list for the treatment of PDU, optimal in terms of clinical and economic analysis, will improve the efficiency and quality of treatment and avoid unnecessary budgetary costs for the treatment of servicemen. Pharmacoeconomic analysis of modern MSS in PDU with antihelicobacter and antipeptic complexes showed the feasibility of switching to bismuth-containing antihelicobacter therapy using domestic esomeprazole and colloidal bismuth subcitrate. Pharmacoeconomically sound management of medical and financial resources in the organization of treatment of servicemen with PDU useing bismuth-containing antihelicobacter and antipeptic therapy based on esomeprazole and colloidal bismuth, optimal in terms of pharmacoeconomic analysis, will help to improve treatment and efficiency economic benefits for the medical service of the AFU in the next 5 years approximately to 1180000 UAH.
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