The aim: to study the factor "cost-utility" in patients after ischemic stroke and neuroprotective pharmacotherapy cytofavin.
Materials and methods: For the pharmaco-economic analysis evaluated only the direct cost oftreating patients with AI Tariff cost of drugs - according to municipal pharmacies, the company "Medserviz Richter." The calculation was performed under the standard methods of clinical and economic analysis "cost-utility". The criteria used in pharmacoeconomic efficacy integral factor endointoxication blood.
The calculation of the direct costs of pharmacotherapy is made with taking only account of the cost of the drugs, the cost of cytoflavin and neuroprotective, as the volume of hospitalization, doctor visits and medical emergencies, laboratory and functional examinations in the two groups was identical.
For the study were taken 32 patients with mild AI (PM) Age of40-60 years. Citoflavin (TF) was administered at a dose of 20 ml saline in the volume of 200ml in 10 days. To evaluate the Integral coefficient (IC) endointoksiatsii (EI) to determine the content of toxic middle molecules (STM) in erythrocytes and blood serum by with the calculation of EI by IRNJ Ormanova [2006] As a control group taken (CG) 22 healthy individuals (ZL) male.
Results: When the concentration of ischemic stroke secondary to toxic molecules in serum and red blood cells exceeds the data of the control data and 32,4%, 66,7%, the index increased by 31endointoksitkatsii compared with healthy individuals. a.
Keep middle of toxic molecules in red blood cells and serum after 5-fold introduction cytofavin decreased by 24.7% and 16.1% as compared with the other treatments, but were still 25.5% and increased 11.2% compared to in healthy individuals. Index endointoxication blood decreased by 10, but remained 18% higher compared to the of healthy people. After 10's introduction cytofavin stroke patients ishemimcheskim medium content of toxic molecules in serum and red blood cells decreased by 45%. he average value of "utility" in comparison with the original data in the group decreased by cytoflavin (tablet form) 21,9 % and (injection) 29,8%, reamberin and aktovegin group-21,9%, in the remaksolovoy and piratsetamovoy groups- 25,8% and 22,6%, PLD influence tserroksana -25,8% (table).
Table - Pharmacoeconomic parameters in patients with ischemic stroke after cytoflavin neuroprotective pharmacotherapy
|
Group |
Value"usefulness" to the treatment (in points) " |
(Ue) own efficiency% |
The total cost of the treatment (KZT) |
(factor "cost-utility) |
Indicator utilities |
|
|
(тенге) |
% |
|||||
|
CT |
|
27,9 42,4 |
4172(Table) 13210(amp) |
149,5 311,5 |
100 208,4 |
«0 |
|
RB |
1. 1,51±0,06 2. 1,19±0,06 |
26,8 |
13035(bottle) |
486,3 |
325,2 |
913,7 19,2 |
|
АВ n = 30 |
1. 1,51±0,06 2. 1,19±0,06 |
26,8 |
9468,0(Table) |
353,2 |
236,2 |
292,6 |
|
RM |
1. 1,51±0,06 2. 1,12±0,06 |
34,8 |
20040,0(Table) |
575,8 |
385,1 |
794,2 |
|
PC |
1. 1,51±0,06 2. 1,20±0,06 |
25,6 |
37800 |
1476,5 |
474,0 |
|
|
Ts |
1. 1,51±0,06 2. 1,12±0,06 |
34,8 |
34303,5 |
985,7 |
659,3 |
|
Note; 1 .2- before treatment after treatment
CT-Citoflavin, RB-Reamberin, AB-Aktovegin, RM-Remaxol, PC-Pyracetam, Ts-Tserakson.
Factor "cost- utility" cytoflavin group were 149.5 tenge (table.) and 311.5 tenge (injection) tenge, in reamberin and aktovegin groups- 486.3 and 353.2 tenge in remaksolovoy and piratsetamovoy groups- 575.8 and 1476, 5 tenge under the influence tserroksana -985.7 tenge .
In the calculation of the ratio of "cost-utility" by the standard procedure was observed increase the cost per unit of "utilitarianism" in the appointment cytoflavin (injection) form 108.4%, and reamberin aktovegina 225,2 % i at 136.2%, 285.1 % remaxol and piracetam and 374%, when assigning tserroksana to 559.3% compared to oral Citoflavin group. 1 group.
Clinical and economic analysis of "cost-effectiveness" has shown that the cost of achieving the effect of this criterion at least pharmacotherapy cytoflavin (tablet form) (4772 tenge ) and has a maximum value in the group piratsetamovoy (37800 tenge).
Therefore, a comparative analysis of "cost-effectiveness of treatment," the index endointoxication blood established benefit of treatment in patients treated with cytoflavin in tablet form with a maximum effect at minimum cost.
Conclusions
1. Application cytoflavin for 10 days reduced content of toxic molecules in average serum and red blood cells by 45% and 56.4% approaches the value of healthy people
2. The coefficient of "cost-utility" is influenced cytoflavin 149.5 tenge (injectable) and 311.5 tenge (tablet form) and the application reamberin - 486.5 tenge aktovegina -353.2 tenge remaxol - 575 8 tenge piratsetamovoy group- 474,0 tenge when applying tseroksana -985.7 tenge.