The purpose of presented retrospective analysis was to identify retrospectively and estimate the economic benefits that can occur when comparing the costs of using desflurane or sevoflurane for anesthesia during surgery. Formalization and evaluation were carried out in accordance with the industry standard “Health technology assessment”, approved and signed into law June 14, 2014 by Order of the Federal Agency for Technical Regulation and Metrology of the Russian Federation GOST №568-art and ISPOR recommendations, and meet the requirements of statistical significance, allowing to develop recommendation conclusions on the use of each product in any given situation. Pharmacoeconomic evaluation is based on data from official registration licenses and patient information leaflets, randomized controlled clinical trials data and information on value, pricing and costs obtained from the public independent sources. In accordance with the objectives, indications and limitations on the use of these drugs for anesthesia, the target population of this study were patients of diff erent ages, who required the use of inhalation anesthesia during the ongoing surgical procedures: patients with physiological status not higher than Class I (ASA I) on the scale of the American Association of Anesthesiologists. Compared medical technologies were III generation inhalation analgesics Sevorane and Suprane. Th ere was conducted a cost-effectiveness analysis of the inhalation anesthetics, during which cost of achieving the minimum alveolar concentration (MAC) using compared inhaled anesthetic drugs was estimated. The analysis showed that the difference in favor of desflurane is 155.72 rub for a four-hour operation. The most significant influence on the direct medical costs associated with the use of inhalation anesthesia was shown by the cost of inhalation anesthetic (gas) per 1 ml, the concentration of the gas, the flow rate of fresh gas, duration of anesthesia. Sensitivity analysis confirmed the data obtained. In the current situation of the retrospective evaluation the assumed shift from sevoflurane to desflurane in 1 000 patients aged 12 to 60 years that require inhalation anesthesia, will be accompanied by cost savings of 102,907 rub to 155,720 rub, and with the use of induction of anesthesia with propofol up to 162 900 rub. Whereas during anesthesia in newborns and patients older than 60 years shift of desflurane to sevoflurane in 1 000 patients will reduce the cost by 266,354 rub and 225,672 rub respectively. Therefore the economic benefit from the use of a single inhalation anesthetic both as an induction drug and as a drug anesthetic drug has not been proved clinically and from an economic point of view that may require individual assessment of costs on the basis of regions of the Russian Federation or a particular institution.

Gadolinium based contrast agents are widely used in MRI in a diagnostic of variety of pathologies. The quality of contrast enhancement depends on the total dose. The aim of the study is to conduct a health economic evaluation of gadoversetamide (OptiMARK, Malickrodt Pharmaceuticals) in contrast enhanced MRI. The cost-effectiveness analysis, costminimizing analysis and sensitivity analysis and budget impact analysis were used modeling contrast enhanced MRI. In results, we can say that OptiMARK is cost-effective comparing to gadopentetic acid and gadobutrol.

The purpose of this pharmacoeconomic analysis was to determine the drug Nefopam economic feasibility of its use for postoperative pain relief in terms of the health system of the Russian Federation. Target population are Russian patients older than 18 years with moderate to severe pain after surgery, which requires the use of postoperative analgesia. In the context of this pharmacoeconomic analysis of patients treated with the assessment of the physiological status of not higher than class I or II on the scale of the American Association of Anesthesiologists. Clinical utility criterion: change numeric scale pain score (NPS — Numeric Pain Scale). In calculating the cost-utility ratio (CUR) following data were obtained: the cost of therapy at least a separate application ketoprofen — 19.80 rubles; CUR minimum figure in the application of multimodal anesthesia — 13.78 rubles. Budget impact analysis showed that the cost savings when using multimodal analgesia will be 574,662 rubles 1000 patients compared with nefopam; and in a separate application of ketoprofen — 21 538 rubles.

The purpose of pharmacoeconomic studies of the drug zonisamide is to determine it’s clinical and cost-effectiveness in adult patients with refractory partial epilepsy in comparison with other new antiepileptic drugs in the conditions of the Russian Federation. Target population are Russian patients older than 18 years with the diagnosis of the resistant partial epilepsy with secondary generalization or without it. Results of pharmacoeconomic modeling analysis application zonisamide and topiramate therapy in partial epilepsy for 2 years under the Russian healthcare system on one patient showed that all the above drugs were effective in the treatment of refractory partial epilepsy in their nomination in addition to other antiepileptic drugs. Comparing the efficacy, expressed in the probability of therapeutic response ≥50% after 2 years of treatment, topiramate at — 0.227, zonisamide — 0.194. The cost of the use of drugs is higher in comparison topiramate — 115 082 rubles, zonisamide — 97 342 rubles. Cost-effectiveness ratio (CER) was the lowest in zonisamide — 501 070 rubles, topiramate — 507 762 rubles. QALY at zonisamide — 1,189, topiramate — 1,191. Cost-utility ratio (CUR) was the lowest in zonisamide — 81 886 rubles, topiramate — 96 609 rubles. For all drugs increased doses resulted in an increase of efficiency of treatment, as well as the frequency of adverse events and associated with them, cessation of therapy. With increasing doses up to the maximum performance CER and CUR will be at least topiramate. None of the compared drugs does not exceed the threshold of «willingness to pay ratio», i.e. they are all pharmacoeconomical and be reimbursement. Th e budget impact analysis showed that the overall cost of the therapy will be higher in the group of topiramate is 15.4%, compared with zonisamide. Pharmacoeconomic analysis confirmed the data on effi cacy and safety, and also showed the place of comparators in the cost of treatment of patients with partial epilepsy.

Objective: to evaluate the economic burden of chronic obstructive pulmonary disease (COPD) in Russian Federation. Methods: This paper analyzes the existing evidence base for assessing the value of COPD. The estimation of the economic burden of COPD in Russia using clinical-economic analysis — the «cost of illness» (COI). The study took into account only the direct costs of the state, there were two variants of calculations using statistics in 2007 (according to some indicators more recent data are not available) and extrapolated data based on the incidence in 2012. Results: The economic burden of COPD in Russian Federation (direct costs excluding the costs of drug therapy) for the first version (2007 statistics) calculations was 54.6 billion rubles for the second option (statistics extrapolated to 2012) calculations — 61.6 billion rubles. Structure of direct expenses of the state for the treatment of COPD in Russia was as follows — 77% of hospitalization costs, 21% — the costs of outpatient care, 2% of the cost — emergency medical care. The largest share of costs associated with COPD exacerbation. Conclusion: At the present stage of COPD is an important cause of morbidity and mortality worldwide, resulting in significant economic and social damage, the level of which increases. Prevalence, morbidity and mortality due to this disease varies greatly in different countries and subpopulations within a country and usually depend on the prevalence of smoking. Correct interpretation of the concept of COPD, use of common diagnostic criteria, standardization conducted epidemiological and economic studies are essential estimate of the true damage this disease.

Diabetic ketoacidosis (DKA) is one of the most serious acute complications observed with a frequency of 10-100 cases per year per 1000 patients with type 1 diabetes mellitus (DM1). More than a third of patients with DKA are admitted to hospital in diabetic coma state (DC) with mortality of 19%. In spite of the serious complications and the high social importance, the problem of preventing the DKA has received little attention. Objective: To evaluate the epidemiology of the DKA and pharmacoeconomic aspects of monitoring blood ketones at home, as one of the measures of prevention of diabetic ketoacidosis in patients with type 1 diabetes in Russia. Materials and methods. A literature search was conducted among national and international databases. Direct medical costs for treatment of the DKA and DC were studied in several hospitals of the Russian Federation. Cost-eff ectiveness of preventing the DKA for the public health system was evaluated. Results. Over 2.05 thousands of children’s and adolescents, and 14.9 thousand of adults with DM1 and the DKA are hospitalized annually in the Russian Federation, 0.62 and 7.47 thousands respectively in a state of DC that leads to a total cost of hospitalization of 63.8 millions, and 528.6 millions rubles, respectively. Monitoring of ketone bodies at home is one of the main methods for the prevention of DKA. Two methods for detecting ketosis are currently available in the Russian Federation: blood β-hydroxybutyrate testing and urine acetoacetate testing. Measurement of β-ketones in the blood as an accurate indicator of the amount of ketones in the microcirculation, shows the level of ketones in the blood at the present moment, allows adjust therapy and almost twice reduces the need for hospitalization, that may lead to a reduction in the annual cost of treatment of DKA and DC in hospitals by almost 300 million rubles in Russia. Conclusions. Th e widespread introduction of measuring β-ketones in the blood in routine practice for patients with DM1 will greatly reduce the number of hospitalizations and deaths due to diabetic ketoacidosis, as well as healthcare costs associated with this condition.

In one-stage opened research activity of isoenzymes СYР3А4 and CYP2C9 of system of biotransformation of medicines at patients with chronic diffusive liver diseases — residents of Volgograd and the Volgograd region is defined. It is established that the greatest decrease in activity of isoenzyme СYР3А4 is connected with chronic virus hepatitis C (for 57 % from normal values), in other groups as decrease in activity of an isoenzyme is noted: at primary biliary cirrhosis (for 43,5 %), alcoholic liver disease (for 39 %) and nonalcoholic fatty liver disease (fatty liver) (for 33 %). At all patients with chronic diffusive liver diseases as decrease in activity of an isoenzyme of CYP2C9 is noted. In group of chronic virus hepatitis C (for 48 % from normal values), primary biliary cirrhosis (for 41,2 %), nonalcoholic fatty liver disease (fatty liver) (for 23,4 %), alcoholic liver disease (for 20,5 %).

Given the shortage of funds, the most common response from the authorities responsible for funding, or a desire to direct cuts in funding, or to the greatest possible diffi culty obtaining funding medical organizations involved in the implementation of the program of state guarantees the provision of free medical care to citizens. However, the desired result can be obtained without the use of quarantine measures.