According to the official Russian source, in 2017 only 0.27% of the population of Russia was diagnosed with International Classification of Diseases, tenth revision (ICD-10) F4 category disorders (neurotic, stress-related and somatoform disorders), despite these disorders being among the most prevalent mental disorders worldwide. Here we report the results of a large-scale survey among Russian psychiatrists with the primary objective to assess the proportion of psychiatrists who use the diagnoses of interest (mixed anxiety and depression disorder [MADD], adjustment disorder [AdD], panic disorder [PD], agoraphobia, generalized anxiety disorder [GAD], social phobia, simple phobia, acute stress disorder and posttraumatic stress disorder) and compare results with those of a recent World Psychiatric Association (WPA) and World Health Organization (WHO) survey. We also compared the incidence of these diagnoses between state and non-state psychiatric services in Russia. Mean proportions and distribution of proportions of participants who made diagnoses of interest at different rates were calculated and compared with the results of the recent WPA and WHO survey. Risk ratios (RR) of the incidence of these diagnoses made at a frequency of at least once a week were calculated to compare state and non-state psychiatric services. The 95% confidence intervals of the RRs were calculated using the Koopman asymptotic score method. Responses of 960 Russian psychiatrists were included in the analysis. Of these 95, 89 and 87% reported making diagnoses of MADD, AdD and PD, respectively, during the preceding 12 months, a far larger proportion compared to other disorders of interest. In general, a significantly smaller proportion of participants in our survey made diagnoses of anxiety disorders compared to respondents in the international WPA–WHO survey. Based on RRs, diagnoses of MADD, AdD, PD, GAD and acute stress disorder were less frequently made in the state-operated psychiatric service. Our survey revealed a serious underdiagnosis of anxiety disorders in Russia that may be associated with complex factors that include, but are not limited to the current stigma associated with the state-operated psychiatric service, which is still the exclusive source of official statistical data in Russia.

Objective. The purpose of this study was to study the frequency of achievement of target values of vancomycin residual concentration (RC) and to identify the factors influencing this indicator. Materials and Methods. A retrospective observational study of vancomycin RC was performed in 471 patients who received vancomycin infusions in the department of purulent surgery of the RSRI of TO named after R.R. Vreden about capillary instillation after major orthopedic operations over the period from 01.01.2014 to 05.31.2016. Results. The target RC values on the third day of vancomycin administration reached 12.1% of patients (76.2% below target RC), after correction of the dosing regimen, the target RC was achieved in 20.3% of patients (56.9% below target RC). Multivariate analysis revealed a connection between RC and age (an increase in RC in age patients) and sex (a higher RC in women). In most cases, the prescribed doses of vancomycin corresponded to the recommended, however, the target RC levels of vancomycin were achieved only in a small proportion of patients. Conclusions. At the same time, the lowest frequency of reaching target concentrations was observed in young patients. The study proposed a multifactor model of vancomycin RC, on the basis of which it is possible to carry out the best correction of dosing taking into account the factors of age and sex.

Introduction.Nowadays, lipid-lowering therapy is considered an essential strategy for primary and secondary prevention of cardiovascular outcomes, which is confirmed by numerous studies. Nevertheless, researches are often guided by analysis of surrogate endpoints, which becomes not just everyday practice, but also an actual problem. Surrogate endpoints are wellknown sources of bias that can distort the risk-benefit analysis.Theobjectiveof the study was to assess the significance of lipid-lowering therapy with statins in relation to mortality.Methods and materials.The analysis of prospective controlled trials was carried out with a sample of 2000 patients and more, in which mortality rate was assessed for 2 or more years of statin therapy, as well as systematic literature reviews with a meta-analysis of mortality rates. The search was carried out on websites of the Russian scientific electronic libraries eLibrary and сyberleninka , English-language works – on the PubMed website.Results.An increase in survival during treatment with statins in case of secondary prevention of cardiovascular diseases reached about 2 % after five years’ treatment and was absent after ten years’ treatment. The average increase in life expectancy was only 4.1 days. Primary prevention with statins has not been shown to increase survival significantly.Conclusion.Effectiveness of lipid-lowering therapy with statins as a part of secondary prevention of cardiovascular outcomes assessed by surrogate endpoints could be greatly exaggerated. A biased approach to selecting surrogate endpoints can lead to incorrect results. Similarly, the encouraging results of therapy with statins in the prevention of cardiovascular mortality may be biased when the effect of statins on other causes of death is not considered. Mortality refers to a universal endpoint that characterizes both the effectiveness and safety of a drug.

Tis article presents a literature review of hepatotoxicity of new oral anticoagulants which was obtained by different methods options of pharmacovigilance. Te overview includes 35 information sources 24 articles, 4 methodic or regulatory guidelines, 3 expert group publications, 3 new drug application overviews and 1 source being clinical trial register search results. Upon the results of the literature review, it was concluded that pharmacovigilance methods analyzing data obtained within real world medical practice give more opportunities for safety signal management comparing to those analyzing only data obtained within randomized clinical trials.

Introduction. Steroid-refractory graft-versus-host disease (srGVHD) is one of the most severe and life-threatening complications of allogeneic hematopoietic stem cell transplantation. Currently, there is no standard treatment for this complication. In addition, there is no data on the pharmacoeconomics of various methods in the Russian Federation. The objective is to compare the effectiveness and cost of treatment of acute and chronic srGVHD, as well as the use of different approaches in therapy. Material and methods. We have conducted a pilot study in 12 srGVHD patients treated with ruxolitinib and in 24 patients of wellmatched historical control, who treated with etanercept for the acute srGVHD and with extracorporeal photopheresis for chronic srGVHD. Results. The 6-month therapy of acute GVHD was associated with significantly higher cost than therapy of chronic GVHD (4.138±2.672 vs 1.862±1.122 thd. rub., р=0.004). The major factors driving up the costs were bacterial infections (р=0.022), opportunistic viral infections (р<0.001), severity of GVHD at the start of a therapy (р=0.013) and GI involvement (р=0.006). There was no difference in 1-year failure-free survival in acute (50 % vs 67 %, р=0.9) and chronic GVHD (87.5 % vs 87.5 %, р=1.0) between ruxolitinib and the control group, although the overall response was faster in ruxolitinib group (100 % vs 71 %, р=0.035, when assessed at 28 days in acute and 12 weeks in chronic srGVHD). The mean 6-month overall costs in the ruxolitinib were higher compared to the control group (1534 thd. rub. higher for acute and 541 thd. rub. higher for chronic GVHD), however this might be attributed to higher number of previous lines in the ruxolitinib group. Conclusions. It is revealed that the treatment of acute srGVHD requires significantly higher economic costs than chronic srGVHD. The power of this study does not allow to draw conclusions regarding the efficacy of different methods. Further studies are required to determine the optimal therapy of srGVHD.

The purpose of the study. To evaluate immunogenicity of influenza vaccination in HIV-infected adults initially seronegative to influenza virus.Materials and methods. There were 175 HIV-infected persons and 50 healthy volunteers vaccinated against influenza in Republican center of AIDS (Ufa) in 2016-November. Titers of antibodies to influenza virus (A [H1N1], A [H3N2] and B) were detected in standard hemagglutination-inhibition reaction: before (day 0) and after (on 21th and 150th days) vaccination. Post-vaccination trends of antibodies to influenza virus were analyzed in 12 HIV-infected patients (7%) and 13 subjects from control group (26%) with the titer of antibodies lower than protective level (1/40) according to the criteria of immunogenicity for influenza vaccines for all subtypes of its antigens.Results. The shares of initially seronegative were 2–7% for HIV-infected and 12–24% Saint-Petersburg for healthy persons. Seroconversion coefficient varied from 1,6 to 2,3; seroconversion rate varied from 0 to 25%; seroprotection rate – from 67% for А (H1N1) to 100% for А (H3N2) and В. The titer of antibodies detected on day 21 didn’t decrease up to day 150 in all vaccinated persons.The analysis of the titer in HIV-infected adults with the different levels of CD4-cells demonstrated achievement of minimal protective level (1/40) in the majority of cases, and at least fourfold increase of the titer was determined when CD4-cells level was 350 cells/μl.Conclusion. Single immunization of HIV-infected adults with standard vaccine for seasonal prevention of influenza is insufficient for creation of adequate immune response. A small sample of the study does not allow extrapolating the results of studies to large cohorts of patients with HIV infection. Further research is required to develop recommendations for vaccine prevention of influenza in patients with HIV infection.

Цель работы — провести сравнение эффективности и безопасности частичных агонистов никотиновых ацетилхолиновых рецепторов варениклина и цитизина. Методы. Поиск рандомизированных клинических исследований в базах данных MEDLINE, EMBASE, eLibrary. Оценивали характеристики участников исследования, дозировку, продолжительность лечения, наличие/отсутствие рандомизации, потерю зрения, основные точки эффективности, безопасность. Выполнен иерархический байесовский сетевой метаанализ. Результаты. Цитизин значимо превосходил плацебо на 12, 24 и 52-й неделе терапии. Отношение шансов (ОШ) составило соответственно 3,3 (95 % доверительный интервал (ДИ) 1,8–5,8), 3,9 (2,4–6,7), 3,8 (1,3–11,9). Варениклин в дозе 2 мг/сут также значимо превосходил эффекты плацебо на 12, 24 и 52-й неделе терапии. ОШ составило соответственно 4,0 (3,3–4,7), 3,1 (2,5–3,7), 2,9 (2,2–4,1). Варениклин в дозе 1 мг/сут значимо превосходил эффекты плацебо на 12-й и 52-й неделе терапии, ОШ составило соответственно 3,0 (2,0–4,7) и 2.3 (1,3–4,4). Варениклин в дозе 0,5 мг/сут значимо превосходил эффекты плацебо на 12-й неделе терапии, ОШ составило 2,4 (1,2–4,8). Цитизин и варениклин имели более высокий риск развития нежелательных побочных явлений со стороны желудочно-кишечного тракта по сравнению с плацебо: ОШ для цитизина составило 6,2 (2,1–22,8), варениклина — 2 мг/сут 2,4 (2,0–2,8). Цитизин и варениклин имели более высокие шансы психических нарушений по сравнению с плацебо: ОШ для цитизина — 5,2 (1,9–15,1), варениклина 2 мг/сут — 1,6 (1,3–1,9). Частота серьезных нежелательных явлений у варениклина и цитизина была сравнима с плацебо: ОШ для цитизина — 2,4 (0,8–6,8), варениклина 2 мг/сут — 2,0 (0,5–6,6), варениклина 1 мг/сут — 1,0 (0,3–2,7), варениклина 0,5 мг/сут — 1,0 (0,7–1,4). Заключение. Цитизин имеет сходный с варениклином профиль эффективности и безопасности при лечении никотиновой зависимости.

Objective . We performed post-hoc analysis of results of multicenter open-label randomized comparative trial on antihypertensive efficacy and safety of fimasartan and losartan in parallel groups for adult outpatients with mildto-moderate hypertension (HTN) during 12 weeks of treatment in order to determine characteristics associated with better treatment efficacy. Design and methods. Post hoc analysis included ITT (intention-to-treat) population: 89 patients from fimasartan group and 90 patients from losartan group. We assessed associations between change from baseline in “office” sitting systolic and diastolic blood pressure and gender, age, anthropometric parameters, duration and severity of hypertension, previous antihypertensive treatment, clinical and laboratory parameters on study visits, and doses of studied drugs. Statistical package R (version 3.0.2, The R Foundation for Statistical Computing 2013) was used for analysis. Results . Fimasartan and losartan provided comparable blood pressure lowering effect in gender, age subgroups, in patients with different duration and severity of hypertension, risk factors profiles. There was a trend toward higher blood pressure decrease in patients with body mass index (BMI) ≥ 30 kg/m 2 in fimasartan group. In the overall population BMI ≥ 30 kg/m 2 was associated with 2-fold increase of risk of dose change at any visit: odds ratio (OR) = 2,1 (95 % confidential interval (CI): 1,08–3,91). However, study groups analysis demonstrated that it was true only for losartan: OR = 2,75 (95 % CI: 1,1–6,88; р = 0,036). Fimasartan was equally effective in both obese and normal weight patients: OR = 1,50 (95 % CI: 0,63–3,93; р = 0,356). Conclusions. Hypertensive patients with BMI ≥ 30 kg/m 2 may benefit more from fimasartan treatment. This fact needs confirmation in further studies with larger sample size.

Corticosteroid-refractory (SR) graft versus host disease (GvHD) is one of the most severe and life-threatening complications of allogeneic hematopoietic stem cells transplantation. To date, there are no standards for the treatment of this complication and few pharmacoeconomic analyses of various methods of treatment. The data was collected retrospectively from medical records for 4 patients with acute SR GvHD treated with ruxolitinib, 8 patients with chronic SR GvHD treated with ruxolitinib, 8 patients with acute SR GvHD treated with etanercept, and 16 patients with chronic SR GvHD treated with extracorporeal photopheresis. We analysed effectiveness of the treatments based on overall response (OR) and failure-free survival (FFS), and performed cost minimization analysis with probabilistic sensitivity analysis. OR was assessed on day 28 for acute SR GvHD and after 12 weeks for chronic SR GvHD. There was no difference in 1-year FFS between ruxolitinib and control group in acute (50% vs 67%, p=0.90) and chronic SR GvHD (88% vs 88%, p=1.0). OR was faster in ruxolitinib group (100% vs 71%, p=0.035), however we considered these effects comparable. Cost-minimization analysis demonstrated that six-month treatment with ruxolitinib was more expensive compared to the control group: 5 160 685 vs 3 626 654 rubles/patient for acute SR GvHD (ruxolitinib is more expensive by 43%), and 2 222 354 vs 1 681 221 rubles/patient for chronic SR GvHD (ruxolitinib is more expensive by 32%) accordingly. We showed that ruxolitinib was economically unprofitable comparing to other frequently used therapies (etanercept and extracorporeal photopheresis). The power of this study does not allow to draw conclusions regarding the effectiveness of the therapies and further studies are required to to resolve this issue. However, probabilistic sensitivity analysis confirmed stability of the estimated costs of treatment.

Цель исследования: сетевой мета-анализ (СМА) рандомизированных контролируемых исследований (РКИ) парнапарина, эноксапарина, надропарина и нефракционированного гепарина (НФГ) в режиме краткосрочных курсов в малых и средних дозах для профилактики венозных тромбоэмболических осложнений (ВТЭО) при хирургических и ортопедических вмешательствах у пациентов с высоким риском тромбоза глубоких вен (ТГВ). Материалы и методы. Выполнен смешанный СМА 21 РКИ парнапарина, эноксапарина, надропарина и НФГ у хирургических больных с кратковременной (1-2 недели) профилактикой ВТЭО. Результаты. По сравнению с НФГ применение парнапарина статистически значимо снижало риск развития ТГВ (на 51%) и «больших» кровотечений (на 83%). Эноксапарин и надропарин подобных преимуществ по сравнению с НФГ не продемонстрировали, что вряд ли связано с недостаточной статистической мощностью исследования. Заключение. При прочих равных условиях парнапарин может рассматриваться в качестве препарата выбора для профилактики ВТЭО в хирургии и ортопедии. Aim: network meta-analysis (NMA) of randomized controlled trials (RCTs) of parnaparin, enoxaparin, supraparin, and unfractionated heparin (UFH) in the regime of short-term courses in small and medium doses for prophylaxis of venous thromboembolic complications (VTEC) at surgical and orthopedic interventions in patients with high risk of deep vein thrombosis (DVT). Materials and methods. Mixed CMA of 21 RCTs of parnaparin, enoxaparin, supraparin and UFH was performed in surgical patients with short-term (1-2 weeks) prophylaxis of VTEС. Results. Parnaparin reduced significantly the odds of DVT (by 51%), and the odds of «large» bleedings (by 83%) compared with UFH. Both enoxaparin and nadroparin did not demonstrate convincing advantages over UFH concerning the efficacy and the safety. This fact is hardly explained due to the insufficient statistical power of the study. Conclusion. We conclude that when other things being equal, parnaparin exposes better therapeutic profile resulting parnaparin might to be considered first for VTEC prevention in surgery and orthopedics.

Background. Partial agonists of α4b2 nicotinic acetylcholine receptors are the most effective treatment strategy for tobacco smoking cessation. They are able to alleviate withdrawal symptoms and to reduce smoking satisfaction. The aim of this study was to review the efficacy and safety of nicotinic receptor partial agonists varenicline and cytisine, for smoking cessation. Methods. A search for randomized controlled trials was done using the terms (“cytisine”, “tabex”, “varenicline” or 'partial agonists of nicotinic receptors’) in MEDLINE, EMBASE, eLibrary in May 2018. Types of participants, the doses and duration of the treatments, efficacy and safety parameters, quality of randomization and blinding procedures were evaluated. Bayesian network meta-analysis was performed. Results. Cytisine overcame placebo in the 12, 24 and 52 weeks of therapy with the following odds ratios (ORs) for abstinence: 3.3 (95% CrI 1.8–5.8), 3.9 (2.4–6.7), 3.8 (CrI 1.3–11,9) accordingly. Varenicline in 2 mg/day dose overcame placebo in the 12, 24 and 52 weeks of therapy with the ORs: 4.0 (3.3–4.7), 3.1 (2.5–3.7), 2.9 (2.2–4.1) accor dingly. Varenicline in 1 mg/day dose overcame placebo in 12 and 52 weeks of therapy, the ORs were 3.0 (2.0–4.7) and 2.3 (1.3–4.4) accordingly. Varenicline in 0.5 mg/day dose overcame placebo in 12 weeks of therapy only with the OR 2.4 (1.3–4.4). Cytisine and varenicline 2 mg/day were associated with more gastrointestinal disturbances than placebo with the ORs 6.2 (2.1–22.8) and 2.4 (2.0–2.8) accordingly. Cytisine and varenicline 2 mg/day were associated with more psychiatric problems than placebo with ORs 5.2 (1.9–15.1) and 1.6 (1.3–1.9) accordingly. There was no difference in serious adverse events between the investigated drugs and placebo: OR for cytisine was 2.4 (0.8–6.8), varenicline 0.5 mg/day – 2.0 (0.5–6.6), varenicline 1.0 mg/day – 1.0 (0.3–2.7), varenicline 2 mg/day – 1.0 (0.7–1.4). Conclusion. Cytisine was proved to be as effective and safe aid for smoking cessation as varenicline.

The objective of the study was to describe psychological features of abstinent heroin users undergoing rehabilitation in Saint Petersburg, Russia. Study subjects (n = 197) were recruited prospectively at the time of their admission to rehabilitation between March 2010 and May 2011 at 7 inpatient opiate addiction rehabilitation centers in Saint-Petersburg and neighboring regions, Russia. The centers provided varying rehabilitation programs; 6 of them were religious centers. Socio-demographic information and self-reported HIV status were collected. Personality profiles and severity of drug-associated problems were estimated before and after rehabilitation using the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and the Addiction Severity Index (ASI).

Antibiotic overuse in infants is associated with an increased risk of serious adverse events. Development of antibiotic stewardship programs aimed at reducing overall antibiotic consumption requires epidemiological surveillance. Retrospective surveillance and evaluation of all antibiotics provided to every infant admitted to maternal wards or neonatal intensive care units (NICUs) from 01 January 2014 to 31 December 2014 were performed in five medical centers of Saint Petersburg, Russia. Types of antibiotics and dates of administration were recorded. Antibiotic use was quantified by length of therapy (length of therapy, LOT, per 1000 patient-days, PD) and days of therapy (DOT/1000 PD). An additional parameter named "instant DOT/1000 PD" was introduced by authors for assessment of longitudinal patterns of administrations. Antibiotic load was 825.6 DOT/1000 PD in maternity wards and 1425.8 DOT/1000 PD in the NICUs. These levels are two to four times higher than DOTs reported in the USA for a level III NICU (348 DOT/1000PD). Antibiotic load was associated with the length of hospital stay (LOS) and birth weight. These associations were distorted when assessed using the conventional parameters, LOT and DOT, because they do not reflect the longitudinal component of treatment and underestimate antibiotic load when a patient stays in hospital without treatment. The proposed additional parameter successfully overcame these flaws and uncovered hidden associations. Severe overuse of antibiotics may be taking place in Russia and antibiotic stewardship development should be urged. Instant DOT/1000 PD is a more powerful tool in assessing treatment patterns than DOT/1000 PD.

The process of decision modelling in diabetes mellitus (DM) is often complicated by comorbidity among diabetic patients, complexity of endpoint selection, and unclear time horizons. Aim . To review the available recommendations, relevant methods and mathematical approaches to decision modelling in DM. Materials and Methods . We searched through the PubMed database using the ResearchGate and Mendeley networks; we also collected data from the websites of the key opinion leaders in the field of pharmacoeconomics and decision modelling. Results . This review contains up-to-date information on the validity of the most common DM decision models and on the validity of extrapolating the type 2 DM models to patients with type 1 DM. We also provide some clinically relevant comments on the American Diabetes Association’s requirements concerning the decision models in DM. The review incorporates data on the current mathematical approaches to modelling the changes in glycated hemoglobin levels, the body mass index and the quality-adjusted life expectancy – for both type 1 and type 2 DM. Conclusion . Despite recent successes in DM decision modelling, the existing approaches are not always relevant to some groups of DM patients or to some aspects of the disease. Thus, the use of the novel anti-diabetic drugs (liraglutide, semaglutide, empagliflozin) capable of significantly reducing cardiovascular risks in DM patients, require new approaches to decision modelling in diabetes mellitus.

A health economic study was conducted under the Russian economic conditions to evaluate the feasibility of the use of dexamethasone 0.7 mg as a sustained release intravitreal implant (hereinafter, DEX implant) in the treatment of diabetic macular edema. Cost-effectiveness analyses (CEA) were performed using a decision tree model with calculation of cost effectiveness ratios (CER), as well as incremental cost-effectiveness and cost-utility ratios (ICER and ICUR). Ranibizumab 10 mg/ml, solution for intravitreal administration (hereinafter, ranibizumab), and a­ibercept 40 mg/ml, solution for intravitreal administration (hereinafter, a­ibercept), were used as the comparator drugs; the modeling study covered a three-year period. A probabilistic sensitivity analysis (PSA) was carried out to evaluate the level of uncertainty of the obtained results. A budget impact analysis was also performed. ‹Free scenarios were reviewed for each analysis: the main scenario for phakic and pseudophakic eyes with the weighted average effects of the study drugs; alternative scenario 1 for pseudophakic eyes with the weighted average effects; alternative scenario 2 for pseudophakic eyes with the maximum possible effects of the study drugs. A network meta-analysis of 10 randomized controlled studies (RCT) was performed to evaluate the weighted average effect. ‹e maximum possible effects were determined based on specific studies, including observational studies. ›e results of the main scenario and alternative scenario 1 demonstrated that the comparator drugs were inferior to the DEX implant with regard to the economic feasibility, since they had higher CER; the ICER and ICUR for the comparator drugs exceeded the social willingness to pay threshold. ‹e results of alternative scenario 2 demonstrated that the DEX implant was dominant with regard to ranibizumab, and it was superior to a­ibercept with regard to the CER, ICER, and ICUR. ‹The budget impact analysis demonstrated that a 3-year use of the DEX implant will allow to save the funds equivalent to an additional treatment of 102–189 patients if it replaces ranibizumab (depending on the scenario) or 72–286 patients if it replaces a­ibercept (depending on the scenario). ‹e sensitivity analysis demonstrated low level of uncertainty of study conclusions.

There is absolute lack of statistics on the use of antimicrobial agents in hospitals in Russia. The present study was conducted within the framework of Saint Petersburg’s multi-purpose programmes initiated in 2014 to restrain antimicrobial resistance.

The present study was conducted within the framework of Saint Petersburg’s multi-purpose programmes initiated in 2014 to restrain antimicrobial resistance. The study was observational and retrospective. The analysis included three maternity hospitals; 484 medical records of women were collected, the vast majority of them were women after childbirth (90.3%). The results showed that the antimicrobial agents were administered mainly for the prophylaxis of suspected (unclear) infections (42.9% cases). The second most frequent indication was treatment or prophylaxis of pelvic infection (35.8% of cases). Microbiological examinations were conducted only in 54% of patients. On average, each woman received 1.7 courses of antimicrobials, usually for the prophylaxis of infection (67.2%). Three antimicrobial agents were used in 90% of cases: metronidazole, cefazolin and ceftriaxone. Antimicrobial agents prescribed to pregnant women were considered safe for a long-term use in 54%, the rest of them were safe only for a short-term use. The authors provide recommendations to improve current practices.

Background: Omalizumab is the first and yet the only biopreparation for asthma which combines high efficiency and high cost. The clinical-economic expediency of using omalizumab in asthmatic children has not been previously studied in Russia.Objective: Our aim was to evaluate the clinical and economic expediency of using omalizumab as additive treatment (to basic or supporting therapy) in children with severe uncontrolled atopic asthma under the Russian economic conditions.Methods: We conducted a mathematical simulation of asthma treatment in children with an increased frequency of hospitalization (9 times per year) with an average monthly omalizumab requirement of 558 mg. The model is based on the Markov chain. The model includes direct and non-direct costs. The planning horizons were 2 and 5 years. We analyzed the efficiency and utility of the costs and their influence on the budget. The stability of received data is proven by sensitivity analyzis.Results: Over a 5-year planning horizon the cost of an additional year of quality life (due to using omalizumab) was 1,259,185 roubles, while the “society’s solvency” is 1 341 308 roubles (cost utility analizis). It takes 39,820 rubles to prevent one hospitalization with omalizumab over a 5-year planning horizon (cost efficiency analizis), which is comparable to the cost of hospitalization (43,141 rubles). Total costs for treating 100 children with asthma, 7 of which would be treated with omalizumab, were equal to the amount of money which is enough to treat 105 children without omalizumab (analysis of budgetary influence).Conclusion: The analyses of cost efficiency and utility have shown that the strategy of using omalizumab together with standard treatment is economically expedient. Budgetary influence analysis has not detected a significant burden on the budget.