Aim: To evaluate the economic efficiency of using ferric carboxymaltose (FCM) in patients with chronic heart failure with reduced left ventricular ejection fraction (CHFrEF) and iron deficiency (ID) in the Russian Federation Methods: The analysis of the cost of maintaining CHFrEF with ID was carried out and an analytical decision-making model was built in MS Excel, which allows estimating the costs from the position of the state in the management of patients with CHFrEF with ID when using FCM in comparison with placebo. Results: The use of FCM in 633,301 patients with CHFrEF and ID for 1 year will prevent 72,386 hospitalizations for CHF and reduce the number of days spent by patients in the hospital by 1,136,141 days. Taking into account the direct costs of stopping adverse events, as well as the indirect costs of paying disability benefits and GDP losses, the potential economic benefit of using FCV when prescribing 633,301 CHFrEF and DJ to patients for 1 year can be 4.280 million rubles. per year of therapy. The use of FCM in patients with CHFrEF and ID is advisable immediately after an episode of CHF decompensation in order to reduce the risk of subsequent hospitalizations for worsening CHF and increase the cost per patient by only 4 642 rubles. per year (18 %), while significantly improving the prognosis of patients and their quality of life. Conclusion: FCM can be recommended for inclusion in the standards of medical care, clinical guidelines, formularies of healthcare facilities, application templates within the framework of the regional (RLO) and federal drug benefits, as well as federal and regional programs aimed at improving the control of the clinical course CHFrEF with ID.

Objective: to assess the cost of the severe bronchial asthma (BA) treatment with various biological agents at inpatient and day care setting from the compulsory medical insurance (CMI) system perspective. Methods. The authors constructed the MS Excel® analytical decision-making model and calculated the CMI system’s costs of severe BA treatment with various biological drugs at inpatient and day care setting. The costs of treatment with benralizumab, dupilumab, omalizumab, reslizumab and mepolizumab were compared. The cost difference between benralizumab and other drugs was identified taking into account the frequency of the drugs’ administration. The first administration was assumed to be inpatient, followed by the administrations in day care ward. Results. The use of benralizumab reduces the expenses of the CMI system by 0.8 million rubles per patient (–39%) compared with omalizumab, mepolizumab, resizumab and by 2.9 million rubles per patient (–69%) versus dupilumab due to the lowest frequency of administration, therefore less hospitalizations for therapy. With a 5-year modeling horizon, benralizumab therapy allows to reduce the CMI system expenses by 4.5 million rubles (–48%) compared with omalizumab, mepolizumab, reslizumab and by 13.9 million rubles (–74%) compared with dupilumab. The use of benralizumab will release 5–7 cases per patient per year compared to omalizumab, resizumab and mepolizumab and 18–20 cases per patient per year compared to dupilumab. Conclusion. Benralizumab therapy in patients with severe BA in inpatient and day care settings will lead to the optimization of CMI expenditures and more rational use of budgets allocated to hospitals.

Aim: to assess economic consequences of alectinib compared with the recommended therapy schemes for patients with non-small cell lung cancer (NSCLC) with tumor expression of anaplastic lymphoma kinase (ALK+) without previous experience of targeted therapy from the Russian healthcare system perspective. Material and methods. Markov model was developed in Microsoft Excel 2010 software for cost calculation. 5-year costs of alectinib, crizotinib and ceritinib were calculated, taking into account the differences in clinical effectiveness and safety of the compared drugs. Data about clinical effectiveness and safety were derived from the network meta-analysis Steenrod A. et al, 2018, where alectinib showed superior effectiveness in the first line of therapy for ALK+ NSCLC vs crizotinib and ceritinib: relative risk (RR) of progression-free survival (PFS) was 0,50 (95% confidence interval 0,36–0,70) and 0,41 (0,25–0,67) respectively. Safety of alectinib in the first line therapy was superior to the safety of ceritinib – RR of severe adverse events (SAE)3–4 grade 0,36 (95% CI 0,17–0,79), – and was comparable with safety of chemotherapy and crizotinib – RR of SAE 3–4 grade 0,81 (95% CI 0,44–1,52) and 0,65 (95% CI 0,51–1,04) respectively. Cost effectiveness analyses and budget impact analysis were conducted from the Russian healthcare system perspective. Results. Cost of one year course of alectinib was 3 431 970 rubles, which was comparable with crizotinib (3 435 405 rub.) and 55% higher than the one-year cost of ceritinib. Cost-effectiveness ratio was lower for alectinib compared with crizotinib, incremental cost-effectiveness ratio (ICER) for alectinib vs crizotinib was 2 735 900 rub., which was 66% lower than ICER for ceritinib vs crizotinib. Given the number of patients eligible for alectinib, it’s impact on State Guarantees Program of Free Medical Care is not much. Sensitivity analysis showed that the results of budget impact assessment are stable. Conclusion. Alectinib is a preferred option for patients with ALK+ NSCLC from economic point of view. It doesn’t have a significant impact on the budget within the State Guarantees Program of Free Medical Care, and also has higher effectiveness compared with crizotinib and ceritinib and better safety when compared with ceritinib.

On the basis of multicriteria analysis, a pilot complex system for evaluating medicinal products (MP) used in the therapy of oncohematological diseases has been developed. The obtained results allow to rank MPs by priority of choice when making decisions on procurement of drugs or inclusion in MP lists in the framework of programs of preferential drug provision of the population. It has been shown that, according to the set of criteria, ibrutinib in treatment of chronic lymphocytic leukemia (CLL) has the highest priority, followed by obinutuzumab (CLL treatment) and ruxolitinib (treatment of myelofibrosis).