The human papillomavirus (HPV) infection is one of the major risk factor of development of genital warts, a cervical dysplasia, a cervical cancer, and also some other oncologic diseases. The usage of quadrivalent HPV vaccine in girls reduces the corresponding case rate and the mortality significantly. The objective of this study is to analyze the cost-effectiveness of quadrivalent HPV vaccination cases of 12-yearold girls in Russian Federation. Materials and methods. A Markov model is used on the basis of epidemiological data in Russian Federation. The cost-effectiveness was estimated from societal perspective. We assumed that the effect of vaccination remains throughout all life. The analysis is performed for survival of 12-year-old girls. We considered only effect in the vaccinated population. Costs for therapy of the diseases associated with HPV infection corresponded to compulsory health insurance rates across St. Petersburg for 2016. Costs and life expectancy have been discounted for 3,5% a year. Results. Quadrivalent HPV vaccination of 12-year-old girls in Russian Federation will allow to prevent counting on 10000 the vaccinated persons 293 cases of genital warts, 15 cases of pre invasive cervical cancer, 81 cases of invasive cervical cancer, 6 cases of vulvar cancer, 2 cases of vaginal cancer, 2 cases of anal cancer, 1 case of oropharyngeal cancer. In general, 49 cases of death caused by HPV infection on 10000 vaccinated girls would be prevented. The vaccination will provide cost reduction, caused by HPV-associated diseases, for 68% (58,38 million rubles on 10000 vaccinated), and 96% of the predicted prevented costs will be caused by decrease in incidence of cervical cancer. The quadrivalent HPV vaccination is associated with an incremental cost-effectiveness ratio (ICER) of 172 000 rubles per quality adjusted life-year (QALY) and 411 300 rubles per death caused by HPV-associated diseases. Conclusions. Quadrivalent HPV vaccination of girls prior to the beginning of sex life could be considered in Russian Federation as an economically highly effective technology for preventing HPV-associated diseases.

In the treatment of chronic hepatitis C (CHC) protease inhibitors (PI) are actively used. The aim of this analysis was to evaluate the cost-effectiveness of narlaprevir and simeprevir in the CHC (genotype 1) therapy in treatment-naive patients and relapsers. Material and methods. Analysis of the cost-effectiveness of simeprevir and narlaprevir was conducted from the perspective of the health care system based on QUEST-1, QUEST-2, ASPIRE and PIONEER clinical trials. The relative risk of achieving SVR 24 compared to the peg-INF + RBV therapy was used in the model. Treatment discontinuation in patients receiving narlaprevir assumed in the absence of a SVR after 12 weeks and in patients receiving simeprevir in the SVR absence after 4 weeks. The cost of narlaprevir was calculated on the basis of estimated registration price in case of EDL inclusion, including VAT. Costs of other antiviral drugs were in line with the results of 2016 average auctions prices. Results. In the base case costs on antiviral drugs with narlaprevir as therapy are lower compared with simeprevir by 37,3 % (542,0 and 864,6 thousand rur, respectively), and the cost per patient with SVR 24 by 34,5%. In patients after relapse costs on antiviral drugs with narlaprevir as first-line therapy will decrease compared with simeprevir by 22,8% (542,0 and 702,5 thousand rur, respectively), and the cost per patient with SVR 24 by 41,3%. The sensitivity analysis demonstrated a high reliability of obtained results. Conclusions. With comparable clinical efficacy and tolerability of narlaprevir and simeprevir both in treatment-naive patients and patients with relapse after therapy, which included pegylated interferon and ribavirin, narlaprevir reduces the burden on the budget.

The protease inhibitors (PI) actively using for the treatment of chronic hepatitis C (CHC). The aim of this analysis was to evaluate the cost-effectiveness of narlaprevir and simeprevir in the CHC (genotype 1) therapy in treatment-naive patients and relapses. Material and methods. Analysis of the cost-effectiveness of simeprevir and narlaprevir was conducted from the perspective of the health care system and base on QUEST-1, QUEST-2, ASPIRE and PIONEER clinical trials. The relative risk of achieving SVR 24 compared to the peg-INF + RBV therapy was used in the model. Treatment discontinuation in patients receiving narlaprevir assumed in the absence of a SVR after 12 weeks and in patients receiving simeprevir in the SVR absence after 4 weeks. The cost of narlaprevir was calculate based on estimated registration price in case of EDL (essential pharmaceutical list approved by MOH) inclusion, including VAT (10%) and 10% as trade margin. Costs of other antiviral products were in line with the results of 2015 average auctions prices. Results. In the base case costs on antiviral products with narlaprevir as first-line therapy are lower compared with simeprevir by 12,2% (950,6 and 1083,0 thousand RUR, respectively), and the cost per patient with SVR 24 by 7,8%. In patients group after relapse costs on antiviral products with narlaprevir as first-line therapy will decrease compared with simeprevir by 4,3% (971,3 and 1014,7 thousand RUR, respectively), and the cost per patient with SVR 24 by 25,0%. The sensitivity analysis demonstrated a high reliability of obtained results. Thus, assuming equal clinical effectiveness of narlaprevir and simeprevir, costs of treatment naive patients will be 10.6% lower for narlaprevir group compared to simeprevir group (953,0 and 1066,0 thousand rur, respectively), and by 12,9% for the treatment of relapses (957,9 and 1100,0 thousand RUR, respectively). Conclusions . With comparable clinical efficacy and tolerability of narlaprevir and simeprevir both in treatmentnaive patients and patients with relapse after therapy, which included PEGylated interferon and ribavirin, narlaprevir reduces the burden on the budget. Due to substantial variability of PI prices, it is advisable to take into account local pricing at regional programs implementation.