scholarly journals RATIONAL SUPPORTIVE THERAPY FOR CHEMOTHERAPY INDUCED ANEMIA: A PHARMACO-ECONOMIC ANALYSIS OF ERYTHROPOIETIN THERAPY IN CANCER PATIENTS IN RUSSIAN FEDERATION

2018 ◽  
Vol 13 (2) ◽  
pp. 48-61
Author(s):  
V. B. Larionova ◽  
I. S. Krysanov ◽  
A. V. Snegovoy ◽  
P. A. Zeinalova ◽  
V. S. Krysanova ◽  
...  
Keyword(s):  
Economic Analysis ◽  
Cancer Patients ◽  
Russian Federation ◽  
Darbepoetin Alfa ◽  
Tumor Tissue ◽  
Supportive Therapy ◽  
Epoetin Alfa ◽  
Oncological Patient ◽  
The Russian Federation ◽  
Anemia Treatment

Modern anticancer therapy due to its intensity and molecular biology orientation allows achieving higher efficiency and theoretically reducing the incidence of complications. However, the increase in efficacy in the modern oncology really exists, but reducing complication frequency, unfortunately, is far from being solved. In many respects the problems of diagnosis, treatment and complications monitoring are associated with the impact on the complex physiological processes occurring in oncological patient. Timely implementation of modern and adequate programs for the prevention and treatment of these complications defines the concept of “supportive therapy”, which provides at least half the effectiveness of antitumor treatment.To date, according to most studies, the most frequent complications of antitumor therapy are hematologic, in particular – anemia. In clinical practice, blood transfusions, recombinant human erythropoietins, hemopoiesis stimulating cofactors are used to correct this type of complications. The need for anemia treatment is determined by its negative impact on quality of life, as well as a negative prognostic impact on the life expectancy of cancer patients, because hypoxia of tumor tissue can be associated with resistance to chemoand radiation therapy, the stimulation of genetic mutations and neoangiogenesis, which make it difficult to control of tumor growth. In numerous studies using multivariate analysis confirmed the association of low hemoglobin levels and/or tumor tissue hypoxia with worsening prognosis and overall survival in many types of tumors. The modern anemia treatment should not be determined only by increased in hemoglobin level, but should be considered as an active prophylaxis for its reducing. Recombinant forms of human erythropoietin and intravenous forms of iron preparations should be the most popular correction methods in everyday practice.The high cost of complex anemia therapy and the social significance of oncological diseases necessitate a pharmaco-economic analysis of registered in Russia erythropoietin preparations and the optimization of existing anemia treatment regimens in cancer patients in order to reduce the expenditures of the health budget. At present, an active import substitution program is underway in the Russian Federation to support the development of the Russian pharmaceutical industry and provide the population with more affordable medicines while maintaining its quality and efficiency. The need to address these issues, and the effective use of the domestic biological analogue epoetin alfa, served as an excuse for performing a comparative clinical and economic analysis. They were selected drugs that differ in pharmacokinetic properties: Eralfon® – analogue of epoetin alfa and Aranesp® – darbepoetin alfa.The treatment model of adults oncological patients with anemia receiving chemotherapy was created, which takes into account various therapies using erythropoietin preparations. The total therapy cost for an oncological patient with anemia is less when using short-acting erythropoietin – epoetin alfa – 131 609 rubles in comparison with the long-acting erythropoietin – darbepoetin alfa – 245 159.2 rubles, the difference was 113 550.2 rubles (–46 %) in favor of the epoetin alfa.According to pharmaco-economic analysis, the treatment of anemia with a Russian-produced drug epoetin alfa (Eralfon®) is preferred in comparison to darbepoetin alfa (Aranesp) in adult cancer patients with nonmyeloid malignancies in the Russian Federation, as it allows increasing the number of treated patients at a cost reduction.

scholarly journals Modern geopolitical challenges to russia's economic security: institutional factors and historical continuity

2020 ◽  
Vol 2020 (1) ◽  
pp. 76-81
Author(s):  
S Rabkin
Keyword(s):  
Economic Analysis ◽  
Russian Federation ◽  
Institutional Analysis ◽  
Economic Security ◽  
Institutional Factors ◽  
Modern World ◽  
Historical Continuity ◽  
Analysis Methodology ◽  
The Russian Federation ◽  
The Impact

Using the main elements of the institutional analysis methodology, the author considers the impact of geopolitical factors on Russia's economic security. Based on historical and economic analysis, it is concluded that the decisions of the Crimean (Yalta) and Potsdam (1945) conferences that defined the contours of the multipolar model of the modern world should be followed. As a counteraction to the geopolitical challenges to the economic security of the Russian Federation in a multipolar world, it is proposed to consider the issues of spatial development as an institutional basis for the formation of a future model of global security.

Use and Outcomes of Epoetin Alfa and Darbepoetin Alfa for Anemic Cancer Patients in Outpatient Community Practice Settings.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5588-5588 ◽  
Author(s):  
Kyle R. Fahrbach ◽  
Diana Frame ◽  
Brian Sercus ◽  
Brad Schenkel
Keyword(s):  
Cancer Patients ◽  
Darbepoetin Alfa ◽  
Selection Criteria ◽  
Tumor Type ◽  
Community Practice ◽  
Epoetin Alfa ◽  
Treatment Episode ◽  
End Of Treatment ◽  
Dosing Regimens ◽  
The Cost

Abstract Objective: To assess the treatment patterns and hematologic outcomes associated with epoetin alfa (EPO) and darbepoetin alfa (DARB) for the treatment of anemic cancer patients in the community practice setting. Methods: A retrospective observational study design was used. De-identified data from patients receiving care in community oncology practice settings were obtained from an electronic medical record system. Eligible patients were >= 18 years of age, had a cancer diagnosis, and were treated with an erythropoiesis stimulating agent (ESA: EPO or DARB) during the period July 2002 – July 2004, with baseline anemia (Hb<=11 g/dL) and at least one follow-up Hb value. No other selection criteria were applied (e.g. ESA dose, tumor type, chemotherapy treatment) in keeping with the objective of characterizing outcomes in a real-world setting. Data were summarized by treatment overall and by using a multivariate model adjusting for age, gender, baseline Hb, clinic site, ECOG performance score, type of cancer (solid vs hematologic) and chemotherapy (platinum vs non-platinum vs. none). Patient selection criteria and analytic methods were determined prospectively. The cost for each ESA was calculated based on 2004 average wholesale prices ($13.36 per EPO 1,000 U; $4.99 per 1 mcg DARB). Results: 2382 EPO and 1399 DARB patients were eligible for analysis. The two groups were comparable in terms of baseline characteristics (62% female, 75% solid tumors, mean baseline Hb 9.9 g/dL). Only about two-thirds of patients were treated with standard dosing regimens of the two agents in the US (EPO 40,000 U qw, DARB 200 mcg q2w). Hematologic outcomes observed in patients receiving EPO were consistently better than those in patients receiving DARB. Table 1. Hematologic outcomes by ESA treatment EPO DARB p value Week 4 Hb change (g/dL) 0.79 0.59 <0.001 % Early Hb response (Hb change >=1 g/dL at 4 weeks) 61.5 55.2 0.004 % Hb response (Hb change >=2 g/dL by end of treatment episode) 41.4 34.7 <0.001 % Hematopoietic response (Hb change >= 2 g/dL or reaching 12 g/dL by end of treatment episode) 52.3 44.6 <0.001 The mean treatment durations for patients receiving EPO and DARB were 55.3 and 62.5 days, respectively. Mean cumulative doses were 231,211 U for EPO and 857 mcg for DARB. These doses resulted in an average cost per patient of $3,089 for those receiving EPO and $4,276 for those receiving DARB. Conclusion: These results, based on over 3000 community-treated cancer patients, reinforce previous findings of earlier and greater overall hematologic response for EPO vs. DARB in this setting. Additionally, based on mean cumulative doses, the cost of DARB per patient was substantially greater than that of EPO. Additional studies of variations in dosing regimens used in the community setting are warranted, as are well-powered, randomized, controlled trials to further confirm the clinical results observed here.

scholarly journals Budget Impact Analysis of Darbepoetin Alfa Every 3 Weeks versus Epoetin Alfa Every Week for Cancer Patients with Anemia due to the Effect of Concomitant Myelosuppressive Chemotherapy

10.36469/9836 ◽  
2015 ◽  
Vol 3 (2) ◽  
pp. 214-223 ◽  
Author(s):  
November McGarvey ◽  
Hairong Xu
Keyword(s):  
Cancer Patients ◽  
Health Plan ◽  
Patient Population ◽  
Darbepoetin Alfa ◽  
Impact Analysis ◽  
Budget Impact ◽  
Drug Costs ◽  
Epoetin Alfa ◽  
Annual Average ◽  
Myelosuppressive Chemotherapy

Background: Anemia is a common complication among patients with cancer receiving chemotherapy and can cause significant costs to health plans. Objective: The objective of this study is to estimate the annual budget impact of drug treatment associated with treating cancer patients with anemia due to the effect of concomitant myelosuppressive chemotherapy (i.e., chemotherapy-induced anemia [CIA]) with erythropoiesis stimulating agents (ESAs), either darbepoetin alfa (DA) once every 3 weeks (Q3W) or epoetin alfa (EA) once every week (QW), for a large US health plan in 2014. Methods: Using a patient database from a large US health plan in 2010 (n = 14 811 119), the potential CIA patient population was determined (1842 patients each per DA and EA). A budget impact of ESA treatment on this patient population in 2014 was calculated. The analysis assumed a minimum of 2 additional months of chemotherapy from initiation of the analysis. The 2014 Centers for Medicare and Medicaid Services (CMS) reimbursement rates used were: average sales price +12% of $3.68/mcg (DA) and $11.38/1000 IU (EA), and office-based injection cost of $25.08. Results: The estimated 2014 annual average drug costs per patient with CIA were $5520 (DA) and $5833 (EA). Annual average drug costs for administrations were estimated at $100 (DA) and $301 (EA) for 2014. Per member per year (PMPY) costs for patients with CIA were estimated at $5620 (DA) and $6134 (EA) for 2014. The annual total costs per CIA population (n=1842) were estimated at $10 352 629 (DA) and $11 298 798 (EA) for 2014. Conclusion: DA Q3W has the potential to provide cost savings over EA QW in terms of annual average drug cost per patient with CIA ($313 savings), PMPY costs for patients with CIA ($514 savings), and total cost per CIA population ($946 169 savings).

scholarly journals Characteristics of BRCA-associated breast cancer in the population of the Russian Federation

2021 ◽  
Author(s):  
EI Novikova ◽  
EA Kudinova ◽  
VK Bozhenko ◽  
VA Solodkiy
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Russian Federation ◽  
False Negative ◽  
Brca2 Gene ◽  
Breast Cancer Patients ◽  
Brca1 And Brca2 ◽  
Coding Regions ◽  
Brca1 And Brca2 Genes ◽  
The Russian Federation

"Standard" diagnostic panels allow identification of only a few of BRCA1 and BRCA2 gene mutations most common in a population. Therefore, tests relying on such panels may return false negative results, since the coding regions of these genes may have other defects. For breast cancer (BC) patients, false negative test results may translate into selection of inadequate therapy by their doctors. This study aimed to identify the features of BRCA-associated breast cancer in the population of the Russian Federation. The study included breast cancer patients (n = 4440). At the first stage, all patients were screened for the eight most common BRCA1 and BRCA2 genes mutations with the help of real-time PCR. Next, patients that exhibited clinical signs of a hereditary disease (CSHD) in the absence of common mutations (n = 290) had the entire coding regions of BRCA1 and BRCA2 genes studied with next generation sequencing (NGS). "Standard" mutations in the BRCA1 and BRCA2 genes were identified in 169 (3.8%) cases. In the CSHD group, such mutations were revealed in 15.4% of cases. NGS uncovered 33 rare pathogenic BRCA1 and BRCA2 gene mutations in 40 out of 290 breast cancer patients (13.8%). It was concluded that among the residents of the Russian Federation, the range of pathogenic variants of BRCA-associated breast cancer is wide, and it stretches beyond the mutations considered by the "standard" diagnostic panels. Analysis of the entire coding regions of BRCA1 and BRCA2 genes allows increasing efficiency of detection of germline mutations in breast cancer patients at least twofold.

Organizational and legal aspects of the quality of palliative care for cancer patients at the present stage

2020 ◽  
pp. 52-57
Author(s):  
Lyudmila Ertel
Keyword(s):  
Palliative Care ◽  
Law Enforcement ◽  
Cancer Patients ◽  
Social Services ◽  
Russian Federation ◽  
Legal Aspects ◽  
Present Stage ◽  
High Quality ◽  
The Russian Federation

This article discusses some of results of the change in legislation governing the provision of palliative care for cancer patients. Patients are provided with medical and social services with consideration of their individual needs. Priority of social home services for patients remains when determining the form of social services. It is noted that some measures have been taken to organize affordable and high-quality palliative care to eliminate legislative and law-enforcement difficulties in the Russian Federation at the present stage.

Problems and Prospects of Energy Complex Development in the Russian Arctic Zone

2019 ◽  
pp. 30-37
Author(s):  
O. V. Skotarenko ◽  
V. I. Babenkov ◽  
Yu. A. Nikitin ◽  
M. V. Kutepova
Keyword(s):  
Economic Analysis ◽  
Russian Federation ◽  
Energy Supply ◽  
Legal Framework ◽  
The Arctic ◽  
Russian Arctic ◽  
Arctic Zone ◽  
Energy Complex ◽  
The Russian Federation ◽  
High Level

The presented study examines the specific aspects of operation of energy enterprises in the Arctic zone of the Russian Federation.Aim. The study aims to identify the current problems in the operation of energy enterprises in the Arctic territories by analyzing their state and development and thus to substantiate the selection of perspective directions for improving the efficiency of their management.Tasks. The authors show the role and importance of energy supply for the functioning of the socioeconomic system of the Arctic territories, analyze the major performance indicators of energy enterprises, and substantiate recommendations on improving the organization of their activities.Methods. This study uses the methodology of economic analysis, trend analysis, structural analysis, and specific methods of regional economic analysis.Results. One of the crucial current problems in the development of the energy complex in the Russian Arctic zone is the high level of debt in the accounts, which leads to an imbalance in the current activities of energy enterprises. Furthermore, formation of electricity tariffs depends on the money paid for the generation and transportation of electricity and the services of distribution companies. This is due to the lack of continuous monitoring of the state of accounts and the lack of a legal framework for settling differences between network and energy supply companies, which are not given sufficient attention in economic studies.Conclusions. According to the results of the study, the authors propose the major directions for improving regulation of the development and operation of energy enterprises in the Arctic zone of the Russian Federation. 

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