Medical and economic analysis of the consequences of expanding the drug supply program for patients with chronic obstructive pulmonary disease in the Russian Federation

2019 ◽  
pp. 53-61
Author(s):  
Andrei Georgievich Maliavin ◽  
Alana Viktorovna Dzanaeva ◽  
Maria Vladimirovna Avxentyeva ◽  
Sergei Lvovich Babak
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Russian Federation ◽  
Chronic Obstructive ◽  
Outpatient Basis ◽  
Basic Drug ◽  
Obstructive Pulmonary Disease ◽  
Basic Therapy ◽  
The Russian Federation ◽  
The Cost ◽  
Drug Provision

Purpose of the study. Healthcare budget impact analysis in the Russian Federation of providing adult patients with chronic obstructive pulmonary disease (COPD) with basic therapy for outpatient treatment. Material and methods. The hypothesis of reducing costs for the treatment of exacerbations of COPD was tested while providing all patients with basic therapy on an outpatient basis. The model calculates the direct medical costs of drug provision and treatment of exacerbations in patients with COPD in the current situation and when all patients with COPD are covered with basic therapy as part of a program of preferential drug provision. The simulation period is 1 year. The analysis does not take into account social losses associated with disability, payment of disability certificates, reduced labor productivity and mortality. Results. The cost of providing all patients with COPD with the recommended basic drug therapy on an outpatient basis is substantially offset by a decrease in the cost of treating exacerbations: drug costs should increase by 14.1 billion rubles compared with the current situation, while the cost of providing medical care to patients with exacerbations is reduced by 9.7 billion rubles. As a result, the difference in direct medical costs, or the necessary additional investments, is 4.4 billion rubles. The price of drugs used for basic therapy has the greatest impact on the size of the required additional investments. Conclusion. Providing all patients with COPD with the recommended basic drug therapy on an outpatient basis, we can expect a decrease in the number of moderate exacerbations per year by 14.7% and severe exacerbations by 31.2%. Taking into account not only medical, but also socio-economic costs can not only offset additional investments, but also demonstrate significant savings. When implementing a pilot project of preferential drug provision for patients with COPD in a specific region of the Russian Federation, it is possible to reduce the cost of purchasing medicines when forming a municipal order.

scholarly journals GENDER FEATURES OF MORBIDITY IN CORRECTIONAL FACILITIES OF THE RUSSIAN FEDERATION

2017 ◽  
pp. 33-37
Author(s):  
E.A. Samarina ◽  
S.B. Ponomaryov ◽  
S.A. Sterlikov
Keyword(s):  
Russian Federation ◽  
Cerebrovascular Diseases ◽  
Mastoid Process ◽  
Chronic Obstructive ◽  
Peripheral Nervous System Diseases ◽  
Obstructive Pulmonary Disease ◽  
Ulcer Disease ◽  
The Russian Federation ◽  
Artery Disease ◽  
Gender Based

A comparison of the morbidity for different classes of diseases and groups of diseases for women and men who are in prisons of the Russian Federation. The morbidity of the disease by separate nosological units and groups of women in prison is higher than that of men by: neoplasms, thyrotoxicosis, obesity, diabetes mellitus, diseases of the blood and blood-forming organs, certain immune disorders, rheumatoid arthritis, non-infectious enteritis and colitis, bronchitis chronic and unadjusted, hypertension, asthma and asthmatic conditions, chronic disease of tonsils and adenoids, disease of the gallbladder and biliary tract, osteoporosis, pancreatic diseases, cerebrovascular diseases, rheumatic valvular disease, peripheral nervous system diseases, insulin-dependent diabetes, infectious and parasitic diseases, mental and behavioral disorders, arthrosis. Men were sick more often than women by ankylosing spondylitis, acute myocardial infarction, peptic ulcer disease, atherosclerosis of arteries, injuries, poisoning and certain other consequences of external reasons, reactive arthropathy, chronic rhinitis, pharyngitis, nasopharyngitis. There was no gender-based frequency eye diseases and adnexa, ear and mastoid process, pneumonia, chronic obstructive pulmonary disease, liver disease, kidney stones, coronary artery disease, acute rheumatic fever, epilepsy and status epilepticus.

Non-drug rehabilitation of patients with chronic obstructive pulmonary disease concurrent with hypertension

2016 ◽  
Vol 88 (8) ◽  
pp. 19-24
Author(s):  
E V Sevostyanova ◽  
Yu A Nikolaev ◽  
N V Bogdankevich ◽  
V G Lusheva ◽  
E N Markova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Chronic Obstructive ◽  
Study Group ◽  
Basic Drug ◽  
Obstructive Pulmonary Disease

Aim. To evaluate the efficiency of decimeter wave therapy and halotherapy, which were additionally added to basic therapy, in patients with chronic obstructive pulmonary disease (COPD) concurrent with hypertension at the inpatient stage. Subject and methods. 36 patients aged 20 to 75 years with Stages I—II COPD concurrent with Stages I—II, first-second grade hypertension were examined and treated. The clinical examination included collection of complaints and medical history data, clinical laboratory and instrumental (electrocardiography, spirography) studies, and health-related quality of life (using the SF-36 questionnaire). The patients were randomized into two groups: a study group and a comparison group. The study group patients received decimeter wave therapy and halotherapy in addition to basic drug treatment; the comparison patients had basic drug therapy. Results. Pre- and postoperative comparative analysis of the major clinical manifestations of comorbidities revealed more pronounced positive changes with the lower rate of clinical manifestations in the study group. It was also observed to have a more marked reduction in blood pressure (BP) with its goal levels achieved. The mean pulse BP decreased by 28% in the study group (p=0.000005) and did not statistically reduced in the comparison group. In the study group patients, the integral quality-of-life indicator after a package of medical rehabilitation measures became statistically significantly higher by 35%. This indicator in the comparison group was statistically significantly unchanged. Conclusion. The directionality of the proposed rehabilitation complex towards the common pathogenetic components of the development and progression of COPD and hypertension, as well as the high efficiency of the complex justify its appropriate inclusion in the combination treatment and rehabilitation of this category of patients.

scholarly journals Clinical Characteristics of the Combined Course of Chronic Obstructive Pulmonary Disease and Gastroesophagal Reflux Disease

2021 ◽  
Vol 6 (4) ◽  
pp. 91-98
Author(s):  
O. I. Lіakh ◽  
◽  
M. I. Tovt-Korshуnska ◽  
M. A. Derbak
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Pulmonary Disease ◽  
Reflux Disease ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Outpatient Basis ◽  
Obstructive Pulmonary Disease ◽  
Respiration Function

The comorbid diseases can occur at any stage of bronchial obstruction, and, regardless of the severity or phase of chronic obstructive pulmonary disease, significantly affect disability, increase the frequency of hospitalizations, and increase the cost of medical care. The presence of concomitant gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease is an independent aggravating risk factor for exacerbations and is associated with health deterioration of this group of patients. The purpose of the study was to study the features of the clinical course of chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease. Materials and methods. Retrospective analysis of 138 patients who were treated in the pulmonology department for exacerbation of the disease and outpatient treatment by a gastroenterologist was carried out. 3 groups of patients were formed: 1 group (n=60) – patients with chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease, 2 group (n=42) – patients with chronic obstructive pulmonary disease without signs of gastroesophageal reflux disease, who were treated in the pulmonology department for exacerbation of the disease and 3 group (n=36) – patients with gastroesophageal reflux disease who were treated on an outpatient basis. The patients were similar in age, stage of disease and duration of illness. The average age of the patients was 55±1.64. It should be noted, regarding the gender characteristics of the groups, that among the examined patients by gender, men predominated – 78.4% (80 out of 102). Results and discussion. The main clinical and anamnestic features of the combined pathology were studied. The significance of the assessment of functional changes in spirometry indexes in this category of patients is described. A significant decrease in external respiration function was revealed in the indicators of the external respiration function in patients of all groups. In the patients with chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease the frequency of exacerbations increases. These exacerbations were associated with the presence and severity of gastrointestinal symptoms, namely increased heartburn, acid regurgitation causes worsening of respiratory symptoms, until the exacerbation of the disease with subsequent hospitalization. Also the length of stay in the hospital of the patients in this group increased by 1.5±0.4 days, which is associated with a severe exacerbation of chronic obstructive pulmonary disease and the need to use a double dose of glucocorticoids to control the symptoms of respiratory failure. Among the complaints of patients with combined pathology, extraesophageal manifestations of gastroesophageal reflux disease prevailed. Conclusion. The presence of concomitant gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease expands and aggravates the clinical manifestations of the underlying disease

Evaluating the cost-effectiveness of combination inhalers for the management of chronic obstructive pulmonary disease

2020 ◽  
Vol 26 (9) ◽  
pp. 231-233
Author(s):  
Matthew Taylor ◽  
Michelle Green
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cost Effectiveness ◽  
Pulmonary Disease ◽  
Cost Effectiveness Analysis ◽  
Chronic Obstructive ◽  
Valuable Insight ◽  
Obstructive Pulmonary Disease ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Insight Into

Matthew Taylor and Michelle Green provide a valuable insight into methods of vital cost-effectiveness analysis of combination inhalers for the management of chronic obstructive pulmonary disease.

Impact of Body Mass Index Change on the Prognosis of Chronic Obstructive Pulmonary Disease

Respiration ◽  
2020 ◽  
pp. 1-11
Author(s):  
Eun Kyung Kim ◽  
Dave Singh ◽  
Joo Hun Park ◽  
Yong Bum Park ◽  
Seung-Il Kim ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Body Mass Index ◽  
Pulmonary Disease ◽  
Body Mass ◽  
Longitudinal Change ◽  
Chronic Obstructive ◽  
Outpatient Basis ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

<b><i>Background:</i></b> Low body mass index (BMI) is an important prognostic factor in chronic obstructive pulmonary disease (COPD). However, the prognostic value of longitudinal BMI change in COPD has not been well studied. <b><i>Objective:</i></b> We aimed to evaluate the association between longitudinal change of BMI and prognosis of COPD in Korean COPD cohort. <b><i>Methods:</i></b> This study was conducted in a prospective Korean Obstructive Lung Disease (KOLD) cohort where COPD patients were recruited on an outpatient basis at 17 hospitals in South Korea. Annual BMI was measured over a period of 3 years or more. All patients were categorized into underweight (UW), normal weight (NW), and overweight (OW) groups by BMI. Clinical characteristics and outcomes including exacerbation and mortality were compared based on initial BMI grade and longitudinal change of BMI. <b><i>Results:</i></b> This analysis included 537 COPD patients (mean age = 67.4 ± 7.9 years, male = 97.0%, mean BMI = 23.0 ± 3.1) of KOLD cohort. The proportions of UW, NW, and OW groups were 6.9% (<i>n</i> = 37), 68.9% (<i>n</i> = 370), and 24.2% (<i>n</i> = 130) respectively. The UW group showed lower forced expiratory volume in 1 s (FEV<sub>1</sub>) (<i>p</i> &#x3c; 0.001), shorter 6-minute walk distance (<i>p</i> &#x3c; 0.001), higher modified Medical Research Council score (<i>p</i> = 0.002), higher St. George Respiratory Questionnaire score (<i>p</i> &#x3c; 0.001), higher emphysema index (<i>p</i> &#x3c; 0.001) and air-trapping index (<i>p</i> &#x3c; 0.001), and more frequent (<i>p</i> &#x3c; 0.001) and severe exacerbations (<i>p</i> = 0.003). Multivariable analyses demonstrated that decrease of BMI (hazard ratio [HR] = 0.786, <i>p</i> = 0.038) and the descent of BMI group (HR = 3.167, <i>p</i> = 0.016) at 3-year follow-up along with age, initial BMI, post-bronchodilator FEV<sub>1</sub>, and severe exacerbations were significantly associated with mortality. <b><i>Conclusions:</i></b> This study demonstrated that BMI decrease during follow-up was independently associated with exacerbation and higher mortality of COPD, suggesting BMI reduction in COPD should be carefully managed.

ASSESSMENT OF THE IMPACT OF ANTIREFLUX THERAPY ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
Vol 74 (10) ◽  
pp. 2580-2584
Author(s):  
Olesya I. Liakh ◽  
Mariya A. Derbak ◽  
Yelyzaveta S. Sirchak ◽  
Mariana I. Tovt-Korshуnska ◽  
Yana V. Lazur
Keyword(s):  
Clinical Symptoms ◽  
Clinical Signs ◽  
Chronic Obstructive ◽  
Comprehensive Treatment ◽  
Outpatient Basis ◽  
Obstructive Pulmonary Disease ◽  
Basic Therapy ◽  
Complex Therapy ◽  
Antireflux Therapy ◽  
The Impact

The aim: To examine the effect of antireflux therapy on the course of COPD. Materials and methods: Under observation were 60 patients who were hospitalized in the «Transcarpathian Regional Clinical Hospital named after Andrei Novak» with a diagnosis of COPD II gr B in combination with GERD and 36 patients diagnosed with GERD who were treated on an outpatient basis. To study the effectiveness of antireflux therapy and its impact on the course of COPD, patients are divided into 2 groups: 1 group (main) (n = 60) – patients with COPD in combination with GERD, group 2 (control) (n = 36) – patients with isolated GERD. Patients with positive Helicobacter pylori status received antihelicobacter therapy. Patients in group 1 were divided into subgroups: 1a (n = 34) – COPD in combination with esophageal manifestations of GERD and 1b (n = 26) – COPD in combination with extraesophageal manifestations of GERD. Group 1a received complex therapy, which consisted of basic therapy of COPD in combination with antireflux and with rebapimide, group 1b – only basic therapy of COPD in combination with antireflux. Results: After treatment, the clinical signs of GERD significantly decreased in all patients receiving complex therapy, improved the course of respiratory symptoms of COPD. After treatment, patients showed a clinically significant reduction in systemic inflammation, which is best seen in the group with the use of rabipimide. Conclusions: Comprehensive treatment of combined pathology with the use of antireflux therapy has a positive effect not only on the clinical symptoms of the disease, but also on the indicators of external respiratory function in patients with combined COPD and GERD.

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