Pharmacoeconomic analysis of antiretroviral therapy regimes in the Syrian Arab Republic

Background. Due to the significant prevalence of human immunodeficiency virus (HIV) and limited funding in the Syrian Arab Republic (SAR), pharmacoeconomic study of antiretroviral therapy (ART) regimens is relevant, as it allows to choose a rational, pharmacoeconomically reasonable therapy for HIV-i...

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Main Authors: Yu. Sh. Gushchina, А. Yu. Abramov, Y. J. Haitham
Format: Article
Language:Russian
Published: IRBIS LLC 2023-07-01
Series:Фармакоэкономика
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Online Access:https://www.pharmacoeconomics.ru/jour/article/view/812
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author Yu. Sh. Gushchina
А. Yu. Abramov
Y. J. Haitham
author_facet Yu. Sh. Gushchina
А. Yu. Abramov
Y. J. Haitham
author_sort Yu. Sh. Gushchina
collection DOAJ
description Background. Due to the significant prevalence of human immunodeficiency virus (HIV) and limited funding in the Syrian Arab Republic (SAR), pharmacoeconomic study of antiretroviral therapy (ART) regimens is relevant, as it allows to choose a rational, pharmacoeconomically reasonable therapy for HIV-infected patients.Objective: to perform pharmacoeconomic analysis of ART regimens HIV-infected in patients in SAR.Material and methods. The following algorithm of actions was used: assessment of the cost of prescribed antiretroviral drugs; cost analysis of applied ART regimens. From the auction documentation, information was taken on the total number of purchased drugs and their cost at the end of the auction. To calculate prices in rubles, currency conversion was carried out as of January 1, 2021. To calculate the cost of an assigned regimen, the summation of the costs of its components was carried out. Based on the obtained data, the average cost of combinations of certain antiretroviral drugs classes was calculated. To predict the results of using various ART regimens for 5 years, discounting was used for each year of the time horizon, except for the first year.Results. It was revealed that the most expensive drugs are the reserve series: Fuzeon® (enfuvirtide; F. Hoffmann-La Roche Ltd., Switzerland) – 66,492.1 rubles and Isentress® (raltegravir; Merck Sharp & Dohme, Netherlands) – 31,634.6 rubles, and the lowest price per package was noted for Russian drugs Timazid® (zidovudine) – 471.0 rubles and Nikavir® (phosphazide) – 743.8 rubles (both – AZT Pharma K.B. LLC, Russia). The average cost of the first prescribed regimen was 8,970.0 rubles/month, while the most expensive first-line regimens included a protease inhibitors class drug as the third component. As a result of the analysis of the cost of second-line and third-line regimens, it was revealed that the average cost of second-line therapy per month exceeded the average cost of first-line therapy by 4 times (40,154.2 rubles/month). The initial “azidothymidine, zidovudine / lamivudine + efavirenz” group had fewer hospitalizations, lower mortality, and fewer years of life expectancy lost than on “azidothymidine, zidovudine / lamivudine + atazanavir, ritonavir” and “phosphazide + didanosine + efavirenz” regimens.Conclusion. A pharmacoepidemiological study showed that the cost of second-line therapy per month was 40,154.2 rubles, which exceeded the average cost of first-line therapy by 4 times (9,266.1 rubles). It was revealed that the average cost of the first prescribed ART regimen based on two nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitor was 2 times higher than the average cost of regimens based on two NRTIs + non-nucleoside reverse transcriptase inhibitors, which, along with clinical aspects, raised the question of the expediency of their appointment as first-line regimens.
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spelling doaj-art-32d1f3ffe9f248f5830ef28d75f353fa2025-08-20T03:39:49ZrusIRBIS LLCФармакоэкономика2070-49092070-49332023-07-0116218619510.17749/2070-4909/farmakoekonomika.2023.163431Pharmacoeconomic analysis of antiretroviral therapy regimes in the Syrian Arab RepublicYu. Sh. Gushchina0А. Yu. Abramov1Y. J. Haitham2Peoples' Friendship University of Russia named after Patrice LumumbaPeoples' Friendship University of Russia named after Patrice LumumbaPeoples' Friendship University of Russia named after Patrice LumumbaBackground. Due to the significant prevalence of human immunodeficiency virus (HIV) and limited funding in the Syrian Arab Republic (SAR), pharmacoeconomic study of antiretroviral therapy (ART) regimens is relevant, as it allows to choose a rational, pharmacoeconomically reasonable therapy for HIV-infected patients.Objective: to perform pharmacoeconomic analysis of ART regimens HIV-infected in patients in SAR.Material and methods. The following algorithm of actions was used: assessment of the cost of prescribed antiretroviral drugs; cost analysis of applied ART regimens. From the auction documentation, information was taken on the total number of purchased drugs and their cost at the end of the auction. To calculate prices in rubles, currency conversion was carried out as of January 1, 2021. To calculate the cost of an assigned regimen, the summation of the costs of its components was carried out. Based on the obtained data, the average cost of combinations of certain antiretroviral drugs classes was calculated. To predict the results of using various ART regimens for 5 years, discounting was used for each year of the time horizon, except for the first year.Results. It was revealed that the most expensive drugs are the reserve series: Fuzeon® (enfuvirtide; F. Hoffmann-La Roche Ltd., Switzerland) – 66,492.1 rubles and Isentress® (raltegravir; Merck Sharp & Dohme, Netherlands) – 31,634.6 rubles, and the lowest price per package was noted for Russian drugs Timazid® (zidovudine) – 471.0 rubles and Nikavir® (phosphazide) – 743.8 rubles (both – AZT Pharma K.B. LLC, Russia). The average cost of the first prescribed regimen was 8,970.0 rubles/month, while the most expensive first-line regimens included a protease inhibitors class drug as the third component. As a result of the analysis of the cost of second-line and third-line regimens, it was revealed that the average cost of second-line therapy per month exceeded the average cost of first-line therapy by 4 times (40,154.2 rubles/month). The initial “azidothymidine, zidovudine / lamivudine + efavirenz” group had fewer hospitalizations, lower mortality, and fewer years of life expectancy lost than on “azidothymidine, zidovudine / lamivudine + atazanavir, ritonavir” and “phosphazide + didanosine + efavirenz” regimens.Conclusion. A pharmacoepidemiological study showed that the cost of second-line therapy per month was 40,154.2 rubles, which exceeded the average cost of first-line therapy by 4 times (9,266.1 rubles). It was revealed that the average cost of the first prescribed ART regimen based on two nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitor was 2 times higher than the average cost of regimens based on two NRTIs + non-nucleoside reverse transcriptase inhibitors, which, along with clinical aspects, raised the question of the expediency of their appointment as first-line regimens.https://www.pharmacoeconomics.ru/jour/article/view/812pharmacoeconomic analysisantiretroviral therapyavthuman immunodeficiency virushiv infectionsyrian arab republic
spellingShingle Yu. Sh. Gushchina
А. Yu. Abramov
Y. J. Haitham
Pharmacoeconomic analysis of antiretroviral therapy regimes in the Syrian Arab Republic
Фармакоэкономика
pharmacoeconomic analysis
antiretroviral therapy
avt
human immunodeficiency virus
hiv infection
syrian arab republic
title Pharmacoeconomic analysis of antiretroviral therapy regimes in the Syrian Arab Republic
title_full Pharmacoeconomic analysis of antiretroviral therapy regimes in the Syrian Arab Republic
title_fullStr Pharmacoeconomic analysis of antiretroviral therapy regimes in the Syrian Arab Republic
title_full_unstemmed Pharmacoeconomic analysis of antiretroviral therapy regimes in the Syrian Arab Republic
title_short Pharmacoeconomic analysis of antiretroviral therapy regimes in the Syrian Arab Republic
title_sort pharmacoeconomic analysis of antiretroviral therapy regimes in the syrian arab republic
topic pharmacoeconomic analysis
antiretroviral therapy
avt
human immunodeficiency virus
hiv infection
syrian arab republic
url https://www.pharmacoeconomics.ru/jour/article/view/812
work_keys_str_mv AT yushgushchina pharmacoeconomicanalysisofantiretroviraltherapyregimesinthesyrianarabrepublic
AT ayuabramov pharmacoeconomicanalysisofantiretroviraltherapyregimesinthesyrianarabrepublic
AT yjhaitham pharmacoeconomicanalysisofantiretroviraltherapyregimesinthesyrianarabrepublic