nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical Universitynefr-60Research ArticleСтатьиЭФФЕКТИВНОСТЬ ЗАТРАТ НА ПАРИКАЛЬЦИТОЛ И КОМБИНАЦИЮ ЦИНАКАЛЬЦЕТА И НЕСЕЛЕКТИВНЫХ ПРЕПАРАТОВ ВИТАМИНА D ПРИ ХРОНИЧЕСКОЙ БОЛЕЗНИ ПОЧЕК VД СТАДИИ В РОССИЙСКОЙ ФЕДЕРАЦИИHEALTH ECONOMIC EVALUATION OF PARICALCITOL AND COMBINATION OF CINACALCET WITH NON-SELECTIVE VITAMIN D IN PATIENTS WITH CHRONIC KIDNEY DISEASE 5D STAGE IN RUSSIAN FEDERA-TIONНюйтенМ. .NuijtenM. .noemail@neicon.ruРудаковаА. В.RudakovaA. .rudakova_a@mail.ruМаршаллТ. .MarshallT. .noemail@neicon.ruАрс Аксессус МедикаРоссияArs Accessus MedicaRussian FederationСанкт-Петербургская химико-фармацевтическая академияРоссияSt Petersburg State Chemical-Pharmaceutical AcademyRussian FederationЭббВиРоссияAbbVieRussian Federation2014011120141866470Copyright © Нюйтен М..., Рудакова А.В., Маршалл Т..., 20142014Нюйтен М..., Рудакова А.В., Маршалл Т...Nuijten M..., Rudakova A..., Marshall T...Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/60

ЦЕЛЬ ИССЛЕДОВАНИЯ. Сравнительная оценка эффективности затрат на внутривенно вводимый парикальцитол и пероральную комбинацию цинакаль-цет+альфакальцидол у пациентов с хронической болезнью почек (ХБП) 5Д стадии в Российской Федерации. ПАЦИЕНТЫ И МЕТОДЫ. Анализ осуществляли для пациентов на гемодиализе с уровнем паратиреоидного гормона, превышающим 300 пкг/мл, несмотря на стандартную терапию, включающую ограничения потребления фосфора и кальция и прием фосфатсвязывающих препаратов. Использовано марковское моделирование на основе данных клинических исследований и эпидемиологических данных по Российской Федерации с учетом тарифов ОМС по Санкт-Петербургу. Оценка проводилась с позиции системы здравоохранения с использованием 5-летнего временного горизонта. В базовом варианте затраты и продолжительность жизни дисконтировали на 5% в год. РЕЗУЛЬТАТЫ. Показано, что использование парикальцитола обеспечивает экономию в среднем 47,36 тыс. руб. в расчете на 1 пациента и одновременно увеличивает среднюю продолжительность жизни на 0,099 года и 0,067 QALY Таким образом, парикальцитол является доминирующей альтернативой по сравнению с комбинацией цинакальцета и альфакальцидола. ОБСУЖДЕНИЕ. Назначение внутривенного парикальцитола пациентам с ХБП 5Д может рассматриваться в качестве экономически эффективного вмешательства, приемлемого для бюджетного здравоохранения Российской Федерации.

AIM OF RESEARH: The objective of this study was to determine the cost effectiveness of intravenous paricalcitol versus combination cinacalcet+alfacalcidol in patients with chronic kidney dis-ease (CKD) in the health care setting in Russia in 2013. PATIENTS AND METHODS: This analysis is performed for patients on hemodialysis with diagnosed increased parathyroid hormone levels of above 300 pg/ml despite standard treatment consisting of die-tary restriction in phosphorus and calcium containing binders. A Markov process model was developed employing data sources from the published litera-ture, paricalcitol clinical trials, official Russian price/tariff lists and national population statis-tics. The primary perspective of the study was that of the national health care payer. The base case analysis is based on a 5-years time horizon. Clinical and economic outcomes were dis-counted at 5%. RESULTS: The use of paricalcitol leads to a cost saving of RUR 47,36 and an increase in life years gained (0.099 years) and a gain in QALYs (0.067). Consequently the use of paricalcitol is dominant over the use of combination cinacalcet+alfacalcidol. CONCLUSION: The results showed that the favourable clinical benefit of a intravenous parical-citol results in positive short and long-term health economic benefits in patients on hemodi-alysis. This study suggests that the use of paricalcitol in patients with severe chronic kidney disease may be cost-effective from the perspective of the national health insurance fund in Russia.

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The authors declare that there are no conflicts of interest present.