Abstract

Purpose of the study was to conduct comprehensive pharmacoeconomic, clinical and pharmacological, marketing, talkie, normative and legal studies of pharmacotherapy of depressive diseases during global coronavirus epidemic. Pharmacoeconomic styles of analysis, in particular ABC/ VEN analysis were used to elect effective and safe medicines of pharmacotherapy of depression. According to the results of the ABC cost analysis, medicines for the pharmacotherapy of depression were distributed in descending order of their cost group A( most precious) includes medicines whose pharmacotherapy costs were equal to 81.76 of total costs; to group B( average cost) – 14.21, and to group C( cheapest) – 4.03. Group A included 10 Auberge medicines( including Citaloprame, Olanzapine, Fluvoxamine), the cost of one cure was 4956.5 UAH, which reckoned for 81.76 of the total cost of pharmacotherapy for depression. Group B included four Auberges( Sertraline, Escitaloprame, Mianserine, Sulpiride), the total cost of one cure of which was 861.3 UAH( 14.21). As part of group C – four Auberge( Doxepine, Lithium, Fluoxetine, Amitriptyline), the cost – 244.54 UAH per cure( 4.03). According to VEN analysis, it was experimentally proven that the loftiest costs of pharmacotherapy of depression were 77.7 for medicines of order V( vital) and 22.3 for medicines of order E( essential). During the VEN analysis it was set up that fourteen Auberge medicines are included in order V( Vital). order E includes four Auberges. No Auberges were included into order N( unnecessary). The attained results made it possible to make executive and directorial opinions in determining the pharmacotherapy of cases with depressive diseases.

Keywords

Pharmacoeconomics, Cost-effectiveness analysis, Depression, ABC/VEN analysis, Quality-adjusted life-years (QALYs), Economic evaluation, Healthcare policy, Cost-minimization analysis, Resource allocation, Patient-centered care.

Introduction

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Pharmacoeconomics  Methodologies

       
           
       
    

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This method compares the costs and health outcomes of different healthcare interventions. The outcomes are typically measured in natural units (e.g., life-years gained, quality-adjusted life-years), and the results are presented as a ratio of incremental cost per unit of health outcome gained.

Cost-Effectiveness Analysis (CEA) is a vital method within pharmacoeconomics for comparing the costs and health outcomes of different healthcare interventions. Here's a breakdown of how CEA works within pharmacoeconomics:

Identifying Interventions: CEA begins by identifying the interventions or treatments under consideration. These could include pharmaceuticals, medical devices, procedures, or healthcare programs aimed at preventing, diagnosing, or treating a specific health conditions

Measurement of Costs: CEA involves the comprehensive measurement of both direct and indirect costs associated with each intervention. Direct costs typically include the costs of drugs, medical procedures, hospitalizations, and healthcare provider visits. Indirect costs may include productivity losses due to illness or treatment-related side effects.

Measurement of Outcomes

: In addition to costs, CEA evaluates the outcomes or health benefits associated with each intervention. These outcomes may include improvements in health status, reduction in symptoms, increased life expectancy, or improvements in quality of life. Outcomes are often measured in natural units (e.g., life-years gained) or using preference-based measures such as quality-adjusted life-years (QALYs).

Calculation of Incremental Cost-Effectiveness Ratio (ICER):

The primary outcome of  CEA is the incremental cost-effectiveness ratio (ICER), which represents the additional cost incurred to achieve an additional unit of health outcome compared to an alternative intervention. The ICER is calculated as the difference in costs between two interventions divided by the difference in their outcomes.

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A positive ICER indicates that intervention A is more costly and more effective than intervention B, while a negative ICER indicates that intervention A is less costly and less effective than intervention B.

Interpretation of Results:

The ICER provides a measure of the value for money of each intervention compared to the alternatives. Decision-makers can use the ICER to assess whether an intervention is cost-effective based on a predetermined willingness-to-pay threshold. If the ICER falls below the threshold, the intervention may be considered cost-effective, indicating that the health benefits gained justify the additional costs. If the ICER exceeds the threshold, the intervention may not be considered cost-effective. Uncertainty Analysis: Sensitivity analysis is often performed to assess the robustness of CEA results to variations in key parameters and assumptions. This helps to quantify uncertainty and provides decision-makers with insights into the reliability of the findings.

 Cost-utility analysis (CUA):

Similar to CEA, CUA compares the costs and outcomes of healthcare interventions, but the outcomes are measured in terms of utilities or preference-based measures (e.g., quality-adjusted life-years). This allows for the comparison of interventions across different disease areas and enables decision-makers to consider the trade-offs between quantity and quality of life.

Steps of Cost-Utility Analysis

1. Identification of two or more alternatives
2. Identification of perspectives
3. Determination of costs
4. Determination of outcomes in utility terms
5. Calculation of cost-utility ratio
6. Decision making

Cost- mileage Analysis( CUA) is another essential  system within pharmacoeconomics,  fastening on comparing the costs and health  issues of different healthcare interventions by measuring  issues in terms of  mileage or preference- grounded measures,  generally quality- acclimated life- times( QALYs). Then is how CUA works within pharmacoeconomics  Identification of Interventions analogous to Cost- Effectiveness Analysis( CEA), CUA begins by  relating the interventions or treatments under consideration. These could include  medicinals, medical  bias, procedures, or healthcare programs aimed at  precluding, diagnosing, or treating a specific health condition.  dimension of Costs CUA involves the comprehensive  dimension of both direct and  circular costs associated with each intervention,  analogous to CEA. Direct costs  generally include the costs of  medicines, medical procedures, hospitalizations, and healthcare provider visits, while  circular costs may include productivity losses.  dimension of Health issues in QALYs Unlike CEA, which may measure  issues in natural units( e.g., life- times gained), CUA measures health  issues in terms of QALYs. QALYs combine both the  volume and quality of life into a single measure, where one QALY represents one time of life in perfect health. Health  countries are assigned  mileage weights on a scale from 0( representing death) to 1( representing perfect health), and the  mileage weights are multiplied by the duration of time spent in each health state to calculate QALYs.  computation of Incremental Cost- mileage rate( ICUR) The primary  outgrowth of a CUA is the incremental cost-  mileage  rate( ICUR), which represents the  fresh cost incurred to gain an  fresh QALY compared to an indispensable intervention. The ICUR is calculated as the difference in costs between two interventions divided by the difference in their QALYs.  ???????????????? =  ???????????????????? ? ???????????????????????????????????????? ? ????????????????????ICUR =  QALYA ? QALYBCostA ? CostB  analogous to CEA, decision- makers can use the ICUR to assess whether an intervention is cost-effective grounded on a destined  amenability- to- pay threshold.However, the intervention may be considered cost-effective, indicating that the health benefits gained justify the  fresh costs, If the ICUR falls below the threshold.  Interpretation of Results The ICUR provides a measure of the value for  plutocrat of each intervention compared to the  druthers , considering both the costs and health benefits in terms of QALYs. Decision- makers can interpret the ICUR to prioritize interventions that offer the  topmost health benefits relative to their costs.  query Analysis perceptivity analysis is  frequently performed to assess the robustness of CUA results to variations in  crucial parameters and  hypotheticals,  analogous to CEA. This helps decision- makers understand the  query  girding the cost- effectiveness estimates.

Cost-benefit analysis (CBA):

 CBA evaluates healthcare interventions by comparing the costs and benefits in monetary terms. Benefits are often monetized using willingness-to-pay or other economic valuation methods. CBA provides a comprehensive assessment of the economic impact of interventions but may be more challenging to implement due to the need to assign monetary values to health outcomes.  Pharmacoeconomics is a branch of health economics that evaluates the cost-effectiveness of pharmaceuticals and healthcare interventions. Cost-benefit analysis (CBA) is one of the tools used within pharmacoeconomics to assess whether the benefits of a particular intervention outweigh its costs. Here's a basic outline of how a cost-benefit analysis might be conducted within pharmacoeconomics:

Identify Alternatives:

 Begin by identifying the different pharmaceuticals or healthcare interventions that are being considered.

Define the Scope:

Clearly define the scope of the analysis, including the population being studied, the timeframe over which benefits and costs will be assessed, and the perspective from which the analysis will be conducted (e.g., healthcare provider, payer, societal).

Identify Costs:

Determine all relevant costs associated with each alternative. These costs might include the direct costs of the pharmaceutical or intervention itself, as well as indirect costs such as healthcare utilization, productivity losses, and adverse effects.

Quantify Benefits:

Quantify the benefits associated with each alternative. These might include improvements in health outcomes, quality of life, or productivity gains. Benefits can be measured in various ways, such as life years gained, quality-adjusted life years (QALYs), or disability-adjusted life years (DALYs).

Monetize Benefits:

Assign a monetary value to the benefits identified in step 4. This can sometimes be challenging, especially when dealing with improvements in health outcomes or quality of life.

Calculate Net Benefits:

Calculate the net benefits of each alternative by subtracting the total costs from the total benefits. This provides a measure of the overall economic value of each alternative.

Sensitivity Analysis: Conduct sensitivity analysis to assess the impact of uncertainty in key parameters on the results of the analysis. This might involve varying assumptions about costs, benefits, discount rates, and other factors.

Interpret Results:

Finally, interpret the results of the analysis and make recommendations based on the findings. Consideration should be given to both the quantitative results (e.g., net benefits) and qualitative factors such as equity, ethical considerations, and feasibility of implementation.

Overall, cost-benefit analysis in pharmacoeconomics provides a systematic framework for comparing the economic value of different pharmaceuticals and healthcare interventions, helping decision-makers allocate resources efficiently to maximize health outcomes.

Cost- minimization Analysis

 Cost- minimization Analysis is a tool used in pharmacoeconomics and is applied when comparing multiple  medicines of equal  efficacity and equal tolerability.  CMA shows only a" cost savings" of one program or treatment over another.  Employing CMA is applicable when comparing two or  further therapeutically original agents or alternate dosing  rules of the same agent.  Cost minimization analysis( CMA) is another  system used in pharmacoeconomics to compare the costs of indispensable interventions when they're assumed to have original clinical  issues. Unlike cost- benefit analysis, which compares both costs and benefits, CMA focuses solely on  relating the least  expensive option among treatments that are considered therapeutically original. Then is how a cost minimization analysis is  generally conducted   Identify Therapeutically Equivalent Alternatives Begin by  relating two or  further  medicinals or healthcare interventions that are considered therapeutically original for the condition being treated. These  druthers should have  analogous  efficacity, safety, and other applicable clinical  issues.  Define the compass easily define the  compass of the analysis, including the population being studied, the timeframe over which costs will be assessed, and the perspective from which the analysis will be conducted( e.g., healthcare provider, payer, societal).  Identify Costs Determine all applicable costs associated with each  volition. These costs might include the direct costs of the  medicinals or interventions themselves, as well as any associated costs  similar as administration, monitoring, and adverse event  operation.

Calculate Total Costs:

Calculate the total costs associated with each alternative by summing the costs identified in step 3.

Compare Total Costs:

Compare the total costs of each alternative to identify the least costly option. If one alternative is less expensive than the others and they are considered therapeutically equivalent, it is considered the preferred option from a cost minimization perspective.

Sensitivity Analysis:

As with other economic analyses, it's important to conduct sensitivity analysis to assess the impact of uncertainty in key parameters on the results of the analysis. This might involve varying assumptions about costs, discount rates, and other factors.

Interpret Results:

Finally, interpret the results of the analysis and make recommendations based on the findings. In a cost minimization analysis, the focus is on selecting the least costly alternative among therapeutically equivalent options. Consideration should be given to factors such as availability, ease of administration, and patient pre

CHALLENGES

Pharmacoeconomics, the study of the economic aspects of pharmaceuticals, including their cost, effectiveness, and value, faces several challenges:

Data Availability and Quality

Obtaining accurate and reliable data on healthcare costs, patient outcomes, and drug efficacy can be challenging. In many cases, the data may be incomplete or inconsistent, making it difficult to conduct robust analyses.

Complexity of Analysis:

Pharmacoeconomic analysis often involves complex methodologies such as cost-effectiveness analysis, cost-utility analysis, and budget impact analysis. These analyses require expertise in economics, epidemiology, and health outcomes research.

Time and Resources:

Conducting pharmacoeconomic studies can be time-consuming and resource-intensive. Researchers need to invest significant time and resources in data collection, analysis, and interpretation.

Generalizability of Findings:

Findings from pharmacoeconomic studies conducted in one setting may not be generalizable to other settings due to differences in healthcare systems, patient populations, and clinical practices.

Incorporating Patient Preferences:

Assessing the value of pharmaceuticals requires consideration of patient preferences and quality of life. However, measuring and incorporating patient preferences into pharmacoeconomic analyses can be challenging.

Dynamic Nature of Healthcare:

The healthcare landscape is constantly evolving due to changes in technology, treatment guidelines, and healthcare policies. Pharmacoeconomic analyses need to adapt to these changes to provide up-to-date and relevant information.

Reimbursement and Market Access:

Pharmaceutical companies often face challenges in demonstrating the value of their products to payers and healthcare decision-makers. Pharmacoeconomic evidence plays a crucial role in reimbursement decisions and market access strategies.

Ethical Considerations:

Pharmacoeconomic analyses raise ethical questions related to resource allocation, access to healthcare, and the prioritization of certain patient populations over others. Balancing economic considerations with ethical principles is a key challenge in pharmacoeconomics.

CONCLUSION  

The principles and  styles of pharmacoeconomics  give the means to quantify the value of pharmacotherapy through balancing costs and  issues. By understanding the principles,  styles, and  operation of pharmacoeconomics, healthcare professionals will be prepared to make better, more informed  opinions regarding the use of pharmaceutical products and services.

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