Pulmonary hypertension (PH) is a group of rare diseases, malignant in nature, without optimal treatment quickly lead to death. Such patients usually require expensive, continuous and lifelong treatment. Therefore, the study of the assortment structure of drugs used for the treatment of drugs in adults in the domestic market of medicines (drugs) is very relevant. The aim of the study was to analyze the range of drugs for the pharmacotherapy of drugs in the modern pharmaceutical market of Ukraine. The object of the study was information on drugs registered in Ukraine, which are included in the protocol of treatment of patients with PH. In the process of research, system-review, graphic, documentary and marketing research methods were used. The result of the study showed that in the pharmaceutical market of Ukraine there are no drugs based on INN Epoprostenolum, Treprostinil, Beraprostum, Selexipagum, Macitentan, Tadalafilum, Vardenafilum, recommended by the Adapted clinical guidelines for the treatment of adult patients with PH and Unified clinical protocol of emergency, primary, secondary (specialized) and tertiary (hypersensitivity) medical care «Pulmonary hypertension in adults». Simultaneously INN Rivaroxabanum, Apixabanum, Dabigatranum etaxilatum, Iloprostum, Torasemide, Bosentanum, Ambrisentanum, Riociguat are included in the Unified clinical protocol of emergency, primary, secondary (specialized) and tertiary (hypersensitivity) medical care «Pulmonary hypertension in adults» and tertiary (hypersensitivity) Ukraine, however, are not included in the National List of Essential Medicines, which legally limits the possibility of their purchase by health care institutions for budget funds, but only centrally by the Ministry of Health of Ukraine. The structure of drugs for the treatment of PH in adults according to the ATX classification indicates that the largest share have groups С03С – Diuretics – 36.47%, С08С – Selective calcium antagonists with a predominant effect on blood vessels – 32.94%. The import dependence of the pharmaceutical market of medication for PH treatment is relatively high and constitutes about 60% of the number of trade names of medication for PH pharmacotherapy that needs research in the directions of its expansion through import substitution and legislative settlement of questions of improving the accessibility of this medication group.
Pulmonary arterial hypertension (PAH) is a rare, progressive disorder characterized by high blood pressure (hypertension) in the arteries of the lungs (pulmonary artery) for no apparent reason. Because symptoms are nonspecific and physical signs may be subtle, the disease is often diagnosed at late stages. Over the past few decades, significant progress has been made in the field of pulmonary arterial hypertension. Technological progress allows to diagnose the disease in the early stages, as well as to better assess the severity of the disease. Today, screening studies are becoming increasingly important to establish a clinical diagnosis and minimize lost opportunities without timely diagnosis, especially in patients with idiopathic PAH. Therefore, the issue of early diagnosis of patients with suspected PAH and confirmation of the diagnosis is a very important and urgent issue today. The objective of the paper: to study the methods of implementation of technologies for early diagnosis and pharmacotherapy of pulmonary arterial hypertension and conceptual presentation of the results of their implementation. The work used available scientific sources of information on the results of the implementation of diagnostic screening for early detection of PAH and pharmacotherapy in the world. The analysis of input data was carried out using systematic, documentary, informational and graphical research methods. The result of the analysis of information materials showed that over the past two decades, significant progress has been made in the treatment of PAH and more than doubled the survival rate of patients. It has been found that diagnostic screening is a relatively unique medical technology in relation to other medical interventions and can be defined as the systematic use of diagnostic technologies in individuals at risk to detect the disease before the onset of symptoms. The study proposes a systematic concept of economic evaluation of the diagnostic screening program for PAH to determine its optimal design. At the same time, this concept embodies the complex effect of the introduction of technologies for early diagnosis and pharmacotherapy of PAH, which is expressed in the positive dynamics of clinical indicators, reduced mortality and improved quality of life. It should be noted that a number of new tools and approaches for diagnostic screening give hope that advances in the diagnosis of PAH will also affect the effectiveness of medical care.
Мета нашої роботи полягала в обґрунтуванні створенні нормативно-визначеного асортименту ліків на засадах доказової фармації у відповідності до уніфікованих клінічних протоколів медичної допомоги та протоколів провізора (фармацевта) для спеціалізованих аптек сімейної фармації та аптек загального типу при закладах сімейної медицини. Методи. Використовувались методи структурно-логічного аналізу, контент аналізу, анкетування комерційною назвою «Сімейна аптека» та взаємодії сімейних аптек з закладами сімейної медицини, дані власних досліджень. Результати. В статті вперше в Україні наведені результати вивчення та узагальнення аналізу нормативно-правової бази протоколів провізора (фармацевта) та клінічних протоколів медичної допомоги і необхідну нормативноузгоджену структуру в створенні необхідного асортименту ліків для аптек сімейної фармації при закладах сімейної медицини. Висновки. Створено моделі спеціалізованих аптечних установ сімейної фармації внаслідок переформування аптек загального типу, що обслуговують заклади сімейної медицини. Розроблена відповідна нормативно-правова база, інструктивно-методичних рекомендації щодо їх функціонування, визначено необхідний асортимент лікарських засобів відповідно до уніфікованих клінічних протоколів сімейного лікаря та протоколів провізора Ключові слова: аптека, сімейна фармація, сімейний провізор (фармацевт), асортимент ліків, протоколи провізора, уніфіковані протоколи медичної допомоги
The growth of expenses on drug supply in healthcare requires effective methods for their analysis in the specific healthcare institutions. On the example of a conditional healthcare institution an integrated ABC/VEN-analysis of the expenses on the drug supply for the year has been conducted using the index of utility for each drug. The results of the analysis performed will allow to optimize the purchase of drugs in accordance with the structure of diseases registered in the given healthcare institution, as well as the structure of the local formulary.
In the article the standardization of local form based on the formalization of the text is described, which allows to use computer technology in Grid applications Microsoft Office Excel. It significantly accelerates the development of local form.
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