Introduction. The economic aspects of providing cancer care to the public attract increasing attention of scientists, economists, physicians and other healthcare professionals. Currently, the healthcare economics of oncological institutions is defined as part of the national economy that implements cancer care programs and provide a wide range of medical and pharmaceutical services to the public.Aim. The study was conducted as part of the program for improvement of financial spending in order to facilitate cancer care for Moscow residents. The aim of this study was to identify the crucial areas of the cost analysis and thus improve the public health service.Materials and methods. We used the methodology of targeted and consistent search of the literature. The data search and analysis was carried out using the US National Medical Library (PubMed database), National Electronic Library (e-LIBRARY, Russia), and other Internet resources. Whenever possible, articles on the most common and socially significant types of cancer (breast, colon, prostate, lung etc.) were selected. In addition, we focused on significant studies conducted either on the national or international level.Results and discussion. In principle, the structure of total costs is determined by the health policy regarding the cancer care system. Six main areas of oncological care that require careful economic analysis have been identified: those are prevention, oncoscreening, diagnosis, treatment, rehabilitation, and palliative care. In order to implement the economic goals of the healthcare system, the cost of cancer treatment should be discussed. The relevant programs are expected to be based on 1) prevalence and incidence; 2) impact on health; 3) results of the integrative methodological approach to cancer treatment; 4) implementation of comprehensive measures of medical and social assistance; 5) use of financial mechanisms and their impact on economic indicators.Conclusion. The set of measures related to the direct costs as identified in this study include the development, planning and provision of cancer care. These specific features of the direct cost analysis are important for organizing medical care in oncological institutions.

Objective: scientific rationale of changing approaches to medical care payment for hospitalization of patients suffering from severe asthma (SA) that require the prescription of biologic disease-modifying drugs (bDMDs) within the constraints of diagnosis-related groups (DRGs) on the level of the Moscow Region.Material and methods. For the federal model regional adaptation, the authors used the mechanism of subgroups selection in the structure of basic DRG No. 336 st36.003 and No. 139 ds36.004 “Treatment with biologic disease-modifying drugs and selective immunosuppressants” in the round-the-clock (RH) and day-time hospital (DH). Budget impact analysis (BIA) was performed to provide scientific and economic feasibility for the improvement of medical care payment for bDMDs proscribed to patients with SA within DRG at the level of the Moscow Region.Results. The analysis of cost of drug therapy and medical services per 1 case of hospitalization of patients with SA, that required bDMDs therapy, considering the classification criterion (international nonproprietary name of drugs and drug therapy regimens), showed 10 subgroups in DRG No. 336 st36.003 (level 1) and 9 subgroups in DRG No. 139 ds36.004. Expert estimates on the rate of hospitalizations and drug dosage regimen indicated for patients with SA were used to calculate the relative cost weights (CW). The highest CW was observed in the subgroup that received benralizumab in RH (CW=7.46) and in DH (CW=12.08) conditions. BIA demonstrated 110,103,901.53 rubles (or 31%) budget savings for the health care system of the Moscow Region.Conclusion. The implementation of the adapted DRG federal model in the conditions of the health care system of Moscow Region is an economically feasible approach to the organization of the inpatient medical care provided to patients with SA needing bDMDs prescription.

Objective: Budget impact analysis of teriflunomide inclusion as first-line disease modifying drugs (DMD) therapy in the List to ensure patients with relapsing-remitting multiple sclerosis (RRMS) within the programme '7 high-cost nosologies' on the budgets of Russian Federation (RF) federal and regional public authorities in the field of health care. Methods 132,89 RUB in 2017 and 16 893 811 827,74 RUB in 2018. Inclusion of teriflunomide is connected with total costs for patient management equal to 14 908 830 663,19 RUB (2017) and 16 406 368 100,05 RUB (2018). Conclusion:Inclusion of teriflunomide into the programme '7 high-cost nosologies' will cause total cost saving for budget of federal authorities of the RF in the field of healthcare of 268 666 174,08 RUB and 517 023 249,99 RUB in 2017 and 2018, respectively, and total costs of federal and regional authorities of the RF in the field of healthcare for provision of patients with multiple sclerosis will be reduced by 239 237 469,70 RUB in 2017 and by 487 443 727,70 RUB in 2018.

Научно-исследовательский институт организации здравоохранения и медицинского менеджмента Департамента здравоохранения города Москвы 115088, Российская Федерация, г. Москва, Шарикоподшипниковская ул., д. 9 Введение. Угревая сыпь встречается у не менее 85 % юношей и девушек, часто протекает длительно, с рецидивами процесса на 3-м и 4-м десятилетиях жизни. С 2000 года технология фотодинамической терапии (ФДТ) стала активно использоваться во многих странах. За два последних года проведено много важных дополнительных исследований эффективности ФДТ для лечения акне. Цель исследования: получение и обобщение новых данных об эффектах ФДТ и ее применимости в реальной клинической практике. Методы. Поиск и анализ данных проведен с использованием Национальной медицинской библиотеки США (база данных PubMed), интернет-ресурсов E-library. В исследование включены оригинальные статьи, опубликованные за последние два года и посвященные или связанные с использованием ФДТ для лечения обыкновенных угрей. Результаты. Было найдено в общей сложности около 55 статей. Всего отобрано 9 клинических исследований или описаний клинических случаев отвечающих предъявляемым критериям анализа. В клинических исследованиях применялись различные и неоднозначные, нестандартизированные периоды инкубации фотосенсибилизатора, кумулятивные дозы энергии источника света, количество сеансов терапии. При анализе публикаций обнаруживается тенденция к применению сокращенного периода инкубации и менее активных формуляров фотосенсибилизаторов с целью снижения риска развития нежелательных явлений, таких как эритема, отек, гиперпигментация, образование волдырей. Обсуждение и выводы. ФДТ является эффективной и перспективной медицинской технологией лечения акне. ФДТ может применяться при легких и тяжелых воспалительных и кистозных акне, у пациентов с различными типами кожи и локализацией элементов. Данный вид терапии акне выполняется различными способами и необходимы дальнейшие исследования для разработки оптимальных и стандартных процедур реализации этой актуальной и клинически выгодной медицинской технологии. Ключевые слова: фотодинамическая терапия, вульгарные угри, акне, медицинская технология Конфликт интересов: авторы заявляют об отсутствии потенциального конфликта интересов, требующего раскрытия в данной статье.