An Economic Analysis on Optimal Management of Fragility Hip Fractures In Geriatric Patients Adopting The Geriatric Fracture Program

Abstract

To assess total costs of intrathecal baclofen therapy (ITB) for the treatment of spastic cerebral palsy in the Russian healthcare conditions. MethOds: Information retrieval of pharmacoeconomic studies on ITB therapy and cerebral palsy burden of disease was performed, Russian legislative acts on medical care on cerebral were examined. The following costs were taken into account: cost of baclofen test, cost of pump implantation/removal, costs of pump refill visits, costs of complications connected with ITB therapy and costs of medical care. In Russian healthcare provision system ITB is included in high-tech medical care list, according to the Program of state guarantees of rendering free medical care of Government of the Russian Federation in 2016 the total sum subsidized for a single case of treatment (a single capacity of medical care) is 1,281,490 RUB/19,930 $. This sum includes as direct medical costs as ones for baclofen test and pump implantation/removal as indirect cost such as wage costs and accruals for wages, acquisition costs of drugs, consumables, food, soft equipment, medical instruments, reagents and chemicals, the cost value of laboratory and instrumental the cost of communication services, social security of employees of medical organizations etc. Costs of pump refill visits is calculated separately as cost for baclofen drug and cost for the service of refill. Costs of medical care and complications treatment were taken from the available Russian pharmacoeconomic studies. Results: Total one-year costs for one patient acquiring intrathecal baclofen therapy equal 1,654,256 RUB/25,030 $. Current rate taken as for 15.06.2016 is 1$ = 66,09 RUB. cOnclusiOns: Intrathecal baclofen therapy is rather high-costly cerebral palsy treatment, thus promising long-term results and chronic type of disease make it necessary to perform comparative pharmacoeconomic analysis of ITB and standard care in the Russian healthcare conditions.