Economic Impact of the Highly Active Antiretroviral Pharmacotherapy on Cost and HIV/AIDS Control in Bulgaria

Dimitrova, Maria; Petrova, Guenka; Manova, Manoela; Savova, Alexandra; Konstantin,; Stefanova, Mona; Kirov, I

doi:10.5504/bbeq.2012.0076

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…The average price of ART for a patient with HIV per year in Bulgaria is €8,139. At the same time, the prices are lower in other EU Member States (with significantly higher gross domestic product per capita rates) including Italy, the Netherlands, Spain, and the United Kingdom (Dimitrova et al 2011;Dimitrova et al 2013;ECDC 2017a).…”

Section: Drug and Treatment Costsmentioning

confidence: 99%

Tackling the World's Fastest-Growing HIV Epidemic: More Efficient HIV Responses in Eastern Europe and Central Asia

Zhao¹,

Benedikt²,

Wilson³

2020

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This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries.Nothing herein shall constitute or be considered to be a limitation upon or waiver of the privileges and immunities of The World Bank, all of which are specifically reserved.

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Section: Drug and Treatment Costsmentioning

confidence: 99%

Tackling the World's Fastest-Growing HIV Epidemic: More Efficient HIV Responses in Eastern Europe and Central Asia

Zhao¹,

Benedikt²,

Wilson³

2020

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“…Certain Central and Eastern European countries currently experience significant delays in the introduction of new expensive innovative medicines on their positive medicines lists. In some countries, marketing authorization holders are not interested in launching certain products in less favorable and attractive markets possibly due to economies of scale while another reason for delays in the launch of new medicines on national markets are stringent price controls alongside external reference pricing (Heads of Medicines Agencies, 2007 ; Leopold et al, 2012 ; Dimitrova et al, 2013 ; Kamusheva et al, 2013 ).…”

Section: Framework Initiatives and Tools Supporting The Early Accessmentioning

confidence: 99%

Adaptive Pathways: Possible Next Steps for Payers in Preparation for Their Potential Implementation

et al. 2017

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Medicines receiving a conditional marketing authorization through Medicines Adaptive Pathways to Patients (MAPPs) will be a challenge for payers. The “introduction” of MAPPs is already seen by the European Medicines Agency (EMA) as a fait accompli, with payers not consulted or involved. However, once medicines are approved through MAPPs, they will be evaluated for funding by payers through different activities. These include Health Technology Assessment (HTA) with often immature clinical data and high uncertainty, financial considerations, and negotiations through different types of agreements, which can require monitoring post launch. Payers have experience with new medicines approved through conditional approval, and the fact that MAPPs present additional challenges is a concern from their perspective. There may be some activities where payers can collaborate. The final decisions on whether to reimburse a new medicine via MAPPs will have more variation than for medicines licensed via conventional processes. This is due not only to increasing uncertainty associated with medicines authorized through MAPPs but also differences in legal frameworks between member states. Moreover, if the financial and side-effect burden from the period of conditional approval until granting full marketing authorization is shifted to the post-authorization phase, payers may have to bear such burdens. Collection of robust data during routine clinical use is challenging along with high prices for new medicines during data collection. This paper presents the concept of MAPPs and possible challenges. Concerns and potential ways forward are discussed and a number of recommendations are presented from the perspective of payers.

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“…Bulgaria is a country with low HIV infection prevalence in the general population (2.8 per 100,000) but still there is a risk of rapid spread of epidemics in certain "most-at-risk" groups-injecting drug use and sex between men. There is already an epidemiological evidence for these groups and the main concern is the possibility of transmission of the infection to the general population [20]. In the resent years there is also a tendency in increase in the transmission via heterosexual contact (39% for 2016).…”

Section: Nutrition Guidelines and Recommendations In Bulgariamentioning

confidence: 99%

Nutrition Habits in People Living with HIV/AIDS in Bulgaria: Review of Current Practice and Recommendations

Dimitrova¹

2020

Nutrition and HIV/AIDS - Implication for Treatment, Prevention and Cure

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The innovations in the medical science and development of new biotechnology medicines changed significantly the course of the human immune-deficiency virus (HIV) infection toward a chronic condition. Along HAART, habits in nutrition place an important role in the improvement of the health status of people living with HIV. Proper diet and nutrition may enhance the adherence and concordance to prescribed therapy and its effectiveness, to reduce the risk of adverse drug events and to boost the immune function. In the resent years a tendency towards increased food supplements consumption is observed, especially in patients with chronic diseases. There is a risk of possible interactions between selected dietary supplements with the antiretroviral medicines which may result in decrease of the drug concentrations in the blood plasma and subsequent decreased therapeutic effect and increased risk of viral resistance. Still there are gaps in respect with such information in the guidelines and recommendations for treatment, monitoring and nutrition in HIV. More studies are needed to fully evaluate such interactions and to put recommendations both for the healthcare professionals and for the people living with HIV for their use in order not to compromise HAART and to maintain the desirable therapeutic outcome.

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Economic Impact of the Highly Active Antiretroviral Pharmacotherapy on Cost and HIV/AIDS Control in Bulgaria

Cited by 4 publications

References 10 publications

Tackling the World's Fastest-Growing HIV Epidemic: More Efficient HIV Responses in Eastern Europe and Central Asia

Tackling the World's Fastest-Growing HIV Epidemic: More Efficient HIV Responses in Eastern Europe and Central Asia

Adaptive Pathways: Possible Next Steps for Payers in Preparation for Their Potential Implementation

Nutrition Habits in People Living with HIV/AIDS in Bulgaria: Review of Current Practice and Recommendations

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