Pharmacoeconomic analysis of treatment of patients with severe and moderate ischemic stroke (NIHSS score > 12)

Abstract

this study includes pharmacoeconomic analysis of treatment of patients with severe and moderate ischemic stroke (NIHSS score > 12 IntroductionIschemic stroke (IS) is a clinical syndrome manifesting as an acute disorder of local cerebral functions which lasts for more than 24 hours or causes death; it can be caused either by insufficiency of blood supply in certain brain area due to cerebral blood flow reduction, thrombosis or embolism connected with vascular, cardiac or blood diseases [1,2].About 16 million cases of stroke are registered in the world annually, including 5,7 million with lethal outcome which equals 10% of total mortality in the world [3][4][5][6]. It should be especially noted that sever and moderate ISs take about 40-65% and this category of patients is characterized with high mortality [7][8][9][10].Today severe and moderate IS are one of the main causes of people disability. Expansion of disability of the patients suffered a stroke is caused by a small number of patients who were urgently admitted to hospital (not more than 15 -30%). About one third of patients suffered a stroke are of working age [11]. Only 20% of patients remain socially and professionally adapted and not more than 10% return to their working activity [12, 133]. Nearly 20% of patients suffered a stroke remain seriously disabled for the rest life [144]. Moreover nearly 50% of patients require assistance and 30% need care [1]; so the stroke is a burden for the patient's family members reducing their labor potential and quality of life.Therefore the stroke is an important medicinal and social problem. High level of morbidity, mortality, disability makes this disease an essential economic burden for the state and the society in general. Considering the current situation in the Russian Federation (RF) with limited health care resources, an optimization of medical care for the patients suffered severe and moderate IS is a priority task for the public health authorities in the context of the budget of the health care system [15]. A pharmacoeconomic assessment is one of the important tools for choosing the most effective therapy from both clinical and economic point of view. Therefore a pharmacoeconomic analysis of treatment of the patients suffered from severe and moderate IS (NIHSS score > 12) is interesting for the Russian health care system.The goal of the investigation is a comparison of neuroprotective drugs in the context of pharmacoeconomic analysis: cerebrolysin, cortexin, actovegin, ceraxon, cytoflavin, cellex and mexidol for treatment of patients suffered from severe and moderate IS (NIHSS score > 12) on the basis of analysis of costefficiency ratio, drug safety and the quality of life of the patients. Data search as a part of analysis of efficiencyTo perform pharmacoeconomic investigation according to the above goal an analysis was performed. Data search by publications with the topic of the investigation was performed by database PubMed, Medlink, Cochrane. The search request was made in such a way that the fo...