Validation of the pharmacoeconomic model of cost-effectiveness analysis of insulin degludec (Tresiba®) in comparison with the insulin glargine u300 in the treatment of type 2 diabetes mellitus in the Russian Federation

The global pharmacoeconomic model of cost-effectiveness analysis of insulin degludec (Tresiba®) use in comparison with insulin glargine U300 in the treatment of type 2 diabetes mellitus, was validated. As the result, it was found that the model is relevant to local clinical practice, fully complies with the pharmacoeconomics methodology, takes into account the entire spectrum of costs relevant for the pharmacoeconomic evaluation of insulin in Russia, and the computations built in it is correct. Based on the actual cost data entered, the model calculated the ICER of degludec insulin, which was 214,714 rubles, which does not exceed the sum of three GDP per capita – 2,184,562 rubles and corresponds to the willingness to pay threshold in the Russian Federation. Thus, the insulin degludec (Tresiba®) can be considered as cost-effective from the standpoint of the conducted pharmacoeconomic analysis.

Comparative clinical and economic evaluation of pharmacogenetic testing application for dabigatran in patients with atrial fibrillation

Aim. To evaluate the clinical and economic feasibility of pharmacogenetic testing (PGT) for dabigataran etexilate administration in the treatment of atrial fibrillation (AF) without valve in comparison with tactics without pharmacogenetic testing. Materials and methods. The pharmacoeconomic model was done using generalized data from published clinical, epidemiological and clinical - economic studies. Results and discussion. Application of PGT on the carrier of allelic variant rs2244613 of CES1 gene for adjustment of dabigatrane etexilate dosage in patients with non - valve AF may be more cost - effective strategy for prevention of thromboembolic complications in patients with non - valve AF. Thus, due to the decrease in the number of undesirable drug reactions in the form of minor and major bleedings, the difference in treatment costs in the group with PGT compared to the group with standard pharmacotherapy tactics per 100 patients was 11 827.65 rubles. The expected cost per patient per year for standard treatment was 36 051.35 rubles, while in the group with PGT it was 35 933.07 rubles. The difference was 1182.76 rubles in favor of the pharmacogenetic approach Conclusion. A PGT approach to correct dabigatrane dosage can reduce the cost of pharmacotherapy by reducing the risk of adverse reactions of minor and major bleeding.