Health and social effectiveness of the expansion of medicine assistance programs for patients with coronary artery disease and comorbidities

Abstract

Aim. To assess the potential need for expanding medicine assistance programs for patients with coronary artery disease (CAD) and comorbidities, as well as to model its health and social effectiveness in the Russian Federation.Material and methods. To assess the scope and cost of medicine assistance for the healthcare system, the number of patients with CAD and comorbidities was determined based on data from 5 registers of cardiovascular patients organized by the National Medical Research Center for Therapy and Preventive Medicine. We took into account the frequency of drug provision according to standard therapy regimens for stable CAD in combination with comorbidities and (or) conditions that increase the risk of adverse events. To determine the cost of medicine assistance, we used data from the state register for maximum ex-works prices for the medicinal products included in the list of vital and essential drugs. To assess the impact of medicine assistance for patients with CAD and the highest cardiovascular risk on survival prognosis in the period 2023-2025, the number of deaths prevented was calculated. A one-year forecast and a cumulative forecast were performed, taking into account annual increase in the patient population.Results. Patients with CAD and the highest cardiovascular risk (myocardial infarction, stroke, diabetes, chronic obstructive pulmonary disease in history), including in combination with hypertension, heart failure, atrial fibrillation, are priority groups where the prophylaxis of cardiovascular events and death, the expansion of medicine assistance programs will save a greater number of lives. With a one-year forecast, the potential number of deaths prevented by 2025 will be 33582 cases per year, with a cumulative total of 90500 cases over three years, with the costs of 114,8 billion rubles for three years (40 billion rubles per year).Conclusion. Considering the potential of modern therapy in patients with CAD, comorbidities and high cardiovascular risk, the expansion of current of medicine assistance programs for such patients, along with medical follow- up programs, seems to be an important component in health improvement, mortality reduction and life expectancy increase in the population.