Pharmacoeconomic analysis of edaravone usage in the treatment of patients with acute ischemic stroke in Ukraine

Abstract

Every year, the number of new cases of strokes is increasing all over the world. More than 62% of all strokes are ischemic strokes. Ischemic stroke is a serious medical and social problem and one of the main causes of death and disability in Ukraine and around the world. The use of drugs, the main task of which is to increase the safety of nervous tissue, has the great importance in the pharmacotherapy of ischemic stroke. The aim of the study was to analyze the results of cost-effectiveness calculations and the impact on the budget during the use of the drug Xavron® for the treatment of patients with acute ischemic stroke in Ukraine. Research materials: regulatory and legal framework of Ukraine, scientific and methodological guidelines for the medical use of medicines, clinical trials and relevant recommendations, analytical materials, data on drug prices from drug aggregators and the electronic public procurement system, tariffs for medical services under the program of state guarantees of medical care for the population. Research methods: cost analysis (bottom-up and decision tree methods), cost-effectiveness and budget impact analysis, cost-effectiveness plane method, and sensitivity analysis. It was established that the method of treatment using Xavron® in combination with standard therapy is less expensive and more effective: the «cost-effectiveness» indicator for medical therapy based on Xavron® amounted to UAH 84,639.24, while for standard therapy – UAH 88,340.62. The results of the analysis of the incremental efficiency indicator (ICER) for the treatment of acute ischemic stroke based on Xavron® amounted to UAH 24,838.69. This indicates that the method of treatment using Xavron® in combination with standard therapy is more effective and less costly. The conducted sensitivity analysis confirmed the stability of pharmacoeconomic calculations regarding changes in the main parameters of the model. The method of treatment using Xavron® in combination with standard therapy and inpatient rehabilitation is the best strategy in terms of budget impact analysis. It results in savings of UAH 237,641,992.50 from the Ukrainian healthcare budget for all patients and additional costs of UAH 6,804.10 per patient. According to the results of the forecast, the amount of saved funds from the healthcare budget of Ukraine for 2023–2027 (5 years) for all patients will amount to UAH 1,247,480,956.10. The implementation of the proposed methods of treatment will make it possible to improve the results of treatment of patients with ischemic stroke, as well as reduce the social and economic burden of this disease.