Pharmacoepidemiological and pharmacoeconomic study of the structure of prescribing antidepressants in anxiety-depressive disorders

Abstract

Introduction. The problem of choosing antidepressants in the pharmacotherapy of depression remains relevant over the past decades, not only due to the annual steady increase in the number of depressive disorders around the world, but also with the appearance of new drugs of this group on the pharmaceutical market. In addition, the costs of diagnosing and treating anxiety-depressive states are increasing, as is the financial loss associated with the disability of patients due to depression. Thus, it is extremely important to analyze the structure of prescribing antidepressants in anxiety-depressive disorders and the structure of financial costs. Purpose of the study: To conduct a pharmacoepidemiological and pharmacoeconomic analysis of the prescription of antidepressants to patients with neurotic disorders of an anxiety and anxiety-depressive nature (F 41.0 – Panic disorder (episodic paroxysmal anxiety), F 41.2 – Mixed anxiety and depressive disorder, F 45 – Somatoform disorders, F 06.41 – Organic anxiety disorder in connection with cerebral vascular disease (according to ICD-10)) on the basis of the Department of Crisis Conditions of the Clinic of Hematology and Occupational Pathology of the SSMU in 2019-2021 and to reveal the correlation between the structure of costs and the structure of prescribing antidepressants. Materials and methods. The volume of antidepressant prescriptions, taking into account dosages, treatment regimens and treatment outcomes using the method of “Defined daily doses”, was assessed. The structure of financial costs for prescribed drugs was investigated, and an analysis of the demographic data of patients (gender and age), as well as their history of life and illness, was carried out. Results. The carried out pharmacoepidemiological and pharmacoeconomic studies made it possible to determine that there are discrepancies between the structure of prescribing antidepressants and the structure of financial costs. The most commonly prescribed antidepressant was amitriptyline, while it accounted for a very small proportion of the cost. Trazodone incurred the maximum financial costs, and therefore its high cost seriously limited the possibilities of its prescription. Pipofezin, which has great potential for expanding use, ranks second in both the cost structure and the structure of prescriptions. In the course of the study, the features of the drugs that determined the prevalence of their prescription were identified and their advantages and disadvantages were assessed. It was noted that some antidepressants, which could potentially be more effective, turned out to be unavailable to patients due to the high price or absence in the city pharmacies. Conclusion. Based on the study, it can be concluded that it is advisable to conduct a full-scale clinical study in order to determine the pharmacoeconomic effect of pipofezin in comparison with other antidepressants.