DOI: https://doi.org/10.24959/ubphj.18.198

Complex assessment of expenditure on diabetes mellitus pharmacotherapy 2 type from the position of ABC- and VEN-analysis

L. Iakovlieva, N. Tsubanova, O. Berdnik

Abstract


Topicality. Diabetes mellitus is a significant health problem, as it is one of the common non-infectious diseases. The provision of medical care to patients with diabetes mellitus inUkraine is regulated by a number of documents and orders from the Ministry of Health. There is a tendency towards disproportionate consumption of health resources by a population suffering from diabetes, which is associated with the cost of treating micro- and macro-complications of diabetes in inpatient settings. One of the directions of the reform of the provision of assistance to patients with diabetes mellitus is the more active implementation of the actual clinical practice of providing outpatient care to patients.

Aim. Comprehensive assessment of real financial costs for pharmacotherapy of type 2 diabetes in a health facility.

Materials and methods. A comprehensive assessment of the real financial costs for the pharmacotherapy of type 2 diabetes patients was performed using an integrated analysis: ABC and VEN. In the work carried out, the ABC analysis was conducted on international non-proprietary names.

Results and discussion. In the period from May to June 2017, 50 letters of appointments of endocrinologic department patients hospitalized with type 2 diabetes in the University Hospital of KhNMU were analyzed. According to the history of the disease, it was found that all patients with type 2 diabetes had prescribed 58 drugs. According to the results of ABC-analysis, 11 drugs were included in group A, which amounted to 77.37 % of the funds for their purchase. Drugs that are included in Group A are not used for the treatment of type 2 diabetes, but for the treatment of its complications. Group B included 16 drugs. This group contains the largest number of oral hypoglycemic agents. Group C included the largest number of drugs 31 TN for the treatment of patients with type 2 diabetes, as well as drugs for the treatment of concomitant cardiovascular and nervous system pathologies. According to the results of VEN-analysis in Group V - vital NF, included 33 TN, which was 56.9 % of the total number of drugs. In group A, the number of drugs that were included in the current state formulation was 7 TN. 4 TN from group A, which proved to be the most expensive for the clinic, were not included in the State Form of Ukraine, they were classified as N (not important), these are drugs of metabolic action. In group B included 16 TN, among which only 5 are vital necessities, and 11 TN were not included in the current issue of the State Formula of Ukraine drugs, but they are a medium-cost medical institution and, unfortunately, prescribed by physicians for almost every third patient of the endocrinology department. In group C, the number of TN of which is 31 out of 58 subjects, 21 TN has entered the State drug form ofUkraine and is necessary for the purpose. Almost all drug treatment groups included in the analyzed medical and technological documents (State drug form of Ukraine (Current Issue 9), Unified Clinical Protocol for the Treatment of Disease Type 2 Disease 2012 Type Approvals, the current British National Form) have a strong evidence base, which are registered on the Pharmaceutical the Ukrainian market justifies their effectiveness and safety at their choice, except for the drug of the group of inhibitors of sodium glucose catheter type 2 (sglt2) INN, which is not a substitute for the UCPTD.

Conclusions. The analysis of presence the oral hypoglycaemic drugs in  regulations showed that the range of oral hypoglycaemic drugs on  Ukrainian pharmaceutical market  is wide and sugar-lowering medicines are included in various normative documents, which provides real opportunities for their application in clinical practice. The results of determining the quality of pharmacotherapy in patients with diabetes mellitus type 2 indicate the need to correct the choice of drugs in accordance with ND, regulating pharmacotherapy for patients with type 2 diabetes.


Keywords


diabetes mellitus type 2; VEN-analysis; ABC-analysis; lists of appointments

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