ANALIZA ODNOSA TROŠKOVA/KLINIČKE EFIKASNOSTI TIOTROPIJUM-BROMIDA I SALMETEROLA U LEČENjU TEŠKE HRONIČNE OPSTRUKTIVNE BOLESTI PLUĆA

Stefan Dragan Stojanović

doi:10.5937/racter4-1421

Stefan Dragan Stojanović Univerzitet u Kragujevcu, Medicinski fakultet

DOI: https://doi.org/10.5937/racter4-1421

Ključne reči: severe COPD||, ||teška HOBP, cost-effectiveness analysis||, ||analiza odnosa troškova/kliničke efikasnosti, salmeterol||, ||salmeterol, tiotropium bromide||, ||tiotropijum bromid,

Sažetak

Hronična opstruktivna bolest pluća (HOBP) je bolest koju karakteriše ograničenje protoka vazduha koje nije potpuno reverzibilno. Ograničenje protoka vazduha je obično progresivno i udruženo sa abnormalnim inflamatornim odgovorom pluća na štetne čestice ili gasove. Ograničenje protoka vazduha je povezano sa simptomima hroničnog kašlja, iskašljavanja i dispneje na napor. Cilj ove farmakoekonomske studije je da se ispita i uporedi odnos troškova/kliničke efikasnosti tiotropijum-bromida i salmeterola u lečenju teške HOBP. Analiza je izvršena Markovljevim modelom, korišćenjem podataka iz literature o efikasnosti i izračunavanjem troškova iz perspektive Republičkog fonda za zdravstveno osiguranje u Srbiji. Efekti za svako stanje pacijenata su izraženi u godinama života korigovanim za kvalitet (eng. QALYs). Simulacija modela je izvršena pomoću Monte Karlo simulacije za 1000 hipotetičkih pacijenata. Vremenski horizont je podešen na pet godina (60 ciklusa). Trajanje jednog ciklusa iznosi mesec dana. Takođe, izvršena je analiza senzitivnosti sa varijacijom vrednosti parametara za ± 50% i prikazana tornado dijagramom. Rezulatati Monte Karlo simulacije su pokazali veoma malu razliku između ova dva leka. Pokazalo se da je tiotropijum-bromid isplativija opcija od salmeterola, odnosno 76 873,80 RSD/QALY naspram 77 252,15 RSD/QALY. Rezultati ove studije su pokazali da je primena tiotropijum-bromida korisnija u terapiji teške HOBP (III stadijum) jer ostvaruje veću kliničku efikasnost uz nešto veće troškove lečenja u poređenju sa salmeterolom.

Biografija autora

Stefan Dragan Stojanović, Univerzitet u Kragujevcu, Medicinski fakultet

Doktorske akademske studije-

Molekulska medicina, Klinicka i eksperimentalna farmakologija

Magistar farmacije

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