Pharmacoeconomic assessment of providing patients with tableted non-narcotic opioid analgestics upon their discharge from the hospital: opportunities and realities

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Abstract

The balance of the drug portfolio of healthcare facilities contributes to the prolongation of the provision of medical care at the proper level, ensuring interaction and continuity between the inpatient and outpatient stages of care, which is especially important in organizing and conducting pain syndrome therapy. Currently, the patient's need for pain therapy already at the time of discharge from the hospital before an appointment with an outpatient doctor is expressed by the legislative possibility of handing over potent drugs to the patient for a period of up to 5 days.

Objectives: justification of medicine provision with a fixed-dose combination (FDC) of Paracetamol and Tramadol to patients with pain syndrome during their transition from inpatient to outpatient care based on a pharmacoeconomic approach and to evaluate the costs of such pharmacotherapy.

Material and methods. The results of previous studies on the evaluation of the effectiveness of the analgesic action of the Paracetamol and Tramadol FDC in comparison with the injectable monodrug Tramadol product and the cost of obtaining 1 unit of effectiveness in the conditions of emergency surgical and trauma departments of a hospital, content analysis of legislation and internal regulations on the circulation of drugs of controlled groups, statistics of the bed capacity of the emergency surgery department for the period of 2021–2022.

Results and discussion. The use of Paracetamol and Tramadol FDC for pain therapy, taking into account the comparison and grouping of patients, made it possible to reduce the cost of pain syndrome therapy by 23,472.68 rubles within 4 months. Extrapolation of the obtained data for 4 months for an annual period showed the possibility of reducing the cost of treating pain syndrome by 70,418.04 rubles while ensuring a comfortable transition of patients to outpatient care.

Conclusion. The studies show the clinical and economic feasibility of using a Paracetamol and Tramadol FDC both in hospital care and when moving from a hospital to an outpatient clinic.

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About the authors

Anna Lavrentievna Mymrina

NSIFTPh – Branch Campus of the FSBEI FPE RMACPE MOH Russia; JSC «Organika», Novokuznetsk Kuznetsk Highway,

Author for correspondence.
Email: Anna812481@mail.ru
ORCID iD: 0000-0002-4727-9753

Candidate of Pharmaceutical Sciences, Associate Professor of the Department of Pharmacy of the NSIFTPh – Branch Campus of the FSBEI FPE RMACPE MOH Russia, Head of the Marketing Department of JSC «Organica»

5, Stroiteley street Novokuznetsk city, Kemerovo region - Kuzbass, 654005, Russian Federation; 3, Novokuznetsk, 654034, Russian Federation

Lev Nikolaevich Geller

Irkutsk State Medical University

Email: levng@mail.ru
ORCID iD: 0000-0002-3598-6514

Doctor of Pharmaceutical Sciences, Professor of the Department of Pharmacy Management and Economics, Irkutsk State Medical University, Professor

Krasny Vosstaniya str., 2, Irkutsk, 664003, Russian Federation

Ildar Gabdulkhayevich Mugatasimov

G.P. Kurbatov Novokuznetsk City Hospital One

Email: mugatasimov.ildar@yandex.ru
ORCID iD: 0000-0002-0764-9895

surgeon of the highest category, Head of the surgical department of the G.P. Kurbatov Novokuznetsk City Hospital One, Director of the surgical clinic, Candidate of Medical Sciences

Bardina Ave., 30, Novokuznetsk, 654000, Russian Federation

Irina Vladimirovna Golubeva

JSC «Organika»

Email: cucurbita2008@mail.ru
ORCID iD: 0000-0002-5131-8073

Candidate of B Sciences, qualified person responsible for pharmacovigilace

Novokuznetsk Kuznetsk Highway, 3, Novokuznetsk, 654034, Russian Federation

References

  1. Палехов А.В., Введенская Е.С. Вопросы выбора опиоидных анальгетиков в практике врача-терапевта. Боткинские чтения: материалы всероссийского терапевтического конгресса с международным участием; под ред. академика РАН Мазурова В.И., доцента Трофимова Е.А. СПб.: Изд-во «Человек и его здоровье», 2019; 191–2. [Palekhov A.V., Vvedenskaya E.S. The choice of opioid analgesics in the practice of a general practitioner. Botkin readings: materials of the All–Russian Therapeutic Congress with international participation; edited by academician of the Russian Academy of Sciences V.I. Mazurov, Associate Professor E.A. Trofimov. St. Petersburg: Publishing House «Man and his Health», 2019; 191–2 (in Russian)].
  2. Мымрина А.Л., Кан С.Л., Мугатасимов И.Г., Шапкина В.А., Аксенов Е.Ю., Поветьев А.В., Голубева И.В. Эффективность фиксированной комбинации парацетамола и трамадола в пероральной лекарственной форме в условиях хирургической и травматологической практиким. Врач. 2021; 32 (11): 70–3. [Mymrina A.L., Kan S.L., Mugatasimov I.G., Shapkina V.A., Aksenov E.Yu., Povetyev A.V., Golubeva I.V. Efficacy of a fixed combination of paracetamol and tramadol in oral dosage form in surgical and traumatology practice. Vrach. 2021; 32 (11): 70–3. doi: 10.29296/25877305-2021-11-14 (in Russian)].
  3. Мымрина А.Л., Туева И.А., Геллер Л.Н., Плащинский А.А., Грищенко В.А. Перспективы и возможности использования фиксированной комбинации твердой лекарственной формы парацетамола и трамадола в травматологии (послеоперационный период). Врач. 2021; 32 (12): 79–82. [Mymrina A.L., Tueva I.A., Geller L.N., Plaschinsky A.A., Grishchenko V.A. Prospects and possibilities of using a fixed combination of a solid dosage form of paracetamol and tramadol in traumatology (postoperative period). Vrach. 2021; 32 (12): 79–82. doi: 10.29296/25877305-2021-12-13 (in Russian)].
  4. Мымрина А.Л., Геллер Л.Н., Туева И.А., Плащинский А.А., Мугатасимов И.Г. Фармакоэкономическое обоснование выбора ненаркотических анальгетиков при лекарственном обеспечении стационаров хирургических и травматологических профилей. Фармация. 2022; 71 (6): 46–51. [Mymrina A.L., Geller L.N., Tueva I.A., Plaschinskiy A.A., Mugatasimov I.G. Pharmacoeconomic justification of the choice of non-narcotic analgesics in the medicine provision of surgical and traumatological hospitals. Farmatsiya. 2022; 71 (6): 46–51. (Russian)].

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