Pharmacoeconomic justification of the choice of non-narcotic analgesics in the medicine provision of surgical and traumatological hospitals

Clinical and economic approaches to the choice of appropriate pharmacotherapy based on the principles of evidence-based medicine are presented by a comprehensive cost analysis of various treatment technologies, including pharmacotherapy of pain. Such approaches make it possible to achieve the efficient allocation of resources in the industry by applying the most clinically effective and economically reasonable treatment technologies. One of these methods is the cost - effectiveness analysis (CEA). The purpose of the study - evaluation and comparison of the costs of a healthcare facility for postoperative analgesia with the same drug, but in different pharmaceutical forms and presentations (tablets with a fixed dose combination with paracetamol and ampoules). Material and methods. The compared drugs were evaluated using the CEA indicator. The previous studies conducted by the authors in 3 general clinical centers (Novokuznetsk and Sochi) showed the absence of statistically significant differences in analgesic effect between a fixed combination of Paracetamol + Tramadol film-coated tablets, 325 mg + 37.5 mg, and the injectable drug Tramadol alone, 50 mg/ml injection solution in 135 patients of surgical and traumatology specialties in the early postoperative period with pain syndrome at the age of over 18 years. In both groups, effective anesthesia was observed in 100% of cases. The assessment of the costs of analgesic therapy by the considered drugs consisted in calculating the cost of direct hard, direct soft and indirect costs. Results and discussion. The cost calculation showed significant differences in the cost of analgesic therapy with a fixed combination of paracetamol and tramadol and an injectable form of tramadol in surgical and traumatology patients (p<0.0001). The obtained CEA values showed that the cost of 1% of the effectiveness of anesthesia when using a fixed combination of paracetamol and tramadol in the solid dosage form is 5.29 rubles, and it is 15.96 rubles when using the injectable form of tramadol. Conclusions. Thus, the results of the conducted pharmacoeconomic analysis of the efficiency and effectiveness of using the same non-narcotic opiate, but in different types of dosage forms (tablets and ampoules) support the tablet form in a fixed combination with paracetamol, and also leads to a noticeable (triple) reduction in the financial costs of the healthcare facility. The presence and use of a tablet form - a fixed combination of Paracetamol + Tramadol coated tablets, 325 mg + 37.5 mg (manufactured by Organica, JSC, Novokuznetsk), clearly demonstrate the modern capabilities of the pharmaceutical industry in the field of pain relief.