Vol 22, No 6 (2017)

Tuberculosis worldwide is a serious problem for the health system and for society. Despite the fact that in recent years there has been a tendency to the decline in the incidence of tuberculosis, it remains to be one of the socially significant infections in the Russian Federation. Significant difficulties in the treatment of tuberculosis include the overcoming of the drug resistance of mycobacteria to the existing therapy, as well as the available limitations of the resources of the healthcare system in the Russian Federation. In this regard, there is a need to find additional opportunities to improve the effectiveness of the treatment and clinical and economic evaluation of existing treatment regimens. Interferon-gamma is an effective preparation for the management of tuberculosis. As a result of the pharmacoeconomic analysis, the administration of interferon-gamma (Ingaron) contributed to an increase in the quality of life by 2.1 QALY, and in terms of an addition to the therapy will be accompanied by savings of the budget of the Russian Federation up to 284 million rubles, or up to 27.3% of funds for the treatment of patients from this group.

The article presents the pharmacoeconomic rationale for the inclusion of vaccination against varicella in the regional calendar of preventive vaccinations on the example of the Penza region. Varicella remains one of the most common infectious diseases in the studied region and in the Russian Federation as a whole. With the limited amount of budget funds allocated for the program of vaccination, it is necessary to assess their economic efficiency. For the economic evaluation, there was developed the algorithm of calculations contained in the software based on MS Excel in order to get the result when you change the source of regional data. As a result of calculations, the vaccination in the Penza region was revealed to be a profitable investment. The sustainability of the two-time vaccination of a cohort of children aged 1 year against the Varicella held in 2016, will come in for 2018, and further savings (prevented damage) will increase steadily. By the end of 2029, “net economic benefit” will be about 246.5 million rubles, the damage prevented would exceed the cost of the vaccination of a cohort of 6 times.

The category “risk factor” is widely used in the clinical epidemiological studies. To date, a large number of applied studies on the specific characteristics of risk factors for individual nosological forms has been published. At the same time, there is a minimum of publications concerning dealing with a general pattern concerning the theoretical basis for the application of this epidemiological category. In connection with this, the purpose of this report is the theoretical presentation and justification for the use in the epidemiological studies of the category “risk factor”. The authors give an epidemiological definition to this term. The risk factor is any property or feature of the human population, any impact on it, which increases the probability of a negative effect on the incidence and/or its consequences on the prevalence of any epidemiological phenomenon. The article considers the main variants of grouping risk factors and their detailing by various classification criteria (external and internal factors, managed and unmanaged factors). The need to study the complex impact of risk factors, especially in combination and/or comorbidity diseases, is shown. The authors gave an epidemiological interpretation of the risk-related concepts: “risk determinant” and “risk marker”, the areas of correct application of these terms in clinical epidemiological studies are indicated. A proposal was made to use the term “determinant of risk” only in those cases when the investigated factor has a high degree of evidence of causality with the event being studied and is not disputed by other specialists. Examples of the substitution of the concepts “risk factor” and “risk marker” are given. There is marked the situation in which clinical and epidemiological studies mask real risk factors. In conclusion, the authors indicate to the evident level of designation and identification of risk factors as a necessary condition for the success of anti-epidemic measures and the adoption of adequate management decisions in the epidemiological surveillance system.