Clinical and economic analysis of public procurement of anti-tuberculosis medicines for treatment of patients with multi-resistant tuberculosis

Анотація

Aim. To make clinical and economic analysis of tender procurement of drugs for the treatment of patients with multiple resistance tuberculosisinUkraine.Materials and methods. The Ministry of Health of Ukraine for the years 2014-2018 on the volume of public purchases of anti-tuberculosis medicines has been used for the study. The total amount of public purchases of anti-tuberculosis medicines by all trade names, groupings of purchases by international non-proprietary nameshas been determined. During the study, the following methods of clinical and economic analysis used: ABC, XYZ, VEN-analyzes, integrated ABC/XYZ, ABC/VEN, U1U2U3U0/ABC-analyzes. Based on the results of integrated analyzes, matrix projections have been formed.Results. According to the results of the ABC-public procurement analysis of tuberculosis medicines for 2014-2018, it was found that the total cost of purchasing medicines for the treatment of patients with multidrug-resistant tuberculosis had uneven dynamics. It is proved that during 2014-2018 the group A is dominated by anti-tuberculosis medicines of foreign production. The results of the matrix projection analysis of the integrated ABC/XYZ analysis show that, with significant financial costs for the procurement of anti-TB drugs, the frequency of purchases is unpredictable. Based on the results of the VEN analysis, it is proved that public procurement is carried out in compliance with the requirements of the relevant legal framework. The integrated ABC/VEN analysis demonstrates that during 2014-2015, the cost share for group A/E (meropon) was higher than for group A/V (levofloxacin, moxifloxacin, capreomycin), which does not fully meet the criteria of rational procurement. According to the results of the analysis of the matrix projection of the integrated U1U2U3U0/ABC-analysis, it is established that the group of not recommended medicines for the treatment of patients with multidrug-resistant tuberculosis includes three ATM (kanamycin, capreomycin, ofloxacin) with a cost amount of UAH 42520.3 thousand (part – 8.5 %).Conclusions. Based on the results of a retrospective clinical and economic analysis of public procurement of anti-tuberculosis medicines for the period 2014-2018, it is possible to state the need for scientific substantiation for outpatient model providing medical and pharmaceutical assistance to patients with MRTB in accordance with their real needs in certain names of ATM health care capabilities and international standards.

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