Analysis of pharmaceutical supply of breast cancer patients

Abstract

The aim: to conduct a clinical and economic analysis of the state of pharmaceutical support for patients with breast cancer in women.Materials and methods. During the research, data from the National List of Essential Medicines, the 14th State Formulary of Medicines, the Ukrainian clinical protocol, the clinical protocols of Great Britain and the United States of America for the treatment of breast cancer, and a depersonalized database ofdrug prescriptions were used. The research used such methods as clinical-economic, organizational-economic, mathematical-statistical, graphic, grouping and generalization.Research results. It was established that 46 schemes of schemes for the treatment of breast cancer are presented in Ukrainian and international clinical protocols (Great Britain, USA). In all three protocols, there were 5 regimens for the treatment of breast cancer, such as CMF (Cyclophosphamide, Methotrexat, Fluorouracil), AC (Doxorubi-cin, Cyclophosphamide), DC (Docetaxel, Cyclophosphamide), TC (Trastuzumab, Capecitabin), EC (Epirubicin, Cyclophosphamide).Analysis of the pharmaceutical component in the protocols for individualdrugs showed that they included 23drugs according to the INN, which belong to the group of antineoplasticdrugs. The Ukrainian clinical protocol includes 17drugs, the British protocol – 14drugs, and the American one – 15drugs. The frequency analysis of antineoplas-ticdrugs included in the Ukrainian clinical protocol revealed the TOP-3 in terms ofdrug prescription frequency: L01A A01 Cyclophosphamide (Ki=0.037), L01C D02 Docetaxel (Ki=0.029), L01D B01 Doxorubicin (Ki=0.026). The largest number of prescribeddrugs are vitaldrugs – 61.96%, the smallest share – essentialdrugs – 2.17%, and the share of non-essentialdrugs is 35.87%. The ABC analysis made it possible to determine the group of the most expensivedrugs in the treatment of breast cancer – these are antineoplastic and immunomodulating agents. The total expenses for this group amounted to UAH 772,459.96, which according to the US dollar exchange rate of the National Bank of Ukraine at the end of August 2022 was USD 21,122.77. According to the analysis of the ma-trix of the integrated ABC-VEN-frequency analysis, it was established that the largest number of prescriptions be-longed to the group of less expensive and vitaldrugs (B/V) – 7drugs (48.73% of the total amount. At the same time, the largest amount of expenses is observed in for the A/V group – UAH 772,459.96 (52.83% of all costs directed to the pharmaceutical support of patients). The results of the structural analysis of the group of the most expen-sivedrugs showed that the highest costs were characteristic of L01CD02 Docetaxel (UAH 1166,531.31; 39.81% of the total cost in the group), and the lowest – for L01DB01 Doxorubicin – UAH 63,694.14 (5.46%, respectively).Conclusions. According to the results of the conducted research, it was established that the largest costs fall on the group of essentialdrugs (1047735.07 UAH, 71.65% of all costs). This determines the need for further pharma-coeconomic calculations of breast cancer treatment to optimize the costs of antineoplasticdrugs.