Pharmacoeconomic analysis of different treatment regimens for Crimean hemorrhagic fever


DOI: https://dx.doi.org/10.18565/epidem.2019.9.3.78-83

Abuova G.N.

South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan
In recent years, the efficiency of therapy for various diseases has been evaluated not only by clinical and laboratory parameters, but also by pharmacoeconomic indicators.
Objective. To carry out a pharmacoeconomic analysis of the efficiency of Crimean hemorrhagic fever (CHF) therapy with ribavirin and immunized convalescent plasma, performed in the Republic of Kazakhstan
Subjects and methods. The investigation enrolled 94 CHF patients treated at hospitals in the endemic areas of southern Kazakhstan in 2001–2019. Group 1 patients (n = 32) received only pathogenetic therapy according to the clinical diagnostic and treatment protocol used in the Republic of Kazakhstan. Group 2 patients (n = 32) were additionally treated with ribavirin according to the WHO regimen. Group 3 patients (n = 30) had combination therapy with ribavirin and immunized plasma from CHF convalescents. The overall cost of illness (COI) and cost-effectiveness analysis (CEA) were determined to provide a comparative pharmacoeconomic evaluation of the treatment regimens.
Results. The mortality rates were 15.6, 9.4, and 3.3% in Groups 1, 2, and 3, respectively. A higher average amount of money spent on medications per patient in Group 3 than that in Groups 1 and 2 did not lead to a statistically significant difference in overall COI. CEA studies showed that the lowest costs per unit of treatment efficiency were in Group 3: these were 2.5 and 1.5 times lower in Group 3 than in Groups 1 and 2, respectively. CEA was 1.6 times less in Group 2 than in Group 1.
Conclusion. The use of ribavirin and immunized plasma to treat CHF contributed to a more rapid reduction in the clinical and laboratory manifestations of the disease, reduced the risk of death. This treatment regimen is most beneficial in the pharmacoeconomic indicator CEA.
Keywords: immunized plasma, Crimean hemorrhagic fever, ribavirin, pharmacoeconomic analysis
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Literature

  1. Nurmakhanov T., Sansyzbayev Y., Atshabar B., Kazakov S., Derjabin P., Kazakov S. et al. Crimean-Congo hemorrhagic fever virus in Kazakhstan, 1948–2013. Int. J. Infect. Dis. 2015; 38: e19–23. DOI:10.1016/j.ijid.2015. 07.007
  2. WHO. Crimean-Congo haemorrhagic fever. 31 January 2013. https:// www.who.int/news-room/fact-sheets/detail/crimean-congo-haemorrhagic-fever
  3. Al-Abri S.S. et al. Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions. Int. J. Infect. Dis. 2017; 58: 82–9.
  4. Pshenichnaya N.Yu., Leblebicioglu H., Bozkurt I., Sannikova I.V., Abuova G.N. et al. Crimean-Congo hemorrhagic fever in pregnancy: A systematic review and case series from Russia, Kazakhstan and Turkey. Int. J. Infect. Dis. 2017; 58: 58–64
  5. Johnson S. et al. Ribavirin for treating Crimean Congo haemorrhagic fever. Cochrane Database of Systematic Reviews. 2018, Issue 6. http://dx.doi.org/10.1002/14651858.CD012713.pub2
  6. Leblebicioglu H., Bodur H., Dokuzoguz B., Elaldi N., Guner R. et al. Case management and supportive treatment for patients with Crimean-Congo hemorrhagic fever. Vector Borne Zoonotic Dis. 2012; (12): 805–11.
  7. Mardani M., Keshtkar M.J., Holakouie K.N., Zeinali M. The efficacy of oral ribavirin in the treatment of Crimean-Congo hemorrhagic fever in Iran. Clin. Infect. Dis. 2003; 36(12): 1613–8.
  8. [Сlinical Protocol of Diagnosis of Treatment of the Ministry of Health and Social Development of the Republic of Kazakhstan from 12.12.2014 № 9 «Congo-Crimean fever»]. https://online.zakon. kz/m/Document/?doc_ id=39136838 (In Russ.) .
  9. Ujmautov M.U. [Crimean-Congo hemorrhagic Fever]. In: Abstracts of scientific and practical conference of young scientists and students «Molodezh’ i meditsinskaya nauka». Tver’, 2010; 204. (In Russ.).
  10. Abuova G.N., Akimzhanova E.A., Zhaiykbaeva Zh.T., Zhabikenova G.D., Seithanova B.T. [The state of the problem of diagnosis and treatment of Congo-Crimean hemorrhagic fever in South Kazakhstan: achievements and prospects. In: Abstracts of V Annual All-Russian Congress on Infectious Diseases]. Moscow, 2016; 6–7. (In Russ.).
  11. Ermakova L.A., Pshenichnaya N.Yu., Аmbalov Yu.M., Chernikova E.А. [Evaluation of the effectiveness of multiple scatological studies for the diagnosis of giardiasis]. Meditsinskaya parazitologiya i parazitarnye bolezni 2007; (4): 32–4. (In Russ.)
  12. Ambalov Yu. M., Pshenichnaya N.Yu., Kovalenko A.P. [Application of methods of mathematical modeling in the pharmacoeconomic analysis of the treatment of erysipelas of the lower extremities]. Uspekhi sovremennogo estestvoznaniya 2005; (10): 32–6. (In Russ.).
  13. Ermakova L.A., Tverdohlebova T.I., Pshenichnaya N.Yu.. [Diagnostic significance of enzyme immunoassay in case of larvial helminthiases (trichinosis, echinococcosis, toxocariasis)]. Profilakticheskaya i klinicheskaya meditsina 2012; (3): 59–63. In Russ.).
  14. Vorob’ev P.A. [Clinical and economic analysis]. 3 ed. Moscow: N’yudiamed, 2008. 778 p. (In Russ.)
  15. Oestereich L., Rieger T., Neumann M., Bernreuther Ch., Lehmann М., Krasemann S. et al. Evaluation of Antiviral Efficacy of Ribavirin, Arbidol, and T-705 (Favipiravir) in a Mouse Model for Crimean-Congo Hemorrhagic Fever. PLOS Neglected Tropical Diseases 2014; (5): e2804.
  16. Switula D. Principles of Good Clinical Practice (GCP) in Clinical Research. Science and Engineering Ethics 2000; (6): 71–7. http://dx.doi.org/10.1007/s11948-000-0025-z.
  17. Keshtkar-Jahromi M., Kuhn J.H., Christova А.I., Bradfute S.B., Jahrling P.B., Bavari S. Crimean-Congo hemorrhagic fever: current and future prospects of vaccines and therapies. Antiviral Res. 2011; 90(2): 85–92. doi: 10.1016/j.antiviral.2011.02.010


About the Autors

Prof. Gulzhan N. Аbuova, Cand. Med. Sci., Head, Department of Infectious Diseases and Dermatovenerology, South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan; е-mail: dr.abuova @gmail.com; ORCID:http://orcid.org/0000-0002-1210-2018


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