Pharmacoeconomical affordability of antipsychotic drugs for patients with mental disorders in the structure of dementia at the regional level

Objective. To analyze the pharmacoeconomical affordability of antipsychotic drugs (APD) in patients with mental disorders in the structure of dementia at the level of the Gomel region of the Republic of Belarus

Materials and methods. The study used data from the State Register of Medicines of the Republic of Belarus (2022); Clinical Protocol for providing medical care to patients with mental and Behavioral Disorders (2010); website data https://myfin.by about the average pension amount and the minimum subsistence budget of the Gomel region for 2022; data from «State Register of Medicines of the Republic of Belarus» website. For the analysis, the price list for medicines (drugs) of the largest pharmacy chains in Belarus was used, which included the state pharmacies of the Gomel UP «Pharmacy» and commercial pharmacies of the well-known brands in Belarus «ADEL» and «Dobrya Leki». Parameters such as the price affordability of the APD and 4 availability coefficients (Cd) were determined, allowing to correlate the average cost of antipsychotic drugs packaging and the cost of the average daily dose of antipsychotic drugs with the consumer income, as well as the total affordability coefficient (Cd total.).

Results. According to all criteria, the most economically affordable drug from the group of typical APD was the generic Haloperidol–Ozone (Ozon, Russia), and the least affordable from the group of atypical ones was the generic Olanzapine (Belmedpreparaty, Republic of Belarus).

Conclusion. There is a large selection of APD on the pharmaceutical market of the Gomel region. Generic APD predominate on sale, which are more affordable compared to the original APD. But one should not forget about the advantages of the original drugs – efficiency, safety, innovativeness, reproducibility of the effect and strict quality control, confirmed in clinical trials. However, the genetic drug Olanzapine (Belmedpreparations, RB) is not in any way more superior in terms of affordability, but even inferior to some drugs. This study allowed us to establish that in the Gomel region of the Republic of Belarus, a patient with dementia is provided with a wide choice of APD and the ability to determine the criteria for preference when buying a specific drug.

1. Shved ZHZ, Avditovsky BB, Girdyuk VP. Assessment of mental and physical well-being in the elderly. In: Collection of materials of the regional scientific and practical seminar dedicated to the 25th anniversary of the Medical and Psychological Faculty of Grodno State Medical University; 2018 May 18; Grodno: GrSMU, 2018;184-186. [date of access 2022 May 15]. Available from: http://elib.grsmu.by/handle/files/8429 (in Russ.).

2. Order of the Republic of Belarus No. 1387 On the Clinical Protocol for the Provision of medical care to Patients with Mental and Behavioral Disorders, dated 31.12.2010. [Electronic resource]. Global website Codes, laws and legislative documents of the Republic of Belarus. [date of access 2022 May 15]. Available from: https://belzakon.net/%D0%97%D0%B0%D0%B A%D0%BE%D0%BD%D0%BE%D0%B4%D0%B0%D1%82%D 0%B5%D0%BB%D1%8C%D1%81%D1%82%D0%B2%D0%BE /%D0%9F%D1%80%D0%B8%D0%BA%D0%B0%D0%B7%D1 %8B/2010/99772 (in Russ.).

3. The budget of the subsistence minimum, 2022. [Electronic resource]. Global website Myfin.by. [date of access 2022 June 25]. Available from: https://myfin.by/wiki/term/byudzhetprozhitochnogo-minimuma (in Russ.).

4. Average retirement pension, 2022. [Electronic resource]. Global website Myfin.by. [date of access 2022 June 25]. Available from: https://myfin.by/wiki/term/pensiya-po-vozrastu-v-belarusi (in Russ.).

5. Average social pension, 2022. [Electronic resource]. Global website Myfin.by. [date of access 2022 June 25]. Available from: https://myfin.by/wiki/term/pensiya-po-invalidnosti-v-belarusi (in Russ.).

6. Puchkova OM, Samoshchenkova IF, Lebedev AV, Shinkarenko TO. Analysis of the economic availability of cardiovascular vital and essential medicines in the Orel region. In: Collection of scientific papers on the results of the international scientific and practical conference «Topical issues and prospects for the development of medicine»; 2018 May 12; Omsk, ICRON, 2018;5:107. [date of access 2022 May 15]. Available from: https:// izron.ru/articles/aktualnye-voprosy-i-perspektivy-razvitiya-meditsiny-sbornik-nauchnykh-trudov-po-itogam-mezhdunarodno/ sektsiya-49-organizatsiya-farmatsevticheskogo-dela-spetsialnost-14-04-03/analiz-ekonomicheskoy-dostupnosti-serdechno-sosudistykh-zhiznenno-neobkhodimykh-i-vazhneyshikh-lekar/ (in Russ.).

7. Generic. [Electronic resource]. The global Wikipedia website. [date of access 2022 June 11]. Available from: https:// ru.wikipedia.org/wiki/%D0%94%D0%B6%D0%B5%D0%BD%D0 %B5%D1%80%D0%B8%D0%BA (in Russ.).

8. Illarioshkin SN. Parkinson’s disease and the problem of Generics. Nervous diseases. 2015;(5):1-4. Available from: https:// www.neurology.ru/sites/default/files/assets/documents/2015/12/ nb-1-2015-02.pdf?download=1 (in Russ.).

9. Treatment of schizophrenia: methods and modern possibilities [Electronic resource]. IsraClinic global website. [date of access 2022 June 11]. Available from: https://www.israclinic. com/nashi-publikatsii/psikhiatriya/lechenie-shizofrenii-metodiki-isovremennye-vozmozhnosti/ (in Russ.).

10. State Register of Medicines of the Republic of Belarus. [Electronic resource]. The global website of the Ministry of Health of the Republic of Belarus Registers of the UP «Center for Expertise and Testing in Healthcare». [date of access 2022 June 10]. Available from: https://www.rceth.by/Refbank/reestr_ lekarstvennih_sredstv/results (in Russ.).

11. Alexopoulos GS, Streim J, Carpenter D, Docherty JP. Expert Consensus Panel for Using Antipsychotic Drugs in Older Patients. Using antipsychotic agents in older patients. J Clin Psychiatry. 2004;65 Suppl 2:5-99; discussion 100-102; quiz 103- 4. Режим доступа: https://pubmed.ncbi.nlm.nih.gov/14994733/

12. Sokolov AB, Lipatova IS. Original drugs and generics: the problem of choice. Medical technologies. Evaluation and selection. 2010;(2):44-48. [date of access 2022 June 18]. Available from: https://cyberleninka.ru/article/n/originalnyepreparaty-i-dzheneriki-problema-vybora-1 (in Russ.).

13. Belousov YUB. Generics are Myths and realities. Remedium. 2003;(7-8):4–9. [date of access 2022 June 18]. Available from: https://cyberleninka.ru/article/n/dzheneriki-mify-irealii/viewer (in Russ.). 14. Zyryanov SK, Fitilev II, Shkrebneva II, Vozhaev AV. Interchangeability of drugs — clinical efficacy, safety. Neurology, neuropsychiatry, psychosomatics. 2017;(1):4-10. (in Russ.). DOI: https://doi.org/10.14412/2074-2711-2017-1S-4-10

14. Kirkham J, Sherman C, Velkers C, Maxwell C, Gill S, Rochon P, Seitz D. Antipsychotic Use in Dementia. Can J Psychiatry. 2017 Mar;62(3):170-181. DOI: https://doi.org/10.1177/0706743716673321