ANALYSIS OF REAL DATA OF DRUG PRESCRIPTIONS IN PROTOCOLS OF STIMULATION FOR ASSISTED REPRODUCTIVE TECHNOLOGIES IN UKRAINE
DOI:
https://doi.org/10.11603/2312-0967.2019.3.10405Keywords:
assisted reproductive technologies, ABC / VEN-analysis, short protocol of stimulation, long protocol of stimulation, infertilityAbstract
Significant prevalence of infertility rates among women and men in Ukraine in the last 5 years has grown by 3 times, requires the use of assisted reproductive technologies (ART).
The aim of the work was to study the real data of prescribing drugs and their costs in stimulation protocols for ART on the basis of a retrospective analysis of patients' medical cards in public and private medical centers of ART.
Materials and methods. The analysis of the frequency of appointments, the ranking of costs and the degree of importance of drugs was carried out with ABC, VEN - analysis and integrated frequency/ABC, VEN-analysis.
Results and discussion. Frequency analysis showed that the most prescribed drugs in frequency were in the protocols of stimulation of women, included in the State Program of treatment: chorionic gonadotrophin, acetylsalicylic acid, ganirelix. In thr private medical center for women with a long or short protocols were multivitamins with minerals, progesterone, acetylsalicylic acid. Thus, the structure of ART prescribing protocols for stimulating ovulation for women in a private center showed that the highest frequency of appointments were vitamin and mineral complexes that are not included in the Treatment Protocols. We found that the cost of the treatment course in 2019 (using wholesale prices of drugs) in a private centre for a woman's short protocol for ovulation stimulation was 15237.48 UAH, for a long protocol was 22793.86 UAH, that is 33, 2% higher costs for a patient.
Conclusions. It is established that when using a long protocol of stimulation, 77% of expenditures are spent on drugs that are vital in DRTs, 16% in important medicines and 7% non-essential medicines. Costs for the short protocol for stimulation of ovulation, 73% were belong to the V category, 10% for the E category and almost 17% for the non-essential drugs, so the directions of optimization of appointments in these ART schemes has been identified.
It was found that in long and short protocols of stimulation of ovulation in a private center used drugs, which belong to non-essential drugs, it requires optimization of allocations for rationality of costs. The prospective is a pharmacoeconomic analysis of stimulation schemes based on cost-effectiveness indicators for determining cost-effective drugs for the course of treatment.
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