The cost of a monthly course of antihypertensive therapy: the impact on acquisition of antihypertensive drugs in the Far Eastern Federal District

The aim of the study is to analyze the structure of acquisition of antihypertensive drugs in six regions of the Far East Federal District at the cost of a monthly course of therapy. Design and methods. The following indices were analyzed: level of the average per capita income, a living wage, morbidity of the population of Kamchatka Krai, Sakhalin Region, Republic of Saha, Jewish Autonomous Region, Republic of Buryatia, Zabaykalsky Krai. We analyzed data from 6 regions out of 11. We used the data from three regions with the largest and three regions with the lowest indicators of income of the population. We applied the intragroup marketing analysis of the pharmaceutical market (52 pharmaceutical organizations) based on defined daily doses (DDD) in quantitative and monetary equivalents, and the statistical analysis (descriptive statistics, intermediate results, dispersive analysis, coefficient of correlation of Spearmen, criteria Mann–Whitney). Results. Regions of the Far Eastern Federal District are characterized by differences in distribution of an indicator “income level / a living wage” from 3,3 to 1,7, to average in Russian Federation — 2,9. The highest rates of drug acquisition (over 40 %) was found in a segment with the cost of a 30-day course of therapy till 100 rubles at regions with the low income of the population, and over 35 % — in regions with high income. In total over 50 % packages of used drugs are within the range “till 300 rubles per monthly treatment”. Differences in quantitative and monetary value between two groups are not statistically significant. The highest sales in a money equivalent was in a segment of “100–300 rubles” in the regions with low level of income of the population and “500–1000 rubles” — in the regions with high income. The average cost of a 30-day course of antihypertensive therapy in regions varies from 350–450 rubles. Conclusions. The cost of a monthly course of antihypertensive therapy correlates with acquisition by patients of medicines in regions, both with low, and with high level of income of the population. Our data show the need for consideration of the patient’s expenses when prescribing the drugs and forming the assortment in the pharmaceutical organizations in regions of the Far Eastern Federal District.

Far Eastern Federal District, level of income of the population, arterial hypertension, drugs, treatment cost

1. Rumyantsev NA, Rumyantsev AS, Rumyantsev AA, Magomedova RG, Kukes V.G Main groups of antihypertensive drugs consumption in 2007–2013 in Russian Federation. Lekarstvennye Preparaty i Racional’naya Farmakoterapiya. 2014;(3):18–25. In Russian.

2. Grinshtein YI, Petrova MM, Shabalin VV, Ruf RR, Topolskaya NV, Kosinova AA et al. What drugs do hypertension patients take in clinical practice? Structure of antihypertensive drugs in a large Siberian region. Medicinskij Sovet. 2016;(17):24–27. In Russian.

3. Safiullin RS, Yarkaeva FF, Bariev MF. Prediction of needs for antihypertensive drugs in the Republic of Tatarstan. Farmaciya. 2016;65(1):16–19. In Russian.

4. Ionov MV, Emelyanov IV, Rotar OP, Avdonina NG, Zvartau NE, Konradi AO Risk profile and antihypertensive treatment efficacy in patients referred to the cardiological centre: post-hoc analysis. Translyastionnaya Meditsina = Translational Medicine. 2017;4(4):5–13. In Russian.

5. Ebzeeva EYu, Kirichenko AA. Hypertensive disease in the practice of the therapist. Spravochnik Poliklinicheskogo Vracha. 2017;(3):10–13. In Russian.

6. Chazova IE, Zhernakova YuV on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Syst Hypertension. 2019;16(1):6–31. doi:10.26442/2075082X.2019.1.190179. In Russian.

7. 2018 ESH/ESC Guidelines for the management of arterial hypertension. Russ J Cardiology. 2018; 23(12):143–228. doi: 10.15829/1560-4071-201812-143-228. In Russian.

8. Filippova OV. Hypertensive crisis at the prehospital stage: patient management algorithm. RMJ. 2018;1(1–2):76–81. In Russian.

9. Kartasheva YD, Vinogradov OI, Zamyatin MN. Fixed-dose drug combinations for blood pressure control. Klinicheskaya Patofiziologiya. 2017;23(1):32–39. In Russian.

10. Morozova TE, Vartanova OA, Andreev SS. Current issues in the choice antihypertensive drugs. Consilium Medicum. 2016;18(5):17–22. In Russian.

11. Leonova MV, Belousov YuB, Shteinberg LL, Belyavskaya DV, Vydrina OI, Pasternak EYu et al. The results of the pharmacoepidemiological study PIFAGOR IV concerning arterial hypertension (AH patients survey). Sistemnye Gipertenzii. 2015;12(3):11–18. In Russian.

12. Incidence of all population of Russia in 2017. Statistical materials. Part II, Ministry of Health of the Russian Federation. Department of monitoring, analysis and strategic development of health care. Federal State Budgetary Institution Central Research and Development Institute of the Organization and Informatization of Health Care of the Russian Ministry of Health. Moscow. 2018:90–91. URL: https://www.rosminzdrav.ru/ministry/61/22/stranitsa-979/statisticheskie-i-informatsionnyematerialy/statisticheskiy-sbornik-2017-god (Date of the address February 2, 2019). In Russian.

13. Federal State Statistics Service. Official statistics. Population. Standard of living. Average monetary per capita income of the population. Operational data on territorial subjects of the Russian Federation. URL: http://www.gks.ru/free_doc/new_site/population/urov/urov_11sub.htm (Date of access 31.07.2019). In Russian.

14. Federal State Statistics Service. Official statistics. Population. Standard of living. Living wage. The size of a living wage on the main social and demographic groups of the population. URL: https://www.fedstat.ru/indicator/30957 (Date of access 31.07.2019). In Russian.

15. Mirzoyan A. Welcome to the chain. Pharmaceutical messenger. 2016;11(840). URL: https://pharmvestnik.ru/articles/dobro-pozhalovatj-v-set.html (Date of the address 11/01/2019). In Russian.

16. Efimenko Yu. Sample size is a sampling method of sociological research. URL: https://fb.ru/article/263333/obyem-vyiborki-vyiborochnyiy-metodsotsiologicheskogo-issledovaniya (Date of the address 11/01/2019). In Russian.

17. Koshevoj OS, Karpova MK. Determination of the volume of sample population during regional sociological research. News of higher education institutions. Volga region. Social sciences. 2011;2(18):98–104. In Russian.

18. ATC/DDD Index URL: https://www.whocc.no/atc_ddd_index/?code=C (Date of access 31.07.2019).