Pharmacoeconomic Evaluation of Standard Treatment Regimes of Tuberculosis Resistant to Isoniazid

The article presents the study of pharmacoeconomic aspects of isoniazid-resistant tuberculosis. The literature review was conducted on this topic; the treatment results of patients that were registered in the Kharkiv region (Ukraine) with diagnosis of isoniazid-resistant tuberculosis, according to the results drug-sensitive test and treated by standard regimens were retrospectively studied. Cost-effectiveness analysis and modeling in the system "tree of solutions" were done. Materials and Methods. The retrospective study showed that in group treated by short-term regimen 65,9% were cured and in group treated by long-term regimen 77,7% got effective treatment. The cost of treatment is 1567 UAH and 3539 UAH, according to short-term and long-term regimens. The cost of treatment includes only funds for anti-tuberculosis drugs, does not include symptomatic and pathogenetic therapy, diagnostic methods, monitoring of treatment, etc. Indicator CER (cost-effectiveness ratio) for the short-term regimen is 23.78 UAH, and for the long-term regimen – 45.55 UAH. According to the pharmacoeconomic modeling, the difference in the cost is 2394 UAH, in the percentage long-term regime is more expensive than short-term by 51.6%. The results show that the short-term regimen prevails over the "cost-effectiveness" indicator, but the number of treatment failure after this regimen, which requires an extension of therapy, or the re-registration to the 4th category for the expansion of the Mycobacteria tuberculosis resistance spectrum, offset such benefits. Conclusions. As a result of the conducted pharmacoeconomic analysis it was set that among the charts of chemotherapy of advantage the chart of the Ministry of Health Care of Ukraine order № 1091. However, the amount of failures treatments on this chart in need for continuation of the appointed therapy for 9 more months, or translations in 4 categories on more valuable 20 months treatment, according to the results of drug sensitiveness test level such advantages. Modes of anti TB treatment taking into account their efficiency and financial viability must become the basis of modern phthisiatric practice. Perspectives for further research are direct and indirect charges on treatment of the tuberculosis caused by the different profiles of resistance to TB, for forming of adequate recommendations.