Veselov A V, Belousova E A, Bakulin I G, Uspenskiy Y P, Dreval R O, Shkurko T V, Kashnikov B N, Fominykh Y A, Knyazev O V, Romanov R I, Skalinskaia M I, Shipitsyn V V
National Medical Research Center of Coloproctology named after A. N. Ryzhikh, 123423, Moscow, Russian Federation,
Moscow Regional Research Clinical Institute named after M. F. Vladimirsky, 129110, Moscow, Russian Federation.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2020 Oct;28(Special Issue):1137-1145. doi: 10.32687/0869-866X-2020-28-s2-1137-1145.
to estimate the quality and availability of medical care for patients with ulcerative colitis (UC) and Crohn's disease (CD), to assess the impact of the economic burden of these diseases on the healthcare budget of Russia and to systematize the main problems in the organization of medical care and drug supply for patients with inflammatory bowel diseases (IBD). Regional IBD databases (2016-2018), official statistical databases, costs of treatment and results of expert interviews with specialists in IBD were used in the study. The analyzed databases showed 104,668 patients with UC in Russia in 2018 (prevalence rate 71 per 100,000 people) and 66,647 patients with CD (prevalence rate of 45 per 100,000 people). The economic burden including agents for biologic therapy (ABT) for the UC was 39.54 billion rubles a year (495 rubles per capita), and CD - 32.98 billion rubles a year (378 rubles per capita). It requires an additional 9.87 billion rubles annually for UC and 9.20 billion rubles annually for CD patients to provide the complete supply with ABT. The annual burden of IBD is 72.52 billion rubles, which is comparable to the costs of other socially significant diseases, including malignant tumors. It shows the high social and economic value of IBD for the country. The main problems of medical care and drug supply for IBD patients are the mismatch of official statistical data and real IBD prevalence in Russia due to absence of comprehensive register and the insufficient supply with ABT due to limited funding. A federal center for IBD should be founded for better quality of registration, for the precise monitoring and for the active management of personal drug supply.
评估溃疡性结肠炎(UC)和克罗恩病(CD)患者的医疗质量和可及性,评估这些疾病的经济负担对俄罗斯医疗保健预算的影响,并梳理炎症性肠病(IBD)患者医疗服务和药物供应组织中的主要问题。本研究使用了地区IBD数据库(2016 - 2018年)、官方统计数据库、治疗费用以及对IBD专家的访谈结果。分析的数据库显示,2018年俄罗斯有104,668例UC患者(患病率为每10万人71例)和66,647例CD患者(患病率为每10万人45例)。UC的经济负担包括生物治疗药物(ABT),每年为395.4亿卢布(人均495卢布),CD为每年329.8亿卢布(人均378卢布)。为UC患者完全供应ABT每年还需要额外98.7亿卢布,为CD患者每年需要额外92.0亿卢布。IBD的年度负担为725.2亿卢布,这与包括恶性肿瘤在内的其他具有社会意义的疾病的费用相当。这表明IBD对该国具有很高的社会和经济价值。IBD患者医疗服务和药物供应的主要问题是,由于缺乏综合登记,俄罗斯官方统计数据与IBD实际患病率不匹配,以及由于资金有限ABT供应不足。应设立一个联邦IBD中心,以提高登记质量、进行精确监测并积极管理个人药物供应。