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16PHARMACEUTICS
PHARMACOECONOMIC EVALUATION OF AVAILABILITY OF MEDICINAL PRODUCTS USED IN SYMPTOMATIC THERAPY OF RESPIRATORY DISEASES
Nemchenko A.,
Doctor of Pharmaceutical Sciences, Professor, Head of the Department of Organization and Economics of
Pharmacy at the National University of Pharmacy, Kharkiv, Ukraine
Gladukh Ie.,
Doctor of Pharmaceutical Sciences, Professor, Head of the Department ofIndustrial Pharmacy at the National University of Pharmacy, Kharkiv, Ukraine
Bondarenko A.,
Postgraduate student of the Department ofIndustrial Pharmacy at the National University of Pharmacy,
Kharkiv, Ukraine Mishchenko V.
Ph.D. in Pharmaceutical Sciences, Assistant Professor of the Department of Organization and Economics
of Pharmacy at the National University of Pharmacy, Kharkiv, Ukraine
Abstract
Diseases accompanied by cough are classified as respiratory diseases (RDs). Currently, according to the State Statistics Service of Ukraine, these diseases remain one of the most common pathologies in the morbidity structure of the Ukrainian population, which in 2017 occupied 45.2% of all registered diseases. Therefore, the problem of increasing the efficacy and availability of RD treatment is still relevant. To determine the socioeconomic availability of medicines that are used in symptomatic treatment of RDs, the cost characteristics were analysed and a pharmacoeconomic assessment of the indicators for 2014-2018 was made. In the course of research, methods of system analysis, mathematical, comparative, analytical and content analysis were used. Objects of research: data of the State Statistics Service of Ukraine, purchasing prices for drugs, analysed for 2014-2018. The increase of competitiveness among drugs by expanding their assortment, as evidenced by the analysis of the liquidity coefficients of drugs prices, has been determined. The general tendency to decrease the value of average coefficients of adequacy of solvency in 2014-2018 both in domestic and foreign drug research has been examined, which indicates an increase in the availability of the analysed drugs. The lowest coefficient of solvency adequacy had domestic drug - "Bromhexin-Darnitsa", which indicates an adequate solvency of the population for the purchase of this drug. The calculated indicators confirm the traditionally higher availability of domestic drugs for the Ukrainian population.
Keywords: drugs, pharmacoeconomic evaluation, respiratory diseases, economic availability, indicators of liquidity of prices and adequacy of solvency for drugs.
Introduction. According to ICD-10 (International Classification of Diseases), diseases that are accompanied by cough, belong to the class of respiratory diseases (RDs). Treatment for RDs is aimed at overcoming a pathogen (etiotropic therapy) and reduction of symptoms (symptomatic therapy). At present, these diseases remain one of the most common pathologies in the structure of the morbidity of the population of Ukraine. According to the State Statistics Service of Ukraine, in 2017 the number of the first registered cases of diseases was more than 12 million people, which was 45.2% of all diseases (the number of newly registered cases of all diseases in 2017 amounted to 26.6 million persons) [1, 2].
For analysis, we have selected medicines that are used in symptomatic therapy and eliminate the main symptom of RD - cough [3]. In the conditions of limited resources of health care and low solvency of the population, the pharmacoeconomic assessment of medicines availability is becoming increasingly socioeconomic, which is what this publication is devoted to.
Based on the above, the purpose of the study was to conduct an analysis of price indicators for the availability of drugs for the treatment of RDs, in particular, for symptomatic treatment of cough.
Research methods. The analysis of price indices dynamics, indicators of prices liquidity and availability of medicines for the treatment of RD have been carried out using methods of system analysis, mathematical, comparative, analytical and content analysis.
The objects of the study were: data of the State Statistics Service of Ukraine for 2014-2018, Compendium directory, price lists of pharmacies.
To determine socio-economic affordability, we have conducted an analysis of the price characteristics of drugs that are used in symptomatic treatment of RD. For this purpose, procurement prices for drugs in 20142018 were analysed and the index of price growth has been calculated taking into account the country of origin according to the formula:
. Pi
Ip = — where Po
P i is the weighted average price of the i-th preparation in the current period,
P 0 - average weighted price of the i-th drug in the previous period [4].
The results of the analysis of the dynamics of price indices for drugs used in symptomatic treatment of RD of domestic and foreign production are shown in Fig. 1.
1.6 1.4 1.2 1
0.8 0.6 0.4 0.2
0
□ Domestic manufacturers
□ Foreign manufacturers
2015/2014 2016/2015 2017/2016 2018/2017
Fig. 1. Analysis of the dynamics ofprice indices for domestic and foreign production drugs used in symptomatic
treatment of RD during 2014-2018.
It was established that in 2015, relative to 2014, purchasing prices for domestic drugs have increased by 42%, while foreign ones - by 36%. In 2016 compared with 2015, the relative stability of prices for domestic medicines (I p = 1.09) and for foreign (I p = 1.02) was noted. In 2017, the growth of average purchasing prices for drugs was observed again, as shown by the growth of price indices for domestic medicines (I p = 1.17) and foreign ones (I p = 1.16). This fact can be explained by a significant devaluation of hryvnia and, consequently, by the rise in prices for drugs that are used in symptomatic treatment of RD. The increase in prices for foreign drugs in 2017 was due to the fluctuation of the exchange rate, to which all imported drugs are tied up, and in domestic ones - due to the increase in the cost of foreign raw materials from which drugs are produced. At the same time, in 2018, again, as in 2016, prices of domestic medicines (I p = 1.12) and foreign (I p = 1.02) have declined, indicating a slight decrease in average purchasing prices.
The next stage of the research was the analysis of the price liquidity coefficients (Cliq) for the drugs for
the period 2014-2018, which were calculated by the formula:
P max- P min
Lhq =- , where
P min
P max is the maximum price of a drug for the corresponding period of time;
P min - the minimum price of drugs for a similar period of time [5].
It is known that Cliq reflects the degree of competition in the pharmaceutical market and to some extent characterizes the availability of drugs. The lower the value of the liquidity ratio (usually from 0 to the maximum allowable value of 0.5), the higher is the level of competition prevailing in the market, and the more available the analysed drugs are [4]. Calculated and generalized mean values of Cliq for drugs that are used in symptomatic therapy of RD, taking into account their country of origin during 2014-2018, are shown in Fig. 2.
0.05 0
^ Domestic medicines
□ Foreign medicines
2014
2015
2016
2017
2018 years
Fig. 2. Analysis of dynamics ofprice liquidity coefficients for domestic and foreign production drugs, which are
used in symptomatic therapy of RD in 2014-2018.
It has been established that the value of Cnq , which does not exceed 0.5, was observed for the entire period of 2014-2018, which indicates the competitive environment in this segment of the market and positively characterizes the relative availability of these drugs to the population. At the same time, in domestic drugs, starting from 2014, there was a significant decrease in the average value of Cnq by 4.1 times (from 0.419 in 2014 to 0.102 in 2015 ).In 2016, its gradual increase in 1.7 times (to 0.175) has been established .In 2017, there was a slight decrease in the indicator in 1.1 times (0.166), and in 2018, the decrease in the indicator was 2.7 times (0.058), which indicates an increase in the availability of both domestic and foreign drugs for symptomatic therapy of RD. The highest value of Cnq was observed in 2014 in domestic drugs - 0.419, and the lowest in 2018 in foreign drugs - 0.048.
In the course of the study, the coefficients of solvency adequacy (Cas) have been calculated and determined - one of the relative indicators of socioeconomic
availability of drugs, which was calculated by the formula:
P
Ca.s =
%, where
Wa .w
C as - coefficient of adequacy of solvency;
P - average retail price of drugs for a certain period of time;
W aw. - Average salary for the relevant period of time [5].
It is known that the smaller the value of this indicator is, the more accessible to the population are drugs considered to be. The low coefficient of solvency adequacy ensures the availability of a medicine and guarantees its sale in conditions of low solvent demand of the population.
The general tendency to decrease the average coefficients C as was established in 2014-2018 for both domestic and foreign drugs, indicating an increase in the availability of analysed drugs (table).
Table
Dynamics of average coefficients of adequacy of solvency for domestic and foreign drugs in 2014-2018
years domestic C as, % foreign C as ,%
2014 0.51 1.54
2015 0.50 1.53
2016 0.40 1.24
2017 0.37 1.05
2018 0.41 0.99
Analysis of C as. in the dynamics of years, taking into account the country of origin, has shown that during the 2014-2018, the lowest values of C as were observed in domestic production drugs. The value of C as. ranged from 0.37% (2017) to 0.51% (2014).
Analysing the results, it has been found that the largest indicator of adequacy of solvency was in 2014 in "Synecod syrup", 1.5 mg / ml for 200 ml (Novartis Consumer Health S.A., Switzerland) C as = 3.09%. and during the 2015-2018 - "Umcalor", oral solution 50 ml (Dr.Wilmar Schwabe GmbH & Co. KG , Germany): in
2015C as. = 4.48 %; in 2016 C as = 3.44 %; in 2017 C as. = 2.81%; in 2018 C as= 3.03%.
The lowest coefficient of solvency adequacy during 2014-2018 had domestic production drug - "Brom-hexin - Darnitsa", tablets 8 mg No. 10 (Pharmaceutical Company "Darnitsa", Ukraine): in 2014 C as. = 0.09%; in 2015 C as. = 0.08%; in 2016 C as. = 0.07%; in 2017 C as. = 0.05%; in 2018C as. = 0.03%. This indicates the adequate solvency of the population for the purchase of the drug "Bromhexin - Darnitsa".
Next, we have calculated and analysed the availability of drugs that are used in symptomatic treatment of RD, taking into account their country of origin for 2014-2018, calculated by the formula:
_ Ix * W min
D =- , where
Is *Vk
Ix - the index of changes in the average wage for a certain period;
Is - a consolidated price index for drugs for the same period;
Wmin - minimum wage in the country;
Vk - the value of the consumer basket for the period under investigation [5, 6].
The calculations of the above indicators were carried out according to the data of the State Statistics Service of Ukraine for 2014-2018. [2]. Literary sources indicate that for a state-guaranteed pharmaceutical aid, the availability of drugs should be equal or greater than one: D >1 [4, 6].
The results of the availability analysis of domestic and foreign production drugs that are used in symptomatic therapy of RD during 2014-2017 are shown in Fig. 3.
Fig. 3. Analysis of the average availability indicators of domestic and foreign production drugs that are used in
symptomatic therapy of RD in 2014-2017.
According to the results of the conducted research, it was found that in the crisis of 2014 there is a tendency for a significant decrease in the average indicators of availability (below 1), which is due to a significant decrease in the level of incomes due to the rapid increase of the exchange rate in the specified period. In 2014, the average value of D for domestic production drugs was 0.84 and foreign - 0.87. At the same time, it is necessary to note the positive trend of the increase in the availability of medicines in 2015.( D for domestic drugs was 1.16 and foreign - 1.24) compared with the crisis of 2014This testifies to the positive development of the investigated pharmaceutical market segment .At the same time, in 2016, the tendency towards a decrease in the availability rate (D for domestic drugs is 0.95 and for foreign - 0.90) is observed, which is associated with a decrease in the level of incomes and a significant increase in the exchange rate. In 2017, a sharp increase in D was observed for domestic drugs in 2.6 times (D = 2.46), while in foreign products it was 2.66 times (D = 2.39) due to an increase in the average wage to UAH 8777.00. The conducted researches can be used in practical activity of pharmaceutical enterprises with the purpose of formation of optimal assortment and carrying out the purposeful promotion policy of drugs that are used in symptomatic therapy of RD.
Conclusions
1. To determine the socioeconomic availability of drugs used in symptomatic treatment of RD, the analysis of their price indices for the period 2014-2018 has been carried out. The analysis of the liquidity ratios of drug prices, (which does not exceed the value of 0.5),
has allowed determining an increase in the competitiveness of drugs, which occurred due to the expansion of their range.
2. Due to the growing competition among medicines, which are used in symptomatic therapy of RD a reduction in the adequacy of solvency ratios and their accessibility indicators have been determined. This indicates an increase in the availability of drugs of the analysed group for Ukrainian population. Among domestic drugs this happens at the expense of PJSC "Halychpharm".
3. The indicators estimated for domestic and foreign drugs, which are used in symptomatic therapy of RD, have confirmed the fact that for the vast majority of the Ukrainian population, domestic drugs are more available.
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UDC 577.115.3:581.192:581.47:615.322:582.971.1
FATTY ACIDS IN THE COMPONENTS OF VIBURNUM OPULUS FRUIT
Leontiiev B.,
Student
National University of Pharmacy, Kharkov, Ukraine
Khvorost O.,
Doctor of Pharmacy (Dr. habil.), professor of the Department of Chemistry of Natural Compounds,
National University of Pharmacy, Kharkov, Ukraine
Fedchenkova Yu.
Doctor of Pharmacy (Dr. habil.), professor of the Department of Chemistry and Pharmacy
Nizhyn Mykola Gogol State University, Nezhin, Ukraine
Abstract
Aim. To study the composition of fatty acids of the components of Viburnum opulus fruit collected in Ukraine. The object of the study was fatty acids obtained in the kernel and the pericarp of domestic Viburnum opulus fruit. The study of fatty acids was performed by GC/MC.
Eight fatty acids in the kernel and 14 fatty acids in the pericarp have been identified, among of them 8 acids are common. Oleinic and linoleic acids (each - approximately 50 % from the total amount of fatty acids and about 30 % from the amount of fatty acids, respectively) were found in significant amounts in the kernel and in the pericarp. These compounds are of interest in pharmacy and medicine as components with the anti-inflammatory, energetic and plastic activity.
Conclusions. The qualitative composition of fatty acids in the kernel and the pericarp of domestic Viburnum opulus fruits has been studied. The results obtained indicate the prospects of creating new drugs based on the biologically active complex Omega-9 containing in the kernel and the pericarp of Viburnum opulus fruit.
Keywords: Viburnum opulus; GC; fruits; fatty acids
Recently the popularity of unsaturated fatty acids has grown steadily in medicine [1, p. 75, 2, p. 6849, 3 p. 1445]. Depending on the location of double bonds in the fatty acid molecule there are three families of these compounds. Calculations start from the methyl group at the end of the fatty acid chain. These are polyunsaturated fatty acids named Omega-3, Omega-6 and Omega-9. First of all, Omega-3 polyunsaturated fatty acids are promising to use, primarily hexadecatrienoic and eicosapentaenoic acid in the prevention of premature aging and the treatment of chronic obstructive pulmonary disease [1, p. 75]. Compounds of this class of biologically active substances (BAS) are effective in promoting growth, treating coronary heart disease, arrhythmias, cardiomyopathy, and dyslipidemia. Representatives of Omega-6 polyunsaturated acids - y-linolenic and arachidonic acids - play the same role as Omega-3 in the normal growth, but they have a better effect for the skin and the kidney function. However, the representatives of Omega-6 fatty acids under the action of some enzymes give rise to inflammatory substances - eicosanoids: prostaglandins, thromboxanes, prostacyclins and leukotrienes. Omega-3 forms eico-sanoids much slower, and their role in formation of inflammation is less. When it has been known that Omega-6 eicosanoid thromboxane affects platelet
sticking, and leukotrienes play an important role in the immune-inflammatory response of the body in arthritis, lupus erythematosus, asthma and infectious diseases, this competitive effect of Omega-3 and Omega-6 acquires particular importance. The most effective way of reducing the synthesis of Omega-6 eicosanoids is to consume more Omega-3 polyunsaturated fatty acids for the optimal ratio of Omega-3: Omega-6 - 1 : 2. In the human body the Omega-9 complex, which main component is monounsaturated oleic acid, has anti-inflammatory, energy and plastic properties. Humans do not need Omega-9 so much due to its synthesis in the body. However, the most important factors are the ratio of Omega-3 and Omega-6, as well as the intensity of the synthesis of Omega-9 [1, p. 75]. Therefore, obtaining a representative of the Omega-9 family - oleic acid from external sources is relevant. Recently, the popularity of studying lipid-containing the raw material has increased [4, p. 113, 5, p. 101, 6, , p. 128, 7, p. 711, 8, p. 260].
Viburnum opulus is a common bush of the domestic flora, one of the representatives of the genus Viburnum and family Caprifoliaceae. It is found in wild and cultivated state. The bark of Viburnum is the pharma-copoeial type of the raw material and has the hemostatic activity [9, p. 360]. The fruits of Viburnum opulus are
