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ОРГАНИЗАЦИЯ И ЭКОНОМИКА ЗДРАВООХРАНЕНИЯ
© КОЛЛЕКТИВ АВТОРОВ, 2016 УДК 615.03
R. M. Abdullabekova, D. Zh. Tayzhanova, Ye. S. Zhunussov
STRUCTURE OF PHARMACEUTICAL MARKET OF ANTIAGGREGANTS OF KARAGANDA REGION
Karaganda State Medical University (Karaganda, Kazakhstan)
In this article the market of antithrombotic medical drugs has been analyzed from the point of view of marketing at the level of Karaganda region. The structure of antithrombotic drugs has been studied depending on dosage form, country of origin, sales lines. It was identified three main antiplatelet drugs that are used in the treatment of diseases of the circulatory system, namely, acetylsalicylic acid, clopidogrel, ticagrelor. These drugs are used in urgent conditions (e.g. acute coronary syndrome), and preventive treatment consisting of double antiplatelet therapy. Key words: pharmaceutical market, marketing analysis, antiaggregants, Clopidogrel, Ticagrelor
In the recent twenty years of independence of the Republic of Kazakhstan the indexes of gross domestic product has shown primary strong growth, although the rates of growth substantially vary every year (thus, annually estimative index of physical volume of gross domestic product expressed as a percentage by the previous year varies within 1.2-13.5% and rates of growth depend primary on environment at external commodity markets). In 2013 according to data of Committee on Statistics the gross domestic product has increased by 5.8% compared to last year, in 2014 the growth has been 4.1% and in 2015 -1.2% (http://www.stat.gov.kz/)
The market of medical drugs represents one of the most significant and actively developing segments of domestic market. Only in 2011 overall growth of medical drugs (MD) compared to 2010 has been 9-10%. Consumption of MD reflecting degree of development of pharmaceutical market is objective need conditioned by health state of population, demographical, economical and other factors [3,4]. Although pharmaceutical industry takes approximately 0.2% of overall volume of Kazakhstan industry the industry, however, is extremely important for development of the country acting as one of the proxy measures of social standard of living. Analysis shows that production of the basic pharmaceutical products in Kazakhstan from 1997 to 2014 has shown positive dynamics increased for 18 years in 42 times [3, 4, 6].
In 2015 year 11 403 tons of medicine have been produced as well as 297.7 tones of other pharmaceutical drugs, that is in total 1/3 more than in 2014, although in monetary terms production has been decreased compared to 2014. In times of crisis the prices for medicine has changed, however, marketing researches has shown that demand for them has left the same as before crisis as pharmaceutical products belong to group of essential commodities [2, 3].
As to export and import of products of pharmaceutical industry it is worth mentioning that volume of imports has significantly exceeded the volume of exports. As experts estimated the domestic production of medical drugs provides internal demand only for 20%. Thus, in deficit of local pharmaceutical products the population has to provide their needs due to import [3, 6]. Market analysis of pharmaceutical products has shown that for the previous five years volume of imports has increased from 974 685 thousand US dollars to 1 219 385 thousand US dollars, herewith the largest value accounts for 2013, after which volume of imports has decreased. Researches proved that volume of exports for 20102015 has been constantly growing, in 2015 index of export pharmaceutical products amounted to 27 617 thousand US dollars.
Currently, cardiovascular diseases are still leading reasons of death rate in many developed countries that is 40% of all the death cases [1, 2]. Therefore, significant part of health budget is spent for therapy of cardiovascular diseases; in some countries up to 12-13% of the costs for medical service accounts for treatment of this group of diseases [1, 2, 4].
In relation to the above, cardiovascular agents are the largest in sales volume in the world and one of the most actively developing pharmacological class of medical drugs. These drugs are approximately 18% of total amount of sales at the worldwide market of MD.
The object of this work is investigation and analysis of segment of antithrombotic drugs at the regional market.
We used statistic methods of grouping for processing and marketing analysis of the market structure of antithrombotic drugs.
Today 7 394 titles of medical drugs are registered in the Republic of Kazakhstan (National register of medical drugs in Kazakhstan, www.dari.kz). Of those, drugs of synthetical and
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biological origin is 96% and drugs of vegetable origin is 4% [5].
Antithrombotic drugs that widely used in Karaganda region in clinical practice in patients with acute coronary events are represented by the following drugs: Acetylsalicylic acid, Clopidogrel and Ticagrelor (fig. 1).
■ ASA
■ Clopidogrel
■ Ticagrelor
Figure 1 - Structure of antithrombotic drugs market in Karaganda region, 2015 (as to data of Amanat LLP)
Figure 1 shows that basic drugs with anti-aggregant effect in our region are represented by Acetylsalicylic acid, Clopidogrel and Ticagrelor having percent of 47%, 19% and 34% respectively. Acetylsalicylic acid takes leading position in given structure. Currently ASA has the widest and the most effective evidential basis and is the necessary component of double antithrombotic therapy in treatment of heart diseases and acute coronary events particularly. Key mechanism of anti thrombocyte effect of Acetylsalicylic Acid is irreversible inhibition of cyclooxygenase - 1 in thrombocytes that causes blocking of formation of Thromboxane A2. This results in inhibition of one of the channels on which aggregation of thrombocytes is activated [7]. Ticagrelor is relatively new antiaggregant that is selective and reversible antagonist of P2Y12 receptor to adenosine diphosphate (ADP) and can prevent ADP mediated activation and aggregation of thrombocytes [8, 9]. Clopidogrel is one of the most studied antithrombotic drugs with high level of proof. Mechanism of action is conditioned by irreversible selective interference of linking of adenosine di-phosphate (ADP) with receptors of thrombocytes and blockage of ADP induced linking of fibrinogen with complex of glycoprotein IIb/IIIa [10]. These drugs along with good efficiency have high safety profile and adherence of treatment.
Further analysis of antithrombotic drugs has shown that large part of drugs is imported from the near and far-abroad countries as domestic producers takes much lesser percent in total structure (fig. 2).
Figure 2 - Analysis of nomenclature of antithrombotic drugs at Karaganda market depending on local content of production, 2015 (according to data of Amanat LLP)
Analysis shows that in spite of relatively recent beginning of activity domestic pharmaceutical enterprises takes approximately 24.85% of total market of antiaggregants. Also analysis of drugs on dosage forms has been conducted. It has been established that main part is represented by solutions, powders for solutions that is 45.67%; tablets, pills are 54.33% (fig. 3). Also we have conducted analysis of the structure of ambulatory and hospital segments of the market at the regional market of antiaggregants (fig. 4, 5).
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54,33 ■ Tablets, pills
■ Solutions, powder for making
solutions
Figure 3 - Analysis of nomenclature of antithrombotic drugs at Karaganda market depending on dosage form, 2015
Analysis has shown that percent of new antithrombotic drug - Ticagrelor is significantly increasing in the structure of both ambulatory and hospital segment every year. It is explained by the fact that Ticagrelor is active drug but not prodrug in contrast to Clopidogrel, has more expressive antiaggregant effect and corresponds to safety with Clopidogrel [8, 9]. According to the results of international randomized study PLATO Ticagrelor is applied to international recommendations for case management with acute coronary events [8, 9].
We have conducted marketing analysis of pharmaceutical market of antiaggregants regis-
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
37
54
78
63
46
22
i i i
i Ticagrelor Clopidogrel
2013
2014
2015
Figure 4 - Segmentation of ambulatory market in Karaganda according to data of Amanat LLP, 2013-2015
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
25 34
67
75 66
33
i i i
i Ticagrelor Clopidogrel
2013
2014
2015
Figure 5 - Segmentation of hospital market in Karaganda as to data of Amanat LLP, 2013-2015
tered in Kazakhstan at the regional level. Structure of antithrombotic drugs is represented by three basic antiaggregants which widely used in urgent and general cardiological practice in our region: Acetylsalicylic acid (47%), Clopidogrel (19%) and Ticagrelor (34%).
It has been established that a percent of relatively new antiaggregant Ticagrelor in segments of hospital and ambulatory supplement is constantly increased every year.
Depending on local content of production domestic drugs with antiaggregant effect totally
takes 24.85%; drugs produced in near-abroad countries is 9.45%; drugs produced in far-abroad countries is 65.7%.
Thus, conducted marketing analysis has shown that domestic pharmaceutical producers having begun their industrial activities recently take significant percent of the market. Besides, domestic enterprises are intended to receive GMP certificate that will definitely lead to increasing in quality of locally produced drugs as well as expansion of range of released medical drugs. We are confident that this factor will positively impact
the development of industry market of Kazakhstan and macroeconomic situation in our country totally.
ЛИТЕРАТУРА
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2 Абсеитова С. Р. Острый коронарный синдром: Современные аспекты диагностики и лечения. - Астана, 2014. - 204 с.
3 Гелашвили Н. Н. Развитие фармацевтического рынка в Казахстане в условиях глобального экономического кризиса: проблемы и перспективы //Вестн. Омского ун-та. Сер. «Экономика». - 2009. - С. 54-59.
4 Каирбекова С. З. Развитие стратегии интервенционного лечения острого коронарного синдрома в Казахстане //Клинич. медицина Казахстана. - 2011. - №3-4. - С. 7-8.
5 Омарова Б. А. Обзор Казахстанского рынка лекарственных средств растительного происхождения / Б. А. Омарова, О. В. Сермуха-медова, З. Б. Сакипова //Фармация Казахстана. - 2015. - №6. - С. 7-11.
6 Сванова А. Влияние экономических процессов на фармацевтический рынок //Каз. фарм. вестн. - 2009. - №9. - С. 13.
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8 Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study /C. P. Cannon, R. A. Harrington, S. James et al. //Lancet. - 2010. - V. 375. - P. 283-293.
9 Held C. Ticagrelor versus clopidogrel in patients with acute coronary syndromes undergoing coronary artery bypass surgery, results from the PLATO /C. Held, N. Asenblad, J. P. Bassand //J. Amer. Coll. Cardiol. - 2011. - V. 57. - P. 672-684.
10 Savi P. Clopidogrel: an antitrombotic drug acting on the ADP-dependent actiwation pathway of human platelets /P. Savi, E. Heilmann, P. Nurden //Clin. Appl. Thrombosis. Hemo-stasis. - 1996. - V. 2. - P. 35-42.
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Received 14.11.2016
Р. М. Абдуллабекова, Д. Ж. Тайжанова, Е. С. Жунусов
СТРУКТУРА ФАРМАЦЕВТИЧЕСКОГО РЫНКА АНТИТРОМБОТИЧЕСКИХ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ В КАРАГАНДИНСКОЙ ОБЛАСТИ
Карагандинский государственный медицинский университет (Караганда, Казахстан)
В статье с позиций маркетинга проанализирован рынок антитромботических лекарственных препаратов на уровне Карагандинского региона. Изучена структура антитромботических препаратов в зависимости от вида лекарственной формы, страны производителя, каналов продаж. Выделены три основных антитромботических препарата, которые применяются в лечении болезней системы кровообращения, а именно ацетилсалициловая
кислота, клопидогрел, тикагрелор. Указанные препараты используются как при ургентных состояниях (например, острый коронарный синдром), так и в качестве профилактического лечения в составе двойной ан-титромбоцитарной терапии.
Ключевые слова: фармацевтический рынок, маркетинговый анализ, антиагреганты, клопидогрел, ти-кагрелор
Р. М. Абдуллабекова, Д. Ж. Тайжанова, Е. С. Жунусов
КАРАРАНДЫ ОБЛЫСЫНДАFЫ АНТИТРОМБОТИЯЛЫК ДЭР1Л1К ПРЕПАРАТТАРДЫН ФАРМАЦЕВТИКАЛЫК НАРЫРЫНЬЩ К¥РЫЛЫМЫ
КараFандыl мемлекеттк медицина университеты^ (КараFандыl, Казахстан)
Макалада Караранды ен1р1 денгей1нде антитромботиялык дэр1л1к препараттардын нарыры маркетинг туррысынан талданран. Дэр1л1к форманын тYрiне, енд1руш1 елге, сату каналдарына байланысты антитромботиялык препараттардын курылымы зерделенген. Кан айналу жYЙесiнiн ауруларын емдеуге колданылатын Yш нег1зг1 антитромботиялык препарат атап керсеттген, атап айтканда ацетилсалицилд1 кышкыл, клопидогрел, тикагрелор. Аталран препараттар ургентлк жардайларда (мысалы, етк1р коронарлык синдром) да, косарланран антитромбоцитарлы терапиянын курамында да профилактикалык ем рет1нде колданылады.
Шлтт сездер: фармацевтикалык нарык, маркетинг™ талдау, антиагреганттар, клопидогрел, тикагрелор
