Medikamentozās ārstēšanas izmaksu–derīguma analīzes iespēju noteikšana Latvijā

Usage of the knowledge of pharmacoeconomics is gaining popularity and recognition all over the world due to the introduction of increasingly new technologies in medicine and pharmacy that facilitate achieving unexperienced summits in treating patients, however, simultaneously make the treatment
process more expensive. Consequently, the issue about the efficiency of the applied technologies, including medicines, becomes topical. The assessment of the efficiency of medicines lies in the competence of pharmacoeconomics. The most popular methods of the pharmacoeconomic analysis are:
• Cost-minimisation analysis
• Cost-benefit analysis
• Cost-effectiveness analysis
• Cost-utility analysis
• Quality-of-life analysis’s etc.
Health-related quality of life is a multidimensional construct measuring the physical, social and emotional aspects that are relevant and important for a patient’s well-being. With regard to the instruments used to measure quality of life, there are those that ask the patient directly and those where the doctor
assesses the patient’s quality of life (self-assessment and assessment by specialist). There are two types of questionnaires: disease-specific quality-of-life questionnaire and general quality-of-life questionnaire. The disease-specific quality-of-life questionnaires are instruments used for the quantitative determination of the subjective state of health or well-being of patients suffering from the same illness. The general quality-of-life questionnaires are used for measuring health-related quality of life and can be used for a wide
range of illnesses of varying degrees of severity or for different types of treatment. These instruments are not concerned with just one specific illness but can be used for all types of ailment as well as for healthy people.
In scope of this work the author investigates the possibilities of using cost-utility analysis of medication in Latvia. The cost-utility analysis is a sub-form of cost-effectiveness analysis where benefits are expressed as Quality-Adjusted Life Years (QALYs). With QALYs, both the quality and quantity of the years of life a patient is expected to have are assessed and summarised. QALYs are calculated by estimating the total life-years gained from a treatment and weighting each year with a quality-of-life score (from 0, representing worst health, to 1, representing best health). Author chooses the measure of marginal scope of the QALYs for a labour to use the cost-utility analysis. As the specialised literature does not provide a clear view on this marginal scope, the author has used the health-related quality-of-life questionnaire for the measuring of data of the pharmacies’ clients with the assumption that these data
could be extrapolated to all adults, because every adult regularly visits pharmacies.
The main conclusions are:
1. The cost-utility analysis as one of the pharmacoeconomic analysis methods could be successfully used in Latvia, but there is a lack of specialists which could perform the analysis and interpret data. Due this reason the Riga Stradins University study programme for clinic pharmacists which includes a course on pharmacoeconomics is appreciated.
2. In accordance with the questionnaires’ data the marginal scope of QALYs for retired persons in Latvia averagely reduces twice to 0.5.
3. Health-related quality-of-life questionnaires should be widely used in Latvia for assessment of treatment process and monitoring of health-related data. The international comparison of these data could be useful for an analysis of the impact of social, demographic, economic and geographical factors.