ASSESSMENT OF THE EFFECTIVENESS OF PREVENTION PROGRAMS FOR COUNTERMEASURE OF SPREAD OF SOCIALLY IMPORTANT INFECTIONS

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Purpose of the study. To evaluate the effectiveness of the prevention programs aimed at the prevention of the spread of socially important infections on example of HIV infection, as well to express it in units permitting the comparison with other fields of health care and to compare with to expenses for the prevention and treatment of sequelae of infection. Materials and methods. Results of the panel study, executed in 2006-2013 in 10 regions of the Russian Federation in HIV infection risk groups (4 waves). The total number of participants is 9891. Study protocol included detailed survey of risk behavior, involvement in prevention programs and HIV testing. Obtained data were used for the assessment of the change of the morbidity rate as a result of prevention and calibration of the dynamic (Markov) model of the effect of the prevention on the length of quality-adjusted life and treatment cost. Expenses for the prevention were estimated from field reports of prevention projects. Results. Programs for the comprehensive prevention of socially important infections, first of all HIV-infections, among injecting drug users result in the significant decrease in HIV incidence. The assessment of the effect of the prevention within framework of the multivariable model shows odds ratio to be of 0.56 (95% CI=0.40-0.78). This relative reduction corresponds to the decline of the absolute incidence from 3.98 per 100 person per year in the group of persons who was not involved in prevention programs (95% CI=3.37-4.69) to 2.22 per 100 person per year (95% CI=1.89-2.62) among participants. Such effect of the prevention leads to the increase in quality-adjusted life-years per each person (QALY=0.23, 95% CI=0.10-0.37), and the saving of budget cost by 226 thousand rubles (95% CI=209,6 - 822,2 thousand rubles). With the use of more pessimistic assumptions in relation to expenses for the prevention and treatment, the cost per quality-adjusted life per year failed to surpass the threshold of society’s willingness to pay for health technology, with demonstrating high cost-effectiveness of investing in the prevention. Conclusion. Programs of the comprehensive prevention of socially important infections in the Russian Federation have significant effectiveness and under most plausible assumptions are cost-saving. For the solution the problem of financing preventive measures it is necessary to apply the same principles of health technology assessment as it is done is the area of drug coverage.

作者简介

A. Barinova

I.I. Mechnikov North-Western State Medical University

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O. Khurtsilava

I.I. Mechnikov North-Western State Medical University

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S. Plavinskii

I.I. Mechnikov North-Western State Medical University

Email: s.plavinskij@szgmu.ru
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参考

  1. Колбин А.С., Павлыш А.В. Оценка медицинских технологий при ВИЧ-инфекции. ВИЧ-инфекция и иммуносупрессии. 2014; (1): 110-6.
  2. Баринова А.Н. Обоснование концептуальной модели профилактики социально-значимых заболеваний, опасных для окружающих. Комплексная оценка эффективности профилактики в группах риска на примере ВИЧ-инфекции. СПб.: СПб ИОЗ; 2016.
  3. Баринова А.Н., Плавинский С.Л., Виноградова Н.Х. Влияние программ комплексной профилактики ВИЧ-инфекции на опасное поведение лиц, употребляющих инъекционные наркотики, в ряде регионов Российской Федерации. Российский семейный врач. 2014; 18(4): 18-23.
  4. Kawichai S., Celentano D.D., Vongchak T., Beyrer C., Suriyanon V., Razak M.H. et al. HIV voluntary counseling and testing and HIV incidence in male injecting drug users in northern Thailand: evidence of an urgent need for HIV prevention. J. Acquir. Immune Defic. Syndr. 2006; 41(2): 186-93.
  5. Niccolai L.M., Verevochkin S.V., Toussova O.V., White E., Barbour R., Kozlov A.P. et al. Estimates of HIV incidence among drug users in St. Petersburg, Russia: continued growth of a rapidly expanding epidemic. Eur. J. Public Health. 2011; 21(5): 613-9.
  6. Holtgrave D.R., Pinkerton S.D. Updates of cost of illness and quality of life estimates for use in economic evaluations of HIV prevention programs. J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 1997; 16(1): 54-62
  7. Ягудина Р.И., Куликов А.Ю., Зинчук И.Ю. Фармакоэкономическое моделирование применения лекарственных средств при лечении ВИЧ-инфекции. Фармакоэкономика. Современная фармакоэкономика и фармакоэпидемиология. 2011; 4(3): 14-8
  8. Neumann A., Schwarz P., Lindholm L. Estimating the cost-effectiveness of lifestyle intervention programmes to prevent diabetes based on an example from Germany: Markov modelling. Cost. Eff. Resour. Alloc. 2011; 9(1): 17.
  9. Roux L., Pratt M., Tengs T.O., Yore M.M., Yanagawa T.L., Van Den Bos J. et al. Cost effectiveness of community-based physical activity interventions. Am. J. Prev. Med. 2008; 35(6): 578-88.
  10. Littlewood K.J., Ouwens M.J., Sauboin C., Tehard B., Alain S., Denis F. Cost-effectiveness of routine varicella vaccination using the measles, mumps, rubella and varicella vaccine in France: an economic analysis based on a dynamic transmission model for varicella and herpes zoster. Clin. Ther. 2015; 37(4): 830-41.
  11. Куликов А.Ю., Бабий В.В. Фармакоэкономический анализ применения лекарственного средства эвиплера (рилпивирин/тенофовир/эмтрицитабин) для лечения ВИЧ-инфицированных пациентов на территории Российской Федерации. Фармакоэкономика: Теория и практика. 2015; 3(1): 3-12.
  12. Рудакова А.В., Поддубная И.В., Зарицкий А.Ю., Стадник Е.А. Эффективность затрат на бендамустин в терапии индолентных неходжкинских лимфом. Современная онкология. 2011; 13(2): 26-30.
  13. Ягудина Р.И., Куликов А.Ю., Нгуен Т. Определение «порога готовности платить» в России, в Европейских странах и в странах СНГ. Фармакоэкономика. Современная фармакоэкономика и фармакоэпидемиология. 2011; 4(1): 129.
  14. Bhakta N., Martiniuk A.L., Gupta S., Howard S.C. The cost effectiveness of treating paediatric cancer in low-income and middle-income countries: a case-study approach using acute lymphocytic leukaemia in Brazil and Burkitt lymphoma in Malawi. Arch. Dis. Child. 2013; 98(2): 155-60.
  15. Aspinall E.J., Nambiar D., Goldberg D.J. Hickman M., Weir A., Van Velzen E. et al. Are needle and syringe programmes associated with a reduction in HIV transmission among people who inject drugs: a systematic review and meta-analysis. Int. J. Epidemiol. 2014; 43(1): 235-48.
  16. Des Jarlais D.C., Feelemyer J.P., Modi S.N., Abdul-Quader A., Hagan H. High coverage needle/syringe programs for people who inject drugs in low and middle income countries: a systematic review. BMC Public Health. 2013; 13: 53.
  17. Vickerman P., Kumaranayake L., Balakireva O., Guinness L., Artyukh O., Semikop T. et al. The cost-effectiveness of expanding harm reduction activities for injecting drug users in Odessa, Ukraine. Sex. Transm. Dis. 2006; 33(Suppl. 10): S89-102.
  18. Kumaranayake L., Vickerman P., Walker D., Samoshkin S., Romantzov V., Emelyanova Z., et al. The cost-effectiveness of HIV preventive measures among injecting drug users in Svetlogorsk, Belarus. Addiction. 2004; 99(12): 1565-76.
  19. Wilson D.P., Donald B., Shattock A.J., Wilson D., Fraser-Hurt N. The cost-effectiveness of harm reduction. Int. J. Drug Policy. 2015; 26(Suppl. 1): S5-11.

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