Relevance. Assessment of the burden of disease provides information on the economic consequences of the disease, allows you to assess the social significance, identify areas that require additional clinical and economic research, changes in methodological approaches to the organization of measures for the prevention, early detection and treatment of diseases.The aim. Assessment of the socioeconomic and global burden of COVID-19 in the Russian Federation (RF).Materials and methods. Identification and assessment of direct medical, direct non-medical, and indirect costs associated with the development of the coronavirus epidemic. When calculating the socioeconomic burden, the variant of calculations was chosen taking into account the prevalence of the disease. The sources of data on the epidemiology of the disease were data from the Ministry of Health and data from the Government of the RF.Results. The socioeconomic burden of COVID-19 in 2020 in the RF amounted to about 5.4 trillion rubles (5 % of nominal GDP in 2020) and was largely due to indirect costs due to GDP losses due to a 1.5-month period of self-isolation. The estimated global burden of disease is more than 4 million YLLs globally, of which in the RF 2,486.30 among men and 1,378.22 YLL among women.Conclusion. The epidemic of the new coronavirus infection has led to colossal economic losses in Russian society. The data presented underscore not only the clinical, but also the economic importance of investing in the development of strategies for the treatment and prevention of new coronavirus infection.

Objective: аssessment of orlistat, liraglutide and sibutramine consumption in the Russian Federation as drugs recommended by the Russian clinical guidelines for the pharmacotherapy of obesity.Material and methods. From IQVIA database, the information was selected on retail sales and procurement of the specified drugs at the expense of the federal and regional budgets in the period of 2011–2021. The consumed volumes of each drug were recalculated into the number of defined daily doses (DDDs) for each international nonproprietary name in accordance with the World Health Organization methodology.Results. It was demonstrated that over a 10-year period there was a tendency to reduce the consumption of drugs for the treatment of obesity from 83.03 million DDDs in 2011 to 71.7 million in 2021. Sibutramine consumption dominated throughout the observation period: its share ranged from 76% to 84%. The proportion of people receiving obesity pharmacotherapy in the Russian Federation was about 0.5%. Herewith 58–66% of DDDs sales took place in 3 regions: Moscow, Moscow Region and Saint Petersburg.Conclusion. Low efficacy, high frequency of adverse effects, frequent weight gain after therapy termination, as well as low orientation of doctors to the need for pharmacotherapy are probably the main factors determining the low prevalence of using drugs for the treatment of obesity in Russia.

Objective: to assess the compliance of the actual practice of conducting clinical and economic research with the requirements applicable in the Russian Federation (RF) when including drugs in the Federal Program of High-Cost Nosologies (HCN).Material and methods. In the CyberLeninka and eLibrary databases, a search was made for clinical and economic studies of medicines included in the HCN list published in the RF in the period from 2011 to June 2021.Results. Information was obtained on 23 published clinical and economic studies of the effectiveness of drugs, which is less than 30% of all drugs included in the HCN program during the specified period. More than half of the studies of chronic disabling diseases had a modeling horizon of 1 year. The sensitivity analysis of the results in over 1/3 of cases considered only the deviation of the price of the strategies under consideration, and in a quarter of cases it was not carried out at all. Only 4 studies evaluated the increase in quality-adjusted life year, although, for chronic disabling diseases, quality of life is one of the key performance indicators.Conclusion. In the RF, less than 30% of the results of pharmacoeconomical studies of drugs included in the HCN Program are published, which does not allow to make adequate evaluation of pharmacoeconomical approaches to its formation. To analyze the effectiveness of the tools used in assessing the economic efficiency of expensive medical technologies, a further retrospective research of the studies conducted in the RF is required.

Социально-экономическое бремя COVID-19 в Российской Федерации

Objective. The purpose of this study was to evaluate the economic efficiency of using surgical tactics for the treatment of obesity at the expense of the healthcare system of the Russian Federation. Material and methods. An analysis of the impact on the budget was carried out, within which the costs of the healthcare system for providing care to obese patients were modeled in the event of an increase in the proportion of people who underwent bariatric interventions. The data obtained in the framework of a previously conducted case—control study (A. Aminian et al., 2019) regarding the achievement of clinical outcomes in the group of conservative and surgical management of patients were selected as information on the effectiveness. Direct medical costs are taken into account. Annual 5% cost discounting has been applied. Results. The total cost per 1 patient for 8 years in the surgical treatment group is 1.109.407 rubles, in the conservative treatment group — 1.242.501 rubles. The total difference in costs per 1 patient over 8 years is 133.093 rubles in favor of a group of operated patients, which does not cover the costs associated with surgical intervention in case of reimbursement of costs at the expense of the healthcare system. The increase in costs in all variants of the simulated practice for the entire simulated population of obese patients in the Russian Federation over an 8-year period amounted to no more than 0.068% of the costs of the healthcare system. The minimum increase (0.03% of all costs) was a variant of practice, when about 6.000 surgical interventions are performed annually at the personal expense of patients and another 1.000 at the expense of the budget of the healthcare system. Conclusions. Currently, about 1.5 million people in the Russian Federation need surgical treatment for obesity, while in real practice access to this type of medical care is extremely limited. The results of this study can be used as support in decision-making on the development of a comprehensive national strategy for financing medical care for patients with obesity and related diseases.

Background. Bariatric surgery is an effective long-term treatment for obesity and associated metabolic disorders such as type 2 diabetes mellitus (DM), hypertension, dyslipidemia, and sleep apnea. Despite the fact that the safety and effectiveness of bariatric interventions has now been proven, like any other surgical intervention, it’s associated with complications. Objective. To assess the incidence of early complications and 10-day mortality in patients undergoing bariatric surgery in the Russian Federation. Material and methods. Information on the frequency of interventions performed, associated complications and mortality was obtained from the Russian National Bariatric Registry database, containing anonymized data of patients who underwent bariatric intervention in the period from 03/03/2004 to 04/12/2023. The analysis included patients aged 18—70 years who underwent primary surgery. In addition to assessing 10-day mortality rates and the frequency of early postoperative complications, a comparative analysis of the likelihood of developing complications depending on the class of obesity, the patient’s age and the presence of comorbid conditions was carried out. Results. The analysis included 33.627 patients. The 10-day postoperative mortality rate was 0.098%. The rate of early postoperative complications was 1.77% for all types of operations and groups of patients. Bleeding and leakage were the most common: up to 1.2% and 1.5%, respectively, depending on the type of operation. The frequency of their development was statistically significantly influenced by the patient’s age, gender, BMI and the presence of concomitant pathology. Conclusion. Minimal postoperative risks of complications were observed in patients after sleeve gastrectomy. The proportion of bleeding cases in this group did not exceed 0.8%, and the failure of the stapler line did not exceed 0.5%. The 10-day postoperative mortality rate after sleeve gastrectomy was 0.05%.