Vestnik Roszdravnadzora Vestnik Roszdravnadzora Вестник Росздравнадзора 2070-7940 30322 10.35576/article_5d651dbc201140.18252870 ОРГАНИЗАЦИЯ МЕДИЦИНСКОЙ ДЕЯТЕЛЬНОСТИ THE ORGANIZATION OF MEDICAL ACTIVITIES ОРГАНИЗАЦИЯ МЕДИЦИНСКОЙ ДЕЯТЕЛЬНОСТИ Prescription drug coverage in high cardiovascular risk patients as an important part of the national goals achievement Льготное лекарственное обеспечение пациентов высокого сердечно-сосудистого риска как важный компонент достижения национальных целей Соловьева Анжела Евгеньевна Solov'eva Anzhela Evgen'evna

кандидат медицинских наук;

candidate of medical sciences;

 Яковлев Алексей Николаевич Yakovlev Aleksey Nikolaevich

кандидат медицинских наук;

candidate of medical sciences;

 Виллевальде Светлана Владимировна Villeval'de Svetlana Vladimirovna

доктор медицинских наук;

doctor of medical sciences;

 Звартау Надежда Эдвиновна Zvartau Nadezhda Edvinovna

кандидат медицинских наук;

candidate of medical sciences;

 Шляхто Евгений Владимирович Shlyahto Evgeniy Vladimirovich

доктор медицинских наук;

doctor of medical sciences;

 Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В.А. Алмазова» Министерства здравоохранения Российской Федерации Санкт Петербург Россия Almazov National Medical Research Centre Saint Petersburg Russian Federation Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В.А. Алмазова» Министерства здравоохранения Российской Федерации Санкт Петербург Россия Almazov National Medical Research Centre Saint Petersburg Russian Federation Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В.А. Алмазова» Министерства здравоохранения Российской Федерации Санкт Петербург Россия Almazov National Medical Research Centre Saint Petersburg Russian Federation Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В.А. Алмазова» Министерства здравоохранения Российской Федерации Санкт Петербург Россия Almazov National Medical Research Centre Saint Petersburg Russian Federation Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В.А. Алмазова» Министерства здравоохранения Российской Федерации Санкт Петербург Россия Almazov National Medical Research Centre Saint Petersburg Russian Federation 2019 4 20 27 https://vestnikrzn.editorum.ru/en/nauka/article/30322/view

Представлены перспективы и возможные барьеры при реализации программы льготного лекарственного обеспечения (ЛЛО) пациентов высокого сердечно-сосудистого риска. Наибольшую клиническую пользу и экономическую оправданность следует ожидать от ЛЛО, во-первых, препаратами с доказанной эффективностью в отношении предотвращения неблагоприятных событий, и во-вторых, в группах высокого риска, вносящих наибольший вклад в структуру смертности населения.

The manuscript represents perspectives and possible barriers on the way of implementation of prescription drug coverage programme. The greatest clinical efficacy and economic justification should be expected from, firstly, full coverage of drugs with proved evidence on outcomes improvement and, secondly, in high-risk groups mostly contributed to the overall mortality.

 сердечно-сосудистые заболевания управление сердечно-сосудистым риском льготное лекарственное обеспечение приверженность cardiovascular diseases cardiovascular risk management subsidized drug prescription adherence

Benjamin EJ, Muntner P, Alonso A, et al.; on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics - 2019 update: a report from the American Heart Association Circulation. 2019 Mar 5;139(10):e56-e528. Benjamin EJ, Muntner P, Alonso A, et al.; on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics - 2019 update: a report from the American Heart Association Circulation. 2019 Mar 5;139(10):e56-e528. Wilkins E, Wilson L, Wickramasinghe K, et al. European Cardiovascular Disease Statistics 2017. European Heart Network, Brussels. Wilkins E, Wilson L, Wickramasinghe K, et al. European Cardiovascular Disease Statistics 2017. European Heart Network, Brussels. Данные Федеральной службы государственной статистики (Росстат), 2018 год, http://www.gks.ru, дата обращения 11.07.2019. Dannye Federal'noy sluzhby gosudarstvennoy statistiki (Rosstat), 2018 god, http://www.gks.ru, data obrascheniya 11.07.2019. Jernberg T, Hasvold P, Henriksson M, et al. Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term per- spective. Eur Heart J 2015; 36: 1163-1170. Jernberg T, Hasvold P, Henriksson M, et al. Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term per- spective. Eur Heart J 2015; 36: 1163-1170. Feng W, Hendry RM, Adams RJ. Risk of recurrent stroke, myocardial infarction, or death in hospitalized stroke patients. Neurology. 2010; 74:588-593. Feng W, Hendry RM, Adams RJ. Risk of recurrent stroke, myocardial infarction, or death in hospitalized stroke patients. Neurology. 2010; 74:588-593. Allen NB, Holford TR, Bracken MB, et al. Trends in one-year recurrent ischemic stroke among the elderly in the USA: 1994-2002. Cerebro- vasc Dis. 2010;30:525-532. Allen NB, Holford TR, Bracken MB, et al. Trends in one-year recurrent ischemic stroke among the elderly in the USA: 1994-2002. Cerebro- vasc Dis. 2010;30:525-532. Hillen T, Coshall C, Tilling K, et al. Cause of stroke recurrence is multi- factorial: patterns, risk factors, and outcomes of stroke recurrence in the South London Stroke Register. Stroke. 2003;34:1457-1463. Hillen T, Coshall C, Tilling K, et al. Cause of stroke recurrence is multi- factorial: patterns, risk factors, and outcomes of stroke recurrence in the South London Stroke Register. Stroke. 2003;34:1457-1463. Steger C, Pratter A, Martinek-Bregel M, et al. Stroke patients with atrial fibrillation have a worse prognosis than patients without: data from the Austrian Stroke registry. Eur Heart J. 2004 Oct;25(19):1734-40. Steger C, Pratter A, Martinek-Bregel M, et al. Stroke patients with atrial fibrillation have a worse prognosis than patients without: data from the Austrian Stroke registry. Eur Heart J. 2004 Oct;25(19):1734-40. Yang E, Stokes M, Johansson S, et al. Clinical and economic outcomes among elderly myocardial infarction survivors in the United States. Cardiovasc Ther. 2016;34:450-459 Yang E, Stokes M, Johansson S, et al. Clinical and economic outcomes among elderly myocardial infarction survivors in the United States. Cardiovasc Ther. 2016;34:450-459 Мареев В. Ю., Фомин И. В., Агеев Ф. Т., и др. Сердечная недостаточность: хроническая (ХСН) и острая декомпенсированная (ОДСН). Диагностика, профилактика и лечение. Кардиология. 2018;58 (S6):8-164). Mareev V. Yu., Fomin I. V., Ageev F. T., i dr. Serdechnaya nedostatochnost': hronicheskaya (HSN) i ostraya dekompensirovannaya (ODSN). Diagnostika, profilaktika i lechenie. Kardiologiya. 2018;58 (S6):8-164). Maggioni AP, Dahlstrom U, Filippatos G, et al. EURObservational Research Pro- gramme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail 2013;15:808-817. Maggioni AP, Dahlstrom U, Filippatos G, et al. EURObservational Research Pro- gramme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail 2013;15:808-817. Ma TT, Wong ICK, Man KKC, et al. Effect of evidence-based therapy for secondary prevention of cardiovascular disease: Systematic review and meta-analysis. PLoS One. 2019 Jan 18;14(1):e0210988. doi: 10.1371/journal.pone.0210988. eCollection 2019. Ma TT, Wong ICK, Man KKC, et al. Effect of evidence-based therapy for secondary prevention of cardiovascular disease: Systematic review and meta-analysis. PLoS One. 2019 Jan 18;14(1):e0210988. doi: 10.1371/journal.pone.0210988. eCollection 2019. Burnett H., Earley A., Voors AA., et al. Thirty Years of Evidence on the Efficacy of Drug Treatments for Chronic Heart Failure With Reduced Ejection Fraction: A Network Meta-Analysis. Circ Heart Fail. 2017 Jan;10(1). pii:e003529. doi: 10.1161/CIRCHEARTFAILURE.116.003529. Burnett H., Earley A., Voors AA., et al. Thirty Years of Evidence on the Efficacy of Drug Treatments for Chronic Heart Failure With Reduced Ejection Fraction: A Network Meta-Analysis. Circ Heart Fail. 2017 Jan;10(1). pii:e003529. doi: 10.1161/CIRCHEARTFAILURE.116.003529. Choudhry NK, Avorn J, Antman EM, et al. Should patients receive secondary prevention medications for free after a myocardial infarction? An economic analysis. Health Aff (Millwood) 2007;26:186-94. Choudhry NK, Avorn J, Antman EM, et al. Should patients receive secondary prevention medications for free after a myocardial infarction? An economic analysis. Health Aff (Millwood) 2007;26:186-94. Choudhry NK, Patrick AR, Antman EM, et al. Cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiaries. Circulation 2008;117:1261-8. Choudhry NK, Patrick AR, Antman EM, et al. Cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiaries. Circulation 2008;117:1261-8. Dhalla IA., Smith MA, Choudhry NK, Denburg AE. Costs and benefits of free medications after myocardial infarction. Healthc Policy. 2009;5(2):68-86. Dhalla IA., Smith MA, Choudhry NK, Denburg AE. Costs and benefits of free medications after myocardial infarction. Healthc Policy. 2009;5(2):68-86. Ito K., Avorn J, Shrank WH, et al. Long-term cost-effectiveness of providing full coverage for preventive medications after myocardial infarction. Circ Cardiovasc Qual Outcomes. 2015;(3):252-9. Ito K., Avorn J, Shrank WH, et al. Long-term cost-effectiveness of providing full coverage for preventive medications after myocardial infarction. Circ Cardiovasc Qual Outcomes. 2015;(3):252-9. Khatana SAM, Khatana SAM, Bhatla A, Nathan AS, et al. Association of Medicaid Expansion With Cardiovascular Mortality. JAMA Cardiol. 2019 Jun 5. doi: 10.1001/jamacardio.2019.1651. Khatana SAM, Khatana SAM, Bhatla A, Nathan AS, et al. Association of Medicaid Expansion With Cardiovascular Mortality. JAMA Cardiol. 2019 Jun 5. doi: 10.1001/jamacardio.2019.1651. Choudhry NK, Avorn J, Glynn RJ, et al.; Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) Trial. Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) Trial. Full coverage for preventive medications after myocardial infarction. N Engl J Med. 2011;365(22):2088-97. Choudhry NK, Avorn J, Glynn RJ, et al.; Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) Trial. Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) Trial. Full coverage for preventive medications after myocardial infarction. N Engl J Med. 2011;365(22):2088-97. Wang TY, Kaltenbach LA, Cannon CP, et al. Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction: The ARTEMIS Randomized Clinical Trial. JAMA. 2019;321(1):44-55. doi: 10.1001/jama.2018.19791. Wang TY, Kaltenbach LA, Cannon CP, et al. Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction: The ARTEMIS Randomized Clinical Trial. JAMA. 2019;321(1):44-55. doi: 10.1001/jama.2018.19791. Kulik A, Desai NR, Shrank WH, et al. Full prescription coverage versus usual prescription coverage after coronary artery bypass graft surgery: analysis from the post-myocardial infarction free Rx event and economic evaluation (FREEE) randomized trial. Circulation. 2013;128(11 Suppl 1):S219-25. Kulik A, Desai NR, Shrank WH, et al. Full prescription coverage versus usual prescription coverage after coronary artery bypass graft surgery: analysis from the post-myocardial infarction free Rx event and economic evaluation (FREEE) randomized trial. Circulation. 2013;128(11 Suppl 1):S219-25. Choudhry NK, Fischer MA, Avorn JL, et al. The impact of reducing cardiovascular medication copayments on health spending and resource utilization. J Am Coll Cardiol. 2012;60(18):1817-24. Choudhry NK, Fischer MA, Avorn JL, et al. The impact of reducing cardiovascular medication copayments on health spending and resource utilization. J Am Coll Cardiol. 2012;60(18):1817-24. Volpp KG, Troxel AB, Mehta SJ, et al. Effect of Electronic Reminders, Financial Incentives, and Social Support on Outcomes After Myocardial Infarction: The HeartStrong Randomized Clinical Trial. JAMA Intern Med. 2017;177(8):1093-1101. Volpp KG, Troxel AB, Mehta SJ, et al. Effect of Electronic Reminders, Financial Incentives, and Social Support on Outcomes After Myocardial Infarction: The HeartStrong Randomized Clinical Trial. JAMA Intern Med. 2017;177(8):1093-1101. Danchin N, Neumann A, Tuppin P., et al. Impact of free universal medical coverage on medical care and outcomes in low-income patients hospitalized for acute myocardial infarction: an analysis from the French National Health Insurance system. Circ Cardiovasc Qual Outcomes. 2011;4(6):619-25 Danchin N, Neumann A, Tuppin P., et al. Impact of free universal medical coverage on medical care and outcomes in low-income patients hospitalized for acute myocardial infarction: an analysis from the French National Health Insurance system. Circ Cardiovasc Qual Outcomes. 2011;4(6):619-25 Maron DJ, Boden WE, O'Rourke RA, et al. Multifactorial Intervention for Stable Coronary Artery Disease Optimal Medical Therapy in the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation). J Am Coll Cardiol 2010;55:1348-58. Maron DJ, Boden WE, O'Rourke RA, et al. Multifactorial Intervention for Stable Coronary Artery Disease Optimal Medical Therapy in the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation). J Am Coll Cardiol 2010;55:1348-58.