Clinical and economic assessment of using IRS®19 for the treatment and prevention of acute respiratory infections in children
https://doi.org/10.17749/2070-4909/farmakoekonomika.2024.244
Abstract
Objective: to perform pharmacoeconomic analysis of the feasibility of using topical bacterial lysate in the form of nasal spray (IRS®19) for the treatment and prevention of upper respiratory tract infections in pediatric population in comparison with other drugs registered in Russia, belonging to the class of topical interferons.
Material and methods. Based on the Rosstat data and information from open sources, the population of patients with acute respiratory infections (ARI) was calculated. Considering the Russian clinical recommendations “Acute respiratory viral infection (ARVI)” and “Acute tonsillitis and pharyngitis (acute tonsillopharyngitis)”, the direct medical costs of providing medical care to specialized patients were determined. Direct costs on the part of parents included all costs for purchasing medicines for basic or concomitant therapy. Direct costs on the part of the healthcare system and the state included the costs of providing medical care at the outpatient stage. Direct non-medical costs included payments for disability leaves, indirect costs – lost gross domestic product (GDP) due to absence from work.
Results. The total costs of the healthcare system and the state for 1 AVI patient are 42,472 rubles in case of uncomplicated course and 70,649 rubles in case of complicated course. In case of IRS®19 application from the first day of the disease, it is possible to reduce its duration by more than two-fold. Thus, the costs of medical care amount to 2,078 rubles. Payments for disability leaves by the Social Fund of Russia will amount to 2,287 rubles, and the lost GDP – 9,148 rubles (total costs 13,513 rubles).
Conclusion. For the first time in Russian economic conditions, the use of IRS®19 for ARI treatment and prevention in children was evaluated. IRS®19 application from the first symptoms of the disease allows refusing the use of topical interferons, reduces the duration of symptoms and the need for prescription of antitussives, vasoconstrictors, and antibiotics.
About the Authors
A. S. KolbinRussian Federation
Alexey S. Kolbin – Dr. Med. Sc., Professor, Chief of Chair of Clinical Pharmacology and Evidence-Based Medicine, Pavlov First Saint Petersburg State Medical University; Professor, Chair of Clinical Pharmacology, Saint Petersburg State University
WoS ResearcherID: G-5537-2015
Scopus Author ID: 19836020100
6–8 Lev Tolstoy Str., Saint Petersburg 197022
7–9 Universitetskaya Emb., Saint Petersburg 199034
A. R. Kasimova
Russian Federation
Alina R. Kasimova – MD, PhD, Associate Professor, Chair of Clinical Pharmacology and Evidence-Based Medicine, Pavlov First Saint Petersburg State Medical University; Clinical Pharmacologist, Vreden National Medical Research Center of Traumatology and Orthopedics
WoS ResearcherID: AAV-3882-2021
Scopus Author ID: 57203792549
6–8 Lev Tolstoy Str., Saint Petersburg 197022
8 Academician Baykov Str., Saint Petersburg 195427
References
1. Williams B.G., Gouws E., Boschi-Pinto C., et al. Estimates of worldwide distribution of child deaths from acute respiratory infections. Lancet Infect Dis. 2002; 2 (1): 25–32. https://doi.org/10.1016/s1473-3099(01)00170-0.
2. Choi E., Ha K.S., Song D.J., et al. Clinical and laboratory profiles of hospitalized children with acute respiratory virus infection. Korean J Pediatr. 2018; 61 (6): 180–6. https://doi.org/10.3345/kjp.2018.61.6.180.
3. Ramaekers K., Keyaerts E., Rector A., et al. Prevalence and seasonality of six respiratory viruses during five consecutive epidemic seasons in Belgium. J Clin Virol. 2017; 94: 72–8. https://doi.org/10.1016/j.jcv.2017.07.011.
4. Acute respiratory viral infection (ARVI). Clinical guidelines. 2022. Available at: https://cr.minzdrav.gov.ru/recomend/25_2 (in Russ.) (accessed 25.02.2024).
5. Thompson M., Vodicka T.A., Blair P.S., et al. Duration of symptoms of respiratory tract infections in children: systematic review. BMJ. 2013; 347: f7027. https://doi.org/10.1136/bmj.f7027.
6. Svistushkin V.M., Nikiforova G.N., Zolotova A.V., Stepanova V.A. Using of topical bacterial lysates in modern clinical practice. Meditsinskiy sovet / Medical Council. 2021; 6: 49–56 (in Russ.). https://doi.org/10.21518/2079-701X-2021-6-49-56.
7. Leonova M.V., Efremenkova O.V., Shmeleva N.I., Belousov Yu.B. The use IRS 19 in children for the treatment and prevention of upper respiratory tract infections. Detskie Infektsii / Children Infections. 2004; 3 (4): 45–8 (in Russ.).
8. Kladova O.V., Uchaykin V.F., Demina E.D., et al. Local immunomodulator IRS 19 in complex therapy of acute respiratory infections. Detskie Infektsii / Children Infections. 2006; 5 (4): 51–4 (in Russ.).
9. Kreminets' O.I., Kozak L.Ya., Maksymiv O.V., et al. Experience of application of preparation IRS 19 in treatment of sharp diseases of the top respiratory ways at children. Meditsina transporta Ukrainy / Medicine of Ukrainian Transport. 2005; 2: 59–62 (in Russ.).
10. Korovina N.A., Lepiseva I.V., Platnikova L.V., et al. The effectiveness of topical immunotherapy with bacterial lysates in frequently ill children. Pediatrics. Journal named after G.N. Speransky. 2009; 88 (5): 104–9 (in Russ.).
11. Federal State Statistics Service. Available at: https://rosstat.gov.ru/ (in Russ.) (accessed 10.02.2024).
12. Acute tonsillitis and pharyngitis (acute tonsillopharyngitis). Clinical guidelines. 2021. Available at: https://cr.minzdrav.gov.ru/recomend/306_2 (in Russ.) (accessed 10.02.2024).
13. The official website of the Territorial Fund of the Ministry of Health of Saint Petersburg. The Commission for the Development of the Territorial Program of Compulsory Health Insurance in Saint Petersburg. General Tariff Agreement for 2023. Available at: https://spboms.ru/page/docs (in Russ.) (accessed 10.02.2024).
14. Federal Law of 29.12.2006 No. 255-FZ “On Compulsory Social Insurance in case of temporary disability and in connection with maternity”. Available at: https://base.garant.ru/12151284/ (in Russ.) (accessed 25.02.2024).
15. Sologub T.V., Golobokov G.S., Tsvetkov V.V., Tokin I.I. Interferongamma in the treatment of influenza and other respiratory viral infections. Meditsinskiy sovet / Medical Council. 2015; 7: 54–8 (in Russ.).
16. Osidak L.V., Golovacheva E.G., Afanasyeva O.I., et al. Evaluation of the therapeutic efficacy of two recombinant interferon α-2b medications for intranasal administration (Genferon® light and Grippferon®) for ARVI in infants and young children. Pediatrics. Journal named after G.N. Speransky. 2017; 96 (2): 74–80 (in Russ.).
17. Trukhan D.I., Mazurov A.L., Rechapova L.A. Acute respiratory viral infections: current issues of diagnosis, prevention and treatment for therapists. Terapevticheskii arkhiv. 2016; 88 (11): 76–82 (in Russ.). https://doi.org/10.17116/terarkh2016881176-82.
What is already known about thе subject?
- Acute respiratory infections (ARI) are the main cause of children’s morbidity, applying for medical care and prescribing medicines, as well as they exert economic damage to both the families of patients, the healthcare system and society
- The non-specific components of local immune protection include anatomical and histological barriers, and the specific ones include the synthesis of secretory immunoglobulins А (IgA) that agglutinate pathogens and protect the mucous membrane from their penetration
- When topical bacterial lysates (TBLs) are prescribed from the first days of the disease, the peak of local IgA production occurs on the 4–5thday, when the risk of secondary bacterial infection is the highest
What are the new findings?
- A pharmacoeconomical analysis of the feasibility of using TBLs in the form of nasal spray (IRS®19) for the treatment and prevention of upper respiratory tract infections in the pediatric population in comparison with other drugs registered in Russia belonging to the class of topical interferons was performed
- The costs of the healthcare system and the state and the direct costs of parents for the treatment of a child with ARI were calculated separately
How might it impact the clinical practice in the foreseeable future?
- The intake of IRS®19 from the first ARI symptoms allows refusing the use of topical interferons, decreases the duration of the disease symptoms and reduces the need for prescribing antitussives, vasoconstrictors and antibiotics
- Due to preventive use of IRS®19 it is possible to decrease the frequency of ARI in a child and, as a result, reduce the parents' expenses
Review
For citations:
Kolbin A.S., Kasimova A.R. Clinical and economic assessment of using IRS®19 for the treatment and prevention of acute respiratory infections in children. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2024;17(2):182-190. (In Russ.) https://doi.org/10.17749/2070-4909/farmakoekonomika.2024.244

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.