ABC-analysis of pharmacotherapy in children hospitalized with bronchial asthma exacerbations

Aims. To analyze the costs of pharmacotherapy in children hospitalized with bronchial asthma exacerbations. Materials and methods. The data from 336 medical reports were used. In this study, patients with severe bronchial asthma were analyzed separately from those with moderate asthma. The economic analysis of pharmacotherapy was carried out in accordance with the ABC guidelines for an international non-proprietary name. In relation to the field of medicinal use, the analyzed drugs were distributed into three classes (A, B and C) according to the selected criteria. In the present study, the selection criterion was the amount of expenses needed to purchase the given medicine. Results. The ABCanalysis showed that about 80% of the amounts spent for the treatment of moderately severe asthma were due to the costs of medications. Among them, Montelukast – 31.27%; Budesonide – 28,49%; Umifenovir – 5.69%; Azithromycin – 5.50%; Salmeterol / fluticasone propionate – 4.74%; Formoterol / budesonide – 3.32%; Ipratropium bromide / fenoterol hydrobromide acetylcysteine – 3.20%; (In total, the percentage amounts to 82.15%). In the treatment of severe asthma, the same 80% of the costs consisted of: Montelukast – 28.13%; Salmeterol / fluticasone propionate – 25.54%; Formoterol / budesonide – 13.51%; Acetylcysteine 6.64%; Budesonide – 5.67% (in total, the percentage amounts to 79.48%). In moderately severe asthma, the largest part of the costs is due to inhaled glucocorticosteroids – budesonide (28.42%), while in severe cases, it is due to combined salmeterol / fluticasone propionate (25.54%) and formoterol / budesonide (13.51%). In the treatment of asthma of moderate severity, a certain part of segment A is taken by macrolide antibiotics of the azithromycin group (they account for 5.50% of the total costs) and antiviral drugs – umifenovir (5.59%). The introduction of antibiotics and anti-viral drugs is rationalized by asthma exacerbations developing on the background of viral and / or bacterial, often “atypical” infections. Conclusion. This pharmacoepidemiological analysis shows that the costs of treatment with Montelukast of moderate (31.27%) and severe (28.13%) bronchial asthma are comparable. For other drugs, the treatment costs significantly differ between the moderate and severe asthma therapies. 

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