Comparative pharmacoeconomic effectiveness of menopausal hormone therapy: oral versus transdermal preparations
Astapovskii A.A., Drozdov V.N., Astapovskaya O.V., Shikh E.V.
Objective: To evaluate the economic benefit of transdermal menopausal hormone therapy (MHT) compared to the oral treatment using the method of scientific modeling.
Materials and methods: Clinical economic modeling was used to conduct the pharmacoeconomic analysis. The results of published studies were used as sources for the effectiveness analysis. The Scottish Intercollegiate Guidelines Network (SIGN) methodology, with a minimum level of evidence of 2, was used to select studies, perform clinical and economic modeling, develop the study design, and assess the methodological quality of the studies. A pharmacoeconomic analysis was conducted to compare two regimens of menopausal hormone therapy and assess the risk of adverse complications, namely venous thromboembolism (VTE) and acute circulatory failure (ACF).
Results: The pharmacoeconomic analysis showed that the use of MHT with transdermal estradiol (Oestrogel) in continuous mode demonstrated efficiency in cost savings due to the reduction of costs for the treatment of adverse events (VTE and ACF) and their consequences; savings per one patient amount to 6,389.4 rubles per year. Savings per 1,000 women during the year will amount to 6,389,400 rubles, or 31,947,000 rubles for 5 years.
Conclusion: Transdermal MHT may prove to be cost-effective compared to oral MHT due to the reduced cost of complications associated with oral MHT. The use of the Oestrogel preparation will reduce the total cost of MHT by 11.3% compared to oral MHT.
Authors’ contributions: Drozdov V.N., Shikh E.V. – developing the concept and design of the study; Astapovskaya O.V. – collecting and processing materials; Astapovskii A.A., Drozdov V.N. – the analysis of the obtained data, writing the text. All authors made a significant contribution to the study and article preparation, read and approved the final version of the article before its publication.
Conflicts of interest: The authors declare that they have no apparent and potential conflicts of interest related to the publication of this article.
Funding: The study was carried out without sponsorship.
For citation: Astapovskii A.A., Drozdov V.N., Astapovskaya O.V., Shikh E.V.
Comparative pharmacoeconomic effectiveness of menopausal hormone therapy: oral versus transdermal preparations.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (12): 186-192 (in Russian)
https://dx.doi.org/10.18565/aig.2024.307
Keywords
menopausal hormone therapy
estrogens
transdermal therapy
pharmacoeconomics
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Received 02.12.2024
Accepted 12.12.2024
About the Authors
Alexandr A. Astapovskii, PhD, Associate Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119048, Russia, Moscow, Trubetskaya str., 8-2, +7(499)248-53-83, al.astapovskii@gmail.com,https://orcid.org/0000-0002-7430-3341
Vladimir N. Drozdov Dr. Med. Sci., Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119048, Russia, Moscow, Trubetskaya str., 8-2, +7(499)248-53-83, vndrozdov@yandex.ru,
https://orcid.org/0000-0002-0535-2916
Olga V. Astapovskaya, obstetrician-gynecologist, V.V. Veresaev City Clinical Hospital DZM, 127644, Russia, Moscow, Lobnenskaya str., 10, +7(499)450-55-81,
olgunnnnn@gmail.com
Evgenia V. Shikh, Dr. Med. Sci., Head of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119048, Russia, Moscow, Trubetskaya str., 8-2, +7(499)248-53-83, chih@mail.ru, https://orcid.org/0000-0001-6589-7654
Corresponding author: Alexandr A. Astapovskii, al.astapovskii@gmail.com
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