Abstract. COVID-19, a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in China in December 2019. Economically, the spread of COVID-19, the ever-increasing number of patients, and complications of the disease have resulted in high direct medical and indirect costs to patients, the healthcare system, and the government as a whole. Direct medical costs vary depending on the number of patients, disease severity, average length of hospital stay and other factors. The aim of the study was to identify ways to optimize COVID-19 drug therapy costs using pharmacoeconomic analysis methods. Case histories of 334 patients treated in a reassigned infectious disease unit of a hospital with a diagnosis of Covid-19 novel coronavirus infection were analyzed. 80% of the medical organization's costs were for 8 medications (5.6%): levilimab, baricitinib, olokizumab, heparin, dalteparin, levofloxacin, cefotaxime+sulbactam, and propofol. Comparative analysis of the cost of drug therapy with the recommended treatment regimens of the Temporary Methodological Recommendations of the Ministry of Health of the Russian Federation showed that only when using the scheme № 2 for a moderate course of the disease and the choice of the cheapest drugs, the cost of completed cases covers the cost of treatment of patients, other treatment regimens for medical organization are economically unjustified. The cost of therapy with these drugs exceeds the cost of paid cases depending on the scheme and variant from 65% to 198%. The study aims to assess the cost of clinical management of patients hospitalized with COVID-19, depending on their severity, by examining the resources used to provide medical care.

Abstract. A new coronavirus infection, like other infections of viral etiology, is not an indication for the use of antibiotics. The cause of lung damage in COVID-19 is immune mechanisms, in which macrophages are activated and a "cytokine storm" develops, which is not affected by antibiotics. Antibacterial therapy is prescribed only if there are convincing signs of bacterial infection adherence. Therefore, a competent and reasonable approach to prescribing antibacterial drugs during a pandemic new coronavirus infection is necessary. The aim of the study was to conduct a pharmacoeconomic analysis of COVID-19 antibiotic therapy and to identify cases of irrational prescribing of antibiotics. Case histories of 334 patients treated in a reassigned hospital infectious disease unit in October 2021 with a diagnosis of Covid-19 new coronavirus infection were analyzed. The study found that antibiotic therapy was prescribed in 52.5% of patients aged 60 years or older and 38.5% of those younger than 60 years. A single antibacterial was the most frequently prescribed antibiotic 66.4% in the elderly and 78% in the young. Levofloxacin was most frequently prescribed as a starting antibiotic (32.7% of all AB prescriptions in the elderly and 54% in the young). Ceftriaxone (17.8%), Cefotaxime (15.9%), and Cefotaxime + Sulbactam (13.1%) were also commonly prescribed in those over 60 years of age. The effectiveness of antibacterial agents in the treatment of NKI was calculated using a cost-effectiveness pharmacoeconomic analysis using the criteria of therapy duration, length of hospital stay, and prescription of a second antibiotic. The best cost-effectiveness ratio was observed for prescribing ciprofloxacin (5.5), ceftriaxone (13.2), and cefotaxime (32.1) to the elderly. Irrational prescribing of antibiotics was noted in 10.8% of all antibiotic prescriptions. Of all irrational prescriptions, levofloxacin accounted for the largest number (64.7%).