Introduction. The article considers the issues of forming a reserve of antibacterial agents designed to eliminate medical and sanitary consequences of emergencies from the perspective of national drug security.Aim. To determine the degree of import substitution of antibacterial agents included in the regional drug reserve.Materials and methods. We carried out a content analysis of data from regulatory documents and research papers related to formation of drug reserves, a logical and structural analysis of the range of antibacterial agents included in the reserve of the Tomsk region, and an analysis of data from the National Drug Register. In the study, we used the Anatomical Therapeutic Chemical (ATC) Classification System of drugs.Results and discussion. It was established that for 19 international nonproprietary names (INN) of antibacterial agents belonging to the group of antibacterials for systemic use (ATC code J01) and forming the reserve of the Tomsk region, 294 brand names (BN) were registered on the pharmaceutical market of the Russian Federation in 2021. The share of registered domestic BN was 49.3 %, and the degree of import dependence of domestic drug manufacturing on foreign-made active pharmaceutical ingredients (APIs) was 81.4 %. It was found that 6 Russian enterprises manufacture APIs that supply production of 10 antibacterial agents included in the drug reserve. A classification of medicines by strategic availability for replenishing the drug reserve was developed. A map on strategic availability of domestically manufactured antibacterial agents included in the reserve was drawn up.Conclusion. We demonstrated high dependence of antibacterial reserve formation on import of this group of medicines and APIs to the Russian Federation. The classification of medicines which takes into account the possibility of replenishing the drug reserve in emergency conditions and if import of medicines stops can be recommended for use by the center for disaster medicine to optimize the nomenclature of drug reserves at various levels from the perspective of national drug security promotion.

Practice of treatment standard application experiences the certain difficulties. On the one hand, the most treatment standards lay on insufficient economical base, on the other hand, the limitation of health protection in bankroll leads to the insufficient treatment efficiency.An analysis of diagnostic study costs in Tomsk special treatment-and-prophylactic institutions has been made on the example of inflammatory pelvis minor organ diseases.The results of the investigation have shown that the character of diagnostic study of patients with inflammatory pelvis minor organ diseases differed significantly from the treatment standard. At the same time this fact defines not only the necessity of expense increase for diagnostic study but, first of all, the necessity of changes of diagnostic study structure that has been proved by modern pharmaeconomical methods.

Pharmacoepidemiological and pharmacoeconomical analysis of endometrit drug therapy at special treatment-and-prophylactic institutions of the city of Tomsk. Estimate the intensity of the appointment of antibacterial drugs endometrit therapy using the methodology of the WHO ATC/DDD, calculated indicators of the intensity of the consumption of drugs in the course of treatment per patient. It was shown that 70% of the established daily dose had to beta-lactam antibiotics and macrolide. For the most common options for antibiotic therapy established nosology of the indicators of clinical efficacy. The calculation of the cost of the schemes of antibiotic therapy, which showed that the cost of treatment is maximal during therapy with ceftriaxone + clarithromycin (4902 RUR); further descending follow: amoxicillin / clavulanic acid + roxithromycin (4658 RUR); benzylpenicillin and gentamicin (4231 RUR). Economic efficiency of antibacterial treatments endometritis a “cost – effectiveness”. The cost of the patient, achieved remission, made during therapy with amoxicillin/clavulanic acid and roxithromycin (5416 RUR), During therapy with ceftriaxone and clarithromycin (6052 RUR), the treatment of benzylpenicillin and gentamicin (14420 RUR). Pharmacoeconomic evaluation results showed that the least acceptable scheme of antibacterial therapy of endometrit in the hospital is the combination of benzyl penicillin and gentamicin. Тhe antibiotic therapy for endometrit may be recommended by a combination of amoxicillin / clavulanic acid and roxithromycin and clarithromycin and ceftriaxone, for which there was no statistically significant differences in clinical efficacy and cost of antibiotic therapy.

Ñèáèðñêèé ãîñóäàðñòâåííûé ìåäèöèíñêèé óíèâåðñèòåò, ã. Òîìñê РЕЗЮМЕ Â ðåòðîñïåêòèâíîì èññëåäîâàíèè ïðîâåäåí ôàðìàêîýïèäåìèîëîãè÷åñêèé è ôàðìàêîýêîíîìè÷åñêèé àíàëèç ëåêàðñòâåííîé òåðàïèè ýíäîìåòðèòà â ñïåöèàëèçèðîâàííûõ ëå÷åáíî-ïðîôèëàêòè÷åñêèõ ó÷ðåaeäåíèÿõ ãîðîäà Òîìñêà â ïåðèîä 2013-2014 ãã. Îöåíåíà èíòåíñèâíîñòü íàçíà÷åíèÿ àíòèáàêòåðèàëüíûõ ïðåïàðàòîâ òåðàïèè ýíäîìåòðèòà ñ ïîìîùüþ ìåòîäîëîãèè ÂÎÇ ATC/DDD, ðàññ÷èòàíû ïîêàçàòåëè èíòåíñèâíîñòè ïîòðåáëåíèÿ ïðåïàðàòîâ íà êóðñ ëå÷åíèÿ íà îäíó ïàöèåíòêó. Áîëåå 70% óñòàíîâëåííûõ ñóòî÷íûõ äîç ïðèõîäèëîñü íà áåòàëàêòàìíûå è ìàêðîëèäíûå àíòèáèîòèêè. Äëÿ íàèáîëåå ðàñïðîñòðàíåííûõ âàðèàíòîâ àíòèáàêòåðèàëüíîé òåðàïèè äàííîé íîçîëîãèè óñòàíîâëåíû ïîêàçàòåëè êëèíè÷åñêîé ýôôåêòèâíîñòè. Ïðîèçâåäåí ðàñ÷åò ñòîèìîñòè ñõåì àíòèáàêòåðèàëüíîé òåðàïèè, êîòîðûé ïîêàçàë, ÷òî ñòîèìîñòü ëå÷åíèÿ ìàêñèìàëüíà ïðè ñî÷åòàííîé òåðàïèè öåôòðèàêñîíîì è êëàðèòðîìèöèíîì (4902 ðóá.); äàëåå ïî óáûâàþùåé ñëåäóþò: àìîêñèöèëëèí/êëàâóëàíîâàÿ êèñëîòà è ðîêñèòðîìèöèí (4658 ðóá.); áåíçèëïåíèöèëëèí è ãåíòàìèöèí (4231 ðóá.). Ðàññ÷èòàíà ýêîíîìè÷åñêàÿ ýôôåêòèâíîñòü àíòèáàêòåðèàëüíûõ ñõåì ëå÷åíèÿ ýíäîìåòðèòà ìåòîäîì «çàòðàòû-ýôôåêòèâíîñòü». Çàòðàòû íà ïàöèåíòêó, äîñòèãøóþ ðåìèññèè, ñîñòàâèëè ïðè ñî÷åòàííîé òåðàïèè àìîêñèöèëëèíîì/êëàâóëàíîâîé êèñëîòîé è ðîêñèòðîìèöèíîì 5416 ðóá., ïðè òåðàïèè öåôòðèàêñîíîì è êëàðèòðîìèöèíîì-6052 ðóá., ïðè òåðàïèè áåíçèëïåíèöèëëèíîì è ãåíòàìèöèíîì-14103 ðóá.