The studies on the application of topical preparations are reviewed. The data obtained demonstrate that in most cases the quantities of sunscreens, industrial protective creams and topical medications may differ greatly on different anatomic sites and may also vary due to numerous factors. The data on influencing factors in various studies were partially controversial, therefore a possible study design is suggested to resolve these controversies. It is also suggested that the standard layer thickness of sunscreens, used by standardization authorities to evaluate the sun-protective factor, should be reviewed, due to the evident failure of the majority of sunbathers to comply with the standard layer thickness used now by the ASA (2 mg/m²) or DIN (1.5 mg/m²). It is also important to have a standard of applied amounts of topical medications to be able to compare the effectiveness and bioequivalence of different topical medications precisely. The use of special delivery methods (such as flurandrenolide tape) demonstrates one approach to the standardization of topical treatment dosing.

We have developed an algorithm for automatic colour correction of skin images obtained in imperfect conditions. The algorithm has been incorporated into a computer program, TransImage. In a set of 31 digital skin images (including cases of dermatitis, eczema, mycotic lesions and skin cancer), 19 images underwent colour correction with the computer program, while 12 remained uncorrected. The images were presented to three experienced dermatologists who reviewed them without knowing if they had been corrected or not. The mean colour accuracy score (on a scale from 1 ¼ very poor to 5 ¼ excellent) for the corrected skin images was 4.1, while the mean score for uncorrected images was 3.7; the difference was significant (Po0.05). Using the 19 corrected images, the dermatologists made 11 inaccurate diagnoses out of 57 (a mean diagnostic accuracy of 81%). Using the 12 uncorrected images, three dermatologists made 16 inaccurate diagnoses out of 36 (i.e. a mean diagnostic accuracy of 56%); the difference was significant (Po0.05). Colour correction increased the diagnostic accuracy of teledermatology.

Фармакоэкономический анализ применения лекарственного препарата реслизумаб в лечении тяжелой бронхиальной астмы с эозинофильным типом воспаления дыхательных путей1 -Федеральное государственное бюджетное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» (Сеченовский университет) Министерства здравоохранения Российской Федерации: 119991, Москва, ул. Трубецкая, 8, стр. 2; 2 -Федеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентства: 105077, Россия, Москва, ул. 11-я Парковая, 32, корп. 4; 3 -Федеральное государственное бюджетное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И.Пирогова» Министерства здравоохранения Российской Федерации: 117997, Москва, Москва, ул. Островитянова, 1; 4 -Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации: 125993, Москва, ул. Баррикадная, 2 / 1, стр. 1; 5 -Федеральное государственное бюджетное образовательное учреждение высшего образования «Северо-западный государственный медицинский университет имени И.И.Мечникова» Министерства здравоохранения Российской Федерации: 191015, Санкт-Петербург, ул. Кирочная, 41; 6 -Федеральное государственное бюджетное учреждение «Государственный научный центр "Институт иммунологии"» Федерального медико-биологического агентства: 115478, Москва, Каширское шоссе, 24; 7 -Общество с ограниченной ответственностью «Тева»: 115054, Москва, ул. Валовая, 35 Информация об авторах Куликов Андрей Юрьевич -д. э. н., профессор кафедры организации лекарственного обеспечения и фармакоэкономики Федерального государственного автономного образовательного учреждения высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» (Сеченовский университет) Министерства здравоохранения Российской Федерации; Макарова Елена Ивановна -аспирант кафедры организации лекарственного обеспечения и фармакоэкономики Федерального государственного автономного образовательного учреждения высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» (Сеченовский университет) Министерства здравоохранения Российской Федерации; Авдеев Сергей Николаевич -д. м. н., член-корреспондент Российской академии наук, профессор, заведующий кафедрой пульмонологии Федерального государственного бюджетного образовательного учреждения высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» (Сеченовский университет) Министерства здравоохранения Российской Федерации, заместитель директора Федерального государственного бюджетного учреждения «Научно-исследовательский пульмонологии» Федерального медико-биологического агент-

Telemedicine, or distant medical consultations using communication via electronic networks, is gradually becoming a standard of medical care delivery in distant areas worldwide, including both the most developed and the developing countries. For instance, in 2007, telemedical centres existed in 55% of the Russian regions (on average, about 4 centres in each region). In most of the cases, nurses are actively involved in the organization of various types of distant consultation. Main types of telemedical services include: (1) emergency consultations of patients by telephone, (2) telemedical consultations using videoconferences or store-and-forward systems, and (3) home telecare systems. Possible roles of nurses in different types of telemedical consultations are discussed.

During last few years, the approaches to the management of patients with severe asthma have been revised. Monoclonal antibodies (MABs), inhibitors of interleukin-5 (reslizumab, mepolizumab, benralizumab) have been recently introduced for the treatment of severe eosinophilic asthma. The mentioned drugs were approved in Russia and included into the list of Vitally Essential Drugs. Aim.The aim of this study was to compare the clinical and economic consequences of the use of biological agents that antagonize IL-5 in the treatment of severe eosinophilic asthma in adults. Materials and methods.Two methods of clinical and economic research were used: assessment of the cost-effectiveness ratio and analysis of the budget impact. The effectiveness of the drugs was assessed using indirect comparison; special attention was paid to comparability of the patient groups in the studies chosen for such an assessment. Two approaches were used for calculation of the cost of therapy for severe asthma: using DRGs (applicable to most regions of Russia), and without the use of DRGs, which is relevant only for few Russian regions. Results.Basing on the data obtained from a budget impact study without the use of DRG, it was shown that reslizumab was dominating for patients with body mass of up to 70 kg, while for the patients with body mass of 70 to 110 kg, mepolizumab was dominating, while utilization of reslizumab appeared to be somewhat more expensive. In the group of patients with body mass over 110 kg, mepolizumab also was dominating. The calculation of the cost-effectiveness ratio (CER) showed that reslizumab appeared to be dominating over two other MABs, The results of the study using the DRG demonstrated that the cost of an annual course of benralizumab in most cases in Russia would exceed the amount that can be compensated by Territorial Funds for Mandatory Medical Insurance to a healthcare institution for therapy of bronchial asthma in one adult patient with genetically engineered drugs. Therefore, further comparisons were made for reslizumab and mepolizumab only. Analysis of the impact on the budget demonstrated that treatment with reslizumab and mepolizumab would represent a similar burden for the budget. When applying cost-effectiveness analysis, reslizumab was more cost-effective than mepolizumab (regardless of patient body mass). Conclusion.Thus, the results of the clinical and economic study suggested that, basing on the cost-effectiveness analysis, reslizumab appeared to be the dominant IL-5 antagonist (regardless of body mass if DRG approach was used and in patients with body mass up to 110 kg, if such an approach was not used). Basing on budget impact analysis, calculations without use of DRG approach showed superiority of reslizumab over mepolizumab and benralizumab for the patients with body mass up to 70 kg and the DRG-based approach showed equal burden for the budget for reslizumab and mepolizumab for the patients with any body mass.