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Objectives.According to literature and experts, prostate cancer (PC), breast cancer (BC), colon cancer (CC), melanoma (MEL) and renal cell carcinoma (RCC) are the most high-cost oncological diseases. The aim of our study was to calculate the charges for each of these nosologies from the point of view of Moscow’s budget and compare them with each other.Methods.To assess the annual costs of drug therapy in Moscow in patients with PC, BC, CC, MEL and RCC there has been developed an analytical model in MS Excel software, considering the data of Cancer Register, as well as literature sources.Results.There has been estimated that if the costs of drug therapy for all five of assessed types of cancer are taken as 100 %, then the most costly is BC (41 % of costs), then MEL (20 %), RCC (15 %), CC (13 %) and PC (12 %). There has been also calculated, that if the number of patients with all five types of assessed cancer undergoing drug therapy, we would consider as 100 %, the highest percentage of them is in BC (50 % of all patients), then PC (36 %), CC (9 %), MEL (3 %) and RCC (1 %).Conclusions. The structure of drug therapy costs in patients with PC, BC, MEL, CC and RCC in Moscow shows that the most expensive is the treatment of patients with melanoma (for 3 % of patients Moscow City Health Department spends 20 % of charges) and RCC (1 % of patients spends 15 % of charges).

Objective: to review the data on the efficacy and consumption of octocog alfa and rurioctoctog alfa pegol in standard prophylaxis and individualized prophylaxis in hemophilia A patients based on published international data. Material and methods: a systematic literature search and review were performed. Among 25 sources identified within the systematic search 7 relevant sources describing the comparison of treatment with octocog alfa and rurioctocog alfa pegol in adult and pediatric patients with severe and moderate hemophilia A based on personalized assessment of the pharmacokinetic curve using the interactive tool myPKFit versus the standard (non-personalized) dosage regimen were selected. Data on individual patients, as well as data from secondary subgroups defined by age, bleeding rate, risk of bleeding associated with the daily physical activity were combined and analyzed. Results. In observational studies, adjustments of the dose and administration of octocog alfa in patients with severe hemophilia based on personalized assessment of the pharmacokinetic curve using myPKFit resulted in the reduced consumption and/or increased efficacy of prophylaxis — a reduced annual bleeding rate. In an extended controlled study of rurioctocog alpha pegol a trend toward reduced bleeding rate and increased mean annual consumption of the drug was reported in patients who received myPKFit guided prophylaxis compared to a non-personalized treatment regimen. In the single-cut studies, myPKFiT use resulted in the regimen revisions in less than a quarter of patients. Summary. Personalized dosing for octocog alpha and rurioctocog alpha pegol based on pharmacokinetic curve built using pharmacokinetic population model enables reasonable dose adjustments and improves outcomes.

Objective: to determine the economic and clinical consequences of using atezolizumab in metastatic urothelial cancer compared with pembrolizumab and nivolumab.Materials and methods. An assessment of the effectiveness and safety of medicines for urothelial cancer was carried out on the basis of a systematic search and review of clinical studies and an analysis of direct medical costs for medicines from public procurement in Moscow in 2019-2020 and information from official instructions for medical use.Results. Systematic search identifies 4, 4 and 7 clinical trials of nivolumab, pembrolizumab and atezolizumab, respectively, as well as 2 meta-analyses. The obtained data on the efficacy and safety did not allow us to identify greater or lesser effective options. Calculation of cost of three months therapy revealed that the cost of atezolizumab (935 thousand rubles) is 7 % lower vs. pembrolizumab (1 million rubles) and 18 % lower vs. nivolumab (1,136 million rubles). Thus, when using atezolizumab instead of pembrolizumab or atezolizumab, budget savings may occur, or allowing additional therapy to be provided to every 14th or every 6th patient, respectively within fixed budget.Conclusion. The use of atezolizumab in metastatic urothelial cancer led to budget savings or the possibility of additional treatment coverage with immuno-oncological therapy.