Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region
Objective: scientific rationale of changing approaches to medical care payment for hospitalization of patients suffering from severe asthma (SA) that require the prescription of biologic disease-modifying drugs (bDMDs) within the constraints of diagnosis-related groups (DRGs) on the level of the Mos...
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| Format: | Article |
| Language: | Russian |
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IRBIS LLC
2021-07-01
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| Series: | Фармакоэкономика |
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| Online Access: | https://www.pharmacoeconomics.ru/jour/article/view/523 |
| _version_ | 1797878880232538112 |
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| author | A. D. Ermolaeva V. S. Krysanova T. N. Ermolaeva K. I. Polyakova K. A. Kokushkin |
| author_facet | A. D. Ermolaeva V. S. Krysanova T. N. Ermolaeva K. I. Polyakova K. A. Kokushkin |
| author_sort | A. D. Ermolaeva |
| collection | DOAJ |
| description | Objective: scientific rationale of changing approaches to medical care payment for hospitalization of patients suffering from severe asthma (SA) that require the prescription of biologic disease-modifying drugs (bDMDs) within the constraints of diagnosis-related groups (DRGs) on the level of the Moscow Region.Material and methods. For the federal model regional adaptation, the authors used the mechanism of subgroups selection in the structure of basic DRG No. 336 st36.003 and No. 139 ds36.004 “Treatment with biologic disease-modifying drugs and selective immunosuppressants” in the round-the-clock (RH) and day-time hospital (DH). Budget impact analysis (BIA) was performed to provide scientific and economic feasibility for the improvement of medical care payment for bDMDs proscribed to patients with SA within DRG at the level of the Moscow Region.Results. The analysis of cost of drug therapy and medical services per 1 case of hospitalization of patients with SA, that required bDMDs therapy, considering the classification criterion (international nonproprietary name of drugs and drug therapy regimens), showed 10 subgroups in DRG No. 336 st36.003 (level 1) and 9 subgroups in DRG No. 139 ds36.004. Expert estimates on the rate of hospitalizations and drug dosage regimen indicated for patients with SA were used to calculate the relative cost weights (CW). The highest CW was observed in the subgroup that received benralizumab in RH (CW=7.46) and in DH (CW=12.08) conditions. BIA demonstrated 110,103,901.53 rubles (or 31%) budget savings for the health care system of the Moscow Region.Conclusion. The implementation of the adapted DRG federal model in the conditions of the health care system of Moscow Region is an economically feasible approach to the organization of the inpatient medical care provided to patients with SA needing bDMDs prescription. |
| first_indexed | 2024-04-10T02:40:03Z |
| format | Article |
| id | doaj.art-6fa6e460def349b2b41b02f37b4df9c1 |
| institution | Directory Open Access Journal |
| issn | 2070-4909 2070-4933 |
| language | Russian |
| last_indexed | 2024-04-10T02:40:03Z |
| publishDate | 2021-07-01 |
| publisher | IRBIS LLC |
| record_format | Article |
| series | Фармакоэкономика |
| spelling | doaj.art-6fa6e460def349b2b41b02f37b4df9c12023-03-13T07:48:17ZrusIRBIS LLCФармакоэкономика2070-49092070-49332021-07-0114210.17749/2070-4909/farmakoekonomika.2021.093341Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow RegionA. D. Ermolaeva0V. S. Krysanova1T. N. Ermolaeva2K. I. Polyakova3K. A. Kokushkin4Scientific and Practical Center for Clinical and Economic Analysis of the Ministry of Health of the Moscow Region; Sechenov UniversityScientific and Practical Center for Clinical and Economic Analysis of the Ministry of Health of the Moscow Region; Sechenov University; Medical Institute of Continuing Education, Moscow State Food Production UniversityScientific and Practical Center for Clinical and Economic Analysis of the Ministry of Health of the Moscow RegionScientific and Practical Center for Clinical and Economic Analysis of the Ministry of Health of the Moscow RegionScientific and Practical Center for Clinical and Economic Analysis of the Ministry of Health of the Moscow RegionObjective: scientific rationale of changing approaches to medical care payment for hospitalization of patients suffering from severe asthma (SA) that require the prescription of biologic disease-modifying drugs (bDMDs) within the constraints of diagnosis-related groups (DRGs) on the level of the Moscow Region.Material and methods. For the federal model regional adaptation, the authors used the mechanism of subgroups selection in the structure of basic DRG No. 336 st36.003 and No. 139 ds36.004 “Treatment with biologic disease-modifying drugs and selective immunosuppressants” in the round-the-clock (RH) and day-time hospital (DH). Budget impact analysis (BIA) was performed to provide scientific and economic feasibility for the improvement of medical care payment for bDMDs proscribed to patients with SA within DRG at the level of the Moscow Region.Results. The analysis of cost of drug therapy and medical services per 1 case of hospitalization of patients with SA, that required bDMDs therapy, considering the classification criterion (international nonproprietary name of drugs and drug therapy regimens), showed 10 subgroups in DRG No. 336 st36.003 (level 1) and 9 subgroups in DRG No. 139 ds36.004. Expert estimates on the rate of hospitalizations and drug dosage regimen indicated for patients with SA were used to calculate the relative cost weights (CW). The highest CW was observed in the subgroup that received benralizumab in RH (CW=7.46) and in DH (CW=12.08) conditions. BIA demonstrated 110,103,901.53 rubles (or 31%) budget savings for the health care system of the Moscow Region.Conclusion. The implementation of the adapted DRG federal model in the conditions of the health care system of Moscow Region is an economically feasible approach to the organization of the inpatient medical care provided to patients with SA needing bDMDs prescription.https://www.pharmacoeconomics.ru/jour/article/view/523diagnostic related groupsrelative cost weightsgenetically engineered biological drugsregional adaptationbronchial asthmasevere asthma |
| spellingShingle | A. D. Ermolaeva V. S. Krysanova T. N. Ermolaeva K. I. Polyakova K. A. Kokushkin Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region Фармакоэкономика diagnostic related groups relative cost weights genetically engineered biological drugs regional adaptation bronchial asthma severe asthma |
| title | Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region |
| title_full | Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region |
| title_fullStr | Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region |
| title_full_unstemmed | Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region |
| title_short | Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region |
| title_sort | medical care payment improvement within diagnosis related groups of patients with severe asthma requiring biologic disease modifying drugs by regional adaptation mechanism in the moscow region |
| topic | diagnostic related groups relative cost weights genetically engineered biological drugs regional adaptation bronchial asthma severe asthma |
| url | https://www.pharmacoeconomics.ru/jour/article/view/523 |
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