V. V. Omelyanovsky

Federal State Budgetary Institution "Center for Expertise and Quality Control of Medical Care"

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Co-Authors

M. Avxentyeva

Sechenov University

V. K. Fedyaeva

Financial Research Institute of the Ministry of Finance of the Russian Federation

I.A. Mikhailov

Lomonosov Moscow State University

V. Ignatyeva

Russian Medical Academy of Continuous Professional Education

O. Ivakhnenko

Sechenov University

E.V. Derkach

Rambam Health Care Campus

D. V. Fedyaev

Federal State Budgetary Institution "Center for Expertise and Quality Control of Medical Care"

НЗ

Н. З. Мусина

Central Research Institute

I. Krysanov

Moscow State University of Medicine and Dentistry

Maria Avxentieva

The Russian Presidential Academy of National Economy and Public Administration

Cooperative Institutions

Ministry of Health of the Russian Federation

Federal State Budgetary Institution "Center for Expertise and Quality Control of Medical Care"

Sechenov University

Russian Medical Academy of Continuous Professional Education

The Russian Presidential Academy of National Economy and Public Administration

State Scientific Center of Coloproctology

Pirogov Russian National Research Medical University

City Clinical Hospital

Financial Research Institute of the Ministry of Finance of the Russian Federation

Russian Academy of Sciences

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Comparative Economic Analysis of Retreatment Strategies for HCV Genotype 1 Patients in Russia

Value in Health (2013)

O. Ivakhnenko V. V. Omelyanovsky O. Yu. Rebrova G. Khachatryan

To assess the cost-effectiveness of retreatment with pegylated interferon and ribavirin in combination with boceprevir of HCV genotype 1 patients, who failed to respond to previous treatment, in comparison with absence of retreatment and retreatment with pegylated interferon and ribavirin. We performed cost-effectiveness analysis. Based on the published data we modeled the number of long-term unfavorable outcomes of HCV (liver cirrhosis, hepatocellular carcinoma and death) in the hypothetic cohort of HCV genotype 1 patients following one of three retreatment strategies: “no treatment” (NT), “peginterferon+ribavirin” (PR) and “peginterferon + ribavirin + boceprevir” (PRB). We have evaluated direct medical costs for a short-term (only cost of HCV retreament) and for a long-term (costs of medical care for adverse outcomes) periods for all strategies. Costs were estimated on the basis of average price for the drugs and reimbursement rates for medical services in the compulsory medical insurance system. Incremental cost-effectiveness ratio (ICER) for PR and PRB strategies vs NT were calculated as additional cost per unfavorable outcome avoided. It is expected that in hypothetic cohort of 10000 HCV genotype 1 patients 58,1% would fail to respond to the treatment. The estimated costs of retreatment for this group were EURO 69,07 mln in case of PR strategy and EURO 235,58 mln for PRB. The cumulative number of unfavorable outcomes of HCV during 25-year period would be 5075 cases for NT strategy, 4262 for PR and 2012 for PRB. The long-term costs of NT strategy were EURO 205,35 mln, EURO 168,37 mln in case of PR strategy and EURO 81,4 mln for PRB. ICER for PR strategy was EURO 44532 and for PRB - EURO 36379 per unfavorable outcome avoided. The use of PRB strategy is efficient as it allows reducing the number of unfavorable outcomes of HCV at a lesser cost.

Boceprevir

Incremental cost-effectiveness ratio

Reimbursement

Pegylated interferon

Hepatitis C

10.1016/j.jval.2013.08.1120

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ECONOMIC JUSTIFICATION FOR TELEHEALTH TECHNOLOGY USE FOR PREVENTIVE MEDICAL EXAMINATION OF THE POPULATION IN REMOTE REGIONS

DOAJ (DOAJ: Directory of Open Access Journals) (2015)

D. V. Fedyaev V. K. Fedyaeva V. V. Omelyanovsky

in this article we analysis possibility of application telemedical technologies for regular medical examination, among the adult population living far from hospitals in the Khanty-Mansi Autonomous Okrug – Yugra. The model developed medicoeconomic assumes comparison of two possible strategy of carrying out medical examination of patients with application of telemedical technologies and without it and estimates funds volume of the compulsory health insurance which came for to medical institutions. Results of research show that application of a telemedical complex allows to return costs of its acquisition due less than one and a half years to coverage increase by medical care of the handicapped and removed population of Khanty-Mansi Autonomous Okrug – Yugra.

Telehealth

Source

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PMH24 Cost of Long-Acting Risperidone Injection Versus Long-Acting Paliperidone Palmitate in Patients With Schizophrenia in Russia

Value in Health (2012)

V. V. Omelyanovsky M. Avxentyeva O. Ivakhnenko P. Khailov Ф.М. Цфасман

Paliperidone Palmitate

Paliperidone

Medication Adherence

10.1016/j.jval.2012.08.814

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An Analytical Study of the Recommendations for Molecular Genetic Testing in the Russian and Foreign Clinical Guidelines for Non-Small Cell Lung Cancer

Annals of the Russian academy of medical sciences (2024)

V. V. Omelyanovsky A.O. Ryzhov Yulia A. Ledovskih

Background. Molecular genetic tests play an important role in the care of patients with cancer. Prescribing a number of precision medicines requires concomitant diagnostic testing. Clinical guidelines accelerate implementation of approved clinical interventions, including molecular genetic testing. Aims — to analyze and compare recommendations for ordering molecular genetic testing in non-small cell lung cancer (NSCLC) between Russian and foreign guidelines. Methods. The study included guidelines published in the Rubricator of Clinical Guidelines of the Ministry of Health of Russia, the European Society of Medical Oncology, the American Society of Clinical Oncology and the National Network of Multidisciplinary Oncological Institutions. Recommendations for genetic testing to identify sensitizing mutations in genes in NSCLC and information on study methods were extracted from the selected guidelines. Results. This resulted in a list of genes recommended for testing in NSCLC: EGFR, BRAF, ALK, ROS1, NTRK, ERBB2, MET, RET, KRAS. The list of genes recommended for testing was the same in all included guidelines, except the Rubricator guideline. Recommendations for assigning tests to identify gene variants within guidelines for the same association tended to have the same level of evidence. However, for some genes, the level of evidence differed between associations. We found that not all guidelines describe research methods. An analysis of the recommended testing methods has shown that a significant proportion of studies are recommended to be conducted using next-generation sequencing, including using genetic panels. Conclusions. The results of the analysis show the differences between foreign and Russian guidelines in the approaches to prescribing molecular genetic testing and methods of performing it. Currently, EGFR, BRAF, ALK, ROS1, ERBB2, MET, RET are the main genes recommended for testing, and studies are usually performed in metastatic NSCLC. A significant proportion of studies are recommended to use NGS, including the use of genetic panels.

10.15690/vramn17892

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Fixed Dose Combinations of Nucleoside Reverse Transcriptase Inhibitor for Naïve Patient with Hiv Infection in Russia: Cost Comparison Analysis

Value in Health (2014)

V. Ignatyeva E. Pyadushkina V. V. Omelyanovsky

Efavirenz

Regimen

Emtricitabine

Fixed-dose combination

Abacavir

10.1016/j.jval.2014.08.2475

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Совершенствование системы ведомственной статистической отчетности в сфере здравоохранения (Improving the System of Departmental Statistical Reporting in the Field of Health)

SSRN Electronic Journal (2019)

V. V. Omelyanovsky I.A. Zheleznyakova

Russian Abstract: Действующая система государственной статистической отчетности в сфере здравоохранения характеризуется низкой эффективностью формирования, сбора и обработки данных. Результатами неоптимальной структуры отчетных форм становятся избыточная нагрузка на персонал медицинских организаций, ограниченная доступность информации для организаторов здравоохранения и иных заинтересованных лиц, распространение случайных ошибок и целенаправленных искажений данных.В работе проведен анализ ключевых причин низкой эффективности системы государственной статистической отчетности в сфере здравоохранения. Предложены меры по оптимизации системы показателей, совершенствованию системы сбора и обработки данных, нормативно-правовому обеспечению предлагаемых изменений.English Abstract: The existing system of state statistical reporting in healthcare is characterized by low efficiency of data forming, collecting and processing. The results of non-optimal records structure are unnecessary burden on medical workers, limited access to data for health management and other interested parties, large amounts of accidental errors and conscious data manipulations.The work includes an analysis of key inefficiencies of state statistical reporting in healthcare. Measures have been proposed for optimizing the system of indicators, improvement the system for collecting and processing information and legal formalization for proposed changes.

10.2139/ssrn.3347552

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PMH26 Cost-Effectiveness of Atypical Versus Typical Antipsychotics in Patients With Schizophrenia in Russia

Value in Health (2012)

V. V. Omelyanovsky M. Avxentyeva O. Ivakhnenko P. Khailov I. Krysanov

To estimate cost-effectiveness of different (7 drugs) peroral atypical antipsychotics (AAP) vs haloperidol (H) for the treatment of schizophrenia. Cost-effectiveness analysis of AAP compared to H for schizophrenia treatment was performed. A mathematical model based on simulation of treatment outcomes in hypothetical cohort of patients was developed. Key parameters of the model were determined using systematic review of the RCTs results (improvement in clinical and functional status as measured by the PANSS and CGI, frequency of relapse, adverse events), e-STAR observational study (local data for Russia), epidemiological data and expert panel opinions. For each option direct costs of treatment were considered: hospitalization and outpatient care, and the cost of medications for AAP- and H-based treatment. ICER (cost of a day without exacerbation of the disease) for each AAP was calculated vs H. According to published trials the treatment of schizophrenia in the AAP-based therapy was associated with a significant improvement in PANSS and CGI, decreased rate of relapse and adverse events compared to H-based treatment. Analysis of the results of RCTs has not shown superiority of any certain drug inside the AAP group. In case of application of AAP-based therapy hospitalization rate decreases by 38% compared to H-based treatment but the total cost of treatment remains lower for H. Depending on the drug ICERaap for AAP vs H varies from 4,202 USD to 18,157 USD per day without exacerbation of the disease. In group AAP paliperidone has the lowest ICER vs H - 4202 USD. Results of the study suggest that AAP-are more efficacious compared to H, the total cost of treatment remains lower for H. In-group AAP paliperidone is more cost-effective.

Paliperidone

10.1016/j.jval.2012.08.816

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Evaluation of the reference value of the incremental parameter "cost-effectiveness" for Russian healthcare system

FARMAKOEKONOMIKA Modern Pharmacoeconomics and Pharmacoepidemiology (2021)

Т. S. Teptsova Н. З. Мусина V. V. Omelyanovsky

Introduction. Presently, the willingness-to-pay threshold (cost-effectiveness threshold, incremental cost-effectiveness ratio) is used as one of the decision-making criteria for reimbursement in some foreign countries with a developed system of healthcare technologies evaluation (HTE). However, in Russia, the willingness-to-pay threshold (WPT) is undetermined, which complicates the evaluation of clinical-economical effectiveness of medical technologies, including medicines. Aim . The study aimed to calculate WPT for the Russian healthcare system using the available foreign experience. Materials and Methods . WPT was calculated with the following methods: the method proposed by the WHO, hemodialysis cost-effectiveness standard, case-based reasoning (CBR), and the evaluation of the shadow cost of the budget. Results . WPT was calculated for the Russian healthcare system using four different methods of calculation. According to the method proposed by the WHO, WPT was 2,235,201.60 Rub for DALY in the RF; according to the hemodialysis cost-effectiveness standard, it was 1,748,623.36 Rub for QALY; according to the method of the evaluation of the shadow cost of the budget, it was 313,878.21 Rub for DALY and 365,060.31 Rub for QALY; and according to the method of the case-based reasoning, it was 7,494,944.00 Rub for QALY. Conclusion . The study results showed that the optimal WPT values for the Russian healthcare system were those obtained by the method of the WHO (2,235,201.60 Rub). The authors propose to use this value as one of the decision-making criteria for the reimbursement of medical technologies, including medicinal drugs.

Reimbursement

Economic Evaluation

Healthcare system

Value (mathematics)

10.17749/2070-4909/farmakoekonomika.2020.071

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Identification of indicators used to assess needs for telemedicine consultations in various profiles of medical care

Digital Diagnostics (2024)

Е. S. Samsonova I.A. Mikhailov V. V. Omelyanovsky M. V. Avksentieva I.A. Zheleznyakova

BACKGROUND: A unified system for assessing the results and real contributions of telemedicine consultations to improving medical care quality in the healthcare system of the Russian Federation has not yet been developed. AIM: To develop a system of indicators for differentiated assessment of the needs for telemedicine consultations in the provision of medical care. MATERIALS AND METHODS: In the first stage, reports on the results of on-site activities of national medical research centers in regions of the Russian Federation and their annual public reports (2020–2022) were analyzed to identify indicators that determine the need for telemedicine consultations. The identified indicators were clarified and validated in an open interview with the representatives of the national medical research centers. In the second stage, the value of each indicator was determined based on the expert survey: 18 experts assessed each indicator on a scale of 1–5. Then, the weight coefficient of each indicator was calculated for their subsequent use in planning the coverage of telemedicine consultations. RESULTS: Three groups of indicators that determined the need for telemedicine consultations for different medical care profiles were as follows: (1) indicators that affect the planned volumes of telemedicine consultations, (2) indicators that characterize the efficiency and effectiveness of telemedicine consultations, and (3) indicators that characterize the validity of requests for telemedicine consultations. Group 1 included indicators of lethality, disability, hospital mortality, frequency of emergency/urgent consultations, and frequency of consultations of patients requiring intensive care. Group 2 included indicators for assessing the effectiveness and efficiency of telemedicine consultations, both subjective (result satisfaction) and objective (number of positive and negative treatment and hospitalization outcomes for cases that received where telemedicine consultations). Group 3 included indicators that characterize the validity of requests for telemedicine consultations: thoroughness of a patient’s examination before a telemedicine consultation and accuracy of the diagnosis. The weight coefficients of group 1 indicators ranged from 0.05 to 1.61 and varied for different profiles. CONCLUSION: A system of indicators was proposed for the differentiated assessment of the needs for telemedicine consultations when providing medical care.

Identification

Medical care

10.17816/dd622846

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Expert questionnaire for proposals to improve the organization of medical care in cancer patients

Medical Technologies Assessment and Choice (2024)

Zhanna V. Khailova А. Д. Каприн I.A. Mikhailov V. V. Omelyanovsky Yuriy Komarov

Medical care

10.17116/medtech20244603133

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