Analysis of pharmaceutical supply of breast cancer patients
Authors: Rafalska Yaroslava , Kosyachenko Kostyantyn 
Published: July 2023

The aim: to conduct a clinical and economic analysis of the state of pharmaceutical support for patients with breast cancer in women.
Materials and methods. During the research, data from the National List of Essential Medicines, the 14th State Formulary of Medicines, the Ukrainian clinical protocol, the clinical protocols of Great Britain and the United States of America for the treatment of breast cancer, and a depersonalized database of drug prescriptions were used. The research used such methods as clinical-economic, organizational-economic, mathematical-statistical, graphic, grouping and generalization.
Research results. It was established that 46 schemes of schemes for the treatment of breast cancer are presented in Ukrainian and international clinical protocols (Great Britain, USA). In all three protocols, there were 5 regimens for the treatment of breast cancer, such as CMF (Cyclophosphamide, Methotrexat, Fluorouracil), AC (Doxorubicin, Cyclophosphamide), DC (Docetaxel, Cyclophosphamide), TC (Trastuzumab, Capecitabin), EC (Epirubicin, Cyclophosphamide).
Analysis of the pharmaceutical component in the protocols for individual drugs showed that they included 23 drugs according to the INN, which belong to the group of antineoplastic drugs. The Ukrainian clinical protocol includes 17 drugs, the British protocol – 14 drugs, and the American one – 15 drugs. The frequency analysis of antineoplastic drugs included in the Ukrainian clinical protocol revealed the TOP-3 in terms of drug prescription frequency: L01A A01 Cyclophosphamide (Ki=0.037), L01C D02 Docetaxel (Ki=0.029), L01D B01 Doxorubicin (Ki=0.026). The largest number of prescribed drugs are vital drugs – 61.96 %, the smallest share – essential drugs – 2.17 %, and the share of non-essential drugs is 35.87 %. The ABC analysis made it possible to determine the group of the most expensive drugs in the treatment of breast cancer - these are antineoplastic and immunomodulating agents. The total expenses for this group amounted to UAH 772,459.96, which according to the US dollar exchange rate of the National Bank of Ukraine at the end of August 2022 was USD 21,122.77. According to the analysis of the matrix of the integrated ABC-VEN-frequency analysis, it was established that the largest number of prescriptions belonged to the group of less expensive and vital drugs (B/V) – 7 drugs (48.73 % of the total amount. At the same time, the largest amount of expenses is observed in for the A/V group – UAH 772,459.96 (52.83 % of all costs directed to the pharmaceutical support of patients). The results of the structural analysis of the group of the most expensive drugs showed that the highest costs were characteristic of L01CD02 Docetaxel (UAH 1166,531.31; 39.81 % of the total cost in the group), and the lowest – for L01DB01 Doxorubicin – UAH 63,694.14 (5.46 %, respectively).
Conclusions. According to the results of the conducted research, it was established that the largest costs fall on the group of essential drugs (1047735.07 UAH, 71.65 % of all costs). This determines the need for further pharmacoeconomic calculations of breast cancer treatment to optimize the costs of antineoplastic drugs