[Pharmacoeconomic and pharmacogenetic aspects of the implementation of a personalized approach in the treatment of cardiac patients]

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Aug;29(Special Issue):1258-1263. doi: 10.32687/0869-866X-2021-29-s2-1258-1263.
[Article in Russian]

Abstract

Purpose: To investigate the possibilities of pharmacoeconomic and pharmacogenetic factors monitoring to assess the effectiveness of treatment of a cardiological profile patients as a part of the implementation of a personalized approach.

Material and methods: 200 patients with arterial hypertension and CHD were examined. Pharmacotherapy was analyzed. ABC/VEN and DDD analysis, pharmacoeconomic analysis were applied. Genetic analysis of the polymorphism of the genes CYP2D6*4 and CYP2D6*10 encoding the subfamily of the cytochrome isoenzyme Р-450 was carried out. An original monitoring method was used to assess the effect of pharmacoeconomic and pharmacogenetic factors on the performance of cardiac care.

Results: When conducting a pharmacoeconomic analysis of cases of cardiac care, it was found that the costs of drug therapy are significant and take over 10% of the total costs. However, its effectiveness is insufficient in 58% of cases in inpatient and 37% in outpatient care. The analysis showed that there is an inverse mean correlation between gene polymorphism and clinical performance of cardiac care (r = -0.62) and a direct strong correlation between polypharmacy in pharmacotherapy, not accounting for interdrug interaction and clinical performance (r = 0.89).

Keywords: medical care; personalized therapy; rational pharmacotherapy.

MeSH terms

  • Costs and Cost Analysis
  • Cytochrome P-450 CYP2D6 / genetics
  • Economics, Pharmaceutical*
  • Humans
  • Pharmacogenetics*
  • Polymorphism, Genetic

Substances

  • Cytochrome P-450 CYP2D6