Health technology assessment regarding the clinical and pharmacoeconomic justification for the treatment of Cardiovascular-Kidney-Metabolic syndrome

- Білоусова, Наталя Анатоліївна (orcid.org/0000-0001-6732-426X), Маганова, Тамара Валерієвна (orcid.org/0000-0001-7008-3102), Ткаченко, Наталя Олександрівна (orcid.org/0000-0002-8566-5938) and Долженко, Марина Миколаївна (orcid.org/0000-0002-8559-9598) (2026) Health technology assessment regarding the clinical and pharmacoeconomic justification for the treatment of Cardiovascular-Kidney-Metabolic syndrome In: Український кардіологічний журнал. Матеріали XXVІІ Національного конгресу кардіологів України (Київ, 22–25 вересня 2026 р.) , 1 (33). ТОВ «Четверта хвиля», м. Київ, Україна, pp. 100-101. ISBN 1608-635X

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Abstract

The pharmacotherapy of patients with Cardiovascular-Kidney-Metabolic syndrome (CKMs) requires the simultaneous use of multiple medications. Treatment cost is a key factor influencing adherence to pharmacotherapy, and effective medication co-payment models help balance treatment accessibility with the financial sustainability of the healthcare system. A budget impact analysis (BIA) was conducted: co-payment scenarios were modeled for 565 trade-name solid oral medications containing a single active ingredient; data from the reimbursement program registry as of March 5, 2026, were utilized; financial affordability criteria based on World Health Organization (WHO) recommendations were applied; and the maximum co-payment level for CKMs medications was calculated, factoring in the subsistence minimum (2,595 UAH) and an average consumption of three medications. The study determined that the threshold for financial affordability regarding CKMs pharmacotherapy is 28.83 UAH per medication. A comparative analysis of the scenarios examined the base-case analysis model, which incorporates fixed parameter estimates - most commonly arithmetic mean values ​​derived from clinical trials or meta-analyses. The average cost of the treatment course, the average probability of complications, and the average patient quality-of-life (utility) score were consolidated into a single summary figure of 63.65 UAH. A "1% Linear" model was used to test the model's robustness. We linearly adjusted a parameter value by exactly +1% relative to the standard healthcare model while keeping all other variables constant, thereby allowing for the calculation of the elasticity coefficient. This model indicated potential costs of up to 252.50 UAH per medicinal product. The minimum-scenario model (lower-bound scenario)—which supplements the standard healthcare model by projecting budgetary and efficacy outcomes based on minimum threshold values—recorded a cost of 6.39 UAH per medicinal product; while socially acceptable, it lacked sufficient flexibility. The strict constraint model, which defines the criteria for a payer's willingness to reimburse a medical technology, set a 1% adjustment with a cap of 28.83 UAH and proved to be the optimal approach. Financial results showed savings of 711.91 UAH per package of the medicinal product, with relative savings of 0.55%; projected annual savings amounted to approximately 8.5 million UAH when extrapolated against total expenditures of 2.41 billion UAH; it was determined that 64.8% of expenditures were attributable to medicines provided free of charge. The implementation of uncontrolled co-payment models can lead to increased healthcare system costs and reduced financial accessibility to medicines. A differentiated co-payment model with a cap of UAH 28.83 is optimal, striking a balance between social protection for patients with chronic rheumatic diseases and economic efficiency.

Item Type:	Book Section
Keywords:	Health technology assessment, financial access to medicines, pharmacotherapy, cardiovascular-kidney-metabolic syndrome
Subjects:	Science and knowledge. Organization. Computer science. Information. Documentation. Librarianship. Institutions. Publications > 6 Applied Sciences. Medicine. Technology > 61 Medical sciences
Divisions:	Institute of Pedagogical Education and Education for the Adults > Common resources institute
Depositing User:	ИПТО НАПН Natalia Bilousova
Date Deposited:	28 Sep 2026 08:04
Last Modified:	28 Sep 2026 08:04
URI:	https://lib.iitta.gov.ua/id/eprint/750364

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