Health Technology Assessment of Coronary Artery Disease Treatment with comorbid conditions: General Clinical and Pharmacoeconomic Approaches

- Долженко, Марина Миколаївна (orcid.org/0000-0002-8559-9598), Білоусова, Наталя Анатоліївна (orcid.org/0000-0001-6732-426X), Ткаченко, Наталя Олександрівна (orcid.org/0000-0002-8566-5938) and Маганова, Тамара Валерієвна (orcid.org/0000-0001-7008-3102) (2026) Health Technology Assessment of Coronary Artery Disease Treatment with comorbid conditions: General Clinical and Pharmacoeconomic Approaches In: Український кардіологічний журнал. Матеріали XXVІІ Національного конгресу кардіологів України (Київ, 22–25 вересня 2026 р.) , 1 (33). ТОВ «Четверта хвиля», м. Київ, Україна, p. 23. ISBN 1608-635X

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Abstract

Stable Coronary Artery Disease (CAD) remains a significant clinical and economic challenge for Ukraine’s healthcare system. Despite the "Affordable Medicines" reimbursement program, the reliance on monotherapy with generic drugs is often associated with poor patient adherence to CAD pharmacotherapy, largely because the program excludes many medications used for CAD with comorbid conditions. This situation results in suboptimal treatment efficacy and high rates of serious adverse cardiovascular events and mortality. The study evaluated the pharmacoeconomic feasibility of shifting from a "generics-only" model to a value-based approach—combining branded fixed-dose combination drugs with active pharmaceutical support—within the context of the Ukrainian healthcare system. A cost-benefit analysis (CBA) was conducted over a one-year time horizon for a cohort of 100 patients. The study compared the standard care model using only generic drugs (Model 1) with an enhanced model (Model 2) that incorporated branded fixed-dose combination drugs and pharmacist-led educational support. Model 2 consistently outperformed Model 1 across all metrics (exchange rate: 1 EUR = 50 UAH): Scenario 1: The benefit-to-cost (B/C) ratio was 2.24 for the new model versus 1.84 for the standard one, indicating a 22% increase in economic efficiency per hryvnia invested. Scenario 2: When patient costs were factored in, the B/C ratio reached 2.24 compared to 1.69, demonstrating that the improved model generates 32% more value for the patient's investment. Scenario 3: The maximum net social impact reached €46,584, driven by a €15,300 increase in preserved productivity compared to an approach limited solely to system costs. These results challenge the prevailing "lowest-price" procurement principle. Integrating branded fixed-dose combination drugs and pharmaceutical support into the national strategy could transform cardiovascular care from a cost center into a powerful source of value creation for the state. To enhance healthcare system efficiency, it is advisable to expand the reimbursement program to include original fixed-dose combination drugs currently excluded from the scheme and to officially recognize pharmaceutical support for patients with ischemic heart disease and comorbidities as an integral component of clinical practice.

Item Type:	Book Section
Keywords:	Health technology assessment, Coronary Artery Disease, Financial access to medicines, Pharmacotherapy
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 08:23
Last Modified:	28 Sep 2026 08:23
URI:	https://lib.iitta.gov.ua/id/eprint/750366

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