Author/Editor		Mrkaić, Mićo; Pezdir, Rado
Title		Ekonomska analiza stroškovne učinkovitosti natalizumaba pri zdravljenju multiple skleroze (semi markovski pristop)
Translated title		Cost effectiveness analysis of natalizumab in multiple sclerosis treatment (semi Markov model)
Type		članek
Vol. and No.		Letnik 25, št. 1
Publication year		2009
Volume		str. 5-11
ISSN		1318-2927 - Asian philosophy
Language		slv
Abstract		Multipla skleroza je kronična vnetna bolezen osrednjega živčnega sistema. Praviloma se začne pri mladih odraslih ljudeh in lahko v številnih primerih privede do invalidnosti in nezmožnosti za delo. Vzroki multiple skleroze niso poznani, utemeljeno pa sklepamo, da gre za kombinacijo genetskih in okoljskih dejavnikov. Čeprav zdravila za multiplo sklerozo ni, pa obstajajo zdravila, kispremenijo potek bolezni in upočasnijo njeno napredovanje ter zmanjšajo njene posledice. Zdravila, ki spreminjajo potek bolezni (po angleško disease modifying drugs ali kratko DMD), nosijo s sabo pri svoji uporabi tako stroške kot koristi: stroški so seveda v njihovi nabavi ter v uporabi, ki zahteva strokovne storitve, koristi pa so v manjši pogostosti zagonov bolezni in zmanjševanju prizadetosti obolelih. Cilj te analize je izračunati stroške in koristi uporabe teh zdravil. Za vrednotenje uporabimo semi markovski model napredovanja bolezni po lestvici invalidnosti. V analizi smo naredili oceno skupnih stroškov zmanjšane produktivnosti bolnikov z multiplo sklerozo na eno leto in skozi življenjski cikel. Izkazalo se je, da znašajo povprečni stroški zagonov 1100 evrov letno na bolnika, da so celotni povprečni stroški (upoštevajoč tudi invalidnost) približno 6900 evrov na bolnika. Zdravljenje z zdravilom natalizumab pomembno zniža stroške bolezni: stroške zagonov za 62 % in stroške dolgoročne invalidnosti za približno polovico.Multiple sclerosis is a chronic progressive illness of the central nervous system. It is usually first diagnosed in young adults and in many cases leads to disability and early retirement. The cause of the disease is not known, butit is reasonable to suspect both genetic and environmental factors. Despitethe fact that there is not cure for the disease, there exist disease modifying drugs (DMD) which slow the progression of the disease and reduce thedisability caused by it. The use of DMDs carries both costs and benefits: the cost of use and accompanying care and the benefit of less disability, improved quality of life and increased productivity. The goal of this analysisis to evaluate both costs and benefits in the case of Slovenia. We usea semi Markov model of disease progression. The analysis calculates the total cost of lost productivity in Slovene multiple sclerosis patients per year and per life cycle. The average annual cost due to relapses is 1100 eurosand the total average annual cost is 6900 euros. Treatment with natalizumab significantly reduces both costs, the cost of relapses by 62 percent and the cost of long term disability by approximately 50 percent.
Keywords		multipla skleroza stroški zdravljenja zagoni bolezni koristi zdravljenja interferoni nalalizumab multiple sclerosis the cost of care relapses therapeutic benefit interferon nalalizumab