Научно-практический журнал Медицинские технологии. Оценка и выбор
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Issue № 28 | 2017 (2)

Abstract

A reform of medical care delivery is now conducted in the Russian health care system. It is largely connected with the growth of personal expenditures of patients on medical services, which requires the implementation of legal mechanisms of co-funding of medical care. The article analyses the international practices in health care funding, which may be of utmost importance to solve this task.

Keywords

health care model, health care system, co-funding of medical care, co-payments, medical co-insurance, funding and organization of medical care, sources of funding of health care, international practices.

For citations

Lukyantseva D. V., Tatarinov A. P., Melnikova L. S. International Practices in Funding of Health Care System. Medical Technologies. Assessment and Choice. 2017; 2(28): 20–29.

Issue № 26 | 2016 (4)

Abstract

The current legislation of the Russian Federation allows patients to pay for hospitality services associated with medical care. Also, it is possible to pay for medical services that are not included into the Program of State Guarantees of Free Medical Care for Russian Citizens (Program of State Guarantees). Almost all types of medical care are included into the Program of State Guarantees. However, according to the data of the Organization for Economic Co-operation and Development (OECD), the share of private expenditures on health care in Russia in 2014 was about 37.4% of all expenditures on health care, which was higher than the average level of private expenditures in OECD member states (27.3%). This statistics suggest the necessity of legalization of private payments for the medical care, and introduction of mechanisms of participation of citizens in legal private funding of medical services (full payment for some services), i.e. co-financing mechanisms. The article analyses the international experience in order to draw conclusions on the results of the introduction of the system of co-funding of medical care by population.

Keywords

co-funding of medical care by population, co-financing, co-payments, co-insurance, franchise, cost distribution methods, international experience, model of health care, health care system, funding and organization of medical care, sources of health care funding, positive and negative effects of the introduction of co-funding methods, regulator of the amount of medical care.

For citations

Tatarinov A. P., Lukyantseva D. V., Melnikova L. S. The Influence of Private Co-funding of Medical Care on the Effectiveness of Health Care Systems in Different Countries. Medical Technologies. Assessment and Choice. 2016; 4(26): 20–25.

Issue № 26 | 2016 (4)

Abstract

This publication reviews the experience of organization and functioning of structures that define (select), plan and control screening and prevention activities/programs in US, Canada, Netherlands and Germany healthcare. We describe the objectives and principles of the responsible authorities in the issuance of screening recommendations. It was found that this organizations consists of independent experts and issue recommendations based on strong scientific evidences and oriented to a specific target audience.

Keywords

task force, screening, prevention, examinations, recommendations, international experience.

For citations

Dombrovskiy V. S., Khachatryan G. R. Organization of the Evaluation of Screening Programs in the United States, Canada, the Netherlands and Germany. Medical Technologies. Assessment and Choice. 2016; 4(26): 11–19.

Issue № 25 | 2016 (3)

Abstract

Screening is an examination performed for the detection and treatment of diseases, conditions, anomalies and developmental disorders in theasymptomatic stage. Screening programs feasible from medical and economic perspective should match a number of criteria formulated by various authors and organizations, e. g. World Health Organization. We used available information to compare screening programs for chronic non-communicable diseases in adult population, which are recommended in countries have extensive experience in early disease detection, i. e. the United Kingdom and in the USA. In the USA, more programs are recommended including screening for oncological, cardiovascular diseases and diabetes, and also alcoholism, depression, obesity andosteoporosis. In the UK, screening programs are recommended for some oncological diseases (breast cancer, cervical cancer, and colorectalcancer), diabetic retinopathy, and abdominal aortic aneurysm.

Keywords

screening, clinical examination, early disease detection, economic effectiveness.

For citations

Pyadushkina Ye. A., Avksentyeva M. V., Omelyanovskiy V. V. Recommendations for the Early Detection of Chronic Non-Communicable Diseases in the UK and the USA. Medical Technologies. Assessment and Choice. 2016; 3(25): 20–33.

Issue № 24 | 2016 (2)

Abstract

Informed decision-making is an essential element of any justified decision. This is based on transparency and openness which allow for efficient operation of the medicinal products circulation system and constitutes essential elements of the latter. Various mechanisms are intended to ensure transparency and openness. In many cases they are contained in legal acts governing medicinal products. In this paper, important means of communication between main participants of the system are described, including rules of decision-making, access to information, policy-making, and proportionate dialogue. Where system is based on these rules, it efficiently satisfies public health needs and those of healthcare system, as well as ensures high performance of bona fide manufacturers and other members of the pharmaceutical industry.

Keywords

social control, transparency, openness, public health protection, public disclosure, competition.

For citations

Niyazov R. R. Transparency of Regulatory Data in Governing of Medicinal Products. Medical Technologies. Assessment and Choice. 2016; 2(24): 22–34.

Issue № 22 | 2015 (4)

Abstract

Profession of a medical employee is one of the risky ones in terms of possible undesired complications caused by medical activities. The article gives data on the number of lawsuits connected with that as well as the public opinion about the introduction of liability insurance for medical staff. It stresses the need for implementation of liability health insurance for medical staff in Kazakhstan and considers some possible ways of developing this system.

Keywords

lawsuits, medical professional liability insurance, patterns of liability insurance.

For citations

Tsoy A.V., Shoranov M.E., Demesinov A.R. Prerequisites of Developing Medical Professional Liability Insurance in Kazakhstan, Analysis of the Current Situation and a Possible Way of its Development. Medical Technologies. Assessment and Choice. 2015; 4(22): 20–26.

Issue № 3 | 2015 (21)

Abstract

Most countries of the world are striving (by different ways and with different success) towards a total coverage of citizens with accessible and affordable health care including preferential drug supply. Russia is still using the approach to the drug supply adopted in the Soviet period which is based on preferences given to certain categories of citizens. Figuratively, the present system of drug supply “is wearing out” the ideology cut out in the country which disappeared almost a quarter of a century ago. The level of medicines consumption in Russia is lower than that in industrialized countries, which cannot be explained by high indicators of public health. Statistics of death rate in the country causes a lot of concern among a number of specialists. Death rates are included as indicators in the Strategy of drug supply. The rights of all the people to the preferential access to drugs are not officially recognized, which goes against the international agreements on human rights adopted at the UN level. World experience is not used in this field, for example, medicine reimbursement included in social medical insurance or preferential access to the main medicines within the framework of the national drug policy. The strategy of drug supply was drafted without the WHO recommendations being considered. The procedure of making a list of the most essential medicines has no analogues in the world practice. The area where this main list can be used is extremely limited. The problems touched upon above are not discussed in detail either in the press or at specialized forums.

Keywords

drug supply, accessibility of drugs, a list of the essential medicines, national drug policy.

For citations

Meshkovskiy A.P. On the Problems of Public Drug Supply. Medical Technologies. Assessment and Choice. 2015; 3(21): 21–33.

Issue № 2 | 2015 (20)

Abstract

The article touches upon the work of three international organizations on the issues of public drug supply: WHO, ICH and EEU. Plans to considerably reorganize ICH were considered. The perspectives of participation expansion of Russian organizations and specialists in the collaboration on the global, interregional and sub-regional levels were shown.

Keywords

drug supply, quality, accessibility and rational use of the medicinal products, harmonization of the regulatory requirements, WHO program on pre-qualification of manufacturers and suppliers of MP, Global Cooperation Group.

For citations

Meshkovskiy A.P. On the Topic of International Cooperation in the Area of Drug Supply of the Population. Medical Technologies. Assessment and Choice. 2015; 2(20): 24–32.

Issue № 4 | 2014 (18)

Abstract

The goal of Health Technology Assessments (HTA) is to inform policymakers and clinicians to make more rational decisions with regard to health care resource allocation. This paper introduces the reader with a commonly performed and reported in medical economic literature terms used for HTA results interpretation such as Incremental Cost Effectiveness Ratio (ICER) and Sensitivity Analysis. The role of the cost-effectiveness threshold in decision making, and the importance of one-way, multiway and probabilistic sensitivity analyses for exploring and describing parameter and structural uncertainties presented in the paper. Importance of the “Discussion” section in economic analysis is considered, and Medical Decision Making journal requirements for this section are described in this paper. Illustrative examples of the cost-effectiveness plane and the results of sensitivity analysis from published studies are also discussed.

Keywords

economic evaluation, ICER, cost-effectiveness plane, threshold value, sensitivity analysis.

For citations

Djalalov S.Ch., Djalalova D.K., Hoch J.S. Interpreting the Results of Health Technology Assessment. Medical Technologies. Assessment and Choice. 2014; 4(18): 19–28.

Issue № 3 | 2014 (17)

Abstract

In this article we analyze risk-sharing agreements between producer and payer as an important alternative way to finance expensive and innovative medicines, restrict uncontrolled growth of state expenses on such medicines and ensure patients access to the latest achievements of the pharmaceutical market. As follows form the experience of leading countries, such agreements are used in cases where traditional patient access schemes are not feasible. International experience analyzed by the authors shows that reimbursement and price levels for new medicines determined under risk-sharing agreements are to a significant extent based on the results of HTA evaluation conducted after marketing authorization approval. The article also discusses the main types of risk-sharing agreements, their most commonly used methods of reimbursement and price controls as well as specificity of regulatory aspects of such agreements and their differences in European countries vs. USA.

Keywords

risk sharing, risk-sharing agreement, Health Technology Assessment, innovative drugs, reimbursement system, framework for patient access.

For citations

Fedyaev D.V., Maximova L.V., Omelyanovsky V.V. The Role of Health Technology Assessment, Reimbursement and Pricing Systems in Risk-Sharing Agreements. Medical Technologies. Assessment and Choice. 2014; 3(17): 25–31.