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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">endoserg</journal-id><journal-title-group><journal-title xml:lang="ru">Эндокринная хирургия</journal-title><trans-title-group xml:lang="en"><trans-title>Endocrine Surgery</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2306-3513</issn><issn pub-type="epub">2310-3965</issn><publisher><publisher-name>Типография «Печатных дел Мастер»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14341/serg201314-15</article-id><article-id custom-type="elpub" pub-id-type="custom">endoserg-6366</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Клиникоэкономический анализ применения препарата эпидермального фактора роста (ЭберпротП                  ®) у больных с синдромом диабетической стопы</article-title><trans-title-group xml:lang="en"><trans-title>Pharmacoeconomic analysis of epidermal growth factor (HeberprotP                  ®) for the treatment of diabetic foot ulcers</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="western" xml:lang="en"><surname>Galstyan</surname><given-names>G R</given-names></name></name-alternatives><bio xml:lang="en"><p>doktor med. nauk, professor, zav. otdeleniem “diabeticheskaya stopa” FGBU ENTs</p></bio><email xlink:type="simple">foot@endocrincentr.ru</email></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="western" xml:lang="en"><surname>Ignatieva</surname><given-names>V I</given-names></name></name-alternatives><bio xml:lang="en"><p>menedzher Natsional'nogo tsentra po otsenke tekhnologiy zdravookhraneniya</p></bio><email xlink:type="simple">-</email></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="western" xml:lang="en"><surname>Avksentieva</surname><given-names>M V</given-names></name></name-alternatives><bio xml:lang="en"><p>professor kafedry obshchestvennogo zdravookhraneniya i profilakticheskoy meditsiny Pervogo MGMU im. I.M. Sechenova</p></bio><email xlink:type="simple">-</email></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="western" xml:lang="en"><surname>Dedov</surname><given-names>I I</given-names></name></name-alternatives><bio xml:lang="en"><p>akademik RAN i RAMN, direktor FGBU ENTs, prezident RAMN</p></bio><email xlink:type="simple">-</email></contrib></contrib-group><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>15</day><month>03</month><year>2013</year></pub-date><volume>7</volume><issue>1</issue><issue-title>№1 (2013)</issue-title><fpage>4</fpage><lpage>15</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Galstyan G.R., Ignatieva V.I., Avksentieva M.V., Dedov I.I., 2013</copyright-statement><copyright-year>2013</copyright-year><copyright-holder xml:lang="ru">Galstyan G.R., Ignatieva V.I., Avksentieva M.V., Dedov I.I.</copyright-holder><copyright-holder xml:lang="en">Galstyan G.R., Ignatieva V.I., Avksentieva M.V., Dedov I.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.surg-endojournals.ru/jour/article/view/6366">https://www.surg-endojournals.ru/jour/article/view/6366</self-uri><abstract><p>Введение. Предложен новый подход к лечению длительно незаживающих язв, характеризующихся глубоким поражением тканей (3–4-я степень по Вагнеру), у больных с синдромом диабетической стопы (СДС), основывающий ся на использовании эпидермального фактора роста (препарата Эберпрот-П                  ®) в дополнение к стандартным методам лечения. Эффективность данного подхода, проявляющаяся в сокращении времени до полного заполнения язвенного дефекта грануляционной тканью, а также до его полной эпителизации, была показана в рандомизированных клинических исследованиях (РКИ), однако стоимость лечения этим препаратом очень высока. Цель исследования: провести клинико-экономический анализ применения эпидермального фактора роста (препарата Эберпрот-П                  ®) у пациентов с СДС в условиях оказания высокотехнологичной медицинской помощи (ВМП). Материалы и методы. Гипотеза исследования заключалась в том, что применение препарата Эберпрот-П                  ®у пациентов с СДС 3–4-й степени по Вагнеру может способствовать снижению частоты ампутаций и, соответственно, увеличению продолжительности жизни больных при приемлемых для системы здравоохранения РФ дополнительных расходах. На основании литературных данных было проведено моделирование исходов лечения для когорты больных для варианта с использованием только стандартных методов лечения и при добавлении к лечению препарата Эберпрот-П                  ®. В модели рассчитаны прямые затраты на ведение больных при обоих вариантах лечения с уче том вероятности проведения ампутаций. Результаты. Использование препарата Эберпрот-П                  ®может предотвратить 52 ампутации в когорте из 100 человек с СДС 3–4й степени по Вагнеру и сохранить в результате 29,54 года жизни. Затраты на 1 дополнительный год жизни составят 1,17 млн руб., что не превышает порогового значения затратной эффективности, равного трехкратному размеру ВВП в расчете на душу населения. Заключение. Результаты моделирования показали клиникоэкономическую целесообразность использования препарата Эберпрот-П                  ®в дополнение к стандартным методам лечения СДС в условиях ВМП.</p></abstract><trans-abstract xml:lang="en"><p>Introduction. The epidermal growth factor (EGF; HeberprotP                  ®) is the new treatment for deep persistent diabetic foot ulcers (Wagner grade 3–4). The effectiveness of EGF measured as the reduction of the time to complete granulation of tissue lesions was confirmed in randomised clinical trials, but the cost of this new treatment is high. Aim. To analyze the costs and outcomes of the use of EGF (Heberprot-P®) for the treatment of DFU in high- ly specialized medical institutions. Material and methods. We tested the hypothesis that the use of Heberprot-P® in diabetic foot ulcers – DFU – (Wagner grade 3–4) would reduce the rate of amputations and increase survival at acceptable cost for the Russian healthcare system. We used the data from international published literature to construct mathematical model representing clinical outcomes in the cohort of patients treated with only standard methods or standard methods in combination with Heberport-P®. We calculated direct costs associated with both strategies of treatment taking into account the risk of amputation. Results. The use of Heberprot-P® may prevent 52 amputations and save 29.54 years of life in a cohort of 100 DFU patients (Wagner grade 3–4). The incremental costs of EGF treatment were RUR 1.170.000 per life year gained and did not exceed the accepted threshold of less than three times GDP per capita. Conclusion. Mathematic modelling demonstrated the feasibility of introduction of EGF in combination with standard treatment for DFU in highly specialized medical institutions.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>эпидермальный фактор роста</kwd><kwd>диабетическая язва стопы</kwd><kwd>риск ампутации</kwd><kwd>ЭберпротП</kwd></kwd-group><kwd-group xml:lang="en"><kwd>epidermal growth factor</kwd><kwd>diabetic foot ulcers</kwd><kwd>risk of amputation</kwd><kwd>Heberprot+P</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Дедов И.И., Шестакова М.В., и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом (5-й выпуск). Сахарный диабет. 2011;(3s):2-72. doi: 10.14341/2072-0351-5612</mixed-citation><mixed-citation xml:lang="en">Дедов И.И., Шестакова М.В., и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом (5-й выпуск). 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