Study of Development problems dynamics of Ukrainian market of stomach ulcer treatment drugs

 

Hanna Panfilova1*, Oleh Samborskyi2, Natalia Bogdan3, Oksana Tsurikovа4, Liusine Simonian1

1Faculty of Pharmacy, Department of Organization and Economics of Pharmacy,
National University of Pharmacy, Ukraine.

2Faculty of Pharmacy, Department of Organization and Economy of Pharmacy and Drug Technology,
Ivano-Frankivsk National Medical University,
Ukraine.

3Faculty of Pharmacy, Department of Pharmacy of Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine.

4Faculty of Pharmacy, Department of Quality Management, National University of Pharmacy, Ukraine.

*Corresponding Author E-mail: panf-al@ukr.net

 

ABSTRACT:

This article presents the analysis results of Ukrainian pharmaceutical market segment of stomach ulcer treatment drugs. It was determined that, judging by the quantitative indexes, Ukrainian market of anti-ulcer medication is an actively developing structure that maintains the stability of its development qualitative characteristics nonetheless. For example, during two years (01 June 2016 – 01 June 2018) the quantities of medicinal products and companies that represent these products in Ukraine have both grown: from 396 to 448 names (13.13%) and from 90 companies (25 of them Ukrainian) to 98 (28, correspondingly). On the background of quantity growth of Ukrainian-made drugs from 84 (2016) to 92 (2018), the specified market segment has shown significant dependency on import. For example, the proportion (%) of foreign production drugs has grown from 78.79% (2016) to 79.46% (2018). KRKA is an uncontested leader by the quantity of marketed medicinal products (2016 – 28 products, 2018 – 32 products). The products of Takeda Pharmaceutical Company Limited are presented in the second place (22 and 23 products, corresponding to the years under study). The products of Dr. Reddy's Laboratories take the third place (20 and 21 products, corresponding to the years under study). The said pharmaceutical market segment has kept its monopolistic pattern of distribution as judged by the manufacturing companies whose products are presented in Ukraine, and by international non-proprietary names of products and their pharmacotherapeutic groups. For example, just 8 foreign manufacturing companies were responsible for 40.17% (2016) and 31.92% (2018) of imported assortment of anti-ulcer drugs, and 7 domestic companies were responsible for 64.29% (2016) and 61.54% (2018) of domestic assortment of these drugs. In 2016 75.76% and in 2018 – 71.65% of the whole assortment of anti-ulcer drugs were presented by the drugs from the following groups: A02B-Drugs for peptic ulcer and gastro-oesophageal reflux disease (Gord), A02BC Proton pump inhibitors (55.30% and 50.22%, corresponding to the years under study). Five drugs (A02BC02-Pantoprazole, A02BC01-Omeprazole, A02BC05-Esomeprazole, A02BC03-Lansoprazole, A02BD Combinations for eradication of Helicobacter pylori) presented more than a half of marketed assortment of anti-ulcer products (2016 – 56.57%, and 2018 – 55.14%). Tableted dosage forms (2016 – 58.33%, and 2018 – 55.80%) and drugs of synthetic origin (2016 – 76.26%, and 2018 – 78.13%) have kept their leading positions on the market. Authors have discovered that during 2015-2018 the average retail prices of anti-ulcer drugs have shown the trend of systematic growth. The highest growth of average retail prices was observed for A02BX13-Alginic acid (avg.=1.37), and the lowest ‒ for A02BC06-Dexlansoprazole (avg.=1.04). The given above characteristics of the market segment that was studied allow us to state the need to develop and establish the national program of import substitution for the assortment of anti-ulcer drugs in Ukraine.

 

KEYWORDS: Stomach ulcer, Ukrainian Pharmaceutical Market, Ukraine, Anti-ulcer drugs, Anti-ulcer drugs Segment.

 

 

INTRODUCTION:

Stomach ulcer takes the leading position in the distribution of diseases related to internal organs pathology among the population. The increase of stomach ulcer morbidity rate among children and young adults makes the problem of its prophylaxis and effective treatment organization a priority for the health care systems of different countries1,2. That being said, it should be noted that this problem doesn’t lose its significance with each passing year, regardless of the organization level and efficiency of health care system. It has been long known that the stomach ulcer is a pluricausal disease, whose treatment requires the use of comprehensive measures3,4. With each year the socio-economic significance of the question of early prophylaxis and disease relapse prevention grows, even in the countries with developed economy1,5,6. Within the memory of the last generation of doctors and pharmacists the revolutionary changes in the questions of etiology, pathogenesis and, as a result, of treatment and prophylaxis of human stomach ulcer disease were observed7-9. As recently as 1994 the National Institutes of Health (NIH) of USA published the data that confirmed the connection between the development and progression of gastritis with superacidity, and of stomach ulcer and cancer – with Helicobacter pylori7,10,11. In the ensuing years the scientists have proven that the development of duodenal cancer and duodenitis can also appear due to contagion with Helicobacter pylori, and international organizations recommended to include additional diagnostic methods and antimicrobial drugs into national treatment guidelines and diagnostics of gastroenterological patients7,10,12-14. In 2005 Australian scientists John Robin Warren and Barry James Marshall were awarded the Nobel prize in Physiology and Medicine for their significant contribution towards changing of the medical community position about the etiology and pathogenesis of gastritis, stomach ulcer and duodenal ulcer7,10. Unfortunately, despite the significant changes in the strategy and tactics of prophylaxis and treatment of stomach ulcer, the question of patients’ pharmacotherapy efficiency improvement is still open 10,12,14-17. In accordance with international data, the prevalence rate of stomach ulcer is, on average, 6.2%-10.0% of the total quantity of the adult population, and the mortality rate varies between 6 and 9.7 per 100 thousand1,2,18. In Ukraine the quantity of patients with stomach ulcer varies widely between the different regions, mainly from 2.5% to 17.0%10.

 

Of particular concern to the specialists is the fact of rapid spread of ulcer disease among children, teenagers, young adults, high recurrence rate (20.0 ‒ 25.0%) of this pathology, and also the high probability of numerous complications during treatment of elderly patients1,2,18-20. The low compliance level of ulcer disease patients in Ukraine is worth to be mentioned. As evidenced by the results of systematization of data from professional literature, more than a half of ulcer disease patients do not comply with the doctors’ advice for any reasons, and practice self-treatment21-23. Absence of comprehensive treatment of stomach ulcer disease and cases of self-treatment of patients nullify the efforts of specialists directed at long-lasting therapeutic effect provided by usage of contemporary anti-ulcer agents. All of the above noted facts determine the increase of financial expenses in the domestic health care system, and early disablement and sudden death of able-bodied patients arise as one of the social instability forming factors in the society10. That is why, in the conditions of economic crisis in Ukraine and harsh lack of funding of the health care system, the development dynamics analysis of the current state of segment of anti-ulcer drugs presented on the pharmaceutical market of Ukraine gains significant relevance.

 

MATERIALS AND METHODS:

Analysis of domestic anti-ulcer drugs market over time became the goal of our studies. Data about market authorization of anti-ulcer drugs, presented on the official site of the Ministry of Health of Ukraine, namely on the site of the State Center of Expertise (http://www.dec.gov.ua/index.php/ua), became the object of our studies. Monitoring of average retail prices was conducted using the data of information retrieval program “Morion”. In the studies we used the following methods: historical, logical, comparative, graphic, mathematically statistical, and also methods of marketing analysis. We compared the data about marketing authorization of anti-ulcer drugs in Ukraine as of 01 June 2016 and 01 June 2018. Taking into account the fact that the stomach ulcer disease is a pluricausal disease, whose treatment requires comprehensive use of a whole range of drugs, presented in different pharmacotherapeutic groups (antisecretory, antacid and coating, gastroprotector, anti-helicobacter drugs, and also combinations and others), on the preliminary stage of our study arose the question of determining the group of drugs to conduct a marketing assortment study with. To form a group of anti-ulcer drugs we used the data of medical care delivery protocol in case of peptic stomach ulcer and duodenal ulcer, as approved by the order of Ministry of Health of Ukraine 613 of 03 September 2014, and also data from professional literature discussing the question of providing effective pharmacotherapy to the patients with stomach ulcer disease10,17,24-27. The analysis of assortment of drugs was conducted using both international non-proprietary names (INN) in accordance with different levels of ATC-classification system (http://compendium.com.ua/atc), and also by trade names, taking into account all of the dosage forms that were authorized in Ukraine for the given period of time.

 

Change dynamics analysis for the quantitative indexes was done using calculations of chain index of data growth rate (%) and increment (%) rate. To assess the influence of financial and economic crisis on the retail drug prices we conducted the change dynamics analysis for individual (Ip) and group (Ig) chain price indexes (Table 1). Change analysis for the indexes Ip and Ip was conducted using all of the trade names of drugs that were presented on the retail pharmaceutical market from 2013 through June 2018.

 

Table 1: Indexes that were used for analysis and their calculation

Index

Calculation of indexes used in analysis

 

– retail price of і-th antiulcer drug (trade names with dosage form taken into account);

– frequency with which the drugs with this price are observed at a certain time period (as of 01-Jun-13 and 01-Jun-18) 28,29.

 

– prices chain index for the anti-ulcer drug;

– weighted arithmetic average of the i-th drug retail price for the current period;

– weighted arithmetic average of the i-th drug retail price for the previous period;

– quantity of anti-ulcer drugs in the studied group 28,29

 

– group chain index for the prices of drugs;

– chain index for the prices of drugs;

– quantity of studied anti-ulcer drugs 28,29

 

The need to conduct dynamics analysis of anti-ulcer drugs retail prices was determined by a whole range of factors. Firstly, there are no programs of anti-ulcer drug price reimbursement in Ukraine. That is, patients buy these drugs using their own money. In view of this the question of anti-ulcer drugs affordability is a pressing issue on the road to solving of a more global problem, namely increasing of efficiency of medical care delivery in the hospital conditions and of pharmaceutical care delivery in the outpatient setting to the ulcer disease patients. Secondly, the low level of ulcer disease patients’ compliance determines the need to develop and implement an awareness-raising program for patients that would explain to them a whole range of questions concerning relapse prophylaxis organization, and also to widen the range of exposure to new over-the-counter drugs, presented on the national pharmaceutical market. Thirdly, the results of anti-ulcer drugs retail prices change dynamics analysis can be used in analysis of socio-economic availability of the specified drugs for the different social groups, and also to predict the demand for the drugs with the before mentioned pharmacotherapeutic action. Fourthly, taking into account the prominent dependency of the national pharmaceutical market on the import of pharmaceutical products, the results of analysis of change dynamics Ip and Ig retail prices would allow determining the price range for the national pharmaceutical products manufacturers to introduce a domestically made anti-ulcer drug on the pharmaceutical market.

 

With a goal of creation of an authentic informational base of statistical data over the years, we used a single methodological approach in our studies. All statistic calculations were performed using the statistic package StatSoft. Inc. (2014), STATISTICA version 12.0, and Excel spreadsheet. A p-value <0.05 was considered as statistically significant. We used standard software for applied statistical analysis Statistica 6.0 (software product license V.7. English – V.6 Russia K 892818) to process the data.

 

RESULTS AND DISCUSSION:

Analysis of the marketing authorization data for the anti-ulcer drugs (group A02-Drugs for acid related disorders) over the years allowed us to determine the following. As of 01 June 2016 396 products, with all dosage forms taken into account, were marketed in Ukraine, or 155 products without regard to the dosage form. In 2018 the studied pharmaceutical market segment increased significantly. As of 01 June 18 448 products, with all dosage forms taken into account were marketed in Ukraine, or 188 products without regard to the dosage form. Therefore the increment of marketed anti-ulcer drugs quantity indexes was 13.13% (with all dosage forms taken into account) and 21.29% (without regard to the dosage form). In the conditions of absence of effective drug price reimbursement mechanisms the price of the drug becomes the main factor for the motivation of the pharmaceutical services consumers; the price, in its turn, depends on the drug dosage form. That's why, taking into account the development circumstances of the system of pharmaceutical supply for the population in Ukraine, we consider it appropriate to continue the analysis of the drugs assortment by their trade names, with all dosage forms presented on the pharmaceutical market taken into account. For example, in 2016 the proportion (%) of foreign production drugs was 78.79% (312 products), and in 2018 – 79.46% (356 products). The quantity of national drugs has grown from 84 (2016) to 92 (2018). As we can see, despite quantity growth of foreign and national drugs a significant structural change of drug proportion in the totality of anti-ulcer products was not observed. Therefore, we can confirm that Ukrainian market of anti-ulcer drugs stays dependent on the import of pharmaceutical production into the country. On average, there are three foreign products for every product of national production. In 2016 90 pharmaceutical companies presented anti-ulcer drugs on the market, among which 25 were Ukrainian medicinal products manufacturers. In 2018 anti-ulcer drugs were presented on the market by 98 companies (28 Ukrainian ones and 70 companies-manufacturers of medicinal products). Leading positions, as judged by the quantity of marketed drugs, and traditionally for national pharmaceutical market, are taken by the companies from the European Union (EU), first and foremost by the companies from Germany, Slovenia, Bulgaria, Poland, Slovakia and India. It has to be noted that the composition of companies that are leading by the quantity of marketed drugs was quite stable in the years under study. KRKA (Slovenia) is an uncontested leader by the quantity of marketed medicinal products (2016 – 28 products, 2018 – 32 products). The next one is Takeda Pharmaceutical Company Limited (22 TN in 2016 and 23 products in 2018). Traditional for the national pharmaceutical market is the presence of three leading Indian companies, first and foremost, Dr. Reddy's Laboratories (20 products in 2016 and 21 products in 2018). Reckitt Benckiser Healthcare International (United Kingdom) and Bayer Consumer Care (Germany) each present 17 products on the market. Nobel Pharma (Turkey) – 15 products (2016) and 14 products (2018), Balkanpharmaceuticals (Bulgaria) – 11 products (2016) and 10 products (2018), and Slovenian company Lek – 11 products (2016) and 9 products (2018) are also among the leading foreign companies. Consequently, in 2016 eight leading companies (by the quantity of presented products) accounted for 45.19% (141 products), and the rest (65 companies) ‒ for 54.81% (171 products) of imported assortment of anti-ulcer drugs. In 2018 eight leading companies accounted for 40.17% (143 products) of imported assortment of anti-ulcer drugs, and the rest (59.83% or 213 products) of assortment was presented by seventy pharmaceutical companies. This allows us to confirm that the noted segment of the Ukrainian pharmaceutical market is significantly monopolized. The same trend is observed for the national anti-ulcer drugs market segment as well. In 2016 and 2018 seven Ukrainian companies-manufacturers of anti-ulcer drugs accounted for 64.29% (54 products) and 61.54% (56 products) of drugs assortment. Just as in the case with foreign companies, the qualitative composition of national companies that present the most products remained quite stable during 2016-2018. Pharmaceutical company Zdorovye, Arterium Corporation, Farmak JSC, JSC Monfarm, PrJSC Technolog, and PrJSC Pharmaceutical firm Darnitsa present the majority of anti-ulcer drugs on the market. With regard to free competition development on the pharmaceutical market, the discovered decrease of foreign products proportion in the totality of anti-ulcer drugs presented on the market by the leading companies can be assessed as positive.

 

The analysis of structural changes on the market by ІNN of the products and by different levels of АТС classification system became the next stage of our study. The results of conducted studies are presented on the Figure 1. The segment of the pharmaceutical market that presents the anti-ulcer drugs is highly disproportional by the pertaining of drugs to the III level of ATC classification system. The leading positions on this market segment in 2016 and 2018 were consistently taken by the products from the group A02B-Drugs for peptic ulcer and gastro-oesophageal reflux disease (Gord) (Figure 2). Disproportional distribution of drugs can also be observed for the ІV level of product classification. From 396 products that were studied in 2016, 219 (55.30%) medicinal products pertained to the group A02BC-Proton pump inhibitors. In 2018 the noted dependence persists; out of 448 anti-ulcer products 225 (50.22%) product items still pertained to the group A02BC Proton pump inhibitors. Therefore we can confirm that Ukrainian segment of anti-ulcer drugs is consistently characterized by the disproportional drug distribution by the III and IV levels of ATC classification system. Analysis of structural changes of the anti-ulcer drugs assortment in Ukraine by the above noted levels of ATC classification system is given in the Table 2. As we can see, the decrease of proportion of medicinal products from the groups А02А-Antacids and А02Х-Other drugs for acid related disorders in the totality of anti-ulcer drugs was the predominant trend in 2018, in comparison with 2016 data. It has to be noted that the drugs from the group A02BC-Proton pump inhibitors are viewed as the most promising anti-ulcer products, and different aspects of their action and use are studied, primarily the clinical use efficiency parameters during short- and long-term use by the patients. Special attention of scientists is given to the question of use risk assessment for products from the group A02BC-Proton pump inhibitors and to pharmacoeconomic studies using the parameters “consumption cost-efficiency” and “consumption cost-benefit”30,31. In general, out of 10 drug groups (by the IV level of ATC classification system) only products from 2 pharmacotherapeutic groups have shown positive values of structural changes of drug proportion in the totality of anti-ulcer drugs.

 

The next important characteristic of the studied Ukrainian market segment is the constant composition of the five leading medicinal products (by the quantity of marketed drug trade names). Using the data of 2016 and 2018, the first five positions (by the quantity of marketed drugs) were taken by the following names (INN):

А02ВС02-Pantoprazole (2016 – 83 TN or 20.96% of the total quantity of anti-ulcer drugs; 2018 – 86 TN or 19.20%);

А02ВС01-Omeprazole (2016 – 49 TN or 12.37%; 2018 – 52 TN or 11.61%);

А02ВС05-Esomeprazole (2016 – 35 TN or 8.84%; 2018 – 40 TN or 8.93%);

А02ВС03-Lansoprazole (2016 – 30 TN or 7.58%; 2018 – 38 TN or 8.48%);

А02ВD-Combinations for eradication of Helicobacter pylori (2016– 27 TN – 6.82%; 2018 – 31 TN or 6.92%).


 

Figure 1: Change dynamics of anti-ulcer drugs quantity presented on the pharmaceutical market (by the III level of ATC classification system)

 


In general, in 2016 five products by INN accounted for 56.57% (224 TN) of anti-ulcer drugs assortment presented on the national pharmaceutical market. In 2018 the five above-noted drugs by INN accounted for 55.14% of current anti-ulcer drug segment by trade names of medicinal products (247 products). Among the characteristics of the anti-ulcer drugs national market the prevalence of drugs of synthetic origin (2016 – 76.26%, 2018 – 78.13%) and tableted dosage forms (2016 – 231 products or 58.33%; 2018 – 250 products or 55.80%) also has to be noted (fig. 3,4). Uncontested prevalence (2016 – 79.3%; 2018 – 81.69%) of tableted dosage forms (tablets, incl. chewable tablets, capsules) on the pharmaceutical market is caused by distinctive features of anti-ulcer drugs use and by existing approaches to treatment presented in the national medical care delivery protocols for the cases of stomach ulcer disease and duodenal ulcer disease27.

 

Results systematization for the conducted studies is given in the Table 3. As we can see, the highest values  of average retail prices were observed in 2015 (1.62), while the lowest – among the data of the previous year, 2014 (=1.08). Growth of average retail prices by 62.0% in 2015 in comparison with 2014 data is, in our opinion, due to two main factors. Firstly, in 2015 almost three-fold devaluation of the national currency was observed in the country. By the data of the National Bank of Ukraine the official USD exchange rate as of 10 January 2014 was 799.3 hryvnias for 100 USD, and as of 01 June 2014 it was 1177.5 hryvnias (increment of the chain growth index was 47.32%). As of 01 June 2015 the noted index was 2104.82, and as of 01 June 16 – 25414.16 hryvnias for 100 USD32. From 2016, a relative stabilization was observed on the country's financial market, which indirectly influenced the price policy of the distribution and retail sales of anti-ulcer drugs in Ukraine. Devaluation of the national currency continued, but the rate of USD exchange rate growth decreased, and the financial policy in the country became more predictable. In addition to that, miniscule buying power of majority of the population stimulated market operators to implement more flexible price policies on the pharmaceutical market.


 

Figure 2: Change dynamics analysis results for the quantity of anti-ulcer drugs marketed in Ukraine (by the IV level of ATC classification system)

Table 2: Results of structural analysis of anti-ulcer drugs assortment (by the III level of ATC classification system)

ATC classification system code of the drug group

 

Proportion (%) from the total quantity of products

Structural changes of indexes (%)

01.06.2016

01.06.2018

A02A-Antacids

A02AB Aluminium compounds

1.01

1.56

0.55

A02AD Combinations and complexes of aluminium, calcium and magnesium compounds

7.83

8.48

0.65

A02AF Antacids with antiflatulents

4.80

5.13

0.33

A02AX-Antacids, other combinations

5.81

6.25

0.44

Sum

19.45

21.42

1.97

A02B-Drugs for peptic ulcer and gastro-oesophageal reflux disease (Gord)

A02BA H2-receptor antagonists

8.84

8.71

-0.13

A02BB01-Misoprostol

0.25

0.67

0.42

A02BC-Proton pump inhibitors

55.30

50.22

-5.08

A02BD Combinations for eradication of Helicobacter pylori

6.82

6.92

0.1

A02BX-Other drugs for peptic ulcer and gastro-oesophageal reflux disease (GORD)

4.55

5.13

0.58

Sum

75.76

71.65

-4.11

A02X-Other drugs for acid related disorders

A02X-Other drugs for acid related disorders

4.79

6.93

2.14

Sum

4.79

6.93

2.14

Total sum

100.0

100.0

 


Secondly, the national pharmaceutical market in general, and, noticeably, its anti-ulcer segment are dependent on the import of medicinal products into the country. That’s why the process of uncontrollable devaluation of the national currency on the background of the pharmaceutical market dependency on import lead to a fast growth of retail prices of drugs used in the treatment of stomach ulcer. As was already stated, there are no effective programs of drug price reimbursement in Ukraine, and no effective mechanisms of state price regulation for the retail prices of anti-ulcer drugs. Only in April 2017 Ukraine implemented a national program “Available medicines”, which provided drug price reimbursement for the cardiovascular pathology, asthma, and type 2 diabetes mellitus patients33,34. All of the noted factors resulted in the growth of retail drug prices in Ukraine in general, and of retail prices for the anti-ulcer drugs in particular. At the same time it has to be noted that the average retail price growth rates were different for different years. The fact that in 2016 the average retail price growth rates (for anti-ulcer drugs) in Ukraine were decreasing seems positive.

 

 

 

Figure 3: Structural analysis of anti-ulcer drug assortment that’s presented on the Ukrainian pharmaceutical market as of 01 June 2016 (by dosage form)

Figure 4: Results of analysis of anti-ulcer drug assortment that’s presented on the Ukrainian market as of 01 June 2018 (by dosage form)

 

 


For example, avg. of average retail prices was 1.17, while during the next year, 2017, the market has shown again the trend to growth of the noted index up to 1.19 (2017 in comparison with 2016 data) and 1.25 (2018 in comparison with 2017 data). Therefore, we can confirm that during 2015-2018 the average retail prices of anti-ulcer drugs have shown the trend of systematic growth. While characterizing the change of average retail prices indexes (by medicinal products groups), we can state the following. The highest growth of average retail prices during the whole studied period was observed for A02BX13-Alginic acid (avg.=1.37), and the lowest ‒ for A02BC06-Dexlansoprazole (avg.=1.04).

 

In general, for the whole assortment of anti-ulcer drugs we can confirm the tendency towards the growth of average retail prices (avg.=1,23). The exceptions are the data for the following products: A02AB03-Aluminium phosphate for 2016

(=0.92) and 2017 (=0.98), A02AB10-Combinations in 2014 (=0.98), A02AD02-Magaldrate in 2014 (=0.99), A02BC01-Omeprazole in 2013 and 2014 (each =0.99) and A02BX03-Pirenzepine in 2016 (= 0.94), 2017 (= 0.97) and 2018 (= 0.98). It has to be noted that only the A02BX03-Pirenzepine products have shown systematic decrease of average retail prices indexes after their two (and more) fold growth in 2015 (= 2.33).

 

CONCLUSION:

In the structure of the global pharmaceutical market the segment of anti-ulcer drugs belongs to dynamically developing ones35,36. In the top 20 of pharmacotherapeutic groups by the sales volume on the global pharmaceutical market the anti-ulcer drugs take the 13th place36. In 2017 the global market of anti-ulcer drugs was USD 1 million, and in 2018 the growth of this index by 15.0-20.0% is predicted35,36. The national market of anti-ulcer drugs is not an exception. By the results of the conducted studies we outlined the main development characteristics of the abovementioned pharmaceutical market segment. The dynamic development, major prevalence of imported medicinal products, monopolistic position of certain drugs by INN and of certain pharmacotherapeutic groups, systematic, almost 1.5-fold growth of the average retail prices in comparison with 2015 allow us to state the following. A national program of import substitution has to be developed and established in Ukraine for the assortment of medicinal products that are used for treatment of socially significant diseases and those of great socio-economic importance for effective development of state and society in general.


 

Table 3: Results of change dynamics analysis of average retail prices indexes of anti-ulcer drugs in Ukraine during 2013-2018

Medicinal products and their groups by ATC classification

 of average drug retail prices

2013/

2012

2014/

2013

2015/

2014

2016/

2015

2017

2016

2018

2017

avg.

A02AB Aluminium compounds

A02AB03-Aluminium phosphate

1.09

1.24

1.85

0.92

0.98

1.06

1.19

A02AB10-Combinations

1.32

0.98

1.54

1.13

1.16

1.34

1.25

A02AD Combinations and complexes of aluminium, calcium and magnesium compounds

A02AD01-Ordinary salt combinations

1.06

1.04

1.68

1.23

1.09

1.23

1.22

A02AD02-Magaldrate

1.33

0.99

1.27

1.13

1.12

1.11

1.16

A02AF Antacids with antiflatulents

A02AF01-Magaldrate and antiflatulents

1.01

1.22

-

-

1.23

1.28

1.19

A02AF02- Ordinary salt combinations and antiflatulents antiflatulents

1.12

1.13

1.45

1.15

 

1.04

 

1.07

 

1.16

A02AX-Antacids, other combinations

1.02

1.07

1.57

1.16

 

1.34

 

1.23

 

1.23

A02B-Drugs for peptic ulcer and gastro-oesophageal reflux disease (Gord)

A02BA H2-receptor antagonists

A02BA02-Ranitidine

1.13

1.09

1.46

1.21

1.04

1.08

1.17

A02BA03-Famotidine

1.05

1.16

1.81

1.19

1.16

1.21

1.26

A02BB-Prostaglandins

A02BB01-Misoprostol

1.03

1.00

1.38

1.10

1.15

1.19

1.14

A02BC-Proton pump inhibitors

A02BC01-Omeprazole

0.99

0.99

1.63

1.60

1.69

1.78

1.45

A02BC02-Pantoprazole

0.96

1.09

1.75

1.07

1.12

1.21

1.20

A02BC03-Lansoprazole

1.10

1.10

1.34

1.19

1.21

1.23

1.20

A02BC04-Rabeprazole

1.06

1.09

1.84

1.05

1.11

1.15

1.22

A02BC05-Esomeprazole

1.11

0.99

1.56

1.11

1.15

1.37

1.22

A02BC06- Dexlansoprazole

-

-

-

0.93

1.07

1.12

1.04

A02BC53-Lansoprazole, combinations

1.14

1.02

1.55

1.27

1.41

1.34

1.29

A02BD Combinations for eradication of Helicobacter pylori

1.18

0.99

1.46

1.16

 

1.21

 

1.32

 

1.22

A02BX-Other drugs for peptic ulcer and gastro-oesophageal reflux disease (GORD)

A02BX01-Carbenoxolone

1.11

1.11

1.33

1.47

1.25

1.38

1.28

A02BX02-Sucralfate

1.05

1.11

2.21

1.11

1.23

1.31

1.34

A02BX03-Pirenzepine

1.03

1.16

2.33

0.94

0.97

0.98

1.24

A02BX05-Bismuth subcitrate

1.05

1.10

1.76

1.10

1.03

1.09

1.19

A02BX13-Alginic acid

1.09

1.12

1.46

1.49

1.51

1.56

1.37

A02X-Other drugs for acid related disorders

1.04

1.14

1.50

1.21

1.23

1.41

1.26

Average indexes values

1.09

1.08

1.62

1.17

1.19

1.25

1.23

 


In some degree stomach ulcer disease can be treated as one of such diseases. The question of national assortment of anti-ulcer drugs expansion becomes even more socially important in the context of the gathered data for the change dynamics of average retail price values. The presence of consistent dynamics of growth of average retail prices for almost all of the assortment of drugs makes the efficiency of treatment-and-prophylactic process organization for the stomach ulcer disease patients doubtful, with regard to the low income of the population and the absence of effective mechanisms of drug price reimbursement in the country.

 

AUTHOR CONTRIBUTIONS:

Based on the analysis of the work conducted and also on the order of study results processing we can state the following. All of the authors made equal contributions to the justification of study direction, development of research design, determination of the goal, object and description of research methods. The authors took equal parts in gathering and processing of statistical material, carrying out of research, writing and editing of the paper, and also composing and styling of the references list in accordance with requirements.

 

CONFLICT OF INTEREST STATEMENT:

The authors declare that they have no conflict of interest to disclose.

 

REFERENCES:

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Received on 11.06.2019           Modified on 21.11.2019

Accepted on 02.03.2020         © RJPT All right reserved

Research J. Pharm. and Tech. 2021; 14(5):2502-2510.

DOI: 10.52711/0974-360X.2021.00441