Assessment of the need for financial provision of pharmacotherapy for anemia in patients with malignant neoplasms through funds from compulsory medical insurance

Aim: To evaluate the economic feasibility of reimbursing healthcare organizations for the costs of pharmacotherapy for anemia associated with malignant neoplasms during the period of antitumor pharmacotherapy and to propose mechanisms for its financial provision through funds from compulsory medical insurance.

Materials and methods: А retrospective economic evaluation was conducted in 13 federal subjects of the Russian Federation, assessing various treatment options for anemia associated with malignant neoplasms in terms of financial expenditures for subsequent medical care delivery. This evaluation determined the effectiveness of anemia treatment based on prevented complications (predictable consequences of progression, including hypoxia, ischemia of organs and tissues, and reduced efficiency of pharmacotherapy), which require insurance coverage through funds from compulsory medical insurance.

Results: The estimated costs for procuring erythropoiesis-stimulating agents range from 597.4 million rubles per year to 668.2 million rubles per year. Due to the savings achieved by eliminating the need for insurance coverage to compensate for the costs of treating anemia associated with malignant neoplasms following anticancer drug therapy (prevented insurance cases), a return on investment of 35.0 % is projected within the first 12 months, and 101.7 % within 36 months.

Conclusions: The introduction of a separate payment method for medical care, which would enable reimbursement of costs for treating anemia associated with malignant neoplasms concurrently with antitumor pharmacotherapy for each administration of erythropoiesis-stimulating agents, is justified by a prognostic calculation indicating full cost recovery for the procurement of such agents over a 3-year observation period.

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