ANALYSIS OF MEDICINES FOR SYMPTOMATIC TREATMENT OF HEADACHE

Abstract

The order of the Ministry of Health (MOH) of Ukraine No. 7 in January 2022 approved the Pharmacist Protocols for the dispensing of medicines (Ms) without a prescription, in particular for “Symptomatic treatment of headache (HA)”. The purpose of this study was to conduct a marketing analysis of Ms for the symptomatic treatment of HA. The objects of the study were pharmaceutical, regulatory and marketing information about Ms for the symptomatic treatment of HA, their assortment and price characteristics. The State Register of Medicines of Ukraine (SRMU), the Pharmacist’s Protocol for dispensing over-the-counter (OTC) Ms for the symptomatic treatment of HA (hereinafter referred to as the Protocol), and data from the tabletki.ua web resource were used as sources of information. Methods of information search, generalization, comparative and marketing analysis, and system analysis of the data set (literary data and results of our own research) were used. A wide range of Ms is used for the symptomatic treatment of HA, among which the Protocol includes a list of such Ms that are available without a prescription: analgesics and antipyretics; non-steroidal anti-inflammatory and antirheumatic drugs. The analysis of SRMU regarding the availability of over-the-counter drugs for HAB showed that the leaders are paracetamol (241 drugs) and ibuprofen (131 drugs). Combined Ms containing several active substances are also widely represented (97 drugs). Marketing analysis showed that the cost of treatment with nimesulide (leader of the top 20 Ms) can vary significantly depending on the manufacturer, dosage and form of release. Tablets are usually cheaper than granules. Domestic manufacturers offer a wider range of drugs and lower prices. Conclusion. 1) On the basis of the analysis of the data of SRMU as of March 2024, it was established that the most OTC drugs for the symptomatic treatment of HA are analgesics and antipyretics – 351 drugs and NSAIDs – 160 drugs. 2) Among the top 20 drugs by volume of sales in Ukraine (2023) there are 5 drugs that can be used for HA (according to the instructions for medical use): Nimesyl, Nurofen, Citramon, No-shpa, and Fervex. The results of the marketing analysis of these drugs regarding the dosage forms and manufacturers (according to the SRMU), as well as their presence on the Lviv market (according to the tabletki.ua website) as of November 20, 2023 are as follows: Nimesyl has one dosage form, while the rest Ms – from 4 (No-shpa, Fervex) to 15 (Nurofen); 3 out of 5 drugs are produced by only one manufacturer (Nimesyl, Nurofen, Fervex); the market leaders are Citramon and No-shpa (412 and 411 pharmacies, respectively). A high level of competition on the local market is inherent in Nurofen and Fervex (Cliq – 0.40 and 0.46, respectively). 3) As a result of the study of the marketing characteristics of nimesulide drugs and their economic evaluation based on the cost of a daily dose (DDD), it was established that there are 27 nimesulide preparations for oral use (as of 04/01/2024) in SRMU, but there are only 21 drugs on the market (according to the website tabletki.ua). The most represented in Lviv pharmacies is Nimid, tablet. (available in 421 pharmacies). The minimum price of tablets ranges from UAH 23.07 per blister to UAH 47.35. The cost of a similar number of sachets with granules for preparing a suspension varies between UAH 80.20 and UAH 149.00. The DDD price for nimesulide tablets ranges from UAH 4.34 to UAH 14.79, and for sachets – from UAH 16.04 to UAH 38.37. In total, 6 tablets of nimesulide (28.6% of the studied drugs) have a DDD cost of up to UAH 10.00 per RPmin and RPmax: Nimid, Nimesulide, Nimelgan, Nimedar, Remesulide, Nimid Forte, and 5 tablets in the form of granules (26.3%) for preparations of suspension have DDD from UAH 20.00 to 30.00: Affida-fort-Nimesulid (No.1), Nimesulid, Daimysil, Dolorsil, Remisar. Drugs of domestic production predominate (17 out of 21 drugs, 81.0%). When buying a package with a larger number of doses of drugs, the savings at the DDD level ranges from 15.2% to 35.1%.