OBJECTIVES: To determine the preferential scheme of medical therapy in perioperative management of cardiac surgery patients with extracorporeal circulation, with ischemic heart disease or with chronic heart insufficiency from the point of view of pharmacoeconomic analysis with the use of standard therapy in comparison with standard therapy + phosphocreatine.

METHODS: The developed pharmacoeconomic model was based on the results of meta-analysis of Landoni G. and co-authors, and an open-label non-interventional comparative study by FSBI A.N. Bakoulev Scientific Center of the MOH of Russia. Final result of the cost analysis included the direct expenses associated with complications due to the surgery. The time horizon was 1 year.

RESULTS: Use of phosphocreatine in perioperative management of cardiac surgery patients has led to the higher values of LYG in comparison with the use of standard therapy and is more efficient as a result of improvement of such parameters as: frequency of myocardial infarction cases, frequency of arrhythmia cases, the need in inotropic therapy, the need to stay in emergency department and the number of inpatient days. In case of the standard therapy + phosphocratine, the values of LYG constituted 0.96 years, and in case of the standard therapy – 0.88 years. The cost of a 12-months treatment with standard therapy and with standard therapy + phosphocreatine constituted 83,566 rubles and 75,337 rubles respectively. Cost-effectiveness analysis reveals that the cost-effectiveness ratio in the group of standard therapy + phosphocreatine constitutes 78,444 rubles, whereas in the group of standard therapy – 95,176 rubles.

CONCLUSIONS: Insignificant increase of the standard therapy cost by adding phosphocreatine makes it possible to prevent perioperative complications and mortality of cardiac surgery patients, is cost saving and make expenses efficient. Standard therapy + phosphocreatine is a dominant treatment method in comparison with the standard therapy.