Pharmacoeconomics: Open Access

Geriatric depression, a prevalent and often underdiagnosed mental health condition in older adults, poses significant challenges for healthcare systems globally. It is not merely a natural consequence of aging but a complex interplay of biological, psychological, and social factors that can severely impact the quality of life in older populations. Addressing geriatric depression requires a nuanced understanding of its unique manifestations and the adoption of innovative approaches tailored to the specific needs of this age group. The integration of personalized medicine and age-appropriate therapeutic strategies offers a promising path forward, albeit one fraught with challenges that must be carefully navigated. Older adults often present with atypical symptoms of depression, making accurate diagnosis a primary challenge. Instead of the classical symptoms like persistent sadness or loss of interest, they may exhibit physical complaints such as fatigue, sleep disturbances, or chronic pain, which can be mistakenly attributed to normal aging or comorbid physical illnesses. Cognitive impairments, which are common in the elderly, further complicate the diagnostic process. Depression in older adults is frequently overshadowed by conditions such as dementia, cardiovascular diseases, or arthritis, leading to a phenomenon often referred to as "diagnostic overshadowing." Consequently, healthcare providers must be vigilant in identifying subtle signs of depression and employ comprehensive screening tools specifically designed for older populations.

The study of oxidative stress biomarkers in patients undergoing ant tuberculosis treatment provides valuable insights into the complex biological changes occurring during the therapeutic process. Oxidative stress refers to the imbalance between the productions of reactive oxygen species and the body’s ability to detoxify these harmful molecules or repair the damage they cause. In the context of tuberculosis, oxidative stress has been implicated in the disease's pathogenesis, affecting both the infection itself and the subsequent healing process during treatment. This pilot study aimed to investigate the variations in serum oxidative stress biomarkers in patients receiving first-line antituberculosis therapy, contributing to a deeper understanding of how such therapies influence the body’s oxidative status. Tuberculosis remains one of the leading infectious diseases globally, primarily affecting the lungs but capable of impacting other organs.

The COVID-19 pandemic has profoundly affected global healthcare systems, reshaping treatment protocols and altering the dynamics of pharmaceutical consumption and expenditure. Among the therapeutic areas impacted, the use of anticoagulants has seen significant shifts due to the pandemic's thromboembolic complications and their management. In Russia, the consumption and expenditure of direct oral anticoagulants provide a compelling case study of how clinical needs and policy decisions intersect during a global health crisis.

The study of biomarkers in faecal samples, such as zonulin and calprotectin, has provided critical insights into gut health and immune system activity during early childhood. Zonulin is a regulator of intestinal permeability, while calprotectin is a marker of intestinal inflammation. Monitoring these biomarkers during the first two years of life offers an opportunity to understand how gut health develops in healthy children, shedding light on normal physiological changes and potential early indicators of gastrointestinal disorders. This observational prospective cohort study aimed to evaluate the concentrations of faecal zonulin and calprotectin in healthy children throughout their first two years of life, providing a baseline for normal levels and patterns over time. The first two years of life are marked by rapid changes in a child’s physiology, particularly in the gastrointestinal system. During this period, the gut undergoes significant development, influenced by factors such as diet transitions, microbial colonization, and immune system maturation. Zonulin, a protein linked to the regulation of tight junctions between intestinal epithelial cells, plays a key role in maintaining the gut barrier. Its dysregulation can lead to increased intestinal permeability, often referred to as "leaky gut," which has been associated with various conditions, including allergies, autoimmune disorders, and gastrointestinal diseases.

The evaluation of the cost-effectiveness and cost-utility of Palbociclib and Ribociclib in the treatment of women with stage IV breast cancer, using real-world data, is crucial in understanding the value these treatments provide within a clinical and economic context. Stage IV breast cancer, also known as metastatic breast cancer, presents one of the most significant challenges in oncology due to its advanced progression and the complexity of treatment options. In recent years, targeted therapies such as Palbociclib and Ribociclib, both of which are cycling-dependent kinase inhibitors, have been introduced as promising options for treating HR-positive, HER2-negative metastatic breast cancer. These therapies, however, come with high costs, raising questions about their value in terms of both clinical outcomes and economic implications

The treatment of schizophrenia has evolved significantly over the years, with neuropsychopharmacological interventions remaining central to symptom management and improving patient outcomes. Schizophrenia, a complex and chronic psychiatric disorder, affects millions of individuals worldwide, posing significant challenges for healthcare systems, patients, and caregivers alike. The condition is characterized by symptoms such as delusions, hallucinations, disorganized thinking, and impaired cognitive functioning, necessitating a multifaceted therapeutic approach. This scoping review examines global trends in the prescription of neuropsychopharmacological agents for adults with schizophrenia, explores associated clinical correlates, and discusses the implications for clinical practice. Across the globe, antipsychotic medications serve as the cornerstone of schizophrenia treatment. These drugs are broadly categorized into two classes: typical (first-generation) and atypical (secondgeneration) antipsychotics.

Persistence, defined as the duration of time a patient continues to take a prescribed medication without discontinuation, is increasingly recognized as a critical indicator of medication adherence. Adherence encompasses not only whether a patient takes their medication as prescribed but also the consistency and duration over which they do so. Among the various metrics used to evaluate adherence, persistence stands out as a particularly robust measure because it provides a temporal dimension, reflecting the sustained commitment of patients to their therapeutic regimens. This focus on persistence offers unique insights into adherence-related quality and performance, shedding light on the challenges and opportunities in optimizing long-term medication use. Medication adherence is a cornerstone of effective treatment for chronic diseases, influencing clinical outcomes, healthcare costs, and patient quality of life.

The use of utility values in pharmacoeconomic evaluations plays a crucial role in determining the cost-effectiveness of treatments, particularly in chronic and debilitating conditions like schizophrenia. Utility values represent the preferences for different health states, often quantified on a scale where 0 represents death and 1 represents perfect health. These values are essential in calculating quality-adjusted life years, a key measure used in cost-utility analyses to assess the value of medical interventions. In the context of schizophrenia, a condition characterized by profound impacts on mental health, functioning, and quality of life, utility values are central to understanding the trade-offs between treatment costs and patient outcomes [1]. This systematic review examines the utility values used in pharmacoeconomic evaluations for schizophrenia, highlighting their implications on cost-effectiveness results. Schizophrenia is a severe mental disorder that affects millions of individuals worldwide, imposing significant personal, societal, and economic burdens. Treatments for schizophrenia include antipsychotic medications, psychosocial interventions, and support services, all of which aim to alleviate symptoms, improve functioning, and enhance quality of life.

The relationship between socio-demographic factors, lifestyle choices, and psychiatric indicators on treatment adherence in patients with rheumatoid arthritis is a growing area of interest. Rheumatoid arthritis, a chronic autoimmune disease characterized by persistent inflammation of the joints, can lead to long-term disability if not adequately managed. Effective treatment requires consistent adherence to prescribed regimens, which often include medications, physical therapy, and lifestyle modifications. However, adherence rates among RA patients remain suboptimal, influenced by a complex interplay of personal, social, and psychological factors. Socio-demographic characteristics, such as age, gender, education, income, and employment status, play a crucial role in shaping treatment adherence [1]. Older patients, for instance, may experience greater challenges in following treatment regimens due to comorbidities, cognitive decline, or physical limitations. Conversely, younger individuals might struggle with adherence due to their perception of invulnerability, busier lifestyles, or financial constraints. Gender differences have also been observed, with women often reporting better adherence due to their tendency to engage more actively in health-related behaviors.

Osteoporosis is a prevalent metabolic bone disorder characterized by reduced bone mass and structural deterioration, leading to increased fracture risk. It predominantly affects postmenopausal women due to the sharp decline in estrogen levels, which accelerates bone resorption. Identifying biomarkers that can predict the development and progression of osteoporosis is critical for early diagnosis and targeted therapeutic interventions. Among the numerous candidate genes, the osteoprotegerin gene has emerged as a potential biomarker due to its pivotal role in regulating bone metabolism. Osteoprotegerin, a glycoprotein encoded by the TNFRSF11B gene, functions as a decoy receptor for the receptor activator of nuclear factor kappa-Β ligand. RANKL is a critical mediator of osteoclast differentiation and activation, promoting bone resorption.