PHARMACOECONOMIC EFFECTIVENESS OF THERAPY FOR RECURRENT BACTERIAL VAGINOSIS IN WOMEN WITH ASYMPTOMATIC SHEDDING OF HERPES SIMPLEX VIRUS

Introduction. The presence of the herpes simplex virus (HSV) type 2 in the body increases the likelihood of developing bacterial vaginosis (BV) by 1.6 times. This creates a serious problem given the high prevalence of HSV among the population. Relapses of the disease within a year after treatment occur in 70% of women with BV. Aim of the research. To evaluate the pharmacological and economic effectiveness of a combination of an an-tibiotic and a topical immunomodulator for the treatment of recurrent BV (RBV) in women with asymptomatic HSV shedding. Materials and methods. 80 women of reproductive age with RBV and asymptomatic HSV shedding were randomized into two groups (n = 40 each). Group 1 received antibacterial therapy and a local immunomodulator (a complex of natural antimicrobial peptides and cytokines), group 2 – only an antibiotic. Group 3 (n = 20) included conditionally healthy women. Cost-effectiveness analysis was performed with calculation of the incremental coefficient. When determining the cost of BV treatment, the total costs of the main and additional courses of treatment were taken into account (depending on the number of relapses within 12 months in each group). A negative difference in coefficients indicated that the first treatment option was more cost-effective and vice versa. Results. The highest effectiveness was observed in the group of patients receiving combination therapy, in-cluding a complex of natural antimicrobial peptides and cytokines and clindamycin. The effectiveness of treatment in group 1 was characterized by recovery in 95% of patients and 100% microbiological effectiveness, a relapse-free period for a year in 87.5% of patients and a 3.3-fold decrease in the risk of developing recurrent episodes of BV. The costs of treatment in the group receiving immunomodulatory therapy were lower by 242 rubles per unit of effect. Conclusion. A complex of natural antimicrobial peptides and cytokines in combination with antibacterial therapy has clinical and pharmacoeconomic advantages compared to antibiotic monotherapy.