Journal «MEDICINA» 2/2013

This Perspective describes (a) the current situation, (b) challenges and initiatives, (c) and formulates recommendations to valorize and create access to innovative medicines in the EU. We are currently still far away from optimal assessment of value for money in the EU. On the one hand, valorizing innovative medicines involves a local appraisal by health technology assessment (HTA) bodies and competent authorities about the value for money, the budget impact, and the local medical need that can be filled with new medicines. Therefore, local priorities and national health care policy environments should be reflected in the processes and criteria used for assessing value for money and ultimately for reimbursement decisions. On the other hand, a pan-European assessment of both relative effectiveness and medical need (including general ethical and social considerations) should be envisaged in order to feed part of the data needed for the local decisions in an efficient way. This could be the task of the European Medicines Agency, HTA bodies, and competent authorities together.

Key words: pharmaceutical innovation, health technology assessment, cost–effectiveness, relative effectiveness, budget impact, medical need, access

Birth rates, maternal and child mortality are often viewed as means of improving demographic situation and economic potential of a country. However in Russian case this is unlikely to be the case. Birth rates fluctuation seen in the last 25 years are the result of a series of social and political changes, while the measures to increase fertility do not seem to have significant effect. Maternal mortality is very low and doe not exceed 300 cases per annum. Perinatal mortality constituting 2/3 of all child deaths is not much higher than in the developed world. Abortions rates remain relatively high, however this indicator is also improving. While investment in maternal and child health are needed to bring health of these groups to the developed countries level, this will not change demographic situation needed to drive modernized economy.

Key words: reproductive health, birthrate, Russia, perinatal mortality, maternal mortality, demographic situation, abortions

The article states that even the use of simple STIs models can facilitate the estimations of the epidemic rate, specify its course and outline the corresponding prevention strategy.

Key words: STI, mathematical modeling, public health, epidemiology, infection, model

The author discusses the current state and prospects of development of national health care in view of recently developed by an expert group «Basic Principles for Health Strategy in the Russian Federation»

Key words: health care strategy, Russian Federation, interdepartamentary approach, compulsory health insurance, budgetary medicine

The paper assessed the level of knowledge about the transmission and prevention of HIV infection of Roma groups from the two regions of the Russian Federation. It concludes that intravenous drug use was prevalent only among respondents in Pskov, where a quarter of the respondents reported the practise. It is stated that the interviewed group has serious social and economic problems – poor education, high unemployment, but has a relatively high level of knowledge about HIV, and in Tver – a relatively favorable risk profile (a small number of sexual partners, low levels of mobility and drug use).

Key words: STI, HIV, community, sexual behavior, interview, drugs, socio-economic problems, high risk behavior