Analysis of the pharmaceutical market for topical pain relief drugs

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Introduction

The article analyzes the market of nonsteroidal anti-inflammatory drugs (NSAIDs), which are used to treat diseases of the musculoskeletal system. The listed diseases include lumbago, osteoarthritis and osteochondrosis, arthralgia, myalgia, spondylitis, Bechterew's disease, jaw fractures, gonarthrosis and others.

All diseases of the musculoskeletal system are characterized by the development of chronic pain syndrome, the most common cause of which is the presence of chronic inflammation of the synovial membrane.

NSAIDs are the most frequently prescribed drugs in the treatment of chronic joint pathology and are also used to relieve acute pain syndrome [1].

The main effects of NSAIDs on the human body include analgesic, anti-inflammatory and antipyretic effects [2]. It is known that the main element of the mechanism of action of NSAIDs is the inhibition of the synthesis of prostaglandins (PG) from arachidonic acid by inhibiting the enzyme cyclooxygenase (COX) [3]. The most common adverse drug reactions can be gastric and duodenal ulcers, gastrointestinal bleeding, renal dysfunction and blood diseases (anemia, leukopenia) [4, 5, 6].

Purpose of the study– assessment of the pharmaceutical market of non-steroidal anti-inflammatory drugs and their availability to patients in real clinical practice.

Research results- There are 11 international nonproprietary names (INN) on the Russian pharmaceutical market: aceclofenac, benzydamine, diclofenac, ibuprofen, indomethacin, ketoprofen, ketorolac, meloxicam, nimesulide, piroxicam, phenylbutazone and 91 trade names (TN) of NSAID drugs.

An analysis of manufacturers of finished dosage forms (DF) of drugs registered in the Russian Federation showed that Russia occupies a leading position (52.7%), Germany (9.9%), India (9.9%), Bulgaria (7.7%), Italy (4.4%); Turkey and North Macedonia (2.2%); while Hungary, Serbia, Switzerland, Japan, France, Great Britain, Korea and Poland are represented significantly less - approximately equally, 1.1% each.

In studying the market accessibility, the study analyzed the websites "I'm at the Pharmacy" and "Apteka.ru", which present 84 drugs (93.63%). Drugs that are not on the websites: "Lorangin" - a dosed spray for local use, "Inlartex" - a dosed spray for local use, "Ibuprofen" - rectal suppositories, "Indomethacin 100 Berlin-Chemie" - rectal suppositories, "Indomethacin 50 Berlin-Chemie" - rectal suppositories, "Nimesulide Forte" - gel for external use, "Ambenium Trivium" - ointment for external use.

To draw a conclusion about the prevalence of drugs, for each INN, trade names presented in most pharmacies in the Voronezh region were determined. Thus, the most popular was "Dolgitblok" (Ibuprofen), presented in 198 pharmacies, then "Indomethacin" (Indomethacin) - in 192 pharmacies, "Diclofenac Altpharm" (Diclofenac) - in 189 pharmacies, "Teraflex Hondrocream" (Meloxicam) - in 176 pharmacies, "Oralsept" (Benzidamine) - in 173 pharmacies, "Fastum" (Ketoprofen) - in 167 pharmacies, "Nise Activegel" (Nimesulide) - in 154 pharmacies, "Aertal" (Aceclofenac) - in 153 pharmacies, "Ketorol" (Ketorolac) - in 75 pharmacies, "Butadion" (Phenylbutazone) - in 6 pharmacies, "Piroxicam" (Piroxicam) – in 3 pharmacies.

Average cost of a 10-day coursetreatment with piroxicam - 60 rubles, ibuprofen - 280 rubles, aceclofenac - 384 rubles, benzydamines - 424 rubles (for 7 days), ketorolac - 430 rubles, indomethacin - 448 rubles, phenylbutazone - 460 rubles, nimesulide - 462 rubles, meloxicam - 507 rubles, ketoprofen - 524 rubles, diclofenac - 528 rubles. The spread in the cost of a 10-day course of treatment from 60 rubles to 528 rubles is primarily due to the manufacturer and the crap that is involved in the production of the drug.

At the time of the study, it turned out that 47 drugs out of 91 presented on the market are available on the Ozon marketplace, which is a significant share (52%). This fact emphasizes that Ozon acts as an important distribution channel for consumers who need to quickly and conveniently purchase the necessary medications. Piroxicam and phenylbutazone are completely absent from the marketplace.

Table 1

Pharmaceutical market of NSAIDs in the Voronezh region

INN	TN	Country of origin	Dosage form	Number of pharmacies where the drug is available
Ibuprofen	Dolgitblock	Germany	Gel	198
Indomethacin	Indomethacin	Russia	Ointment	192
Diclofenac	Diclofenac Altpharm	Russia	Rectal suppositories	189
Meloxicam	Teraflex Hondrocream	Russia	Cream	176
Benzydamine	Oralsept	S. Macedonia	Spray	173
Ketoprofen	Fastum	Italy	Gel	167
Nimesulide	Nise Activegel	India	Gel	154
Aceclofenac	Aertal	Hungary	Cream	153
Ketorolac	Ketorol	India	Cream	75
Pheniobutazone	Butadion	Russia	Ointment	6
Piroxicam	Piroxicam	Russia	Gel	3

 

Analyzing the nature of the dosage forms presented on the pharmaceutical market, it turned out that the majority of drugs (51.6%) are presented in the form of a gel, 15.4% - sprays, 15.3% - suppositories, 6.7% - creams, 5.5% - ointments, 3.3% - solutions for local use, 2.2% - transdermal patches.

As part of the study, a survey of patients hospitalized in the hospital - ChUZ KB "RZhD-Medicine" in Voronezh was conducted to assess real clinical practice. The survey was carried out in the departments of pulmonology, gastroenterology, cardiology, neurology, medical rehabilitation, rheumatology and endocrinology. 68 respondents took part in the survey, which made it possible to consider the data obtained sufficient to assess the use of NSAIDs in various groups of patients. The age from 46 to 60 years made up the majority of the presented group (83%).

In terms of social status, the majority of patients were employed (66.2%) and pensioners (38.2%).

The most frequently used drugs were: Nimesulide (43.1%), Diclofenac (33.3%), Ibuprofen (33.3%) and Ketoprofen (31.4%). The indications for the use of NSAIDs were mainly joint pain (58.3%) and back pain (64.6%).

Regarding the question of the effectiveness of the analgesic effect of the drug, patients noted it as moderate (67.9%) and high (21.4%).

Knowledge of possible risks and contraindications for the use of NSAIDs was present in 71% of respondents. The drugs were used to relieve pain (71%), but 81% of respondents had abdominal pain after taking the drugs.

Patients purchased the drug based on a doctor's recommendation (75.8%) and independent choice (15.2%). The decisive factors in choosing a drug were efficacy (75.8%), safety (30.3%) and cost (24.2%).

The guarantee of quality when choosing a drug was the drug's fame (62.1%), domestic production (20.7%) or foreign production (17.2%). When answering the questionnaire, 95.5% of respondents answered that they study the instructions before taking drugs.

Thus, the results of the study demonstrate a wide range of available dosage forms and the diverse practice of using NSAIDs for pain relief.

In the future, it is necessary to continue studying the dynamics of NSAID consumption and the specifics of their use in accordance with the needs of different population groups, aiming to improve the quality of medical care and maintain the health of patients.

About the authors

Daria Victorovna Ozerova

Voronezh State Medical University named after N. N. Burdenko

Email: d.korina2013@yandex.ru
ORCID iD: 0000-0002-5385-8559
SPIN-code: 4614-4345

4th year student of the Faculty of Pharmacy

Russian Federation, 394036, Russia, Voronezh, st. Studencheskaya, 10

Anastasia Vitalyevna Davidyuk

Voronezh State Medical University named after N. N. Burdenko

Author for correspondence.
Email: anastasiadavidyuk@yandex.ru
ORCID iD: 0009-0000-0320-5819

4th year student of the Faculty of Pharmacy

 

Russian Federation, 394036, Russia, Voronezh, st. Studencheskaya, 10

References

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