MARKETING ANALYSIS OF THE DRUGS USED FOR THE TREATMENT OF AFFECTED MILITARY MEN WITH BRAIN INJURIES

During the research the comparative analysis of protocols of medical care for patients with brain injuries and information of scientific literature and evidence-based medicine has been conducted. It has demonstrated that for the treatment of affected military men with brain injury the following groups of drugs are used: antibacterial agents for systemic use, psychoanaleptics, blood substitutes and perfusion solutions, antiepileptics, vitamins, peripheral vasodilators, cardiac drugs, calcium channel blockers, analgesics, antihemorrhagic drugs, drugs for treating wounds and ulcers, diuretics, antithrombotic agents, antiparkinsonian drugs, psycholeptics, vasoprotectives, beta adrenoreceptor antagonists, etc. Marketing analysis of certain groups of drugs has been conducted according to the following criteria: legal (registration in Ukraine), economic (commercial: country, company), pharmaceutical (types of dosage forms, the composition of active substances, method of application), pharmacotherapeutic (ATC-classification). The analysis of the domestic pharmaceutical market has shown that drugs for treatment of head injuries comprise 1034 drugs manufactured in 39 countries. It has been found that the Ukrainian producers are able to provide the necessary level of rendering medical care in treatment of the traumatic brain injury, they produce 549 names of drugs, and it is almost 53% of the total range of medicines. The first place among the Ukrainian companies manufacturing drugs for treatment of the brain injury has “Darnitsa pharmaceutical company” JSC, the second one – “Yuriа-Farm” Ltd., the third place – Pharmaceutical company “Zdorovye” Ltd. Foreign producers supply 485 drugs (47%). The leaders are India, Germany and Slovenia, which take the first, second and third places in the import of drugs, respectively.

Modern principles of qualitative medical care are associated with unification and standardization of the medical technologies, and it fully regards to drug provision of affected military men with with brain injuries. The introduction of standardized schemes of diagnosis and treatment in traumatic brain injury helps to reduce the fatality rate from 38 to 23% [6,9,14,17]. At present recommendations only for sections of hyperventilation and anticonvulsant therapy have been formulated at the level of standards, but other effective methods of pharmacotherapy of patients with brain injuries directed to correction of homeostasis, stabilization of the function of cell membranes of neurons and glial cells, reduction of the harmful effects of hypoxia on the structure of the brain, stimulation of redox processes, intensification of oxygen and glucose utilization are fixed at the level of options [7,10,12,16,17]. There is also no research concerning generalization and systematization of the information about medicines used for drug therapy of military men with brain injuries. Therefore, development and introduction of formulary lists of drugs for treating the traumatic brain injury is relevant.

Materials and Methods
During analysis the research materials were data of protocols of medical care for patients with brain injuries, information of scientific literature and evidencebased medicine [1]. For analysis of groups of drugs the system-overview and marketing methods have been used. When conducting marketing analysis the following groups of parameters were used: 1) legal (registration in Ukraine), 2) economic (commercial: country, company), 3) pharmaceutical (types of dosage forms, the composition of active substances, method of application), 4) pharmacotherapeutic (ATC-classification, the mechanism of action) [5].

Results and Discussion
In order to standardize the provision of medical care, implementation of modern methods of diagnosis and treatment of brain injuries into the activities of medical preventive institutions, as well as the quality control of medical care, in 1998 the standards of medical care for victims of brain injury were developed, in 2004 the guidance "Modern principles of diagnosis and treatment of patients with urgent neurosurgical disorders (traumatic brain injury)" was writen, and in 2006 twelve protocols of rendering medical care in the specialty "Neurosurgery" were approved, in them the main directions of drug therapy of patients and pharmacological groups of drugs were determined [1,3,4]. However, when assessing the possibilities of practical use of protocols at the hospital level it has been found that they have no specific lists of drugs.
The rational selection of drugs to these lists can be made using the methods of pharmacoeconomic analysis; the first step is determining the basic pharmacological groups of drugs used to treat brain injuries, followed by carrying out marketing analysis of the given drugs. For this purpose the treatment protocols are analyzed, and the data of scientific literature and evidence-based medicine are systematized.
According to the protocols of medical care in the specialty "Neurosurgery" for treating patients with brain injuries the following groups of drugs are used. They are psychoanaleptics (N06), blood substitutes and perfusion solutions (B05), peripheral vasodilators (С04), calcium channel blockers (С08), analgesics (N02) and psycholeptics (N05); their use can provide only the minimum level of the necessary drug aid to the injured military men with brain injuries. They do not consider other group of drugs that are able to provide a higher level of care. Therefore, we decided to conduct the mar-keting analysis of all groups of drugs that could be used in the treatment of the traumatic brain injury [2,8,10,11,13,15,18,19] (Fig. 1).
The analysis of the domestic pharmaceutical market as of 01/12/2013 showed that the aforementioned pharmacotherapeutical groups of drugs comprised 1034 drugs manufactured in 39 countries.
Ukraine produces 549 names of drugs, and it is almost 53% of the total range of medicines. The first place among the Ukrainian companies manufacturing drugs for treatment of the brain injury has "Darnitsa pharmaceutical company" JSC, the second one -"Yuriа-Farm" Ltd., the third place -Pharmaceutical company "Zdorovye" Ltd., the fourth one -"Kyivmedpreparat" PJSC, the fifth place -Scientific-Production Centre Borshchahivskiy Chemical-Pharmaceutical  Plant PLC, which supply 62, 37, 30, 26 and 23 medicines, respectively, and it is 17% of the total assortment (Fig. 2). Foreign producers supply 485 drugs (47%). The leader is India that provides the domestic market with 91 drugs, Germany and Slovenia take the second and third places in the import of drugs with 55 and 35 drugs, respectively (Fig. 3).
Next we analyzed drugs by dosage forms (Table). Approximately 49% of drugs are produced in the peroral forms, such as tablets, capsules, powders and solutions for oral use, syrups and pills. Dosage forms for injections are second -48%. These drugs include solutions for injections and infusions, powders and concentrates for preparation of injections and infusions. Almost 3% of the total assortment are solutions for oral use, powders for preparation of suspensions, drops, etc.

CONCLUSIONS
As a result of market research, we can conclude that the Ukrainian firms produce a sufficient number of medicines: 60 producers supply 549 types of drugs to the domestic pharmaceutical market, and it is sufficient to meet the needs of the affected military men with brain injuries in drugs.