Marketing study of selective serotonin reuptake inhibitors for the treatment of post-traumatic stress disorder in military servants and war veterans

Abstract

The aim of the work: to present the results of a marketing study of medicinal products of the ATC classification group N06AB "Selective serotonin reuptake inhibitors" (SSRIs) in terms of registration and legal status, the state of the wholesale and retail market, presence in socio-economic regulatory lists of medicinal products, as well as to evaluate the results of an anonymous survey of doctors regarding the prescription of SSRIs to military personnel and war veterans with post-traumatic stress disorder (PTSD).

Materials and methods. Methods such as analysis, synthesis, comparison, specification, systematization, generalization, and reliability assessment were used; an anonymous survey of 35 psychiatrists and 25 neurologists was conducted regarding the prescription of drugs for patients with PTSD.

Results and discussion. It was found that SSRIs should be considered as first-line pharmacotherapy for military personnel with PTSD. At the same time, escitalopram, which, according to the literature, demonstrates the best safety and efficacy indicators, which was preferred by 97% of the surveyed doctors, the market of which showed the greatest growth in terms of assortment and which was most numerously included in the List of Drugs Subject to Reimbursement, remains absent from the updated Unified Clinical Protocol for the Treatment of PTSD.

Conclusions. 100% of doctors confirmed the choice of SSRIs, among which, with a probability of type I error α = 0.05, a reliable probability of p ≥ 0.95 regarding the unanimity of responses, psychiatrists most often prescribed escitalopram and sertraline, neurologists - citalopram and escitalopram, in general - escitalopram.

As of 01.10.2024, 45 trade names of SSRIs were registered in Ukraine (4 - fluoxetine, 1 - citalopram, 7 - paroxetine, 9 - sertraline, 2 - fluvoxamine, 22 - escitalopram), 80% of the drugs were of foreign origin, 20% of which were manufactured to order by domestic manufacturing companies. Imported drugs came from 15 countries, most of them - from India (28%); among 9 domestic companies, Pharma Start LLC supplies the largest number of medicines (33%).

It was found that currently the lowest prices for drugs in Ukraine are offered by the drug booking service Tabletky.UA. The state reimburses the cost of PTSD treatment with the most affordable drugs paroxetine and sertraline (1 trade name each), fluoxetine (3), escitalopram (5). Therefore, given the results of the study, it is recommended to include escitalopram in the Unified Clinical Protocol of Primary and Specialized Medical Care “Acute Stress Reaction. PTSD. Adaptation Disorders”.