Financial and economic rationale for using emerging cell therapy technologies for treatment of traumatic injuries of the central nervous system in high technology healthcare

Trauma of the spinal cord is a severe injury of the structure of the central nervous system leading to deep and enduring disability in most patients. Treatment and rehabilitation of such patients are associated with high costs to the state. Disability imposes even greater financial burden: loss of ability to work, expenses for financial assistance, yearly reha‑ bilitation, etc. Currently, methods of regenerative medicine are being actively developed and they are promising from the clinical point of view. However, effective treatment of spinal cord injury and recovery of even partial ability to work in patients should also have positive results from the financial standpoint. In 2018, we have completed the first part of a clinical trial confirming safety and high effectiveness of systemic use of umbilical-placental blood in the acute period of spinal cord injury. Based on the trial results, we have calculated potential financial benefit for the state from development of new methods of regenerative therapy for treatment of spinal cord injuries. In this article, we present financial and economic rationale for using such trials in current conditions.

1. Akshulakov S.K., Kerimbaev T.T. Epidemiology of spinal cord and spinal cord injuries. In: Proceedings of the 3rd Congress of Neurosurgeons of Russia. St. Petersburg, 2002. P. 182. (In Russ.).

2. Murphy K.P., Opitz J.L., Cabanela M.E., Ebersold J. Cervical fractures and spinal cord injury: outcome of surgical and nonsurgical management. Mayo Clin Proc 1990;65(7):949–59. DOI: 10.1016/s0025-6196(12)65156-8

3. Kondakov E.N., Simonova I.A., Polyakov I.V. Epidemiology of spinal cord and spinal cord injuries in St. Petersburg. Zhurnal Voprosy neirokhirurgii im. N.N. Burdenko = Burdenko’s Journal of Neurosurgery 2002;2:34.(In Russ.).

4. Bogdanova L.P. Restorative treatment of patients with traumatic spinal cord disease with complicated spinal fractures. In: Abstracts of the VI All-Russian Congress of Physiotherapists. St. Petersburg, 2006. P. 188. (In Russ.).

5. Mironov E.M. Analysis of primary disability among patients with the consequences of spinal cord injury. Mediko-sotsialnaya ekspertiza i reabilitatsia = Medical and Social Expertise and Rehabilitation 2004;1:33–4. (In Russ.).

6. Shpachenko N.N., Klimovitsky V.G., Stegny S.A. et al. Features of medical care and prognosis of outcomes in spinal cord injury at the prehospital stage. Proceedings of the Scientific Conference dedicated to the 40th Anniversary of the Department of Spinal Pathology “Spine Surgery – Full Spectrum”. Мoscow, 2007. Pp. 336–339. (In Russ.).

7. Perlmutter O.A. Spinal cord and spinal cord injury combined with extravertebral injuries (clinic, diagnosis and surgical tactics). Abstract of dis. ... candidate of medical sciences. Moscow, 1988. 24 p. (In Russ.).

8. Data from the Federal State Statistics Service on the number of persons recognized as disabled. Available at: https://rosstat.gov.ru/search?q=лиц%2C+признанных+инвалидами. (In Russ.).

9. Data from the Federal State Statistics Service on the number of people with disabilities by disability groups in the Russian Federation. Available at: https://rosstat.gov.ru/search?q=лиц%2C+признанных+инвалидами+по+группам&date_from=&content=on&date_to=&search_by=all&sort=relevance. (In Russ.).

10. Housing in Russia. 2016. Statistical collection. Rosstat. Moscow, 2016. 63 p. Available at: gks.ru/free_doc/doc_2016/jilhoz16.pdf 12 (In Russ.).

11. Tariff agreement for payment of medical care provided under the Territorial program of compulsory medical insurance of the city of Moscow for 2018. Moscow City Compulsory Medical Insurance Fund. Available at: Доступно по: http://www.mgfoms.ru/medicinskie-organizacii/tarifi (In Russ.).

12. Tariffs for payment of medical care provided in inpatient settings for completed cases of disease treatment using high-tech medical care within the framework of the Territorial Compulsory Health Insurance Program. Supplment No. 9 to the Supplementary Agreement No. 1 dated 01/31/2018 to the Tariff Agreement for 2018 dated December 29, 2017. Available at: https://www.mgfoms.ru/system/files/prilozhenie_no_9_k_dopolnitelnomu_soglasheniyu_no_1_ot_31.01.2018_g._418185_v1.pdf (In Russ.).

13. Resolution of the Government of Moscow dated 12/23/2016 No. 935-PP (ed. dated 07.11.2017) “On the Territorial program of State guarantees of free medical care to citizens in the city of Moscow for 2017 and for the planning period of 2018 and 2019”.

14. Information on salaries of employees of organizations by categories of personnel and professional groups of employees for October 2017 (updated 05.28.2018) . Available at: http://www.gks.ru/wps/wcm/connect/rosstat_main/rosstat/ru/statistics/wages/labour_costs/ (In Russ.).