EVALUATION OF THE CLINICAL AND PHARMACOECONOMIC EFFECTIVENESS OF TREATMENT FOR RECURRENT BACTERIAL VAGINOSIS

Introduction. Recurrent bacterial vaginosis (BV) is associated with frequent repeat therapy and a substantial burden on healthcare budgets. Pharmacoeconomic assessment of combination regimens allows joint consideration of clinical outcomes and costs. Objective. To evaluate the pharmacoeconomic effectiveness of a developed multicomponent treatment for recurrent BV versus traditional therapy. Material and Methods. Prospective randomized controlled trial: traditional local antibacterial monotherapy (Group I, n=35) vs the developed combination regimen (Group II, n=30). Time horizon: 9 months; perspective: healthcare system. Primary clinical–laboratory endpoints: vaginal pH ≤4.5, negative amine test, and absence of clue cells. Economic evaluation: cost-effectiveness analysis (ICER per prevented recurrence), cost–utility analysis (QALY derived from quality-of-life dynamics using trapezoidal integration), and incremental net monetary benefit (INMB) at willingness-to-pay thresholds of 18,000–54,000 BYN per QALY. Results. Mean direct medical costs per patient over 9 months were 660.3 BYN with the traditional approach and 345.6 BYN with the developed method (savings: 314.7 BYN; annualized 419.6 BYN). For 100 treated cases, the annual economic effect reached 41,960 BYN. The combination regimen yielded a marked increase in recurrence-free patients at 9 months (+76.7%) and a utility gain of +0.117 QALY. The ICER per prevented recurrence was -410.5 BYN/case, and the ICER per QALY was -2,690 BYN/QALY, indicating dominance (lower costs with better outcomes). INMB was positive across all willingness-to-pay thresholds, confirming economic acceptability. Conclusions. The developed multicomponent regimen for recurrent BV is clinically superior and economically preferable to traditional monotherapy over a 9-month horizon, reducing recurrences and direct medical costs while increasing QALY.