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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="research-article" dtd-version="1.1d1" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher">Bulletin of Semashko National Research Institute of Public Health</journal-id><journal-title-group><journal-title>Bulletin of Semashko National Research Institute of Public Health</journal-title></journal-title-group><issn publication-format="print">2415-8410</issn><issn publication-format="electronic">2415-8429</issn><publisher><publisher-name>FSSBI «N.A. Semashko National Research Institute of Public Health»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">2977</article-id><article-id pub-id-type="doi">10.25742/NRIPH.2023.01.008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Научная статья</subject></subj-group></article-categories><title-group><article-title>Analytical decision-making model regarding the possible transfer of funding for several rare diseases</article-title></title-group><contrib-group><contrib contrib-type="author"><name name-style="western"><surname>Komarov</surname><given-names>Ilya A.</given-names></name><bio></bio><email>iliya_komarov@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff id="aff-1">FSSBI «N. A. Semashko National Research Institute of Public Health» 105064, Moscow, Russian Federation</aff><pub-date date-type="epub" iso-8601-date="2023-12-15" publication-format="electronic"><day>15</day><month>12</month><year>2023</year></pub-date><issue>1</issue><fpage>46</fpage><lpage>52</lpage><history><pub-date date-type="received" iso-8601-date="2025-10-16"><day>16</day><month>10</month><year>2025</year></pub-date></history><permissions><copyright-statement>Copyright © 2023,</copyright-statement><copyright-year>2023</copyright-year></permissions><abstract>In recent years, for a number of life-threatening and chronic progressive rare (orphan) diseases, leading to a reduction in life expectancy of citizens or their disability, the powers to provide patients with drugs have been transferred from the regional level to the federal one. The most expensive diseases that have consistently formed the main financial burden for regional budgets since the creation of the List of the Government of the Russian Federation include paroxysmal nocturnal hemoglobinuria (Marchiafava-Mikeli), idiopathic thrombocytopenic purpura (Evans syndrome), other sphingolipidoses: Fabry disease (Fabry-Anderson), Niemann-Pick, as well as pulmonary (arterial) hypertension (idiopathic) (primary). In order to assess the impact on the budget of these diseases, an analytical decision-making model was developed that allows real-time calculation of how much federal budget funds will be required depending on the number of patients, the cost of drug therapy and the proportion of the patient population receiving a particular treatment. depending on the course of the disease. In addition, the developed model will make it possible to estimate at the regional level the necessary costs for drug provision for these diseases, if this authority remains at the level of the constituent entities of the Russian Federation.</abstract><kwd-group xml:lang="en"><kwd>rare diseases, orphan drugs, drug maintenance, healthcare, financing, federalization, budget, regions of the Russian Federation, analytical decision-making model</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>редкие болезни, орфанные лекарственные препараты, лекарственное обеспечение, здравоохранение, финансирование, федерализация, бюджет, регионы РФ, аналитическая модель принятия решений</kwd></kwd-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Комаров И. А., Красильникова Е. Ю., Алексанлрова О. Ю., Зинченко Р. А. 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