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Video: “The Problem Cannot Be Reduced Only To The Provision Of Medicines To Beneficiaries”
“The problem cannot be reduced only to the provision of medicines to beneficiaries”
Half of Russians find it difficult to buy medicines due to lack of money, two-thirds are faced with low-quality drugs, and 90% believe that the drug supply system needs to be changed. These are the results of the study "Quality and Availability of Medicines-2019". It's time for Russia to move from preferential coverage to drug insurance for everyone, experts say.
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Half of Russians experience difficulties in purchasing drugs due to lack of funds, two-thirds have encountered low-quality drugs, and almost 90% believe that the existing system of drug supply in the country needs to be changed. These are the results of the patient study "Quality and Availability of Medicines-2019". According to experts, Russia should move from preferential provision of drugs to certain categories of citizens to drug insurance for all.
Research carried out within the framework of the 1st All-Russian pharmaceutical run “National goals in the field of health care. Priority Development Issues ", conducted by the National Research Institute of Public Health named after N.А. Semashko and the interbranch association "Farmprobeg". 1237 Russians from different regions took part in the 2019 survey. The number of respondents was approximately the same in a similar study by VTsIOM and the National Research Institute of Public Health, conducted in 2013–2014, which made it possible to analyze the data obtained over time.
49% of respondents reported difficulties in purchasing drugs. Among the main reasons they named the lack of money for this (55%), as well as the lack of familiar drugs (38%). Another 2% of the respondents indicated that the drugs they need were not available (2%). 66% of the respondents faced the problem of the quality of drugs, which is 8% less than in the survey five years ago. The number of cases of purchase of expired drugs decreased by a quarter, and there were 8% fewer corrections in the labeling or on the packaging of the drug. The indices of "doubts about authenticity" (by 8%) and changes in the appearance of goods (3%) increased slightly.
As before, Russians do not trust the domestic pharmaceutical industry. Moreover, the number of patients preferring imported drugs increased by 30% (from 26% to 56%). A quarter of respondents consistently trust Russian medicines, a third of respondents found it difficult to answer this question.
Russians have more and more complaints about the existing preferential drug provision. Among its main shortcomings, respondents named the replacement of the necessary drugs with their analogues (29% in 2019 versus 5% in 2013–2014), and the need to constantly go to the doctor for a prescription (19% versus 7%). However, there were fewer complaints about the lack of drugs in the pharmacy (21% versus 32%). In general, 89% of the survey participants believe that the system of preferential drug provision should be changed. Five years ago, 57% of the respondents thought so.
According to the scientific director of the National Research Institute of Public Health named after N.A. Semashko, academician of the Russian Academy of Sciences Ramil Khabriev, the problem cannot be reduced only to the provision of medicines to the privileged category of citizens. Russian beneficiaries make up only 10-15% of the population, while most Russians need medicines at the stage of outpatient treatment. “It is important to cover absolutely all the needs of our citizens and create all conditions for the availability of drugs,” said Khabriev. “A good example is the successful launch of a pilot project on drug reimbursement in the Kirov region: there is already an understanding that it is necessary to introduce regional pilots in 8-10 additional regions”.
Recall that since 2015, the Ministry of Health has announced testing of drug insurance schemes in pilot regions. One such experiment, carried out at the initiative of the Kirov region, was then called by the head of the department Veronika Skvortsova a project of "fantastic efficiency." According to the rules of the project, patients with cardiovascular diseases began to receive drugs from the regional budget, paying only 10% of their cost. As a result, according to the regional health department, mortality from diseases of the circulatory system has significantly decreased, the number of heart attacks and strokes has decreased. The minister promised that the Kirov experiment will be taken as a basis in order to expand it to 15-16 regions. But the matter did not go further than this.
In addition, Roszdravnadzor continues to record a decrease in the number of beneficiaries of preferential medicines: not receiving the necessary medicines, people prefer to leave the preferential medicine programs. According to the ministry, today only one fifth of the people who have the right to receive subsidized medicines receive them. And this situation further reduces the possibilities of preferential drug provision: the fewer patients remain in the program, the lower the volume of its funding.
According to the head of the League of Patients, Alexander Saversky, according to the Constitution of the Russian Federation and treatment standards, all medical care should now be financed by the state, but in practice, the implementation of outpatient care standards does not include drug provision. This will help solve the current problem of low availability of medicines, even for beneficiaries.
Investments in medicines cannot be viewed only as irreversible expenses of the state, Saversky said. Investments in, for example, outpatient medicines will reduce costs for ambulances, inpatient care, sick leave and disability. “The effectiveness of drug provision for citizens is very high,” the expert believes. - The problem is that nobody knows how to count. As shown by European studies, each ruble invested in the prevention of cardiovascular diseases gives an economic benefit of seven rubles, in case of diseases of the musculoskeletal system - 3.5 rubles."