Availability of medicines and the sustainable development of the national health system in Russia

The modernization of the drug supply system for citizens as a multifaceted process that ensures the sustainable development of the national health system is the focus of attention of the economy, the state and society. In order to study this, authors from Russia carried out a study to analyse the availability of medicines for the population for the treatment of cardiovascular diseases in 2011 and 2019 [1].

A special place is occupied by the problem of the availability of medicines for the treatment of cardiovascular diseases. This is due to their exceptional social importance as a result of their position as one of the leading causes of death.

It is known that the system of medical care for the treatment of cardiovascular diseases is represented by several interrelated stages: the outpatient stage, the stage of emergency medical care, the hospital stage, and the rehabilitation stage. At each stage, according to the diagnosis and for medical reasons, the necessary drug therapy is carried out, the financing of which is carried out by the structure of the state drug supply system at both the federal and regional levels.

Thus, the problem of assessing the availability of medicines intended for the treatment of cardiovascular diseases at all stages of providing medical care to citizens of similar social groups in the regions of Russia is being updated.

By studying the availability of medicines, we understand the possibility for a patient to receive the necessary medicine at the right time and at an acceptable price or on preferential terms.

Based on this, the key elements of the availability of medicines are:
– assortment availability of medicines as their availability in sufficient volume and variety in accordance with the stage and type of treatment
– financial availability of medicines at an acceptable price or under preferential conditions for obtaining them
– logistical availability of medicines as the timeliness of their receipt and delivery by the stage and type of treatment.

The purpose of this study was to analyse the availability of medicines for the population using the example of the treatment of cardiovascular diseases in 2011 and 2019 to assess the assortment, financial and logistical availability of medicines as a determinant of the sustainable development of the national health system. (based on monitoring the assortment and prices for vital and essential medicines in the Sverdlovsk region, Russia).

As a result of the analysis of assortment availability, it was found that:
– for all therapeutic classes, the share of generics in the hospital segment is higher than in the outpatient segment
– the patient’s transition from the hospital to the outpatient segment is accompanied by a structural shift in the range of medicines: the share of originator drugs increases and there is a shift in favour of more expensive generics.

The analysis highlighted several limitations of financial accessibility:
– the price availability of originator brands decreases in comparison with generics
– the average price availability of generics is growing, and the employee with the lowest salary could purchase a drug for a month’s therapy, spending less than one-day’s salary. Among the originator medicines, there were inaccessible ones, for the purchase of which the employee spent more than five days’ salary.

Analysing the logistical availability, it can be argued that increasing the availability of generics reduced the burden of the disease for the state.

Thus, by analysing the accessibility of medicines as determinants of the sustainable development of the national health system, the following conclusions were made: drug provision at the outpatient stage is carried out at the expense of the state for socially unprotected groups of the population and in turn, at the hospital stage – due to the funds of the territorial fund of compulsory medical insurance from the list of vital and essential medicines. There is no continuity in the formation of the list for the hospital and outpatient stages of medical care, which reduces the overall level of availability of medicines.

Conflict of interest
The authors of the research paper [1] did not provide any conflict of interest statement.

Abstracted by Svetlana Begicheva, Ural State University of Economics, Yekaterinburg, Russia.

Editor’s comment
Readers interested to learn more about the availability of generics are invited to visit www.gabi-journal.net to view the following manuscript published in GaBI Journal:

Availability and procurement of generics in hospitals among medium-sized European countries

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Reference
1. Begicheva S, Kalabina E. Availability of medicines for the population as a determinant of the sustainable development of the national health system. Adv Soc Sci, Educ Humanities Res. 2021;632:12-17.

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