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Providing Medications to the Russian Population
26 May 2018
08:30—09:45
KEY CONCLUSIONS
The provision of medicine helps to increase both length and quality of life

The objectives set by the President to the Government contain some rather ambitious requests – to increase life expectancy to 78, and to 80 by 2030. We must ensure the provision of medicine to a certain level in order to meet these objectives — Dmitry Khalilov, Partner, Head of the Group for the Provision of Services to Enterprises of the Consumer Goods Sector, CIS, EY.

On a global basis, life expectancy increases by approximately three months per year. <...> Forty per cent of this progress is thanks to pharmaceuticals — Niels Hessmann, General Director, Bayer; General Representative, Russia and CIS, Bayer.

The provision of medicine accounts for a fifth of all healthcare expenditure

We spend RUB 5 trillion on healthcare in Russia. This includes both public and private expenditure. How much of this goes on medicines? A little over RUB 1 trillion. <...> Taken together, the population and the government spend around RUB 800 billion on outpatient services. From this figure, the government subsidizes RUB 200 billion, i.e. 20–25% — Guzel Ulumbekova, President of the Board, Association of Medical Societies for Quality of Medical Care and Medical Education; Head, Higher School of Healthcare Organization and Management.

Preferential treatment has helped increase the share of domestically produced medicines on the market

A preferential approach with regard to local producers is part of government policy to build expertise in the Russian Federation, increase production volumes, and increase provision of Russian-made medicines to citizens, which are produced not in final dosage form, but from the active ingredient. <...> Preferential treatment is required to increase the competitiveness of the sector as a whole. <...> In the growing domestic medicines market, the policy of preferential treatment has enabled us to increase our share and production volumes. Over the past five years, annual growth in production has been 20% — Aleksey Alekhin, Deputy Director of the Department of pharmaceutical and medical device industry development - ‎Ministry of industry and trade of the Russian Federation.

Sample checks are improving the quality of medicines

Quality is essential for medicines. <...> Sample checks are of fundamental importance when it comes to ensuring quality — Mikhail Murashko, Head, Federal Service on Surveillance in Healthcare.

ISSUES
The inaccessibility of free medication for most of the population is impeding the delivery of high-quality treatment

In the outpatient segment, flaws in the medicine provision system are as follows: only 17% of the population have access to free medicine. <...>This creates specific difficulties. It means neither continued treatment nor receipt by the patient of the required medication over a period of time are guaranteed — Elena Maksimkina, Director of the Department of Drug Supply and Regulation of Medical Devices at the Ministry of Health of the Russian Federation.

The standard of treatment need to be reviewed

We are still very much behind international standards when you look at healthcare reporting and global reporting. <...> When we look at some diseases, like hepatitis C, HIV, rheumatism, arthritis, and osteoporosis, what we see is significantly lower ranges of diagnosis and of treatment. And what we very often see is a mixture of treatment regimes which combine some international standards, and very often standards which are out-dated — Stefan Tuschen, Partner and Regional Director of Health Care Practice in Europe and the Middle East, The Boston Consulting Group.

The low level of doctor training

Preliminary testing has shown that doctors who in two months are to work in hospitals are least adept in two disciplines, which lead to negative results. These are healthcare management, and pharmacology and clinical pharmacology. Throughout the world, a widening gap is being observed between academia and industry. Due to their conservative approach, universities often fail to change their courses, projects and programmes in time — Alexey Kolbin, Professor of the Department of Pharmacology, St. Petersburg State University.

Difficulties in providing medicines for diseases that are costly to treat

The main problem is the federalization of the list of 24 rare diseases. Not everything should be federalized, but the most expensive ones of course should be, in order to make space for the 218 diseases that are on the waiting list — Svetlana Karimova, President, ‘Genetica’ National Association of Organizations of Patients with Rare Diseases.

Unfortunately, we are shut out entirely from the legal environment. We are tasked with treating some of the most difficult patients, who require special treatment. And this special treatment is not included in any clinical recommendations. We cannot legally make planned purchases of the medicines, which are needed to treat our patients. We can buy them for each specific patient, but if the cost of the medicine exceeds RUB 200,000, then the procedure takes multiple weeks, and the medication may be needed at that exact minute — Alexey Moshchan, Deputy General Director, National Research Centre of Pediatric Hematology, Oncology and Immunology.

SOLUTIONS
Shared responsibility for providing medicines

The money which we want for our healthcare sector will of course not be enough if only the employer pays. We need our healthy population to take shared responsibility for providing medicines to the people who need them — Elena Maksimkina, Director of the Department of Drug Supply and Regulation of Medical Devices at the Ministry of Health of the Russian Federation.

We must all work together to propose solutions – market participants, producers, distributors, patients, and doctors — Vladimir Shipkov, Executive Director, Association of International Pharmaceutical Manufacturers (AIPM).

The social component is very important in our sector, and as responsible companies, we are obliged to not simply write it off — Irina Panarina, General Manager, Russia and Eurasia, AstraZeneca.

The creation of an environment conducive to development and innovation

There are various ways that have proven to be successful at the European level. <...> Underpinning the development of new medicines and the access of new medicines for patients is of course the right environment for innovation — Nathalie Moll, Director-General, European Federation of Pharmaceutical Industries and Associations (EFPIA).

Government support for investments in high-tech production

We need to broaden and supplement the special investment contract to make it more attractive to invest specifically in high-tech production — Oksana Monge, General Manager of Prescription Business Unit, Sanofi in Russia and Belarus.

Improving the government procurement procedure for medicines

An auction is not an appropriate means of procurement when there is an original drug and a single producer who is not competing with anyone. We need to enter into more price negotiations based on long-term demand and price vs. volume — Vasiliy Ignatiev, CEO, R-Farm.

The material was prepared by the Russian news agency TASS