The drug assistance system for patients entitled to government support is currently lacking, with regional inequality in drug supply, a lack of brand choice, inappropriate expenditure of monetary benefits, duplication of benefit registers, and monitoring of treatment effectiveness all remaining problem areas. A development strategy for the pharma industry that is based on drug security principles must take into account the evolution of the drug supply system. Any efforts to modernize the existing system for benefit-entitled citizens and other groups of patients with serious diseases must be built on principles of improving its intrinsic tools and its ability to be integrated into a system featuring any model of drug supply, be it drug reimbursement, elements of co-pay, or anything else. The strategy must enable more citizens to be able to count on social preferences, expand the outpatient list of drugs, increase the preventive role of the outpatient sector, and stimulate investment in the pharma industry. What assumptions and objective factors form the basis of the current drug supply system? What tools will help better supply drugs to patients qualifying for benefits? What criteria define economic models of drug reimbursement that are most acceptable to Russia, and what models of full or partial reimbursement of drug costs may be the most effective? Is the Russian Federation ready for universal outpatient drug supply?