Recently, the state has been trying to replace foreign medicines with domestic ones Source: Maxim Serkov / NGS42.RU Recently, important medicines have been regularly disappearing from pharmacies throughout Russia. In the first days of April, diabetics could not find Fiasp ultra-fast insulin on the shelves. Following this, the indispensable oncology drug Uromitexan disappeared. At the same time, Roszdravnadzor ensures that medicines continue to be produced in the country, and they are even available in reserve. But why aren’t they in pharmacies and what will happen next to the assortment? MSK1.RU asked these and other questions about “Schrodinger’s preparations” to experts in the field of pharmaceuticals. This is how they explained the disappearance of the drugs. They did not have time to collect what they needed. Pharmacies supply most of the drugs for the treatment of oncology, diabetes, HIV and similar serious diseases. To do this, the authorities must collect applications from the regions, form a tender purchase and deliver the received drugs to pharmacies. However, as pharmaceutical market expert Nikola Milevcic told MSK1.RU, failures often occur in these processes: “If there was no such offer, this procedure does not begin. There have been no preferential purchases for a long time; pharmacies have run out.” remaining medicines, and at the retail level we see a shortage of these products,” he explained that there is enough medicine in stock. But sometimes you have to be content with leftovers Source: Anastasia Shcheglova / 93.RU According to the expert, delays in procurement occur for various reasons, for example, if the Ministry of Health has not yet collected applications from the regions or they themselves did not have time to provide the necessary information. In addition, medications may not be purchased because pharmacies have stocks. since last year, and they don’t need it – The first trimester is always quite difficult, because the money is allocated for a year, and until the state distributes it, makes an offer, delivers the goods, it’s several months,” Milevcic explained in an interview with MSK1. RU. – It happens that deliveries from the fourth quarter are charged to the first quarter due to the previous year. In addition, priority areas, products and the list of vital drugs are constantly changing. They want to raise the price, but they can’t. One of them is sanctions. In 2022, many foreign pharmaceutical companies made statements about changes in their work in Russia. Some have stopped investing, others have suspended clinical trials. Most of them stopped providing medications altogether. In some places you can still find remnants of foreign medicines, but they are not endless. But producing analogues takes time. And although the government has already compiled a list of priority molecules that are now being actively introduced for production at Russian factories, most of the components for the production of equivalent substitutes have to be imported from abroad. Currently, Russia is 90% dependent on the supply of pharmaceutical substances. from abroad Yuri Banny, a former neurosurgeon, specialist in the field of pharmacology, and logistics over the past two years have become noticeably more complicated and, as a result, increased in price. The rest is simple mathematics. In order to not only recoup costs, but also make money, it is advisable for manufacturers to increase prices for their products. But they can’t do it. Especially when it comes to those drugs that are included in the list of vital and essential drugs (VED). By law they must be sold at a fixed registered price. And here there is almost no gain: “Factors often refuse to register and leave the market because they do not have the opportunity to re-register their price,” Nikola Milevcic told MSK1.RU. However, there are no analogues. According to one of MSK1.RU’s sources in the pharmaceutical field, analogues of some drugs have not yet been produced in Russia. And the original must be brought from abroad, but through neutral intermediary countries – Some production, of course, is localized, but there remains a wide range of drugs that are included in the list of vital and essential drugs, the production of which. For one reason or another, it is impossible inside the country,” our interlocutor said. “Because of this, we have to reorient supply chains and add neutral countries that did not exist before. It is possible to bring medicines from abroad, but it is time-consuming and expensive Source: Leonid Menshenin / 74.RU If previously medicines could be directly imported to Russia from Switzerland or France, now neutral countries are added to this chain, which includes, for example, India , China and some Asian countries. And this directly affects both delivery times and the cost of drugs on the market – due to increased transportation costs, those drugs that disappear from pharmacies are returned at much higher prices. One of the striking examples is the drug “Zepatir” for the treatment of hepatitis C. Until 2022, it cost up to 10 thousand rubles, and now it is 90 thousand,” said the interlocutor of MSK1.RU “Zepatir”. American pharmaceutical company MSD She informed the Russian Ministry of Health that supplies would stop in 2023. According to pharmacists, there are no analogues of the drug. According to this principle, drugs for ASIT therapy (allergen-specific) have also become more expensive. immunotherapy, when small doses of the allergen are administered – “Staloral-mites”, “Oralair-herbs”. Prices for medicines reach 9 thousand rubles if any drug included in the list of vital and essential drugs disappears. pharmacies, the Ministry of Health must solve the problem of its shortage. He can offer an analogue or contact the manufacturer and demand acceleration of deliveries – There are funds and social groups that, with the support and consent of the Ministry of Health, make urgent purchases and supplies for individual patients with a threat to life due to. the fact that the required drug is not available. This is a kind of force majeure, a way out of a situation where, of course, the state must find a solution for these patients,” Milevcic noted. When the Ministry of Health finds an analogue of the missing drug, it adds it to the list. list of vital and essential medications. However, even an analogue must undergo some research and registration, so it will not be possible to do this in a short time. Our experts were unable to explain how long this would take.
Experts explained why drugs are increasingly disappearing from pharmacies: shortage of drugs, drug analogues, Zepatir, why drugs are disappearing, sanctions, crisis, details – May 2, 2024.
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