It is assumed that after the bill is passed, all Russians, being treated not only in a hospital, but also at home, will be able to receive medicines from the current list of vital and important medicines prescribed by a doctor for free or at a big discount.
Yana Alekseeva, Managing Partner and Head of Legal Support, Med-YurConsult, told MN about who and what free drugs are currently in place, as well as about the prospects for a new outpatient drug support system, which is scheduled to be launched in 2022.
– Yana Valeryevna, for whom is the current list of Vital and Essential Drugs developed?
– It covers almost all types of medical care, which is provided under state guarantees, as well as ambulance and medical care, inpatient care, and specialized medical care. The main task of the state in forming the list of Vital and Essential Drugs is the control of manufacturers in determining the maximum selling prices for this category of medicines.
– Is the list of Vital and Essential Drugs a list of medicines issued on a preferential basis?
– No, it’s not, but from this list a list of preferential medicines is formed, from which (only from it!) You can get drugs for free or at a discount only to people in privileged categories.
The List of Vital and Essential Drugs for the provision of medical care, as well as for those dispensed to the population during outpatient treatment as prescribed by doctors, free of charge or with a 50% discount, is approved by the Government of the Russian Federation annually. In the presence of medical indications, the attending physician may prescribe a different drug that is not on the list of vital drugs, which is necessary specific patient.
– How do you assess the prospects of the initiative of the Ministry of Health? Currently, options for providing medicines at a great discount, or only for children, are also being discussed. Which option do you think is most likely and why?
– The initiatives of the Ministry of Health are often sound, but they receive a poor and non-viable embodiment. Sometimes initiatives are completely out of touch with reality.
As for the initiative announced by Veronika Skvortsova, for my start, in my deep conviction, it is necessary to raise the question of whether all prescribed drugs really receive free preferential categories of the population, that is, how is the current program currently working?
Second: we do not have a clear understanding of the responsibility of patients for their health, that is, investments in this project may simply not pay off.
Third: there may be, and often are, prescribed ineffective medicines, which are included in preferential lists rather than the mystical thinking of healthcare organizers than with scientific evidence.
Fourth: not all practitioners are able to prescribe drugs adequately due to the lack of a clear and up-to-date education system for medical workers, including postgraduate education.
Fifth: there are no clear legislative mechanisms governing the administration of drugs. Thus, the instructions for medicines indicate the diagnoses and conditions in which the prescription of the drug is possible, however, these drugs may not be mentioned in the standards and clinical recommendations.
The standards of medical care do not contain the entire list of medicines used for a certain pathology. However, in clinical recommendations, mention is not always made of drugs, the use of which is clearly perceived from the standpoint of evidence-based medicine.
Thus, it seems to me that this initiative is an attempt to solve pressing issues in an expensive and inefficient way.