The law and practice. Why you need a monitoring system for public procurement of medicines

About how it may affect the development of the pharmacy business, said the Dean of the pharmaceutical faculty of Nizhny Novgorod state medical Academy, Chairman of the Nizhny Novgorod Association of pharmacists, member-correspondent RAEN Svetlana Kononov.

The beneficiaries will be engaged

Elena Shitova, “Lambos”: what is the purpose of creation of information-analytical system and what will change for pharmacies after its introduction?

Svetlana Kononova: One of the main objectives is the reduction of variation in purchase prices, finding the best budget conditions, building an effective medicines. Declared that is planned to release additional funds to expand the groups of latopalmata. The system provides for the tracking of competitive procedures, the calculation of the average market price, the formation of the initial contract price. In real life the changes will affect those pharmacies that are engaged in drug supply is decreed groups of the population.

The price of the pills. How are drugs and formed their value

– State and municipal pharmacies are concerned that they will have to procure on a competitive basis medicines and to support their activities.

– If “the activities of partorganizatsii (GUP and MUP) does not apply to the procurement of goods, works, services for state and municipal needs, the changes of the Federal law № 321 from 03.07.2016”, their purchases do not apply. Such explanations were given in the letter of MZ of the Russian Federation from 16.09.16 No. 1008847/25–2 and the letter of the RF Ministry of economic development from 14.09.16 No. Д28 and of 2342.

– That is, the direct effect of innovation on the development of the pharmaceutical retail market, not globally. Is there an indirect impact?

– Of course! Benefits in kind, receive 15 million citizens and 13 million preferred to replace them with monetary compensation. These people need medicines and are a key target audience of pharmacies. But I don’t know of examples where pharmaceutical retail carries out individual work with this category of beneficiaries, and this is a big reserve, especially considering the current state of the market.

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The need is there, not possible

– How do you assess the current state of the Russian pharmaceutical market?

Unfortunately, the development of the market can not speak, the challenge is to stay afloat. At the forefront of financial problems in the wholesale and retail sectors. Late payments on government contracts, falling incomes, reduced consumption of drugs – all this is a very adverse trend.

– People buy fewer drugs and in packages and in monetary terms. Maybe the population has become healthier?

– The demand for drugs has not decreased, which is confirmed by statistical indicators, such as morbidity and mortality. But the flow of consumers is shrinking, and is linked to the overall drop in welfare. According ipsoshealthcare, in the spring of 2015, only 38% of the surveyed pervostolnik talked about reducing the number of buyers, and in the spring of 2016 – 49%. If previously patients purchased drugs on the course of treatment, now often purchase the same pack. Buy whether second is unknown. Perhaps feeling the improvement, they will give the following purchase, “save” and will remain undertreated.

Help

Information-analytical system of procurement of medicines will start working in test mode since 1 March 2017 and 1 January 2018 in full. As stated by the head of the government of the Russian Federation Dmitry Medvedev, the system “will allow us to analyze information on the procurement of drugs in each region, to avoid unreasonable price dispersion and to prevent violations in the pricing”.


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Pervostolnik will be obliged to help its competitors?

– To solve the contradiction between the desire of the purchaser to purchase the drug cheaper and the desire of pharmacies to sell more expensive?

– This issue, the government proposes to address through legislation. In particular, it is assumed to require pharmacies to tell customers about the cheapest drug that fits the concept of import substitution. In this case inform the buyer about the pros and cons of all medications, regardless of, they have in stock at the pharmacy or not.

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– So, pervostolnik in fact will have to promote competition? For example, if they don’t have cheap drugs, and the pharmacy around the corner there.

We do not share this point of view. But if this happens, in addition to the “competitors” there are still a number of negative aspects. In particular, one name for INN can label up to 200 trade names. Can you imagine a situation where pervostolnik tells the buyer about the 200 drugs? As he learns of the price in the pharmacy half the drugs missing? And who, ultimately, prescribes medicine: MD, specialist of “first table”, the patient? I repeat that this initiative will not lead to the good effects, expected its authors.

A prescription and no

– One of the most important changes in the regulations concerning the pharmaceutical market, should be complete ban the prescription prescription drugs, particularly antibiotics. What do you say about that?

Apothecary no one writes. Why pharmacists to dispense medication without a prescription

In accordance with the current legislation of over-the-counter release of antibiotics is prohibited. However, the evidence suggests that this law is not enforced. If in 1994 the antibiotics without a prescription dispensed in 31% of cases, in 2016 and 68%. These figures, of course, can not be confirmed by official statistics, they were going on the basis of anonymous surveys. But the trend is very worrying, because the mindless use of antibiotics leads to drug resistance and other adverse consequences. In this regard, the interdepartmental Commission is created, which includes the development of an effective mechanism for monitoring the implementation of the antibiotic prescribed by doctors.

– What hitherto prevented to act in accordance with the law and not dispensing antibiotics without a prescription?

– Prerequisites several. It is no secret that very often the doctors instead of prescriptions given to patients list of medications on a piece of paper. They probably have the time to design full of recipes may not always have the prescription pad might have other reasons. Which, by the way, not to say aloud: none is not the enemy itself, to openly admit to the violations. On the other hand, it often happens that the sick person is drawn not to the clinic, and once in the pharmacy. It is faster and easier than an appointment, wait your turn, spend time on the trip. I do not condone those who prefer a doctor of a pharmacist, these people endanger their own health, not to mention the fact that they are breaking the law. But understand that without a real increase availability and convenience of medical care and stricter legal requirements for doctors who violate the rules for prescribing, the issue of uncontrolled vacation prescription drugs can not be solved.

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Wrong side of good intentions

– The state had shown special attention to the sphere of medicinal maintenance of the population, in particular, adopted a programme Pharma‑2020, took the course to support domestic pharmaceutical manufacturer, announced drug policy of import substitution. What are the practical results of these projects?

– According to the Union of pharmaceutical and biomedical clusters, the effectiveness of the implementation of the state program Pharma 2020, in 2015 amounted to 59.4%. This, of course, is not enough. It is encouraging that over the past five years in the country built 37 pharmaceutical enterprises. However, the share of medicines of a domestic production was only 28%, while the planned figure of 37%. And since January 2017 it will decrease as the packaging process of the drug will not be sufficient for the recognition of his domestic. That is, some drugs that are now considered as Russian, next year we can go to the imported category.

– What action is proposed to take to remedy the situation?

Chairman of RF Government Dmitry Medvedev voiced a number of areas to ensure sustainable economic growth. They include stringent requirements to public administration, high personal responsibility, cost optimization, revenue mobilization, modernization of the system of subsidies.

– Cost optimization usually means reducing costs, and generating revenue – new ways of “relatively honest obtaining money” from the public. Of this list will be implemented in the near future?

– The reduction in the budget for health has repeatedly stated. With regard to revenue mobilization, it is logical to expect some tax surprises. But that is no reason for pessimism. The demand for pharmaceutical products remains stable, and the task pharmacy business in how to best to respond adequately to the challenges of the time. Crisis can be an important stage of improvement, this should be easy to understand and accept.

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