However, to boast of a strong nature health many can. Therefore, the topic of drugs and their availability almost all concerned.
Our expert – the doctor of pharmaceutical Sciences, Professor, head of Department of organization of drug supply and pharmacoeconomics, head of laboratory of pharmacoeconomics and outcomes research Institute of pharmacy First MGMU them. I. M. Sechenov Rosa Yagudina.
Large expenses are profitable
Elena Nechaenko, “Lambos”: Rosa Ismailovna, despite the fact that the quality of medicines is growing, for some reason people do not become healthier. How can we explain this phenomenon?
Heal health! How to defend the right to free medical care
Rosa yagudina: Between the two concepts, in my opinion, there is no connection. Because drugs need not healthy, and sick people. Just today, increased diagnostic capabilities, whereas many diseases are simply not timely detected. International classification of diseases (ICD) becomes from year to year bigger – at the expense of not only the disease but also its subtypes (e.g., recent varieties of breast cancer, colorectal cancer and other diseases).
But if we talk about the effectiveness of modern drugs, it is very high. For example, if earlier a period of life in some cancer types was a few months, now this. Patients with diabetes, according to statistics, today live longer than in the General population, because of the drugs and that they better control their health. Or take the hepatitis C 10 years ago from this disease, people died. But today there are drugs that can completely cure this disease.
The price of the pills. How are drugs and formed their value
Once innovative products are extremely expensive, if feasible such a burden to our economy? The more expensive drugs in all still not enough.
– And all not necessary. Innovative medicines are needed, not all, but a strictly defined group of patients. For example, to take a new direction, such as immunohistology. Immune drugs are not necessary for all patients, but only those who have increased activity of a particular gene. For the rest, they will be useless. But for those who are shown to be very effective.
Government spending on medicines will continue to grow, and that’s good. Healthy, nebuleuse population – the key to an efficiently operating economy. And the need to economize not on innovative drugs and generics. It is also very important to the quality control system worked so poorly the drug just couldn’t be on the market.
It would be very sad if the progress today has been achieved in pharmacology, bypassed our country. Of course, no country in the world can provide its citizens with all the current drug. Each state calculates their capabilities and the needs of their citizens and, on this basis, makes the choice. Of course, the cost of treatment is increasing every year, but the life expectancy of people is increasing. Once the researchers calculated that in the XX century, humanity was aging every minute for 45 seconds. Therefore, to save on expensive innovative medicines is impossible. As the saying goes, “better a man without money than money without a man.” Also, speaking of expensive drugs, it is necessary to consider not only their actual value but also the additional costs which their use helps avoid: the cost of hospital and hospitalization in particular. And anyway, I want to emphasize that drug supply is not an area where you want to save. And the costs will grow. But people will live longer.
The patent without the right to defense. Whether compulsory licensing of medicines
Whether it is necessary to control pharmaceutical companies?
As to whether justifiably sky-high prices of innovative drugs?
– This, alas, no one can count, because the price of a drug includes the cost of thousands of studies that led to the creation of the most healing molecules. Moreover, not every study is productive – sometimes years of scientists ‘ work in vain. Somebody has that job to Finance. So year by year, the cost of innovative medicines is growing strongly.
Why are some drugs more than others, similar in composition?
But, of course, pharmaceutical companies do not give complete freedom. Need to achieve a balance between the public wishing to purchase drugs, and companies that want to sell their goods. So, last year in the “new York times” published a long article calling for the need to restrain the growth of prices for innovative drugs. The Committee on Finance of the USA has asked pharmaceutical companies justify such high cost of drugs. The same thing happened in France. It is hoped that this process will yield results.
– Who should support the government – pharmaceutical companies or the consumer?
– There cannot be two points of view – the state should support its population. But, in doing so, it thereby provides support and companies. After all, without them production is impossible care of the population. Therefore, an important balance. For example, now there is talk about the need to index the price of medicines facing cheaper 50 rubles. Of course, it should be done! Or we’ll release the prices for them, raising their cost by 15-20%, or even left without these drugs.
Caring about the population, the state has created a support system for those patients who are not able to buy expensive drugs. This has established a preferential list of drugs included in the essential drugs list (vital and essential drugs). Have included in the list of the drug price freeze and the entire year, despite any jumps in the exchange rate remains unchanged.
What drugs are included in the new list of essential medicines?
– What else exactly is the government doing for people who need expensive treatment?
– There is a government program “7 high-cost nosologies” – the best ever implemented in Russia health programmes. People whose diseases are in it, are provided with medications free of charge.
For example, in one of these diseases is hemophilia – patients before it died, and now live an active life (even climb on Elbrus). There is a program, ONLS (Provision of essential medicines), according to which 3.5 million people receive subsidised medicines.
Unfortunately, the rest of the 15 million people chose to participate in this program, monetary compensation, which, alas, is not the best way affected the effectiveness of the program as a whole.
– How to explain the effectiveness of drugs, which from a scientific point of view, no one checked? We are talking about medications type of pills or tablets.
– Indeed, these drugs are used almost exclusively in Russia, and it is difficult to say that there is evidence about their effectiveness. But despite this, many people (especially the elderly) they are used and they are, according to them, well help. From one kind of familiar medicine is becoming easier. This can be explained in different ways, including other than the placebo effect. As one respected expert, what would we say about the inefficiency and insecurity of a number of drugs, they leave the market only with that part of the population, which is accustomed to use them.