The pandemic has caused a rush in Russia, not only for some essential goods, but also for medicines. In a panic, the Russians bought up drugs for the treatment of coronavirus infection and made such supplies for future use. However, some of the disruptions in the availability of anticancer drugs in pharmacies are related to other factors. Yevgeny Nifantiev, First Deputy Chairman of the Commission of the Public Chamber of the Russian Federation for Economic Development and Corporate Social Responsibility, Chairman of the Coordination Council of the Russian Association of Pharmacy Chains, spoke about this in an interview with NEWS.ru. About what will help prevent a shortage of anticonvulsants in the future, how to deal with the drug labeling system and why it should not be abandoned - in the material NEWS.ru.
- How did the pandemic as a whole affect the pharmaceutical supply system?
- The drug supply system in the commercial segment has always worked like clockwork. Everyone is ready to work 24/7 so that the Russians have enough medicines. This was clearly seen in mid-March, when the load on pharmacies and the distribution system doubled, while everything was done and there were no empty shelves. In general, regulators began to work faster and in conjunction with other participants in the distribution chain. Even take the decree of 1779.
It is important that the Ministry of Industry and Trade realized that serious problems were beginning, prepared a decree transferring the work of the marking system to a notification mode, and it was quickly adopted. Thanks to this, it was possible to stop the problem, albeit not as quickly as desired, but it was definitely possible to prevent a collapse in drug supply. Now there are interruptions in the supply of individual drugs, but in general, the drug supply system continues to work effectively.
- What are the reasons for these interruptions?
- Three reasons agreed at the same time: the first is that the demand for anticonvulsants has increased significantly. The second is the difficulties with the passage of medicines in the labeling system, the third is that the registered prices in the register of vital and essential medicines (VED) are not promptly indexed. When the demand in the drug supply system is not fully satisfied, then it is absolutely correct and logical to first saturate the segment of public procurement with anticancer drugs. That is, hospitals and those who are treated for free at home, and only then what remains to be sent to pharmacies.
It is very important that a decision was made in most of the subjects to issue such drugs to Russians for outpatient treatment free of charge (with confirmed COVID-19). It is important to understand that in today's situation, it is necessary to provide drugs to patients who are already ill. Now is not at all the time to buy anticonvulsants "just in case" and "in reserve" in a home first-aid kit.
- In your opinion, what could help prevent a shortage of these drugs in the future?
- One of the factors is the methodology for determining the maximum selling prices for medicines included in the list of vital drugs. I consider the VED price regulation system very important, for many years it saved us from price increases in difficult periods. But there is also a downside. The substances from which anti-anxiety drugs are made, we compete with other countries for access to them. Of course, the demand for them all over the world is growing and prices can increase several times.
It is very important for the regulator to change the basic principle of regulation and move on to preventing deficits. That is, to start responding not at the moment when the drug has already disappeared, but to engage in preventive work. Interdepartmental interaction (Ministry of Industry and Trade, Ministry of Health, Roszdravnadzor and FAS) should be strengthened. It is necessary to monitor this kind of drugs and collect feedback from manufacturers so that the production cost does not rise above the registered prices.
It is for this reason that medicines of the lower price segment were leaving the market earlier. In such a difficult time, it is necessary to help even more manufacturers who have the equipment, technology and potential for the production of those drugs with which there are currently interruptions.
- Should Russians worry that in the near future there will still be problems with the supply of drugs and they will not be able to buy the necessary drug?
- There are no systemic problems with drug supply in our country, there are pinpoint shortcomings with anticancer drugs and problems in certain regions, where local authorities could not predict needs and make purchases in the required volumes. But the regulators work 24/7.
We have a strong pharmaceutical industry of our own, and now we are able to multiply the production volumes. The likelihood that sanctions will be imposed on the supply of substances and drugs from abroad is reduced to zero. Therefore, there are no prerequisites for the deterioration of the situation with drug supply, on the contrary, it will gradually improve. The authorities are very concerned about providing the Russians with all the medicines they need.
- In the first wave of coronavirus, for obvious reasons, there was an exuberant demand for all drugs. What is the difference between the situation that occurred during the second wave?
- Increased demand in October - November was for antibiotics, anticoagulants and vitamins D and C. Unfortunately, such an increased demand could not be satisfied. Plus, the situation was aggravated by the drug movement monitoring system (MDM). She did not work as she would like. The root of the problem is not even in the system operator himself, but in principle of obtaining permission at every stage in order to ensure full traceability along the distribution chain.
Only at the stage of the manufacturer is it necessary to contact the system seven times and obtain permission from it each time. When at each stage she can not give an answer for several hours, this leads to failures. Therefore, at some point in the market there were big problems with drug supply. As a result, an important and wise decision was made - for a while, in order to establish the system, to make the process notifiable. The only problem is that this procedure is valid until February 1. And, of course, the entire market has certain concerns.
- Maybe then the marking system should be abandoned altogether?
- No, this is an important and necessary process. A lot has already been done for this, and it cannot be abandoned. Marking carries a lot of positives, you just need to make it work without failures. It solves a number of serious issues for the state - the fight against counterfeiting, counterfeiting, unscrupulous entrepreneurship.
To completely defeat counterfeits is to save human lives. With the help of this system, it will also be possible to track the number of drugs in the hospital segment. This will help prevent future scarcity situations. But once again to discuss the issue of simplifying the system - this definitely makes sense. Today it is too complicated. I think we need to do it now with less functionality, and then gradually increase it.