Pharmacy loan

Regions will ask to increase co-financing of drug purchases for beneficiaries

For the third Monday in a row, President Vladimir Putin has made Minister of Health and Social Development Mikhail Zurabov nervous. At traditional meetings with members of the government at the beginning of the week, the head of state made it a habit to inquire about the problems of providing medicines to beneficiaries . Since the information about the shortage of drugs and the increase in unsold prescriptions from the regions that comes to the Kremlin does not always correspond to the victorious reports of the Ministry of Health and Social Development, Mr. Zurabov has to listen to not the most pleasant things. Yesterday, however, the president did not scold the minister, but only scolded him for his sluggishness: “The situation is changing, but very slowly.” And he pointed out exactly how to speed up the process.

“I ask you to speed up the work, speed up the work in the regions,” said Vladimir Putin. Considering that all the problems of the additional drug supply program (ADS) are caused by the miscalculations of officials involved in the budget process, and, as a consequence, the lack of money for medicines (after the release of the program of all citizens who preferred cash to benefits in kind, its 2007 budget amounted to only 34.9 billion rubles), the president’s words in the relevant departments were regarded as a call to increase pressure on the regions in order to force the administrations of the constituent entities of the federation to increase their share of co-financing of the program. or find new payment schemes with suppliers and beneficiaries until the federal ministries find additional money. In any case, the Federal Compulsory Health Insurance Fund (FFOMS) is now working in exactly this direction.

For the past two weeks, the acting director of the fund, Dmitry Reichart, has been constantly traveling around the regions, trying during meetings with local leaders to convince them to help federal beneficiaries in whatever way they can. And some territories met the FFOMS halfway. For example, the governor of the Kemerovo region, Aman Tuleyev, proposed an original scheme: beneficiaries buy medicines with their own money, and then write applications to local veterans’ councils to provide them with compensation; in the end, the municipalities will have to pay the money. True, as the FFOMS press service explained to Vremya Novostei, Mr. Tuleyev has not yet set a deadline for repaying this debt. In turn, the director of the Nizhny Novgorod Health Department after the meeting signed an order stating that in March, “if necessary,” prescriptions for cancer patients will be purchased at the expense of the regional budget. And the Omsk authorities have allocated 100 million rubles for DLO, part of which will be used to pay off last year’s debts, and part will have to cover the costs of beneficiaries for expensive medicines and become a source of financing for hemodialysis centers.

But since such an increase in the share of regional co-financing is not prescribed by law, only the president can demand it. The Ministry of Health and Social Development, and especially the Federal Compulsory Medical Insurance Fund, apparently do not enjoy such authority. Thus, in St. Petersburg, Mr. Reichart, at first glance, reached an agreement with Vice-Governor Lyudmila Kostkina and the local authorized pharmaceutical organization Imperia-Pharma. The city seems to have promised to more actively co-finance certain nosologies, taking into account the specific composition of beneficiaries (among them there are many blockade survivors with serious illnesses who constantly need expensive drugs). But less than two weeks after the meeting, reports emerged that the application for the second quarter from St. Petersburg was “two and a half times higher than the funding limits approved by the Federal Compulsory Medical Insurance Fund.” The Fund proposed that all benefit recipients of the northern capital meet 1.367 billion rubles in 2007, despite the fact that the estimated need of the city is 3.352 billion.

In such conditions, bargaining with the regions and approving applications can take a very long time. “In fact, we are seeing a repetition of the situation in January-February 2005, when there was a technical delay in deliveries due to the fact that applications were approved only in December. As a result, beneficiaries who had the right to come to pharmacies with prescriptions on January 1 actually received their medications in March-April,” Gennady Shirshov, executive director of the Union of Professional Pharmaceutical Organizations (SPFO), told Vremya Novostey. According to him, logistics takes a certain time and the start of deliveries can be accelerated only by generating orders as quickly as possible. Since they are already detained, only regional authorities can speed up the process if they buy the medicines at their own expense. “This is already happening in some regions,” the expert said.

Galina PAPERNAYA