Doctors without abroad

On April 2, the government published an import substitution plan in medical and pharmacological industries.

These are more than 600 items, whose share of imports by 2020 should be reduced significantly - in many positions from almost 100 % to 10–20 %. How rational are the wishes of the Russian leadership and what will happen if foreign medical equipment and medicines are really replaced by Russian?
“Since the German Baclofen we switched to Russian, it has become noticeably worse, additional symptoms have appeared: cramps, involuntary muscle movements,”-Alan Fidarov, a half-gray man of the Caucasian appearance, about forty years old, puts a blank foreign white and blue box on the table. “The preparations brought with them from Germany were enough for less than a year. It is impossible to officially order German pills in Russia, since they are not certified, and there was no one to carry illegally in bags - the crisis, ”he says gloomily. Here, in a two-room apartment on the outskirts of the capital, Alan lives with his 12-year-old son David. The Vera Assistance Fund is rented by the apartment, four years ago David received a traumatic brain injury and has since been in a “vegetative state”-most of the brain has been affected. Two years of treatment abroad were expensive, I had to sell my own housing in Moscow, it is pointless to go home in Ossetia: there are no doctors who can provide the child with the necessary assistance.

Distonic attacks ceased only when the dose of the Russian analogue was doubled. “The doctors first did not want to admit that it was because of the pills, they said that they were identical, but in the end they recognized our suspicions,” Alan gloomily shows the domestic bubble. And adds indifferently: "But there are no others."

In February , the Government of the Russian Federation has published a decree on the restriction of the admission of medical devices originating from foreign states. Now it is impossible to purchase foreign drugs and equipment for hospitals and clinics if, in addition to a foreign manufacturer, at least two applications from Russian manufacturers have been submitted for the competition.

In the case of drugs for import substitution, there are only three ways: to create your own drugs, buy technology in the West or develop technology yourself, preserving the formula of the already known active substance.

The first way is the most expensive and therefore the most unlikely, because the development of one new medicine costs an average of $ 1-2 billion. The second is more economical, but the production site must comply with international standards. According to a member of the Scientific and Expert Council for Health under the Council of the Federation Vitaly Omelianovsky, there are about 30 %in the country.

If the third path is chosen - the production technology is not bought, but is developed on the spot - then the properties of the drug can change significantly. The only way out is the transfer of foreign production to Russia (the so -called localization). Now localized products occupy about 10 %on the market. By 2020, their number may increase. But sanctions and crisis threaten to freeze the parish of new manufacturers. “Some have already encountered the problems of importing high -tech equipment from Europe into the country,” says Sergey Shulyak, Director General of DSM Group.

On the needle with medical equipment, things are even worse. In Russia, there are almost no competitive devices and consumables. The share of imported catheter in Russia is 96 %, injection needles-89 %, probing instruments-100 %, there are no domestic operating tables on the Russian market (100 %are brought from abroad). This list can be continued for a long time (prostheses, strollers, x -rays and ultrasonic devices).

“We are too carried away by foreign goods. This led to the fact that most of the Russian industries went bankrupt, ”says Vitaly Omelianovsky. Alexander Smirnov, Deputy Chairman of the RSPP Commission for the Pharmaceutical and Medical Industry, agrees with him: “Previously, the domestic medical industry provided a healthcare system by almost 100 %. For such a country as Russia, it is important to have its powerful medical industry. This is a matter of social well -being and security of the state. ” But how much the modernization of the production of drugs and medical equipment on the country's scale will cost, not one of the experts with whom NT had talked to. According to Shulyak, only a third of pharmacological production for 7 years took about $ 1.5 billion investments to modernize: both foreign and state.

From the point of view of the doctors, the picture looks different: “In our institution, I have not seen a single Russian catheter and I think that this is right,” the head categorically declares. Department of Neurology of the Federal State Budgetary Institution “FNCC of Children's Hematology, Oncology and Immunology named after Dmitry Rogacheva »Ella Kumirova. In her opinion, the Russian analogues lost the Western not because the doctors were “carried away with something”, but because the equipment and consumables of domestic production are worse in quality.

The hasty decision “When I was the director of the European Medical Center, we did not have Russian equipment at all. It does not meet modern requirements, ”says Artem Gapeev, General Director of the Clinic Management Group. Charity funds that buy drops and probes for their own, and not with budget money, are avoided using Russian materials: “Russian probes have to change too often, their introduction hurts the child, we cannot use them,” says Lida Moniava, a well -known blogger and manager of the Vera charity foundation. In addition to the probes, according to her, Russian tracheostomic tubes, dressings, aspirators ... and even needles are unsuitable for children to care for children.

“I can’t answer why they don’t make normal needles. The fighter can, but no injection needle. Everyone buy foreign only because Russian after four sterilizations rust, ”says Gapeev. According to him, as part of the modernization of the clinic, which was produced in Moscow, Russian equipment was almost not purchased. "What do you think?" - Gapeev asks rhetorically. “The government does not work on equipment, its solutions depend on the lobbying efforts of various groups, but the final customer is still a doctor. That's when the surgeon says that he can use the domestic endoscopic stance for operations, it will be possible to talk about import substitution, but not earlier, ”he is convinced. Already today, many patients are forced to independently bring the drugs and materials they need. Alas, it is impossible to carry the equipment unnoticed in manual luggage. Whether the new Russian technique will comply with modern standards - it is difficult to say so far. But many experts agree that in the absence of competition with Western samples, it is unlikely. And that is why it is worth it to postpone with total replacement.