Exacerbation of the surplus – Kommersant

According to the results of 2023, the budget surplus of the state fund “Circle of Kindness” may amount to several tens of billions of rubles, even despite the fact that the increase in high wages, from the additional tax on which the fund is financed, lags behind the indicator for the labor market of the Russian Federation as a whole. At the end of 2022, it follows from the report of the fund, its expenses amounted to only a third (61.5 billion rubles) of the amount of receipts from the federal budget and carry-over balances (in total – 192.6 billion rubles). However, the need for a large surplus, according to experts, is due to the specifics of the fund’s work – the constant expansion of the number of wards.

At the end of 2022, the expenses of the Circle of Kindness fund amounted to only a third of its income, follows from the annual report. At the end of last week, he was presented by the head of the fund, Archpriest Alexander Tkachenko. Recall that the state fund “Circle of Goodness” was established by presidential decree in 2020 – the main source of its funding is income from increased personal income tax on salaries over 5 million rubles. per year (2%). Now the fund provides assistance to patients with 71 orphan pathologies, purchasing drugs, medical devices for them and paying for medical care.

In 2022, the fund received 148.5 billion rubles from the federal budget. At the same time, since in 2021 the amount of increased personal income tax collection exceeded the forecast (the fund received 75 billion rubles), 44 billion rubles. were transferred to the budget of 2022 – as a result, its size amounted to 192.6 billion rubles. The volume of the fund’s expenses turned out to be significantly lower – 61.5 billion rubles, although this figure almost doubled compared to 2021. The largest expenditure item of the fund, as expected, fell on the purchase of registered drugs by a subordinate institution of the Ministry of Health – 40.2 billion rubles. In second place are drugs that the fund purchases on its own, including unregistered ones (20.6 billion rubles), in third place are expenses for medical devices (383.7 million rubles). The lists of purchases approved by the Board of Trustees of the Foundation, at the end of 2022, included 52 items of expensive drugs and 7 types of medical devices. The cost of medicines purchased by the fund in 2022 ranged from 1,000 to 100 million rubles. for packing. The fund’s administrative expenses amounted to 175.9 million rubles, most of which (130.7 million rubles) were employees’ salaries.

At the end of 2023, the fund’s budget surplus is likely to continue to grow. So, in addition to the balance of the state grant funds at the end of 2022 (131.2 billion rubles), this year the fund, as predicted by the federal budget, will receive another 144.7 billion rubles. income from the payment of increased personal income tax. As a result, by the end of the year, the fund’s revenues will be comparable to the federal and regional budgets’ expenditures on all drug benefit programs — in 2022, according to the DSM Group analytical company, they amounted to 303 billion rubles.

The fund’s expenses will obviously also exceed the figures of previous years – since the beginning of this year the fund has already spent 76.1 billion rubles – due to the constant expansion of the list of patient groups that can access its financing. So, at the end of 2022, the State Duma approved amendments, according to which the fund will provide drugs to the wards of the program “14 high-cost nosologies” (VZN) up to the age of 18 (about 15 thousand people), future costs were estimated at about 20 billion rubles. per year (for details, see Kommersant dated October 30, 2022). In addition, the Foundation was also instructed to start purchasing drugs for children from List-24, a list of orphan diseases, the treatment of which is now provided by the regions. The fund’s expenses will also increase due to the launch in the Russian Federation from the beginning of the year of the state program of neonatal screening, which makes it possible to detect a number of diseases in infants, some of which are included in the fund’s lists. As Alexander Tkachenko noted during a press conference, experts have already identified 30 children with spinal muscular atrophy, 13 of them were prescribed Zolgensma, which means, in particular, that the number of such wards of the fund has grown by almost a quarter in just a few months ( during the operation of the fund, this drug was prescribed to 157 children, the costs amounted to 16 billion rubles).

At the same time, it is likely that the fund’s income will be higher than expected. According to Igor Polyakov, an expert at the Central Maritime Facility, according to the results of 2023, the salaries of qualified specialists who are subject to increased personal income tax, although they may grow more slowly than in the labor market on average, will nevertheless increase by 8–9% in nominal terms. “We are talking about deductions from the salaries of 200-300 thousand people employed mainly in the gas and oil industries, the banking sector and the manufacturing industry,” he notes. According to the co-chairman of the All-Russian Union of Patients Yuri Zhulev, although the situation of a surplus of any funds for the health care system of the Russian Federation is surprising, it is obvious that due to the specifics of the work of the fund (providing patients with innovative drugs) and the constant expansion of the number of wards, a reserve in its budget is necessary. At the same time, according to him, with a constant increase in the volume of funds, the fund will have to optimize its work – for example, abandon the practice of approving each application for providing a patient with the entire composition of the expert council.

Anastasia Manuylova