In Russia, more and more often they buy drugs by trade names

Federal medical centers have begun to purchase individual drugs by trade names more often, which may require a review of approaches to the organization of such purchases. Amendments to FZ-44, prepared in the State Duma, may allow government customers to group purchases of specific drugs for patients who have been prescribed them by a medical commission. According to industry experts, this will facilitate the work of contract services and reduce the price per unit of the purchased drug due to economies of scale.

In the Russian Federation, the number of state purchases of drugs by trade names is growing, which, in turn, requires their optimization, follows from a letter from State Duma deputy Airat Farrakhov to the government (Kommersant has it). Recall that according to the norms of Federal Law-44, state customers must purchase medicines by forming lots for the purchase of drugs according to their international non-proprietary name (INN), under which both original medicines and generics are registered. This allows any bidder with the lowest price to win the bid, and generic manufacturers often win because they are cheaper than the original drugs. At the same time, the medical community regularly raises questions about the quality of generics – although they go through all the necessary registration procedures, the likelihood of complications in patients when taking them may be higher. It is allowed to purchase drugs by trade name as an exception for individual patients – each such case is considered by a medical commission, which subsequently prescribes a specific drug in prescriptions. In 2020, specialists from a number of federal medical centers even turned to the government with a request to expand the possibilities for using this mechanism (for more details, see Kommersant dated February 27, 2020).

But even without this, according to Mr. Farrakhov, in recent years, the volume of purchases of drugs by trade names, despite the complexity of the procedure, has increased significantly – for example, they have become more often prescribed in federal medical centers, especially when choosing treatment for children with disabilities. He cites the purchase of the Humira drug as an example – in the first half of this year alone, 30 children planned to spend 17 million rubles on its purchase for therapy. The situation is similar for other trade names, he notes. The trend is also confirmed in the All-Russian Union of Patients, notes its co-chair Yuri Zhulev.

As Mr. Farrakhov notes in his letter, separate purchases for each patient increase the burden on contract services and cause discrepancies in the prices for the purchase of the same drugs. Therefore, he proposes that the government amend two articles of Federal Law-44, which will allow government customers to group such purchases and purchase the drug for several patients at once. “This is a smart decision that will help streamline the procurement process. In addition, by purchasing medicines by trade names in large volumes, government customers will have the opportunity to discuss various discount options with the supplier,” notes Mr. Zhulev. At the same time, as Sergey Shulyak, head of DSM-Group, says, it is still unclear how exactly government customers could accumulate information about the necessary drugs in order to combine their purchases. “Even if the appointments are reflected in the patient’s electronic medical record, it is unlikely that its functionality now allows you to select patients with the same appointments by the hands of one of the state customers,” he notes.

However, in the future, the digitalization of state medicine will probably make the introduction of such a mechanism possible. The experience of centralization and coordination of such purchases de facto already exists – for example, the FKU “Federal Center for Planning and Organization of Drug Supply” of the Ministry of Health already centrally purchases drugs under the program “14 high-cost nosologies” and distributes them by region.

Anastasia Manuylova