Patients will be assigned other money – Newspaper Kommersant No. 202 (7403) dated 10/31/2022

The State Duma approved in the first reading a bill, the adoption of which will allow the wards of the 14 High-Cost Nosologies Program (VZN) up to the age of eighteen to receive expensive drugs at the expense of the Circle of Kindness fund. We are talking about about 15 thousand children with rare diseases, whose treatment costs now amount to 20 billion rubles. Since the level of funding for the VZN program will be maintained with a reduction in the number of patients, it will finally become deficit-free. The Circle of Kindness reports that the fund’s good financial position will allow it to provide additional drug purchases for new patients.

Starting from 2023, the state fund “Circle of Goodness” will begin to provide children with orphan (rare) diseases with drugs that they received under the state program “14 high-cost nosologies”. The corresponding draft amendments to the law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” were adopted by the State Duma last week in the first reading.

The 14 Nosologies program was launched in 2008 to give patients with orphan diseases access to expensive original drugs, removing the corresponding costs from the regions.

In 2021, federal budget expenditures on the program amounted to 64.3 billion rubles, a threefold increase compared to 2008. However, patient communities regularly complained to the authorities that the program was in short supply. According to the estimates of the All-Russian Union of Patients, the number of people in need of drugs under the program from 2012 to 2022 increased from 100,000 to 233,000 people (of which 15,000 are patients under the age of 18). In 2021, the Ministry of Health also recognized the financial problems of the program, allocating an additional 8.9 billion rubles for the purchase of medicines.

In 2020, the government announced the creation of another drug supply system – through the state fund “Circle of Good”, which now receives tax deductions from the increased personal income tax rate (15% instead of 13%) from high salaries.

Orphan patients were also in the focus of the Foundation’s attention, but only under the age of 18 and with diseases that are not on the VZN list (there are currently 44 diagnoses on the Foundation’s list).

The amendments add another 14 positions to it – due to the transfer of the wards of the VZN program to the jurisdiction of the Circle of Kindness. The Fund will provide them with drugs until the age of 18, after which patients will be able to apply for funding from the VZN budget. As stated in the conclusion of the State Duma Committee on Health Protection, first of all, the fund’s budget will be used for the treatment of patients with four diseases (pituitary dwarfism, mucopolysaccharidoses of the 1st and 2nd types, cystic fibrosis and juvenile arthritis with a systemic onset), since they the proportion of children ranges from 82% to 99%.

The costs of the VZN program for the treatment of children and adolescents amount to up to 30% of its costs – about 20 billion rubles. Despite the transfer of obligations, there are no plans to cut spending on VZN in the federal budget. “This will finally make it possible to achieve a deficit-free VZN program and begin to provide the adult patients remaining in it with the necessary drugs in sufficient quantities,” said Yuri Zhulev, co-chairman of the All-Russian Union of Patients.

As Kommersant was told in the press service of the Circle of Kindness, the fund’s budget is quite capable of providing new patients with the necessary drugs.

Since in 2021 the amount of increased personal income tax collection exceeded the forecast (the fund received 75 billion rubles), 44 billion rubles. have been included in this year’s budget. “Taking into account the balance of the 2021 grant, the projected amount of funds in 2022 is 122.7 billion rubles. It is expected that at the end of the year the fund will conclude contracts for the supply of medicines in the amount of about 60 billion rubles, ”Kruga Dobra explained to Kommersant. They noted that now it is possible to guarantee care for a much larger number of children with diseases that require expensive therapy. “The Foundation assumes responsibility for children with such diseases, including those who received part of the assistance they need under the VZN program. The “Circle of Kindness” organically becomes a home for all “orphan” children,” the foundation said.

It should be noted that the amount of free funds of the fund may turn out to be temporary, in the future the number of its patients may increase due to the launch of a mass neonatal screening program in 2023 (it is designed to more effectively identify patients with rare diseases). Of the 36 diseases planned to be included in this program, eight are already on the fund’s list.

Anastasia Manuylova