Pharmacies will have to take their word for it – Picture of the Day – Kommersant

The hotline of the All-Russian Union of Patients (VSP) receives complaints from citizens who have been refused by pharmacies in fixing delayed servicing of preferential prescriptions. Since September 1, the norm of legislation has ceased to operate, obliging pharmacies, if they do not have the medicine necessary for the beneficiary, to record the appeal to the journal and provide the drug within a period of one to ten days. As Kommersant found out, the initiators of the changes were representatives of the medical community, since, in their opinion, this paragraph violated the rights of patients to access to medicines. Patients, on the other hand, fear that the innovation “virtually legitimized drug failure.” The Ministry of Health assured Kommersant that the obligation to accept prescriptions for deferred maintenance remains.

From September 1, 2022, clause 12 of the order of the Ministry of Health of Russia No. 1093n on the rules for dispensing medicines by pharmacy organizations ceased to be valid. This item dealt with the so-called deferred maintenance of preferential prescriptions. Previously, if a beneficiary came for a medicine, but the required drug was not available, the pharmacy recorded an appeal to the deferred demand journal. Paragraph 12 of the order of the Ministry of Health, depending on the medicine, set the waiting time. For example, a prescription marked statim (immediately) had to be served within one working day from the date of request, marked cito (urgently) – within two. Work with a prescription for a medicine included in the minimum range of drugs for medical use was supposed to be completed within five working days from the date of application. With prescriptions for medicines prescribed by decision of the medical commission – within ten working days.

The All-Russian Union of Patients (VSP) Kommersant reported that already on September 1 they began to receive calls to the hotline from citizens who were refused “in fixing deferred prescriptions.” This was complained, in particular, by parents of children with diabetes who could not get insulin and do not know when the drug will appear in the pharmacy. “We assume that pharmacies will still have to dispense medicines, but without fixing the prescription in the journal, this process is not formalized. It is not clear from what day the counting is being carried out and by what date the drug will be delivered, ”VSP told Kommersant. The patient organization did not rule out that some pharmacies will abuse the absence of such requirements in the legislation.

The co-chairs of the Supreme Council, Yan Vlasov and Yuri Zhulev, sent an appeal to the Minister of Health of the Russian Federation Mikhail Murashko (Kommersant has it). They ask for clarification on how the fact of a citizen’s going to a pharmacy will be recorded if it is impossible to provide prescription medicine, as well as the time frame for ensuring various types of deferred requirements. Mr. Zhulev admits that a different procedure has already been legalized, but emphasizes that there is no open information about this.

VSP experts say they do not know why the drug dispensing rules have been amended. The Ministry of Health also did not comment on this issue.

A source familiar with the situation told Kommersant that the limitation of the validity of clause 12 of the drug dispensing rules was a condition under which the draft order was agreed upon by the health working group within the framework of the “regulatory guillotine”.

According to members of this group of representatives of the medical community, this rule violated the rights of patients to access to medicines.

According to the federal curator of the All-Russian Organization of Parents of Disabled Children (VORDI) Yulia Pankova, information about the invalid paragraph of the rules has probably not yet reached the regional ministries of health: she does not know about the facts of denial of deferred maintenance of preferential prescriptions, at least in Moscow. However, the patient community, emphasizes Ms. Pankova, is really concerned. “In fact, the failure to provide medicines and medical supplies that are not available in pharmacies has been legalized,” says Yulia Pankova. She notes that in the past, deferred maintenance was essentially “indefinite,” meaning the prescription remained valid until it was dispensed.

By order No. 1093n, which came into force in March, any prescription was valid for 90 days from the date of contacting the pharmacy and fixing it in the journal. Now, the prescription that was not served is valid for exactly the period for which it was written by the doctor. For example, most children with diabetes have prescriptions for a month. “It turns out that the patient must go to the pharmacy every day and ask if the medicine has been brought. And who will be responsible if in a month the drug is still not issued, and the prescription runs out? says Mrs. Pankova. She adds that having a deferred prescription has been proof for many patients who have gone to court to recover out-of-pocket funds spent on preferential treatment. Now, according to her, it is “absolutely unclear” how to confirm the absence of the drug. Yulia Pankova claims that VORDI also intends to apply to the Ministry of Health for clarifications, since “the deterioration of the patient’s rights to preferential provision of medicines” is obvious.

The Ministry of Health of the Russian Federation told Kommersant that the obligation to accept a prescription for deferred maintenance (in the event of a temporary absence in the pharmacy organization of the medicinal product specified in the prescription, medical product or specialized medical food product for children with disabilities) is established in the Procedure for the provision of a set of social services to certain categories citizens (Order of the Ministry of Labor of Russia No. 929n, Ministry of Health of Russia No. 1345n dated December 21, 2020), which continues to operate. At the same time, clause 11 of the rules for the dispensing of medicinal products provides that the dispensing of medicinal products is carried out within the period of validity specified in the prescription when a person applies to a retail trade entity.

“The authority to organize the provision of medicines to citizens is assigned to the state authorities of the constituent entities of the Russian Federation in the field of health protection, which must ensure timely treatment of the patient, including the provision of necessary medicines to privileged categories of citizens,” the press service of the department said.

Natalia Kostarnova