The community of patients “Together against hepatitis” demands that the president’s instructions be fulfilled to provide money for treatment

The patient community expressed dissatisfaction with the absence of expenses for the treatment of hepatitis C as a monoinfection in the draft federal budget. They note that Russian President Vladimir Putin ordered to find a source of funding for these purposes by October 20. The organization “Together against Hepatitis” sent letters to the Ministry of Health and the State Duma demanding “as soon as possible” information about the status of implementation of the order of the head of state. Deputy Alexey Kurinny confirmed that the budget does not include expenses for hepatitis C, however, “according to preliminary data,” there are funds for this in reserves.

On November 17, the third and final reading will take place project federal budget for 2024 and for the planning period 2025–2026. It involves the allocation of 2.662 billion rubles. annually to provide medicines to people infected with HIV, including those in combination with hepatitis B and C viruses. The Russian Ministry of Health, together with “interested federal executive authorities,” proposed to allocate these funds from revenues from the indexation of excise taxes on cigarettes and cigarettes.

However, the draft budget does not include expenses for the treatment of patients with hepatitis C, the interregional public organization “Together against hepatitis” noted. Meanwhile, President Vladimir Putin, following the results meetings On August 22, 2023, the Council for Strategic Development and National Projects instructed the government to identify sources of additional funding for treatment of this particular category of citizens by October 20.

Health Minister Mikhail Murashko linked the existence of problems with agreeing on a source of funding for outpatient treatment of chronic viral hepatitis C.

According to him, “some departments have a special opinion on this matter,” but he did not disclose the details of the contradictions. Now the outpatient segment is mainly covered by preferential drug provision from regional budgets, and the inpatient segment, starting from 2023, by the compulsory medical insurance budget.

It should be noted that about 620 thousand patients with hepatitis C are registered in the Ministry of Health register. The estimated number of cases ranges from 2.2 million to 4.9 million. No more than 2–3% of patients receive treatment annually. Thus, from January to September of this year, about 30 thousand people received therapy (this is approximately 4.8% of the register list, 1.2% of the estimated number).

The chairman of the organization “Together against Hepatitis” Nikita Kovalenko sent a letter to Mikhail Murashko and the head of the State Duma Committee on Health Protection Badma Bashankaev (available to Kommersant). He asked “as soon as possible” to inform public figures about the status of implementation of the instructions of the President of the Russian Federation and the reasons for the absence of expenditures on measures to combat chronic viral hepatitis C in the draft federal budget.

Nikita Kovalenko noted that in recent years, coverage of therapy has been expanding, and “serious plans” for treatment under compulsory medical insurance have been announced. But in order to fulfill the president’s instructions within the time frame he has set, it is necessary to increase coverage by at least an order of magnitude, and only a few regions can afford this, Mr. Kovalenko believes. “Therefore, it is unrealistic to do this without additional funding. Since the end of last year, the government has been saying that part of the excise tax on tobacco products will be used to purchase drugs for the treatment of hepatitis C as a monoinfection (treatment of hepatitis C in HIV-infected people is a completely different budget item). We were really looking forward to this. Therefore, we are very alarmed that the budget does not include expenses for hepatitis. Another conflict is that the Health Care Development program provides for a mechanism for distributing these funds. But according to our data, there is nothing to distribute,” commented Mr. Kovalenko.

The Ministry of Health of the Russian Federation told Kommersant that funds for the treatment of patients with hepatitis come from a number of sources, including from the budgets of the constituent entities of the Russian Federation, the compulsory medical insurance fund, and the federal budget.

“If we talk about the draft federal budget, then the appropriate funds are provided for and will be allocated for these purposes by separate government decisions,” the department assured.

Deputy Chairman of the State Duma Committee on Health Protection Alexei Kurinny (Communist Party of the Russian Federation) recalled that after the president’s order, a committee meeting was held, during which the Minister of Health confirmed that “funds will be found in the budget.” “We really don’t see them as a separate line, but, according to preliminary data, these funds are provided for in the reserves that exist today,” Mr. Kurinny assured. “I can’t say whether in full or in part, but within the framework of budget execution they should appear, apparently , in parallel with program events. “I have not yet heard of a direct order from the president being ignored.”

Natalia Kostarnova