The Ministry of Health proposed to allow the sale of prescription drugs through vending machines
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Moscow entrepreneurs appealed to the Russian Ministry of Health with a request to allow the sale of prescription drugs through vending machines. They believe that this will help residents of remote regions where there are not always full-fledged pharmacies. Representatives of the pharmaceutical industry note that medications should be dispensed by a pharmacist, who “will protect the person from possible mistakes and give the correct advice.” But vendors point out that in some countries selling medicines in devices is already a normal practice, and in Russia it can technically also be implemented.
The appeal to the Ministry of Health was written by members of the working group on digitalization under the Ombudsman for the Protection of the Rights of Entrepreneurs in Moscow. Founder and CEO of the vvCube consulting group, member of the working group, Vadim Tkachenko, clarifies that social activists have repeatedly received relevant requests from pharmacy chains and, on their basis, have developed an initiative that is designed to improve the availability of medicines. They clarify that prescription drugs can be sold using an electronic prescription system based on a QR code.
Vending machines are devices designed to sell various goods and services without the help of sellers. The first vending machines with parapharmaceutical products appeared in Russia at the end of 2012. The main groups of products selected for sale through pharma boxes are dietary supplements, personal hygiene items, snacks, first aid products, and cosmetics. But prescription drugs in Russia are prohibited from being sold through vending machines, as well as in grocery retail. And over-the-counter medicines can only be sold through a vending machine in a pharmacy, in the presence of a pharmacist.
According to Vadim Tkachenko, vending machines with tablets could be installed both in clinics and in individual stores or other institutions. This would be especially true for remote regions and hard-to-reach areas, especially rural ones, he says, where it may be difficult to get to a hospital to get a prescription and medication. He emphasizes that the idea is “quite technically feasible” and is also attractive to investors and beneficial for business. “This measure will enable small and medium-sized businesses to compete with large players. Since to install vending machines it will not be necessary to obtain the appropriate permits and register pharmacy points in accordance with regulatory documents,” continues Mr. Tkachenko. “At the same time, of course, precautions must be observed. Thus, the devices themselves will be equipped with cameras and technical protection measures. There will also be a register of both devices and issued electronic prescriptions, which will be monitored by the Ministry of Health or Roszdravnadzor.” The Ministry of Health of the Russian Federation did not comment on the initiative at the time of publication.
Executive Director of the Union of Professional Pharmaceutical Organizations Liliya Titova recalls that in recent years many have come up with the initiative to increase the availability of medicines: Russian Post, gas station enterprises in the non-fuel sector (with a proposal to open pharmacy points at gas stations), and marketplaces. However, no one has been able to implement projects to deliver medicines to remote regions. “Many expectations were associated with the law on distance selling, which was supposed to solve the problem of providing medicines to hard-to-reach regions. It turned out that the demand for online delivery is relevant only for large cities, but not for remote regions, primarily due to the cost of logistics services. To what extent will the initiative of automated drug dispensing systems be in demand in rural areas?” – Mrs. Titova asks a question. She also notes that the main function of a pharmacy – to provide the patient with medicines and medical products for the prevention and treatment of diseases – can only be performed by a pharmacist, that is, “a specialist who will protect the person choosing a medicine from possible errors or give competent advice.” Liliya Titova expressed hope that the initiative to introduce automated drug dispensing “will not find support, and common sense will prevail over entrepreneurial creativity.”
The general director of the Ryazan chain “Apteka Pharma”, Alexander Mironov, was also critical of the proposal of Moscow entrepreneurs. He believes that this initiative could create different conditions for pharmacies and vending operators. “To store prescription drugs, pharmacies need to comply with a huge pool of requirements: for light, temperature conditions, and recording turnover. Vending machines simply cannot meet these conditions. If we give relief to the vending business, then it is necessary to give relief to pharmacies,” argues Mr. Mironov. In addition, he adds, the electronic prescription system has only become operational in some regions, and they are not used actively: 14 Moscow Pharmacy Pharma pharmacies have not issued a single drug using an electronic prescription.
Vendor representatives are more optimistic. Boris Belotserkovsky, president of the Uvenco group of companies and president of the Union of Vending Machine Operators, notes that, for example, in France, the sale of over-the-counter drugs such as aspirin through vending machines is “normal practice.” And it solves several problems at once: machines can be installed on an area of 1–2 square meters. m in almost any location with sufficient traffic; they work 24/7; The formation of queues at the machines is unlikely, which reduces the risk of infection during epidemics. Technically, it is possible to sell medicines in vending machines using electronic prescriptions in Russia, Mr. Belotserkovsky believes. Modern machines, he said, are capable of recognizing not only QR codes on electronic prescriptions, but also faces. They can work with the Unified Biometric Database, which eliminates the risk of uncontrolled sale of medicines, as well as other goods that currently have certain restrictions for free sale.
A member of the board of the Union of Vending Machine Operators, Ivan Popov (supervises the unit for the sale of medical products in vending), believes that such machines could operate as part of a pharmacy – as, for example, in Italy, where almost every pharmacy has a vending machine built into the display window, which at night sells part of the pharmacy range.
Assistant to the Minister of Health of the Russian Federation Alexey Kuznetsov told Kommersant that the entrepreneurs’ proposal raises questions, first of all, about patient safety. “Medicines require special storage conditions – where is the guarantee that these conditions will be met throughout the entire period the package is in the device? How will the disposal of sold medicines be processed in the labeling system and buyer identification? – comments Mr. Kuznetsov. “Well, there is no opportunity to get advice from a pharmaceutical worker, which is available when visiting a pharmacy in person.”
Let us recall that last week a group of senators and deputies introduced a bill to the State Duma that would allow local hospitals to sell medicines on the same basis as pharmacies and first-aid stations in villages in order to expand their availability of medicines for rural residents. One of the authors of the initiative, Deputy Chairman of the State Duma Committee on Health Protection, Evgeny Nifantiev, explains: dispensing will be carried out exclusively by specialists with pharmaceutical education and in health care facilities in those settlements where there are no stationary pharmacies. “As for the proposal of my colleagues, in my opinion, it is impossible to simplify the sale of prescription drugs to such an extent, this will lead to negative consequences,” comments Mr. Nifantiev. “We must maintain a balance between the physical availability of drugs and the safety of patients, including protecting our fellow citizens from self-medication. And in this case, who will check the prescription, who will be able to provide additional advice on the use of the drug?”
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