Study on the availability of medicines in the context of regional healthcare system development (case study of the Sverdlovsk Region)

Abstract

Subject. Increasing the availability of modern effective and safe medicines is one of the key objectives for the development of regional health systems in pursuit of the goals of the national Healthcare project. As a complex process, the modernisation of the pharmaceutical provision system is an important issue for the economy, the state, and society. The availability of medicines for cardiovascular diseases has a special place among the issues of reforming the system of pharmaceutical provision for citizens. The high prevalence of cardiovascular disease among people causes a negative economic impact and a significant cost to public healthcare systems around the world. The cause of this economic loss is the cardiovascular disease mortality and morbidity rate in the working-age population, which results in a substantial loss of human capital. Objectives. The aim of the study was to analyse and assess the assortment, financial, and logistical availability of medicines for cardiovascular diseases at all levels of medical care in the context of the development of the regional healthcare system, based on materials from the Sverdlovsk Region for 2011-2019. Methodology. The study was based on data from the Monitoring of Assortment and Prices for Vital and Essential Drugs (VED) in the Sverdlovsk Region for the period of 2011-2019. A comparative and structural analysis of the availability of medicines for the treatment of cardiovascular diseases was carried out using the WHO and Health Action International (WHO/HAI) methodology. It was based on the calculation of the median ratios of local prices to international reference prices of medicines for groups of domestic and foreign drugs, original brands, and generics. We also considered price groups for the outpatient and inpatient market segments. Conclusions. A study of the availability of medicines for cardiovascular diseases in the Sverdlovsk Region revealed that medicines at the outpatient level are provided predominantly for socially disadvantaged groups at the expense of public funds. At the inpatient level, the medicines are funded by the Territorial Fund of Compulsory Medical Insurance, the range of medicines provided is limited to the VED list. The list of medicines for the treatment of cardiovascular diseases for the inpatient and outpatient levels of medical care has virtually no continuity, which reduces the overall level of availability of medicines. To improve the quality of pharmaceutical provision for the development of the regional healthcare system, additional research on price dynamics and pharmacoeconomic analysis is required. It should consider the trends in the Russian pharmaceutical market.

Keywords

• medicine prices
• availability of medicines
• regional healthcare system
• who/hai
• reference prices