Cure health: why is Russia like “proven” means

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The situation on the Russian drug market is a model example of how, with the support of officials “domestic producers” win “domestic consumers”

Health problems of organization, cost and quality — in recent years, attract in Russia the special attention. In the country for several years now is “optimization” of medical institutions in which a c 2000 2015 closed half (5.3 thousand from 10.7 thousand) hospitals; number of health workers is reduced. The quality of the training year is deteriorating, and restrictions on the use of certain drugs, especially analgesics, border measures aimed at the continuous humiliation of human dignity and sometimes bring cancer patients to suicide.

All this written thousands of articles and dozens of recipes offered to remedy the situation, among which are very thorough and rational. However, today I want to touch other, much less discuss the problems.

“Unique” means

Not so long ago the official defender of children’s rights Anna Kuznetsova proposed to abandon the compulsory use for the diagnosis of tuberculosis of the so-called Mantoux test and replace it with the application of the preparation “Diaskintest”. Many commentators have drawn attention to the fact that this decision will lead to higher income group of pharmaceutical companies owned by Victor Haritonin, which is already a supplier of several drugs included in the government approved list of vital and essential medicinal products. However, this is not so important as the fact that the drug, developed by a group under the leadership of academician Michael Paltseva in 2000 years, anywhere in the world is not used and a replacement for the Mantoux test, which it represented in Russia, can not be considered.

The problem of the prevalence of such drugs in Russia rises rare, but its relevance can hardly be overestimated. Unlike most developed countries, in Russia, 70% of the pharmaceutical market in volume is accounted for by drug-prescription drugs, then how in the world this percentage does not exceed 28%. While a suspiciously large share of the Russian market of medicines, clinical trials are conducted in limited volume and in a short time, as well as those that are produced and offered to the market in Russia or the former Soviet Union. Consider a few cases.

Sold, but does not cure

Let’s start with the famous “Arbidol”, “advertising agent” who acted in 2010 Vladimir Putin himself. Developed by a group of Soviet scientists in the mid 1970-ies by order of the Ministry of defense, he has no open studies on the effectiveness (held in the Soviet era work classified). Almost all publications about this drug registered in the database Medline, owned by Russian and Ukrainian authors. In 2010, the us Food and Drug Administration refused to register the “Arbidol” as medicines, and although the term of the patent for this drug in 2011-2012 held in Russia the first line in sales, expired in 2007, interest in his production has not shown in any country in the world. Sales today are limited to Russia, Ukraine and Belarus. In recent years the hype surrounding “Arbidol” subsided, but “Pharmstandard” launched “Kagocel”, which in many ways is its counterpart and which by the end of 2015, took second place in sales among OTC drugs in Russia.

It is worth mentioning, for example, and “Actovegin” is a drug included in the top five of the most actively traded in Russia in the last ten years. Manufactured by Nycomed, it is not mentioned on its international website and not sold in Europe and the USA, as the use there of extracts from the blood of cattle, which is the “Actovegin”, banned since the early 1990-ies. Nycomed came out with the drug on the Soviet market, so today, more than 80% of sales come from CIS countries. Despite the fact that the drug is certainly out of date, it is still actively promoted in Russia and covers about 0.8% of the commercial market of medicines in the country.

“Anaferon”, another child of Russian scientists registered as “the drug activates antiviral immunity”. Developed at the Tomsk Institute of pharmacology at the end of 1980-ies, he commercialized the company “Materia Medica holding” and more than 10 years was in the list of essential drugs, but he was expelled at the request of the manufacturer, as the presence in the list are not allowed to raise prices on the drug. With “Anaferon” is associated purely Russian record: all 18 publications about his ordeal, was on Medline, were written by its developers. For the time of release of the drug outside the CIS was not sold any packaging medicines, but sales in Russia (15-th place in early 2010-ies) provided “Materia Medica” sixth place by turnover among domestic pharmaceutical companies.

Obvious leader of Russian pharmaceutical market, the drug “Essentiale” in its various incarnations (the first place in sales for eight of the last ten years) is another example of a niche product Western company SanofiAventis. Studies conducted in the United States in 2003 did not reveal any positive effects on liver function, but set its protivopokazannosti in viral hepatitis. In Russia, the drug is present solely due to the fact that our legislation allows to market medicines that have not undergone double-blind controlled trials and it holds the leadership in sales, despite the fact that the Formulary Committee of Russian Academy of medical Sciences in 2009 placed him in the list of drugs with unproven efficacy.

Among the most common in the pharmacy networks of Russia means almost all the above applies also to “Mezim”, “Lenexa”, “Mildronate”, “Amiksina” “Oscillococcinum” and dozens of other drugs, which in most developed countries not even heard of.

Another way

The development of the pharmaceutical industry, which in times already forgotten Medvedev’s “modernization” was hailed as one of its drivers, all over the world is associated not with a marginal over-the-counter drugs, and prescription drugs (prescription drugs), a market which has reached last year of $772 billion and has a growth potential of 5.8–6.6% in the year on the horizon until 2020. In this truly original designs are highly appreciated by the market: the share of generics in total sales in this sector now exceeds 11.5 percent. The main sales are concentrated in four sectors — the treatment of cancer and hepatitis; diabetes; help with arthritis and psoriasis; the relief of various types of multiple sclerosis and Alzheimer’s disease. In Russia practically is not made of modern drugs in any of the directions; no domestic remedy in these sectors are not certified by the FDA.

In my opinion, the problem of reduced funding of the Russian healthcare system today is the main. In early 2010-ies, the average expenditure on medicines in Russia lagged behind the US in 10 times, they will lag behind in 8 or 12 times, does not matter. The main issues are those on which drugs these funds are spent and how the effectiveness of their use can be expected. Unfortunately, in Russia, the authorities either do not pay attention or deliberately lobbying for let and cheap, but useless “medication”. The most important task in such a situation are the maximum reorientation on the funds and the treatment protocols that are used in North America and Europe; the rejection of drugs that are not certified in the US or the EU; the abolition of additional certification in Russia, those drugs that this certification; and revision in the light of all this government-approved list of essential drugs. And rising prices, which one can fear such a reform will help to avoid a reorganization of the procurement process and the exclusion of unnecessary intermediaries.

The situation on the Russian drug market is a model example of conflict of interest “domestic producers” and “domestic consumers”, in which once again with the support and interests of the officials wins the first. However, if this can be tolerated in the case of production of industrial goods and agricultural products, lose health and lives of our fellow citizens for Mercantile and ideological interests of the bureaucrats and the Nouveau riche — is, in my opinion, still too much. Unhealthy health care is not to cure non-certified tablets.

The authors ‘ point of view, articles which are published in the section “Opinions” may not coincide with ideas of editorial.

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