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Assessment of the impact of procurement centralization on the drug provision for patients within the High-Cost Nosology Program in the Russian Federation

https://doi.org/10.17749/2070-4909/farmakoekonomika.2024.268

Abstract

Background. In the Russian Federation, patients receive expensive drugs from the federal budget funds within High-Cost Nosology (HCN) Program.

Objective: to assess the impact of drug procurement centralization on the weighted average price (WAP) per 1 unit of measurement (UM) of a drug, the procurement structure within HCN Program over 5 years (2019–2023), as well as the annual volume of procurements for each nosology and the additional annual growth compared to the previous year.

Material and methods. The data on public procurement within HCN Program, regional and federal drug provision programs over the specified time period have been analyzed. During the analysis of individual nosologies, 22 drugs for the treatment of 12 HCN have been considered.

Results. The median value of the change of WAP per 1 UM for all drugs within HCN Program was 6.01%. Aplastic anemia was characterized by the lowest volume of procurements over 5 years, while for malignant neoplasms was the largest. The growth in procurements from year to year within nosologies varied from +1% to +661%, while a decrease was from –97% to –1%.

Conclusion. The results can be used as a basis for further research related to the process of implementation of preferential drug provision, and to development of additional tools to improve the efficacy of pharmacotherapy choice for included drugs and management decisions regarding the further expansion of HCN Program.

About the Authors

V. V. Omelyanovskiy
Center for Healthcare Quality Assessment and Control; Financial Research Institute; Russian Medical Academy of Continuing Professional Education; Semashko National Research Institute of Public Health
Russian Federation

Vitaly V. Omelyanovskiy, Dr. Sci. Med., Prof

6/20 bldg 2 Pokrovsky Blvd, Moscow 109028

3 bldg 2 Nastasyinskiy Passage, Moscow 125375

2/1 bldg 1 Barrikadnaya Str., Moscow 125993

12 bldg 1 Vorontsovo Pole Str., Moscow 105064



V. A. Ryagina
Center for Healthcare Quality Assessment and Control
Russian Federation

Veronika A. Ryagina

6/20 bldg 2 Pokrovsky Blvd, Moscow 109028



A. G. Kharitonova
Center for Healthcare Quality Assessment and Control; Sechenov University
Russian Federation

Anna G. Kharitonova

6/20 bldg 2 Pokrovsky Blvd, Moscow 109028

8 bldg 2 Trubetskaya Str., Moscow, 119048



K. I. Matrenin
Center for Healthcare Quality Assessment and Control
Russian Federation

Kirill I. Matrenin

6/20 bldg 2 Pokrovsky Blvd, Moscow 109028



A. A. Kingshott
Center for Healthcare Quality Assessment and Control; Russian Medical Academy of Continuing Professional Education
Russian Federation

Anastasia A. Kingshott

6/20 bldg 2 Pokrovsky Blvd, Moscow 109028

2/1 bldg 1 Barrikadnaya Str., Moscow 125993



O. V. Ashikhmina
Center for Healthcare Quality Assessment and Control
Russian Federation

Olga V. Ashikhmina

6/20 bldg 2 Pokrovsky Blvd, Moscow 109028



M. V. Zhirov
Center for Healthcare Quality Assessment and Control
Russian Federation

Maksim V. Zhirov

6/20 bldg 2 Pokrovsky Blvd, Moscow 109028



References

1. Federal Law dated 21.11.2011 No. 323-FZ “On the basics of public health protection in the Russian Federation”. Available at: https://base.garant.ru/12191967/ (in Russ.) (accessed 18.08.2024).

2. Federal Law dated 03.08.2018 No. 299-FZ “On amendments to the Federal Law "On the basics of public health protection in the Russian Federation”. Available at: https://base.garant.ru/72005588/ (in Russ.) (accessed 18.08.2024).

3. Decree of the Government of the RF dated 23.11.2020 No. 3073-r “On amendments to the Decree of the Government of the Russian Federation dated October 12, 2019 No. 2406-r”. Available at: https://docs.cntd.ru/document/566395865 (in Russ.) (accessed 18.08.2024).

4. Decree of the Government of the RF dated 26.11.2018 No. 1416 “On the procedure for organizing the provision of medicines to persons with hemophilia, cystic fibrosis, pituitary nanism, Gaucher disease, malignant neoplasms of lymphoid, hematopoietic and related tissues, multiple sclerosis, hemolytic-uremic syndrome, systemic juvenile arthritis, mucopolysaccharidosis of types I, II and VI, aplastic unspecified anemia, hereditary deficiency of factors II (fibrinogen), VII (labile), X (Stewart–Prauer), persons after organ and (or) tissue transplantation, and also on the invalidation of certain acts of the Government of the Russian Federation”. Available at: https://base.garant.ru/72113444/ (in Russ.) (accessed 19.08.2024).

5. Decree of the Government of the RF dated 23.12.2021 No. 3781-r “On amendments to the Decree of the Government of the Russian Federation dated October 12, 2019 No. 2406-r”. Available at: https://www.garant.ru/products/ipo/prime/doc/403194845/ (in Russ.) (accessed 18.08.2024).

6. Decree of the Government of the RF dated 16.04.2024 No. 938-r “On amendments to the Decree of the Government of the Russian Federation dated October 12, 2019 No. 2406-r”. Available at: https://www.garant.ru/products/ipo/prime/doc/408801469/ (in Russ.) (accessed 19.08.2024).

7. Decree of the Government of the RF dated 12.10.2019 No. 2406-r “On approval of the list of vital and essential medicines for medical use for 2020, the list of medicines for medical use, including medicines for medical use prescribed by decision of medical commissions of medical organizations, the list of medicines intended to provide persons with hemophilia, cystic fibrosis, pituitary nanism, Gaucher disease, malignant neoplasms of lymphoid, hematopoietic and related tissues, multiple sclerosis, hemolytic-uremic syndrome, juvenile arthritis with systemic onset, mucopolysaccharidosis of types I, II and VI, persons after organ and (or) tissue transplantation and a minimum range of medicines necessary for medical care”. Available at: https://docs.cntd.ru/document/563469457 (in Russ.) (accessed 19.08.2024).

8. Denisova A.I., Sozaeva D.A., Gonchar K.V., Aleksandrov G.A. Im- proving the methodology for assessing the economic efficiency of public E-procurement of medicines. Financial Journal. 2023; 15 (4): 63–81 (in Russ.). https://doi.org/10.31107/2075-1990-2023-4-63-81.

9. Rudakova A.V., Ugrekhelidze D.T., Krylov V.A. Economic conse- quences of mandatory price re-registration for medicines from the high-cost nosology program. Kachestvennaya klinicheskaya praktika / Good Clinical Practice. 2020; 3: 27–33 (in Russ.). https://doi.org/10.37489/2588-0519-2020-3-27-33.

10. Trofimova Е.О., Denisova M.N., Utomova A.S. Structural changes and import substitution processes in the VZN segment in 2008–2018. Remedium. 2019; 6: 14–9 (in Russ.).

11. Fokina D.S., Zhukova O.V., Khokhlov A.L., Volkova S.A. Economic analysis of the use of drugs for the treatment of hemophilia A, B and Willebrand's disease. Kachestvennaya klinicheskaya praktika / Good Clinical Practice. 2023; 4: 15–24 (in Russ.). https://doi.org/10.37489/2588-0519-2023-4-15-24.

12. Tolkushin A.G., Fedorov A.A., Zhulev U.A., et al. Directions of development of the program of drug provision for expensive diseases. Health Care of the Russian Federation. 2019; 63 (5): 237–44 (in Russ.).

13. Ivakhnenko O.I., Ryazhenov V.V., Maksimkina E.A., et al. Analysis of actual results of drug supply implementation within framework of High-Cost Nosologies Program. Pharmacy & Pharmacology. 2024; 12 (1): 15–31 (in Russ.). https://doi.org/10.19163/2307-9266-2024-12-1-15-31.


What is already known about thе subject?

 During implementing High-Cost Nosology (HCN) Program difficulties regularly arise upon the distribution of limited financial resources for satisfying the requirements of all patients

 Many researchers have repeatedly considered options for solving this problem and assessed the activity within the HCN Program as a whole

What are the new findings?

 The changes were shown in weighted average price per 1 unit of measurement on drugs included in HCN Program due to centralization of procurements, starting from 2019

 The changes have been demonstrated in procurement structure within HCN Program over 2019–2022, particularly due to centralization of procurements for new drugs and nosologies

 The ratio of the procurement volume between nosologies has been traced in each year under considered period (from 2019 to 2023), and the annual additional growth in each nosology has been determined

How might it impact the clinical practice in the foreseeable future?

 The data obtained can be used to solve the difficulties associated with the financial restrictions of HCN Program by assessing the real effect of drug procurement centralization and proper distribution of financing between drugs within the individual nosology

Review

For citations:


Omelyanovskiy V.V., Ryagina V.A., Kharitonova A.G., Matrenin K.I., Kingshott A.A., Ashikhmina O.V., Zhirov M.V. Assessment of the impact of procurement centralization on the drug provision for patients within the High-Cost Nosology Program in the Russian Federation. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2024;17(3):285-300. (In Russ.) https://doi.org/10.17749/2070-4909/farmakoekonomika.2024.268

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ISSN 2070-4909 (Print)
ISSN 2070-4933 (Online)