Analysis of the strategy of drug provision of certain categories of the population of the krasnodar region

The research devoted to providing the population with preferential medicines is quite relevant, since it is a priority area in the framework of state social assistance. The state program of preferential drug provision affects the effective economic development of the domestic pharmaceutical market, the successful overcoming of social risks, prevents a decrease in the standard of living of the population, in particular, it assumes a significant reduction in patient costs for high-tech medical care. The priority state tasks of improving the preferential drug supply for certain categories of citizens until 2025 are defined in the Strategy for drug provision of the population of the Russian Federation. The article presents the regulatory framework for the implementation of the Strategy on the example of the Krasnodar Territory. Analysis at the regional level of preferential drug provision has made it possible to identify some modern trends in financing this area. The dynamics of growth in funding for drug provision to the privileged category of citizens from the federal budget has been revealed on the basis of the obtained data. The analysis of the provision of preferential drugs on a regional scale, proposed in the research, also tends to increase, which undoubtedly improves the condition of patients in a number of nosological forms. The results of the research are presented by a detailed analysis of the dynamics of the number of citizens eligible for state social assistance in terms of drug provision. The proportion of citizens using preferential drug provision over the past several years is stable. An analysis of the financing of preferential drug provision for residents of the region has revealed a tendency for the growth of subventions to municipalities for the implementation of powers to provide the necessary drugs, respectively, the average amount of funds for drug provision of one resident of the region, who has a corresponding benefit, has increased. Moreover, the analysis has revealed an increase in financing of the privileged category of citizens from the regional budget. As a result of the research, a downward trend in preferential drug provision for citizens from other regions has been revealed, which is due to the limited attendance of the region due to the coronavirus infection. The analysis of the provision of drugs to the population by «high-cost nosologies» indicates an increase in the cost of financing them. The results of the analysis of the implementation of the Strategy for drug provision in the Krasnodar Territory have made it possible to identify the effectiveness of financial state support for certain categories of the population.

ANTIHISTAMINES: RESEARCH AND ANALYSIS OF THE REGIONAL RETAIL MARKET

the aim. Focused on optimizing the assortment portfolio of pharmacy organizations and improving the process of drug supply to end-consumers, the aim of the study was to analyze the regional pharmaceutical market for antihistamines.Materials and methods. In the study, the following methods were used: a content analysis of regulatory documents; a documentary observation method of the volume of antihistamines sales; a sociological survey method. The objects of the study were accounting registers in 32 pharmacy organizations for 2020, as well as the sociological survey results of 174 respondents – consumers of antihistamines.Results. The classification analysis of 38 international non-proprietary trade names of antihistamines, represented by 187 names of drugs, revealed the prevalence of the first-generation drugs (63%). On the Russian pharmaceutical market, there were also 55% of foreign production drugs. At the regional level, there are 66 types of drugs in circulation, 50% of which are second-generation ones. The cost analysis showed rather a wide rage of the pricing proposal and the economic availability of antihistamines for patients. The sociological survey revealed the fact that 46% of the consumers were ready to pay for the necessary drugs in the price range “over 100 and up to 500 rubles” (over $ 1.38 and up to $ 6.88) for one conventional package. A medical-demographic profile of the antihistamines consumer at the regional level has been made up, and guidelines for pharmaceutical specialists on managing the assortment portfolio of pharmaceutical organizations have been developed.Conclusion. As a result of the study, the following facts have been established: the seasonal peaks in the antihistamines consumption; a gradual renewal of the pharmacies assortment portfolio due to the increased consumption of the second and third generation antihistamines. The medical and demographic profile of the consumer should be taken into consideration when planning a drug provision for the patients with allergic pathologies, and it is connected with the growth in pharmacies profits due to the sale of drugs in the range from 100 to 500 rubles (from $ 1.38 to $ 6.88). The methodical recommendations have been brought to the attention of the management of regional pharmacy organizations.

ANALYSIS OF THE MANAGEMENT OF DRUG PROVISION FOR INPATIENTS IN A MEDICAL AND PROPHYLACTIC INSTITUTION

В статье представлена схема распределения лекарственных средств в лечебно-профилактических учреждениях. Приводятся основные положения логистики ЛС в медицинских организациях, наиболее распространенные типы нерационального использования ЛС, причины и последствия неправильного использования ЛС. Обоснована необходимость модернизации работы аптеки в лечебно-профилактической организации. The article presents a scheme for the distribution of drugs in medical institutions. The main provisions of drug logistics in medical organizations, the most common types of drug misuse, causes and consequences of drug misuse are given. The necessity of modernizing the work of a pharmacy in a medical and preventive organization has been substantiated.

Orphan diseases and associated problems

Objective: to study the main aspects of assistance to children with orphan diseases in the Russian Federation. Materials and methods: the most relevant literature sources were studied that covered a concept of orphan diseases in various countries of the world and in the Russian Federation as well as the tactics and regulation of mechanisms for helping patients with rare diseases. Results: the study showed that not all countries have legislative regulations of assistance to orphan patients. The United States and Western Europe are the most advanced in this regard. They have clear criteria for determining orphan pathology and a number of measures are taken to improve the quality of medical care for patients with rare diseases. These activities are not only aimed at improving the health care system but also encourage pharmaceutical companies to develop and produce medicines as well as contribute to the research in this area. The clinical cases covered in the article provide an idea of rare diseases, the complexity of their diagnosis, the severity of the course, and the drugs that are necessary to help patients. Conclusion: orphan diseases have been the focus of attention by the health system and national legislation in the past decades. Their extremely low prevalence in the human population creates difficulties with the timely diagnosis, provision of qualified medical care, and drug provision.

ANALYSIS OF POPULATION SATISFACTION WITH THE QUALITY OF PROVIDING SERVICES ON PREMIUM MEDICINAL PROVISION

Drug therapy is one of the main components of medical care for the population, and the provision of drugs is an important indicator of its availability and quality. The purpose of our work was to analyze satisfaction with the quality of the provision of services for preferential drug provision. The works of domestic and foreign scientists in the field of preferential drug provision, as well as regulatory and organizational documentation on pharmaceutical activities were taken as an information base. The survey method served as the main research method. The objects of the study were the visitors of the pharmacy organizations of the Oryol region, who receive drugs under the program of preferential drug provision. The study found that 49.0% of respondents had difficulties in making an appointment with a doctor; cases of refusal to issue a prescription were indicated by 29.0% of the respondents; 45.0% of the respondents had to spend a long time on obtaining a preferential prescription for a drug by the decision of a medical commission. The majority of respondents (54.0%) do not receive medicines on preferential terms on time (postponed for more than 10 days). Almost half of the surveyed respondents (48.0%) are not satisfied with the treatment with prescription drugs prescribed under the program of preferential drug provision, due to the lack of drugs prescribed by a doctor in the pharmacy organization at the time of contact and their preference for drugs from other manufacturers. Most of the respondents (61.0%) consider the range of preferential drugs to be insufficient for the treatment of their underlying disease. Some respondents (20.0%) are not satisfied with the service in a pharmacy organization; 19.0% are dissatisfied with the quality and completeness of information about medicines received from a doctor and a pharmacy worker. The results obtained were communicated to the management of medical and pharmaceutical organizations serving privileged categories of citizens in the Oryol region. The authors of the study developed a Standard Operating Procedure “Procedure for Selling Medicines to Beneficial Categories of Citizens”, which helps to optimize the quality of service in pharmacies for the population receiving medicines under the preferential drug provision program.

FEATURES OF THE DRUG ENFORCEMENT OF THE RURAL POPULATION OF THE REPUBLIC OF ADYGEA

Improving the availability of medical and medicinal care is the most important task of all levels of government and especially relevant in the context of modernization of the health system. The purpose of the work was to analyze the peculiarities of the functioning of the Drug Provision System of the Rural Population of the Republic of Adygea to identify reserves for its development and substantiate directions for further improvement, taking into account regional conditions. It was established that in the Republic of Adygea out of 160 units of medical organizations, the right of retail trade in drugs, 112 medical and obstetric items that have licenses for pharmaceutical activities are used by drug trading. A feature of the implementation of pharmaceutical activities in rural areas is the absence in most places of modern transport highways, which creates logistics problems and significantly complicates the regular delivery of drugs to the population. Among the positive points, the appearance of an additional way of delivering drugs to the feldsher-obstetric items located in hard-to-reach (mountainous) areas implemented in the federal population to ensure the necessary drugs is noted. The inclusion of pharmacies of partners in the system of ensuring the population did not require additional agreements and expenditures on their services, since this function does not carry additional costs, but at the same time increases their image. It has been established that over the past 2 years, the quality of drugs in the countryside residents decreased significantly. In the region, the number of current pharmaceutical activities has decreased by 21%, the number of operating paramedic-obstetric items has also decreased by 18%, and the number of pharmacies of the program has decreased by 2.8 times. Currently, unresolved problems of the organizational nature came to the fore, among which: the absence of working capital organizations for the acquisition of drugs, in the presence of extrabudgetary funds received from the implementation of paid medical services; insufficient legal training of individual officials of medical organizations in state procurement issues; the absence from the overwhelming number of retail trade licenses for transportation of goods of pharmacy assortment and others. The identified problems are based on the basis of the work plan of health authorities, pharmaceutical activities, medical and pharmaceutical organizations of the Republic of Adygea to improve the forms and working methods for the provision of agricultural drugs.

The efficacy of the interleukin 17 inhibitor ixekizumab in psoriatic arthritis: data from real clinical practice

The article describes the peculiarities of drug provision for patients with psoriatic arthritis (PsA) in the Republic of Karelia. We present a clinical case of effective treatment with interleukin 17 inhibitor ixekizumab (IXE) in a randomized clinical trial and real clinical practice in a patient with PsA. The distinctive feature of this case is the severity of PsA course that was not controlled by standard methods of therapy. IXE treatment was characterized by a rapid clinical improvement of both articular and skin symptoms and subsequent achievement of remission, which lasted for 3 years (on the therapy). The forced interruption of the treatment led to the relapse of the disease in a short amount of time. In 2 years IXE therapy was resumed; after 6 months of continuing treatment a stable remission of PsA was achieved. The patient is still in clinical remission (on therapy).

Pharmacoeconomical approaches for assessing the rational use of ophthalmic drugs in polyclinic settings

Purpose. To evaluate the results of the rational use of ophthalmic medicines with the use of pharmacoeconomical analysis. Material and methods. With the help of ABC-VEN analysis, a comparative study of the quality of pharmacotherapy and drug provision of patients who were monitored and treated by an ophthalmologist of the polyclinic in 2015 and 2019 was conducted. Results. As a result, it was found that the share of costs for vital drugs increased by 10.1% and amounted to 71.1% in 2019, which corresponds to the standardized criterion (70-80%). There was a reduction in the cost of purchasing secondary drugs by 7.6%, which indicates a rational drug supply of ophthalmic drugs. The most commonly used drugs for the treatment of glaucoma were 27.8% in 2015 and 35.1% in 2019. The share of their acquisition costs was 54.9% and 67.9%, respectively. There was a significant increase in the range and number of drugs for the treatment of patients with glaucoma: a 2.8-fold increase in the number of purchased eye drops for monotherapy and a 12% increase in the number of combined drugs. Conclusion. Pharmacoeconomical analysis showed an optimization of spending money on the purchase of drugs used in ophthalmology: an increase of 10.1% in the share of vital drugs and a decrease of 7.6% in the cost of purchasing secondary drugs. There was an increase in the range and quantity of drugs for the treatment of patients with glaucoma. Key words: ABC-VEN-analysis, drugs, ophthalmology, pharmacoeconomics.