RESULTS OF THE STUDY OF PUBLIC SATISFACTION ABOUT THEAVAILABILITY AND QUALITY OF THE DRUG SUPPLY SYSTEM IN RUSSIA

The article analyzes the results of monitoring the availability and quality of the drug supply system among the population of various age groups and financial situation. The purpose of this study is to study the satisfaction of citizens in the drug supply system in Russia and to build a medical and social portrait of the patient, which was developed based on the analysis of the results of a sociological survey conducted in dynamics for 2019-2021. In the course of the research, such methods as: sociological, study and generalization of experience, analytical, methods of descriptive statistics were used. The results of the sociological study indicate the need for additional work to improve the availability and quality of LLR and the level of awareness of patients about the system of drug reimbursement. The obtained data can be used for health management bodies at various hierarchical levels, confirm the special social significance of solving this problem and the need to introduce preventive measures to involve patients in healthy lifestyle, increase public confidence in domestic drugs.

STUDY OF THE QUALIT Y OF PHARMACEUTICAL INFORMATION FOR PATIENTS FROM THE PERSPECTIVE OFTHE PROPER USE OF ANTI-ASTHMATIC DRUGS

RELEVANCE. Bronchial asthma, along with cardiovascular and oncological diseases, is one of the three most common chronic non- communicable diseases. For the most part, anti-asthmatic drugs (LP) are presented in the form of aerosols, powders, solutions for inhalation and other dosage forms intended for administration directly into the human respiratory tract. It is obvious that misunderstanding of the method of application and / or insufficient effectiveness of LP due to improper use can lead to a decrease in patients’ adherence to the prescribed therapy. In this regard, the availability of pharmaceutical information in the instructions becomes important, i.e. the more accessible the information in the instructions is to the patient, the higher the probability of proper use of the drug, maintaining patient compliance and preserving the patient’s quality of life. PURPOSE. The aim of the study was to analyze the completeness of pharmaceutical information provided in the instructions for the medical use of anti-asthmatic drugs (LP) and on the websites of manufacturing companies, from the standpoint of patients’ compliance with the rules for the use of LP. The main objectives of the analysis were: identification of the proportion of anti- asthmatic drugs that have a detailed scheme of use in the instructions; analysis of the instructions of anti-asthmatic drugs from the position of having indications of additional features of the use / use of drugs; analysis of instructions for anti-asthmatic drugs, the use of which is possible for groups of patients with physical or cognitive disabilities; identification of the share of companies producing anti-asthmatic drugs that support patients by conducting a specialized consulting service on the use of drugs. METHODS. The assessment of the quality of pharmaceutical information for patients was carried out on the basis of an analysis of 165 instructions for the medical use of pharmacotherapeutic groups of drugs designated in GINA-2021 (Global Initiative for Asthma-2021) and Federal Clinical Guidelines for the Treatment of Bronchial Asthma of the Russian Respiratory Society (2019) as anti-asthmatic drugs. The analysis was also carried out in relation to the information content of the websites of anti-asthmatic LP manufacturers, additionally, by creating a direct search query, the presence of a private page on the Internet for specific LP was determined. In the course of the research, methods of logical, comparative analysis, as well as generalization and grouping were used. To process the results obtained, the Excel computer program of the Microsoft Office 10 package was used. RESULTS. As a result of the analysis, it was revealed that the vast majority of anti-asthmatic drugs of all the studied pharmacotherapeutic groups are intended for administration directly into the respiratory tract, the article presents the results of a study on the ratio of inhaled and non-inhaled dosage forms in the context of the analyzed pharmacotherapeutic groups. The article presents data on the proportion of anti-asthmatic drugs that have a detailed description in the instructions in addition to the standard method of application (figure, diagram, pictogram) the method of introduction / use of LP. The fact of the absence of a detailed method of application in the instructions of various pharmacotherapeutic groups has been established. The results of the analysis of the number of instructions with the additional properties of LP indicated in them, allowing the use of LP data in patients with physical or cognitive characteristics (limitations), are presented. The number of companies producing anti-asthmatic drugs that have posted detailed information for consumers regarding the use of these drugs on their websites, as well as the number of drugs that have their own website, has been revealed. CONCLUSION. The information in the instructions for the medical use of anti-asthmatic drugs and on the official websites of the manufacturing companies (holders of registration certificates) of the studied drugs is not always exhaustive in terms of the use of inhaled dosage forms, which does not fully ensure the safe and effective receipt of anti-asthmatic pharmacotherapy. According to the authors, improving the quality of information for patients about the rules of using drugs for the treatment of bronchial asthma will simplify the use of dosage forms specific for its therapy, increase patients’ adherence to prescribed pharmacotherapy, reduce the risks from insufficient effectiveness of anti-asthmatic pharmacotherapy and preserve the quality of life of patients associated with the disease.

PHARMACY CONSULTING: NEW DRUG FORMS AND NEW OPPORTUNITIES

Pain syndrome of various origins and varying intensity is the most common and leading reason for seeking medical care in the world. The main drugs for the relief of both acute and chronic pain syndrome from the 20th century to the present are non- steroidal anti-inflammatory drugs (NSAIDs). More than 30 million people worldwide receive them every day. Along with pain, other common indications for NSAIDs are fever and inflammation. All NSAIDs differ in the degree of effectiveness, form of release, speed of onset of clinical effect and dosage. That is why one of the fundamental tasks of the pharmacist, in the framework of pharmacy counseling, is to provide the patient with quality medicines and teach them how to use them rationally. With the rapid development of medical and information technologies in the modern world, the fulfillment of this task becomes more and more important, complex and responsible action. The appearance, on the pharmaceutical market innovative NSAIDs in accelerated-release dosage’s forms (for example, Ketorol® Express), makes it possible to expand the pharmacy list.

ANALYSIS OF MEDICAL PURPOSES ANDPRICE AVAILABILITY OF THE ASSORTMENT OF BETA-ADRENOBLOCKERS USED FOR THE TREATMENT OF MYOCARDIAL INFARCTION

Patients who have had myocardial infarction (MI) represent a group of patients with a very high risk of cardiovascular complications: first of all, recurrent myocardial infarction, chronic heart failure and cardiovascular death. Clinical studies have shown an increase in life expectancy after MI when prescribing selective β-blockers for long-term prophylaxis, especially in the presence of chronic heart failure complicating the course of MI. The main clinical goals of prescribing β-blockers are to improve the supply of oxygen to the myocardium and to prevent the development of life-threatening cardiac arrhythmias. In view of the above, drugs in this group should be used indefinitely in patients with MI [7]. In recent years, the analysis of the affordability of the use of treatment technologies, including for cardiovascular diseases (CVD), has stood out as a serious scientific area with its methodology, scientific tools and is currently an important source of information that helps in making management decisions in healthcare [3.6]. The purpose of this article was to conduct such an analysis in relation to the use of β-blockers in MI in Kuzbass.

THE STATE OF THE PHARMACEUTICAL INDUSTRY IN THE KINGDOM OF MOROCCO

IThe purpose of the article was to study the main characteristics of the pharmaceutical industry in Morocco. As materials were studied the official websites of pharmaceutical manufacturers in Morocco, policy documents of industrial pharmaceutical associations, specialized pharmaceutical press of Morocco, educational resources of Morocco and France. As a result, it was found that the pharmaceutical industries of Morocco and Russia are already interacting with each other: BIOCAD supplies high-tech drugs and production technologies to Morocco, Morocco has placed an order with R-Pharm for the purchase of a vaccine against COVID-19, produced under the license of AstraZeneca, and also ordered a million doses of Sputnik V vaccine. Morocco is one of the fastest growing countries in the Middle East and Africa with an economy of $119 billion, a population of 37 million,andtotalhealthspendingof5.5%ofGDP.Expendituresforhealthcarearequitehigh-53.6%oftotalfamilyexpenditures. 31.7% of total health care expenditure is spent on drug purchases. The pharmaceutical industry in Morocco began to develop in 1960 after the end of the French protector and the introduction of the obligation to localize drugs sold in Morocco by foreign pharmaceutical companies. The pharmaceutical industry in Morocco is represented by 51 factories, which cover 2/3 of the country’s drug needs. Mostly generics are produced, 10% of production is exported. The volume of the issue is $1.68 billion (2nd place in Africa). The products are of high quality and certified according to European standards. Morocco is endeavoring to transform its pharmaceutical industry into a strategic asset for influencing African countries through the creation of an «African House of Medicines» based in Morocco, which is the manufacturing and logistics center for medicines in Africa. The main documents regulating the pharmaceutical industry are: Law No. 17-04 of 2006. “Code of Medicines and Pharmacy” and Order of the Minister of Health No. 902-08 5654 of 2008. “Requirements for the premises of pharmaceutical organizations.” Thus, we conclude that the Kingdom is a regional leader with ambitious plans and a large backlog that needs new technologies, markets for pharmaceutical products, a large number of qualified personnel, high-tech drugs at affordable prices. The intensification of cooperation between Russia and Morocco will help both countries to gain a foothold in the rapidly growing pharmaceutical market in Africa.

ANALYSIS OF COMPLIANCE WITH THE REQUIREMENTS OF GOOD PHARMACY PRACTICE FOR PHARMACEUTICAL CONSULTINGWHEN CHOOSING OTC DRUGS ON THE WEBSITES OF ONLINE PHARMACIES

Purpose of the study: to analyze the current state of Internet pharmacy websites in terms of compliance with Good Pharmacy Prac- tice requirements for pharmaceutical counseling for OTC-medicines. Methods. The study used the method of content analysis; a search was carried out in the search engines Google and Yandex for the keywords, «buy a pharmacy», «a drug store to buy a drug», «online pharmacy». TOP 25 pharma- cy websites were subjected to logical, comparative and structural analysis. The study consisted of 2 stages: an anal- ysis of the requirements of regulatory documents for pharmaceutical consulting when selling OTC drugs and an as- sessment of pharmacy websites in terms of ensuring compliance with these requirements when carrying out online commerce. Results. Studies of online pharmacy websites showed that most of the sites did not fully comply with the regulated require- ments: a pharmaceutical license is presented on 80% of sites, information on the type of pharmacy organization, on the impossibility of returning and exchanging pharmacy goods - on 76% of sites. The choice of OTC drugs based on symptoms within the framework of responsible self-medication was available on 24% of Internet pharmacy sites, but there were no indications of symptoms requiring immediate medical attention. Links to the State Register of Maximum Selling Prices were available on 8% of Internet pharmacy sites. Conclusion. Comparative analysis of information requirements in relation to pharmaceutical consulting in a pharmacy, reg- ulated by Orders of the Ministry of Health of Russia No. 80 «On approval of the Industry standard» Rules for the dispensing (sale) of medicines in pharmacies. Basic provisions «and No. 647n dated 31.08.2016» On approval of the Rules Good Pharma- cy Practice of Medicinal Products for Medical Use ”, Government Decree No. 697 of May 16, 2020“ On Approval of the Rules for Issuing Permits for Remote Retail Sale of Medicinal Products for Medical Use, Implementation of Such Trade ... ”, showed that most of the requirements for offline pharmacy were reflected in relation to Internet pharmacies, however, as a result of the analysis of Internet pharmacy websites, it was found that these requirements are not fully met. Additional criteria for evaluating online pharmacy sites corresponding to the level of pharmaceutical care in an offline pharmacy are proposed: the ability to select an OTC drug by symptoms within the framework of responsible self-medication, the presence of indications of symptoms that require immediate medical attention, the presence of instructions for the medical use of the drug in in ac- cordance with the State Register of Medicines, ensuring access to the State Register of maximum selling prices, availability of information on the actual shelf life of the medicinal products being sold.

АSSESSMENT OF THE PRODUCTIVE AND RESOURCE CAPABILITIES OF COUNTRIES FOR MULTIDRUG-RESISTANT TUBERCULOSIS CONTROL

The spread of multidrug-resistant and extensively drug-resistant tuberculosis (MDR and XDR) requires the search and implementation of not only new diagnostic methods, but also innovations in the treatment of the disease. Aim. The assessment of current treatment options for multidrug-resistant tuberculosis in different countries. Materials and Methods. There was carried out the content analysis of the official sources of 24 countries concerning the drugs that had been registered at these countries and recommended by the World Health Organization for the treatment of multidrug-resistant tuberculosis and put into circulation from 2000 to 2020: linezolid, bedaquiline, delamanid, clofazimine (as of 07.2020). The data were compared with the characteristics of the epidemiological situation in the country. Results. There was developed a six-digit classification by the following criteria: the presence of international nonproprietary names for drugs; the availability and range of dosage forms; the number of drugs subject to all dosage forms, dosages, pharmaceutical forms and units of packaging; the presence in the domestic market of the original product; the time of registration of drugs in the specified territory; the level of multi-drug resistance of the pathogen in the country per 100,000 population. Among the countries with the highest market coverage with a low (up to 0.5 per 100 thousand) level of multidrug resistance, a large share falls on European countries. As for a number of African States, there may be a threat of spreading the disease taking into account the epidemiological situation for multidrug-resistant tuberculosis and with only linezolid registered. The list of countries with a level of the same indicator above 15 per 100,000 population includes Russia and Namibia with radically different market characteristics. If Russia possesses the entire available range of medicines with the number of nomenclature items above 200, then Namibia has no more than 10 linezolid preparations registered only in tablet form. The main supplier of innovative products in the field of tuberculosis control is the Asia-Pacific region. Сonclusion. It is defined that the characteristics of the drug market differ significantly depending on the economic development of states and are determined by the indicator of the disease burden. Success in the tuberculosis control is impossible without the active development of the pharmaceutical industry and the replenishment of the market with innovative products.

MARKETING STUDY OF ORAL FORMS OF OMEPRAZOLE PREPARATIONS USED FOR THE TREATMENT AND PREVENTION OF GASTROESOPHAGEAL REFLUX DISEASE AND GASTRIC ULCER

Some of the most widespread illnesses of alimentary canal are the stomach (gastric) ulcer, duodenal ulcer disease, gastroesophageal reflux diseases. The ethanol of antisecretory treatment of the given acid-dependent diseases are the preparations of the proton pump inhibitor group with omeprazole which is considered to be more effective and investigated. The goal of the research is the oral medications omeprazole (20 mg) assortment market investigation. Materials and methods. The research objects are the State register of medicines data of oral medicinal products including omeprazole dosing 20 mg recorded on the pharmaceutical market as well as the State price register data on the vital medicinal products on April, 4, 2021. Results. According to the SRMP 30 trade names of medicinal products including omeprazole dosing 20 mg as active ingredient in capsules and tablets are registered on the pharmaceutical market in Russian Federation. The omeprazole products distribution in the countries holding registration certificates showed the predominance of domestic production medicinal products (18 trade names, 60 %). The cost analysis of standard daily and course dose oral omeprazole form (20 mg) of different trade names allowed to select economically profitable preparations (”Omeprazole”, LLC “Production of Medicines”, Russia; “Omeprazole”, OJSC ‘‘Synthesis”, Russia; “Omeprazole” LLC BFMP, Russia), the insert of which into the list of medicines to provide the gastroesophageal reflux disease and stomach (gastric) ulcer patients at the regional level is economically feasible as well the medicines with the high price (Losec MUPS AstraZeneca AB, Sweden). Сonclusion. The results of the pharmaceutical market research of oral omeprazole form (20mg) indicates a great majority of generic medicine, a sufficient market capacity, medicine predominance of domestic production (60%).

RESEARCH OF THE FEATURES OF DRUG PROVISION OF THE REPUBLICAN DERMATOVENEROLOGIC SIMFEROPOL DISPENSARY

In the structure of the total morbidity of the Russian Federation population in 2018, skin and subcutaneous adipose tissue diseases made about 3,5 of the total number of cases, which amounted to 8330 thousand registered cases of diseases. The purpose of the research was to analyze the expenditure of material resources allocated for drug provision of the State Budgetary Institution of Healthcare of the Republic of Crimea “Clinical Dermatovenerologic Dispensary” (SBIH RC “CDVD”) for the period from January 1, 2020 to December 31, 2020. Materials and Methods. Based on the data obtained from the Statistical Department of SBIH RC “CDVD” on the financial means expenditures on the purchase of drugs, an assessment of the budgetary funds expenditures was carried out by means of ABC/VEN analysis. Results and discussion. According to the data received, for the period from January 1, 2020 to December 31, 2020, 3 156 patients were admitted to inpatient departments. 9, 072, 064, 00 rubles were spent on the treatment of patients’ nosologies, while the list of all drugs used included 98 names. The ABC analysis showed the feasibility of spending monetary resources, which confirms the lack of “N”- category (minor) drugs among “A” – category drugs (80% of the budget). The results of VEN-analysis indicated that 50% of the drugs used are referred to “V” category, which indicates that the Healthcare Institution predominantly purchased vital drugs. Conclusion. Active implementation of the methodology of management of medical care with help of modern technologies of ABC- and VEN- analyses allows timely implementation of measures to rationalize drug procurement in inpatient and outpatient healthcare institutions, as well as the choice of drugs for inclusion into the formulary and treatment standards.