Regulations 

The procedure for providing federal beneficiaries with medicines. Preferential provision of medicines

We are glad to welcome you on our page preferential medicine!

  1. What you need to know about preferential medicinal provision.

Program "Providing the necessary drugs" (ONLS), implemented in accordance with Law No. 122 - FZ "On State social assistance"Dated 22.08 2004, is a grand and large-scale project to provide drugs to certain categories of citizens eligible for state measures social support.

Regulations on the organization of preferential medicinal support:

Constitution Russian Federation;

Federal Law of 17. 07. 99 №178- FZ "On State Social Assistance"

Decree of the Government of the Russian Federation No. 890 dated 07/30/1994 "On State Support for the Development of Medical Industry and Improving Population and Health Institutions with Medicines and Products medical prescription»

Order of the Ministry of Health and social Development RF№ 110 from 12. 02. 2007. "On the procedure for appointing and writing medicines, medical products and specialized products medical nutrition»;

Order of the Ministry of Health of the Russian Federation of December 20, 2012 N 1175n Moscow "On approval of the procedure for appointing and writing medicinal preparationsAs well as forms of prescription forms for drugs, the order of design of these forms, their accounting and storage "

Order of the Ministry of Health and Social Development of the Russian Federation of 18. 09. 2006 No. 665 "On approval of a list of medicines released by the doctor's recipes during the provision of additional free medical care individual categories of citizens with the right to receive social assistance ";

Order of the Government of the Moscow Region from 04. 02. 2013 № 106 "On approval of a list of medicines and medical products necessary to ensure certain categories of citizens, with an outpatient treatment on doctors' recipes for free and with 50% discount";

The territorial program of state guarantees for citizens of the Russian Federation in the Moscow region of free medical care. "

II. Who belongs to the preferential category of citizens (According to the Decree of the Government of the Russian Federation No. 890 of 07/30/1994) :

There are 2 categories of preferential support of citizens of the Russian Federation:
- at the expense of the federal budget (federal beneficiaries);
- at the expense of the regional budget (regional beneficiaries);

1. Categories of the populationreceiving preferential from the federal budget:
- disabled of war;
- Participants Great Patriotic War;
- servicemen who have become disabled;
- veterans of hostilities;
- Persons awarded the "resident of the Blocade Leningrad" sign;
- family members of the dead (deceased) participants in the Great Patriotic War and host veterans;
- Citizens exposed to radiation due to the Chernobyl catastrophe
in 1986-1987;
-Infooted labor 1, 2, 3 groups;
- minor prisoners of concentration camps, recognized as disabled;
- imperfect prisoners of concentration camps created by the fascists.

2. Diseases and categories of citizensregistered on the territory of the Moscow region, the treatment of which occurs at the expense of the budget of the Moscow region:
2.1. free provision Drugs for diseases:
-bronchial asthma;
- diabetes;
- oncological diseases
(and other diseases, according to the Decree of the Government of the Russian Federation No. 890 of 07/30/1994);

2.2. Providing drugs with 50% discount from free prices:
- Tire workers;
- rehabilitated;
- Persons born until 01.01 1935.

III. What documents should be submitted to the patient when contacting medical and prophylactic The establishment for discharge recipes for the first time:

To make data on a new patient in a computer base of federal and regional beneficiaries, it is necessary to provide the operator of the Cabinet on the discharge of preferential recipes (Cabinet No. 23 in the Polyclinic on Matrosov, 13 or in the receptionist Polyclinic on Freight, 34) the following documents:
- passport of a citizen of the Russian Federation;
- a document confirming the right to receive a set of social services (certificate confirming the fact of disability);
- decision on the appointment of a monthly cash payment issued by the Pension Fund (certificate of EDA);
-insurance medical Policy;
-Snils;

IV. Who has the right to the statement of preferential recipes:

Plot therapist, general practitioner, doctor specialistincluded in the register of doctors eligible for the statement of preferential recipes and directly carrying the patient's treatment.

V. What drugs can you get on preferential medicinal provision:
-The precipitory drugs for federal beneficiaries Formed according to the order of the Ministry of Health and Social Development of the Russian Federation of September 18, 2006 No. 665.
- A list of drugs released by the preferential category of the population of the Moscow region (regional beneficiaries), according to the order of the Government of the Moscow region from 04. 02. 2013 No. 106.

Vi. The procedure for issuing preferential recipes:

After full-time inspection patientfrom a preferentately category, the doctor prescribes treatment with the range and volume of preferential drugs in the pharmacies of Mytishinsky district, makes an entry in an outpatient map about the name of the prescribed drug. Drugs are prescribed by medical indicationsBased on the diagnosis of the patient and the approved list of medicines.
The patient with the recommendations of the attending physician goes to the computer statement office of preferential recipes (Cabinet number 23 in the clinic at Matrosov, 13 or in the receptionist of the polyclinic on flight, 34), where the operator, following the algorithm for the data entry action algorithm for registration of a preferential recipe, automatically, using Programs "Corvette", draw up a preferential recipe.

The recipe is discharged in 3 copies, signed by the attending physician or medical commissions of the clinic. One of their copies is inserted into the outpatient map, two others are given to the patient.

On one prescription Blanco The installed vacation form is free to discharge the name of the drug on latin According to the international non-proprietary name. Also indicates the release form, dosage, required amount Medicinal preparation on the recommended course of treatment. The recipe is wrapped with policianic printing.


Drugs for the preferential category of citizens are discharged for a course of treatment up to 1 month. Preferential category of citizens pension age and disabled groups 1 possible registration of a preferential recipe on the course of treatment up to 3 months (According to the Order of the Ministry of Health of the Russian Federation No. 1175 of December 20, 2012).
IN some cases (expensive drugs, extract for a period of more than 1 month, etc.) Recipes are signed by the medical commission of the Polyclinic.

Medicines can be obtained by presenting a recipe only in that pharmacy, which is indicated in the information sheet of the recipe.

In case of temporary absence the necessary drug, the pharmacy organization organizes deferred recipe service.

Patient inpatient treatment, Extract freemedicinal medicines and medical products are not allowed. The exception is the treatment in day hospitals with an outpatient polyclinic institution.


The formation of the application for drugs for the preferential category of citizens:

The formation of an application for drugs for providing persons entitled to receive state social assistance is carried out by the treatment of clinics in accordance with the lists of preferential categories of citizens and data of passports of medical sites, taking into account the list of medicines released by the doctor's recipes for free.

The electronic register of the personalized drug need for federal and regional benefits on the basis of applications from attending physicians forms the deputy chief physician for the work on preferential medicinal support for work on preferential drug provision.

Application for drugs To ensure a preferential category of citizens is drawn up on a blank approved by the Ministry of Health of the Moscow Region, on time and in accordance with the established amounts of financial resources.

If the patient under life testimony is necessary for the medicine, not included in the approved listThe extract of such a recipe is carried out by decision of the Expert Commission of the Ministry of Health of the Moscow Region

What should I do in case of a loss of a recipe for free medicines?
In the event of a loss of the recipe, it is necessary to refer to the doctor who has written the recipe. This is necessary for obtaining a new recipe and so that no one can use the lost recipe. The doctor must record a record in an outpatient map of the patient and send information about the recipe for the pharmaceutical organization.

Actual information about the presence of drugs in pharmacies:

If you have any questions about the provision of drugs, contact
To Grigorovskaya Irina Yuryevna (deputy head doctor in CER)
at Ul.Matrosova d.13 cab. 28.

All this in the complex improves the quality of life of all groups of citizens, reducing cost-effective types of medical care. With the state of drugs in the residents of Moscow in 2015 and prospects for 2016 of the participants of the scientific and practical conference "Pharmaceutical service of the city of Moscow" in the framework of the annual - already the 14th Moscow Assembly "Health of the Capital" introduced the head of the Pharmacy Department of the Health Department . Moscow, Ph.D. Konstantin Alexandrovich Kokushkin.
- The main directions of drugs are: preferential drug provision of patients on the outpatient stage of treatment, the provision of patients in the hospital, lecture deregistration own funds Citizens in retail pharmacy organizations. Preferential provision Drugs in Russia are carried out through regional and federal budgets. Under the federal budget, the categories of beneficiaries are determined according to the Federal Law of July 17, 1999 No. 178-FZ (ed. From 07.21.14) "On State Social Assistance". The drugs released by this category are included in the appropriate federal list approved by the Order of the Ministry of Health of Russia. The regional aspect of the LAN is carried out according to the order of the Government of Moscow No. 1506-RP of 10.08.05 "On the implementation of measures of social support for certain categories of residents of the city of Moscow to provide medicines and medical products released by the recipes of doctors for free or with a 50 percent discount", which Determines as preferential categories Population and socially significant diseases.

About the Federal and Regional Budget

The total number of beneficiaries in the capital is 1 million 686 thousand people, this figure fluctuates a bit, but throughout recent years is on the same level; In dynamics, only the ratio between federal and regional beneficiaries - the number of federal beneficiaries decreases, and regional - increases. Patients usually make a choice not in favor of medicinal support, but in favor cash payments. After that, federal beneficiaries living in Moscow are addressed to medical institutions with a request to allocate medicines for regional benefits ... To date, the number of federal beneficiaries is 563 thousand, the number of regional beneficiaries - over 1 million people.

According to statistics, average cost The treatment of one patient at the expense of the regional budget is 5 thousand rubles, about 2.5 thousand rubles. Compensates the federal budget. The average cost of the recipe paid from the federal budget in 2015 was 866 rubles, the regional budget pays the recipe, the cost of which is 3 times more. Medicinal preparations and medical studies go to the Warehouse of the Center for the Medicinal Support of the Moscow Department of Health, then distributed through districts to the corresponding 364 pharmacy organizations that carry out preferential leave. The number of beneficiaries is in proportion to the population of Moscow districts, their largest number is distributed in Yua, Yuvao, Wa, and Swao. The smallest number Grearables in the recently attached districts - Troitsk and Novomoskovsky.

Among the federal beneficiaries, the overwhelming majority (95%) are disabled, disabled children and veterans of hostilities, among regional beneficiaries the greatest number (71%) holds a category for the list of socially significant diseases (onco-scattering, diabetes, hepatitis B and C, mental disorders and disorders of behavior, AIDS, etc.). A significant part (24%) from regional beneficiaries occupy children, large families.

According to the dynamics of the number of those who applied according to the program of providing the necessary drugs (ONLP), the burden on the regional budget increases. The sale of drugs with certain categories of citizens, according to ONLP programs and 7 high-cost nosologies (7 PBC), occurs according to applications that are preparing regions, and then provide in the Ministry of Health of Russia.

As of November 2015, LD was released with preferential categories of citizens in the amount of 18.5 billion rubles, about 9 billion rubles were paid to the regional budget., Federal - 5.61 billion rubles, incl. According to the program 7 PBC - 4.06 billion rubles. I note that the number of beneficiaries receiving LP according to the program 7 PBC is growing, - from 2012 to 2015 with 100 thousand patients up to 163 thousand, respectively. In the context of the list of diseases, the costs are unevenly distributed, which is due different quantity beneficiaries and various costs of medicines. The lion's share of state costs occupy multiple sclerosis and hemophilia (up to 38%). The total number of beneficiaries of 7 fees for last year Ground from 16.5 thousand to 17.488 thousand people. The number of points of vacation LS in the drug security centers under the program 7 PBC for the year practically did not change (21-22). In 2015, for ten months, LS was released in the amount of 4 billion rubles., In 2014, this figure amounted to 4.5 billion rubles. The cost of one recipe for the program 7 PBC was 77.5 thousand rubles.

Relying on the main indicators of the implementation of the ONLP program in 2015, the total number of people entitled to state social assistance from the federal budget is 562,672 people, from regional - 1,123,892 people. In medical institutions that implement the ONLP programs, this year turned 411 thousand patients at the expense of the federal budget, 510 thousand - at the expense of regional funds. In general, in 2015, 11 million recipes were already discharged, 99.09% of preferential recipes were provided, which is higher than the remaining regions of the Russian Federation. The cost of LPs released by preferential categories of citizens in 2015 was 14, 5 billion rubles, and the average cost of treatment of one patient is about 4 thousand rubles. per month. For the federal budget, this figure amounted to 2.5 thousand rubles, for the regional - about 5 thousand rubles. The cost of the recipe funded from the federal budget compared with 2014 has slightly decreased, the cost of the recipe paid from the regional budget has increased and amounted to 2.5 thousand rubles.

The share of domestic drugs in the implementation of the program of the ONLP of individual categories of citizens is gradually increasing. According to a survey conducted by Roszdravnadzor in 2015, the possibilities of the Russian pharmacy for the fulfillment of the tasks of import substitution positively estimated 64% of respondents, and only 31% are not confident that the Russians will cost without imported drugs. As of November 2015, in the number of packages in the procurement of drugs for the state needs of the Moscow region, 60% is LS domestic producers.

Outpatient treatment and drugs: prospects

What are the prospects for medicinal provision of patients who are on an outpatient stage of treatment, for 2016? The obligations taken by the state will be fulfilled. To ensure citizens lexured, funding is provided for from 19.5 billion rubles, a claim company has been held, a consolidated need for LP and MI, as well as in specialized foods for children with disabilities, has been identified. Currently, their centralized purchase is carried out, about 1.5 thousand auctions formed applications will be held. In the Department of Health Created working group on the monitoring of medicinal support, which carries out weekly control of medicinal support.

Now about drug provision of citizens undergoing treatment in the hospital. With the transition of medical institutions in Moscow to the system of single-channel financing, the main part of the LS is carried out at the expense of the OMS, on the basis of applications of the main doctors of medical institutions at joint trading, which regularly holds the Department of Health of the City. Centrally they are purchased for state medical institutionsnot working in the OMS system, for therapeutic organizations, hospitals for the profiles "Oncology", "Hematology" and "Neonatology". The Department of Health is purchased by drugs under the Vaccinoprophilaxian program, the fight against HIV infection and tuberculosis, both at the expense of federal and regional budgets. The amount of concluded contracts for the acquisition of drugs for the needs of hospitals as of November 12, S.G. amounted to 2.5 billion rubles.

Supplies B. medical organizations drugs in the context of the relevant programs in the amount of expression on November 2015 are in rubles:

  • under the program "Vaccinoprophilax" - 252 million;
  • according to the program of struggle against HIV infection, taking into account regional and federal monetary transfers - about 1MLD 200 million;
  • according to the Tuberculosis Combination Program, given the transfers 2014 and 2015. Together, fluctuates at the level of 85 million.

Pricing control on zhvlp

The third component of medicinal support at the expense of its own funds of citizens requires no less close attention of state structures. The work of the Department of Health is to monitor the compliance of pricing rules, in the absence of prerequisites for the overestimation of prices, compulsory monitoring of prices for drugs, monitoring the minimum needed assortment of pharmacy organizations. The level of trade premises is limited to the ZHHVLP group, drugs that are not included in this list are regulated in accordance with market laws. The basis for the implementation of functions to control the formation of prices for drugs of the LVLP list is whole line regulatory acts.

The meaning of regulation is the registration of the manufacturer's selling prices, which is carried out by federal executive bodies, also regulation allows you to establish the level of limit wholesale trade allowances for each region of the Russian Federation. The size of trade premises should not exceed the permissible value.

Everyone interested citizen of Russia can go to the Moscow Department of Health and familiarize yourself with all necessary information On the list of ZHHVLP, with the level of extremely permissible retail premises, the size of possible limit retail prices, which are formed taking into account the values \u200b\u200bof these allowances. Work on monitoring the implementation of extremely permissible retail premises is carried out by the Directorate for coordinating the activities of the Department's Medical Institutions, which is its subordinate agency. Information about the maximum permissible prices for the LAN is published on the site www.mosgorzdrav.ru The pharmacy price should not exceed the price that anyone who wishes a citizen of the Russian Federation sees on the site. The price control is made through the "Our City" portal on the topic "Control of the limit prices for ZHHVLP". Citizens can independently control prices when handling a person:

  • through the portal "Our City" in the section "Pharmacies";
  • by written in mind to the Directorate for Coordination for the activities of medical institutions;
  • through phone call on the hot line Department, addressing the electronic reception room on the office site.

Any appeal of citizens will not be ignored. According to a registered violation, prescription is given, the violation is eliminated, measures of administrative impact on pharmacy organizationHis allowed. The number of appeals of citizens in the dynamics is growing, if in 2014 65 appeals were registered, then in 10 months of 2015 - already 173 appeals, of which only 19% affect pricing violations on ZHHVLP.

The Moscow Department of Health is carried out on monitoring drugs for drugs, taking into account inflation. The growth dynamics of LS prices does not exceed the cost of rising prices for consumer goods. During the year the dynamics of rising prices for drugs from the LVLP list on cheap preparations (up to 50 rubles) amounted to 14.5%, on expensive drugs (over 500 rubles) - 7.7%. In general, it can be noted that the pricing is kept under control. this work It will be continued, so every citizen can be sure - without drugs and the necessary state support, it will not remain.

Providing disabled people needed. stable means in accordance with the standard. Tami medical care for the recipes of a doctor (Feld. Shera) enters the system of social guarantees.
These guarantees are established by the Federal Law of July 17, 1999 No. 178-FZ "On State Social Assistance" (hereinafter referred to as the Federal Law "On State Social Assistance"). After the reforms carried out in 2005, a part of persons with disabilities was entitled to receive free medicinesAnd the other part is to receive cash for independent acquisition of drugs. After the reform in the country were observed serious problemsassociated with underfunding or misuse in pharmacy institutions of the necessary drugs.
All citizens, including disabled people with the right to free receipt drugs are made to the federal register. Such persons have the right to receive free drugs in accordance with the appointment of the attending physician and a list of drugs (a list of drugs, including a list of drugs appointed by the decision of the medical committee of medical and preventive institutions, which are carried out in accordance with the standards of medical care Recipes of the doctor (Feldscher) in the provision of state social assistance in the form of a set of social services, appreciated by the order of the Ministry of Health and Social Development of the Russian Federation of September 18, 2006 No. 665 (hereinafter - the list of medicines)).
Disabled person who has the right to receive social services, including receiving free drugs, has the right to apply for territorial body Pension Fund of the Russian Federation at the place of residence on the replacement of medicinal provision of monetary payments. The deadline for submission of such a statement is established: it is possible to apply until October 1 of the current year for the period from January 1 of the year following the year after the year specified statement. The application for the resumption of the provision of a set of social services (social services) is submitted until October 1 of the current year for the period from January 1 of the year following the submission of the application.
In art. 6.5. Federal Law "On state social assistance" found that instead of providing medicines and medical care, compensation may be issued. To pay for the provision of a citizen of a collection of social services, 705 rubles a month is sent, including:
- for the payment of social services provided for in paragraph 1 of Part 1 of Article 6.2 of this Federal Law, 543 rubles;
- to pay social services provided for in paragraph 1.1 of Part 1 of Article 6.2 of this Federal Law, 84 rubles;
- For payment of social services provided for in paragraph 2 of Part 1 of Article 6.2 of this Federal Law, 78 rubles.
The procedure for providing disabled drugs does not differ from the procedure for providing drugs in other categories of citizens specified in Art. 6.1. Federal Law "On State, Social Assistance", for example, participants of the Great Patriotic War or veterans of militants; actions.
Disabled people have the right to receive free;
1) drugs included in the list of medicines;
2) medical products included in the list of medical products and specialized drug food products for disabled children who are allowed by the doctor's recipes (Feldscher) when providing additional free medical care to certain categories of citizens with the right to receive state social assistance approved by the order of the Ministry of Health and Social Development RF dated January 9, 2007 No. 1;
3) anti-tuberculosis drugs.
According to the Decree of the Government of the Russian Federation of July 30, 1994 No. 890 "On State Support for the Development of Medical Industry and Improving Population and Healthcare Institutions for Medicines and Medical Products" of the Persons with disabilities of the 1st group in non-working people with disabilities, children with disabilities in Aged up to 18 years old have the right to free provision of medicines for doctors recipes, as well as not a free acquisition of medical rehabilitation and dressing facilities (for medical reasons). Working disabled people of the 2nd group, the disabled of the 3rd group, recognized in the installed! The unemployed order is entitled to purchased! Medicines for doctors recipes with 50% SKYD "Koy. Persons with disabilities of the 3rd group, recognized as an installer by the unemployed, except for medicinal funds, have the right to purchase with a 50% discount of certain medical products, dressing drugs for medical testimony.
The executive authorities of the constituent entities of the Russian Federation are committed in a timely manner to pay for medicines and medical products that are allowed in the prescribed manner to the population of doctors for free or discount.
At the level of the subjects of the Russian Federation, lists of medicines and medical products are also approved. For example, in the Moscow region by order of the Ministry of Health of the Moscow Region of December 31, 2008 No. 1038 from January 1, 2009, the lists of medicines and medical products were approved to ensure certain categories of citizens eligible for state social assistance assigned to the Russian Federation and Moscow region. In some regions of Russia, the provision of drugs is solved by creating "social pharmacies" that have privileges for taxation. Prices for medicines in such pharmacies are much lower. For example, in the city of Yaroslavl there is already a whole network of such pharmacies.
Unfortunately, the reality is that not in all regions lists of free drugs include all the vital drugs with disabilities.
Example from judicial practice. A lawsuit is sent to the court of Marquesvgo District in the interests of the four-pharynne-song Yakovlev, which suffers from a severe genuine disease of Mukopolisacharidosis. As the prosecutor's office believes, the doctors of the municipal hospital and representatives of the regional Ministry of Health violated the constitutional right of a child to life, refusing to write free medicines to Him. The district prosecutor's office considered that this case "The constitutional rights of a disabled child for life and social Security In case of illness. " " Russian legislation It does not directly envisage that citizens with such a disease must be ensured by this drug for free. But in the Saratov region there is a list of diseases for which preferential medicines are made at the expense of the regional budget. Mukopolisaccharidosis is not specified in it, but this list is people, you can make add-ons there, the federal legislation allows. " The case is on the claim of the prosecutor is at the stage of consideration.
In St. Petersburg, there are so-called regional beneficiaries, which, unlike federal, drugs are distinguished by the list of diseases. For example, if a person is sick scarmed sclerosis, regardless of the availability of disabilities, it has the right to receive the necessary medicines for free. In St. Petersburg, there is no strictly designated list of drugs that will be discharged by Petersburger for free, but he will receive a medicine that he needs to recipe. "Regional" recipe is valid for one month.
Disabled people need to take into account the next moment: Everyone can be or regional, or federal beneficia. If the disabled refused the social package (i.e., he chose the "monetary" replacement for free medicinal support), then there will be no drug to receive any drugs as a federal, nor as a regional beneficiary.
With a list of medicines that a disabled can get free, he is obliged to familiarize the attending physician. The list of medicines provided for free, published in print and is publicly available.
Drugs are issued in pharmacy institutions based on recipes. To obtain a free medication, a disabled person needs to appeal to his doctor who will write down the recipe and calls a pharmacy or pharmacy point in which medications will be issued in accordance with the recipe. For example, diabetic patients who are disabled are eligible for free medicines and syringes. The legal statement of the recipe possess the doctors (Feldshera) Polyclinic included in the compulsory medical insurance system: therapists, neuropathologists, etc. The list of doctors (surnames of specific specialists), which are entitled to the recipe statement, is determined in the prescribed manual the health authority of the subject of the Russian Federation and is available in medical institution. It must be provided at the request of any patient attached to this medical institution. Recipes are issued for medicines for medical reasons, based on the diagnosis of the patient's disease and the approved list of free medicines.
In the event that the medicine required for the disabled1 is not included in the list, but it is vital to BLN, then the doctor coordinates the decision to write a recipe with the medical committee of the medical and preventive institution. Decision Approved by the chief physician of such an institution. The recipe indicates the number and dose of drug intake based on the diagnosis of the disease and the condition of the patient. The resulting recipe disabled is presents to a pharmacy. If the person's disabilities itself personally go to the pharmacy institution is difficult, then for him getting medicine has the right to any other person who just suits the recipe. Information on the duration of the recipe is contained on its form.
If, when contacting the pharmacy, the necessary drug is temporarily absent (due to high demand, the dissiput of the distributor of pharmaceuticals, etc.), the pharmacist must take into account the recipe in special journal. If it is impossible to provide a drug, then the pharmacy may simply give a recommendation for further actions.
Unfortunately, refund moneywho spent disabled with disabilities, not waiting for the vital medication and acquired it independently for their money, is not provided by law. That is why many are dissatisfied with the free medicinal system. However, despite the imperfection of legislation, judicial practice goes on a different way. The judges often satisfy the claims for the reimbursement of the costs spent with disabilities for the acquisition of drugs that they could not "receive free on the basis of the recipe they have.
An example from judicial practice. M. appealed to the pharmacy owned by LLC "Pharmacy" Be Hormone "" For a preferential medicine for a doctor's prescription for his child, but during the month she was denied the extradition of medicine. Refuses of Pharmacy workers motivated by the fact that required medicine They were not received from Biotek LLC (Moscow), an authorized pharmaceutical organization. Since the medicine of the marina son was required to take constantly due to severe form bronchial asthmaShe was forced to acquire a medicine at his own expense, which was more than two thousand rubles. In the course court sessions It turned out that LLC "Pharmacy" be omitous "" did not send an application for the supply of the drug in LLC "Biotek" in a timely manner, did not provide the necessary 15-day supply of medicines, etc. The judge satisfied the claim. Permian regional Court He left the cassation appeal LLC "Pharmacies" be healthy "" without satisfaction, and the decision entered into force.
In this case, the responsibility of the distribution organization for the delay in fulfilling its obligations was expressed in reimbursement of the cost of the acquisition of medication. According to the law, it is impossible to attract to other types of responsibility neither pharmacy rhinezation, no intermediary-distributor.
If the right medication is not, then, most likely, the disabled will be offered to get a drug with a similar or similar pharmacological action. As a rule, drugs offered in pharmacies instead of the required are cheaper and less efficient.
The only thing that can be done in case of refusal pharmacy institution in set time To issue the right medicine, it is to contact the Regional Ministry of Health or the Mandatory Medical Insurance Fund, which includes the protection of the rights of citizens, to inform the doctor.
The disabled person, which is located on inpatient treatment in medical institutions, is provided within the framework of the State Guarantees program in accordance with its diagnosis, therefore, no additional drug receipt is required on the basis of recipes.

This article I decided to start a small complex of articles on the enlightenment of citizens about our (Russian) free medicine. My friend who works by a precinct therapist in the Ryazan Polyclinic, agreed to help in this difficult to inform the population.

We will try to the whole complex of articles most fully, accurately and clearly displaced the situation in our healthcare. Also, all articles will be directed to the preferential categories of citizens (mainly disabled and retirees).

The first article concerns the discharge of drugs according to programs.

Who are federal beneficiaries, do you feel about them, and that they are supposed to clarify here http://www.pfrf.ru/federal_beneficiars. Immediately you can find a list of medicines.

When I ran into the refusal of medicinal statements, I decided to find out - why don't you write medications that are not discharged, motivating various reasons - expensive, there are no pharmacies, etc. etc.

So, what about and what it is eaten with.

Deciphered as additional preferential support.

The DLO program begins with the advent of the Federal Law of August 22, 2004 No. 122-FZ. This is one of the most sensible laws. So-called Law on monetization benefits. A person is allowed to "take the benefits in kind" and money. This can be clarified in the local PF branch.

It seems to be fine. According to the benefits, we reimburse part of the costs of some services (how much percent of municipal payments, fare in suburban train, treatment in sanatorium-pretentiator, etc.). And the medicines are still given. But only the word "extra" does not mean compulsory.

Additional implies that the state does not guarantee us all medicines on all of our diseases, but only the fact that on the basis of their financial opportunities and recommendations of the Ministry of Health will consider it necessary. That is what is in the DLO list. This sends us to the list of JNVLS - vital and necessary medicines that fixed prices are introduced. Is not full list all drugs DLO, although with frequent changes It is not possible to clearly define the same or not.

In accordance with the order of September 18, 2006 N 665 (http://www.consultant.ru/online/base/?req\u003ddoc ;base\u003dlaw ;n\u003d84391#c1e78e6f2ddf46534b98d2fe48d34b98d2fe48d60052)) Doctor (or when it is not It may be discharged in the list of the list (the composition of which in the second paragraph "Appendix").

The list of medicines varies quite often (almost once every six months). True varies slightly, some drugs.

With the laws dealt with, what a law for what is responsible, and in what indicated. Move actually to the discharge of drugs - how it happens and what medications (including in which volume) are laid.

In the theory, the therapist should have all its own plot (1700+ people) with all their diseases and medicines, incl. And on nosologies of narrow specialists (including surgeons, ophthalmologists, hematologists, etc.) know and remember. And also know which of the narrow specialists to whom (from his site) that ordered for a bottom, but what is not and re-tie in the case of anything (and at the time of filing your application). But it is in theory.

SAMI large group Doo - disabled.

As disabilities have already been mentioned, being federal beneficiaries, they can enjoy both natural benefits, and take the money equivalent. So they can from year to throw there and here.

The doctor is everything that has changed over the past six months needs to be kept in the head. The updated list of beneficiaries (who moved for money, and who, on the contrary, moved from money for medicines) Yes, and not the full comes after applying for medicines. Those. For example, one disabled person decided that this year he did not need medicine (or they cost a penny) and refused to extract free medicines, in favor of obtaining money. Posted a statement in the pension fund and all.

But the doctor still does not know about it and accordingly apply for his medicine. It's on the one hand positive moment - It may be formed by a small surplus, which will go to another disabled person. But there may be a reverse option. Two disabled people decided to return from cash payments to "Nature". Similarly, wrote a statement in pension Fund and that's it. But their doctors do not know about it. And accordingly, do not order drugs on them. There is a lack of medicines.

The same medication from the list is not accused not randomly, and in accordance with the standard protocols of patients with nosologies or, if this nosology has not been developed, then in accordance with domestic (and if they are not, then with international) clinical guidelines.

What is nosology is a unit of illness. Two (three, five) nosological forms are two (three, five) independent diseases. For example, diabetes mellitus + tachycardia + arthrosis is three nosological forms. Those. Three diseases.

Standard is how this disease is properly diagnosed and treated in accordance with the laws of the Russian Federation, includes the mandatory minimum surveys and treatment.

Only forced to warn. Like Vysotsky sang - Giraffe is big, he is more visible. Those. The doctor himself will write down the direction. When he deerates (and deems at all) fit. Accordingly, you, not possessing medical education, Can't require a doctor from a doctor to you or another examination, even if it is listed.

Let's go back to our branches.

Making a sofamile application, the therapist leaves it in itself, and only the names and the number of packages are transmitted, and the number of packages as needed for the next six months. The departments are collecting applications from their branches and transfer the deputy head. He also plots everything and transfers to Grange. From Gorzvvwa in Oblast, from Wolnzveva to Moscow.

In general, it is not easy to understand domestic medicine. Everything is specifically so confusing so that no one can immediately see where money actually goes.

Starting from the deputy head of clinices / hospitals, the application is calculated and adjusting the application to meet the money that plan to issue. In Ryazan (and most likely in other regions, with the exception of Moscow and Peter), on the first half of 2011, 531 ruble per person per month was allocated. Those. Adjustment may be concluded, for example, in the fact that part of expensive drugs is replaced by cheaper counterparts, and part of the drugs can simply throw out from the list.

After the application went to Moscow, trading begins between firms, whose drugs will be issued in pharmacies, and in what quantity.

Perhaps (and most likely it is so) in connection with bribes and rollers, bidding is very often delayed. For example, from November to February. In the end, January and part of February have to take remnants since last year (this is if they are).

Those. here as in the game "giveaway" who sells cheaper and / or who gave the paw " reception Commission", He wins. Ideally, there must be a correspondence price / quality.

In real life, everything is different.

And in the end we get a non-original product (which we just need, but which is expensive) and generic (cheap or not very analog).

The original drug is the one that was first. All tests were held on it. Its effectiveness and was established by many years of annual research in various clinics and on various patients.

Generic passed a test only to equivalence with the original. In it is the main thing active substance The same as in the original. But in all the rest there are differences. In the rest, this is the composition and quality of impurities, form, etc.

One thing is neutral admixture (in the original), another thing is highly active in generic.
Although the main formula is one. And since medicine is not mathematics, in fact, generic efficiency can decrease to 50 times plus a sharp increase in adverse reactions.

Some manufacturers of generics, cooler, conduct research on bioequivalence to the original drug. And even take it to the control group.

But the original drug will always be one. And generics (analogs) can be a lot.

There is also such a situation when the original drug is not registered in the Russian Federation, and generics are registered.

As a result, the trading passed, but it happens that manufacturers / intermediaries are delayed with the delivery of a particular drug, so it will never be able to calculate this drug a specific therapist, whether this drug is discarded during the counting of money or instead of it will come analogue, etc. . It creates circular order (Therapists suck out the finger "necessary" drugs and their quantity, because they do not know the inhabitants of their site and who / how many of them moved to benefits / took the money, the bosses on the same principle they cut them down, etc.) But as a result, the extreme One who is lower than the post.

With what medicines, from where and how they appear in pharmacies for issuing them by federal recipes, figured out.

Come to the end - why don't we give the medicines that we need.

You discharged a recipe, you come to the pharmacy, and they say that there is no medication.

Some pharmacies offer to leave a recipe for them, sign up for receiving this drug etc. And then notify the supplier. But the recipe is valid for only 30 days. Even if he is taken to the pharmacy. Accordingly, if there is a delivery of this medicine within 30 days, you will also be notified. If not, it means there. At the same time, the polyclinic reports weekly to higher instances about the "overswar" recipes. And the leaders who "hung up" a lot of recipes are knocking on top of the top. And no excuses in the ministry are listening. You are obliged and point. Therefore, there are programs on computers in polyclinics that do not allow to write out medicines that are not in their pharmacy (in the pharmacy paragraph of the polyclinic).

And with the help of the program installed and on the computer in the pharmacy paragraph, the polyclinics and in their office, the doctor may test the necessary medicine in this pharmacy or not. And accordingly, write it out or not.

You can find in your city information about the company that serves urban pharmacies within the federal program, call and clarify in which of the pharmacy there is a medicine you need. Sometimes, in some unknown way, some of the drugs from one pharmacy fall into another and the patients go beyond them through the whole city. If you reported that there is there then there, go to the doctor, tell him where you found this medicine, he discharges (if anyway), you call this pharmacy, reserve the right amount and get to receive.

Although much theoretically depends on the doctor, it depends on the decision of your treatment and discharge of medicines, it is constantly fascinated by the sticks in the form of cutting the list of patients needed for "it", replacing the truly necessary original drugs on those that managed to knock / obtain, failures in the work of suppliers etc. Therefore, you don't have to blame in everything. In reality, it depends very little from it - know "their" and draw up a list for them. And howles there will be no longer dependent on it.

The pharmaceutical business business is dark - on profitability costs immediately for drug trafficking and weapons.

In the next article we will try to talk about the situation with regional beneficiaries.

Programs to ensure the state help of all those who have free medicines are laid, in recent decades, a dead point has moved. The qualitative organization of the procedure for obtaining medicines is the key to successful solving problems and overcoming the crisis in the field of health associated with not enough attentive attitude authorities to diagnostic, medical and preventive measures population.

Tasks and benefits of preferential medicinal support

Medicinal support First of all, should affect the most vulnerable and defenseless categories of the population. Social significance of such projects is difficult to overestimate. It is worth noting that such an action is directed to early overcoming and preventing probable risks. Supply unprotected people required drugs - an important component to maintain their health and, as a result, normal level and quality of life.

In addition, it is important to pay attention to the fact that the availability of medicines makes it possible to achieve the success of therapeutic measures, reduce the statistical number of patients, in dire need of hospitalization and passage of inpatient treatment. Thanks to the government provided, even expensive types of drugs and medical devices have become accessible to patients who, in their own expense, would never have been able to purchase them.

Fastening the issue of medicinal support at the legislative level

Who are made free medicines, and that drugs are provided to people on a humanitarian basis and how to get them, you can find out, familiarizing yourself with the regulatory this question legislative Base. The main regulatory act to which clarifications should be asked is the document "On the treatment of medicines", adopted in 2010. It is important to dwell on the interpretation by the legislator of the term "drugs". Deputies in the State Duma believe that this group Any components and combined combinations should be attributed to the human or animal organism and actively penetrating biological tissue deep into. Applying any of the drugs is accounted for:

  • preventive measures;
  • treatment;
  • surveys;
  • postoperative recovery and rehabilitation;
  • to save, prevent or interrupt pregnancy.

The same group includes drugs produced by the most diverse way:

  • from blood;
  • organs and tissues of an animal or man;
  • plants;
  • mineral components;
  • obtained by biological or chemical synthesis.

Pets for medicines: from the 90s and until today

By paying attention to the pharmaceutical market, it is worth a consideration of the problems accompanying the preferential drug provision. The first time about the need to solve this problem was seriously spoke at the end of the last century. Then, in the early 1990s, due to the many unfavorable factors of socio-economic development in people who need help on the acquisition of drugs, to buy independently required drugs it was not possible. Low income in the predominant part of the inhabitants of the country, high level morbidity, significant reduction medium duration Life, etc. - all this became the rootary factors that led to an increase in debts to pharmacies that laid the beginning of the holiday drug addicts on a non-nice or preferential basis by recipes from the doctor.

In this regard, in 1994, the Government of the Russian Federation adopted a resolution "On State Support for the Development of Medical Industry ...". According to this subtitle, a separate category of residents of the country, as well as persons suffering from various pathologies (a list of few senses to the decision was made), it was preferential vacation of drugs. The poor basis of drugs for individual groups of the population was reflected in the most the best way On medical support of citizens and health care facilities.

Changes in drug support tasks

Preparations, therapeutic products have become available for the population during the restructuring of political and economic domestic relations in the field of drug production. Despite the fact that the rapid increase in prices and decay of the level of income of the population became the main causes of the unavailability of various drugs, the concept of "free medicine" did not acquire an empty value.

The policy of the Russian state is aimed at eliminating obstacles to obtaining citizens of the country, regardless of their material status, required treatment. The appendix to the above decree was the addresses of pharmacies, in which preferential groups of the population could receive the necessary drugs.

Drug Equipment, Principles and Schemes of which were revised by the Government in 2004, acquired the following characteristics:

  • individualization of drug accounting provided in the form of state aid;
  • a single level of price valid in the framework of the generally accepted list of medicines;
  • the previous disproportionate drug provision by regions of Russia is eliminated.

Amendments to some legislative acts in 2005 special attention The need for prescribing at the official level of a more accurate mechanism for obtaining people of "medicinal benefits" was paid. In addition, the block of the above amendments provides for adjustments regarding directly the process of implementing state support to socially unprotected segments of the population.

Who has the right to provide assistance from the state?

To date, the program for the provision of drugs and medicines on an indifferent basis to those in need of citizens is actively implemented by the state.

Getting prescribed by the doctor's funds The winner of benefits can absolutely without paying a product or using such a privilege as a 50% discount on the purchase of drugs. In accordance with medical standards and legislative acts, the right to receive free medicines have:

  • disabled people who received injury or disease due to military operations;
  • participants of the direct battles of World War II;
  • veterans and servicemen who served in military schools, in military units, institutions from 1941 to 1945;
  • persons having a breasthold order "resident of the Blocade Leningrad";
  • employees of air defense facilities and local air defense institutions during the Great Patriotic War;
  • persons involved in the work and construction of protective structures, bases navy, airfield, etc.;
  • family members of the dead disabled people, participants of the Second World War and Veterans;
  • disabled people and children with disabilities 1, 2 groups;
  • participants in rescue work in the zone of Chernobyl and Semipalatinsky radioactive defeat.

Social pharmacies: Where can I get medicines?

To obtain preferential medicines, patients must come to a specialized pharmacy. Pharmacist-provincial will be able to provide the necessary drug only if the recipe, certified by the seal of the attending physician and the head physician of the medical institution. The recipe is discharged on the form designed for this, decorated in accordance with the approved form.

In each Russian city, the privileges of preferential drugs to the population carries out a pharmacy network, which has won a pre-conducted tender. The tasks of the selected enterprise include storage, transportation and issuance of medicines to needy citizens. Over the past few years, the process of obtaining the necessary medicines has changed in positive side. A convenient registration system operated in the online mode has come to replace the endless "alive" queues in many cities.

The social pharmacy network contest, as a rule, is as adapted as possible to accepting visitors with limited features. Many rooms have ramps and special calls to call the diaproof. Most often, the halls in which citizens take are located on the ground floor in order to create maximum amenities. Addresses of pharmacies in a particular settlement, leaving the recipe for a non-nice-based drug or discount, can be found in the directory or on the official website of the city.

To whom free drugs are laid: a list of beneficiaries and patients

Money instead of drugs: Is it possible?

Free medicines - optional benefits. The law of Russia today provides for the right of citizens who have grounds for obtaining social medicines to refuse to be assumed to them. In addition, instead of a package of medicines, a person can receive monetary compensation. To do this, you need to apply with the appropriate statement in the authorities. social protection Population, confirming the desire to refuse to receive benefits in natural form.

The period for providing social services to citizens from the category of those who need free or preferential provision of drugs is the calendar year. In the primary appeal for the provision of medicines, it is necessary to present medical polis Oms, SNILS (citizens belonging to the federal register) and free recipe. The extract of drugs is carried out by the Doctor immediately after examining the patient.

How do preferential medicines write out?

Among the specialists who can appoint drugs related to the category of preferential, the legislative level marked:

  • palate therapist;
  • plot pediatrician;
  • family doctor (general practitioner);
  • feldsher.

Specialists of a narrow profile may discharge prescriptions for preferential drugs in accordance with the approved list of major diseases. In some "non-standard" cases, drug extract is made by the attending physician in coordination with a narrow-profile specialist.

The number of preparations provided on a preferential basis, as a rule, corresponds to the required volume of medicines for the passage of a full course of therapy. If necessary prolonged treatment And, accordingly, the use of a larger number of medicines by decision of the Special Commission, the extract of medicines can be appointed no more than 2 months. Exceptions are drugs and medical products to be regular subject-to-quantitative accounting.

In cases where the course of treatment coincides with the time of the patient's stay in the sanatorium, the attending doctor is obliged to write recipes for medicines in such a volume that will be enough for the entire period of finding a medical and preventive institution. As a rule, we are talking about the therapy of chronic pathologies having a long-term protracted flow.

To familiarize yourself with the right to obtain preferential medicines of a person related to a particular privileged category, must have a doctor or ambulance officer. Drug provision of everyone who in good need needs is one of their important tasks of a modern socially developed state.