The increase of the state funding of the provision of cancer medicines actualizes the question of access to treatment. This research provides an analysis of the of cancer medicines purchasing and the possibilities of using these medicines on an outpatient basis in frame of state healthcare system
Introduction. The outpatient stage of management of patients with malignant neoplasms does not have additional funding. Availability of patients to prescribed drugs on outpatient review of funds allocated by the Russian Federation for the purchase of drugs based upon budgets providing for benefits. In connection with the study of the problem of procurement of drugs for the treatment of patients with malignant neoplasms in outpatient treatment, an urgent task arises, the solution of which is the essence of the development of a study on the planning of drug treatment of patients.
Purpose is to study the accessibility of patients with malignant neoplasms to drug provision at the outpatient stage of treatment in the Federal Districts of the Russian Federation.
Material and methods. To study the availability of patients with malignant neoplasms, the supply of medicines for the treatment of patients with malignant neoplasms in 2019 and 2020 to hospitals purchased at the expense of the constituent entities of the Russian Federation and the federal budget in the Federal Districts was analyzed. We compared the funds spent between the subjects of the Russian Federation in terms of patients with a first diagnosis. To compare the provision of patients with drugs, we recalculated the amount of funds spent on the purchase of drugs per patient with a newly diagnosed oncological disease living in the Federal District.
Results. Significant differences were found in the provision between the Federal Districts, reaching almost four times the size.
Limitations. When studying the accessibility of patients with malignant neoplasms to drug provision at the outpatient stage of treatment, purchases of all Federal Districts of the Russian Federation at the expense of both the subjects of the Russian Federation and the federal budget were analyzed, which is a sufficient reference sample.
Conclusion. A significant difference in the amount allocated per patient both from the funds of the regional and federal budgets, with the newly diagnosed malignant neoplasm in the Federal Districts creates unequal conditions for treating patients on an outpatient basis.
The aim of the study was to study the compliance of the list of drugs for the treatment of malignant neoplasms in the territorial state guarantee programs (TSGP) with the list of vital and essential drugs (VED) in the constituent entities of the Russian Federation and the practice of purchasing drugs at the expense of regional preferential provision (RPP) funds. Material and methods. The analyzed territorial programs of state guarantees were compared with the list of drugs for RPP for the patients with malignant neoplasms with the VED. An assessment of medication procurement in 2019 and 2020 was carried out and compared with the current list of RLO in all constituent entities of the Russian Federation. Results. Only 14% of the Russian Federation regions in 2019 and 20% in 2020 met the territorial state program of guarantees requirement. The average number of medications included in the territorial state program of guarantees was 73 INNs in 2019 and 100 INNs in 2020. The number of regions with a complete list of drugs accounted for 7% to 33% in the corresponding Federal Districts. In 2020 the number of regions with a complete list of medications in a territorial program of state guarantees did not change. Discussion. Reduction of medications from the VED purchased at the expense of RPP reduces the number of possible treatment regimens, and limits oncologists’ ability to provide care on an outpatient basis. Conclusion. Most Russian Federation regions violate the requirements of the territorial program of state guarantees do not harmonize the list of medications in the Program with EDL. The practice of purchasing medications from the territorial program of state guarantees indicates the absence of finance mechanisms for providing medications to patients at the outpatient stage of treatment.
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