Programs to provide public assistance to all who are en titled to free medicines have moved the dead center over the past decades. High-quality organization of the procedure for obtaining medicines is the key to successfully solving problems and overcoming the crisis in the he althcare sector associated with the insufficient attention of the authorities to the diagnostic, therapeutic and preventive measures of the population.
Objectives and benefits of subsidized drug coverage
Drug provision should primarily affect the most vulnerable and defenseless categories of the population. The social significance of such projects is difficult to overestimate. It should be noted that such an action is aimed at overcoming and preventing possible risks as soon as possible. Providing unprotected people with the required medicines is an important component for maintaining their he alth and, as a result, a normal level and quality of life.
In addition, it is important to pay attention to the fact that accessibilitymedicines makes it possible to achieve success in therapeutic measures, reduce the statistical number of patients who are in dire need of hospitalization and inpatient treatment.
Thanks to state assistance, even expensive types of drugs and medical devices have become available to patients who would never be able to purchase them at their own expense.
Fixing the issue of drug provision at the legislative level
Who is en titled to free medicines, as well as what kind of medicines are provided to people on a humanitarian basis and how to get them, you can find out by reading the legislative framework regulating this issue. The main legal act to which one should turn for clarifications is the document “On the Circulation of Medicines”, adopted in 2010. It is important to dwell on the legislator's interpretation of the term "drugs". Deputies in the State Duma believe that this group should include any components and their combinations that come into contact with the human or animal body and actively penetrate deep into biological tissues. It is necessary to use any of the medicines for the purpose of carrying out:
- preventive measures;
- treatment;
- examinations;
- postoperative recovery and rehabilitation;
- to maintain, prevent or terminate a pregnancy.
The same group includes drugs obtained in a variety of ways:
- from blood;
- organs and tissues of an animal or human;
- plants;
- mineral components;
- derived from biological or chemical synthesis.
Drug Benefits: From the 90s to Today
Leaving aside the pharmaceutical market, it is worth considering the problems that accompany preferential drug provision of the population. For the first time, the need to solve this problem was seriously discussed at the end of the last century. Then, in the early 90s, due to many unfavorable factors of socio-economic development, people who needed help in purchasing medicines could not buy the necessary drugs on their own. Low incomes among the majority of the country's residents, a high incidence of morbidity, a significant decrease in life expectancy, etc. - all this became the root causes that led to an increase in debts to pharmacy companies, which laid the foundation for the start of dispensing medicines on a free or preferential basis for prescriptions from a doctor.
In this regard, in 1994, the Government of the Russian Federation adopted a resolution "On state support for the development of the medical industry …". According to this by-law, a certain category of residents of the country, as well as people suffering from various pathologies (a list of ailments was attached to the decree), were en titled to preferential dispensing of drugs. The free basis for obtaining medicines for certain groups of the population had the best effect onmedical support for citizens and he althcare institutions.
Changes in the tasks of drug provision
Drugs, therapeutic products have become available to the population in the course of the restructuring of political and economic interstate relations in the field of circulation of medicinal products. Despite the fact that the rapid rise in prices and the decline in the income level of the population have become the main reasons for the inaccessibility of various drugs, the concept of "free medicine" has not acquired an empty meaning.
The policy of the Russian state is aimed at removing obstacles to getting citizens of the country, regardless of their financial situation, the necessary treatment. The addresses of pharmacies where privileged groups of the population could get the necessary medicines by prescription were an annex to the above resolution.
Drug provision, the principles and schemes of which were revised by the Government in 2004, has acquired the following characteristics:
- individualization of accounting for medicines provided in the form of state aid;
- single price level operating within the generally accepted list of medicines;
- the former disproportionate provision of medicines in the regions of Russia has been eliminated.
Introducing amendments to some legislative acts in 2005, special attention was paid to the need to prescribe at the official level a more precise mechanism for people to receive a “drug benefit”. In addition, the block of the above amendments providesmaking adjustments regarding the direct process of implementing state support for socially vulnerable groups of the population.
Who is eligible for government assistance?
Today, the program of providing medicines and medicines on a free basis to needy citizens is actively implemented by the state.
The owner of the benefit can receive the funds prescribed by the doctor absolutely without paying for the goods or using such a privilege as a 50% discount on the purchase of drugs. In accordance with medical standards and legislation, the following are en titled to receive free medicines:
- disabled people who were injured or ill as a result of military operations of the Second World War;
- participants in the direct battles of World War II;
- veterans and servicemen who served in military schools, military units, institutions from 1941 to 1945;
- persons with the breastplate "Resident of besieged Leningrad";
- workers of air defense facilities and local air defense during the Great Patriotic War;
- persons involved in the work and construction of protective structures, naval bases, airfields, etc.;
- family members of deceased war invalids, WWII veterans and veterans;
- disabled and disabled children of groups 1, 2;
- participants of rescue operations in the zone of Chernobyl and Semipalatinsk radioactive destruction.
Social pharmacies: where to getmedicines?
To get discounted medicines, patients must go to a specialized pharmacy. A pharmacist-pharmacist will be able to provide the necessary drug only if a prescription certified by the seal of the attending physician and the head physician of the medical institution is provided. The prescription is written out on the forms intended for this purpose, drawn up in accordance with the approved form.
In every Russian city, subsidized drugs are distributed to the population by a pharmacy chain that has won a preliminary tender. The tasks of the selected enterprise include the storage, transportation and distribution of medicines to needy citizens. Over the past few years, the process of getting people the necessary medicines has changed in a positive way. The endless "live" queues in many cities have been replaced by a convenient online registration system.
The network of social pharmacies that has passed the competition, as a rule, is maximally adapted to accepting visitors with disabilities. In many rooms there are ramps and special bells-buttons for calling a pharmacist. Most often, the halls in which citizens are received are located on the ground floor in order to create maximum comfort. Addresses of pharmacies in a particular locality that dispense free or discounted prescription drugs can be found in the directory or on the official website of the city.
Who is en titled to free drugs: a list of beneficiaries and patients
Guarantees for the provision of social assistance inthe form of benefits for obtaining medicines is carried out by state authorities of the constituent entities of the Russian Federation in accordance with the territorial federal program. As already mentioned, funds are released to vulnerable segments of the population based on the lists of groups of categories of citizens and individual diseases. For outpatient therapy, drugs are prescribed free of charge, and in some cases there is a 50% discount for people. Medicines are dispensed free of charge to people like:
- Heroes of the USSR, Heroes of the Russian Federation and holders of orders of Glory;
- prisoners of the camps during the Second World War, prisoners of the ghetto and victims of fascist actions;
- children under 3 and children under 6 from large families;
- disabled 1, 2 non-working groups, disabled children.
Patients suffering from certain ailments are also en titled to free drug care.
Specific diseases include:
- childhood diseases of the central nervous system, cerebral palsy;
- phenylketonuria and hepatocerebral dystrophy;
- cystic fibrosis (in children);
- acute porphyria;
- AIDS, HIV infection;
- malignant tumors.
Discount drugs
Preferential drugs with a 50% discount most often throughout the state receive certain groups of people, including:
- Pensioners. People in the older age group who receive the minimum cash benefit for reaching retirement age, disability, and in case of loss of a breadwinner.
- Disabled 2 groups continuingwork, and 3 groups in the absence of official employment and the correct procedure for confirming it.
- People who have experienced political repression, who have been imprisoned for political reasons, who have undergone unjustified forced treatment in psychiatric hospitals, etc.
Free medicines are dispensed separately for people with diseases belonging to special categories of pathologies. These are hemophilia, cystic fibrosis, Gaucher disease, pituitary dwarfism, multiple sclerosis, blood cancer. Patients after transplantation of individual organs and tissues also need specific drug provision. Funds for the implementation of such a program, approved at the legislative level, are provided by subsidized interbudgetary transfers.
Money instead of drugs: is it possible?
Free drugs are optional benefits. The law of Russia today provides for the right of citizens who have grounds for receiving social medicines to refuse the drugs they are supposed to. In addition, instead of a package of medicines, a person can receive monetary compensation. To do this, you must apply with a corresponding application to the social protection authorities, confirming the desire to refuse to receive benefits in kind.
The period for the provision of social services to citizens in the category of those in need of free or subsidized provision of medicines is a calendar year. Upon initial application forproviding medicines, it is necessary to present a medical policy of compulsory medical insurance, SNILS (citizens included in the Federal Register) and a free prescription. The prescription of medicines is carried out by the doctor immediately after examining the patient.
How are subsidized medicines prescribed?
Among the specialists who can prescribe drugs that are classified as preferential, the following are noted at the legislative level:
- district therapist;
- district pediatrician;
- family doctor (general practitioner);
- paramedic.
Physicists can write prescriptions for subsidized medicines in accordance with the approved list of major diseases. In some "non-standard" cases, the prescription of drugs is carried out by the attending physician in agreement with a highly specialized specialist.
The number of drugs provided on a preferential basis, as a rule, corresponds to the required volume of medicines for a full course of therapy. If it is necessary to carry out long-term treatment and, accordingly, the use of a larger number of medicines, by decision of a special commission, an extract of medicines can be prescribed for no more than 2 months. The exceptions are drugs and medical devices that are subject to regular subject-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 out prescriptions for medicines in the amount that will beenough for the entire period of stay in a medical institution. As a rule, we are talking about the treatment of chronic pathologies that have a long protracted course.
To familiarize with the right to receive preferential medicines of a person belonging to one or another privileged category, the attending physician or ambulance officer should. The provision of medicines to everyone who is in dire need of it is one of the important tasks of a modern socially developed state.
