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Big Money Raw over Medicaments
December 1, 2006 12:42

Russia has never witnessed the corruption scandal of such a size: all highest ranks working for the federal fund of compulsory medical insurance have been arrested. The range of activity shown by the institution makes other ministries and departments envy: the budget of over 100bn rubles, hundreds of branches all over the country, its representatives work with the vast majority of the population.

However, the current situation can’t be so positively estimated due to seven top-managers of the organization arrested for inappropriate use of budgeting funds and bribery. Besides, the searches conducted in about two dozens of regions resulted in confiscation of money and values amounted to millions of dollars. What could produce such an effect? Arrested civil servants must have stepped on the tenderest corn of the state – its social policy. Passions about monetization of privileges (the bill allowing social security beneficiaries to receive a money equivalent to the number of privileges they are supposed to get) barely have settled down, but another problem has come to light: the Federal fund of compulsory medical insurance responsible for financing of this program is suspected in kickback taking. Once again the social program of the federal significance is at risk.

The Russian federal fund of compulsory medical insurance is occupied with financing the government program for pharmacological support of privileged citizen categories, in other words de facto provides the disabled, ex-servicemen and preteen children with free or less costly (compared to the retail market prices) medicines. Nevertheless, that was the distribution of medicaments which caused the abuse. The General Prosecutor’s Office charged the Fund’s administrative authority of bribery. Nevertheless, current difficulties are unlikely to disappear the moment the interchange of the senior management takes place. Especially as to answer the obligations to citizens the government needs a spare billion Euro.

 Actually, the problem is even more acute than it may seem. Medicaments are distributed via the program of pharmacological support at a higher price, moreover, pharmaceuticals sold at the state chemists shops cost much more compared to that at the commercial ones. It should be mentioned that, in keeping with data provided by the international consulting company ACNielsen, 95 % of the current world pharmacological market is controlled by huge corporations. Market share of local manufacturers can hardly make up 5% which is common to Russia. Despite the fact that pharmacological market is acknowledged as one of the fastest growing, only five selected companies participate in the program. Although the total share of Russian medicaments must be no less than 30%, that doesn’t give relief to national manufacturers.

Nevertheless, not many can say that the program was ill-made. The Russian public health service claimed not once that the financing mechanism of the program was well-circumspect. Manufacturers sell pharmaceuticals as a commodity credit, their partner-suppliers provide chemists shops with medicaments and then it’s patients’ turn to exchange special prescriptions (operating simultaneously as a documentation of financial statement) for necessary medicaments. Financing is conducted through the Federal fund of compulsory medical insurance: money goes to local branches collecting data about the number of handed out medicaments. The Fund exercises control of the documentation and only after that manufacturers get paid for distributed pharmaceuticals at fixed tariffs. As only used prescriptions (on which people have received medicaments) are reimbursable, such things as accumulation of unused but prepaid and out of date medicaments, which haven’t reached the patients, are impossible.

 However, in the General Prosecutor’s Office they believe that money budgeting the program slowly moved to the Fund representatives’ pockets. The new system introduced in February makes doctors write out prescriptions for medicaments under the International nonproprietary name. Investigators suspect that the new system became a perfect loophole as each International nonproprietary name stands for numerous trade names authorized by different manufacturers and, certainly, prices vary a lot. This kind of ambiguity established conditions for unregulated debiting of the program funds along with budget overrun.

The case is under investigation.


Olga Pletneva

Tags: Russian medicine health    

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