Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Availability and Affordability of Medicines for the Treatment of Cardiovascular Diseases in Pharmacies in Six Regions of the Russian Federation

https://doi.org/10.20996/1819-6446-2018-14-6-804-815

Full Text:

Abstract

Aim. To evaluate the availability and affordability of medicines used to treat of cardiovascular diseases (CVD) in several regions of the Russian Federation with different climatic, geographic, economic and demographic characteristics. Material and methods. The study was conducted in 6 regional capitals, chosen to differ in geographically, economically, and demographically. In each city, 5 pharmacies providing free medicines to certain categories of citizens (beneficiaries) and 5 private pharmacies serving anyone were selected at random. Medicine availability was assessed in all pharmacies, along with price only in the private pharmacies. Data were obtained for both original drug and appropriate generics. A list of 25 of the most frequently prescribed medicines for cardiovascular diseases was compiled. Results. Some general findings emerged. With the existence of a generic drug, the original drug was not available in the pharmacy supplying beneficiaries. Diuretics, as well as some ACE inhibitors, are not available in a number of pharmacies for beneficiaries. Enalapril in most licensed pharmacies is represented by generics, lisinopril in a number of cities is represented by both the original drug and generics. The presence of sartans was much lower than ACE inhibitors. Bisoprolol was most common beta-blocker. Calcium antagonists: if amlodipine was present in all licensed pharmacies, at list as generic, then nifedipine was not available in many licensed pharmacies. Among antiplatelet agents, aspirin was available in most pharmacies, and clopidogrel was mostly represented by generics. As for statins, only simvastatin could be found in almost all pharmacies. When analyzing the cost of drugs in licensed pharmacies, it was found that drugs containing furosemide are the cheapest among generics – about 17 rubles. The most expensive treatment with generics of rosuvastatin – about 4,374 rubles a month. The most expensive original medicine was also rosuvastatin – about 4,500 rubles for 30 tablets, the cheapest – the original drug of furosemide – about 35 rubles. On average, the cost of CVD treatment with major classes of drugs, including ACE inhibitor, beta-blocker, antiplatelet drug and statin, is 1,921.9 rubles per month. Conclusion. The basic cardiovascular medicines were characterized by a relatively high availability in 6 regions of the Russian Federation included in the analysis both by the criterion of the availability of drugs and by the criterion of the minimum price.

About the Authors

A. E. Imaeva
National Medical Research Center for Preventive Medicine. Petroverigsky per. 10, Moscow
Russian Federation
MD, PhD, Senior Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases, National Medical Research Center for Preventive Medicine


Yu. A. Balanova
National Medical Research Center for Preventive Medicine. Petroverigsky per. 10, Moscow
Russian Federation
MD, PhD, Leading Researcher, Laboratory of Economic Analysis of Epidemiological Researches and Preventive Technologies, Department of Epidemiology of Chronic Non-Communicable Diseases, National Medical Research Center for Preventive Medicine


A. V. Kontsevaya
National Medical Research Center for Preventive Medicine. Petroverigsky per. 10, Moscow
Russian Federation
MD, PhD, MSc (LSE), Deputy Director on Science and Analytics, National Medical Research Center for Preventive Medicine


A. V. Kapustina
National Medical Research Center for Preventive Medicine. Petroverigsky per. 10, Moscow
Russian Federation
MD, PhD, Senior Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases, National Medical Research Center for Preventive Medicine


D. V. Duplyakov
Samara Regional Cardiology Clinic. Aerodromnaya ul. 43, Samara
Russian Federation
MD, PhD, Professor, Medical Director, Samara Regional Cardiology Clinic


O. H. Malysheva
Medical Information-Analytical Centre. Herzena ul. 49, Kirov
Russian Federation
Head of Medical Information-Analytical Centre (Kirov)


I. V. Osipova
Altai State Medical University. Lenina prosp. 40, Barnaul
Russian Federation
MD, PhD, Professor, Head of Faculty Therapy Chair, Altai State Medical University


T. A. Petrichko
Postgraduate Institute for Public Health Workers. Krasnodarskaya ul. 9, Khabarovsk
Russian Federation
MD, PhD, Head of Chair of Therapy and Preventive Medicine, Postgraduate Institute for Public Health Workers (Khabarovsk)


G. I. Kropanin
Regional Center for Medical Prevention. Gubkina ul. 15V, Belgorod
Russian Federation
MD, Chief Doctor, Regional Center for Medical Prevention (Belgorod)


R. A. Kasimov
Vologda Regional Center of Medical Preventive Care. Mira ul. 9, Vologda
Russian Federation
PhD (Pedagogics), Director, Vologda Regional Center of Medical Prevention Care


D. A. Leon
London School of Hygiene and Tropical Medicine. Keppel Street, London WC1E 7HT; The University of Tromsø – The Arctic University of Norway. Hansen Hansen Road 18, Tromsø
Russian Federation
PhD, Professor of Epidemiology, Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine; Department of Community Medicine, Faculty of Health Sciences, The University of Tromsø – The Arctic University of Norway


M. McKee
London School of Hygiene and Tropical Medicine. Keppel Street, London WC1E 7HT
Russian Federation
DSc, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine


References

1. Shkolnikov V.M., Andreev E.M., McKee M., Leon D.A. Components and possible determinants of decrease in Russian mortality in 2004-2010. Demogr Res. 2013;28:917-50. doi:10.4054/Dem-Res.2013.28.32.

2. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459-544. doi:10.1016/S0140-6736(16)31012-1.

3. Schwalm J-D., McKee M., Huffman M.D., Yusuf S. Resource Effective Strategies to Prevent and Treat Cardiovascular Disease. Circulation. 2016;133(8):742-55. doi:10.1161/CIRCULATIONAHA. 115.008721.

4. Khatib R., McKee M., Shannon H. et al. Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries: An analysis of the PURE study data. Lancet. 2016;387(10013):61-9. doi:10.1016/S0140-6736(15)00469-9.

5. Popovich L., Potapchik E., Shishkin S. et al. Russian Federation. Health system review. Health Syst Transit. 2011;13 (7):1-190 xiii – xiv.

6. Indicators of the pension and social security system of the Russian Federation. [cited by Nov 20, 2018]. Available from: http://www.pfrf.ru/opendata/. (In Russ.)

7. WHO Model Lists of Essential Medicines. [cited by Nov 20, 2018]. Available from: http://www.who.int/medicines/publications/essentialmedicines/en/.

8. Order of the Government of the Russian Federation of December 28, 2016 No.2885-p “List of essential and essential drugs for medical use for 2017”. [cited by Nov 20, 2018]. Available from: http://static.government.ru/media/files/CCfPFzQvKjOEoRT5z9SeobntD7hnmX2t.pdf. (In Russ.)

9. Group D. Russian pharmaceutical market. [cited by Nov 20, 2018]. Available from: http://www.dsm.ru/marketing/free-information/analytic-reports/. (In Russ.)

10. World Health Organization. Measuring medicine prices, availability, affordability and price components. WHO Tech Rep Ser. 2007;20(8):763-5.

11. Guidelines “Organization of the work of additional medicinal maintenance of separate categories of citizens eligible for the provision of a set of social services” (approved by the Ministry of Health and Social Development of the Russian Federation 10 July 2006. [cited by Nov 20, 2018]. Available from: http://onls.pro/upload_files/Federal/MetodRekMZSR_20050312.pdf. (In Russ.)

12. Pismennaya E.E., Mozhenkova E.M. Access and Quality of Medical Care in the Russian Health Service. Humanitarian sciences. Bulletin of the Financial University. 2016;2(22):36-9. (In Russ.)

13. Petrukhina I.K., Kurkin V.A. Analysis of the implementation of the programmes medical drug provision of persons with benefits in regions. Siberian Medical Journal. 2015;134(3):81-4. (In Russ.)

14. Burykin I.M., Aleeva G.N., Khafizianova R.K. The burden of hypertension at the regional level Health and Education Millemmium. 2017;19(8):76-80. (In Russ.)

15. Tukhbatullina R.G., Nagaeva A.R. Consumption of cardio-vascular medications purchased from private pharmacy chain by population. The Bulletin of Contemporary Clinical Medicine. 2017;10(1):71-8. (In Russ.)

16. Tolpygina S.N., Martsevich S.Y. Problem of generic replacement: advantages and disadvantages. Rational Pharmacotherapy in Cardiology. 2009;1:63-8. (In Russ.)


Review

For citations:


Imaeva A.E., Balanova Yu.A., Kontsevaya A.V., Kapustina A.V., Duplyakov D.V., Malysheva O.H., Osipova I.V., Petrichko T.A., Kropanin G.I., Kasimov R.A., Leon D.A., McKee M. Availability and Affordability of Medicines for the Treatment of Cardiovascular Diseases in Pharmacies in Six Regions of the Russian Federation. Rational Pharmacotherapy in Cardiology. 2018;14(6):804-815. https://doi.org/10.20996/1819-6446-2018-14-6-804-815

Views: 1205


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)