Clinical and economic analysis as an instrument for harmonizing import substitution in the preferential segment of medicinal support

Abstract

Clinical / Economic Analysis and the common ABC / VEN analysis are currently used to estimate the qualitative and quantitative indicators of drug supply. Materials and methods . We used the official information from the national portals www.grls.rosminzdrav.ru and http://zakupki.gov.ru, on the imported medicines and the manufacturing countries related to “The Program for Providing Essential Medicines to Certain Categories of Citizens in the Russian Federation” in two regions of the Far Eastern Federal District. Results. In Region 1, the highest level of domestically produced drugs (68.7%) was observed in 2014; in 2014-2015 it dropped significantly to 53.8% and 54.1%, respectively. In Region 2, the similar values were 69.6% in 2014, with a trend to decrease to 66.0% in 2015, and 62.4% in 2016. The highest replacement rates were recorded for the moderate and low consumption categories – «B» and «C», and also for essential and non-essential medicines – «E» and «N». Discussion . The import replacement in the subsidized medicine supply is a complex dynamic process. The authors suggest that the reduced replacement of the imported drugs can be explained by both objective (the actual absence of the respective Russia-made analogues) and subjective (irrational approaches to the procurement of medicines due to the lack of an appropriate algorithm). Therefore, further work is needed to rationalize and advance the priority of the domestic medicines for the subsidized segment of drug supply. Conclusion . The study shows that the situation with the import replacement in the subsidized segment is satisfactory. However, the reduced number of domestically-produced medicines found in this study, necessitates changes in the procurement policy regarding the medicines fully manufactured in Russia. The present article proposes criteria for the assessment of import replacement and recommends measures for improving the work in this direction.