THE SYSTEM OF PREFERENTIAL PROVISION OF MEDICINES IN SMOLENSK REGION: MODERN FEATURES AND PROBLEMS

The aim of this study was an assay of key indicators of preferential provision of medicines in Smolensk region during 2015-2021. Methods. The preferential provision of medicines was carried out by the economic and sta- tistical analysis of data from Smolensk department of health and completed by an assessment of infrastructure availability of medicinal support. Results. There was an increase financing for program of medical support 2.32 times over the past 7 years. The number of prescriptions increased equally the number of ben- eficiaries who did not refuse a set of social services (1.05 times). The rate for one pa- tient was stable and tended to increase. The actual costs for one person increased (2.47 times) and exceeded state’s standards. The number of points of sale is grow- ing and leading to the increase of availability of medicines. There was a decrease of infrastructure burden with an increase of financial burden on 1 pharmacy. Conclusion. The growth financing with decrease in the number of beneficiaries, including those who retained the right of the preferential provision, with a decrease in the population, can be explained by an increase in costs for each citizen per month. This fact may indicate that there are patients with chronic diseases in the system. The decrease in those who refuse drugaccess program allows to think about insig- nificant returning of citizens to the system. However, a sufficient number of those who replaces medicines into cash, the discrepancy between the standard and the actual costs of treatment for one person indicate problems associated with incom- plete coverage of the need of medicines and require to revise approaches of system in region. Transferring the purchase of expensive drugs for treatment of rare (orphan) diseases including spinal muscular atrophy, paroxysmal nocturnal hemoglo- binuria, Fabry disease and a defect in the complement system to the state level can reduce the burden on the regional budget.