List of tranquilizers that are sold without a doctor's prescription. List of medications dispensed during the provision of additional free medical care - Rossiyskaya Gazeta New Law on Medicines

According to statistics, about 20 million people in Russia have the right to free, so-called preferential, medicines. Approximately 15.5 million of these people choose cash compensation over drugs, and only about 4 million people exercise their full right.

Who is entitled to such medications in 2019 and in what cases can the state pay for treatment? First things first.

What medications are given free of charge?

The list of free medicines is regulated by the government.

The document approving their receipt is the order of the Ministry of Health and Social Development of Russia “On approval of the list of medicines dispensed by prescription when providing additional medical care to certain groups of citizens entitled to receive state social assistance,” adopted in September 2006.

This document is updated regularly as some drugs are added to the list and others are removed from it.

In 2019, the group of free medicines included all categories of medicines:

non-narcotic and opioid analgesics;
non-steroidal anti-inflammatory drugs;
drugs for the treatment of allergies, gout, and parkinsonism;
anxiolytic, anticonvulsant, antipsychotic substances;
antidepressants, antibiotics, sleeping pills;
antiviral and antifungal drugs;
medications for the treatment of the cardiovascular, respiratory, and digestive systems;
hormones and many other drugs.

Almost any disease can be cured exclusively with the help of free drugs.

Who is eligible for free medicines

The categories of persons who have the right to free medicines are specified in Article 6.1 of Law No. 178-FZ “On State Social Assistance” dated July 17, 1999, in Article 125 of Law No. 122-FZ of August 22, 2004.

The prescription must indicate its validity period, usually one month. This is the time within which the medicine must be obtained from the pharmacy. If the drug is not available, a drug with a similar effect may be offered. The validity of the prescription can be extended, and in this case the pharmacy is obliged to organize the issuance of the requested drug within 10 days.

If it is necessary to continue treatment, as well as in case of loss of the prescription, the doctor is obliged to prescribe the drug again.

Any person to whom the prescription is given can receive free medicine with a prescription prescribed by a doctor. This is especially important when the patient himself is not able to pick up the medicine he needs.

Free medicines for children

Today, children under three years of age have the right to free medicines in Russia, in addition, children under 6 years of age from large families. This also includes children suffering from rare, life-threatening diseases, the treatment of which is extremely expensive.

It is enough to register the child at the place of residence and obtain a medical insurance policy and SNILS at the pension fund branch in order to receive free medications in the future if necessary.

If the medicines are not available at the pharmacy

In 2018, the Ministry of Health increased the volume of allocations for public procurement of medicines for HIV-infected people to 21.6 billion rubles. Previously, 17.8 billion rubles were allocated.

According to a social study conducted by the All-Russian Popular Front, most Russians in 2018 do not even have access to subsidized medications, since many localities experience a shortage of them in public medical institutions and pharmacies.

Dear readers!

We describe typical ways to resolve legal issues, but each case is unique and requires individual legal assistance.

To quickly resolve your problem, we recommend contacting qualified lawyers of our site.

Last changes

From January 1, 2019, new Rules for organizing the provision of medicines to persons with rare diseases will be in effect, the list of which for budgetary drug provision has been expanded by Federal Law-299 of August 3, 2018. It includes the following diseases:

hemophilia,
pituitary dwarfism,
cystic fibrosis,
Gaucher disease,
malignant neoplasms of lymphoid, hematopoietic and related tissues,
hemolytic-uremic syndrome,
multiple sclerosis,
juvenile arthritis with systemic onset,
mucopolysaccharidosis types 1-2 and 6,
post-transplant period.

New INNs included in the list of free medicines:

Name of the drug		Dosage form
Drugs for the treatment of liver and biliary tract diseases
Succinic acid + meglumine + inosine + methionine + nicotinamide	r/r for infusions
Antidiarrheal, intestinal anti-inflammatory and antimicrobial drugs
Mesalazine		suppositories, suspension, tablets
Medicines for the treatment of diabetes mellitus
Lixisenatide		r/r for subcutaneous administration
Empagliflozin		pills
Other drugs for the treatment of diseases of the gastrointestinal tract and metabolic disorders
Eliglustat		capsules
Hemostatics
Eltrombopag		pills
Drugs affecting the renin-angiotensin system
Valsartan + sacubitril		pills
Lipid-lowering drugs
Alirocumab		r/r for subcutaneous administration
Evolocumab		r/r for subcutaneous administration
Hormones of the pituitary gland and hypothalamus and their analogues
Lanreotide		gel for subcutaneous administration prolong. actions
Antibacterial drugs for systemic use
Telavantzin
Daptomycin		lyophilisate for preparing solution for infusion
Tedizolid		pills,
Antiviral drugs for systemic use
Dasabuvir; ombitasvir + paritaprevir + ritonavir		tablets set
Narlaprevir		pills
Daclatasvir		pills
Dolutegravir		pills
Antitumor drugs
Cabazitaxel
Brentuximab vedotin		lyophilisate for the preparation of concentrate for the preparation of solution for infusion
Nivolumab		concentrate for the preparation of solution for infusion
Obinutuzumab		concentrate for the preparation of solution for infusion
Panitumumab		concentrate for the preparation of solution for infusion
Pembrolizumab		concentrate for the preparation of solution for infusion
Pertuzumab		concentrate for the preparation of solution for infusion
Trastuzumab emtansine		lyophilisate for the preparation of concentrate for the preparation of solution for infusion
Afatinib		pills
Dabrafenib		capsules
Crizotinib		capsules
Nintedanib		soft capsules
Pazopanib		pills
Regorafenib		pills
Ruxolitinib		pills
Trametinib		pills
Aflibercept		concentrate for the preparation of solution for infusion
Vismodegib		capsules
Carfilzomib		lyophilisate for preparing solution for infusion
Tumor necrosis factor alpha-1 [thymosin recombinant]*
Antitumor hormonal drugs
Enzalutamide		capsules
Degarelix		lyophilisate for the preparation of solution for subcutaneous administration
Immunomodulators
Peginterferon beta-1a		r/r for subcutaneous administration
Immunosuppressants
Alemtuzumab		concentrate for the preparation of solution for infusion
Apremilast		pills
Vedolizumab		lyophilisate for the preparation of concentrate for the preparation of solution for infusion
Tofacitinib		pills
Canakinumab		lyophilisate for the preparation of solution for subcutaneous administration
Secukinumab		lyophilisate for preparing a solution for subcutaneous administration; solution for subcutaneous administration
Pirfenidone		capsules
Anti-inflammatory and antirheumatic drugs
Dexketoprofen		r/r for intravenous and intramuscular administration
Levobupivacaine		injection
Perampanel		pills
Dimethyl fumarate		enteric capsules
Tetrabenazine		pills
Drugs for the treatment of obstructive airway diseases
Vilanterol + fluticasone furoate		dosed powder for inhalation
Glycopyrronium bromide + indacaterol		capsules with powder for inhalation
Olodaterol + tiotropium bromide		dosed solution for inhalation
Other drugs for the treatment of diseases of the respiratory system
Beractant		suspension for endotracheal administration
Drugs for the treatment of eye diseases
Tafluprost		eye drops
Aflibercept		solution for intraocular administration
Other remedies
Complex of b-iron(III) oxyhydroxide, sucrose and starch		chewable tablets
Yomeprol		injection

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in accordance with the list of population groups and categories

diseases, for outpatient treatment of which medicinal

drugs and medical products are dispensed according to

doctor's prescriptions free of charge, as well as in accordance with the list

population groups for which outpatient treatment

medications are dispensed according to doctor's prescriptions

with a 50 percent discount from free prices

I. Anticholinesterase drugs
Galantamine	long-acting
Ipidacrine	pills
Pyridostigmine bromide	pills
II. Opioid analgesics and mixed action analgesic
Buprenorphine	solution for intravenous and intramuscular injection; pills sublingual; therapeutic system transdermal
	shell
Morphine + Narcotine + Papaverine hydrochloride + Codeine + Thebaine	injection
Tramadol	capsules; injection; long-acting, coated shell; pills
Trimeperidine	injection; pills
Fentanyl	transdermal therapeutic system
III. Non-narcotic analgesics and non-steroidal anti-inflammatory drugs facilities
Aceclofenac	pills
Acetylsalicylic acid	film-coated
Dexketoprofen	pills
Diclofenac	gel; eye drops; ointment; suppositories rectal; tablets, coated enteric coated; pills prolonged action; solution for intramuscular injection
Ibuprofen	gel for external use; cream for external use; tablets, coated shell; suspension for oral administration; rectal suppositories
Indomethacin	suppositories; film-coated tablets
Ketoprofen	capsules; cream; suppositories; pills retard; Forte tablets, film-coated
Ketorolac	intramuscular injection
Lornoxicam	pills; lyophilisate for preparation solution for intravenous and intramuscular injection
Meloxicam	pills
Nimesulide	pills; ointment
Combined drugs containing metamizole sodium	pills
Paracetamol	rectal suppositories; pills
Phenazone + lidocaine	ear drops
Flupirtine maleate	pills
IV. Medicines for the treatment of gout
Allopurinol	pills
V. Other anti-inflammatory drugs
Hydroxychloroquine	film-coated tablets
Leflunomide	film-coated tablets
Mesalazine	rectal suppositories; suspension rectal; tablets, coated enteric coated
Penicillamine	pills
Sulfasalazine	pills
Chloroquine	pills
VI. Means for the treatment of allergic reactions
Dimetinden	drops for oral administration
Ketotifen	pills
Clemastine	pills
Loratadine	pills
Mebhydrolin
Chloropyramine	pills
Cetirizine	drops for oral administration; pills, coated
VII. Anticonvulsants
Benzobarbital	pills
Valproic acid	drops for oral administration; syrup; pills, enteric-coated; coated; granules prolonged for oral administration
Gabapentin
Carbamazepine	actions; extended-release tablets covered actions
Clonazepam	pills
Lamotrigine	pills
Levetiracetam	film-coated tablets
Oxcarbazepine	; suspension for oral administration
Primidon	pills
Topiramate
Phenobarbital	pills
Phenytoin	pills
Ethosuximide
VIII. Drugs for the treatment of parkinsonism
Bromocriptine	pills
Levodopa + Carbidopa	pills
Levodopa + Benserazide	capsules; dispersible tablets; pills
Piribedil	coated
Pramipexole	pills
Rasagiline mesylate	pills
Selegilin	pills
Cyclodol	pills
IX. Anxiolytics
Alprazolam	pills; extended-release tablets actions
Diazepam	pills; solution for intramuscular introduction
Hydroxyzine	film-coated tablets
Medazepam	pills
Nitrazepam	pills
Phenazepam	pills
X. Antipsychotics
Alimemazine	pills
Haloperidol	drops for oral administration; pills
Haloperidol	(oil)
Zuclopenthixol	film-coated tablets; solution for intramuscular injection (oil)
Quetiapine	film-coated tablets
Clozapine	pills
Levomepromazine	film-coated tablets
Paliperidone	extended-release tablets, coated
Perphenazine	film-coated tablets
Periciazine	oral solution; capsules
Promazine	film-coated tablets; dragee
Risperidone	lozenges; pills, coated
Sulpiride	capsules; pills
Thioridazine
Trifluoperazine	film-coated tablets
Flupenthixol	film-coated tablets
Fluphenazine	solution for intramuscular administration (oil)
Chlorpromazine
Chlorprothixene	film-coated tablets
XI. Antidepressants and mood stabilizers
Amitriptyline
Venlafaxine	pills
Imipramine
Clomipramine	film-coated tablets
Lithium carbonate	extended-release tablets
Maprotiline	film-coated tablets
Milnacipran
Paroxetine	film-coated tablets
Pipofezin	pills; tablets with modified releasing
Pearlindol	pills
Sertraline	film-coated tablets
Fluvoxamine	film-coated tablets
Fluoxetine
Escitalopram	film-coated tablets
XII. Medicines for the treatment of sleep disorders
Zaleplon
Zolpidem	film-coated tablets
Zopiclone	film-coated tablets
XIII. Other drugs affecting the central nervous system
Baclofen	pills
Betagistine	pills
Vinpocetine	pills; film-coated tablets
Hopantenic acid	pills; syrup
Piracetam	; film-coated tablets
Tizanidine	pills
Tolperisone	film-coated tablets
	pills
Fenotropil	pills
Cinnarizine	pills
XIV. Means for the prevention and treatment of infections
Antibiotics
Azithromycin	ingestion
Amoxicillin	capsules; film-coated tablets; pills
Amoxicillin + Clavulanic acid	powder for preparing a suspension for ingestion; dispersible tablets;
Josamycin	pills; dispersible tablets
Doxycycline
Clarithromycin	film-coated tablets
Midecamycin	film-coated tablets
Rifamycin	ear drops
Tetracycline	eye ointment
Tobramycin	eye drops
Fosfomycin	granules for preparing a solution for ingestion
Synthetic antibacterial agents
Cotrimoxazole
Nitrofurantoin	pills
Nitroxoline	film-coated tablets
Nifuroxazide	capsules; suspension for oral administration
Norfloxacin	film-coated tablets
Ofloxacin	film-coated tablets
Pipemidic acid
Sulfacetamide	eye drops
Furazidin	capsules; pills
Ciprofloxacin	eye drops; tablets, coated shell
XV. Antituberculosis drugs
Isoniazid	pills
Pyrazinamide	pills
Prothionamide	film-coated tablets
Rifampicin
Ethambutol	pills
XVI. Antiviral agents
	film-coated tablets; capsules
Acyclovir	pills; ointment for external use; eye ointment
Imidazolylethanamide pentanedioic acid
Ribavirin	pills
Entecavir	film-coated tablets
XVII. Antifungal agents
Clotrimazole	cream for external use
Nystatin	ointment for external use; vaginal suppositories; suppositories rectal; film-coated tablets
Terbinafine	cream for external use; spray; pills
Fluconazole

Mebendazole	pills
Metronidazole	pills
XIX. Antineoplastic, immunosuppressive and related drugs
Azathioprine	pills
Anastrazole	film-coated tablets
Aprepitant	capsules set
Bleomycin	injections
Bleomycetin	Injections
Busulfan	pills
Vinblastine	powder for preparing a solution for injections
Vincristine	injection; lyophilized powder for preparing a solution for injections
Dactinomycin	lyophilized powder for injection; infusions
Daunorubicin	powder for preparing a solution for injections
Doxorubicin	intravascular and intravesical solution for intravascular and intravesical administration; concentrate for introduction
Ibandronic acid	concentrate for preparing a solution for infusions
Idarubicin	capsules; lyophilisate for preparation solution for intravenous administration
Ifosfamide	powder for preparing a solution for injections; powder for cooking solution for infusion
Calcium folinate
Carboplatin	concentrated solution for infusion
Carmustine	lyophilisate for preparing a solution for infusions
Clodronic acid	capsules; concentrate for preparation solution for infusion
Lenograstim	lyophilized powder for
Letrozole	film-coated tablets
Lomustin
Medroxyprogesterone	pills
Melphalan	film-coated tablets
Mercaptopurine	pills
	film-coated tablets; solution for intravenous administration; solution for infusion concentrated
Methotrexate	pills; concentrate for preparation solution for injection; solution for injections in graduated syringes
Mitoxantrone	injection
Mitomycin	powder for preparing a solution for injections; lyophilisate for preparation solution for injection
Ondansetron	film-coated tablets
Pamidronic acid	concentrate for preparing a solution for infusions
Procarbazine
Sehydrin	enteric coated tablets shell
Tamoxifen	pills
Flutamide	pills
Fotemustine	powder for preparing a solution for infusions
Fluorouracil	injection; concentrate for preparing a solution for infusion
Ftorafur
Fulvestrant	solution for intramuscular injection
Chlorambucil	film-coated tablets
Cyclosporine	capsules; oral solution
Cyclophosphamide	film-coated tablets
Cyproterone	pills
Cisplatin	concentrated solution for preparing infusions
Cytarabine	injection; lyophilisate for preparation of solution for injection
Epirubicin	concentrate for preparing a solution for intravenous and intracavitary administration; lyophilized powder for preparation of solution for injection
Estramustine	capsules; lyophilized powder for
Etoposide
XX. Drugs for the treatment of osteoporosis
Alfacalcidol
Dihydrotachysterol	drops for oral administration; solution for ingestion
Calcitriol
Colecalciferol	drops for oral administration
XXI. Drugs affecting hematopoiesis and coagulation system
Warfarin	pills
Heparin sodium	gel for external use
Dipyridamole	dragee; film-coated tablets
Iron (III) hydroxide polymaltose	syrup; chewable tablets; drops for ingestion
Iron sulfate + Ascorbic acid acid	film-coated tablets
Methoxypolyethylene glycol- Epoetin beta	introduction
Pentoxifylline	film-coated tablets
Folic acid	pills
Epoetin alfa	injection
Epoetin beta	lyophilisate for preparing a solution for
XXII. Drugs affecting the cardiovascular system
Amiodarone	pills
Amlodipine	pills
Amlodipine + lisinopril	pills
Atenolol	pills
Acetazolamide	pills
Bisoprolol	film-coated tablets
	sublingual capsules; sublingual tablets
Verapamil	film-coated tablets; pills long-acting, coated shell
Hydrochlorothiazide	pills
Hydrochlorothiazide + Triamterene	pills
Digoxin	pills
Diltiazem	film-coated tablets; pills long-acting, coated shell
Isosorbide dinitrate	sublingual dosed aerosol; extended-release tablets; pills
Isosorbide mononitrate	retard tablets; pills
Indapamide	capsules; film-coated tablets; modified release tablets
Captopril	pills
Captopril + Hydrochlorothiazide	pills
Carvedilol	pills
Clonidine	pills
Corvalol	drops for oral administration
Lappaconitine hydrobromide	pills
Lisinopril	pills
Metoprolol	film-coated tablets; pills
Moxonidine	film-coated tablets
Molsidomin	retard tablets; pills
Peppermint oil + Phenobarbital + Hops cones oil + Ethyl bromoisovalerate	drops for oral administration
Nitroglycerine	dosed sublingual spray; pills sublingual; extended-release tablets actions; transdermal therapeutic system
Nifedipine	capsules; extended-release tablets covered actions; pills rapid retard, coated; pills modified release; pills
Perindopril	pills
Perindopril + Amlodipine	pills
Perindopril + Indapamide	pills
Propaphenone	film-coated tablets
Propranolol	pills
Ramipril	pills
Rilmenidine	pills
	pills
Torasemide	pills
Spironolactone	pills
Felodipin	extended-release tablets, coated
Fosinopril	pills
Furosemide	pills
Enalapril	pills
Enalapril + Hydrochlorothiazide	pills
Enalapril + Indapamide	pills
Ethacizin	film-coated tablets
XXIII. Drugs for the treatment of diseases of the gastrointestinal tract
Medicines used to treat diseases accompanied by erosive and ulcerative processes in the esophagus, stomach, duodenum gut
Algeldrate + Magnesium hydroxide	suspension for oral administration; pills chewable
Aluminum phosphate	gel for oral administration
Bismuth tripotassium dicitrate	film-coated tablets; pills
Metoclopramide	pills
Omeprazole
Ranitidine	film-coated tablets
Famotidine	film-coated tablets
Antispasmodics
Bencyclane	pills
Drotaverine	pills
Mebeverine	extended release capsules
Laxatives
Bisacodyl	rectal suppositories; pills, coated
Lactulose
Antidiarrheals
Loperamide
Pancreatic enzymes
Pancreatin	capsules; film-coated tablets
Pancreatin + Bile components + Hemicellulose	dragee; tablets, coated enteric coated
Holenzym	film-coated tablets
Drugs used to treat liver and biliary diseases ways
Ursodeoxycholic acid
Phosphogliv
Means for restoring intestinal microflora
Bifidobacterium bifidum	lyophilisate for preparing a solution for oral and topical use

XXIV. Hormones and agents affecting the endocrine system
Non-sex hormones, synthetic substances and antihormones
Aminoglutethimide	pills
Betamethasone	cream; ointment
Hydrocortisone	eye ointment; ointment for external applications; pills
Dexamethasone	eye drops; pills
Desmopressin	pills; nasal spray
Levothyroxine sodium	pills
Cortisone	pills
Levothyroxine sodium + Liothyronine + Potassium iodide	pills
Liothyronine	pills
Methylprednisolone	pills
Methylprednisolone aceponate	external use; ointment for external applications (oily); emulsion for external use
Prednisolone	eye drops; ointment for external applications; pills
Somatropin	lyophilisate for preparing a solution for injections;
Thiamazole	film-coated tablets; pills
Triamcinolone	ointment for external use; pills
Fluocinolone acetonide	gel for external use; ointment for external use
Fludrocortisone	pills
Medicines for the treatment of diabetes mellitus
Acarbose	pills
Glibenclamide	pills
Glibenclamide + Metformin	film-coated tablets
Gliquidone	pills
Gliclazide	tablets with modified release; pills
Glimepiride	pills
Glipizide	pills
Insulin aspart	solution for intravenous and subcutaneous introduction
Insulin aspart biphasic
Insulin glargine	solution for subcutaneous administration
Insulin glulisine	solution for subcutaneous administration
Biphasic insulin	suspension for subcutaneous administration
Insulin detemir	solution for subcutaneous administration
Insulin lispro	injection
Insulin soluble (human genetically engineered)	injection
Insulin isophane (human genetically engineered)	suspension for subcutaneous administration
Metformin	film-coated tablets; pills
Metformin + Rosiglitazone	film-coated tablets
Repaglinide	pills
Rosiglitazone	film-coated tablets
Gestagens
Dydrogesterone	film-coated tablets
Norethisterone	pills
Progesterone
Estrogens
	vaginal cream; suppositories vaginal; pills
Ethinyl estradiol	pills
XXV. Drugs for the treatment of prostate adenoma
Doxazosin	pills
Tamsulosin	modified release capsules; controlled release tablets, coated
Terazosin	pills
Finasteride	film-coated tablets
XXVI. Drugs affecting the respiratory system
Ambroxol	syrup; pills; oral solution and inhalations
Acetylcysteine	effervescent tablets; granules for preparing a solution for oral administration; powder for preparing a solution for ingestion
Beclomethasone	(easy breath); nasal spray;
Beclomethasone + Formoterol	dosed aerosol for inhalation
Bromhexine	syrup; film-coated tablets; pills
Bromhexine + Salbutamol + Guaifenesin + Menthol
Budesonide	; suspension for inhalation;
Ipratropium bromide	aerosol for inhalation; solution for inhalations
Ipratropium bromide + Salbutamol	solution for inhalation
Ipratropium bromide + Fenoterol	solution for inhalation
Sodium cromoglycate	dosed aerosol for inhalation; solution for inhalation
Nedocromil sodium	dosed aerosol for inhalation
Oxymetazoline	nasal drops
Salmeterol	aerosol for inhalation
Salmeterol + Fluticasone	dosed aerosol for inhalation; dosed powder for inhalation
Salbutamol	breath-activated aerosol inhaler (easy breath); solution for inhalation; pills; film-coated tablets prolonged action; aerosol for dosed inhalations
Theophylline	extended-release capsules; retard tablets
Tiotropium bromide	capsules with powder for inhalation
Fenoterol	dosed aerosol for inhalation; solution for inhalation
Fenspiride	film-coated tablets; syrup
Formoterol	capsules with powder for inhalation; powder for inhalation dosed; aerosol for dosed inhalations
Formoterol + Budesonide	dosed powder for inhalation
XXVII. Drugs used in ophthalmology
Azapentacene	eye drops
Betaxolol	eye drops
Brinzolamide	eye drops
Idoxuridine	eye drops
Latanoprost	eye drops
Pilocarpine	eye drops
Pilocarpine + Timolol	eye drops
Proxodolol	solution - eye drops
	eye drops
	eye drops
Travoprost	eye drops
Emoxipin	eye drops
XXVIII. Vitamins and minerals
Gendevit
Potassium iodide	pills
Potassium and magnesium aspartate	pills
Neuromultivitis	pills
Cytoflavin	; pills
XXVIX. Antiseptics and disinfectants
Hexethidine	aerosol for topical use; solution for topical use
Chlorhexidine	solution for external use
	solution for external use and preparation of dosage forms
XXX. Other means
Gentamicin + Betamethasone + Clotrimazole	cream for external use; ointment for external use
	film-coated tablets
Diosmin + Hesperidin	film-coated tablets
Canephron	oral solution; dragee
Ketosteril	film-coated tablets
Bacteria lysates mixture	capsules; suspension for intranasal introduction; lozenges; spray nasal
Troxerutin
Ethylmethylhydroxypyridine succinate	capsules; film-coated tablets
XXXI. Means used according to the decision of the medical commission approved chief physician of a medical institution
Abatacept	lyophilisate for preparing a solution for infusions
Ademetionine	enteric coated tablets shell
Alendronic acid	pills; film-coated tablets
Altretamine
Aripiprazole	pills
Asparaginase	lyophilisate for preparing a solution for
Atorvastatin	film-coated tablets
Afenilac	dry mixture
Bevacizumab	concentrate for preparing a solution for infusions
Bicalutamide	film-coated tablets
Botulinum toxin	lyophilized powder for preparation of solution for injection
Buserelin	actions
Valganciclovir	film-coated tablets
Valsartan	film-coated tablets
Vinorelbine	concentrate for preparing a solution for infusions
Ganciclovir
Gemcitabine	lyophilized powder for preparation of injection solution
Gefitinib	pills
Hydroxyurea
Goserelin	subcutaneous capsule
Chorionic gonadotropin	lyophilisate for preparing a solution for intramuscular injection
Granisetron	film-coated tablets
Dacarbazine	lyophilisate for preparing a solution for intravenous administration
Dalteparin sodium	injection
Darbepoetin alfa	injection
Decitabine	lyophilisate for preparing a solution for infusions
Dornase alpha	solution for inhalation
Docetaxel	concentrate for preparing a solution for infusions
Iron (III) hydroxide polyisomaltose	solution for intramuscular administration
Iron (III) hydroxide sucrose complex	solution for intravenous administration
Ferrous sulfate + Serine
Ziprasidone
Zoledronic acid	concentrate for preparing a solution for infusions
	liquid mixture
Isotretinoin
Imatinib
Human immunoglobulin normal (IgG + IgA + IgM)	solution for intravenous administration
Interferon alpha-2a	lyophilisate for preparing a solution for injections; injection
Interferon alpha-2b	lyophilisate for preparing a solution for injections and topical application; lyophilized powder for preparation of solution for injection; injection; rectal suppositories
Itraconazole	capsules; oral solution
Infliximab	lyophilized powder for preparing a solution for intravenous introduction
Irbesartan	pills
Irinotecan	concentrate for preparing a solution for infusions
Cabergoline	pills
Calcitonin	nasal spray
Candesartan	pills
Capecitabine	film-coated tablets
Carboplatin	concentrate for preparing a solution for infusions
Clopidogrel	film-coated tablets
Colecalciferol + Calcium carbonate	chewable tablets
Levocetirizine	film-coated tablets
Levofloxacin	film-coated tablets
Lovastatin	pills
Losartan	film-coated tablets
Losartan + Hydrochlorothiazide	film-coated tablets
Mycophenolate mofetil	film-coated tablets; capsules
Mycophenolic acid	enteric coated tablets shell
Moxifloxacin	film-coated tablets
Moexipril	film-coated tablets
Nadroparin calcium	solution for subcutaneous administration
Nebivolol	pills
Oxaliplatin	powder for preparing a solution for infusions
Oxybutynin	pills
Octreotide	microspheres for preparing a suspension for injections; solution for intravenous and subcutaneous administration; injection
Olanzapine	dispersible tablets; capsules
Omega-3 triglycerides (EPK/DKG-1.2/1-90%)
Paclitaxel	concentrate for preparing a solution for infusions
PAM-universal	dry mixture
Peginterferon alfa-2a	injection
Peginterferon alfa-2b	lyophilisate for preparing a solution for subcutaneous administration
Rabeprazole	enteric coated tablets shell
Raltitrexide	lyophilisate for preparing a solution for infusions
Ribavirin
Risperidone	powder for preparing a suspension for intramuscular injection of prolonged actions
Rituximab	concentrate for preparing a solution for infusions
Rosuvastatin	film-coated tablets
Roxithromycin	film-coated tablets
Sertindole	film-coated tablets
Simvastatin	film-coated tablets
Sorafenib	film-coated tablets
Spirapril	pills
Sunitinib
Tacrolimus

Telmisartan	pills
Temozolomide
Tetrafen-30	dry mixture
Tetrafen-40	dry mixture
Tetrafen-70	dry mixture
Thioctic acid	film-coated tablets
Tolterodine	extended-release capsules; film-coated tablets
Topotecan	powder for preparing a solution for infusions
Tocilizumab	concentrate for preparing a solution for infusions
Trabectedin	lyophilisate for preparing a solution for infusions
Trastuzumab	lyophilisate for preparing a solution for infusions
Tretinoin
Trimetazidine	film-coated tablets; tablets with modified release, coated shell; capsules
Triptorelin	lyophilisate for preparing a suspension for intramuscular injection of prolonged actions
Tropisetron

Filgrastim	solution for intravenous and subcutaneous introduction; concentrate for preparation solution for infusion



Flupenthixol	solution for intramuscular injection depot
Fluticasone	aerosol for inhalation dosed
Quinapril	film-coated tablets
Cerebrolysin	injection
Cefazolin	powder for preparing a solution for intravenous and intramuscular administration
Cefixime	powder for preparing a suspension for ingestion; capsules
Ceftriaxone	powder for preparing a solution for intravenous and intramuscular administration
Cilazapril	film-coated tablets
Cyproterone	pills
Everolimus	pills
Exemestane	film-coated tablets
Enoxaparin sodium	injection
Eprosartan	film-coated tablets
Eprosartan + Hydrochlorothiazide	film-coated tablets
Erlotinib	film-coated tablets

Table 1

Approved cost of the territorial program

state guarantees for the provision to the population of Ryazan

areas of free medical care by source

its financial support for 2011

Sources of financial support territorial program state guarantees for the provision free to the population of the Ryazan region medical care	Approved cost programs
		on the 1st resident
	(million rubles)

The cost of the territorial program is total (sum of lines 02 + 09), including for check:
Ryazan region
consolidated budget funds Ryazan region for maintenance medical organizations working in compulsory medical insurance system
at the expense of the compulsory medical insurance system, including:
working population
insurance premiums (payments) for compulsory medical insurance non-working population
tax revenues
other income, including subsidies from the Federal Compulsory Medical Insurance Fund
Cost of the territorial compulsory medical insurance program total (sum of lines 03 + 04)

IP and IBLP

In general, in order No. 403n the topic of IBP release is spelled out separately, which is not in order 785. It will be regulated by paragraph 13 of the first mentioned act. This paragraph, in particular, determines that when an IBP is dispensed, the exact time of this same dispensing, in hours and minutes, is indicated on the prescription or prescription counterfoil, which remains with the buyer.

Violation of secondary

With the entry into force of Order No. 403n, new emphasis will appear on the topic of the possibility of violation of secondary (consumer) packaging of medicines. The “retiring” norm of Order No. 785 allows this to be done in exceptional cases, if the pharmacy organization is unable to fulfill the doctor’s prescription.

The order No. 403n that replaced it is in this regard more specific and more in line with modern requirements, medical practice and consumer demands. Paragraph 8 of the order determines that violation of secondary packaging and dispensing of a medicinal product in primary packaging is permitted in cases where the amount of the drug indicated in the prescription or required by the consumer (for over-the-counter dispensing) is less than the amount of the drug contained in the secondary packaging.

In this case, the buyer must be provided with instructions for use or a copy thereof, and tampering with the original packaging is prohibited. By the way, the new order does not contain the rule that in case of violation of the secondary order, the drug must be dispensed in pharmaceutical packaging with the obligatory indication of the name, factory batch, expiration date of the drug, series and date according to the laboratory packaging register, which is determined by order No. 785.

"The medicine has been released"

Clause 4 of Order No. 403n of the Ministry of Health of the Russian Federation regulates the topic of prescription forms and the list of drugs dispensed on them. In particular, narcotic and psychotropic drugs of Schedule II are dispensed using Form No. 107/u-NP, with the exception of narcotic and psychotropic drugs in the form of transdermal therapeutic systems.

The remaining prescription drugs, as is known, are dispensed using forms No. 107-1/u. According to paragraph 22 of the order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing medications, as well as forms of prescription forms...”, prescriptions written on the forms of this form are valid for two months from the date of prescription. However, for patients with chronic diseases, it is allowed to set the validity period of the prescription form No. 107-1/u within up to one year and exceed the recommended amount of the drug for prescribing per prescription, established by Appendix No. 2 of this order.

Such a prescription, which also indicates the periods and quantity of the drug dispensed (in each period), is returned to the buyer, of course, with the required notes on the date of dispensing, dosage and quantity of the drug dispensed. This is prescribed by paragraph 10 of order No. 403n. It also determines that the next time the patient comes to the pharmacy with the same prescription, the chief must take into account the notes on the previous dispensing of the drug.

The prescription remains at the pharmacy

There are some changes on the topic indicated in the title of this chapter. Paragraph 14 of the new order establishes that the retail trade entity retains (with the mark “The medicinal product is dispensed”) and stores:

within 5 years prescriptions for:

within 3 years prescriptions for:

within 3 months recipes for:

Order No. 403n of the Russian Ministry of Health did not come without a cherry on the cake, albeit a dubious one. Paragraph 15 of the order states that prescriptions not specified in the previous 14th paragraph (we listed them just above) are marked with the stamp “The drug has been dispensed” and are returned to the indicator. It seems to follow from this that prescriptions of form No. 107-1/y with a two-month validity period become “disposable”. We advise readers to pay special attention to this new norm.

The topic of combating the abuse of alcohol-containing drugs in pharmacies, which was recently trumpeted by the media, is also reflected in the new order on the rules of dispensing. According to the current procedure, prescriptions for such drugs are returned to the patient (with a “dispensed” stamp); under the new order, they must remain in the pharmacy organization.

To avoid getting caught

The procedure for working with incorrectly written prescriptions is now described in a little more detail (clause 15 of order No. 403n). In particular, when they are registered by a pharmacist in a journal, it is necessary to indicate the identified violations in the execution of the prescription, the full name of the health worker who wrote it, the name of the medical organization in which he works, and the measures taken.

Paragraph 17 of Order No. 403n contains the rule that a pharmacist does not have the right to provide unreliable or incomplete information about the availability of drugs in the pharmacy’s assortment - including drugs that have the same INN - and also to hide information about the availability of drugs that have a lower price. Similar provisions are contained in subparagraph 2.4 of Article 74 of the Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” and paragraph 54 of the Rules of Good Pharmacy Practice (Order of the Ministry of Health of the Russian Federation dated August 21, 2016 No. 647n). The only thing new here is that this rule appears for the first time in the order on vacation rules.

This was a review of the order, so to speak, “on fresh trail.” Readers will probably find in it other points and norms that deserve special attention. Write to the editors of Katren-Style magazine about them, and we will address your questions to leading industry experts. We will also ask them about the problem of “disposable” prescriptions with a two-month validity period, which was mentioned above, as well as the dispensing of ethyl alcohol and alcohol-containing drugs in the light of the provisions of the new order No. 403n.

Materials about the order of the Ministry of Health No. 403n:

What could be more important for a pharmacy organization than the order in which medications are dispensed. Pharmacists barely had time to return from their summer vacation and look around when a new order of the Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n was published with appendices “On approval of the rules for the dispensing of drugs for medical use, including immunobiological drugs, by pharmacy organizations, individual entrepreneurs with license for pharmaceutical activities." Order No. 403n on the vacation procedure was registered with the Ministry of Justice of the Russian Federation on September 8; it begins on September 22 of the current year.

The first thing I want to say in this regard is that now forget the number “785”. The new order 403n with amendments and additions invalidates the well-known order of the Ministry of Health and Social Development dated December 14, 2005 No. 785 “On the procedure for dispensing medicines,” as well as the orders of the Ministry of Health and Social Development No. 302, No. 109 and No. 521 that amended it. At the same time, many points of a new regulatory legal act repeat - sometimes almost verbatim - the corresponding fragments of the predecessor order. But there are also differences, new provisions, on which we will focus more, setting out the first observations and notes in the margins of the freshly issued order of the Ministry of Health No. 403n.

IP and IBLP

Order of the Ministry of Health of the Russian Federation No. 403n consists of three appendices. The first approves new rules for the dispensing of medicinal products, including immunobiological medicinal products (IBP); the second is the requirements for the dispensing of narcotic and psychotropic drugs, drugs with anabolic activity, and other drugs subject to subject-quantitative accounting (SQR). The third appendix establishes the rules for the dispensing of medicines according to the invoice requirements of medical organizations, as well as individual entrepreneurs (IP) with a license for medical activities.

Under the new order, the dispensing of over-the-counter drugs will be allowed both to pharmacies and pharmacy points, as well as individual entrepreneurs and pharmacy kiosks. For the rest, if we summarize points 2 and 3 of order No. 403n and the list of drugs, the following picture emerges.

The dispensing of narcotic and psychotropic drugs can only be carried out by pharmacies and pharmacy points that have the appropriate license.
The remaining prescription drugs are dispensed by pharmacies, pharmacy points and individual entrepreneurs (of course, those with a license for pharmaceutical activities - this clarification will be further considered accepted by default and omitted).
The dispensing of immunobiological prescription drugs is carried out by pharmacies and pharmacy points. Individual entrepreneurs are not mentioned in this provision of paragraph 3, which means that they cannot dispense drugs of this group, which we advise you to pay special attention to.

In general, in order No. 403n the procedure for dispensing IBP drugs is prescribed separately, which is not in order 785. It will be regulated by paragraph 13 of the first mentioned act. This paragraph, in particular, determines that when an IBP is dispensed, the exact time of this same dispensing, in hours and minutes, is indicated on the prescription or prescription counterfoil, which remains with the buyer.

IBLP can be released if two conditions are met. Firstly, if the buyer has a special thermal container in which the required mode of transportation and storage of these thermolabile drugs can be observed. The second condition is an explanation (from the pharmacist to the buyer) of the need to deliver this drug to a medical organization, despite the fact that it can be stored in the mentioned container for no more than 48 hours.

Let us recall in this regard that this topic is also regulated by subclause 8.11.5 of the Sanitary and Epidemiological Rules “Conditions for transportation and storage of immunobiological preparations” (SP 3.3.2.3332–16), which were approved by Resolution of the Chief State Sanitary Inspector of the Russian Federation dated February 17, 2016 No. 19 It obliges the pharmacy employee to instruct the buyer on the need to comply with the “cold chain” when transporting biomedical products.

The fact of this instruction is recorded with a mark on the drug packaging, prescription or other accompanying document. The mark is certified by the signature of the buyer and the chief clerk (or another representative of the pharmacy organization) and also includes the date and time of dispensing. However, the SanPiN does not specify that the time in this case should be indicated in hours and minutes.

Violation of secondary

With the amendments and additions to Order No. 403n, new emphasis will appear on the topic of the possibility of violation of secondary (consumer) packaging of medicines. The “retiring” norm of Order No. 785 allows this to be done in exceptional cases, if the pharmacy organization is unable to fulfill the doctor’s prescription.

The order No. 403n that replaced it with a list of drugs in this regard is more specific and more in line with modern requirements, medical practice and consumer demands. Paragraph 8 of the order determines that violation of secondary packaging and dispensing of a medicinal product in primary packaging is permitted in cases where the amount of the drug indicated in the prescription or required by the consumer (for over-the-counter dispensing) is less than the amount of the drug contained in the secondary packaging.

In this case, the buyer must be provided with instructions for use or a copy thereof, and tampering with the original packaging is prohibited. By the way, in the new order of the Ministry of Health of the Russian Federation No. 403n there is no provision that in case of violation of the secondary drug must be dispensed in pharmaceutical packaging with the obligatory indication of the name, factory series, expiration date of the drug, series and date according to the laboratory packaging register, which is determined by order No. 785.

What does this mean in practice? Let's assume two situations: first - drug X tablets (or dragees) No. 56, primary packaging - blister; the second is drug N tablets No. 56, in a bottle. And in both cases, the question arises about its release to the patient who has presented the chief of staff with a prescription on which, say, 28 tablets or 42 tablets (dragées) are prescribed.

It is clear that in the first case this is acceptable, since it is possible to dispense 28 or 42 tablets without breaking the primary packaging (blister), and in the second case it is unacceptable, since the primary packaging in this situation is a bottle, and breaking it is strictly prohibited. So, our first capital officials do not have the right to count out tablets or dragees from a bottle, as they do in pharmacies in some foreign countries.

"The medicine has been released"

According to form No. 148–1/у-88 the following are issued:

Schedule III psychotropic drugs;
narcotic and psychotropic drugs of Schedule II in the form of transdermal therapeutic systems;
drugs included in the list of drugs subject to PCU, with the exception of those drugs that are dispensed in form No. 107/u-NP;
drugs that have anabolic activity and are classified as anabolic steroids according to the anatomical-therapeutic-chemical classification (ATC) recommended by the World Health Organization (code A14A);
drugs specified in paragraph 5 of the “Procedure for the dispensing to individuals of drugs containing, in addition to small quantities of narcotic drugs, psychotropic substances and their precursors, other pharmacological active substances” (order of the Ministry of Health and Social Development of the Russian Federation dated May 17, 2012 No. 562n);
preparations manufactured according to a prescription for a medicinal product and containing a narcotic drug or psychotropic substance included in Schedule II and other pharmacological active substances in a dose not exceeding the highest single dose, and provided that this combined medicinal product is not a narcotic or psychotropic drug Schedule II drug.

The list of other prescription drugs, as is known, is dispensed on form No. 107-1/u. According to paragraph 22 of the order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing medications, as well as forms of prescription forms...”, prescriptions written on the forms of this form are valid for two months from the date of prescription. However, for patients with chronic diseases, it is allowed to set the validity period of the prescription form No. 107-1/u within up to one year and exceed the recommended amount of the drug for prescribing per prescription, established by Appendix No. 2 of this order.

Such a prescription, which also indicates the periods and quantity of the drug dispensed (in each period), is returned to the buyer, of course, with the required notes on the date of dispensing, dosage and quantity of the drug dispensed. This is prescribed by paragraph 10 of order No. 403n. It also determines that the next time the patient comes to the pharmacy with the same prescription for a list of drugs, the chief must take into account the notes on the previous dispensing of the drug.

When the maximum quantity specified in the prescription is purchased, it must be stamped “Dispensed.” And a one-time release of the entire quantity, according to the same paragraph, is allowed only in agreement with the doctor who wrote this prescription.

The prescription remains at the pharmacy

There are some changes on the topic indicated in the title of this chapter. Paragraph 14 of the new order No. 403n of the Ministry of Health establishes that the retail trade entity retains (with the mark “The medicinal product is dispensed”) and stores:

within 5 years prescriptions for:

narcotic and psychotropic drugs of Schedule II, psychotropic drugs of List III (according to the outgoing 785th order, they are stored for 10 years);

within 3 years prescriptions for:

drugs dispensed free of charge or at a discount (according to forms No. 148–1/u-04 (l) or No. 148–1/u-06 (l));
combination drugs containing narcotic drugs or psychotropic substances included in Schedules II and III, manufactured in a pharmacy, drugs with anabolic activity, drugs subject to PCU;

within 3 months recipes for:

drugs in liquid dosage form containing more than 15% ethyl alcohol by volume of the finished product, other drugs classified by ATC as antipsychotics (code N05A), anxiolytics (code N05B), hypnotics and sedatives (code N05C), antidepressants (code N06A ) and not subject to PCU.

Note that Order 785 does not contain this group of recipes for three-month storage.

Order No. 403n of the Ministry of Health did not come without a cherry on the cake, albeit a dubious one. Paragraph 15 of the order states that prescriptions not listed in the previous 14th paragraph (we listed them just above) are marked with the stamp “The drug has been dispensed” and are returned to the indicator. It seems to follow from this that prescriptions of form No. 107-1/y with a two-month validity period become “disposable”. We advise readers to pay special attention to this new norm.

The topic of combating the abuse of alcohol-containing drugs in pharmacies, which was recently trumpeted by the media, is also reflected in the new order on the procedure for dispensing drugs. According to the current procedure, prescriptions for such drugs are returned to the patient (with a “dispensed” stamp); under the new order, they must remain in the pharmacy organization.

To avoid getting caught

The procedure for dispensing incorrectly written prescriptions is now described in a little more detail (clause 15 of order No. 403n). In particular, when they are registered by a pharmacist in a journal, it is necessary to indicate the identified violations in the execution of the prescription, the full name of the health worker who wrote it, the name of the medical organization in which he works, and the measures taken.

According to this clause, when dispensing a drug, the pharmacist informs the buyer not only about the regimen and doses, but also about the rules for storing it at home and interactions with other drugs.

In theory this means the following. The pharmaceutical inspector can approach the first table in the guise of an ordinary buyer - so to speak, make a test purchase. And if the inspector, when dispensing the medicine, does not inform him, for example, that this medicine must be stored at a temperature no higher than 25 ° C, or does not ask whether he is currently taking other medicines, then the inspector can “reset the mask” and draw up an act of administrative violation. So the norm in paragraph 16 is serious and fraught. And, of course, it requires that the chief captain be thoroughly versed in the complex and voluminous topic of drug interactions.

Paragraph 17 of Order No. 403n, as amended, contains the rule that a pharmacist does not have the right to provide false or incomplete information about the availability of drugs in the pharmacy product range - including drugs that have the same INN - and also to hide information about the availability of drugs that have a lower price . Similar provisions are contained in subparagraph 2.4 of Article 74 of the Law dated November 21, 2011 No. 323 Federal Law “On the fundamentals of protecting the health of citizens in the Russian Federation” and paragraph 54 of the Rules of Good Pharmacy Practice (Order of the Ministry of Health of the Russian Federation dated August 21, 2016 No. 647n). The only thing new here is that this rule appears for the first time in the order on the vacation procedure.

These were explanations of order No. 403n, so to speak, “on a fresh trail.” Readers will probably find in it other points and norms that deserve special attention. Write to the editors of Katren-Style magazine about them, and we will address your questions to leading industry experts. We will also ask them about the problem of “disposable” prescriptions with a two-month validity period, which was mentioned above, as well as the dispensing of ethyl alcohol and alcohol-containing drugs in light of the provisions of the new Order No. 403 of the Ministry of Health.

On October 5, a webinar by Larisa Garbuzova, Ph.D. will be held on our website. D., Associate Professor of the Department of Management and Economics of Pharmacy at Northwestern State Medical University (St. Petersburg), dedicated, and on October 25, Executive Director of the National Pharmaceutical Chamber Elena Nevolina on the same topic. Register for both webinars.

Materials on the order of the Ministry of Health No. 403n.

First of all, the innovation threatens with alarming rumors and panic. If in advanced Moscow people are nervous that soon you won’t be able to buy simple brilliant green without a prescription, then in the regions there is a real rush - they are buying antibiotics for future use, Valocardine, unknown to many Reforts, and even Viagra, which, supposedly, is about to disappear from free sale in pharmacies. The list of drugs, now available only with a doctor’s prescription, has been circulating on the Internet for two years. It contained medications with psychotropic effects and good old antibiotics. Some indignation was caused by the fact that the heart medication Valocardine was included in this list. Curantil, so often prescribed to pregnant women, was also there, as well as Nimesil, a well-known painkiller.It is unclear who compiled this list and where it came from, but any user can add “their own prohibited” drug to the initial positions,this makes the horror of horrors even more terrible.

The NI correspondent tried to figure out how it all started and what kind of order the Ministry of Health was, which made life so difficult for already unhealthy Russians.

Rospotrebnadzor has been trying for several years to ban the sale of medicines in Russia without prescriptions. However, if earlier we were talking only about antibiotics (which, by the way, are considered by law to be strictly prescription drugs), then last summer the head of the department, Anna Popova, took the initiative to sell all medicines by prescription - even potent ones, even homeopathic ones and categorically ban the sale of medicines over the Internet.

The position, in general, is understandable. How else to deal with self-medication, which today everyone is addicted to? Moreover, there are no harmless drugs - each has its own side effects, indications and contraindications. And only a doctor can really figure out what a particular patient needs.

By the way, today, if you follow the letter of the law, from 60 to 80% of drugs in our pharmacies must be dispensed with a prescription. And some you really can’t buy without it: narcotic analgesics, potent and psychotropic drugs. Dispensing them without a prescription is a serious crime. The share of over-the-counter drugs on the market is very small. However, Rospotrebnadzor ensured that we could not even buy nasal drops without visiting a doctor.

It could have been foreseen that the introduction of prescriptions for all medications in the context of a shortage of doctors and difficulties with making appointments would significantly complicate the lives of patients,” head of the Foundation Eduard Gavrilov told NI. - According to the Ministry of Health, the shortage of professional therapists in Russia is almost 27%. And prescribing medications is, first of all, a burden on these primary care specialists. People with illnesses today cannot wait to see a doctor, and if the queue to see him grows due to those who came for a prescription for the simplest drug, then paid clinics can celebrate another victory, their clientele will increase.

However, experts do not argue that the idea of dispensing prescription drugs is not inherently bad and is even correct. “You need to be treated as prescribed and under the supervision of a doctor, but now the availability of medical care is low, and it is impossible to do everything “as it should.” And when there is no doctor in the state clinic, the patient will have to go to a paid clinic, that is, in fact, “buy” a prescription,” says the Health Foundation. There is another problem: in most cases, patients receive oral prescriptions from doctors, at best - the name of the drug is written on a piece of paper. Previously, this filk certificate was accepted at the pharmacy without asking for an official prescription or a stamp signed by a doctor. Now the sick are being turned away. One can imagine what kind of “walking through agony” a patient with a headache or back pain turns into at the clinic. “This creates the preconditions for the growth of the shadow pharmaceutical sector and entails risks to the health of patients,” notes Gavrilov.

However, the revolution started by Rospotrebnadzor did not die out. In August last year, it was “brought to fruition by the Ministry of Health by order No. 647-n. “On approval of the Rules of Good Pharmacy Practice for Medicinal Products for Medical Use.” It must be said that this order does not contain any rules that in any way change the division of drugs into prescription and over-the-counter:In 2017, all the medications that were dispensed in 2016 will be dispensed by prescription in Russia. No relaxations have been made in this list, but no new restrictions have been added.And in general, 90% of the information provided in the document is devoted to the organization of pharmacy activities, regulation of the work of management and staff, rules for the acceptance and storage of medicines, and similar technical issues that do not affect ordinary buyers.

It seems that that’s it, there are no reasons for panic and no reasons to urgently stock up on medicines today. Then where do the legs grow from? And here’s where it comes from: on March 1 of this year, new rules for the dispensing of prescription drugs and monitoring compliance with the rules for their sale came into force.Fines for dispensing medications without a prescription have increased: a pharmacist or pharmacist can now be fined 5-10 thousand rubles. (previously 1.5-3 thousand rubles), an official - by 20 - 30 thousand rubles. (previously 5 - 10 thousand rubles), legal entity - by 100-150 thousand rubles. (previously 20-30 thousand) or suspend the pharmacy’s activities for up to 90 days.

For six months, regulatory authorities looked closely, stirred up interest in the work of pharmacies, by October some of them got into real money, and the excitement around prescriptions reached its climax. Consumers, caught between two fires, took the side of pharmacists. Not everyone likes that only the pharmacy is still recognized as a violator; for some reason Rospotrebnadzor has no complaints against doctors who do not write prescriptions as expected.

Other trends have also emerged that may influence the further development of this situation.

The logic of the regulatory authorities is clear, and in general we support the new requirements for pharmaceutical activities. But the devil, as we know, is in the details. We have already had a case: a buyer has a severe asthma attack, he knows the name of the medicine and its dosage perfectly well, but he does not have a prescription with him. In this case, the choice is small: either refuse the suffocating person, or break the law. Therefore, in this matter the most important thing is to avoid excesses,” the director of external communications of PJSC Pharmacy Chain 36.6 told NI.Alexey Kiselev - Romanov.

According to Boris Gorodetsky, an expert at the “Your Pharmacist” service, increasing fines or introducing additional measures, such as suspension or revocation of a license, will have the effect of increasing prices for all medical products, the prices of which are not regulated by the state.

“Pharmacies will need to compensate for the loss of prescription drug revenue,” he explained. “Pharmacies regularly pay fines, but continue to sell prescription drugs without a prescription because they make up a significant portion of their revenue.”

Marketing Director of the FARM-Liniya pharmacy Rostislav Milenkov believes that tightening the legislation will not lead to fundamental changes in this issue, since it does not address the problem of counterfeit prescriptions at all.

Enter the query “buy a recipe” into a search engine - you will see for yourself how many sites with offers will pop up, he advised New Izvestia. There are plenty of offers; some, along with the prescription, immediately impose medicine with home delivery. The price of the issue is tolerable, at least for those who need to receive a prescription in a timely manner, and not sit in the clinic for weeks.

However, Milenkov warns that a forged prescription is dangerous, just like a drug bought second-hand. Experts consider a ban on the sale of prescriptions and medicines on the Internet to be a timely and overdue measure, but the devil is again in the details. “Before introducing such regulations, the following questions must be answered: will all patients have the opportunity to receive a prescription in a timely manner? For example, if there is already a queue for appointments with doctors in some specialties under compulsory medical insurance for several weeks in advance, is there any understanding of how the burden on the healthcare system (primarily in compulsory medical insurance) will increase with the introduction of such standards and what measures should be taken to avoid this?"

Some experts are in favor of toughening penalties for dispensing prescription drugs without prescriptions. “In no European country does self-prescription of treatment and choice of medicine on the advice of a pharmacist or on the advice of friends exist - there is only a doctor’s prescription,” reminds the chief physician of the Sfera clinic. Erica Esquina . The CEO of the pharmaceutical company “Apteka+” also calls this situation an extremely positive trend.”Alexander Koshkin:“Since the entry into force of Order No. 647 of the Ministry of Health of the Russian Federation, the requirements for the sale of prescription drugs have become more stringent... And, in my opinion, only the patient will benefit from this measure.”

According to market participants, the situation related to the dispensing of prescription drugs should change for the better due to the expansion of telemedicine capabilities. The burden on both doctors and pharmacy workers will be relieved by the widespread introduction of electronic prescriptions. These are the main innovations that the pharmacy business is waiting for.

Despite the fact that everyone is reassuring worried consumers and not predicting storms in the pharmaceutical industry, the NI correspondent decided to check what was really happening in the pharmacy closest to home. I came in and asked for Monopril (the kind of tablets for high blood pressure). They gave it easily. Already on the way out I looked at the inscription on the box “Dispensed from pharmacies with a prescription. Use as prescribed by your doctor."

According to the current rules, if there is information about the sale by prescription, the over-the-counter sale of such drugs is prohibited. Pharmacies appear to be ignoring the rule in order to increase revenue.

What did you just give me without a prescription? – I say reproachfully to the girl.

You didn’t write it out for yourself, did you? - she answers. - Surely the doctor advised?

Yes, it was about fifteen years ago...

The girl looked through some list - it looked like a prescription list from the Ministry of Health. I didn't find Monopril.

Not your profile. The list includes only psychotropic and potent drugs. And these harmless ones are from Poland. Drink to your health! This Europe is always playing it safe.

Yeah, it’s not our way...

And here's more news on the same topic. Not only will prescription drugs be sold strictly according to the prescription, but now pharmacists will be punished for violating the sale. In these conditions, it will become difficult to “pressure pity” on customers, because the punishment is serious: from a five thousand fine for a pharmacy employee to a three-month closure of the pharmacy itself.

In light of new legislative trends, antibiotics, a number of painkillers, cardiovascular and other drugs disappeared from free sale in March. Supervisory authorities claim that this was done for the sake of the health of patients, while many refer to foreign experience. Why are patients not happy with such care?

In fact, the ban on the free sale of prescription drugs has existed for a long time, since 2005. But neither pharmacists nor their clients were in a hurry to implement it. The doctors continued to scribble prescriptions on scraps of paper. Unless drugs from special lists, subject to strict accounting, were dispensed and purchased strictly according to prescription.

The Ministry of Health and Rospotrebnadzor decided to take the violators seriously. However, in the fight for our health, the patients themselves, faced with the need to sit under the doctor’s door for every sneeze, and pharmacists turned out to be at the extreme.

If a pharmacy employee sells a prescription drug without a doctor's order, he or she will face a serious fine. Minimum five thousand rubles. And for the pharmacy itself, the punishment can result in 100 thousand rubles. But that's not all. it may even be closed for up to three months.

Medicines marked “dispensed only by prescription” are now prohibited from even being displayed on display. About 70% of the entire pharmacy assortment is subject to restrictions. These are not only psychotropic and narcotic drugs, but also all antibiotics, hormonal drugs (including contraceptives), potent painkillers, ampoule dosage forms, a number of cardiovascular drugs, medications for diabetics and others.

No queue!

If you need the drug, but have neither the time nor the desire to sit in a long-hour line, you can pay for consultations with a doctor at a private medical center. In most cases, you can get a prescription there too. A doctor in a private clinic has the right to write prescriptions for medications, with the exception of those included in lists II and III of the “List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation.”

The most unpleasant thing is that there is still no exact and complete list of medicines that cannot be commercially available. The list should have been approved by the Ministry of Health back in January; it could be found at this link. But it’s unlikely to be found there! Therefore, pharmacists are advised to follow the instructions. If it contains the entry “dispensed with a doctor’s prescription,” then it cannot be sold just like that.
However, some believe that the instructions in the medicines are the very document that you need to rely on without any orders from the Ministry of Health.

In Gubkin and Stary Oskol pharmacies they sell herbs, ointments, antipyretics, some antivirals and nasal drops without a prescription. But pentalgin, ketorol, festal - only by prescription. Papaverine and no-spa are needed in tablet form; some pharmacists dispense them freely, but in ampoules - with a prescription. Ketonal is similar: a cream or gel is sold for external use, but to obtain it in other forms of release, it is advised to consult a doctor.

But pharmacists believe that there is no reason to panic. After all, even before, many medications were only available by prescription. Those same diabetics knew this very well. There are painkillers, stomach and heart medications, which have always been and remain on the market. Anything more potent is a no. And this is justified: serious drugs have more serious side effects. In addition, if you need strong medications, then you need serious treatment and go to the doctor.

In general, if you are going to the pharmacy, look on the Internet and look at the instructions for the medicine you are going to buy. It may be available only by prescription, in which case you must first visit a doctor.