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CIS nations' drug reimbursement plans "could completely change their markets"

Russia, Ukraine and Kazakhstan have recently taken steps to introduce drug reimbursement schemes which, if introduced, could completely change the operating environment for both their innovative drug and generic markets, says new research.

At present, the rate of growth for innovative medicines in these Commonwealth of Independent States (CIS) nations is lower than for generics; last year the former grew 10% to almost 6 billion euros at wholesale prices, while generics were up 16% to 5.7 billion euros wholesale, says the study, from Central and Eastern European research and consulting specialist PMR.

In February 2012, Russia's Minister of Health approved a new strategy for supplying the Russian population with medications to 2025. The document sets priorities for the development of pharmaceutical supplies and improvement of legal regulations for trade in the sector, and focuses on areas such as increasing the availability of medicines, supporting the use of domestically-made products and increasing the scope of preventive measures in medicines.

The strategy will be the foundation for introducing wider drug reimbursement in Russia; it is currently limited to certain population groups such as veterans, invalids and children aged up to three.

 The strategy's implementation will be funded from the federal state budget, the budgets of regional and local units and extra-budgetary sources; the latter are to be defined by 2016, when the first stage of implementation is due to be completed. There are plans to implement an effective drug supply model during the third stage of the programme, between 2017 and 2025.

Turning to Ukraine, the report notes that the country launched a pilot project last year introducing state regulation of the prices of hypertension drugs, along with partial reimbursement of the cost from the state and local budgets. The government regulates the prices of enalapril, lisinopril, bisoprolol, metoprolol, nebivolol, amlodipine and nifedipine. Around 12 million people in the country suffer from hypertension, says the Health Ministry.

By August 1 last year pharmacies had reduced the prices of generics registered in Ukraine, and in November the partial reimbursement of the cost of hypertension drugs was introduced, reimbursing the difference between the official, Health Ministry-set price and the actual retail price at pharmacies. At the start of 2013, the scheme was extended to this December, and 18.7 million euros was approved by the government from the budget for reimbursement of the cost of drugs included in the pilot this year. This would provide around 600 million defined daily doses of antihypertensive medicines, 66 million more than in 2012.

Ukraine is also considering state regulation of prices of drugs to treat diabetes and other diseases of the endocrine system by imposing a limit on wholesale and retail prices.

Meantime, Kazakhstan is creating a new reimbursement model, under which consumers who previously paid 50% of the cost of their medicines are set to obtain them free of charge.

In 2012, ambulatory patients began to receive free drugs which had previously carried a 50% discount. Also, the list of free medicines for such patients was extended by 40%, adding treatments for coronary heart disease, hypertension, chronic obstructive pulmonary disease, pneumonia, peptic ulcers, chronic heart failure and cardiac arrhythmia.

In Kazakhstan, more than 400 prescription medicines are provided free to population groups including children aged under 18 and pregnant women. Last year, the government spent over 500 million euros on these medicines, says PMR.


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