Ulumbekova G.E.
Association of Medical Societies for Quality of Medical Care and Medical Education, Moscow

Summary. In this article the effectiveness of increased expenditures on outpatient pharmaceuticals is proved on the bases of the analysis of health indices of the population of Russian Federation and spending on outpatient pharmaceuticals in comparison with the OECD countries.

The importance of such increase arises from unsatisfactory health status of Russian population. In Russian Federation crude death mortality rate is 27% higher, than it was in 1990 and is in «new» EU countries today. Total morbidity is also high – it is 1,5 times higher than it was in 1990. Especially unsatisfactory health status in RF is among working age group of population and among children. Thus, premature (preventable) mortality is 1,8 times higher than in «new» EU countries, which have the same GDP per capita as RF.

In EU countries the 2 fold decrease in mortality during the last 20 years was achieved due to massive healthy lifestyle programs and availability of highly effective medical drugs to treat hypertension, ischemic heart disease, ulcer etc. sponsored by the government.

Today the expenses on outpatient medical drugs in Russia are subsidized by government only for 3.5% of population. They are mainly the patients, suffering from chronic diseases and disabled. At the same time, in the OECD countries the majority of citizens, to whom the doctor has prescribed a medical drug, have the right to receive them free of charge or with partial ”co-payment” which on the average in these countries is no more than 40 %. In fiscal terms public expenses for pharmaceuticals in Russian Federation as share of GDP are 3,6 times lower and in absolute values (in $PPP per capita per year) are 5,6 times lower than in average in the OECD countries.

In this article is proved, that it’s highly effective to increase the public expenses at the rate of 200 billions rubles on drugs for children and the patients, suffering from circulatory system diseases. One extra ruble invested by the government will generate income by 4,5 rubles. This is achieved thanks to the 1,5% per year increase of the GDP due to the prolongation of pension age, decrease in mortality and morbidity associated days-off among working age population and also due to non direct gains.

Key words. Public spending on outpatient pharmaceuticals, efficiency of investments, expenses on pharmaceuticals, mortality of population, morbidity of population.

References

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