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President of Russia Dmitry Medvedev: Good afternoon,

Lately, we have been working actively on a number of issues concerning senior citizens. Today, let’s talk about provision of medicines to retirees. This is a difficult subject, but an extremely important one for our nation’s elderly.

The reason I had the idea to meet here is that earlier, I was in a different region where, in a small town very similar to Kozelsk, people complained about adequate medicine supply. They said that their pharmacy does not receive a full range of pharmaceuticals. It wasn’t even a problem of benefits; there simply wasn’t enough medicine. And I would like all the governors to give this matter their attention, because it is important to monitor the pharmaceutical situation in towns like this one very carefully. The situation with business competitiveness here is somewhat different. There are not that many pharmacies or kiosks. And when there is just one pharmacy, that can lead to some serious problems. Granted, I went to the pharmacy here and spoke with the elderly ladies there, and they said that there is just one municipal pharmacy and about ten relatively small private pharmacies. So, in general this creates a sort of a competitive field.

Availability of medicine and essential pharmaceuticals greatly influences the health and life span of elderly people. Senior citizens buy pharmaceuticals constantly, and in large quantities. So, their availability is probably the key issue that I suggest we discuss today.

According to the statistics, since the beginning of 2010, there has generally been a downward trend in prices, but these are just statistical data, because prices are decreasing in some places, but not in others. And it depends on the category of pharmaceuticals. The people I spoke with here said the following: ‘The situation is more or less decent as far as domestic pharmaceuticals are concerned (prices haven’t grown, and in some cases, they have even decreased). Foreign pharmaceuticals, however, are another story.’ Naturally, we need to work on import substitution, we need to revive our industry, but still, at this point we cannot ignore the situation on the foreign pharmaceuticals market.

Overall, the situation this year is stable, because just recently, the growth in pharmaceutical prices was surpassing the inflation level. This was very worrisome for everyone. We put in a great deal of effort to stop that growth. Now, prices have stabilised in most regions. But clearly, the efficacy of state purchasing at the federal level, as well as regional and municipal levels, is a matter of concern for all of us, including the retirees who are entitled to pharmaceutical benefits.

As far as I understand, we currently have about four million such individuals, which is 70 percent of the total number of all people entitled to benefits. Clearly, this is our most vulnerable group of citizens, as it includes disabled individuals and veterans of war and labour. It is difficult for these people to get the so-called special prescriptions giving them right to get free or subsidized medicines. They sometimes have to wait for months to get to see a doctor in a clinic, and thereafter they try to have their prescriptions fulfilled. 

Thus, there are at least two issues we should address. The first is the issue of what we can do about the expiration dates for such prescriptions. Perhaps we will need to extend them. And the second issue or manner of resolving this problem is implementing different ways to deliver pharmaceuticals, including mail or home delivery for elderly people. We could use courier delivery or postal deliveries, depending on where the recipients live and how developed these services are in a particular area.

I want to stress again that pharmaceutical prices are an important indicator of living standards. Providing medicine (and those of you here know this well) is not only a federal responsibility, but also, to a great extent, the responsibility of the regions. Perhaps we should look into the issue of compiling a separate list of pharmaceuticals specifically for our senior citizens, which would be subsidised or purchased with regional and municipal budget funds. In this case, the Government must explore the possibility of signing long-term fixed price contracts for the regions.

I have already stated that providing medicines to residents of small towns and villages is a separate issue. I spoke about it in Kursk, and have said a few words about it here. But in addition to small towns such as Kozelsk, we also have villages. And this is a matter where we need to actively use the mechanism that we have launched starting from September 1 of this year – namely, the opportunity to sell pharmaceuticals at rural medical assistance centres. Frankly, this is an example of how slowly these decisions are implemented. I worked in the Cabinet and to this day, I remember how I came to a rural medical assistance centre in Samara Region. They told me, ‘it would be good if you permitted us to sell these medicines.’ That was four years ago, but it is finally happening only now.

One of the main reasons for this relatively difficult situation is the lack of domestic products. I was just talking with senior citizens, elderly ladies at the pharmacy. They say that they would be happy to buy Russian-made pharmaceuticals, because for most issues, for most illnesses, which elderly people suffer from (common, simple illnesses), Russian medicines are quite competitive and cost much less. But for the moment, our situation is quite the opposite. The lion’s share of our pharmaceuticals is imported. Thus, a key challenge – and this is one of our priorities in technological modernisation – is to develop a domestic pharmaceuticals industry and create modern pharmaceuticals and medical equipment.

Incidentally, there is some good experience with this here in Kaluga Region. The governor was just briefing me on the fact that production is underway. And it seems that people are buying these products not only in our nation, but abroad as well. So we need to work on it more quickly. We need to improve the quality of our creations and pharmaceuticals, making cheap counterparts to foreign medicines and stimulating the implementation of new domestic technologies.

We have many issues to address, but at the same time, our meeting is quite concrete. Thus, I suggest that we stay on topic, listen to what the minister has to say, and then discuss this with our colleagues present here, including regional governors.

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