Not issuing subsidized medications, no one to complain about. Complaint about the lack of subsidized medications (preferential medications are not provided). What is required to receive preferential drug coverage?

Victoria Ryzhkova. Photo: Ksenia Ivanova

"Copper people" and their misfortune

Victoria Ryzhkova is the coordinator of the St. Petersburg charitable organization Nochlezhka, which helps the homeless. But recently she had to do something that was not related to the problems of homelessness - coordinating the supply of the drug “Kuprenil” throughout Russia.

In January 2015, Victoria was found rare disease– Wilson-Konovalov disease. People with this disease do not remove copper from their bodies. If a person is not treated correctly, he will die slowly and painfully - all organs gradually fail.

There are not very many “copper people” in Russia - less than 700 people, but this does not make it any easier for them. It becomes easier only from regular use of the drug “Kuprenil”, which helps remove copper from the body.

"Kuprenil" is a vital medicine and is sold free of charge. But in March of this year it disappeared from Russian pharmacies.

It turned out that the pharmaceutical company Teva, which produces the drug, moved production from Poland to Israel, and according to Russian legislation, re-registration of the drug was required. Because of this, government procurement fell through, and those suffering from Wilson-Konovalov disease were left alone with the question: where to get Cuprenil?

Fantastic warehouse "Kuprenila"

Victoria Ryzhikova: “I feel that my apartment will soon turn into a fantastic warehouse.” Photo: Ksenia Ivanova

Victoria Ryzhkova had a supply of medicine - she bought it six months in advance. Therefore, she began to share with those “copper people” who had nowhere to get “Kuprenil” - the only way to receive it at that time is delivery from abroad.

Colleagues in misfortune found each other through social media. “I seem to recognize most of the Wilsonites from Russia (about 400 people - Ed.),” Victoria wrote in July. – And it all started with the fact that someone monitored my post about “Kuprenil” on VKontakte. And he asked what was happening with the wheels in Belarus and Ukraine. Then I started monitoring VK. Since March, people have been looking for “Kuprenil”, they are ready to buy it for any money, just to live; many Konovalovo residents’ condition is deteriorating, severely deteriorating, even to the point of seizures. People scream for help and essentially die slowly. From my reserves I sent “Kuprenil” to Tyumen and Krasnoyarsk - very sharp. I told the others I found where to buy and how to transport them.”

The drug was delivered from Ukraine and Belarus by Victoria’s friends, stocked up in advance pink pills“Kuprenil” was shared among other “Wilsonites” - this is what Victoria calls people suffering from an excess of copper in the body. Those whose condition was not yet critical refused life-saving medicine in favor of seriously ill patients.

“I’ve never seen anything like this anywhere,” Victoria wrote on Facebook. - It would seem that there are no drugs - sit and don’t give your supplies to anyone. But no, we share them to our own detriment... I feel that my apartment will soon turn into a fantastic warehouse.”

Her apartment actually became a warehouse - from there the drug was distributed throughout the country. In addition, Victoria appealed to the prosecutor's office with a request to understand why Cuprenil disappeared from pharmacies, putting the lives of hundreds of people at risk.

In July 2016, supplies of the drug to Russia were resumed. At the end of August, the drug appeared in most Russian regions. This is how Victoria spoke about it:

“My Wilson children receive “Kuprenil” according to prescriptions in the Trans-Ural region in Saransk and Saratov, in Rostov-on-Don, in Voronezh, in Yelets, in Belgorod, in Engels, Krasnodar and Volgograd, in Samara, Kazan and Omsk and probably elsewhere -That. And yes, this is a victory. Thanks to everyone who wrote, reposted, imported and transported, everyone who wrote prescriptions, who bought pills with their own money, for the very poor. There is no need for any state when a person is a person to another.”

Now “Kuprenil” can be bought or obtained by prescription in Moscow and St. Petersburg.

What to do if the medicine is not in the pharmacy?

At the request of Victoria Ryzhkova, Nochlezhka lawyer Ekaterina Dikovskaya developed instructions for patients on what to do if a vital medicine is not in the pharmacy.

– Need to put prescription for deferred care at a pharmacy. There they are required to register it in the register of unsatisfied demand. Such a magazine should be in every pharmacy that dispenses drugs on preferential prescriptions.

– If a prescription is registered in the backlog, it does not need to be left at the pharmacy. The patient takes it with him, but it must be marked with a mark indicating its acceptance for service: date of registration, pharmacy number, signature of the pharmacist.

– After registering the recipe the pharmacy must form an application for the drug to the pharmaceutical company authorized to supply subsidized drugs to the region and provide the drug to the patient within 10-15 days.

– The patient can call the pharmaceutical company himself, which supplies subsidized drugs to the region, and find out whether the required drug is in stock, when it will be delivered to the pharmacy, and why it is not available. You can also notify the company that the prescription has been accepted by the pharmacy for deferred service (the pharmacy may not inform the company about the deferred prescription). The phone number of the pharmaceutical company can be found at the pharmacy.

– If 16 days have passed and the drug has not yet arrived at the pharmacy, you need to write a complaint to the authorized pharmaceutical company that you never received the preferential medicine.

You need to wait for a response, which may indicate that the Ministry of Health did not hold scheduled tenders for the purchase of medicines or the medicine was not indicated in the specification for public procurement. The company's response will be the basis for going to court - based on the content of the response, the defendant is determined: the Ministry of Health and Social Development, a pharmacy, a pharmaceutical company, etc.

– Medicine provided to the patient free of charge according to a preferential prescription, can be purchased for own funds, and then demand payment of compensation from the pharmacy. To do this, you need to write a claim to the pharmacy with a request to reimburse the costs. If the pharmacy does not reimburse the money spent, you can go to court.

- Court may refuse to satisfy a claim for reimbursement of funds, if the medicine is purchased independently and the prescription has not been put on deferred maintenance.

• 24. 11. 2016

What do doctors and officials do to avoid giving patients their dues? free medicines

"You are not sick." “That’s not what you’re sick with.” "You don't need this medicine." “You need this medicine, but another, cheaper one will also do.” “You need this drug, but it’s not there, wait.” This is how doctors and officials respond to thousands of people who are entitled to subsidized medicine by law. They are deceiving. They know that a person is sick and they know what medicine he needs. But according to rough estimates, the state is already short of 45 billion rubles for drug provision. . In some regions discounted drugs only 10% of those who apply can provide. Officials and doctors refuse patients in such a way as to make breaking the law as difficult as possible to prove. The Ministry of Health and Roszdravnadzor regularly report: the situation with preferential drug coverage in the country is stable. The numbers underlying these reports have no relation to reality. The true scale and cruelty of the war between patients and the state is amazing

“Every time they say: “Sorry, there are no medicines!” I can’t help it!” But they are entitled to me by law. If they are not available today, the state must purchase them tomorrow. Is not it so?"

Veronica has repeated this question many times, but her voice still sounds surprised. When she speaks, her hands with long, graceful fingers tremble slightly, as if she, too, cannot contain her amazement. She has been taking hormonal inhalers for 15 years and cannot breathe without them. She has asthma, lots of concomitant diseases and disability. She has the right to receive free the dose she needs is at the pharmacy, but the medicine has not been given out for a year and a half.

“They were always issued intermittently,” says Veronica. “We had to find out in advance the day when the drug would appear, and run to the clinic when it opened in order to get it in time.” If you don’t have time, they’ll say it’s over, and do whatever you want. But I only came across the fact that there are no medicines for months last year.”

The pharmacy said that there was no point in asking - there would be no medicine.

Then, after six months of waiting, Veronica first contacted the Moscow Department of Health. All you had to do was leave a request, and the inhaler, which was missing from the pharmacy in the morning, was found in the evening. But the magical effect of calling the department did not last long. After a couple of months, the medications were stopped being given again. This time, when Veronica called the department, she was told that the situation was complicated. You can leave a request, but no one knows when the drugs will be available. On the same day, she received a call from the pharmacy and was told that there was no point in asking - there would be no medicine. Now Veronica’s relatives buy inhalers, the amount is several thousand rubles a month. According to Veronica, for many people waiting in line to see a pulmonologist, this amount is unaffordable. The words “there are no cures” sound like a death sentence for them.

Veronica's case is one of thousands. It is enough to flip through the regional press over the past month to read a dozen such stories. In Mordovia, pharmacies for beneficiaries do not have not only prednisolone, but even iodine and bandages. In the Oryol region, a woman with lymphoma managed to get medicine only after local media wrote about this case. In Khakassia, due to the huge number of patient complaints, the situation with preferential medicines will be investigated by the Chamber of Control and Accounts. Organizations involved in protecting patients' rights constantly talk about the growing number of requests. Such growth is recorded, for example, by the Movement Against Cancer society. In September of this year, cases of refusal to people with oncological diseases there were so many that the General Prosecutor’s Office dealt with violations of the law in a number of regions. According to online monitoring as of September 2016, conducted by the head of the League of Patients society, Alexander Saversky, more than 80% of respondents experience difficulties in obtaining subsidized medications. Only 35% of them manage to obtain a prescription for the drug without any problems. Similar figures were given in last year’s monitoring by the All-Russian Popular Front: half of the patients who apply for medications are not given medications on time.

Illustration: Rita Cherepanova for TD

A 2016 government report stated that about 45 billion rubles are missing for drug provision.. This is not surprising: the standard cost per citizen receiving free drugs decreased from 849 rubles per month in 2011 to 758 rubles in 2016. At the same time, according to Rosstat, drug prices have increased by 24% this year. In 2015, the government even allocated an additional 16 billion rubles to save the situation - but they unexpectedly turned out to be not in demand. The Ministry of Health stated that all necessary medicines have been purchased.Roszdravnadzor regularly monitors drug provision in the country and remains satisfied with its results. According to reports from these departments, in the Moscow region, for example, about 98% of beneficiaries receive drugs, and in other regions the situation is stable. The ability of the Ministry of Health to force health officials to shape reality in accordance with reporting goals surprises even the president.

If not in a good way

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Despite the fact that quite a few citizens have the legal right to receive free medications, pharmacists either refuse to dispense medications or declare that they do not have the necessary medications. Roszdravnadzor has developed a clear algorithm for the actions of pharmacists in pharmacies that do not have the requested drug, but citizens do not know about it. In this article, we will tell you what to do if the pharmacy does not have subsidized medications, how a pharmacy employee should act in the absence of medications, how soon medications should be provided, and how and where to file a complaint.

Algorithm of actions of a pharmacy pharmacist in the absence of subsidized drugs

Important! According to the text of Federal Law No. 122-FZ dated August 22, 2004, if a citizen has completed all the actions prescribed by law to receive free drugs (or discounted drugs), that is, collected Required documents, went to the clinic, received a discounted medicine and came with it to the pharmacy on time to the pharmacy that participates in state program providing citizens with preferential medications, the pharmacy pharmacist has no right to refuse to dispense the drug.

If on the date of the patient’s request the pharmacy does not have the subsidized medicine he needs in stock, the pharmacist has the right to offer the citizen analogues of this medicine, the effect of which is completely similar to the medicines prescribed by the doctor.

• offers to contact another social pharmacy located in the same locality and with which this institution has an agreement;
• if the citizen refuses, accepts a prescription for a subsidized medicine from the applying citizen;
• registers the fact of its receipt in a pharmacy journal, specially established for recording cases of unsatisfied demand;
• assigns the citizen’s request the status of “deferred service”;
• enters information from the prescription form into computer program pharmacies;
• sends a request to the supplier for medications that are out of stock;
• waits for a response from the supplier company about the availability or absence of the requested drug;
• if the medicine is delivered, the pharmacist waits for delivery and notifies the patient about the availability of the medicine by phone;
• if the medicines are not available from the supplier, the pharmacy purchases them independently at its own expense (the costs will be reimbursed later from the federal budget).

How soon will the pharmacy provide a discounted medicine that is out of stock?

If a citizen applies to a social pharmacy with a prescription, but it doesn’t have the right medicine, Roszdravnadzor allows you to assign the application the status of “deferred service”, take the patient’s phone number and call him back when the drug appears in the pharmacy. No more than 10 working days are allotted to resolve this issue (that is, weekend pharmacies are not included in the calculation).

However, if a prescription for a subsidized drug was issued by a medical commission medical institution, it is allowed to provide it to the citizen within 15 working days.

What to do if there are no discounted medications at the pharmacy - where to complain

Unfortunately, it happens that pharmacy pharmacists completely refuse to accept a prescription from a beneficiary or report the absence of the required medicine. First, you can complain about the pharmacist to the pharmacy manager. If this does not help, there are still many options to protect your rights:

What to do if the pharmacy does not have discounted medications

Here is how they comment on the situation with the refusal to issue preferential medications lawyers. If a citizen is not provided with what he has a right to, the algorithm of actions should be as follows:

1. It is necessary to record the fact of refusal to provide a medicine for which there is a special, correctly completed prescription. To do this, you first need to submit an application addressed to the head physician of the clinic where the drug was prescribed.
2. If there is no response to the application, and the medicine suddenly appears in the pharmacy, or nothing happens at all for unexplained reasons, you should file a complaint with the regional department of the Ministry of Health or directly with the Prosecutor's Office.
3. If there are no subsidized life-saving medications available at the pharmacy, or a refusal to issue them is received, you need to contact Rospotrebnadzor. The most effective way is to write a statement to the prosecutor.

Legislative acts on the topic

Common mistakes

Error: The pharmacy pharmacist called back the citizen, for whom the subsidized medications were not available on the date of the call, a month later.

Good afternoon.

1. To receive discounted medications at a pharmacy, you must write out a prescription for them from your local doctor. The basis for issuing a prescription is a written recommendation (extract) received from a specialized medical institution where the patient is being observed for his underlying disease.
2. The local doctor may refuse to issue a prescription due to lack of this drug at the pharmacy. This refusal is illegal, because even if the drug is not available this moment at a pharmacy, upon receipt of a prescription, the pharmacy is obliged to purchase the drug specified in the prescription within ten days. If there is no prescription, then the pharmacy is not obliged to do ANYTHING, and you will never see the medicine. Therefore, you need to “remind” your local doctor about this and continue to insist on writing out a prescription. 3. If the doctor continues to refuse to issue a prescription, demand it and write it down on the card: “the prescription was not issued due to the lack of medicine in the pharmacy.” He cannot write something like that, so he will either write out a prescription or refuse to write down on the card that he did not write it out. In this case, it is necessary that the doctor MUST make an entry in the card stating that the patient on such and such a date was at an appointment and was examined by a doctor on such and such (he will not be able to refuse this).
4. Immediately after leaving the doctor’s office, write a complaint in 2 copies addressed to the head doctor of the clinic with approximately the following content: “To the head doctor so-and-so from so-and-so... Please explain on what basis the therapist so-and-so refused to write me a prescription for medicine (name) , necessary for my life's indications. I consider this refusal illegal on the basis of the Order of the Ministry of Health and social development RF dated 02/12/2007 N 110, RF Government Decree dated 07/30/1994 No. 890...
5. Give one copy of the letter to the secretary of the head physician, ask the secretary to put a stamp on the second copy.
6. If the secretary refuses to accept the complaint, you must send it by mail - registered mail with a list of attachments and acknowledgment of delivery. The inventory will be given in two copies, one to be placed in the letter, the second to be attached to a copy of the complaint stored in your home. Attach there a receipt for payment for a registered letter and a notice of receipt of the complaint signed by the secretary of the head physician. 7. In the future, act depending on the reaction of the head physician. He may offer to agree verbally, but it is necessary to insist on a written response. After this, a prescription for the medicine is usually given.
8. If unsubscribes begin (they are prohibited from writing out this medicine in the Department of Health, there is no money in the budget, etc.), then you need to contact the prosecutor’s office, regional Ministry healthcare, Roszdravnadzor (you can go to 3 of these places at once). Send there COPIES (not originals) of all documents (your complaint, postal documents - list of attachments, receipt, delivery of notification; responses from the head physician). If there was no response from the head physician, you can safely complain to the prosecutor’s office. Usually, after a complaint to the prosecutor's office, doctors themselves call home and ask when it is convenient for you to come for a prescription.

In the event of a refusal to provide medications according to a prescription from the attending physician, the patient can file a complaint and get him to receive necessary medications free of charge.

We will tell you how to write a complaint and provide examples of application forms to various authorities and institutions.

Rules for writing a complaint about non-supply of a prescription drug

When completing and writing a complaint application, you should adhere to the following recommendations:

1. Keep it formal.
2. Don't make grammatical or stylistic mistakes. Corrections to the text are also prohibited!
3. Enter truthful information. She will all be checked.
4. Fill out your complaint on an A4 sheet of paper.
5. Visually divide the complaint into three parts: introduction, main part and conclusion.
6. In the introduction, create a “header”. It must contain the full names of the institutions to which you are filing a complaint, as well as information about the applicant. If the patient's legal representative applies, then information about him.
7. The “hat” is designed with right side, at the top of the sheet.
8. The title of the document must be written in the middle of the line, with a capital letter. There is no dot after the name - this is a serious mistake.
9. The main part will follow. Tell us in it what happened, why and when the extradition was refused medicine, what exactly, in what amount, how the pharmacist responded to the request to give out the medicine for free, etc.
10. Support the text with legal acts and make references to them to confirm that you are right.
11. Provide accurate information about the pharmacy, as well as the medical specialists who refused to provide medications.
12. State your requirements. Usually they ask that the drug be given for the entire duration of treatment, and they indicate which particular drug is needed.
13. Attach documents to your complaint that have been submitted to other authorities, so you can confirm that you tried to resolve the issue earlier. Copies of responses from institutions must also be attached.
14. List all documentation in the list at the end of the complaint.
15. Please sign and date it. If a representative applies, he puts his signature.

If you have difficulty writing a document, contact a lawyer. They will help you file your complaint correctly and tell you whether you have written everything correctly.

Samples of complaints about refusal to provide free medicine with a doctor’s prescription for various situations

Let's look at what some complaints look like when addressed to different authorities and under different circumstances. life circumstances patients.

1. Sample complaint to the head physician of the clinic about the failure to provide prescription medication

2. An example of a complaint about the lack of medicine for a WWII veteran

A ready-made sample complaint about the lack of medicine for a WWII veteran it's free

3. Sample complaint about refusal to provide preferential medications for malignant neoplasms

A ready-made sample complaint about the failure to provide preferential medications to a cancer patient it's free

4. Sample complaint for a cancer patient