Expenditure item of covid // The third wave of state purchases of drugs has begun

In anticipation of the third wave of the pandemic, government procurement operators have quadrupled the cost of purchasing drugs for COVID-19. Over 40 billion rubles were spent on all drugs included in the latest version of the recommendations of the Ministry of Health. Most of the costs fell on favipiravir, the effectiveness of which doctors still doubt.

From December 2020 to May 2021, government spending on the procurement of drugs for state clinics included in the 11th version of the recommendations of the Ministry of Health for the treatment of COVID-19 reached 40.5 billion rubles, which is four times more at the start of the pandemic in December 2019 – May 2020. Such data are provided by the Headway Company at the request of Kommersant. The most expensive of this list was favipiravir, traditionally used for influenza: the volume of its purchases from December 2020 to May this year amounted to 6.6 billion rubles. Favipiravir generics are produced by three Russian companies – R-Pharm by Alexey Repik, Promomed Rus by Petr Bely and Khimrar by Andrey Ivaschenko.

In second place in terms of purchases – by 6.3 billion rubles – is artelegia, developed for the treatment of rheumatoid arthritis. This drug is manufactured by R-Pharm under license from the Belgian UCB. Another 5 billion rubles. public procurement operators spent on the anticoagulant Xarelto from the German Bayer.

In pharmacies, sales of drugs recommended by the Ministry of Health for COVID-19 also increased – by 22% year-on-year, to 17.7 billion rubles, according to DSM Group. The Russians spent the most – 5.2 billion rubles – on arbidol from Pharmstandard by Viktor Kharitonin. 5.1 billion rubles spent on xarelto, 3.4 billion rubles – on the anticoagulant eliquis from Pfizer. Retail sales of efleira (originally used for psoriasis) from Dmitry Morozov’s Biocad increased by 477% to RUB 45.4 million.

Moreover, over the year, the average cost of a package of drugs for coronavirus increased from 772.2 rubles. up to RUB 924.8 in the commercial segment, and in the public sector – from 909.9 rubles. up to 2.2 thousand rubles., follows from the data of DSM Group. Tatiana Shapovalenko, medical director of Medsi Group of Companies, confirms that a year ago, the cost of drug therapy for coronavirus was a small part of the cost of its treatment, but now the cost of drugs has increased due to the wider use of monoclonal antibodies and expensive antibiotics. Dmitry Kuznetsov, vice president of the All-Russian Union of Insurers, notes that no detailed studies on the cost of specific treatment protocols for coronavirus have been carried out yet.

The Ministry of Health told Kommersant that now the cost of a completed case of treatment of a mild form of COVID-19 under compulsory medical insurance is 67.3 thousand rubles, and extremely difficult – 283.1 thousand rubles. They added that with long-term treatment of extremely difficult patients and patients with concomitant pathologies, the tariff for them can be indexed.

The doctors interviewed by Kommersant believe that since the beginning of the pandemic there have been improvements in the diagnosis and treatment of COVID-19, but no effective antiviral drugs have yet been found for it. Thus, favipiravir, developed in Japan, has not received regulatory approval for the treatment of coronavirus in the home market, says clinical pharmacologist Oleg Talibov. “Seriously ill patients are already admitted to hospitals, for whom the effect of favipiravir, like other antiviral drugs, is modest,” he adds.

Clinical studies of favipiravir are either not completed, or their results (for example, from Russia or Egypt) are not credible, notes Alexander Melnikov, head of the NMITSO FMBA department. “It can still be argued that favipiravir is an unproven drug,” he adds. Also, according to Mr. Melnikov, the effectiveness of efleira and arthlegia in the treatment of COVID-19 has not yet been proven.

R-Pharm said a study of favipiravir in 168 patients showed “clinical improvement” in inpatients four days earlier and in outpatients eight days earlier. Promomed Rus reported that the results of the post-registration study of their version of favipiravir are planned to be summed up in September.

Alexander Osipov

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