Thanks to changes in recommendations and orders of the Ministry of Health Russian Federation, many medications will be available by prescription starting March 1, 2017. The beginning of this year turned out to be stormy for many pharmacy chains, as well as the pharmaceutical industry in general. Some instructions have already entered into force, others will come into force soon. Some orders introduced a moratorium on the work of pharmacists, while others made dispensing prescription drugs significantly more difficult.

What prescription drugs are available as of March 1, 2017?

By order of the Ministry of Health, certain restrictions are introduced on the sale of drugs medicinal purposes. Implementation medical supplies in one hand is carried out in limited quantities. This refers to the sale of syrups and tinctures that contain ethyl alcohol in a concentration of at least 15%. Pharmacists can sell no more than two packages per person. The purpose for which they do this is clear to many. Today, not all drugs are bought by people to fight illnesses. This fact is confirmed by the mass poisoning with hawthorn tinctures in Irkutsk, where more than 70 people were injured.

In addition, pharmacists are prohibited from advising clients on more expensive medications if there are inexpensive analogue. Although, according to many representatives of the pharmaceutical industry, such standards were previously prescribed in the instructions for pharmacy workers.

Pharmacists are also required to provide their clients with information about the characteristics and contraindications of medications, as well as their shelf life, storage conditions and dosage. Previously, such things were not talked about at all.

Prescription drugs

According to the law of the Ministry of Health No. 785, medicines are available by prescription from March 1, 2017. An exception is the list of drugs that can be dispensed without a prescription.

The list of prescription drugs since March 1, 2017 is quite extensive. It includes drugs from literally all medicinal groups. Most of all on the list are antibiotics. According to the ministry's idea, they should all be prescription. Therefore, if we act strictly according to the law, more than 50% of all drugs in pharmacies must be sold only with a prescription from the attending physician.

Opinion of representatives of the pharmacy business

According to representatives of the pharmaceutical industry, at present there are practically no recipes in the classical sense. Doctors write prescriptions on pieces of paper. At the same time, according to the director of one of the pharmacy chains, Kakhaber Bakuradze, today many pharmacy pharmacists are retraining in new way. He also reports that every day everything more people they come to the pharmacy with prescriptions, and pharmacists work exclusively according to instructions, that is, in accordance with current legislation.

Today sale of prescription drugs medicines without availability necessary documents threatens with a fine of up to 50 thousand rubles. Authorities are considering making penalties for selling prescription drugs without a prescription more severe. It's about about potential cessation of activity for a period of up to 90 days.

Information about over-the-counter medications may be placed on shelves, in wobbler and poster formats, as well as on other media so that the buyer can fully familiarize themselves with the product. In a comfortable view, it is necessary to place a price tag with the name, number of doses in the package, dosage, and manufacturer.

Barcode on medical products

In addition, another important innovation comes into force - labeling on each medicine. In several Russian cities a trial project of the appropriate sample is launched. The main goal of the event is to combat counterfeiting and counterfeiting medical supplies.

According to preliminary data, this project will help track about six billion packs of medical supplies. At the initial stage in March, barcodes will be placed on 60 product items. Including 10 drugs for the treatment of rare ailments, as well as more than 30 names of drugs that are included in the list of vital necessary medications by prescription since March 2017. It is planned that by the end of this year, automation of the accounting system is considered voluntary. Next year it will be compulsory.

According to Rospotrebnadzor, each package of a medical product at production will be equipped with a two-dimensional barcode. It will be located next to information about the period until which the medicine may be valid. Such a system will allow you to determine the origin of the drug without leaving the pharmacy counter.

Difficulties in using the barcode

However, some problems were also discovered. On mobile device A program must be installed to read the code. There is another option. The buyer can use a pharmacy scanner, which must be installed in pharmacies participating in the project. The system will give the buyer comprehensive information about where, who and when the drug was manufactured.

Kakhaber Bakuradze claims that there should be no problems with the new barcodes. The IT department specialists produced all the required templates long ago. This will make it possible to forever forget about counterfeit and gray drugs, the origin of which is unknown. Honest pharmaceutical businessmen will only benefit from such changes.

Are medicines becoming more expensive?

Many are interested in the question of whether these changes will affect ordinary people V financial sense? According to pharmaceutical market experts, the changes will not affect the cost of drugs in any way. As they report, the new requirements will be useful to buyers, as well as owners of honest pharmacies that do not use illegal schemes for selling drugs.

The cost of drugs should not increase. This is also evidenced by the prices of drugs in pharmacies in January. Prices have hardly changed.

List of free medicines for 2017

It is worth noting that there is a specific list of free medicines for 2017 for preferential categories of the population. However, information about free medicines provided by the attending physician. He himself is obliged to inform the patient. If the doctor ignores his duties, the patient has the right to clarify the information. Information about free medications is also provided by the insurance company.

By the way, in 2017 the film “A Cure for Health” was released, which colorfully illustrates the situation with medications in our country.

The Ministry of Health has published clarifications regarding the order approving a new list of drugs subject to subject-quantitative registration. Despite the fact that it has been in effect for almost a month - since August 16, it is from pharmacy workers who do not know how to work with the new list.

The new list consists of three sections:

1. First includes pharmaceutical substances and medicines that are considered narcotic, psychotropic substances and their precursors in Russia. They, as before, are subject to subject-quantitative accounting.

Accounting for medications such as diethyl ether(in a concentration of 45% or more) and potassium permanganate (in a concentration of 45% or more) when handling up to 10 kg per month, it is carried out according to “simplified” requirements (an entry in the registration log about the total amount of substances dispensed, sold, purchased or used is made monthly , And documentary evidence each operation is not required),” writes the Ministry of Health.

That is, potassium permanganate in powder, as the department explains, 3, 5 or 15 grams, as before, is dispensed without a doctor’s prescription, but is subject to registration as a precursor of narcotic and psychotropic substances.

2. Second section includes drugs and substances considered potent toxic substances. Ointments, creams and gels containing bee and snake venom and 1-testosterone have been removed from registration. But testosterone preparations for internal use banned: "Testosterone propionate" (solution for intramuscular injection), "Andriol TK" (capsules), "Nebido" (solution for intramuscular administration), "Sustanon-250" (solution for intramuscular administration), "Omnadren-250" (solution for intramuscular administration).

The Ministry of Health reports that drugs are subject to registration as the only active substance and calls them - Slimia (capsules), Meridia (capsules), Goldline (capsules) and Lindaxa (capsules). At the same time (capsules) are not subject to subject-quantitative accounting, since they contain a combination active substances: sibutramine + microcrystalline cellulose, and therefore does not belong to potent substances.

Only medicines containing the sum of belladonna alkaloids as the only active substance. That is rectal suppositories Belladonna extract and Bellataminal tablets not subject to accounting, reports the Ministry of Health.

The list of strictly registered included ethanol, which means the drug is in pure form subject to subject-quantitative accounting.

3. In the third section hit combination drugs. Subject-quantitative accounting, as the Ministry of Health explains, is subject to:

• Medicines containing codeine ( "Caffetin", "Codelac", "Solpadein" ( effervescent tablets), “Terpinkod”, “Unispaz” and others), in which the amount of codeine exceeds 20 mg in 1 tablet;
• Medicines containing pseudoephedrine from 30 to 60 mg per tablet - "Rinasek";
• Medicines containing up to and including 200 mg of dextromethorphan hydrobromide per 100 ml/100 g liquid dosage form(syrups "Glycodin", "Coldrex Knight", "Tussin Plus", "Terasil-D");
• Preparations containing up to 75 mg of phenylpropanolamine in one tablet ( "Dietrin", "Koldakt", "Kontak") or up to 300 mg of substance per 100 ml/100 g of syrup ( "Triaminik");
• Medicines containing up to 20 mg inclusive of phenobarbital with codeine, regardless of the amount per dose of the medicine ( “Pentalgin Plus”, “Pentalgin-N”, “Piralgin”, “Sedalgin-Neo”, “Sedal-M”, “tetralgin” and others);
• Medicines containing up to 20 mg of phenobarbital with ephedrine hydrochloride, regardless of the amount per dose of medicine ( "Neo-Teofedrin", "Teofedrin-N").

At the same time NOT subject to subject-quantitative accounting the following medications: “Nurofen Stopcold”, “Caffetin Cold”, “Toff Plus”, “Bellataminal”, “Amixid”, “Caffetamine”- they are dispensed according to “regular” prescriptions of form No. 107-1/u. WITHOUT prescription drugs sold "Grippeks", "Gripend", "Alex Plus" (lozenges), "Andipal".

Doctor Peter

Since September 22, antibiotics have not been sold without a prescription in Russia. This is what the order of the Ministry of Health says. But in reality, the sale of such drugs looks different.

Russians are increasingly faced with the fact that some drugs are not sold to them if there is no prescription or it is filled out incorrectly. Pharmacies refer to new order Ministry of Health, which clarifies the procedure for the sale of such medicines.

True, the Business FM experiment showed that it is still possible to buy medicines without a prescription, even if you should have one. Autumn, rain, colds. Nothing new: this is repeated year after year. Only today it has become difficult to buy drugs to treat this very cold. Since the beginning of October, there have been reports on social networks that pharmacies are requiring prescriptions for antibiotics.
Business FM columnist Ivan Medvedev also encountered this.

Ivan Medvedev Business FM columnist“My wife is sick. She called a doctor to the house. The doctor prescribed antibiotics, in particular the drug Amoxiclav. But the doctor prescribed it simply on hospital letterhead, that is, it is not a full-fledged prescription, which, as I accidentally found out, is now of fundamental importance. I went to the pharmacy, where they told me that from September 22, pharmacies do not have the right to dispense antibiotics without a doctor’s prescription, that is, they can dispense antibiotics only by exchanging them for a prescription.”

Another Business FM columnist had better luck. In another pharmacy they were ready to sell him the same drug just like that, without any prescription.

Mikhail Safonov Business FM columnist“Are you for yourself?” I say: “Yes.” She assessed my build and said: “You need 500 milligrams.” I say: “Okay, do you need a recipe?” She looked at me sternly and said: “Actually, I need a recipe!” I say: “But I don’t.” She says: “How do you buy it? What did your doctor tell you?” And I say: “But the doctor didn’t tell me anything, because the doctor is my friend.” She says, “Well, if your friend takes responsibility, then please buy.”

IN pharmacy In the supermarket, next to the Business FM editorial office, there were no problems with purchasing antibiotics either. No one could explain why pharmacies don’t require a prescription when they should. Perhaps they are not afraid of fines, although such violations can even result in a license suspension for three months. However, the fact remains.

In fact, pharmacies previously were not allowed to sell prescription drugs without an official prescription. And the order of the Ministry of Health, which came into force on September 22, simply clarifies the rules for their leave. In particular, the pharmacy now keeps the so-called one-time prescription after it has sold the medicine. Why this is being done, explains the executive director Russian Association pharmacy chains Nelly Ignatieva.

Nelly Ignatieva Executive Director of the Russian Association of Pharmacy Chains“If, according to all the documents, the pharmacy received ten medications, and it has five left - we record this, these are separate accounting documents - therefore, there should be five prescriptions, and correctly written prescriptions. If something is written incorrectly in the prescriptions, again this is a violation. In this system, a doctor, a patient, a pharmacy are involved, and for some reason, responsibility for all violations at the moment is only assigned to the pharmacy. But in fact, the problem is completely different. Our doctors have stopped writing prescriptions and, accordingly, have confused all patients, and for some reason patients do not demand their rights to write a prescription.”

An official prescription must be issued on a standard form, stamped, indicating the international generic name drug in Latin. The use of specific trade names is acceptable if the drug has no analogues. David Melik-Guseinov, head of the State Budgetary Institution of the Moscow Healthcare Organization Research Institute, told Business FM why doctors violate these rules.

Director of the State Budgetary Institution Research Institute of Healthcare Organization and Medical Management“Only 10% come with some kind of recommendations and about half of these 10%, that is, only 5% of the population, come with correctly filled out prescriptions. Doctors, of course, tried not to write prescriptions, because any prescription with a stamp and signature is official document. A document that can be presented in court, a document that can be presented executive branch so that they carry out the appropriate checks. That's why medical workers, doctors very often shied away from the obligation to write an official prescription.”

Pharmacies, by the way, are also unauthorized. They are required to return to customers so-called reusable prescriptions valid for up to a year, which prescribe drugs for treatment chronic diseases. In this case, the pharmacy must make a note in such a prescription about the sale of the medicine. But sometimes they also try to confiscate such recipes. The Ministry of Health wanted to put things in order with the sale of prescription drugs. We wanted the best, but it turned out as always.

Lyudmila Lapa therapist “This can’t lead to anything good, because now I prescribed antibiotics, for example, today, but the girl says she doesn’t need a prescription. She didn't even ask because she was told that she would buy it, no problem. That is, she has some kind of pharmacy nearby that dispenses everything. And who is right and who is wrong is very difficult to determine. Confusion actually exists. This is an indisputable fact."

To the question of what to do if you were not sold the medicine, there are currently two answers. Either go to your doctor and ask him to write you an official prescription, or find a pharmacy that doesn't require prescriptions. As our experiment showed, they can still be found.

There is a rush in Kursk - the population is massively buying medicines from pharmacies. The unprecedented demand for medicines among Kursk residents is caused not by a seasonal surge in ARVI and influenza, but by information that from January 1, 2017 in Russian pharmacies medicines will be dispensed with a doctor's prescription.

In some pharmacies, the excitement is fueled by pharmacists themselves, who read out to customers a list of medications that will be impossible to buy after the New Year without presenting a prescription. At the same time, they refer to the bill that State Duma deputies adopted in mid-June 2016.

Correspondents of the Kursk city portal website tried to understand the situation.

We started with the bill. If the State Duma adopted it, then it must be signed by the country's Prime Minister Dmitry Medvedev. From the beginning of June to this day, on the government website there is not a single new legislative act that would talk about the sale of medications only by prescription.

Control over pharmacies

On official website of the State Duma At a meeting on June 21, 2016, the people's representatives considered and adopted in the first reading bill No. 1093620-6 "On amendments to the Code of the Russian Federation on Administrative Offenses in terms of improving administrative responsibility in the field of healthcare." This is what pharmacists refer to. But there is not a word in it about retail sales medicines to the population strictly according to prescriptions. Amendments were made to the Code of Administrative Offenses of the Russian Federation (CAO).

This bill is intended to tighten control and supervision of pharmacies. This is due to the fact that now Roszdravnadzor cannot effectively influence pharmacies that neglect the quality and safety of medical and pharmaceutical activities.

The current version of the Code of Administrative Offenses is not established administrative responsibility for a number of violations in the field of laboratory rules and clinical practice when conducting clinical and preclinical studies of medicines for medical use, procedures for providing medical care in terms of non-compliance with the mandatory requirements established by them, procedures for conducting medical examinations, examinations and examinations, as well as the procedure for prescribing and prescribing medications.

The new law proposes completely different fines and other types of punishment for violating the rules of trade in medicines, including for dispensing prescription drugs over the counter.

So, from January 1, 2017, if it is discovered that a medicine is being sold without a prescription, Roszdravnadzor may fine the pharmacist who violated the law in the amount of 5 to 10 thousand rubles (now - from 1,500 to 3 thousand rubles); the official will have to pay from 20 to 30 thousand rubles (now - from 5 to 10 thousand rubles); legal - from 100 to 150 thousand rubles (now - from 20 to 30 thousand rubles). The apogee may be the closure of the pharmacy for 3 months (90 days).

Analgin without a prescription

So why do pharmacies persistently report that all medications from January 1 will be dispensed only as prescribed by a doctor? Or will this affect only a certain category of medicines?

The situation State Duma deputy from the Kursk region Viktor Karamyshev commented:

- Just the day before I went to a pharmacy in Moscow, bought medicine and did not see anyone buying medicine en masse,- the people's representative is surprised. - The State Duma did not raise the issue that from January 1, all medicines in pharmacies should be sold strictly according to the prescription prescribed by the doctor. I do not rule out that in the near future it will no longer be possible to buy antibiotics freely in pharmacies. This is due to the fact that in lately There were several cases when small children died, to whom their parents independently, without a doctor’s prescription, gave or injected them with antibiotics.

According to the deputy, this is an artificial rush that the pharmacies themselves create in order to increase their sales.

So there is no reason to panic. Since 2011, the clear list of drugs that must be dispensed with a prescription has been abolished. It was too long and bulky.

From January 1, 2017, prescriptions will be dispensed in pharmacies, medications whose instructions say “Only with a doctor’s prescription.”

How told the Kursk Region Health Committee, In accordance with the order of the Ministry of Health of the Russian Federation “On the procedure for dispensing medicines,” all medicines must be dispensed by pharmacies (organizations) only according to prescriptions filled out in the prescribed manner on prescription forms of the relevant accounting forms.

Medicines are dispensed without prescriptions and medical products, in the instructions for use of which there is a corresponding entry - “dispensed without a prescription”.

From January 1, 2017, you can only go to the pharmacy to buy medicine with a prescription in hand. This innovation is widely discussed in Russia today. However, as experts say, this will not cause any inconvenience. What changes await us? Is it true that drugs will now be dispensed strictly according to a “document from the doctor”?

As it turns out, this is no longer news for pharmacy workers. Order No. 785 “On the procedure for dispensing medicines” has been in effect since December 14, 2005. It lists groups of drugs that are prohibited from being sold without a prescription. In Russia this is two thirds of total number medicines sold through pharmacy chains. The very form of the “note from the doctor” is changing. Yulia Antipova, pharmacist.

Yulia Antipova: “A prescription is considered to be just a sheet on which it is written by the doctor’s hand. And from 2017 it will change - there must be a prescription form, this one is the 107th. It will be necessary to ensure that the assignments on these forms are correct. There must be a personal seal of the doctor, a seal of the health care facility, the dosage and frequency of use must be correctly indicated.”

Not all drugs are classified as “prescription only”. Everything on pharmacy windows is freely available. Natalya Dementieva, chief physician Kursk city clinic No. 5.

Natalya Dementieva: “We take 1 tablet 2 times a day - morning and evening. It is better to take the tablets after meals. We are already prescribing medications. Our patients know that for many years all subsidized medications have been prescribed only by prescription. The medications prescribed are the same, there are no changes. And we have enough recipes.”

So no patient will be left without a form. By the way, recipes have their own expiration dates. Natalya Dementyeva, chief physician of Kursk city clinic No. 5.

Natalya Dementyeva: “Because now the prescription is valid for 60 days. We can issue orders for up to a year for any period. A person with this prescription will go, with the same thing, for the medicine prescribed to him.”

There is no official list of all drugs that must be sold strictly according to a prescription. They will focus primarily on the instructions for the medications. State Duma deputies plan to tighten control over pharmacies. You can still get a fine for selling drugs without a doctor’s prescription, but legislators propose increasing it to 10 thousand rubles. The most extreme measure should be to close the pharmacy for 3 months.

Olga Eremina