No abstract

The aging of the population in the Russian Federation and other countries has led to an increase in the number of chronic non-communicable diseases requiring higher costs of medical care. A 10% increase in the proportion of the aging population with chronic diseases reduces economic growth by 0.5% per year. Therapy with genetically engineered biological preparations for chronic diseases of the musculoskeletal system is burdensome for regional budgets, because patients suffering from these diseases receive drugs under the subsidized drug provision. The article discusses the need to reform the system of preferential provision on the example of RA patients receiving genetically engineered biological drugs (GEBD). Among all RA patients who chose preferential drug provision, the proportion of patients receiving GIBP grew from 1.88% in 2011 to 6.20% in 2017 with a further tendency to decline, which is probably due to the fact that in the period 2018-2019 in the Novgorod region, there was a change in the procedure for receiving GIBP by patients with RA. Since 2019, their purchase has been made only by the regional clinical hospital as part of the provision of hightech medical care, and patients with RA receive them parenterally in the rheumatology department, where they are hospitalized for 1-2 days. Therefore, most likely, such a reorganization of the system is associated with a decrease in drug procurement in 2018. In addition, such a system for providing patients with preferential drugs is also designed to eliminate interruptions in the provision of "preferential" prescriptions with necessary drugs.