In Russia, the price of medicines and medical equipment produced by countries that have imposed sanctions on Russia over its invasion of Ukraine is skyrocketing or disappearing from the market. This has put at risk many people who are forced to take such medicines.
The Russian service of the BBC spoke with patients, representatives of charitable foundations, and pharmaceutical companies about what is happening now with medicines. The sanctions imposed on Russia for the invasion of Ukraine do not apply to medical supplies, but due to logistical peculiarities and procurement in the Russian market, drugs and medical equipment still disappear.
“Because there is no established logistics, manufacturers are ready to deliver… but nobody understands how to deliver,” says neurologist Galina Tishchenko. She notes that sellers “hold back goods in the hope of trading them later at a higher price,” and the fact that people started stockpiling drugs “exposed the retail market.”
On Tuesday, Russia introduced a temporary ban on the export of foreign medical equipment from the country. The decision was signed by Prime Minister Mikhail Mishustin. The restriction will apply to medical devices delivered from countries that have joined the sanctions and are currently stored by importers or undergoing customs procedures.
On March 3, Mishustin announced at a government meeting a series of measures to stimulate pharmaceutical production in Russia, and also promised to expand opportunities for medical institutions to purchase any drugs through a simplified procedure.
Patients and representatives of charity funds say that problems with foreign drugs have already begun. People with type 1 diabetes were among the first to experience a shortage of the daily insulin they needed.
“I immediately ran to the pharmacies,” says Konstantin Svirin of Moscow, who has insulin-dependent diabetes. “Now it is quite difficult to find insulin in them, I had to do various searches for medicines and their availability in databases. The queues at pharmacies are very long.” He hasn’t even tried to get a prescription for free insulin in the last ten days – he’s been busy buying the medicines he needs with his own money. However, after seeing the price increase, Konstantin plans to get prescriptions from his local polyclinic in the future. Svirin uses insulin produced abroad, and he has no idea whether its supply will be guaranteed in the future.
Anna Mukhina, the mother of a child with insulin-dependent diabetes from Saratov, says that on March 2 she was able to get a prescription for European-made insulin at the polyclinic, but she does not know if the necessary medication is actually available in pharmacies. “They say that “Novorapid” is insulin produced in Denmark, and it sometimes appears in pharmacies, but the same “Humalog” is no longer available at all,” she says. “As for what will happen next – I think the manufacturer will not be interested in selling insulin in the retail market if they have lost out on large government purchases.”
Mukhina says that the diabetic community has already begun to “actively advocate” Russian insulin. “On the one hand, we thank God that these analogs exist, but on the other hand, everyone approaches Russian “pharmaceuticals” with caution, based on their own experience. We are all alarmed and agitated,” she adds.
There are no analogues of domestically produced drugs such as Risdiplam, Spinraza, and Zolgensma – drugs that are vital for people with spinal muscular atrophy, an orphan (rare) disease. Alexander Kurmyshkin, a neurologist and head of the charitable foundation “Help for SMA Families,” explains that physically, these drugs should be available in Russia “sometime by the end of April. It is difficult to analyze what will happen next in terms of logistics and procurement. “We have adults [people with SMA] who have been on Risdiplam, who have received injections – and it is unclear what will happen next. Because children were given guarantees for the near future, but it is more difficult with adults.” Kurmyshkin notes that particular concern – even assuming that ways of supplying medicines will be found – are caused by purchases made from regional budgets. “They were simply not prepared for such expenditures – prices have already increased by one and a half times,” he adds.
“Now we have the last bottle of Risdiplam,” said Tatiana Sveshnikova, mother of a child with SMA. “On March 14, Dima and I are expected at the Orphan Polyclinic of the Morozov Hospital, where they will provide us with another 60 days of medication.”
“For now, everything is fine for us. The manufacturers have assured us that there will be no interruption in deliveries to Russia, but logistics have become more complicated,” says Olga Germanenko, director of the Families with SMA Foundation. “As for the rest, we do not know yet. Everyone is busy with the delivery routes and the deliveries themselves. “We are supposed to get our medicine on April 9, and we are really hoping for it,” says Beso Surmanidze, the father of a two-year-old child with SMA.
Svetlana Sakharova, head of the community of parents of children with disabilities “Growth”, notes that problems have already arisen for children with bullous epidermolysis – in this disease, the skin is damaged by the slightest mechanical impact, and a variety of technological dressings are needed to compensate for the consequences. “The situation is acute. Especially in Crimea (annexed by Russia from Ukraine in 2014 – BBC), they did not have time to procure the necessary supplies through tenders – and we were told that there would be no more deliveries,” she adds.
Elena Meshcheryakova, director of the “Fragile” Foundation for people with imperfect osteogenesis (increased bone fragility), says: “We have already run out of German medicine and it is impossible to buy it anymore. “Thank God, our medicines are being replaced by Russian-made ones,” she adds. “The situation is currently solvable, it’s just unfamiliar to switch to Russian equivalents.”
We explain quickly, simply, and clearly what happened, why it matters, and what will happen next. The number of offers should remain: episodes. End of story: Advertising Podcasts Fatima Medvedeva, a mother of two children with spina bifida, tells how she tried to buy catheters. Without them, the kidneys of people with spina bifida do not work. “A day before the start of the “special operation” they cost 700 rubles for a pack of ten. On the second day of the “special operation” I wanted to buy more – and they were practically nowhere to be found, and where they were available, they already cost between 1300 and 1900 rubles per pack”.
The woman ordered catheters everywhere she could – and one of the suppliers delivered “five catheters in a small bag, not in a package” instead of four packages of ten catheters each. Medvedeva has been trying to get a refund for the second day, but to no avail.
“Today I called a website specializing in the sale of catheters and asked how many of them were in stock – I was told there were a hundred at the old price. The operator strongly advised me to take them because either they will become much more expensive or they will not be available at all. In my son’s case, a hundred catheters will last a little over a week,” she adds.
“The supply of basic ‘chemicals’ in clinics is available, but it is unclear how long it will last and what will happen with new deliveries,” says Anastasia Zakharova, director of the “Enbi” Foundation for children with neuroblastoma (the second most common type of childhood cancer). “The main issue is logistics. It seems that options are emerging and the pharmaceutical company is looking for logistical solutions. Logistical solutions are vital for those in need of a bone marrow transplant, and so far they have been successfully solved. For example, the “Gift of Life” foundation reported that it managed to deliver stem cells from a foreign donor to a child in Moscow during a situation of closed airspace over Europe. To achieve this, a meeting of two couriers took place in Istanbul, with which air communication for Russia has not yet been closed – and the critical 48-hour deadline necessary for the preservation of stem cells was not exceeded.
But patients from Moscow clinics where bone marrow transplants are performed told the BBC anonymously that they had been informed that the search for donors in European registries was “currently suspended”. Moscow resident Maria V., who preferred not to give her last name for security reasons, said she donated blood for typing on March 7 to be included in the Russian donor registry. Russia has a terribly small bone marrow donor base: just over sixty thousand for the whole country. Matches occur less than once in a thousand, which means that Russians who cannot now receive donor cells from foreign donors will simply be left without help. In other words, they will die. The Russian government is currently at war not only with Ukraine, but also with its own citizens. And to become a donor is to become part of the resistance.
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