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We are all accustomed to change. We are no longer so frightened by reports of another economic crisis, because in our memory there have already been several of them. Innovations in educational standard schools and higher educational institutions. But news in the field of healthcare and access to medicines cannot but cause concern. IN modern world Hardly ever healthy people. We all have some kind of chronic disease and are often forced to purchase certain medications. And when news feeds contain information that changes are coming in this process at some point, we experience anxiety.

From the beginning of 2017, a new order of the Ministry of Health on the rules for dispensing medicinal products from pharmacy chains comes into force. The new order will directly affect every citizen.

In particular, a ban is being introduced on the sale of a number of medicines in large quantities to one person. This restriction is introduced for alcohol-containing tinctures and syrups, the mass fraction of ethyl alcohol in which is higher than 15%. Now they will be sold per person in quantities of no more than two bottles. And it is with these means that many of us treat our own colds at home. We advise you to make sure you have them in advance, since during the peak of the disease you will have to frequently visit the pharmacy under the new conditions of dispensing. The advice is especially relevant given the long shelf life of the latter.

Fans of online shopping should also listen to the innovations, since starting from the new year, any online pharmacy in Moscow will follow them.

A pleasant change is that patients with chronic diseases will be able to purchase the necessary medications for future use using prescriptions. Today this can only be done for the next two months. In this case, it is necessary to provide documentary evidence of the fact of departure or inability to get to the pharmacy in the future. From January 2017, this period has been extended to a calendar year.

If the pharmacy does not have drugs on the list of vital and necessary drugs, it will have to purchase them and make them available for sale no later than a week after the patient’s request. Today this period is stated as five calendar days. But if the buyer needs to take the medicine immediately, which is indicated on the prescription by the doctor’s note “statim”, the pharmacy is obliged to provide this product on the day of application.

According to the new document, pharmacy workers are prohibited from advising the buyer of more expensive drugs when a cheaper analogue is available. Pharmacists will also be required to provide detailed advice on the properties and contraindications of a particular medicine, its expiration date, storage methods and doses used. Currently, such information is provided only at the request of the pharmacy employee and is not necessarily regulated in any way. Therefore, even when purchasing medications from an online pharmacy. In 2017, you can count on the professional participation of a specialist in choosing a particular product, and on advice on its use and storage.

We can only hope that all these innovations will be implemented and will benefit the interests of pharmacy customers.

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What medications will be available by prescription starting in 2017?

In-first, according to recipes in 2017 In 2016, all the drugs that were dispensed by prescription in 2016 will be dispensed in Russia. Unfortunately for buyers of medicines, no relaxations are planned in this list.

In-secondly, Rospotrebnadzor (its head) made a rather unexpected statement-proposal that it is very desirable to sell all drugs that are in pharmacies exclusively by prescription. That is absolutely everything. Maybe with the exception of those medications that are necessary to complete all kinds of first aid kits. Read about it. The Ministry of Health proposes to soften this proposal, and we will see to what extent this softening will occur.

In a word, drug consumers can expect, if not a revolution in the dispensing system, then at least a reformation of the list of prescription drugs in the direction of a clear increase. The list will be replenished with those medications that are not needed urgently, but have a negative effect on the body when self-medicated.

All new medications that contain narcotic drugs are psychotropic. And such funds are only increasing on the pharmaceutical market every year. Alas, people do not solve problems, but accept everything for years.

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The third group is combined drugs: narcotic drugs, psychotropic substances and their precursors. They decided to designate this group separately: antibiotics. We are used to prescribing them for ourselves, but sometimes there is no other way, especially if we got sick on the weekend. Many people send their relatives to the pharmacy for antibiotics.

We'll see how it turns out in practice.

Definitely, new tranquilizers and antidepressants will also join the ranks of prescription drugs.

Here are some drugs that will be sold by prescription.

What is sometimes surprising is that the drug remains the same, the same active ingredient, but the packaging is different 3D, and the price is already higher and they may ask for the recipe.

Many live without medication at all! Well done!

On this moment Work is underway to compile such a list. On similar work The Ministry of Health of the Russian Federation was allocated enough time, up to January thirty-first, 2017.

It is already known that the list will definitely include drugs on the prescription form with the following line:

Presumably, only thirty percent of the medicines offered for sale in pharmacies will be available without a prescription.

There is also the following list of medicines

Since January 2017, the dispensing of medicines in pharmacies has become more strict. Many medications that previously could be bought without a doctor’s prescription are now simply not sold. Most of these drugs include antibiotics, but there are also regular painkillers.

The instructions for these medications previously included the clause “dispensed with a doctor’s prescription.” But pharmacies sold them without any prescriptions. Now it is planned to organize unscheduled inspections, which will entail the issuance of fines to those pharmacies where drugs are sold without a prescription.

Another question arises: how should patients receive prescriptions? Everyone knows how long the queues are at the offices of local therapists. Therefore, they are now actively deciding this question so that the “prescription-only medicine” system is fully operational.

Already at the beginning of 2017, a list was posted in which a list of medications appeared that were prohibited from being released without a prescription.

People now really cannot live without medicines and pills, as they help us extend our lifespan when we are sick.

This year, only those medications that contain Khlopinin will be dispensed by prescription:

Also included in this list is the well-known Valocordin:

And here, full list medications that will not be given to everyone, but only to those who have a special “prescription” paper from a doctor:

In 2017, changes occurred in the pharmaceutical field that are now being actively discussed.

The list of drugs that cannot be purchased without a prescription from a doctor has become longer. It contained medications with psychotropic effects and good old antibiotics. Some indignation was caused by the fact that the cardiac drug Valocordin was included in this list. Curantil, so often prescribed to pregnant women, was also there, as well as Nimesil, a well-known painkiller.

Most likely, the list will be replenished with new titles.

Since 2017, pharmacies will not be able to sell prescription drugs if instead of an official document with a doctor’s signature and seal there is a “handwritten piece of paper”

When going to the pharmacy to buy medicine, don’t be lazy, open the Internet. Type the required medication into a search engine and look at the instructions for it. If there is a note “Only with a doctor’s prescription,” it means that without this very prescription the product you need will not be sold.

Medicines are divided into those that can be freely purchased at a pharmacy and those that are available only with a doctor's prescription. For the latter, from January 1, 2017, the rules for their leave are being tightened. The category “prescription only” does not include medications that are in free access- on pharmacy windows. You can easily purchase antivirals, many medicines for coughs and runny noses, some enzyme and painkillers.

And although the innovation has caused a lot of controversy, it is by no means news for pharmacy workers. Order No. 785 “On the procedure for dispensing medicines” has been in effect since December 14, 2005. But now the very form of the “doctor’s note” is changing.

If previously a prescription was considered a banal piece of paper on which the doctor’s hand had scribbled the prescribed medicine, this “gag” will no longer pass in the new year. A prescription form is required (form No. 107/u). With the personal seal of the doctor, the seal of the medical institution, dosage and frequency of use.

Remember, recipes also have an expiration date. Now it is 60 days. For chronic patients, the validity period of the prescription may be longer.

There is no official list of all drugs that must be dispensed strictly according to a prescription. During January, the Ministry of Health will compile a list of medications that will be available only by prescription. In the meantime, they will focus on the instructions for the medications.

State Duma deputies plan to tighten control over pharmacies. For selling drugs without a doctor’s prescription, you can still face a fine, but people’s representatives propose increasing the administrative penalty to 10 thousand rubles. And as the most extreme measure, it is proposed to close the pharmacy for three months.

Starting from 2017, control over the sale of drugs will be strengthened. Is it worth purchasing drugs? (TV and radio company "Seim")

they have last years mania prohibit everything limit punish etc. all laws are aimed at the negative there is not a single law to give provide provide increase in favor of the people even with authoritarianism you rarely see this, well, well, let's see where this curve will lead

Here you go. I've read a lot of nonsense) The comments are about nothing. Why stand in line with a blood pressure of 180, when there is an ambulance for such a situation. Although, in general, it is necessary to stock up on medications as soon as they come to an end, and not on the day of the crisis (. Someone wrote about an antibiotic, which should always be in the first aid kit . Are you sure? And what (read, for what) should be at home? Do you think one antibiotic cures everything? Nonsense! And they will do the right thing by not selling it. Otherwise, citizens drink a “harmful antibiotic for 2.5 days.. and so It is the bacteria that cause its resistance (addiction to the drug), the next time it no longer affects the microbe. This is how we returned tuberculosis to society, for which it became difficult to select drugs and the mortality rate increased. If you are afraid of the drug, do not start taking it.. it will be completely bad , then the doctor will write out a prescription, and in a difficult situation, you yourself will drink it to the end. And Valocordin is not a harmless drug at all, because it contains Phenobarbital (we read on Wiki), but it does not save you from death at all. Rather, from fear)) So, an ambulance and an ambulance again, if you really feel bad. PS. I ALWAYS get a coupon through the Internet, I’ve never sat at the office for 3 hours. strictly on time and almost always on time. Doctors are not interested in accepting 35 people instead of 15. Why is it “impossible to get in”?!

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Give me a piece of paper. Starting from the new year, the sale of drugs without a prescription will be tightened

IN recent months Kursk residents, making purchases at the pharmacy, hear from pharmacists a warning that from January 1, 2017 most of Medicines will be dispensed strictly according to prescriptions. But is this so and what barriers will now be put in front of patients?

Whose order?

On June 21, 2016, the State Duma adopted in the first reading government bill No. 1093620-6 “On Amendments to the Code Russian Federation on administrative offenses in terms of improving administrative responsibility in the healthcare sector.” And in September, at a meeting with Roszdravnadzor of the Russian Federation, it was announced that from January 1, 2017, prescription drugs will be under special control of the department.

“Actually, the order of the Ministry of Health and social development RF No. 785 “On the procedure for dispensing medicines” is valid from December 14, 2005. It is he who regulates the procedure for dispensing medicines from pharmacies, regardless of the form of ownership. That’s why we still fine pharmacies for selling medicines without a prescription,” explained the deputy head of the department of licensing, supervision and control in the field of medical and social activities Regional Office of Roszdravnadzor Lyudmila Ilyukhina.

Lethal injection. Kursk children are dying from a “harmless” drug

Let us remind you that 70% of drugs registered in the Russian Federation are sold strictly according to prescriptions, and only 30% are sold without it. But what then will change in the new year? Nothing but tougher legislation regarding control and supervision of pharmacies. Currently, Roszdravnadzor is constrained by current legislation and cannot effectively influence pharmacies for violations of the quality and safety of medical and pharmaceutical activities. It’s just that pharmacists did not always pay attention to these requirements, and the population did not see the problem and did not understand it.

How will they be punished?

IN current edition The Code of Administrative Offenses does not establish administrative liability for a number of violations in the field of rules of laboratory and clinical practice during clinical and preclinical studies of medicinal products for medical use, procedures for the provision of medical care in terms of non-compliance with the mandatory requirements established by them, procedures for conducting medical examinations, examinations and certifications, as well as procedure for prescribing and prescribing medications. Therefore, changes have been made to the Code of Administrative Offenses of the Russian Federation (CAO).

The price of health. Do beneficiaries have enough medicine?

The new law proposes completely different fines and other types of punishment for violating drug trade regulations, including dispensing prescription drugs without a prescription.

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); official you 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).

Therefore, you understand, most pharmacies, if not all, will not want to take risks and will work strictly according to the letter of the law.

Self-medication is to blame

The impetus for the changes was the level of self-medication of the population, which has recently gone through the roof, and sometimes turns into very tragic consequences. Here it is already worth dealing with another problem - the shortage of doctors and queues in hospitals, which force people to go to the pharmacy and consult with a pharmacist about what medications should be taken for a particular disease.

“But the pharmacy must follow the doctor’s recommendation, draw the buyer’s attention to storage conditions and frequency of administration, nothing more. And the prescription itself is the doctor’s request to the pharmacist about what exactly he should give to the patient,” notes Ilyukhina. - And now it also happens that a person actually visited a doctor, but came to the pharmacy not with a prescription written on an official form, but with a piece of paper on which the doctor indicated the name of the drug. And pharmacists dispense medications based on these scraps. This whole situation must change."

The level of self-medication may be off the charts, but there is a logical explanation for this trend - how long will a person have to wait in line at a hospital for a prescription? Especially considering that the majority prefer not to go on sick leave with every cold, but to endure it on their feet, since the authorities do not favor sick leave, and many of us do not consider a sluggish ARVI to be a real disease, supporting our immunity with medications (not even antibiotics) from the nearest pharmacy. But now, before going to the pharmacy, you will have to go on a “crusade” to the hospital and sit in line there, most likely not for an hour or two.

Shortages and queues

It is impossible to say right now exactly which medications will be dispensed only by prescription: in fact, there is no clear list; it was abolished in 2011 because it was too long and cumbersome. So you will have to focus on the packaging of the drug, which should indicate the name, dose, release form, manufacturers, expiration date, storage conditions and dispensing rules - with or without a prescription.

On September 22, new rules for the dispensing of medicines came into force - order of the Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n “On approval of the rules for dispensing medicines,” which regulates the sale of medicines in pharmacies. The document caused a lot of noise and confusion among both patients and pharmacy employees. Today we tried to answer the most important questions about the new order that an ordinary pharmacy visitor may have.

New order makes all drugs prescription drugs?

No. The new dispensing rules only slightly change how some prescription drugs are sold. It does not place any restrictions on common over-the-counter medications.

And now you can’t just buy a prescription drug?

In fact, selling prescription drugs without a prescription has always been prohibited. For this, the pharmacy faces a considerable fine and loss of license. But, as everyone knows, the severity of the law is compensated by the optionality of its implementation. Therefore, a number of pharmacies ignore the rules. However, the emergence of new dispensing rules means close attention to their implementation, and therefore, pharmacies have now become more sensitive to prescription dispensing.

How do you even know if you need a prescription for the drug?

Whether the drug is prescription or not is stated in the instructions for use. In addition, such information is always indicated on the packaging. Of all drugs registered in Russia, approximately 70% are prescription drugs.

IN ideal world The doctor knows by heart which drugs require a prescription and which do not. But in harsh reality, very often you have to check such information yourself. Therefore, when a doctor advises you on any medications, you can check them online right at your appointment and immediately ask for a prescription.

Prescriptions are written only on special forms. The most common is form No. 107-1/у. It looks like this:

To check whether a drug is a prescription drug, you can go to the website and enter the name of the drug. All prescription medications on our website are marked “prescription.” By the way, not so long ago we got a special label for drugs for which the prescription remains in the pharmacy.

How do you mean “the prescription stays at the pharmacy”?

The pharmacy has a list of drugs that are subject to strict registration. As a rule, these are medications containing narcotic or psychotropic substances included in a special list. Prescriptions for such drugs always remain in the pharmacy in order to control their sale. The circulation of narcotic substances is checked not only by Roszdravnadzor, but also by the structures of the Ministry of Internal Affairs.

But now, according to the new dispensing rules, the pharmacy must also keep prescriptions for certain medications (antidepressants, tranquilizers, antipsychotics, sleeping pills and sedatives, as well as alcohol-containing medications with an alcohol content of more than 15%) *.

“Medicines containing alcohol”? So, now you need to get a prescription for Corvalol or valerian?

No. Let us repeat that the new order does not make medications prescription drugs. It's about only about prescription drugs. Corvalol, valerian tincture and many other popular tinctures and elixirs are over-the-counter. Accordingly, no one can require a prescription for them unless this is stated in the instructions for use.

Okay, let's say I have a prescription, but it contains several drugs, and one of them is marked "remains at the pharmacy." And I want to buy only one. Will they take my prescription?

Yes. Exceptions are made only for annual prescriptions, provided that you do not purchase the entire prescribed amount of the drug at one time (for this you also need the permission of the doctor who wrote the prescription).

For example, you are prescribed a course of antidepressants for a year, but you only need to purchase one package. In this case, the pharmacy does not have the right to take away your prescription. The pharmacist only makes a note of how much of the drug you bought and returns the prescription.

Can I get medications if the prescription is not written for me?

Yes. Almost all medicines are dispensed simply to the bearer of a prescription. Both the patient himself and his friend, relative, or just an acquaintance can get the drug at the pharmacy. The main thing is to have a recipe.

An exception is made only for narcotic or psychotropic drugs. Prescriptions for such drugs are written out on a special form No. 107/u-NP. It is easy to distinguish from other recipes because it Pink colour. When receiving such drugs at a pharmacy, you must have a power of attorney to receive medications and a passport confirming that you are the one for whom the power of attorney was issued.

At the same time, the Ministry of Health especially notes that the power of attorney can even be handwritten. You can write in it that “I trust such and such to receive such and such medications according to such and such a prescription to such and such a person.” And be sure to indicate the passport details of this person. In addition, it must indicate the date of its compilation. Notarization of such a power of attorney is not required.

What else has changed with the new procedure for dispensing medications?

Now all prescriptions are stamped with the statement that “the drug has been dispensed.” Thus, they cannot be reused. Therefore, if you suddenly need another standard of the drug, you will need to get a new prescription.

Also, the pharmacist is now obliged to inform the buyer about the rules for storing the medicine, its interaction with other drugs, as well as its method and dosage. In addition, a pharmacy employee cannot hide information about the availability of drugs with the same active ingredient, but cheaper. Such a norm existed previously in the law “On the Fundamentals of Protecting the Health of Citizens” and the Rules of Good Pharmacy Practice, but is now duplicated in the dispensing procedure.

* Below is a list of INNs, prescriptions for which, according to the new order, will now remain in the pharmacy. Please note that the active substances (INN) listed here are not specific brand names.

INN
agomelatine
asenapine
aminophenylbutyric acid
amisulpride
amitriptyline
aripiprazole
Belladonna alkaloids+Phenobarbital+Ergotamine
bromod
buspirone
venlafaxine
vortioxetine
haloperidol
hydrazinocarbonylmethy
hydroxyzine
dexmedetomidine
doxylamine
duloxetine
zaleplon
ziprasidone
Zuclopenthixol
imipramine
quetiapine
clomipramine
lithium carbonate
lurasidone
maprotiline
melatonin
mianserin
milnacipran
mirtazapine
olanzapine
paliperidone
paroxetine
pericyazine
perphenazine
pipofezin
pirlindole
podophyllotoxin
promazine
Common twig fruit extract
risperidone
sertindole
sertraline
sulpiride
tetra
tiapride
thioridazine
tofisopam
trazodone
trifluoperazine
morpho
fluvoxamine
fluoxetine
flupenthixol
fluphenazine
chlorpromazine
chlorprothixene
citalopram
escitalopram
etifoxine

Main photo istockphoto.com

The data set allows you to get detailed information about dispensing points for subsidized medications, check their location on the map, as well as find out the exact address, opening hours and other contact information.

Drug provision is integral part healthcare system and is aimed at guaranteed, timely and high-quality satisfaction of the needs of the Moscow population for medicines for medical use, medical devices, as well as specialized medical nutrition products for disabled children.

Medicine provision as one of the most important components of the treatment process, and first of all free medicine provision to certain categories of citizens entitled to state social assistance, is subject to state regulation and control, since it has the most important economic and social significance. IN modern conditions The state must act as a guarantor of the safety, quality and effectiveness of pharmaceutical goods and services to the consumer.

Federal Law of July 17, 1999 No. 178-FZ “On State social assistance"(as amended) establishes the right to receive state social assistance in the form of a set of social services, which includes the provision, in accordance with the standards of medical care, of necessary drugs for medical use according to prescriptions for drugs, medical products according to prescriptions for medical products, and also specialized medical nutrition products for disabled children, for certain categories of citizens specified in articles 6.1. and 6.7. named Federal Law. Also, by order of the Moscow Government dated August 10, 2005 No. 1506-RP “On the implementation of social support measures for certain categories of residents of the city of Moscow to provide medicines and medical products dispensed according to doctors’ prescriptions free of charge or with a 50 percent discount” (as amended) to certain categories Social support measures are provided for Moscow residents.

The provision of medicines for medical use, medical devices, as well as specialized medical nutrition products for disabled children of certain categories of citizens entitled to state social assistance is carried out in pharmacies located in medical organizations, which makes it possible to make drug assistance targeted and accessible. At the same time, preferential prescriptions are dispensed in the pharmacy departments of the State Budgetary Healthcare Institution “TsLO DZM” (narcotic drugs and psychotropic substances, as well as drugs prepared according to an individual prescription). Many pharmacy organizations are located in close proximity from medical organizations (city hospitals, clinics, oncology clinics), providing the population with easy access to the necessary medical care.

If there are medical indications, citizens who seek medical help from a medical organization, as well as if it is necessary to continue treatment after the patient is discharged from the hospital, are prescribed medications and prescriptions for them are written out in the prescribed manner. Based on the nature and severity of diseases in preferential categories citizens, medications for the treatment of diseases on an outpatient basis are prescribed in the required quantities directly by the attending physician in accordance with the approved list of medications and are one of the types of state social assistance.

In accordance with the order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing medicines, as well as forms of prescription forms for medicines, the procedure for completing these forms, their recording and storage”, the prescription and prescription of medicines is carried out by medical an employee under an international nonproprietary name, and in its absence - a group name. In the absence of an international nonproprietary name and generic name of a medicinal product, the medicinal product is prescribed and prescribed by a medical professional under its trade name.

If there are medical indications (individual intolerance, for health reasons), by decision of the medical commission of the medical organization, medications are prescribed and prescribed: those that are not included in the standards of medical care by trade name. The decision of the medical commission of the medical organization is recorded in the patient’s medical documents and the journal of the medical commission.

The temporary absence of a medicinal product in a pharmacy on the day of treatment is not grounds for refusal to issue a prescription. In the event of a temporary lack of medicines and medical products at a pharmacy that dispenses medicines and medical products to certain categories of citizens, the pharmacy worker is obliged to supply prescriptions for deferred supply and enter them in the “Unmet Demand Journal.” In accordance with the established procedure, measures must be taken to ensure them within the time frame approved by the Ministry of Health of Russia: for drugs included in the “federal” List (Order of the Government of the Russian Federation dated December 26, 2015 No. 2724-r) - 10 working days from the moment the patient contacts the pharmacy organization and 15 for medications prescribed by decision of the medical commission of a medical organization.

1. On prescription forms, a stamp of the medical organization is affixed in the upper left corner indicating its name, address and telephone number. Additionally, the code of the medical organization is indicated on prescription forms.

2. On prescription forms issued individual entrepreneurs, licensed to medical activities, in the upper left corner, the doctor’s address, license number and date, and name of the authority must be indicated in typography or by stamping state power who issued the license.

3. Prescription forms are filled out by the doctor legibly, clearly, in ink or with a ballpoint pen.

4. Registration is allowedall details (except for the details “Signature of the attending physician”) of prescription forms using printing devices.

6. On prescription forms, in the “Age” column, the number of full years of the patient is indicated.

7. On prescription forms, in the column “Address or medical card number of the patient receiving medical care on an outpatient basis,” the full postal address of the patient’s place of residence (place of stay or place of actual residence) and the medical card number of the patient receiving medical care on an outpatient basis are indicated.

8. In the column “Full name of the attending physician” of the prescription forms, the full last name, first name, patronymic (if any) of the medical worker who has the right to prescribe and prescribe medications is indicated.

9. In the “Rp” column of the prescription forms the following is indicated:

1) on Latin name of the medicinal product (international non-proprietary or group, or trade), its dosage;

2) in Russian or Russian and national languages method of administration of the drug.

10. It is forbidden to be limited to general indications, for example, “Internal”, “Known”.

Only abbreviations accepted by the rules are allowed; solid and bulk pharmaceutical substances are prescribed in grams (0.001; 0.5; 1.0), liquid - in milliliters, grams and drops.

11. The prescription is signed by a medical professional and certified with his personal seal. Additionally, the prescription is certified by the seal of the medical organization “For Prescriptions”.

12. Only one name of a medicinal product is allowed to be prescribed on one prescription form.

13. Corrections to the prescription written out on the prescription form are not allowed.

14. The validity period of the prescription written on the prescription form (15 days, 30 days, 90 days) is indicated by crossing out or underlining.

It is prohibited to write prescriptions for drugs:

In the absence of medical indications;

For medicinal products not registered in the Russian Federation;

For medications that, in accordance with the instructions for medical use, are used only in medical organizations.

In accordance with paragraph 2 of Article 6.3 of the Federal Law of July 17, 1999 No. 178-FZ “On State Social Assistance” (as amended), the period for providing citizens with a set of social services is a calendar year.

A citizen may, before October 1 of the current year, submit an application for refusal to receive a set of social services (social services) for the period from January 1 of the year following the year in which the application was submitted, and until December 31 of the year in which the citizen applies for the resumption of provision to him set of social services (social services). An application for the resumption of the provision of a set of social services (social services) is submitted before October 1 of the current year for the period from January 1 of the year following the year of filing the application (clause 4 of Article 6.3 of the Federal Law of July 17, 1999 No. 178-FZ “On State Social Assistance” ).

The current situation in Russia.

The Strategy for the provision of medicines to the population of the Russian Federation for the period until 2025, approved by the Russian Ministry of Health in 2013, provides for pilot implementation various models drug provision.

Co-financing from patients (with the exception of certain categories of citizens for whom free drug coverage is provided) should depend on the nature of the patient’s disease and the cost of treatment, for example:

Costs are fully reimbursed by the state - for life-threatening, socially significant diseases that make the largest contribution to mortality in Russia,

A high share of reimbursement is provided for drugs for the treatment of non-life-threatening diseases, but requiring long-term expensive treatment,

Low reimbursement rate - for diseases requiring therapy with low-cost drugs.

It is necessary to analyze the results of various models of pilot projects for drug provision with various categories of citizens participating in pilot projects, various diseases (by course and cost of treatment) to formulate calculations of financial costs.

The introduction of drug insurance in the city of Moscow is possible when the Russian Ministry of Health sums up the results of pilot projects in the constituent entities of the Russian Federation within the framework of the Drug Supply Strategy, which are carried out not for individual nosologies, but in full.

Do you know what?

Already in ancient times, people tried to save their lives using various natural medicinal substances. Most often these were plant extracts, but preparations were also used that were obtained from raw meat, yeast and animal waste. Some medicinal substances are available in easily accessible form in plant or animal raw materials, and therefore medicine has successfully used a large number of drugs of plant and animal origin since ancient times. Only with the development of chemistry did people become convinced that the therapeutic effect of such substances lies in the selective effect on the body of certain chemical compounds. Later, such compounds began to be obtained in laboratories by synthesis.

For selling prescription drugs without a prescription, a pharmacist can be fined five thousand or more rubles. And the pharmacy will be closed completely for three months. Antibiotics, a number of painkillers, cardiovascular and other drugs disappeared from “free sale.” Supervisory authorities claim that this was done for the sake of the health of patients, while many refer to foreign experience. Why are patients not happy with such care?

In fact, the ban on the free sale of prescription drugs has existed for a long time; Order No. 785 “On the procedure for dispensing medicines” has been in effect since December 14, 2005. But neither pharmacists nor their clients were in a hurry to implement it. And the doctors continued to scribble prescriptions on scraps of paper. Unless medicines from special lists, subject to strict accounting, were dispensed and purchased strictly according to a prescription.

The Ministry of Health and Rospotrebnadzor decided to take the violators seriously. Pharmacists were last in line. If a pharmacy employee sells a prescription drug without a doctor’s prescription, he may be fined at least five thousand rubles. And that is not all. The fine for the pharmacy itself can be one hundred thousand rubles; the supervisory authority has the right to even close the outlet for up to three months. Medicines marked “dispensed only by prescription” are now prohibited from even being displayed on display.

Moreover, the doctor must formalize the prescription accordingly: not on a piece of paper, not on a card, but on an official prescription form with the seal of the medical institution (form 148/u or No. 107/u, depending on the drugs), certified by the personal signature and seal of the doctor. The recipe indicates the international nonproprietary name, as well as the dosage and frequency of use. The issued prescription is valid for 60 days; for chronic patients, it can be issued for a year, indicating the frequency of purchase of the medicine.

About 70% of the entire pharmacy assortment is subject to restrictions. These are not only psychotropic and narcotic drugs, but also all antibiotics, hormonal drugs (including contraceptives), potent painkillers, ampoule dosage forms, a number of cardiovascular drugs, medications for diabetics, etc.

The most unpleasant thing is that there is still no exact and full list medicines that cannot be commercially available. The list should have been approved by the Ministry of Health back in January, it was proposed to find it follow this link. But try to find it there yourself! Today, pharmacists are asked to follow the instructions; if it contains the entry “dispensed with a doctor’s prescription,” it means that it cannot be dispensed just like that.

Walking through Stary Oskol pharmacies, you can see that local pharmacists do not have a consensus on what can be sold and what cannot be sold.

“Our management has ordered the sale of antibiotics and drugs in ampoules by prescription,” said one of the pharmacies. – There are no changes for other medications.

“We can sell herbs, ointments, antipyretics, some antivirals and nasal drops without a prescription,” said another. – Pentalgin, ketorol, papaverine, festal – only by prescription!

- What kind of papaverine and no-spa do you need? – clarified in the third. – Tablet forms are dispensed freely, in ampoules – according to prescription. Ketonal is similar: we will sell a cream or gel for external use, but if you need other forms of release, contact your doctor.

“I don’t think there is any reason to panic,” explained the pharmacist at the fourth point. – And before, many drugs were sold by prescription. Those same diabetics knew this very well. There are painkillers, stomach and heart medications, the same medications for diabetics, which have been and remain on the market. Anything more potent is a no. This, I think, is justified: serious drugs also have more serious ones. side effects. In addition, if you need strong medications, then you need serious treatment and go to the doctor.

In general, if you are going to the pharmacy, at least look on the Internet and look at the instructions for the medicine you are going to buy. It may be prescription only, in which case you will need to see a doctor first.

If you need this or that drug, but have neither the time nor the desire to sit in a long-hour queue, but it is possible to pay for consultations with a doctor in a private medical center, in most cases you can get a prescription there too. A doctor at a private clinic has the right to write prescriptions for medications, with the exception of medications included in Lists II and III of the “List of Narcotic Drugs, Psychotropic Substances and Their Precursors Subject to Control in the Russian Federation.”

Other innovations:

Now pharmacists are required to inform customers about all analogues of medicines. We are talking about medications with the same international nonproprietary name. The client himself can choose: to purchase an expensive medicine, or its cheap equivalent. If a pharmacy employee does not provide such information, he may be fined.
In addition, pharmacists and pharmacists cannot refuse customers to familiarize themselves with the accompanying documentation for drugs and medical devices (certificates and declarations of conformity).
At the client's request, the pharmacist must tell in detail about the dosage, method of administration, and interaction of the drug with other medications. In general, the pharmacist was required by law to do everything that he actually does today.
Pharmacies that are open to visitors 24 hours a day must have a lighted sign with information about night hours.

Opinion. Why do Russians prefer self-medication?

This state of affairs can only surprise those who are not familiar with the reality of the Russian hinterland. The fact that pharmacies need revenue and don’t want to lose customers is just the tip of the iceberg. the main problem– inaccessibility of fast and high-quality medical care. Try standing in line for hours at the doctor's office in the midst of a flu epidemic! Or suffer without pain medication for several weeks until your appointment with a neurologist comes up. So people run to the nearest pharmacy, tearfully begging: give me at least something! Well, doctors, although they dissuade citizens from self-medication and “on camera” ardently support the slogan “medicines are strictly according to prescription,” deep down in their hearts they are glad that patients do not run to them for papers for every trifling reason. Given the shortage of medical personnel (according to the same Ministry of Health, the shortage of therapists in the country is 27%), they sometimes have to serve a lot of patients Furthermore, which is required by the standards: therapists and pediatricians are sometimes “hung” with two or three sections. If you still have to spend time writing out prescriptions for basic analgins, papaverines, and pentalgins, there will be absolutely no time left for examining patients.

Without boring you with listing examples from personal practice (everyone has their own sad experience), I will say that not many doctors in practice thoughtfully select a drug for a patient, based on the results of tests, examinations and examinations. They make mistakes when prescribing dosages and dosage regimens, and selecting combined drugs. Without this, patients would not think that the best adviser is the Internet.

In many cities, the innovation caused violent outrage. People call the ban on over-the-counter drugs a “quest for survival.” Citizens are collecting signatures on petitions to various authorities asking them to keep the “previous procedure for dispensing medications.”