Reckoning: there are not enough medicines for rheumatic diseases in the regions
In four Russian regions, patients complained of problems with the availability of the drug, which contains the active ingredient etanercept. Difficulties in obtaining the medicine arose in Moscow, the Moscow region, as well as the Nizhny Novgorod and Lipetsk regions, Izvestia found out. The drug is used for the treatment of rheumatic diseases, patients receive it free of charge in state medical organizations. At the same time, more such medicines were delivered in 2025 than in the past. The problem is of an organizational nature, experts interviewed by Izvestia are sure. For example, according to them, the lack of a drug could be caused by untimely tenders or an incorrectly calculated need for a drug.
Where is there no drug and when will it appear
Patients with rheumatic diseases faced a shortage of drugs with the active ingredient etanercept in four Russian regions, Izvestia found out. Such medications are used for the treatment of rheumatoid and psoriatic arthritis, polyarthritis, spondylitis, psoriasis and juvenile arthritis.
The problem arose in Moscow, as well as in the Moscow region, Nizhny Novgorod and Lipetsk regions. For example, Valeria, a Muscovite with polyarthritis, told Izvestia about problems with the availability of medicines in the capital. She said that she had not been given the drug with etanercept for a week, which she was prescribed under a regional benefit.
— In early October, I went to the pharmacy on Leninsky Prospekt to get medicine. I was assigned it three years ago, there were no problems until the fall of 2025, it was consistently issued. I couldn't get the drug this time," the girl said. — At the pharmacy, they told me that drugs with etanercept have been missing for more than three weeks, and recommended that I see a doctor to change my therapy.
According to her, the fact of the lack of medicines with this active substance was confirmed to her at the hotline for preferential drug provision in Moscow.
— I was told that my prescription is in the database, but it has been transferred to a deferred one, — said Valeria.
She clarified that in order to change therapy, she needs to undergo a medical examination, which she has so far been denied.
"The hospital told me that the drug is expected to arrive soon, so patients are not being transferred to other medications yet," the patient said. — I was also offered monetary compensation for my self-purchase of the drug. But I don't have an extra 20 thousand rubles.
The girl also said that she sent a letter to the hospital addressed to the chief physician with a request to provide her with the drug or provide an official refusal to issue it with a prescription "for further appeal to law enforcement agencies to protect their rights." But, according to her, no response has been received yet.
Another patient from Moscow, Alexey, also reported problems with the delivery of the drug to the editorial staff.
— At the face—to-face appointment, the doctor told me about the absence of the drug and stressed that I was not the only one who faced such a problem, - he said.
In addition, Alexander Elonakov, ex-chief rheumatologist of the Moscow Region, told Izvestia about the problem with the availability of etanercept drugs in the Moscow, Lipetsk and Nizhny Novgorod regions. Experts from two other federal medical institutions also confirmed this information on condition of anonymity.
Izvestia sent requests to the Moscow Department of Health, as well as to the Ministry of Health for the Moscow, Lipetsk and Nizhny Novgorod regions, asking them to comment on patients' complaints about the inability to receive drugs with etanercept.
The press service of the Moscow Department of Health reported that "the planned delivery of the drug is carried out this week." They also reminded that the medicine is included in the list of vital and essential drugs, and if it is not available in pharmacies of the department's Drug Supply Center, the patient can receive monetary compensation for self-purchase of the drug at any pharmacy.
And the press service of the Ministry of Health of the Nizhny Novgorod region told Izvestia, citing data from the regional pharmacy, that from the beginning of 2025 to the present, "there is no defect in drugs with etanercept."
"The drugs are available in sufficient quantities in the warehouse of the Nizhny Novgorod regional Pharmacy," the department stressed and clarified that it is indicated to about 130 patients in the region.
How much of the drug was purchased
Etanercept is included in the list of vital and essential medicines and in the state program "14 high-cost nosologies," recalled Alexander Elonakov. Thus, medicines with this active substance can be purchased from both the regional and federal budgets.
According to the automated information system of Roszdravnadzor, in 2020-2025 there is a "steady introduction into civil circulation of drugs based on etanercept," the press service of the Ministry of Health emphasized.
— In 2024, 35% more drugs were introduced to the market compared to the annual average. And in the first nine months of 2025, 15% more drugs were brought to the market than in the same period of 2024, they added.
As of September 30, 2025 in Moscow, the remaining 25 mg of the drug under the "14 VZN" program is seven months, and 50 mg is four months. In the Lipetsk region, the remaining medication at a dosage of 50 mg/ml is 13 months old.
According to the government's Analytical Showcase, the availability of the drug in Russia is 10.5 months, including 3.3 months in medical organizations and two months in pharmacy organizations.
According to the state register of medicines, three drugs with etanercept have been registered in Russia — Enbrel from the American Pfizer, Erelzi from the Slovenian Sandoz and Rivia from the Russian PSK Pharma.
— In most cases, patients receive the drug Rivia, — said Alexander Elonakov.
The RNC Pharma analytical company clarified that in January – August 2025, 122.8 thousand packages of medicines with etanercept entered the market, compared with 73.6 thousand for the same period in 2024. However, as part of public procurement in September 2025, 7.16 thousand packages of drugs with etanercept were purchased, while for the same period in 2024 — 8.7 thousand, according to data from another analytical company Headway Company.
The problem with the etanercept-based drug in the regions is of an organizational nature, Alexander Elonakov believes. According to him, problems with accessibility may be related to late applications for medical care for patients.
Nikolay Bespalov, Director of Development at RNC Rhagma, agreed with him.
"I do not rule out that the tender could have been announced at the wrong time or the need for the drug was incorrectly determined," he said.
Alexander Elonakov recalled that about 2 million people with various rheumatological diseases live in the country.
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