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- Groan from the heart: free medicines are being asked for patients with low cholesterol
Groan from the heart: free medicines are being asked for patients with low cholesterol
A whole group of patients has been forgotten in the federal project "Combating Cardiovascular Diseases," according to a letter from the All-Russian Union of Patients (VSP) to the Ministry of Health. We are talking about people with dyslipidemia, an abnormally low cholesterol level that increases the risk of strokes, heart attacks and heart failure. Such patients should be given targeted drugs free of charge, adding them to the federal project, the VSP believes. The interviewed doctors confirmed that this category of patients is in dire need of modern intensive lipid-lowering therapy.
What is the danger of low cholesterol?
Patients with low cholesterol (dyslipidemia) in Russia are not allowed free medicines, the All-Russian Union of Patients drew attention. Currently, such a program is available only in one region of the country — Moscow. The city authorities have allocated a separate budget for this, at their own discretion, but they have no such responsibilities.
In order to provide patients with this dangerous condition with free medicines, VSP proposes to supplement the federal project "Fight against cardiovascular diseases" — in this case, drugs will be purchased at the expense of the state budget. The patient organization sent an appeal with such a proposal to the Ministry of Health.
"Without reaching the target cholesterol level, the risk of heart attacks and strokes, including repeated ones, is extremely high," the letter says. — Current clinical guidelines contain drugs that allow it to reach its target levels, thereby preventing cardiovascular events and deaths. But they are not available to patients for free. This limits their access to life-saving medicines."
Dyslipidemia is more or less detected in about 60-65% of Russians, Nana Pogosova, Deputy Director General for Scientific and Analytical Work and Preventive Cardiology at the National Medical Research Center of Cardiology named after Academician E.I. Chazov, told Izvestia.
"This category of patients is in urgent need of modern intensive lipid—lowering therapy," she stressed.
According to the doctor, the threat of premature death and the negative impact of "bad" cholesterol levels on life expectancy are extremely underestimated.
— The problem requires special attention from the medical community for the timely initiation of therapy and the effectiveness of subsequent treatment, and from the authorities to provide patients with the necessary drugs, — said Nana Pogosova.
VSP offers to provide medicines for free to not all patients with dyslipidemia. First of all, we are talking about 11.5 thousand patients with extreme cardiovascular risk who have suffered two or more cardiovascular events within two years. According to the estimates of the organization, 3.8 billion rubles are required for this. Secondly, about 5.8 thousand patients with very high cardiovascular risk with familial hypercholesterolemia — this is another 1.8 billion rubles.
The list of patients for inclusion in the federal project is being formed by the Ministry of Health, said Andrey Fedorov, head of VSP projects. According to him, the ministry has included in it the most critical conditions in terms of mortality.
"In order to receive therapy under the federal project, the patient must be under medical supervision, that is, undergo an acute event or surgery," he added.
Not all regions can afford to expand social support measures, as the capital does, which creates unequal access of patients to high-quality medical care, the VSP draws attention to.
The list of categories of patients in Moscow who are eligible for free medication is broader than under the federal project, and it includes, in particular, patients with dyslipidemia, Anna Sapina, Deputy chief freelance cardiologist for outpatient work at the city Clinical Hospital No. 23 of the Metropolitan Department of Health, told Izvestia.
The All-Russian Union of Patients has been cooperating with the Ministry of Health for the third year on the issue of expanding the category of patients included in the federal project and the list of drugs in it, but there are no significant changes yet, Andrei Fedorov emphasized.
"In Russia, lipid metabolism disorders (dyslipidemia), which underlie the progression of atherosclerosis, occupy a leading position in terms of the contribution to mortality from cardiovascular diseases. But patients with this disease are now outside the perimeter of preferential drug provision within the framework of the federal project," follows from the letter of the VSP.
The solution to this problem, the document emphasizes, is especially important for achieving the goals of increasing life expectancy.
Izvestia sent a request to the Ministry of Health with a request to inform how many patients with dyslipidemia currently live in Russia and whether the ministry plans to include drugs for the treatment of this disease in the federal project.
Regional experience
Patient Andrey Uvarov from one of the Russian regions told Izvestia that he had shortness of breath at the age of 63.
— The examination showed angina pectoris. According to the compulsory medical insurance, I was sent to the Bakulev Center for Cardiovascular Surgery, where a coronary angiography was performed. The diagnosis turned out to be serious — multivessel coronary artery disease. In October 2021, I underwent coronary artery bypass surgery," he said.
After his discharge, he was given a list of recommendations, and under the supervision of a cardiologist, Andrei Uvarov began therapy, but his condition did not improve until a targeted drug was added. But he buys it at his own expense. The average price is about 13-15 thousand rubles, this is a syringe with a drug that needs to be injected once every two weeks.
Levenbert Bagramyans, a patient from Moscow, told Izvestia that he suffered his first heart attack 32 years ago. And ten years later — again.
— I had a bypass operation. Then the stents were installed. Two years ago, my attending physician included me in the testing program for a targeted drug, and it was only on it that my cholesterol levels reached their targets," he shared.
Now, according to him, he regularly receives medicine at the pharmacy in the polyclinic — it is given on a prescription from the attending physician.
The damage to GDP due to the disability of patients with impaired cholesterol levels and a shorter life span is estimated at 209 billion rubles annually, said Vitaly Omelyanovsky, Director General of the Center for Expertise and Quality Control of Medical Care at the Ministry of Health.
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