Enough for pills: patients ask to add 11 billion for expensive medicines
An additional 10.7 billion rubles are required to provide medicines to people from the state program "14 high-cost nosologies" in 2025 and 2026, the All-Russian Union of Patients (VSP) has estimated. In 2024-2025, problems with provision arose in 28 regions. In particular, due to underfunding: costs have increased due to an increase in the number of patients, as well as an increase in the price of drugs. But the government is unlikely to be able to allocate additional funding in the near future, experts interviewed by Izvestia are confident. On the contrary, the relevant ministries assure that the possibility of expanding spending on the state program is already being worked out.
For health protection
The All-Russian Union of Patients has asked to increase funding for the state program "14 high-cost nosologies" by 10.7 billion rubles. The organization sent such an appeal to the State Duma Committee on Health Protection, the document is available to Izvestia.
The amount of almost 11 billion rubles will cover the need for drugs in 2025 and 2026, according to the patient organization.
"According to the procurement analysis for the end of 2024-10 months of 2025, the total amount of funds actually spent on the program amounted to 91.7 billion rubles," the letter says. — But, according to our estimates, the actual need stated by the regional ministries has not been closed in the amount of 9.7 billion rubles, as well as 1 billion rubles for the provision of medicines as part of the distribution of funds from the Circle of Goodness foundation. Thus, the undersupplied volume of medicines, based on the needs of 2025, amounts to 10.7 billion, provided that the volume of drugs is calculated taking into account the rolling balance."
The patient organization recalled that four years ago they raised the issue of underfunding the 14 WNV program and the problem was solved for a while, but now it has become relevant again.
"In 2021, when the All-Russian Union of Patients appealed to the government on this issue, and the funding deficit was about 20 billion rubles, this problem was solved by switching funding for the pediatric cohort of patients from the high-cost nosology program to the sources of the Circle of Goodness Foundation. But after almost five years, the effect can be called lost, and the issue of drug supply is relevant again," the appeal says.
VSP believes that it is necessary to double-check the calculation of regional needs at the level of federal and regional information systems, which should take into account 15 months.
The Federal Center for Planning and Organization of Drug Provision for Citizens is engaged in the organization and implementation of drug purchases under the state program "14 VZN".
within the limits of budget obligations brought to him by the Ministry of Health,
— The organization of the provision of the Federal Center at the expense of the federal budget to patients with drugs from the "14 VZN" is carried out in accordance with the procedures for providing medical care approved by the Ministry of Health, taking into account the standards of medical care and based on clinical recommendations based on the monthly actual need of patients for medicines and the need to form a stock of drugs for 15 months, — noted in the press- the department's service.
They also reported that applications from patients with multiple sclerosis in the third quarter of 2025 were associated with a delay in the delivery of the drug by the manufacturer and now the situation is under the control of the Ministry of Health.
What medicines are missing
The VSP letter notes that residents of 28 regions reported problems with the provision of medicines for the "14 VZN" in 2024-25. The complaints concerned, for example, medications for hemophilia or multiple sclerosis.
"For most drugs, purchases for 2025 were carried out at least in the amount of six months of annual demand, but in these regions, for some reason, the continuity of preferential drug provision has not been ensured," the appeal emphasizes.
According to the VSP, as of October 2025, the most significant delays are in the procurement of five drugs for the treatment of hemophilia, two for the treatment of malignant neoplasms and five for multiple sclerosis.
The patient organization clarified that drugs for hemophilia were not purchased in the amount of about 3.3 billion rubles, for the treatment of malignant neoplasms — about 3.1 billion and for multiple sclerosis — 2.7 billion.
For example, patients from Moscow, Moscow region, St. Petersburg, Ulyanovsk, Saratov, Tver, Tyumen, Orel, Rostov, Smolensk regions, as well as Tatarstan, Bashkiria, Perm and Krasnoyarsk territories reported problems with drug provision under the state program only in 2025, it follows from the data of relevant organizations.
A patient with hemophilia, on condition of anonymity, told Izvestia that in April 2025 she was faced with the non-release of the drug and stayed without therapy for more than a month.
— Until May, I used the leftovers that I had accumulated during treatment, then they ran out, and I had to look for a cure among other patients. I was given my medicine only in June," she said.
Another patient from the Moscow region with multiple sclerosis told Izvestia that in the fall of 2024 she was faced with the non-delivery of a vital drug to her, and the situation was resolved only a few months later. According to her, while she did not have the medicine, patients from other regions shared it with her.
Elena Khvostikova, head of the Genome Patient Care Center, stressed that it is necessary to provide orphan patients with uninterrupted treatment under the state program, because such patients cannot wait. According to her, the interruption of therapy is often fraught with irreversible consequences.
Count us, please
The underfunding of the 14 VZN program has been a problem for more than a year, said Yuri Zhulev, co—chairman of the VSP, to Izvestia.
— The lack of money in the state program is largely a consequence of natural processes. In particular, the increase in the number of patients enrolled in the program, the growing age of the pediatric cohort and the rising cost of drugs," he said.
According to VSP estimates, over the past four years, more than a thousand new patients have been added to the registry.
Nikolay Prokhorenko, an expert in the field of public health, agreed that problems with the provision of medicines to patients from the "14 VZN" may be related to their incorrect accounting.
— Since the Soviet era, no one has systematically assessed the population's need for medical care. The last serious research was 40 years ago. Therefore, there is an imbalance between the need and the money that is allocated," he stressed.
Also, according to Yuri Zhulev, drugs are becoming more expensive due to logistics and rising prices for raw materials, which also leads to increased costs for the state program.
— If the program were adjusted annually at least for inflation, it would avoid the deficit, which today forces the regions to look for internal reserves and redistribute drugs, — he is sure.
The share of foreign supplies and equipment is still quite large, so industry inflation, if calculated, will be higher than the official state inflation, which exacerbates the financial situation, explained Nikolay Prokhorenko.
What possible sources of financing
The issue of underfunding the state program "14 health insurance" was raised on October 8 at a meeting of the State Duma Committee on Health Protection, its head Sergey Leonov told Izvestia.
— I addressed my question to Pavel Kadochnikov, Deputy Minister of Finance. He confirmed that work is underway in this direction, and noted that the Ministry of Finance will seek funds to increase funding under the state program, he added.
Larisa Popovich, Director of the Institute of Health Economics at the National Research University of Higher School of Economics, agreed that healthcare is always underfunded.
— No matter how much money you allocate, it will always be insufficient. We need to learn how to make do with what we have, spend this money in a focused and efficient way," she stressed. — Now I am not sure that money for additional financing of the program can be found. Regardless of the situation, Russia always spends about 10% on healthcare, and this is quite comparable with European figures.
But Nikolay Bespalov, Director of development at the RNC Rhagma analytical company, is confident that it will be feasible to find money for additional financing of the 14 VZN state program. But he noted that there are other areas in healthcare in which the situation with underfunding is more complicated. These, for example, according to him, include hepatitis C and HIV.
Izvestia sent a request to the Ministry of Finance with a request to assess the situation with the financing of the state program "14 VZN" and comment on whether the ministry is discussing an increase in costs for it and from what sources.
The press service of the ministry, in response to a request from the editorial board, reported that, together with the Russian Ministry of Health, "they are working on the possibility of allocating budget allocations in this area." However, they noted that it is premature to talk about specific amounts of funding now.
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