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- The law changes the need: the State Duma proposed to provide certificates for the purchase of medicines to the poor
The law changes the need: the State Duma proposed to provide certificates for the purchase of medicines to the poor
A new measure of support for low-income citizens may appear in Russia. We are talking about special certificates for the purchase of medicines. The corresponding initiative was made in the State Duma. The proposal looks timely and socially significant, since today many low-income families cannot afford even the most necessary medicines, experts say. Whether the adoption of the bill will help poor citizens is in the Izvestia article.
A new measure to support the poor
The State Duma proposed to introduce a special certificate for the poor to receive medicines. A corresponding inter-factional bill has been submitted to the lower house of parliament. The new rule will affect a number of citizens whose per capita income is below the subsistence level. We are talking about poor families, poor people living alone and people who find themselves in a difficult life situation.
The certificate will allow its owner to purchase medicines for a fixed amount of money allocated. The measure will apply to medicines from the list of vital and essential medicines.
The certificate will be valid on the territory of the subject of the Russian Federation that issued it. Its nominal value will be 25% of the subsistence minimum per capita in Russia.
The proposed support measure will be declarative in nature. The authorities of the constituent entities of the Russian Federation will be authorized to appoint and provide medical certificates. The costs of the initiative will be financed with the help of subventions from the federal budget.
"Low—income citizens, as well as citizens who find themselves in a difficult life situation, who do not belong to the categories of citizens eligible for free or preferential purchase of medicines, very often do not have the means to purchase medicines recommended by their doctor in case of illness and treatment at home," the authors of the initiative emphasize in an explanatory note. to the draft law.
The adoption of the bill, according to parliamentarians, will allow needy citizens to buy medicines without seeking help from social protection authorities, strengthening their health. It is also expected that this will have a positive impact on the demographic situation in the country. If adopted, the law will enter into force on January 1, 2026.
Help for those in need
The initiative of the parliamentarians looks timely and socially significant, said Artur Tumashevich, a practicing dentist and adviser to the Russian Association of Anesthesia and Safe Dentistry. Today, many low-income families face the fact that they cannot afford even the most necessary medicines.
— According to research, up to 80% of low-income citizens refuse to buy drugs at least once a year due to financial reasons. Therefore, an addressable form of support in the form of certificates for medicines is a really necessary tool that can partially close this gap, the Izvestia interlocutor is sure.
Certificates for the purchase of medicines are a significant help to the poor, especially in the current situation in a country characterized by high inflation and a cooling economy, when price increases significantly outstrip incomes, Alexey Nezhivoy, head of the operational headquarters of the independent trade union Novy Trud, is convinced. This measure will be especially relevant for large families.
"Today, the state faces the task of overcoming the demographic decline, and this law can become one of the tools to solve it, because in times of economic crises, large families often find themselves below the poverty line, especially in the regions," the expert draws attention.
An additional measure of social support will solve the problem of access to medicines for groups of the population who do not fall under the existing preferential categories, but face financial difficulties due to rising prices for medicines, agrees Sean Betrozov, a lawyer at the Moscow Chamber of Lawyers and a member of the Russian Bar Association.
— Now the poor, who are not included in the preferential medical categories, often find themselves between the two systems: Compulsory medical insurance covers services, but not most outpatient medications, and regional benefits are targeted at narrow groups. A personalized certificate closes this problem," he believes.
Taking into account the deficit
According to the initiative, the nominal value of the certificate will be 25% of the federal minimum subsistence level per capita, which in 2025 is 4.5 thousand rubles, Betrozov recalls. This amount may be a starting amount, but to fully cover the needs of the poor, it should be increased to 7-10 thousand rubles or tied to 40-50% of the subsistence level.
"This is based on estimates where the average cost of medicines for low—income Russians, including pensioners, exceeds 5-6 thousand rubles per month for chronic diseases, and for families — up to 10% of total income," the lawyer explains.
A sufficient amount should be calculated based on the fact that drug prices are rising by 5-10% annually, and regional differences should be taken into account, the Izvestia interlocutor emphasizes. An individual calculation based on medical needs, as in the pension compensation program, would be ideal.
At the same time, it is important to understand that the certificate covers only medicines from the list of vital and essential medicines (VED), adds Betrozov.
"Its nominal value may be enough for basic needs such as antibiotics, painkillers or cold remedies, but it will not be enough for expensive medicines, for example, for oncology or rare diseases," he draws attention.
If we are talking about maintaining general health, for example, the prevention of seasonal diseases, then the money offered is enough, Alexey Nezhivoy agrees. However, in the case of diabetes, progressive lung diseases, cardiovascular pathologies and other ailments that cause serious and long-term damage to health, the proposed amount will not be enough.
For chronically ill people or families with children, the amount should be higher, Artur Tumashevich urges.
— In order for the measure to really work, it is necessary that the amount of the certificate is not symbolic, but corresponds to the average monthly cost of medicines per person, — the doctor is convinced.
The issue of the availability of medicines in pharmacies remains significant, says Nezhivoy. Due to the disruption of global connections, many technological supply chains could not be restored. This is especially true for European and American-made drugs.
— Therefore, the certificate must be supported by legislative quotas of vital medicines for these categories of citizens. That is, when supplying analogues or original drugs to the regions, a certain amount should be allocated, reserved specifically for these purposes, so that the certificate can really work, the expert believes.
Bring it to the ideal
The main source of funding for the initiative, according to the bill, is the federal budget, which already provides funds for the provision of medicines to citizens, said Sean Betrozov. In 2025-2026, expenditures will exceed 580 billion rubles, including programs for beneficiaries.
The project can also be financed by redistributing funds from less effective social programs, admits Artur Tumashevich. At the same time, it is important to introduce digital control so that assistance really reaches those in need.
Among other options for financing the purchase of medicines, Betrozov allocates compensation from the state budget for spending on medicines over 10% of family income, discounts on VED and targeted taxes or fees for healthcare.
— The Ministry of Finance is already providing full financing for such obligations, so that the initiative can be integrated without significant deficit, — the lawyer believes.
In the long term, its implementation will lead to a reduction in the burden on the healthcare system, Tumashevich does not exclude, because timely treatment will reduce the number of hospitalizations and exacerbations of chronic diseases.
"The introduction of personalized drug certificates is the right step if it is implemented in a targeted, transparent manner and taking into account the real economic situation," the doctor is convinced.
However, there are also open questions that the bill leaves behind, says lawyer Yuri Kapshtyk. In particular, it should be borne in mind that the algorithm for using medicines implies that the drug is needed here and now.
— And according to the bill, you need to go through the identification procedure and prove that you fall into a privileged category of the population. And here the timing of formal approval, registration of the certificate, and so on, which are not defined by the document, play an important role," the expert points out.
The procedure for issuing and accounting drugs according to the certificate has not been clarified, he clarifies. It is not even clear whether pharmacies that sell these drugs should be certified in any way.
— The wording that the certificate applies to the issuance of medicines recommended by a doctor is also confusing. It is important to keep in mind that the recommendation does not mean mandatory application. And besides, doctors have some personal preferences regarding medications. Sometimes doctors are interested in promoting a certain range of drugs, for which they can receive additional remuneration from pharmaceutical companies," Kapshtyk recalls.
With this in mind, the bill seems to him to be unfinished and has many inconsistencies and shortcomings, and therefore the document requires serious revision.
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