Medical disguise: how Russians are looking for scarce cancer drugs
In Russia, there is a paradoxical situation with the antitumor drug abraxane: since 2024, its purchases at the expense of the Compulsory Medical Insurance Fund (CHI) have stopped, but doctors continue to prescribe it. Several specialists noted at once that patients for whom the remaining possibilities of chemotherapy have already been exhausted need it, that is, there are no complete analogues of it. The regions can buy the medicine at their own expense, but the volume of purchases is extremely small. Therefore, doctors recommend that patients find the drug on their own, and they turn to resellers. The danger of such purchases is described in the Izvestia article.
How to buy the drug
The drug abraxane for the treatment of breast and pancreatic cancer has been rapidly disappearing from pharmacies since 2024, Izvestia wrote. That year, they stopped buying it for compulsory medical insurance — for hospitals and polyclinics. But regions can purchase the drug at their own expense.: its registration in Russia is valid until the end of 2028.
Oleg Kryzhanovsky, a Muscovite, is 49 years old and has metastatic pancreatic cancer of the fourth stage. Since September 2025, he has been undergoing treatment with abraxane under the compulsory medical insurance, his wife Oksana told Izvestia.
— The doctor prescribed treatment with abraxane, which is used in combination with gemcitabine (an antitumor drug. — Ed.). This is a special scheme for this type of oncology. But recently, on April 6, the doctor reported that Abraxane was not in the clinic. We were told to look for the drug on our own, they wrote out a prescription," she explained.
According to her, two vials are needed for one infusion (the cost of each is about 75 thousand rubles), you can not take a break from treatment.
— I found one bottle each in two pharmacies in Moscow, I booked it, but they called me from the pharmacy for one package and said it was defective, the reservation was canceled. I looked in other regions, the website indicates the availability of one or two pieces in five regions," Oksana said. — We are starting a new course on Thursday, and it is not yet known whether the clinic will have the drug or not. The doctor said that if there was no abraxane, we would continue treatment with one drug. But the effectiveness of treatment is achieved by combining two drugs, of which abraxane is the most important.
A year ago, Nadezhda's mother died of pancreatic cancer in Moscow. And there were interruptions with the drug even then.
— When my mother was undergoing chemotherapy with this drug, I met a woman. Her mother was in a private clinic, too, and she gave me the phone number of a private provider," the woman explained.
Now Nadezhda is engaged in volunteering and helps cancer patients find medicines. Just the other day, five people approached her with a request to find abraxane.
— Everyone is ready to buy and go. This is hopelessness: people have chemistry on Saturday, but there is no drug," said Nadezhda Lee.
Svetlana Antonova faced a similar situation, her father is being treated for cancer in Moscow, and there is no such drug in the medical facility.
— And there is no abraxane anywhere in large chain pharmacies. I came across an opportunity to order at one of the online pharmacies. You can't pick up the drug at their address, only by courier," she said.
The woman met with the courier, but did not buy the medicine from him.: She was confused by the packaging of the drug, which had a barcode smeared on it and all the information about the drug was in a foreign language. Svetlana decided not to take any chances.
Izvestia talked to one of the private suppliers, but he did not say where exactly the medicine was coming from.
"Maybe it's some kind of primary or secondary packaging," the man said.
Why did you stop buying compulsory medical insurance
—There are no complete analogues of abraxane, it is the only such drug of its kind," Marina Shorina, oncologist and chemotherapist at the Euroonko clinic, explained to Izvestia. — A large number of Russians need it, for whom the remaining possibilities of chemotherapy have already been exhausted.
Evgeny Ledin, the head physician of the Ledin Clinic, also confirmed that abraxane has no analogues.
— In the case of pancreatic cancer, the drug has virtually no alternative. It has proven its effectiveness in the treatment of various types of tumors and is included in all international recommendations, including Russian ones," he added. — Currently, the treatment options for our patients are slightly lower than the best international practices.
But he is a member of the Human Rights Council (HRC) under the President of Russia, president of the All-Russian Association of Cancer Patients "Hello!" Irina Borovova said that instead of abraxane, a drug with the international nonproprietary name paclitaxel is being purchased under compulsory medical insurance (it is produced, in particular, in Russia, Belarus and India).
— And abraxane was in analogues and cost more expensive — six or seven times. The manufacturer has left the Russian market, but we have an absolute copy — paclitaxel," she said.
Polina Gabay, a lawyer and chairman of the Board of founders of the National Analytical and Expert Center for Healthcare, reminded Izvestia that abraxane was excluded from the schemes of antitumor drug therapy, which can be prescribed for a particular clinical and statistical group of diseases in hospitals. The reason is that starting in 2024, drugs that are not included in the list of vital and essential medicines (VED) will not be included in the CSG payment system.
— This is due to the fact that there is no registered price for drugs outside the list of VED, which means it is impossible to calculate the tariff, — said the expert.
antitumor picray (INN alpelisib) suffered a similar fate to abraxane in 2024, but later it was included in the VED, and now there is a separate treatment regimen for it in combination with another drug.
Irina Borovova noted that Russian patients receive treatment almost in full, otherwise the budgetary institution is severely punished.
— Every cancer patient needs drug therapy. However, sometimes they cannot receive certain medications. In some cases, the patient has the opportunity to buy something on their own. But when the cost of life—saving therapy is measured in hundreds of thousands of rubles, a person begins to panic and bang on all doors to get a drug that will save his life," she said.
At the same time, she noted that budgetary medical institutions are unlikely to agree to administer the drug purchased by the patient.
— Patient organizations have helped ensure that patients have a legitimate opportunity to buy the drug on their own. However, the final decision on its administration remains with the attending physician, since he is responsible for the life and health of the patient. He must make sure of the quality of the drug," she said.
The fact that abraxane is not on the list of VED does not mean a ban on its purchase at the expense of budgetary funds, Irina Gritsenko, a lawyer in the field of medical law, confirmed to Izvestia.
The list primarily regulates issues of pricing and guaranteed provision, but does not completely limit the possibility of prescribing and purchasing medicines.
"The drug can be prescribed to a patient by decision of a medical commission if there are medical indications, including individually and in the absence of alternative therapy," the lawyer added. — In such cases, the regions have the right to purchase the drug within the framework of territorial programs of state guarantees, oncological programs or other financing mechanisms.
How regions purchase abraxane
Over the past four years, the supply of abraxane to the Russian market has been small, averaging about 21 thousand tons. packages per year, Nikolai Bespalov, Director of Development at RNC Pharma, told Izvestia.
— In 2024, the market received 19 thousand packages of the drug, and in 2022 — 22 thousand. The drug was last put into circulation in November 2025. Probably, the accessibility problem is related to this fact," he explained.
The expert stressed that another delivery took place in March 2026, but so far it has probably not reached the patients.
— The very fact of continued supplies can be perceived positively, which means that the situation should improve, — said Nikolai Bespalov.
He specified that the vials are produced in the USA, then the drug is packaged in Germany.
According to the expert, in 2024, the Indian company Jodas Expoim supplied a small batch of alternative medicines, but they could not reach large volumes.
According to the Cursor analytical company, reviewed by Izvestia, since the beginning of 2026, abraxane has been purchased by state clinics in 27 regions of Russia — for a total amount of more than 340 million rubles.
Moscow purchased the largest amount of the drug (more than 3.6 thousand), Omsk Region purchased more than 750 packages, Chuvashia purchased more than 350 packages, and Arkhangelsk, Lipetsk, Sakhalin, and St. Petersburg purchased more than 200 packages. The rest are less than 100 packages.
Why is it dangerous to buy drugs by hand?
Drugs illegally imported into Russia are mostly sold through online pharmacies and Telegram channels, pharmaceutical safety expert Alexander Nosenko told Izvestia.
"People in difficult situations take risks and buy medicine not from official distributors, but where it is available, but it is contraband," he said. — The so-called ant smuggling, when sellers and couriers carry these medicines in suitcases, bags, and airbags. And this is all done on a daily basis. And this is how these drugs enter the Russian market.
Indirect signs of contraband goods, according to him, are a low price, payment in cash or by transfer, as well as the ability to receive goods only through a courier.
Alexander Nosenko warned that buying by hand, you can get not medicines, but fake pacifiers.
— You need to be extremely attentive to your health, not to experiment and not to chase a cheap price, — he stressed.
It is dangerous to buy medicines by hand, as they can sell another drug under the guise of one drug, Marina Shorina also warned.
— It is unknown whether the norms of light, temperature storage, and humidity of the room were observed. This is always monitored during the official purchase," she noted. "There can be no getting away with it. You can critically harm yourself, and the treatment will follow a sad scenario.
Abraxane does not require special storage conditions, which reduces the likelihood of buying a tainted drug, Evgeny Ledin told Izvestia. According to him, there are practically no clandestine drugs or drugs stolen from the healthcare system in Russia right now. But sometimes patients' relatives may sell them.
— People still have some drugs, they post this information on the forums. Someone abroad brings drugs for personal use," he said.
But buying with your own hands is always a pig in a poke, the expert emphasized.
The trafficking of counterfeit, substandard or illegally imported medicines is a criminal offense against pharmacies and other organizations, Iryna Hrytsenko said.
"In this case, Article 238.1 of the Criminal Code of the Russian Federation, which provides for liability for the handling of falsified, substandard and unregistered medicines, is subject to application," she explained.
The expert stressed that prescription drugs cannot be sold through a courier.
"If a prescription drug is actually dispensed without a prescription, this may qualify as a violation of licensing requirements and entail administrative liability, up to and including suspension of operations," she said.
The expert stressed that the courier can be considered as an accomplice to the offense.
A private individual in Russia does not have the right to sell medicines — this is possible only through organizations that have the appropriate license, Irina Gritsenko emphasized. Even if we are talking about the remnants of drugs purchased legally for treatment.
Anton Pivovarov, a lawyer at the Moscow Sed Lex Bar Association, stressed that the case could be initiated not only under art. 238.1, but also under art. 159 of the Criminal Code of the Russian Federation "Fraud". For example, a clinic may purchase a large number of supposedly certified drugs, but in fact they turn out to be counterfeit.
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