Antiresus factor: immunoglobulin for pregnant women has disappeared from pharmacies
In 75 Russian regions, pharmacies do not have antiresus immunoglobulin, which is vital for some pregnant women, Izvestia estimates. However, it can be said that there is practically no drug in the rest of the country — there is only one package of medicine available in pharmacies in some regions. According to the Ministry of Health, 45 thousand packs of the drug should be delivered to medical institutions in the near future. The interruptions are related to the re-registration of the maximum selling price, the regional Ministries of Health noted.
Where there is no antiresus immunoglobulin
The drug for the prevention of Rhesus conflict in pregnant women, antiresus immunoglobulin, is currently available only in 14 Russian regions, Izvestia calculated using a pharmaceutical aggregator in the Honest Sign labeling system.
The drug is available in several pharmacies in Moscow, Tatarstan and Bashkiria. But in the Moscow, Rostov, Samara, Orenburg, Chelyabinsk, Sverdlovsk regions, St. Petersburg, Krasnodar and Krasnoyarsk territories, Karachay-Cherkessia and Dagestan, there is an extremely limited amount of it: in some places there is only one package per region.
In the remaining 75 subjects, there is no antiresus immunoglobulin in pharmacies.
Pregnant women complain on social media that they cannot get the injection they need in their region of residence. So, Irina from Nizhny Novgorod shared that she was forced to look for a medicine in several cities, and its price reached 26 thousand rubles. As a result, she found the drug in Moscow, and her friends helped with its transportation.
"There is no availability in the antenatal clinic, there is no maternity hospital, I searched pharmacies — neither in stock nor on order. A call to the insurance company did not help, as a result, they did not put it either in the previous pregnancy, or now, in the second one," wrote another pregnant Julia.
Another social media user shared that she could be given antiresus immunoglobulin, but needed to take a bus to another city and "stay in the hospital for four days." In addition, women report that they have not been able to receive medicine in hospitals in their region of residence. Some of them called the hotlines of the local ministries of health, after which they received the necessary injection.
According to the Leningrad Region Health Committee, 338 packages of the drug remain in the region's public hospitals with an annual requirement of 1.5–2 thousand doses.
"The drug is currently not on the market. As soon as it goes on sale, purchases are carried out immediately," Izvestia was informed there. — In 2026, the committee received three requests regarding the provision of antiresus immunoglobulin. Two patients were provided from the reserves of medical organizations, one administered the drug on her own, and its cost was reimbursed by the medical organization at the place of attachment."
There are 1,408 vials of medicine in medical institutions in the Irkutsk region, and 62 in Karelia. There are 1,282 ml left in the Vladimir region, which covers the need for two months. This was reported in the regional Ministries of Health. The availability of the drug was also reported in Moscow, Khakassia and the Bryansk region.
What is the reason for the supply disruptions?
"Human immunoglobulin antiresus" belongs to the hospital category, the press service of the Ministry of Health reminded Izvestia, that is, medical organizations purchase it directly for day and obstetric hospitals, the drug is administered free of charge under the state guarantees program.
According to the ministry, there are now more than 47 thousand packs in civil circulation. The department called such a reserve sufficient.
"Additionally, we note that on April 23, Roszdravnadzor issued a permit to put about 45 thousand packages into civil circulation, which will arrive in the regions of the Russian Federation in the near future," the ministry said. "The total amount of the drug in 2026 has already amounted to 53% of the volume of input in 2025."
According to the most conservative estimates, the need for antiresus immunoglobulin is 220-230 thousand packs per year, Nikolai Bespalov, Director of Development at RNC Pharma, told Izvestia.
Permission to enter the previous batch was received on January 19, the Ministry of Health of the Irkutsk region clarified.
"The interruption in the timing of the introduction of a medicinal product into civil circulation is associated with the re—registration of the maximum selling price," the response to a request from Izvestia says. "After the introduction into civil circulation, deliveries under the concluded contracts will resume in the near future."
The price re-registration is due to the fact that the drug is on the list of vital and essential medicines (VED), explained Nikolay Bespalov.
"Rather, the reason is that the price does not cover the costs of production and logistics, and supplies are becoming unprofitable for the company," he added.
The Ministry of Industry and Trade provided Izvestia with slightly different data on drug stocks.
"As of April 2026, the subjects of drug circulation have remnants of drugs with the INN "Human Immunoglobulin antiresus" Rho[D] with a total volume of more than 50 thousand packages, which corresponds to 25% of the average annual consumption of these drugs for 2023-2025," the ministry said.
They noted that the Ivanovo regional Blood Transfusion station has already produced about 9 thousand packages of the drug, and this batch should be put into circulation by the end of April.
"The Ministry of Industry and Trade, together with interested federal executive authorities, is working on the issue of increasing production in the Russian Federation of both the drug itself and the raw materials for it," the ministry added.
Since the beginning of 2026, more than 25 thousand packs of antiresus immunoglobulin have been delivered to Russian hospitals, the Headway Company monitoring company told Izvestia. In addition, contracts were signed for the supply of another 21 thousand packages of the drug. According to the company, in 2024, 153 thousand packs of antiresus immunoglobulin were delivered to government agencies, and in 2025 it was already less than 120 thousand.
Causes of drug shortage
Last year, the situation with antiresus immunoglobulin improved: by the end of 2025, the Russian healthcare system received a total of 185.5 thousand packages of the drug, which is 88% more than in 2024, said Nikolai Bespalov.
"But it's noticeably less than the actual need for the drug,— he said.
This year, in the first quarter of 2026, the Russian market received 16.6 thousand packages of the drug, while 69.2 thousand were shipped during this period last year.
— There are several reasons for this. First of all, extremely high import dependence. The only Russian manufacturer is the Ivanovo Blood Transfusion Station. Over the past three years, they have been producing approximately 9,000 packages of antiresus immunoglobulins, and in the best years they provided a maximum of 22-23 thousand," said Nikolai Bespalov.
The company accounts for only 4-5% of the market, he stressed.
"The second important factor is related to the total shortage of hyperimmune human blood plasma in the world, and due to the events in Iran, this problem will only increase in the near future, since it was the Islamic Republic that acted as one of the largest suppliers of plasma," the expert said.
According to him, positive developments should not be expected in the near future. It is technically difficult to increase the total volume of drug production in Russia, as it will require a serious expansion of the processing capacity.
Who needs immunoglobulin
Pregnant women with a negative Rh factor need immunoglobulin if their child's father is Rh-positive or his status is unknown, gynecologists told Izvestia.
"The first injection is given prophylactically at 28-30 weeks of pregnancy, since it is during this period that the risk of fetal blood entering the mother's bloodstream increases," explained Angelina Lebedeva, an obstetrician—gynecologist at the Be Healthy clinic on Sushchevsky Val. — The second injection is given strictly within 72 hours after delivery, if the baby was born Rh-positive. If he has a "minus", a second injection is not needed.
If a woman does not prevent Rhesus sensitization (an injection of immunoglobulin), then a serious complication may develop - rhesus conflict, and as its outcome, fetal hemolytic disease, said Artemy Shifts, an obstetrician—gynecologist at the UNI Clinic Medical Center.
"The mother's immune system attacks the fetal blood, destroying it, which causes severe anemia in the unborn child," the doctor explained.
Among the consequences are brain damage, swelling, and even the death of a baby in the womb, Angelina Lebedeva added.
— For the first pregnancy, the risk is minimal, but without an injection, the mother's body can produce antibodies. During the next pregnancy, these antibodies will already start attacking the red blood cells of the fetus," she said.
There is no way to prevent Rhesus conflict before pregnancy, except for the IVF procedure, noted Artemy Shifts.
There is a non-invasive test that allows you to determine the Rh factor of the fetus from the tenth week of pregnancy using the mother's blood. If the test shows that the fetus is Rh-negative, you will not have to give the injection, Angelina Lebedeva clarified.
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