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- Technique of loss: in the regions, there are interruptions with cancer drugs methotrexate and etoposide
Technique of loss: in the regions, there are interruptions with cancer drugs methotrexate and etoposide
In 80 Russian regions, pharmacies do not have etoposide, a drug that is used to treat several types of cancer, Izvestia found out. And 57 subjects do not have methotrexate, another antitumor drug. Mass complaints about the shortage of these drugs were also reported to the publication in patient organizations. According to doctors, these drugs are especially urgently needed for the treatment of childhood cancer. At the same time, the supply of etoposide and methotrexate in tablets is decreasing, analysts noted.
Which regions lack etoposide and methotrexate
Cancer—stricken Russians complain en masse about the lack of medicines they need, which are included in the list of vital and essential medicines, such as the antitumor drugs methotrexate and etoposide. A member of the Human Rights Council under the President of Russia (HRC), president of the All-Russian Association of Cancer Patients "Hello!" told Izvestia about this. Irina Borovova.
— This is a tense topic, because calls to the Hello! association about the absence of methotrexate and etoposide are received from patients from Kaliningrad to Kamchatka. If earlier it was spot—on, there were solutions, now it is a large-scale problem," she explained.
According to Irina Borovova, high-dose methotrexate is in short supply, and patients have not found the remnants of the drug even in pharmacies. Charitable foundations in some regions are going to purchase an Indian drug, the expert noted.
Methotrexate and etoposide are important in the treatment of cancer and hematological diseases. Methotrexate is also used to treat rheumatoid arthritis (an immune disease in which the body's own cells attack joint tissue), Marina Shorina, an oncologist and chemotherapist at the Euroonko clinic network, told Izvestia.
"The drugs are suitable for many types of chemotherapy, they have no analogues," she said. — There are intravenous and tablet forms of administration, but replacing one form with another depends on the treatment regimen, sometimes this cannot be done.
These drugs are especially important for the treatment of pediatric oncology, said Evgeny Ledin, chief physician of the Ledin Clinic. According to him, these drugs are used in protocols for children more often than for adults.
— Adult oncologists in general can survive their absence. Although there are two diseases where etoposide is more important: testicular tumors in men and small cell lung cancer," he noted.
Methotrexate and etoposide are absolutely necessary elements of chemotherapy for many tumor diseases in children, confirmed pediatrician, oncologist Alexey Maschan.
— Their deficiency can lead to a violation of treatment protocols and, consequently, to a deterioration of delayed results. These deteriorations are not visible on the horizon of a year or two, but may manifest themselves in five to seven years, when it becomes clear that the removal of some key element from the protocols has an absolutely unfavorable effect," he noted.
The remnants of methotrexate and etoposide are concentrated in Russian hospitals, Roszdravnadzor told Izvestia.
"The situation with the release of these oncological drugs into civilian circulation is stable, manufacturers are fulfilling their stated production plans. The latest release into civil circulation of a drug with INN (international nonproprietary name. — Ed.) "Etoposide" was produced on April 13, and with INN "Methotrexate" — on April 27," they added.
The agency noted that now the remains of methotrexate in various forms amount to more than 2.4 million packages, and etoposide — more than 135 thousand packages.
Izvestia also sent a request to the Ministry of Health.
Where are the medicines available
Medicines with the active substance etoposide "Izvestia" were found in pharmacies in only nine Russian regions — Moscow, St. Petersburg, Rostov, Sverdlovsk, Orenburg, Chelyabinsk regions, Krasnodar Territory, Tatarstan and Bashkiria. These are data from both pharmacy aggregators and the Honest Sign pharmacological aggregator system.
In the first quarter of 2026, the Russian market received 51.6 thousand packages of this drug, Nikolai Bespalov, Director of Development at RNC Pharma, told Izvestia. This is 58% less than in the same period of 2025.
— The volume of supplies has been fluctuating noticeably over the past few years. But the overall trend is still downward: in the period from 2016 to 2020, the average annual volume of receipts was 416 thousand packages, and in the period from 2021 to 2025 — only 326 thousand packages," the expert noted.
According to Nikolai Bespalov, the drug is practically not available in retail. About 4 thousand packages are sold there per year, that is, less than 2% of the total volume.
Medicines with the active ingredient methotrexate are sold in 32 regions. These are, in particular, Moscow and the Moscow region, Tatarstan, Kaluga, Voronezh, Nizhny Novgorod, Samara, Tula, Tver, Yaroslavl, Bryansk, Orel, Vologda and Kursk regions, as well as St. Petersburg.
In the first quarter of 2026, 1.32 million packages of medicines entered the Russian market (+34% year-on-year), Nikolay Bespalov added. Most of them are methotrexate for injection (1.2 million packages).
— The pills are getting worse. In the first quarter of 2026, the market received 121.6 thousand packages. Almost the same number was recorded in the first quarter of 2025. The total volume in 2025 amounted to 362.6 thousand packages, which is 38% less than in 2024. There has been a clear downward trend in tablet forms of release in recent years," said Nikolai Bespalov.
The drug is sold in a noticeably larger volume at retail, he said. So, in the first quarter of this year, pharmacies sold 717 thousand packages of injectable methotrexate, which is 31% more than in the same period last year. As well as about 166 thousand packs of tablets (+33%).
— In 2024-2025, sales of tablet forms in pharmacies were relatively stable — at the level of about 537 thousand packages, but given that supplies are stagnating here, they probably do not cover the demand, which has increased significantly this year, — said Nikolay Bespalov.
According to the analytical company DSM Group, in the first quarter of 2026, sales of methotrexate packages in pharmacies increased by 32% compared to the same period last year. In addition, the volume of public procurement has increased in exactly the same way. For etoposide, the volume of government purchases increased by 14% over the same period.
The Headway Company monitoring company told Izvestia that since the beginning of 2026, state contracts have been concluded for the supply of 1.39 million packages of methotrexate and 170.6 thousand packages of etoposide. At the moment, 1.16 million and 65.3 thousand packages have actually been delivered, respectively.
According to the company, in recent years, public hospitals have signed fewer and fewer contracts for the purchase of these drugs. So, in 2024, contracts were signed for the supply of 4 million packages of methotrexate and 287 thousand packages of etoposide. And in 2025, only 3 million and 198,000, respectively.
At the same time, according to the invoices available to the Headway Company, in 2024, only 2.08 million packages of methotrexate and 216.3 thousand packages of etoposide were delivered. In 2025 — 2.2 million and 160.3 thousand, respectively.
Переведено сервисом «Яндекс Переводчик»
