What medications are available by prescription? 1. New rules for dispensing medications: stop panicking
On September 22, new rules for the sale of medicines in pharmacies came into force. Now it can be difficult or impossible to buy the right drug. Pharmacies require prescriptions and even take them for storage. And they may not sell the medicine to relatives at all: they will ask for a power of attorney.
We've looked at the new rules and will explain how they work. The order of the Ministry of Health is complex and incomprehensible even for pharmacists, so clarifications have already been issued for it. We also studied them.
How was it before?
Prescription drugs have always had to be sold by prescription. Each category has its own sales and accounting rules. Such drugs are marketed under strict federal regulations, but pharmacies have not always complied with them.
Previously, you could take one prescription and use it to buy as much medicine as you wanted. Doctors did not indicate the timing, and pharmacists did not pay attention to this. And they could only collect prescriptions in rare cases and for dangerous drugs.
No one monitored the dosages of conventional sedatives and did not mark on the prescription how much and when it had already been purchased. And often they didn’t ask for the recipe at all.
Even if you previously bought an antibiotic, a sedative, or medicine for your grandmother without a prescription, this does not mean that the drug is actually on sale. Even common medications are on the prescription list, and purchasing them can now be a problem.
How now? Where can I buy medicine?
It depends on whether a prescription is needed and what category the drug belongs to. There are several such categories; it is pointless to study them all in advance, but you need to keep it in mind.
Narcotic and psychotropic drugs can only be sold by pharmacies with special permission. There are limitations for immunobiological preparations: for example, a vaccine for inoculating a child can only be bought at a pharmacy or pharmacy point, and only if there is a thermal container. There are also differences in the prescription forms.
If your doctor has given you a prescription, it is best to find out in advance where you can buy it. And don’t be surprised if some pharmacies don’t sell the drug. This is not their whim, but a requirement of the law.
If you need a prescription for a medicine, what should you do?
You need to get this prescription: otherwise the pharmacy will not sell the drug. Even if the medicine is needed urgently or is taken constantly, and there is no time to go to the doctor, it still won’t sell. Maybe in some cities there are pharmacies that manage to circumvent the rules, but it’s better not to count on this: the law is the law.
If you need a prescription for a medicine, you will have to present it at the pharmacy. And the pharmacy has the right to take away this prescription if required by the new rules. That is, you will not be able to buy this medicine a second time using the same prescription.
Recipes are also divided into several types. There are recipes for one time, urgent, for free holidays and various others. The prescription may last for several days, months or a year. You can buy a prescription medication only while it lasts. The pharmacy can take it away for good or return it with a note: how much and when it was sold, in what dosage and for how long it will last.
Is it possible to buy in reserve? More antibiotics, painkillers and blood pressure pills.
No, now you won’t be able to buy in reserve. According to the rules, the prescription will sell as much of the drug as the doctor prescribed.
Pharmacists should monitor this. Even if you ask the doctor for a prescription with a reserve, the pharmacy will not sell that much, and they will even report a violation.
How do I know how long a prescription lasts?
Not all prescriptions indicate an expiration date. Some doctors don’t pay attention to this, but pharmacists generally didn’t care: the main thing is that there is a prescription.
Pharmacists must monitor deadlines and report violations if they are discovered.
So now the prescription will be taken away? And will you have to go for a new one every time?
The pharmacy is required to pick up and store prescriptions for some drugs. They are listed in clause 14 of the new rules. Read and check the instructions for your medications. Maybe this is your case.
If you or someone in your family takes these medications regularly, you will need to get a new prescription for each batch. Even if these pills are needed constantly - for example, painkillers for a seriously ill person. Or sleeping pills and sedatives for regular use. The situation is the same with alcohol-containing drugs - the prescription will remain in the pharmacy.
Whether it is possible to write out a prescription not for one time, but for a long period, the doctor decides and checks the pharmacies.
If the prescription is issued for a year, will it also be taken away? Will you need to go to the same pharmacy all the time or get a new prescription every time?
No, such a recipe will not be taken away. Although there are rumors that they are taking it away. Don't believe rumors - read the law. They can pick it up only if the prescription was issued before September 22, and then the sales rules for this drug changed.
How to deal with long-term prescriptions is described in paragraph 10 of the new rules.
When a pharmacy fills a prescription that is valid for a year, the pharmacist must note when and how much of the drug was sold. And the recipe is returned. Next time, the required amount of medicine will be sold for this prescription again: past sales will be taken into account and the mark will be marked again.
Once your prescription expires, you will no longer be able to buy the medicine using it. If the prescription is stored, the pharmacy will pick it up. If you don’t need to store it, they’ll give it away, but you still won’t be able to use it.
What are the rules for selling vaccines?
The vaccine for vaccination will be sold only if the buyer has a thermal container. You cannot take it to the clinic in an ordinary bag: the vaccine will spoil and the vaccination will be useless.
You can buy the container directly at the pharmacy. These are additional costs that need to be taken into account: you will have to pay extra or bring your own. You cannot buy the vaccine in advance. Such drugs can be stored for a maximum of two days. If you are going to vaccinate your child with a paid vaccine, keep these restrictions in mind.
By the way, you cannot buy the vaccine without a prescription either. You will first have to get a prescription from the doctor, then buy the drug using it and within 48 hours go to the clinic again - this time for vaccination.
Sometimes it’s easier to sign up for a paid clinic: they will conduct an examination, give you a referral, and do all the procedures in one go. Or agree to a free vaccination with a cheap vaccine from the state.
On September 22, new rules for the dispensing of medicines came into force - order of the Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n “On approval of the rules for dispensing medicines,” which regulates the sale of medicines in pharmacies. The document caused a lot of noise and confusion among both patients and pharmacy employees. Today we tried to answer the most important questions about the new order that an ordinary pharmacy visitor may have.
New order makes all drugs prescription drugs?
No. The new dispensing rules only slightly change how some prescription drugs are sold. It does not place any restrictions on common over-the-counter medications.
And now you can’t just buy a prescription drug?
In fact, selling prescription drugs without a prescription has always been prohibited. For this, the pharmacy faces a considerable fine and loss of license. But, as everyone knows, the severity of the law is compensated by the optionality of its implementation. Therefore, a number of pharmacies ignore the rules. However, the emergence of new dispensing rules means close attention to their implementation, and therefore, pharmacies have now become more sensitive to prescription dispensing.
How do you even know if you need a prescription for the drug?
Whether the drug is prescription or not is stated in the instructions for use. In addition, such information is always indicated on the packaging. Of all drugs registered in Russia, approximately 70% are prescription drugs.
In an ideal world, the doctor knows by heart which drugs require a prescription and which do not. But in harsh reality, very often you have to check such information yourself. Therefore, when a doctor advises you on any medications, you can check them online right at your appointment and immediately ask for a prescription.
Prescriptions are written only on special forms. The most common is form No. 107-1/у. It looks like this:
To check whether a drug is a prescription drug, you can go to the website and enter the name of the drug. All prescription medications on our website are marked “prescription.” By the way, not so long ago we got a special label for drugs for which the prescription remains in the pharmacy.
How do you mean “the prescription stays at the pharmacy”?
The pharmacy has a list of drugs that are subject to strict registration. As a rule, these are medications containing narcotic or psychotropic substances included in a special list. Prescriptions for such drugs always remain in the pharmacy in order to control their sale. The circulation of narcotic substances is checked not only by Roszdravnadzor, but also by the structures of the Ministry of Internal Affairs.
But now, according to the new dispensing rules, the pharmacy must also keep prescriptions for certain medications (antidepressants, tranquilizers, antipsychotics, sleeping pills and sedatives, as well as alcohol-containing medications with an alcohol content of more than 15%) *.
“Medicines containing alcohol”? So, now you need to get a prescription for Corvalol or valerian?
No. Let us repeat that the new order does not make medications prescription drugs. We are talking only about prescription drugs. Corvalol, valerian tincture and many other popular tinctures and elixirs are over-the-counter. Accordingly, no one can require a prescription for them unless this is stated in the instructions for use.
Okay, let's say I have a prescription, but it contains several drugs, and one of them is marked "remains at the pharmacy." And I want to buy only one. Will they take my prescription?
Yes. Exceptions are made only for annual prescriptions, provided that you do not purchase the entire prescribed amount of the drug at one time (for this you also need the permission of the doctor who wrote the prescription).
For example, you are prescribed a course of antidepressants for a year, but you only need to purchase one package. In this case, the pharmacy does not have the right to take away your prescription. The pharmacist only makes a note of how much of the drug you bought and returns the prescription.
Can I get medications if the prescription is not written for me?
Yes. Almost all medicines are dispensed simply to the presenter of a prescription. Both the patient himself and his friend, relative, or just an acquaintance can get the drug at the pharmacy. The main thing is to have a recipe.
An exception is made only for narcotic or psychotropic drugs. Prescriptions for such drugs are written out on a special form No. 107/u-NP. It is easy to distinguish from other recipes because it is pink in color. When receiving such drugs at a pharmacy, you must have a power of attorney to receive medications and a passport confirming that you are the one for whom the power of attorney was issued.
At the same time, the Ministry of Health especially notes that the power of attorney can even be handwritten. You can write in it that “I trust such and such to receive such and such medications according to such and such a prescription to such and such a person.” And be sure to indicate the passport details of this person. In addition, it must indicate the date of its preparation. Notarization of such a power of attorney is not required.
What else has changed with the new procedure for dispensing medications?
Now all prescriptions are stamped with the statement that “the drug has been dispensed.” Thus, they cannot be reused. Therefore, if you suddenly need another standard of the drug, you will need to get a new prescription.
Also, the pharmacist is now obliged to inform the buyer about the rules for storing the medicine, its interaction with other drugs, as well as its method and dosage. In addition, a pharmacy employee cannot hide information about the availability of drugs with the same active ingredient, but cheaper. Such a norm existed previously in the law “On the Fundamentals of Protecting the Health of Citizens” and the Rules of Good Pharmacy Practice, but is now duplicated in the dispensing procedure.
* Below is a list of INNs, prescriptions for which, according to the new order, will now remain in the pharmacy. Please note that the active substances (INN) listed here are not specific brand names.
INN
agomelatine
asenapine
aminophenylbutyric acid
amisulpride
amitriptyline
aripiprazole
Belladonna alkaloids+Phenobarbital+Ergotamine
bromod
buspirone
venlafaxine
vortioxetine
haloperidol
hydrazinocarbonylmethy
hydroxyzine
dexmedetomidine
duloxetine
zaleplon
ziprasidone
Zuclopenthixol
imipramine
quetiapine
clomipramine
lithium carbonate
lurasidone
maprotiline
melatonin
mianserin
milnacipran
mirtazapine
olanzapine
paliperidone
paroxetine
pericyazine
perphenazine
pipofezin
pirlindole
podophyllotoxin
promazine
Common twig fruit extract
risperidone
sertindole
sertraline
sulpiride
tetra
tiapride
thioridazine
tofisopam
trazodone
trifluoperazine
morpho
fluvoxamine
fluoxetine
flupenthixol
fluphenazine
chlorpromazine
chlorprothixene
citalopram
escitalopram
etifoxine
Main photo istockphoto.com
From November 1, the city's pharmacies begin to operate in a new way. The list of medications that can no longer be obtained without a doctor's prescription has expanded significantly. It contained drugs such as diphenhydramine, motilium, omeprazole and many others. Hospitals are preparing for an influx of patients in the near future and are determining operating procedures. We will tell you more about this in the new issue of the weekly magazine “Your Chance” on November 7. Below is a complete list of medications that tomorrow will no longer be available in local pharmacies without a doctor's prescription.
Medicines in all dosage forms that are dispensed with a doctor’s prescription (form form No. 107-1/u).
Medicines that act primarily on the central nervous system.
donormil (doxylamine) - sleeping pills
Carbamazepine, finlepsin, depakine- anticonvulsants
Mydocalm, baclofen, sirdalud- antispastic
aminazine (chlorpromazine), teraligen (alimemazine),
Tizercin (levomepromazine), triftazine, moditen-depot
(fluphenazine), mazeptil (thioproperazine), neuleptil
(periciazine), chlorprothixene, sonapax (thioridazine),
Haloperidol, droperidol, azaleptin (clozapine),
Eglonil (sulpiride), speridan (rispiridone) - neuroleptics
phenazepam, Grandaxin (tofisopam), atarax (hydroxyzine) -
tranquilizers
melipramine (imipramine), anafranil (clomipramine),
Amitriptyline, azaphene, ludiomil (maprotimene),
Fluoxetine, fevarin (fluvoxamine), serlift (sertraline),
Rexetine (paroxetine)- antidepressants
phenibut, pantogam, picamilon, encephabol, aminalon,
piracetam, lucetam, fezam, cinnarizine- nootropics
caffeine benzoate, caffeamine, sydnocarb, camphor, sulphocamphocaine, cordiamine, pantocrine, Viagra (sildinafine citrate), Levitra (vardenafil), Cialis (tadanafil) - CNS stimulant drugs
akatinol (memantine), pronaran, mirapex (pramipexole), amantadine (midantan), madopar- drugs for the treatment of parkinsonism
Neuroleptics in ampoules - moditen-depot, eglonil, haloperidol, aminazine
Prozerin, platifillin
NSAIDs
Diclofenac and ketorolac containing drugs
Meloxicam and nimulide containing drugs
Ketonal and other NSAIDs
Drugs that stimulate metabolic processes -chondroitin containing, actovegin, riboxin, methyluracil, potassium orotate, mildronate, trianol, apilak
Antiemetic drugs -metoclopramide, cerucal, motilium (domperidone), emeset (ondansetron)
Drugs acting on peripheral neurotransmitter processes.
Alpha blockers -cornam (terazosin), dalfaz (alfuzozone), camiren, cardura, doxazozone, omnic (tamsulosin)
Beta blockers -propranol, obzidan (anaprilin), atenolol, metoprolol, bisoprolol, lokren (betaxolol), nebiliet (nebivalol), carvedilol
Dopaminergic drugs -bromocriptine, dostinex (cabergoline).
Drugs acting on serotonergic processes - sumatriptan (imigran. Amigrenin), zolmitriptan (zomig), eletreptan (relpax).
Antihistamines - betahistine-containing drugs (betaserc, vestibo, tagista, betahistine).
Antihistamine H1-histamine receptor blockers -diphenhydramine, azelastine (allergodil), fenspiride (erespal).
Drugs that inhibit histamine release -sodium cromoglycate, nedocromil sodium (Tyled), ketotifen.
Antihistamine H2-histamine receptor blockers -cimetidine, famotidine.
Gastric proton pump inhibitors -omeprazole, esomeprazole (Nexium), pantoprazole, lansoprozole, rabeprazole (Pariet).
Drugs acting on the cardiovascular system.
Cardiotonic drugs -digoxin
Antiarrhythmic -propanorm (propafenone), allapinin, cordarone (amiodarone), sotahexal (sotalol).
Antianginal -sidnopharm (molsidomine), preductal (trimetazidine)
Nitrates - nitrosorbitol, cardiket, efox, erinit
Drugs that improve cerebral circulation -cinnarizine, stugeron, cavinton (vinpocetine), instenon.
Antispasmodics that relax the smooth muscles of blood vessels - mebeverine (duspatalin), halidor (bencyclane), aminophylline, theophylline, pentoxifylline, xanthinol nicotinate.
Calcium channel blockers - verapamil, nifedipine, amlodipine, diltiazem.
ATP enzyme inhibitors - captopril, lisinopril, perindopril, fosinopril, zofenopril (Zocardis)
Enalapril-containing drugs -enalapril
Angiotensin 2 receptor blockers - losartans, valsartans, telmisartan (Micardis), irbesartan (Aprovel), moxonidine (imidazoline receptor stimulator), raunatin.
Angioprotectors — Etamzilat, troxevasin, detralex, Aescusan, anavenol, tanakan, tranexamic acid
Lipid-lowering statins -simvastatin, rosuvastatin, atorvastatin, nicotinic acid.
Antiplatelet drugs - warfarin, clopidogrel.
Drugs that enhance renal excretory function.
Diuretics- hydrochlorothiazide, indapamide, furosemide, ethacrynic acid (uregid), Diacarb, Spironolactone, triampur, lespenefril, torasemide (diuver).
Drugs that inhibit the formation of urinary stones - allapurinol
Hepatoprotective drugs.
Phosphogliv forte, Heptral (ademetionine), urodeoxycholic acid.
Thyroid hormones -l-thyroxine, mercazolil (tyrosol), myacalcic.
Glucocorticosteroid drugs -prednisolone, metypred, dexamethasone, triamcinolone, budesonide (pulmicort), beclomethasone (aldecine, beclazone, nasobek), fluticasone (flixonase, flixotide), mometasone (nasonex).
Synthetic p/diabetic drugs -glibenclamide, gliquidone (glurenorm), gliclazide (glidiab, diabeton, glimepiride (amaryl, glemaz), metformin.
Female sex hormone preparations -estrol, estradiol, estriol, combination drugs.
Drugs that regulate metabolic processes.
Calcium supplements with drugs for the treatment of osteoporosis- osteogenone, oleanderic acid
Preparations containing iron -tardiferon, sorbifer, ferrum lek, maltofer.
Various drugs - methyluracil, Riboxin, Actovegin.
Antihypoxants-mexidol
Drugs for the treatment of alcoholism -Teturam, Lidevin, Metadoxine.
Anorexigenic drugs -sibutramine
Antibiotics
Penicillins -ampicillin, amoxicillin, amoxiclav
Cephalosporins -cephalexin, cefazolin, ceftriaxone, cefotaxime
Tetracyclines -tetracycline, doxycycline
Macrolides- erythromycin, spiramycin, oletethrin, midecamycin (macropen), clarithromycin, azithromycin
Lincomycins -lincomycin, clindamycin
Levomecithin
Antibiotics of different groups - fosfomycin (monural)
Sulfonamides - sulfadimethoxine, biseptol, sulfasalazine.
8-hydroxyquinoline derivatives -nitroxoline, intetrix
Fluoroquinols -palin, abactal (pefloxacin), ofloxacin, levofloxacin, ciprofloxacin, lomefloxacin (xenaquin, lomflox), sparfloxacin (sparflo).
Nitrofuran derivatives- McMiror (naturalist).).
Rifampicins -rifampicin
Antiviral drugs -oseltamivir
Preparations for the treatment of protozoal infections -metronidazole. Tinidazole, ornidazole, naxogin (nimorazole)
Antifungal antibiotics -nystatin, pimafucin (natamycin)
Synthetic fungal preparations -ketokenazole (nizoral),
itraconazole (irunin), terbinafine
First of all, the innovation threatens with alarming rumors and panic. If in advanced Moscow people are nervous that soon you won’t be able to buy simple brilliant green without a prescription, then in the regions there is a real rush - they are buying antibiotics, Valocardine, unknown to many Reforts, and even Viagra, which supposedly are about to disappear from free sale in pharmacies. The list of drugs, now available only with a doctor’s prescription, has been circulating on the Internet for two years. It contained medications with psychotropic effects and good old antibiotics. Some indignation was caused by the fact that the heart medication Valocardine was included in this list. Curantil, so often prescribed to pregnant women, was also there, as well as Nimesil, a well-known painkiller.It is unclear who compiled this list and where it came from, but any user can add “their own prohibited” drug to the initial positions,this makes the horror of horrors even more terrible.
The NI correspondent tried to figure out how it all started and what kind of order the Ministry of Health was, which made life so difficult for already unhealthy Russians.
Rospotrebnadzor has been trying for several years to ban the sale of medicines in Russia without prescriptions. However, if earlier we were talking only about antibiotics (which, by the way, are considered by law to be strictly prescription drugs), then last summer the head of the department, Anna Popova, took the initiative to sell all medicines by prescription - even potent ones, even homeopathic ones, and categorically ban the sale of medicines over the Internet.
The position, in general, is understandable. How else to deal with self-medication, which today everyone is addicted to? Moreover, there are no harmless drugs - each has its own side effects, indications and contraindications. And only a doctor can really figure out what a particular patient needs.
By the way, today, if you follow the letter of the law, from 60 to 80% of drugs in our pharmacies must be dispensed with a prescription. And some you really can’t buy without it: narcotic analgesics, potent and psychotropic drugs. Dispensing them without a prescription is a serious crime. The share of over-the-counter drugs on the market is very small. However, Rospotrebnadzor ensured that we could not even buy nasal drops without visiting a doctor.
It could have been foreseen that the introduction of prescriptions for all medications in the context of a shortage of doctors and difficulties with making appointments would significantly complicate the lives of patients,” head of the Foundation Eduard Gavrilov told NI. - According to the Ministry of Health, the shortage of professional therapists in Russia is almost 27%. And prescribing medications is, first of all, a burden on these primary care specialists. People with illnesses today cannot wait to see a doctor, and if the queue to see him grows due to those who came for a prescription for the simplest drug, then paid clinics can celebrate another victory, their clientele will increase.
However, experts do not argue that the idea of dispensing prescription drugs is not inherently bad and is even correct. “You need to be treated as prescribed and under the supervision of a doctor, but now the availability of medical care is low, and it is impossible to do everything “as it should.” And when there is no doctor in the state clinic, the patient will have to go to a paid one, that is, in fact, “buy” a prescription,” says the Health Foundation. There is another problem: in most cases, patients receive oral prescriptions from doctors, at best - the name of the drug is written on a piece of paper. Previously, this filk certificate was accepted at the pharmacy without asking for an official prescription or a stamp signed by a doctor. Now the sick are being turned away. One can imagine what kind of “walking through agony” a patient with a headache or back pain turns into at the clinic. “This creates the preconditions for the growth of the shadow pharmaceutical sector and entails risks to the health of patients,” notes Gavrilov.
However, the revolution started by Rospotrebnadzor did not die out. In August last year, it was “brought to fruition by the Ministry of Health by order No. 647-n. “On approval of the Rules of Good Pharmacy Practice for Medicinal Products for Medical Use.” It must be said that this order does not contain any rules that in any way change the division of drugs into prescription and over-the-counter:In 2017, all the medications that were dispensed in 2016 will be dispensed by prescription in Russia. No relaxations have been made in this list, but no new restrictions have been added.And in general, the information provided in the document is 90% devoted to the organization of pharmacy activities, regulation of the work of management and staff, rules for the acceptance and storage of medicines, and similar technical issues that do not affect ordinary buyers.
It seems that that’s it, there are no reasons for panic and no reasons to urgently stock up on medicines today. Then where do the legs grow from? And here’s where it comes from: on March 1 of this year, new rules for the dispensing of prescription drugs and monitoring compliance with the rules for their sale came into force.Fines for dispensing medications without a prescription have increased: a pharmacist or pharmacist can now be fined 5-10 thousand rubles. (previously 1.5-3 thousand rubles), an official - by 20 - 30 thousand rubles. (previously 5 - 10 thousand rubles), legal entity - by 100-150 thousand rubles. (previously 20-30 thousand) or suspend the pharmacy’s activities for up to 90 days.
For six months, regulatory authorities kept an eye on them, stirred up interest in the work of pharmacies; by October, some of them got into real money, and the hype around prescriptions reached its climax. Consumers, caught between two fires, took the side of pharmacists. Not everyone likes that only the pharmacy is still recognized as a violator; for some reason Rospotrebnadzor has no complaints against doctors who do not write prescriptions as expected.
Other trends have also emerged that may influence the further development of this situation.
The logic of the regulatory authorities is clear, and in general we support the new requirements for pharmaceutical activities. But the devil, as we know, is in the details. We have already had a case: a buyer has a severe asthma attack, he knows the name of the medicine and its dosage perfectly well, but he does not have the prescription with him. In this case, the choice is small: either refuse the suffocating person, or break the law. Therefore, in this matter the most important thing is to avoid excesses,” the director of external communications of PJSC Pharmacy Chain 36.6 told NI.Alexey Kiselev - Romanov.
According to Boris Gorodetsky, an expert at the “Your Pharmacist” service, increasing fines or introducing additional measures, such as suspension or revocation of a license, will have the effect of increasing prices for all medical products, the prices of which are not regulated by the state.
“Pharmacies will need to compensate for the loss of prescription drug revenue,” he explained. “Pharmacies regularly pay fines, but continue to sell prescription drugs without a prescription because they make up a significant portion of their revenue.”
Marketing Director of the FARM-Liniya pharmacy Rostislav Milenkov believes that tightening the legislation will not lead to fundamental changes in this issue, since it does not address the problem of counterfeit prescriptions at all.
Enter the query “buy a recipe” into a search engine and you will see for yourself how many sites with offers will pop up, he advised New Izvestia. There are plenty of offers; some, along with the prescription, immediately impose medicine with home delivery. The price of the issue is tolerable, at least for those who need to receive a prescription in a timely manner, and not sit in the clinic for weeks.
However, Milenkov warns that a forged prescription is dangerous, just like a drug bought second-hand. Experts consider a ban on the sale of prescriptions and medicines on the Internet to be a timely and overdue measure, but the devil is again in the details. “Before introducing such regulations, the following questions must be answered: will all patients be able to receive a prescription in a timely manner? For example, if there is already a queue for appointments with doctors in some specialties under compulsory medical insurance for several weeks in advance, is there any understanding of how the burden on the healthcare system (primarily in compulsory medical insurance) will increase with the introduction of such standards and what measures should be taken to avoid this?"
Some experts are in favor of toughening penalties for dispensing prescription drugs without prescriptions. “In no European country does self-prescription of treatment and choice of medicine on the advice of a pharmacist or on the advice of friends exist - there is only a doctor’s prescription,” reminds the chief physician of the Sfera clinic. Erica Esquina . The CEO of the pharmaceutical company “Apteka+” also calls this situation an extremely positive trend.”Alexander Koshkin:“Since the entry into force of Order No. 647 of the Ministry of Health of the Russian Federation, the requirements for the sale of prescription drugs have become more stringent... And, in my opinion, only the patient will benefit from this measure.”
According to market participants, the situation related to the dispensing of prescription drugs should change for the better due to the expansion of telemedicine capabilities. The burden on both doctors and pharmacy workers will be relieved by the widespread introduction of electronic prescriptions. These are the main innovations that the pharmacy business is waiting for.
Despite the fact that everyone is reassuring worried consumers and not predicting storms in the pharmaceutical industry, the NI correspondent decided to check what was really happening in the pharmacy closest to home. I came in and asked for Monopril (the kind of tablets for high blood pressure). They gave it easily. Already on the way out I looked at the inscription on the box “Dispensed from pharmacies with a prescription. Use as prescribed by your doctor."
According to the current rules, if there is information about the sale by prescription, the over-the-counter sale of such drugs is prohibited. Pharmacies appear to be ignoring the rule in order to increase revenue.
What did you just give me without a prescription? – I say reproachfully to the girl.
You didn’t write it out for yourself, did you? - she answers. - Surely the doctor advised?
Yes, it was about fifteen years ago...
The girl looked through some list - it looked like a prescription list from the Ministry of Health. I didn't find Monopril.
Not your profile. The list includes only psychotropic and potent drugs. And these harmless ones are from Poland. Drink to your health! This Europe is always playing it safe.
Yeah, it’s not our way...
On June 21, 2016, the State Duma adopted in the first reading government bill No. 1093620-6 “On amendments to the Code of the Russian Federation on Administrative Offenses in terms of improving administrative responsibility in the field of healthcare.” And in September, at a meeting with Roszdravnadzor of the Russian Federation, it was announced that from January 1, 2017, prescription drugs will be under special control of the department.
“Actually, the order of the Ministry of Health and Social Development of the Russian Federation No. 785 “On the procedure for dispensing medicines” is valid from December 14, 2005. It is he who regulates the procedure for dispensing medicines from pharmacies, regardless of the form of ownership. That’s why we still fine pharmacies for selling drugs without a prescription,” explained Lyudmila Ilyukhina, deputy head of the department of licensing, supervision and control in the field of medical and social activities of the regional Office of Roszdravnadzor.
Let us remind you that 70% of medicines registered in the Russian Federation are sold strictly according to prescriptions, and only 30% - without it. But what then will change in the new year? Nothing but tougher legislation regarding control and supervision of pharmacies. Currently, Roszdravnadzor is constrained by current legislation and cannot effectively influence pharmacies for violations of the quality and safety of medical and pharmaceutical activities. It’s just that pharmacists did not always pay attention to these requirements, and the population did not see the problem and did not understand it.
How will they be punished?
The current version of the Code of Administrative Offenses does not establish administrative liability for a number of violations in the field of rules of laboratory and clinical practice when conducting clinical and preclinical studies of medicinal products for medical use, procedures for the provision of medical care in terms of non-compliance with the mandatory requirements established by them, procedures for conducting medical examinations, examinations and examinations , as well as the procedure for prescribing and prescribing medications. Therefore, changes have been made to the Code of Administrative Offenses of the Russian Federation (CAO).
The new law proposes completely different fines and other types of punishment for violating drug trade regulations, including dispensing prescription drugs without a prescription.
So, from January 1, 2017, if it is discovered that a drug is being sold without a prescription, Roszdravnadzor may fine the pharmacist who violated the law in the amount of 5 to 10 thousand rubles (now - from 1,500 to 3 thousand rubles); the official will have to pay from 20 to 30 thousand rubles (now - from 5 to 10 thousand rubles); legal - from 100 to 150 thousand rubles (now - from 20 to 30 thousand rubles). The apogee may be the closure of the pharmacy for 3 months (90 days).
Therefore, you understand, most pharmacies, if not all, will not want to take risks and will work strictly according to the letter of the law.
Self-medication is to blame
The impetus for the changes was the level of self-medication of the population, which has recently gone off scale, and sometimes turns into very tragic consequences. Here it is already worth dealing with another problem - the shortage of doctors and queues in hospitals, which force people to go to the pharmacy and consult with a pharmacist about what medications should be taken for a particular disease.
“But the pharmacy must follow the doctor’s recommendation, draw the buyer’s attention to storage conditions and frequency of administration, nothing more. And the prescription itself is the doctor’s request to the pharmacist about what exactly he should give to the patient,” notes Ilyukhina. - And now it also happens that a person actually visited a doctor, but came to the pharmacy not with a prescription written on an official form, but with a piece of paper on which the doctor indicated the name of the drug. And pharmacists dispense medications based on these scraps. This whole situation must change."
The level of self-medication may be off the charts, but there is a logical explanation for this trend - how long will a person have to wait in line at a hospital for a prescription? Especially considering that the majority prefer not to go on sick leave with every cold, but to endure it on their feet, since the authorities do not favor sick leave, and many of us do not consider a sluggish ARVI to be a real disease, supporting our immunity with medications (not even antibiotics) from the nearest pharmacy. But now, before going to the pharmacy, you will have to go on a “crusade” to the hospital and sit in line there, most likely not for an hour or two.
Shortages and queues
It is impossible to say right now exactly which medications will be dispensed only by prescription: in fact, there is no clear list; it was abolished in 2011 because it was too long and cumbersome. So you will have to focus on the packaging of the drug, which should indicate the name, dose, release form, manufacturers, expiration date, storage conditions and dispensing rules - with or without a prescription.
By the way, a similar “innovation” was introduced in Crimea in June. But this was more likely due to the widespread sale of near-narcotic drugs, which was widespread even when Crimea was part of Ukraine. Using the example of the peninsula, it can be assumed that from January 1, 2017, it will not be possible to buy blood pressure lowering medications, stimulants such as caffeine, drugs with a narcotic effect (any codeine-containing painkiller), hormonal drugs, and antihistamines that cause drowsiness at a pharmacy without a prescription. By the way, prescriptions for most medications have a long term - three months.
Of course, there is no point in panicking and stocking up on medications on an industrial scale, but it is worth reviewing your home medicine cabinet and replenishing it with some essential medications. After all, the New Year holidays are coming, during which it will be possible to see a doctor only by calling an ambulance. And judging by the fact that the Office of Rospotrebnadzor in the Kursk Region predicted the peak incidence of ARVI during the New Year holidays, the number of people wishing to see a doctor and receive the coveted prescription from him will increase sharply.
