Do not buy without a prescription: from September 1, pharmacies will start selling medicines in a new way

IRINA MISHINA

From September 1, the life of pharmacies will change dramatically. The advice of the pharmacist to customers, what is better to choose and what to be treated, the requests «please let go» — all this will become a thing of the past. If there is no prescription for the medicine, the receipt for it will simply not be punched.

What will the new system in the pharmacy give a refusal for?

The problem arose due to the entry into force of the Decree of the Government of the Russian Federation No. 468 of 24.03.2023. It prescribes pharmacies to enter prescription data into the drug movement monitoring system and other forms of reporting, that is, it requires patients to have prescriptions for all prescription drugs.

It is worth explaining here that more than 70% of drugs in pharmacies are actually prescription. At the same time, today only 10% of all prescription drugs in the country are actually dispensed by prescription. It has become a tradition to come to the pharmacy and ask the pharmacist for advice. It won't go away now. The medicine can be obtained only if there is a prescription, and the correct one, drawn up in all its form.

«Among the prescription drugs are antibiotics, cardiovascular and hypotensive drugs, some painkillers, inhalers that are used for asthma, drugs for lung diseases, almost all medications that are taken for thyroid diseases. All this should be dispensed exclusively by prescription. At the same time, it should be understood: if the data for the recipe is not entered, the system will issue a refusal. In any case, pharmacists are now concerned. We hope for the introduction of electronic prescriptions, which will have both a number and a date, but now the healthcare system is technically only being rebuilt. It seems that doctors are not ready for the new rules either. There are precedents when pharmacy chains returned a prescription to a patient because it was incorrectly filled out by a doctor. Well, it is clear that patients will spend more of their personal time to purchase the right medicine. There is also a question with medications that are recommended in the hospital at discharge. Prescriptions, as you know, are not prescribed there, so patients after the hospital will also have to visit a polyclinic doctor to get the right prescription,» said Victoria Presnyakova, director of the SRO Association of Independent Pharmacies, head of the Alliance of Pharmaceutical Associations.

What to do in emergency situations?

In general, there will be an unprecedented tightening of pharmacy control over the past 30 years. To purchase the right drug, you will definitely need to visit a doctor. Various options for prescribing the drug on a piece of paper and the like, as is common now, will gradually become a thing of the past. And most of us know firsthand what it means to make an appointment and get to a doctor. Wild queues in district polyclinics risk doubling or even tripling. It will be useless to demand or beg to sell the drug without a proper prescription.

And then a lot of questions arise. After all, there are also emergency situations. For example, a person has run out of pills that he drinks in a continuous course, and it is impossible to get to the doctor to write a prescription: there is simply no record for the next few days. It is superfluous to say what consequences this may lead to. Or, for example, people who, after installing a stent, constantly drink blood-thinning drugs. In this case, a break in the treatment of death is similar in the literal sense of the word. And asthmatics who will not be able to breathe and live at all without an inhaler? Or, for example, such a situation: a person has a hypertensive crisis. The ambulance responds that it cannot arrive quickly and recommends giving the person a blood pressure lowering drug. And they are all prescription without exception!

«People apply from different regions of the country. If there are enough polyclinics and pharmacies in big cities, then there are FAP in rural areas, and a paramedic works there with a huge load, it will not always be possible to get to him right away,» explains Victoria Presnyakova, director of the SRO Association of Independent Pharmacies, head of the Alliance of Pharmaceutical Associations.

Pharmacists are also perplexed

Pharmacy workers also have a lot of questions. As Nelly Ignatieva, executive director of the Russian Association of Pharmacy Chains, told NI, a letter with questions was sent to the Minister of Health Murashko from the professional community. No response has been received yet. Soyuzpharma also appealed to several relevant ministries with a request to clarify how to apply the new resolution in practice. For example: will it be necessary to reconfigure, update the software of cash registers? Is it really necessary to enter information into the MDLP system for all forms of recipes? What should I do if the form of the recipe in accordance with the legislation of the Russian Federation does not provide for the presence of a number and a series? Is filling in the prescription details in the receipt mandatory for all prescription drugs? What should I do if the doctor made a mistake? And such mistakes, we suspect, will be massive at first, because doctors have forgotten how to write prescriptions on forms, most often it is an entry on a piece of paper with a seal.

It came to an appeal to the president

The patient community is also alarmed. The president of the League of Patient Defenders, Alexander Saversky, contacted our editorial office, who acquainted us with the letter sent to the president. In particular, it says:

«Pharmacies cannot simply be obliged to fill out the appropriate forms under penalty of fines, but a set of measures aimed at normalizing the circulation of prescription drugs is needed. The first problem will be that patients will massively try to come to doctors, who, as is known, are not enough. As you know, the healthcare system has been optimized more than once and just without taking into account those patients who themselves bought medicines once recommended by a doctor. Now there is a chance that they will come to the doctors en masse (if they don't come, it's even worse). It is extremely difficult to estimate the number of such people.»

But even the first factor — the shortage of doctors ‑ is enough to talk about a possible collapse of the healthcare system. The consequences of this can be disastrous — many patients will never get to the doctor for a prescription, as a result they will be left without the medications they have been used to for years and which they need vitally. In this regard, the League of Patient Advocates warns of the consequences: «the increase in morbidity in more severe forms and mortality. The first result will be that by September 1, patients will have bought up all prescription drugs, and those who really need them will not be able to get them or will buy them on the black market. Falsifications and a black market will inevitably appear.»

In this regard, the League appealed to the President with a request to postpone the entry into force of the Decree of the Government of the Russian Federation No. 468 of 24.03.2023. for at least 2 years.

Before starting such large-scale reforms, it would be worth thinking about the primary care system. And to begin with — to teach and train doctors to write prescriptions correctly. Unless, of course, this resolution is in the interests of patients.