The Supreme Court of the Russian Federation explained what to do if the pharmacy does not have the necessary medicine. How to get preferential medicine Where to complain if there are no preferential medicines

The Supreme Court of the Russian Federation indicated the procedure for pharmacists if the pharmacy does not have the necessary medicine for a beneficiary. In such cases, the pharmacist is obliged to register the person who needs the medicine and guarantee to provide the necessary drug within 10 days, and in urgent cases, do this within 48 hours. If possible, the required drug can be replaced with a generic.

The basis for the decision of the Supreme Court was the complaint of a disabled woman from the Krasnoyarsk Territory, Irina Mushallaeva. When she went to the pharmacy for a drug to treat cancer, it was not there. She had to buy the necessary medicine at her own expense, spending 95 thousand 550 rubles on it. Moreover, the pharmacy sent a letter to the medical institution in which it asked to withdraw the prescription, since the stock of this medicine in the pharmacy had run out.

Irina Mushallaeva went to court demanding compensation for her treatment expenses. The court of first instance sided with her, but the Krasnoyarsk Regional Court overturned the decision to recover damages. Then the woman appealed to the Supreme Court of the Russian Federation.

Instructions:

What should a patient with primary immunodeficiency do if the doctor does not write a preferential prescription?

The Supreme Court overturned the appeal decision and outlined the procedure if the pharmacy did not have the necessary medicine for beneficiaries. In particular, the pharmacist is obliged to register him and guarantee to provide him with the necessary medicine within 10 days, and in urgent cases, do this within 48 hours. If possible, the required drug can be replaced with a generic.

The pharmacy must inform the supplier if the required medicine is unavailable. At the same time, the pharmacy does not have the right to ask to withdraw a prescription for a medicine, citing the fact that its supplies have run out.

Good afternoon.

1. To receive discounted medications at a pharmacy, you must write out a prescription for them from your local doctor. The basis for issuing a prescription is a written recommendation (extract) received from a specialized medical institution where the patient is being observed for his underlying disease.
2. The local doctor may refuse to issue a prescription due to the lack of this drug in the pharmacy. This refusal is illegal, because even if the drug is not currently in the pharmacy, upon receipt of the prescription, the pharmacy is obliged to purchase the drug specified in the prescription within ten days. If there is no prescription, then the pharmacy is not obliged to do ANYTHING, and you will never see the medicine. Therefore, you need to “remind” your local doctor about this and continue to insist on writing out a prescription. 3. If the doctor continues to refuse to issue a prescription, demand it and write it down on the card: “the prescription was not issued due to the lack of medicine in the pharmacy.” He cannot write something like that, so he will either write out a prescription or refuse to write down on the card that he did not write it out. In this case, it is necessary that the doctor MUST make an entry in the card stating that the patient on such and such a date was at an appointment and was examined by a doctor on such and such (he will not be able to refuse this).
4. Immediately after leaving the doctor’s office, write a complaint in 2 copies addressed to the head doctor of the clinic with approximately the following content: “To the head doctor so-and-so from so-and-so... Please explain on what basis the therapist so-and-so refused to write me a prescription for medicine (name) , necessary for my life's indications. I consider this refusal illegal on the basis of Order of the Ministry of Health and Social Development of the Russian Federation dated February 12, 2007 N 110, Decree of the Government of the Russian Federation dated July 30, 1994 No. 890...
5. Give one copy of the letter to the secretary of the head physician, ask the secretary to put a stamp on the second copy.
6. If the secretary refuses to accept the complaint, you must send it by mail - registered mail with a list of attachments and acknowledgment of delivery. The inventory will be given in two copies, one to be placed in the letter, the second to be attached to a copy of the complaint stored in your home. Attach there a receipt for payment for a registered letter and a notice of receipt of the complaint signed by the secretary of the head physician. 7. In the future, act depending on the reaction of the head physician. He may offer to agree verbally, but it is necessary to insist on a written response. After this, a prescription for the medicine is usually given.
8. If unsubscriptions begin (the Department of Health prohibits prescribing this medicine, there is no money in the budget, etc.), then you need to contact the prosecutor’s office, the regional Ministry of Health, Roszdravnadzor (you can go to 3 of these places at once). Send there COPIES (not originals) of all documents (your complaint, postal documents - list of attachments, receipt, delivery of notification; responses from the head physician). If there was no response from the head physician, you can safely complain to the prosecutor’s office. Usually, after a complaint to the prosecutor's office, doctors themselves call home and ask when it is convenient for you to come for a prescription.

An increasing number of patients are faced with the impossibility of obtaining free medicine prescribed by their attending physician. The reason for this is not only the frequent lack of necessary drugs in pharmacies, but also the dishonesty of their employees who refuse to serve beneficiaries. How to protect your rights?

According to the requirements of Roszdravnadzor, there is a clear algorithm of actions that the pharmacist must adhere to if the pharmacy does not have the subsidized medicine needed by the patient. But not all citizens know about it. Therefore, upon hearing a refusal, they purchase expensive drugs with personal funds, while leaving violators of their rights without punishment.

What should a pharmacy employee do if there are no subsidized medications?

If the free drugs prescribed by the doctor are not available in the pharmacy at the time of the patient’s request, the pharmacist has the right to offer similar drugs that are available. If the client refuses to receive substitute medications, then the pharmacist is obliged to act according to the following algorithm:

1. Accept a discounted prescription from the patient.
2. Register it in a special pharmacy journal of unmet demand, assigning it the status of deferred maintenance.
3. Enter prescription data into the institution's electronic program.
4. Submit a written/electronic request for medications to the supplier company.

The authorized pharmaceutical organization must also register the incoming request and provide an official response to the pharmacy regarding the presence/absence and availability of this drug. If the application cannot be satisfied on its part, the pharmacy must purchase the drug itself, and the costs incurred will subsequently be compensated by the state.

If the drug is not available at the pharmacy indicated by the doctor who wrote out the preferential prescription, the patient has the opportunity to get it at another social pharmacy, provided that it is located on the territory of the same municipality, and the heads of both institutions have agreed on this point among themselves. If the drug in the required dosage is not available, the pharmacist can replace it with a drug with a lower dosage, but increasing its volume to an amount that will be sufficient for therapy. At the same time, to dispense the drug in a larger dosage than prescribed, you must contact your doctor for another prescription. No pharmacy has the right to limit the volume of subsidized medicine. Only the attending doctor has this competence.

How long does it take for the pharmacy to provide medications?

Roszdravnadzor allocates 10 working (not calendar!) days for the delivery of previously unavailable medications. If the drugs were prescribed through a medical commission, then this period increases to 15 days. The client is notified of the arrival of the order often by telephone on the same day that the necessary funds arrive at the pharmacy.

Where should I file a complaint against a pharmacy?

If, after the specified period, the delivery of the missing medicine was not carried out, or the pharmacist completely refused to serve the client with a preferential prescription, you can first try to resolve the controversial situation by filing a complaint with the manager of the pharmacy. If the violation is not eliminated, you must file an oral or written complaint against the establishment, outlining the essence of the problem. Below are the main ways to file a complaint against a social pharmacy that violates the rights of a beneficiary to receive medicines:

• Call the hotline of the Department of Health of your city/region. You can find out its number from the help desk operators or on the structure’s website, where you can also familiarize yourself with the specialists’ work schedule;
• Contact the hotline operators of the Pharmacy Department of the Department of Health of your city/region, finding out its contact information in a similar way;
• Leave a request on the official website of Roszdravnadzor, indicating your contact information, the name and address of the pharmacy, and a detailed description of the current situation;
• Contact the administration of the clinic where the preferential prescription was issued. The specialist on duty is responsible for resolving controversial issues that arise with patients, including the provision of subsidized medications. Information about his work schedule, as well as a contact phone number, can be obtained from the reception desk;
• Submit an application to the prosecutor's office against the organization or official who created obstacles to the patient receiving free medicines, attaching copies of the passport, beneficiary ID, and prescription.

Each pharmacy has the right to refuse to issue a medicine to a person if the preferential prescription was not written on an official form or its validity period has expired. In this case, complaints against the pharmacy will not be considered. And the patient will need to contact his doctor with a request for a new prescription.

Victoria Ryzhkova. Photo: Ksenia Ivanova

"Copper people" and their misfortune

Victoria Ryzhkova is the coordinator of the St. Petersburg charitable organization Nochlezhka, which helps the homeless. But recently she had to do something that was not related to the problems of homelessness - coordinating the supply of the drug “Kuprenil” throughout Russia.

In January 2015, Victoria was diagnosed with a rare disease - Wilson-Konovalov disease. People with this disease do not remove copper from their bodies. If a person is not treated correctly, he will die slowly and painfully - all organs gradually fail.

There are not very many “copper people” in Russia - less than 700 people, but this does not make it any easier for them. It becomes easier only from regular use of the drug “Kuprenil”, which helps remove copper from the body.

"Kuprenil" is a vital medicine and is sold free of charge. But in March of this year it disappeared from Russian pharmacies.

It turned out that the pharmaceutical company Teva, which produces the drug, moved production from Poland to Israel, and according to Russian legislation, re-registration of the drug was required. Because of this, government procurement fell through, and those suffering from Wilson-Konovalov disease were left alone with the question: where to get Cuprenil?

Fantastic warehouse "Kuprenila"

Victoria Ryzhikova: “I feel that my apartment will soon turn into a fantastic warehouse.” Photo: Ksenia Ivanova

Victoria Ryzhkova had a supply of medicine - she bought it six months in advance. Therefore, she began to share with those “copper people” who had nowhere to get Cuprenil - the only way to get it at that time was delivery from abroad.

Colleagues in misfortune found each other through social networks. “I seem to recognize most of the Wilsonites from Russia (about 400 people - Ed.),” Victoria wrote in July. – And it all started with the fact that someone monitored my post about “Kuprenil” on VKontakte. And he asked what was happening with the wheels in Belarus and Ukraine. Then I started monitoring VK. Since March, people have been looking for “Kuprenil”, they are ready to buy it for any money, just to live; many Konovalovo residents’ condition is deteriorating, severely deteriorating, even to the point of seizures. People scream for help and essentially die slowly. From my reserves I sent “Kuprenil” to Tyumen and Krasnoyarsk - very sharp. I told the others I found where to buy and how to transport them.”

The drug was delivered from Ukraine and Belarus by Victoria’s friends, and other “Wilsonites”, which Victoria called people suffering from an excess of copper in the body, shared the pink “Kuprenil” tablets they had stored in advance. Those whose condition was not yet critical refused life-saving medicine in favor of seriously ill patients.

“I’ve never seen anything like this anywhere,” Victoria wrote on Facebook. - It would seem that there are no drugs - sit and don’t give your supplies to anyone. But no, we share them to our own detriment... I feel that my apartment will soon turn into a fantastic warehouse.”

Her apartment actually became a warehouse - from there the drug was distributed throughout the country. In addition, Victoria appealed to the prosecutor's office with a request to understand why Cuprenil disappeared from pharmacies, putting the lives of hundreds of people at risk.

In July 2016, supplies of the drug to Russia were resumed. At the end of August, the drug appeared in most Russian regions. This is how Victoria spoke about it:

“My Wilson children receive “Kuprenil” according to prescriptions in the Trans-Ural region in Saransk and Saratov, in Rostov-on-Don, in Voronezh, in Yelets, in Belgorod, in Engels, Krasnodar and Volgograd, in Samara, Kazan and Omsk and probably elsewhere -That. And yes, this is a victory. Thanks to everyone who wrote, reposted, imported and transported, everyone who wrote prescriptions, who bought pills with their own money, for the very poor. There is no need for any state when a person is a person to another.”

Now “Kuprenil” can be bought or obtained by prescription in Moscow and St. Petersburg.

What to do if the medicine is not in the pharmacy?

At the request of Victoria Ryzhkova, Nochlezhka lawyer Ekaterina Dikovskaya developed instructions for patients on what to do if a vital medicine is not in the pharmacy.

– Need to put prescription for deferred care at a pharmacy. There they are required to register it in the register of unsatisfied demand. Such a magazine should be in every pharmacy that dispenses drugs on preferential prescriptions.

– If a prescription is registered in the backlog, it does not need to be left at the pharmacy. The patient takes it with him, but it must be marked with a mark indicating its acceptance for service: date of registration, pharmacy number, signature of the pharmacist.

– After registering the recipe the pharmacy must form an application for the drug to the pharmaceutical company authorized to supply subsidized drugs to the region and provide the drug to the patient within 10-15 days.

– The patient can call the pharmaceutical company himself, which supplies subsidized drugs to the region, and find out whether the required drug is in stock, when it will be delivered to the pharmacy, and why it is not available. You can also notify the company that the prescription has been accepted by the pharmacy for deferred service (the pharmacy may not inform the company about the deferred prescription). The phone number of the pharmaceutical company can be found at the pharmacy.

– If 16 days have passed and the drug has not yet arrived at the pharmacy, you need to write a complaint to the authorized pharmaceutical company that you never received the preferential medicine.

You need to wait for a response, which may indicate that the Ministry of Health did not hold scheduled tenders for the purchase of medicines or the medicine was not indicated in the specification for public procurement. The company's response will be the basis for going to court - based on the content of the response, the defendant is determined: the Ministry of Health and Social Development, a pharmacy, a pharmaceutical company, etc.

– Medicine provided to the patient free of charge according to a preferential prescription, can be purchased with your own funds, and then demand payment of compensation from the pharmacy. To do this, you need to write a claim to the pharmacy with a request to reimburse the costs. If the pharmacy does not reimburse the money spent, you can go to court.

- Court may refuse to satisfy a claim for reimbursement of funds, if the medicine is purchased independently and the prescription has not been put on deferred maintenance.