The crisis that developed during the pandemic, on the one hand, gave an impetus to the development of the drug market in the country, on the other hand, exacerbated the problems that existed before it. Experts spoke about this during the round table “COVID-19 as a test of the strength of the country’s drug supply system”, which took place in the Public Chamber of the Russian Federation.
According to the head of the OP Commission for Economic Development and Corporate Social Responsibility Yevgeny Nifantiev, in recent years the drug supply system in the country has demonstrated stability, but today it is under attack, and not even under one. “In fact, the system survived in March when there were interruptions in paracetamol. We must pay tribute to the participants in the pharmaceutical market and regulators, who then worked in a single burst and went through a difficult period. “
However, the problems with medicines began long before the pandemic. The head of the League of Patients, Alexander Saversky, recalled that over the past year, according to data from various sources, from 170 to 270 drugs were excluded from the State Register of Medicines. The situation with prednisone was indicative, which disappeared in April, but the defect (absence in pharmacies) was officially recognized only in October. “The main problem has not been resolved: we do not know the needs of the population for medicines. And we do not need a law on drug circulation, but a law on drug provision, ”the expert said.
Industry representatives noted that the most serious tests for the market this year were a rash pricing system (due to the fact that manufacturers were forced to sell drugs below cost, many left the market) and the introduction of a completely unfinished drug labeling mechanism at the height of the pandemic.
Alexander Martynenko, a representative of the Association of International Pharmaceutical Manufacturers, said that the pandemic has pressed on acute problems. Secretary of the Russian Society of Physicians, Russian pulmonologist Andrei Malyavin urged doctors not to prescribe ineffective and harmful drugs to patients with COVID. “Now a real orgy with polypharmacy: dozens of medications are prescribed to patients. Yesterday I consulted a patient from Omsk, who was prescribed 22 drugs at once. Antibiotic prescriptions are rampant everywhere. This is not pneumonia at all, this is not a bacterial infection – antibiotics should never be prescribed for the purpose of prevention! Today we are already faced with severe complications after treatment with them, for example, with pseudomembranous colitis. Now there is not only free sale, but also distribution of azithromycin and levofloxacin to the population. In the recommendations of the Ministry of Health, we see that it is necessary to prescribe antibiotics to such patients only on the basis of research results, but in reality they are distributed free to everyone. This is not only the formation of superinfections, but also wasted money. The All-Russian Health Organization has unequivocally refused to prescribe hydroxychloroquine to patients with coronavirus, and in our country they continue to poison people, this is a toxic drug. If we talk about antivirals, then there are no direct antiviral drugs against SARS-CoV-2, just like there are none for any other ARVI. We need to calm down and wait patiently for them to appear. Another of our all-Russian fun is the fascination with interferon inducers and interferons. Both poor and excessive immunity pose a threat in COVID-19. All severe manifestations of the disease are associated with excessive immunity, and this situation cannot be spurred on. Pigelated interferons are good for chronic infections, and it makes no sense to bet on them in the treatment of coronavirus infection: their bioavailability does not exceed 3%, ”the expert said.
But there is good news as well. COVID-19 can be effectively treated even now – groups of drugs that have a good effect are known. These are steroid hormones and anticoagulants (direct and indirect action).
Most patients with COVID-19 get sick easily, and they do not need to be treated with anything at all, the expert emphasized. “I hope that reason will prevail, and the Ministry of Health will remove dangerous and ineffective drugs from clinical guidelines for COVID-19,” the doctor said.
In addition, the expert stressed that today the situation with the treatment of patients is greatly complicated by unfair competition. For example, we still massively put heavy patients on mechanical ventilation, while non-invasive ventilation of the lungs gives a much lower mortality rate. “But today we have 800 patients on mechanical ventilation, and only 12 people on non-invasive ventilation, which are mainly used at the Sklifosovsky Institute, Burdenko hospital, First Honey clinic, and there are excellent results. Why this is happening, I do not know, ”said Andrei Malyavin.