Complaint about the lack of preferential medicines in the pharmacy. Samples of complaints about the denial of drug provision and recommendations for their preparation

If you have any difficulties in obtaining subsidized medicines (queues at polyclinics, lack of medicines in the pharmacy) - do not give up. Believe that you will succeed, and be patient! The state provides for the possibility of obtaining free medicines certain categories of the population. But people do not always know how to defend their rights, get the guarantees that they are entitled to under the law.

• a document according to which you are entitled to preferential treatment (pension certificate, veteran's certificate);
• a certificate from the Pension Fund confirming that you have not refused a social package that includes preferential treatment (for the disabled);
• SNILS;
• OMS policy.

Good afternoon.

1. To obtain preferential medicines at a pharmacy, you must write a prescription for them from a local doctor. The basis for issuing a prescription is a written recommendation (extract) received in a specialized medical institution where the patient is 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 - accordingly, the pharmacy is not obliged to ANYTHING, and you will never see the medicine. Therefore, it is necessary to “remind” the local doctor about this and continue to insist on 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 such a thing, so he will either write out a prescription or refuse to write it 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 that the patient on such and such a date was at the reception and was examined by a doctor on such and such (he will not be able to refuse this).
4. Immediately upon leaving the doctor’s office, write in 2 copies a complaint addressed to the head physician of the polyclinic with approximately the following content: “To the head physician of such and such from such and such ... Please explain on what basis the therapist such and such refused to write me a prescription for medicine (name) necessary for me according to vital indications. I consider this refusal illegal on the basis of the Order of the Ministry of Health and social development RF 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 need to send it by mail - registered mail with a list of attachments and acknowledgment of receipt. The inventory will be given in two copies, one to be placed in the letter, the second to be pasted to the copy of the complaint kept at your home. There also attach a receipt for payment of a registered letter and a notice of receipt of a complaint with the signature of the secretary of the head physician. 7. In the future, act depending on the reaction of the head physician. He may offer to negotiate verbally, but you must insist on a written answer. After that, a prescription for the medicine is usually given.
8. If unsubscribes begin (they prohibit prescribing this medicine in the Department of Health, 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 - an inventory of attachments, a receipt, delivery of a notification; answers from the head physician). If there was no answer 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.

Despite the fact that quite a few citizens have a legal right to receive free medicines, pharmacy pharmacists either refuse to dispense medicines or declare that they are not available. necessary medicines. Roszdravnadzor has developed a clear algorithm for the actions of pharmacists in pharmacies that do not have the requested drug, but citizens do not know about it. In this article, we will tell you what to do if the pharmacy does not have discount medicines, how the pharmacy employee should act if the medicine is not available, how soon the medicines should be provided, and how and where to file a complaint.

Algorithm of actions of a pharmacy pharmacist in the absence of subsidized medicines

Important! According to the text of the Federal Law of August 22, 2004 No. 122-FZ, if a citizen has completed all the actions prescribed by law to receive free drugs (or drugs at a discount), that is, he has collected the necessary documents, contacted the clinic, received a preferential drug and came with it to the pharmacy on time to the pharmacy, which participates in the state program for providing citizens with preferential medicines, the pharmacy pharmacist is not entitled to refuse to dispense the drug.

If, on the date of the patient’s request, the pharmacy of the medicine he needs at a reduced price was not available, the pharmacist has the right to offer analogues to the citizen this medicine, the effect of which is completely similar to medicines prescribed by a doctor. But the pharmacist has no right to impose a replacement on the client. In case of refusal of substitute medicines, the pharmacist acts as follows:

• offers to apply to another social pharmacy located in the same locality, and with which this institution has an agreement;
• if the citizen refuses, he accepts a prescription for a preferential medicine from the citizen who applied;
• registers the fact of its receipt in a pharmacy journal, specially established for making records of cases of unsatisfied demand;
• assigns the citizen's appeal the status of "deferred service";
• enters information from the prescription form into the pharmacy computer program;
• sends a request to the supplier for medicines that are not available;
• waiting for a response from the supplier company about the presence or absence of the requested drug;
• if the medicine is brought, the pharmacist waits for the delivery, informs the patient about the availability of the medicine by phone;
• if the supplier does not have the medicines, the pharmacy purchases them independently at its own expense (expenses will be reimbursed to it later from the federal budget).

How soon the pharmacy will provide a discounted drug that is not in stock

If a citizen applied with a prescription to a social pharmacy, but it did not have the necessary medicine, Roszdravnadzor allows you to assign the status of “deferred service” to the application, take the patient’s phone number and call him back when the drug appears at the pharmacy. On decision this issue no more than 10 working days are given (that is, weekend pharmacies are not included in the calculation).

However, if a prescription for a preferential medicine was issued by the medical commission of a medical institution, it is allowed to provide it to a citizen within 15 working days.

What to do if the pharmacy does not have subsidized medicines - where to complain

Unfortunately, it happens that pharmacy pharmacists refuse to accept a prescription from a beneficiary at all or report that the required medicine is not available. For starters, you can complain about the pharmacist to the pharmacy manager. If this does not help, there are many more options to protect your rights:

What to do if the pharmacy does not have subsidized medicines

Here is how they comment on the situation with the refusal to issue preferential medicines lawyers. If a citizen is not provided with what he has the right to, the algorithm of actions should be as follows:

1. It is necessary to record the fact of refusal to provide a medicine for which there is a special, correctly executed prescription. To do this, you first need to submit an application addressed to the head physician of the clinic where the drug was prescribed.
2. If there is no response to the application, and the medicine suddenly appears in the pharmacy, or nothing happens at all for unexplained reasons, you should file a complaint with the regional department of the Ministry of Health or immediately with the Prosecutor's Office.
3. If the pharmacy did not have subsidized medicines of vital necessity, or a refusal to issue them was received, you need to contact Rospotrebnadzor. The most effective way is to write a statement to the prosecutor.

Legislative acts on the topic

Common Mistakes

Error: The pharmacy pharmacist called back the citizen, for whom subsidized medicines were not available on the date of the request, a month later.

An increasing number of patients are faced with the inability to get free medicine, which is due according to the prescription of the attending physician. The reason for this is not only the frequent absence the right 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 follow if the pharmacy does not have a preferential medicine that the patient needs. But not all citizens know about it. Therefore, having heard a refusal, they purchase expensive drugs at their own expense, while leaving violators of their rights without punishment.

What should a pharmacy employee do in the absence of preferential medicines?

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 available. If the client refuses to receive substitute medicines, then the pharmacist must act according to the following algorithm:

1. Take a prescription from the patient.
2. Register it in a special pharmacy magazine of unsatisfied demand, assigning it the status of deferred service.
3. Enter prescription data into the electronic program of the institution.
4. Send a written/electronic application for medicines to the supplier company.

The authorized pharmaceutical organization must also register the incoming request and give 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 on its own, 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 issued 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 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 indicator that will be sufficient for therapy. At the same time, for the issuance of a drug in a larger dosage than prescribed, you must contact your doctor for another prescription. None of the pharmacies has the right to limit the amount of medicines. Only the attending physician has such competence.

How long does a pharmacy have to provide medicines?

Roszdravnadzor allocates 10 working (not calendar!) days for the delivery of previously missing medicines. If the drugs were prescribed through a medical commission, then this period is increased to 15 days. Notification of the client about the arrival of the order is often made by telephone on the same day when necessary funds entered 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 contacting the pharmacy manager with a claim. If the violation is not eliminated, it is necessary to file an oral or written complaint against the institution, outlining the essence of the problem. The following describes 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 Health Department of your city/region. Its number can be obtained from the help desk operators or on the website of the structure, where at the same time you can get acquainted with the work schedule of specialists;
• Contact the operators of the "hot line" of the Department of Pharmacy of the Department of Health of your city / region, having learned its contact details in a similar way;
• Leave an appeal on the official website of Roszdravnadzor, indicating your contact details, the name and address of the pharmacy, a detailed description of the current situation;
• Contact the administration of the polyclinic within which the preferential prescription was issued. The specialist on duty deals with the resolution of controversial issues that have arisen in patients, including the provision of preferential medicines. Information about the schedule of its work, as well as a contact phone number, can be obtained at the registry;
• File an application with the prosecutor's office against the organization or official that created obstacles for the patient to receive free medicines, attaching copies of the passport, beneficiary's certificate, and prescription to it.

Each pharmacy has the right to refuse to dispense a medicine to a person if the preferential prescription is not written on the official letterhead or if it has expired. Complaints against the pharmacy in this case will not be considered. And the patient will need to contact their doctor with a request for a new prescription.

We already know that medicines for cancer patients are provided with federal and regional benefits, depending on the status of the beneficiary. At the same time, medications included in the standard of care and in the preferential Lists are prescribed. Let me remind you that in outpatient treatment, the basis for obtaining subsidized medicines for people with disabilities is the Federal Law of July 17, 1999 N 178-FZ "On State Social Assistance", and the list of subsidized medicines is contained in the Order of the Ministry of Health and Social Development Russian Federation dated September 18, 2006 N 665 "On approval of the list of medicines dispensed by prescription of a doctor (paramedic) when providing additional free medical care certain categories of citizens who are entitled to receive state social assistance, which includes all subsidized medicines. That is, see if the medicine prescribed for you is included in the specified List.

The basis for obtaining subsidized medicines for citizens suffering from oncological diseases, but not having a disability group, is Decree of the Government of the Russian Federation of July 30, 1994 N 890 "On state support for the development of the medical industry and improving the provision of the population and healthcare institutions with medicines and products medical purpose", in Appendix No. 1 of which the right of people with oncological diseases to preferential receipt of all medicines is indicated. In turn, the List of these medicines is contained in the annex to the territorial program of state guarantees of the region (see the regional list of medicines is called: "in accordance with the list of population groups and categories of diseases).

Always find out if the medicine prescribed for you is included in the federal and regional list (you can find out from the insurance company, TFOMS, from the annex to the territorial state guarantee program, published on the Internet along with the Drug Lists).

It happens that the medicine is not included in the standard and in the preferential list, but in this case it can also be prescribed to the patient for medical reasons, although it is much more difficult to obtain it.

Clause 5 of Article 37 of the Federal Law of the Russian Federation of November 21, 2011 N 323-FZ "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation": "Prescription and use of drugs, medical devices and specialized health food products that are not included in the relevant standard of medical care are allowed if there are medical indications (individual intolerance, according to vital indications) by decision medical commission».

Paragraph 6 of the Procedure for the provision of primary health care to citizens entitled to receive a set social services(Appendix 1 to the order of the Ministry of Health and Social Development of the Russian Federation of November 22, 2004 N 255): “In case of insufficient pharmacotherapy in the treatment of certain diseases for vital indications and in case of a threat to the life and health of the patient, other medicines may be used by decision of the medical commission approved by the chief physician medical institution "(for the disabled).

Now why is it impossible for disabled people with cancer to refuse the social package. Medicines for the treatment of oncology are expensive and it is not always possible to provide a patient who has refused a social package with a medicine at a regional benefit due to the regular lack of money from the budget of a constituent entity of the Russian Federation. Moreover, many people with cancer do not have a disability group, but at the same time they need expensive antitumor treatment, and they should be provided with preferential medicines in the first place. Although, as they say in the Ministry of Health, there is no money for them. The right to receive medical care and receive a discounted medicine is not dependent on funding. However, references to the lack of funding are the main obstacle to obtaining subsidized medication, which the oncologist will not prescribe, the attending physician will not issue a prescription, and the Regional Ministry of Health will not purchase. It is true that money may not be enough, but it may also be that there is money, but they simply do not want to treat a cancer patient and spend federal money on the purchase of expensive medicine, not to mention the money of the region. But patients also want to live, as well as officials and doctors who do not complain about their health, who refuse medicines to patients. In this case, cancer patients are forced to fight for their lives and for the provision of medicines guaranteed by the state. Some succeed. In this regard, it may be possible to invite patients who are denied preferential medicines to file complaints about the denial of treatment.

To begin with, you need to write a complaint to the Ministry of Health of the region about a refusal in drug provision, and it is desirable to receive a written response. (True, at this method preliminary application to the Ministry of Health has a minus - the consideration period is within one month). Usually, the regional Ministry of Health is refusing treatment with references to the lack of funding for both federal and regional benefits, which is already becoming an official and “valid” reason for refusing to treat a cancer patient. After receiving such a response, you can write a complaint to the territorial body of Roszdravnadzor for the constituent entity of the Russian Federation that controls drug provision (albeit only for people with disabilities). Roszdravnadzor is obliged to respond to the patient's complaint. Upon receipt of a complaint, as a rule, Roszdravnadzor sends a letter to the Ministry of Health of the region with a request to "understand the situation, provide the patient with medicine and report on the measures taken." If, despite this, the preferential medicine is not received, then you will have to complain to the prosecutor's office. But it should be borne in mind that if the patient did not attach a response from the Ministry of Health to the complaint to the prosecutor's office, then the prosecutor will redirect the patient's complaint to the regional Ministry of Health and everything could end up like this, because the Ministry of Health simply will not respond. If the patient is attached a written response to the refusal from the Ministry of Health, then the complaint in the prosecutor's office must consider and take measures of the prosecutor's response. Federal Law of January 17, 1992 N 2202-I "On the Prosecutor's Office of the Russian Federation" in Article 1 refers to the powers of the prosecutor's office the supervision of the implementation of laws and the observance of human rights and freedoms. Article 10 provides for the obligation to resolve applications, complaints and other appeals with the preparation of a reasoned response in the prosecutor's office. At the same time, “it is prohibited to send a complaint to an authority or official whose decisions or actions are being appealed. But, unfortunately, the prosecutor's office often forwards complaints to the Ministry of Health of the region, although a response has already been received from there refusing to treat the patient, which does not comply with Article 10 of the Law on the Prosecutor's Office.

If drug provision is denied to a person with an oncological disease who does not have a disability group, then after the Regional Ministry of Health refuses treatment, the complaint must be addressed to the prosecutor's office. You can, of course, write an appeal to the territorial Roszdravandzor, which will not take control measures, but can express its opinion on the current situation. So, according to one of the appeals of a regional beneficiary to the territorial Roszdravnadzor, he expressed his position on the right of a patient with cancer to receive medicines under a regional benefit, which may also be useful to the patient during further appeals.

When writing a complaint, in addition to the last name and first name, you should also indicate the presence of a disability group, where and by whom the medicine was prescribed (to prove that you yourself recommended it at your own request), if the medicine has already been provided, then indicate how many times you received the medicine and under what conditions (on a preferential prescription, in a hospital) and other information. Or describe a different situation. The complaint indicates all addressees, you can attach a copy of the ITU certificate, discharge summary, documents on prescribing the medicine. If responses were received from the Ministry of Health, then indicate links to them and attach them to the complaint to Roszdravnadzor and the prosecutor's office. One copy of the complaint remains with the applicant, which is marked by the body that accepted it. Complaints may also be submitted by registered mail with acknowledgment of receipt. A copy of the complaint addressed to the Ministry of Health of the region can also be sent to the prosecutor's office, which does not exclude, as indicated above, sending a separate complaint to the prosecutor in case of a negative response from the Ministry of Health, which has a different status. Also, a complaint in a copy can be sent to the region's human rights ombudsman so that he knows about the situation with the denial of drug provision in the region. For information, the “subject of the Russian Federation in the field of health care” mentioned in the text of the complaints is the Ministry of Health of the region.

After the complaints are sent, you will have to wait for a response. Sometimes it happens that officials delay the response time up to 1 month or do not respond at all. In order to still get an answer and, possibly, speed up its time, you can’t just wait for it.

According to the rules of office work, complaints are transferred for execution to a specific person of the organization. Therefore, you need to call the reception of the Ministry of Health, Roszdravnadzor. Prosecutor's office and ask for the phone number of the person to whom your complaint has been forwarded for execution. Then call the contractor and clarify the timing and content of the response, including if the complaint is not answered for more than 1 month.

Below are examples of complaints about the denial of drug provision for a disabled person and the denial of drug provision for a cancer patient who does not have a disability group, which can be sent to the regional Ministry of Health, Roszdravnadzor and the Prosecutor's Office.

In the text of the complaint below, the main attention should be paid to the regulations that give the patient the right to preferential drug coverage.

Disabled and cancer patients should also be provided with subsidized medicines for any disease they have (depending on the status of the beneficiary and on the availability of the medicine in the preferential List). After making sure that the medicine prescribed by your doctor is included in the List corresponding to the status of the beneficiary, when communicating with doctors, you can also refer to the regulations indicated in the complaints. For example, when demanding medication to treat hypertension, diabetes, arthritis, etc.

1. Sample complaint

Copy: Prosecutor's Office ______________________
Address:__________________________________
Applicant ______________________________
Address:_________________________________

A complaint
for denial of prescription medication

I, full name I was born in 1946, I am a disabled person of the 2nd group due to the disease of rectal cancer of the 4th stage. In the Oncological Dispensary No. 1 of the city of Kva, I underwent surgical removal of the tumor and for further treatment at the Oncology Dispensary No. 1 on 05.09. 2013 was prescribed the drug Gleevec

(INN imatinib). But in polyclinic No. 4 of the city of K-va, the attending physician refused to issue a preferential prescription for the indicated drug. With complaints about the refusal of treatment, I applied to the Administration of the city of K-va, to the Ministry of Health of the city of K-va. The reason for refusing treatment was the lack of Money on medicines for beneficiaries and the high cost of the drug.

In accordance with Article 37 of the Federal Law of the Russian Federation of November 21, 2011 N 323-FZ "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation", medical care is organized and provided on the basis of medical care standards.

On the basis of the Federal Law of November 24, 1995 N 181-FZ "On social protection Disabled Persons in the Russian Federation”, Federal Law No. 178-FZ of 17.07.1999 “On State Social Assistance”, persons with disabilities are recipients of a set of social services and have the right to provide them with the necessary medicines on prescription in accordance with the standards of medical care.

Imatinib is included in the standard of care in the provision of primary health care for malignant metastatic and recurrent neoplasms of the colon and rectum of stage IV (chemotherapeutic treatment), approved by Order of the Ministry of Health of the Russian Federation of December 24, 2012 N 1531n ".

In accordance with the Federal Law "On State Social Assistance" N 178-FZ of July 17, 1999, the powers of the Russian Federation in the field of providing state social assistance in the form of a set of social services were transferred for implementation to the state authorities of the constituent entities of the Russian Federation.

The procedure for prescribing and dispensing medicines within the framework of state social assistance is carried out in accordance with the provisions of the Order of the Ministry of Health of the Russian Federation dated December 20, 2012 N 1175n "On approval of the procedure for prescribing and prescribing medicines, as well as forms of prescription forms for medicines, the procedure for issuing these forms , their accounting and storage. According to clause 4.1. Orders, the disabled are provided medicines in accordance with the List of medicines dispensed by prescription of a doctor (paramedic) when providing additional free medical care to certain categories of citizens entitled to receive state social assistance "(approved by order of the Ministry of Health and Social Development of the Russian Federation of September 18, 2006 N 665 ).

Glivec under the INN Imatinib is included in the specified federal List of subsidized drugs, therefore, for medical reasons, it should be provided to me on a subsidized prescription at the expense of the federal budget within the framework of the indicated powers transferred to the subject of the Russian Federation.

I am also a “regional beneficiary” and, in the absence of funding from the federal budget under the DLO program, I should have been provided with medicine at the expense of the regional budget.

This is stated in the letter of the Ministry of Health and Social Development of the Russian Federation dated February 3, 2006 N 489-VS "On the sale of medicines to the population according to the prescriptions of doctors for outpatient treatment free of charge and with a 50% discount": "with the simultaneous existence of the right to receive drug supply as part of a set of social services provided at the expense of the federal budget, as well as under the preferential procedure for providing medicines provided at the expense of the constituent entity of the Russian Federation, citizens have the right to receive drug provision on two grounds.

The list of population groups and categories of diseases for regional beneficiaries was approved by Decree of the Government of the Russian Federation of July 30, 1994 N 890 “On state support for the development of the medical industry and improving the provision of the population and healthcare institutions with medicines and medical products”. Appendix No. 1 to the Decree states that citizens suffering from oncological diseases are entitled to free provision of all medicines on prescription by doctors.

Besides, malignant neoplasms included in the list of social significant diseases(Decree of the Government of the Russian Federation of December 1, 2004 N 715). In this connection, Article 16 of the Federal Law No. 323-FZ refers to the powers of state authorities of the subjects of the Russian Federation in the field of health protection the establishment of social support measures to organize the provision of these persons with medicines.

The above means that I should have been provided with the prescribed subsidized medicine for one of the indicated reasons at the expense of one of the two above-mentioned funding sources. However anticancer drug glivec (INN imanitib) I was not provided with either a “federal benefit” or a “regional benefit”.

According to Art. 4, 10, 11 of the Federal Law of November 21, 2011 N 323-FZ "On the fundamentals of protecting the health of citizens in the Russian Federation", the main principles of protecting health in the Russian Federation are the priority of the patient's interests in the provision of medical care, the availability and quality of medical care and the inadmissibility of refusal in its rendering.

Insufficient funding is not a reason for the release of the regional health authority from the treatment of patients suffering from socially significant diseases and non-compliance with federal guarantees of drug provision for beneficiaries. Lack of treatment will lead to the progression of the disease and a poor prognosis for life.

Take measures to provide me with the life-saving drug "imatinib" for the entire course of treatment under the "additional drug provision" program at the expense of the federal budget or at the expense of the regional budget.

Application:

Date, signature.

2. Sample complaint about the refusal to provide preferential medicine (disabled person)

Note: the complaint contains some medications specified in the treatment standards for breast cancer and included in the List of Order No. 665. In this connection, when writing a complaint, you can choose the medications included in the standard of care and the List of Order No. 665 for the specified diagnosis

Where: Regional Ministry of Health
Address___________________________________
Where: Territorial Roszdravnadzor

Address:___________________________________
Address:__________________________________

A complaint
to refuse to provide preferential medicine (disabled person)

I, full name born 1965 , I suffer from stage 4 breast cancer, am disabled and included in the Federal Register of Beneficiaries. For the treatment of the disease with the consultation of the C - th OKOD 04.08. 2013 for health reasons, I was prescribed the drugs paclitaxel (INN paclitaxel), herceptin (INN trastuzumab), zoladex (INN zoledronic acid).

I received treatment with these drugs from 08/24/2013 to 11/20/2013.

However, since October 2013 I have not been treated with these drugs (note: indicate the name of the drug) neither inpatient nor outpatient through subsidized prescriptions. Refusal to receive treatment is justified by the Ministry of Health of the region by the lack of funding for drug provision under the federal benefit (answer No. 545 dated September 24, 2013).

I consider the refusal to treat me with the indicated drugs vital to me illegal based on the following.

The Constitution of the Russian Federation in Article 7 establishes that the Russian Federation is welfare state whose policy is aimed at creating conditions that ensure a decent life and free development of a person.

Article 41 of the Constitution of the Russian Federation establishes the right of everyone to health care and medical care at the expense of the relevant budget and other revenues.

According to Article 37 of the Federal Law of November 21, 2011 N 323-FZ "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation", medical care is organized and provided on the basis of medical care standards. At the same time, the prescription and use of drugs ... that are not included in the relevant standard of medical care are allowed if there are medical indications (individual intolerance, for life reasons) by decision of the medical commission ”(clause 5 of article 37 of the Fundamentals - Federal Law No. 323).

The drugs paclitaxel, trastuzumab, zoledronic acid are included in the Standard for specialized medical care for primary generalized and recurrent forms of malignant neoplasms of the breast IV stage - primary; I-IV stages - progression (approved by the Order of the Ministry of Health of the Russian Federation of November 7, 2012 N 612n), and paclitaxel, trastuzumab are included in the Standard of specialized medical care for malignant neoplasms of the breast I-III stages (approved by the Order of the Ministry of Health of the Russian Federation of November 9, 2012 N 723n).

(note: if the patient has a disease stageI-III (T1N0M0 - T any N3M0), then the complaint must refer to the standardNovember 9, 2012 N 723n).

If the stage IV - primary; I-IV - progression,then to the standard of November 7, 2012 N 612n).

In accordance with the provisions of the Federal Law of November 24, 1995 N 181-FZ "On the Social Protection of Disabled Persons in the Russian Federation and the Federal Law of July 17, 1999 N 178-FZ "On State Social Assistance", disabled persons, as recipients of a set of social services, are entitled to receive medicines as part of the provision of state social assistance at the expense of the federal budget.

In accordance with Art. 4.1 of the Federal Law "On State Social Assistance" N 178-FZ of July 17, 1999, the powers of the Russian Federation in the field of providing state social assistance in the form of a set of social services are transferred for implementation to the state authorities of the constituent entities of the Russian Federation.

At the same time, the prescription and prescription of medicines for beneficiaries is carried out in accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated September 18, 2006 N 665 "On approval of the list of medicines dispensed by prescription of a doctor (paramedic) when providing additional free medical care to individual categories of citizens entitled to receive state social assistance ". (This is indicated in clause 4.1 of the Procedure for prescribing and prescribing medicines, as well as prescription forms for medicines, the procedure for issuing these forms, their accounting and storage, approved by Order of the Ministry of Health and Social Development RF dated December 20, 2012 N 1175n).

The list of the order of the Ministry of Social and Health Development of the Russian Federation No. 665 includes drugs paclitaxel, tratuzumab, zoledronic acid.

Decree of the Government of the Russian Federation of 01.12.2004 N 715 "On approval of the list of socially significant diseases and the list of diseases that pose a danger to others" malignant neoplasms are classified as socially significant diseases.

Article 16 of the Federal Law "On the Basics of Protecting the Health of Citizens in the Russian Federation" dated November 21, 2011 No. 323-FZ refers to the powers of state authorities of the constituent entities of the Russian Federation in the field of health protection the establishment of social support measures for organizing the provision of medical care to persons suffering from social significant diseases and diseases that pose a danger to others, and on the organization of the provision of these persons with medicines.

It follows from these regulations. that I have the right to receive these medicines for health reasons as part of the provision of state social assistance at the expense of the federal budget within the framework of the federal powers transferred to the region.

According to Art. 4, 10, 11 of the Federal Law of November 21, 2011 N 323-FZ "On the fundamentals of protecting the health of citizens in the Russian Federation", the main principles of protecting health are: the priority of the patient's interests in the provision of medical care, the availability and quality of medical care and the inadmissibility of refusal to its rendering.

Insufficient funding is not a reason for the release of the regional health authority from the treatment of patients suffering from socially significant diseases and non-compliance with federal guarantees of drug provision for beneficiaries. As a result of the failure to provide me with a vital drug, my constitutional right to health care and medical care, social security in case of illness, disability, provided for in Art. Art. 39 and 41 of the Constitution of the Russian Federation and the above federal regulations. Lack of treatment will lead to the progression of the disease and a poor prognosis for life.

Based on the above, please:

Based on the above, please:

1. Understand the situation with the refusal of treatment, take measures to provide me with trastuzumab and zoledronic acid for the entire course of treatment by the Ministry of Health of the city of Sva and its subordinate structures.

Application:

Date, signature.

3. Regional benefit (cancer patient without a disability group)

Note: it is necessary to check whether the medicine prescribed or recommended to the patient is contained in the annex to the territorial program of state guarantees for the provision of free medical care to citizens for the corresponding year in the section: “list of medicines, specialized medical foods and medical products sold to the population in accordance with the list groups of the population and categories of diseases, in the outpatient treatment of which medicines, specialized medical foods and medical devices are dispensed free of charge by prescription of doctors ....”. In some areas, the regional List may be contained in separately adopted regulations, which should be indicated in the program of state guarantees. In the text of the complaint, it is necessary to refer to the fact that the medicine is included in this List.

Where: Regional Ministry of Health
Address___________________________________
Where: Territorial Roszdravnadzor
Address:___________________________________
Prosecutor's Office _____________________________
Address:___________________________________
Applicant _______________________________
Address: __________________________________

From whom: ________________________________

A complaint
for denial of drug provision under a regional benefit
(cancer patient without a disability group)

I, full name Born in 1971, I suffer from a malignant neoplasm: hormone-dependent HER2-positive breast cancer, stage 3.

The treatment was surgery and radiation therapy. I am not disabled. To continue treatment at the Federal Medical Research Center ( note: indicate whether such recommendations were made and where _) I was recommended and also prescribed by the oncologists of the territorial oncology center of V-ka medicines herceptin (INN trastuzumab) and tamoxifen (INN tamoxifen). However these drugs I did not receive treatment. In response to my appeal to the Ministry of Health of the region ( specify - orally, in writing) a response was received about the refusal of treatment due to the lack of funds for the treatment of regional beneficiaries.

I consider the actions of the Ministry of Health of the region and its subordinate structures, refusing to treat me, illegal on the basis of the following.

According to Article 37 of the Federal Law of November 21, 2011 N 323-FZ “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” (hereinafter referred to as the Fundamentals), “medical care is organized and provided on the basis of medical care standards. “The prescription and use of drugs ... that are not included in the relevant standard of medical care are allowed if there are medical indications (individual intolerance, according to vital indications) by decision of the medical commission” (clause 5, article 37 of the Fundamentals).

Trastuzumab is included in the standard of specialized medical care for stage I-III breast cancer (systemic drug treatment, including chemotherapy) (Order of the Ministry of Health of the Russian Federation dated November 9, 2012 N 723n ").

Tamoxifen is not included in the specified standard, but it should also be provided to me for medical reasons on the basis of clause 5 of Art. 37 Basics.

Article 16 of the Fundamentals refers to the powers of state authorities of the constituent entities of the Russian Federation in the field of health care to organize the provision of medicines to persons suffering from socially significant diseases. Decree of the Government of the Russian Federation of 01.12.2004 N 715 "On approval of the list of socially significant diseases and the list of diseases that pose a danger to others" malignant neoplasms are classified as socially significant diseases.

In pursuance of the decree, paragraph 2 of Article 81 of the Fundamentals, the duties of public authorities in the field of healthcare include the formation, within the framework of the territorial program of state guarantees, of a list of drugs dispensed to the population in accordance with the List of population groups and categories of diseases, in the outpatient treatment of which drugs are dispensed by prescription doctors for free.

Law No. 143-PK dated December 25, 2012 approved the territorial program of State guarantees of free provision of medical care to the population of the Vth region for 2013 and the planned period of 2014 and 2015.

Annex 3 "List of drugs dispensed to the population in accordance with the list of population groups and categories of diseases, in the outpatient treatment of which drugs and medical devices are dispensed free of charge by prescription of doctors ..." includes trastuzumab and tamoxifen.

The list of population groups and categories of diseases, approved by Decree of the Government of the Russian Federation of July 30, 1994 N 890 "On state support for the development of the medical industry and improving the provision of the population and healthcare institutions with medicines and medical products." Annex No. 1 to it “List of population groups and categories of diseases, in the outpatient treatment of which medicines and medical devices are dispensed free of charge by doctors' prescriptions”, states that people with oncological diseases have the right to free provision of all medicines by doctors' prescriptions.

According to Art. 19 of the Federal Law “On the Basics of Protecting the Health of Citizens in the Russian Federation” dated November 21, 2011 No. 323-FZ, everyone has the right to medical care in a guaranteed amount, without charging a fee in accordance with the program of state guarantees of free provision of medical care to citizens.

According to Art. 4, 10, 11 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation", the main principles of health protection are the priority of the patient's interests in the provision of medical care, the availability and quality of medical care and the inadmissibility of refusal to provide it in accordance with the program of state guarantees of free provision of medical care to citizens.

Article 41 of the Constitution of the Russian Federation guarantees the right of everyone to health care and medical care free of charge at the expense of the relevant budget.

Thus, as a resident of the V-th region, I have the right to receive the drugs trastuzumab and tamoxifen included in the regional list on the basis of Decree of the Government of the Russian Federation No. 890 and the territorial program of state guarantees of the region for 2013.

The lack of funding for the provision of medicines to beneficiary categories of citizens cannot serve as a legal basis for limiting state guarantees for the provision of free medical care.

With the specified constitutional, federal and regional guarantees for drug provision of the patient, the medical workers there is a refusal to provide medical care to a cancer patient suffering from a socially significant disease (oncology) and who is also a regional beneficiary.

The drugs trastuzumab and tamoxifen are life-saving for me. importance, non-receipt of which in a short time will lead to the progression of the disease and the onset of adverse consequences for life.

Based on the above, please:

Take measures to provide me with trastuzumab and tamoxifen for the entire course of recommended treatment by the health authorities of the V-th region and their subordinate structures.

Application:

Signature, date.

4. Complaint about the denial of a drug benefit (disabled person)

(if the drug is not included in the standard of care and benefit lists

Where: Regional Ministry of Health
Address___________________________________
Where: Territorial Roszdravnadzor
Address:___________________________________
Prosecutor's Office _____________________________
Address:___________________________________
Applicant _______________________________
Address:__________________________________

From whom: ________________________________

A complaint
to refuse to provide preferential medicine (disabled person)

I am full name I am a disabled person of group 1 due to the disease: cancer of the sigmoid colon T4N2M1. On February 26, 2013, the Council of the N-th OKOD made a decision to prescribe cetuximab to me. ( or indicate that the drug was recommended ___ where) .

However, the Ministry of Health of the N - th Region refused to provide the drug "cetuximab" because it is not included in the standard of care for my illness and is not included in the preferential federal list of drugs, namely, in the list of the order of the Ministry of Health and Social Development of the Russian Federation dated September 18, 2006 g. N 665 "On approval of the list of medicines dispensed by prescription of a doctor (paramedic) in the provision of additional free medical care to certain categories of citizens entitled to receive state social assistance.

The drug "cetuximab" is indeed not included in my standard of care and in the List of drugs for federal beneficiaries, approved by Order of the Ministry of Health and Social Development of the Russian Federation of September 18, 2006 N 665.

However, the possibility of using drugs that are not included in the preferential Lists, in particular, in the list of the order of the Ministry of Health and Social Development of the Russian Federation, is indicated in paragraph 6 of the Procedure for the provision of primary health care to citizens entitled to receive a set of social services (Appendix 1 to the order of the Ministry of Health and Social Development of the Russian Federation dated 22 November 2004 N 255), containing the provision that the therapist, the specialist doctor prescribes the medicines provided for by the "List of Medicines", approved by the order of the Ministry of Health and Social Development of the Russian Federation of 02.12.2004 N 296 "On Approval of the List of Medicines" in accordance with the standards of medical care approved in the prescribed manner. In case of insufficiency of pharmacotherapy in the treatment of certain diseases for vital indications and in case of a threat to the life and health of the patient, other drugs may be used by decision of the medical commission, approved by the head physician of the medical institution "( instead of the order of December 02, 2004 N 296, the above order of the Ministry of Social and Health Development of the Russian Federation of September 18, 2006 N 665 applies).

Also, Part 5 of Article 37 of the Federal Law “On the Basics of Protecting the Health of Citizens in the Russian Federation” dated November 21, 2011 No. 323-FZ allows, for health reasons, the provision of medicines that are not included in the standards.

Based on the above, a medicine that is not included in the standard and list of the order of the Ministry of Health and Social Development of the Russian Federation No. 665 can be provided to me by decision of the medical commission medical institution according to vital indications.

A medicine that is not included in the list and standard should be provided to me at the expense of the budget of a constituent entity of the Russian Federation as a regional beneficiary on the basis of Decree of the Government of the Russian Federation of July 30, 1994 N 890 "On state support for the development of the medical industry and improving the provision of the population and healthcare institutions with medicines and medical devices". Attached to it, Appendix No. 1 "List of population groups and categories of diseases in the outpatient treatment of which medicines and medical devices are dispensed free of charge by prescription of doctors" provides that “disabled people of groups 1 and 2 and people with cancer have the right to receive medicines free of charge” and that all medicines are prescribed free of charge.

A similar position is set out in the Letter of the Ministry of Health and Social Development of the Russian Federation of February 3, 2006 N 489-VS "On the sale of medicines to the population according to the prescriptions of doctors for outpatient treatment free of charge and with a 50% discount" "with the simultaneous existence of the right to receive drug provision as part of a set of social services provided at the expense of the federal budget, as well as under the preferential procedure for providing medicines provided at the expense of the constituent entity of the Russian Federation, citizens have the right to receive drug provision on two grounds.

The drug cetuximab was prescribed to me by oncologists for health reasons and, according to the current legislation, should be provided to me for health reasons. Failure to receive the drug in a short time will lead to the progression of the disease and the onset of adverse consequences for life.

Based on the above, please:

1. Take measures to provide me with the drug cetuximab for the entire course of recommended treatment by the health authorities of the S-th region and their subordinate structures and allocate the necessary funds for this.

Application:

1. refusal of the Committee for the protection of the health of the population of the region.
2. decision to prescribe cetuximab.
3. extract from the medical history.

Signature, date.

5. Cancer patients who refused social. package

But if the cancer patient refused the social package, did not have time to restore it, while he is in an incurable condition, then you can write a complaint about the denial of drug provision under the regional benefit on the basis of Decree of the Government of the Russian Federation of July 30, 1994 N 890 and the territorial program of state area guarantees

A complaint
for denial of drug provision under a regional benefit

I am ___________, ______year of birth, I am a disabled person of ______ group for the disease C20 Ca of the rectomygmoid (intestinal cancer) with metastases to the brain and multiple metastases to the lungs. For pain relief, I need drugs lasix (INN furosemide), dexamethasone (INN dexamethasone), ketarol (INN ketorolac), tramadol (INN tramadol).

I refused the social package, in connection with which the local doctor of polyclinic No. ______ of the ______ district does not write out a preferential prescription for painkillers. However, people suffering from oncological diseases are at the same time regional beneficiaries and have the right to receive subsidized medicines at the expense of the budget of the constituent entity of the Russian Federation.

Article 41 of the Constitution of the Russian Federation establishes “the right of everyone to health care and medical care. Medical assistance in state and municipal health care institutions is provided to citizens free of charge at the expense of the relevant budget, insurance premiums, and other revenues.

Article 16 of the Federal Law "On the Basics of Protecting the Health of Citizens in the Russian Federation" dated November 21, 2011 No. 323-FZ refers to the powers of state authorities of the constituent entities of the Russian Federation in the field of health protection the establishment of social support measures for organizing the provision of medical care to persons suffering from social significant diseases and diseases that pose a danger to others, and on the organization of the provision of these persons with medicines. Decree of the Government of the Russian Federation of 01.12.2004 N 715 "On approval of the list of socially significant diseases and the list of diseases that pose a danger to others" malignant neoplasms are classified as socially significant diseases.

Clause 2 of Article 81 of these Fundamentals refers to the duties of state authorities of the constituent entities of the Russian Federation the formation, within the framework of the territorial program of state guarantees, of a list of medicines dispensed to the population in accordance with the List of population groups and categories of diseases, in the outpatient treatment of which medicines are dispensed by prescription of doctors free of charge.

The list of regional beneficiaries depending on the "groups of the population" and "categories of diseases" is contained in Appendix No. 1 to Decree of the Government of the Russian Federation of July 30, 1994 N 890 "On state support for the development of the medical industry and improving the provision of the population and healthcare institutions with medicines and medical products ", which provides for the right of people with cancer to receive all medicines free of charge, while financing the costs of paying for them is carried out at the expense of the constituent entity of the Russian Federation and other sources attracted for these purposes.

The prescription and prescribing of medicines for regional beneficiaries with references to Decree of the Government of the Russian Federation of July 30, 1994 N 890 is indicated in paragraph 34 of the Order of the Ministry of Health of the Russian Federation of December 20, 2012 N 1175n "On approval of the procedure for prescribing and prescribing drugs, as well as forms prescription forms for medicinal products, the procedure for issuing these forms, their accounting and storage.

In pursuance of the indicated federal regulations, a territorial program of state guarantees of free provision of medical care to citizens in the territory of the Kth region for 2013 and for the planning period of 2014 and 2015 is in force in the region.

Its Appendix 4 “List of medicines dispensed to the population in accordance with the list of population groups and categories of diseases, in the outpatient treatment of which medicines and medical devices are dispensed free of charge by prescription of doctors ...” includes INN drugs furosemide, dexamethasone, ketorolac, tramadol.

The right of federal beneficiaries who have refused the social package to receive preferential medicines under a regional benefit is explained in the letter of the Ministry of Health and Social Development of the Russian Federation dated February 3, 2006 N 489-BC "On the sale of medicines to the population according to doctors' prescriptions for outpatient treatment free of charge and with a 50% discount". It is indicated that with the simultaneous existence of the right to receive medicines provided at the expense of the federal budget, as well as under the preferential procedure for providing medicines provided at the expense of the constituent entity of the Russian Federation, citizens have the right to receive medicines for two reasons. In turn, in case of refusal of a set of social services for citizens who have the right to drug provision on two grounds, they retain the right to receive medicines provided at the expense of the constituent entity of the Russian Federation in accordance with Decree of the Government of the Russian Federation dated July 30, 1994 N 890.

On the basis of these federal and regional regulations, persons who have refused the social package are regional beneficiaries and are entitled to receive subsidized drugs in accordance with the territorial program of state guarantees and included in the regional list of subsidized drugs.

According to Art. 19 of the Federal Law "On the Basics of Protecting the Health of Citizens in the Russian Federation" dated November 21, 2011 No. 323-FZ, everyone has the right to medical care in accordance with the program of state guarantees of free provision of medical care to citizens and to alleviate pain associated with the disease with affordable methods and drugs.

According to Art. 4, 11 of the Federal Law of November 21, 2011 N 323-FZ "On the fundamentals of protecting the health of citizens in the Russian Federation", the basic principles of health protection are: the priority of the patient's interests in the provision of medical care, the availability and quality of medical care and the inadmissibility of refusal to provide medical assistance in accordance with the program of state guarantees.

Based on the above, please:

Take measures to provide me with the indicated painkillers for pain relief by the regional health authorities and their subordinate structures at the expense of the regional budget.

Application:

Date, signature.

Larisa Zvereva, lawyer