home Audience 3 They do not provide medications. How to get preferential medicine. How soon will the pharmacy provide a discounted medicine that is out of stock?

They do not provide medications. How to get preferential medicine. How soon will the pharmacy provide a discounted medicine that is out of stock?

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 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 available this moment at a pharmacy, upon receipt of a 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 need to send it by mail - by registered mail with a list of investments and notification 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 unsubscribes begin (they are prohibited from writing out this medicine in the Department of Health, there is no money in the budget, etc.), then you need to contact the prosecutor’s office, regional Ministry healthcare, 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.

HOW TO GET FREE MEDICATIONS.
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 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 to be illegal on the basis of Order No. 110 of the Ministry of Health and the law on the relevant disease (you need to see if your disease is included in the 7 nosoologies, the List of social significant diseases etc.).
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 answer from the head physician, feel free to complain to the prosecutor’s office.

1. Look for your medicine according to the DLO list (you need to look not by company name and according to the active substance). Even if your exact active ingredient is not available, they should prescribe a drug with another active substance the same group (for example, nimesulide (Nise) as a non-steroidal anti-inflammatory drug can be replaced with meloxicam, diclofenac, ketoprfen, etc.).
2. Demand (not ask, but demand) from your doctor to write you a prescription for a subsidized drug, even if he says that he cannot write it because he is unavailable at the pharmacy. He must do this!!! In case of refusal, call the regional health department with a complaint (you shouldn’t call the city department - as a rule, this situation exists with their knowledge) and say that if no action is taken, send the complaint by registered mail (oral can be ignored, but written appeals by registered mail are all registered and have legal force even in court).
3. when you have been given prescriptions, you go to the pharmacy and if they tell you that there are no medications, then you MUST be placed on delayed service by registering in a special journal. This rule is valid for all regions (based on ORDER No. 785 dated December 14, 2005 ON THE PROCEDURE FOR DISpensing MEDICINES). The pharmacy is obliged to provide you with the medicine no later than 15 days, and even if the prescription is expired when the medicine becomes available, you should not refill it.
4. If you need medications urgently and cannot wait, buy the medications with your own money and keep the receipts so that your insurance company that issued them will later pay for them medical insurance. Please note that this applies to medications included in the list of benefits. In addition, purchased medications should be written down on a card, and not on a piece of paper by hand, since the insurance company may require extracts from the card (whether the doctor actually prescribed it and when).

We already know that subsidized medications for cancer patients are provided under federal and regional benefit depending on the status of the beneficiary. At the same time, medications included in the standard of treatment and in the preferential Lists are prescribed. Let me remind you that when outpatient treatment the basis for receiving preferential medications for people with disabilities is the Federal Law of July 17, 1999 N 178-FZ “On State social assistance", and the list of preferential medications 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 medicines dispensed according to prescriptions from a doctor (paramedic) with the provision of additional free medical care individual categories citizens entitled to receive state social assistance, which includes all preferential medications. That is, see if the medicine prescribed to you is included in the specified List.

The basis for receiving preferential medications for citizens suffering from cancer, but not having a disability group, is Decree of the Government of the Russian Federation dated July 30, 1994 N 890 “On state support development medical industry and improving the provision of medicines and products to the population and healthcare institutions medical purposes", Appendix No. 1 of which indicates the right of persons with cancer to preferential receipt all medicines. 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 whether the medicine prescribed to you is included in the federal and regional list (you can find out from the insurance company, TFOMS, from the appendix to the territorial state guarantee program, published on the Internet along with the Lists of medicines).

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

Article 37, paragraph 5 Federal Law RF dated 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 products and specialized products therapeutic nutrition, not included in the relevant standard of medical care, are allowed in case of medical indications (individual intolerance, for health reasons) by decision of the medical commission.”

Clause 6 of the Procedure for providing primary health care citizens eligible to receive the kit social services(Appendix 1 to the order of the Ministry of Health and Social Development of the Russian Federation dated November 22, 2004 N 255): “In case of insufficiency of pharmacotherapy in the treatment of certain diseases for life-saving important indications and if there is a threat to the life and health of the patient, other medications may be used according to the decision of the medical commission, approved by the chief physician of the medical institution" (for disabled people).

Now why should disabled people with cancer refuse social package it is forbidden. Medicines for the treatment of oncology are expensive and it is not always possible to provide a patient who refuses the social package with medicine at a regional benefit due to regular absence 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 require expensive antitumor treatment, and they should be provided with preferential medications 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 to receive subsidized medications does not depend on funding. However, references to lack of funding are the main obstacle to obtaining a subsidized drug that the oncologist will not prescribe, the attending physician will not write a prescription for, and the regional Ministry of Health will not purchase. It’s true that money may not be enough, but it may also be that there is money, but they simply don’t want to treat the cancer patient and spend it on purchasing expensive medicine federal funds, not to mention regional money. But patients also want to live, as do officials and doctors who do not complain about their health and who refuse medicine to patients. In this case, cancer patients are forced to fight for their lives and for what is guaranteed to them by the state drug provision. Some people succeed. In this regard, it is possible to invite patients who are denied subsidized medications to file complaints about the refusal of treatment.

First, you need to write a complaint to the regional Ministry of Health about a refusal to provide medicine, and it is advisable to receive a written response. (True, this method Preliminary application to the Ministry of Health has a disadvantage - the consideration period is within one month). Usually, the regional Ministry of Health issues a refusal to treat with references to the lack of funding for both federal and regional benefits, which already becomes 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 (though only for disabled people). Roszdravnadzor is obliged to respond to the patient’s complaint. Upon receiving a complaint, Roszdravnadzor usually sends a letter to the regional Ministry of Health with a request to “understand the situation, provide the patient with medicine and report measures taken" If, despite this, discounted medicine not received, then you will have to complain to the prosecutor's office. But it should be borne in mind that if the patient does not attach a response from the Ministry of Health to the complaint to the prosecutor’s office, then the prosecutor will forward the patient’s complaint to the regional Ministry of Health and this may all end there, since the Ministry of Health simply will not respond. If the patient attaches a written response to the refusal from the Ministry of Health, then the prosecutor’s office is obliged to consider the complaint and take prosecutorial response measures. Federal Law of January 17, 1992 N 2202-I “On the Prosecutor’s Office of the Russian Federation” in Article 1 includes supervision over the implementation of laws and the observance of human rights and freedoms as the powers of the prosecutor’s office. Article 10 provides for the obligation to resolve applications, complaints and other requests to the prosecutor's office with the preparation of a reasoned response. At the same time, “it is prohibited to forward a complaint to the body or official whose decisions or actions are being appealed.” But, unfortunately, the prosecutor's office often forwards complaints to the regional Ministry of Health, although a response has already been received from there about the refusal to treat the patient, which does not comply with Article 10 of the Law on the Prosecutor's Office.

If medication is denied to a person with cancer 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. Thus, according to one of the appeals of a regional benefit recipient to the territorial Roszdravnadzor, he expressed his position on the right of a patient with cancer to receive medications at a regional benefit, which may also be useful to the patient in future appeals.

When writing a complaint, you should indicate, in addition to your last name and first name, the presence of a disability group, where and by whom the medicine was prescribed (to prove that you recommended it for yourself at will), if the medicine has already been provided, then indicate how many times the medicine was received and under what conditions (under a preferential prescription, in a hospital) and other information. Or describe another current situation. The complaint indicates all addressees, you can attach a copy ITU certificates, discharge summary, medication prescription documents. If responses were received from the Ministry of Health, then provide 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, on which is marked the body that accepted it. The complaint can also be sent by registered mail with acknowledgment of receipt. A copy of the complaint addressed to the regional Ministry of Health can also be sent to the prosecutor’s office, which does not exclude, as indicated above, the sending of a separate complaint to the prosecutor in the event of a negative response from the Ministry of Health, which has a different status. Also, a copy of the complaint can be sent to the regional human rights ombudsman so that he is aware of the situation with the refusal of medicines 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 regional Ministry of Health.

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

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

Below are examples of complaints about the refusal to provide medicine to a disabled person and to the refusal to provide medicine to 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 regulations that grant the patient the right to preferential drug coverage.

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

1. Sample complaint

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

Complaint
to refuse to provide subsidized medicine

I, full name Born in 1946, I am a group 2 disabled person with stage 4 rectal cancer. At Oncology Center No. 1 of K-va, I was surgical removal tumors and for further treatment at the council of Oncology Dispasner No. 1 05.09. In 2013, the drug Gleevec was prescribed

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

Based on Federal Law dated November 24, 1995 N 181-FZ “On social protection disabled people in the Russian Federation", Federal Law of July 17, 1999 N 178-FZ "On State Social Assistance" disabled people are recipients of a set of social services and have the right to be provided with necessary medicines according to doctor’s prescriptions in accordance with the standards of medical care.

Imatinib is included in the standard of treatment 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 are transferred for implementation to the authorities state power subjects of the Russian Federation.

The procedure for prescribing and prescribing medicines within the framework of state social assistance is carried out in accordance with the provisions of 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 medicines, as well as forms of prescription forms for medicines, the procedure for completing these forms , their accounting and storage." According to clause 4.1. Order, disabled people are provided medicines in accordance with the List of medicines dispensed according to prescriptions 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 dated September 18, 2006 N 665 ).

Gleevec under the INN Imatinib is included in the specified federal List of preferential drugs, therefore, for medical reasons, it should be provided to me on a preferential prescription at the expense of the federal budget within the framework of the specified powers transferred to the constituent entity 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 indicated in the letter of the Ministry of Health and Social Development of the Russian Federation dated February 3, 2006 N 489-BC “On the dispensing of medicines to the population according to doctors’ prescriptions for outpatient treatment free of charge and with a 50 percent discount”: “with the simultaneous existence of the right to receive medicines as part of the set social services provided at the expense of the federal budget, as well as within preferential treatment provision of medicines provided at the expense of the constituent entities of the Russian Federation, citizens have the right to receive medicines 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 supply of medicines and medical products to the population and healthcare institutions.” Appendix No. 1 to the Resolution states that citizens suffering oncological diseases, have the right to free provision of all medicines according to doctors’ prescriptions.

Besides, malignant neoplasms are included in the List of Socially Significant Diseases (Resolution of the Government of the Russian Federation of December 1, 2004 N 715). In this connection, Article 16 of Federal Law No. 323-FZ includes the establishment of measures as the powers of state authorities of the constituent entities of the Russian Federation in the field of health protection social support on organizing the provision of these persons with medicines.

The above means that the prescribed subsidized medicine should have been provided to me on one of the specified grounds at the expense of one of the two above-mentioned sources of financing. However antitumor drug Gleevec (INN imanitib) I was not provided with either a “federal benefit” or a “regional benefit”.

According to Art. 4, 10, 11 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 health protection 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 provision.

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

Take measures to provide me with the vital 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 refusal to provide preferential medicine (disabled person)

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

Where: Regional Ministry of Health
Address___________________________________
Where: Territorial Roszdravnadzor

Address:___________________________________
Address:__________________________________

Complaint
for refusal to provide preferential medicine (disabled person)

I, full name Born 1965 , I suffer from stage 4 malignant neoplasm of the mammary gland, I am disabled and included in the Federal Register of Beneficiaries. For the treatment of the disease by consultation with the S - 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 August 24, 2013 to November 20, 2013.

However, since October 2013 I have not received treatment with these medications (note: indicate the name of the medicine) neither inpatient nor outpatient by issuing preferential prescriptions. The regional Ministry of Health justifies the refusal of treatment by the lack of funding for drug provision under federal benefits (response No. 545 of September 24, 2013).

I consider the refusal to treat me with these vitally needed drugs to be illegal based on the following.

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

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 corresponding 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 medications... that are not included in the relevant standard of medical care are allowed in the case of medical indications (individual intolerance, for health 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 of Specialized Medical Care for primary generalized and recurrent forms of stage IV breast cancer - primary; Stages I-IV - progression (approved by Order of the Ministry of Health of the Russian Federation dated 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 Order of the Ministry of Health of the Russian Federation dated November 9, 2012 N 723n).

(note: if the patient has a stage of the diseaseI-III (T1N0M0 - T any N3M0), then the complaint must refer to the standarddated November 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 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 people, as recipients of a set of social services, have the right 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 government 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 according to prescriptions of a doctor (paramedic) when providing additional free medical care to certain 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 forms of prescription forms for medicines, the procedure for completing these forms, their recording and storage, approved by the Order of the Ministry of Health and Social Development RF dated December 20, 2012 N 1175n).

The List of Order of the Ministry of Social Health Development of the Russian Federation No. 665 includes the drugs paclitaxel, tratuzumab, zoledronic acid.

By Decree of the Government of the Russian Federation of December 1, 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.

It follows from these regulations: that I have the right to receive the indicated medications 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 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 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 its provision.

Insufficient funding is not a basis for exempting the regional health care authority from treating 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 was violated, 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 progression of the disease and a poor prognosis for life.

Based on the above, I request:

1. Understand the situation with refusal of treatment, take measures to ensure that the Ministry of Health of the city of St. Va and its subordinate structures provides me with the drugs trastuzumab and zoledronic acid for the entire course of treatment.

Application:

Date, signature.

3. Regional benefit (cancer patient without disability group)

Note: it is necessary to check whether the medicine prescribed or recommended for 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 nutrition products and medical products sold to the population in accordance with the list population groups and categories of diseases, for outpatient treatment of which medicines, specialized medical nutrition products and medical products are dispensed free of charge according to doctor’s prescriptions....” In some areas, the regional List may be contained in separately adopted regulations, which should be indicated in the state guarantee program. The text of the complaint must 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: ________________________________

Complaint
for denial of drug provision under a regional benefit
(cancer patient without 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 carried out 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 the drugs Herceptin (INN trastuzumab) and tamoxifen (INN tamoxifen) by the oncologists of the territorial oncology hospital in Vka. However, I did not receive these medications for treatment. In response to my appeal to the regional Ministry of Health ( indicate - orally, in writing) a response was received about refusal of treatment due to lack of funds for the treatment of regional beneficiaries.

I consider the actions of the regional Ministry of Health and its subordinate structures in refusing me treatment to be 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 medications... that are not included in the relevant standard of medical care are allowed in the case of medical indications (individual intolerance, for health reasons) by decision of the medical commission” (clause 5 of Article 37 of the Fundamentals).

Trastuzumab is included in the standard of specialized medical care for stage I-III malignant breast tumors (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 this standard, but should also be provided to me for medical reasons on the basis of clause 5 of Art. 37 Basics

Article 16 of the Fundamentals includes the organization of providing persons suffering from socially significant diseases with medicines to the powers of state authorities of the constituent entities of the Russian Federation in the field of health protection. By Decree of the Government of the Russian Federation of December 1, 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.

Pursuant to the decree, paragraph 2 of Article 81 of the Fundamentals, the responsibilities of state authorities in the field of healthcare include 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 for the outpatient treatment of which medicines are dispensed by prescription doctors for free.

The Law of the Second Region dated December 25, 2012 No. 143-PK approved the territorial program of State guarantees of free provision of medical care to the population of the Second Region in 2013 and the planning period of 2014 and 2015.

Appendix 3 “List of drugs dispensed to the population in accordance with the list of population groups and categories of diseases for the outpatient treatment of which drugs and medical products are dispensed free of charge according to doctors’ prescriptions...” includes the drugs trastuzumab and tamoxifen.

The list of population groups and categories of diseases 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 medicines and medical products to the population and healthcare institutions.” Appendix No. 1 to it “List of population groups and categories of diseases for the outpatient treatment of which medicines and medical products are dispensed free of charge according to doctors’ prescriptions” states that persons with cancer have the right to free provision of all medicines according to doctors’ prescriptions.

According to Art. 19 of the Federal Law “On the Fundamentals 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 volume, without charging a fee in accordance with the program of state guarantees of free medical care to citizens.

According to Art. 4, 10, 11 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 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 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 corresponding budget.

Thus, as a resident of the V-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 to provide medicines to privileged categories of citizens cannot serve legal basis to limit state guarantees of free medical care.

With the specified constitutional, federal and regional guarantees for the patient’s drug supply, from 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 vital for me important, non-receipt of which in short term will lead to the progression of the disease and the onset of adverse consequences for life.

Based on the above, I request:

Take measures to ensure that the health authorities of the 2nd region and their subordinate structures provide me with the drugs trastuzumab and tamoxifen for the entire course of recommended treatment.

Application:

Signature, date.

4. Complaint about refusal to provide preferential medicine (disabled person)

(if the drug is not included in the standard of treatment and preferential lists

From whom: ________________________________

Complaint
for refusal to provide preferential medicine (disabled person)

I am Full Name I am a disabled person of group 1 due to the disease: sigmoid colon cancer T4N2M1. On February 26, 2013, the council of the Ny OKOD decided to prescribe me the drug cetuximab. ( or indicate that this drug was recommended ___ where) .

However, the Ministry of Health of the N region refused to provide the drug “cetuximab”, since it is not included in the standard of treatment for my disease and is not included in the preferential federal list medicines, namely in the list of 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 according to prescriptions of a doctor (paramedic) when providing 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 dated September 18, 2006 N 665.

However, the possibility of using medications not included in the preferential Lists, in particular, in the list of the order of the Ministry of Social Health Development of the Russian Federation, is indicated in clause 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 a therapist or medical specialist prescribes medications provided for in the “List of Medicines”, approved by Order of the Ministry of Health and Social Development of the Russian Federation dated December 2, 2004 N 296 “On Approval of the List of Medicines” in accordance with the standards of medical care approved in accordance with the established procedure. In case of insufficiency of pharmacotherapy in the treatment of certain diseases for vital indications and if there is a threat to the life and health of the patient, other drugs may be used by decision of the medical commission approved by the chief physician of the medical institution" ( Instead of order dated December 2, 2004 N 296, the above order of the Ministry of Social Health Development of the Russian Federation dated September 18, 2006 N 665 is in effect).

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

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 must 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 the 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 supply of medicines to the population and healthcare institutions and medical products." The attached Appendix No. 1 "List of population groups and categories of diseases for the outpatient treatment of which medicines and medical products are dispensed free of charge according to doctors' prescriptions" stipulates that "right to free receipt disabled people of groups 1 and 2 and people with cancer” and that all medications are prescribed free of charge.

A similar position is set out in Letter of the Ministry of Health and Social Development of the Russian Federation dated February 3, 2006 N 489-BC “On the dispensing of medicines to the population according to doctors’ prescriptions for outpatient treatment free of charge and with a 50% discount” “with the simultaneous existence of the right to receive drug coverage within the framework of a set of social services provided at the expense of the federal budget, as well as within the framework of the preferential procedure for providing medicines provided at the expense of the constituent entities of the Russian Federation, citizens have the right to receive medicines on two grounds.

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

Based on the above, I request:

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

Application:

refusal of the Regional Population Health Committee.
decision to prescribe cetuximab.
extract from the medical history.

Signature, date.

5.Cancer patients who have given up social services. package

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

Complaint
for denial of drug provision under a regional benefit

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

I refused the social package, and therefore the local doctor at clinic No. ______ district ______ preferential prescription does not prescribe painkillers. However, persons suffering from cancer are at the same time regional beneficiaries and have the right to receive preferential medications at the expense of the budget of the constituent entity of the Russian Federation.

Article 41 of the Constitution of the Russian Federation establishes “everyone’s right to health care and medical care. Medical care in government and municipal institutions healthcare is provided to citizens free of charge at the expense of the corresponding budget, insurance premiums, and other revenues.”

Article 16 of the Federal Law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” dated November 21, 2011 No. 323-FZ includes the powers of state authorities of the constituent entities of the Russian Federation in the field of health protection to establish measures of social support for organizing the provision of medical care to persons suffering from social significant diseases and diseases that pose a danger to others, and on organizing the provision of these persons with medicines. By Decree of the Government of the Russian Federation of December 1, 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.

Paragraph 2 of Article 81 of these Fundamentals includes among the responsibilities 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 for the outpatient treatment of which medicines are dispensed according to doctors’ prescriptions free of charge.

The list of regional beneficiaries depending on “population groups” and “categories of diseases” is contained in Appendix No. 1 to the 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 supply of medicines and medical products to the population and healthcare institutions ", which provides for the right of persons with cancer to receive all medicines free of charge, while the costs of paying for them are financed from the funds of the constituent entity of the Russian Federation and other sources raised for these purposes.

The prescribing and prescribing of medications for regional beneficiaries with references to the 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 medications, as well as forms prescription forms for medicines, the procedure for completing these forms, their recording and storage."

In pursuance of these federal regulations, a territorial program of state guarantees of free medical care to citizens in the territory of the K-th region is in effect in the region for 2013 and for the planning period of 2014 and 2015."

Its Appendix 4 “List of medicinal products dispensed to the population in accordance with the list of population groups and categories of diseases for the outpatient treatment of which medicinal products and medical products are dispensed free of charge according to doctors’ prescriptions...” 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 dispensing of medicines to the population according to doctors’ prescriptions for outpatient treatment free of charge and with a 50 percent discount.” discount." It is indicated that while simultaneously having the right to receive medicines provided at the expense of the federal budget, as well as within the framework of the preferential procedure for providing medicines provided at the expense of the constituent entities of the Russian Federation, citizens have the right to receive medicines on two grounds. In turn, if a set of social services is refused to citizens who have the right to receive medicines on two grounds, they retain the right to receive medicines provided at the expense of the constituent entities of the Russian Federation in accordance with Decree of the Government of the Russian Federation dated July 30, 1994 N 890.

Based on the specified federal and regional regulations, persons who have refused the social package are regional beneficiaries and have the right to receive preferential medications in accordance with the territorial program of state guarantees and included in the regional list of preferential medications.

According to Art. 19 of the Federal Law “On the Fundamentals 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 medical care to citizens and to relief of pain associated with the disease available methods and medications.

According to Art. 4, 11 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 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 care assistance in accordance with the state guarantee program.

Based on the above, I request:

Take measures to provide me with the regional health authorities and their subordinate structures with the specified painkillers to relieve pain at the expense of the regional budget.

Application:

Date, signature.

Larisa Zvereva, lawyer