К вопросу об обязательном медицинском страховании с точки зрения лекарственного обеспечения населения

Abstract

Страхування в будь-якому сучасному суспільстві відіграє велику роль у функціонуванні економіки і підтримки життєвого рівня населення. Страхування є одним з інститутів економічного розвитку суспільства, незалежно від його політичного устрою. Забезпечення населення ліками є однією з важливих проблем у всіх країнах. Однак в умовах недостатнього фінансування системи охорони здоров’я, структура управління допомогою ліками, не дозволяє в повній мірі забезпечувати населення та медичні організації (МО) необхідними лікарськими препаратами (ЛП), а також дотримуватися державних гарантій в цій області; Страхование в любом современном обществе играет большую роль в функционировании экономики и поддержке жизненного уровня населения. Страхование является одним из институтов экономического развития общества, независимо от его политического устройства. Лекарственное обеспечение населения является одной из важных проблем во всех странах. Однако в условиях недостаточного финансирования системы здравоохранения, сложившаяся структура управления лекарственной помощью, не позволяет в полной мере обеспечивать население и медицинские организации (МО) необходимыми лекарственными препаратами (ЛП), а также соблюдать государственные гарантии в этой области; Insurance in any modern society plays an important role in the functioning of the economy and support living standards. Insurance is one of the institutions of economic development, regardless of its political system. Drug provision of the population is one of the important problems in all countries. However, in the conditions of insufficient financing of the health system, the current structure of the management of pharmaceutical assistance, does not allow to fully provide the population and medical organizations (MO) with necessary medicines (PL), and to comply with state guarantees in this area. It is possible to observe some differences between the structure of consumption of medicines in the hospital sector of the pharmaceutical market of the Russian Federation and in the group insured under the voluntary health insurance. For example, the main share in total hospital purchases is ATC group J01 — Antibacterial agents for systemic use — 20,4, in the system of drug insurance, its importance increases by more than half (42,6). Also almost two times more significant niche occupied by plasma-substituting and perfusion solutions (17,25 against 9.6), which may indicate the need to improve the quality of financing of pharmaceutical provision to these groups of drugs. In the structure of consumption of medicines in the DMS virtually no costs for antineoplastic and psychotropic drugs, which account for a significant share in the total consumption of drugs (3 and 5 place in importance, respectively). Primarily, this is due to the fact that the LCA system, the legislation excluded a number of severe chronic diseases, including cancer, mental disorders and behavioural disorders. All this partly explains the increasing share of the total consumption of the other drug groups. The total share of top ten ATC groups in the drug insurance system is 93,99% against 56.2 per cent in the total hospital purchases, which indicates strict targeting of drugs insurance on a very specific expensive drugs. According to the world Health Organization, 90% of medical problems can be solved with the help of 210 chemicals, as other means are not available for most of the population. Forms of organization of pharmaceutical support may be different. In developed countries it is usually free or reduced provide doctor prescribed treatment, diagnostic or prophylactic agents. All this is termed «pharmaceutical care», it also applied the principles of insurance. The cost of medical treatment at the hospital is entered in the expense of hospital services, and paid from the payment sources of inpatient care. In some countries, pharmaceutical care is included in the program of the MLA. Insurance companies pay the bills for the payment of medicines, appointed by the insured persons. In the end, they participate in the development and implementation of methods of regulation of prices for medicines. The law of Azerbaijan Republic «On medical insurance» defines the organizational, legal and economic basis of health insurance of the population, regulates the relations between subjects of medical insurance. The legislation of the Azerbaijan Republic on health insurance consists of the Constitution of the Azerbaijan Republic, present law, other normative-legal acts and international agreements wherein the Azerbaijan Republic. Medical insurance (compulsory and voluntary) citizens is carried out in the order established by the legislation of the Azerbaijan Republic. Compulsory health insurance is an integral part of state social insurance, as well as ensure that the population proportionate health and medical assistance.