Pre-paid access to out-patient medications as a method of reducing economic barriers in Russia

Modern medical technologies have significantly expanded the scope of outpatient treatment. Given that, the lack of prepaid access to outpatient medications for the majority of Russian citizens can reduce the effectiveness of treatment. Using household survey data, this study shows that one in five households faces inability to purchase necessary medications due to the lack of funds. Households with relatively low incomes, as well as households with members in poor health and chronically ill individuals, are most at risk of unaffordable medications. The existing system of rationing of the prepaid access (the remedies benefits system) fails to address the issue of medication access, even for vulnerable groups. In particular, less than a quarter of elderly people are eligible for subsidized medications. Moreover, more than a third of those receiving benefits monetize the benefit, receiving a small monetary reimbursement. Refusal to use benefits in kind is often due to the high costs of obtaining and dispensing subsidized prescriptions. This raises questions about the goal-setting and targeting of the drug benefits system, which is mostly ineffective in reducing economic barriers to accessing healthcare.