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Moscow hosted the 9th annual conference "Health Technology Assessment", dedicated to improving the drug supply strategy

In the new economic conditions, the issue of increasing the efficiency of organizing and financing the healthcare system to ensure the quality and accessibility of medical care both at the federal and regional levels is extremely acute. 

“Health technology assessment is an internationally accepted tool for decision support in healthcare management. Defining a strategy for organizing, financing, improving the quality of medical care both at the federal and regional levels requires an assessment of the effectiveness, economic acceptability and social effect of the introduction or use of medical technologies. Today, at the federal level, such an instrument is enshrined in law and is used only for medicines - as part of the listing procedure. Obviously, such approaches should be applied to any technology - from medical devices to digital and design solutions and at all levels - national, regional and medical organizations," said Vitaly Omelyanovsky, Director General of the Center for Expertise and Quality Control of Medical Care of the Ministry of Health Russia, Doctor of Medical Sciences, Professor. The availability of innovative technologies for patients determines the level of healthcare development and the quality of medical care. According to IQVIA, Russia is significantly inferior in terms of the availability of new technologies to many countries European Union - as of January 01, 2022, our country tops the last ten in the ranking of 39 European countries. Over the past year, a major breakthrough has been made in ensuring the withdrawal of such drugs at the level of the Eurasian Economic Union - in March this year, changes were introduced to Decision No. 78 of the Council of the Eurasian Economic Commission "On the rules for registration and examination of medicines for medical use", providing for conditional expertise drugs, in particular for drugs of particular importance to public health. These changes require the development of criteria for classifying drugs as particularly significant for public health, taking into account such components as unmet medical need and the therapeutic value of the drug. Currently, the national legislation is being harmonized in accordance with these changes. The extremely high cost of personalized technologies with a low level of evidence of their effectiveness is a new challenge for the system, which requires new approaches to public financing - based on direct price negotiations with manufacturers and risk-sharing agreements between the payer and the drug manufacturer to increase the efficiency of spending financial resources . The Committee for Health Protection of the State Duma of the Russian Federation prepared a draft law on amendments to Federal Law-44 “On the contract system in the field of procurement of goods, works, services to meet state and municipal needs”, which provides for additional obligations of the supplier depending on the results of the use of medicines. To ensure the operation of the risk-sharing system and, in general, for the health care economy, it is critical to monitor the effectiveness of new technologies - the collection of real clinical practice data (RWE\RWD). It should be noted that in the EAEU the concept of collecting RWE has already been developed, however, in this country such a mechanism has not yet been developed and there are no conditions for its implementation. As noted by the All-Russian Union of Patients, the program of subsidized drug provision requires changes - the expansion of drug coverage for other diseases that significantly affect overall life expectancy. The effectiveness of ongoing therapy in a hospital is largely determined by how this therapy can be supported on an outpatient basis, therefore, today the issue of expanding the drug provision of patients under the CHI program to the outpatient level is extremely acute, but this requires additional funding. In order to achieve the national goals of maintaining health and well-being, increasing the life expectancy of the population, since 2019, 8 federal projects have been implemented as part of the national Healthcare project. Currently, the issue of launching a new project - to combat diabetes mellitus - is being considered. The development of new programs is impossible without a thorough assessment of the effectiveness of planned activities, the required amount of funding to achieve the goals - that is, the application of health technology assessment approaches. In order to increase efficiency and support decisions in healthcare management at the regional level, since 2022, a program for the development of competencies in the field of health technology assessment is being implemented - a joint project. As part of the program, local health authorities form separate functional HTA units, whose employees undergo a one-year training course in the application of HTA to solve the challenges in the field healthcare. This educational program is a joint project of the Federal State Budgetary Institution "TsEKKMP" of the Ministry of Health of Russia and the FGBOU DPO RMANPO of the Ministry of Health of Russia, and this year 12 regions are participating in it. In addition, a separate educational program is provided for the management staff of the health authorities of the constituent entities of the Russian Federation.