Pharmacy cooking. New INNs included in the list of free medicines. What happens in practice

Thanks to changes in the recommendations and orders of the Ministry of Health Russian Federation, many prescription drugs will be dispensed from March 1, 2017. The beginning of the current year for many pharmacy chains, as well as the pharmacological sphere as a whole turned out to be turbulent. Some guidelines have already entered into force, others will soon come into force. Some of the orders introduced a moratorium on the work of pharmacists, while others make it much more difficult to dispense prescription drugs.

What kind of prescription drugs are dispensed from March 1, 2017?

By order of the Ministry of Health, certain restrictions are introduced on the sale of drugs medicinal purpose. Implementation medical devices in one hand carried out in limited quantity. This refers to the sale of syrups and tinctures that contain ethyl alcohol in a concentration of at least 15%. Pharmacists can sell no more than two packages per hand. For what purpose they do this, it is clear to many. Today, far from all drugs people buy to fight ailments. This fact confirms the mass poisoning with hawthorn tinctures in Irkutsk, where more than 70 people were injured.

In addition, pharmacists are prohibited from advising a client more expensive medicines, if there is inexpensive analogue. Although, according to many representatives of the pharmacological industry, such standards were previously prescribed in the instructions for pharmacy workers.

Also, pharmacists are required to provide their client with data on the characteristics and contraindications of medications, as well as their expiration date, storage conditions and dosage. Previously, such things were not discussed at all.

Prescription drugs

According to the law of the Ministry of Health No. 785, since March 1, 2017, medicines are dispensed by prescription. An exception is the list of those drugs that can be dispensed without a prescription.

The list of prescription drugs since March 1, 2017 is quite extensive. It includes drugs from literally all medicinal groups. Most on the list are antibiotics. According to the idea of ​​the Ministry, they should all be prescription. Therefore, if we act strictly according to the law, more than 50% of all drugs in pharmacies must be sold only if there is a prescription from the attending physician.

The opinion of representatives of the pharmacy business

According to representatives of the pharmaceutical industry, there are practically no recipes in the classical sense at present. Doctors write appointments on pieces of paper. At the same time, according to the director of one of the pharmacy chain Kakhaber Bakuradze, today many pharmacy pharmacists are being retrained for new way. He also reports that every day everything more people they come to the pharmacy with prescriptions, and pharmacists work exclusively according to the instructions, that is, in accordance with the current legislation.

Today, the sale of prescription drugs without availability necessary documents threatens with a fine of up to 50 tr. Authorities are considering making the penalties for over-the-counter sales of prescription drugs tougher. It's about about the potential termination of activities for a period of up to 90 days.

Information about over-the-counter medicines is allowed to be placed on the shelves, in the formats of wobblers and posters, as well as on other media so that the buyer can fully familiarize himself with the product. In a comfortable view, it is necessary to place a price tag with the name, number of doses in the package, dosage, manufacturer.

Barcode on medical products

In addition, another important innovation comes into force - labeling on each drug. A pilot project of the corresponding type is being launched in several Russian cities. the main objective action is to combat counterfeiting and counterfeiting medical preparations.

According to preliminary data, this project will help track about six billion packs of medical supplies. At the initial stage in March, the barcode will be placed on 60 products. Including - 10 drugs for the treatment of rare ailments, as well as more than 30 types of drugs that have been included in the list of essential prescription drugs since March 2017. It is planned that by the end of this year, the automation of the accounting system is considered voluntary. Next year it will be mandatory.

According to Rospotrebnadzor, each pack of a medical product in production will be equipped with a two-dimensional barcode. It will be located next to information about the period until which the medicine may be valid. Such a system will allow you to determine the origin of the drug without leaving the pharmacy cash desk.

Difficulties in operating a barcode

However, some problems were also found. On the mobile device A program to read the code must be installed. There is another option. The buyer can use a pharmacy scanner, which must be installed in the pharmacies participating in the project. The system will give the buyer comprehensive information about where, who and when the drug was manufactured.

Kakhaber Bakuradze argues that there should be no problem with the new barcodes. The IT department specialists produced all the required templates a long time ago. This will make it possible to forget about falsification forever and gray preparations whose origin is unknown. Honest pharmacological businessmen will only benefit from such changes.

Are medicines getting more expensive?

Many are interested in the question of whether these changes will affect ordinary people in a financial sense? According to pharmacological market experts, the changes will not affect the cost of drugs in any way. As they report, the new requirements will be useful to buyers, as well as owners of honest pharmacies that do not use illegal drug sales schemes.

The cost of drugs should not be higher. This is evidenced by the prices of drugs in pharmacies in January. Prices have hardly changed.

List of free medicines for 2017

It should be noted that there is a list free medicines for 2017 for preferential categories population. However, information about free drugs is provided by the attending physician. He himself is obliged to inform the patient. If the doctor ignores his duties, the patient has the right to clarify the information. Information about free medicines is also provided by the insurance company.

By the way, in 2017 the film “Health Cure” was released, which vividly illustrates the situation with medicines in our country.

IP and IBLP

In general, in order No. 403n, the topic of IBLP leave is spelled out separately, which is not in order No. 785. It will be regulated by paragraph 13 of the first of the mentioned acts. This paragraph, in particular, determines that when the IBLP is dispensed, the prescription or prescription spine that remains with the buyer is indicated exact time this very vacation, in hours and minutes.

Violation of the secondary

With the entry into force of Order No. 403n, new accents will appear on the topic of the possibility of violating the secondary (consumer) packaging of medicines. The norm of the “retiring” order No. 785 allows doing this in exceptional cases, if the pharmacy organization cannot fulfill the doctor's prescription.

Order No. 403n, which replaces it, is more specific in this regard and more in line with modern requirements, medical practice and consumer needs. Paragraph 8 of the order determines that violation of the secondary packaging and dispensing of the medicinal product in the primary packaging is allowed in cases where the amount of the drug specified in the prescription or required by the consumer (in case of over-the-counter dispensing) less quantity drug contained in the secondary packaging.

In this case, the buyer must be provided with instructions for use or a copy of it, and violation of the primary packaging is prohibited. By the way, the new order does not contain a rule that, in case of violation of the secondary drug, the drug should be dispensed in a pharmacy package with the obligatory indication of the name, factory batch, expiration date of the drug, series and date according to the laboratory packing journal, which is determined by order No. 785.

"Medication Released"

Clause 4 of Order No. 403n of the Ministry of Health of the Russian Federation regulates the topic of prescription forms and the list of drugs dispensed on them. In particular, Form No. 107/y-NP dispenses narcotic and psychotropic drugs of Schedule II, with the exception of narcotic and psychotropic drugs in the form of transdermal therapeutic systems.

The remaining prescription drugs, as you know, are dispensed according to the forms of the form No. 107-1 / y. According to paragraph 22 of the order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing medicines, as well as forms of prescription forms ...”, prescriptions written out on the forms of this form are valid for two months from the date of issuance. However, for patients with chronic diseases it is allowed to set the validity period of the prescription form No. 107-1 / y up to one year and exceed the recommended amount of the drug for prescribing per prescription, installed by the application No. 2 of this order.

Such a prescription, which also indicates the periods and the amount of dispensing of the medicinal product (in each period), is returned to the buyer, of course, with the appropriate notes on the date of dispensing, dosage and quantity of the dispensed drug. This is prescribed by paragraph 10 of order No. 403n. He also determines that the next time the patient contacts the pharmacy with the same prescription, the first-timer must take into account the notes on the previous release of the drug.

The prescription remains in the pharmacy

There are some changes on the topic indicated in the title of this chapter. Paragraph 14 of the new order establishes that the subject retail remain (marked "Drug product dispensed") and stored:

within 5 years prescriptions for:

within 3 years prescriptions for:

within 3 months recipes for:

The order of the Ministry of Health of Russia No. 403n did not do without a cherry on the cake, however, a dubious one. In paragraph 15 of the order, it is written that prescriptions that are not indicated in the previous paragraph 14 (we listed them a little higher) are marked with the stamp “The drug is dispensed” and returned to the indicator. This seems to imply that Form 107-1/2-month-validity prescriptions become "single use." We advise readers to pay special attention to this new norm.

The topic of combating the abuse of alcohol-containing drugs in the pharmacy assortment, which was recently trumpeted by the media, was also reflected in the new order on the rules of dispensing. By current order, prescriptions for such drugs are returned to the patient (with a stamp "released"); under the new order, they must remain in the pharmacy organization.

To not get caught

The procedure for working with incorrectly written prescriptions is now described in a little more detail (paragraph 15 of order No. 403n). In particular, when they are registered by a pharmacist in the journal, it is necessary to indicate the identified violations in the preparation of the prescription, the name of the health worker who issued it, the name of the medical organization in which he works, and the measures taken.

Clause 17 of Order No. 403n contains a rule that a pharmacist is not entitled to provide false or incomplete information about the presence of medicines in the assortment of a pharmacy facility - including drugs that have the same INN - and also hide information about the presence of drugs that have more than low price. Similar provisions are contained in subparagraph 2.4 of article 74 of the Law of November 21, 2011 No. 323-FZ “On the basics of protecting the health of citizens in the Russian Federation” and paragraph 54 of the Rules of Good Pharmacy Practice (Order of the Ministry of Health of the Russian Federation of August 21, 2016 No. 647n). What is new here is that this norm first appears in the leave regulations order.

It was a review of the order, so to speak, "on a fresh trail." Probably, readers will find in it other points and norms that deserve special attention. Write to the editors of Katren-Style magazine about them, and we will address your questions to leading industry experts. We will also ask them about the “one-time” issue of prescriptions with a two-month expiration date discussed above, as well as vacation ethyl alcohol and alcohol-containing preparations in the light of the provisions of the new order No. 403n.

Materials about the order of the Ministry of Health No. 403n:

What could be more important for a pharmacy organization than the order in which drugs are dispensed. As soon as the pharmacists had time to return from their summer vacation and look around, it was published new order Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n with annexes “On approval of the rules for dispensing medicines for medical use, including immunobiological drugs, pharmacy organizations, individual entrepreneurs licensed for pharmaceutical activities. Order No. 403n on the vacation procedure was registered with the Ministry of Justice of the Russian Federation on September 8; the beginning of its action is September 22 of the current year.

The first thing I want to say in this regard is to forget now the number "785". The new order 403n with amendments and additions recognizes as invalid the well-known order of the Ministry of Health and Social Development dated December 14, 2005 No. 785 “On the procedure for dispensing medicines”, as well as the orders of the Ministry of Health and Social Development No. 302, No. 109 and No. 521 that made changes to it. new normative legal act repeat - sometimes almost verbatim - the corresponding fragments of the predecessor order. But there are also differences, new provisions, on which we will focus to a greater extent, setting out the first observations and notes in the margins of the freshly baked order of the Ministry of Health No. 403n.

IP and IBLP

Order of the Ministry of Health of the Russian Federation No. 403n consists of three appendices. The first approves new rules for dispensing medicinal products, including immunobiological medicinal products (IBLP); the second - the requirements for the dispensing of narcotic and psychotropic medicinal products, drugs that have anabolic activity, and other drugs subject to subject-quantitative accounting (PKU). The third annex establishes the rules for dispensing medicines according to the requirements of invoices of medical organizations, as well as individual entrepreneurs (IEs) who have a license for medical activities.

The release of over-the-counter drugs and under the new procedure will be allowed both for pharmacies and pharmacy points, and for individual entrepreneurs and pharmacy kiosks. Otherwise, if we sum up points 2 and 3 of order No. 403n and the list of drugs, the following picture emerges.

• The release of narcotic and psychotropic drugs can only be carried out by pharmacies and pharmacy points that have the appropriate license.
• Leave the rest prescription drugs are carried out by pharmacies, pharmacy points and individual entrepreneurs (of course, those who have a license for pharmaceutical activities - this clarification will be further considered accepted by default and omitted).
• The release of immunobiological prescription drugs is carried out by pharmacies and pharmacy points. Individual entrepreneurs are not mentioned in this provision of paragraph 3, which means that they cannot dispense drugs of this group, which we advise you to pay special attention to.

In general, in order No. 403n, the procedure for dispensing IBLP drugs is prescribed separately, which is not in order No. 785. It will be regulated by paragraph 13 of the first of the mentioned acts. This paragraph, in particular, determines that when the IBLP is dispensed, the exact time of this very issue, in hours and minutes, is indicated on the prescription or prescription spine that remains with the buyer.

It is possible to release IBLP under two conditions. Firstly, if the buyer has a special thermal container, in which it is possible to comply with the required mode of transportation and storage of these thermolabile drugs. The second condition is an explanation (pharmacy worker to the buyer) of the need for delivery this drug to a medical organization, despite the fact that it can be stored in the mentioned container for no more than 48 hours.

Recall in this regard that this topic is also regulated by subparagraph 8.11.5 of the Sanitary and Epidemiological Rules “Conditions for transportation and storage immunobiological preparations"(SP 3.3.2.3332-16), which are approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation of February 17, 2016 No. 19. It obliges the pharmacy employee to instruct the buyer on the need to comply with the" cold chain "when transporting IBLP.

The fact of this briefing is recorded by a mark - on the drug package, prescription or other accompanying document. The mark is certified by the signature of the buyer and the first owner (or other representative of the pharmacy organization) and also includes the date and time of the vacation. However, SanPiN does not specify that the time in this case must be entered in hours and minutes.

Violation of the secondary

With the amendments and additions to Order No. 403n, new accents will appear on the topic of the possibility of violating the secondary (consumer) packaging of medicines. The norm of the "retiring" order No. 785 allows this to be done in exceptional cases, if the pharmacy organization cannot fulfill the doctor's prescription.

Order No. 403n, which replaces it, with a list of drugs in this regard, is more specific and more in line with modern requirements, medical practice and consumer needs. Clause 8 of the order determines that violation of the secondary packaging and dispensing of the medicinal product in the primary packaging is allowed in cases where the amount of the drug indicated in the prescription or required by the consumer (in case of over-the-counter dispensing) is less than the amount of the drug contained in the secondary packaging.

In this case, the buyer must be provided with instructions for use or a copy of it, and violation of the primary packaging is prohibited. By the way, in the new order of the Ministry of Health of the Russian Federation No. 403n there is no rule that, in case of violation of the secondary drug, the drug should be dispensed in a pharmacy package with the obligatory indication of the name, factory batch, expiration date of the drug, series and date according to the laboratory packing journal, which is determined by order No. 785.

What does this mean in practice? Let's assume two situations: the first - preparation X tablets (or pills) No. 56, primary packaging - blister; the second - the preparation of N tablets No. 56, in a vial. And in both cases, there is a question about his release to the patient who presented the prescription to the head of state, on which, say, 28 tablets or 42 tablets (pellets) are written.

It is clear that in the first case this is permissible, since it is possible to release 28 or 42 tablets without breaking the primary packaging (blister), and in the second case it is unacceptable, since the primary packaging in this situation is a vial, and it is strictly forbidden to violate it. So count out pills or dragees from a bottle, as they do in some pharmacies foreign countries, our pervostolniki do not have the right.

"Medication Released"

Clause 4 of Order No. 403n of the Ministry of Health of the Russian Federation regulates the topic of prescription forms and the list of drugs dispensed on them. In particular, Form No. 107/y-NP dispenses narcotic and psychotropic drugs of Schedule II, with the exception of narcotic and psychotropic drugs in the form of transdermal therapeutic systems.

According to the form No. 148–1 / y-88, the following are released:

• psychotropic drugs of Schedule III;
• narcotic and psychotropic medicinal products of Schedule II in the form of transdermal therapeutic systems;
• drugs included in the list of medicines subject to PKU, with the exception of those drugs that are dispensed in accordance with the form No. 107 / y-NP;
• drugs with anabolic activity and related to the anatomical-therapeutic-chemical classification (ATC) recommended by the World Health Organization, to anabolic steroids(code A14A);
• preparations specified in paragraph 5 of the "Procedure for dispensing individuals medicines containing other than small amounts drugs, psychotropic substances and their precursors other pharmacological active substances"(Order of the Ministry of Health and Social Development of the Russian Federation dated May 17, 2012 No. 562n);
• preparations manufactured according to a prescription for a medicinal product and containing a narcotic drug or psychotropic substance included in Schedule II, and other pharmacologically active substances in a dose not exceeding the highest single dose, and provided that the combination medicinal product is not a Schedule II narcotic or psychotropic medicinal product.

The list of other prescription drugs, as you know, are released according to the forms of the form No. 107-1 / y. According to paragraph 22 of the order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing medicines, as well as forms of prescription forms ...”, prescriptions written out on the forms of this form are valid for two months from the date of issuance. However, for patients with chronic diseases, it is allowed to set the validity of the prescription form No. 107-1 / y up to one year and exceed the recommended amount of the drug for prescribing per prescription, established by Appendix No. 2 of this order.

Such a prescription, which also indicates the periods and the amount of dispensing of the medicinal product (in each period), is returned to the buyer, of course, with the appropriate notes on the date of dispensing, dosage and quantity of the dispensed drug. This is prescribed by paragraph 10 of order No. 403n. He also determines that the next time the patient contacts the same prescription for the list of drugs at the pharmacy, the first-timer must take into account the notes on the previous release of the drug.

At the time when the maximum amount specified in the prescription is purchased, it must be stamped “Medicinal product dispensed”. And a one-time vacation of the entire amount, according to the same paragraph, is allowed only in agreement with the doctor who wrote out this prescription.

The prescription remains in the pharmacy

There are some changes on the topic indicated in the title of this chapter. Paragraph 14 of the new order No. 403n of the Ministry of Health establishes that the retailer retains (with the mark “Drug product dispensed”) and stores:

within 5 years prescriptions for:

• narcotic and psychotropic drugs of Schedule II, psychotropic drugs of Schedule III (according to the outgoing Order 785, they are stored for 10 years);

within 3 years prescriptions for:

• drugs dispensed free of charge or at a discount (according to forms No. 148-1 / y-04 (l) or No. 148-1 / y-06 (l));
• combined medicinal products containing narcotic drugs or psychotropic substances included in Schedules II and III, manufactured in a pharmacy organization, drugs with anabolic activity, drugs subject to PKU;

within 3 months recipes for:

• preparations in liquid dosage form containing more than 15% ethyl alcohol by volume finished products, other drugs related to ATC to antipsychotics(code N05A), anxiolytics (code N05B), sleeping pills and sedatives(code N05C), antidepressants (code N06A) and not subject to PKU.

Note that in the 785th order there is no this group of recipes for three-month storage.

Order No. 403n of the Ministry of Health did not do without a cherry on the cake, however, a dubious one. In paragraph 15 of the order, it is written that prescriptions that are not indicated in the previous paragraph 14 (we listed them a little higher) are marked with the stamp “The drug is dispensed” and returned to the indicator. This seems to imply that Form 107-1/2-month-validity prescriptions become "single use." We advise readers to pay special attention to this new norm.

The topic of combating the abuse of alcohol-containing drugs in the pharmacy assortment, which was recently trumpeted by the media, was also reflected in the new order on the procedure for dispensing drugs. According to the current procedure, prescriptions for such drugs are returned to the patient (with a stamp "released"); under the new order, they must remain in the pharmacy organization.

To not get caught

The order of vacation with incorrectly written prescriptions is now described in a little more detail (paragraph 15 of order No. 403n). In particular, when they are registered by a pharmacist in the journal, it is necessary to indicate the identified violations in the preparation of the prescription, the name of the health worker who issued it, the name of the medical organization in which he works, and the measures taken.

According to this paragraph, medicinal leave the pharmacist informs the buyer not only about the mode of administration and doses, but also about the rules of storage at home and interaction with others medicines.

Theoretically, this means the following. The pharmaceutical inspector can approach the first table in the guise of an ordinary buyer - so to speak, make a test purchase. And if the primate, dispensing the medicine, does not inform him, for example, that this medicine must be stored at a temperature not exceeding 25 ° C, or will not ask if it accepts given time other medicines, then the inspector can “throw off the mask” and draw up an act on an administrative offense. So the norm of paragraph 16 is serious and fraught. And, of course, it requires that the pervostolnik be thoroughly savvy on the complex and voluminous topic of drug interaction.

Clause 17 of Order No. 403n, as amended, contains a rule that a pharmacist is not entitled to provide false or incomplete information about the availability of drugs in the assortment of a pharmacy facility - including drugs that have the same INN - and also hide information about the availability of drugs that have a lower price . Similar provisions are contained in subparagraph 2.4 of article 74 of the Law of November 21, 2011 No. 323 FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” and paragraph 54 of the Rules of Good Pharmacy Practice (order of the Ministry of Health of the Russian Federation of August 21, 2016 No. 647n). Here, the only new thing is that this norm first appears in the order on the order of vacation.

These were explanations of order No. 403n, so to speak, "on a fresh trail." Probably, readers will find in it other points and norms that deserve special attention. Write to the editors of Katren-Style magazine about them, and we will address your questions to leading industry experts. We will also ask them about the problem of “one-time use” of prescriptions with a two-month validity period, which was discussed above, as well as the dispensing of ethyl alcohol and alcohol-containing drugs in light of the provisions of the new Order No. 403 of the Ministry of Health.

On October 5, our website will host a webinar by Larisa Garbuzova, Ph.D. in Economics, Associate Professor, Department of Management and Economics of Pharmacy, North-Western State medical university(St. Petersburg), dedicated, and October 25 Executive Director"National Pharmaceutical Chamber" Elena Nevolina on the same topic. Register for both webinars.

Materials on the order of the Ministry of Health No. 403n.

Photos from open sources

We are all used to change. We are no longer so afraid of reports of the next economic crisis, because in our memory there have already been several of them. Innovations in the educational standard of schools and universities are not surprising. educational institutions. But the news in the field of health care and access to medicines cannot but cause concern. AT modern world Hardly ever healthy people. We all have some kind of chronic disease and are often forced to purchase certain medicines. And when there is information in the news feeds that changes are coming in this process from a certain period, we experience feelings.

From the beginning of 2017, a new order of the Ministry of Health on the rules of vacation comes into force medicinal products from pharmacy chains. The new order will directly affect every inhabitant.

In particular, a ban is introduced to sell a number of medicines in large quantities in one hand. This restriction is introduced for alcohol-containing tinctures and syrups, mass fraction ethyl alcohol in which above 15%. Now they will be sold in one hand in the amount of no more than two bottles. Namely, with such means, many of us treat our own at home. colds. We advise you to take care of their availability in advance, since at the peak of the incidence you will often have to visit the pharmacy under the new vacation conditions. The advice is especially relevant, taking into account the long shelf life of the latter.

Fans of online shopping should also listen to the innovations, since any online pharmacy in Moscow will follow them from the new year.

A pleasant change is that prescriptions for patients with chronic diseases can be purchased necessary medicines for the future. Today it is possible to do this only for the next two months. In this case, documentary evidence of the fact of departure or the impossibility of getting to the pharmacy in the future is required. Since January 2017, this period has been extended to a calendar year.

If the pharmacy does not have drugs from the list of vital and necessary drugs, then it will have to purchase them and provide them for sale no later than a week after the patient's request. Today this term is prescribed as five calendar days. But if the buyer needs to take the medicine immediately, which is indicated on the prescription by the doctor’s note “statim”, the pharmacy is obliged to provide this product on the day of the request.

According to the new document, pharmacy employees are prohibited from advising the buyer more than expensive drugs with a cheaper alternative. Also, pharmacists will have to give detailed advice on the properties and contraindications of a particular drug, its expiration date, storage methods and doses used. Currently, such information is provided only at the request of the pharmacy employee himself and is not necessarily regulated in any way. Therefore, even when purchasing medicines in an online pharmacy. In 2017, you can count on the professional participation of a specialist in choosing one or another product, on advice on its use and storage.

We can only hope that all these innovations will be implemented and will benefit the interests of pharmacy customers.

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What drugs will be available on prescription from 2017?

In- first, according to the recipes in 2017 In 2016, all the drugs that were dispensed by prescription in 2016 will be dispensed in Russia. No easing is planned in this list, unfortunately for drug buyers.

In Secondly, in Rospotrebnadzor (its head) they made a rather unexpected statement-proposal that it is very desirable to sell all the drugs that are in pharmacies exclusively by prescription. That is absolutely everything. Maybe, with the exception of those medicines that are necessary for completing all kinds of first-aid kits. Read about it. The Ministry of Health proposes to soften this proposal, and we will see to what extent this softening will take place.

In a word, drug consumers are waiting for, if not a revolution in the dispensing system, then at least a reorganization of the list of prescription drugs in the direction of a clear increase. The list will be replenished with those medicines that are not required urgently, but negatively affect the body during self-medication.

All new medicines containing narcotics are psychotropic. And such funds in the pharmaceutical market are only increasing every year. Alas, people do not solve problems, but accept everything for years.

Read also: Complaint for labor disputes - sample

The third group is combined preparations Key words: narcotics, psychotropic substances and their precursors. It was decided to designate this group separately: antibiotics. We are used to prescribing them ourselves, but sometimes there is no other way, especially if you get sick on the weekend. Many send their relatives to the pharmacy for antibiotics.

How it will be in practice, we will see.

Definitely, new tranquilizers and antidepressants will also join the ranks of prescription drugs.

Here are some drugs that will be sold by prescription.

It is sometimes surprising that the drug has remained the same, the same active substance, but the packaging is different 3D, and the price is already higher and the recipe may be asked.

Many live completely without drugs! Well done!

Currently, work is underway to compile such a list. Enough time was allocated to the Ministry of Health of the Russian Federation for such work, up to January 31, 2017.

It is already known that the list will definitely include drugs in the prescription form of which the line is indicated:

Presumably, it will be possible to buy without a prescription only thirty percent of the medicines that are presented for sale in pharmacies.

Also walks following list medicines

Since January 2017, the dispensing of medicines in pharmacies has become more strict. Many medicines that could previously be bought without a doctor's prescription are now simply not sold. Most of these drugs are antibiotics, but there are also conventional painkillers.

In the instructions for these drugs and previously there was a clause "dispensed by prescription." But pharmacies sold them without any prescriptions. Now it is planned to organize unscheduled checks, which will entail the issuance of fines to those pharmacies where medicines are sold without a prescription.

Another question arises - how should patients receive prescriptions? Everyone knows what queues are at the offices of district therapists. Therefore, now they are actively solving this issue so that the system of "prescription drugs only" will work in full.

Since the beginning of 2017, a list has been posted, which includes a list of drugs that are prohibited from being released without a prescription.

People, now, really cannot live without drugs, and pills, as they help us to increase our lifespan when we are sick.

This year, only those medicines that contain Khlopinin will be dispensed by prescription:

Also on this list is the well-known Valocordin:

But, full list drugs that will not be issued to everyone, but only to those who will have a special piece of paper "prescription" from a doctor:

In 2017, changes took place in the pharmaceutical sector, which are now being actively discussed.

The list of drugs that cannot be purchased without a prescription from a doctor has become longer. It contained drugs with a psychotropic effect, and good old antibiotics. Some indignation was caused by the fact that cardiac remedy Valocordin. Curantyl, so often prescribed for pregnant women, was also there, as well as Nimesil, a well-known painkiller.

Most likely, the list will be replenished with new names.

Since 2017, pharmacies will not be able to sell prescription drugs if instead of an official document with a doctor’s signature and seal there is a “handwritten piece of paper”

Going to the pharmacy for medicines, do not be lazy, open the Internet. Type in the search engine the desired medication and look at the instructions for it. If there is a note “Only by prescription”, it means that without this very prescription, the remedy you need will not be sold.

Medicines are divided into those that can be freely bought at a pharmacy, and those that are dispensed only by prescription. In relation to the latter, from January 1, 2017, the rules for their vacation are being tightened. Under the heading "only by prescription" do not fall medicines that are freely available - on the windows of pharmacies. without problems, you can buy antiviral, many cough and cold medicines, some enzyme and painkillers.

And although the innovation caused a lot of controversy, for pharmacy workers this is by no means news. Order No. 785 "On the procedure for dispensing medicines" has been in force since December 14, 2005. But now the very form of the “doctor's note” is changing.

If a before prescription a banal piece of paper was considered, on which the scribbles of the prescribed medicine were drawn by the doctor’s hand, this “gag” will not pass from the new year. A prescription form (form No. 107 / y) is required. With the personal seal of the doctor, the seal medical institution, dosage and frequency of use.

Remember, recipes also have an expiration date. Now it is 60 days. For chronic patients, the duration of the prescription may be longer.

So far, the official list of all drugs that must be dispensed strictly by prescription. In January, the Ministry of Health will draw up a list of medicines that will be dispensed only by prescription. In the meantime, they will focus on the instructions for medicines.

State Duma deputies plan to tighten control over pharmacies. For the sale of drugs without a doctor's prescription, and now you can "run into" a fine, but people's representatives propose to increase the administrative penalty to 10,000 rubles. And as the most last resort It is proposed to close the pharmacy for three months.

Since 2017, control over the sale of medicines will be strengthened Is it worth buying medicines? (TV and radio company "Seim")

they have last years the mania to prohibit everything, limit punish, etc., all laws are directed at the negative;

Here you go. I've been reading nonsense) Comments about nothing. Why stand in line with a pressure of 180 when there is an ambulance for such a situation. Although, in general, it is supposed to stock up on medicines as soon as they come to an end, and not on the day of the crisis (. Someone wrote about an antibiotic that should always be in the first aid kit Are you sure? And what (read, from what) should be at home? Do you think that one antibiotic cures everything? Nonsense! And they will do the right thing not to sell it. otherwise citizens drink " harmful antibiotic 2.5 days..and thus cause its resistance to bacteria (addiction to the drug), the next time it no longer affects the microbe. So we brought tuberculosis back into society, for which it became difficult to select drugs and mortality increased. If you are afraid of the drug, don't start drinking it. And Valocordin is not at all a harmless drug, because it contains Phenobarbital (read on Wiki), but it does not save from death at all. rather from fear)) So, an ambulance and an ambulance again, if you really feel bad. PS. I ALWAYS take a coupon through the Internet, I have never sat at the office for 3 hours. strictly on time and almost always on time. Doctors are not interested in accepting 35 instead of 15 people. why "get unrealistic"?!

Read also: Working without an employment contract

You give me a paper. Starting from the new year, the sale of medicines without a prescription will be tightened

AT recent months residents of Kursk, shopping at a pharmacy, hear from pharmacists a warning that from January 1, 2017 most of drugs will be dispensed strictly by prescription. But is this true and what barriers will now be put up for patients?

Whose order?

On June 21, 2016, the State Duma adopted in the first reading government bill No. 1093620-6 “On Amendments to the Code of Administrative Offenses of the Russian Federation in terms of improving administrative responsibility in the healthcare sector”. And in September, at a meeting with Roszdravnadzor of the Russian Federation, it was announced that from January 1, 2017, prescription drugs will be under special control of the department.

“Actually, the order of the Ministry of Health and social development Russian Federation No. 785 “On the procedure for dispensing medicines” is effective from December 14, 2005. It is he who regulates the procedure for dispensing medicines from pharmacies, regardless of the form of ownership. Therefore, we still fine pharmacies for selling drugs without a prescription, ”explained Lyudmila Ilyukhina, deputy head of the department for licensing, supervision and control in the field of medical and social activities of the regional department of Roszdravnadzor.

Lethal injection. Kursk children are dying from a "harmless" medicine

Recall that 70% of drugs registered in the Russian Federation are dispensed strictly according to prescriptions, and only 30% - without it. But what will change in the new year? Nothing but tougher legislation in terms of control and supervision of pharmacies. Now Roszdravnadzor is constrained by the current legislation and cannot effectively influence pharmacies for violating the quality and safety of medical and pharmaceutical activities. It's just that pharmacists did not always pay attention to these requirements, and the population did not see the problem and did not understand it.

How will they punish?

The current version of the Code of Administrative Offenses does not establish administrative liability for a number of violations in the field of laboratory and clinical practice when conducting clinical and preclinical studies of medicinal products for medical use, procedures for providing medical care in terms of non-compliance with the established mandatory requirements, procedures medical expertise, examinations and examinations, as well as the procedure for prescribing and prescribing drugs. Therefore, amendments were made to the Code of Administrative Offenses of the Russian Federation (CAO).

The price of health. Do beneficiaries have enough medicines?

The new law proposes very different fines and penalties for violating the drug trade rules, including over-the-counter dispensing of prescription drugs.

So from January 1, 2017, if the fact of selling a drug without a prescription is revealed, Roszdravnadzor can fine a pharmacist who violated the law in the amount of 5 to 10 thousand rubles (now - from 1,500 to 3 thousand rubles); the official will have to pay from 20 to 30 thousand rubles (now - from 5 to 10 thousand rubles); legal - from 100 to 150 thousand rubles (now - from 20 to 30 thousand rubles). Closing of a drugstore for 3 months (90 days) can become apogee.

Therefore, you understand, most pharmacies, if not all, will not want to take risks and will work strictly according to the letter of the law.

Blame self-medication

The impetus for the changes was the level of self-treatment of the population, which has recently gone off scale, and sometimes turns into very tragic consequences. Here it is already worth dealing with another problem - the lack of doctors and queues in hospitals that force people to go to the pharmacy and consult a pharmacist, which medicines should be taken for a particular disease.

“But the pharmacy must follow the doctor's recommendation, draw the buyer's attention to the storage conditions and the frequency of administration, no more. And the prescription itself is an appeal from a doctor to a pharmacist, what exactly he should give to the patient, - Ilyukhina notes. - And now it also happens that a person really visited a doctor, but came to the pharmacy not with a prescription written on official letterhead, but with a piece of paper on which the doctor indicated the name of the drug. And on these scraps pharmacists dispense drugs. This whole situation needs to change.”

The level of self-medication may be going through the roof, but this trend has a logical explanation - how long will a person have to sit in a hospital queue for a prescription? Especially considering that the majority prefers not to go on sick leave with every cold, but to carry it on their feet, since hospital authorities do not favor hospitals, and many of us do not consider a sluggish SARS a real illness, supporting your immunity with medicines (not even antibiotics) from the nearest pharmacy. But now, before going to the pharmacy, you will have to go on a “crusade” to the hospital and sit there in line, most likely not an hour or two.

Shortage and queues

It is impossible to say right now which drugs will be dispensed only by prescription: there is no clear list in fact, it was abolished in 2011, as it was too long and cumbersome. So you will have to focus on the packaging of the drug, which should indicate the name, doses, form of release, manufacturers, expiration date, storage conditions and the release rule - with or without a prescription.

For the sale of prescription drugs without a prescription, a pharmacist can be fined five or more thousand rubles. And the pharmacy will be completely closed for three months. Antibiotics, a number of painkillers, cardiovascular and other drugs have disappeared from the “free sale”. Supervisory authorities assure that this was done for the sake of the health of patients, while many refer to foreign experience. Why are patients not happy with such care?

In fact, the ban on the free sale of prescription drugs has existed for a long time, Order No. 785 “On the procedure for dispensing medicines” has been in force since December 14, 2005. But they were in no hurry to fulfill it - neither pharmacists nor their clients. Yes, and the doctors continued to strike appointments on scraps of paper. Unless drugs from special lists, subject to strict accounting, were dispensed and purchased strictly by prescription.

The Ministry of Health and Rospotrebnadzor decided to take violators seriously. Pharmacists were last in line. If a pharmacist sells, without a doctor's prescription, a medicine subject to prescription, he can be fined at least five thousand rubles. And that is not all. The fine for the pharmacy itself can be one hundred thousand rubles, supervisory authority even has the right to close the outlet for up to three months. Medicines marked “only by prescription” are now prohibited even from displaying on display.

Moreover, the doctor must issue the prescription in the appropriate way: not on a piece of paper, not on a card, but on the official prescription form with the seal of the medical institution (form 148 / y or No. 107 / y, depending on the drugs), certified by the personal signature and seal of the doctor. The prescription indicates the international non-proprietary name, as well as the dosage and frequency of use. The issued prescription is valid for 60 days, for chronic patients it can be issued for a year, indicating the frequency of purchase of the medicine.

About 70% of the entire pharmacy range falls under the restrictions. These are not only psychotropic and narcotic drugs, but also all antibiotics, hormonal agents(including contraceptives), strong painkillers, ampoule dosage forms, row cardiovascular drugs, diabetic drugs, etc.

The most unpleasant thing is that there is still no exact and complete list medicines that cannot be freely available. The list was supposed to be approved by the Ministry of Health in January, it was proposed to find it by this link. But try to find it yourself! Today, pharmacists are encouraged to focus on the instructions, if it contains the entry “dispensed by prescription”, then it cannot be released just like that.

Walking through the Stary Oskol pharmacies, you can be sure that local pharmacists do not have a common opinion about what can be sold, and what - in no case.

- Our leadership ordered to sell antibiotics and drugs in ampoules by prescription, - they said in one of the pharmacies. There are no changes for other drugs.

“We can sell herbs, ointments, antipyretics, some antivirals and nose drops without a prescription,” another said. - Pentalgin, ketorol, papaverine, festal - only by prescription!

- And what papaverine and no-shpa do you need? - clarified in the third. - We release tablet forms freely, in ampoules - according to the prescription. Ketonal - similarly: we will sell a cream or gel for external use, and if you need other forms of release, contact your doctor.

“I don’t think there is any reason to panic,” explained the pharmacist of the fourth point. “In the past, many medicines were sold by prescription. Those diabetics knew this very well. There are painkillers, gastric, heart drugs, the same drugs for diabetics, which both were and remain on free sale. More powerful - no. This, I think, is justified: serious drugs have more serious side effects. Also, if you need strong medicines, means it is necessary to be treated seriously, and to go to the doctor.

In general, if you are going to a pharmacy, look at least on the Internet and look at the instructions for the medicine you are going to buy. Perhaps it is only available by prescription, in which case you need to see a doctor first.

If you need this or that drug, but have neither the time nor the desire to sit in a queue for many hours, but it is possible to pay for a doctor's consultation in a private medical center, in most cases you can get a prescription there as well. Doctor private clinic entitled to write prescriptions for medicines, with the exception of medicines included in Lists II and III of the "List of Narcotic Drugs, Psychotropic Substances and Their Precursors Subject to Control in the Russian Federation".

From other innovations:

• Now pharmacists are required to inform customers about all analogues of medicines. We are talking about medicines with the same international generic name. The client himself can choose: to purchase expensive medicine, or his cheap analogue. If a pharmacy worker fails to provide such information, they may be fined.
• In addition, pharmacists and pharmacists cannot refuse buyers to get acquainted with the accompanying documentation for drugs and medical devices(certificates and declarations of conformity).
• At the request of the client, the pharmacist must tell in detail about the dosage, method of application, interaction of the drug with other drugs. In general, the pharmacist was obliged by law to do everything that he actually does today.
• Pharmacies that are open to visitors around the clock must have an illuminated sign with information about work at night.

Opinion. Why do Russians prefer self-treatment?

Only those who are not familiar with the reality of the Russian hinterland can surprise such a state of affairs. The fact that pharmacies need revenue and don't want to lose customers is just the tip of the iceberg. The main problem is the inaccessibility of fast and high-quality medical care. In the midst of a flu epidemic, try to stand in a queue for hours at the therapist's office! Or suffer without an anesthetic drug for several weeks until your appointment with a neurologist comes up. So people run to the nearest pharmacy, tearfully begging: give me at least something! Well, while doctors, although they dissuade citizens from self-medication and “on camera” ardently support the slogan “medicines strictly according to prescription”, deep down they are glad that patients do not run to them for papers on every trifling occasion. In the context of a shortage of medical personnel (according to the same Ministry of Health, the shortage of therapists in the country is 27%), they sometimes have to serve patients much more than what is required by the standards: sometimes therapists and pediatricians are sometimes “hung” for two or three sections. If you still have to spend time writing prescriptions for elementary analgins-papaverines-pentalgins, there will be absolutely no time left for examining patients.

Without tiring by listing examples from personal practice (anyone has their own sad experience), I will say that not many doctors in practice thoughtfully select a drug for a patient based on the results of tests, examinations and examinations. They make mistakes when prescribing dosages and regimens, selecting combined drugs. Without this, patients would not think that the best adviser is the Internet.

In many cities, the innovation caused violent indignation. People are calling the OTC drug ban a "survival quest." Citizens are collecting signatures for petitions to various authorities with a request to leave the "former order for dispensing medicines."

On September 22, new rules for the sale of medicines in pharmacies came into force. Buy Now the right drug may be difficult or impossible. Pharmacies require prescriptions and even store them. And the medicine may not be sold to relatives at all: they will ask for a power of attorney.

We have reviewed the new rules and will explain how they work. The order of the Ministry of Health is complex and incomprehensible even for pharmacists, so clarifications have already been issued to it. We also studied them.

As it was before?

Prescription drugs have always had to be sold by prescription. Each category has its own sales and accounting rules. Such drugs are marketed subject to strict federal requirements, but pharmacies have not always complied with them.

It used to be possible to take one prescription and buy as many medicines as you like with it. Doctors did not indicate the terms, and pharmacists did not pay attention to it. And they could only take prescriptions in rare cases and dangerous drugs.

No one followed the dosages of conventional sedatives and did not note on the prescription how much and when it was already bought. And often the recipe was not asked at all.

Even if you used to buy an antibiotic, sedative or medicine for your grandmother without a prescription, this does not mean that the drug is really on sale. Even common drugs are on the prescription list, and buying them can now be a problem.

As it is now? Where can I buy medicines?

It depends on whether a prescription is needed and what category the drug belongs to. There are several such categories, it is pointless to study them all in advance, but you need to keep in mind.

Narcotic and psychotropic drugs can only be sold by licensed pharmacies. Its limitations for immunobiological preparations: for example, a vaccine for vaccination of a child can only be bought at a pharmacy and pharmacy, and only if there is a thermal container. There are also differences in prescription forms.

If the doctor has prescribed a prescription medicine, it is better to find out in advance where you can buy it. And do not be surprised if some pharmacies do not sell the drug. This is not their whim, but the requirement of the law.

If a prescription is needed for a medicine, what should I do?

You need to get this prescription: otherwise the pharmacy will not sell the drug. Even if the medicine is needed urgently or it is taken constantly, and there is no time to go to the doctor, it still will not sell. Maybe in some cities there are pharmacies that manage to get around the rules, but it’s better not to count on this: the law is the law.

If you need a prescription for a medicine, you will have to present it at the pharmacy. And the pharmacy has the right to take this prescription if it is required by the new rules. That is, the second time to buy this medicine according to the same prescription will not work.

Recipes are also divided into several types. There are recipes for one time, urgent, for a free vacation and various others. The prescription may be valid for several days, months or a year. You can buy a prescription drug only while it is valid. The pharmacy can take it away permanently or return it with a note: how much and when sold, in what dosage and for how long this is enough.

Can I buy a spare? More antibiotics, painkillers and blood pressure pills.

No, you won't be able to buy in reserve now. According to the rules, the prescription will sell as much of the drug as prescribed by the doctor.

This should be monitored by pharmacists. Even if you ask the doctor for a prescription with a margin, the pharmacy will not sell that much, and even report a violation.

How do you know how long a prescription is valid?

Not all prescriptions have an expiration date. Some doctors do not pay attention to this, but pharmacists generally did not care: the main thing is that the prescription is.

Pharmacists must keep track of deadlines and report irregularities if they are found.

It turns out, now the recipe will be taken away? And you have to go for a new one every time?

Pharmacies must collect and store prescriptions for certain drugs. They are listed in paragraph 14 of the new rules. Read and check the medication instructions. Suddenly this is your case.

If you or someone in your family regularly takes these medicines, you will have to go for a new prescription for each batch. Even if these pills are needed all the time - for example, painkillers for a seriously ill person. Or sleeping pills and sedatives for regular use. The same situation with alcohol-containing drugs - the prescription will remain in the pharmacy.

Whether it is possible to write out a prescription not for one time, but for a long period, the doctor decides and pharmacies are checked.

If the prescription is issued for a year, will it also be taken away? Will I have to go to the same pharmacy all the time or get a new prescription every time?

No, this recipe will not be taken away. Although there are rumors that they are being taken away. Do not believe the rumors - read the law. They can pick it up only if the prescription was issued before September 22, and then the sales rules for this drug changed.

How to deal with prescriptions long term, written in paragraph 10 of the new rules.

When a pharmacy sells a prescription drug that is valid for a year, the pharmacist must note when and how much the drug was sold. And the prescription is returned. Will sell this recipe next time right amount medicines: take into account past sales and put a mark again.

When the prescription expires, you will no longer be able to buy the medicine with it. If the prescription is to be kept, the pharmacy will collect it. If you don’t need to store it, they will give it away, but you still won’t be able to use it.

What are the rules for the sale of vaccines?

The vaccine for vaccination will be sold only if the buyer has a thermal container. It is impossible to deliver it to the clinic in an ordinary bag: the vaccine will deteriorate and the vaccine will be useless.

You can buy a container directly at the pharmacy. These are additional costs that you need to consider: you will have to pay extra or go with your own. You cannot buy a vaccine in advance. You can store such drugs for a maximum of two days. If you are going to vaccinate your child with a paid vaccine, consider these restrictions.

By the way, you can’t buy a vaccine without a prescription either. You will first have to take a prescription from a doctor, then buy a drug on it and within 48 hours get back to the clinic - already for vaccination.

Sometimes it's easier to sign up paid clinic: they will conduct an inspection there, give a referral and do all the procedures at a time. Or agree to a free vaccination with a cheap vaccine from the state.