Speaking of the “R-Pharma”, it is usually first of all recalled that we are leading in the rating of operators of public procurement of medicines. However, I would say that the main difference between our company and its competitors is the longest planning horizon in the Russian pharmaceutical market. Now we pay attention primarily to reflections on the changes that can and should occur in the market in 2019-2021, when the new state budget will be adopted.
We use all available mechanisms to explain to the authorities how the approach to financing health care should change by that time.
We have to work with the state for one very simple reason – it is the state in Russia who pays a large share of medications. In the United States, this is mainly done by insurance companies – and I must say that their system is much more complex and less transparent. The only advantage is that insurers, unlike the state budget, do not have a deficit.
The current system in Russia prevents the introduction of innovations in the medical market. For example, domestic hospitals can not afford long-term use of funds, they need to report on the use of finance strictly by the end of the calendar year. As a result – late with the reports, the hospital management can buy twenty unnecessary scanners, simply because they can be quickly brought and reported. Although in practice it would be more logical to spend thoughtfully and leisurely money on the creation of an information system or the retraining of personnel. But these projects can not be completed within the time frame specified in the budget.
We will actively recommend to the state from 2019-2021 to focus not on reports on the use of funds, but on reports on the results of their use. The whole bureaucratic system should be changed in such a way that hospitals spend money not on anything that is conventionally related to health care, but only on resources that will allow them to develop, innovate and ultimately better perform their work.
However, we should admit that the “R-Pharm” itself in its present form is not entirely suitable for the introduction of innovations. Now the company is managed on a vertical model, which complicates and slows down the adoption of decisions. By 2021, we plan to move to a flat model. In fact, one company will turn into a lot of different, dealing with different tasks. And all decisions in this system will be taken very quickly.
Colleagues sometimes call me romantic and argue that the distant horizon of planning speaks of the lack of pragmatism. But I’m inclined to think that plans are called a dream only when there is no money for their realization. I can responsibly say that R-Pharm has money to implement all our plans – which means that these are not empty dreams. It’s just the future that we build.
And I believe that communication with the authorities is also likely to be productive. Recently, authorities are increasingly listening to business, fewer decisions are made behind the scenes and without discussion. If desired, a successful businessman can act very much on many levers – and act absolutely openly, by legal methods. The times of passive adjustment to state policy, which is changing in an unpredictable manner, have already passed. I believe that in Russia there are all prospects for creating a quality market.
In 2008-2009, when we decided to start manufacturing medicines, we bought a plant in the Kostroma region and built it in Yaroslavl, many experts also took our idea skeptically. Then in Russia there were no prospects for the development of its own production of drugs. However, in the end we did it.
Now I do not think it’s senseless to talk about import substitution – because in the pharmaceutical sphere it took place. We can produce everything, and it is better than many foreign competitors. It is important only to change the model of financing, the management model, to create conditions for entering foreign markets. Russian pharmaceuticals have all the developments for development, there are no necessary administrative mechanisms for a leap forward.
At the same time, I believe that the pharmaceutical industry needs to eliminate senseless barriers and encourage entry to the world market – but not greenhouse conditions inside the country, not thoughtless flooding with money. Hothouse conditions and wide opportunities for receiving subsidies and benefits will only allow the business to relax, which in the end will inevitably lead to its stagnation