Ecosystem approach to the management of regional programs of preferential drug provision based on assortment aggregation

Introduction. The system of state management of preferential drug provision (LLO) includes regulatory regulation of public procurement of medicines (LP) for the needs of federal and regional LLO programs (RLLO). The problem of accessibility of drug provision for certain categories of citizens and nosological categories of patients is solved on the basis of rational consumption and financial support, the introduction of new mechanisms for resource provision of such programs is relevant. The implementation of accessibility within the framework of the territorial program of state guarantees is promising due to the aggregation of the range of medicines of subjects of the local pharmaceutical industry and the introduction of new platform mechanisms for organizing the supply of medicines. Objective: assessment of organizational, pharmacoeconomical and assortment prerequisites for ecosystem management in the process of implementing regional preferential drug supply programs based on contracting an aggregated assortment of local manufacturers of medicinal products of the Ural Federal District (Ural Federal District). Material and methods. The object of the study was data on consolidated applications of medicinal products purchased under the RLLO "Affordable Medicines" program implemented by the Ministry of Health of the Sverdlovsk Region for the period 2021–2022. 59 INN of medicinal products in the form of release; a consolidated assortment of manufacturers located in the regions of the Urals (10 enterprises, 910 TONS of medicinal products); data on marginal selling prices of enterprises manufacturers of medicinal products from the list of vital and essential medicines (VED) in the studied group of drugs (N=59). An economic analysis of LP prices was carried out: calculation of the median values of the LP sample, calculation of relative and absolute savings in the LP supply budget. Software was used to process the primary data: Statistica, MS Excel. Results. An organizational and pharmaceutical justification of the expediency of aggregating a local drug assortment to fill offset contracts was carried out, and a platform of the territorial pharmaceutical ecosystem was proposed as an institutional aggregator. An assessment of the prospective savings of the regional budget due to the aggregation of the territorial supply of medicines was carried out on the example of the Ural Federal District and the Sverdlovsk region, as a result of which the potential for saving the regional budget in the localization of the allocated assortment in the amount of 14.06 million rubles per year was determined. The study of the structure of the local assortment matrix of medicinal products for the regional program of preferential drug provision was carried out: the high potential of involvement of individual manufacturers in the resource provision of the program was shown, three nosological segments of medicinal products with the maximum aggregation potential were identified. Conclusion. The assessment of organizational, pharmacoeconomical and assortment prerequisites for ecosystem management of the territorial system of guaranteed drug provision based on the expansion of the functionality of public-private partnership was carried out: the expediency of aggregation of the range of medicines for the Sverdlovsk region program "Affordable Medicines" with a potential saving of 14.06 million rubles per year was shown, key nosological segments of medicines for implementation in offset contracts (class IX (E10-E15) – Hypertension, class IV (E10-E14) – Diabetes mellitus, class VI (G40) – Epilepsy).