4. Sales value in the segment of health care institutions (HCI)
As it is known, the state sets an ambitious goal: in 2011 to begin a radical restructuring of healthcare system in Russia. Over 2010 the Ministry of Health prepared the legislative ground for the launch of major reforms in healthcare and health insurance systems in the next year. The results of healthcare system reform should be upgraded infrastructure, switching to modern medical care standards, healthcare system computerization. Significant changes are expected already by 2013. During this time, on the one hand, the legislation should gradually change; on the other hand the medical care system should finally be formed. Despite the fact that the reforming will last for at least two or three years, by 2011 Russian citizens should receive a new policy of compulsory medical insurance and the right to choose an insurance company in the CMI system. Future healthcare reform is supported by money. In two years the ministry and regional authorities expect to spend 460 billion rubles to implement this reform or, more precisely, on its computerization, repair and re-equipment of medical institutions, increasing healthcare professionals salaries, medical services standardization due to the gradual introduction of standards and procedures of providing medical care. This money will be obtained by increasing the insurance contributions to the system of compulsory medical insurance (CMI) from 3.1 up to 5.1%, that is, in fact it will be “taken� from the pockets of employers. The funds are intended for the total transformation of the entire healthcare system in the country: 300 billion - to repair the hospitals, the rest - to purchase new medical equipment, procure drugs, increase salary fund for healthcare professionals and implement the modern plastic medical policies. Taking into account the increasing importance of the hospital segment, the results of 2010 shown by RTU sector are not surprising. The growth of hospital procurement segment is maximal and amounts to 9%. In rubles, the HCI segment capacity amounted to about 61.5 billion rubles, which are 488 million units in real terms. Positive is the fact that procurement has also increased by units. Taking into account that healthcare costs in 2011 will increase, we can assume that the trend of this year remains - this segment will continue to show steady growth by at least 10%. Let us have a look at the basic indicators of the hospital procurement segment. The cost of one drug unit purchased by HCI was 126 rubles. In 2010, the increase of average cost of unit in the HCI segment was about 4%. The domestically produced drugs cover 28% of sales value in the HCI segment (their share has decreased in 2010, in 2009 it amounted to about 31%). In real terms there is a prevalence of the domestic drugs, their share amounts to 77% (see Diagram 19). In most cases, this is related to the large purchase of cheap domestic drugs. The price of one imported unit is 9-fold higher than the price of one domestic unit purchased by HCI: in 2010 the cost of one imported drug unit amounted to 395 rubles on average, and that of domestic unit was 46 rubles. The gap between the cost of imported and domestic units is increasing. Moreover, one domestic unit cost for hospitals is by 6% cheaper than in 2009, and imported one is by 7% more expensive. The imported drugs procurement in 2010 grew in rubles by 14%, and that of domestic drugs on the contrary decreased by 2%. In real terms the dynamics is practically the same – growth by 6% for imported and by 4.7% for domestic drugs, respectively.
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