Improving the efficiency of the medicine provision system for patients with malignant neoplasms

Background. One of the priorities of health care is the balance between the financial resources and the availability of effective medical care. The current approach of access to cancer medicines limits the timeliness and availability of treatment. At the same time, financial support from the government provides great costs on cancer drugs. However, these great costs are not rational.Objective: to assess the financing needs of the complete transfer of financial support of medical care in the field of oncology to the Compulsory Health Insurance (CHI) system by means of optimizing the functions of the day hospital.Material and methods. The achievement of the goal is planned to be reached by eliminating the unusual functions of oncological day hospital. We analyzed the regulatory legal documents regulating drug care and drug provision in the Russian Federation, data from depersonalized (anonymized) registers of the structure of hospitalizations in a day hospital for 2021. The methods of expert assessments, mathematical modeling, as well as literature data analysis were used. The study developed a model for assessing the need to finance the full transfer of medicine provision to the CHI system, including taking into account the hidden deficit.Results. The total amount of funds released from the reduction of irrational hospitalizations in day hospital conditions amounted to 2.08% of the funding level of the analyzed schemes. Taking into account the data of hospitalizations in oncological day hospital for 2021, the number of irrational hospitalizations in case of transfer of selected schemes to the outpatient stage will decrease by 16.1%. The transfer of all the medicine therapy to financing from the CHI funds will require significant additional budget expenditures in the amount of 62.5 billion rubles or 2.65% of the total costs of the State Guarantees Program for Provision of Free Medical Care to Citizens.Conclusion. Despite the rationality of the proposed changes in the field of improving access to medicine provision concerning cancer drugs and the identified justifications for changing the distribution of financial resources within the State Guarantees Program, there are difficulties. In order to solve this problem, a coordinated consideration of potential strategies to address the access to cancer medicines is needed.