The Possibility to Use Medications Purchased at the Expense of a Patient in Intensive Care Units of Healthcare Institutions

The purpose of the study: to identify a legally justified possibility for a patient (patient's relatives) to purchase a drug product (DP), which has not been purchased by a healthcare institution but is recommended by the doctor in charge «by lifesaving indication» as the most effective one.

Materials and methods. Federal Law N 323-FZ «On the Fundamentals of Health Protection in the Russian Federation» as of 11/21/2011 and a number of current normative legal acts (NLA) regulating medical activities were analyzed.

Results. The analysis demonstrated the absence of a concept of «lifesaving indications» in the normative legal acts. It demonstrated that the patient's illness that may require the prescription of DP by the «lifesaving indications» should be diagnosed by medical consultants' board of the healthcare institution. It also prescribes DPs «for lifesaving indications» not included in the standard of care (SC) and in the List of Essential Medicines (LEM) and not payable «outpocket of» (personal) funds.

Conclusion. The use of DPs «for lifesaving indications» in urgent and emergency medical care should not be arranged on a feepaying basis. If a patient (or patient's relatives) would demand compensation for material damage (cost of purchased drug) by applying to a Obligatory Medical Insurance Company or bringing the case before the court, this demand should be satisfied. 

1. The federal law «On the fundamentals of protecting the health of citizens in the Russian Federation» from 21.11.2011 № 323-FZ. [In Russ.]

2. Decree of the Government of the Russian Federation from 04.10.2012 № 1006 «On approval of rules for the provision of paid medical services by medical organizations». [In Russ.]

3. Ministry of Health Care of Russia. Order from 05.05.2012 № 502 «On approval of the procedure for the establishment and activities of a medical commission of a medical organization». [In Russ.]

4. Ministry of Health Care of Russia. Order from 02.12.2013 № 886n «On amendments to the procedure for the establishment and activity of the medical commission of a medical organization». [In Russ.]

5. Ministry of Health Care of Russia. Order from 20.12.2012 № 1175 «On the approval of the procedure for prescribing and prescribing medicinal products, as well as the forms of prescription forms, the procedure for processing these forms, their recording and storage». [In Russ.]

6. Letter № 14-0/10/2-2564 of the Ministry of Health Care of the Russian Federation, № 7155/30 from 26.09.2012 «On the direction of the Methodological recommendations» Emergency medical care in the system of compulsory medical insurance: the stage of formation, development prospects «. [In Russ.]

7. Ministry of Health Care of Russia. Order from 24.04.2008 № 194n «On the approval of medical criteria for determining the severity of harm caused to human health». [In Russ.]

8. «The Criminal Code of the Russian Federation» from 13.06.1996 N 63-FZ (Edited on 07.06.2017). Criminal Code of the Russian Federation, Article 124. Refusal of assistance to the patient. [In Russ.]