The costs of HIV treatment in 2024 reached record values
The total budget for the purchase of drugs for HIV therapy in 2024 grew by 17%, experts of the Zdravresurs group in the traditional annual report indicate. “Record a lot” also bought annual courses of drugs – more than 600 thousand. Nevertheless, this is still only half of the number of people who, according to Rospotrebnadzor, have a positive test for HIV. However, the Ministry of Health assures that « all patients will be provided with the necessary drugs. »
The expert group « Zdravresurs » (analyzes the market for drugs for the treatment of socially significant diseases in the Russian Federation) has prepared a report on the situation with HIV therapy in 2024. Analysts calculated how many means were allocated by the state for antiretroviral (arv) drugs. Both centralized purchases of the Ministry of Health of the Russian Federation and the waste of regional budgets were taken into account. In 2023, the total amount amounted to 31.54 billion rubles, and in 2024 it was already 36.76 billion rubles – an increase of 17%.
The money was purchased with this money, 610 368 annual courses were purchased, which is a record indicator in recent years, they emphasize in the « health resource ». As analysts calculated, last year the therapy covered 70% of patients with HIV if you rely on the data of the Ministry of Health, which only takes into account the AIDS centers.
But if we apply the approach of Rospotrebnadzor and take into account everyone who received a positive result of the HIV test in Russia, it turns out that therapy is available 50.23% of those in need.
This is still not enough, says the head of the research department of epidemiology and the prevention of AIDS of the Central Research Institute of Epidemiology of Rospotrebnadzor Vadim Pokrovsky: “The problem is also that the number of people infected with HIV is growing. Therefore, it is inevitable to increase the purchase of drugs, the cost of treatment should grow. It is still difficult to say that we have such a noticeable success in this matter. ”
Most ARV preparations reached patients through centralized purchases of the Ministry of Health of the Russian Federation (85.9% of the total). But the amount of regional purchases in 2024 reached a record values - 5.07 billion rubles. (24% more than a year earlier). Three regions spent the most funds on therapy of HIV: Moscow (32%of the procurement amount of all constituent entities of the Russian Federation), the Moscow Region (16.5%) and the Sverdlovsk Region (14%). Nevertheless, due to regional budgets in 2024, only 9% of patients were provided-the main financial burden is still on the Ministry of Health.
Also, the Analysts of the « Zdrav resource » noted an impressive increase in the procurement of combined therapy, in which only one tablet is used (a fixed combination of doses; FKD). Such a scheme is considered optimal, since it simplifies the use of drugs and increases the adherence of patients to treatment, experts explain. In 2023, 42 thousand FKD courses were purchased, and in 2024 it was already 76 thousand. If we count from 2020, then the volumes of procurement increased by almost six times. However, the proportion of patients receiving such therapy remains relatively low (12%), which indicates the need to expand access to it, writes in the Zdravreys report.
The proportion of generics also increased significantly.
In 2023, 87% of the purchases of the Ministry of Health (24.6 billion rubles) were for original ARV-preparations, and only 13% (3.8 billion rubles) for generics. But in 2024, this ratio changed: 58% were occupied by original drugs (18.2 billion rubles), and 42% – generics (13.4 billion rubles). At the same time, the average cost of HIV therapy for one patient in 2024 decreased by 9% compared to 2023 – now it is 85,297.05 rubles. per year. Analysts consider it necessary to « continue to increase the share of high -quality and economically effective generics in the total amount of purchases, which allows optimizing budget expenditures. » According to their estimates, the purchase of ARV recreation requires an increase in the state budget expenses by half-to 74.5 billion rubles. per year.
The infectious disease specialist Vadim Pokrovsky notes that providing people with therapy is the main method of combating the spread of HIV infection in Russia. “But so far we are not observing a decrease in the scale of the epidemic: new cases are still more than 50 thousand per year. And this indicator is very high, ”the expert says.“ Say in the USA, where the population is more, about 35 thousand new cases a year. ” According to Mr. Pokrovsky, the US successes are associated with the active informing of citizens about the risks of infection, as well as with the spread of drugs for prevention, which can protect against infection even after contact with an HIV-positive partner. “According to various estimates, they are accepted by about 500 thousand Americans who are in risk groups. And we have officially only 40 people drink them. If we consider those who buy for their money – 100 maximum, ”says Vadim Pokrovsky.“ The position of the Ministry of Health is as follows: citizens must lead a moral lifestyle, and not protect themselves with such drugs with unreliable behavior. ”
In the response to Kommersant’s request, the press service of the Ministry of Health referred to the data of the federal register: according to the results of 2024, the share of citizens with HIV infection receiving antiretroviral therapy amounted to 90.5%. This even exceeds the target indicator of the state strategy of counteracting the spread of HIV infection in the Russian Federation-87%, the department said. “The register functionality allows on a personified basis to plan the requirements for drugs for HIV-infected citizens. This allows both to prevent interruptions in drugs and create conditions for the early start of antiretroviral therapy, ”the press service said. It was also noted there that financing of this area in 2025 was increased by 25% compared to 2024; Additional resources are allocated to regions for independent procurement. In addition, the redistribution of drugs between the regions is carried out. “All patients will be provided with the necessary drugs,” the Ministry of Health assured.
It should be noted that in 2024, the specialized website of Pereboi.ru received a record number of complaints for all years of observation-668 reports of interruptions in the supply of ARV consignment in 65 regions of Russia, the FSIN and the FMMM. The most commonly reported deficiency of Lamivudin, Tenofovir and Dolutravir.
