It will have a disastrous impact on each of us
Alexey Maschan, one of the leading oncologists in Russia, deputy director of the Federal Scientific and Clinical Center for Pediatric Hematology, Oncology and Immunology of the Federal Agency for Health Care
If the decision on sanctions is still taken, it will have a disastrous impact on people, on each of us, because all innovations, all the most modern drugs come, in particular, from America.
To understand this, you can take any modern high-level medicine developed over the past five to ten years, from the most complex antibodies to the inhibitors that are used in cancers of various localizations and for which there are no generics. And if there is, it is absolutely unverified drugs.
I will not even give concrete examples – all the developed treatment processes, all the modern protocols that we have implemented with such difficulty and blood, all this will prove to be not just under threat, if the drug sanctions are introduced, it will all become simply impossible.
Yes, if a decision is made, some loopholes can be found – for example, the production of some American medicines is localized in Russia, some preparations are produced by international large concerns not in the US. But, maybe it’s better to let the doctors do their own thing, and not to force to look for loopholes to help the patients somehow ?!
I repeat, if the sanctions are adopted, it will be much more difficult for us to cure, because all new technologies that can really change the prognosis of the disease in patients previously thought to be incurable are 98% from America, because it is in America that intellectual production in medical technologies.
Without the original drug can not do, the generic generic drug – the difference
Grigory Sheyanov, a pediatrician of the highest category, Ph.D. For many years he worked in the emergency department of the Children’s City Clinical Hospital No. 9 named after G.N. Speransky
When State Duma deputy Peter Tolstoy proposes, even within the framework of the discussion, to treat his opponents with bark of oak and a decoction of hawthorn, then you can spread your hands and remember Saltykov-Shchedrin. Remember, he wrote that “the purpose of the publication of laws is twofold: some are published for the great peoples and countries of the dispensation, others are for the legislators not to put in idleness.”
In modern Russia, it seems to me, there is a third kind of laws that are needed for trolling, creating information noise and maintaining a degree of controversy . Tolstoy’s words are frank trolling, in which, initially, apparently, no common sense was invested. Only this way I can explain it. I think he just waits for the HYIP in response to his words.
In fact, pediatrics use a number of drugs, vaccines, infant formulas that are produced either in America or in allied countries for anti-Russian sanctions. In general pediatrics without these drugs, of course, will be much worse than with them. And withdrawal from the market of several products will be felt painfully, though not so fatal, as in narrow and more “serious” specialties, such as oncology, rheumatology or palliative care.
To a greater extent, severely ill children will suffer from the sanctions, for example, with orphan (rare) diseases. For their treatment, sometimes drugs that exist literally in a single number or have a very meager choice of analogues are vital.
For example, now patients with spinal muscular atrophy (SMA) are waiting for the drug to appear on the market for its treatment. This is the first drug in the world, “Spinraz”, which is produced only in America. Currently he is in the process of registering and should very soon be on sale.
Parents are waiting for him as a miracle. If he does not appear in Russia, I can not even imagine what the parents of these incurably sick children will feel.
In pediatrics of a broader profile, the choice of drugs is greater, most of them have analogs, there are generics – and pediatricians can maneuver between manufacturers, seeking an adequate replacement. For antibiotics, the same “Augmentin”, which can get on the list , there is a number of generics that are almost not inferior to it in effectiveness. Still, the drug is quite old, and its manufacturing technology is simple.
But the generic generic drug is different. There is always a gap between the quality of the original drug and the generic. The more complex the production and the more expensive manufacturing technology, the more this gap is more important. Generic is often an order of magnitude less effective than the original drug.
This applies primarily to chemotherapy drugs, biological therapy (such as “Humira” ). And then without the original drug can not do.
It is not always possible to find a substitute for the drug in the treatment, for example, of epilepsy. There are frequent situations of pharmacoresistant epilepsy, when only one drug is suitable for a patient, only he can prevent convulsions. So nature wanted. It is necessary to understand that antiepileptic drugs do not happen much. Leaving the market of any of them can turn into a huge problem for a single patient.
The list can also include the anti-epileptic “Lyrics”, which is also used in palliative care to strengthen the action of pain medications (I do not need to explain how hard it is to fight pain in cancer patients even with the whole arsenal of drugs).
A separate story with vaccines. Almost the entire last year in Russia was marked by a problem with their supplies. Those then other vaccines disappeared, which was due to re-registration of drugs. Vaccine for pneumococcal infection Prevenar for today has in our market only one Belgian analog. So, in case of any interruptions in supplies, which now happen exceptionally often, we leave the babies without the vaccine, which is quite sad, you will agree.
It is a question of conjugated vaccines from pneumococcal infection, which are used in infants. Unfortunately, all vaccines are a piece product, which is extremely unstable on the domestic market.
The conclusions are obvious.
Let’s return to the stone age to tincture of hawthorn and oak bark – these are our deputies so decided, this is our own choice
Anton Rodionov, cardiologist, assistant professor of the medical faculty of the First Moscow State Medical University named after IM Sechenov
Perhaps the most accurate anecdote on the topic under discussion is: “In response to the next American air strikes against Syria, we will bomb Voronezh.”
Already, we have lost many good imported vaccines, and, as is known, if there is no competition, then why produce a high-quality product? For most patients, the ban on the import of American drugs will go unnoticed: many drugs have decent Eastern European generics, some companies have long been located in Russia. However, some patients in reality can remain without drugs, which bind them to life.
This applies to patients with viral hepatitis, with HIV infection, with certain hematological and oncological diseases. Often, the available generics on the market are much worse than the original, and replacement can lead to loss of efficacy or serious side effects.
However, it is not necessary to go into professional details.
Following the drugs may come the turn of medical equipment and spare parts, which means that there will be tomographs, ultrasound devices, diagnostic equipment.
“Nazlo Mama frostbitten ears,” back in the Stone Age to tincture of hawthorn and oak bark. In the end, our deputies have decided this way, this is our own choice.
From the prohibition of medicines, only domestic companies that produce generics will win
Mikhail Laskov, oncologist, hematologist, head of the Clinic for Out-patient Oncology and Hematology
If, nevertheless, the sanctions to be discussed are introduced, then, first of all, Russian patients will suffer.
Who will benefit from this? Our companies that produce generics, which, as it were, will get a new market without hitting a finger on their finger. In the absence of free competition, they can quietly raise prices without improving quality.
Generics are not always very bad. There are normal generics, they are registered all over the world, but there are domestic, registered only with us. In principle, companies produce generics – this is good, because it is cheaper for patients. But if the company has developed quality generics, it is logical to register them in large markets, for example, in Europe, to increase the sales market, because it becomes tens more times.
When a generic is registered only with us, the question arises: why, because it is clearly against business logic. The company does not want to get more profit and be on the new market? Perhaps, we somehow have a special test and do not need to bother about quality so much? Or on some other aspects?
How to get out of this situation in practice if she becomes a reality from the project, we will think, if this happens. “I’ll think about it tomorrow,” the heroine of the novel Gone with the Wind said. I would like to hope that we will not have to think about it and we will work as it worked, and the patients will have the opportunity to get or buy the drug they need, and not the one that they offer in the pharmacy without any choice.