Course for treatment: heart patients lack 6 billion rubles from the budget

Providing modern drugs for people with heart disease requires an additional 6 billion rubles in the federal budget for 2025-2027, the All-Russian Patients' Union has calculated. These funds are needed for patients with elevated cholesterol levels (hypercholesterolemia). The organization sent a corresponding appeal to the State Duma Committee on Health Protection. Such a measure, according to the HSP, will save the lives of almost 6 thousand people and reduce further costs for such patients. For the purchase of what drugs are proposed to allocate additional funding - in the material "Izvestia".

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The federal budget for 2025-2027 lacks at least 1.8 billion rubles annually for the provision of medicines for patients with cardiovascular diseases (CVD) from the extreme risk group with hypercholesterolemia with modern therapy, calculated in the VSP. With such a letter (Izvestia has it) the organization appealed to the State Duma Committee on Health Protection.

"Patients who have suffered two or more cardiovascular catastrophes, which include, for example, stroke and myocardial infarction, as well as with a concomitant disease - hypercholesterolemia - and receiving treatment with statins (cholesterol-lowering drugs. - Ed.) in high doses, but not reaching the target cholesterol level, are in dire need of modern intensive lipid-lowering therapy," the letter reads.

The patient organization noted that so far such patients remain outside the scope of measures of the federal project to combat cardiovascular disease. According to VSP calculations, there are more than 5.8 thousand people with heart disease and high cholesterol in Russia.

- Nowadays patients have to buy modern lipid-lowering therapy at their own expense. Or it is purchased at the expense of regional budgets, but for this patients first need to pass a medical commission, which is not always on their side, - said in conversation with "Izvestia" co-chairman of the VSP Yuri Zhulev. - The drugs in question are Praluent (active ingredient - alirocumab), Repatha (evolocumab) and Sibrava (inclisiran).

He noted that for each of the patients from the extreme risk group, receiving innovative therapy is practically the only chance to preserve life, the opportunity to live and work fully.

The patient organization also reminded that the main goal of the health care system is to extend the total life expectancy of the population up to 78 years by 2030. And, according to experts, the task can be solved by allocating additional funding for patients with CVD and hypercholesterolemia. In Russia, elevated cholesterol is the leading contributor to cardiovascular mortality, the VSP noted.

"Ensuring the availability of therapy with modern lipid-lowering drugs simultaneously with the achievement of target program indicators will reduce the burden on the health care system and will reduce government spending on such patients," the letter said.

The VSP also reported that the economic damage from hypercholesterolemia amounts to almost 1.3 trillion rubles a year, which is equivalent to 1.5% of Russia's GDP.

"Izvestia" sent a request to the Ministry of Health to assess the initiative of patients and the prospects for its implementation.

The staff of the Health Protection Committee confirmed the receipt of the patients' requests to "Izvestia" and said that conceptually they support such a proposal.

Fedot Tumusov, the first deputy chairman of the Health Committee, reminded that the federal budget for 2025-2027 should be adopted in the next few days and all the planned amendments have already been made.

- But we will definitely consider the patients' proposal in the future," he said. - I believe that ideally people with cardiovascular diseases, as well as with oncology, should receive free therapy for life, rather than buy it out of pocket.

First Deputy Chairman of the Committee Leonid Ogul agreed that the appeal of the VSP is unlikely to be taken into account now.

- But in general, the committee is on the side of patients. If the proposal is not taken into account now, we will pay attention to it later, - he emphasized.

Prevention measures

The number of patients with cardiovascular diseases has increased significantly in recent years, cardiologist Yuri Serebryansky told Izvestia. According to him, heart disease has become more frequently detected in young people.

- Hypertensive heart disease ranks first in terms of frequency of occurrence, and ischemic heart disease ranks second," he said. - The main factors of their development are hereditary predisposition.

But, the expert noted, doctors do not have enough time at the reception to ask the patient all the necessary questions. In addition, many neglect dispensary monitoring. This, according to him, leads to extremely negative consequences - disease progression, disability and death.

The most frequent causes of cardiovascular accidents in people 40-60 years old are atherosclerosis and thrombosis, added neurologist Pavel Khoroshev. The main causes of atherosclerosis, he said, are high blood pressure, overweight, stress, smoking and alcohol. Thrombosis can be provoked by cardiac arrhythmia due to low physical activity and violation of blood viscosity.

Dr. Alexandrovsky Medical Center cardiologist Dimitri Leskov named hypercholesterolemia as the leading risk factor for adverse cardiovascular events. They can also be provoked, for example, by diabetes mellitus, chronic kidney disease and obesity, added Valeria Bonadykova, a cardiologist at the Euroonco Clinic.

With any comorbidities, regardless of age, the key measure to prevent cardiovascular diseases is a change in lifestyle, said therapist Svetlana Kanevskaya. The main preventive measures, according to her, include daily physical activity of at least 30 minutes, control of diet - moderate consumption of sweets and fast food. She urged to give preference to vegetables and fruits, to give up smoking and alcohol, and also recommended to develop stress management skills, to observe the sleep and wakefulness regimen, as well as to undergo annual check-ups.