[The normative legal regulation of medical care support of rare (orphan) diseases in adult population of The Russian Federation]

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Mar;29(2):270-277. doi: 10.32687/0869-866X-2021-29-2-270-277.
[Article in Russian]

Abstract

The article considers the results of legal regulation analysis of medical care support including medication maintenance of adult patients suffering from rare diseases exemplified by life-threatened and chronic progressed rare (orphan) diseases resulting in life expectancy decrease and or disability ("List-24").

Materials and methods: Law database was analyzed in terms of current orders of medical care provision, standards of medical care, and clinical guidelines for rare diseases from "List-24" regarding to adult patients.

Results: It is concluded that there are no determined rules of medical care provision to adult population in case of rare diseases from "List-24". There are standards of medical care on 6 rare diseases (25% of total diseases amount) from this list for adult patients. However, based on content analysis data of approved standards it was established that there are only 3 from 11 standards (27.28%) for primary medical care support, 4 standards (33.34%) for medical care provision in planned condition, and only 1 standard (9.09%) had appropriate legal basis for its development (clinical guidelines availability). Nevertheless, there is negative prognosis for this the only standard due to legal necessity of all clinical guidelines revision till the end of 2021.

Conclusion: Revision and creation of clinical guidelines and standards of medical care afterwards are needed for adult patients treatment with rare diseases from "List-24". The conclusion was made in terms of medical care standardization improvement for adult patients suffering from rare diseases from "List-24" based on its alignment with current legal regulation.

Keywords: citizens; health care; legal regulation; medical care; rare disease; standardization; state guarantee program.

MeSH terms

  • Adult
  • Humans
  • Patient Care*
  • Primary Health Care
  • Rare Diseases* / therapy
  • Russia