Doctor's Consultation in Russia Doesn’t Depend on Family Income and Is Available to Everyone

HSE University economists have found that more than 60% of Russians rely on self-treatment instead of visiting a doctor, something which is facilitated by the easy availability of medicines in Russian pharmacies. This is especially typical for mild illnesses. Buying medicines depends on income, and quite often people replace expensive medicines with cheaper ones. The article was published in the International Journal of Health Economics and Management.

Determining the elasticity of health spending by income is one of the classic topics in health economics. In other words, scientists assess how much health spending changes when the level of income changes. If they change dramatically, these costs are elastic, if they remain approximately the same, they are inelastic. Such studies help us understand to what extent health services are available to different population segments. However, most studies in this area are devoted to Western countries, and the situation in Russia hasn’t been researched properly before now.

Researchers from HSE University in St. Petersburg conducted a study based on the Russian Longitudinal Monitoring Survey. Respondents were asked if they had suffered from any health problems in the last 30 days. The severity of the disease could be very different — from a  mild illness to far more serious cases. In addition, the respondents were asked how they were treating this: had they gone to the doctors or were they self-medicating. They then provided information about how much had been spent on consultations and on medications. As a result, the calculations of economists included the answers of more than 10,000 Russians from different regions of the country.

It turned out that in more than 60% of cases, Russians prefer self-treatment, something which is caused by the easy availability of medicines in Russian pharmacies. In many countries, it is difficult to buy drugs without a prescription, so people visit doctors more often. In Russia, a person can go to the clinic once, and then take medication for several years according to the doctor’s prescription. In addition, Russians often take information from the Internet or consult with friends.

Self-medication is common in Russia, which is not bad per se, since it can take some of the burden away from the healthcare system. It becomes problematic when a patient uses medicines incompetently. An example of this is the misuse use of antibiotics, but this is the topic of other studies.

Evgeny Zazdravnykh
Author of the article, Research Fellow of theInternational Centre for Health Economics, Management, and Policy at HSE University in St. Petersburg

Calculations have shown that consulting a doctor does not depend on the income of families, which means that it is available to a wide range of the population in Russia, primarily due to the system of free medicine. However, the system of compulsory and voluntary insurance often does not cover the costs of medicines. As a result, the cost of medicines for professional and self-treatment depends almost entirely on income, and, accordingly, people with high earnings spend more on drugs.

This result suggests that for a low-income population, the availability of healthcare may be limited by the high cost of medicines. This means that they will have to look for cheaper analogues or give up on expensive drugs. This is an alarming signal, because medications are an integral part of any treatment.

Evgeny Zazdravnykh
Author of the article, Research Fellow of theInternational Centre for Health Economics, Management, and Policy at HSE University in St. Petersburg

IQ

August 29, 2023