Problems of biological therapy for rheumatic diseases

Introduction. Rheumatic diseases are one of the most common pathologies in the world, occupying a leading position in primary disability and chronicity among the group of musculoskeletal system diseases in both Russia and worldwide. The important problem is patients’ resistance to standard disease-modifying therapy, which requires biological therapy to achieve remission of the disease. With an increase in epidemiological indicators, there is an acute problem of the availability of expensive high-tech therapy with biological agents. Objective: to analyze the drug supply system for patients with rheumatic diseases at the federal and regional levels. Material and methods. The investigation materials were the legal framework regulating drug provision for patients with rheumatic diseases; statistical data of the Ministries of Health of the Russian Federation and the Republic of Tatarstan; and guidelines for the treatment of these diseases. Content analysis methods and documentary research and statistical studies were used. Results. The list of drugs sold on preferential terms for the treatment of patients with rheumatic diseases was made. In many cases, disease-modifying therapy cannot control disease progression. In this case, the disease-modifying therapy is substituted for expensive treatment with biological agents. Gene therapy is indicated for 15% of patients with these diseases; however, the high cost makes this therapy unaffordable for everyone in need. Conclusion. There is a problem of the availability of gene therapy in the treatment of rheumatic diseases due to the stable growth of the need for expensive drugs in the context of a budget deficit. It is necessary to modernize the system for providing rheumatic disease patients with biological agents and to elaborate methodological approaches to providing these drugs at the regional level.