ECONOMY
Medications in Russia Are in Short Supply and Getting More Expensive
June 12, 2025
-
Ksenia Buksha
Journalist and writer
Journalist Ksenia Buksha looks at how the exit of pharmaceutical companies from Russia and the government’s import substitution push are affecting ordinary Russians and their health.
The original text in Russian was published in Republic and is being republished here with their permission.
In 2024, Russian pharmacies had 134 fewer essential drugs than the year before. Of these, about 15% treat cancer. The remaining are antibiotics, anticonvulsants, immunosuppressants, insulin for pregnant women and drugs for migraines, allergies, tuberculosis, HIV, malaria and so on.
In 2024, Russian pharmacies had 134 fewer essential drugs than the year before. Of these, about 15% treat cancer. The remaining are antibiotics, anticonvulsants, immunosuppressants, insulin for pregnant women and drugs for migraines, allergies, tuberculosis, HIV, malaria and so on.
Virion (pictured), located in Tomsk, is a branch of the state-run Microgen, which is Russia's largest producer of immunobiological products and one of the three largest pharmaceutical companies in Russia. Source: Wiki Commons
Constant shortages
For example, Endoxan, used as chemotherapy and to suppress the immune system, disappeared in May 2024, as did other drugs used in the treatment of lung and biliary tract cancer.
Last summer, doctors and patients complained about a shortage of the laxative Senade, which is included in the official list of essential drugs.
In October, many regions ran short of antibiotics with different active ingredients.
In November, immunoglobulin, which is extremely important for pregnant women with the Rh negative blood type, disappeared across almost all of Russia.
Meanwhile, even in Moscow and St Petersburg there was a serious shortage of saline solution for several months. For example, in the northern capital’s clinics the wait for procedures with saline solution took up to two months, and pharmacies had only ampoules of 5-10 milliliters.
Though saline solution and antibiotics have since reappeared on pharmacy shelves, many more complex drugs have consistently been in short supply, and their number has been increasing. This is driven mainly by the exit of pharmaceutical companies from Russia, the Kremlin’s import substitution push, the termination of clinical trials and rising prices due to disrupted supply chains.
Chats instead of pharmacies
Sanctions, restrictions and the (poor) quality of generics have led to the emergence of a real black market for brand-name, original drugs. Suppliers buy batches of them in Turkey, India and European countries and then sell them through messenger chats.
In 2024, Russians bought off these resellers more than 1,200 different types of drugs, half of which are not available in pharmacies.
After the war started and the Hydra darknet marketplace (where not only medications but also narcotics were bought and sold) was liquidated, Telegram became a popular platform to get medications. In 2024, dedicated Telegram chats saw the average number of offerings per month jump 150% versus 2023. There are also groups on social media where people give away unneeded drugs for free.
For example, Endoxan, used as chemotherapy and to suppress the immune system, disappeared in May 2024, as did other drugs used in the treatment of lung and biliary tract cancer.
Last summer, doctors and patients complained about a shortage of the laxative Senade, which is included in the official list of essential drugs.
In October, many regions ran short of antibiotics with different active ingredients.
In November, immunoglobulin, which is extremely important for pregnant women with the Rh negative blood type, disappeared across almost all of Russia.
Meanwhile, even in Moscow and St Petersburg there was a serious shortage of saline solution for several months. For example, in the northern capital’s clinics the wait for procedures with saline solution took up to two months, and pharmacies had only ampoules of 5-10 milliliters.
Though saline solution and antibiotics have since reappeared on pharmacy shelves, many more complex drugs have consistently been in short supply, and their number has been increasing. This is driven mainly by the exit of pharmaceutical companies from Russia, the Kremlin’s import substitution push, the termination of clinical trials and rising prices due to disrupted supply chains.
Chats instead of pharmacies
Sanctions, restrictions and the (poor) quality of generics have led to the emergence of a real black market for brand-name, original drugs. Suppliers buy batches of them in Turkey, India and European countries and then sell them through messenger chats.
In 2024, Russians bought off these resellers more than 1,200 different types of drugs, half of which are not available in pharmacies.
After the war started and the Hydra darknet marketplace (where not only medications but also narcotics were bought and sold) was liquidated, Telegram became a popular platform to get medications. In 2024, dedicated Telegram chats saw the average number of offerings per month jump 150% versus 2023. There are also groups on social media where people give away unneeded drugs for free.
“The most popular drugs on the internet are those for cancer treatment. This is unsurprising: most antitumor drugs cannot be found in pharmacies anymore.”
It is these drugs that have been most affected by the exit of pharmaceutical companies from Russia and the disruption of supply chains. In addition, the registration of these drugs in Russia is a very long process, and pharmaceutical companies, for obvious reasons, are not selling their drugs in Russia.
According to a survey conducted by the nonprofit Movement Against Cancer, every third cancer patient now faces a shortage of medications (and in rural areas, every second patient) and every fourth has to buy them out of pocket.
Meanwhile, many Russians buy antidiabetic drugs like Ozempic and Mounjaro in messenger chats, as well as medications for circulatory and nervous system diseases and antiviral drugs for hepatitis and HIV.
Even if a drug can be bought at a pharmacy, the retail price can be much higher than in chats. For example, the cancer drug Xtandi costs about RUB 152,000 in stores but less than RUB 100,000 through resellers.
According to a survey conducted by the nonprofit Movement Against Cancer, every third cancer patient now faces a shortage of medications (and in rural areas, every second patient) and every fourth has to buy them out of pocket.
Meanwhile, many Russians buy antidiabetic drugs like Ozempic and Mounjaro in messenger chats, as well as medications for circulatory and nervous system diseases and antiviral drugs for hepatitis and HIV.
Even if a drug can be bought at a pharmacy, the retail price can be much higher than in chats. For example, the cancer drug Xtandi costs about RUB 152,000 in stores but less than RUB 100,000 through resellers.
“The Russian consultancy RNC Pharma estimates the cost of imported drugs increased a third in 2024.”
Prices have risen for the most common therapies as well, such as over-the-counter anti-inflammatory drugs and asthma drugs. The reason is that many locally produced medications are made with imported components, which have become much more expensive.
Generics are not the solution
But what about import substitution? Alas, it works poorly in this area. Though drug production in Russia is increasing, the leaders of domestic production, according to RNC Pharma, are relatively simple drugs such as paracetamol and naphazoline. Most complex drugs still have to be imported.
Meanwhile, Russia produces many cheap generics, for which reason, however, brand-name drugs are leaving the country due to low selling prices. Another problem is that Russian generics do not undergo the required cycle of clinical trials. Their real efficacy is unknown, and they often have many more side effects.
This is the case not only for cancer drugs but also, for example, HIV drugs. In addition, Russia does not produce combination drugs, meaning patients on local treatment regimens need to take several pills at once instead of one, which is much less convenient.
Orphan diseases: No hope
In the prevailing conditions, patients with orphan diseases find themselves in a hopeless situation. Their drugs are often very expensive, and almost no family can afford them on their own, even though they mean the difference between life and death.
In 2024, 77% of orphan disease patients complained about difficulties in obtaining drugs.
Take patients with cystic fibrosis. Purchases of the US drug Trikafta were ended; it was to be replaced by the Argentine generic Trilexa, which had not undergone any clinical trials and was used neither in Argentina itself nor in any European countries or the US.
The supplier emerged as a company called Irwin with links to the family of Putin aide Alexei Dyumin. That aside, the drug was purchased in half the amount needed, and many patients received nothing at all. The alternative of buying Trikafta out of pocket is all but impossible: it costs RUB 1.5 million for a month’s worth of treatment.
This year, the situation with drugs in Russia will only get worse due to a new state procurement rule.
Generics are not the solution
But what about import substitution? Alas, it works poorly in this area. Though drug production in Russia is increasing, the leaders of domestic production, according to RNC Pharma, are relatively simple drugs such as paracetamol and naphazoline. Most complex drugs still have to be imported.
Meanwhile, Russia produces many cheap generics, for which reason, however, brand-name drugs are leaving the country due to low selling prices. Another problem is that Russian generics do not undergo the required cycle of clinical trials. Their real efficacy is unknown, and they often have many more side effects.
This is the case not only for cancer drugs but also, for example, HIV drugs. In addition, Russia does not produce combination drugs, meaning patients on local treatment regimens need to take several pills at once instead of one, which is much less convenient.
Orphan diseases: No hope
In the prevailing conditions, patients with orphan diseases find themselves in a hopeless situation. Their drugs are often very expensive, and almost no family can afford them on their own, even though they mean the difference between life and death.
In 2024, 77% of orphan disease patients complained about difficulties in obtaining drugs.
Take patients with cystic fibrosis. Purchases of the US drug Trikafta were ended; it was to be replaced by the Argentine generic Trilexa, which had not undergone any clinical trials and was used neither in Argentina itself nor in any European countries or the US.
The supplier emerged as a company called Irwin with links to the family of Putin aide Alexei Dyumin. That aside, the drug was purchased in half the amount needed, and many patients received nothing at all. The alternative of buying Trikafta out of pocket is all but impossible: it costs RUB 1.5 million for a month’s worth of treatment.
This year, the situation with drugs in Russia will only get worse due to a new state procurement rule.
“From now on, if a tender includes drugs that are wholly produced in Russia, the remaining bids will be automatically rejected.”
This applies both to life-saving drugs and to strategically important drugs.
Because of the rule, prices will rise further and there will be even fewer medications on shelves – a fact acknowledged even by official Russian sources.
Because of the rule, prices will rise further and there will be even fewer medications on shelves – a fact acknowledged even by official Russian sources.
Share this article
Read More
