Why Moscow pays so dearly for medications

There's no competition in many tenders, so the orders are placed at the maximum price.
In December last year in Moscow there was a scandal around the city cancer hospital number 62. Its chief doctor Anatoly Mahson criticized the City Health Department decision to deprive the autonomous status of the medical establishment, and thus the right to buy their own medicines. He said the hospital bought the drug several times cheaper department. According to the industry publication Vademecum and analyst firm Headway Company, a hospital number 62 in 10 of the 13 procurement of antineoplastic drugs had similar prices 13-79% lower than department.

In response, the deputy mayor of Moscow, Leonid printers said that the 62 th hospital bought drugs on the verge of expiry. In late December Mahsona fired. Already this year, printers explained that among other things the producers were selling drugs at the hospital "charity" price. So did a large pharmaceutical company "Biokad": first it supplied drugs free of charge at the request of the chief doctor, and then started selling them at a symbolic price, said General Director of "Biocad" Dmitry Morozov.

"The situation is trying to submit my personal conflict with Pechatnikov, they say, I raised the issue of public procurement, because it did not want to lose a warm place, but I would have gone to the post of the head physician in any case, because the work becomes impossible," - said Mahson "Vedomosti" . Non-transparent procurement system leads to high prices, supply disruptions and lack of drugs, says former chief doctor. Printers stated that purchases are not supervised, and referred questions to the Department of Health. Department spokesman did not respond to questions about the purchase.

"Vedomosti" learned how and what buys the mayor's office and its structure. The bottom line is - the competition was surprisingly low among suppliers. And although the market are active all the major federal players, most orders goes less well-known companies based owners of the group of companies "European Medical Center» (European Medical Center, EMC), which once worked himself printers, or their partners.

Close customer

How many purchases Moscow? On medicines and equipment the city spends about as much as the Ministry of Health and Russian. According to the government procurement website, the latter placed the orders for 54.43 billion rubles in 2016. Moscow Health Department (DMD) and its controlled CCU "Procurement Agency (contractual service) DMD" - to 54.79 billion rubles. In the city there is one major customer, rather, customers with orders of more than 20 billion rubles. per year - over 30 city hospitals, conducting independent procurement.

Expensive purchases whether Moscow? Anticancer drugs are one of the largest suppliers - "Biocad" department treated less expensive than the national average, according to a representative of the company with reference to procurement data. According to him, the department saved depending on the drug 10 to 68% compared to the average purchasing prices. Moreover, one of the last auction of Moscow made "Biocad" of such drugs on price reductions, such as never sought one another, Morozov said.

One of the leaders of the federal pharmaceutical market - "R-Pharm" is trying to keep the same level of price across the country, said the company's top manager.

However, the documentation of procurement can be seen that very often the pharmaceutical auctions win their only participants - at the initial price. Overall, bids are arranged so. Set the initial price. It is determined according to the state register of limiting the manufacturer's selling prices on the drugs included in the list of vital and essential medicines plus 10% VAT. This is the maximum price at which the manufacturer can sell their products to wholesalers. Bidders are playing for a fall. Who will offer the lowest price - the winner.

But the competition is very often not the case. For example, last year at CCU 26 major auctions with a starting price of lots exceeding 200 million rubles. application made only participant. Trades were recognized invalid, and with a single supplier to enter into contracts for an initial maximum price. "R-Pharm" thus received six contracts for 2.6 billion rubles. "Pharmstandard" - five to 2.4 billion rubles, "Irwin 2." - Three at 1.4 billion rubles.

In the infrequent cases when the auction appeared a second party, drug prices have fallen significantly. So, at the December auction of the Civil Code the right to delivery of anticancer drugs trastuzumab and bevacizumab competed "R-Pharm" and "Biokad Farm." The victory went to the latter. The company cut the price of trastuzumab in more than two-fold to 628 million rubles, and bevacizumab -. Almost tripled to 223 million rubles. With an initial price of trastuzumab in 71 364 rubles. per pack (440 mg № 1) "Biokad" put the drug agency for 34 712.80 rubles.

For comparison, according to the results of the auction DMD in August 2016 a contract was concluded with the sole member, FC "Progress". The company sold antineoplastic drugs at the maximum initial price - 66 180 rubles. (Excluding VAT). This limit wholesale price for "Biocad" specified in the registry of drugs.

The lowest prices for the drug in public procurement "Vedomosti" found in Chechnya. The Ministry of Health of the Republic purchased the drug at 31,866 rubles last year. packing. A 62-th Hospital bought trastuzumab for 49,740 rubles last year. packing.

Those who often buys Moscow? As the amount of transactions in the lead "Farmadis", "Tagore", "Ezra" and "Akvista". All of them were somehow connected with the founders, managers or partners EMC, counted "Vedomosti" (cm. Incision). Over the past year, according to estimates of "Vedomosti", the listed company won the city auctions at 14.7 billion rubles. This is 27% of the procurement department and the Civil Code of 2016 Nearest rivals - "Pharmstandard" and belonging to him "Biokad" received orders for 8.9 billion rubles, "R-Pharm." - 7.4 billion rubles.

Highest winning tenders not only the city, but also hospitals. And only 62-I hospital in 2016 is nothing they did not buy. Mahson said that the company does not know. But notes that, after the centralization of purchases at the end of 2014 tenders for steel winning antineoplastics little known before the company.

Company-ram

Over the past six years, the company, founded by a former owner of the juice company "Nidan" and co-owner Igor Shilov EMC and its partners began for Moscow's largest suppliers of scanners, various pharmaceuticals, consumables, from gloves to parts of medical equipment, and even baby food.

They began with the scanners. "Farmadis" and two other companies associated with the former owners of "Nidan" and their partners have become major suppliers of these devices to hospitals in Moscow, received from the Department of contracts for 12 billion rubles. (Including deliveries in early 2012).

Printers then explained that his former partners in the EMC helped to "break" the market and reduced the price of medical equipment in several times. "In 2011-2012,. I and the other shareholders of EMS responded to the call of the then Minister of Health in Moscow Leonid Mikhailovich Pechatnikova help break the current corrupt procurement system scanners and other heavy medical technology, in which the price of the equipment supplied for state needs, has been in two or even three times higher than the EMC purchased to equip their hospitals, "- gave" Vedomosti "Shilov. According to him, the goal was achieved: "Not only do we, of course, but the antimonopoly agency, the police broke through the wall - the state began purchasing medtekhniku ​​of real market prices."

But then, continues to Shilov, he gave up procurement business and decided they did not do. "The result was not so rosy for us: lost time and health; made doubtful business reputation, because we have those who work with the state - it is certainly crooks, and prove that you are not a camel, not enough life; return on own investment is such that it would be more profitable to deposit money put - Shilov said. - All the time there are additional costs: flat urban hospital of the installation of medical equipment is sometimes prepared with a 12-month delay, the department did not pay on time, have currency fluctuations, costs are incurred for equipment storage. "

He and his partners decided to sell all of the company's top managers. This was done, continues Shilov. He himself left Russia. Now his business interests are focused in South-East Asia, the businessman says. Co-owned by EMC, he remains, but the control is not engaged, Shilov continues.

Medical communications

Printers worked as the head physician of the European Medical Center (EMC) in Moscow since 2004 and owned a 2.6% stake in the company. If it is a small boutique hospital has evolved into a major medical holding. In 2008, EMC for $ 110 million bought Igor Shilov, Leonid Shaiman and Csaba Baler. A year ago, they sold the juice company "Nidan" for $ 400 million. In 2010, Pechatnikova appointed head of the Moscow Department of Health in 2012 was promoted to deputy mayor. After leaving the mayor's office of the company in Pechatnikova associated with EMC shareholders, suppliers of steel department.

Sixth in July 2011 in Cyprus it was established two companies - ARS-Medicine Limited and ARS-Phoebea Limited. ARS-Medicine Limited, established in Moscow, JSC "Farmadis". Later, printers and Shilov told "Vedomosti" that "Farmadis" belongs EMC shareholders. "Farmadis" and belonging to the Cypriot Nidan Juices «G en e-Invest" and JSC "Inoprom honey" Vladimir Smagina scanners have become major suppliers to the Moscow hospitals.

ARS-Phoebea Limited was later renamed Olemed Holding Limited and acquired 70% of JSC "Ezra" (transaction involved a former lawyer "Nidan" Sergei Shumei). The remaining 30% of "Ezra" received Israeli company Elsmed Healthcare Solutions, the official dealer Vairan, Philips and IBA in Russia. Since 2015, "Ezra" has become a major supplier of parts for complex medical equipment on request "Gormedtehniki". For companies accounted for almost 80% of all purchases: 2.9 billion from 3.7 billion rubles spent "Gormedtehnikoy" in 2015-2016..

Structures EMC serviced by the marketing agency "Pomegranate tree", since 2012 owned personally Shilov. Among the agency's clients was the company "Laval", which was listed as the owner of Irina Koshelev. In 2012, she sold the "Laval" Sergei Chushkin. The company soon became a major supplier of ultrasound and other medical equipment - in 2012, she entered into five contracts with the Department of 1.5 billion rubles. In 2013, Chushkin sold "Laval" Panamanian company Itaka Ventures, the company is no longer repeated the record of deliveries.

In 2013, purchased from the Cyprus Chushkin Peachtree Developments Limited has just created "Soventa" LLC. This company from 2013 to 2015, won the competition for 1.5 billion rubles. "Soventa" supplied catheters, diagnostic reagents, measuring instruments and other supplies. In 2015, the company merged with "G en e-Invest", creating of "Tagore". In 2016 "Tagore" won the competition by almost 6 billion rubles. As "Akvista", "Tagore" specializes in the supply in the Moscow hospital diagnostic reagents, instruments, syringes, catheters, sutures and other consumables.

In 2014, Chushkin acquired 50% of "Agat" company, in 2015 sold them. The portfolio of state orders "Agatha" in 2015 reached 5.8 billion rubles. According to the Vademecum, "Agatha" and "Tagore" e-mail address registered on emcmos.ru domain, which is used by EMC. A contact phone number "Tagore" also uses the charity 'Pelagia' Fund, its president is Shilov. In 2013, Cyprus Cascavella Holdings Limited established a joint-stock company "Akvista". According to SPARC, service domain name acvesta.ru representatives EMC. Set as contact their e-mail - [email protected] The site was registered in April 2014, the month before the company's CEO has been appointed Alexander Achikalov which, together with Boris owned Aizikovich Novosibirsk company "HLB End B Medical Group." Aizikovich was a partner of the former shareholders of "Nidan" Shaiman - they belonged in Novosibirsk medical center "Avicenna". With the advent of "Akvistu" Achikalova company more than 3-fold increased deliveries on the state order - up to 801 million rubles. in 2014. At the end of December 2014 Achikalov resigned from "Akvisty", was replaced by Ali Saatov about which no information to SPARK. In 2015, the portfolio "Akvisty" state orders grew even 5 times -. To 4 billion rubles, the same volume is preserved in 2016

Wholesale buyer

Businessman Sergei Chushkin confirms that he was among those who bought the company from Shilova, when he decided to leave. From 2012 through his hands he held a series of companies that rapidly breaks one of the largest suppliers and basically just as quickly losing ground after leaving Chushkin. But there are two exceptions - "Agat" and "Tagore", who receive even more orders after leaving Chushkin.

50% in the "Agatha" Chushkin acquired in 2014. The company just won a contract for the supply of baby food in the administrative districts of Moscow for 745 million rubles. In 2015, the share of Chushkin sold 25-year-old Vladimir tinsel. Three years earlier, he was searching online job Telejob.ru personal driver. "The situation in 2015 changed a bit, I have sold a certain amount of property and bought 50% of" Agatha ", - says Tinsel. It was his first business. The sum of the deal he did not disclose, and states that acts as an independent businessman. Already at Tinsel "Agat" I have received from the Department of contracts for the supply of baby food for more than 5.8 billion rubles. However, the activists of the Popular Front in December 2016 sent a statement to the Prosecutor General of the cartel in the procurement department of dairy products, reported the "first anti-corruption media". "Agate" is going to continue to work with the department, said Tinsel.

According to the calculations of "Vedomosti", the suppliers, in which the co-owners was Chushkin the last three years, we have received contracts to not less than 4 billion rubles. But the businessman says that almost nothing on it did not work - projects were unprofitable. So he sold all the assets and the subsequent fate was not interested.

Existing shareholders 'Tagore' in SPARK not disclosed - is a joint-stock company. In October 2015, the company reported the government customer that it is owned and established Chushkin Cypriot lawyers Viviana Investments Ltd, formerly part of a group of "Nidan". Documents on changes of owners 'Tagore', although this is a significant fact yet. Chushkin says that "Tagore" was created through the merger of his company and the company bought from Shilov. He said he sold "Tagore" partner.

Chushkin now focused on a new market for him antineoplastic drugs and insulin. FC "Progress" was created only in 2015, it came up for auction in 2016, when it bought Chushkin, and immediately received contracts for 1.7 billion rubles. The success is explained by experienced investors and professional team, says CEO of "Progress" Sergei Kuznetsov. The company plans this year to enter the federal market, he said. The company's business is not related to "Farmadisom" and "Tagore", he said.

After three quarters of work, the company received a loss for the year it is hoped to get out on the break-even handed Chushkin. Now "Promotion" is in talks about getting an exclusive on the products of several major manufacturers and hopes distributirovat them across the country. "We started with Moscow, which is justified: the largest area, the largest budget. We want to get in the top five suppliers, to build the plant. A large number of drugs is getting out of patent protection in the next couple of years, it is necessary to use "- says Chushkin.