Prescribing Drugs not in Accordance with the Official Instructions for Medical Use (Off-label), Clinical Guidelines, Standards of Medical Care and Legal Regulation in the Russian Federation. Part 2

Author:

Navasardyan A. R.1ORCID,Martsevich S. Yu.2ORCID,Gabay P. G.3ORCID

Affiliation:

1. Bayer JSC

2. National Medical Research Center for Therapy and Preventive Medicine

3. Faculty of Medical Law, LLC; Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia

Abstract

Prescribing drugs not in accordance with the official instructions for medical use (off-label) has medical and legal aspects. From a medical point of view, such an appointment can be dictated by clinical urgency, when there is no alternative therapy, and on the other hand, doctors often prescribe off-label drugs unknowingly, and also when there is another drug with registered indications. The article analyzes the regulations governing such appointments. The article describes possible inconsistencies between clinical guidelines and standards of medical care in this matter, the role of the medical commission, the impact on the quality and safety of medical care, as well as the types of legal liability of a medical worker that may arise when a drug is prescribed not according to instructions.

Publisher

Stolichnaya Izdatelskaya Kompaniyaizdat

Subject

Pharmacology (medical),Cardiology and Cardiovascular Medicine

Reference29 articles.

1. Decision of the Council of the Eurasian Economic Commission dated November 3, 2016 N 87 “On Approval of the Rules of Good Pharmacovigilance Practice of the Eurasian Economic Union” [cited by Jan 08, 2021]. Available: https://www.alta.ru/tamdoc/16sr0087/ (In Russ.)

2. Martsevich SY, Navasardjan AR, Komkova NA. Off-Label Prescribing. Possible Causes, Types and Consequences. Legal Regulation in the Russian Federation. Rational Pharmacotherapy in Cardiology. 2017;13(5):667-74 (In Russ). DOI:10.20996/1819-6446-2017-13-5-667-674.

3. Federal Law “On the fundamentals of protecting the health of citizens in the Russian Federation” of November 21, 2011 N 323-FZ (last version) [cited by Jan 08, 2021]. Available: http://www.consultant.ru/document/cons_doc_LAW_121895/ (In Russ.)

4. Order of the Ministry of Health of Russia dated March 28, 2019 No. 167n [cited by Jan 08, 2021]. Available: https://rulaws.ru/acts/Prikaz-Minzdrava-Rossii-ot-28.03.2019-N-167n/ (In Russ.) [Приказ Минздрава России от 28.03.2019 №167н [цитировано 08.01.2021]. Доступно: https://rulaws.ru/acts/Prikaz-Minzdrava-Rossii-ot-28.03.2019-N-167n/].

5. Order of the Ministry of Health of Russia dated 02.28.2019 N 101n "On approval of the criteria for the formation of a list of diseases, conditions (groups of diseases, conditions) for which clinical guidelines are developed" (Registered with the Ministry of Justice of Russia 05.28.2019) [cited by Jan 08, 2021]. Available: http://www.consultant.ru/document/cons_doc_LAW_325476/ (In Russ.)

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