When little Sasha had a cold his mother would light a taper and place it in a small empty jar which she then turned upside down and pressed against each of Sasha's vertebrae in turn, using the suction created by the warm air cooling to create small round bruises the length of his spine.
Thirty years later, grownup Sasha prefers to give Soviet-style acupuncture cures a miss. Now, when he has the sniffles he takes Coldrex, a branded drug produced by pharmaceutical giant GlaxoSmithKline containing paracetamol, phenylephrine and guaiphenesin.
Sasha's behavior is becoming more of the norm in a society that is consuming ever larger quantities of pharmaceutical products. Last year, total per capita spending on medicines in Russia rose to $82.3 (2,021 rubles), twice the amount consumers spent in 2004. The overall value of the market that year was estimated at $11.7 billion, representing 20 percent year-on-year growth in dollar terms, according to data from Business Monitor International.
The bulk of these buyers are consumers, followed by government authorities, hospitals and polyclinics. In the first six months of this year state orders increased by 43 percent to $2.51 billion, thanks to a nationwide program by the federal government to provide low-cost medicine to those most in need.
Over the same period the commercial segment grew by 30 percent to $4.55 billion. Consumer pharmaceutical sales have been spurred on by a combination of rising disposable income levels, increasing awareness of products and the low health levels of a population that, generally speaking, smokes heavily, eats poorly and continues to age.
According to Euromonitor a growing number of consumers are buying a wider variety of over the counter pharmaceuticals and are making purchases more frequently. Major players in the market have responded to this trend by launching more and more products to take advantage of sales dynamism, while chained pharmacies continue to expand across the country.
Current consumer spending patterns are a stark contrast to the state of the market just 10 years ago. After the fall of the Soviet Union, dramatic price increases on consumer pharmaceuticals combined with the collapse of domestic production lead to widespread shortages of drugs.
A report by the World Health Organisation states that in 1994 only 62 percent of citizens were able to get all their prescribed medications.
"It was a difficult time," recalls Larissa, who worked as a doctor throughout the turbulent 1990s. "There were so many charlatans, claiming they could cure you of anything. Some practiced eastern medicine, others said they used ancient folk-wisdom, some even claimed that they could perform magic. And they made these claims openly. One man even went on television and told viewers to put bottles of water in front of the television set, then he waved his arms around and said that he had turned the water into a medicine for whatever ailed the viewer."
Many people were taken in by these con men and paid the price both financially and physically:
"People would take these potions and then convince themselves that they were well again and go about their normal business, while in reality their condition was getting worse," says Larissa.
Access to both prescribed and over the counter medicine has improved drastically since that time and Russians are embracing the opportunity they now have to pop an ever widening array of pills. But consumption levels still remain low relative to western countries, which has made the Russian market an attractive prospect for multinational pharmaceutical companies.
Multinationals now dominate the market and continue to gain ground over domestic producers as many consumers ‘trade up' from domestic generics and unbranded products to big brand names, which are often viewed as offering higher quality.
But the tactics used by these pharmaceutical giants to speed up sales may not always be in the best interests of consumers. A WHO report, Healthcare Systems in Transition, argues that aggressive advertising by pharmaceutical companies in Russia in the early 2000s has influenced citizens to expect that every consultation with a doctor should lead to a prescription. The report found particularly disturbing a series of intensive television advertising campaigns for codeine-based analgesics which should be sold only on prescription but could be freely purchased at pharmacies and kiosks across Russia .
Over the last few years the government has made great strides in improving both the regulation and enforcement of prescription drug supplies. Tough new advertising regulations have also been introduced. But some people feel that the crackdown has come too late:
"The pendulum has swung from one extreme to the other; nowadays people are ready to swallow a pill for any reason," comments Larissa.
By Rebeccah Billing
