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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">farmaec</journal-id><journal-title-group><journal-title xml:lang="en">FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology</journal-title><trans-title-group xml:lang="ru"><trans-title>ФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2070-4909</issn><issn pub-type="epub">2070-4933</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2070-4909/farmakoekonomika.2026.338</article-id><article-id custom-type="elpub" pub-id-type="custom">farmaec-1306</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ПУБЛИКАЦИИ</subject></subj-group></article-categories><title-group><article-title>Studying the risks of drug provision for breast cancer patients in the public procurement system of Russia</article-title><trans-title-group xml:lang="ru"><trans-title>Изучение рисков лекарственного обеспечения пациентов с раком молочной железы в системе государственных закупок</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7311-4549</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шаталова</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shatalova</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шаталова Ольга Викторовна, д.м.н., проф. </p><p>Scopus Author ID: 57188798913. </p><p>пл. Павших Борцов, д. 1, Волгоград 400066</p></bio><bio xml:lang="en"><p>Olga V. Shatalova, Dr. Sci. Med., Prof.</p><p>Scopus Author ID: 57188798913. </p><p>1 Pavshikh Bortsov Sq., Volgograd 400066</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5647-0568</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ганичева</surname><given-names>Л. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Ganicheva</surname><given-names>L. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ганичева Людмила Михайловна, д.фарм.н., проф. </p><p>пл. Павших Борцов, д. 1, Волгоград 400066</p></bio><bio xml:lang="en"><p>Ludmila M. Ganicheva, Dr. Sci. Pharm., Prof. </p><p>1 Pavshikh Bortsov Sq., Volgograd 400066</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9025-3030</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Борискина</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Boriskina</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Борискина Мария Александровна</p><p>пл. Павших Борцов, д. 1, Волгоград 400066</p></bio><bio xml:lang="en"><p>Maria A. Boriskina </p><p>1 Pavshikh Bortsov Sq., Volgograd 400066</p></bio><email xlink:type="simple">maria_boriskina@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Федеральное государственное бюджетное образовательное учреждение высшего образования «Волгоградский государственный медицинский университет» Министерства здравоохранения Российской Федерации<country>Россия</country></aff><aff xml:lang="en">Volgograd State Medical University<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>07</day><month>05</month><year>2026</year></pub-date><volume>1</volume><issue>19</issue><fpage>34</fpage><lpage>49</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Shatalova O.V., Ganicheva L.M., Boriskina M.A., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Шаталова О.В., Ганичева Л.М., Борискина М.А.</copyright-holder><copyright-holder xml:lang="en">Shatalova O.V., Ganicheva L.M., Boriskina M.A.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.pharmacoeconomics.ru/jour/article/view/1306">https://www.pharmacoeconomics.ru/jour/article/view/1306</self-uri><abstract><p>Background. Breast cancer is a socially significant disease. In Russia, the drug provision of breast cancer patients at all stages of treatment is carried out within the public procurement (PP) system. A systematic risk analysis of the PPs of antitumor drugs is an essential requirement for the safety and effectiveness of chemotherapy treatment.Objective: Identification of the main stages in the PPs of antitumor drugs used in breast cancer therapy; assessment of possible risks at each stage, development of a heat map for the studied risks.Material and methods. The methods of content and comparative analysis of scientific publications, legislative acts and protocols of open auctions, requests for quotations from four Russian oncological hospitals in the Southern and Central Federal Districts were used. In order to obtain a quantitative estimate of the overall risk for each group and to construct a risk heat map, the severity of consequences and the probability of risk occurrence were combined in a multiplicative model.Results. The key stages in the PPs of antitumor drugs were established to include tender planning, PP realization, government contract conclusion, and its execution. At the stage of tender planning, the following groups of the risks were identified: the risk of delaying the implementation of innovative chemotherapy treatment regimens into the real clinical practice; the risk of prescribing the chemotherapy treatment regimens classified as an increased risk of adverse reactions; the risk of excessive uniformity and/or variety of dosage regiments. At the stage of PP realization and contract conclusion, the risks are related to a cancellation of the purchase and forced procurements of more affordable analogues. The stage of contract execution involves the risks of reduced patient compliance due to the transfer of tablet drug forms to the ambulatory release; emergence of an urgent need for particular drugs due to changes in the treatment strategy; reduced effectiveness of thermolabile drugs due to a violation of the temperature regime of their transportation. The risk of forced procurements of more affordable analogues was rated as the highest level, while the risks of purchase cancellation and the emergence of an urgent need for drugs were ranked among the lowest.Conclusion. The results obtained may serve as a basis for improving the risk-based approach to PPs through minimizing negative consequences for patients, hospitals and the entire healthcare system.</p></abstract><trans-abstract xml:lang="ru"><p>Актуальность. Рак молочной железы – социально значимая онкопатология, лекарственное обеспечение которой на всех этапах детерминируется системой государственных закупок (ГЗ). Системный анализ рисков ГЗ противоопухолевых лекарственных средств является необходимым условием безопасности и эффективности химиотерапии.Цель: определение основных этапов ГЗ противоопухолевых лекарственных препаратов, применяемых в терапии рака молочной железы, оценка возможных рисков на каждом этапе, разработка тепловой карты изучаемых рисков.Материал и методы. В исследовании использованы методы контент- и сравнительного анализа научных публикаций, нормативных актов, протоколов открытых аукционов и запросов котировок четырех государственных медицинских организаций онкологического профиля Южного и Центрального федеральных округов. Для получения количественной оценки общего уровня риска для каждой группы и построения тепловой карты рисков тяжесть последствий и вероятность возникновения риска объединены в рамках мультипликативной модели.Результаты. Установлены ключевые этапы ГЗ лекарственных средств: планирование тендера, проведение ГЗ и заключение государственного контракта, исполнение контракта. На этапе планирования закупки выделены следующие группы рисков: риск задержки внедрения инновационных режимов химиотерапии в реальную клиническую практику, назначение схем химиотерапии, относящихся к категории повышенного риска развития нежелательных реакций, риск чрезмерного однообразия и/или разнообразия режимов дозирования. На этапе проведения ГЗ основной пул рисков – отмена закупки, вынужденная необходимость закупки более доступных аналогов. На этапе исполнения контракта – риск снижения комплаентности пациента ввиду переноса таблетированных лекарственный форм на амбулаторный отпуск, возникновение срочной потребности в препарате ввиду изменения стратегии лекарственной терапии, снижение эффективности термолабильных препаратов вследствие нарушения температурного режима транспортировки. В категорию наиболее высокого риска отнесен риск вынужденной необходимости закупки более доступных аналогов, наименее высокого риска – риски отмены закупки и возникновения срочной потребности в препарате.Заключение. Результаты исследования могут стать основой для совершенствования риск-ориентированного подхода при ГЗ ввиду минимизации негативных последствий для пациентов, медицинских организаций и системы здравоохранения в целом.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак молочной железы</kwd><kwd>государственные закупки</kwd><kwd>риски</kwd><kwd>противоопухолевые лекарственные средства</kwd><kwd>инновационные режимы химиотерапии</kwd><kwd>комплаентность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>breast cancer</kwd><kwd>public procurements</kwd><kwd>risks</kwd><kwd>antitumor drugs</kwd><kwd>innovative chemotherapy treatment regimens</kwd><kwd>compliance</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Каприн А.Д., Старинский В.В., Шахзадова А.О. (ред.) Состояние онкологической помощи населению России в 2024 году. М: МНИОИ им. П.А. 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