Access to healthcare in Russia: the role of socioeconomic factors and digital technologies
https://doi.org/10.26425/2658-347X-2025-8-4-38-53
Abstract
The analysis of the structural determinants of medical care availability in Russia has been carried out. The research focuses on the mutual impact of socio-economic factors (social stratification and territorial inequality), economic mechanisms (government financing and commercialization), and digitalization on forming a dualistic healthcare model. The empirical basis of the study has been made up of data from 20 semi-structured in-depth interviews with the heads of Russian pharmaceutical companies and leading healthcare professionals. The study results have revealed the persistence of key systemic challenges: regional asymmetry in the resources provision, staff shortages, and the growing burden on the compulsory health insurance system. The analysis of the experts’ discourse demonstrates its ambivalent nature: with the declared support for the policy of import substitution and economic sovereignty, respondents emphasize the issue of the technological gap and institutional barriers. The thesis has been argued on the need for a paradigm shift from extensive “disease control” to proactive “health management” with the integration of regular monitoring of public attitudes into the process of public policy formation. The effectiveness of import substitution depends not only on the amount of financing, the level of technology, and digitalization, but also on transformation of the symbolic capital of domestic medical products in the eyes of the professional community and the population.
About the Authors
D. A. ChizhovRussian Federation
Dmitry A. Chizhov - Postgraduate Student
Moscow
D. I. Cherkasov
Russian Federation
Dmitry A. Chizhov - Postgraduate Student
Moscow
References
1. Binagwaho A., Mathewos K., Davis S. Time for the ethical management of COVID-19 vaccines. The Lancet Global Health. 2021;8(9):e1169-e1171. https://doi.org/10.1016/S2214-109X(21)00180-7
2. Chaudhuri S. Can foreign firms promote local production of pharmaceuticals in Africa? In: Making Medicines in Africa: The Political Economy of Industrializing for Local Health. 2026. Pp. 103–121. https://doi.org/10.1007/978-1-137-54647-0_7
3. Cherian J., Rahi M., Singh S., Reddy S., Gupta Y. et al. India’s road to independence in manufacturing active pharmaceutical ingredients: Focus on essential medicines. Economies. 2021;2(9):71. https://doi.org/10.3390/economies9020071
4. Civaner M. Sale strategies of pharmaceutical companies in a “pharmerging” country: The problems will not improve if the gaps remain. Health Policy. 2012;3(106):225–232. https://doi.org/10.1016/j.healthpol.2012.05.006
5. Cowart T., Rashi T., Bock G. Should pharma companies waive their COVID-19 vaccine patents? A legal and ethical appraisal. Laws. 2023;3(12):47. https://doi.org/10.3390/laws12030047
6. Dneprovskaya I., Arakelova I., Legenkova N., Danilenko E., Tikhonova A. The prospects for the development of the domestic pharmaceutical industry in the context of import substitution. In: Anticrisis Approach to the Provision of the Environmental Sustainability of Economy. 2023. Pp. 43–51. https://doi.org/10.1007/978-981-99-2198-0_5
7. Dorzhieva V.V. Strategy of the new industrialization of the pharmaceutical industry: national priorities and new challenges. Scientific works of the Free Economic Society of Russia. 2023;2(240):198–215. (In Russian).
8. Dosi G., Marengo L., Staccioli J., Virgillito M. Big pharma and monopoly capitalism: a long-term view. Structural Change and Economic Dynamics. 2023;65:15–35. https://doi.org/10.1016/j.strueco.2023.01.004
9. Gajbhiye D., Choudhry S., Goel S. Changing Dynamics of Indian Pharmaceutical Sector: Opportunities and Challenges. Journal of Development Economics and Finance. 2022;1(3):77–98. https://doi.org/10.46791/jdef.2022.v03i01.04
10. Galitskaya V.A., Meshcheryakova N.N. “Digital paradoxes” in the healthcare system. Issues of state and municipal management. 2022;4:176–196. (In Russian). https://doi.org/10.17323/1999-5431-2022-0-4-176-196
11. Gonzalez Pena, O., Lopez Zavala M., Cabral Ruelas H. Pharmaceuticals market, consumption trends and disease incidence are not driving the pharmaceutical research on water and wastewater. International Journal of Environmental Research and Public Health. 2021;5(18):2532. https://doi.org/10.3390/ijerph18052532
12. Gubina M.A. Import substitution and/or export orientation: the experience of the pharmaceutical industry in India. Bulletin of St. Petersburg University. Economy. 2019;2(35):197–222. (In Russian). https://doi.org/10.21638/spbu05.2019.202
13. Gusev A.B., Shiryaev A.A. Pain points of Russia’s strategic development. Journal of Economic Regulation. 2021;3(12):6–25. (In Russian). https://doi.org/10.17835/2078-5429.2021.12.3.006-025
14. Horner R. Global value chains, import orientation, and the state: South Africa’s pharmaceutical industry. Journal of International Business Policy. 2021;5. https://doi.org/10.1057/s42214-021-00103-y
15. Ivanova N.I., Mamedyarov Z.A. Specifics of the development of the Russian pharmaceutical industry. Journal of the New Economic Association. 2022;1(53):248–255. (In Russian). https://doi.org/10.31737/2221-2264-2022-53-1-15
16. Klarin A., Ray P. Political connections and strategic choices of emerging market firms: Case study of Russia’s pharmaceutical industry. International Journal of Emerging Markets. 2019;3(14):410–435. https://doi.org/10.1108/IJOEM-05-2016-0138
17. Kumar P., Tripathy S., Dureja H. Pharma emerging market’s scaning by look and feel of its opportunities and challenges. Applied Clinical Research, Clinical Trials and Regulatory Affairs. 2015;2(3):115–122. https://doi.org/10.2174/2213476X03666151125220257
18. Mamedyarov Z.A. Trends and prospects of the Russian pharmaceutical industry and the applicability of world experience. MIR. 2017;4(8):772–780. (In Russian). https://doi.org/10.18184/2079-4665.2017.8.4.772-780
19. Mamedyarov Z.A. Development of science and technology: post-crisis assessments. World economy and international relations. 2022;5(66):14–22. (In Russian). https://doi.org/10.20542/0131-2227-2022-66-5-14-22
20. Nalimov P.A., Rudenko D.Y. The global pharmaceutical market: the polarity of global health. ECO. 2015;3(489):116–128. (In Russian).
21. Nezhnikova E., Maksimchuk M. Pharmaceutical industry in Russia: Problems and prospects of development. RUDN Journal of Economics. 2019;1(27):102–112. https://doi.org/10.22363/2313-2329-2019-27-1-102-112
22. Okereke M., Essar M. Time to boost COVID-19 vaccine manufacturing: The need for intellectual property waiver by big pharma. Ethics, Medicine, and Public Health. 2021;19:100710. https://doi.org/10.1016/j.jemep.2021.100710
23. Pourraz J. Making medicines in post-colonial Ghana: State policies, technology transfer and pharmaceuticals market. Social Science & Medicine. 2022;311:115360. https://doi.org/10.1016/j.socscimed.2022.115360
24. Pylaeva I.S., Podshivalova M.V., Podshivalov D.V. The impact of the COVID-19 pandemic on the sustainable development of Russian pharmaceutical companies. Economic issues. 2022;10:86–112. (In Russian). https://doi.org/10.32609/0042-8736-2022-10-86-112
25. Tannoury M., Attieh Z. The influence of emerging markets on the pharmaceutical industry. Current Therapeutic Research. 2017;86:19–22. https://doi.org/10.1016/j.curtheres.2017.04.005
26. Ustyuzhanina E.V., Dementyev V.E., Evsyukov S.G. Problems of distribution of power and economic rent in value creation networks. Economics and mathematical methods. 2020;1(56):5–17. (In Russian). https://doi.org/10.31857/S042473880008468-3
27. Van Dijk J.A.G.M. The evolution of the digital divide: The digital divide turns to inequality of skills and usage. In: Bus J., Crompton M., Hildebrandt M., Metakides G. (eds.) Digital enlightenment yearbook. Amsterdam: IOS Press; 2012. Pp. 57–75.
28. Volgina N. Business models of big pharma in Russia: A pharmaceutical value chain perspective. RUDN Journal of Economics. 2022;1(30):57–69. https://doi.org/10.22363/2313-2329-2022-30-1-57-6
29. Volgina N.A. “Link” restructuring of global pharmaceutical chains under the influence of the COVID-19 pandemic. Bulletin of MGIMO University. 2022;1(15):126–142. (In Russian). https://doi.org/10.24833/2071-8160-2022-1-82-126-142
30. Zolotov A.A., Panikarova S.V. Personnel shortage in regional healthcare: myths, causes, solutions. Vocational education and the labor market. 2025;1:75–94. (In Russian). https://doi.org/10.52944/PORT.2025.60.1.005
Review
For citations:
Chizhov D.A., Cherkasov D.I. Access to healthcare in Russia: the role of socioeconomic factors and digital technologies. Digital Sociology. 2025;8(4):38-53. (In Russ.) https://doi.org/10.26425/2658-347X-2025-8-4-38-53
JATS XML




























