Substitution of the Imported Medical Devices in the Russian Federation: Coronary Stents Market

Import substitution industrialization in strategically important sectors, including medical devices (MD) manufacturing, has been implemented by the Government of the Russian Federation since 2009, when the first strategy, that postulated among the main priorities the protection of the domestic manufacturers and increasing their competitiveness, was adopted. For 10 years, a number of strategic and tactical documents were focused on measures that support Russian companies and displace foreign. In this paper, the author tries to analyze the state policy of the Russian Federation in the field of import substitution of MD and evaluate the results of its implementation on the example of the coronary stents market. It is shown that the coronary stent market underwent significant structural changes due to many factors: external sanction impact, internal legislative regulation, monopolistic ambitions of one player and opposition from other domestic players. The main results of the policy is a significant drop in the cost of the coronary stent in government procurement, accompanied by a dramatic decrease in the number of foreign players. Still, there is a number of reasons not to evaluate these changes as totally positive. The analysis of international experience of import substitution in healthcare shows that import substitution was mostly used not as a tool for technological re-equipment, but as a way of cutting national losses in a belt-tightening time. Juxtaposition of global trends in coronary stenting and the domestic coronary stents market demonstrates high risks of failure of cardiology medical care system, both quantitatively and qualitatively. Expert interviews also show that doctors, manufacturers and healthcare managers are very cautious about import substitution, carried out in coronary stenting. Thus, there is an urgent need for deep integrated work with this particular segment of the MD market to overcome barriers for the development of the domestic coronary stents market. In this regard, the work offers a number of recommendations for improving state, administrative, organizational and economic management, as well as recommendations for improving the work with the Russian medical community.