Problems and their solutions in accompanying therapy of oncological patients: regulatory and financial strategic approaches to solutions

Accompanying therapy (AT) is vital for oncological patients as it allows to alleviate complications associated with both cancer and antitumor therapy. These complications include anemia, febrile neutropenia, nausea, and chronic pain syndrome. The problem is that many patients do not receive sufficient AT because of the lack of clinical guidelines and regulations. Currently, clinical guidelines only for anemia are approved and none for the other complications. The main barriers are the absence of legislative funding of AT and impossibility to obtain medications on the outpatient basis. The system of clinical-statistical disease groups also causes difficulties with payment for medical treatment. Low cost ratios and impossibility to combine AT payment with payment for the main therapy also limit its availability.To solve these problems, separate clinical guidelines for AT should be developed, tariffs for the clinical-statistical disease groups should be revised, and coefficients of treatment complexity should be increased for wider medication coverage.