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Background and Objectives One of the most acute problems of current healthcare in Russia is the absence of drug provision in ambulatory care. Only invalids and war veterans are eligible for the free drugs. In 2005 this and other natural privileges were monetized - eligible people were offered to opt out for the money equivalent. The aim of this study was to evaluate the effectiveness of the monetary substitution of the social services, specifically the inflation of the money substitution of drugs. Materials and Methods We use the official state statistics and evaluate the inflation using the official inflation rate and using the BigMac Index from 2005 to 2019. Results Over the past 10 years, the nominal value of the monetary equivalent of the set of social services has grown by 149% in nominal prices (from 450 to 1121 roubles, years 2005-2018). Official inflation over these years was 197%. Measured by BigMac Index the set of social services depreciated from 10.7 to 8.3. The cost of the drug provision subset had depreciated even more - from 9.52 to 6.39 units. The pensions during this period had increased in nominal, inflation-adjusted monetary size, and as measured by BigMac index. A set of social services in the natural equivalent decreased by 22.4%. The drug subset had depreciated even more - by 67.1%. Conclusions During the period from 2005 to 2019, the cost of a set of social services provided to the eligible citizens in monetary terms grew, while inflation-adjusted value and in physical terms it depreciated. Especially significant was the decrease of the value of the drug provision due to incomplete indexation for inflation. The decrease in the real value of the set of social services provided to vulnerable groups of citizens is an alarming trend. It is long lasting, and reflect the low priority of the drug provision for the decision makers. Key messages The value of the drug provision package is insufficiently corrected for inflation. The depreciation of the drug provision is long term and different from the other components of social support.

Privileged access to drugs in Russia and differential inflation of its monetary substitute