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making purchases more frequently. Major players in the market have
responded to this trend by launching more and more products to take
advantage of sales dynamism, while chained pharmacies continue to
expand across the country.
Current consumer spending patterns area stark contrast to the
state of the market just 10 years ago. After the fall of the Soviet Un-
ion, dramatic price increases on consumer pharmaceuticals combined
with the collapse of domestic production lead to widespread shortages
of drugs. A report by the World Health Organisation states that in
1994 only 62 percent of citizens were able to get all their prescribed
medications.
"It was a difficult time," recalls Larissa, who worked as a doctor
throughout the turbulent 1990s. "There were so many charlatans,
claiming they could cure you of anything. Some practiced eastern
medicine, others said they used ancient folk-wisdom, some even
claimed that they could perform magic. And they made these claims
openly. One man even went on television and told viewers to put bot-
tles of water in front of the television set, then he waved his arms
around and said that he had turned the water into a medicine for what-
ever ailed the viewer:'
Many people were taken in by these con men and paid the price
both financially and physically:
"People would take these potions and then convince themselves
that they were well again and go about their normal business, while in
reality their condition was getting worse," says Larissa.
Access to both prescribed and over the counter medicine has im-
proved drastically since that time and Russians are embracing the op-
portunity they now have to pop an ever widening array of pills. But
consumption levels still remain low relative to western countries,
which has made the Russian market an attractive prospect for multina-
tional pharmaceutical companies.
Multinationals now dominate the market and continue to gain
ground over domestic producers as many consumers 'trade up' from
domestic generics and unbranded products to big brand names, which
are often viewed as offering higher quality.
But the tactics used by these pharmaceutical giants to speed up
sales may not always be in the best interests of consumers. A WHO
report, Healthcare Systems in Transition, argues that aggressive adver-