Russia plans to cut funding for its federal cancer-control project from 148.46 billion roubles in 2025 to 3.87 billion in 2027. The proposed 38-fold reduction comes as patients are already buying a growing share of oncology medicines themselves, including treatments that should be supplied free through the public health system.
The figures point to a widening gap between the formal promise of state-funded cancer care and what patients can obtain in hospitals and pharmacies. As federal support recedes, access may depend increasingly on regional budgets, procurement systems and the money available to individual households.
A steep reduction as demand rises
The federal project known as “Combating Cancer” was allocated 148.46 billion roubles in 2025. Its funding fell to 44.9 billion in 2026, while the plan for 2027 provides just 3.87 billion. The final figure is a budget proposal rather than a completed spending report, but the scale of the planned reduction would mark a sharp retreat from direct federal financing.
The available figures do not establish the reason for every reduction or prove that each rouble withdrawn from the project has been transferred to another budget line. They do, however, place the decision within a wider period in which defence and security spending are receiving strong priority. The practical question for patients is whether other public funds will replace the money being removed from cancer care.
There are already signs of pressure outside the state system. Media reports on 6 October 2026 cited research showing that roughly one in six oncology medicine packages was bought by patients themselves during 2019-25. In 2025, personal spending on cancer medicines reached 11.4 billion roubles, up from 8.8 billion the year before.
The increase was not simply a result of higher prices. The number of packages purchased also rose, from 5 million in 2024 to 5.8 million in 2025. Together, the figures indicate both a rise in the average cost of a package and a larger underlying need for cancer medicines.
The research was conducted by the international civic movement Movement Against Cancer and reported by Russian media. The findings on private purchases were covered by Vedomosti; the planned funding reduction was also reported by .
Medicines meant to be free are being bought privately
About 94% of the packages bought independently in 2025 belonged to Russia’s list of vital and essential medicines. These are the drugs intended to be provided without charge through state-funded healthcare mechanisms.
That proportion does not prove that every purchase followed a formal refusal by a hospital or regional authority. It does, however, weaken the explanation that patients are mainly paying voluntarily to obtain premium brands or optional treatments. Most of the private spending concerned medicines that form part of the system’s basic obligations.
The cost of cancer care is also rarely confined to a single purchase. Patients may need repeated treatment cycles, supportive medicines and continuing monitoring. A gap in public supply can therefore turn one pharmacy purchase into a long-term financial burden.
The potential scale of that burden varies sharply between treatments. An annual course of trastuzumab deruxtecan is cited as costing 10 million to 12 million roubles. That illustrates the distance between the price of some modern therapies and the resources of an ordinary household; it does not establish that every patient pays the full amount personally.
Where public supplies fail, families may have to draw on savings, borrow money or sell assets. The available figures do not measure how many households have taken those steps, so they cannot be presented as a universal outcome. They do show that both the number of packages bought privately and the total bill are rising.
Cheaper alternatives have not removed the problem
The purchasing pattern also challenges the idea that Russians pay out of pocket chiefly because they prefer original medicines to cheaper generics. Between 2019 and 2025, the share of original cancer medicines with available equivalents fell by 8 percentage points in monetary terms, to 22%. Measured by the number of packages, it fell by 3 percentage points, to 13%.
Patients were therefore turning relatively more often to alternatives rather than choosing only the most expensive branded medicines. Yet their total spending still climbed to 11.4 billion roubles. The figures are more consistent with a shortage, interruption or uneven distribution of publicly supplied treatment than with a general desire for premium products.
A generic may cost less than its original equivalent, but it is not free when a patient has to buy it at a pharmacy. For someone undergoing prolonged treatment, even a lower-priced medicine can become unaffordable when payments recur month after month. The growing use of alternatives has not prevented the overall private bill from increasing.
Thirty-two different funding realities
Federal financing is only one layer of Russia’s cancer-care system. Regional spending per oncology patient differs by a factor of 32. The disparity reflects several variables, including the number of patients, the treatment protocols used, the strength of local budgets and the planning of medicine purchases.
The difference does not, by itself, prove that every region provides a different standard of care. It does show that the financial resources available for an individual patient are far from uniform. Better-funded regions can supplement federal programmes and absorb the cost of more expensive therapies. Regions with tighter budgets have less room to maintain stocks, meet price increases or finance newer regimens.
That makes geography an important part of the access question. A patient in one region may receive a costly treatment through the public system, while someone elsewhere may face a delay, a substitute medicine or the need to search outside the state supply chain. The available data do not identify which particular drugs are unavailable in each region, but the size of the spending gap shows how uneven the underlying capacity is.
A formal national right to free treatment therefore does not guarantee the same practical experience across the country. If federal support falls without a compensating source of funding, regional health systems will carry more responsibility despite starting from very different fiscal positions. The consequences of that inequality will be felt most directly by patients and their families.
Domestic production is not the same as access
Russian authorities have highlighted the growth of domestic pharmaceutical production and progress in replacing imported medicines. Those claims address manufacturing capacity, but production alone does not guarantee that every necessary drug will reach a patient in sufficient quantity, at the right time and in every region.
The sharper test takes place in hospitals and pharmacies. When patients are buying medicines listed as vital and essential, the issue concerns not only what Russia can manufacture but also how treatment is financed, procured, distributed and delivered.
With only 3.87 billion roubles planned for the federal cancer project in 2027, the distance between a promise of free care and treatment that is actually available is likely to become more consequential. The unresolved question is whether other public funds will close the gap—or whether an increasing share of cancer treatment will be determined by the wealth of a patient’s region and family.
