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- In pursuit of misfortune: more than half of medical clinics in the Russian Federation work illegally
In pursuit of misfortune: more than half of medical clinics in the Russian Federation work illegally
Over 60% of medical cosmetology companies in Russia operate without a license, with drugs unregistered in the labeling system, without paying taxes and meeting safety requirements. Public activists are asking the Prosecutor General's Office and the government to take measures against illegal businesses. The Association of Enterprises and Professionals of the Beauty Industry recognizes the existence of a gray market, while believing that it will not be possible to solve the problem solely through stricter controls and penalties. Izvestia investigated what measures are being proposed in the industry and how the problem can be solved.
Where is the most shadow business
The Public Consumer Initiative (OPI), based on the results of a study of the medical cosmetology market, appealed to the Prosecutor General's Office and the government with a request to take measures against illegal industry participants. Izvestia has reviewed the document. The study is based on data from the Federal Tax Service and the state labeling system, and was conducted using the Luch information system developed by the OPI in collaboration with the Public Council under Rospotrebnadzor. The analysts studied the activities of 1,233 organizations with the main OKVED 86.22.1 code in 85 regions of Russia, as well as open data arrays on the Internet.
According to the results of the study, only 80 companies (6.5%) operate entirely in the legal field. At the same time, 792 organizations (64.2%) provide medical services without a mandatory license. Another 156 licensed clinics (12.7%) have no information about legal purchases of drugs and medical devices. According to the authors of the study, this may indicate the use of products with unconfirmed origin, including contraband or counterfeit goods.
At the same time, as noted in the document, the scale of the illegal market is much higher if it is assessed not by officially registered OKVED codes, but by data from Internet sites and services where ads for the provision of such services are placed.
"Only on the Pro platform.<url> has posted 2,433 cosmetologists' questionnaires in Moscow, as well as 744 aesthetician cosmetologists' questionnaires and 363 dermatocosmetologists' questionnaires. Another 259 questionnaires of dermatocosmetologists and 192 questionnaires of cosmetologists and aestheticians are presented in St. Petersburg. In total, 3991 specialist questionnaires are posted on one platform for only two agglomerations, which is more than 11 times the number of all officially registered organizations with OKVED 86.22.1," the document says.
Advertisements with such doctors visiting their homes are particularly dangerous, social activists say. For example, there are 256 specialists in St. Petersburg who are ready to perform invasive procedures at home, which is strictly prohibited.
According to the OPI, all this poses very high risks to the health and life of consumers. Firstly, they are not protected from the use of drugs of unconfirmed origin and quality. Secondly, there is no guarantee that the services will be provided by a licensed professional. Thirdly, working outside the medical circuit means that there is no sterilization of instruments, improper storage of drugs. Such procedures in the home create a real risk of mass infection with hepatitis B, C and HIV viruses.
The Astrakhan Region and Kirov Region (100% each), Orenburg Region (91%), Chechen Republic (89%), Perm Krai (89%), Yaroslavl and Saratov Regions were among the regions with the largest share of organizations that do not have a medical license or registration in any labeling system.83% each), Volgograd and Belgorod regions (82% each), the Republic of North Ossetia—Alania (77%).
The OPI proposes to develop and submit to the State Duma a bill providing for joint legal and financial responsibility of owners of Internet sites for the placement of advertisements for the provision of medical services by persons who do not have the appropriate license.
In addition, public activists propose to introduce an automated response system that will identify cases of missing information about the turnover of medicines in the Federal State Information System for Monitoring the Movement of Medicines (FGIS MDLP), as well as medical products in the Honest Sign labeling system. If such violations are detected, the authors of the initiative suggest considering revoking the organization's license.
It is also proposed to instruct the Ministry of Health to conduct a federal information campaign on the risks of injectable cosmetic procedures in unlicensed clinics and offices. In addition, the agency is asked to check whether all organizations providing such services are registered in the state health system. To do this, data from medical registries and companies will be compared with the OKVED 86.22.1 activity code, which will identify organizations operating without registration.
— A consumer who applies to an unlicensed craftsman is practically deprived of legal protection. The contract and informed voluntary consent are not formalized, medical documentation is not kept, which makes it impossible to prove harm and bring the perpetrators to justice," Oleg Pavlov, head of the OPI, outlined the main danger for those who visit illegal specialists.
The editors contacted several companies involved in the study. One of them stated that they would send the license via Telegram, but they did not send anything. In another case, they offered to come and see the document in person. At the same time, in some organizations they work only for cash, without cash registers.
Izvestia sent a request to the Federal Tax Service with a request to comment on the research data of public figures, as well as to the Cabinet of Ministers and the Prosecutor General's Office with a request to clarify whether measures will be taken against such a business.
Why is business going into the shadows and what to do about it
Lyalya Sadykova, President of the Association of Enterprises and Professionals of the Beauty Industry (APIC), in a conversation with Izvestia, acknowledged the existence of a gray market for cosmetology services. According to her, it did not appear today, but it has become especially increasing recently. Companies began to fade into the shadows after the introduction of the requirement for a medical license, which requires employees with higher medical education to work in the organization.
— With the advent of self-employment, this trend has scaled up. People started renting offices and running private practices there, as no one explained to them that doctors could not be self-employed without a medical license. The largest outflow to the gray zone occurred after recent tax changes," the business representative explained.
According to her, the situation was the result of several factors at once — a complex procedure for legalizing business, freely ordering medicines on the Internet, an increasing tax burden and a decrease in demand for the services of legally operating clinics.
— As long as these problems persist, the shadow market will continue to grow, despite criminal cases and inspections. The stricter the regulation of the legal sector, the greater the difference in the cost of services between official clinics and illegal offices becomes. With declining incomes, many consumers choose cheaper deals, even if they involve increased risks," Lyalya Sadykova believes.
In her opinion, the problem cannot be solved by punishments alone. Restrictions on the free sale of injectable drugs, easier and more affordable business legalization, and increased consumer awareness are needed. Clients should check for a medical license before the procedure as habitually as they read the composition of medicines, she believes. Otherwise, the struggle will be aimed only at the consequences, and not at the reasons for the existence of the shadow market, she noted.
According to the Deputy General Director of the Center for Advanced Technologies (CRPT, the operator of the Honest Sign labeling) Revaza Yusupova, in the field of medicines, including those used in cosmetology, illegal turnover decreased to 0.01%, counterfeit cancer drugs decreased 10 times.
— According to the Ministry of Health, in recent years, more than 250 criminal cases have been initiated into the detection of falsified medical products. At the same time, some of the products used in cosmetology still remain outside the labeling contour, and that's where the gray area remains," he said.
The labeling of fillers and filaments is still in effect as part of the experiment, and the mandatory requirements for these products will come into force on September 1, 2026, Revaz Yusupov recalled. At the same time, biorevitalizants, which also belong to injectable drugs, are not yet subject to mandatory labeling. However, Roszdravnadzor is considering the possibility of extending it to this category of products.
Georgy Ostapkovich, head of the HSE Center for Market Research, believes that a significant volume of the illegal market poses a threat to human life and health. According to him, his growth was influenced, among other things, by the economic situation, but the problem can be solved with increased control by law enforcement agencies.
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