The Russian retail pharmaceutical market is demonstrating a steady trend toward larger consumer packages, with the average package size in retail having grown noticeably over the past three years. According to the "Retail Audit of Drug Sales in Russia (total sell out)" from the analytical company RNC Pharma, in 2025 the fragmentation index of packaging in the retail segment across Russia as a whole stood at 20.5 — meaning that on average, each package sold last year contained over 20 minimum dosage units (MDU). Based on the results of 2022, this indicator was at 19.3, and based on Q1 2026, it has already exceeded 21 MDU per package. Several factors influence the growth of this indicator. In the modern world, buyers often choose a "wholesale purchase" strategy, as the cost per single dose is typically lower. Additionally, one can speak of increased treatment adherence, which implies purchasing a volume designed for a course of therapy, which again stimulates demand for larger packages. The role of market participants should also be mentioned; for pharmacy chains, larger packages allow for an increase in the average receipt while simultaneously reducing operating costs for shelving, inventory, and other aspects of retail operations.

The fragmentation index varies significantly by region. Sometimes a high index depends on the population's income level or the geographical location of a particular oblast or republic. According to our calculations, packages with the highest number of MDU were purchased in the Republic of Karelia. Here, based on last year's results, each package contained over 23 MDU, with the growth of this value compared to 2022 amounting to +6.8%. For Karelia, the transition to larger packages is not only an economic trend but also a way of adapting to challenging geography. As a rule, in remote regions, increasing package size is a forced measure; residents of hard-to-reach areas prefer to buy drugs in advance to minimize the number of trips to the pharmacy. Next in the ranking for this indicator are Tambov and Tyumen Oblasts, where on average each purchased package of drugs contained over 22 MDU. In the first case (Tambov Oblast), the choice of larger packages is dictated primarily by the desire to save money, while for residents of Tyumen Oblast with higher income levels, the geographical factor again comes to the fore.

Interestingly, in Moscow, the fragmentation index is somewhat lower than the Russian average. Based on the results of 2025, it stood at 20.2, showing growth of 5.4% over the past three years. In Moscow Oblast, the value is even lower — 19.7 MDU per package — but here the long-term dynamics are more pronounced (+6.7%). The leader in package size among Russian megacities remains St. Petersburg: the fragmentation index in the northern capital reached 21.2, which is 6.2% higher than the 2022 level, although the region does not claim a spot in the top five.

The lowest fragmentation indices for drug packages sold in pharmacies are recorded in the republics of the North Caucasus and Tyva. In these regions, the index ranges from 15.6 (Republic of Ingushetia) to 17.8 (Karachay-Cherkess Republic). It is noteworthy that even in these federal subjects, a clear trend toward larger package sizes is recorded. However, in some federal subjects the changes are minimal; for example, in the Republic of Tyva, the index changed by only 2.5% since 2022, and in Ingushetia even less — by 1.4%.

The greatest demand for larger packages is concentrated in segments involving long-term therapy. This primarily applies to cardiovascular drugs, anticoagulants, and drugs for treating gastrointestinal diseases. In this context, brands such as Cardiomagnyl (Nizhpharm Group), Anaprilin from various manufacturers, De-Nol (Cheplapharm), and many others are indicative.