At the beginning of 2026, the Russian retail market shows a noticeable decline in physical sales of drugs against the backdrop of continued spending growth. According to the "Retail Audit of Drug Sales in Russia (total sell out)" from the analytical company RNC Pharma, in Q1 2026, Russians purchased 1.19 billion packages of drugs, spending more than RUB 502 billion (at retail prices, including VAT). Compared to January–March 2025, retail (including online with delivery to consumers) grew by 7.7% in monetary terms, but physical demand for drugs decreased by -5.9%.

This result is largely due to the shift of consumers toward "large" packages that contain more single doses. When recalculating packages sold into volume in minimum dosage units (MDU), the dynamics are noticeably better, although still in negative territory (-1.7% compared to Q1 2025). In 2025, consumption volume in MDU (+4.8% compared to 2024) also outpaced dynamics in packages (+1.8%). It is worth noting that in Q1 2026, on average, each package sold by pharmacies contained more than 21 MDU, whereas in 2025 the fragmentation index was 20.5.

In January–March of this year, retail drug sales in packages fell in almost all Russian regions. Growth in physical demand was recorded in only a few federal subjects, including the Chechen Republic (+15.1%)*, the Republic of Dagestan (+0.5%), and Nenets Autonomous Okrug (+0.04%). However, when calculated in MDU, positive dynamics were already observed in 14 regions. The most notable increase in consumption volume in minimum dosage units was demonstrated by Amur Oblast, where the indicator increased by 5.6% compared to the same period in 2025.

The leaders in physical drug sales volume remain Moscow, Moscow Oblast, and Krasnodar Krai. Together, these three regions account for about 20% of the entire Russian retail market (including new territories, but excluding online sales with delivery to consumers). In the capital, over 95.5 million packages were sold in pharmacies in Q1 2026. This is 4.5% lower in packages and 0.5% lower in MDU compared to the same period last year. At the same time, among large regional markets, the smallest decline in package sales was shown by Leningrad Oblast. Its residents purchased 16.1 million packages, which is only 0.6% below the result of the first three months of 2025 — the suburbs of St. Petersburg are being actively built up, which stimulates the expansion of pharmacy infrastructure and drives demand.

The most pronounced declines were recorded in the Altai Republic, the Republic of Ingushetia, and the Republic of Tyva. In these regions, market contraction ranged from 11.2% to 11.6%, with total purchases in Q1 only slightly exceeding 1 million packages. The top five federal subjects with the largest decline in physical demand also included larger markets — Astrakhan Oblast and Altai Krai. Dynamics here were recorded at -10.9% and -10.6% in packages, respectively.

* The Chechen Republic is the absolute leader in terms of sales dynamics with an indicator of +15.1% (in packages) compared to Q1 2025. This is due to the completion of the period of online cash register implementation in the region, which was scheduled to be completed by the end of 2025.