Foreign pharmaceutical companies that supply cancer treatment drugs to Russia spend about $500 million a year on “bonuses” for intermediaries, suppliers, and staff at Russian hospitals, according to an investigation by Proekt, a Russian investigative outlet. The investigation is based on the testimony of a senior executive at an international pharmaceutical company operating in the Russian market.

Pharmaceutical companies worldwide offer bonuses for large drug purchases, but these deals are usually negotiated directly with governments and insurance companies, returning a few percent of the purchase price to public budgets and lowering drug costs for patients.

In Russia, the market works differently: pharmaceutical companies spend about 30% of a government purchase on bonuses on average (in large tenders, the bonus share can exceed 60%), but this is “money out of thin air that exists only to feed a conveyor belt of bribes,” Proekt wrote.

Manufacturers pay the bonus to distributors, who resell the drugs to smaller intermediaries involved in government tenders. The intermediaries keep part of the money, while another share — roughly 10% to 20% of the cost of each government purchase — goes toward bribes for chief physicians, officials, and security service personnel who decide which drugs to buy and at what price. As a result, the final price the state pays for the drug does not go down.

People connected to the Russian government also profit from Big Pharma’s bonuses. At the Wholesale Medical Company, for example, Dmitry Bortnikov — a nephew of Alexander Bortnikov, the head of Russia’s Federal Security Service (FSB) — became director for special projects. Before Bortnikov, the company was “protected” by Roman Koval, a member of the St. Petersburg Legislative Assembly, who helped it win government contracts in exchange for kickbacks worth 20% of their value. Koval was sentenced to nine years in prison for the scheme.

Alexey Repik, owner of R-Pharm, and Viktor Kharitonin, owner of Pharmstandard, control a large share of the government drug procurement market. In 2025, their companies supplied the state with cancer drugs worth 52.8 billion rubles. Both men have close ties to the government.

Repik flew Vladimir Putin’s daughter Katerina Tikhonova to Europe aboard his personal Bombardier Global 5000 jet, while Kharitonin is closely acquainted with Russian Deputy Prime Minister Tatyana Golikova, according to the investigation. While heading the Health Ministry, Golikova lobbied for the federal reserve to purchase Arbidol, a drug manufactured by Pharmstandard.

Zolgensma is another example. The drug is manufactured in the United States and delivered to Russia by special transport for a specific child. In the final stage, an intermediary, Pharmimex, collects a bonus of 3–6% of the drug’s cost for delivering it from the Russian warehouse to the hospital. Pharmimex is linked to Yelena Maksimkina, who heads the Health Ministry body that handles procurement of the drug for Russian children.

In 2025, the Russian state purchased 386.3 billion rubles’ worth of drugs from eight of the largest foreign pharmaceutical companies. If at least 10% of that amount goes toward bribes, bribery costs 38.6 billion rubles (about $475 million) a year. Without corruption, prices for these drugs could be 15–25% lower, a source who spoke to Proekt said.

Both Russian and American officials are aware of this corruption chain. In 2024 and 2025, several complaints were filed with the U.S. Justice Department requesting an investigation into corruption and collusion in Russian drug tenders, but after returning to the White House, Donald Trump suspended investigations under the Foreign Corrupt Practices Act.